5 ms·

Lower Obesity Rate During Residence at High Altitude Among a Military Population

38 points by atticora 3y ago

grecy 3y ago
I thought it was very well known that higher elevation results in reduced appetite. I certainly have not been interested in eating whenever I've been above 5000m
- robertlagrant 3y ago
  I can't say no to aeroplane food.
- silisili 3y ago
  I assumed, naively, this may have something to do with gas/air. Anyone whose lived at elevation and at sea level has probably noticed how bags of chips are flat at sea level, and bursting at the seems at 5k feet. Could that effect make us feel more full?
  - isthatafact 3y ago
    No part of you has gas and is sealed like a bag of chips, and any stomach gas would quickly reset to a new altitude. Otherwise scuba diving would probably not work at all. Equalizing your inner ear to pressure changes, and possibly farting, is all it takes to reset your internal gas pressure to altitude changes.
kjkjadksj 3y ago
This paper did a pretty poor job of controlling for cultural factors IMO. I would think there are significant differences in local base culture between locations. E.g. maybe if you are assigned to Colorado Springs there is more of a local focus on outdoor activities that leads to improved fitness, vs if you were closer to sea level in the Mojave desert where its simply too hot to be so active outdoors outside of forced marching.
- seattle_spring 3y ago
  Exactly my thought. High elevation could mean proximity to cool hikes, skiing, mountain biking, etc, while low elevation could equal corn fields and drinking beer while fishing on a lake. ... and please don't respond with counterpoint examples. Yes, I'm aware high elevation can be flat/boring and low elevation can be exciting and full of outdoor adventure.
  - hammock 3y ago
    There is a condition called “altitude anorexia”(1) where individuals who move to a high-altitude location sometimes lose a lot of weight all at once - see also (2), (3), and weight loss results(4). This effect also seems to apply to lab rats who are moved to labs at higher altitudes.(5) (1)https://pubmed.ncbi.nlm.nih.gov/18284032/ https://pubmed.ncbi.nlm.nih.gov/18284032/ (2)https://www.wired.com/2010/02/high-altitude-weight-loss/ https://www.wired.com/2010/02/high-altitude-weight-loss/ (3)https://www.liebertpub.com/doi/abs/10.1089/152702904322963753?journalCode=ham https://www.liebertpub.com/doi/abs/10.1089/15270290432296375... (4)https://academic.oup.com/icb/article/46/1/25/661337?login=false https://academic.oup.com/icb/article/46/1/25/661337?login=fa... (5)https://jn.nutrition.org/ https://jn.nutrition.org/
  - fred_is_fred 3y ago
    I live in Colorado. A large chunk of the state intentionally moved here specifically due to outdoor recreation opportunities and had kids who also do these (skiing, hiking, climbing, biking, etc). We also have ample public land and parks/green space/trails in which to recreate - which states like Texas lack. The military may not have the same choice on where to move, but when they get here there's opportunities and communities to be active.
  - pengaru 3y ago
    This subject about CO being fit came up recently when Robert Lustig was on the Huberman podcast: https://www.youtube.com/watch?v=n28W4AmvMDE&t=7000s https://www.youtube.com/watch?v=n28W4AmvMDE&t=7000s
- chunkymilk 3y ago
1-6 3y ago
I wonder if swimming has a similar effect.
hammock 3y ago
