Wednesday, March 12, 2014

Lack of Cortisol characteristic for young obesity patients. Plus: Self-Esteem Changes During Puberty Would Actually Increase Diurnal Cortisol Production

Cortisol is not your enemy. In fact, cortisol is one of the few hormones you really need to survive.
Cortisol is a problem. However, just as it is the case with insulin, it's not the fact that your body produces it that's problematic. It's the fact that it tends to so in copious amounts and chronically, simply at the wrong time or - believe it or not - not at all / enough. All that, i.e. changes / problems with the natural rhythm, the up and down, the spikes and troughs that get lost, when you are chronically stressed and/or inflamed - that's the actual problem and not the fact that your body produces a hormone without which you can't survive.
You can learn more about cortisol at the SuppVersity

Kaatsu, cortisol, gains?

Roibos for relaxation

Leucine + cortisol = bad news

BB = max cortisol = max fat loss?

7-keto save and effective?

Cortisol reducing bites
Against that background, it may go against everything the supplement industry is trying to tell you, but still cannot be really surprising to hear that E. Allansson Kjölhede and colleagues from the Linköping and Ume a Universities present in their latest paper in Acta Pædiatrica results that show that obese children have low, not high cortisol levels (Kjölhede. 2014).

Using three salivary samples from 342 children aged 6–12 years the scientists had tried to reconcile previous, inconsistent findings and found that the
"average cortisol levels in early morning, late morning and evening were significantly lower in overweight and obese children than in their normal weight counterparts."
What's particularly interesting is that the early morning spike, we have identified as critical component of a healthy biorhythm, previously (see "All About Cortisol"), was reduced by -33% (see Figure 1):
Figure 1: Morning (8:30 am), late morning (10:30 am) and evening (9:00pm or pre-bed, if earlier) salivary cortisol in 342 normal-weight, overweight and obese children (Kjölhede. 2014).
As Kjölheide et al. point out, these results should be followed up by more comprehensive studies that would allow us to better classify and understand the "relationship between stress and obesity in
children" - and I would like to add: Which of these comes first - being obese or having low morning cortisol and thus not being able to benefit from the "wake-up and get going" effects of cortisol.
This is not a statistical outlier: The results of the study at hand are not a statistically irrelevant outlier or something that would be observed in children, only. In 2013 Champaneri et al. a corresponding correlation between high early morning cortisol levels and lower body fatness and waist circumference, when they analyzed data from the 1,002 subjects of the Multiethnic Study of Atherosclerosis (Champaneri. 2013)
That's also interesting, because previous studies by Toledo-Corral et al. have shown that a dampened cortisol awakening response is not just associated with obesity, it is also a predictive factor of higher carotid artery intima-media thickness (CIMT) in overweight African American and Latino youth (Toledo-Corral. 2013), which in turn is a risk factor for myocardial infarction and stroke.

And Ursache et al. (just because it's funny: "Ursache" means "cause" in German ;-) report that  dolescents with insulin resistance exhibited
  • a blunted cortisol awakening response (CAR),
  • smaller hippocampal volumes, and 
  • greater frontal lobe atrophy 
compared to controls. Closer scrutiny of the data also revealed that "a smaller CAR was associated with higher BMI which was in turn associated with fasting insulin levels" (Ursache. 2012).

Despite the fact that it is virtually impossible to tell what exactly the "ursache" for the irrefutable correlation between low morning cortisol levels and high body fatness, artery intima-media thickness, myocardial infarction and stroke is, the cumulative evidence clearly speaks against the use of cortisol-reducing drugs and supplements - at least if their effects are not extremely short-lived and will thus not mess with the natural up-and-down that's lost not just in obese, but also in chronically fatigued patients.
Bottom line: In view of the data presented above, people with low morning cortisol levels would thus be better advised to start their day with some "delicious" licorice - or better a capped extract - to benefit from its cortisol boosting effects, instead of "cortisol blockers".

Figure 2: Comparison of reduction in % body fat in response w/ licorice (blue, Tominaga. 2009) and no dietary restriction vs. 7-keto + dietary restriction (red, Zenk. 2002 - sponsored study).
Bullshit? Well, what about the side-effect free (no change in Hb1AC, improved not worsened blood pressure and pulse rate and in range serum electrolytes) reversal of fat gain Tominaga et al. observed in obese subjects who consumed a polyphenol-laden licorice extract (main ingredient glabradin) at dosages of 300mg and 1800mg per day for 12 weeks (Tominaga. 2006), then?

Or the significant decrease in body fat the same researchers observed in another study, three years later with 300, 600 and 800mg/day of a licorice flavonoid oil (see Figure 2)? Significantly more than in allegedly only 8 weeks on 7-keto, by the way; and that a despite the fact that the sponsored study on the DHEA-metabolize by Zheng et al. (2002) used a combined diet + supplementation protocol (see Figure 2).

Reference: 
  • Champaneri, Shivam, et al. "Diurnal salivary cortisol is associated with body mass index and waist circumference: the Multiethnic Study of Atherosclerosis." Obesity 21.1 (2013): E56-E63.
  • Toledo-Corral, Claudia M., et al. "Blunted nocturnal cortisol rise is associated with higher carotid artery intima-media thickness (CIMT) in overweight African American and Latino youth." Psychoneuroendocrinology 38.9 (2013): 1658-1667.
  • Tominaga, Yuji, et al. "Licorice Flavonoid Oil Effects Body Weight Loss by Reduction of Body Fat Mass in Overweight." Journal of health science 52.6 (2006): 672-683.
  • Tominaga, Yuji, et al. "Licorice flavonoid oil reduces total body fat and visceral fat in overweight subjects: A randomized, double-blind, placebo-controlled study." Obesity research & clinical practice 3.3 (2009): 169-178.
  • Ursache, Alexandra, et al. "Preliminary evidence for obesity and elevations in fasting insulin mediating associations between cortisol awakening response and hippocampal volumes and frontal atrophy." Psychoneuroendocrinology 37.8 (2012): 1270-1276.
  • Zenk, John L., et al. "The effect of 7-Keto Naturalean™ on weight loss: A randomized, double-blind, placebo-controlled trial." Current therapeutic research 63.4 (2002): 263-272.