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marylin monroe
Showing posts with label vagus nerve. Show all posts
Showing posts with label vagus nerve. Show all posts

Weight Loss Acupuncture: Study Reports 5% Weight Loss in 8 Weeks. More Than the Exception That Proves the Rule?

It's the ear, not the belly that has to be (acu-)punctured to make the nasty pounds disappear.
I am pretty sure that at least some of you will have seen the headlines about one week ago: "Acupuncture Facilitates Effortless Weight Loss!" It sounds like a scam. If you actually read the corresponding press release, however, you'll have realized that the headlines were based on the results of a the results of a study that was conducted at the East-West Medical Research Institute of the Kyung Hee University in Korea, where the stimulation of the tested five ear acupuncture points (Shen-men, Spleen, Stomach, Hunger, Endocrine) has been used traditionally to curb the appetite of overweight patients for centuries.

6.1% and 5.7% reduction in BMI without diet or exercise

As it turned out, it was not even necessary to "nail" all 5 of the trigger points. As you will probably have learned from the press release, already, even the subjects in whom the researchers had "punctured" only the Hunger point lost 5% of their initial BMI within the 8-week study period.
Figure 1: Illustration of the trigger points and the results of the Yeo study (Yeo. 2013)
For the average slightly overweight Westerner with a weight of 100kg on a 180cm frame this 5%+ reduction in BMI would translate into a pretty significant decrease of ~5kg on the scale. An impressive figure, I know, but is this study actually more than a statistical outlier?
"How is this acupuncture thing supposed to work, anyway?" The absence of conclusive hypotheses that would explain the weight loss effects of acupuncture is actually one of the reason scientists doubt its efficacy. Theories that have been propose so far are generally based on the assumption that the trigger points are wired with the vagus nerve. Consequently, the stimulation of the auricular nerves could interfere with the transduction of appetite signals from the gastrointestinal tract (Dung. 1986).
If we take a look at the contemporarily available evidence, it is easier to find evidence to support the the results Yeo et al. present in their latest paper, than you may have thought:
  • Figure 2: Effects of 9 weeks of active or sham (inactive trigger points) acupuncture on % of subjects above ideal body weight; a good example of insignificant, but positive effects (Mok. 1976)
    Hsu et al. report a significantly greater weight loss and reduction in waist circumference with electroacupuncture treatment (vs. situp exercise or no intervention; Hsu. 2005).
  • Cabıoǧlu  et al. observed decreases in serum total cholesterol, triglyceride, and LDL cholesterol levels that were mediated by increases in serum beta endorphin in response to electroacupuncture of the ear points, Sanjiao (Hungry) and Shen Men (Stomach), and the body points, LI 4, LI 11, St 25, St 36, St 44 and Liv 3, once daily, for 30 minutes, for 20 days (Cabıoǧlu. 2005).
While these are not the only relevant studies, the fact that there are the general concerns with the quality of the corresponding paper, t  would be futile to attempt to cite all the contemporarily available evidence that would support the efficacy of acupuncture as a weight loss treatment. 

Scientists are still debating how acupuncture induced weight loss could work. The vagus nerve is yet part of almost every currently harbored hypothesis (Lacey. 2003).
In their 2001 review Linde, et al. use accupuncture as an example of the low rates of adequate allocation concealment and other shortcomings that may compromise their validity (Linde. 2011a). It is thus not really surprising, that you will also find conflicting evidence that would support our suspicion that Yeo's most recent study is nothing but a statistical outlier.
  • Despite using the exact same auricular acupuncture points, Hsu et al., whose previous study had yielded encouraging results (Hsu. 2005), did not observe significant differences in percent reduction in body weight, BMI, and waist circumference two groups of obese women, of which one received an active, one a sham treatment (Hsu. 2009)
This is a particular interesting result, because the most significant difference between the Hsu study from 2009 and the more recent study by Yeo et al. (2013) is actually the previously mentioned allocation concealment, or insufficient blinding, if you will. Contrary to the subjects in the Hsu (2009) study, Yeo et al. used no sham control, they simply "removed [the needles] immediately after insertion", again.

