First let me tell you what the heck lipodystrophy is:
Lipodystrophy syndromes are a group of genetic or acquired disorders in which the body is unable to produce and maintain healthy fat tissue.
Why is this bad and why is getting fat protecting us?
Fat is a way for us to store energy for use later or when there is no other fuel source around. It was how we were able to survive harsh winters and long dark nights and how we evolved to deal with food shortage. For those with this disorder, they are simply unable to store fat. Sure they can sometimes look very lean and fit but in reality they can be very, very sick.
With no way to store energy these poor folks end up with excess energy floating in the blood in both the form of fat and glucose. This is toxic to the body. Those with Diabetes know the dangers of chronic high blood sugar. People with lipodystrophy quickly become diabetic and need insulin and they do not require small amounts, the require massive doses. Sometime more than 10 times what the average type 1 diabetic needs. Lets look at why that is what it means.
First lets look at a normal person and how energy is dealt with. In previous posts I’ve talked about what happens when we eat a meal of mixed macros. I’m only going to get into fat and carbs for simplicity sake.
1. Carbs get broken into glucose and other sugars which goes to blood and raises blood sugar levels which stimulates insulin.
2. Fat gets stored in fat cells.
3. Glucose gets pushed into liver and muscle for storage with any extra getting turned to fat for storage
This cycle goes on and on in the normal person keeping energy levels stable in the blood and the person none the wiser. Now if we start exceeding the energy usage for the day and we are keeping insulin high the fat we eat can’t be used and the liver and muscles have no more room for glucose storage so we end up accumulating fat.
Now if we look at people with Lipodystrophy, they eat a meal and this happens:
1. Carbs get broken down into glucose and other simple sugars which go to blood and raises blood sugar which stimulates insulin.
2. Fat……Wait, fat can’t go to fat cells since they don’t have the ability to create new fat cells. Triglycerides start accumulating in blood. That can’t be good. High blood triglyceride is bad.
3. Glucose gets pushed into liver and muscle for storage with any extra getting turned to fat for storage….Wait, they can’t create more fat and there is already elevated levels of trigs in the blood so what happens to this glucose? It sits in the blood keeping levels high.
This now looks exactly the same as insulin resistance and type 2 diabetes doesn’t it. That is because it is exactly the same thing.
Have you ever noticed that some people can get extremely obese and not get diabetes while others seem to be very lean and still get diabetes? Why is that? Well it comes down to the persons genetic ability to create new fat cells. Everyone is different in this aspect. Some people can create them very easily while others cannot. This is why you see some people who are able to eat candy all day long and stay lean while others can’t even smell candy without gaining weight. I can’t say with 100% certainty that my theory is right but it seems to make sense. If your ancestors grew up in a place of extreme energy availability like a tropical climate with lots of fruit, veg and land for animals then they would have never developed the need to store fat or create new fat cells to any degree so the stress would have never been in place to push those epigenetic buttons and evolve that way. Now if you look at people that came from an extreme environment where there was no vegetation and food was scarce, it would make sense to evolve the ability to store whatever energy you could get your hands on for an emergency. It seems logical that stressors would push evolution. The stress of starvation would push the buttons for evolving the ability to easily store energy while not necessarily evolving the ability to quickly burn off energy. On the flip, the stress of constant intake of food would push the buttons for a fast metabolism and the ability to quickly dispose of energy while not necessarily evolving the need to store energy.
Type 2 diabetes is essentially the inability to create new fat cells. Once you reach your genetic capacity for fat cell creation the cells don’t want any more fat and the body doesn’t want to create any new cells. This is insulin resistance. The body will start to compensate by making more insulin. The greater insulin load forces the body to create new fat cells. Eventually the pancreas cannot make enough insulin to overcome the new genetic capacity to create fat and there is still a need to get the energy out of the blood so the person is now required to inject exogenous insulin. Again, the increased insulin load forces the creation of new fat cells and the person can now get the energy out of the blood and they can no get fatter again. It is a vicious cycle.
People who suffer from Lipidystrohy are just very unlucky in that they have none of the genes needed for easy fat creation so they are pushed into the above described state very quickly in life.
So why doesn’t everyone that can eat candy all day without getting fat immediately get, or ever get, diabetes and some get it easily? Well that comes down to gene variations and what genes you got from your parents and their parents. If for whatever reason you were in a line of people that had mostly the genes for not being able to create fat cells while also not having the fast metabolism genes and your family was unlucky enough to keep reproducing with other people with similar gene patterns, you end up with multiple copies of two forms of genetics that make you unlucky enough to have both poor ability to dispose of energy while also a poor ability to make fat to deal with the excess energy. That is the unlucky genetics lottery that results in this condition. On the other side you have people who have been successfully cross pollinated if you will, with different genetic adaptations so they will have some ability to create new fat cells as well as the ability to quickly deal with the extra energy via a fast metabolism. Genetically gifted people we call them. These are the ones we really do hate. 🙂
So to summarize:
– Creating fat easily is a genetic adaptation to help us to have energy reserves for hard times.
– Since there are no more hard times and too much high carb/high fat energy sources this protective adaptation is now a huge problem.
– People that don’t have the ability to create new fat can actually be at a higher risk of getting diabetes, among other chronic diseases, despite not being obese which makes it even more important for lean people to be aware of their energy intake and specifically what kind of energy they intake.
As always I hope this makes sense to everyone. It makes sense in my head but that doesn’t mean anything really. It gets messy up there sometimes 🙂
Some links to some info on what I discussed here:
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