If you've had a recent blood test and markers like HBO and C, fasting glucose, triglycerides, HDL cholesterol and LDL cholesterol are out of range, chances are your metabolic health is less than optimal. You might even know that, but remain confused as to what you can do about it. While the majority of people online are arguing about what diet is best for metabolic health, low carb or high carb and obsessing of a protein for muscle growth,
they are overlooking the root cause of metabolic disease. And that is exactly what today's video is about. Simplifying metabolic health so that you can optimize yours. So what is the root cause of poor metabolic health that I mentioned that many are overlooking? Storing fat in the wrong place. Yes, that's right. Where your body is storing fat under your skin or deep within organs like your liver and pancreas,
has a huge influence on blood glucose control, insulin resistance and insulin levels, inflammation, and blood lipids like ApoB. In this video, I'm going to teach you why body fat distribution matters so much, how to assess where your body is storing fat, along with six actionable strategies to optimize your body fat distribution, and in turn, optimize your metabolic health.
High quality research on the last few years shows that in many cases if we can get fat out of places where it shouldn't be, what's known as ectopic fat, we can shift these important biomarkers in a favorable direction and turn our metabolic health around. Even saying goodbye to diagnoses like non-alcoholic fatty liver disease and type 2 diabetes.
I'm also going to explain why two people standing in front of you, both overweight with the same amount of total body fat, can be faced with very different metabolic health fates. One can have type 2 diabetes, while the other can actually have normal blood glucose control. Most importantly, by the end of the episode, you will appreciate the physiology that underpins poor metabolic health, and be able to see right through a great deal of misinformation that exists on this topic online.
Ready to understand the secrets behind where your body stores fat? Okay, let's dive into it. Fat storage 101. Understanding ectopic fat is the first step towards reclaiming your metabolic health. Did you know that not all fat in your body is created equal? Understanding where your body stores fat is crucial for managing your metabolic health. Let's break down the three main compartments where fat resides.
Number one, subcutaneous fat, fat under the skin. Number two, visceral fat, fat deep in the abdomen between organs. And number three, ectopic fat, fat within organs like liver and pancreas. The latter two, visceral and ectopic fat, they tend to go hand in hand. People with a large amount of visceral fat generally have a high amount of ectopic fat. And these are the most dangerous forms of fat that send our metabolic health into a downward spiral. Before we unpack what this downward spiral looks like,
Where does the visceral and ectopic fat come from in the first place? It's now well understood that each of us have what's known as a personal fat threshold. This idea of a personal fat threshold is the first key concept in this episode that I want you to understand to walk away with. This threshold determines how much fat we can store in the subcutaneous fat compartment, fat under our skin. Some of us, due to genetics and environmental factors, can store more fat in this compartment.
Whereas others, again due to a combination of genetics and environment, have less capacity to store fat under their skin, less ability for their subcutaneous fat cells to expand, and therefore at a given body fatness will store more fat in and around their organs, ectopic and visceral fat.
To hammer this point home, here's a quote from a wonderful review titled Insulin Sensitive Obesity. And I quote, both genetic and environmental factors could contribute to increased ectopic visceral fat accumulation and hypertrophy of adipocytes, fat cells. And this condition might represent the inability of an obese patient to become more subcutaneously obese.
This is why the healthy BMI range for Asians is lower than it is for Caucasians. Because at a lower total body fat, Asians, due to genetics, are more likely to store fat in their organs. So the driver of ectopic fat and visceral fat is an energy surplus, excessive calories, within the context of having no more room to store subcutaneous fat.
Once that subcutaneous fat storage compartment is full, i.e. you have reached your personal fat threshold, excess energy goes central into and around our organs. Okay, so let's come back to why this matters. How does ectopic and visceral fat send out metabolic health into a downward spiral? To answer this, I'm going to borrow from an important image that's published in Roy Taylor's peer-reviewed papers, as well as his book, Life Without Diabetes.