A similar argument is brought forward by Cho et al. who question the significance of their own generally positive assessment of the use of accupuncture as an obesity treatment (additonal weight loss of 0.50–2.93kg; Cho. 2008) due to the "poor methodological quality" of the 31 studies the Korean and Canadian researchers had reviewed.
Fat Loss Wraps: Green slime + cellophane, a similarly questionable weight loss alternative | learn more
Bottom line: In view of the insufficient blinding and contradictory results, it is not really suprising that reviews of the British Medical Association (2000), Ernst (1999) and Vickers et al. (2001) clearly state that the contemporarily available evidence would suggest that accupunkture does not promote weight loss. Linde et al. (2001b) and Tait et al. (2002) argue that the evidence was contradictory and a definitive answer to the question whether acupuncture can / will promote weight loss would require further, more rigorous and better controlled trials.

As of now, the Yao study is thus a methodologically somewhat questionable exception that proves the rule - the rule that says that diet and exercise are without any alternative.
References:
  • Cho, S. H., Lee, J. S., Thabane, L., & Lee, J. (2009). Acupuncture for obesity: a systematic review and meta-analysis. International Journal of Obesity, 33(2), 183-196.
  • Cabıoǧlu, T. M and Ergene, T. (2005) Electroacupuncture therapy for weight loss reduces serum total cholesterol, triglycerides, and LDL cholesterol levels in obese women. The American journal of Chinese medicine, 33.04, 525-533.
  • Dung, H. C. (1986). Role of the vagus nerve in weight reduction through auricular acupuncture. Am J Acup, 14(3), 249.
  • Ernst E. (1999) Clinical effectiveness of acupuncture: an overview of systematic reviews. In: Ernst E, White A, eds. Acupuncture: A Scientific Appraisal. Oxford, Butterworth-Heinemann.
  • Hsu, C. H., Hwang, K. C., Chao, C. L., Chang, H. H., & Chou, P. (2005). Electroacupuncture in obese women: a randomized, controlled pilot study. Journal of Women's Health, 14(5), 434-440.
  • Hsu, C. H., Wang, C. J., Hwang, K. C., Lee, T. Y., Chou, P., & Chang, H. H. (2009). The effect of auricular acupuncture in obese women: a randomized controlled trial. Journal of Women's Health, 18(6), 813-818. 
  • Lacey, J. M., Tershakovec, A. M., & Foster, G. D. (2003). Acupuncture for the treatment of obesity: a review of the evidence. International journal of obesity, 27(4), 419-427.
  • Linde, K., Jonas, W. B., Melchart, D., & Willich, S. (2001a). The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture. International Journal of Epidemiology, 30(3), 526-531.
  • Linde, K., Vickers, A., Hondras, M., ter Riet, G., Thormählen, J., Berman, B., & Melchart, D. (2001b). Systematic reviews of complementary therapies-an annotated bibliography. Part 1: Acupuncture. BMC complementary and alternative medicine, 1(1), 3. 
  • Mok, M. S., Parker, L. N., Voina, S., & Bray, G. A. (1976). Treatment of obesity by acupuncture. The American journal of clinical nutrition, 29(8), 832-835.
  • Tait, P. L., Brooks, L., & Harstall, C. (2002). Acupuncture: evidence from systematic reviews and meta-analyses. Edmonton, Alberta, Canada: Alberta Heritage Foundation for Medical Research.
  • Vickers A. (2001). Acupuncture. Eff Health Care, 7:1–12.

Gear for Your Ear! Fast & Slow Songs Can Both Speed You Up on the First 800m of a 5K. Plus: Calm Songs Increase Vagal Tone & CNS Activity, Fast Songs Spike You Up!

