Also known as meta-inflammation (from “metabolic-triggered inflammation”) or chronic background inflammation associated with obesity, lipoinflammation refers to the low-grade inflammation that arises in adipose (fat) tissue as it increases in volume, i.e. as a person gains weight. This has negative consequences for the body.
Why does lipoinflammation arise?
Increased cell size
As a person puts on weight due to fat accumulation, the adipocytes (fat cells) must store this fat. They can do this either by increasing in size or by increasing in number. In the human body both processes take place. When cells get too large, the cell membrane becomes tense, like blowing up a balloon. This tension causes stress, which leads to the onset of inflammation; it also makes the cell more delicate, making it more likely to rupture, which will further increase the inflammatory reaction.
Some fat stores, such as the subcutaneous fat, have the ability to increase the number of fat cells, making inflammation less likely. Other stores, however, are prone to store excess fat by increasing cell size; this is particularly true of the intra-abdominal fat around the organs. This increases the likelihood of inflammation, which will start to cause harmful effects around the body. You will probably have heard doctors saying that it is your abdominal fat that is most dangerous – here you have one of the reasons why that is the case.
Insufficient blood supply
Another factor is that the increasing volume of adipose tissue can lead to areas with insufficient blood supply, meaning that not all cells receive the oxygen they need. This will cause some cells to die, further increasing the inflammatory reaction.
Lipoinflammation is believed to be closely related to diet-induced inflammatory changes in the bowel wall, very likely associated with alterations in the intestinal microbiota. This is an extensive topic and one I shall return to in another article.
What changes does lipoinflammation provoke in the body?
Acute inflammatory reactions are essential to heal our body when something is wrong – a cut, a fracture, an infection. Acute inflammation is necessary for the body to fight foreign organisms and repair damaged tissue. But the reaction must then be switched off. If that doesn’t occur, we get what is called a chronic inflammatory reaction, with many negative consequences:
- Lipoinflammation is associated with changes in the way the body handles carbohydrates and fats, causing us to store more fat. As the stores fill up, some fat starts to accumulate in tissues not normally meant to hold fat: muscle, liver, pancreas. Fat stored in tissues where it should not normally be present is harmful. In the muscle, liver and pancreas, it can lead to insulin resistance and decreased insulin secretion. Insulin is the hormone that controls the concentration of sugar in the blood. When it does not work properly, blood sugar levels can rise, causing type 2 diabetes.
- Lipoinflammation alters the secretion or activity of hormones that control our desire to eat, leading to increased appetite and decreased satiety. This provokes a vicious circle, in which increased weight leads to an increased food intake.
- Dyslipidaemia develops. This is an alteration of the fats in the blood, with elevated triglycerides and low HDL-cholesterol, recognised as a pattern associated with atherosclerosis and heart disease.
- Increased oxidative stress. The metabolism of fats through alternative pathways increases the production of highly reactive oxidative substances that can damage many structures within cells, including our DNA, increasing the risk of cancerous changes.
The intensity of these changes will develop depends on many factors: weight, diet, lifestyle, and genetic and epigenetic factors.
The consequences are that obesity is self-perpetuating and there is a significant increase in the risk of chronic diseases:
- Type 2 diabetes
- Heart disease
- High blood pressure
- Non-alcoholic fatty liver disease
- Degenerative joint disease
How can we treat lipoinflammation?
Two actions are central to reducing lipoinflammation:
- Reduce the stimulus (lose weight)
- Turn off the inflammation already present
Returning to a healthy weight will remove the stimulus to inflammation by reducing the size of the fat cells and decreasing the volume of the adipose tissue so that oxygen can reach all areas. Obviously, the sooner this occurs the better. Rapid weight loss is therefore beneficial, but the weigh that it must be fat, not fluid or muscle. PronoKal is designed so that weight loss is almost all fat and is rapid (in clinical trials, the average loss in the first month was 9 kg, of which over 90% was fat).
When weight is lost, inflammation will decrease to a certain degree. However, it will not resolve unless we actively do something to turn it off. Docosahexaenoic acid (DHA), one of the omega-3 fatty acids present in oils from fish and certain algae, is known to be a source of the anti-inflammatory molecules in the body. PronoKal has developed a unique, patented ingredient, Protein-DHA®, which, in combination with specific omega-3 supplementation, has been shown in clinical trials to provide molecules used by the immune system to switch off inflammation; it thus favours the resolution of chronic inflammation.
What effects will the resolution of lipoinflammation have?
Resolving inflammation will break the vicious circle that increases your appetite and reduces satiety. This will help you achieve and maintain a healthy weight. Apart from the great feeling and the boost to self-esteem that comes from the accomplishment, other very important benefits are gained, in particular a reduction in the risk of chronic disease associated with obesity and an improvement in the symptoms of some diseases that may already have developed.