Lower Micronutrient Status in the Obese
Investigators have noted repeatedly that obese people have a lower blood concentration of a number of nutrients, including vitamin A, vitamin D, vitamin K, several B vitamins, zinc and iron (1). Although there is evidence that some of these may influence fat mass in animals, the evidence for a cause-and-effect relationship in humans is generally slim. There is quite a bit of indirect evidence that vitamin D status influences the risk of obesity (2), although a large, well-controlled study found that high-dose vitamin D3 supplementation does not cause fat loss in overweight and obese volunteers over the course of a year (3). It may still have a preventive effect, or require a longer timescale, but that remains to be determined.
Hot off the Presses
A new study in the journal Obesity, by Y. Li and colleagues, showed that compared to a placebo, a low-dose multivitamin caused obese volunteers to lose 7 lb (3.2 kg) of fat mass in 6 months, mostly from the abdominal region (4). The supplement also reduced LDL by 27%, increased HDL by a whopping 40% and increased resting energy expenditure. Here's what the supplement contained:
Vitamin A(containing natural mixed b-carotene) 5000 IU
Vitamin D 400 IU
Vitamin E 30 IU
Thiamin 1.5 mg
Riboflavin 1.7 mg
Vitamin B6 2 mg
Vitamin C 60 mg
Vitamin B12 6 mcg
Vitamin K1 25 mcg
Biotin 30 mcg
Folic acid 400 mcg
Nicotinamide 20 mg
Pantothenic acid 10 mg
Calcium 162 mg
Phosphorus 125 mg
Chlorine 36.3 mg
Magnesium 100 mg
Iron 18 mg
Copper 2 mg
Zinc 15 mg
Manganese 2.5 mg
Iodine 150 mcg
Chromium 25 mcg
Molybdenum 25 mcg
Selenium 25 mcg
Nickel 5 mcg
Stannum 10 mcg
Silicon 10 mcg
Vanadium 10 mcg
Although the result needs to be repeated, if we take it at face value, it has some important implications:
- The nutrient density of a diet may influence obesity risk, as I speculated in my recent audio interview and related posts (5, 6, 7, 8, 9).
- Many nutrients act together to create health, and multiple insufficiencies may contribute to disease. This may be why single nutrient supplementation trials usually don't find much.
- Another possibility is that obesity can result from a number of different nutrient insufficiencies, and the cause is different in different people. This study may have seen a large effect because it corrected many different insufficiencies.
- This result, once again, kills the simplistic notion that body fat is determined exclusively by voluntary food consumption and exercise behaviors (sometimes called the "calories in, calories out" idea, or "gluttony and sloth"). In this case, a multivitamin was able to increase resting energy expenditure and cause fat loss without any voluntary changes in food intake or exercise, suggesting metabolic effects and a possible downward shift of the body fat "setpoint" due to improved nutrient status.
Does this mean we should all take multivitamins to stay or become thin? No. There is no multivitamin that can match the completeness and balance of a nutrient-dense, whole food, omnivorous diet. Beef liver, leafy greens and sunlight are nature's vitamin pills. Avoiding refined foods instantly doubles the micronutrient content of the typical diet. Properly preparing whole grains by soaking and fermentation is equivalent to taking a multi-mineral along with conventionally prepared grains, as absorption of key minerals is increased by 50-300% (10). Or you can eat root vegetables instead of grains, and enjoy their naturally high mineral availability. Or both.
"Avoiding refined foods instantly doubles the micronutrient content of the typical diet."
Sigh. I guess I'm gonna have to give up my hot links and Diet 7-Up.
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This means that we should all monitor our diet with excellent tools like Cron-O-Meter and decide what particular vitamin or mineral need supplementation. You've got to have a very very carefully constructed diet to avoid ALL risks of micronutrient inadequacies and imbalances once for all. I'm personally on a diet with no wheat, minimal omega-6, and lots of greens/vegetable and a lot of high quality fat. Wee bits of gaps in vitamin and mineral intake still remain that I prefer to eliminate with supplements.
Yet mostly I agree that supplementation is not crucial ass far as you've an excellent diet.
What I completely disagree with is that you've need no supplemental Vitamin D, just sunlight. From all the huge number of studies we've got it seems that sunlight is just too unreliable for practical purposes, and the issue of UV radiation and photoaging really do exist. Also, if your aim is to set 25(OH)D serum with some precision, gelcaps are the only working way to go.
