The Secret Root Causes of Belly Fat. #1: Chronic Inflammation—The Hidden Saboteur

Root Cause #1: Chronic Inflammation—The Hidden Saboteur

Let’s get right to it. Now that we know that inflammation is one of the main underlying factors that makes the body store weight around the waist, even in otherwise skinny individuals, let’s take a closer look at where this inflammation is coming from, and why it matters for more than just looking better in a swimsuit.

First things first. Inflammation is not all bad! In fact, it is the body’s natural defense mechanism, and we need it to survive.

When we are injured or fighting off infections, our immune system creates inflammation to help us heal.

But here’s the catch: when inflammation becomes chronic, it slowly erodes your health from the inside out. Think of it as a slow-burning fire—one that doesn’t heal but harms.

Early Signs of Chronic Inflammation include:

• Acne, eczema, or skin irritation
• Irregular periods or hormonal imbalances (PCOS, endometriosis)
• Joint pain and body aches
• Anxiety or brain fog
• Poor sleep quality
• Fatigue
• Trouble sleeping
• Bloating and belly fat, while being overall skinny, ie ‘skinny fat’ – with a redistribution of fat towards the belly.

The Inflammation–Belly Fat Connection

Inflammation changes the way your brain controls fat storage. When you are inflamed, the brain tells your body to store fat around your waist—even if you are eating well, exercising, and doing ‘all the right things’. I commonly see this in my health conscious clients when they first come in to see me. They are trying their best, yet that layer of belly fat won’t budge. As always within Functional Medicine, we want to know ‘what is the underlying root cause?’ – in this case, ‘Why is there chronic inflammation’?

But this is (unfortunately) not where it stops. If inflammation continues to persist over longer periods of time, it literally can be likened to a slow burning fire, that gradually degrades our body’s tissues, anywhere from the brain, to the heart, to the lining of our blood vessels and more.

Chronic inflammation and how it is linked to faster ageing

Inflammation, if chronic, is that pervasive that it has been coined ‘inflammaging’ by scientists, and it constitutes one of the main 12 hallmarks of ageing we touched upon in the previous chapter. The hallmarks of ageing have been found to be root underlying trigger for pretty much all age related decline and disease, such as:

• Alzheimer’s disease, Parkinson’s and other neurodegenerative conditions
• Cancers
• Cardiovascular disease such as atherosclerosis, heart attacks and strokes.

As you can see, not great overall!

But rather than this being all scary (don’t stop reading just yet!) – we can do something about this chronic inflammation. Ideally the earlier the better, but any time, no matter if that is as a child or senior can make a large impact on your health trajectory!

First step, and the way Functional Medicine works, is to look at ‘why is there chronic inflammation’, rather than just suppressing it with yet another supplement, drug or restrictive and expensive ‘anti-inflammatory diet’ (though we will look into how to properly put together an anti-inflammatory diet that actually works in a future post!).

Common Triggers of Chronic Inflammation:

As we explored earlier on, acute inflammation is essential for survival, to fight off infections and heal wounds and cuts, but why would the immune system decide to stay activated and turn against your own body? Often this can be due to said infection persisting, at a low level, continuously activating the immune system to try and fight them of (= inflammation), yet not being successful at it, letting it linger. Alternatively, anything else that the immune system does not recognise, and as such perceives as an invader, can equally trigger the immune system to produce chronic inflammation.

Some of the most common triggers for low grade inflammation include:

• An imbalanced gut microbiome: Many have heard by now about the importance of certain ‘good bugs’ in the gut. They help digestion, produce nutrients, and keep the gut lining nice and strong. However, there are also some ‘bad bugs’ that can cause havoc and inflammation, such as parasites, candida, or bacterial overgrowth (such as H. pylori, small intestinal bacterial overgrowth (SIBO), and others). When they linger, inflammation results.

• Chronic viral load: In addition, research suggests chronic viral infections, that aren’t well controlled by the immune system, playing a major role in immune system and inflammation activation. Some of the most common offenders include cytomegalovirus and Epstein Barr virus, which people generally know from the ‘kissing disease’ Glandular fever, which can result in chronic fatigue in some. But even people that didn’t knowingly contract them, often have the virus lingering in their system, creating havoc.

• On the other hand, not having enough ‘good bugs’ can also contribute to inflammation. Why? Research suggests that having enough ‘good guys’ in the gut is needed to produce something called Treg cells, which is the regulatory portion of our immune system, tasked to calm it down (R)

• Hidden food intolerances Furthermore, these ‘good bugs’ are needed to keep our gut lining healthy and strong. If they are missing, the gut lining can become weakened (more permeable, which you might have read about as a ‘leaky gut’), and then allow food particles to pass from the gut lumen into the blood stream at a different shape than what the immune system is used to. Having an overgrowth of ‘bad bugs’ similarly can contribute to a ‘leaky gut’. Once these food particles have sneaked their way through the permeable gut lining into the blood stream at a different shape, the immune system in some individuals then mistakenly classifies them as ‘invaders’, and mounts an immune response, aka inflammation, to fight off them off! The end result of this being an inflammatory reaction to what would have normally been a perfectly healthy foods. ‘Health foods’ this frequently happens to include  almonds, eggs or yeast, in addition to the most common cow dairy and gluten you likely have heard about.

