Weight, or body composition and distribution.

[Roy Batty]

There seems to be little discussion of body composition and distribution. the focus seems to be primarily on losing weight, not reducing fat and gaining muscle.

I know from a DEXA scan my body fat % and it's distribution. If I were to shed weight it's probably going to be more muscle than I'd like lose and it's very difficult at age 66 to increase muscle mass. Losing muscle mass will have a detrimental effect on blood glucose levels and insulin sensitivity, not good.

 

[AndBreathe]

There seems to be little discussion of body composition and distribution. the focus seems to be primarily on losing weight, not reducing fat and gaining muscle.

I know from a DEXA scan my body fat % and it's distribution. If I were to shed weight it's probably going to be more muscle than I'd like lose and it's very difficult at age 66 to increase muscle mass. Losing muscle mass will have a detrimental effect on blood glucose levels and insulin sensitivity, not good.

In an ideal world, I agree with you, however, in the early days of messaging about T2, simplicity is important.

Personally, I find it more comfortable that those carrying spare poundage at diagnosis be told to trim up than to eat lots of carby stuff, or to join a gym. Even many on here who enjoy exercise in one form or another might not have been so enthusiastic at the outset.

How many folks do we see who immediately discount exercise because they have bad knees, hips, or other stuff going on. There is also the misconception that exercise immediately means playing footie, running marathon or pumping iron, rather than parking a bit further from the supermarket entrance or getting off the bus a stop earlier than usual.

Choosing early messaging is important.

As a matter of interest, where did you have your body composition DEXA done? I know of one, but haven't managed to swing going on it yet. My interstitial, and major organ fat was measured as part of a research project, but on a day to day basis, I keep an eye on my score on my Omron Body Comp scales. Not incredibly sophisticated, but seems consistent for me.

 

[SimonP78]

There seems to be little discussion of body composition and distribution. the focus seems to be primarily on losing weight, not reducing fat and gaining muscle.

I know from a DEXA scan my body fat % and it's distribution. If I were to shed weight it's probably going to be more muscle than I'd like lose and it's very difficult at age 66 to increase muscle mass. Losing muscle mass will have a detrimental effect on blood glucose levels and insulin sensitivity, not good.

You will preferentially use fat though rather than muscle if you eat fewer calories than you are using, and exercise will also add muscle mass as well as burning more fat - so the latter is potentially a problem if it increases your overall weight, however, I don't know what the rates of change of fat (downwards) and muscle (upwards) are when exercising and whether one is greater than the other for a given exercise regimen, but I'd be fairly confident that fat reduces faster than muscle increases.

 

[Roy Batty]

You will preferentially use fat though rather than muscle if you eat fewer calories than you are using, and exercise will also add muscle mass as well as burning more fat - so the latter is potentially a problem if it increases your overall weight, however, I don't know what the rates of change of fat (downwards) and muscle (upwards) are when exercising and whether one is greater than the other for a given exercise regimen, but I'd be fairly confident that fat reduces faster than muscle increases.

Why is increasing weight through adding muscle problematic? If at the same time the % of body fat reduces then this has to be good doesn't it?

It seems to me that changing body composition is much more important than pure weight loss. A greater % of muscle mass means better insulin sensitivity and a reduction in blood sugar level.

I'm very wary of losing muscle mass to lower my weight in order to reduce my blood sugar level and becoming frail as a result.

 

[jpscloud]

Our bodies store fat as insurance against starvation - and we are (when healthy) perfectly adapted to use that fat as fuel for everything, including muscle energy, without "eating" muscle. In metabolic disease (type 2 diabetes specifically), our bodies have become unable to use the stored fat and continually adding fructose in the form of table sugar and added to foods keeps insulin levels high and that stored fat unavailable.

Reducing carbohydrates and cutting out fructose - and in some cases, fasting - is the way to use the fat stores and change your body composition if you keep it up (that's the hard bit for me).

Edit: Some exercise is good of course, but it's not the only or even best way to address fat stores in someone who is metabolically unwell.

 

[SimonP78]

Why is increasing weight through adding muscle problematic? If at the same time the % of body fat reduces then this has to be good doesn't it?

It seems to me that changing body composition is much more important than pure weight loss. A greater % of muscle mass means better insulin sensitivity and a reduction in blood sugar level.

I'm very wary of losing muscle mass to lower my weight in order to reduce my blood sugar level and becoming frail as a result.

I saw the comment about losing weight, and presumed this was in that context, indeed no harm in putting weight on though additional muscle.

 

[AndBreathe]

You will preferentially use fat though rather than muscle if you eat fewer calories than you are using, and exercise will also add muscle mass as well as burning more fat - so the latter is potentially a problem if it increases your overall weight, however, I don't know what the rates of change of fat (downwards) and muscle (upwards) are when exercising and whether one is greater than the other for a given exercise regimen, but I'd be fairly confident that fat reduces faster than muscle increases.

If the deficit is sufficient, our bodies will eat muscle in preferences to the harder to metabolise fat. This is what can happen to those with eating disorders.

 

[SimonP78]

Is this to do with how hard it is to metabolise? I'm not sure it is as fat metabolism occurs all the time in most people.

