UNDERSTANDING STUBBORN FAT .. ITS NOT JUST CALORIES

I'm including in my blog today an email I received from a doctor friend of mine. It is a problem that I address ALL the time. You diet you exercise but there is just that 'problem' area which wont budge.

I can totally explain why this happens and how to address it and it is so much more than just counting calories and increasing your training. Imagine you wanted to fill a bucket with water but the more water you poured in the level just didnt change .... would you just keep pouring in water ? or would you check to see if there were holes in the bucket ?

My point being .. stubborn fat is only addressed with calories and exericse and people get frustrated .. but there are holes in the bucket ... meaning there is so much more going on on a hormonal and chemical level. Once you understand what is happening then you have more power to address the problem

so heres the letter:

Joanne, Can you look at this diet diary of this 40ish female triathlete? She would like to lose a little body fat and have consistent energy throughout the day. I think she needs more protein especially in the evening and maybe some more healthy fats with less carbs (again, particularly in the evening).What are your thoughts?
Darren F. X. Clair, MDVibrance Medical Group Beverly Hills Triangle Medical Plaza 462 North Linden Dr., Suite 440 Beverly Hills, CA 90212 USAwww.VibranceMedicalGroup.com

and here is my reply .. its brief, but if you want to know more, please contact me joanne@joannelee.com and we can discuss your spercific concerns

www.vibrancemedicalgroup.com
I just briefly looked the ladies diet but I few thoughts before I retire
1. Although she is burning up a lot of calories i am guessing that she has 'problem' areas (either hips and thighs or abdominal and back)

2. The amount of carbohydrates that she is consuming (even after exercise) will cause an increased rate of insulin production

3. Insulin has been shown to stimulate more LPL formation (lipoprotein lipase) which transports (stores) triglycerides (fat) into the cell ..

4. Insulin also makes the Alpha receptors more sensitive. cells have alpha and beta receptors. Alpha receptors block the breakdown of fat, beta receptors increase the breakdown of fat (women usually have more alpha than beta in the lower body) By sensitizing the alpha receptors you are stopping the breakdown of fat. A natural alpha antagonist is Yohimbine .. but some people are sensitive and I'm not sure how good really works .. but in theory ? maybe

5. Insulin inhibits HSL (hormone stimulating lipase) needed for lipolysis (note insulin also blunts yohimbine .. i know I read that somewhere)

6. She could get the carbs she needs for all the activity from better sources or by adding more fiber .. she could test her blood sugar. Natural (unprocessed foods) will have a higher thermic affect and will regulate her blood sugar (and therefore her insulin)

7. Women actually burn up a greater % of fat (than men who use more stored glcogen) with exercise but most of it comes from Intra Muscular fat and not those floppy rolls :)

8. epinephrine is the primary hormone that stimulate lipolysis - with all the activity this lady is certainly producing epinephrine - however (again) epinephrine works on both the beta and alpha receptors and we need to stimulate the beta for fat breakdown (alpha inhibit fat loss) .. so again it could come down to minimizing the alpha sensitivity (through insulin)

In a nutshell .. I doubt it is down to calories as she does so much activity and only eats 3 times a day.
I think it is more down to the responses her body is making on a more hormonal level. Im going to look at it properly tomorrow, but I think maybe her food sources and as you say, the evening carbohydrates.
Also, does she take any estrogen products/meds ? We know that women with higher levels of estrogen have smaller waists and more stubborn fat on their thighs and butt. When they hit menopause and estrogen drops they get that middle aged spread which can often be minimized with hormone therapy.

I would have to discuss with her ...

Joanne www.joannelee.com
joanne@joannelee.com