Subcutaneous Fat Confusion

Can you burn subcutaneous fat?  If you scour the internet and health books on the topic  of “how to  burn subcutaneous fat”, you find a lot of bad news.  Most articles offer up the obvious “proper diet and nutrition over a long period of time” advice without factual evidence and others theorize that it’s the hardest thing to do when losing weight and leaning up, even stating liposuction might be the only alternative. It’s clear than nobody seems certain on the issue, most fitness sites sounding more like advice columns rather than presenting empirical evidence.

subcutaneous fatSubcutaneous fat (e.g. “love handles”) is that layer of fat immediately below that outer skin (epidermis) that wiggles and jiggles and can be pinched and molded.  The word “subcutaneous” actually translates to “under the skin”.

Comparatively, visceral fat, is found much deeper in our bodies and is fat that surrounds and cushions many of our organs.  Visceral fat is considered easier to get rid of (easier access) through diet and exercise and that’s good because it’s far more dangerous.  Too much visceral fat and you increase your risks of diabetes, heart disease, insulin resistance, stroke and a myriad of other health problems.

“Extremely loose skin” in another animal altogether and most people tend to approach loose skin with a “subcutaneous fat burning” mindset.  Unfortunately, there is a point where

Why is Subcutaneous Fat Hard to Burn?

Because it’s positioned just under the epidermis layer, subcutaneous fat has far less blood flow than visceral fat.  As a results, it gets used as a resource (using fat for energy) far less than visceral fat.

Furthermore, subcutaneous fat is more responsive to insulin.  Remember that insulin’s effect on a fat cell is a decrease in fat release and an increase in fat storage.  If a cell is more sensitive to insulin, only a small amount of insulin triggers the response.

Scientific Studies on Fat

In search of scientific findings, I put my search goggles on and looked to websites with actual published studies and my local library. Here’s what I turned up.

The Study: With a focus on body composition change in 91 obese women, this study lasted three months and examined the effects of exercising 5 days a week for 45 minutes at a maximum of 78% of heart rate vs dieting without exercise.
The Findings: Moderate aerobic exercise did not create any noticeable body change.
Source: Utter AC, Nieman DC, Shannonhouse EM, Butterworth DE, Nieman CN, Influence of diet and/or exercise on body composition and cardiorespiratory fitness in obese women. Int J Sports Nutr. 1998 Sep;8(3):213-22.
http://www.ncbi.nlm.nih.gov/pubmed/9738131

The Study: 35 obese individuals participated in a 6 month study that examined fat reduction after diet and exericse vs diet alone
The Findings: Cardiovascular fitness was improved but fat reduction was the same for both groups.
Source: Redman et al. Effect of calorie restriction with or without exercise on body composition and fat distribution. J Clin Endocrinol Metab. 2007 Jan 2.
http://jcem.endojournals.org/content/92/3/865.abstract

The Study: For 20 weeks, participants burned 29,000 calories while engaged in endurance training. For 15 weeks, participants burned under 14,000 calories while engaged in HIIT (high-intensity-intermittent training or interval training).
The Findings: Participants who engaged in HIIT interval training lost 9X more subcutaneous fat than those who did endurance training.
Source: Tremblay A, Simoneau JA, Bouchard C. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Metabolism. 1994 Jul;43(7):814-8.
http://www.ncbi.nlm.nih.gov/pubmed/8028502

The Study: With no change in diet, “unfit” participants, aged 45-70 years old exercised for an entire year. The men went at it for just over an hour a day and females exericsed just under an hour a day.  Both groups did this 6 days a week.
The Findings: Average weight loss after one year was 3.5 lbs or about 0.3 lbs per month. The average was 3.08 lbs for women and 3.96 lbs for men.
Source: McTiernan et al. Exercise Effect on Weight and Body Fat in Men and Women. Obesity 2007 June – 15:1496-1512.
http://www.nature.com/oby/journal/v15/n6/abs/oby2007178a.html

