The market is filled with pills. Pills to lose weight. Pills to lower cholesterol. Pills to suppress appetite and pep you up. Pills to chill you out and make you happy so you don’t eat. Pills that prevent you from digesting fat… and in the process, possibly requiring a change of pants.
Some of the more effective pills for weight loss are also the most dangerous. They’ve been pulled off the market because people abused them using the “If one is good, then 25 should be fantastic!” logic. Some of the more effective pills for lowering cholesterol also do a host of other nasty things, although they have cool names and should probably be served with most fast food combos.
We’re always looking for a pill that’s better, badder, and more belly-busting — the superpill that’ll solve all our problems. We imagine this pill being very sciencey and sophisticated.
But what about a boring old multivitamin pill? Could it help you lose weight… and make you and your doctor happy?
Diet, malnutrition and weight loss
For the most part the medical community only promotes vitamin supplementation for pregnant women to ensure proper fetal development, believing that everybody else can and does hit their essential nutrient mark with healthy eating.
However, last week I reviewed an article that found that most weight loss diets are severely deficient in most essential vitamins and minerals. John reviewed an article that found most people are lacking essential nutrients. And people eating the standard Western diet… oy. (For more information, see All About Nutrient Deficiencies.)
You’re probably thinking, Big deal, so I have some vitamin and mineral deficiencies. But I don’t have scurvy. I’m not losing my hair. I can see… if I squint.
So who cares?
Well, your nutritional deficiencies might be preventing you from losing weight and improving your cholesterol levels. Yes, that’s right: If you don’t have enough vitamins and minerals, you might not be able to lose fat or get healthy. Now I’ve got your attention.
What does cholesterol do?
When you get to a certain age your yearly doctor’s check-up involves getting your blood lipid profile. Then instead of chatting with your friends about the new single hottie that moved in next door you talk about your cholesterol levels.
I can imagine a reunion show with cast of Friends having this conversation at the coffee shop.
“My LDL is too high,” says Chandler.
“Really? My HDL is in the toilet,” responds Rachel, adjusting her elastic waistband pants, and sipping her Central Perk coffee spiked with Metamucil.
Meanwhile Phoebe is burning her results as a sacrifice to the cholesterol gods.
Joey turns to his bottle of statins. “How you doin?”
Cholesterol’s had a bad rap recently. But you need cholesterol to stay alive. It’s part of some really important things like:
- the sac (membrane) that keeps your cell’s insides on the inside;
- your brain and nervous system tissues;
- certain hormones like estrogen and testosterone (steroid hormones); and
- vitamins A, D, E and K.
If cholesterol is so great, why bother controlling it?
Cholesterol: the good, the bad, and the risky
For one thing, we’re not necessarily as concerned with cholesterol — a fatty, waxy substance — as we are with the lipoproteins that transport cholesterol. You see, fat-based cholesterol isn’t a very good traveller in water-based blood. It needs a ride through the bloodstream from something else.
Lipoproteins, as their name implies, are proteins that can carry lipids (fats), sort of like those floating inner tubes you get at water park rides. What we’re actually looking at in cholesterol tests are levels of these lipoproteins.
Usually, when you get basic blood lipid tests done, the tests measure three things:
- Low density lipoprotein (LDL), aka “bad cholesterol”, brings cholesterol from your liver to cells throughout your body (to be incorporated into the membrane). If you have too much LDL and the right underlying conditions (such as inflammation), LDL can stick to your arteries’ insides, pile up, get inflamed, and start causing problems like hardening of the arteries (arthrosclerosis) and coronary heart disease.
- High density lipoprotein (HDL), aka “good cholesterol”, goes around and brings wayward cholesterol back to the liver for safe disposal.
- Total cholesterol, which is LDL + HDL
There are other types of lipoprotein particles as well, such as very low density lipoprotein (VLDL) and chylomicrons, but these aren’t usually measured as part of standard blood testing.
The test may also give you a ratio of HDL to LDL. This is useful because a high total cholesterol may be from high LDL or high HDL — so it’s helpful to understand what the breakdown is.
What do the numbers mean?
Here are some tables to help you sort through the numbers you get from your doctor.
For more, see All About Cholesterol.
This week’s review looks at how multivitamins change cholesterol levels and weight in obese women.
Li Y, Wang C, Zhu K, Feng RN, Sun CH. Effects of multivitamin and mineral supplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women. Int J Obes (Lond). 2010 Jun;34(6):1070-7.