This image on screen for those who are watching along on YouTube shows Roy Taylor's twin cycle hypothesis, which now thanks to multiple clinical trials, it's considered no longer a hypothesis, but really a working model to explain deteriorating metabolic health and type 2 diabetes. The twin cycle model is the second key concept in this episode that I want you to understand.
As mentioned earlier, it all begins with a positive calorie balance, ingesting in more calories than our body is expanding. Our body's way of dealing with that excess energy is storing it as fat. If the subcutaneous fat storage capacity is exceeded, that excess fat has to find a new home. And the first stop, the liver. This is the most underappreciated aspect of metabolic health.
Your liver is the master regulator of your metabolic health. Fat inside the liver is foundational to almost all chronic metabolic diseases. As the liver becomes more and more fatty, two really detrimental things happen.
If you want to know more than about 99% of folks online about metabolic health, these are very important points to understand. The first critical issue is that the liver becomes insulin resistant. One of the main roles of the liver is to produce glucose.
especially overnight when we aren't eating to help maintain a healthy blood glucose level. What stops the liver producing too much glucose? Insulin, a hormone produced by pancreas. Insulin is what tells the liver cells to stop or slow down glucose production. As fat builds up in the liver, the liver cells become insulin resistant. Insulin resistance means, as the name implies, resistant to insulin.
insulin is no longer as effective at telling these cells in the liver to slow down glucose production. So more glucose leaves the liver and enters the bloodstream than we want. Initially, the beta cells in the pancreas respond by producing more insulin in an attempt
to force the liver to slow down glucose production, which is why one of the early signs of fat building up in the liver before someone develops diabetes is actually elevated insulin levels. In fact, you might see normal glucose levels, but raised insulin.
The pancreas in this case is simply compensating for what's happening in the liver, but this comes at a cost. The beta cells are being stressed out and can only operate at this level for so long. Eventually, if not addressed, the person will be at high risk for developing type 2 diabetes. So the first major consequence of increasing liver fat is the development of insulin resistance in the liver.
The second detrimental thing that occurs as the liver builds up with fat is that more and more fat gets pushed into circulation in the form of triglycerides from the liver into the bloodstream. These triglycerides get packaged with cholesterol in lipoproteins called very low-density lipoproteins or VLDLs. This causes an increase in VLDLs in the blood. VLDLs are an APOB containing lipoprotein.
which eventually shrink down to become ideals and then eventually LDLs, all ApoB containing lipoproteins. This is why ApoB typically goes up as you develop more and more fat in the liver. A recent review in the Journal of Nature summarized this as, and I quote,
And this secretion is increased with increasing degrees of liver fat. End quote. Now you might be wondering, where does this excess fat in these VLDLs go once it enters the bloodstream? Well, remember the reason that the liver built up with fat in the first place was because the subcutaneous fat compartment, fat under our skin was already at capacity. It was full. So this surplus fat can't be stored under the skin and is instead directed to other organs like the pancreas.
So this is usually when other organs, like the pancreas in the heart, start building up with fat. Slowly with time, this fat accumulation of the pancreas impairs the function of the beta cells, meaning that less and less insulin is produced, and as a result, glucose builds up in the blood. When you get a blood test, this liver and pancreatic fat can show up as elevated HBA1C, fasting blood glucose, and also APOB.
If you catch it early enough, your blood glucose and HBA1c may appear normal, but insulin levels are high. This is that scenario when your pancreas is working really hard and doing a good job at maintaining blood glucose homeostasis, but remember, it can only do that for so long. If these markers are out of range,
and your waist circumference is greater than half of your height, then you can be pretty sure that you along with 40% of adults in countries like Australia have excessive fat in your liver and it's somewhere along the spectrum, the journey to metabolic disease. While this may sound discouraging, here's the great news. Once you understand where this liver fat comes from, you can take actionable steps to reverse your metabolic health, to restore optimal metabolic health.
