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Adipocyte Hyperplasia - Good or Bad?

First, a picture:-


The above picture is from Fig. 4 of Cytokine-mediated modulation of leptin and adiponectin secretion during in vitro adipogenesis: Evidence that tumor necrosis factor-α- and interleukin-1β-treated human preadipocytes are potent leptin producers.

I've posted the above picture to show that leptin secretion increases non-linearly with increasing culture period. As adipocyte content almost certainly increases non-linearly with increasing culture period (like THIS), leptin secretion almost certainly increases very non-linearly with increasing adipocyte content. As adipocyte content increases, there's no/minimal leptin secretion up to a certain level of fullness. Above this level of fullness, leptin secretion increases rapidly. What this means is that reducing adipocyte content by x% reduces leptin secretion by much more than x%.

If somebody's adipocytes become 100% full due to caloric excess, there are two extreme possibilities.

1a: If there is continued caloric excess, no preadipocytes are converted into adipocytes. There is no storage capacity available for excess nutrients, so they remain in circulation. T2DM has developed - BAD.

1b: If there is subsequent caloric deficit, adipocytes start to deplete, storage capacity becomes available and T2DM goes away (if beta cells haven't been completely destroyed in the meantime). The relatively full adipocytes secrete plenty of leptin, so metabolic rate is high and hunger is low - GOOD.

2a: If there is continued caloric excess, pre-adipocytes are converted into adipocytes. This is adipocyte hyperplasia. There is storage capacity available for excess nutrients, so T2DM doesn't develop - GOOD.

2b: If there is subsequent caloric deficit, adipocytes start to deplete. However, there are more adipocytes than in 1), so for a given fat mass, adipocytes are emptier than in 1). The greater number of emptier adipocytes secrete less leptin than in 1), so metabolic rate is lower and hunger is higher than in 1) - BAD.

Adipocyte hyperplasia is good for preventing T2DM as fat mass increases, but bad for metabolic rate and hunger after subsequent fat mass loss. I believe that growing children are much more likely to get adipocyte hyperplasia than adults. Therefore, childhood obesity is highly likely to result in misery after subsequent fat mass loss. This is why I believe that growing children should be protected from the evul greedy manufacturers of Crap-in-a-Bag/Box/Bottle (CIAB).

EDIT: Jane Karlsson just e-mailed me a link to the following study:- Adipocyte Turnover: Relevance to Human Adipose Tissue Morphology.
"Occurrence of hyperplasia (negative morphology value) or hypertrophy (positive morphology value) was independent of sex and body weight but correlated with fasting plasma insulin levels and insulin sensitivity, independent of adipocyte volume (β-coefficient = 0.3, P < 0.0001). Total adipocyte number and morphology were negatively related (r = −0.66); i.e., the total adipocyte number was greatest in pronounced hyperplasia and smallest in pronounced hypertrophy. The absolute number of new adipocytes generated each year was 70% lower (P < 0.001) in hypertrophy than in hyperplasia, and individual values for adipocyte generation and morphology were strongly related (r = 0.7, P < 0.001). The relative death rate (∼10% per year) or mean age of adipocytes (∼10 years) was not correlated with morphology."

So, if you want to remain slim, high fasting serum insulin (due to hepatic and/or muscular insulin resistance) is bad mmm-kay?

A comment, a simile and insanity.

A lot of my recent titles contain three items.

1) The comment: I'm just about to leave the following comment on Peter (Hyperlipid)'s blog post Insulin and the Rewards of overfeeding. I thought that it was so good at summing-up, I'll post it here first!

"All,

Insulin increases the amount of glucose & FFAs entering fat cells, muscle cells & the liver.

Insulin decreases the amount of glycerol & FFAs exiting fat cells & the amount of glucose exiting the liver.

Hyperinsulinaemia (which can produce sedation) results when one or more of the following tissues loses insulin sensitivity:- fat cells, muscle cells & the liver.

So, why do people keep saying that hyperinsulinaemia locks nutrients away in fat cells only, thus robbing other cells of nutrients, thus causing lethargy?

The relative insulin sensitivity of tissues determines the relative partitioning of nutrients into those tissues.

