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Life as an Apple Ain't Easy

Nancy Bennett, MS, RD, CDE

Where you "wear" your fat has a profound effect upon your ability to burn it. Those who tend to wear their fat around their waist, the apple-shaped folks, have a much more difficult time losing fat as compared to "pears." Pears, or those who tend to wear fat around their hips and thighs, do not have to deal with insulin resistance. But apples do; this is where the trouble begins.

Insulin resistance is trouble because it actually decreases the number of calories burned and increases the ability to make and store fat. This means that gaining weight around one's waist enhances their tendency to gain more weight. The whole situation is a vicious cycle; much like a snowball picking up both more snow and more momentum as it barrels down the hill.

This is not to say that apples can't lose weight; they can and do all the time. Yet, the task of losing weight is a bit more difficult and complicated than just cutting back on calories. It involves overcoming or reversing the effects of insulin resistance.

The best to start and tackle this grim situation is to define what insulin resistance is, describe what effect it has on metabolism and then discuss what literally reverses it. A lot has been written about insulin resistance. Many authors would have you believe carbohydrates cause insulin resistance. This is, in a word, bull.

Obesity, those excess groceries that collect around one's waist, cause insulin resistance. Most health professionals would refer to this type of obesity as "central adiposity." Who cares what they call it; we all know what it is and why it is. We already know that obesity is caused by an excess energy.

Some authors would have you believe it is those evil carbohydrate calories. Truth is, it doesn't matter where those extra calories come from. If you eat more calories than you burn, regardless of whether they come from carbohydrates, proteins or fats, you end up wearing them. If you are wearing them around your waist, you are at risk for insulin resistance. (Where you wear them is not under your control anyway. Genetics has a lot to say about where you put excess calories. Some people, especially men, tend to put them around their waist; women tend to put them around their hips. The real truth is that hormones, which are also controlled by your genes, dictates wear you wear these calories. This topic is an entire book's worth of discussion so it may be best to move on before digressing from the real issue.)

Normal insulin metabolism works like this: Insulin opens up the doors on a muscle cell or liver cell so that carbohydrates (glucose), fats and proteins can gain entry into the cell. The cell then uses the glucose as energy to do its work, like making new molecules, enzymes or whatever.

When an apple develops insulin resistance, the cells can't recognize insulin. It is almost as if the cells are in a trance. Insulin knocks on the cell doors and tries to wake them up. But, no dice, the cells remain asleep.

As these sleepy cells become hungry, they send a message throughout the body for food. The liver hears the call for food and releases more glucose to the blood. The pancreas senses the extra glucose and responds by pumping out more insulin. Now the body has excessive amounts of insulin floating around. This condition referred to, as "hyperinsulinemia" is simply trouble with a capital "T".

Martha Stewart would not call hyperinsulinemia a "good thing", especially if she wanted to lose those delectable hors d'oeuvres she's carrying around her waist. While extra insulin helps with getting glucose into sleeping cells, it also works amazing well at squeezing fat into fat cells. The last thing every deserving apple needs is more of the hormone that jams additional fat into their fat cells. It's like watching some idiot trying to put out a fire with lighter fluid, definitely not a good thing.

Now would be an excellent time to move on to the solution. Activity, simply moving around, makes insulin more effective. The solution is, in a word, "MOVE"!

Move early and often. Move a lot, for every time you move, you wake those cells up out of their trance. The cells begin to recognize the insulin again at their doors. They use the insulin to pull glucose into the cell, burn it for energy and/or use it to make molecules like glycogen.

Glycogen is glucose reservoir within muscle and liver cells. As it turns out, making glycogen is a very expensive endeavor. Cells use up 15% of the calories in glucose making glycogen. This means that if you eat 300 calories of carbohydrate, like a Noah's bagel, 250 calories will be stored as glycogen and 50 calories will be burned up making the glycogen. In fact, the more glycogen you store, the more calories you burn making it. The more you move, the more glycogen you can make.

This is just one reason I don't see a lot of physically fit people in my office for weight reduction. They move a lot, they make a lot of glycogen and they use a lot of carbohydrate calories simply making glycogen. Then, they burn a lot of calories by moving their weight around.

Amazing, isn't it? So much has been written recently about diet and insulin resistance, when it isn't so much about diet as it is about lifestyle. It is about how much a person moves.

Health professionals with in the diabetes education community would tell you that movement, or exercise, increases "insulin sensitivity." This essentially means that the insulin you have works ten times better when you move. This means your body doesn't have to produce as much insulin to do the same about of work. This means you lower your insulin levels by moving. This means moving around lowers the amount of hormone in your blood that jams fat into your fat cells! Moving around is every apple's magic bullet; it cuts to the core of the problem and nips it in the bud.

This is not to say that changing your diet isn't helpful. If you interpret a high carbohydrate diet as permission to dive head first into a box of "Snack well" cookies or bowl of jellybeans, you'll get no sympathy from me. You, quite frankly, are asking for it.

A diet that is rich in carbohydrates means, of the calories you need, at least half should come from carbohydrates. The key words here are "of the calories you need". Many seem to have glossed over these recommendations and have come up with their own version, which goes "of the calories I want." Unfortunately, experience has shown this plan doesn't work very well.

What works well is moving around. Moving around, in conjunction to eating the calories you need, changes an apple's metabolism from one that stores fat to one that burns fat. And this makes an apple's life a whole lot easier.