In episode 118 of his video series, Dr. Larson discusses:

Although we’re concerned about lots of health conditions, cardiovascular disease is the number one killer in the United States. It is the number one killer not just for men, but also for women. Women are, however, usually more worried about breast cancer than cardiovascular disease. Breast cancer is the one that most often comes up as a health goal to prevent when I talk to women in my office. What I would like to hear, however, is that women are more interested in preventing cardiovascular disease. As clinicians, we need to do a better job of educating women about the risk factors for coronary artery disease. Women still need to be concerned about other diseases like diabetes, breast cancer, and Alzheimer’s disease, but we need to make a greater effort to educate them about the risks for CAD.

In a recent study published in a journal Menopause, researchers evaluated factors for obstructive CAD, which is the kind that kills people. The researchers in this study specifically wanted to evaluate obesity compared to body fat. They wanted to know if it just bodyweight or if there is a certain type of distribution of fat in the body that is more harmful. The researchers in this study looked at BMI, which is not a very sophisticated measurement of body fat composition. And they compared it to visceral adipose fat, which is a much better tool to measure at-risk body fat. Visceral adipose fat is the type of weight accumulation that increases the risk factors for cardiovascular disease.

This study evaluated 700 menopausal women. Postmenopausal women are more at risk because estrogen has a buffering effect on CAD. And as women go into menopause; their risk factors for CAD goes up. The researchers in this study wanted to measure obesity and see which is truly a more specific risk factor for CAD; BMI (all-over body fat) or adipose fat accumulation (visceral belly fat). What they found was that waist circumference is a greater risk factor for CAD in postmenopausal women than BMI. What that indicates, is that, overall obesity fat, or fat stored in multiple places, which increases BMI, is not as much of a risk factor as truncal body fat. What they called adipose tissue accumulation in the stomach region in this study was lipotoxic android truncal fat mass. I was only able to read the abstract, not the full study, but I would have liked to know how they measured adipose fat tissue.

It would be interesting to know if they just used a tape measurement or if they did more specific testing like an MRI or DEXA Scan. Although I have had clinics where I bring a DEXA Scan to measure the adipose fat tissue, a tape measure is just as informative. To measure adipose fat tissue, just measure your waist around the level of the belly button. Researchers in this study found that it was a significant risk factor for cardiovascular disease, more so than the BMI. What they didn’t talk about in this study was the waist to height ratio. To determine your risk factor for excess visceral fat, you can divide your waist by your height. You want your waist measurement to be less than half that of your height, or a ratio of less than .5. If it is more than .5, you have a higher risk factor for developing coronary artery disease.


So, what do you do if you have a waist to height circumference that is more than .5? A recent study published in Cell Metabolism yesterday might answer that question. The researchers in the study wanted to evaluate fasting. Studies show that there is no faster way than fasting to drop insulin. If you want to fat burn, you have to drop insulin, which is the gatekeeper of fat burning. The lower the insulin, the greater the fat burning. When insulin is high, fat burning doesn’t work, especially adipose fat burning. 



The researchers, in this particular study, looked at alternate-day fasting. One group ate normally, and the other group did alternate-day fasting. The alternate-day fasting group ate at intervals of 36 hours of not eating, followed by 12 hours of eating. Fasting differs from caloric restriction, which is where you take a reduced amount of calories daily. Eating less calories makes weight loss less sustainable because your metabolism stops. Fasting has become a more popular way to drop weight. And the studies are showing that it might be a better way to burn body fat. When you just reduce calories, you never cause hormones to work by going into a self-cleaning and fat-burning mode. It is only in a fat-burning mode that you can effectively burn adipose fat tissue. The participants who were alternate fasting had a significant difference in body fat composition and fat burning. They didn’t just drop weight; they dropped adipose fat.

So, how do we prevent or mitigate risk factors for CAD? One of the things you can do is some type of intermittent fasting. You can do 12-hour, 14-hour, or 16-hour daily fasting. The best method depends on what you are comfortable with personally. The intensive nature of this study might be too much unless you have a real health concern. An easier type of fasting that you can weave into your day without any significant consequences might make it easier to stick with. And easier types of fasting will work better without side effect. This study showed a significant amount of fat-burning for those who fasted, but there were other things like the release of ketones. We have discussed the importance of being in a state of ketosis, even if it is just cyclical. There is a long list of longevity effects created by fasting, like anti-inflammation in the body. If we can bring the inflammation down, it can help to mitigate chronic diseases.

There have been multiple generations where the body is well adapted for food scarcity and low food consumption. The body has this mechanism that is dormant until the anti-inflammatory, self-cleansing process is allowed to express itself, which leads to a decrease in insulin and an increase in fat-burning hormones. When that happens, there are multiple benefits to reap, like changing your genetic expression. The researchers talked about all of these things when reporting the study’s conclusion in Cell Metabolism. So, keep educating yourself in these types of fasting tools. The medical community is becoming more and more interested in fasting, so more studies are coming out at a great rate. I will continue to read and report them, and until next time…keep it real.


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