THE SKINNY ON BROWN FAT AND ELIMINATING OBESITY
Weight loss is one of the top New Year’s resolutions. Say the word “fat” and you may think of the bodily kind—what happens when you torpedo too many tacos or cozy up on the couch too often. Or you may think of the nutritional kinds—saturated, unsaturated, and all of the foods that contain them. In any case, the word often triggers strong emotions, because of the societal and medical struggle associated with being overweight or obese. But like many words, “fat” doesn’t just have to be a word that you associate with a quadrupledecker cheeseburger. In fact, “fat”—a very specific kind—may be one of the keys that can help us live longer and live “younger.” Brown fat (no, that’s not fat that comes when you eat too much milk chocolate) is one of the primary areas being explored as a path to increased longevity and youthfulness.
LIVE YOUNGER: THE BIGGEST TREND IN HEALTH AND MEDICINE
Perhaps the ultimate health question is this: How can you live longer without experiencing the symptoms of “old age”? That is, can you live long—without disability or frailty, without losing our knees, our eyes, our minds, our hearts, and our everything else? Can we stay young for a long, long time?
THE OBESITY ISSUE OF TODAY
You undoubtedly know of the trend to obesity and its metabolic consequences: In the US in 1960, only 11% of adult men were obese. Today, it’s 43%. Among adult women, the obesity rate rose from 17% to 54%. And among children ages 2 through 19, it’s up from 3% to 19%.
In addition, the inflammation of this increased amount of visceral, or belly, fat causes all kinds of problems:
- Exacerbates depression, stress, fatigue, and osteoarthritis
- Reduces the ability of the body to repair itself when damaged
- Increases the risk of type 2 diabetes, heart disease, dementia, and non-alcoholic fatty liver disease
- Is a major cause of six cancers, including breast and colon
Unless you’re a sumo champ or an offensive lineman (and even then, it can get you!), it’s safe to assume that fat in your viscera (belly) is bad.
But the wellness-longevity industry is leading a fight against this trend. No, I am not referring to GLP-1 plus medications that seem to need be taken forever like semaglutide (Ozempic) and tirzepatide (Monjaro), which are still major breakthroughs. I’m talking about induced tissue reprogramming and other means to eliminate obesity by activating brown fat from white fat.
HERE’S HOW IT WORKS
Before efficient central heating, humans utilized internal thermoregulatory mechanisms to generate warmth in cooler nighttime and seasonal temperatures. These mechanisms include brown/ beige fat cells that burn stored fat to raise body temperature and remove excess food energy.
That worked back before we had easy access to high-energy, hyperpalatable, calorically dense foods. Calorically dense food had been limited to harvest times when genome-based preferences for sweet-tasting foods encouraged pre-winter feasting and fat accumulation. Due to food preparation and limited storage capabilities, eating usually happened in discrete meals during daylight hours.
Humans experienced occasional prolonged periods of enforced calorie restriction. If extended for too long, starvation degrades health and may even cause death. Sublethal starvation, however, activates metabolic pathways that enable beneficial genetic maintenance and repair systems.
But not all fat is created equal. Most people picture white fat—the white-yellow kind under the skin. But you’re also born with brown fat (which, unsurprisingly, looks brown). Brown fat—found in the neck and shoulders of newborns—has an increased density of mitochondria (that’s what makes it brown) and is metabolically efficient in that it burns lots of calories, which serves the purpose of keeping you warm (important for newborns).
We lose brown fat as we age. By age six, you have less than 5% of the brown fat you were born with; the fat we gain over time is almost all white fat. White fat is metabolically inefficient, which means it’s relatively inactive and doesn’t use much energy. In addition, it is hard to burn off and it accumulates, causing those other health problems like inflammation we refer to above.
So the bottom line: If we have more brown fat, we can burn off the damaging white fat.
SO HOW WILL WE DO IT?
This is where the “breakthrough” part comes in. We know the potential of brown fat, but the questions are: How do we get it, how do we activate it, how do we get it to work to eliminate the white fat so we can live younger and healthier?
Some options:
PLURIPOTENT CELL TRANSFORMATION
Pluripotent fat cells can turn into white adipose tissue (WAT) and/ or brown adipose tissue (BAT). BAT uses fat and sugar to produce heat, while white adipose tissue produces metabolic problems including type 2 diabetes, insulin resistance, heart disease, stroke, cancer, and dementia. BAT cells are relatively abundant in infants, who cannot shiver and must utilize uncoupling thermogenesis to control body temperature. Adults tend to lose BAT as they age.
