But weight; there’s more

I detest reality TV. I don’t just mean American reality TV; I mean any reality TV.

I have watched a little of this kind of TV and can’t help but apply to the spectacle my general practice and functional medicine experience, specifically to the ‘biggest loser’ type of trash.

Large people being pushed into excessive exercise by small people with shiny muscles – in an effort to reduce the large people’s largeness – demonstrates the fundamental lack of understanding in society as to why in the last five decades we have seen an obesity epidemic. It does sell moronic television well though.

To understand this epidemic, we need to consider the three domains that collide to cause this crisis. The first of the three is the genetic structure specific to that individual, the second is the nutritional exposure, and the third is the environment in which that individual is immersed.

Evolution has taught us to be efficient in the collection and storage of fuel.

It is said that in the last 100 years, the average American has increased their intake of sugar from 5 pounds per year to over 100 pounds per year. There are consequences to this. In the search for energy, the body takes in complex carbohydrates, emulsifying and fermenting them down (extracting the micronutrients so necessary for efficient bodily functions), and finally distilling glucose to be used to generate energy in the mitochondria (the human engine). By short-circuiting this process – through providing excess sugar – the body attempts to balance this by storage. Different genetic variations produce different storage outcomes. Sugar is stored as fat. Some individuals are better at storage (better at being a caveman) or discharge than others, and some are better at mobilising the fat stores when the signal to do so occurs.

Evolutionarily speaking, we believe that the ability to store fat or energy allows the individual to survive times of low nutritional availability. We also know that when an individual is under stress – and in a primal sense that stress would be an external threat – the body secretes adrenaline and cortisol. This secretion allows several things to occur. One is to turbocharge all muscles, and second is that we mobilise fat to be used as fuel for a short period of time – and the homeostasis around this works in a balanced environment. Much of our modern-day stress is generated internally, and the balanced environment is absent.

If we look at the modern-day situation, which for many people means an excess of macronutrients(sugar) and chronic stress, storage mode is up-regulated. Routine bloodwork (hsCRP) shows that as the individual becomes more burdened with fat, inflammation starts to build. Inflammation represents a threat and this threat may be recognised biologically and thus inappropriately lead to further storage. It’s a nasty, vicious cycle.

Add to this increased workload of excessive exercise, the fact is that to move a larger body requires more energy. However, ‘reality shows’ pushing fat-to-the-limit type exercise means further burning of fuel and the removal of waste from the production of that extra energy. Add in here the genetics of detoxification for the individual, and again the variances in the gene code will for some be more than adequate and others less adequate with regards to their capacity for removing those by-products. The ‘globesity’ epidemic shows that more of the population are affected by genetic variances less favourable to this environment.

So when you see a large person trying to burn off calories by excess exercise, it may be wrong and dangerous in both the short and long term for many reasons – recognising that all individuals are very efficient in the use of energy. For example, one needs to sing opera for an hour to use up the energy provided by one medium-sized hard-boiled egg.

Sitting on the couch watching reality TV burns around 1 1/4 kcal per minute, walking briskly around 2, running around 3, running up and downstairs around 7, and marathon swimming up to 10.

It’s the perfect storm – ending in more storage and increasing weight gain, inflammation and the associated increase in insulin demand, hyperglycaemia, and body tissue damage.

In a small number of individuals, the stress causes them to stop eating and they start to autophage (eat oneself).

I’ll keep this subject for another time. But wait; there’s more…