Lack of Cortisol characteristic for young obesity patients Plus Self Esteem Changes During Puberty Would Actually Increase Diurnal Cortisol Production

Cortisol is not your enemy. In fact, cortisol is one of the few hormones you really need to survive.

Cortisol is a problem. However, just as it is the case with insulin, its not the fact that your body produces it thats problematic. Its the fact that it tends to so in copious amounts and chronically, simply at the wrong time or - believe it or not - not at all / enough. All that, i.e. changes / problems with the natural rhythm, the up and down, the spikes and troughs that get lost, when you are chronically stressed and/or inflamed - thats the actual problem and not the fact that your body produces a hormone without which you cant survive.

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Against that background, it may go against everything the supplement industry is trying to tell you, but still cannot be really surprising to hear that E. Allansson Kjölhede and colleagues from the Linköping and Ume a Universities present in their latest paper in Acta Pædiatrica results that show that obese children have low, not high cortisol levels (Kjölhede. 2014).

Using three salivary samples from 342 children aged 6–12 years the scientists had tried to reconcile previous, inconsistent findings and found that the

"average cortisol levels in early morning, late morning and evening were significantly lower in overweight and obese children than in their normal weight counterparts."

Whats particularly interesting is that the early morning spike, we have identified as critical component of a healthy biorhythm, previously (see "All About Cortisol"), was reduced by -33% (see Figure 1):

Figure 1: Morning (8:30 am), late morning (10:30 am) and evening (9:00pm or pre-bed, if earlier) salivary cortisol in 342 normal-weight, overweight and obese children (Kjölhede. 2014).

As Kjölheide et al. point out, these results should be followed up by more comprehensive studies that would allow us to better classify and understand the "relationship between stress and obesity in
children" - and I would like to add: Which of these comes first - being obese or having low morning cortisol and thus not being able to benefit from the "wake-up and get going" effects of cortisol.

This is not a statistical outlier: The results of the study at hand are not a statistically irrelevant outlier or something that would be observed in children, only. In 2013 Champaneri et al. a corresponding correlation between high early morning cortisol levels and lower body fatness and waist circumference, when they analyzed data from the 1,002 subjects of the Multiethnic Study of Atherosclerosis (Champaneri. 2013)

Thats also interesting, because previous studies by Toledo-Corral et al. have shown that a dampened cortisol awakening response is not just associated with obesity, it is also a predictive factor of higher carotid artery intima-media thickness (CIMT) in overweight African American and Latino youth (Toledo-Corral. 2013), which in turn is a risk factor for myocardial infarction and stroke.

And Ursache et al. (just because its funny: "Ursache" means "cause" in German ;-) report that  dolescents with insulin resistance exhibited

• a blunted cortisol awakening response (CAR),
• smaller hippocampal volumes, and 
• greater frontal lobe atrophy 

compared to controls. Closer scrutiny of the data also revealed that "a smaller CAR was associated with higher BMI which was in turn associated with fasting insulin levels" (Ursache. 2012).

Despite the fact that it is virtually impossible to tell what exactly the "ursache" for the irrefutable correlation between low morning cortisol levels and high body fatness, artery intima-media thickness, myocardial infarction and stroke is, the cumulative evidence clearly speaks against the use of cortisol-reducing drugs and supplements - at least if their effects are not extremely short-lived and will thus not mess with the natural up-and-down thats lost not just in obese, but also in chronically fatigued patients.

Bottom line: In view of the data presented above, people with low morning cortisol levels would thus be better advised to start their day with some "delicious" licorice - or better a capped extract - to benefit from its cortisol boosting effects, instead of "cortisol blockers".

Figure 2: Comparison of reduction in % body fat in response w/ licorice (blue, Tominaga. 2009) and no dietary restriction vs. 7-keto + dietary restriction (red, Zenk. 2002 - sponsored study).

Bullshit? Well, what about the side-effect free (no change in Hb1AC, improved not worsened blood pressure and pulse rate and in range serum electrolytes) reversal of fat gain Tominaga et al. observed in obese subjects who consumed a polyphenol-laden licorice extract (main ingredient glabradin) at dosages of 300mg and 1800mg per day for 12 weeks (Tominaga. 2006), then?