I can see how improved micronutrient intake makes an obese person crave less food, but you are saying that they did not consume any less energy? Even a small (but constant) drop in calorie intake would result in weight loss over 6 months.
completely disagree with your conclusion "Does this mean we should all take multivitamins to stay or become thin? No".
even if we really try to eat in a way that *should* give us all the nutrients we need, we still often lack one or more vitamins/minerals. just go to nutritiondata.com and enter the stuff you eat in an average day, and see if you constantly reach 100% of all the nutrients. for me, there's no chance i can do that persistently. also,m it would be much too expensive (quality meat and veggies are incredibly expensive where i live).
also, what's the potential harm in taking a low dose MV/MM daily? i'd say, pretty much ZERO. so why take any unnecessary risk, if real-life data shows that most are deficient anyways? i know I WAS, and i thought i was very conscious with regard to what i eat.
saying a MV/MM is generally not needed, even with proper nutrition, is irresponsible at best. otherwise, good post :)
doesn't the mix of zinc and iron in one pill prevent the absorption of iron?
Stephen, If this is the study you are referring to, http://www.nature.com/ijo/journal/v34/n6/full/ijo201014a.html the size of the groups studied is so small that I question the actual significance as it involved 96 Chinesewomen divided into three groups of whom only 87 completed the study.
In addition, since it is a Chinese study so one has to question its applicability to a Western population who have more choices in food and more access to fortified foods.
I wouldn't read too much into this study. There is too much large-study long term data taken from American and W European populations that links vitamin and mineral supplementation with negative outcomes.
"I can see how improved micronutrient intake makes an obese person crave less food, but you are saying that they did not consume any less energy? Even a small (but constant) drop in calorie intake would result in weight loss over 6 months."
A small prolonged drop in caloric intake leading to weight loss is the "calories in, calories out" hypothesis that Stephan was referring to, effectively debunked in Good Calories, Bad Calories (GCBC to those of us who've drunk the kool-aid). It presupposes that our bodies have no feedback mechanisms. A more likely explanation for the explosion of obesity is that recent changes in diet have led to hormonal imbalances such as chronic insulin production blocking fat mobilization. Eating neolithic traditional foods in a non-traditional way, ie white bread instead of sourdough, probably exacerbates screwed up metabolisms by allowing more anti-nutrients and blocking nutrient availability. Some would consider that to be the root problem. Either way, the idea that our complex bodies, with untold numbers of feedback systems, able to survive millions of years as hunter-gatherers need simply to be tricked into losing weight by dropping a small food indulgence has little backing in research.
"Even a small (but constant) drop in calorie intake would result in weight loss over 6 months."
From the above statement, I'm willing to bet that JLL probably has never had a serious problem with obesity.
"Even a small (but constant) drop in calorie intake would result in weight loss over 6 months."
From the above statement, it's pretty obvious that JLL has never had a serious fight with obesity.
oops, sorry for the double post.. thought I lost the first one. haha
Stephan, Of these many micronutrients listed, is the richest source by far seafood.
And you need to eat only a fairly small amount of oysters, wild-caught salmon and tuna to obtain abundant, highly bio-available quantities of everything listed? By comparison, plants even in very large quantities really can't compare given how mineral deficient our soils are today? In fact, seafood is a truly irreplaceable food source?
I understand that it may seem too expensive to obtain high-quality seafood, but on a scale of cost-effectiveness, isn't high-quality seafood in small quantities still the best value for your money, too?
And doesn't the lake of oil now covering 40% of the Gulf of Mexico create a dead zone where no sea life can exist? And isn't this lake of oil therefore a real threat to the survival of our entire species, which simply can't exist without seafood?
For all these reasons, I ask that you and the community here give voice to this ecological disaster, the most important threat to whole health of our lifetimes.
I think the other key argument against eating poor-quality food and relying on supplementation is that you're at the mercy of the state of the art.
We don't know all the nutrients that the body needs, as the recent recognition of the importance of omega-3 oils demonstrates.
If you eat an ancestral diet, you're getting enough to keep a person healthy, by definition.
The evidence so far, looking around us, is that the lousy food and supplementation approach doesn't work so great.
I'm really digging this article!! I'm not saying that to be nice either. I'm saying that because my obese Inlaws have been giving us grief for our son's diet. He developed malnutrition due to bowel problems (possible crohn's and Celiacs), severly restrictive eating patterns and severe food intolerances. Since we're not letting them feed him Poptarts, Nerds and Dr Pepper, we're terrible parents.
