Tag: VO2 Max

GLP-1 receptor agonists, such as semaglutide or tirzepatide (brand names like Wegovy, Ozempic, and Mounjaro), have become game-changers in the treatment of Type II diabetes and obesity, helping individuals lose weight and control blood sugar. However, the true power of these medications is unlocked when combined with essential lifestyle changes. To ensure lasting success, individuals using GLP-1 medications must focus on reducing organ fat and improving muscle mass. Monitoring progression with reliable metrics like BMR scales, DEXA scans, and VO2 Max tests may be helpful for individuals on GLP1 medications. These holistic changes can not only enhance the medication’s effectiveness but also improve overall longevity and metabolic health.

Understanding the Link Between Organ Fat and Longevity

Not all fat is created equal. Organ fat, also known as visceral fat, is stored deep within the abdomen and surrounds vital organs like the liver, pancreas, and intestines. Unlike subcutaneous fat, which is stored beneath the skin, visceral fat is metabolically active and has profound negative health implications.

Visceral fat increases the risk of insulin resistance, Type II diabetes, cardiovascular diseases, and even certain cancers. According to Harvard Medical School, visceral fat triggers chronic inflammation in the body, which contributes to atherosclerosis (the hardening of the arteries), significantly increasing the risk of heart disease and stroke. The National Institutes of Health (NIH) also found that people with higher levels of visceral fat have a 2.4-fold increase in mortality risk, regardless of their BMI. Yikes! Reducing visceral fat, therefore, is crucial for improving long-term health outcomes and promoting longevity.

How Organ Fat Develops: Pathophysiology and Risk Factors

Organ fat doesn’t accumulate overnight; it results from a combination of poor diet, inactivity, chronic stress, and hormonal imbalances. Here’s a breakdown of the pathophysiology behind visceral fat and the populations most at risk:

1. Insulin Resistance and Fat Storage: When cells become resistant to insulin, excess glucose is stored as fat, particularly around organs. Visceral fat can worsen insulin resistance, trapping people in a cycle of fat accumulation and poor glucose control.
2. Hormonal Imbalances: Elevated cortisol levels, caused by chronic stress, promote fat storage in the abdominal area. Additionally, as women enter menopause and estrogen levels decline, they are more prone to visceral fat accumulation. The same occurs in men with declining testosterone levels.
3. Inflammation and Cytokines: Visceral fat is metabolically active, releasing inflammatory cytokines that contribute to chronic inflammation and increased risk of cardiovascular disease. This inflammation is linked to metabolic dysfunction, further promoting visceral fat development.
4. Lipotoxicity: Excess visceral fat can spill over into organs like the liver and pancreas, impairing their function. Fatty liver disease is one example, leading to inflammation and scarring in the liver. Similarly, fat deposition in the pancreas can disrupt insulin production, exacerbating Type II diabetes.

Who Is at Risk?

Certain groups of people are at greater risk of developing unhealthy levels of visceral fat:

• Individuals with Insulin Resistance or Type II Diabetes: People with these conditions are predisposed to store excess fat around their organs. According to the Journal of Clinical Endocrinology & Metabolism, people with Type II diabetes tend to have significantly higher levels of visceral fat, regardless of their overall body weight.
• People with Obesity: While obesity is a known risk factor, even those with a normal BMI can carry excess visceral fat. Johns Hopkins Medicine notes that around 20% of people with a normal BMI are “metabolically obese normal weight” (MONW), meaning they have harmful levels of visceral fat despite appearing lean.
• Postmenopausal Women: Declining estrogen levels during menopause can shift fat storage to the abdomen, increasing visceral fat. Yale University research shows that postmenopausal women have significantly more visceral fat than premenopausal women, even when they weigh the same.
• Individuals Leading Sedentary Lifestyles: Lack of physical activity and strength training can lead to muscle loss and a slowed metabolism, both of which promote visceral fat accumulation. The CDC emphasizes that sedentary lifestyles, combined with poor diet, are primary drivers of obesity and visceral fat.
• Chronic Stress Sufferers: Chronic stress raises cortisol levels, which promotes abdominal fat storage. The CDC highlights that stress-induced weight gain typically appears in the form of increased visceral fat, especially for those predisposed to anxiety or depression.

Muscle-Resistant Exercise: A Key Tool for Reducing Organ Fat

One of the most effective ways to combat visceral fat is through muscle-resistant exercise, or strength training. Unlike cardio, which burns calories during the workout, resistance training builds lean muscle mass, which boosts metabolism and helps the body burn fat even at rest.

Yale University studies have shown that resistance training is particularly effective in reducing visceral fat compared to cardio alone. In fact, a study published in the Journal of Obesity found that a combination of strength training and cardio led to greater reductions in visceral fat than aerobic exercise alone.

Building muscle mass is critical for overall metabolic health, especially for individuals on GLP-1 medications. These drugs help reduce appetite and promote weight loss, but maintaining muscle mass through resistance exercise ensures that the body doesn’t lose vital muscle tissue while shedding fat.

