“BREATHE YOUR FAT OUT”

      In the last 50 years, we have been suffering from a lot of chronic ailments, particularly NCDs ( Non Communicable Disease) like diabetes, hypertension, fatty liver, obesity, PCOS, high cholesterol, heart disease and strokes. These disorders are generally considered as chronic and progressive, for which a lot of drugs are given lifelong, by the healthcare professionals to keep the parameters in check. Such symptomatic reductionism cannot stop the progression of the disease nor the complications associated with those disorders. This is what we call 'learned helplessness'.

        The first step in finding a solution to any problem is to define the problem ; without a complete understanding of pathophysiology we cannot prevent or reverse the condition even with newer drugs, genetic  or stem cell research or high-tech medical equipment.

       There has been a silent twin epidemics of obesity and TOFI ( thin outside fat inside ) which is largely overlooked and mistreated by the healthcare system. This is largely due to westernization & the changes in the food system – ultra processing of foods , use of artificial fertilizer and pesticides ; big food industry also impacts the health of the population by the introduction of high energy foods, excess sugars and refined oils.

       According to the NHANES study an average adult over 20 years of age is pre diabetic, so it is at most imperative to find the solution to this silent epidemic of NCDs for improving the quality of life and to prevent these metabolic disorders from occurring in the future generations. 

      Our body has innate intelligence and memory to thrive in the environment which has developed over millions of years. Several adaptations have evolved in the living beings mainly for the survival and the perpetuation of species. One such mechanism for survival is by storing the energy whenever is possible so that the surplus of energy could be used in the time of food scarcity or famine. Insulin is a hormone produced in the pancreas for appropriate energy utilization. 

       We are no longer facing the times of food scarcity or famine in the last 4 to 5 decades and we are living in a world of surplus – simply like “ cactus in the rainforest ". Even one third of the children are suffering from metabolic disorders.

     The modern man is a completely modified species compared to ancestors, both hormonally and metabolically. Ultra processing of food produces biological mismatch that produces a higher amount of insulin ( 2 to 4 times) than what is required . This hyperinsulinemia drives excess fat deposits ( lipotoxicity) in the liver, muscle, pancreas and viscera along with subcutaneous ( external) obesity and hence drives the development of all the metabolic disorders over a period of time, through Insulin resistance.

      The most common disorder which the entire population suffers is hyperinsulinemia but majority of the scientific communities and healthcare professionals are unaware of it. The sad part is that most of the consequences of these disorders are symptomatically managed with drugs lifelong.

Obesity , the new normal !!!

Nearly half of the adult population & even ⅓ of pediatric age groups are suffering from the silent epidemic of overweight & obesity. 

 Is Obesity all about Genes ?

                                   We had prevalence rate of obesity of only 1% before 100 years now it has become rampant particularly in the last 5 decades.Now the prevalence of Obesity in  India is 40 % ( at least abdominal ) that poses the metabolic risks as well.Many of us still believe that the Overweight & Obesity is mainly genetic !!! But contrary to the belief , it is mostly epigenetic ( bad food & poor lifestyle ) because the prevalence of Obesity due to genetics cannot change from its constant rate of 1 % even after several hundreds of generations whereas the Obesity due to epigenetics ( Hormonal imbalance because of ultra processed foods) can greatly vary ( now 39% ) in accordance with the environment. 

                                  Conventionally , Obesity is defined by weight or BMI ( Body Mass Index ) for quantification of Obesity. Obesity simply means Overfatness and not necessarily overweight.Another fact is we need to demarcate between the benign subcutaneous obesity ( pinchable fat ) and the dangerous invisible visceral fat which drives the metabolic disorders.

“ Insulin - The Game Changer "

            The primary function of insulin is not only anabolic ( storage of excess energy in the form of glycogen in the muscles and liver & fat in the subcutaneous adipose tissues) but also anticatabolic ( prevents the breakdown of stored form of energy , particularly lipolysis). The problem with current day societies is 'we are swimming in high insulin levels and yet unaware of it'. The hyperinsulinemia due to ultra processed foods had essentially signaled our biology to store more and more fat all the time ( high fat storage) and decreased utilization of fats for energy ( low fat burning) . This energy toxicity intoxicates our entire body that most of the metabolic disorders are simply the manifestations of the common denominator called insulin resistance. 

Energy Trap & Toxicity under high insulin levels 

Not only the energy is stored but it's getting trapped under persistent high insulin levels. In a normal insulin sensitive person, there is ease in switching over from carb burning to fat burning particularly in the fasting period. This is called Metabolic Flexibility. But in insulin resistant persons, the insulin is persistently elevated hence the lipolysis is often suppressed which means you are having plenty of energy, but it is underutilized due to the abnormal high insulin levels. This is called Metabolic Inflexibility. The most interesting fact about the energy toxicity is that it predominantly occurs in the visceral space making each & every organ to be metabolically unhealthy over a period of time. High Insulin levels causes Functional leptin resistance & slows down body metabolism.

    “What could be the potential solution?"

