Weight Problems, Diet, and Cortisol
A very aggressive marketing plan for a vitamin product has recently brought cortisol into the spotlight among dieters. High stress, the theory goes, increases cortisol levels, which increases appetite and abdominal fat storage. So the cure to being overweight is to block or balance cortisol. To be sure, cortisol is one of several fat storing hormones that require the dieter’s attention. But when I visited the website of the particular product I have in mind, I noticed that it is completely devoid of even a weak attempt at explaining the scientific rationale of how it supposedly works. Also the ingredients are not listed anywhere.  So we are supposed to believe that people are stressed out (true), cortisol produced by stressed out individuals causes abdominal fat gain (partially true), and (the big leap of faith) this new product does something to cortisol that helps people lose weight (no evidence, not even a theory. Not true). Well, this is about all you can expect from a hyped TV advertised weight loss product. It joins the ranks of those discredited “lose weight while you sleep” products. But we should not throw the baby out with the bathwater.

Testing for cortisol, as well as estradiol, growth hormone, testosterone, and insulin gives the astute physician an idea of the hormonal factors that may impact a patient’s body composition. A glucose insulin tolerance test is needed to assess the patient’s ability to metabolize carbohydrates. The other important piece of the puzzle is a Nova panel which measures venous blood acidity levels and blood minerals. This latter test helps us understand the end metabolic effect of each patient’s eating habits. The blood pH will be the opposite of the tissue pH. Thus, if you are eating a very acid forming diet of heavy protein and caffeine, your tissue will be acidic, but built in buffers will compensate and will make the blood show up as alkaline. The interesting thing is that the type of diet you eat will also impact the levels of the fat storing hormones l mentioned earlier. For example a high carbohydrate diet will increase estradiol, cortisol, and insulin levels. A high protein diet is also capable of increasing cortisol over and above a normal protein intake, apparently because of its acidifying tissue effect. This happens because 2 sulfur containing amino acids within protein get metabolized to sulfuric acid in the body. Similarly, studies also suggest that alkalinizing the blood through a higher potassium intake via fruits and vegetables, or through the use of alkaline salts (sodium and potassium bicarbonate) supplementation, can reduce cortisol secretion. Cortisol secretion is necessary for life, but excess cortisol promotes obesity and interferes with cellular responsiveness to insulin, moving the person in a prediabetic and insulin resistant direction.

It is especially intriguing that the literature is beginning to suggest that all other things being equal, an acid forming diet may promote visceral obesity and insulin resistance via increased cortisol production. This data contradicts my clinical experience which is that a low carb high protein diet is the most effective way of reducing the waist measurement. Perhaps this is because of the non-cortisol related benefits of the appetite reducing effects of a high protein diet promoting leanness, the resultant lower insulin levels, and the improved insulin sensitivity. Certainly alkaline salts supplementation or inclusion of high potassium ash containing vegetables is a rational therapeutic intervention even in those whose metabolic typing suggests the need for a higher protein intake. The inclusion of high potassium containing fruits would be advisable only for those patients very close to their ideal weight.

These considerations should make it clear that weight gain is a highly complex metabolic phenomenon. Only a competent physician can help sort out these complexities and guide you in your quest to achieve and maintain a normal weight and body composition. If you are overweight you should have a metabolic typing and complete medical evaluation. Don’t entrust yourself to fad diets or miracle supplements. Get good advice, bring your common sense and motivation, and settle on an eating plan and lifestyle that isn’t something foreign or temporary. It is simply the way you are supposed to live and eat for the best health, function, and longevity.