Everyone ought to read "A Chemical Hunger"(1) which posits that the relationship between altitude and obesity is real(2), and is mediated by lithium in the drinking water. (1)https://slimemoldtimemold.com/2021/08/02/a-chemical-hunger-part-vii-lithium/ https://slimemoldtimemold.com/2021/08/02/a-chemical-hunger-p... (2) -Higher altitudes are associated with lower obesity rates in the US and other countries, including Spain and Tibet. -Colorado, the highest-altitude US state, has the lowest obesity incidence. -County-level obesity data in the US reveals clear patterns in the Rockies, Sierra Mountains, and Appalachians. -"Altitude anorexia" causes sudden weight loss in individuals relocating to high-altitude areas. -Similar weight loss effect is observed in lab rats moved to higher-altitude labs. -Evidence suggests a relationship between altitude and lower diabetes rates, independent of variables like age and BMI. -Oxygen and carbon dioxide variations with elevation alone do not explain the altitude-weight relationship. -Submarines with elevated CO2 levels do not consistently lead to weight gain, refuting atmospheric explanations.
- JumpCrisscross 3y ago
  > Submarines with elevated CO2 levels do not consistently lead to weight gain, refuting atmospheric explanations How are the reduced partial pressure of oxygen and low temperature rejected as causes? The two largest metabolic taxes I experience at altitude are the fatigue during acclimation, which I understand to be the production and maintenance of red blood cells (as well as dehydration), and lower temperatures.
  - rsofaer 3y ago
    Submarines also have reduced partial pressure of oxygen, (18-19%). https://www.sciencedirect.com/science/article/pii/0378427489900350?via%3Dihub https://www.sciencedirect.com/science/article/pii/0378427489...
    - JumpCrisscross 3y ago
      > Submarines also have reduced partial pressure of oxygen, (18-19%) The article defines high altitude at 1.96km, or 6,430 feet. That’s a less-than 16.5% effective oxygen atmosphere [1]. [1] https://www.higherpeak.com/altitudechart.html https://www.higherpeak.com/altitudechart.html
atticora 3y ago
Thermodynamics is a prime suspect. Higher equals colder. The increased cost of temperature regulation would account for some extra fuel burning. The data should be available to separate the effects.
- irrational 3y ago
  Wouldn't colder cause the body to want to pack on the pounds as insulation?
- SOLAR_FIELDS 3y ago
  You would expect cold climates not at altitude to show similar effects. I am not sure that is the case.
irrational 3y ago
Isn't there also higher suicide rates among people living at high altitude? If so, do they have similar causes?
- flappyeagle 3y ago
  Lithium
padseeker 3y ago
higher altitude means less oxygen, means you need to inhale/exhale more to get the proper amount of oxygen, and also faster heart rate. Is it possible the metabolism of people at higher altitudes burn more calories just trying to get the same amount of oxygen?
iancmceachern 3y ago
This tracks with my anecdotal experience being from Colorado https://www.axios.com/local/denver/2021/09/20/colorados-obesity-rates-lowest-nationwide https://www.axios.com/local/denver/2021/09/20/colorados-obes...
mobilejdral 3y ago
From extensively researching the hpa-axis space my educated guess of what is going on: At higher altitude you have higher levels of vitamin D, that in turn downregulates 21-Hydroxylase which means higher CRH is needed for the same levels of cortisol. The higher CRH means higher levels of Leptin, NPY, and Gastrin meaning less hunger and lower obesity rates. This is presumably the same reasons why you gain weight all fall for winter/spring babies and lose it in the spring/summer. Just so happens at high altitudes you get more sun, more vitamin D.
