Contrary to what you may think, body fat is not simply an inert storehouse of unused calories encasing your body and organs.
Actually, your fat cells are metabolically very active. For example, they produce hormones (such as estrogen) and other signaling molecules that have far-reaching effects throughout your body.
The signals that are sent and received by your fat cells will influence how much fat you retain and how easy or difficult it will be for you to lose weight. Some of these signals are created as the result of inflammation.
What Is Inflammation?
Body Fat Causes Inflammation
Fat-Immune System-Inflammation Link
SOCS and Leptin Resistance
Resistin
C-Reactive Protein
Oxidative Stress
Vicious Cycle of Diet-Inflammation-Weight
How to Break the Vicious Cycle
A number of studies indicate that PCOS women who are overweight tend to be in a state of chronic inflammation.(1,2,3,4)
Even adolescents with PCOS symptoms of high insulin and testosterone have elevated white blood counts, suggesting that the immune system is aroused and an inflammatory process may be occurring.(5) The white blood count is elevated even more when birth control pills are taken.
Chronic inflammation appears to play an under-recognized but central role in the pathology of PCOS and obesity.
What Is Inflammation?Inflammation is part of your body’s response to injury or infection. It is a byproduct of the body's attempt to heal itself. Usually, you are aware of inflammation by its classic signs of redness, heat, swelling and pain. However, there is a very complex, hidden, powerful biochemical process that results in these classic signs of inflammation.
Inflammation is not always as obvious as pain or swelling. It can occur at a low, unnoticeable level. This is referred to as sub-clinical, chronic inflammation. In other words, the inflammatory biochemical process is occurring, but you are not aware of it. Chronic, low-grade inflammation is what we are concerned about in dealing with PCOS and weight problems.(6)
Body Fat Causes Inflammation
You can think of your fat cells as an endocrine and secretory organ, just like your ovaries, thyroid, adrenal glands, liver, hypothalamus, or any other organ or gland in your body.(7) Fat cells produce a bewildering array of biochemicals that influence what goes on in your body.(8)
One family of biochemicals produced by your fat cells are "cytokines", many of which are involved in the inflammatory process. They include leptin, adiponectin, tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), to name a few. Most cytokines promote inflammation while some others inhibit inflammation.
The more fat cells you have, especially around your middle, the more cytokines you will produce and the more likely it is that you are promoting inflammation.
Fat-Immune System-Inflammation Link
Your fat cells increase inflammation in another way, by attracting a type of white blood cell known as a macrophage, which produces inflammatory cytokines.(9) Macrophages are scavenger cells. Their job is literally to gobble up foreign organisms and cellular debris.
Macrophages seem to be drawn to body fat because fat cells tend to leak and break open, especially in people with abdominal obesity. Macrophages move into the leaky fat tissue in order to clean up debris and then they themselves begin to release inflammatory factors. Macrophages appear to be a major contributor to inflammation.(10)
SOCS and Leptin Resistance
To limit the damage produced by inflammation, your body produces anti-inflammatory biochemicals that are triggered by the inflammation itself. This is a compensating mechanism that attempts to maintain a balance in the healing process.
When pro-inflammatory cytokines enter a cell to initiate or promote a biochemical processes to increase the inflammatory response, the cell simultaneously produces anti-inflammatory chemicals called "suppressors of cytokine signaling", or simply "SOCS". SOCS molecules suppress the cell's response to inflammatory cytokines. Two SOCS molecules, SOCS-1 and SOCS-3, are able to interfere with a cell's ability to respond to leptin, which increases leptin resistance.(11,12) SOCS-3 also blocks the response to insulin, which increases insulin resistance.(13,14,15)
Some researchers believe that SOCS production is an important cause of leptin resistance and consequently contributes to the development of obesity.
ResistinFat cells and macrophages (a type of white blood cell) produce a hormone called resistin. Resistin appears to cause tissues -- especially the liver -- to be less sensitive to the action of insulin and thus lead to increased blood sugar levels. There is a strong association between elevated levels of resistin and obesity and diabetes.
Resistin is a potent stimulator of inflammation.(16,17) In experiments, increased levels of resistin also appear to induce increased SOCS-3.(18) As we said, SOCS-3 contributes to leptin resistance and insulin resistance.
The amount of body fat you have may also increase resistin. While resistin in produced by fat cells, it is also produced by the macrophages that are attracted to debris leaking from fat cells. Increased macrophage activity could lead to more resistin.(19)
Although resistin levels are not elevated in all PCOS women, these women appear to be more inclined to produce resistin than those without PCOS.(20)
C-Reactive Protein (CRP)
C-reactive protein (CRP) is a protein that is a general indicator of inflammation and is associated with being overweight. CRP is a fairly common blood test that you can get from your doctor. A high level of CRP is a strong predictor of future cardiovascular disease and stroke.
