CoQ10 and Obesity
“Overweight” and “obese” are terms used to describe individuals whose weight is above what is generally considered healthy for a given height. Obesity has been shown to increase the risk of health problems and certain diseases. Physicians usually define overweight and obesity by using height and weight to calculate a number called the “body mass index” (BMI) using the following equation:
BMI = weight (in pounds) x 704.5 / height x height (in inches)
An adult who has a BMI between 25 and 29.9 is considered overweight.
An adult who has a BMI of 30 or higher is considered obese.
For more in depth information on obesity, visit the Centers for Disease Control (CDC).
Obesity is a leading public health problem in the United States and exacerbates a variety of diseases including cardiovascular disease and diabetes. The figure below from the Centers for Disease Control (CDC) demonstrates the alarming increase in obesity in the United States over the last 15 years.
Individuals become overweight when calories consumed (energy in) exceed calories burned (energy out) and fat cells store the extra energy as fat. Even a small imbalance between calories in and calories out can lead to a large weight gain over time. For example, an obese 40 year old who is 100 pounds overweight has only consumed about 25 more calories per day than (s)he has burned - or the equivalent of one apple every three days!
Factors which contribute to obesity include: inactivity, high calorie diet, family history, underlying disease such as hypertension, certain medications, age, stress, too little sleep, and quitting smoking. Obese individuals face increased morbidity (sickness) and mortality (death) relative to their non-obese counterparts.
Obesity has been associated with lower levels of antioxidants in the blood and, in some cases, with impaired energy production. Individuals with a family history of obesity have a 50% reduction in the ability to burn dietary fat to produce energy!
In mammals, two types of adipose (fat) tissue exist: white adipose tissue (WAT) and brown adipose tissue (BAT). Adipose tissue is located beneath the skin and around internal organs. In the subcutaneous layer of the skin, it provides insulation from heat and cold. Around organs, it provides protective padding. BAT is a specialized form of adipose tissue found primarily in human infants and some animals. Due to the presence of “uncoupling proteins”, BAT is capable of generating heat instead of energy by “uncoupling” the respiratory chain of oxidative metabolism within mitochondria. So, food is burned to generate heat rather than energy (ATP). This thermogenic (heat generating) process may be vital to infants exposed to cold, since they are unable to shiver, and to animals coming out of hibernation, allowing them to re-warm.
The heat produced by brown fat can actually be visualized using an infrared camera. If one takes such a picture of an unswaddled infant sleeping at room temperature, “hot spots” can be seen in the skin overlying brown fat deposits. Finally, it seems that brown fat may play a role in the control of body weight and that mitochondrial uncoupling proteins may be one of many factors involved in development of obesity. A demonstration of this is found in a study in which mice born without brown fat developed obesity in the absence of overeating! Animals with more brown fat weigh less that their “white fat counterparts”, even when caloric intake is equal. 1 Humans with a family history of obesity have a reduced thermogenic response to a meal than non-obese patients. 2
The tendency to become overweight is associated in some cases with impaired energy production. Since coenzyme Q10 is an essential cofactor for energy production, the information about brown fat led researchers to study the effect of coenzyme Q10 in obese patients. It is conceivable that coenzyme Q10 deficiency may contribute to some cases of obesity.
Role of Coenzyme Q10
Coenzyme Q10 was studied by Van Gaal and coworkers in 27 morbidly obese patients. 3 Fourteen (52%) of the obese patients had coenzyme Q10 levels that were lower than the average. Nine of these individuals, five of whom had reduced coenzyme Q10 levels received 100 mg/day of coenzyme Q10 along with a reduced calorie diet for 8-9 weeks. Upon completion of the study, the mean weight loss in the coenzyme Q10 deficient group was 13.5 kg, compared with 5.8 kg in those with normal levels. The authors suggested that dietary supplementation with coenzyme Q10 may accelerate weight loss in obese patients who are deficient in coenzyme Q10. Although, the decreased blood levels of coenzyme Q10 in these obese individuals may be associated with other metabolic abnormalities related to their obesity. Still, this promising study suggests that more research needs to be done regarding coenzyme Q10 and obesity.
VITamins And Lifestyle (VITAL) was a survey of 15,655 men and women 53 to 57 years of age asked to fill out questionnaires regarding their long-term (10 year) use of nutritional supplements that are sometimes marketed for weight loss. The survey analyzed weight gain in relationship to the intake of the following supplements : multivitamins; vitamins B6 and B12; chromium; coenzyme Q10, dehydroepiandrosterone, essential fatty acids (EFAs), fiber, garlic (Allium sativum), ginkgo (Ginkgo biloba),ginseng (Panax spp.), melatonin, soy, and St. John’s wort. The data suggest that long-term users of vitamins B6 and B12, and chromium, but not coenzyme Q10 experienced less weight gain than individuals who did not use the supplements. 4 In another study, coenzyme Q10 blood levels were measured in 67 obese children and were compared to a control group of 50 healthy normal weight children. No significant difference in the coenzyme Q10 blood levels was noted between the two groups of children. 5 In conclusion, the importance of coenzyme Q10 supplementation for obese patients requires further study. Some doctors may recommend coenzyme Q10 supplementation as a way to treat obesity.
Diagnosis
In addition to calculation of BMI, physicians also look at waist circumference and measurement of percent body fat. The presence of life-threatening diseases associated with obesity such as heart disease, atherosclerosis, type 2 diabetes, hypertension, and sleep apnea are other reasons to diagnose and start treatment of obesity.
Treatment
The treatment for obesity is to set a realistic goal for weight loss with a healthy lifestyle including a reduced calorie diet and an increase in exercise. While weight loss is very difficult, studies have shown that even a loss as little as 5% of body mass can create enormous health benefits. Still, maintenance of weight loss is an even bigger problem than achieving weight loss. When diet and exercise are not enough to reach realistic weight goals, medications are often added. Surgery is an increasing part of weight control of obesity, but it is not without risk.
For more information regarding the treatment of obesity visit The American College of Physicians at http://www.acponline.org or the United States Department of Health & Human Services.
- Rothwell NJ, Stock MJ. Similarities between cold- and diet-induced thermogenesis in the rat. Can J Physiol 1980;58:842-848.
- Shetty PS, Jung RT, James WP, Barrand MA, Callingham BA. Postprandial thermogenesis in obesity. Clin Sci (Lond). 1981 May;60(5):519-25
- van Gaal, L., et al. Exploratory study of coenzyme Q10 in obesity. In: Biomedical and Research Aspects of Coenzyme Q, Vol 4. Folkers, K., & Yamura (eds.). Elsevier Science Publishers. Amsterdam, 1984, pp. 369-373.
- Nachtigal MC, Patterson RE, Stratton KL, Adams LA, Shattuck AL, White E. J Dietary supplements and weight control in a middle-age population. Altern Complement Med. 2005 Oct;11(5):909-15.
- Menke T, Niklowitz P, de Sousa G, Reinehr T, Andler W. Comparison of coenzyme Q10 plasma levels in obese and normal weight children. Clin Chim Acta. 2004 Nov;349(1-2):121-7.
- Rothwell NJ, Stock MJ. A role for brown adipose tissue in diet-induced thermogenesis. Nature.1979 Sep 6;281(5726):31-5.