Depending on how long the fat has been accumulating, there's a strong chance that you can turn things around. Before we get to what we can do about it, now that you understand the physiology that underpins increasing liver and pancreatic fat and the onset of type 2 diabetes, I want to quickly answer two questions that may be on your mind. Number one.
Why is it that two overweight people with the same body fatness can have different metabolic health? One with type 2 diabetes and one without. And number two, how is it that one out of six people who develop type 2 diabetes have a normal BMI? They aren't overweight.
This first scenario is explained by the personal fat threshold concept that we went through earlier. Two people that are overweight, both of the same body fatness, can have very different levels of fat inside their organs. Person A may have a much greater capacity to store fat subcutaneously than person B, so for a given amount of total body fat, less fat enters person A's liver and pancreas, and thus they're less likely to develop type 2 diabetes.
Of course, if they gain more weight and exceed their personal fat threshold, they too can develop type 2 diabetes. But for that to happen, it will take more body fat compared to person B. It's also worth noting that just because person A does not have type 2 diabetes, someone who may be described as having a metabolically healthy obesity, it does not mean that they are at less risk of chronic disease than a normal weight person.
It's pretty well established in the literature, and this is often a point of confusion that even someone who's classified as having metabolically healthy obesity is still at significantly higher risk of a number of chronic diseases compared to someone of normal BMI. This second scenario also comes back to the personal fat threshold. A minority of people have a very small, subcutaneous fat storage compartment, which means even at a normal BMI,
excess energy is stored within their organs. This is the person who develops prediabetes or type 2 diabetes who doesn't really look overweight from the outside. The good thing is, in both contexts, be it overweight or not, people can put their type 2 diabetes into remission if they take action soon enough.
This brings us to the next crucial topic, how to reduce ectopic and visceral fat stores to restore metabolic health. Thanks to Professor Roy Taylor's research, we now understand that in many cases people can restore their metabolic health, even those with type 2 diabetes who are on the far right end of the metabolic health spectrum. The goal, as you might now expect, is getting fat out of your liver and pancreas.
And Roy Taylor's work has identified how much weight people need to lose on average to achieve this. If someone is overweight or obese, they need to lose approximately 15% of their body weight. So if someone weighs 250 pounds, they would need to lose about 37 and a half pounds in order to get below their personal fat threshold and see these important biomarkers that we've discussed move into a more favorable direction.
This of course needs to be done under medical supervision because as the weight comes out of these organs and blood glucose control gets better, you are going to very likely need a lower dose of blood glucose lowering medications. The risk here is that if you lose this weight and don't titrate your dose down with your doctor, you may end up with low blood glucose, which can be very dangerous.
What I think is really interesting is that in Roy Taylor's trials, it became clear that if people lost 15% of their body weight and kept the weight off, they were able to stay free of diabetes, even if they were still overweight or obese. What mattered was getting under their personal fat threshold to get enough fat out of the pancreas and liver. Of course, if they were to regain that weight, the diabetes would come back.
Now, you might be thinking, you mentioned that 1 in 6 people with type 2 diabetes are not overweight. Is it really safe for them to lose 15% of their body weight? Great question. Actually, until very recently, it wasn't even understood if liver and pancreatic fat was to blame for type 2 diabetes.
in people with a normal BMI. Just last year Roy Taylor and his team published a study called the ReTune study that confirmed. The twin cycle model applies to all people with type 2 diabetes, even those who are a normal BMI. The only difference is that these people do not need to lose 15% of their body weight to put type 2 diabetes into remission.
70% of subjects in this study entered remission with an initial weight loss of 6.5% of their total body weight. So for a 170 pound individual, that's about 11 pounds of weight loss. And while we don't have this data, these weight loss targets would presumably be even less if someone had prediabetes.
The same principle applies. Weight loss is required to get below your personal fat threshold. How much weight will depend on your starting point. But really, one should work with their doctor and be guided by biomarkers. HBA1C, fasting blood glucose, ABOB, waist to high ratio, HDL cholesterol, and blood pressure.
