This article is the fourth installment in the Metabolic Flexibility Series. Before proceeding, it would be a good idea to check out articles 1, 2, and 3.
Each time we make a mindful decision about how to act to improve the health of our bodies, it is important to keep a particular goal in mind along with an idea of how the decision allows us to reach that goal.
Sometimes when making a decision, it is simple to clearly see the entire pathway, step-by-step, from the decision to the end goal. Other times though, this pathway is not as clear, and in these cases, it is useful to build up a model to represent the information in a useful framework.
Given the specific system we are dealing with in our healthy decision-making case – that of a complex, dynamic system – a significant problem immediately arises. This problem is that it is difficult, if not impossible, to clearly see how our actions impact the health of our bodies when multiple variables are interacting via numerous mechanisms. Add in that all of this is happening over time, and that the system may look very different on one day as compared to the next, and it makes it very difficult to be able to make predictions on how a particular decision will impact the health of the body.
Not to lose hope though, as there are methods that we can employ to help us understand complex, dynamic systems. The Reprogrammed Systems Approach uses such methods, and today, as we continue our discussion on metabolic (inf)flexibility, we will use it as we take a step back and look at the bigger picture that is our overall approach to making healthy decisions.
Note that The Reprogrammed Systems Approach has two essential pieces:
- The approach to making healthy decisions, overall, involves understanding that the human body is a complex, dynamic system. What this means is that we as mere humans do not have the ability to fully comprehend everything that is happening inside our bodies in response to a decision; rather, we can only hope to gain some level of insight into the inner workings of the body.
- Given this understanding, we still need some method of making a decision. The method used in The Reprogrammed Systems Model is that of the black box approach. The idea – even though we do not know all of the workings of the system, we can make educated guesses about particular inputs, and then by measuring the outputs, we can learn more about the system (in turn, improving our educated guesses about inputs). In this way, we improve our ability to make healthier decisions over time.
- Even though we cannot fully comprehend the complexity of the system, we can still make an effort to unravel the pathways involved. We will never be able to fully understand all of the pathways involved (at least, not for ourselves in our own lifetimes), but we can still work to pick out the most important pieces and to bring them all together in an organized fashion.
- In this way, we improve our ability to make healthier decisions over time.
Given that we can make an effort to unravel the mystery of the black box that is our own bodies, with this series, we are focusing on one particular pathway: that of metabolic (in)flexibility. So far, we have three articles worth of information regarding how this pathway unfolds, along with an idea of how our decisions impact the unfolding of this pathway.
Now, with this final article, my intention is to help us piece it all together in one framework for making healthy decisions based on our knowledge of metabolic (in)flexibility.
Again, understand that this framework has two pieces.
First is the process for building an understanding of what the healthy decision is. Given the assumption that we want to start making healthier decisions right now, and that we want to keep improving this ability, making even healthier decisions tomorrow and even healthier decisions next month, we need a process in place to help us continuously improve.
This process is the black box approach introduced above:
- starting from a place in which we know very little information about our system, the human body, we can start at the beginning with information about the general design of the system
- moving into a process that involves researching specific inputs, making specific decisions based on this information, and measuring the resulting outputs.
Second is the unraveling of the information contained within the black box. While we go through the process of testing out inputs and measuring outputs, we can go the extra mile to research how our bodies function so that we can make better educated guesses about how our decisions (inputs) tie into the health of our body (output).
Now that we understand where we are coming from and where we are headed, let’s get to work.
Start at the beginning – Key Principles and Practices of Good Health
Within The Reprogrammed Systems Approach framework, our ultimate goal is a life of good health, which means that the body is capable of effectively performing the functions it needs to do in order to:
- Maintain the functioning of systems supporting our life so that we continue to live out a long life
- Provide the physical ability to perform the actions we desire
- Provide the cognitive capacity to perform tasks, solve problems, and enjoy life
- Provide us with the energy we need to perform the actions we desire each and every day
Because this idea of overall good health is rather broad, it is useful to break it down into more specific topics. With this particular series, we are focusing on metabolic flexibility as one key aspect of overall good health.
So, where are we in this process? Let’s check in with what we already established.
So far, we have seen how the ability to switch back and forth between fuel sources is essential for maintenance of the health of the system, overall. We have also seen how specific actions….
- choosing a diet based on real, whole foods
- engaging in regular and dynamic movement
- practicing a balance of stress and rest
… leads us to reaching that goal. Because these decisions are aligned with the basic biological design of the human body, they support the ability of the systems supporting the body to function as nature designed.
If you need a refresher on exactly how these 3 key decisions improve different aspects of metabolic flexibility, head back to article 2 for how they tie into insulin sensitivity, and check out article 3 for how they enhance fatty acid oxidative capacity.
Note that this is the first phase of The Reprogramming Process. When it comes to making healthy decisions, a good starting place is with these 3 key principles and practices. Simply by choosing the well-established practices that align with basic biological principles, we can make large strides towards the goal that is a life of good health.