         High insulin drives metabolic disorders and hence the only effective and sustainable solution could be to decrease the inappropriate insulin secretion due to the ultra-processed foods. So we have developed a scientific solution called WINSULIN  protocol ( loW INSULIN diet and lifestyle) by introducing minimally processed foods back to the food system.

Is the current solution more problematic ? 

We are currently focusing too much on the calories - eating less and moving more; it can produce some short term results but ultimately it slows down the metabolism & in the long run , weight gain comes back in vengeance. 

Is there anything better than the Calorie model ?

Now we have understood that the calorie model is outdated and no longer valid. The Hormonal theory could explain obesity and the metabolic disorders thereby providing clues to reverse those conditions as well !!

*HME - Hormonal-Metabolic-Energy 

*satiety hormones - Ghrelin , GLP-1 & PYY  

Comparison between Calorie model & Hormonal theory for weight loss 

                                                                                                                                         Vs

  “ Lowering the energy toxicity could be the appropriate solution” 

           WINSULIN protocol ( low insulin diet and lifestyle) including minimally processed or unprocessed traditional grains and pulses, organic farmed foods, intermittent fasting , optimal cooking methods such as rice drain method, appropriate macronutrient ratio in a given meal, elimination of excess sugars ultra processed carbs  and refined oils, avoidance of unnatural combination of carbohydrates and fat at the same time in a given meal could be the universal solution to all the metabolic disorders.

 “ Wasting your energy under low insulin levels”

           Low insulin state causes accelerated lipolysis that the body runs in a state of nutritional ketosis during which our body runs predominantly on ketones ( acetone, acetoacetate & beta- hydroxybutyrate) . The body which had been a miser in spending energy under high insulin levels has become a king lavishly spending the stored form of energy !!! The best part is not much of any effort is made to burn the excess calories except for “eating real food with fasting” 

          The excess released energy from the fat stored ( increased lipolysis) is not only utilized for meeting daily requirements but it is wasted or expelled out from our body in the form of acetone during breathing ( sweet smell of acetone in breath ) and elimination of acetoacetate and beta hydroxybutyrate also occurs, in the urine.The first to go fat is from the viscera ( particularly liver fat ) in preference to the subcutaneous fat since the visceral fat is metabolically active and readily undergoes lipolysis.

Increased ketones in your urine could signal more fat burning

When you drop refined carb intake and extend your fasting window, your ketone levels increase.

There are three different types of ketone bodies that can be measured – these are called acetone, acetoacetate and beta-hydroxybutyrate.

One way to measure ketones is to test your urine. You’re not measuring fat per se but you are measuring the increase in ketones – a sign of potential fat metabolism increase.

Testing your urine using specialized (and often expensive) ketone strips helps to give you a rough idea of how far into ketosis you are.

By holding the strip in your urine you’ll note a color change if the number of ketones in your body has increased excessively – specifically acetoacetate because it is expelled from the body via urine, as opposed to acetone which is expelled via breathing (one of the reasons why those in ketosis often report having sweet smelling breath).

        This nutritional ketosis is different from starvation ketosis which is accompanied by acidosis. In conventional medicine, whenever there is detection of ketones in the urine or its increased levels in the blood, a red alert is made that something is very serious. We need to understand the demarcation between the nutritional ketosis ( in which insulin levels are low physiologically during fasting window and the body essentially runs on ketones and fatty acids except the tissues like nerves, red blood cells, part of the kidney which runs only on glucose ) vs ketoacidosis ( in which there is pathologically low insulin levels causing ketones to go high beyond the physiological limits and accompanied by acidosis).We have to remember that we are all natural fat burners except during the periods of eating and few hours of postprandial period. 

        In a world in which the healthcare community is primarily focused on the calorie model of producing a illusory calorie deficit and hence weight loss by 'eating less and moving more' and encouraging zero calories' foods, both of which have failed again and again in the last 40 years , Low insulin could be the ultimate bio hack in preventing , treating and reversing all the metabolic disorders of the modern era. 

       If We want to burn calories without much effort, then choose low insulin protocol or if you want to burn calories with great effort but in vain choose calorie counting. Any sensible person, if they understand the real science, may not choose the calorie model of eating less and moving more because it's tiring and against their will. Who wants to consciously stretch themselves toiling in physical exertion when there is an autopilot subconscious mode of burning the excess fat without even being aware of it by just making the changes in the hormonal levels, particularly insulin.

    Another myth propagated by the big food industry is that Zero calorie foods ( e.g diet soda) are better alternatives and are safe. But the reality is that adding artificial sweeteners disrupts the microbiome , some are neurotoxic and impacts the metabolism in an indirect way although it does not contain glucose in the first place. How many people do you know, who feel fantastic and lose weight after switching over to diet soda ? 

     "You cannot outrun your bad food habits out of exercise" meaning you cannot burn the excess fat produced by high insulin levels due to ultra-processed foods by increasing physical activity. Most of the wellness programs are unfortunately based on this failure model and the history repeats. It's time to shift our paradigm from Calorie Centric theory to the Hormonal theory of Obesity for better metabolism and reversal of Metabolic disorders with ease.