Saturday, May 25, 2013

30 Min of Exercise Can Avoid Costly & Unhealthy Gestational Diabetes. Carbohydrate Oxydation Determines Appetite After Workouts. Using a Measuring Tape to Judge Visceral Fat Mass. Update: Vitamin D, Age & Obesity.

85 sessions (general fitness class, three times/week, 55-60 min/session from weeks 8-10 to weeks 38-39 of pregnancy are nothing but healthy for mother + child (Barakat. 2013)
Obese mothers with gestational diabetes are more than just a financial burden. That's what the SuppVersity Figures of the Week clearly indicate.

According to a recently published paper from the National University of Ireland Galway woman who develop gestational diabetes during pregnancy (mostly due to pre-existing extra fat-pounds; not BMI), produce 34% higher health-care costs (Gillespie. 2013). Just as the 75% increase in the necessity to have the kids being delivered by cesarean section, this would still be tolerable, though, if their poor offspring did not also have a increased risk of being born with pathological ventricular hypertrophy (Ullmo. 2007) and a 214% higher likelihood of having to be admitted to the neonatal unit, which, in turn, is associated with "increased and/or aberrant adiposity, in addition to postnatal growth retardation" (Gianni. 2012).

Another good reason to (a) get healthy (and contrary to what the soothing news in the mainstream media will tell you this involves having normal body fat levels), before you even think of bringing a baby into this world and (b) not dropping your exercise regimen all-together, when you're pregnant:
 "A supervised program of moderate exercise performed throughout pregnancy is not a risk of preterm delivery for heal thy pregnant women." (Barakat. 2013) 

This, by the way, works not only in type II, but also type I diabetic mothers, whose chance of developing gestational diabetes and/or even more hazardous extreme spikes and troughs in blood glucose can be reduced from 19% to ZERO with only 30 min of light exercise per day (a self-paced walk in the park is enough!) and making the right food choices (Kumareswaran. 2013).
  • Related D-News from Japan: Vitamin D deficiency in Japan comes with current smoking, being female, lack of regular walking and low dietary vitamin D intake, study shows (Yoshimura. 2013).
    Overall, 81.3% of the subjects in the study from the University of Tokyo were vitamin D insufficient - only 1.2%, though, had a full-blown deficiency, defined as 25OHD levels below 10 ng/ml.
    Being fat is a critical determinant of baseline vitamin D levels and the response to vitamin D supplement in older Irish adults (Forsythe. 2013).
    "In older adults, vitamin D status was inversely associated with BMI (kg/m2), WC (cm), FM (kg and %), FMI (kg/m2) and FM:FFM (%) at baseline (r − 0·33, − 0·36, − 0·33, − 0·30, − 0·33 and − 0·27, respectively, all P values < 0·01). BMI in older adults was also negatively associated with the change in 25(OH)D following supplementation (β − 1·27, CI − 2·37, − 0·16, P = 0·026)."
    What's surprising, though, is the fact that this correlation of which I have previously argued that is is probably based on the pro- and anti-inflammatory effects of obesity and vitamin D and initiated by being fat, not vitamin D deficient, was not present in the younger study participants.

    Just as a review I mentioned only a couple of days ago said: There is still much to learn about vitamin D - in that case D2 & D3 - and how their enzymatic hydroxylation influences both our baseline levels as well as their metabolic downstream effects (read more)
  • Exercise does not make you hungry, per se, but the more carbs you burn during your workout the hungrier you're gonna be afterwards (Hopkins. 2013) That's the main finding of a recent study from the Leeds Trinity University in the UK.

    There comes a time, when getting fat and sick is no longer only about making the "wrong" food choices or a non-warranted urge to eat. A time, when neither the apple nor granny's pie will satisfy your hunger, and your cells will be starving within a nutritious cocktail of partially oxidized fatty acids and sticky glucose molecules... yet still, or I should say, exactly for that reason simply "cutting calories" won't solve the problem. Learn more about how this state is creeping up on the obesity generation (read more)
    According to the data the researchers gathered in the course of a bout of cycling individually tailored to expend 400 kcal (EX) or a time-matched no exercise control condition in a randomized, counter-balanced order,
    "[...] there was a marked individual variability in compensatory EI. The difference in EI between EX and the control condition ranged from -234.3 to 278.5 kcal. Carbohydrate oxidation during exercise was positively associated with postexercise EI, accounting for 37% of the variance in EI (r=0.57; p=0.02)" (Hopkins. 2013)
    That's particularly interesting, because the average total energy intake did not differ significantly between the exercise and the control condition (666.0±203.9 vs 664.6±174.4 kcal, respectively) in the overweight and obese women with a mean BMI of 29.6±4.0 kg/m².

