A note to the reader: The following article is written for two audiences. The first is for those who are taking the time to follow the entire intro series in which I describe the Reprogrammed Systems Approach to modern disease. At this point we have made our way through the introductory articles and Part I, the building of the Reprogrammed Systems Model. This article is used to summarize Part I and move into Part II.
However, it has a second use, for those of you who have not taken the time to go through all of Part I and instead simply want a quick overview of the model so that you can begin using it in Part II. If this describes you, consider this as an introduction to the Reprogrammed Systems Model, a model that you can use to understand the design of the system that is your own body.
Whatever path you are on, I hope you find this next article useful as a tool to guide you through the decisions you make in your lifetime. My hope is that this summary article will help us all lead into Part II of my intro series, in which I describe how the Reprogrammed Systems Model can be used to help guide the decisions we make in our own lives.
To get us started, here’s a reminder of the key reasons why a systems-based model is necessary to effectively address modern disease:
- Modern disease most often arises from the gradual breakdown of the complex systems supporting the human body. The traditional approach that involves targeting individual mechanisms involved in this progression in order to address this entire dysfunctional system is inadequate to effectively address modern disease
- The human body is a non-linear, dynamic network, itself made up of sub-systems with the same complex qualities. As the systems supporting the body break down, poor health and disease may arise.
- To address this breakdown we must examine the systems supporting the body as they are – as complex, non-linear, dynamic systems – systems consisting of a large number of tightly interlinked mechanisms, which feed off each other to form emergent properties larger than the sum of their parts.
- Traditional reductionist approaches commonly used in clinical practice fail to effectively address the issue because they attempt to break apart these systems, treating them as simple, linear systems.
To address modern disease in this manner, I built a model that we can use to help us understand how modern disease arises. The following figure summarizes the basic essence of the model:
Modern disease is commonly an emergent property of metabolic dysfunction, a state in which the systems supporting the functioning of the human body malfunction and begin to break down. These mechanisms work in a complex, non-linear, dynamic fashion, so we must remember that when addressing the disorder in these mechanisms we need to target them as an entire system.
To address the entire system at once we begin by examining the most obvious factors driving this dysfunction. If we can effectively target the driver of the overall dysfunction, then we end up addressing the dysfunction of the system as a whole.
The primary driver that I have identified I termed energy dysregulation. When the body loses its tight control over energy (including energy levels in circulation, energy storage, and energy conversions), the components supporting this system become disrupted (e.g. the liver, pancreas, muscle, etc. begin to fail), leading to metabolic dysfunction.
For example, the body is designed such that long term energy stores (i.e. fat deposits) remain in a balanced flux. In times of excess energy availability energy is stored up. This is crucial for the survival of our species because we need that energy in times of low energy availability (e.g. while we sleep).
If, however, the body loses its ability to respond to the signals dictating the energetic state of the body, then it loses its ability to properly regulate those energy stores, as well as energy availability throughout the body. We’ll discuss this dysregulation and resulting dysfunction up next, but before that, let me remind you of our big picture approach.
We must not forget, our overall approach consists of using this model in the context of a systems approach:
Internal Pathways from Energy Dysregultion to Metabolic Dysfunction and Modern Disease
When the ability to control energy levels becomes dysregulated, the body loses its ability to control the levels of lipids (fat) and glucose (sugar) circulating through the bloodstream. This is important for two reasons. First, a steady supply of this energy is what fuels the body, and therefore any disruptions in this flow will result in dysfunction of the body. But even more dangerous are the effects that we don’t see, and this is what needs to be discussed in greater depth. Most significantly, energy dysregulation can result in high blood sugar levels (hyperglycemia), high blood lipid levels (hyperlipidemia), and excessive fat storage (obesity).
Therefore, it is of utmost importance to understand the pathways by which this dysfunction arises. With this knowledge we can make educated decisions leading to the avoidance of these damaging pathways, thus avoiding pathways to metabolic dysfunction and metabolic disease.
To help you understand some of these pathways and the mechanisms driving them, I have simplified energy dysregulation into two categories: macro and micro signals.
The signals that directly influence the flow of this energy I have termed macro signals as they drive the bulk of energy flow (hence, the direct flow of our macros / our energy sources). These signals primarily consist of hormones, including, but not limited to, insulin, leptin, and glucagon.
Moreover, we have additional signals that indirectly influence the flow of energy by affecting the components involved in metabolism. These I have named micro signals, as these signaling molecules are often of (relatively) microscopic size and indirectly affect the flow of energy. The star signal in this category is inflammation, although reactive oxygen species and other signaling molecules also contribute.
To get to the implementation of this model in our own lives we still have a few more steps to go. At this point we have a solid understanding of the internal mechanisms driving metabolic dysfunction. Now, if we can put all of this knowledge together into specific internal pathways driving the progression of modern disease, then we can start to think about how we can make decisions that lead to the avoidance of these pathophysiologic internal pathways.