One of the runners in the study (original image from Bigliassi. 2014)
Music-related interventions have been widely used in sports and exercise; and despite the fact that you've read about respective studies here at the SuppVersity before I thought the publication of a recent study from the Center of  Physical  Education  and  Sports at the State  University of Londrina was a good reason to address the issue once more.

It goes without saying that there are numerous external factors which determine the optimal workout music, as well as how and when to use it. Against that background, it should be obvious that the following study outcomes are not entitled to be "universal".
HIIT workouts probably require different music than LISS workouts

Never Train To Burn Calories!

Tabata = 14.2kcal /min ≠ Fat Loss

30s Intervals + 2:1 Work/Rec.

Making HIIT a Hit Part I/II

Making HIIT a Hit Part II/II

Triple Your Energy Exp.
Just think about personal preferences, for example. A classic fan is probably not going to work out listening to music by Dr. Dre... well unless he's boxing, maybe! A thought that takes us to another important factor: Who knows if the same music that helps you to lift harder will also make you run longer and vice versa?

Why is this important? Well, in the study at hand, the exercise of choice was running. An exercise type the authors considered particularly fit for their study, because it's "a common physical exercise worldwide, due to its own features (low cost and availability for practice) and high aerobic benefits". Moreover, previous research has demonstrated that music can aid running by acting in parallel to exercise. It was thus logical to try to expand our still incomplete knowledge of the effects of music on exercise performance - albeit this time in a long term study with many degrees of freedom:
"Acoustic gear" - (Re-)Read my previous research summary from 2013 | go ahead
"This study was divided into 3 stages that were performed in the course of 30 weeks. In the first stage, all participants were interviewed separately before the experiment. At this time, they gave their anthropometric measures (weight and height), personal information (age, time of continuous training, number of running competitions and training volume), and answered the Eysenck personality questionnaire (EPQ), which gives possible stratifications according to personality, checking whether music could act differently in accordance with personal features."
The subjects had to select 30 motivational songs (10 – slow speed tracks, 10 medium speed tracks and 10 fast speed tracks) and the only provided information was to select songs capable of increasing their vigor and motivation to accomplish a severe aerobic physical exercise (when the number of tracks did not achieve the required number, they were asked to choose other songs to complete the playlist). The song stratification was performed initially via specific software solutions and thereafter by the examination of an expert musician.
How did the tests look like? The actual exercise tests consisted of 5 physical tests. Each of them involved a 5km run which was to be completed as fast as possible. The time between the tests ranged from 3-7 days. All tests were performed at the same time of the day.
In the second stage, all participants were called in to the laboratory, where they had to fill their questionnaires and to perform a neuroimaging test involving listening to a variety of songs. This technique was conducted to demonstrate how self-selected songs could act in emotional areas of the brain and how the subsequent activation of specific brain correlates with physiological assessments and the effectiveness of motivational music in inducing emotional consequences and downstream metabolic / ergogenic effects. All-in-all, the present study evaluated five experimental conditions:
  • PM: Motivational songs, ranging from 110 – 150 bpm, applied before 5 km of running; 
  • SM: Slow motivational songs, ranging from 80 – 100 bpm,applied during 5 km of running;
  • FM: Fast motivational songs, ranging from 140 – 160bpm, applied during 5 km of running; 
  • CS: Calm songs condition – calm songs applied after 5 km of running; 
  • CO: Control condition, without intervention. 
The CO trial was considered the baseline, all other trial were compared to. The CO trial was performed in a silent environment to allow the subjects to focus exclusively on their body signals.
Figure 1: Parasympathetic tone during recovery (in min on x-axes) after control trial (no music)
vs. calm music (left) and motivational music (left | Bigliassi. 2014)..
As you can see the 15 amateur runners (24.87 ± 2.47 years;78.87 ± 10.57 kg; 178 ± 07 cm; 24.92 ± 2.79 kg/m²; 4.85 ± 1.85 years of training; 7 ± 3.49 weekly training hours; 5.67 ± 2.85 competitions) had a significantly reduced parasympathetic tone during recovery, when they trained with motivational music (low parasympathetic tone = "spiked up").

