Family Physiotherapy

Why Optimal Body weight is important

Quitting smoking, improving your sleep, and achieving your optimal bodyweight are three of the most important things you can do to reduce your risk of heart disease, cancer, and stroke, which are the top three leading causes of death according to stats Canada. One in four Canadian adults lives with clinical obesity. Living a lifestyle that doesn’t promote excess adipose tissue (body fat) is one of the surest ways to improve longevity and quality of life.

Adipose Tissue as an Endocrine Organ

Ask most people what the purpose of body fat is and they’ll tell you it’s a reservoir for energy storage.

What most people don’t know is that adipose tissue is actually an endocrine organ, meaning it secretes hormones directly into the bloodstream. These bioactive molecules are known as adipokines, and can have effects both locally and systemically.

Not only that, adipose tissue has receptors that allow it to communicate with traditional hormone systems and the central nervous system. It is through this communication network that adipose tissue affects a variety of processes in the body, including energy metabolism and even immune function. This central role can mean adverse consequences if adipose tissue is either in excess, or deficient. An August 2006 systematic review in The Lancet found patients with a low body-mass index (BMI) below 20 had an increased relative risk for total mortality and cardiovascular mortality. Too little body fat can negatively affect a person’s health as well.

Excess adipose tissue can result in high blood levels of sugar and fat, blood pressure that is too high, and blood that clots too readily. It also can increase general inflammation in the body. Where the body fat is located on the body can change the effect it has as well. Subcutaneous body fat, occurring just below the skin evenly throughout the body, doesn’t have the same negative consequences on organ function as fat surrounding the organs. Food that increases blood sugar rapidly can affect dopamine receptors in the brain and cause addiction, and rev up fat storage hormones like insulin. The science of adipose tissue as an endocrine organ is still relatively new, with the discovery of the hormone leptin first described in 1994. What is clear is that fat does more than just store energy, and it has long-term consequences on all systems of the body.

Barriers to weight loss are different for different people

Losing weight can be complicated for some people. There can be barriers. Many people have tried many times in the past. If you’ve tried before without results, there are certain conditions that can cause weight gain. Hypothyroidism, depression, and menopause are all examples of conditions that can make it difficult for a patient to lose weight. Weight loss strategies need to be personalized, to take into account specific barriers to weight-loss, including situational barriers, stress, depression, food craving, lack of time, lack of motivation. Before barriers can be removed they need to be identified. What is stopping you from eating something different at lunch? Are there any simple barriers that can be removed?  For some it may be not keeping those fast food coupons, even though it’s nice to get mail. Motivation and purpose need to be personal, and real as well.

It’s never too late, benefits occur quickly

A landmark study took place from 1986 to 1992, called the Lifestyle Heart Trial. Its purpose was to determine whether or not patients could sustain intensive lifestyle changes for 5 years, and what the effects of these changes would actually be on coronary heart disease, without the use of lipid-lowering drugs.  These patients already had moderate to severe coronary heart disease. They were split into two groups, one group making moderate small changes, and the other group undergoing a more comprehensive lifestyle overhaul.

In the group that made comprehensive changes, the narrowing of blood vessel pathways improved 4.5% after 1 year, and 7.9% after 5. This was in contrast to the control group, which experienced a worsening of the narrowing by 5.4% after one year, and 27.7% after 5 years. Furthermore, after 1 year the experimental group had a 37.2% reduction in LDL cholesterol, and a 91% reduction in episodes of chest pain. The control group had 6% reduced LDL, and a 165% increase in frequency of chest pain.

These findings were encouraging enough to extend the study for 4 additional years to investigate whether or not maintaining these changes were realistic, as well as if further changes could be seen. 71% of patients completed the 5 year follow-up and had maintained the comprehensive lifestyle changes. 75% of the control group patients still made moderate lifestyle changes.

For the first time it was scientifically proven that heart disease is not only preventable, but is also a reversible process. This means it is never too late to develop good habits, the body responds relatively quickly, and you will reap meaningful benefits, some of which you won’t be able to appreciate immediately.

Weight loss and the role of a naturopathic doctor

Whether you are looking to lose weight for medical reasons, to reduce the pain of arthritic joints or to meet a personal wellness goal, a consultation with a naturopathic doctor can be the first step to provide you with a personalized road map to achieve your goals.

References

 ERIN E. KERSHAW AND JEFFREY S. FLIER “Adipose Tissue as an Endocrine Organ” The Journal of Clinical Endocrinology & Metabolism 2004 89(6):2548–2556

Dean Ornish, MD; Larry W. Scherwitz, PhD; James H. Billings, PhD, MPH; K. Lance Gould, MD; Terri A. Merritt, MS; Stephen Sparler, MA; William T. Armstrong, MD; Thomas A. Ports, MD; Richard L. Kirkeeide, PhD; Charissa Hogeboom, PhD; Richard J. Brand, PhD “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease”  JAMA, December 16, 1998—Vol 280, No. 23

Amanda J Kiliaan, Ilse A C Arnoldussen, Deborah R Gustafson “Adipokines: a link between obesity and dementia?” The Lancet Neurology Volume 13, No. 9, p913–923, September 2014