In a study at the Rambam Medical Center in Israel, 36.8% of PCOS women had elevated CRP whereas only 9.6% non-PCOS women had elevated levels.(21) Estrogen, which may be in excess in some PCOS women, is one of numerous factors that can increase CRP.(22)
Inflammation, Weight and Oxidative Stress
A condition of "oxidative stress" exists when pro-oxidant factors in the body exceed the anti-oxidant factors. The result is an accumulation of unstable, destructive molecules called "free radical" molecules, which damage components of the cell membranes, proteins or genetic material by "oxidizing" them. This process is the same chemical reaction that causes iron to rust.
Oxidative stress can result from many factors, including exposure to poor quality diet, environmental pollution, alcohol, smoking, medications, trauma, toxins, excessive exercise, or inflammation, to name a few.
Oxidative stress it thought to be a primary cause of degenerative diseases and accelerated aging.
As a group, women with PCOS are more likely to experience oxidative stress than healthy women. For example, a study from the University of Harran in Turkey found an increase in oxidant status in women with PCOS. This increase was related to central obesity, age, blood pressure, serum glucose (blood sugar), insulin and triglyceride levels, and insulin resistance. In addition, their antioxidant status was found to be insufficient. The researchers said these findings suggest that oxidative stress may contribute to the increased risk of cardiovascular disease in women with PCOS.(23)
But oxidative stress does more than increase cardiovascular risk. It also promotes increased inflammation and induces insulin resistance.(24) It may also interfere with reproductive function.(25)
Oxidant stress is part of the vicious cycle of increased inflammation leading to insulin and leptin resistance and thus creating excess weight.
Women in general appear to be more likely to have oxidant stress than men, according to a research study conducted at the University of California at Berkeley.(26)
A diet high in refined carbohydrates and other "fabricated" foods leads to both increased weight and increased inflammation.
Excess weight itself causes chronic inflammation.
Chronic inflammation contributes to more insulin resistance, leptin resistance, and other metabolic disorders. It also decreases favorable adiponectin and increases unfavorable resistin.
Insulin resistance and leptin resistance stimulate accumulation of more weight, make weight loss more difficult, and induce hyperandrogenism (excessive levels of male hormones) and other symptoms of PCOS.
The added weight induces more inflammation and thus more insulin and leptin resistance, which in turn prevents you from burning off fat stores, and causes you to store even more fat.
Here is the vicious cycle of obesity and leptin resistance: Extra fat produces chronic, low-grade inflammation. The chronic inflammation produces a chronic anti-inflammatory response, led by SOCS molecules. The SOCS response stops leptin from reducing obesity. So weight goes up, which causes more inflammation. And the cycle starts all over again
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A very disturbing study has recently come to our attention. Researchers involved in the Nurses Health Study have discovered a dietary pattern that is very closely related to the degree of inflammation and the incidence of diabetes.
As you know, PCOS has an inflammatory component that worsens your symptoms and substantially increases the risk of developing diabetes.
The study revealed that women whose diet was high in sugar-sweetened soft drinks, refined grains, diet soft drinks, and processed meat had much higher levels of inflammation and incidence of diabetes. In fact, the women with the highest consumption of these foods were 2.5 times as likely to develop diabetes compared to women who had the lowest consumption of these items. The women with the most inflammation and diabetes also ate fewer vegetables.
If you're still consuming soft drinks, refined grains and processed meat, it's time for you to stop and think. It's well-known that if you have PCOS, you already have a much higher risk of getting diabetes than other women. By eating these foods, you're only making matters worse. We urge you to improve your diet immediately
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Following on I thought I would add a post about anti-inflammatory foods:
Essential Fatty Acids
The right type of fats in our diets will impact pain and inflammation in a positive way.
Omega-3 oils that are found in cold water oily fish, walnuts, flax and pumpkin seeds will reduce inflammation. It may be beneficial to supplement the omega 3 oils with flax oil or fish oil capsules. Olive oil is another type of oil that won't promote inflammation.
Protein
Good protein choices include lean poultry and oily fish like tuna, salmon, and halibut. Omega eggs are a great source of protein and have higher levels of omega 3 oils than regular eggs. Walnuts, almonds, and legumes round out the list of healthy anti-inflammatory proteins.
Carbohydrates Stay away from the starchier carbs and avoid sugar altogether. Choose green leafy vegetables, green and brightly colored vegetables and fresh fruits.
Berries are a great choice, especially blueberries which are packed with anti-oxidants.