Slow or fast? Does it matter or is it just about music in general?

The calm music (Figure 1; left), on the other hand, led to an increase in parasympathetic tone, as you would expect to see it in someone who meditates or "chills" as the kids like to call it ;-) Now that sounds great for weed-heads, but from a performance perspective it was obviously as detrimental - interestingly, though, not much more detrimental than not listening to music at all.
Figure 2: Effects of control (CO), motivational (PM), slow (SM), fast (FM) and calm (CS) music / songs on fatigue, tension, vigor, and 5k times (in s) - the effects are visible, but not significant (Bigliassi. 2014).
The most important and yet unquestionably somewhat disappointing observation Bigliassi et al. made is however the statistical non-significance of the the visible time-differences in Figure 2. 

If we investigate, why the visible advantage was "no advantage" in the strict sense (i.e. it was statistically non-significant), we will obviously get back to what I said initially: Inter-individual differences and preferences loom too large to make any generalizable recommendations with respect to the optimal workout music.
Performance ain't everything: What could be of interest in future studies, are the recovery effects of an increase in vagal turnus (=pa- rasympathetic acti- vity) after 5 km of running with calm music (P < 0.05) - it's not ergogenic, but could be a great tool to calm down after an intense strength training workout; and thus probably even to speed up recovery and re- duce the likelihood of overtraining.
Bottom line: The scientists are right when they highlight that "the present study accomplished a very real training situation (5 km of running – open space and self-selected songs), making the present findings useful for further applications" (Bigliassi. 2014). Accordingly, the prefrontal cortex activity the researchers observed and the positive emotional consequences they detected via autonomous system analyses have a similar real-world relevance.

Whether this is also true for the significant performance increases on the first 800 meters in the slow and fast music trials is questionable. Personally, I suspect that some of you will benefit from the fast, while others from the slow songs. This conclusion would also be supported by the significant inter-individual differences in the study at hand.

So, if there is any general take home message from the study at hand, it would probably be the notion that there is a "high probability of improving running performance when music [is] applied (SM: 89%; FM: 85%; PM: 39%)," at all - which one is the "best", on the other hand, will depend on the individual, as well as the type of exercise | comment on Facebook!
References:
  • Bigliassi, Marcelo; León-Domínguez, Umberto; Buzzachera, Cosme F.; Barreto-Silva, Vinícius; Altimari, Leandro R. "HOW DOES MUSIC AID 5 KM OF RUNNING?" Journal of Strength & Conditioning Research: Post Acceptance: July 15, 2014.

Mono-Sodium Glutamate (MSG), NAFLD, Leptin Resistance, Trans-Fats, HFCS, Gluttony, Leaky Gut & Brain, the Vagus Nerve and the Chinese Restaurant Syndrome - Bon Appetit!

Image 1 (msg-exposed.com): Is obesity the inevitable, unnatural metabolic long-term equivalent of the dreaded "Chinese Restaurant Syndrome"?
Earlier today, I posted a blurb from a recently published epidemiological study on the effects of mono-sodium glutamate, aka MSG, an umami = all taste receptor activator that is commonly found in all sorts of ready made foods that would otherwise taste as lame as their individual fake ingredients, on the SuppVersity facebook wall (Insawang . 2012). The scientists had evaluated the data from 324 families (349 adult subjects, age 35–55 years) from a rural area of Thailand and found that the prevalence of metabolic syndrome was not just significantly higher in the tertile with the highest MSG intake, but that the "odds ratio", i.e. the chance that a certain parameter, in this case "obese, yes/no" would be found to be true, increased with every 1 g increase in total MSG intake irrespective of  the total energy intake and the level of physical activity.It took roughly 2 minutes for the first sharp-witted "SuppVersity student", in this case that was Wyatt Brown, to spot that post and ask what I believed could explain this observation.