When we're trying to optimize metabolic health, we're looking to normalize these markers as blood glucose lowering medications are titrated down. While one could do a myriad of scans to quantify fat in their liver and pancreas, it's really the normalization of these markers that matters most. They tell you that there is less fat in the liver and pancreas and their function is normal or improving and moving towards normal.
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Before we discuss how to lose weight, it's really important to note the importance of timing here. The earlier you get below your personal fat threshold, the better. In these studies, people who have had type two diabetes for a few years are much, much more likely to reverse the condition than those who have had type two diabetes for 10 or more years. Much of this comes down to the health of the pancreas. If the beta cells are still functional, which is often the case when someone has had type two diabetes,
for only a few years, with weight loss, they can come off all blood glucose lowering medications. However, it is common for people who have had diabetes for over 10 years that those beta cells are completely dysfunctional and it won't regain function with weight loss. This doesn't mean that weight loss for this person isn't helpful. It still is, but they may still require insulin and other blood glucose lowering drugs to make up for that loss of pancreatic function.
Okay, let's talk about the practical aspects of weight loss. How do we actually lose weight and keep it off? I'm going to share six actionable strategies that can help you reduce a topic and visceral fat, optimizing your metabolic health along the way. Number one, create a calorie deficit. The first thing that I would say here is that while some people are very anti against
extreme weight loss diets, losing weight fast. Roy Taylor's dietary approach in his studies, which is also outlined in his book again that his life without diabetes cuts calories down to 600 to 800 per day for a very short period of time. His theory here being that rapid weight loss, getting people below their personal fat threshold and seeing some improvement or normalization in these important biomarkers is incredibly motivating.
But really, the totality of evidence suggests that there is not one single best dietary practice that's proven as the single best method for losing weight and keeping it off. Rather, we see different dietary approaches work better for different individuals. We can put these dietary approaches into three buckets. The first bucket is calorie restriction in the form of counting calories to achieve a calorie deficit. This is what Roy Taylor's dietary approach is built on.
consuming calorie controlled meals that ensure a calorie deficit is achieved. I've gone ahead and put Roy Taylor's specific protocol on screen and in the show notes for those that would like to take a closer look. The second bucket is adopting a low fat or low carb diet with an emphasis on fiber and protein.
Either of these dietary strategies can prove successful with research showing that while on average, there is no difference in weight loss between these two approaches, low fat and low carb. For whatever reason, some people do better on low carb and some do better on low fat. The third bucket limiting the hours in which you eat time restricted eating has been proven to be effective for some people in reducing their total daily caloric intake and promoting weight loss.
My advice here is to choose the strategy or strategies that feel easiest to you. For example, you might be most full with a low fat diet and a quite happy eating in an eight hour eating window from nine a.m. to five p.m. Someone else might feel much more full with a low carb diet and a six hour eating window.
And then someone else might like to adopt Roy Taylor's plan of sticking to 600 to 800 calories per day eating set meals and losing a lot of weight very rapidly. You have options. That's a good thing. If you're having trouble with losing enough weight or keeping it off with these strategies, then this is when powerful weight loss drugs like GLP1 agonist can be very helpful, which is something that you should discuss with your physician if you're interested in doing so.
JLP1 agonists can make it easier for people to eat less calories, thus making it easier to be in a calorie deficit, lose weight and keep it off. Okay, so that was the first strategy to reducing fat within our liver and pancreas and restoring metabolic health.
The second strategy to help you reduce fat in these organs is to eat less saturated fat. We now have an abundance of clinical trial data showing that certain saturated fatty acids, like those that predominate in animal foods like butter, red meat and ghee, increase liver fat and insulin resistance in the liver compared to unsaturated fat sources found in foods like fatty fish, nuts, seeds and vegetable oils.
One of the largest meta-analyses of human randomized controlled trials of this topic was conducted by Imamura and Colleagues, which looked at over 100 clinical trials, including more than 4,000 adults. And they concluded, and I quote, replacing saturated fats with polyunsaturated fats, significantly lowered glucose, HPO1C, state peptide, and hormone. End quote, meaning that when you lower saturated fats in your meals and eat more polyunsaturated fats, you will be more sensitive to insulin.
