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 Subscribe to Videos The Spillover E ect Links Obesity to Diabetes

Michael Greger M.D. FACLM · February 6th, 2015 · Volume 23
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Being obese may result in as much insulin resistance as eating a high-fat diet.

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Free fatty acids, meaning free fat circulating in the bloodstream not packaged into triglycerides, result in in ammation, toxic fat breakdown
products, and oxidative stress, which can gum up the insulin receptor pathways and lead to insulin resistance in our muscles. And insulin resistance
is what causes prediabetes and type 2 diabetes.

As the level of fat in the blood rises the body’s ability to clear sugar from the blood drops. Where does this fat in our blood that’s wreaking all this
havoc come from? It comes from the fat that we eat, and from the fat that we wear.

The number of fat cells we have stays constant in adulthood. It’s interesting; the way they gured that out is by measuring the amount of radioactive
carbon trapped in our DNA from all the nuclear bomb tests. Anyway, after massive weight loss, our fat cells shrink as they o oad fat, but the
number stays the same. Conversely, when we gain weight, our fat cells just stretch as we pack more and more fat into each individual fat cell. So
when our belly, butt, or thighs get big, we’re not adding more fat cells; we’re just cramming more fat into each cell. At a certain point, our cells
become so bloated that they spill fat back into the bloodstream.

This is an illustration of the so-called spillover e ect. Not only does an obese person have more fat on their body, but they’re constantly spilling that
fat into their bloodstream. So that could be the link between obesity and diabetes. Fat is spilling out from our fat cells and gets lodged in our
muscle cells, leading to the insulin resistance that promotes the onset of type 2 diabetes.

Or the fat can enter our bloodstream through our mouth. If you put people on a low-carb diet, fat builds up in their muscles within two hours,
compared to a low-fat diet, and insulin sensitivity drops. And the more fat in the muscle, the lower the ability to clear sugar from the blood. It doesn’t
take years for this to happen; just hours after fatty foods go into our mouths, our bodies have problems using insulin. A fat-rich diet can increase fat
in the blood, and this increase is accompanied by a decrease in insulin sensitivity.

Studies clearly demonstrate that fat in the blood directly inhibits glucose transport and usage in our muscles, which is responsible for clearing about
85% of the glucose out of our blood. These ndings also indicate an important role of nutrition, particularly increased consumption of fat, for the
development of insulin resistance.

Normally we have only 10 to 50 micromoles of free fat oating around in our bloodstream at any one time, but those who are obese are constantly
spilling fat out into their bloodstream. But we can reach those same levels in our blood eating a high-fat diet. So a skinny person eating a low carb
diet can have the same level of fat in their blood as obese people do. Similarly, being obese is like eating some horrible bacon-and-butter diet all
day, because obese persons are constantly spilling fat into their bloodstream no matter what goes in their mouth.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an
approximation of the audio contributed by Katie Schloer.

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DOCTOR'S NOTE
What does “gum up the insulin receptor pathway” mean? See the prequel video: What Causes Insulin Resistance? And the sequel,
Lipotoxicity: How Saturated Fat Raises Blood Sugar, goes into the types of fat and their e ects.

The fat leaking into our bloodstream may also contain fat-soluble pollutants that accumulated from our diet: Pollutants in Salmon and Our
Own Fat

The spillover e ect may also help explain the increased heart disease risk associated with obesity: Low Carb Diets and Coronary Blood
Flow.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

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What Causes Insulin Resistance? Lipotoxicity: How Saturated Fat Raises
(Older Version) Blood Sugar

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