Honestly, I had not really thought about that before, but simply assumed that the effects were probably mediated via not yet fully elucidated effects of dietary glutamate on the balance of excitatory and inhibitory neurotransmitters... after thinking about that for a moment I realized that in the absence of hyperphagia (i.e. extreme hunger and subsequently higher caloric intake), which was obviously not the case for the obese Thais with high MSG intakes, this explanation was not really satisfactory.

Does it all come back to food quality once again?

My next thought was that this could yet again be an issue of food quality vs. food quantity. After all, junk food and all sorts of foodstuff that's made with tons of food-additives to disguise their inferior, nutrient-poor and thus "tasteless" ingredients are the most likely candidates with respect to the MSG exposure in the Western and Eastern "developed" *rofl* world are concerned. In view of the fact that "diet quality" was (as so often) not among the variables Insawang et al. had assessed, their study did not allow for any conclusions in this respect, so that I had to dig deeper and came up with a couple of interesting findings,  I did not want to hold back from me (sorry, Stephen, for postponing the "HIIT Manual"-post, once again, but think about it like that, what's the use of working out if your MSG intake would quash your results anyway ;-)
  • * See figure 2 for exact data on the average daily human intake of MSG - with 91mg MSG /kg body weight, an amount that would translate to a daily intake of ~500+mg MSG in humans, the mice in the Collison were representative of the average American, yet not the Thai, Japanese and Korean MSG intake; against that background it is  important to note that MSG ingestion alone did not result in microscopic fat deposits in the liver. These effects were exclusively observed upon co-ingestion of the MSG with a diet with ~9% TFA content!
    "MSG intake at doses similar to human average daily intake[*] caused hepatic microsteatosis and the expression of beta-oxidative genes." - in a 2009 study, Collison confirmed the negative effects of even moderate MSG intake on liver health in a rodent model; only the common combination of trans-fatty acids (TFA) + MSG that is one of the main characteristics of modern "convenience" foods, did yet induce statistically significant increases in liver weight and hepatic triglyceride content; the increases in total, but also HDL cholesterol due to MSG + TFA were accompanied by profound increases in circulating leptin levels, probably in response to developing leptin resistance and increased storage of lipids in the white adipose tissue stores of the nine-week old C57BL/6J mice (Collison. 2009); in a follow up study Collison et al. confirmed that the double-whammy of trans-fatty acids + MSG becomes even more toxic if a third villain is added to the mixture, high fructose corn syrup (Collison. 2011) - and I don't have to tell you where in the human food chain you will find this unholy trinity, do I?
  • "MSG ingestion reduces weight gain, body fat mass, and plasma leptin levels" - in a 2008 trial Kondoh and Torii observed a very different and in fact surprisingly pronounced beneficial effect of the ingestion of a 1% solution (in biology this means 1g per 100ml) MSG resulted in decreases in weight gain, body fat mass and plasma leptin levels in male Sprague-Dawley rats irrespective of the energy content of their diets (!) and without effecting total energy intake or food intake, but in the presence of a profound decrease in 24h-water intake (2g vs. 9g); these effects were observed in both adult and young animals, in the latter without any negative side effects on the normal development of body length
    Figure 1: Leptin levels (ng/ml) on diets with different energy density and macronturient composition with or without MSG added to the water (data based on Kondoh. 2008)
    this leaves more than enough room to speculate about centrally mediated increases in energy expenditure in response to the ~20mg total MSG (equivalent to 33mg/kg for a rodent and a human equivalent dose of ~5.5mg/kg) intake of which Kondoh and Torii speculate that they may be "mediated via gut [glutamate] receptors functionally linked to the afferent branches of the vagus." (Kondoh. 2008); subsequent studies into the effects of MSG on the "gut brain axis" appear to support this hypothesis (cf. Kondoh. 2009a,b; Otsubo. 2011)