So, already, we have ticked off the basic practices that you can employ today to begin building your healthy body.
Sometimes though, this basic framework is insufficient to address the needs of an individal. This includes specific health problems, genetic abnormalities, performance goals, or any other factors that may influence your desire to dial in your nutrition and lifestyle choices. If this is the case, then it is necessary to go the extra distance to learn more about the functioning of the human body to have the skill necessary to make more precise decisions. This way, every time we go make a decision regarding…
- what foods to eat
- when to eat
- what exercises to engage in
- how frequently to exercise
… we understand the factors that we should be taking into consideration.
If this is the case for you – which I’ll assume it is as you’ve made it all the way to article 4 – then we need a way to organize all of the material into a coherent framework.
Healthy Decision-Making Frameworks
When organizing pieces of a complex, dynamic system into a decision-making framework, it is useful to think about different approaches – or perspectives – we can use to examine the information.
- First is the reductionist approach, in which specific mechanisms are examined and tied together to create a step-by-step picture of the problem. This is the A–>B–>C–>D approach.
- this is an important perspective because it allows us to understand exactly how each pathway unfolds, mechanism by mechanism
- and yet, this perspective is inusfficient on its own because it completely misses the complexity of the system
- moreover, it is difficult to identify each piece of a complex system, difficult to piece together each piece of a dynamic system, and impossible to piece together the entirety of a complex, dynamic system
- Second is an energy balance approach
- this perspective allows us to look at the system, overall, making calculations based on overall energy flow
- we know that in a healthy system there is a balance of energy in and energy out; therefore, we can examine where energy is building up or depleting and pay attention to any related mechanisms and pathways
- Third is the key driver approach
- this approach focuses on the primary signals and mechanisms at play within the system that are driving the flow of energy
- with this approach, we can ask the question, What are the primary mechanisms driving this pathway?
Note that no one perspective gives us all of the information we need to tie our decisions directly to the goal that is good health. Rather, we need a mix of these perspectives to allow us to see the entire picture.
Throughout this series, my hope has been to help you build up an understanding of the metabolic inflexibility pathway via these three approaches.
In the first installment, we stepped through the pathway that arises from metabolic inflexibility in muscle tissue. We saw how, step-by-step, the build-up of stagnant lipid droplets in muscle tissue leads to insulin resistant muscle tissue, progresses further towards systemic insulin resistance, hyperglycemia, hyperinsulinemia, excess fat accumulation, and systemic insulin resistance.
In the second installment, we looked at the specific mechanisms of insulin as a key driver in the progression of this pathway.
In the third installment, we examined the overall imbalance of energy within these systems, driven by the specific mechanism that is fatty acid oxidation.
Let’s look these over one more time.
1. The Reductionist Approach – Back to the pathway of metabolic inflexibility
2. The Key Driver Approach: Key Signals Driving the Metabolic Inflexibility Pathway
The following is a simplified list of the signals and mechanisms involved in the metabolic flexibility pathway. This includes a summary of the material in this series, along with a couple extra pieces of information that you may find interesting or useful. The goal here is not to memorize all of these; rather, it is to understand general themes that we can keep in mind as we learn how our actions lead to the initation of these signals.
1. Insulin, insulin resistance, and hyperinsulinemia:
Insulin plays many roles in the body depending on the exact cell-type that receives it, but there are two big ideas summarizing the role that insulin plays throughout the body:
- pro-energy storage signal – when insulin is elevated, tissues act to stop releasing energy and instread, to store energy
- glucose is elevated and needs to be lowered signal – when insulin is elevated, tissues act in a way that allows for the collective lowering of blood sugar concentration
While each tissue type responds in its own specified fashion, the overall themes are the same.
- adipose tissue responds to insulin by taking in energy (glucose and lipids) and storing these as fat, and also halts its release of fatty acids. Thus, glucose is lowered in the bloodstream and fat is stored.
- muscle tissue responds to insulin by taking in glucose from the bloodstream and either storing it as glycogen or utilizing it as a fuel source to synthesize ATP. Meanwhile, it halts its fatty acid oxidation so that glucose can be oxidized. Thus, glucose is lowered in the bloodstream and fat is stored.
2. Lipotoxicity and lipokines (signaling via lipids)
Lipids are more than just vessicles to store energy. They are strong signaling molecules that communicate to cells important information:
- when lipids accumulate in stagnant droplets, the structure of the lipids is changed, and this structure becomes a signal to the cell for insulin resistance
- a new one for you, not discussed in this series – when lipids accumulate in excess in adipose tissue, some of these lipids are released into circulation to signal to the whole body for help (which we now know often results in insulin resistance).