Tracking Your Progress: BMR Scales, DEXA Scans, and VO2 Max

While weight loss is often measured by the scale, it’s essential to track other health metrics to gain a more complete picture of your health and fitness. Here are three tools that can help:

1. BMR Scales: Basal Metabolic Rate (BMR) is the number of calories your body needs at rest. Understanding your BMR allows you to fine-tune your calorie intake to support weight loss or maintenance. Resistance training, which increases muscle mass, also increases your BMR, helping you burn more calories even when you’re not active.
2. DEXA Scans: Dual-energy X-ray absorptiometry (DEXA) scans measure body composition, including the distribution of body fat and muscle. Unlike BMI, which only measures overall weight, DEXA scans can differentiate between visceral fat and subcutaneous fat. Monitoring your visceral fat through DEXA scans is one of the best ways to track your health improvement over time.
3. VO2 Max: This metric measures your body’s ability to use oxygen during exercise, and it’s an excellent indicator of cardiovascular fitness. A higher VO2 Max is associated with better overall health and longevity. The American Heart Association reports that increasing VO2 Max can reduce the risk of cardiovascular disease by up to 45%.

How to Incorporate Healthy Lifestyle Changes While on GLP-1 Medication

Although GLP-1 medications can help kickstart weight loss, lifestyle changes are key to sustaining those results and improving long-term health. Here’s how you can incorporate healthy habits into your routine:

1. Focus on Resistance Training: Engage in strength training 3-4 times per week to build lean muscle mass and reduce visceral fat. Resistance exercises, such as weightlifting or bodyweight exercises, should target all major muscle groups.
2. Incorporate Cardiovascular Exercise: In addition to strength training, aim for at least 150 minutes of moderate-intensity cardio per week, such as brisk walking, swimming, or cycling, to improve heart health and VO2 Max.
3. Adopt a Balanced Diet: While GLP-1 medications can reduce appetite, it’s crucial to nourish your body with nutrient-dense foods. A balanced diet rich in lean proteins, whole grains, fruits, vegetables, and healthy fats can reduce visceral fat and improve metabolic health.
4. Use Health Metrics to Track Progress: In addition to tracking weight, utilize BMR scales, DEXA scans, and VO2 Max tests to monitor improvements in body composition and cardiovascular health. Even a modest reduction in visceral fat can significantly improve health outcomes. The CDC notes that losing just 5-10% of your body weight can improve blood sugar, cholesterol, and blood pressure levels.
5. Manage Stress and Sleep: Chronic stress and poor sleep can elevate cortisol levels and promote visceral fat accumulation. Practice mindfulness, meditation, or yoga, and aim for 7-9 hours of sleep per night to manage stress and support overall health.

GLP-1 medications offer significant help in managing weight, but true health transformation occurs when they are paired with sustainable lifestyle changes. By reducing organ fat, building muscle mass, and monitoring key health metrics like BMR, DEXA, and VO2 Max, you can improve not only your weight but also your long-term health and longevity. Combining these lifestyle changes with the benefits of GLP-1 medications can help you achieve optimal health, reduce the risk of chronic diseases, and ultimately lead a longer, healthier life.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Heart Association. (2020). Understanding your VO2 max. Retrieved from https://www.heart.org/en/news/2020/03/03/understanding-your-vo2-max

Centers for Disease Control and Prevention. (2022). Adult obesity facts. Retrieved from https://www.cdc.gov/obesity/data/adult.html

Harvard T.H. Chan School of Public Health. (2022). The truth about visceral fat. Retrieved from https://www.hsph.harvard.edu/nutritionsource/visceral-fat/

Johns Hopkins Medicine. (2021). Visceral fat and heart disease. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/obesity/visceral-fat-and-heart-disease

Khera, R., Pandey, A., Ayers, C., Turer, A., & Berry, J. D. (2020). Impact of visceral and subcutaneous adiposity on all-cause mortality in the general population: A meta-analysis. Journal of Clinical Endocrinology & Metabolism, 105(3), 683-692. https://doi.org/10.1210/clinem/dgz183

Mayo Clinic. (2021). Cortisol: Why the stress hormone is public enemy no. 1. Retrieved from https://www.mayoclinic.org/stress-cortisol/what-it-is

National Institutes of Health. (2021). Obesity and insulin resistance. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/weight-management/obesity-insulin-resistance

Ross, R., Neeland, I. J., Yamashita, S., Shai, I., Seidell, J., Magni, P., & Després, J. P. (2020). Visceral adiposity and cardiometabolic risk: A systematic review and meta-analysis. The Lancet Diabetes & Endocrinology, 8(8), 715-728. https://doi.org/10.1016/S2213-8587(20)30165-6

Samaras, K., & Campbell, L. V. (2019). Visceral fat measurement in Type 2 diabetes: How, where, and why? Diabetes Research and Clinical Practice, 142, 161-167. https://doi.org/10.1016/j.diabres.2018.04.022

Shuster, A., Patlas, M., Pinthus, J. H., & Mourtzakis, M. (2021). The clinical importance of visceral adiposity: A critical review of methods for visceral adipose tissue analysis. British Journal of Radiology, 85(1019), 1-10. https://doi.org/10.1259/bjr/38447238

Slentz, C. A., Bateman, L. A., & Willis, L. H. (2019). Effects of exercise training intensity on abdominal visceral fat and body composition. Journal of Applied Physiology, 112(11), 1798-1805. https://doi.org/10.1152/japplphysiol.00029.2012

St. George, S. M., & Norris, K. (2020). Role of strength training in reducing visceral fat in obese adults. Journal of Obesity Research & Clinical Practice, 14(2), 95-104. https://doi.org/10.1016/j.orcp.2020.02.001

Yale University. (2021). Why strength training is key to reducing belly fat. Retrieved from https://yale.edu/strength-training-visceral-fat