  • " MSG, in spite of mild hypophagia [reduced food intake], caused severe increase in fat body weight ratio, via leptin resistance" - in 2011 Afifi and Abbas, two researchers from the Department of Biochemistry at the Zagazig University in Egypt, report that feeding high amounts of MSG to pregnant rat dams had similar negative effects on body composition and leptin sensitivity as a hypercaloric diet and that despite an overall reduction in total food intake; moreover, despite similar gains in body fat, the negative effects on the offspring of those pregnant rats was more pronounced than in the rats on the "normal" hypercaloric diet (Afifi. 2011)
  • If you suffer from "Chinese Restaurant Syndrome", you should check whether increased gastrointestinal permeability could be the root cause of your problems and avoid all foods with any of the following "ingredients": E620 Glutamic acid, E621 Mono-sodium glutamate, E622 Mono-potassium glutamate, E623 Calcium diglutamate, E624 Mono-ammonium glutamate, E625 Magnesium diglutamate!
    "Findings from the literature indicate that there is no consistent evidence to suggest that individuals may be uniquely sensitive to MSG" - in one of the few reviews evaluating exclusively human studies, Freeman did not find any placebo controlled research that would confirm the universal existence of side-effects (e.g. headaches, chest pain, flushing, numbness or burning in or around the mouth, sense of facial pressure or swelling and sweating) as a direct consequence of the consumption of food-borne mono-sodium glutamate; e.g.
    "The present study led to the conclusion that 'Chinese Restaurant Syndrome' is an anecdote applied to a variety of postprandial illnesses; rigorous and realistic scientific evidence linking the syndrome to MSG could not be found." (Tarasov. 1993)
    instead, the author suggests that "unique sensitivities" could explain the documented case reports (Freeman. 2008 // see also Walker. 2000; Geha. 2000); given the emerging evidence of the existence of something you could call a "leaky brain" (in analogy to "leaky gut"), it appears likely that an unnaturally increased permeability of the blood-brain-barrier and subsequent penetration of large amounts of glutamate into the brain even at lower serum concentrations could well explain those differences (although not directly related to MSG, I would still like to point you to the results of a recently released study, which found a profound decrease in the permeability of the BBB in response to an oral 1mg/kg (HED ~0.16mg/kg) Lycium barbarum extract in an experimental stroke model; Yang. 2012)
  • "dietary antioxidants have protective potential against oxidative stress induced by MSG" - in 2006 Faromby and Onyema observed that previously described oxidative damage to the liver and subsequent steatosis (lipid accumulation) in response to the intra-peritoneal administration of ridiculously high amounts of MSG (4g/kg body weight) could be ameliorated by vitamin C + vitamin E + quercitin; these results suggest that exorbitantly high doses of MSG (human equivalent ~51g/day) are probably a result of an increase in reactive oxygen species
  • "after intragastric administration of MSG, the MSG is preferentially metabolized through gluconeogenesis in B6 mice, whereas thermogenesis is the predominant process for 129 mice" - in previous studies scientists had observed profound differences in terms of the effects of MSG on food intake and preference; in 2009 Bachmanov et al. traced those differences back to genetic polymorphisms and respective differences in the metabolic response to / utilization of MSG - if we assume that similar differences exist in human beings, those would provide another explanation for the different incarnations of the "Chinese Restaurant Syndrome" with the classic headaches, high blood pressure and sweating in people who would be long to the human equivalent of the 129 mice and the highly rewarding and appetite stimulating gluconeogenic (hepatic production of glucose from the glutamate) effects in those humans with a similar genetic programming as the B6 mice
I could certainly go on for hours, citing study after study with "evidence" and "counter-evidence", or rather what the respective authors consider as such, but I believe that you have read enough to see a couple of basic patterns emerge, here.
    So what about those differences? Genes, dosages, or what?