I'll take a moment of silence to savor your post. Thanks!
Wow, this is another bombshell nutrition study. Thanks for sharing, Stephan.
For years, we've been told that multivitamins make no difference at all, except in elderly or malnourished individuals. Perhaps what this study shows is not that obese people aren't getting enough trace minerals, but that they're getting so many antinutrients that they end up malnourished.
That said, I think that longterm multivitamin use is still an open question. They're high in iron and manganese (which have been linked to a host of problems when consumed in elevated levels), and defficient in zinc (which is very difficult to get, outside of eating bivalves who may live in polluted water) and grossly defficient in calcium (because the pill would be too big). And epidemiologically, they're associated with advanced prostate cancer, when consumed more than once a day (barely excessive).
In America, I think we put too much faith in the RDA, and have little appreciation for its probability distribution, especially in light of DNA and body mass differences. That said, I think it would be easy to create a more optimal pill.
It would be cool to know which micronutrients mattered here. But I know that's not at all easy to determine.
Your willingness to dive into the data continues to provide a great public service.
It's all about cause and effect. Micronutrient values in the obese are low due to the abundance of carbs (i.e. sugars and starch) they consume. It's not that people get obese due to the fact that they eat a diet low in micronutrients.
I don't get it, how does this prove "calories in, calories out" wrong. Or in other words, are they violating the laws of physics?
People get obese because they take in more calories than they expend. If you want to stipulate WHY they're doing that, sure, but you have to keep the proper framework in mind: that energy can neither be created nor destroyed. These people aren't matter creating machines; they aren't creating energy out of thin air. They're either eating that energy or not using it up.
Taubes proved Newton wrong?
Neither Gary nor I are arguing against the laws of thermodynamics. The common theory of fat balance (sometimes called "calories in, calories out", which I don't like because it leads to confusion) states that fat accumulation depends entirely on how much you eat and exercise. That's what this result argues against.
So bodies stay hungry for nutrition and if they get too much starch in the process, obesity results. That is a more useful explanation than "calories in=calories out" because in this case the deciding factor is the amount of vital nutrients per calorie that may determine total intake.
The simplistic equation doesn't lead you to a higher truth, it just causes you to think that nothing can be done to change the situation.
There were no statistically significant differences in energy intake between groups, although there was a slight trend for lower calorie intake in the multivitamin group. That may or may not represent statistical noise. However, there was an increase in resting energy expenditure in the multivitamin group.
I consistently get well above 100% RDA for all nutrients except vitamin D, which I get mostly from sunlight. But in any case, the RDA is nothing more than a somewhat arbitrary guide. It's useful, but don't get too caught up by it.
You say the risk in taking a multivitamin/mineral is zero, but there's no long-term evidence to support that conclusion. The fact is, there are a million types of these pills, and they're constantly changing, so we have no idea what the long-term effects of any one of them are. In fact, several studies link multivitamin/mineral use to worse health outcomes, as Jenny mentioned above. It could be a meaningless association, or it could be that these man-made nutrient combinations upset the natural nutrient balance of the body, or contain toxic trace by-products of chemical synthesis reactions.
The study size doesn't concern me since the statistical significance was very high. Also, a 9% dropout rate over 6 months is pretty good in my book. Your comment about differences in background diet could be relevant, I don't know. It should be repeated in a Western population.
I have no doubt that obesity is associated with poor micronutrient status. This was a common finding in research I came across when I was a community organizer promoting household and community food security in low-income neighborhoods (U.S.).
As a former believer in supplements, I now approach them with extreme caution. Some of the nutrients included in the multivitamin provided in the study - and in almost all multivitamins - may do more harm than good when it comes to obesity and insulin resistance. These are just a few examples:
Is Nicotinamide Overload a Trigger for Type 2 Diabetes?
Reducing Niacin Intake Can Prevent Obesity, Study Suggests
(Maybe one reason among several that ditching baked goods yields dramatic results for some people.)
Cross-talk Between Iron Metabolism and Diabetes
Even Vitamin C has a Janus face when it comes to diabetes. I found many studies finding an improvement in vascular function with supplementation, but one large study found diabetic women supplementing with Vitamin C had double the death rate of non-supplementers.
Pro Vitamin C supplement (intravenous, actually):
Anti Vitamin C supplement:
Thanks for the discussion.There is a lot of concern about obesity and not knowing what should be the right course of action most are drawn more into it.This study may help them really.
