Aging Fat Can Be Metabolically Dangerous for Senior Men

If you're a senior man who carries a significant amount of excess body fat, here is something you need to be aware of.

Does this older man have aging fat cells? And lots of visceral (dangerous) fat?

(The material below is from a discussion by Ben Bikman, PhD, of this medical review article: "The Ageing Adipose Paradox: Implications for Metabolic Health.".)

As we age past roughly the fourth decade, our capacity to make new fat cells declines sharply. Preadipocytes, the progenitor cells that mature into functional adipocytes (fat cells), become progressively less willing to commit to that fate.

Meanwhile, the fat we're eating and storing doesn't decline at all. It goes into the fat cells we already have, which swell beyond their comfortable working size.

So we gain fat precisely as we lose the ability to store it well.

Why does that distinction matter? Because a healthy fat cell is not a passive bag. It's a buffer and an endocrine organ. When you eat, adipose tissue absorbs the surge of incoming fat and keeps it out of circulation and out of tissues that have no business storing it.

That buffering capacity depends on having enough fat cells to spread the load. Expansion by making new cells, hyperplasia, is metabolically benign. Expansion by inflating existing cells, hypertrophy, is not.

Hypertrophied adipocytes hit their storage limit, develop endoplasmic reticulum stress (internal cell damage), shift their hormone output, and begin recruiting immune cells.

And once subcutaneous fat is out of room, the surplus lipid (fats) gets stored somewhere else, such as liver, skeletal muscle and tissue surrounding blood vessels and the heart. And at each of those sites, insulin resistance develops locally. 

This is the pathway from too much fat to metabolic disease. It runs through the failure of fat tissue rather than the mere presence of it.

Metabolic health depends less on the quantity of fat you carry than on whether your fat tissue continues to function properly.

The medical article lays out four possible molecular defects that converge on this problem.

• Transcription factors (molecular switches to control gene expression).
• NAD and sirtuin imbalances.
• Cell structure abnormalities.
• Cell senescence.

If you wish to get into the weeds on these causes, refer to the article.

The authors of the article list several possible strategies to deal with this fat metabolism dysfunction, none of which have completed Phase III clinical trials.

• Senolytics (enhancing removal of senescent cells).
• Dasatinib plus quercetin.
• Incretin drugs (such as tirzepatide).
• NAD precursors.
• Metformin.

Per our medical disclaimer, consult with a qualified health provider regarding any of these possible therapies.

Metabolic health depends less on how much fat you carry than on whether that fat still works. Aging fat fails in a specific, mechanistically describable way, and its failure propagates outward to the liver, the muscle, the vasculature. This is an underrated health risk for older men.

That reframes adipose (fat) tissue from a passive consequence of aging into one of its engines.

If you're a senior man with a weight problem, it's incumbent upon you to increase your level of physical activity and take a closer look at what you're eating.

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