Now this needs special attention if you choose to follow a low carbohydrate diet because naturally when you eat low carb, most people tend to eat saturated fat rich animal foods. But it is absolutely possible to do a low carb diet with a bias towards unsaturated fats, which would be a sensible option.
With calories and saturated fats in mind, here are some simple swaps that will make a big difference no matter what dietary approach you follow. 1. Reduce ultra processed foods. These foods are often high in sodium and refined sugars that can be high.
in saturated fats too, and low in fiber and protein, making them very easy to over consume. Next, choose lean proteins. Swap fatty cuts of meat for leaner options, or better yet, incorporate more legumes and or omega-3 rich fish, such as anchovies, mackerel, salmon, etc. into your diet. Lastly, switch cooking fats. Replace butter, ghee or tallow with olive oil, avocado oil, or other vegetable oils.
Remember, vegetable oils are not inflammatory or toxic when used correctly. We should definitely avoid cooking at extremely high temperatures that produce smoke or reheating these oils. I know, I know, did he just say vegetable oils are okay to cook with a vegetable oils healthy? While an unpopular view, this is an objective one. There has been a lot of research on this, including a randomized controlled trial published just a few months back that compared ghee
rich in saturated fats with canola oil in individuals with non-alcoholic fatty liver disease, a metabolic health condition. Over 12 weeks, the subjects that were randomized to the canola oil group had significantly better liver function, blood glucose control, and insulin sensitivity, and lost significantly more body weight.
Don't just take my word for it though, read this study in the show notes and also read this new review on linoleic acid titled beneficial effects of linoleic acid on cardiometabolic health and update. Linoleic acid being the Omega-6 fat and primary fat found in most vegetable and seed oils.
And no, this review was not funded by the vegetable oil industry. And interestingly, several of the authors are longtime proponents of Omega 3 fats, not Omega 6 fats. It's beyond the scope of this episode to get into all of the details here, which I have in a previous episode on dietary fats. But really, the only scenario where a high intake of Omega 6s could pose a problem is if you're not getting enough DHA and EPA, Omega 3s in your diet, which if you are eating fish or supplementing,
per my omega-3 episode, you do not have to worry about. Moving on to the third part of our lifestyle that can influence where we store fat and thus our metabolic health exercise. There's now a growing body of research that suggests exercise, both aerobic and resistance training are helpful when it comes to lowering body mass, subcutaneous fat, and visceral fat. But when it comes to ectopic fat,
specifically fat in the liver, aerobic exercise appears to be king. This was the conclusion of a 2024 meta-analysis of 32 randomized controlled trials involving over 2000 subjects with type 2 diabetes. A recent position statement titled
Exercise in the management of metabolic associated fatty liver disease in adults, a position statement from exercise and sports science Australia concluded that the strongest evidence supports the below aerobic exercise protocol. And I quote moderate to vigorous intensity aerobic exercise, for example, brisk walking, jogging, cycling for at least 135 minutes per week across three to five days per week, ideally progressing to 150 to 240 minutes per week.
Resistance training should be included in addition to the recommended volume of aerobic exercise, but not instead of it." I should note that if you do Roy Taylor's very low calorie diet protocol, he recommends limiting exercise during the very low calorie diet phase and resuming exercise during the maintenance phase.
His view, which is somewhat debatable, is that exercise can increase hunger and make the very low calorie diet phase hard to adhere to and less successful. Okay, so that was the third strategy exercise. The fourth strategy to reduce ectopic fat and restore metabolic health is to get enough sleep. There's some evidence suggesting that sleep deprivation and sleep apnea affects body fat distribution.
with sleep deprived people and people suffering from sleep apnea, tending to have more visceral fat and a higher risk of fatty liver disease. An interesting cross-sectional study out of China, looking at the sleep habits of over 5,000 Chinese men, observed that late bedtime
and snoring increased odds of fatty liver disease by 37% and 59% respectively. This observational evidence was supported by a recent randomized controlled crossover trial. This trial took healthy non-obese adults
aged 19 to 39 and had them complete two 21-day inpatient arms. Yes, they must have paid them a lot. A sleep deprivation arm where they slept four hours per night and a control sleep arm where they slept nine hours per night. Participants did the two arms in random orders and there was a washout period in the middle.