@Bryan, I'm not aware of Taubes challenging calculus, the force of gravity or the laws of motion.
One of the important minerals might be manganese, which some evidence suggests is required for regulation of food intake. It activates an enzyme called mTOR, which is downstream of leptin in the hypothalamus.
Here's a paper entitled 'Hypothalamic mTOR signaling regulates food intake':
...and here's a paper showing that mTOR has an absolute requirement for manganese (Fig 2A):
Prevalence of micronutrient deficiency in popular diet plans
Full text free online.
Four popular diet plans (Atkins for Life diet, The South Beach Diet, the DASH diet, The Best Life Diet) were evaluated.
Six micronutrients (vitamin B7, vitamin D, vitamin E, chromium, iodine and molybdenum) were identified as consistently low or
nonexistent in all four diet plans.
Bear in mind they used U.S. Department of Agriculture Nutrient Database for Standard Reference RDI amounts and some of us consider those inadequate for vitamin D and magnesium. I'm not sure they counted water as a dietary source of calcium, magnesium molybdenum?
I'm not sure I like the idea of a standard multivitamin/mineral as replacement source as they tend to be bulked up with synthetic rather than natural forms. Most contain magensium oxide which is only 4% bioavailable.
You may find this paper detailing what happens to core body temperature, activity levels and weight gain when the caloric content of food is modified by the use of noncaloric sweeteners interesting.
A Role for Sweet Taste: Calorie Predictive Relations in Energy Regulation by Rats
increased intake of no-calorie sugar substitutes could promote increased intake and body weight
"Investigators have noted repeatedly that obese people have a lower blood concentration of a number of nutrients, including vitamin A, vitamin D, vitamin K, several B vitamins, zinc and iron "
Hmmm, I wonder if the problem is that the body is regulating its intake of these items, but in the obese the dilution is increased because there's the same amount of nutrient but twice as much person? Especially fat soluble vitamins vs. increased body fat.
"However, there was an increase in resting energy expenditure in the multivitamin group."
Would be interesting to tie down which specific micronutrient(s) are responsible for this.
I spot a feedback loop, insufficient concentration of something deficient in the diet causes more consumption of food in general, which causes obesity, which dilutes the something further, which reduces energy output, which causes more obesity, and round and round we go . . .
There's a depressing thought, maybe some of these "miracle weight loss" pills actually do work.
Of course it's ideal to get all nutrients needed from food. For some (or many) it's not always easy or possible. Plus especially when you are dieting you are eating less (often much less) making it harder to pack the few calories you do consume with all the nutrients you clearly need
There are also many variables:
- genetic variation in humans
- genetic variation in food (e.g. >150 types of tomatoes, 10-fold difference in vitamin C content between different types of apples)
- food preparation
- food storage
Genetics plays a part in nutrient requirement, we publish a small study (being followed up with larger numbers and longer time course, but inital results interesting: http://bit.ly/4Yk4Wg
Insight into just how lame the "calories in, calories out" theory is can be gleaned from the data from the Epic-Heidelberg study on the correlation between vitamin K2 intake and prostate cancer.
In the study, 11,000 men were followed for 8 years and the correlation between K2 intake and prostate cancer was determined based on food frequency analysis.
Men were ranked by quartiles of vitamin K2 intake, and because cheese is rich in K2, cheese consumption among those in the quartile of K2 intake was four times that of the quartile with the lowest K2 intake.
The percentage of those with University degrees was 44% in the highest Q of K2 intake compared to 29% with the lowest K2 intake, suggesting that those that ate a lot of cheese had greater wealth.
Those in the highest quartile of K2 intake had a BMI and 26.8 and a daily caloric intake of 2730. By comparison, those in the lowest quartile of K2 intake had a higher BMI, 27.1, but a caloric intake of of 1724 kcal/day. Other factors such as exercise, smoking and alcohol consumption were about the same for the two groups.
The low K2 group, the less wealthy, ate cheaper food, more omega 6, more carbohydrates, less protein and less fat than the wealthier group and were fatter even though they ate 35% fewer calories. "Calories in, calories out" does not fit the data at all does it.
That squares with what I learned doing food security work in the United States. As income goes up, the quality of food eaten goes up. It's not rocket science. Nor are the food choices just a matter of "ignorance," as many would like to believe of those plagued with both obesity and poverty.