When tissues lose sensitivity to insulin, blood glucose control becomes impaired. This results in roller-coaster blood glucose levels after eating high-glycaemic carbohydrates. A rapidly-falling blood glucose level causes ravenous hunger. I have experienced this during medically-monitored tests (OGTTs & an insulin shock test).

Low-carb/ketogenic diets don't result in a roller-coaster blood glucose level and therefore don't cause ravenous hunger. Simples!

Overeating due to ravenous hunger is NOT gluttony, just as under-moving due to sedation is NOT sloth.

THIS is gluttony."

EDIT: This didn't go in my comment but should have:- "Low-carb/ketogenic diets result in the avoidance of moreish & calorific foods such as sweets, chocolate, cake, biscuits, pizza, Pringles etc. A single bite of such foods has a negligible effect on blood glucose & insulin levels, but encourages another bite and another and another ad nauseam, due to Food Reward.


2) The simile: I use similes. I used the simile "As happy as a pig in shit" in a comment somewhere on Woos blog. Now, you may (or may not) have noticed that my user-name is Nigeepoo. We Brits are obsessed by two things - The weather and our bowel movements. I find things to do with poo and farting amusing (schoolboy humour, I know!). I used the simile "As happy as a pig in shit" because it is amusing.


3) The insanity: According to Woo in the following comment:-
"Re: the comment...Sorry, not convinced.
You are basically refusing to admit your choice of words implied moral judgement. The phrase "happier than a pig in shit" is always applied to examples of people being content in immorality/bad behavior particularly gluttony and sloth... unless it is used ironically. Only an autistic or a non-english speaker would believe this crap."

Woo, you are as mad as a March hare. IMO of course, like everything I write. Duh!

How stuff works, Part 2.

I'm the kind of person that likes to analyse everything to death (and make lists).

1) Here's what I wrote on Synthesis: Low-Carb and Food Reward/Palatability, and Why Calories Count:-
"I’m going to stick my neck out here and state that fat, sedentary people do better on low-carb diets because:-

Fat, sedentary people have severe muscular insulin resistance.
This results in chronic hyperinsulinaemia and acute hyperinsulinaemia on eating carbs (which causes lethargy & increased sedentariness).
Chronic hyperinsulinaemia impairs the Phase I insulin response.
This impairs the stability of the blood glucose control system, resulting in large fluctuations in blood glucose level on eating carbs.
A rapidly-falling blood glucose level causes severe hunger pangs (I’ve experienced this under medical supervision).
Severe hunger pangs cause overeating, resulting in increased fatness.
GOTO 1

Low-carb diets reduce the large fluctuations in blood glucose level. Once normal blood glucose control has been restored by bodyfat loss & exercise, low-carb diet is no longer required."

I added a hot-link that wasn't in the original comment. Thanks to Sam Knox for linking to that study.

Lethargy & increased sedentariness result in very few calories burned (BMR/RMR + TEF). Eliminating (lethargy & increased sedentariness) greatly increases calories burned without conscious effort (BMR/RMR + TEF + TEA + NEAT/SPA). This is why people on low-carb diets can eat more and still lose weight. The Energy Balance Equation still applies.


2) I've noticed that people conflate Food Tastiness with Food Reward. Here's my opinion:-

Excessive reward = Moreish. What your food tastes like is only vaguely relevant. Avoid eating moreish foods, unless you're a body-builder who's trying to bulk.

Here's what I wrote on Food Reward: “There’s Always Room For Dessert”:-
"I believe that obesity is physiological AND neurological (the proportions varying from person to person).

For example, one chocolate doesn’t disturb my blood glucose & insulin, but I still crave another. And another. Ad nauseam."

Physiological cravings take hours to kick-in.
Neurological cravings take seconds to kick-in.

Emily Deans wrote:-
"Multiple times I’ve used naltrexone (an opiate blocker) to stop binge eating. The cravings go away. It only takes a few weeks. It’s a nice way to undo addiction/reward without starving someone… not FDA approved."

That's pretty damning evidence for the existence of Food Reward. How can naltrexone block something that doesn't exist?

Finally Monsieur, a waffer-thin mint.