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Friday, August 28, 2009

VAT, SCAT and CVATT

As you can see, despite my declaration to be off-line for a few days due to a medical conference, I have found the time and internet access to blog today....

As I enjoyed my liquid meditation this morning (aka: swimming laps) in a large, gorgeous pool here at a Tampa Marriott, I can't help but press 'rewind' on this week's VHS of life. Something came to mind during my liquid meditation that I'd like to share with my readers...

This week I saw a severely diabetic female. I believe I can call her case "severe" because she has a fasting glucose of 160 and that's while taking not one, but two, diabetic drugs. She returned for a follow-up with me having been on our program for one month.

I am happy to report many things: 1) she was compliant; 2) she dropped poundage on the scale; 3) her fasting glucose dropped from 160 to below 70 (too low) and 4) our BIA analysis of her body composition showed that she lost 100% fat (no lean muscle mass was loss) during these last weeks. All of this is incredibly positive info! And you'd think all people in the room would have been excited, pleased and happy. I know I was.

But this was not the case.

The patient in this case, however, was not excited with joy. In fact, she continued to display signs of negativity and discouragement. Why? Because despite all the evidence that her lifestyle change and supplements were paying off in spades, she didn't 'feel' like she had lost any fat because her fat around her waist, meaning her fat rolls, appeared unchanged to her.


Having not read my blog yet, she didn't understand about the two types of fat that is around our waist: 1) the subcutaneous adipose fat (SCAT) which lies on top of abdominal wall and 2) the VAT that lies underneath the abdominal wall. As shown in prior blog pictures, SCAT is the fat that we can grab---ie: the tire roll. The VAT is 'the Beast' that lies underneath our abdominal wall.



The reason she couldn't feel or see a reduction in her SCAT (fat rolls) during the last month was because most of the fat she lost (as evidence by the BIA) was from within her VAT deep underneath her abdominal wall.

Since the VAT is a highly metabolically active fat, the first fat to be lost will typically be the VAT.

This is why people can lose only a few pounds of VAT and make tremendous changes in their metabolic blood biomarkers and disease risks.

If the VAT is a metabolically active endocrine organ under the abdominal wall, then why do we even get SCAT on the outside of our abdominal wall?

Current research is indicates that the VAT has a limit to how much it can hold---a tipping point--and this max limit tipping point is different for every single person.

Researchers have called this VAT tipping point CVATT---Critical Visceral Adipose Tissue Threshold.

Once CVATT has been reached is when the metabolic blood biomarkers become most dysfunctional.

This CVATT is also the point where the body starts to store some of its fat on the outside of the abdominal wall (ie: SCAT)---the fat rolls and love handles we can physically grab. In fact, it is hypothesized by researchers that the fat rolls are acting like a "sink" or "buffer" for the excess glucose thereby prohibiting the metabolically active VAT to tip even further over its CVATT.

This CVATT theory explains several things I, other clinics and researchers have noticed:

1. This explains why some people can weigh 300 pounds and still not display signs of overt Limit-Age Syndrome. Why? Because their VAT hasn't reached their genetically unique CVATT tipping point.

2. This explains why some people can be thin or of normal weight yet be displaying signs of Limit-Age Syndrome. Why? Because their VAT has reached its genetically unique CVATT tipping point.

3. This explains the difference between the two types of thick waisted people: Some people have a thick waist due to their big SCAT---belly roll and love handles. These people have a lower CVATT and will show abnormal blood biomarkers/symptoms sooner because their VAT tipping point was already reached.

And then there are the other thick waisted people without the soft, cushy tire roll, love handles and/or jiggling cellulite around the waist. Instead, their thick waist is almost as hard as a rock!

The reason their thick waist looks and feels like an advanced pregnancy is because there is barely any SCAT. These people have a higher CVATT tipping point and thus, their hard girth will continue to grow and grow until one day it too will reach its CVATT and then, seeminly almost overnight their abnormal blood biomarkers and symptoms will appear. I've seen this happen several times in clinical practice.

And so, I hope this blog helps to explain what to expect during your fat loss process. We must NOT keep our eye on the fatty tire roll but instead on the scientific data of the BIA and fasting blood glucose to prove that the battle with the VATty beast is indeed being won. We must be patient and have faith knowing these these objective scientific biomakers are indicating that our unseen VAT below the abdominal wall IS reducing!

And on the other side of the coin has to do with not fat loss, but fat gaining.

Those of us that have successfully put our VAT beast in hibernation and thus, have minimized our SCAT, must remember that just because our SCAT isn't enlarging does NOT mean that we have successfully bargained with the VAT beast--because we haven't. Remember, we aren't able to see or feel a difference in our SCAT until our VAT has become congested and is reaching (or has reached) its CVATT.

Changing gears for a moment, I'd like to point out another important note regarding this severe diabetic patient's case---the role of the fat above her neck---her brain.

Our mind can be our worst enemy...

Or, our mind can be our secret weapon to success.

More on this later...

I love you all. Stay tuned....