It was assumed that reduced thermogenesis was inevitable due to age-related loss of BAT cells. But in 2015, researchers induced pluripotent stem cells (iPSCs) and turned them into induced brown adipocytes (iBAs) by transducing a gene, using a virus vector. The resultant cells produced proteins typically found in BAT. The iBAs also showed remarkably high levels of oxygen consumption, characteristic of BAT thermogenesis, and obesity reduction. So if researchers can take white fat, regress it to a more pluripotent fat, flip a few epigenetic switches and—voilà!—turn it into brown fat, then they could inject the brown fat into the original owner. Those with more brown fat would be expected to get thin and lose metabolic dysfunctions, including diabetes and body-wide inflammatory diseases. This has now been done in three animal species (personal reports) and we understand is moving into human trials.
COLD THERAPY
Brown adipose tissue can be recruited, expanded, and activated by exposure to cold (cryotherapy). Though there is no accepted cold exposure protocol to activate brown fat, Susanna Søberg developed recommendations for increasing BAT mass activation with the least discomfort. As presented in Winter Swimming: The Nordic Way Towards a Healthier and Happier Life, she concludes:
A minimum of 11 minutes per week of water exposure below 60 degrees Fahrenheit produces browning and activates thermogenesis and its benefits.
Those 11 minutes can be separated into different sessions
Allowing the body to warm naturally after a cold session is preferable to using a sauna or hot water.
Stanford University neurologist Andrew Huberman formulated guidelines for using deliberate cold exposure to increase metabolic rate. In Huberman’s published lectures, he emphasizes that the conditions needed to provoke brown fat activation are highly individual and may change over time, even within a single day, due to circadian rhythms. He describes effective cold exposure as an uncomfortable state of cold that causes one to feel a strong urge to end the experience but can be continued safely.
He suggests the following in order of effectiveness:
- “Cold water immersion up to the neck with feet and hands submerged” is the most effective, due to water’s heat transfer properties. Craig Heller, the Stanford University sleep and temperature researcher, suggests that slow movement of the limbs should occur in cold baths to prevent formation of a thermal barrier of warmer water around the body. (“Dr. Craig Heller: Using Temperature for Performance, Brain & Body Health”, Huberman Lab Podcast, Episode 40.)
- Cold showers. Taking cold showers long enough to lower core body temperature will provoke noradrenaline release, which is known to activate UCP1, BAT thermogenesis, and browning. Experiencing elevated heart rate increases in response to cold is a sign of sufficient cold. (“Using Deliberate Cold Exposure for Health and Performance”, Huberman Lab Podcast, Episode 66.)
- Exposure to colder outdoor temperatures with minimal clothing. These techniques are effective when they result in a state of shivering or near shivering. However, cold water can be hazardous, especially for those unaccustomed to lower temperatures. Expect to hyperventilate when first experiencing cold water immersion and acclimatise with very short intervals at first and then slowly increase, and only after your physician/practitioner agrees, can you go longer.
Other Methods:
The most effective cryotherapies involve significant discomfort and time. For this reason, efforts are being made to identify alternatives for activating brown/brite fat cells.
Fasting: Fasting increases BAT, WAT browning, and thermogenesis. The primary reason is “competition between energy conservation to survive long periods of fasting and the metabolic need of NST (non-shivering thermogenesis) to maintain body temperature.” (Reinisch et al., “Regulation of thermogenic adipocytes during fasting and cold”, Molecular and Cellular Endocrinology, 2020.)
This suggests that longer extended fasting (EF) or fasting mimicking diet (FMD)—windows of calorie restriction—increases thermogenesis in humans, but we couldn’t find studies that provide evidence. However, the metabolic benefits of EF and FMD are well-documented and healthy metabolic and mitochondrial function are associated with higher levels of thermogenesis. (Source: GAR Co Reboot Review and Recap 005- 001 Extended Fasting and FMD and GAR Co Reboot Review and Recap 001-004 Intermittent Fasting to Make a Substantial
(We also have a story about how to get you started with Intermittent Fasting)
While science will show incredible advances when it comes to extending and improving life, the fact is that we can’t rely on everyone else to do the work. Over the following decades, you may have dozens of decisions about how to care for your body, but that decision-making should start now. That is self engineering.
The real question is: Will you prepare to be younger longer, and how will you change today? We believe that in all probability, the Great Age Reboot means that no matter what your current age in the next 10 years, you can live longer and healthier. Your “old” years will feel young.
(Extract from Global Wellness Summit: 12 Wellness Trends for 2023)
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