The goal of this study was to figure out if taking a multivitamin would change bodyweight, energy expenditure and lipid profiles (i.e. cholesterol). There was no change in diet or exercise! I had to read through the study twice to make sure I didn’t miss the diet and exercise section, but there is none. Remember this; it’s important.
The researchers in this study used 96 women that were obese (BMI >28), and randomly put them into one of three groups for 6 months:
- Placebo group
- Calcium-only supplement: 162 mg of calcium
- Multivitamin and multimineral supplement
Table 1 below is a list of what was in the multivitamin and multimineral supplement.
What fancy multivitamin did they use? Centrum. Yup, nothing particularly cutting edge or fancy about it, just your grocery store pharmacy shelf Centrum.
These women were in their early forties, mostly inactive (80%) and with a BMI hovering around 30. In other words, there was a lot of room for improvement in their health.
This is where the study gets really interesting.
Multivitamin = fat loss
With no diet or exercise intervention, on average the multivitamin group:
- lost 3.4 kg (7.5 lb) of weight;
- decreased their BMI by 1.4;
- decreased their waist circumference by 2.4 cm (~1 inch); and
- dropped 2.8 kg (6.1 lb) of fat.
The calcium group lost 0.8 kg (1.76 lb) of fat over the 26 weeks, but there was no difference for weight, BMI or waist circumference.
How could you lose weight if you didn’t change how many calories you took in or used? It’s impossible, so how did the multivitamin group lose weight & fat?
Women who took the multivitamin saw an increase in their resting energy expenditure (the amount of calories they used while lying in bed). Yup, their resting energy expenditure went up by 53 kcal/day — not fantastic, but this was with just taking a multivitamin once a day. No exercise or other stuff. After 26 weeks that works out to 9682.4 kcals.
Multivitamin = more fat for fuel
Scientists can use a respiratory quotient (RQ), based on how much oxygen and carbon dioxide you use, to figure out if you are burning more carbohydrate or fat for energy.
- If your RQ is 1 then you’re only burning carbohydrates.
- If it’s 0.7 you’re only burning fat.
- Usually you’re somewhere in between.
With the multivitamin supplementation the women’s RQ dropped from 0.81 to 0.78, meaning that they were burning more fat at rest.
Multivitamin = better cholesterol
Not only did the multivitamin group lose weight, they ended up with:
- more “good” HDL-C (1.4 from 1.0) and
- less “bad” LDL-C (2.6 from 3.3).
Their HDL-C levels went from poor to better and their LDL-C levels bordered on ideal for people at risk for heart disease.
The calcium group had some improvement in HDL-C levels (1.3 from 1.0) getting to the better category, but no change in LDL-C.
Obese women taking a multivitamin for 26 weeks without any changes in diet or exercise lost 3.4 kg and improved their cholesterol levels.
How can a multivitamin can lead to these outcomes?
- First, obese people have lower levels of vitamins and minerals in their blood and these nutrients are less easily used (lower bioavailability). Reproducing the study with lean, healthy people might show different results.
- Vitamin B6, B12 and chromium have been associated with less weight gain over 10 years. Not all that surprising since B6 and chromium are involved in metabolism (B12 is a bit harder to explain since it is involved with keeping nerves and blood cells healthy.)
- Vitamin D deficiency is common in obese people, and plays a role in cardiovascular health.
- Our intestinal bacteria can actually play a huge role in regulating metabolism, digestion, and nutrient uptake. If we’re nutrient deficient our GI health suffers.
- Improvements in cholesterol levels with multivitamins are probably because of the same reasons that there is weight loss — improvement in metabolism.
- If you want to lose weight, don’t starve your body. That causes nutritional deficiencies and sub-optimal metabolism.
- Instead of eating almost nothing, and/or relying on nutrient-poor “diet” foods, you should be eating more nutritious food with fewer calories and supplementing your diet with a multivitamin to help you lose weight. Don’t rely exclusively on a Fred Flintstone or Centrum to make up for a poor diet, though.
- Make each calorie count — consume foods that are high in vitamins and minerals. For more tips on how to do this, see All About Dietary Displacement and the “superfood” list below.
For reference, here’s PN’s list of “superfoods” — foods that give you a lot of nutritional bang for the buck. Of course, there are many more “superfoods” than these… but this is a good start.
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