The areas in which there was the most hunger, according to our research (and there was widespread, intermittent, actual hunger - involuntarily skipping meals, losing weight, and eating less due to lack of food - when you can't even afford the cheap food), also had the most obesity. I'm sure that, along with micronutrient status and fat-producing inputs (HFCS, omega-6), the body's reaction to intermittent caloric shortages (Mark's Daily Apple explained it well recently in a post about carbohydrate refeeding on a low-carb diet), tend to make it hang on to weight in spite of lower calories.
I'm not sure how this is supposed to invalidate the calorie in = calorie out theory.
You said they lost more weight because of an increase in REE.
So it simply influenced the calorie out part of the equation, I don't see how it negate the whole thing.
Just like with the TEF of protein. It's not that the equation does not hold, you simply influence more the calorie out part of it.
I had a sudden thought: parts of China are seriously selenium deficient. Other parts have an excess. Would be interesting to know which part this population inhabited, if the supplements are simply replacing the missing selenium (possibly also iodine) this might be readjusting thyroid function in a beneficial direction.
"Keshan disease" (selenium deficiency related) was first reported in Keshan Heilongjiang province .
Harbin Medical University, Harbin, Heilongjiang province conducted the study Effects of multivitamin and mineral supplementation on adiposity, energy expenditure and lipid profiles. it's likely the study participants were local residents.)
The "calories in, calories out" hypothesis, as commonly defined, does not account for changes in resting energy expenditure. It states that voluntary calorie intake and physical activity behaviors are the determinants of fat mass. In other words, fat mass is under conscious control. It's partially true, but not particularly relevant in practice due to homeostatic feedback mechanisms on fat mass.
You might be interested in this link.
"Vitamin C is a cofactor in the biosynthesis of carnitine, a molecule required for the oxidation of fatty acids. A reduction in the ability to oxidize fat may contribute to the reported inverse relationship between vitamin C status and adiposity."
Thanks for the answer.
Am I wrong or the calorie in = calorie out is actualy
Calorie in = RMR (REE) + TEF + Physical activity (which could be divide in non-spontaneous and spontaneous)
If you influence REE, you simply influence the calorie out of the equation. Or am I wrong?
Yes, that formula is correct as long as you assume a constant fat and lean mass. The "calories in, calories out" question is nothing more than a semantic issue. I'm not questioning the thermodynamics of the human body, only the oversimplified version that has trickled down into the popular consciousness, that people use to justify the "gluttony and sloth" explanation of obesity.
I wanted to follow up on my previous comment with an example to illustrate what I'm talking about. Leptin receptor mutated rats (Zucker rats) are extremely fat. It's literally impossible to make them lean by reducing their food intake. They will die of starvation with large fat depots, because they break down their lean mass to spare their fat. The same is true (to varying degrees) in a number of other obesity models, including ovariectomized rats and diet-induced obese rats.
The same thing happens in humans as well. If you take an obese person and reduce their calorie intake (while keeping diet composition and lifestyle constant), they will lose both fat and lean mass. However, their body goes into "conservation mode" as leptin drops, reducing energy expenditure, increasing appetite, etc. Therefore, in the long term, the body fights fat loss using a number of strategies, so telling a person to eat less or exercise more is virtually useless in practice (in the long term).
Yes, you can lose fat simply by restricting calories if you have an iron will and you can starve yourself enough. But you will also lose lean mass, and be hungry and miserable, because your body will think you're starving even if you still have a high fat mass. Furthermore, 99% of people lack the mental resolve to fight their hypothalamus indefinitely. None of this contradicts the laws of thermodynamics, but it does contradict the oversimplified interpretation of thermodynamics that's most commonly stated by diet authorities and the media.
The calorie equation fits OKish probably for the majority of food eaten - but it's not a perfect sum and therein is the problem. But really why should it be thought to be accurate? Calorie is a measure of heat - all things "contain" calories but a 5000 cal/day diet of grass won't make you fat (just sick), but 5,000 cals of burgers+buns probably would.
Traditional Asian diets definitley consist of various organ meats, land meats, seafood like octopus, various insects and bugs , snakes, (yes, you read that right), rats in some areas. You will find some of the strangest animal foods ever in Asia. It is unreal.
Zimmerman's and Bourdain's shows cearly show how animal food is a major part of all Asian diets, despite vegan propaganda. Anyone who has been there already knows this.
Also, you are right Stephan about common calory theory proponents farcical arguments.
Their "basic thermodynaimcs" argument mixes up E=MC^2 in a way Einstein would not forgive. Humans are not closed systems, and no caloric energy is being turned into matter in a human.
