The Apple Shape, Muffin Top and being ‘skinny fat’ – part 1
Yes, yes, of course, there is always a genetic component. Some people have just won the genetic lottery, with a wonderful hourglass shape despite little efforts paid towards healthy eating and exercise. And.. it is all about embracing our different shapes and forms, as we are each uniquely beautiful. However, did you know that if you feel like your body shape has changed in the recent decades/ years/ months, and you also have some niggly health concerns that have started creeping in, that this can tell us about some hormonal imbalances inside your body – and that once we address these, your shape may get back towards what you feel to be ‘you’, while improving your inner health at the same time?
Why is it that some people store their weight around the midline where others are more prone to bigger thighs, or an overall junkiness? It all has to do with our hormones (and genetics).
And while these seem like vain concerns, they can be alarm signals to other (potentially more serious) inner health imbalances if persisting for too long and not addressed.
Before we get started, a little refresher on what hormones actually are.
Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues. These signals tell your body what to do and when to do it. Hormones are essential for life and your health.
Hormones control many different bodily processes, including:
- Homeostasis (constant internal balance), such as blood pressure and blood sugar regulation, fluid (water) and electrolyte balance and body temperature.
- Growth and development.
- Sexual function.
- Sleep-wake cycle.
With hormones, a little bit goes a long way. Because of this, minor changes in levels can cause significant changes to your body and lead to certain conditions that require medical treatment. https://my.clevelandclinic.org/health/articles/22464-hormones
So let’s dive right into what the different body shapes can reveal about your hormone and your inner health profile:
The Apple Shape = The Muffin Top & ‘Skinny fat’ profile
This shape is often defined by skinny legs and arms, with a larger belly that is seemingly out of proportion with the rest of the (often times, but not always skinny) body. Sometimes this is called ‘skinny fat’. Now, what’s the imbalance, why does it matter.. and what can one do about it?
This shape’s abdominal fat accumulation is usually a sign of an imbalance of insulin and cortisol. Insulin’s main role is to shuttle blood sugar (glucose) into cells for energy (to be used as needed, or to be stored where excessive).
Cortisol is our main stress hormone.
Research suggests that insulin resistance and an imbalanced daily cortisol rhythm both signal to the brain to store more fat around the waist, redistributing it from the limbs to that abdominal area, and in particular around the organs (5).
These findings are congruent with the physiology of insulin accelerating intracellular storage of glucose and fats, whereas reduced serum insulin from a low-carbohydrate approach allows lipolysis and gives the body access to its stored fat as an energy source
Other common symptoms associated with blood sugar and cortisol imbalances can be:
- Cravings, in particular for highly palatable foods such as sugary and fatty foods
- Excess wrinkling and cellular ageing (via a process called ‘glycation’, which is much like ‘rusting’ of our cells, including skin structure!)
- Waking up in the middle of the night
- Low zinc and with it a low immune system, brittle and ridged nails
- ‘Hangriness’ – that absolute urgent need to eat from blood sugar roller coasters
- To PCOS symptoms such as difficulty conceiving acne, coarse hairs (hirsutism), difficulty conceiving
- Recurring UTI’s
- And a more difficult transition period during perimenopause, including hot flash severity
- For men this can contribute to the male version of PCOS, male pattern baldness, and benign prostate hyperplasia (via the upregulation of something called 5-alpha-reductase and resulting higher levels of DHT, a more potent and potentially harmful version of testosterone).
But seemingly small concerns usually can have more serious complications if left for too long, as suggested by research. Some of these can be:
- Metabolic syndrome and with it type 2 diabetes, cardiovascular disease (strokes, heart attacks, etc), Alzheimer’s (also often called ‘type 3 diabetes’ in scientific literature due to its tight link to long term blood sugar issues)
- Cellular damage all the way to increased risk of cancer development
Furthermore, did you know that those troublesome perimenopausal symptoms such as hot flashes aren’t just a nuisance, but they have been linked to a higher risk of cardiovascular morbidity and issues down the line. Some of their common nominators? Blood sugar rollercoasters, insulin resistance and an imbalanced stress biochemistry for decades leading up to it.
How belly fat in and of itself has been linked to some health concerns
Excessive belly fat accumulation is not only a vain issue, but research has linked it to health concerns itself. Central adiposity confers increased risk of mortality from cardiovascular disease, cancer, and all causes among women (31). The inflammatory signals released by visceral adipose tissue (called NLRP3 inflammasome) further have been shown to impair memory and contribute to cognitive decline caused by neuroinflammation such as Alzheimer’s https://www.jci.org/articles/view/126078 .
That layer of abdominal (also called visceral, as in that it is around your organs, rather than just the skin) can act like an endocrine organ (secreting hormones), messing with hormone imbalances like contributing to estrogen dominance (which we will discuss in a next blog post on the pear shape body type), and also compromise the immune system in itself.
