Evidence suggest that certain micronutrient are associated with weight gain and obesity. For example, low levels of vitamin D (25-hydroxyvitamin D3) have been linked to type 2 debates suggesting an association with weight gain, and plasma vitamin C levels show an inverse association with obesity. Beyond the classical deficiency symptoms caused by lack of individual vitamins, there exists a lesser sub-clinical insufficiency or inadequacy that can increase morbidity in an individual. These inadequacies are often difficult to diagnose and multiple-inadequacies can further complicate the underlying cause of the symptoms. For example, low levels of 25-hydroxyvitamin D and vitamin B6 are associated with depression and low levels of vitamin C might be associated with increase risk of all-cause mortality. Interest in the micronutrient inadequacies associated with obesity is growing because they may help explain some of the metabolic changes that occur during weight gain.
For example, research published in the American Journal of Clinical Nutrition in 20081, investigated the micronutrient levels of a number of obese Norwegian individuals with body mass indexes of 45 mk/m2 and control individuals with body mass indexes of 24 kg/m2. The results showed that the morbidly obese individuals had lower levels of vitamin B6, vitamin C, 25-hydroxyvitmain D3 and vitamin E, than control subjects. These vitamins were inadequate in 11 to 38 % of all the obese subjects. The researchers also showed that levels of C-reactive protein were elevated in those patients who had lower levels of vitamin A, vitamin B6 and vitamin C. Low vitamin B6 was associated with low levels of vitamin C and high levels of the enzyme alkaline phosphatase, an enzyme responsible for the removal of phosphate groups from molecules.
The reason for the low levels of certain micronutrients associated with obesity are not know, but it might be due to differences in the intakes of vitamin rich foods such as fruits and vegetables. High intakes of plant based foods are inversely associated with weight gain and plant based foods are also rich in micronutrients. It has also been suggested that obese subjects are able to sequester some vitamins in their adipocytes (such as vitamin D) and the increased extracellular space (due to elevated water levels in obese subjects). may have a diluting effect on certain vitamins. Evidence for this comes from the fact that obese patients have decreased serum levels of vitamins but tend to have normal erythrocyte levels. Raised alkaline phosphatase levels have been reported in obese subjects. Alkaline phosphatase hydrolyses pyrixdoxal-5’-phosphate, which explains the inverse relationship.
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