The Study: For 15 weeks, 45 females aged 18-22 engaged in high-intensity interval training for 20 minutes while others in the group performed low-endurance steady state cardio. The effects on subcutaneous fat and insulin resistance were being studied.
The Findings: Only the group training 20 minutes long lost 5.5 pounds of overall fat (could not find a ratio for subcutaneous) and the group doing long endurance training showed no improvement in fat loss.
Source: Trapp EG, Chisholm DJ, Freund J, Boutcher SH. The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women. Int J Obes (Lond). 2008 Jan 15.
http://www.ncbi.nlm.nih.gov/pubmed/18197184

The Study: This study focused on the preservation of lean muscle mass while limiting diet to only 800 liquid calories p/ day. Two groups were examined. Group 1 engaged in biking, walking or stair climbing 1 hour, 4X a week. Group 2 engaged in resistance training (weight lifting) only 3X a week.
The Findings: After 12 weeks, Group 1 lost more weight but did so by losing all important muscle mass. Only Group 2 maintained all their lean muscle mass, despite the extremely low calorie supply.
Source: Bryner RW, Ullrich IH, Sauers J, Donley D, Hornsby G, Kolar M, Yeater R. Effects of resistance vs. aerobic training combined with an 800 calorie liquid diet on lean body mass and resting metabolic rate. J Am Coll Nutr. 1999 Apr;18(2):115-21.
http://www.ncbi.nlm.nih.gov/pubmed/10204826

What Do The Fat Stats Prove?

I was actually shocked by the overall findings.  I spent the majority of my weekend looking through some 25-30 studies and these were some of the most significant and/or interesting I found but all seemed to point to the same conclusions.

Steady state cardio does little (if anything) to burn fat.  If you’re hitting the treadmill on a daily basis and doing a fast walk or slow jog in hopes of burning fat, chances are that you’re wasting your time.  The studies do show, however, a great improvement in resting metabolic rate and overall better oxygen supply for these individuals and I suspect it improves overall health, so there are definitely health benefits to be had.

 High intensity interval training is the best exercise method to blast fat off your body.  If you’re going to hit the machines or go at it outside with a goal of losing fat, go easy for a bit and then hit it hard for a stretch.  Keep repeating.  Combine walking and sprinting intervals and watch the fat disappear!

You can’t out-train a bad diet.  In the year long study, participants worked out for an hour on average, 6 days a week without changing their diet and lost 3 to 4 pounds each, for the entire year!  Clearly, diet is the secret to burning fat and combined with high intensity interval training, it’s powerful.

Lean muscle mass can be maintained with almost any calorie restriction.  This last study was the most exciting find for me.  If you can maintain all your muscle mass while only indulging in 800 calories a day (lifting weights required), you can seemingly blast through some fat pretty fast.  From a personal point of view, this aligns perfectly with what I’ve witnessed this year.  I’ve completed several 24 hour fasts (the latest just this last week) and have not suffered any loss of muscle.  I don’t even notice a decrease in strength in the gym when I’m fasting.  Keep lifting those weights!

What About Subcutaneous Fat?

I referenced subcutaneous fat in the studies above, where I found it being looked at as a factor.  However, most studies seem to focus on overall body fat.

Can you burn subcutaneous fat?  The answer is definitely yes but the important distinction comes in understanding subcutaneous fat vs. loose skin.

There is a point where loose skin becomes simply too loose (when folds and wrinkles are throughout and excessive) and must be removed by a tummy tuck.  A nice online alternative is to post a picture to realself.com or surgery.org’s “Ask a Surgeon” section and let real doctors offer an opinion on your body.

If you’re headed down the surgical route, don’t get talked into a liposuction alternative when a tummy tuck might be your best option.  Not all liposuction doctors do tummy tucks so the wrong procedure can sometimes get recommended if a doctor makes financial gain a priority over your health concerns.  Liposuction removes excess fat but if you’re after very loose skin, liposuction will do nothing to correct this and a tummy tuck is what you need.

If you’re affected by fat of any kind, stick with the diet and exercise and keep reading all you can find.  Losing that last bit of fat can be the hardest part of getting lean and ripped but where there’s a will there’s a way so keep believing and achieving!

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