Friday, August 14, 2009

Brown Fat: New Improved Single Factor Thinking

Let me predict it here first, folks: Brown Fat will be the Next Big Thing in the Drive for a Single Factor Big Pill Solution to Obesity.

Put "brown fat" into google today and you'll see all sorts of clever people and magazines referencing this new study on how "brown fat" (used a lot for generating body heat in mamals and neonatals) can be used to help burn the evil "white fat" - our abundant adipose tissue.

Yes evil, says the article, in contrast to the "good fat" story from early last week i was telling. The article commences powerfully:
IN THE war on our waistlines, fat is the enemy. It is fat, or adipose tissue, that gives us our beer bellies and our love handles, our man boobs and our muffin tops. And when plastic surgeons sculpt people into slenderness, it is fat tissue they suck up and throw out with the clinical waste.

Electron micrographs of brown fat cells reveal one of their hallmarks: an extraordinary number of mitochondria, which, as described below, are involved in heat generation.
The mitochonria are typically round, with cristae across their entire width.

My favorite quote by one of the researchers from this story exemplifies single factor thinking:

"I exercise on an elliptical trainer and it's pretty hard for me to burn up 500 calories," says Ronald Kahn, head of obesity research at Harvard Medical School's Joslin Diabetes Center. "If I could do it without working and do it every day, it would be pretty great."
Wow, where to begin here? Nigh on 20 years back there was a furor that was kicked off with Matel's "Math is hard" Barbie. What that was saying to kids - young girls especially?

Here, we have a head of a medical group, reminiscent of Barbie, saying gee, working out every day is hard; wouldn't it be great if i had a pill to lose weight for me?"

THis is the height of medical research? Wouldn't it be great to have a pill? Maybe that is the height of medical research: it's not about health, well being, quality of life, but about how far can we push this single thing for that effect.

If medicine were about well being perhaps the kinds of questions it would ask would be What are the issues around such weight gain? how does behaviour (neurology) interact with physical being (physiology)? what's the forensic differences between the Lean minority and the increasingly Fat majority? whether lean or fat what are the complex beneficial interactions of eating and movement and rest/sleep on a whole range of homeostatic factors that impact well being? do they have even greater impact on any level for those who are obese? doing things like improving insulin sensitivity, bone mineral density, cardio vascular fitness, ant-aging, balance, vision, awareness, focus? Knowing these complex interplays of systems to create a myriad of positive effects, is another drug or surgical intervention a good idea?

No? so what's on offer? A pill? and if not a pill how about an invasive procedure?
Researchers are experimenting with various ways to increase the amount or activity of our brown fat, either pharmaceutically or even surgically, by extracting ordinary white fat through liposuction, transforming it into brown fat and re-implanting it. A mere 50 grams of brown fat - well within the range of what some of us already have - could dissipate around 500 calories a day
and why is this single factor thinking?

It's single factor thinking because it gets excited about saying "gee, if we could just tweak this one thing, wouldn't that be great if life were that simple...ok there may be side effects but look at that fat go...ok maybe nothing's happening with bone mineral density or strength, but look at that fat go." And some side effects like anti-anti-aging, are acknowledged:

Manipulating brown fat, whether by drugs or surgery, may not be risk-free, however. By increasing energy expenditure you generate a high-flux metabolic state, points out Celi. This could increase our exposure to potentially harmful free radicals generated by the metabolism, which could conceivably cause cancer or even hasten ageing.
But what if there's a reason that we have fewer brown fat cells as we age; maybe it helps us age better?

Enthusiasm for the potential is unquenched. Here's another quote from the same article:

Nedergaard believes the focus should be on preventing the decline in brown fat as people get older. "Most obesity appears in middle age and onwards, and this is when it seems brown fat activity starts to disappear," he says. It might be possible to identify the cause of this decline and then reverse it, perhaps by replacing a lost hormone. What this hormone might be, though, remains a mystery.

Right, well is that statement true? Increasingly, most obesity appears now in kids. The rate is growing almost exponentially, right? (remember the piece a few weeks about about resistance workouts and obese kids - and how they lost no adipose tissue?) and kids apparently have way more brown fat cells than middle age folks apparently. So, maybe obesity isn't age related, or about just brown fat cell ratios.

You know this may be exciting science and the source of many future publications and god knows how many dead rats in the process of Losing Weight, but it feels (a) arrogant and (b) taking the easy way out.

By analogy in Europe, there's laws against the sale of foods produced from GMO - genetically modified crops. Many farmers and People generally don't trust scientific manipulations in the food supply at such a vast level messing with what is perceived as Nature. There's concern that Something could go Horribly Wrong. To allude to another ancient trope for margarine commercials "It's not nice to fool Mother Nature"

Likewise the arrogance here is that we can find a Single Solution that will work in a Complex System (like us) and not think there'll be significant consequences. The taking the easy way out feels just ignorant. And in no small part disrespectful. We are complex organisms. Worse, we have psychologically reinforced habits wired up to physiological, homeostatically defined responses: we have behaviours wired into us for a non-fuel-abundant environment. And now we have abundant access to personal fuel. No wonder we're getting fatter.

Saying that, i'll say it again, it takes work and skills and practice and support to know how to change habits, to keep them changed and, initially, work against what are bodies are telling us to do: eat! The formula might be easy: eat less/move more, but the implementation is not simple, and sure as heck isn't saying gee let's just change this biological function. I bet that will be great! i won't have to work out. And we'll make lots of money to help other people not have to learn how to cook and move and learn habits of lean eating.

That sound cynical? Afterall these scientists are keen; they want to help solve an epidemic. And at least one of them is motivated to get off the eliptical. And i say Good For You - get off the elliptical and get something healthy like a kettlebell or a water rower.

But that's not what this anti exercise head of a diabetes research group is thinking - at least not as portrayed in this article. He thinks swap activity for pill. One Single Thing (workout: hard) for some Other Single Thing (pill: easy).

But we know that exercise is not a Single Thing - depending on how hard, how long, how frequently etc etc there are all sorts of effects going on inside that are good for us, hitting an abundance of systems: visual, vestibular, proprioceptive, mechanical, chemical, biological.

By comparison what does taking a pill do? We go from rich multi-factor interactions when we move to a far narrower set of internal interactions in ingesting a pill. And this from someone who should Know Better, don't you think?

Thanks to Xafier for pointing out this article to me,
and let me cite Eric Cobb again for framing the notion of single factor thinking, covered in the 9S:sustenance cert.

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