Blood Pressure, Blood Sugar and Weight Do Not Arrive Separately
The short answer
The fat that gathers between the organs is not a storehouse but a tissue that keeps sending signals out. That is why three lines on a check-up sheet so often reach the borderline in the same year.
Contents
Blood Pressure, Blood Sugar and Weight Do Not Arrive Separately
When the waistline grows, fat increases in two places. One is the fat under the skin that you can take hold of; the other packs in between the organs of the abdomen. The second is called visceral fat.
I do not regard this fat as a storehouse for surplus calories. It steadily releases fatty acids and a range of signalling substances, so by what it does it is closer to an organ. If something sits in the middle of the body sending out signals without pause, those signals cannot be reaching only one place.
This is behind the fact that blood pressure, blood sugar and weight so often sit at the borderline together on a check-up sheet.
The Loop That Joins the Three Lines
When the signals from visceral fat reach the liver and the muscles, the same amount of insulin no longer handles as much blood sugar as it once did. This is called insulin resistance. The body puts out more insulin to make up the shortfall. So for a while blood sugar stays close to normal — but with insulin running higher than usual underneath.
Insulin sitting high does not only touch blood sugar. It makes the kidney hold on to a little more sodium, and turns the sympathetic side up a little. Blood pressure rises by that much. Insulin also tends to put surplus calories away as fat, so weight becomes easier to gain, and the added fat increases the original signal again.
This is not a picture of one cause and two consequences. It is closer to a loop in which the three push one another along a little at a time. Nor does insulin alone explain all of it. Shortened sleep, lost muscle, tension that has been switched on for a long time, and reduced activity all lay a hand on the same loop.
So the Three Worsen in the Same Year
What is worth watching in this loop is not the order so much as the timing.
The three values do not move at the same speed. Usually weight rises a little first, blood pressure follows a few millimetres behind, and blood sugar comes up later still, because the body is putting out more insulin and holding sugar down for a long time. So the point at which blood sugar visibly rises is not the point at which the loop began. It is closer to the point at which the side that was holding out began to give.
Look at one year's sheet alone and this lag is invisible. You see only three lines sitting at the borderline together.
On the Sheet the Three Lines Sit Side by Side
"All three are on the edge, but they said it is not enough for medication."
Some people say this as they spread the paper out. Blood pressure a little under 130, fasting glucose around 100, weight up some four kilograms from two years ago. At the end of each line it says "borderline" or "follow up," and there is not a single line in red.
That is correct. But this form draws one line for each item and looks only at whether that line was crossed. It does not tell you whether the lines moved in the same direction. A reference line marks where disease is separated off, not where a healthy body sits, so all three can be inside the boundary while the body is not what it was.
So I do not look only at this year's sheet. I lay last year's and the year before's out with it. Rather than what any one number is, I look at where the three lines are heading. And I ask a few things. When did the waist start to change? What was sleep like around then? Are there times of unusual drowsiness after a meal? What is not written on the sheet often tells us when it started.
This Is Still the Stage Where Direction Changes
This loop has one good property as well. Because the three push one another, moving one place brings the others along. When sleep lengthens, appetite signalling changes; when a little muscle is added, more sugar is handled by the same insulin, and insulin sits lower. Rather than aiming at a few kilograms, turning the direction the three lines are heading in actually arrives sooner.
When I use herbal medicine, what I look at is not which of the three values is highest either. I look at which part of the loop gave first and work on that side. That is why I do not use the same prescription for a body that gave first through shallow sleep and one that gave first through reduced activity.
However, if weight has recently dropped on its own, if thirst and urination have noticeably increased, or if blood pressure is suddenly being read high, that may be a different matter from this story and it is better to be examined first.
Blood pressure, blood sugar and weight look like values handled by three different departments. In the body they are often the same circumstance written down in three places. This loop carries over into the lipid side as well, and I will come to that sequence separately.
A sheet with all three at the borderline is not bad news. None of them is a disease yet, and it means you have just read the fact that the three lines are moving together.
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