Metabolic risk factors that are otherwise difficult to explain are sometimes caused by simple-to-correct nutritional deficiencies
When Kate, a 56-year-old lady, attended the Vitality Clinic with metabolic risk factors including excessive weight gain, lately complicated with high blood pressure, high cholesterol and borderline blood sugar, I did not immediately think about nutritional deficiencies like vitamin D and calcium.
Kate had a complicated family history of anxiety and depression, obesity, high blood pressure, heart disease, dementia and cancer. She had tried many weight management programs with no success, and interestingly she has a twin sister, who is happy, with a healthy weight, and does not seem to have inherited any of the family’s bad legacy of chronic conditions.
My initial response was that it is possible that Kate’s sister was lucky to be healthy because she had randomly picked up normal genes from both parents, or she may have bad family genes, but she has managed to clean them up by pursuing a healthy lifestyle.
Kate confessed that she herself has a highly demanding job in a stressful environment in the financial sector. She does not bother to cook and remains dependent on restaurants and fast food for her meals. She returns home late and enjoys a couple of glasses of wine before bed, waking up regularly at about 3 am and not going back to sleep again.
She kept referring to her twin sister, who is extremely happy running a golf club with her husband. She enjoys healthy meals and is physically active in an outdoor environment most of the day. On top of that, she enjoys nine-hole golf games three times a week and an 18-hole session over the weekend.
While we are reviewing Kate’s history, her routine blood test came back with a surprisingly very low level of vitamin D at 17. For comparison, she texted her sister, whose latest level was optimal at 186!
This raised a very important question: does vitamin D deficiency cause obesity, high blood pressure and metabolic syndrome? If so, how does this nutritional deficiency happen, and why does it put you at risk of these conditions? And finally, how can you modify your lifestyle to replenish this deficiency?
It has long been known that obesity and associated metabolic syndrome can be due to basic nutritional deficiencies of calcium and vitamin D, which can be corrected by dietary changes. The deficiency is likely to be related to fat and sun phobia.
This deficiency could also result in high susceptibility to infections such as Covid-19. The solution is surprisingly simple – take more calcium, vitamin D and fat in your food.
What do vitamin D and calcium do for us?
Vitamin D is crucial for the absorption of calcium in the gut. Vitamin D gets attached to vitamin D receptors in your gut to facilitate calcium absorption. Calcium is an element that is not only necessary for bone health but also for muscular function and for processing energy in your body.
A series of studies have confirmed a pattern of increased bone fractures among today’s children in comparison with those in the 70s. In addition, Ricketts (soft bone disease) is reappearing among children and osteoporosis (low bone density) among adolescents.
A study has also demonstrated that subjects who were fat, given calcium and vitamin D supplements surprisingly lost a significant amount of weight without trying.
Vitamin D is a fat-soluble vitamin that our skin makes on direct exposure to the sun. It does not cost a penny, but we have been led to believe that the sun’s ultraviolet light can cause cancer. This is compounded by the fact that sunscreen prevents light from reaching the skin to produce vitamin D.
Again, we are warned of fat, the culprit of heart disease. This is because cholesterol plaque being deposited along the coronary arteries is considered the sole cause of heart disease. Hence, we are advised to steer away from fat. The cut back on dietary fat is strategically replaced with sugar, the main culprit of metabolic syndrome and vascular disease.
What is insulin resistance?
The central cause of the metabolic syndrome is insulin resistance, but what does this mean? Consider insulin to be the key that opens the gate and allows sugar (fuel) to enter your cells to give you energy and vitality. This happens every time you eat; your pancreas produces insulin.
When you have insulin resistance, the key (insulin) touches the receptor, but the receptor has lost its sensitivity to insulin, and the gate does not open. Sugar continues to increase in your blood while your body cells are starved of it.
The muscles of a patient with metabolic syndrome will not be able to absorb glucose from the blood because this process depends on the insulin produced by the pancreas. And vitamin D and calcium are intimately involved in the process that allows the pancreas to release insulin into the blood.
Again, the actual process that facilitates the absorption of glucose into the muscle cells is also calcium-dependent. This is because calcium is needed for the movement of the catalyst GLUT4 to the muscle cell membrane to help the transfer of glucose across the membrane. Hence, calcium deficiency inhibits not only insulin release from the pancreas but also the entry of glucose into muscle cells.
Craving sugar and refined carbs
Every time the muscles are having difficulty absorbing glucose, blood glucose is set at an artificially higher level. This makes sugar and refined carbohydrates the most effective way to satisfy the cravings caused by poor muscle glucose uptake.
Whilst the high level of glucose helps to satisfy the muscles’ needs, the move to energy-dense food makes more glucose available to the fat cells to store excess sugar as fat. Hence, calcium deficiency leads to excessive weight gain, metabolic syndrome, diabetes, and heart disease.
During the fasting state, fat cells release the stored fat because glucose is not available to provide an alternative fuel for muscle cells. Fat cells provide triglycerides (stored fat) before a meal to keep muscles functioning.
With insulin resistance, the need for fat increases to fuel muscles. The fat cells proliferate to store more fat in order to meet the increased demands. This ends up with the person becoming obese.
The role of leptin
Fat cells encourage muscles to take fat rather than glucose by releasing certain hormones such as leptin. Leptin influences the muscles indirectly via the hypothalamus (the appetite centre) in the brain but also stimulates the muscles directly to burn fatty acids in their mitochondria (energy plants.)
Leptin influences the hypothalamus to suppress appetite; however, adiponectin, another hormone released by the fat cells, generally induces hunger. Leptin levels fluctuate throughout the day and rise at night. This encourages switching from glucose to fat burning. However, leptin levels are typically high in obese people all the time and adiponectin very low. The combination of high leptin and low adiponectin induces appetite, worsening weight gain and the risk of vascular disease.
In summary, limited calcium, due to low vitamin D, stimulates the alpha cells in the pancreas to produce glucagon, to release the glucose stored in the liver, and to increase the appetite for food with a high glycaemic index. This leads to obesity and metabolic syndrome.
How can you correct the problem?
- Sustained aerobic exercise switches your muscles back to a glucose uptake mode.
- A high-fibre diet of fruit, vegetables, beans, nuts, and seeds is best.
- Eliminate empty calories (sugar and processed carbs) and avoid toxic trans-fats.
- Animal food is high in vitamin D, including egg yolk, butter, fatty fish such as sardines, salmon, and mackerel; in plants, mushrooms are the only source.
- Cod liver oil is a natural vitamin D supplement for children in many parts of the world.
- By far, the best way to acquire adequate vitamin D is sun exposure. It is impossible to overdose on vitamin D from the sun and food sources.
- Sunscreen removes any opportunity to manufacture vitamin D in your skin.
- In supplements, vitamin D3 is a better option than D2.
- Sources of calcium classically include milk and dairy products, but it is also present in many real foods, including nuts, seeds, beans and legumes, leafy greens being a great source.
Kate was lucky that the link between her nutritional deficiencies and her metabolic risk factors was relatively obvious – after the blood tests and given the fact that she had a handy control subject in her twin sister!
I wonder if you have noticed anything similar – do you struggle to get sunlight? Is your intake of calcium low? And do you also suffer from difficult-to-explain metabolic risk factors such as obesity, high blood pressure or diabetes?
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The obesity epidemic: is metabolic syndrome a nutritional deficiency disease?