    One of these patterns is also brought up by Kondoha and Torii in the discussion of the results of their study (remember: decrease in body fat and increase in energy expenditure; purported mechanism = activation of glutamate receptors that are linked to the vagus nerve), in which the researchers state that they believe that the diametrically opposed results of their, compared to other studies (most of which report an increase not a decrease in body fat that is accompanied by increases in circulating leptin and decreases in leptin sensitivity and not vice versa as in the Kondoh study), may well be explained by
    [previous] studies [being] designed specifically to produce toxic effects in the brain (where GLU is an excitatory neurotransmitter), through the administration of extremely high doses (2000 mg/kg or more, administered repeatedly) to infant animals, either by single, direct injection or intubation (Kondoh. 2008).
    Those high dosages could in fact have lead to blood glutamate concentrations that would allow the flux of the excitatory amino acid even across intact blood-brain-barriers. The more realistic, orally administered dosages  Kondoh and Torii used in their experiment, on the other hand, did not induce any (not even statistically non-significant) elevations of serum glutamate levels.
    Hence, the effects seen in the present study, as discussed above, are probably linked via a physiologic mechanism, to a local action of GLU in the gut, rather than via a pharmacologic/toxicologic mechanism to a distant action of exogenous GLU forced on the brain (Kondoh. 2008).
    If you review the brief rundown of the literature I've provided in the previous paragraphs you will have to acknowledge the validity of this remark (remember: the steatosis in the Collison study required co-administration of trans-fatty acids /TFA/ and even then the increase solely due to MSG was marginal compared to that of the TFAs, alone).

    Without a leaky gut, you would probably have to eat pure MSG all day to do harm

    If you also take into account, that in healthy individuals only <5% of the dietary glutamate are actually absorbed into systemic circulation, while the rest is used as an oxidative substrate by the intestinal mucosa (Smriga. 2007), the difference between thhe orally consumed 33mg/kg MSG that helped the rodents in the study by Kondoh and Torii to lean out and the intraperitoneally injected 4,000mg/kg that were necessary to induce the touted hepatic side effects in the study by Faromby and Onyema are way above the average intake even the worst offenders among the MSG abusers are exposed to (cf. figure 2):
    Figure 1: Average per capita daily MSG intake in different countries (adapted from Löliger. 2000)
    Even if we discard the oxidative loss within the intestine, those 4,000mg/kg for a rodent (in previous studies Onyema et al. had even used 6,000mg/kg to elicit the hepatic damage; Onyema. 2006) would translate to ~650mg/kg in humans and would mean that you would have to shovel down anywhere between 32g and 64g of pure MSG (depending on whether you weigh 50 or 100kg), i.e. 20-40x more than the average daily intake of a Korean (note: The "rodent model of MSG induced obesity" is induced by injection of 10,000mg/kg body weight; cf. Bunyan. 1976) and the whopping MSG equivalent of 400-800ml of soy sauce (avg. MSG content 80mg/ml), which is probably the worst offender in the E-number-laden ingredient arsenal of the Asian cuisine.

    Figure 3: Protein-bound and free glutamate content of "high" glutamate foods (left) and total glutamate content of selected plant proteins (right; data adapted from Loliger. 2000)
    Your best bet to ingest similar amounts of free glutamate from real foods is, as the data from a review by Loliger suggests (cf. figure 3), would be parmesan cheeese, but in all honesty, in view of the fact that you would have to consume 2.6kg of the Italian delicacy, it is pretty unlikely that the glutamate and not the sheer amount of pure energy in the cheese would be the underlying reason for subsequent weight gain. Against that background it should not be surprising that negative side-effects as they occur as a result of high to unrealistically high MSG intakes and or in especially susceptible individuals, are not exactly common in people who don't eat out and/or consume pre-packaged convenient foods on a regular, if not daily basis.

    Too much of a vitally important thing at the wrong time and as part of the wrong foods...

