Der er også andre årsager til overvægt

stofskifte

 

Oplever du ikke, at overspisning er årsag til din overvægt? Har du styr på din kost og motion, men ser ingen resultater på vægten? Stagnering af vægttab og vægtstigning kan forekomme, selvom man spiser færre kalorier, end man forbrænder. Årsagen kan blandt mange være døde tarmbakterier, nedsat stofskifte, forhøjede kortisolniveauer og inflammation i fedtcellerne.

 

Døde tarmbakterier kan være skurken

Nye undersøgelser tyder på, at der måske kan være en sammenhæng mellem tarmbakteriers indvirkning på lagringen af fedt. Hypotesen er, at lipopolysakkarider (molekyler) kan være årsag til fedtlagring. Molekylerne består af fedtsyrer (lipider) og sammensatte kulhydrater (polysakkarider), som stammer fra bakterier i tarmen.

Når tarmbakterierne dør, så frigives molekylerne i tarmen. Hos overvægtige har man fundet en større frigivelse af lipopolysakkarider end hos normalvægtige. Lipopolysakkariderne binder sig til fedtmolekylerne og danner tilsammen små partikler, der transporteres rundt i kroppen. Fedtpartikler, der indeholder lipopolysakkarider, bliver i særlig grad optaget, da de binder sig til receptorer i fedtvævet. Forskerne har derfor en teori om, at tilstedeværelsen af lipopoly-sakkarider fremmer optagelsen af fedt i fedtvævet.

 

Kilder:

– Obesityreview (2016) Gut microbiota-derived lipopolysaccharide uptake and trafficking to adipose tissue: implications for inflammation and obesity Vol. 17, Issue 4, 297–312

http://www.ncbi.nlm.nih.gov/pubmed/26712364

 

Overvægt og nedsat stofskifte

Hvis stofskiftet (kroppens energiomsætning) er i hormonel ubalance, kan det ligeledes besværliggøre et vægttab. Nedsat stofskifte kan skyldes, at skjoldbruskkirtlen ikke producerer tilstrækkeligt med skjoldbruskhormonerne T3 og T4. Produktionen af disse hormoner er afhængig af tilstedeværelsen af jod. Frigivelsen af hormonerne reguleres af hormonet TSH, som kommer fra hypofysen i hjernen. Det vides endnu ikke i detaljer, hvad der forårsager for lavt stofskifte, men det er sikkert, at både arvelige og miljømæssige forhold spiller ind.

Hypotesen omkring utilstrækkelig produktion af T3- og T4-hormoner antages at være en inflammationstilstand i skjoldbruskkirtlen, som betyder, at kroppen reagerer mod sit eget væv. Mange kan derfor ligefrem opleve en vægtstigning på trods af et mindsket energiindtag, hvis stofskiftet er nedsat.

 

Vidste du at..

Et lavt stofskifte hyppigst opstår hos ældre kvinder. To procent af ældre kvinder lider af sygdommen, og i Danmark diagnosticeres 1600 til 1800 nye tilfælde årligt. Risikoen for at få for lavt stofskifte udgør fire til fem procent.

 

Jods funktion:

  1. Primært er jod med til at sikre dannelsen af hormonerne thyroideahormonerne thyroxin (T4) og triiodothyronin (T3).
  2. Hormonerne dannes i skjoldbruskkirtlen, hvor jod oxideres og indbygge s i T4 og T3.
  3. Hormonerne lagres dernæst i thyroglobinproteinet.
  4. Optagelsen fremmes af en membranreceptor, som frigør hormonerne fra plasmaproteinerne.
  5. Det jod, som fraspaltes thyroxin i vævene, optages igen i skjoldbruskkirtlen og anvendes igen til hormonsyntese.
  6. Normalt udskiller kroppen 50 til 100 μg pr. dag gennem nyrerne.

 

T3 – og T4-hormonernes væsentligste funktioner:

  • Regulerer den basale energiomsætning i kroppen (BMR).
  • Regulerer aflæsningen af gener i hjernen, hjertet, leveren og nyrerne og har derfor stor betydning for væksten.
  • Øger lipolysen (fedtforbrændingen)
  • Øger glykogenolysen (kulhydratnedbrydning)
  • Øger optagelsen af glukose fra tarm og blodbane
  • Forstærker virkningen af adrenalin

En undersøgelse fra Karolinska Instituttet i Sverige viser, at antallet af fedtceller hos både normalvægtige og svært overvægtige mennesker mere eller mindre er blevet bestemt i barn- og ungdommen. I voksenalderen dør omkring otte % af fedtcellerne hvert år, kun for at blive erstattet af nye. Hidtil har man troet, at alle voksne havde et konstant antal fedtceller, selv når man tabte mange kilo. Man er gået ud fra, at det var ændringer i mængden af fedt inden i fedtcel-lerne, der fik kropsvægten til at stige, og ikke dannelsen af nye fedtceller.

Efterfølgende har man fundet ud af, at fornyelseshastigheden af fedtceller er dobbelt så høj hos overvægtige som hos normalvægtige, og det ændres ikke, selvom man taber sig. Det kan i nogen grad forklare, hvorfor det kan være svært at holde vægten efter et stort vægttab.

Fedtvævet har den funktion, at det skal bruges til oplagring af energi og til at producere varme. I takt med at vores fedtceller stiger i størrelse, begynder fedtvævet at udskille inflammatoriske stoffer. Det vil sige, at jo mere vi overspiser, desto mere inflammation skabes der i fedtcellerne. Denne inflammation kan fx føre til insulinresistens.

