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Excess Fat Accumulation Part 3 – Energy Balance from a Systems Perspective

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In the previous article in this series, we took some time to understand energy balance and apply it to the sub-system that is adipose tissue and its interaction with the bloodstream. We saw how a chronic positive energy balance (an excessive build-up of fat) is a problem of two key factors:

  1. excessive insulin secretion
  2. high total energy load

First, when insulin is elevated too often, the body is put in a chronic state of energy storage. This means that:

  1. the bulk flow of energy in the body is getting diverted into storage
  2. the energy that is stored as fat cannot be released back into circulation, and therefore cannot be utilized as a fuel source
  3. the mitochondria cannot utilize fats as a fuel source

Second, when that particular individual is consuming a high concentration of energy, then all of that excess energy will simply go into storage.

To help us understand these two concepts in combination, we can examine the problem of excess fat accumulation in adipose tissue through two lenses:

  1. excess fat accumulation is a problem involving a positive energy imbalance
  2. excess fat accumulation is a problem involving dysregulation of the insulin signal

Now that we understand these two basic principles of excess fat accumulation, with this article, we will take this information and expand on it to see how it ties into higher level systems in the body, including:

  • adipose tissue and its network with other components
  • energy balance across the entire body

In this way, we will see how energy regulation and energy balance can be applied to different systems within the human body. Then, in the next and final installment of this series, we will think through how these sub-systems all connect to the decisions we make regarding our own bodies (e.g. what we eat, how we move).

Remember the big idea here: once we have an understanding of these systems, along with their response to inputs from the environment, we can get started making healthier decisions in our own lives that drive these pathways towards overall strong functioning and away from the pathways of dysregulation, dysfunction, and modern disease.

To get started, let’s review how the build-up of excess energy as fat in adipose tissue can lead to system-wide metabolic dysfunction.

Positive Lipid Imbalance in Adipose Tissue Leads to Systemic Metabolic Dysfunction

  1. Lipid balance in adipose tissue
Figure 1: Energy balance in adipose tissue: energy-containing molecules (lipids, glucose) enter adipose tissue and are stored as fat. In a balanced system, over time the same amount of energy that enters into adipose tissue is released back into circulation.

2. Lipid imbalance in adipose tissue

Figure 2: If more energy enters into adipose tissue than is released, then over time, that adipose tissue will gain a net positive amount of energy which is stored as fat.

3. Chronic positive lipid imbalance leads to local insulin resistance in adipose tissue

Figure 3: If a positive energy balance is maintained for too long, then adipose tissue may reach capacity at which point it will stop listening to the insulin signal to store more energy. Insulin resistant adipose tissue will stop taking in energy to store as fat and will begin releasing fat into circulation.

4. Systemic Insulin Resistance

Figure 4: If adipose tissue is not taking in excess energy from the bloodstream, the pancreas will release even more insulin to, in a sense, send a louder signal to store energy. Over time, insulin levels keep increasing as adipose tissue keeps filling up and levels of energy-containing molecules (lipids, glucose) keep rising in the body. At this point, the body in a state of system-wide metabolic dysfunction including systemic insulin resistance.

Now that we understand the simplified model of this excess fat accumulation pathway, let’s switch to a different model that shows the greater complexity of the human body. With this next series of models, I will take you through the system-wide dysfunction that arises from this hyperinsulinemic state, and then take a moment to briefly discuss the impact on a selection of sub-systems.

As we walk through this series of models, I want you to think about two perspectives:

First, is that of energy (im)balance.

Second, is that of energy (dys)regulation.

  1. Elevated insulin in the bloodstream:
Figure 5: A model of two primary forms of energy-containing molecules (lipids and glucose) and different pathways through which they can travel once in circulation in the bloodstream. These energy-containing molecules enter into circulation from the intestine following a meal. They then pass through the liver, the body’s primary metabolic machinery in charge of converting one form of energy to another based on metabolic demand. As this energy continues through circulation, it may be stored as fat in adipose tissue, stored as glycogen in muscle or liver, or eventually oxidized to produce ATP in the mitochondria. When insulin is elevated, the body is working as a network to lower the concentration of sugar (glucose) in the bloodstream. This results in energy of all kinds (lipids, carbohydrates, proteins) being diverted into storage. Moreover, sugars and proteins may be converted to lipids before being stored as fat.

Remember, this elevation of insulin following is a normal, healthy process. The insulin signal tells components throughout the body (liver, muscle, adipose tissue, etc.) that glucose is elevated in the bloodstream and that they need to function in their own specified way to low blood sugar concentration. Then, later on when blood sugar concentration is low again, these components will reverse this functioning to release energy back into the bloodstream.

In this way, a state of homeostasis is achieved.