A calorie is a unit of heat used in physics. It has has everything to do with the energy liberated from burning a substance. It hs very, very little to do with biological processes- which do not involve combustion. The Caloric Model is a 60 year old rough analogy. It considers food for its combustive energy and completely ignores what actually happens to food molecules inside the body . Overeating is bad, of course. But the phenomenon of obesity is much. much more complex than calorie theory proponents will admit........
The main faults of the Caloric Model is that it attempts to posit a closed system where none exists, it grossly oversimplifies,and it does not attempt to explain many, many observations. A good way to get a theory killed is by ignoring contradictory evidence.
The question is not whether the Laws of Thermodynamics apply to humans. The question is whether we can infer from these laws the behavior of mammalian fat cells.
Thermodynamics requires that energy is conserved in a system , and it is. But whether lipids are stuffed into fat cells , processed to extract chemical energy , or simply eliminated as waste is not predicted by those laws. Those things are governed by other variables.
Anyone who invokes the Laws of Thermodynamics in an obesity discussion has absolutely no idea what they are talking about. They are taking the laws completely out of context and attempting to oversimplify a very complex phenomenon. Funny thing. Actual biologists aren't much into oversimplifying a physiological phenomenon. Mostly where it happens is in the diet industry where proponents have a financial stake in the conclusions drawn.
The Laws of Thermodynamics are not violated by acknowledging that in the non closed system that which is a mammal , how fat cells behave is governed by chemical signals - from hormones and food substances- and by states of disease and genetics.
To lose fat , fat cells must be made to disgorge themselves of their excess lipid molecules and allow the body to eliminate them as waste. Saying this does not violate the Laws of Thermodynamics.
GREAT blog by the way, Stephan. I am very happy this info is getting out there.
I encourage EVERYONE on here to forward this article to ALL calorie theory proponents you know , including all these popular fat loss gurus with massive followings ( who shall remain nameless) on the internet who think they are experts. They're not. They push dieting and diets do NOT work. Anyone who understands anything about obesity would NEVER push dieting. The fact these gurus do, should tell you all you need to know about them.
Science just does not know enough yet about the regulation of mammalian fat cells for such cocksuredness from proponents of the failed caloric model of obesity.
To me, this article simply show that a lack of micronutrient could slowdown BMR and that getting adequate level of micronutrient could make the basal metabolic rate run faster and hence burn more calories. I'm not sure how it's supposed to invalidate the theory. (I've not read the paper tho, not even the abstract, this is only from my reading from Stephan's article.)
How would you explain all of the people who lost weight (weight watcher has a lot of success story of 100+lbs lost and maintained) and maintain the lost with basic dieting principle (ie, consume less than you expend) if they are supposedly a total failure?
I think the mistake that many people do is to be on either side, whereas it's actualy obvious that in term of energy calorie clearly matters, but that differents calories can have differents metabolic effects.
Razwell, are you going to tell me that the answer to the obesity epidemic is to go low-carb? Just like they did in the 70-80' with the low-fat?
I'm a calorie matter proponent, and I clearly understand that obesity is complexe. But calorie still do matter, and albeit not 100% precise, it's still hold in most context.
Surely, guys like Alan Aragon, Lyle McDonald, Martin Berkhan, who have a lot of (awesome) real world results, and who goes by calories quite a lot, know nothing about nutrition. Sure thing.
Why does it have to be black or white? Why can't calorie matter AND metabolic disorder matter too?
I don't want to get into the cliché that people are fat because they mean to get there, but people are always looking for a quick fix, for something to put the blame else than on themselve. People don't wanna work, make the effort, change their habits, etc, etc. This is plain human nature. I see this all the time in the gym at which I work. People want the magic supplements, the magic program, the magic diet. They don't like it when I tell them it takes time, patience, and work. Then you've got thing like "fat is not your fault" and people trying to find multiple reason to obesity, such as obesogens, gut microbiota, insulin resistance, etc. This certainly all matter, to some degree, but taking the responsability off the individual isn't going to help him either.
Anyway, thanks for your answer Stephan. Your blog is a very intelectualy rich place.
Regarding the subject post, I would like your opinion on the hypothesis that the 40% increase in HDL that occurred after vitamin and mineral supplementation was due to decreased inflammation that reduced catabolism of HDL phospholipids by endothelial lipase (EL).