Apples and red onions are great sources of quercetin, which has strong anti-inflammator
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Cold Water Fish:
Salmon, halibut, mackerel, tuna, trout and other cold water fish contain lots of omega-3 fatty acids.
These fatty acids offset the production of arachidonic acid, a major pro-inflammatory compound. Instead, omega-3 fatty acids favor the production of compounds that inhibit inflammation. Eat at least 3 servings of fish every week, or take 1,000 mg of purified omega-3 oil daily.
Flax oil:
This oil works similarly to fish oil to help reduce inflammation. Use it in salads or in fruit smoothies, and never cook with it. It has a strong tendency towards oxidation when it is heated.
Ginger:
Ginger has been shown to be a powerful anti-inflammatory agent. Use it freely in your cooking or make a strong tea with it. It also helps reduce nausea and some forms of abdominal distress.
Whole Grains, Legumes, Soy Products:
These foods are great sources for protein without the pro-inflammatory arachidonic acid. Skinless chicken breasts may also be added since most of the pro-inflammatory fat is found in the skin.
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Anthocyanins Blueberries, strawberries, cranberries, cherries
Quercetin Apples, onions, red wine, green tea
Curcumin Turmeric
Shogaols Ginger root
Isoflavones Soy beans, tofu, soy products
Resveratrol Red wine, red grapes, grape juice, peanuts, vegetables
Exercise is another factor that helps lower CRP levels, which indicates that it may help reduce inflammation. How exercise helps is not yet understood, but we do know that physically fit people have lower CRP levels than unfit people.
The chief fatty acid responsible for inflammation is one called arachidonic acid. A diet rich in arachidonic acid contributes to the cycle of pain and inflammation. Foods that are rich in arachidonic acid include animal meats, egg yolks, and shellfish. One step in stopping inflammation is reducing dietary intake of these foods.
But arachidonic acid (AA) can also be synthesized or produced by our bodies. To reduce the production of AA in our bodies we can increase our intake of “anti-inflammatory fats” such as EPA (eicosapentanoic acid) from fish, and ALA (alpha-linoleic acid) from sources including flax, pumpkin seeds, walnuts and soybeans.
Research has also shown that certain foods and spices can block the enzymes that fuel the process of pain and inflammation. These anti-inflammatory foods and spices include ginger, cayenne, turmeric, garlic & onion, rosemary, and herbs such as Boswellia (an Ayurvedic herb), wintergreen, licorice root, and black willow. Additional nutrients including Vitamin E and Quercetin (a natural anti-inflammatory found in foods such as citrus fruits, apples, onions, parsley, tea, and red wine) also inhibit enzymes that trigger inflammation.
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Take Vitamin A 5000 to 10,000 IU. This is best taken as mixed natural carotenoids.
Take multivitamin and mineral supplement (zinc is especially important – we recommend 15-50 mg per day for adults)
Balanced B complex vitamin
Vitamin E (400 to 800 IU a day in the form of mixed natural tocopherols.
Vitamin C (250 to 2000 mg a day)
Alpha Lipoic acid 100-300mg a day
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Yeah, abdominal fat really takes on a life of its own and becomes almost an organ in itself, and it seems to release hormones to maitain the level of abdominal fat in the body, such as it will release hormones(leptin) that make you hungry if you make too many drastic changes in your diet and also it will shut down your metabolism so you store anything you eat-it's pretty amazing and scary all at once!!! It's really the abdominal fat that does this, weight/fat cells that hover around your hips and thighs actually secrete hormones that protect you from cardiovascular disease. It's always better to not to be overweight, but the worst fat is definitely around your middle, and it's the reason why men have a higher incidence of strokes and heart attacks than women, because more men tend to store their weight around their mid-section than women who gain around their hips.
For me, learning that inflammation can accelerate the aging process(nooooo wrinkles,) even MORE than smoking has been a big incentive in dumping sugar, taking Metformin, exercising, and popping flax pills and a multi-vitamin every day, especially since I has a CRP test done, and it was elevated. Sugar really contributes to inflammation, so it's a great place to start to reduce inflammation, and I've also read that balancing out insulin through diet and exercise and medication reduces inflammatory markers as well.
My CRP was elevated too, and my RE didn't really give me an explanation as to what it meant. He sort of blew it off.
Now I'm worried that I have even more of these risk factors that are linked to problems later on.
__________________ Happily married; 1 amazing daughter born 12/06. short term weight loss goal: 20lbs by year's end long term weight loss goal: 65 lbs overall
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"I'm not lazy. I'm simply judicious about excess movement." -Jen Lancaster
Inflammation, PCOS and your Weight 