    These observations provide further evidence of the detrimental effects of metabolic inflexibility, a classic characteristic of developing or full-blown metabolic syndrome and a state in which your body is heavily (in the worse cases almost exclusively) reliant on glucose as a substrate - a paradox, in view of the fact that thee aberrant insulin resistance of obese individuals has their cells starve in a state of glucose abundance (learn more)
  • Toss your scale and use a measuring tape! Nothing predicts metabolic risk and high risk visceral fat as adequately as the circumference of your midsection (Grundy. 2013)

    As a SuppVersity reader you should actually have banned your scale into the depth of your "things I will never need again (!)"-cupboard, once you achieved a normal body weight (on a side note: I don't have a functional scale). From the many questions I receive on a daily basis, I do yet know that some of you are either hesitant to do that or fill inclined to get it back out from time to time to ruin their days and results by stepping on the scale at least thrice a week. If that's you, I suggest you take a peak at the results of a recent study from the Clinical Nutrition and Center for Human Nutrition and the Division of Cardiology of the University of Texas Southwestern Medical Center in Dallas.

    To find out whether or not a simple measuring tape by the means of which you would assess the circumference of your waist (WC) would be an adequate measure of total abdominal fat (TAF), abdominal subcutaneous fat (ASF) and intraperitoneal fat (IPF) Scott M. Grundy and his colleagues correlated the measuring tape data with results they had obtained from magnetic resonance imaging (MRI) and found an excellent correlation between WC and total abdominal fat (R² = 0.81 − 0.88) "with progressively lower correlations with ASF (0.65–0.82) and IPF (0.29–0.85)" (Grundy. 2013)
    Figure 1: Median intra-abdominal fat (median in kg), waist circumferences and corresponding intraperitoneal to total abdominal fat rario (IP/ABS x10) for quintile 1-5 of total abdominal fat in men (left) and women (Gruny. 2013)
    As hinted at in the arrow in figure 1 the accuracy of the waist circumference as a means to quantify the body fat levels and metabolic risk does not only depend on gender, but also on ethnicity, with African American men and women having lower median IPF masses than Whites and Hispanics, in general, but high(er) greater amounts of subcutaneous. In view of the fact that unlike IPF, ASF correlated only with HOMA2-IR, whereas elevated IPF values were also reliable predictor of high triglyceride levels, as well - African Americans may be at a slightly, but probably not significantly lower risk of developing heart disease (high triglycerides are a neat predictor here) than Whites and Hispanics of whom the latter tend to carry the most vicious visceral fat per cm on their waists.
Believe it or not, but that's it for today! I know that was fast and therefore I'll provide you with a couple of additional facebook news, you may be interested in.
  • The fact that simply dropping the weight and lying around for weeks could lead to fat gains is actually not that surprising right? So what can be done to make constant progress without overtaxing the system? One of the answers certainly is P-E-R-I-O-D-I-Z-A-T-I-O-N and the Step By Step Guide to Your Own Workout Routine is the series, where you can learn about planning your training schedule in the long and short run to maximize your results and accommodate it to your personal goals (read more)
    Is giving up physical culture worse for your health than being a sedentary slob in the first place Rodent study suggests there is propensity for increases in visceral fat gain during 4-week detraining that surpasses in previously trained rats that of the sedentary controlled (read more)
  • Fooled again 2.0: By one way or another Subway bamboozles customers to believe their junkfood was less junky than that of the competition. According to a recent Harvard study, adolescents dining at Subway underestimate the caloric value of their nutrient deficient junk food by more than 500kcal! That's... (read more)
  • The "starve yourself to live longer"-bubble is bursting! Now scientists realize that even in yeast, what you eat is more important than how much you eat and that the simple addition of a pH buffer can go a long way (read more)
  • SuppVersity Suggested Read: Prolotheraphy? Can you actually HEAL those chronically painful tendons, ligaments and cartilage without having to resort to a butcher's... ah, I mean a surgeon's knife? My buddy Sean Casey just posted part II of his scientifically grounded answer (read more).
Now that you're through with these as well, all that's left to be said is: "Have a nice weekend, everyone, and don't forget that the SuppVersity is open on Sundays, as well!"

