How to Deflate Your Spare Tire

Dr. Julian Whitaker’s Health and Healing Newsletter
January 2005
Vol. 15, No. 1

Fat is stored in billions of adipose (fat) cells located throughout your body. But not all fat is created equal. The most visible type of fat is subcutaneous fat, which is located just below the skin. Love handles, cellulite on the thighs, or any fat you can grab and shake are prime examples. The other type is visceral adipose tissue, or VAT, which lies beneath the muscle and around the organs. A potbelly, even on someone who is not otherwise overweight, is a sign of visceral fat.

Abdominal fat is far more problematic than big hips or thighs. This is because fat cells are not simply a passive storehouse for lipids but an active organ that secretes hormones and cytokines (chemical messengers), and responds to signals from the nervous, immune, and endocrine systems. This is particularly true of abdominal VAT, which lies in close proximity to the liver, heard, and other major organs and is far more metabolically active than subcutaneous fat.

A Primary Cause of Metabolic Syndrome

Abdominal VAT increases fat metabolism by the liver. It releases free fatty acids into the bloodstream that raise levels of triglyerides and insulin, thereby increasing risk of cardiovascular disease. It stimulates the production of aldosterone, a hormone that raises blood pressure, and cortisol, a stress hormone. It produces cytokines that cause inflammation and harm endothelial cells lining the arteries. It also inhibits insulin activity and glucose uptake by the cells, increasing risk of diabetes.

What I’ve just described are all the hallmarks of metabolic syndrome, formerly called syndrome X or insulin resistance syndrome), a condition that affects approximately 47 million Americans and dramatically increases risk of heart disease, hypertension, and diabetes. A growing number of studies are showing that excessive visceral fat in the abdominal area may be the most significant determinant of metabolic syndrome.

Exercise, Cut Calories, and Take DHEA

So how can you get rid of abdominal fat? Vigorous exercise helps because it preferentially reduces visceral fat. So does simply losing weight. Since visceral fat is more metabolically active than subcutaneous fat, it comes off easier, which explains why saddlebags and love handles are so hard to lose. It also explains why relatively small amounts of weitht loss (as little as 5-10 percent of total weight) can result in big gains in health: much of that is visceral fat.

An exciting new study recently published in JAMA suggests that DHEA supplementation also reduces abdominal fat in older men and women. DHEA is a hormone produced by the adrenal glands that is the precursor for estrogen, testosterone, and other adrenal hormones. Levels in the blood peak around age 20, then fall as we age. Hundreds of studies link declines in DHEA levels with a number of age-related health problemns, including abdominal obesity and metabolic syndrome.

DHEA Reduces Abdominal Fat

Researches from the Washington University School of Medicine in St. Louis enrolled 52 men and women, ages 65-78, who had low blood levels of DHEA-sulfate, were overweight, and did not exercise regularly. They determined their levels of abdominal fat by magnetic resonance imaging (MRI), then gave them either 50 mg of DHEA or a placebo daily at bedtime.

Repeat MRIs after six months revealed that the visceral abdominal fat in the womrn taking DHEA decreased by an amazing 10.2 percent and in the men by a significant 7.4 percent. Subcutaneous abdominal fat was reduced by approximately 6 percent in both genders. DHEA also effected significant changes in several aspects of metabolic syndrome with improvements in insulin sensitivity, leading the researchers to conclude that “DHEA replacement therapy might reduce the accumulation of abdominal fat and protect against development of the metabolic/ insulin resistance syndrome.”

This is a remarkable study, folks. These men and women did not begin an exercise program. They did not change their diets. All they did was take an inexpensive, over-the-counter nutritional supplement!

A Wakeup Call for Conventional Docs

This should be a clarion call for physicians to prescribe DHEA to their elderly patients. Visceral abdominal fat accumulates with age, and is a significant contributor to the age-related increased risk of metabolic syndrome and its many complications.

I’ve been using DHEA at my clinic for the past 20 years, and it is an integral treatment option for most alternative physicians. Numerous studies have shown that DHEA also reduces symptoms of lupus and, in older people, boosts mood and memory, and heightens libido and sexual function, improves sense of well-being, increases muscle strength and bone density, and helps prevent some of our most common diseases.

If DHEA were a drug, conventional docs would be all over it. However, because it is an inexpensive supplement sold in health food stores, they ignore it, despite the plethora of provocative studies supporting its use. If you are over age 50, fighting the battle of the bulge, diet, exercise, and consider taking DHEA.

Recommendations:
 First, get a DHEA-sulfate blood test to determine your levels of this hormone, then monitor it again three to six months after starting on DHEA to make sure the dose you’re taking is keeping your blood level in the range of a young adult.
 I usually recommend 25 mg of DHEA daily for women and 50 mg for men, although both sexes used 50 mg in this study. Women age 65 and over may consider increasing their dose to 50 mg while monitoring their blood levels.
 To find a doctor who will work with you on this, visit the Website of the American College for Advancement in Medicine, acam.org, or call (800) 532-3688. To schedule an appointment at Whitaker Wellness call (800 488-1500.
 DHEA is available at Hello Gorgeous. Excessive dies cause acne or promote facial hair growth in women. Because DHEA is converted into estrogen and testosterone, it is not recommended for patients with breast, ovarian, or prostate cancer. (In this study, as in most studies, DHEA’s effects on testosterone in men was not significant.

References:
Kershaw EE et al. Adipose tissue is an endocrine organ. J Clin Endocrinol Metab. 2004 June; 89:2548-56.

Villareal, DT et al. Effect of DHEA on Abdominal Fat and Insulin Action in Elderly Women and Men. JAMA. 2004 Nov 10; 292(18)2243:2248.

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