Or the significant decrease in body fat the same researchers observed in another study, three years later with 300, 600 and 800mg/day of a licorice flavonoid oil (see Figure 2)? Significantly more than in allegedly only 8 weeks on 7-keto, by the way; and that a despite the fact that the sponsored study on the DHEA-metabolize by Zheng et al. (2002) used a combined diet + supplementation protocol (see Figure 2).

Reference: 

• Champaneri, Shivam, et al. "Diurnal salivary cortisol is associated with body mass index and waist circumference: the Multiethnic Study of Atherosclerosis." Obesity 21.1 (2013): E56-E63.
• Toledo-Corral, Claudia M., et al. "Blunted nocturnal cortisol rise is associated with higher carotid artery intima-media thickness (CIMT) in overweight African American and Latino youth." Psychoneuroendocrinology 38.9 (2013): 1658-1667.
• Tominaga, Yuji, et al. "Licorice Flavonoid Oil Effects Body Weight Loss by Reduction of Body Fat Mass in Overweight." Journal of health science 52.6 (2006): 672-683.
• Tominaga, Yuji, et al. "Licorice flavonoid oil reduces total body fat and visceral fat in overweight subjects: A randomized, double-blind, placebo-controlled study." Obesity research & clinical practice 3.3 (2009): 169-178.
• Ursache, Alexandra, et al. "Preliminary evidence for obesity and elevations in fasting insulin mediating associations between cortisol awakening response and hippocampal volumes and frontal atrophy." Psychoneuroendocrinology 37.8 (2012): 1270-1276.
• Zenk, John L., et al. "The effect of 7-Keto Naturalean™ on weight loss: A randomized, double-blind, placebo-controlled trial." Current therapeutic research 63.4 (2002): 263-272.

The Acute 24h Effects of 3 Types of High Intensity Circuit Training on Testosterone Cortisol in Young Trained Men

Its obviously to have the 24h effects on testosterone and cortisol than only those measured after the workout , but can we make solid conclusions based on the additional data?

In spite of the fact that the acute testosterone and cortisol response to exercise appears to have little direct effects on the overall training outcome (Schoenfeld. 2013), acute increase in cortisol and reductions in testosterone, i.e. a decrease in the testosterone:cortisol ratio is a classic feature of overtraining and can very well blunt, if not reverse the beneficial effects of exercise on your health and body composition.

Against that background a recent experiment that was conducted by researchers from the University of Chieti-Pescara in Italy could be of great interest to everyone who is performing high intensity interval training on a regular basis. Why?

Well, in contrast to previous studies, Blasio et al. investigated both the acute and 24h effects of a high intensity interval resistance training regimen in trained young men.

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To characterize the effects on heart rate and hormonal responses the subjects, eight trained, healthy trained men (28.61 ±3.51 yrs), performed three different workouts which had the same exercises, the same load and number of repetitions for each exercise, but different exercise order, recovery and speed of execution.

• RANDOM workout: the assigned goal was to complete the assigned repetitions respecting only two duties. The first one was don’t stop until all of the repetitions were completed; the second was that there were no assigned order of execution of exercises and no assigned consecutive repetitions to complete.
  
  Participants were thus free to choose both the order of exercises and number of consecutive repetitions for each exercise (i.e. 2 repetitions of kettlebell swing, 10 repetitions of medicine ball slam, 20 repetitions of squat, 4 repetitions of spin with Bulgarian bag, etc.).
  
  No recovery period was assigned, except the time necessary to move from a station to another, and no speed of execution of exercises was assigned: participants were free to choose the preferred speed. 
• LADDER workout: respecting the following order of execution, kettlebell swing, medicine ball slam, spin with Bulgarian bag, squat, pull-up, burpee, participants had to complete the total repetitions according to a pyramidal scheme (e.g. 1st lap 10 repetitions at each exercise, 2nd lap 9 repetitions at each exercise) until the total number of repetitions of each exercise was executed.
  
  Each lap of the circuit was followed by 1 minute of recovery. No speed of execution of exercises was assigned: participants were free to choose the preferred speed. 
• AS SOON AS POSSIBLE (ASAP) workout : respecting the following order of execution, kettlebel swing, medicine ball slam, spin with Bulgarian bag, squat, pull-up, burpee, participants had to complete the total volume in six laps executed as soon as possible.
  