- inamberclad 3y ago
  Does this mean that supplemental vitamin D could control body weight to some extent?
  - mobilejdral 3y ago
    Yup, here is the first paper from a google search on that topic https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071442/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071442/ There are a number of ways to hack the hpa-axis, vitamin D being an cheap and easy one. Worth noting that there are plenty of reasons why the hpa-axis might shift one way or another, lack of vitamin D is simply one of many. Chronic pain would be another (which low dose naltrexone often works well for).
  - n8henrie 3y ago
    To my knowledge most rigorously performed studies say no. For example, here's from my first pubmed result: > Most MAs as well as the individual RCTs reported null-findings on risk of cardiovascular diseases, type 2 diabetes, weight-loss, and malignant diseases. Rejnmark L, Bislev LS, Cashman KD, et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS One. 2017;12(7):e0180512. Accessed January 5, 2024. https://www.qxmd.com/r/28686645 https://www.qxmd.com/r/28686645 EDIT(S): > Although additional studies in unsupplemented individuals are needed to confirm these findings, our results support the view that the association between obesity and lower serum 25-hydroxyvitamin D may be due to reversed causation with increased adiposity leading to suboptimal concentrations of circulating vitamin D. Mallard SR, Howe AS, Houghton LA. Vitamin D status and weight loss: a systematic review and meta-analysis of randomized and nonrandomized controlled weight-loss trials. Am J Clin Nutr. 2016;104(4):1151-1159. Accessed January 5, 2024. https://www.qxmd.com/r/27604772 > Vitamin D3 supplementation during weight loss did not increase weight loss or associated factors compared with placebo Mason C, Xiao L, Imayama I, et al. Vitamin D3 supplementation during weight loss: a double-blind randomized controlled trial. Am J Clin Nutr. 2014;99(5):1015-25. Accessed January 5, 2024. https://www.qxmd.com/r/24622804 > Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Cefalo CM, Conte C, Sorice GP, et al. Effect of Vitamin D Supplementation on Obesity-Induced Insulin Resistance: A Double-Blind, Randomized, Placebo-Controlled Trial. Obesity (Silver Spring) 2018;26(4):651-657. Accessed January 5, 2024. https://www.qxmd.com/r/29504254 > There was no effect of vitamin D on weight loss. Bassatne A, Chakhtoura M, Saad R, Fuleihan GE. Vitamin D supplementation in obesity and during weight loss: A review of randomized controlled trials. Metabolism. 2019;92:193-205. Accessed January 5, 2024. https://www.qxmd.com/r/30615949
npoc 3y ago
I wonder if the availability of different food types differs between high and low altitude locations?
- genmud 3y ago
  There was a paper about 10-15 years ago where they mentioned that they noticed decreased appetite and increased metabolism at higher altitudes. [1] kind of goes over this. I used to live in a high altitude town (~ 7000 ft) and definitely noticed that my appetite was much lower and whenever I traveled had much more stamina. [1] - https://journals.physiology.org/doi/full/10.1152/japplphysiol.01284.2007 https://journals.physiology.org/doi/full/10.1152/japplphysio...