EL is a member of the lipase family that is primarily synthesized by endothelial cells which has been found to play a key role in metabolism of HDL-C. Inflammation causes an increase in EL activity which results in hydrolysis of HDL phospholipids and decreased HDL-C levels, whereas suppressing EL activity enhances concentrations of HDL. Increased EL concentrations are associated with a deteriorated lipoprotein profile, elevated triglyceride concentrations and smaller LDL particle size. EL concentrations are positively correlated with obesity, fasting insulin and markers of inflammation.
CoQ10 deficiency causes increased Crp which activates EL and thereby reduces HDL. CoQ10 synthesis requires at least seven vitamins and several minerals. CoQ10 deficiency due to nutrient deficiency is common. In the Li study, the supplements provided included nutrients needed for CoQ10 synthesis and therefore would be expected to result in increased HDL due to lower Crp induced catabolism of HDL by EL.
High homocysteine due to B vitamin deficiencies also results in reduced HDL due to increased EL activity.
It is my opinion that the increased HDL that occurred following nutrient supplementation was the result of suppression of EL activity due to increased CoQ10 and decreased Hcy (and probably other things too)
Weight loss would also be effected by EL, for lipoprotien lipase (LPL) is inversely correlated with EL, so reduced inflammation would cause increased LPL thereby enhancing metabolism of fats and carbohydrates.
One of my neighbours has a vintage car which he rallies. It does about 30 mpg (UK gallons) and has the performance of a slug on valium.
I have a modern turbodiesel which has more than adequate performance and does well over 60 mpg.
The basic principles and components are the same, just more finely tuned. A more efficient burn and lower *internal losses* make the fuel calories produce over twice the output energy. IMO that's what we're trying to address in a human system where we can't simply bolt on a turbocharger or reset a fuel pump.
Current diets aren't providing a clean burn and the only way we can get sufficient power out of the system is by overfuelling. Instead of the excess fuel producing smoke and soot it's producing body fat etc.
Even a simple mechanical system only does "calories in, calories out" when you take into account all of the processes involved: internal friction, waste heat and sound energy, semi-burned fuel . . .
Just published in AJCN
Am J Clin Nutr (June 23, 2010). doi:10.3945/ajcn.2010.29468
Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A TO Z study1,2,3
Christopher D Gardner, Soowon Kim, Andrea Bersamin, Mindy Dopler-Nelson, Jennifer Otten, Beibei Oelrich and Rise Cherin
Background: Information on the micronutrient quality of alternative weight-loss diets is limited, despite the significant public health relevance.
Objective: Micronutrient intake was compared between overweight or obese women randomly assigned to 4 popular diets that varied primarily in macronutrient distribution.
Design: Dietary data were collected from women in the Atkins (n = 73), Zone (n = 73), LEARN (Lifestyle, Exercise, Attitudes, Relationships, Nutrition) (n = 73), and Ornish (n = 72) diet groups by using 3-d, unannounced 24-h recalls at baseline and after 8 wk of instruction. Nutrient intakes were compared between groups at 8 wk and within groups for 8-wk changes in risk of micronutrient inadequacy.
Results: At 8 wk, significant differences were observed between groups for all macronutrients and for many micronutrients (P < 0.0001). Energy intake decreased from baseline in all 4 groups but was similar between groups. At 8 wk, a significant proportion of individuals shifted to intakes associated with risk of inadequacy (P < 0.05) in the Atkins group for thiamine, folic acid, vitamin C, iron, and magnesium; in the LEARN group for vitamin E, thiamine, and magnesium; and in the Ornish group for vitamins E and B-12 and zinc. In contrast, for the Zone group, the risk of inadequacy significantly decreased for vitamins A, E, K, and C (P < 0.05), and no significant increases in risk of inadequacy were observed for other micronutrients.
Conclusions: Weight-loss diets that focus on macronutrient composition should attend to the overall quality of the diet, including the adequacy of micronutrient intakes. Concerning calorie-restricted diets, there may be a micronutrient advantage to diets providing moderately low carbohydrate amounts and that contain nutrient-dense foods.
Received for publication March 4, 2010. Accepted for publication May 23, 2010.
The USDA has issued draft dietary guidelines for 2010 which recommend further restrictions on consumption of cholesterol and a reduction in saturated fat intake from 10% to 7% of calories.
The proposed guidelines will result in reduced the consumption of nutrient dense foods such as liver, eggs and dairy fat and coconut oil and will lead to reduced intake of nutrients essential for good health thereby causing increased obesity and disease.