My understanding was that it is to do with the requirement for glucose by some tissues (while others can function using ketones derived from fat/triglyceride breakdown) and the inability of the body to convert triglycerides into glucose, which results in muscular protein breakdown (which can eventually be converted to glucose).

In addition, presumably there is an ongoing requirement for amino-acids which can be produced from protein (muscle breakdown) but not from triglycerides/fat.

Not my area of expertise though, so I am happy to stand corrected.

 

[AndBreathe]

Is this to do with how hard it is to metabolise? I'm not sure it is as fat metabolism occurs all the time in most people.

My understanding was that it is to do with the requirement for glucose by some tissues (while others can function using ketones derived from fat/triglyceride breakdown) and the inability of the body to convert triglycerides into glucose, which results in muscular protein breakdown (which can eventually be converted to glucose).

In addition, presumably there is an ongoing requirement for amino-acids which can be produced from protein (muscle breakdown) but not from triglycerides/fat.

Not my area of expertise though, so I am happy to stand corrected.

I’m talking pur own bodies muscle and fat.

In a starvation scenario, our bodies can metabolise our own muscle. It can happen to anorexics, depending where they are in their starvation. That becomes about survival, not health.

 

[KennyA]

There seems to be little discussion of body composition and distribution. the focus seems to be primarily on losing weight, not reducing fat and gaining muscle.

I know from a DEXA scan my body fat % and it's distribution. If I were to shed weight it's probably going to be more muscle than I'd like lose and it's very difficult at age 66 to increase muscle mass. Losing muscle mass will have a detrimental effect on blood glucose levels and insulin sensitivity, not good.

I'm the same age as you and have noticed the same sort of thing. Before I restarted exercise about two years ago I was losing around 5kg every six months, and have lost a total of around 30kg. Fat is still disappearing, but my weight isn't changing (much). I put this down to exercise - while I'm reacquiring muscle this means my weight is not dropping. I don't see this as a problem.

I am totally unconcerned about my actual weight (although it's what's used for BMI calculations, unfortunately) as long as I'm still using bodyfat.

Incidentally, I have had the experience (when younger and fitter) of doing one of those health circus things - one stand tells you that you have the lowest bodyfat percentage recorded that day, hurray, and the very next stand tells you that you're obese solely on the basis of bodyweight and height rather than amount of fat.

 

[Roy Batty]

My original post was really about how the focus is on losing weight and how that might not always be the best and most appropriate course of action. Losing fat and increasing muscle might be better co-existent objectives.

My body fat % is in the range that's often labelled as athletic, and my FFMI is 21.7. It's not as if I'm carrying a lot of fat and any further weight reduction may reduce my muscle mass and decrease my FFMI.

That isn't desirable as decreased muscle mass has an inverse effect on insulin sensitivity. If insulin sensitivity is reduced then won't that negatively affect my blood glucose level?

There's also the increased frailty that's a function of muscle mass and age. I could reduce my weight, lose muscle mass and become frail in order to reduce blood sugar. I don't know if that's an acceptable trade off.

 

[Roy Batty]

In an ideal world, I agree with you, however, in the early days of messaging about T2, simplicity is important.

Personally, I find it more comfortable that those carrying spare poundage at diagnosis be told to trim up than to eat lots of carby stuff, or to join a gym. Even many on here who enjoy exercise in one form or another might not have been so enthusiastic at the outset.

How many folks do we see who immediately discount exercise because they have bad knees, hips, or other stuff going on. There is also the misconception that exercise immediately means playing footie, running marathon or pumping iron, rather than parking a bit further from the supermarket entrance or getting off the bus a stop earlier than usual.

Choosing early messaging is important.

As a matter of interest, where did you have your body composition DEXA done? I know of one, but haven't managed to swing going on it yet. My interstitial, and major organ fat was measured as part of a research project, but on a day to day basis, I keep an eye on my score on my Omron Body Comp scales. Not incredibly sophisticated, but seems consistent for me.

I had a DEXA scan with Bodyscan UK in London. It was pretty expensive, but worth it as I value my health and well being.

 

[KennyA]

My original post was really about how the focus is on losing weight and how that might not always be the best and most appropriate course of action. Losing fat and increasing muscle might be better co-existent objectives.

My body fat % is in the range that's often labelled as athletic, and my FFMI is 21.7. It's not as if I'm carrying a lot of fat and any further weight reduction may reduce my muscle mass and decrease my FFMI.

That isn't desirable as decreased muscle mass has an inverse effect on insulin sensitivity. If insulin sensitivity is reduced then won't that negatively affect my blood glucose level?

There's also the increased frailty that's a function of muscle mass and age. I could reduce my weight, lose muscle mass and become frail in order to reduce blood sugar. I don't know if that's an acceptable trade off.

Although most things you'll read talk about "losing weight" I think they really mean "losing fat". But nobody much wants to mention "fat" these days.

I don't see that losing muscle mass of itself would reduce blood sugar levels - probably the opposite. I'd normalised my blood sugars (to an A1c of 36 in four months) long before I lost a significant amount of fat (and weight). If you run down your glucose stores and don't top them up (by not eating much carb) there's no excess glucose around to be converted to fat, and the body will itself start to use up its own fat.