Several years ago, I had a heated discussion with a medical colleague of mine about a topic most people prefer to avoid: body fat. I was arguing that fat had hormonal qualities. I believed it acted like an endocrine gland and actually produced estrogen. He refuted my comment as interested spectators began to gather around us. I reiterated my statement and was once again rebuked by my debate opponent. We parted ways respectfully, with the compromise that we would agree to disagree. Today, additional research has upheld my assertion. I was, in fact, correct.

Fat has a few functions in the body, ones that go beyond dictating physical appearance. Regardless of what you think about your body and fat, some body fat is normal and healthy for you to have. However, not all body fat is equal. Its impact on your health depends upon the type of fat and the location in which it is stored.

TYPES OF FAT

Yes, fat comes in different types, and those types have a critical effect on your overall health and wellness. Visceral fat is linked to many forms of disease. Subcutaneous fat is the most abundant type in the body. It can protect against coronary artery disease and type II diabetes.

STORAGE OF FAT

The body uses stored fat for energy when needed, and that storage is called adipose tissue. However, fat can also be considered a highly sophisticated organ according to the 2013 article, “Pathophysiology of Subcutaneous Fat.” It noted that adipose tissue acts as a manager of metabolism and immune function. Adipose tisuse regulates brain function and other organ functions. It also regulates the turnover and regeneration and maintenance of the epidermis, dermis (skin) and cutaneous appendages (hair, nails, sweat glands, and subcutaneous glands (such as the breasts).

In addition to energy supply, fat also supports cell growth, mechanically protecting organs and assisting in the absorption of essential nutrients. It also, in validation of my initial assertion years ago, acts as an endocrine (hormone producing) gland. Adipose cells (adipocytes) produce hormones like estrogen and leptin, leptin being the hormone that suppresses hunger.  

Other hormones produced by adipocytes include cytokine. Cytokines are proteins involved in cellular communication in the inflammatory process. You may have heard the term “cytokine storm” during the COVID outbreak. This referred to a hyper and uncontrolled inflammatory process.

Fat cells also produce tumor necrosis factor (TNFs), which is a substance that causes inflammation. TNFs are important in the regulation of tumor cells. They can cause the death (necrosis) of tumor cells. Or, if TNFs are produced in over abundance, they can lead to autoimmune conditions such as Rheumatoid Arthritis.

So, you see, if you have too much fat or too many adipose cells, your body can end up in a dysregulation of both your metabolism and hormones.

LOCATION OF FAT

Current research has shown that the function of adipose tissue varies depending on the location of fat cells, which are known as adipocytes. An article published in 2010 in the International Journal of Obesity titled “Gluteofemoral Body Fat as a Determinant of Metabolic Health” reviewed the evidence that the “proportion of abdominal to gluteofemoral body fat correlates with obesity-associated diseases and mortality.” Gluteofemoral fat refers to the lower body, which includes the buttocks and thighs, while abdominal fat refers to the stomach.

Abdominal fat has long been associated with metabolic and cardiovascular disease and has been correlated directly with overall morbidity and mortality for years. However, newer research emphasizes that the proportion of abdominal fat to gluteofemoral fat makes this association more directly.

This study emphasizes the potential for a more protective role of gluteofemoral fat, noting that increased gluteofemoral fat “is independently associated with a protective lipid and glucose profile, as well as a decrease in cardiovascular and metabolic risk.”  

Both human and lab studies of adipose tissue from the thighs and buttocks indicate “distinct properties” inherent in this type of fat tissue, which appears to impart positive passive properties regarding lipid breakdown and fatty acid storage, which are two very important properties for overall metabolic health. The production of leptin, the appetite suppressing hormone, is positively affected by gluteofemoral fat, and cytokine production (inflammation) is negatively affected. So, this form of fat deposition may in fact protect us from the adverse effects of abdominal fat deposition.

Meanwhile, visceral fat is commonly referred to as “belly fat.” As noted previously, high levels of this form of fat raise the risk of developing cardiovascular disease and events. However this form of fat is not only deposited externally where it is visible, but also internally around abdominal organs where it is not visible.

I recall an experience during my chiropractic education. While in human dissection class our group was working on a rather obese female cadaver. I was amazed to see the goblets of fat encasing all of her internal organs. I recognized that this would have made it much more difficult for organs such as the heart and the liver to perform their routine activities.
Visceral fat is insulin-resistant. It is a much more reliable predictor of mortality and morbidity. This form of fat also generates more inflammation.

DEPRESSING FAT

In long-term research known as the Framingham Heart Study, the relationship between visceral fat and depressive symptoms in 1,581 women and 1,718 men were studied. It found that there was a relationship in women (but not so in men). Meanwhile, there was no relationship observed between subcutaneous fat and depression in either sex.

LIVER FAT

“Fatty liver disease” is a term that some may be familiar with and one that is heard as an innocuous finding after a CT or MRI scan is performed on the abdomen. This condition arises, as the name implies, when fat is stored in the liver. It results from, among other things, the overconsumption of sugar or saturated fat.

Unfortunately, this condition can significantly impair liver function. It can also lead to the destruction of liver tissue. This unfortunate impact on liver function impairs both metabolism and hormone production. Lower calorie content diets will decrease liver fat, whereas high caloric intake increases fat deposition in the liver. Also, diets high in saturated fat will increase fatty liver deposition, and diets higher in unsaturated fats will reduce fat deposits in the liver.

WHAT’S NEXT?

Understanding the good and the bad about fat will help to clear up some of the misconceptions. We must understand the health risks that body fat poses to our overall longevity. We must also recognize the positive aspects of certain types of body fat.

Armed with this knowledge, you are better able to act accordingly to achieve an optimum personal weight versus embarking on an unhealthy, fad-like quest to “get skinny.” As always, if you need personalized assistance with the issue of body fat and its impact on your health, wellness, and overall longevity, we’re here for you.

Dr. Pfeiffer