Transcription
Visceral fat is metabolically active fat that is surrounding our organs, underneath our typical, like abdominal fat, and it's long been known as one of the worst, most inflammatory kinds of fat.
But I recently had Dr. Sha Omera on my channel, and he piqued my interest with something that's called intrammyiocellular fat, or intramuscular fat, or commonly known as myostattosis. So, myo meaning muscle, stois meaning essentially fatty infiltration. It's where fat infiltrates our muscle. And there's new evidence—like I'm going to talk about a 2024 study here in just a second—that is really leading us to believe that this could be one of the worst kinds of fat from an inflammation perspective, but also just as a marker for where our metabolic health is going. And I'm going to talk about how you can also reduce it because now we have specific ways that you can reduce intramuscular fat specifically with exercise and diet. But we have to talk about how it works, what it all looks like. So stick with me and leave a comment for the algorithm so we can rock this video.
So, there's a study published in 2024 in Nature Communications, and this was a very clear-cut study that took a look at athletes compared to type 2 diabetics, and it was looking at the intramuscular fat of these two different types of people. What they found, plain and simple, is that type 2 diabetics had a significant amount of unsaturated fats inside their muscle, like weaved into, sort of like the marbling of their muscle. And what they found is that there was a direct correlation with how much intramuscular fat, how much of this marbling they had, and insulin resistance. What they also found is that what are called the pulmitate and linoleic kinetics were changed. They were altered. So the more fat that was weaved into the muscle, the less fat was able to be mobilized and ultimately burned. Essentially, the muscle was happy holding on to fat. So we've all seen like cows that have, you know, a cut, a steak that's really well marbled, and we like drool over it because it tastes better. But muscle density is important in a human for our health. We don't want to have fat infiltrated into our muscle. It makes for low muscle quality, poor metabolic function, and let's just be real, a less dense muscle. Like, we've all seen the dude in the gym, even when he's older, like just has a muscle density to him. And I firmly believe, and so does Dr. Sha Omera, that you can see this, right? Like, you can see it in someone that has good quality muscle.
The other thing that was interesting with this nature communication study is that the researchers said there was also a very clear positive correlation with intramiocellular fat or intramuscular fat and age, demonstrating that as we get older we have a higher risk of developing the fat in this muscle, and it probably has to do with disuse more than anything. And with disuse, we turn to a study that was published in PNAS. This study actually took a look at inactivity. You took a look at people that were just in car accidents and had to be immobilized. Shortly after a muscle was immobilized, fat infiltration made its way in. Pretty wild. And it's kind of nature's way of saying, "Hey, we need to be active, and we're going to immediately metabolically punish you for not being active." Now, I'm not talking like an hour or a day. I'm talking a couple of weeks.
And the good news is, is as we talk about this, it's actually pretty easy to flip it on its head and reverse it. And contrary to popular belief, it's actually quite easy to lose visceral fat, too. It's just, you know, we don't see it. So, it's hard to tell when we lose it. We only get DEXA scans once every so often. We just don't know, right? And you're probably wondering, how do you test your intramuscular fat? You could do so really easily with an MRI. Like, you could go get an MRI. Not that everyone just has the disposable income to go do that, but I'm just saying it's the surefire way to do it, right? You could go get an MRI, and you could look at a muscle and see like, oh wow, there's fat weaved in there. But, you know, we could also take proactive measures against it.
There's also an interesting link between diabetes directly, high triglycerides, and a couple other metabolic factors when it comes to intramuscular fat. There's a study published in Arteriosclerosis, Thrombosis, and Vascular Disease. This was a huge study, 2,945 people. Systematic review, okay? And they took a look at a lot of data here. What they found is that there was flat-out lower muscle density when there was intramuscular fat. Obviously, that makes sense. But this was correlated with a 34% increased risk of diabetes and a 40% increased risk of high triglycerides. Even when they factored in visceral fat and BMI, even when they accounted for that, especially in women, it was still the case. It was still a huge indicator of metabolic dysfunction.
So, which came first, the chicken or the egg in this case? Is the intrammyioellular fat or the intramuscular fat? Is this the problem or is it a result? It seems to be a two-way street because as metabolic dysfunction continues to get worse, the intramuscular fat seems to get worse.
