The human body is fairly plastic in that it can assume a number of different shapes. Even in an individual, this is evident as that leaner, athletic build that strutted down the high school hallway eventually acquires what has unfortunately been coined the “dad bod.”
Is that the pinnacle of human development today? Men who look like the apple character from the Fruit of the Loom underwear commercials? “Normal” weight people are the minority, with overweight and obesity affecting about two-thirds of the U.S. adult population.
Beyond the social stigma and functional limitations obese individuals face, is the well-documented association between obesity and a number of chronic health conditions that have ballooned into epidemic proportions during the last half-century: type 2 diabetes, hypertension, liver disease, heart disease and certain cancers, in addition to other less common conditions.
Obesity is sometimes defined by the fat depots that are most affected. For example, many women develop a “gynoid” presentation— with the fat depositing mostly around the hips, buttocks and thighs; even “chicken wings” flapping under the upper arm. Surprisingly, this type of obesity is less harmful than the “android” presentation. No, not fast-food consuming robots, but the typical man with a belly that hangs over the belt like some kind of fleshy wide tie accessory to a fashionable physique. These used to be called “pear” versus “apple” body shapes.
Visceral obesity (fat around the internal organs) is essentially the same thing as central obesity, which is pretty much the same as “android” obesity. Some men have a big belly because of excess subcutaneous fat with little visceral fat, but that is the exception. Also, fat can deposit in certain organs, not just around them. The liver is a vital organ; when fat deposits in the liver, it does not function properly and can generate disease-promoting inflammatory signals and altered hormonal metabolism. There is a condition called “non-alcoholic fatty liver disease” affecting as many as one-third of U.S. adults that describes metabolic impairments that arise as a consequence of “fatty liver.”
So, it is not only for cosmetic reasons that a smaller waist and healthy body composition should be the goal of reasonable individuals, but also to protect or regain overall health and metabolic function— and avoid an early death. Visceral obesity is most closely related to the metabolic conditions associated with obesity listed above, and the role of chronic inflammation is thought to be a unifying factor.3 Recently, the gut bacteria, called the microbiome, have been suggested to play a significant role.
Though bodybuilders are remarkably adept at transforming their physiques, reducing body fat and waist circumference to physiological and anatomical minimums, the general public has struggled. As it stands, the severely obese are being directed to gastric bypass surgery to achieve any significant and lasting weight loss. Obviously, this entails great expense and risk.
The Power of Fasting
Recently, several studies have reported on the effect of one’s eating pattern, as opposed to a diet, on central obesity. Most diets focus on how much a person eats, or perhaps the macronutrient ratio (i.e., carbohydrates:protein:fat), such as the Zone Diet, Atkins Diet, South Beach Diet and various ketogenic programs. These diets rely upon restoring the sensitivity of the body to the hormone insulin, and reducing its fat gain-promoting properties by dropping the carbohydrate content of the diet and the glycemic index/load.
Yet, there is a proposed solution that may be easier yet— when a person eats. The concept of fasting is familiar, referring to a period of time when a person does not eat. Obviously, while this will aid in reducing weight, it is not a long-term solution as the body will begin catabolizing lean mass to support energy needs, and physical as well as cognitive performance will suffer. In fact, prolonged fasting can lead to immune suppression, bone loss, organ damage and eventually death.
Yet, the power of fasting can be utilized in measured doses to provide many of its fat-loss benefits without causing loss of lean mass or impairing health. This has been shown in animal studies, and limited human trial data is available.6 Unfortunately, there is no standard timing pattern, so this practice is still in its infancy.
Various terms have been used, including “intermittent fasting” and “alternate-day fasting,” to describe the patterns used in published studies. Time-restricted feeding involves limiting eating to a set number of hours each day, consuming pretty much whatever you want but only in a four- to eight-hour window; alternate-day fasting is what it sounds like— you eat whatever you want one day, and fast the next day (actually consuming about 25 percent of maintenance calories on “fasting” days).
