Pot Bellies and Insulin Resistance
I love Dr. Mike Eades blog, and he gave permission to quote an excerpt from his recent post about his Seattle trip. I knew that all of you, my reader friends, would like this story…
We started each day with a quick breakfast at Louisa’s, a little restaurant close to the office where we spent our days. One of the menu selections, fittingly enough, was called Mike’s Special, so how could I resist. Especially when it was such a great low-carb option: two poached eggs on a bowl of sautéed spinach, red and green peppers and onions. Good, good, good. It came, of course, with a giant piece of toast that was at least an inch thick, which I ate a couple of bites of just to try.
As we were eating breakfast on the last morning, a man was eating alone while reading the paper at the table next to us. He looked to be about 70 or so and was fairly thin with a pot belly. He had on two pressure stockings on his lower legs and bruising in the crook of one of his arms from where, obviously, blood had recently been taken.
Watching him eat, I created an entire story about him that I’ll bet is not too far from the mark. Even if it is not accurate in this man’s case, it is totally (and sadly) accurate in many thousands of others.
The man was eating a bowl of oatmeal. He had a glass of skim milk so fat free it was almost blue that he poured little bits of into his cereal from time to time. Along with his oatmeal, he was eating one of the giant pieces of toast the restaurant serves. He took one pat of butter (I assume there was no margarine available) and cut it in half. He carefully spread one half pat on one half of his toast then loaded it with an entire individual serving of jelly. After eating the first half piece of toast, he prepared the second half the same way and ate it. The only fat he got from his entire meal was that that came from that one pat of butter. Based on the size of the bowl of oatmeal and the size of the toast (and the skim milk), I calculated that this guy consumed about 100 grams of carbohydrate. (Thirty grams in the oatmeal; at least 30 in the toast; 15 in each container of jelly; and about 10 in the skim milk.)
I imagine (here is where I’m speculating) that he has elevated cholesterol and has been told by his doctor to watch his fat. And he is complying. He got a whopping 4 grams of fat in his one pat of butter (36 calories-worth) while getting 100 grams of carb in the rest of his meal (400 calories-worth). The tiny bit of fat he got contained short-chain fatty acids that are immune enhancing whereas the 100 grams of carb he got provided really no health benefit. Since the 100 grams represents 20 times the amount of sugar circulating in his blood, his pancreas had to release a large amount of insulin to deal with it. His pot belly indicates that he is already insulin resistant with an abdomen full of visceral fat, so he no doubt secreted a lot more insulin than a person without insulin resistance. This excess insulin helps him store fat in his liver, increase his level of visceral fat, ratchet up the inflammatory process, injure his blood vessels even more and increase his risk for heart disease, the very thing his doctor was trying to prevent by putting him on a low-fat diet.
How much better off this guy would have been had he joined me in the Mike’s Special. But, his cardiologist, I’m sure, would have been apoplectic. A sad state of affairs indeed.
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- Does fat make you fat? Part 2: Specific principles related to fats & dieting