Advise – Test, don’t guess!

I test most of my patients for hidden food intolerances, and urge you to as well before blindly cutting out entire food groups, for a number of reasons. One, is that not everyone is intolerant to cow dairy, gluten, or eggs, and cutting them out when not needed, can unnecessarily restrict one’s diet (and social interactions!). Secondly, symptoms of hidden food intolerances most often are vague, and come on as a delayed reaction, hours to days later. This means you likely won’t link that bit of mayonnaise you had with your Saturday night fries to the acne flare on Monday, or the yeast in the glass of champagne to an anxiety attack the next day. We are not talking about the usually more obvious and direct reactions such as allergies or lactose intolerance, that will have you run to the bathroom right after a glass of milk. The food intolerances I am referring to here are triggered by a part of the immune system called IgG, a type of memory cell of the immune system. When we have IgGs to for example a virus, our body should be able to produce a response (inflammation) quickly the next time we are exposed to that virus, with the goal that the immune system kicks it to the curb before it can make us ill. Some are familiar with that concept from vaccines, as part of how vaccines work is to expose the immune system to the bug, for it to create these memory cells, protecting us when we are exposed to the real deal. Now if the immune system has mistakenly produced them against for example an almond, every time you eat almonds your body goes into an inflammatory state, which can last up to several days!

• Environmental pollutants Remember how I mentioned earlier that pretty much anything that the immune system cannot recognise as a ‘friend’, gets attacked by inflammation. In addition to infections and hidden food intolerances, this also includes environmental pollutants such as heavy metals, pesticides, or mold. Examples include lead, often found in old water pipes, mercury from tuna consumption or old amalgam fillings, and mold from water damaged buildings.

• Blood sugar spikes We will go into a lot more depth on blood sugar and its effect on the muffin top and your metabolism in a future post. But regardless of all its other potential pitfalls, blood sugar spikes also trigger inflammation! Research suggests that even within the ‘normal range’, if blood sugar goes above a very narrow ‘optimal range’ of 3.8 – 5.9 mmol/l, it causes microdamage to our blood vessels and other bodily structures, triggering inflammation. Now if this happens here and there, and for a short time period after meals, it’s not a big deal. However, if one is perpetually above that optimal range, this can be one of the often overlooked contributing triggers. Note that this range is a very far way from diabetes or overt blood sugar issues that would be picked up by your routine health checks. More on blood sugar, how best to measure this to see if you are in optimal ranges, and how to improve your levels soon.

• Stress Similar to the blood sugar puzzle piece, we will go into a lot more depth on stress and its impact on belly fat and long term health in a later post. However, as far as inflammation is concerned, stress in itself has been shown to increase inflammation. Interestingly research suggests that acute stress is in fact anti-inflammatory, but in long-term chronic stress situations, the body starts to not respond to the anti-inflammatory signalling of cortisol as well any longer, in addition to a lowered ability to fight off infections, rendering the body overall more inflamed! How many of you know someone that fell ill after a period of severe emotional stress? There is a real reason for it, and it lies in the way our body upregulates inflammation (and lowers our healing capacity) when we are going through an extended stressful time.

• Sleep Did you know that just one night of low quality sleep makes your body more inflamed the next day? When I read that research, my mind was blown. How many of us don’t get enough sleep on a regular basis, or, while getting enough hours, struggle with quality! If sleep is an issue for you, you might find my self-paced course on how to fix your sleep helpful. 

• Deficiencies in nutrients needed to quench inflammation, such as omega 3s: And lastly, if we miss certain nutrients, our body has a very hard time quenching inflammation once it has done its job. As we discussed earlier, inflammation is an essential process for survival. However, we need to be able to stop it once it has done its job. This is called ‘resolution’. One of the main nutrients necessary for this ‘inflammation resolution’ is omega 3. Most have heard of fish oils and how they are important for heart and brain health. Part of that health benefit is due to the anti-inflammatory effects of its DHA and EPA.

Note: We need the active forms of omega 3 called EPA and DHA to quench inflammation, found only in fish (or highly concentrated algae supplements). Vegan versions such as flaxseed and walnuts, albeit packed full of other healthy nutrients, do NOT contain the active and anti-inflammatory form of omega 3s, and humans aren’t great at converting the precursors found in plant-based foods into the active form! More on what to eat and supplement to quench inflammation in a different post.