Now, without restricting how much a person can eat on feeding days, it sounds like these diets are set up to cause an epidemic of binge-eating disorder. However, the limited research seems to show that although people do eat more on their feeding days, the additional amount is not much more than “normal,” and over time becomes less and less— trending down toward the baseline daily calorie intake.
This means that the calories “avoided” by fasting are pretty much subtracted from the weekly intake, and over the course of time can lead to a significant caloric deficit.
The most-referenced study on alternate-day fasting showed an average weight loss of 6.5 percent in eight weeks.9 Intermittent fasting has less extreme variance in caloric intake, but appears to lead to a weekly decrease in calories consumed. Both patterns appear to preserve lean mass, with most of the weight lost coming from fat.
In addition to the long-term calorie deficit that accumulates during the “fasting” days, there appears to be an increase in the liberation and utilization of stored fat, an adaptation in the metabolism and physiology to make greater and more efficient use of stored energy reserves (i.e., fat) and a positive change in cardiovascular markers of health, suggesting other health benefits.6,7
For the person concerned about losing “belly fat,” these diets may be the optimal solution, with a tweak or two. Animal and human data shows that the loss of fat is equivalent, with little-to-no lean mass loss.
Mediterranean-style Diet, Olive Oil and Insulin Sensitivity
Those tweaks mentioned earlier can be easily incorporated into most diets. First, make wise food choices even though you are allowed to eat to your desire. Animal studies show that intermittent feeding induces fat loss with lean mass retention, and is associated with changes in brain chemistry that may combat the slowing of the metabolism often seen with calorie reduction, as well as avoiding issues with hunger.
Among these “wise” food choices, it seems that following a Mediterranean-style diet is one option. A key component of the Mediterranean diet is olive oil, which is rich in the monounsaturated fat oleic acid.
In a study following 11 insulin-resistant people with a family history of type 2 diabetes, three diets were compared.12 The diets, which each subject consumed for four weeks before switching to the next after a short break, were rich in saturated fat, monounsaturated fat or carbohydrates.
All the diets contained only 15 percent protein, and were designed to maintain bodyweight. In the end, it was clear that the carbohydrate-rich diet (65%) was the least beneficial, causing a “redistribution” of fat to the abdomen. This has particular relevance to men who experience “android” fat with weight gain.
More so, the olive oil-rich diet produced greater insulin sensitivity as well as lower adipokine levels. High saturated fat diets are reported to decrease insulin sensitivity.
Adipokines are fat cell “hormones” that in a healthy person, increase calorie burning and suppress appetite (leptin), and improve insulin sensitivity (adiponectin). However, when fat cells get overly large or resistant to regulatory signals, these adipokines increase in an unhealthy manner. This is why studies that look at obese people see decreases in these adipokines, and it is a positive change, as opposed to the same thing happening in a lean person.
Imagine someone yelling at you to make a point in an argument, and their message is clearer as they speak more loudly. Now, imagine a hearing-impaired person who needs everything shouted at them to hear conversations that still may not be perfectly understood. When the hearing-impaired person gets a hearing aid, the conversation quiets down— not because the speaker doesn’t want to communicate, but because the “ears” are working better. With weight loss, or a better diet, adipokines don’t need to “shout” in obese people as loudly.
More exciting than changes on a lab report was the finding that the olive oil diet prevented the fat “redistribution” to the belly seen in the carbohydrate-rich diet. This suggests that a low-carbohydrate diet with supplemental olive oil may provide the best bang for the buck when intermittent or alternate-day fasting for losing the “gut.”
Like any diet, this may be the “one,” or it may not be tolerable. Certainly, there is a lot of promise in the early trials and reports regarding these “when” diets, versus the “what” or “how much” diets. Incorporating the lessons already learned— such as reducing carbohydrates, especially high-glycemic load diets, moderating saturated fat intake and incorporating olive oil— may add to the power of these programs in promoting health and losing inches around the waist. The convenience of watching the clock instead of the calorie counter certainly has its own appeal.