More details on the draft guidelines are given in the action alert from WAPF below:
So here's an interesting idea. Fat people attempting to lose weight often fail at very-low-calorie diets. They retain most or all of their fat stores (unless they exercise a LOT... which then kills their lean mass). Normally this is excused away as "starvation mode" because the body is "panicking" at the low caloric intake.
But wait. Isn't it more accurate to say that ketosis is "starvation mode"? If our fat stores are meant to take us through lean times, ha ha, then it stands to reason that if we're starving, we need to mobilize those fat stores for energy. It makes no sense to keep the energy stored when faced with few available calories. That's just suicidal. It means you get sluggish, slow down and are mentally less inclined to do anything for yourself. As I'm sure you've noticed about many fat people who have not yet made changes to their diets. I've been there myself.
Also, we're smarter, it would seem, on ketosis than out of it--the brain is apparently more efficient. Again, it makes more sense evolutionarily to maintain your energy level and get smarter so that you can find food before you die.
I had already had an idea it wasn't really "starvation mode" that inhibits weight loss on low calories. I have a problem with this myself--I'm working on weight loss, and I often forget to eat. When I track my food and I've had a bad day, I can sometimes find myself under the 1000-calorie mark for intake. I'm in ketosis so it doesn't bother me much until I really get hungry (even then the hunger's different than what occurs from a drop in blood sugar level--a nice change!), but it seems like it is still a problem.
Aaand... I have noticed that my weight loss seems to be faster when I'm eating a good 2000 calories or more per day. If my weight loss slows down, and I've been tracking my food, I will usually note that I haven't been eating at that 2000-calorie minimum. Usually it's more like 1600 or less. I had come to wonder whether micronutrient lack might have been the fundamental problem.
Your post here is helping put the puzzle together for me. I love it when I might be right. Or am right. Oh well, I have a feeling more research will just confirm this finding.
Oh man... JLL, give it up. First off, if you're obese, you want to lose fat, not just "weight." You calorie-restrict to lose the weight and happen to restrict the wrong kinds of calories, the "weight" you lose will be muscle and bone, not fat.
I wish people would get over this... I really do... I mean, we don't even burn all the food we eat for fuel! Has someone worked out how much of it goes to fuel and how much to building materials? Has someone worked out whether or when or how those proportions change? Probably not. There's a lot we still don't understand about human metabolism.
I wish it were about cutting back 500 calories a day. In my experience, I have to add that 500 to see significant weight loss. Then, on top of that, the fatty acids I'm releasing from my adipose tissue? I'm "eating" those too. I never did burn them for fuel from whenever I ate the original foods. Now I am burning them. So that's extra calories, God only knows how many...
...because I'm also in ketosis, which means that when I visit the little girl's room, some of those calories I was supposed to be burning get flushed down the toilet!
I love nice, neat answers too. Unfortunately, they seem to be in short supply in this case.
Oh, and I bet they'd have an even better outcome in that study if they used retinol (from a natural source, preferably) instead of beta carotene. Just saying.
http://www.ncbi.nlm.nih.gov/pubmed/20537171 - That reminds me of this study found in pub med about nutrient deficiencies. In this study the researcher looked at suggested diet plans from four well-known diets: the South Beach diet, the Atkins for Life diet, the Diet Approaches to Stop Hypertension (DASH) and the Best Life Diet. The Idea was if you followed this diet perfectly would you Percentage of RDI of 27 micro nutrients what you get, all the vitamins and minerals? Basically out of all those diets you would only get between 100% of 12-15 micro-nutrients required out of 27. Not so good, but just popping a muti vitamin is not the answer either, It can help with ones who may be dieting, but choosing to eat foods less unprocessed and more whole you can get most of those requirements by that. Hey ADA recommend 5 servings a day of fruits and vegetables. Screw it GO TO 10 servings of fruits of vegetables a day and mix and match and we should be able to meet allot of those requirements. GREAT POST MUCH AGREED ! :)
While USDA are busy making the problem worse,
This is seriously scary. it's already finded by Unilever among others, this will just be carte blanche for more pushers of low-nutrition carbs and Omega 6s to purvey their wares in the name of "health"
Like the poster above explained to you that idea supposed a static fixed system with no feedback mechanisms to thwart your efforts at taking in less or expending more. There is significant scientific evidence that the hypothalamus regulates body fat level the way a thermostat controls the temperature in an air conditioned room. It defends a particular body fat level and makes adjustments to metabolism and hunger and satiety that are too powerful to resist long term to ensure that a particular body fat level is maintained.
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