I have had a few discussions recently regarding the barriers that clients may face when attempting to maintain weight loss. You constantly hear about numerous people who lose weight only to put it all back on and more! Research has found over recent years that weight management is more complex than calories in vs calories out. One area of interest is the role of the hormone leptin in appetite and metabolism control. Therefore, this week’s blog is all about leptin resistance and what current research says on how to tackle it!

What is Leptin?

Leptin is our satiety hormone and works closely with our hunger hormone ghrelin to maintain long term energy balance in the body. Leptin communicates with the brain to regulate food intake and energy expenditure, and with other areas of the body to adjust fat and carbohydrate metabolism accordingly. It is secreted by our fat cells, therefore, the more body fat you have, the more leptin you produce. When fat stores are adequate it tells the brain to reduce calorie intake and increase metabolic rate to maintain energy balance. A reduction in body fat causes a drop in leptin levels, therefore sending a starvation signal to the brain, telling it to increase calorie intake and reduce metabolism. Leptin may also play a role in immune function, bone metabolism, cognition (1) and is possibly involved in the regulation of the absorption of some nutrients (2).

 

Leptin and Obesity

If leptin levels are high, which is common in people who are overweight and obese, the brain and other areas of the body can become resistant to the leptin signal, in a similar way to when the body becomes resistant to insulin in type 2 diabetes. This results in the brain thinking leptin levels are low, which slows metabolism and increases appetite. Starvation mode stimulates the over-consumption of food, a further increase in fat stores and even more leptin, creating a vicious cycle! This is the reason severely restricting calories for weight loss in the long term does not work, if you restrict them too severely the brain receives a starvation signal, slowing metabolism. Once a dieter returns to the normal calorie intake their metabolism is slower than before the diet!

There are many possible contributing factors to leptin resistance, but aside from overeating and becoming overweight to obese in the first place, research suggests that the factors associated with leptin resistance are stress, inflammation, excess carbohydrate intake (especially excess fructose) and lack of sleep (3).

 

What Can You Do About Leptin Resistance?

So if you’re struggling to control what you eat and shift the extra weight despite regular exercise, how do you make your brain more sensitive to leptin?

• Exercise – combined with healthy dietary choices can improve leptin sensitivity (4,5)
• Good sleep hygiene – sleep deprivation can affect leptin levels as well as other appetite hormones (6).
• Eating plenty of protein –  this increases satiety but also improves leptin sensitivity (7,8). Make sure you eat protein with each meal and snack, this can be from a plant or animal source.
• Reduce carbohydrate and fructose intake, especially from processed foods – to reduce triglyceride (fat) levels in the blood, as research shows high triglycerides are involved in both leptin and insulin resistance (9). In addition, low carbohydrate diets are more effective at combatting obesity than low fat diets (10,11).
• Increase fibre – a recent study found oat fibre in particular increased leptin sensitivity (12). In addition, fibre naturally increases satiety via other mechanisms so it is a vital component to an individuals diet where appetite control is an issue.

Yet again all of the above highlights the importance of diet and lifestyle in optimising health. A nutritional therapy consultation can guide you through the best approach for you based on your individual needs. Leptin testing is now available as part of our services at an additional cost.

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References:

1. Dalamaga M, Chou S, Shields K, Papageorgiou P, Polyzos S, Mantzoros C. Leptin at the Intersection of Neuroendocrinology and Metabolism: Current Evidence and Therapeutic Perspectives. Cell Metabolism [Internet]. 2013 [cited 26 March 2018];18(1):29-42. Available from: https://ac.els-cdn.com/S1550413113002003/1-s2.0-S1550413113002003-main.pdf?_tid=adc8d597-a5b6-4da0-8b36-2f497803b300&acdnat=1522085013_0640026f042d4d175796455f41a91d95

2. Sáinz N, Barrenetxe J, Moreno-Aliaga M, Martínez J. Leptin resistance and diet-induced obesity: central and peripheral actions of leptin. Metabolism [Internet]. 2015 [cited 27 March 2018];64(1):35-46. Available from: https://pdfs.semanticscholar.org/12d2/d530d4a5782cc6554c592ffb635a49e73070.pdf

3. Zhou Y, Rui L. Leptin signaling and leptin resistance. Frontiers of Medicine [Internet]. 2013 [cited 29 March 2018];7(2):207-222. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069066/

4. Kang S, Kim K, Shin K. Exercise training improve leptin sensitivity in peripheral tissue of obese rats. Biochemical and Biophysical Research Communications [Internet]. 2013 [cited 27 March 2018];435(3):454-459. Available from: https://www.sciencedirect.com/science/article/pii/S0006291X13007778

5. Ropelle E, Flores M, Cintra D, Rocha G, Pauli J, Morari J et al. IL-6 and IL-10 Anti-Inflammatory Activity Links Exercise to Hypothalamic Insulin and Leptin Sensitivity through IKKβ and ER Stress Inhibition. PLoS Biology [Internet]. 2010 [cited 27 March 2018];8(8):e1000465. Available from: http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1000465

6. García-García F, Juárez-Aguilar E, Santiago-García J, Cardinali D. Ghrelin and its interactions with growth hormone, leptin and orexins: Implications for the sleep–wake cycle and metabolism. Sleep Medicine Reviews [Internet]. 2014 [cited 27 March 2018];18(1):89-97. Available from: https://s3.amazonaws.com/academia.edu.documents/46225142/Ghrelin_and_its_interactions_with_growth20160604-5519-1js9cvq.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1522273719&Signature=Fi2hauWeP9yjMmx04Ff5BIvOvXw%3D&response-content-disposition=inline%3B%20filename%3DGhrelin_and_its_interactions_with_growth.pdf

7. Izadi V, Saraf-Bank S, Azadbakht L. Dietary intakes and leptin concentrations. ARYA Atherosclerosis [Internet]. 2018 [cited 29 March 2018];10(5):266-272. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251481/

8. Weigle D, Breen P, Matthys C, Callahan H, Meeuws K, Burden V et al. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. The American Journal of Clinical Nutrition [Internet]. 2005 [cited 28 March 2018];82(1):41-48. Available from: https://academic.oup.com/ajcn/article/82/1/41/4863422

9. Banks W, Farr S, Salameh T, Niehoff M, Rhea E, Morley J et al. Triglycerides cross the blood–brain barrier and induce central leptin and insulin receptor resistance. International Journal of Obesity [Internet]. 2017 [cited 29 March 2018];42(3):391-397. Available from: https://www.nature.com/articles/ijo2017231

10. Samaha F, Iqbal N, Seshadri P, Chicano K, Daily D, McGrory J et al. A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity. New England Journal of Medicine [Internet]. 2003 [cited 29 March 2018];348(21):2074-2081. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa022637

11. Bazzano L, Hu T. Effects of Low-Carbohydrate and Low-Fat Diets. Annals of Internal Medicine [Internet]. 2015 [cited 29 March 2018];162(5):393. Available from: http://annals.org/aim/article-abstract/1900694/effects-low-carbohydrate-low-fat-diets-randomized-trial

12. Zhang R, Jiao J, Zhang W, Zhang Z, Zhang W, Qin L et al. Effects of cereal fiber on leptin resistance and sensitivity in C57BL/6J mice fed a high-fat/cholesterol diet. Food & Nutrition Research [Internet]. 2016 [cited 29 March 2018];60(1):31690. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989175/

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