    The mere presence of non-negligible amounts of glutamate in all sorts of "real" foods, should yet remind you that glutamate is not a toxin, or a "foreign substance" we are not evolutionary adapted to, but an amino acid that is of utmost importance for the health of your central nervous system (Platt. 2005). So that at the end of this analysis we may not be back at square one, but still have to concede that it brought us back to a set of very common motifs here at the SuppVersity:
    • When consumed in excess, substances that are good, healthy, beneficial and even "vitally" (=vitamin ;-) important can easily turn against you
    • When substances do not have to pass the gut, the dose-response relationship can differ so substantially that results that are acquired using route A (e.g. intraperitoneal injection) cannot simply be transfered to scenarios employing different administration routes (e.g. oral ingestion)
    • Inter-individual/-species differences and differences between healthy and unhealthy individuals / animals, warrant utmost caution, when it comes to interpreting data - the "Chinese Restaurant Syndrome", for example, could be a result of increased gut and blood-brain-barrier permeability that would lead to an increased absorption of glutamate from the intestine into the blood and from there across the blood-brain-barrier right into the brain.
    • Oftentimes, differences due to the aforementioned factors are not of simple quantitative, but of qualitative nature, in the case of MSG this would be the difference between the metabolic activation in response to the local activation of glutamate receptors in the gut that are connected to the vagus nerve, on the one hand, and the systemic / central obesogenic (fattening) effects of glutamate that leaks from the gut into the blood and from there into the brain.
    And lastly, to eventually come full circle and remind you of the results of Collison et al., we cannot ignore that MSG is one of those substances that is usually found in foods with a whole host of other nutrient-poor ingredients, anti-nutrients and proven obesogenic, pro-inflammatory and otherwise unhealthy substances and food additives. They are wrapped in plastics have an extended shelf life due to tons of preservatives and highly adorned with stickers and labels saying "low this", "extra that", "only X amounts of calories", etc. - as long as you avoid those foods on 360+ days of the year, prepare your meals from whole foods, don't dine at cheap restaurants, fast-food outlets and snack bars too often or try to find the "optimal amount of supplemental MSG to stimulate your vagus nerve and help you shed fat" *lol*, you can calmly watch the ever-recurring MSG scares on the Internet and other mass media ;-)

    References:
    1. Afifi MM, Abbas AM. Monosodium glutamate versus diet induced obesity in pregnant rats and their offspring. Acta Physiol Hung. 2011 Jun;98(2):177-88.
    2. Bachmanov AA, Inoue M, Ji H, Murata Y, Tordoff MG, Beauchamp GK. Glutamate taste and appetite in laboratory mice: physiologic and genetic analyses. Am J Clin Nutr. 2009 Sep;90(3):756S-763S. Epub 2009 Jul 1.
    3. Bachmanov AA, Inoue M, Ji H, Murata Y, Tordoff MG, Beauchamp GK. Glutamate taste and appetite in laboratory mice: physiologic and genetic analyses. Am J Clin Nutr. 2009 Sep;90(3):756S-763S. Epub 2009 Jul 1.  
    4. Bunyan J, Murrell EA, Shah PP. The induction of obesity in rodents by means of monosodium glutamate. Br J Nutr. 1976 Jan;35(1):25-39.
    5. Collison KS, Maqbool Z, Saleh SM, Inglis A, Makhoul NJ, Bakheet R, Al-Johi M, Al-Rabiah R, Zaidi MZ, Al-Mohanna FA. Effect of dietary monosodium glutamate on trans fat-induced nonalcoholic fatty liver disease. J Lipid Res. 2009 Aug;50(8):1521-37. Epub 2008 Nov 11.  
    6. Collison KS, Zaidi MZ, Saleh SM, Makhoul NJ, Inglis A, Burrows J, Araujo JA, Al-Mohanna FA. Nutrigenomics of hepatic steatosis in a feline model: effect of monosodium glutamate, fructose, and Trans-fat feeding. Genes Nutr. 2012 Apr;7(2):265-80. Epub 2011 Dec 6. 
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