However, this homeostasis can be disrupted if insulin is elevated too high or too often. Let’s look at what happens when this is the case.

2. Hyperinsulinemia – the chronic and/or elevated amount of insulin in the bloodstream:

Figure 6: When insulin is elevated in excess (elevated too high or too often), then the system faces a series of problems at the level of each component (liver, muscle tissue, adipose tissue) and system-wide.

First, let’s take a quick look at the primary components (components being tissues and organs throughout the body) of The Reprogrammed Systems Models:

  • adipose tissue – this component is the primary site of energy storage. Adipose tissue takes in energy (lipids and glucose) and stores them as fat.
  • liver – this component is the master metabolic regulator; its job is to take in energy from the bloodstream and to manage this energy load based on the supply and demand of energy throughout the entire body.
  • muscle – this component is the main user of energy

We are very familiar with hyperinsulinemia and an excess load of energy in the adipose tissue. Let’s now take a glimpse at the other two components as they are put under the burden of hyperinsulinemia and an elevated load of energy.

System-Wide Dysfunction arises from a hyperinsulinemic condition in:

  1. The Liver

When we consume a meal, the bulk of the energy contained within combines with energy already in the bloodstream and makes its way through the liver. The liver takes in all of this energy while also receiving signals (e.g. insulin) that tell it information about the supply and demand of energy throughout the entire body.

The liver uses all of this information to compute how it needs to process all of the energy it receives such that system-wide metabolic homeostasis is achieved.

Figure 7: The liver performs its job as a master metabolic regulator by continuously sensing the needs of the entire body (via signals like insulin) as it takes in energy-containing molecules from the bloodstream. Based on these inputs, the liver determines what is needed for the body and performs the necessary processing of this energy, shipping it all back into circulation in a way that helps the body maintain system-wide energy homeostasis.

If the liver is taking in a high load of energy and it is receiving a strong insulin signal, then it will:

  • convert sugars to fats, package them in lipoprotein particles, and ship these out into circulation
  • maintain blood sugar homeostasis by regulating the amount of sugar released into circulation

If the liver is consistently taking in a high load of energy and is receiving a strong insulin signal, then it may become resistant to the insulin signal as it attempts to manage this burden of energy:

Figure 8: As excess energy enters the liver, the liver loses its ability to keep up with the load. More specifically, the liver cannot keep up with its two primary functions of regulating glucose and regulating lipids. While the liver has been programmed to make glucose homeostasis its priority, the excess incoming energy forces the liver to switch its attention to managing the load of lipid. The mechanism of action for which the liver is able to make this switch is insulin resistance: by decreasing the ability to respond to the insulin signal to manage glucose, the liver is able to divert its attention to managing lipids.

If the liver becomes insulin resistant as it continues to receive a large burden of energy in the form of fats and carbohydrates, then the body has a problem. The liver needs to be able to understand the insulin signal that blood sugar is elevated so that it will function in a way to decrease blood sugar. It does this by taking in more glucose than it releases.

However, when the liver does not understand the signal that blood sugar concentration is elevated, then it will continue to release sugar back into circulation, such that a hyperglycemic state is maintained.

Meanwhile, the liver continues to take in this large load of energy. The destiny of this energy is among the following:

  1. Glucose released back into circulation as glucose (as just described)
  2. Glucose is converted to fat and stored along with other fats as fat within the liver (which may lead to a fatty liver)
  3. Glucose is converted to fat and shipped out into circulation along with other fats via VLDL particles (which could contribute to the progression of atherosclerosis)

2. Skeletal Muscle

A primary task of the muscle tissue is to oxidize energy-containing molecules to enable contractions of its fibers. As it does this, it is responsible for taking out large amounts of energy from the bloodstream.

If the muscle receives the insulin signal as it is taking in all of this energy, then it understands that it needs to prioritize the utilization of glucose as a fuel source. This means that if insulin is elevated, lipids will not be oxidized by the muscle tissue.

If the muscle is taking in a high load of energy and it is receiving an insulin signal, then it will:

  • utilize sugars as a fuel source
  • turn away fats altogether, or store some of them internally

If the muscle is consistently taking in a high load of energy and is receiving a strong insulin signal, then fat may build up in the muscle and the muscle may become resistant to the insulin signal (check out the previous series on metabolic flexibility in muscle tissue for the full pathway):

Figure 9: A primary task of the muscle tissue is to oxidize energy-containing molecules to enable contractions of its fibers. As it does this, it is responsible for taking out large amounts of glucose from the bloodstream. If muscle tissue becomes insulin resistant, it is unable to effectively take up glucose from the bloodstream, contributing to hyperglycemia.

