Vitamin/Minerals
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Recent research is finding that calcium, magnesium, and vitamin D are all decreased in obesity.  Calcium appears to suppress obesity in humans as well as in test animals.  Vitamin D levels are low in obesity.  Magnesium helps to prevent the development of diabetes.  It appears that calcium supplementation should definitely be an integral part of a weight loss program, but not for men due to it increasing the risk of prostate cancer and Parkinson's disease.  Magnesium probably helps with weight loss and is very important in any case thanks to its lowering the risk of diabetes.  Whether vitamin D should be added or avoided is unclear, although I strongly recommend it in my weight loss program in view of available evidence and the numerous other beneficial effects of vitamin D. 

Chromium doesn't help weight loss and herbal remedies not been proven of benefit at the present time.

Calcium: High Intake Lowers Obesity in Mice and Humans: Increasing adipocyte intracellular Ca(2+) results in a coordinated stimulation of lipogenesis and inhibition of lipolysis. However, increasing dietary calcium of obese patients for 1 year resulted in an 11 pound loss of body fat (P<0.01). Calcitrophic hormones act on adipocytes to increase Ca(2+) and lipid metabolism. 1, 25-(OH)(2)-D in cultures of human adipocytes cause sustained increases in intracellular Ca(2+) and a corresponding marked inhibition of lipolysis (P<0.001).  In mice, weight gain and fat pad mass were reduced by 26-39% by the three high calcium diets (P<0.001). The high calcium diets exerted a corresponding 51% inhibition of adipocyte fatty acid synthase expression and activity (P<0.002) and stimulation of lipolysis by 430% (P<0.015). This concept of calcium modulation of adiposity was further evaluated epidemiologically in the NHANES III data set. After controlling for energy intake, relative risk of being in the highest quartile of body fat was set to 1.00 for the lowest quartile of Ca intake and was reduced to 0.75, 0.40, and 0.16 for the second, third, and fourth quartiles, respectively, of calcium intake for women (n=380;P<0.0009); a similar inverse relationship was also noted in men (n=7114; P<0.0006). Univ Tennessee. Regulation of adiposity by dietary calcium. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. FASEB J. 2000 Jun;14(9):1132-8

Calcium: Obese Have Higher Bone Density and Fewer Fractures: In a Japanese study of 93 women, the incidence of vertebral fracture was found to be negatively correlated with BMI (the incidences of vertebral fracture in slender, normal and obese were 78.6, 48.8 and 22.7%, respectively) and bone mineral density was also BMI-related (0.390, 0.456 and 0.493 g/cm2). The number of years after menopause was shorter in patients with a higher BMI. There was no intergroup difference in serum levels of PTH, vitamin D and estrogens. On the other hand, serum levels of calcitonin, DHEA, DHEAS, delta-4 androstenedione and testosterone were found to be higher in subjects with a higher BMI. Bone mineral density is supported not only by weight-bearing stress upon bone, but also by serum levels of calcitonin and androgens in obese females. Relation between body size and bone mineral density with special reference to sex hormones and calcium regulating hormones in elderly females. Shiraki M, Ito H, Fujimaki H, Higuchi T. Endocrinol Jpn. 1991 Aug;38(4):343-9

Calcium: Supplement During Weight Loss Helps Protect Female Bones: Weight loss (WL) reduces bone mass and increases fracture risk. In a study of 73 overweight women put on a weight loss diet or their standard diet and receiving high or normal calcium in the DB manner, those losing weight and taking normal amounts of calcium had decreased absorption and inadequate calcium supplies with some activation of parathyroid hormone secretion and probable resorption of calcium from bone. Those on the calcium supplement had decrease absorption, but the extra calcium maintained adequate levels to protect bone mass. Weight loss and calcium intake influence calcium absorption in overweight postmenopausal women. Cifuentes M, Riedt CS, Brolin RE, Field MP, Sherrell RM, Shapses SA. Rutgers University. Am J Clin Nutr. 2004 Jul;80(1):123-30