38 points by atticora 3y ago

I thought it was very well known that higher elevation results in reduced appetite. I certainly have not been interested in eating whenever I've been above 5000m

robertlagrant 3y ago
I can't say no to aeroplane food.
silisili 3y ago
I assumed, naively, this may have something to do with gas/air. Anyone whose lived at elevation and at sea level has probably noticed how bags of chips are flat at sea level, and bursting at the seems at 5k feet. Could that effect make us feel more full?
- isthatafact 3y ago
  No part of you has gas and is sealed like a bag of chips, and any stomach gas would quickly reset to a new altitude. Otherwise scuba diving would probably not work at all. Equalizing your inner ear to pressure changes, and possibly farting, is all it takes to reset your internal gas pressure to altitude changes.

kjkjadksj 3y ago

This paper did a pretty poor job of controlling for cultural factors IMO. I would think there are significant differences in local base culture between locations. E.g. maybe if you are assigned to Colorado Springs there is more of a local focus on outdoor activities that leads to improved fitness, vs if you were closer to sea level in the Mojave desert where its simply too hot to be so active outdoors outside of forced marching.

seattle_spring 3y ago
Exactly my thought. High elevation could mean proximity to cool hikes, skiing, mountain biking, etc, while low elevation could equal corn fields and drinking beer while fishing on a lake. ... and please don't respond with counterpoint examples. Yes, I'm aware high elevation can be flat/boring and low elevation can be exciting and full of outdoor adventure.
- hammock 3y ago
  There is a condition called “altitude anorexia”(1) where individuals who move to a high-altitude location sometimes lose a lot of weight all at once - see also (2), (3), and weight loss results(4). This effect also seems to apply to lab rats who are moved to labs at higher altitudes.(5) (1)https://pubmed.ncbi.nlm.nih.gov/18284032/ https://pubmed.ncbi.nlm.nih.gov/18284032/ (2)https://www.wired.com/2010/02/high-altitude-weight-loss/ https://www.wired.com/2010/02/high-altitude-weight-loss/ (3)https://www.liebertpub.com/doi/abs/10.1089/152702904322963753?journalCode=ham https://www.liebertpub.com/doi/abs/10.1089/15270290432296375... (4)https://academic.oup.com/icb/article/46/1/25/661337?login=false https://academic.oup.com/icb/article/46/1/25/661337?login=fa... (5)https://jn.nutrition.org/ https://jn.nutrition.org/
- fred_is_fred 3y ago
  I live in Colorado. A large chunk of the state intentionally moved here specifically due to outdoor recreation opportunities and had kids who also do these (skiing, hiking, climbing, biking, etc). We also have ample public land and parks/green space/trails in which to recreate - which states like Texas lack. The military may not have the same choice on where to move, but when they get here there's opportunities and communities to be active.
- pengaru 3y ago
  This subject about CO being fit came up recently when Robert Lustig was on the Huberman podcast: https://www.youtube.com/watch?v=n28W4AmvMDE&t=7000s https://www.youtube.com/watch?v=n28W4AmvMDE&t=7000s
chunkymilk 3y ago

1-6 3y ago

I wonder if swimming has a similar effect.

hammock 3y ago

Everyone ought to read "A Chemical Hunger"(1) which posits that the relationship between altitude and obesity is real(2), and is mediated by lithium in the drinking water. (1)https://slimemoldtimemold.com/2021/08/02/a-chemical-hunger-part-vii-lithium/ https://slimemoldtimemold.com/2021/08/02/a-chemical-hunger-p... (2) -Higher altitudes are associated with lower obesity rates in the US and other countries, including Spain and Tibet. -Colorado, the highest-altitude US state, has the lowest obesity incidence. -County-level obesity data in the US reveals clear patterns in the Rockies, Sierra Mountains, and Appalachians. -"Altitude anorexia" causes sudden weight loss in individuals relocating to high-altitude areas. -Similar weight loss effect is observed in lab rats moved to higher-altitude labs. -Evidence suggests a relationship between altitude and lower diabetes rates, independent of variables like age and BMI. -Oxygen and carbon dioxide variations with elevation alone do not explain the altitude-weight relationship. -Submarines with elevated CO2 levels do not consistently lead to weight gain, refuting atmospheric explanations.

JumpCrisscross 3y ago
> Submarines with elevated CO2 levels do not consistently lead to weight gain, refuting atmospheric explanations How are the reduced partial pressure of oxygen and low temperature rejected as causes? The two largest metabolic taxes I experience at altitude are the fatigue during acclimation, which I understand to be the production and maintenance of red blood cells (as well as dehydration), and lower temperatures.
- rsofaer 3y ago
  Submarines also have reduced partial pressure of oxygen, (18-19%). https://www.sciencedirect.com/science/article/pii/0378427489900350?via%3Dihub https://www.sciencedirect.com/science/article/pii/0378427489...
  - JumpCrisscross 3y ago
    > Submarines also have reduced partial pressure of oxygen, (18-19%) The article defines high altitude at 1.96km, or 6,430 feet. That’s a less-than 16.5% effective oxygen atmosphere [1]. [1] https://www.higherpeak.com/altitudechart.html https://www.higherpeak.com/altitudechart.html

atticora 3y ago

Thermodynamics is a prime suspect. Higher equals colder. The increased cost of temperature regulation would account for some extra fuel burning. The data should be available to separate the effects.

irrational 3y ago
Wouldn't colder cause the body to want to pack on the pounds as insulation?
SOLAR_FIELDS 3y ago
You would expect cold climates not at altitude to show similar effects. I am not sure that is the case.

irrational 3y ago

Isn't there also higher suicide rates among people living at high altitude? If so, do they have similar causes?

flappyeagle 3y ago
Lithium

padseeker 3y ago

higher altitude means less oxygen, means you need to inhale/exhale more to get the proper amount of oxygen, and also faster heart rate. Is it possible the metabolism of people at higher altitudes burn more calories just trying to get the same amount of oxygen?