The researchers found that sleep deprivation led to a greater propensity to eat more calories, approximately 300 more per day, and store that excess energy deep in the abdomen. Here's an important paragraph from the discussion section of this paper. And I quote, these data show for the first time that experimentally induced sleep curtailment affects regional fat accumulation, favoring abdominal adiposity, and specifically
centralised partitioning of fat into the visceral depot. The early and preferential accumulation of ectopic fat in the intra-abdominal cavity, as seen in our study, indicates that sleep restriction in conjunction with overeating alters lipid storage mechanisms and potentiates susceptibility to visceral fat deposition.
They go on to say that it's still not clear why sleep deprivation promotes more fat to be stored as ectopic fat. Further studies are needed to determine how much of this comes down to the overeating and energy surplus that follows sleep deprivation versus other mechanisms such as acute hormonal changes.
Some good general tips for improving sleep are trying to reduce bright light exposure two hours before bedtime, dimming the lights is preferable. We have a red light at home that we put on in our bedroom so that when we're preparing for bed, cortisol begins to drop, melatonin levels rise, both of which are important to a good night's rest. Keeping your room cool overnight,
around 16 to 20 degrees Celsius or 62 to 68 degrees Fahrenheit. That's a general rule of thumb. There's certainly allies who sleep better in a slightly warmer room too. Upon waking, try to get some natural light exposure in the first 30 minutes of getting up. Open up your blinds and or go outside for a walk if you can.
If you're waking up and it's still dark outside, which is often the case in winter, switch on as many lights as you can. Of course, that's not always possible when you share a room or a house with others. For that, there are special lights known as SAD lamps, companies like Lumi, who are not a sponsor of this show, sell them for around $100, usually the recommended intensity of light being around 10,000 lux. And you sit roughly 30 centimeters in front of it for 30 minutes in the morning.
And while that's not exactly the same as natural light, it's considered much better for your circadian rhythm than waking up and staying in darkness for multiple hours until the sun rises. By getting this early morning light exposure, you are setting yourself up for more energy during the day and a better night's sleep.
The fifth strategy for reducing egg topic fat restoring metabolic health is stress reduction. There's some evidence suggesting that stress and in particular elevated cortisol may increase fat deposition around and inside our organs. Currently, while more research is needed, it seems that being in a constant fight or flight mode causes people to eat more, thus being more susceptible to living in a calorie surplus. And secondly, and very importantly, seems to signal to the body via increased levels of
cortisol to store less fat under the skin and more fat deep within the abdomen. A theory for why this occurs is that when the body is under acute stress physiology changes to protect these vital organs. Shielding organs with a local energy source fat may have been beneficial thousands of years ago when our ancestors were
being chased by lions and faced with periods of famine where the fat would be drawn down on. Whereas today many of us live in chronic states of high stress and have access to an abundance of calories. We're never really drawing down on this fat that we store. There's an interesting condition called Cushing Syndrome, which is characterized by very high levels of cortisol and an increase in abdominal fat and risk of metabolic conditions.
While this is no doubt, different to cortisol levels one would be exposed to from stress, it's interesting to note that it's been observed that when women with Cushing syndrome enter remission and cortisol levels normalize, there is a redistribution of fat from central visceral fat stores to subcutaneous stores.
And while I haven't yet personally seen any clinical trials showing that stress reduction techniques decrease visceral and or ectopic fat, I think it's reasonable to hypothesize based on the data we have that stress reduction may help. And if it doesn't work, then the worst case is that we feel more peace and in control of our lives, which isn't such a bad outcome.
