June 2025

Metabolic Health

• Metabolism & Your Health
• Understanding Metabolic Conditions
• Body Fat – The Good, The Bad & The Ugly
• What To Know About High Fructose Corn Syrup

Being part of diet culture, I have fought to reduce my body fat since my 20s. However, as I recently learned from Dr. Robert Lustig, M.D., M.S.L., not all fats are created equal. Some fats play important roles in your body, while others are a red flag, indicating sustained underlying inflammation and reducing your lifespan. How do you know if your fat tissue is inflammatory?

Body Fat – The Good, The Bad & The Ugly

Our brain, though, is still anticipating a famine and tends to convince us that food might be in short supply; hence, we should take the opportunity to stock on fuel.

Fat tissue is not just passive energy storage; it is important in insulating your organs and keeping you warm. Also, fat plays an active role in the endocrine system. It secretes and regulates hormones such as leptin, insulin, cortisol, and estrogen.  

The anatomy of fat tissue

When you consume more calories (fuel) than your body expands, glucose is distributed in the body for storage. About 85% of the excess energy will be stored in muscle tissue, 10% in the liver, and 5% in fat tissue. Consistent high caloric intake forces your fat cells to accommodate the excess fuel.

Fat cells are very elastic; they can expand up to four times their normal volume. Once a fat cell reaches its full capacity, it will create a new fat cell. This is important because once a fat cell is formed, you can’t get rid of it. Reducing caloric intake can decrease the amount of fat in your fat cells but not the total number of fat cells in your body.

Adipose cells contain small “pockets” that hold the fat within them. When more fats arrive at the cell, they are stored in these pockets surrounded by a thin, skin like membrane. Once the amount of fat inside the membrane exceeds its capacity, the membrane will burst, and the grease will leak into the cell, leading to cell death. 

When a cell in your body dies, the immune system rushes to clean up. Macrophages are a type of immune cell that gobbles up dead cells. A key function of macrophage cells is to signal to the body that cellular damage has occurred, thereby triggering the rebuilding process. Macrophages spread the news by releasing cytokines (immune mailman)

While all fat cells secrete proinflammatory cytokines, the amount of fat and where these cytokines enter the bloodstream make a huge difference in your well-being and life span. 

3 types of fat tissue:

Subcutaneous fat

Subcutaneous fat is the fat located under your skin, the one you can pinch. The body produces subcutaneous fat when you eat more calories than you expand. In the right amount, subcutaneous fat keeps your vital organs warm and protected, stores excess energy for lean time, and plays a crucial role in hormone regulation. 

When subcutaneous fat cells reach their capacity, they leak their contents into the blood circulation. Since your body contains about six liters of blood, the concentration of toxic fats from subcutaneous fats is relatively low.

You need to gain about 22 lbs before the concentration of cytokines released from your subcutaneous fat tissue becomes high enough in the blood circulation to cause sustained systemic inflammation.  

Visceral fat

Visceral fat is the fat tissue stored around your waist behind the abdominal muscle cavity, around vital organs like the pancreas, liver, and intestines. It is produced as a response to stress or high levels of cortisol.

Visceral fat and inflammation

Cytokines from visceral fat tissues don’t empty into the systemic bloodstream. Instead, they are emptied into the portal vein, which directly supplies the liver, resulting in a higher concentration of cytokines in the liver. Therefore, you need to gain only about 5 lbs around your abdomen before the concentration of cytokines released from your visceral fat tissue is too high, which can create inflammatory disease. 

However, inflammation can easily contribute to visceral fat formation by promoting insulin resistance or increasing stress overload.

Visceral fat and stress

Stress and visceral fat can create a vicious cycle; visceral fat produces inflammatory cytokines that activate the HPA (hypothalamic-pituitary-adrenal) axis, potentially leading to increased cortisol production and a self-perpetuating cycle.

Cortisol promotes fat storage in the abdominal region. Visceral fat cells have more cortisol receptors than subcutaneous fat cells, making them more responsive to elevated cortisol levels.

Chronic high cortisol elevation disrupts metabolic processes, leading to insulin resistance and altered fat distribution. This is why people who struggle with chronic stress tend to gain weight, specifically around the abdomen.

The combination of stress, elevated cortisol levels, and visceral fat accumulation, creates a whole body endocrine crisis, including immune dysregulation, psychological distress, and metabolic strain, all reinforcing each other.

Visceral fat and metabolism

Visceral fat reduces the body’s sensitivity to leptin. The hormone that promotes satiety and inhibits insulin production, leading to poor sugar metabolism and increased food consumption, which can contribute to obesity and type 2 diabetes.

Signals from visceral fat can alter mitochondrial function in other tissues, affecting how efficiently cells throughout your body produce and use energy.

If you are a woman with a waist circumference higher than 35 inches or a man with a waist circumference higher than 40 inches, you have an excess fat deposit in your abdomen. Excess abdominal fat is associated with metabolic syndrome, AKA pre-diabetic.

Fatty liver

The liver plays an important role in storing glucose. Between meals, when fasting, or during exercise, the liver releases glucose into the bloodstream to provide energy. 

In a healthy metabolism, only 5-10% of glucose is stored in the liver cells. A healthy liver weighs about 3 lbs and can hold about half a pound of fats before you become metabolically ill. Fatty deposits in the liver can result from either excessive alcohol consumption or excessive sugar intake.

When you consume excess calories, the liver converts them into triglycerides. These triglycerides should be exported from the liver to fat tissue for storage, a process that requires choline as a critical cofactor.

Even if your choline levels remain the same, when you have too many triglycerides, there is not enough choline to shuttle them out of the liver, leading to triglyceride accumulation in liver cells and the development of a fatty liver.

The fat risks of fatty liver disease

Fat accumulates in the liver creates lipotoxicity—a harmful buildup of lipid toxins that bind to insulin receptors and partially or fully block the insulin signal, prompting insulin resistance.

When the body stops responding to insulin, the liver releases more sugar into the blood and, at the same time, deposits more fats in the hepatocytes (liver cells ), leading to nonalcoholic fatty liver disease.

Fatty liver disease is associated with type 2 diabetes and heart disease and reduces the life quality and span of millions of people in America.

Although your Subcutaneous fat looks bad in the mirror, the fat in your liver is most detrimental to your health. Since the liver plays such an important role in metabolism, a fatty liver causes disruption immediately.

Reducing sugar intake, especially fructose and alcohol can help reverse fatty liver disease if done before the liver develops irreversible damage. Reducing stress can help reduce the inflammation generated by visceral fat. If you reduce sugar and alcohol consumption and manage your stress, there is a good chance that excess Subcutaneous fat will follow.