iancmceachern 3y ago

This tracks with my anecdotal experience being from Colorado https://www.axios.com/local/denver/2021/09/20/colorados-obesity-rates-lowest-nationwide https://www.axios.com/local/denver/2021/09/20/colorados-obes...

mobilejdral 3y ago

From extensively researching the hpa-axis space my educated guess of what is going on: At higher altitude you have higher levels of vitamin D, that in turn downregulates 21-Hydroxylase which means higher CRH is needed for the same levels of cortisol. The higher CRH means higher levels of Leptin, NPY, and Gastrin meaning less hunger and lower obesity rates. This is presumably the same reasons why you gain weight all fall for winter/spring babies and lose it in the spring/summer. Just so happens at high altitudes you get more sun, more vitamin D.

inamberclad 3y ago
Does this mean that supplemental vitamin D could control body weight to some extent?
- mobilejdral 3y ago
  Yup, here is the first paper from a google search on that topic https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071442/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071442/ There are a number of ways to hack the hpa-axis, vitamin D being an cheap and easy one. Worth noting that there are plenty of reasons why the hpa-axis might shift one way or another, lack of vitamin D is simply one of many. Chronic pain would be another (which low dose naltrexone often works well for).
- n8henrie 3y ago
  To my knowledge most rigorously performed studies say no. For example, here's from my first pubmed result: > Most MAs as well as the individual RCTs reported null-findings on risk of cardiovascular diseases, type 2 diabetes, weight-loss, and malignant diseases. Rejnmark L, Bislev LS, Cashman KD, et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS One. 2017;12(7):e0180512. Accessed January 5, 2024. https://www.qxmd.com/r/28686645 https://www.qxmd.com/r/28686645 EDIT(S): > Although additional studies in unsupplemented individuals are needed to confirm these findings, our results support the view that the association between obesity and lower serum 25-hydroxyvitamin D may be due to reversed causation with increased adiposity leading to suboptimal concentrations of circulating vitamin D. Mallard SR, Howe AS, Houghton LA. Vitamin D status and weight loss: a systematic review and meta-analysis of randomized and nonrandomized controlled weight-loss trials. Am J Clin Nutr. 2016;104(4):1151-1159. Accessed January 5, 2024. https://www.qxmd.com/r/27604772 > Vitamin D3 supplementation during weight loss did not increase weight loss or associated factors compared with placebo Mason C, Xiao L, Imayama I, et al. Vitamin D3 supplementation during weight loss: a double-blind randomized controlled trial. Am J Clin Nutr. 2014;99(5):1015-25. Accessed January 5, 2024. https://www.qxmd.com/r/24622804 > Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Cefalo CM, Conte C, Sorice GP, et al. Effect of Vitamin D Supplementation on Obesity-Induced Insulin Resistance: A Double-Blind, Randomized, Placebo-Controlled Trial. Obesity (Silver Spring) 2018;26(4):651-657. Accessed January 5, 2024. https://www.qxmd.com/r/29504254 > There was no effect of vitamin D on weight loss. Bassatne A, Chakhtoura M, Saad R, Fuleihan GE. Vitamin D supplementation in obesity and during weight loss: A review of randomized controlled trials. Metabolism. 2019;92:193-205. Accessed January 5, 2024. https://www.qxmd.com/r/30615949

npoc 3y ago

I wonder if the availability of different food types differs between high and low altitude locations?

genmud 3y ago
There was a paper about 10-15 years ago where they mentioned that they noticed decreased appetite and increased metabolism at higher altitudes. [1] kind of goes over this. I used to live in a high altitude town (~ 7000 ft) and definitely noticed that my appetite was much lower and whenever I traveled had much more stamina. [1] - https://journals.physiology.org/doi/full/10.1152/japplphysiol.01284.2007 https://journals.physiology.org/doi/full/10.1152/japplphysio...