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NADIR ALI a” | Where does FAT go? Healthy? to muscle Obese? to toxicity
presents episode 1086 | Dr Nadir Ali
Low Carb Denver podcast

From Low Carb Denver 2023, Dr Nadir Ali…
What is fat toxicity [lipotoxicity] -how it causes insulin resistance & mitochondrial dysfunction?
Obesity is not just overstuffed fat cells, but fat spilling
-into blood stream
-finding places to park
-liver, spleen, pancreas

Normal fat handling: fat into circulation directly…
-bypassed liver
-called chylomicron; unloads fat into muscle or fat cells
-becomes small remnant, goes to liver, cleared
Markers of normal fat handling
-TG less than 100
-HDL greater than 50

Obesity and over consumption, lots more chylomicrons…
-fat cells say ‘cannot take any more’
-muscle full of fat [lipotoxic] -chylomicrons remain in blood stream
-cause fat deposition in organs which should NOT HAVE FAT
-liver; pancreas;
muscle; heart
[ectopic fat deposition]

Fat toxicity markers
-TG greater than 100 [1.13 mmol/L] -HDL less than 50
-high HOMA-IR
-blood markers of fatty liver: SGOT, SGPT, GGT
-low adiponectin
-high blood pressure
-visceral obesity

Muscles deal with insulin from high carb meal…
-insulin recruits GLUT4 receptors in muscle to push glucose in
-muscle burns it for fuel or stores as glycogen
less insulin required = more insulin sensitive
Larger muscle mass = take in much more sugar before IR

Muscles deal with insulin from high fat meal…
-from fat in blood stream, insulin required to metabolize it
-with enzyme lipoprotein lipase [LPL] drives fat into muscle
-muscle can burn for fuel or store as intramyocellular fat

Those who are physically active & younger are insulin sensitive…
-more fat in muscle, along with more healthy mitochondria
-they can burn more fat for fuel
Also, more GLUT4 receptors to take in glucose, make glycogen
Fat is in DYNAMIC FLUX, so, does NOT get converted to
-toxic metabolytes

If obese, T2D, or sedentary…
-mitochondria: fewer & diseased
-not able to CLEAR FAT: it becomes rancid
-converted to toxic lipids:


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