One of the biggest things that I discovered though was a study that was published in Medicine and Science in Sports and Exercise. And what they found is that the more dense the muscle without intramuscular fat, without this myostatis, the significantly less inflammation. The more IMF, the more fat weaved into the muscle tissue, it was secreting inflammatory cytokines, triggering an inflammatory response throughout the body, just like visceral fat does, except in this case, nice little deposits throughout our entire body, depending on where the IMF, where the fat was in the muscle. That is where I start to say, I think this could be more dangerous than visceral fat because visceral fat can just be a proxy for liver fat and vice versa. When you get to the state of myostatis, you're also being somewhat like punished for being inactive or metabolic disease like throughout the entire body. So, we need to have like a serious intervention on how to decrease it. And that's where we get into this. Like, how do we decrease it? We're going to talk about the mechanisms and how it works.
One of the things that I want to say before I even get into like how to diet and how to exercise is muscle quality matters. 100% muscle quality matters. And muscle quality is dictated by your level of mitochondria, your mitochondrial density, that mitochondria's ability to actually produce energy, the mitochondrial efficiency, how much ATP it can produce per unit of oxygen, how much ATP it can produce per milligram of muscle mass on you. And one of the ways that I have seen through supplemental form to improve metabolic function and mitochondrial health is by increasing what is called mitophagy. So it's where you have basically the autophagy of a mitochondria where cruddy mitochondria that are somewhat decrepit and broken down go through a recycling process where they consume components of the mitochondria that are not being used anymore that are inefficient to feed the mitochondria essentially that are stronger and thriving, leaving you with higher quality, a more stronger percentage of good quality mitochondria that can effectively produce energy and burn the fats that are in the intramuscular fat because those are going to be the first fats that burn. So if your mitochondria is functioning well, you can burn those. I popped the link down below for a brand that's been a sponsor on this channel for a while and I've been involved with them for quite some time called Timeline Nutrition. It is called Urolithin A. So that link is a 10% off discount link. It's in the top line of the description. Recommend you check them out. The literature behind urolithin and mitophagy by inducing mitophagy is really fascinating. And if you don't want to take my word for it, there are countless studies published in JAMA, published in other major peer-reviewed journals talking about urolithin A and its ability to improve mitochondrial health and improve muscle health. So it's not just me talking. I stand behind it along with Dr. Gabrielle Lion along with a bunch of other longevity experts in the field because we stand behind the fact that muscle health is probably one of the biggest things that you could focus on for true longevity and metabolic health. So that link is down below for urolithin A from Timeline down below, top line of the description.
So how do we do this with exercise? Well, first off, there's a study published in the Journal of Applied Physiology. Exercise in general is going to decrease intramuscular fat. Plain and simple. Well, that wasn't earthshattering science. Let's get into the more intricate stuff. They were looking at total fat loss, total weight loss. And what they found is that when people lost total fat, they also lost not a proportionate amount but a good amount of intramuscular fat, and that therefore improved the muscle density and the mitochondrial health. And we see that in a large meta-analysis systematic review. But if we go back to that original study I talked about, the 2024 Nature Communications study, there was another element of that study that we didn't talk about earlier and that has to do with how you can actually oxidize this fat a little bit more. What they found is that deconditioning actually changes the muscle very fast. So they took athletes and they actually had the athletes decondition, slow down their training. They put on fat within the muscle very fast. The difference was they put on fat in the muscle that was saturated. That sounds bad, but in this case, it was actually good because the saturated fat would actually only become fuel for them like if they were doing endurance work, but it didn't have any real negative effect. So, in other words, as we get older and we do potentially increase the amount of fat in our muscle and lose muscle quality, it's not going to be as metabolically detrimental if you're an athlete or were an athlete or had good muscle quality in the beginning. The problem is when your people are metabolically damaged, the lipid kinetics, the actual like pulmitate kinetics change, which means how we oxidize fat changes. My point in saying this is that it's more about keeping the body moving all the time. So step one, exercise. Step two, when you're not exercising, do everything in your possible power to keep moving throughout the day. Seriously, we are rewarded in this case for moving throughout the day. Non-exercise activity thermogenesis. Walk around more. Sounds so archaic, and you probably are turning off the video. Please don't. There is some cool stuff on specific reduction in these areas. But it's powerful to move around. Okay.