Combining these three components, we see how an elevated load of energy in the bloodstream combined with hyperinsulinemia leads to system-wide dysfunction that includes:

  • systemic insulin resistance
  • hyperglycemia
  • hyperlipidemia

Now that we see how the pathway of excess fat accumulation leads to system-wide metabolic dysfunction, let’s pose some questions that will be useful in our own lives as we go about making decisions each and every day.

Looking back at this entire system, what conclusions can we draw about what is driving this pathway of excess fat accumulation?

First, two internal factors dictating this pathway:

  1. Elevated insulin is driving the bulk flow of energy into storage and preventing the release and oxidation of fatty acids.
  2. The total amount of energy entering the body is dictating how much excess energy is available to potentially go into storage

Second, if we want to know how this information ties into our decisions, what we need to know is how external factors impact these internal factors. That is:

  1. What causes excessive elevation of insulin?
  2. What causes the consumption of excess calories?

To wrap up this article leaving you with a piece of information that you can put into practice, we will look at the simplified picture that is the basic understanding of these two items. To do this, we will focus on one particular factor in the first step of The Reprogrammed Systems Approach.

Then, if you wish to gain a deeper understanding, with the final installment we will take a step back and use The Reprogrammed Systems Models to formulate a stronger approach to tying these pathways into our own decision-making abilities.

Step back out and look at the entire system that is the human body to make healthy decisions

At this point, we have two important questions. While we could spend the rest of the day exploring these questions to come up with detailed answers, to wrap things up for today and send you on your way with one key practice, let’s focus on the big idea answers:

What causes the excessive elevation of insulin?

  • insulin is released in response to elevated blood sugar

What causes the consumption of excess calories?

  • we eat too much when the body cannot regulate energy intake

Knowing these basic answers, let’s jump to the simple and obvious solution that we can embrace right now that will help our bodies maintain healthy blood sugar levels (and therefore healthy insulin levels), along with an ability to regulate the amount of energy it takes in.

How do we do this? By eating real, whole foods and avoiding industrials not-so-foods.

Figure 10: The Reprogrammed Systems Approach begins with an understanding that there are three key practices that tend to lead to good health. The first of these practices is building a diet based on real, whole foods. This is in contrast to what most modern humans consume, which is a diet in which more than half of the calories come from industrially processed ingredients.

The bottom line: the regular consumption of industrial not-so-foods spike blood sugar and impair the ability of the body to regulate its appetite. These industrial not-so-foods:

  • contain refined carbohydrate and refined protein – both of which spike blood sugar and elevate insulin
  • contain concentrated forms of fat that add an excess burden of energy to a system that is already in a pro-storage state (thanks to elevated insulin)

Also, industrial not-so-foods:

  • contain chemicals that disrupt the ability of the components throughout the body to effectively communicate and function as is necessary to manage energy supply and demand
  • lack nutrients that components throughout the body need to effectively manage metabolic functions, such as the oxidation of energy-containing molecules

This means that when our diet is based largely on industrial not-so-foods, we are regularly spiking blood sugar and keeping insulin elevated (energy dysregulation). Moreover, we deliver high concentrations of energy into a body that is in a pro-storage state (high total energy load). All-the-while, we send a stream of harsh chemicals into the body while depriving it of the nutrients it needs to function optimally (metabolic dysfunction).

Figure 11: The Reprogrammed Systems Approach focuses on understanding how decisions impact the inner working of the human body. This is simplified into two general ideas: 1. Energy regulation is the ability of the systems supporting the body to effectively communicate their energy supply and demand. 2. Metabolic homeostasis is the ability of the systems supporting the body to function as nature designed such that an overall balance is achieved. However, when we make unhealthy decisions, the systems supporting the human body may lose their ability to effectively manage the supply and demand of energy. This happens as 1. the systems lose their ability to effectively communicate (energy dysregulation) or lose their ability to function overall (metabolic dysfunction)

Thus, to simplify the excess fat accumulation problem, we can boil it down to one simple concept: the regular consumption of industrial not-so-foods leads to energy dysregulation, primarily through the hyper- and chronic elevation of insulin; and also, leads directly to metabolic dysfunction by depleting the body of the resources it needs to function.

In turn, to address the excess fat accumulation problem, the actions that you can take right now are straightforward: begin by eliminating industrial not-so-foods from your diet while building a diet based on real, whole foods.

From there, you can then take additional action to improve upon your results. This may include:

  1. adding in the second and third key practices of The Reprogrammed Systems Approach
  2. gaining a deeper understanding of the inner working of the human body so that you can fine-tune your decision-making abilities

Interested in the first option? Follow this link to find out more about The 3 Key Principles and Practices of The Reprogrammed Systems Approach

Want to dig deeper?

We can take one more step to gain a better understanding of specific decisions you can make that may work better for your own body. With the next and last installment of this series, we’ll continue digging into the excess fat accumulation problem as we think of a stronger framework for making healthy decisions.

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