November, 2013 – The Leptin-Obesity Connection

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The Leptin-Obesity Connection

By Meroe Rabieifar, PharmD, My Community Pharmacy

Leptin. Yet another soldier in the battle of the bulge. Let me just preface by saying this was very confusing to me when I began researching the subject. I thought we wanted more leptin to aid in appetite control. Then I found that most obese people have an overabundance of leptin (which makes sense since fat cells secrete leptin). So…we want less leptin? But we need leptin in order to stop eating? Which is it? Is leptin good or bad? The answer is complicated.

Leptin is the hunger and energy regulator. In times when the body has adequate adipose (fat) tissue, leptin is secreted from fat cells and binds to leptin receptors to signal the brain that there is plenty of energy and turns off the hunger response. Conversely, when fat storages are depleted, there is a lack of leptin and the brain’s hunger signals are switched on. That is exactly why obese people have copious amounts of circulating leptin in their bodies. But even though they shouldn’t be hungry, they still are. The problem is either the leptin is not reaching the receptors, or the number of effective leptin receptors have diminished. The latter is known as leptin resistance. Since, for most obese people, leptin supplementation does not help, the most-likely scenario is dulled leptin receptors. The cause is probably our nutrient-poor, highly processed, far-removed-from-nature diet. When leptin levels are chronically high, the receptors stop reacting to them. We already knew a poor diet wrecks insulin balance; now another hormone is jumping on the bandwagon.

There are several things you can do to get your leptin to the normal levels needed to maintain weight and energy. First, avoid fructose, especially high fructose corn syrup (HFCS). Fructose actually appears to desensitize leptin receptors, so even when leptin is present, the receptors aren’t binding. In addition, fructose increases triglyceride levels and triglycerides physically prevent leptin from crossing over to the brain. The result is the hunger mechanism stays switched on. Make sure you’re reading those nutrition labels!

Next, avoid grains. Besides being high in carbs and leading to insulin resistance and diabetes, grains contain high levels of peptides called lectins that are thought to contribute to leptin resistance. Some lectins actually bind to leptin receptors, thus preventing leptin from doing its job. Lectins are also present in most other foods, like beans, soy, dairy, eggs, and even meat. Soaking, fermenting and cooking appear to reduce the concentration of lectin dramatically. When possible, soak your beans for 24 hours prior to cooking, soak raw nuts for 12 hours (then refrigerate if not consumed right away) and stick to fermented dairy and soy products.

Get plenty of good sleep. Sleep appears to increase leptin levels significantly. Since stress produces cortisol, avoiding stress is key when trying to regulate sleep. High cortisol prevents the sleep hormone, melatonin, from doing its job. One way to beat cortisol is to take melatonin supplements. Melatonin supplementation has been shown to be safe in adults at high doses. Generally, 1mg to 3mg taken before bedtime produces good results in most people, although higher doses are possible. If you have questions regarding melatonin supplementation, stop by (2615 State Road 7, Wellington) and one of the pharmacists will help you determine your needs.

One last thing to avoid is ultra-low-calorie diets. Just like eating too much throws off your balance, so does eating too little. Eventually, your hormones will win out and you will eat. Constant dieting has been linked to lowered leptin production.

When battling weight or energy issues, it’s best keep the big picture in mind. Something that might produce immediate results (severe caloric restriction) may end up hurting you in the long run (decreased leptin levels). Be kind to your body by avoiding foods that are harmful, eating adequate amounts of nutritious foods and getting plenty of sleep. Love and respect your body and, trust me, your body will love you for it!