Chromium for Weight Loss No Benefit Although Slight Increase in Lean Body Mass: Chromium picolinate is a popular supplement. Case of rhabdomyolysis in Pharmacother 7/98 18:860-2 and case of hypoglycemia in 5/98 Psychosomatics show it is far from harmless. Nutr Rev 6/98. Chromium is an essential nutrient in regulation of carbohydrate and lipid metabolism. Normal intake said often suboptimal. Said to increase lean body mass and decrease % body fat. RA Anderson, Beltsville USDA, Nutr Rev 9/98 56:566-70. Case of 33 year old woman ingesting 6-12 times recommended dose for 4 months. 1200-2400 microg/d ingested. Presented with weight loss, anemia, thrombocytopenia, liver dysfunction and renal failure. With blood chromium 2-3 times normal. Ann Pharmacother 4/98 32:428-31. 36 obese were treated for 26 weeks with DB placebo or chromium yeast or chromium picolinate with very low cal for 8 weeks them maintenance. Only picolinate group showed increase lean body mass at 26 weeks although all lost a comparable amount of weight. Act Med Austriaca 97;24:185-7 

Chromium Picolinate No Help in Weight Training in Two Studies: 17 overwt women 48-71yo DB PC 12 weeks. Increased strength but high dose chromium no effect. Int J Sport Nutr Exerc Metab 2002 Jun;12(2):125-35; Similar = J Appl Physiol 1999 Jan;86(1):29-39

Chromium Picolinate No Help Weight Loss: Twelve weeks of 400 microg/day of chromium as a CP supplement did not significantly affect body composition, RMR, plasma glucose, serum insulin, plasma glucagon, serum C-peptide and serum lipid concentrations or iron and zinc indices in moderately obese women placed on an exercise program. U Mass. J Am Coll Nutr 2001 Aug;20(4):293-306

Chromium Picolinate No Impact on Lipids: DB PC 19 normal adults 63-77yo. Chromium picolinate supplementation alone does not appear to improve insulin sensitivity, serum lipids, or change body composition in nonobese, healthy men and women of advanced age. J Gerontol A Biol Sci Med Sci 2000 May;55(5):M260-3

Chromium Side-Effects: Various. One severe renal disease on 1200-2400 microg/d x 5 months. Can cause skin allergies and diseases.

CLA Minimal Benefit with Drawbacks: Conjugated linoleic acid (CLA) is a mixture of linoleic acid isomers with conjugated double bonds. In a 1-year 180-patient DB PC study of overweight individuals (BMI 25-30), those receiving 4.5 g/day of CLA free fatty acid capsules lost 2.4 pounds, those on CLA-triacylglycerol lost 4 pounds, and those on olive oil capsules (the placebo control) lost no weight. Unfortunately, low-density lipoprotein (LDL) cholesterol ("bad cholesterol) increased in the CLA-FFA group (P = .008), high-density lipoprotein (HDL) cholesterol ("good cholesterol) decreased in the CLA-triacylglycerol group (P = .003), and lipoprotein(a) (bad) increased in both CLA groups (P < .001). Jean-Michel Gaullier, Kjeller, Norway. Am J Clin Nutr. 6/2004;79:1118-1125

Herbal Weight Loss Remedies All Fail to Show Benefit: Over-the-counter supplements are heavily promoted on the internet and in alternative medicine sales literature for weight loss. These include chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba mate, and yohimbe. In a meta-analysis of all research studies to date, no evidence beyond a reasonable doubt was found that any specific dietary supplement is effective for reducing body weight. The only exceptions are E. sinica- and ephedrine, which have been associated with an increased risk of adverse events. The authors discourage the use of any of these. The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use. Dietary supplements for body-weight reduction: a systematic review. Pittler MH, Ernst E. University of Exeter. Am J Clin Nutr. 2004 Apr;79(4):529-36