So consider this another tool in your toolbox. And while it may be meditation, it doesn't have to be. Stress reduction can look different from person to person. It could be walking your dog, reading a book, playing cards with friends, having deep conversations with friends, breath work, painting and so forth. Really anything that gets us out of the past,
and the future that brings ourselves into the now tends to be helpful. If you're unable to control your stress and you have the means finding a psychiatrist or psychologist may even be helpful. I like to think of our mental fitness in the same way as our physical fitness. Stress reduction being no different to building strength in the gym, something that requires work and consistency and sometimes requires the help of a guiding professional.
Okay, the sixth strategy, hormone optimization. I'm not going to spend a lot of time on this one, but there is some evidence that suggests low estrogen, as occurs post-menopause, if not taking hormone replacement therapy and low or high testosterone.
can increase visceral fat. In fact, an interesting hypothesis is that it's estrogen which protects pre-menopausal women from storing fat around the abdomen relative to men. But of course, that changes when a woman goes through menopause and estrogen production falls off a cliff. There's a new study published in 2023 in Nature Research that looked at menopause hormone replacement therapy.
in a group of post-menopausal women with non-alcoholic fatty liver disease. The results are super interesting, so let me quickly share them. The study looked at 368 post-menopausal women who either received estrogen via transdermal menopause hormone therapy, so via a patch, or oral menopause hormone therapy, a pill.
After menopause hormone therapy, the prevalence of non-alcoholic fatty liver disease decreased from 24 to 17.3% in the transdermal group, but increased from 25 to 29% in the oral group, the oral menopause hormone therapy group.
also experienced significantly increased triglyceride levels. This was a retrospective study and there were some differences in the baseline health of the two groups. So a randomized controlled trial is needed to be a little more confident in these results. But for now it suggests that there may be a difference between oral and transdermal menopause hormone therapy when it comes to non-alcoholic fatty liver disease and that transdermal menopause hormone therapy
may be preferable in this subset of the population. To be a little more convinced by this, as a tool to treat fat in the liver and or pancreas, I would really want to see a randomized controlled trial that compares hormone replacement therapy to placebo and specifically measures the fat levels within these organs and markers of metabolic health that we spoke about earlier, like HBO1C, fasting blood glucose, waste circumference to high ratio, etc.
We'll no doubt come back to menopause hormone therapy and testosterone replacement therapy in future episodes, but for now I just want you to appreciate that working with a physician to get six hormones into an age-appropriate optimal range, as indicated based on your clinical presentation and health history is another tool in your metabolic health toolbox. And that brings us to the end. I think we did it. The root cause of poor metabolic health explained in under an hour. Allow me to quickly summarize.
ectopic fat, particularly excess fat in the liver and pancreas, which gets into these organs when someone is in a calorie surplus and has exceeded their personal fat threshold is the root cause of poor metabolic health. To get fat out of these organs, the most important thing we can do is to get below our personal fat threshold by losing weight. If we are obese or overweight, we typically need to lose about 15% of our body weight. And if we are a normal BMI,
It's about six and a half percent of our body weight that we need to lose. It can also be helpful to reduce our consumption of saturated fats. And we should be aiming to do 150 to 240 minutes of moderate intensity aerobic cardiovascular exercise per week. Things like swimming, jogging, hiking,
etc. Moderate intensity being about 60 to 70% of your maximum heart rate. Then there are a few things we can do that may help our subcutaneous fat cells function better and thus increase our capacity to store fat under our skin. These include optimizing sleep, optimizing our hormones and reducing psychological stress. All makes sense? Good. Thanks again for hanging out with me. I look forward to doing it all over again very soon. Bye for now.
You're still here? Okay, okay, if I masked another dad joke. I woke up the other morning and my partner, Tawny, had written a note on the fridge. It said, babe, this isn't working. I opened the fridge door. It worked just fine. Feel free to use that one with friends and family today. Enjoy the giggles on me and report back in the comments.
