In the past, obesity was understood in fairly simple terms: excess body weight resulting from eating too much and exercising too little. Obesity is now regarded as a chronic medical disease with serious health implications caused by a complex set of factors.
Micronutrients and Obesity:
Obesity is a complex, chronic disease involving multiple components. It is the second leading cause of preventable death in America, second only to cigarette smoking, and increase the risk of illness from over 30 medical conditions including diabetes, hypertension, cancer, infertility, arthritis and heart disease. Prescription medications and procedures used to treat many of
these conditions often induce micronutrient deficiencies as well.
Availability of Nutrients:
Obesity often reduces the availability of certain nutrients. In a recent study, over 50% of obese patients were evaluated for Vitamin D status and found to be deficient. Since fat cells have
their own nutritional requirements, fat cells will draw from nutritional reserves in much the same way other organs do in order to perform normal cellular functions. The combination of reduced availability and increased demand for nutrients caused by excess fat cells ultimately causes multiple deficiencies that need to be corrected.
Regulation of Hormones Linked to Obesity:
Niacin (Vitamin B3) treatment has been shown to increase hormone levels that regulate metabolism of glucose and fatty acids. Decreased levels are associated with obesity and heart disease. Vitamin B5 helps breaks down fat cells so they can be used up by the body.
Low Zinc status is also associated with obesity. This may be due, in part, to the relationship between Zinc and leptin, a hormone that regulates appetite. Zinc depletion reduces leptin levels, while Zinc repletion reverses this effect.
Fat Cell Formation:
Studies suggest that a form of Vitamin E (tocotrienol) inhibits pre-fat cells from changing into mature fat cells, resulting in a decrease in body fat. Calcium intake has also been associated with weight loss through its ability to inhibit the formation of fat cells. It also promotes the oxidation, or burning of fat cells, therefore reducing the risk of obesity.
The Effect of Amino Acids on Body Composition:
Carnitine is an important nutrient that helps muscle cells utilize energy and burn calories. Evidence shows that supplementation with carnitine when combined with an exercise program may induce positive changes in body composition by reducing (belly fat) more efficiently than without supplementation. Glutamine has been shown to reduce fat mass and improve glucose uptake in skeletal muscle and the relatively unknown amino acid Asparagine can improve insulin sensitivity by increasing the amount of sugar taken into muscle tissue to be burned for fuel.
Obesity and Insulin Resistance - Partners in Crime:
Obesity severely impairs the body’s ability to efficiently burn dietary carbohydrates. This is caused primarily by the body’s inability to use insulin, which is the hormone that helps the transport of sugars into muscles where they can be used for fuel instead of being stored as fat. Optimal micronutrient and mineral status are necessary for proper insulin function.
Vascular Health in Obesity:
Blood vessels in overweight individuals are typically not as pliable and healthy as normal weight people. Vitamin C supplementation has been demonstrated to improve vascular function in overweight people. Similarly, minerals such as Magnesium, Zinc, Calcium and Copper have all shown positive effects on blood pressure and vascular health. Overweight people tend to have high blood pressure, which is intensified by vitamin deficiencies. Since so many nutrients (Folate, Biotin, Carnitine, Vitamins A, C, and E and several minerals) are involved in the maintenance of healthy blood vessels of both normal weight and overweight people, a comprehensive evaluation of how they are performing in the cells of obese patients is crucial.
Oxidative Stress and Inflammation:
Numerous studies link oxidative stress and inflammation with obesity. Visceral adiposity (belly fat) is particularly high in dangerous enzymes that cause oxidative stress. Weight loss certainly counteracts this phenomenon and studies show that the amount of weight lost directly correlates to decreases in oxidative stress. Belly fat also causes inflammation of the liver, which is particularly common in obese people. One recent study demonstrated that Coenzyme Q10 decreased obesity-induced inflammation of the liver. Similarly, inflammation in blood vessels of obese patients contributes to heart disease and stroke, which can be alleviated in part through proper antioxidant supplementation. It is imperative that antioxidant status be optimized, especially in obese patients. SpectraCell’s micronutrient testing measures several specific antioxidants and gives an overall picture of how well all the antioxidants are working together.
Malabsorption Issues After Bariatric Surgery:
The impaired ability to absorb nutrients after bariatric procedures routinely causes multiple vitamin and mineral deficiencies in patients. Due to fat malabsorption after bariatric surgery, deficiencies in fat soluble Vitamins (A, D, E and K) are extremely common. Neurological complications such as confusion, impaired muscle coordination, even seizures may occur after bariatric procedures, due to a lack of B Vitamins, especially Thiamine. These complications can occur acutely or decades later. A comprehensive evaluation of nutritional status in bariatric patients is critical in maintaining post-op health.
Also, share with us your experience with the role micronutrients have played in obesity with your patient population! Do you have a particular success?