Hydroycitric Acid Aided Weight Loss in Short Study: Hydroxycitric acid (HCA-SX)  has been shown to reduce appetite, inhibit fat synthesis and decrease body weight without stimulating the central nervous system. Niacin-bound chromium (NBC) has demonstrated its ability to maintain healthy insulin levels. Gymnema sylvestre extract (GSE) has been shown to regulate weight loss and blood sugar levels. In a DB PC 8-week study of 60 overweight and obese people in India,  individuals were randomly divided into three groups. Group A was administered HCA-SX 4667 mg, group B was administered a combination of HCA-SX 4667 mg, NBC 4 mg and GSE 400 mg, while group C was given placebo daily in three equally divided doses 30-60 min before meals. All received a 2000 kcal diet/day and participated in supervised walking. Body weight and BMI decreased by 5-6% in both groups A and B. Food intake, total cholesterol, low-density lipoproteins, triglycerides and serum leptin levels were significantly reduced in both groups, while high-density lipoprotein levels and excretion of urinary fat metabolites increased in both groups. A marginal or non-significant effect was observed in all parameters in group C. Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss. Preuss HG, Bagchi D, Bagchi M, Rao CV, Dey DK, Satyanarayana S.; Georgetown University Medical Center. Diabetes Obes Metab. 2004 May;6(3):171-80. Ed: There was no added benefit from the chromium or the GSE.  

Magnesium Low in Platelets of Obese and Diabetic Children: Platelet magnesium of both type 1 and type 2 diabetes mellitus (DM) and the obesity groups was significantly lower than the values in the nondiabetic control group (377 micromol/L, 312 micromol/L, 373 micromol/L v 594 micromol/L, respectively, P <.05). Intracellular magnesium of platelets in children with diabetes and obesity. Takaya J, Higashino H, Kotera F, Kobayashi Y. Metabolism. 2003 Apr;52(4):468-71

Magnesium, Zinc Intake Low: In a study of 179 obese adults and 384 controls, In women, BMI was directly associated with multiple additional nutritional risk indicators, including intakes of fat (r = 0.26) and saturated fat (r = 0.21), and homocysteine concentration (r = 0.25). Weight status in women was inversely associated with intakes of carbohydrates (r = -0.25), fiber (r = -0.35), folate (r = -0.24), magnesium (r = -0.29), iron (r = -0.22), and zinc (r = -0.23); Healthy Eating Index scores (r = -0.22); and plasma pyridoxal 5' phosphate (r = -0.30). In men, weight status was associated only with plasma B-12 (r = -0.33 for BMI) and B-6 (r = -0.24 for waist circumference). Penn State, Nutritional risk assessment and obesity in rural older adults: a sex difference. Ledikwe JH, Smiciklas-Wright H, Mitchell DC, Jensen GL, Friedmann JM, Still CD. Am J Clin Nutr. 2003 Mar;77(3):551-8

Magnesium: Low Levels Strongly Linked to Metabolic Syndrome: Metabolic Syndrome is least of two of the following: hyperglycemia, HBP (> or =160/90 mmHg), dyslipidemia (fasting triglycerides > or =1.7 mmol/l and/or HDL-cholesterol <1.0 mmol/l), and obesity. In a study of 576 adults, low serum magnesium levels were identified in 126 (65.6%) and 19 (4.9%) individuals with and without MS, p<0.00001. The mean serum magnesium level among subjects with MS was 1.8 mg/dl, and among control subjects 2.2 mg/dl, p<0.00001. There was a strong independent relationship between low serum magnesium levels and MS (odds ratio (OR)=6.8). Among the components of MS, dyslipidemia (OR 2.8) and HBP (OR 1.9) were strongly related to low serum magnesium levels. Low serum magnesium levels and metabolic syndrome. Guerrero-Romero F, Rodriguez-Moran M. Acta Diabetol. 2002 Dec;39(4):209-13

Mn: Smaller Pineal Glands in Obese: This study found a lower pineal width and volume in overweight individuals. Other studies find less sleep associated with more obesity and less night time melatonin in the obsess. Morphometry of the pineal gland in overweight individuals. Torres K, Staskiewicz GJ, et al. Medical University of Lublin. Ann Univ Mariae Curie Sklodowska [Med]. 2003;58(2):270-5