  During each lap participants had to complete the sixth part of total number of repetitions of each exercise without rest among exercises. Each lap of the circuit was followed by 1 minute of recovery.

Salivary samples were collected before and after each workout, at 11:00 p.m. and at 7:00 a.m. of the following day. Salive was also collected during a non-training day. Similarly, before and after the workout, plasma lactate was measured while a beat-to-beat heart rate recording was executed during each workout. Cortisol (C) and testosterone (T) were measured in salivary samples.

2h before the workouts the subjects who had to abstain from sexual intercourse, stimulants and alcohol from 2 days before to the experimental days and until 9:00 a.m. of the following day, consumed a standardized meal that was lower to 400 and consisted of 33 cl of water, 35 cl of orange juice and two 30 g energy bars (Power Sport Double Use, Enervit, Milan, Italy).

Lets look at the results

While the protocols elicited the same heart rate response (the major part of each workout was spent between 80 and 100% of maximal heart rate, confirming the high cardiovascular intensity of the workouts), they elicited different hormonal and lactate variations with the LADDER workout producing the lowest lactate increase and the RANDOM workout eliciting the highest lactate, cortisol and testosterone increases.

Figure 1: Relative changes in hormone and lactate concentration in response to the workouts (Di Blasio. 2014)

When C was considered in ratio with T no significant differences have been shown among workouts-induced variations. Results of the analysis of covariance, executed on significantly modified variables, confirmed that basal hormonal and lactate values did not influence their variations.

When they studied the effects of workouts on prolonged hormones production (i.e. until the morning following the morning, di Blasio et. al. found that observed that observed that

"C had both time (F=179.723; p < 0.001) and group × time effect (F=10.942; p < 0.001): while during non-training day there is a physiological decline of C production at 11:00 p.m., during training days its decline is not present but seems to have a continuous increase from 7:00 p.m. to 7:00 a.m." (Di Blasio. 2014)

For the testosterone production the authors found both time (F=443.340; p < 0.001) and group × time effect (F=3.254; p=0.008) even if the group × time effect seems determined by the samples collected at 7:00 p.m., so that the effects cannot be ascribed fully / exclusively to the workout.

Figure 2: 23h hormone profile after the RANDOM, LADDER, ASAP workouts on a control day (di Blasio. 2014)

What is most interesting, though, is the cortisol to testosterone ratio. It shows the greatest inter-group differences and could potentially be of great physiological relevance (Crowley. 1996). In that, the LADDER workout has the most negative effect, as it will totally blunt the natural decline of the C:T ratio at noon.

In case youre planning to incorporate circuit training into your schedule, make sure to have a huge chunk of beef after your workouts ;-) - "Post-Workout Steak "Supplementation" (135g of Lean Beef) Augments Improvements in Body Composition In Response to 8 Weeks of Circuit Resistance Training" | more

Bottom line: As usual, it is difficult to interpret the results in order to make concrete practical recommendations. The lactate and hormonal data does yet suggest that the "random" order, i.e. a training that involves a self-selected exercise order and rep speed, as well as little to no rest between exercises is the least, the ladder training, with its decreasing 10, 9, ... rep numbers and one minute rest between each lap of the curcuits is the most metabolically demanding workout.

Whether and to which extend this translates into an increased risk of overtraining, let alone increased muscle and strength gains, on the other hand, remains to be seen. In view of the overall effect on lactate levels and the C:T ratio, though, the study does suggest that you better be careful with high intensity circuit / interval resistance training sessions and give your body adequate time to rest and recover | Comment on Facebook!

References:

• Crowley, Michael A., and Kathleen S. Matt. "Hormonal regulation of skeletal muscle hypertrophy in rats: the testosterone to cortisol ratio." European journal of applied physiology and occupational physiology 73.1-2 (1996): 66-72. 
• Schoenfeld, Brad J. "Postexercise hypertrophic adaptations: a reexamination of the hormone hypothesis and its applicability to resistance training program design." The Journal of Strength & Conditioning Research 27.6 (2013): 1720-1730.