Furthermore, visceral fat accumulation contributes to increased cortisol synthesis, which in turn reduces blood zinc levels. Zinc plays a critical role in the secretion and signaling of insulin. Changes in the biochemical parameters of zinc contribute to insulin resistance, making the abdominal fat and insulin resistance state a two way street (chicken and egg, what came first?).
Common reasons for insulin (resistance) and blood sugar issues
- Number 1 is the obvious one: the consumption of too much sugar. Most of you are likely aware of the fact that eating large amounts of processed and refined white flour products, such as bagels, pizza, baked goods and candy are bad for us.
- But what I see often in my patient population is that their diets are high in hidden sugars and healthy carbohydrates. Did you know that even healthy carbohydrates like sweet potatoes, oats or fruit turn into sugar inside the body? Of course, they do also contain a ton of great nutrients such as minerals, vitamins, plant nutrients such as polyphenols, fiber to support a healthy gut and detox system, BUT .. they do turn into sugar once in the blood stream, so too much of even those can lead to blood sugar roller coasters, cellular rusting (‘glycation’) and eventually the cell’s fatigue to respond to insulin’s signalling (‘insulin resistance’).
- Constant snacking. Over the past decades we were told it is best to have numerous small meals, spread out throughout the day, and to snack every few hours. Newer research debunks this and shows that this is only ‘needed’ when a person has blood sugar problems, which are usually caused by a) eating too often, and b) the meals not being balanced but too high in sugars compared to protein and fats – leading their blood sugar to rise after each meal or snack, and then drop – which then necessitates you eat again! Each time you eat a meal high in carbohydrates and sugars (and to a much lesser extent also protein), insulin gets produced to shuttle that energy into your cells for use (or storage if too much gets consumed that isn’t needed for energy at that point in time). If insulin is constantly high from non-stop snacking, your cells eventually get tired of the signal, and stop responding to it (aka ‘insulin resistance’). This then leads to higher blood sugar and increased abdominal fat storage.
- Chronic insulin resistance appears to be directly related to diet-induced inflammation.
Common factors involved are:
- Excess or an imbalanced amount of omega-6 and saturated fatty acids (especially arachidonic acid (AA) and palmitic acid) can be viewed as pro-inflammatory molecules
- Whereas omega-3 fatty acids (especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) can be viewed as anti-inflammatory molecules. This is because they have the ability to generate resolvins (resolving inflammation!) as well as directly binding to specific binding proteins that can decrease insulin resistance in an organ.
- Unrecognized food intolerances. Our body’s natural response to a pathogen like a bacteria or virus is to recruit our immune system to mount an inflammation. This inflammation is a natural way of killing off and getting rid of the invader – for a short period of them. Our bodies are then designed to resolve inflammation and go back to its maintenance state. Now if for some reason our immune system has classified foods (wrongly!) as an invader to be fought off, every time we ingest that food, our immune system creates a low grade inflammation. More on how actual infections can contribute to chronic low grade inflammation further below.
- An overall high intake of calories. When we consume too many calories for what we need, our body turns this into something called ‘palmitic acid’, a type of fat. Palmitic acid can be consumed directly by eating a high fat diet, but the body can produce this substance via ‘de novo lipogenesis’ when overall calories and sugar intake is high. Palmitic acid creates inflammation in the brain (hypothalamus), leading to resistance to the satiety signaling of both insulin and leptin.
- Inflammation caused by other factors than diet: When there is chronic low grade inflammation in the body, our brain yet again signals our cells to become more insulin resistant – and direct fat storage to the abdomen. Common reasons for chronic inflammation are: lingering infections such as Epstein Barr virus, cytomegalovirus, HPV, gut microbiome imbalances such as H. pylori, candida albicans and other pathogenic overgrowth.
- Sleep deprivation. Even after just one single night of inadequate sleep will the brain send signals to the body to become temporarily insulin resistant. To make matters worse, after a night lacking sleep, it becomes much harder to resist urges, our survival part of the brain (the reptilian portion) turns on rather than the rational decision making prefrontal cortex, which wires us to crave more highly palatable, sugary and fatty foods – and so the cycle continues!
- Likewise, certain drugs, such as corticosteroids, can rapidly increase insulin resistance . This goes in hand with what we discussed earlier, how increased cortisol reduces blood zinc levels and thereby tampering with insulin signaling. Let’s look at the stress (cortisol) and abdominal fat connection next. https://link.springer.com/article/10.1007/s12011-018-1629-y
Stay tuned for the next blog post on our stress hormone cortisol, and how that can contribute to the apple shape body type… and what to do about it!