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Deep Compartment, Deep Trouble
The two things that really put you at risk for not just covid but practically every other large contributor to mortality are age and obesity. One of these we have no control over and the other is so difficult that even bothering to argue for it is considered a waste of time. The fat in our body plays a vital and important physiologic role, it acts like a highway of interconnected tissue allowing hormones to be distributed widely. A diet plentiful in calories but insufficient in fat will still lead to starvation. It is essential to our survival and demonization or idolization by popular diets both miss the bigger picture. Excess fat leads not only to a bigger waistline and higher scale readings but the growth of an organ that will now work against you as opposed to for you.
Excess obesity is associated with a wide variety of negative downstream endocrine issues. Insulin resistance is the first step down the long rabbit hole of hormonal dysregulation. As your body’s insulin becomes less effective your insulin levels will rise to compensate. Growth hormone production will be decreased and its metabolism increased resulting in lower circulating levels of growth hormone which is vital to muscle synthesis and exercise capacity. The hypothalamic pituitary adrenal axis regulates your production of the stress hormone cortisol and the entire system is over-responsive in obese patients. In males, testosterone, sexual hormone binding globulin, and gonadotropin releasing hormone are all decreased. In females, testosterone will be increased and this combined with insulin resistance can lead to polycystic ovary syndrome.
Your adipose tissue produces chemicals known as adipokines, dysfunctional secretion of which has been associated with obesity. The authors of a recent study identified some of these adipokines that appear to be altered during covid infection. Adiponectin is one that is associated with anti-inflammatory and anti-diabetic properties and despite being a cytokine secreted from fat cells it is lower in obese patients. Compared to other ICU control patients those with covid ARDS showed a 50% reduction in adiponectin. Animal studies have also shown a decrease in adiponectin during infection. Adipsin which is known to promote insulin secretion and beta cell survival was also lower in the covid ICU patients compared to controls. Loss of these beneficial cytokines is likely aggravating the immune response and worsening insulin resistance. The researchers would go even further and be the first to prove the virus could infect our adipose tissue itself and suggest it likely drives dysfunction that contributes to hyperglycemia.
While obesity and hyperglycemia have been clearly associated with worse outcomes this recent evidence suggests possible mechanisms behind this correlation. If the virus is able to sequester itself in our adipose tissue that could explain some of the lingering effects from infection. Our adipose tissue could be acting as a deep compartment filling up with virus particles during infection to be slowly released later. The problem with deep compartments is at some point they may get filled up and when that happens you are in deep trouble. Obesity’s role in the pandemic has been obvious all along and it should infer that weight loss would be the primary preventative treatment for covid.
Despite all this evidence the most obvious answer to blunting the pandemic’s deadly impact goes ignored and unmentioned. Far less effective things like mask mandates and social distancing have been strongly encouraged to say the least and outright harmful things like lockdowns have been prescribed from on high as the solution to the pandemic. Some areas have created and enforced a two-tiered society to separate the vaccinated from the unvaccinated which is evil but also clearly ineffective. First, it is very difficult to prove who is actually “fully vaccinated” not just because what that term means will evolve almost as fast as the virus itself but what is your proof? That piece of paper anyone could print at home? Unless they are short of breath or complaining of chest pain it can be hard to tell by looking at someone if they are vaccinated or not. Forcing us to rely on some dystopian vaccine passport or electronic version thereof seems unlikely, I can’t even get people to fill out their booster paperwork online.
So where is the weight loss mandate? How can something so simple, easy, and free be so completely ignored? It would also be incredibly easy to enforce, no paperwork needed, it is quite easy to tell who is in violation. I don’t like the idea of lockdowns or mandates but if you have already gone that far why is throwing a Peloton in the package anymore absurd. If a failure to vaccinate makes you a threat to public health, then that same argument certainly applies to obesity. It is very curious that medical tyranny over your body stops so completely at fat-shaming. As for your age and what we can do about it, well the 1976 sci-fi classic Logan’s Run is worth a watch for its unique approach to elder care.
Jacob Hyatt Pharm D.
Father of three, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
https://substack.com/discover/pharmacoconuts
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Further Reading and References
Kokkoris P, Pi-Sunyer FX. Obesity and endocrine disease. Endocrinol Metab Clin North Am. 2003 Dec;32(4):895-914. doi: 10.1016/s0889-8529(03)00078-1. PMID: 14711067.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443335/
Reiterer M, Rajan M, Gómez-Banoy N, Lau JD, Gomez-Escobar LG, Ma L, Gilani A, Alvarez-Mulett S, Sholle ET, Chandar V, Bram Y, Hoffman K, Bhardwaj P, Piloco P, Rubio-Navarro A, Uhl S, Carrau L, Houhgton S, Redmond D, Shukla AP, Goyal P, Brown KA, tenOever BR, Alonso LC, Schwartz RE, Schenck EJ, Safford MM, Lo JC. Hyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2. Cell Metab. 2021 Nov 2;33(11):2174-2188.e5. doi: 10.1016/j.cmet.2021.09.009. Epub 2021 Sep 16. Erratum in: Cell Metab. 2021 Dec 7;33(12):2484. PMID: 34599884; PMCID: PMC8443335.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447553/
Cordeiro A, Ribamar A, Ramalho A. Adipose tissue dysfunction and MAFLD in obesity on the scene of COVID-19. Clin Res Hepatol Gastroenterol. 2021 Sep 17;46(3):101807. doi: 10.1016/j.clinre.2021.101807. Epub ahead of print. PMID: 34543756; PMCID: PMC8447553.
https://pubmed.ncbi.nlm.nih.gov/34899613/
Mohajer N, Du CY, Checkcinco C, Blumberg B. Obesogens: How They Are Identified and Molecular Mechanisms Underlying Their Action. Front Endocrinol (Lausanne). 2021 Nov 25;12:780888. doi: 10.3389/fendo.2021.780888. PMID: 34899613; PMCID: PMC8655100.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607179/
Mahrooz A. Insulin resistance as a common clinical feature in diabetes mellitus, obesity, hypertension, dyslipidemia, and atherosclerosis deserves more attention in COVID-19. J Res Med Sci. 2021;26:98. Published 2021 Oct 18. doi:10.4103/jrms.JRMS_1063_20
Published in Healthcare
I remember being taught it as a kid. It was obviously bogus, a milestone on my road to distrust of the Feral gov’t.
My complaint with the food pyramid and the FDA-recommended food intake guidelines is that both neglect fiber.
For one thing, the FDA combines the two fibers–soluble and insoluble–which is wrong because they are two entirely different substances that play entirely different roles in human health. The amounts cited are way too high and impossible to consume every day. They are simply unrealistic and laughable. So no one pays any attention to them. It’s useless information.
We need to look at food as what the body can process effectively. If we looked at our daily diet as a matter of how to eliminate whatever we are not using each day, we would eat very differently from the way we do.