  • Barakat R, Pelaez M, Montejo R, Refoyo I, Coteron J. Exercise Throughout Pregnancy Does Not Cause Preterm Delivery. A Randomized, Controlled Trial. J Phys Act Health. 2013 May 10.
  • Forsythe LK, Livingstone MB, Barnes MS, Horigan G, McSorley EM, Bonham MP, Magee PJ, Hill TR, Lucey AJ, Cashman KD, Kiely M, Strain JJ, Wallace JM. Effect of adiposity on vitamin D status and the 25-hydroxycholecalciferol response to supplementation in healthy young and older Irish adults. Br J Nutr. 2012 Jan;107(1):126-34. 
  • Giannì ML, Roggero P, Piemontese P, Orsi A, Amato O, Taroni F, Liotto N, Morlacchi L, Mosca F. Body composition in newborn infants: 5-year experience in an Italian neonatal intensive care unit. Early Hum Dev. 2012 Mar;88 Suppl 1:S13-7.
  • Gillespie P, Cullinan J, O'Neill C, Dunne F; ATLANTIC DIP Collaborators. Modeling the independent effects of gestational diabetes mellitus on maternity care and costs. Diabetes Care. 2013 May;36(5):1111-6. 
  • Kumareswaran K, Elleri D, Allen JM, Caldwell K, Westgate K, Brage S, Raymond-Barker P, Nodale M, Wilinska ME, Amiel SA, Hovorka R, Murphy HR. Physical Activity Energy Expenditure and Glucose Control in Pregnant Women With Type 1 Diabetes: Is 30 minutes of daily exercise enough? Diabetes Care. 2013 May;36(5):1095-101. 
  • Ullmo S, Vial Y, Di Bernardo S, Roth-Kleiner M, Mivelaz Y, Sekarski N, Ruiz J, Meijboom EJ. Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study. Eur Heart J. 2007 Jun;28(11):1319-25.
  • Yoshimura N, Muraki S, Oka H, Morita M, Yamada H, Tanaka S, Kawaguchi H, Nakamura K, Akune T. Profiles of vitamin D insufficiency and deficiency in Japanese men and women: association with biological, environmental, and nutritional factors and coexisting disorders: the ROAD study. Osteoporos Int. 2013 May 15.


  1. Re waist circumference, a Jan 12 article in the Wall Street Journal, "A Good Way to Measure Obesity? Fat Chance" contains a chart showing truly astounding adverse health consequences for different waist sizes of people of normal BMI. The source is the European Heart Journal, but I've never been able to find the study. An email to the author went unanswered.

    Can you shed any light on this for me?

    1. I gather you refer to this graphic, right?

      that must be a mistake. There is no study in the journal that discusses all these three problems at once.

    2. That's the one! So, let's assume the author didn't make it all up. Then, let's confine my inquiry to just cardiovascular disease. Is there any evidence ANYWHERE that would show such extraordinary risk ratios? (Remember, the graphic is for subjects with NORMAL BMIs.)

      It would require a superhuman effort on my part to reduce my waist circumferance to 31.5 inches, but if the graphic is even half correct, what an incentive!



      hypertension +126% / +87%
      type 2 diabetes +116% / +52%

      for men / women with normal weight, but high (103cm / 91 cm) waist circumference; the comparison for men is 83.5cm - yep that's a 33er inch waist

    4. Nice find! Thanks. Too bad the cutoff point for normal WC in men was 40 inches, not the 31.5 in the WSJ graphic. The article notes that there is a linearity in the effect of WC, so I'm planning on checking the references to same when I get the time - new baby, you know.

    5. One might also note that only 1% of the normal BMI men had "high" WCs, so it really wouldn't tell us very much.

  2. I found the original reference! "Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality", Romero-Corral, et al. European Heart Journal 2010, Figure 2B.

    The authors only comments on Figure 2B are about mortality which they later admit didn't have much statistical power because of the relatively young age of the subjects.

    I'm going to conclude that I need to see my six-pack for optimum health unless someone can show me why Figure 2B is grossly misleading!

    1. *lol* if you have a 32" waist you don't automatically see your abs, but in general having the same or higher "" for the length of your jeans as for the width is something to aim for, yeah

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