Can you lose fat specifically in that muscle where you have a high amount of fat? Yes. There was a study published in the Journal of Physiology that looked at the localized sort of oxidation of this, and they found that when they had subjects that had high levels of intramiocellular or intramuscular fat, they had them do resistance training at like 40% of their intensity, like 40% intensity for longer periods of time, 2 to 4 hours. Okay, that's not your typical weight training session, but it was for a study. There was a 30% drop in the intramuscular fats compared to those that did not do the resistance training in that specific muscle. 30% drop after 4 hours. So what that tells us is that when you actually move that muscle, you quickly use the fat that's stored up. But if you don't use the fat that's stored up, it cascades into metabolic issues that your body really has a hard time even metabolizing because it's damaging the mitochondria. And again, the palmitate kinetics, the fat kinetics of using energy within the muscle, using fat for energy within the muscle. There was also a higher proportion of what are called non-esterified fatty acids that were put up into circulation. Essentially showing that fat was able to be taken up and able to be oxidized easier when that muscle was being utilized for a longer period of time at a moderate intensity.
So, what does that look like? This is gonna sound crazy, but it sounds like rucking uphill is what it sounds like. It sounds like rucking uphill, like wearing a heavy backpack and going up stairs or doing the stair climber with a couple of weights for an hour. It sounds like laborious work, but if you have this metabolically potentially damaging fat, this metabolically unhealthy state, it's something that I think is worth doing. You could also go do moderate resistance training and just keep moving, keep moving. So 40% work capacity is not super hard work, but it seems as though if you start going higher intensity, you're not burning those fats. You need to keep it in that beta oxidation state at a lower intensity. By all means, please continue to do resistance training. Please do hard resistance training that is vigorous, intense resistance training. But for specifically burning the fat, you need like that moderate range for an extended period of time. So walking upstairs with some weight, doing lots and lots and lots of lunges with a little bit of weight. You know, those kinds of things are going to oxidize those lipids, mobilize the non-esterified fatty acids so that they can get taken up and burned.
Okay, now we need to talk diet for a second. There was a study published in the Clinical Nutrition ESP, not to be confused with ESPN, okay? Okay. And this looked at 193 inpatients, okay? And they did ultrasounds on their muscles, and they could tell that like the muscle density through an ultrasound. They fed them a high-protein diet, and at the end of the high-protein diet, at the end of their stay after having a high-protein diet, they had found that the echo intensity had decreased, indicating that the muscle was now more dense. So they ended up with less intramuscular fat just by going to a high-protein diet. And this is simple because a high-protein diet is going to increase muscle protein synthesis, which is simply going to displace some of the fat, but it's also going to create an energy demand that's going to cause that fat to be used as a basic fuel. There's also more glucagon. When you consume protein, glucagon is a hormone that's going to condition to use fat, right? So, it's going to put you in that deficit state. It's going to trigger fat oxidation within the muscle itself. And lastly, there's going to be a leucine increase from the protein itself, which induces mitochondrial biogenesis. More mitochondria, more places to burn fat. So, high protein along with this kind of exercise stuff I talked about is really good for burning that fat specifically.
But what about the combination of fats and carbs? What's best there? Should we do fat, high fat, high carb? What should we do? Well, with this, we actually have data on it. Fortunately, there was a study published in the American Journal of Physiology that took a look at cyclists over the course of three weeks. For the first week, they had them consume a diet that was 32% fat. The rest was I can't remember exactly what the macros were, but 32% fat. Then for weeks two and three, they had them do either 2% fat or 22% fat with everything else remaining the same in terms of protein. The only thing that would change would be the carbohydrates. So, one was lower fat, higher carb. One was higher fat, lower carb. The low-fat group ended up oxidizing 27% less fat, and they ended up oxidizing 40% less non-plasma or intramuscular fat. 40% less intramuscular fat being oxidized when high carb was in the equation or in this case low fat. So having more fat but less carbs could be the way here. And that makes sense because you're giving yourself the opportunity to oxidize fats versus the carbs. I'm not an anti-carb guy. I'm just saying that if you're in this state, it kind of adds up because you're probably someone that is dealing with insulin resistance or metabolic dysfunction or maybe even type 2 diabetes, which means that you probably have an inability to utilize carbs as well anyway. So, it would make sense that like by reducing those that you would increase the fat oxidation because you're decreasing the carbs. So it makes a lot of sense. So lower carbohydrate, moderate polyunsaturated, monounsaturated fats, some saturated fat, very high protein. I would probably go with like 50% protein, maybe 25% carb, 25% fat, something like that, or maybe even less carbs if you're up for it. You want to do more rucking, you want to do more full-body movement, and you want to move throughout the day as much as possible. As always, keep it locked here, my channel. See you tomorrow.