Mnin: Night Eaters Low in Nighttime Melatonin: Night-eating syndrome (NES) consists of morning anorexia, heavy evening eating, and insomnia. In a behavioral study, compared with 10 control subjects,10 night eaters had more eating episodes in the 24 hours (9.3 vs. 4.2; P<.001) and consumed significantly more of their daily energy intake at night than did controls (56% vs. 15%; P<.001). They averaged 3.6 awakenings per night compared with 0.3 by controls (P<.001). In night eaters, 52% of these awakenings were associated with food intake, with a mean intake per ingestion of 1134 calories. None of the controls ate during their awakenings. In the neuroendocrine study, compared with control subjects, night eaters had attenuation of the nocturnal rise in plasma melatonin and leptin levels (P<.001 for both) and higher circadian levels of plasma cortisol (P = .001). Behavioral and neuroendocrine characteristics of the night-eating syndrome. Birketvedt GS, Florholmen J, et al. University of Tromso, Norway. JAMA. 1999 Aug 18;282(7):657-63

Taurine Might Help Overweight with Weight and Lipids: Taurine has beneficial effects on lipid metabolism in experimental animals fed with high-cholesterol or high fat diets. In a DB PC study, 30 college students with a body mass index (BMI) >/=25.0 kg/m(2), and with no evidence of diabetes mellitus took taurine 3 g/day or the placebo  for 7 weeks. The atherogenic index (AI) was calculated as (Total cholesterol - HDL-C)/HDL-C. Taurine supplementation decreased triacylglycerol and AI significantly. Body weight also reduced significantly in the taurine group. Zhang M, Bi LF, Fang JH, Su XL, Da GL, Kuwamori T, Kagamimori S. Toyama Medical, Japan. Amino Acids. 2004 Jun;26(3):267-71. 

Vitamin D Low in Obese: In a study of 302 adult women, serum intact parathyroid hormone was positively correlated with both the body mass index (BMI) (r = 0.42; P < 0.0001) and body fat mass (r = 0.37; P < 0.0001). Serum 25-hydroxy vitamin D was negatively correlated with BMI (r = -0.4; P < 0.0001) and body fat mass (r = -0.41; P < 0.0001). Serum 1,25-vit D was also negatively correlated with BMI (r = -0.26; P < 0.0001) and body fat mass (r = -0.25; P = 0.0001). Serum 1,25-vit D was significantly lower in obese than nonobese subjects (106 vs. 125 pmol/liter; P < 0.0001) in both Caucasian and African-American adults. The Relationship between Obesity and Serum 1,25-Dihydroxy Vitamin D Concentrations in Healthy Adults. Parikh SJ, Edelman M, Uwaifo GI, Freedman RJ, Semega-Janneh M, J Clin Endocrinol Metab. 2004 Mar;89(3):1196-9; An SIU-Springfield study found that obesity-associated vitamin D insufficiency is likely due to the decreased bioavailability of vitamin D(3) from cutaneous and dietary sources because of its deposition in body fat compartments. Am J Clin Nutr. 2000 Sep;72(3):690-3

Vitamin D Levels Associated with Less Obesity: 410 women ages 20-80 with BMIs of 17-30 were studied. The correlation for obesity and vitamin D blood levels was -0.13 (P = 0.013) after adjusting for race, age, season, and dietary vitamin D intake. Percentage body fat content is inversely related to the serum 25-OHD levels in healthy women. Body fat content and 25-hydroxyvitamin D levels in healthy women. Arunabh S, Pollack S, Yeh J, Aloia JF. J Clin Endocrinol Metab. 2003 Jan;88(1):157-61

Vitamin D Intake Associated with Less Obesity: BMI and vitamin D intake were negatively associated in both sexes (P < 0.001), which to our knowledge has not been reported before. The lowest quartile of vitamin D intake was an independent predictor of obesity (defined as BMI >30 kg/m(2)) in men and women (P < 0.001 in both genders), resulting in odds ratios of 2.24 [95% confidence interval (CI) 1.80, 2.80] in men and 1.51 (95% CI 1.23, 1.85) in women compared with the highest quartile. Intakes of calcium and vitamin d predict body mass index in the population of Northern Norway. Kamycheva E, Joakimsen RM, Jorde R. J Nutr. 2003 Jan;133(1):102-6.