3. ROS and Inflammatory Messengers
- When energy is inefficiently oxidized, the overproduction of reactive oxygen species (ROS) signals to the cell for insulin resistance
- A new one for you, not discussed in this series – when lipids accumulate in excess, the tissue initiates an inflammatory cascade to signal for help. This is the same idea as what would happen if you physically injured yourself (say, you banged your knee on a rock). When there is tissue in trouble, the body releases inflammatory messengers to signal to the body for help.
- These inflammatory messengers may stay in the adipose tissue or go out into circulation, all as a signal for help (which we now know often results in insulin resistance).
To summarize:
One major theme to note here: insulin resistance.
- this can arise due to dysregulation of the bulk flow of energy. When lipids build up in excess, insulin resistance soon arises
- this can arise due to dysregulation of inflammatory cytokines and other chemical messengers. These messengers signal to tissues for help, which often means that insulin resistance soon arises.
Two takeaways for our decision-making:
- How our decisions influence the release of insulin
- How our decisions influence other chemical messengers in the body that operate on a systemic level. This includes systems of the body (inflammatory system), and well as our ability to manage reactive oxygen species.
3. Energy Balance – Within Muscle Tissue and Within Adipose Tissue
In the 3rd installment of this series, I drew our attention to energy balance (energy in – energy out = change in internal energy), and specifically, to the energy out term of the equation. If the systems supporting the body are incapable of effectively oxidizing energy, then the energy out term is decreasing, driving the system towards a positive energy balance.
In that article, we looked at the positive energy balance in both muscle tissue and adipose tissue as lipids build up in excess, driven by an impaired ability to oxidize fatty acids.
With this final installment in this metabolic (in)flexibility series, I want to wrap up with a clear picture of the balance of energy within the entire system that is the body and its interaction withthe world via our decisions.
Let’s begin by recalling energy balance.
Remember the theory:
The model is based on the law of conservation of energy, which states that since energy can neither be created nor destroyed, whatever energy enters a system must be accounted for by energy leaving the system or by energy remaining within that system.
And the equation that summarizes the theory:
Energy In = Energy Out + Change in Internal Energy
It follows that if we wish to change the internal state of energy within our bodies, we can think about how much energy is consumed and how much energy is expended:
Energy In – Energy Out = Change in Internal Energy
Finally, given that a significant problem in the modern world is the build-up of excess energy in various systems within the body, it follows that we could aim to either:
- Decrease Energy In
and/or
- Increase Energy Out
The question for us: which actions should we pursue to make our intended energy balance happen?
Do we simply eat less? Do we simply exercise more? Or is there more to the picture.
Since we have an entire series devoted to explaining the picture, let’s operate under the assumption that the answer to the question is that there is more at play than can be accounted for by restricting the amount of energy in and increasing the amount of energy out.
Does this mean that we should throw out energy balance and only focus on signals? Of course not, and remember, that’s the whole idea here. Energy balance still provides us with extra information about the system.
Let’s explore how the understanding that there is a positive energy balance helps us explore ways in which we can create desired energy balance:
1. A positive energy balance within the muscle tissue
Increasing the energy out term:
- could be accomplished by exercising more
- could also be accomplished by enhancing the capabilities of the metabolic machinery to more effectively oxidize lipids, both at rest and during exercise
- could also be accomplished by paying attention to the foods we consume – making sure to consume real, whole foods that deliver the resources needed by metabolic machinery to function optimally; and, making sure to avoid industrial not-so-foods that overburden the metabolic machinery with high doses of energy and toxic chemicals
2. A positive energy balance within adipose tissue
Increasing the energy out term:
- could be accomplished by exercising more to mobilize fatty acids out of storage and towards muscle for oxidation
- could be accomplished by fasting to allow for mobilization of fatty acids out of storage and towards muscle for oxidation
- could be accomplished by eating low-carb to minimize insulin production, allowing for mobilization of fatty acids out of storage and towards muscle for oxidation
Bringing it all together
If we are going to effectively make healthy decisions, it is useful to think about all of these perspectives. Sometimes, one perspective may be more useful than another, but in each case, all are available to us as perspectives we can call on.
Most importantly, if we want to achieve the goal that is building a healthy body, we need to take care that we never put too much emphasis on one perspective over another. They all have their uses; they all have their limitations.
So, where does all of this leave us in regard to our particular pathway to poor health that is through metabolic inflexibility.
What information can we take away from everything we have learned here?
Given that a healthy body is one in which the many sub-systems are achieving a balance of energy; and also given that the flow of this energy is driven by signaling molecules; and also given that the flow of energy is driven by the ability of metabolic machinery to function as is necessary…
… given all of this, we can now come at the problem with a framework for how our decisions impact the health of the body, overall.
With the completion of this series, you now have a stronger idea of the answer to making decisions as they relate to enhancing or impairing the metabolic flexibility of your muscle tissue. Combining this pathway with knowledge about how it plays into the bigger picture that is the health of your own body, overall – this is what will allow you to make truly healthy decisions.