Internal Pathway 1: Excessive Fat Accumulation
In the last article I discussed a primary internal pathway by which energy dysregulation drives metabolic syndrome, thus causing the progression of modern disease. In this pathway, insulin is excessively stimulated, putting the body in a chronic state of fat storage. When one stays in this state for too long, fat builds up in subcutaneous adipose tissue, until a point in which the adipose tissue can no longer keep expanding. At this point, fat begins to leak back out into the bloodstream along with an inflammatory signal. These two factors (high amounts of fatty acids in the bloodstream and pro-inflammatory cytokines) can go on to cause systemic insulin resistance. Once the body is in an insulin resistant state, it has lost the ability to effectively regulate energy, and resulting damage is likely to occur.
Looking at this same information in the Reprogrammed Systems Model:
Now that you understand how excess fat circulation (hyperlipidemia) and inflammation can contribute to insulin resistance, along with one pathway to reaching this condition, we can finish up this series discussing two additional internal pathways driving insulin resistance, metabolic dysfunction, and modern disease.
Excess fat accumulation is dangerous because, when that excess fat spills over into the bloodstream, it can then go on to forced storage in our organs. This is dangerous because this fat can then interfere with the proper functioning of those organs, most significantly, creating insulin resistant tissue.
However, this isn’t the only pathway by which this dangerous fat accumulation can occur. When the body receives certain signals, fat may go directly into a more dangerous form of fat storage: visceral fat storage, which is fat stored directly in or around our organs. This visceral fat storage bypasses subcutaneous fat storage, thus creating a more direct pathway to metabolic dysfunction.
When energy gets stored directly as visceral fat, the amount of fat mass stored ceases to be the primary issue. In the direct visceral fat storage case, that fat becomes immediately dangerous. Here’s why:
1. Visceral fat storage is naturally pro-inflammatory and “leaky.”
If you think back to the subcutaneous fat pathway, you may remember that when fat accumulates excessively, the body releases a pro-inflammatory signal. This signal is the body’s way of saying “help” – that it needs assistance dealing with a problem.
Well, when fat is stored in visceral fat depots, the body understands this as an immediate threat. Thus, it will release the same pro-inflammatory response, even if smaller amounts of fat are stored (as compared to subcutaneous fat stores).
2. The particular site of visceral fat
Visceral fat is fat stored around the abdomen, which puts it in close proximity to organs. When this particularly pro-inflammatory and leaky fat heads out into the bloodstream, it finds itself on a direct pathway to important organs, most notably, the liver.
This means that visceral fat may result in large amounts of pro-inflammatory cytokines and fat directed to the liver, putting a large load on the liver itself, which can result in its overall dysfunction (we’ll talk more about why this is so terrible later on).
At this point we have discussed two pathways by which hyperlipidemia and pro-inflammatory states arise.
1. Excessive fat accumulation in subcutaneous adipose tissue
2. Direct fat storage as visceral fat.
Now, to finish up, let me introduce one last pathway. We know that fat becomes dangerous in excessive amounts, and we know that fat becomes even more dangerous when stored near organs. But what about fat that gets stored directly inside organs? Moreover, what if that particular organ is one that plays a central role in metabolic function:
Fatty Liver
Today, an estimated 40% of people suffer from non alcoholic fatty liver disease. This means that the liver is so filled with fat that it can no longer function properly. This is incredibly dangerous as the liver is highly involved in the functioning of the entire system under scrutiny. Here’s just a glimpse of the many functions that the liver plays a role in:
- Energy conversions: The liver receives energy in different forms (primarily lipids, glucose, and protein) and has the important job of understanding the needs of the body at the time and then using this knowledge to convert one form of energy to another.
- Energy packaging and distribution: This energy is then sent from the liver into circulation in particular forms (e.g. fat is packaged into lipoprotein particles to be shipped throughout the body)
If the liver is incapable of functioning properly, then the entire body will feel the effects (e.g. disruption with receiving signals informing on the energetic state of the body; responding to these signals with ineffective conversion of energy to other forms).
This means that the dysfunction of the liver due to direct fat accumulation has disastrous consequences – consequences that will have an immediate impact on the entire body.
Moving Forward:
Now that we have a basic understanding of three internal pathways that drive metabolic dysfunction and modern disease, we can now move forward to the exciting part. In Part II of this introduction series, I will help you use this model in the context of the real world. With an understanding of this model, including the understanding of the mechanisms and pathways driving metabolic dysfunction, we can make educated decisions on what signals and resources to send to our own bodies, thus optimizing our internal signaling processes for good health.
With the use of the Reprogrammed Systems Model, we can make better choices that optimize our metabolic programming, leading to a strong, well-functioning metabolism, which will increase the probability of long, healthy lives filled with vitality and, most importantly, free of the medical system.
Moreover, for those who currently deal with any metabolic dysfunction, we can use strong signals and resources to activate pathways that will allow us to reprogram our underlying circuitry – to activate normal, healthy pathways, while shutting down those dangerous pathways to insulin resistance and metabolic dysfunction.***
Congratulations on all your hard work understanding this difficult material – I’ll see you over in part II where we can finally put all of this information to good use.
***Disclaimer: If you are currently suffering from any clinically diagnosed condition, always consult your doctor before making any serious changes to your diet or lifestyle. The information contained on this website should not be taken as medical advice.