“I’ve been doing cardio level exercise for a month at the gym, and I just can’t lose this fat!”

Mrs. V. was frustrated that her aggressive exercise approach had failed to reduce her belly fat. We performed VO2 max testing on her and she truly had been working out at a heart rate that was high into the “cardio” zone for her.

This was great for her heart, but the intensity of her exercise was not allowing proper oxygenation of her skeletal muscles to burn fat.

After the test, I explained that she needed to work out at a lower heart rate, which for her was a heart rate of 80 to100 beats per minute. I showed her on the diagram from her test how her consumption of oxygen increased as her heart rate increased, but only to a certain point. This point is the volume of maximum oxygen consumption (VO2 max), which was at a heart rate of 161 beats per minute for her. I then drew her attention to how her consumption of oxygen stays the same even as her heart rate increases. “Fat burning” zone heart rate was 62% of her “cardiorespiratory” zone heart rate. At the cardiorespiratory heart rate, muscle will contract without the oxygen (as it uses only glucose for fuel) and the fat does not get burned.

I praised her for her consistency in exercise, as she will be rewarded by her muscles for this. When people exercise consistently, their muscles create myoglyobin, a protein molecule that sucks oxygen out of the blood and into the muscle to use to burn fat.


I referred her to page 215 in Chapter 9 Energy, of The Metabolic Makeover: It’s All About Energy by Stephen Cherniske and Natalie Kather, MD

You are what you eat… sort of, AKA How a muffin becomes a “muffin-top.”

Muffin top - The Metabolic Makeover

It starts as a muffin. You chose it, thinking that somehow it must be healthy, after all isn’t it better than a donut? Not really. You break a piece of the top off and slip it into your warm moist mouth where the taste buds respond with glee. The amylase secreted by your saliva glands quickly transform that morsel into a rush of glucose that surges into your blood stream.  Blood sugar levels rapidly rise even before the mushy morsel mixture enters your stomach. Insulin climbs and your vessels twinge from the stress related to the increased effects of the glucose and insulin.

Your genome takes a quick assessment.

Genome: “Okay, Muscles ,we have a huge load of glucose coming in. Are you ready to burn this up into with a lot of movement, like a good 10 mile run?”

Muscles: “What? Yawn! I’ve been relaxing all week. I doubt there’s a 10 mile run planned for today.”

Genome: “Liver, help me out here. This glucose is NOT going to get used. I need you to make it storable.”

Liver: “Well I’ve been converting the excess glucose into fat and sending it to the fat cells above the hips. “

So this is how your muffin becomes the dreaded fashion faux pas “muffin top” waist bulge.

Refer to Page 132 of The Metabolic Makeover: It’s All About Energy by Stephen Cherniske and Natalie Kather, MD to learn more about the process of how foods are broken down from complex forms into very simple forms, then reassembled into the beings we are.

But the story does not end with having a “muffin top” of waist fat.

That irritation to the blood vessels by the glucose and insulin has a cumulative effect that results in a clear increase for cardiovascular  disease. If you find yourself suffering from chest pains, shortness of breath, heart palpitations, heart pounding while resting or fuzzy thinking, any one or more of these symptoms could be related to your intake of muffins, breads, pasta, potatoes, white rice, flour and sugar.

So put that muffin back- unless you are about to run 10 miles and burn those sugars into movement- and instead choose colorful organic vegetables and protein. And MOVE!



Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults ONLINE FIRST

Quanhe Yang, PhD; Zefeng Zhang, MD, PhD; Edward W. Gregg, PhD; W. Dana Flanders, MD, ScD; Robert Merritt, MA; Frank B. Hu, MD, PhD

JAMA Intern Med. Published online February 03, 2014. doi:10.1001/jamainternmed.2013.13563

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