 

Hyperplastisk overvægt

  • En stigning i fedtcelleantal
  • Bidrager til pubertetsovervægt
  • Kritiske tidspunkter for øgning af fedtcelleantal er: Sidste trimester af mors graviditet, første leveår og pubertet

 

80 % af dem med hyperplastisk overvægt har svært ved at reducere overskydende kropsfedt, fordi fedtcellerne er steget i antal i stedet for i størrelse. Antallet af fedtceller kan aldrig reduceres.

 

Hypertrofisk overvægt

  • En stigning i fedtcellestørrelse
  • Bidrager til voksenovervægt
  • Fedtcellestørrelsen øges, når fedtlagring overstiger fedtfrigivelsen

 

Ved hypertrofisk overvægt er det lettere at gennemgå et vægttab, fordi det er nemmere at reducere fedtcellernes størrelse end at reducere antallet af fedtcellerne.

 

M1 makrofager er synderen

Forskere på Columbia Universitet i USA lavede forsøg på mus, som viste, at aktiviteten af makrofagrelaterede gener steg gradvist, i takt med at musene blev fedet op. Antallet af makrofager i musenes fedtvæv steg også gradvist. Hos de mest overvægtige dyr i undersøgelsen var makrofagernes størrelse i fedtvævets celler steget med helt op til 50 %.

Forskerne fandt i et sideløbende forsøg også, at antallet af makrofa ger hos svært overvægtige mennesker var markant højere end hos de normalvægtige.

Flere studier har vist, at makrofagerne spiller en afgørende rolle for inflammation I fedtcellerne. Makrofagen er en betydningsfuld celletype med mange funktioner, da den blandt andet styrer kemiske signalstoffer ved aktivering af immunsystemet og styrer inflammationsprocessen.

På trods af dette har flere studier vist, at langt størstedelen af de inflammationsfremmende stoffer kommer fra makrofagerne.

 

Inflammation skaber inflammation

Teorien er, at hvis der indtages mere fedt, end fedtcellerne kan håndtere, knækker eller lækker de. Fagocytterne er makrofagernes oprydningsteam, som identificerer og optager den lækkende væske. Fagocytterne angriber fedtcellerne og sender kemiske signaler ud i kroppen. Det resulterer i inflammation.

Inflammationen reagerer som en nedadgående spiral, hvor inflammatoriske cytokiner trigger andre immunceller. Immuncellerne afgiver løbende flere inflammatoriske stoffer, hvilket fremprovokerer dannelsen af M1-makrofager. Makrofagdannelsen forværrer inflammationstilstanden og skaber en skræmmende selvforstærkende effekt.

 

Kilder:

-From Science News (2004) Vol. 165, No. 9, p. 139. www.phschool.com/science_news/articles/Inflammatory_fat.html.

-Nature.com (2008) 453, 783-787 www.nature.com/journal/n7196/full/nature06902.html.

-JCEM (2013) Adipose Inflammation in Obesity: Relationship With Circulating Levels of Inflammatory Markers and Association With surgery-induced weight loss.

http://press.endocrine.org/doi/10.1210/jc.2013-2673?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&.

 

Denne teori bliver bekræftet i et andet studie lavet af forskere på Millennium Pharmaceuticals i Cambridge. Da forskerne undersøgte mus, som havde en genetisk prædisponering for diabetes, observerede de en gradvis stigning i makrofagernes aktivitet i takt med at deres overvægt steg.

Musene blev overfordret, hvilket fremprovokerede deres prædiabetiske symptomer efter 16 uger. Musene havde nået en grænse, hvor deres celler pludselig mistede deres følsomhed over for insulin, og deres inflammation var ude af kontrol.

 

Cytokiner er signalproteiner, som har mange funktioner, blandt andet:

  • Reproduktion
  • Vækst
  • Opheling
  • Regulator af immunsystemet

 

Cytokinerne kan have forskellige funktioner, grundet deres evne til at binde sig til specifikke receptorer på de forskellige cellers overflader. Når cytokinet binder sig, fremkalder det et signal i cellen. Signalet aktiverer en gruppe gener, som ændrer cellens aktivitetsmønster.

 

Aspirin til inflammatorisk behandling

Et studie foretaget på Harvard Universitetet i USA viser, at forskerne formåede at omvende fedmerelateret insulin-resistens i mus ved hjælp af høje doser af aspirin. Det antiinflammatoriske lægemiddel arbejdede ved at neutralisere inflammatorisk udskillelse forbundet med svær overvægt.

Denne fremgangsmåde blev afprøvet på Yale University School of Medicine ved behandling af ni overvægtige diabetikere med en høj dosis aspirin i to uger. Denne dosering forbedrede deres insulinrespons, hvilket førte til bedre kontrol af deres blodsukker. Undersøgelsen indikerer, at blodsukkerforbedringer kan sammenlignes med dem, der nås med behandling med metformin, som er et lægemiddel til diabetes. Behandling med aspirin sænkede også fedtkoncentrationerne i blodet.

Der er dog ikke enighed omkring brugen af aspirin som lægemiddel ved inflammation i fedtcellerne, da de har for mange bivirkninger. Der lægges derimod vægt på, at en sådan indsats målrettes de inflammatoriske molekyler, der opstår i fedtvævet. Makrofager har infektionsbekæmpende funktioner andre steder i kroppen, så det vil ikke være hensigtsmæssigt helt at lukke for deres funktion.

Vil du vide mere om naturlige inflammationshæmmende muligheder, så klik ind på sund-forskning.dk

 

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