Genes: Vitamin D Receptor Polymorphisms Associated with Weight and Fat Mass: In a Swedish study of 175 healthy women ages 20-39, the polymorphic regions in the VDR gene (the poly A repeat and the BsmI SNP) found that individuals with shorter poly A repeat, ss and/or absence of the linked BsmI restriction site (BB) have higher hamstring strength (ss vs. LL, P=0.02), body weight (ss vs. LL, P=0.049) and fat mass (ss vs. LL, P=0.04) compared with women with a longer poly A repeat (LL) and/or the presence of the linked BsmI restriction site (bb). Genetic variation in the human vitamin D receptor is associated with muscle strength, fat mass and body weight in Swedish women. Grundberg E, Brandstrom H, Ribom EL, Ljunggren O, Mallmin H, Kindmark A. Eur J Endocrinol. 2004 Mar;150(3):323-8.

Zinc Low in Coronary Artery Disease: In a study of 3575 adults in India, multivariate logistic regression analysis after adjustment for age showed that zinc intake and coronary artery disease were inversely associated. Serum zinc (odds ratio: men 0.77, women 0.57), serum triglycerides (men 0.86, women 0.81), blood pressure (0.83 men, women 0.76), diabetes mellitus (men 0.90, women 0.85), central obesity (men 0.88, women 0.87), glucose intolerance (men 0.66, women 0.57) and low high-density lipoprotein cholesterol (men 0.72, women 0.70) were significant risk factors for CAD (explained by tertiles of zinc status) in urban, but not subjects. Lower consumption of dietary zinc and low serum zinc levels were associated with an increased prevalence of CAD and diabetes and several of their associated risk factors including hypertension, hypertriglyceridemia and other factors suggestive of mild insulin resistance in urban subjects. Current zinc intake and risk of diabetes and coronary artery disease and factors associated with insulin resistance in rural and urban populations of North India. Singh RB, Niaz MA, Rastogi SS, Bajaj S, Gaoli Z, Shoumin Z.  J Am Coll Nutr. 1998 Dec;17(6):564-70

5-HTP Claimed to Help Lose Weight in Three Studies: In a book a Dr. Murray reports on 3 studies of overweight women conducted at the University of Rome. Unfortunately, I could not get his references. The first study reportedly showed that 5-HTP was able to reduce caloric intake and promote weight loss despite the fact that the women made no conscious effort to lose weight. The average amount of weight loss during the five-week period of 5-HTP supplementation was a little more than 3 pounds.

A second 12=week study for the first six weeks gave obese women no dietary recommendations. For the second six weeks, the women were placed on a 1,200-calorie diet. The women who took the placebo lost 2.3 pounds, while the women who took the 5-HTP lost 10.3 pounds. 5-HTP appeared to promote weight loss by promoting satiety-the feeling of satisfaction-leading to fewer calories being consumed at meals. 

In a third study of similar design, the group who received the 5-HTP had lost an average of 4.4 pounds at six weeks and an average of 11.6 pounds at 12 weeks. In comparison, the placebo group had lost an average of only 0.62 pounds at six weeks and 1.87 pounds at twelve weeks. Many of the women who received the 5-HTP (300 mg three times per day) reported mild nausea during the first six weeks of therapy. However, the symptom was never severe enough for any of the women to drop out of the study. No other side effects were reported." at www.doctormurray.com.  

Thomas E. Radecki, M.D., J.D.

modern-psychiatry.com

Email: [email protected]