Higher body mass index is associated with greater severity of alopecia in men with male-pattern androgenetic alopecia in Taiwan: A cross-sectional study.

J Am Acad Dermatol. 2013 Oct 31. pii: S0190-9622(13)01031-1. doi: 10.1016/j.jaad.2013.09.036. [Epub ahead of print]
Higher body mass index is associated with greater severity of alopecia in men with male-pattern androgenetic alopecia in Taiwan: A cross-sectional study.
Yang CC, Hsieh FN, Lin LY, Hsu CK, Sheu HM, Chen W.

Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; International Research Center of Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan.

BACKGROUND:
Obesity is a risk factor for multiple health problems, but its association with androgenetic alopecia (AGA) remains controversial.
OBJECTIVE:
We sought to determine the association between body mass index (BMI) and alopecia severity in men with AGA and early-onset AGA.
METHODS:
A cross-sectional study was conducted. The medical charts and photographs of men with a clinical diagnosis of AGA were reviewed.
RESULTS:
In all, 189 men were enrolled with a mean age of 30.8 years. In male-pattern AGA (n = 142), men with severe alopecia (grade V-VII) had higher BMI than those with mild to moderate alopecia (grade I-IV) (25.1 vs 22.8 kg/m2, P = .01). After multivariate adjustments, the risk for severe alopecia was higher in the overweight or obese (BMI ≥24 kg/m2) subjects with male-pattern AGA (odds ratio 3.52, P < .01). In early-onset male-pattern AGA (n = 46), the risk for having severe alopecia was also higher in the overweight or obese subjects (odds ratio 4.97, P = .03).
LIMITATIONS:
Parameters used to evaluate obesity were limited because of the retrospective nature of the study.
CONCLUSIONS:
Higher BMI was significantly associated with greater severity of hair loss in men with male-pattern AGA, especially in those with early-onset AGA.

I've read that the climate in Taiwan is very humid too, so increased body mass + increased humidity likely equals increased body / scalp heat. Humid air slows down evaporative cooling, so there could be a link there.

BTW CS, I was reading more into the things you said about sodium loss and increased body heat. It was pretty interesting. I thought I absorbed enough salt into my diet, but perhaps not.

ETA: regarding humid air; I think that when there is little breeze during humid periods it prevents sweat from becoming cooler on the skin. The sweat just basically remains warm on the skin and likely slows down heat release. There's probably a more scientific way of describing this, but this is what I've personally observed when in a humid, breezeless environment.

Funny you mention about sodium xenon just mentioned it in the other thread.
This is something that makes sense for me personally.

Could this possibly have something to do with estrogen as well?  I know the bigger you get the more estrogen from the fat and less testosterone and such and I've read here that increased estrogen in the body is a bad thing for hair.

What would be interesting to see would be the total body fat percentage, and percentage of visceral fat vs. subcutaneous.

I've got an idea that a higher percentage of subcutaneous fat is either neutral or protective of hair, while the real villain is visceral fat.

I've looked at a lot of body types over the years and kind of tried to find correlations between guys who went bald young. One of the more common collections of things I find is (obviously doesn't cover every body type of young bald fellas) above average amount of body hair and a tendency to put on weight in the belly and chest. To me, its likely an issue involving both estrogen and DHT.

http://onlinelibrary.wiley.com/doi/10.1002/j.1550-8528.1995.tb00233.x/pdf

"T treatment was also followed by a specific decrease of visceral fat mass (measured by CT-scan), by increased insulin sensitivity (measured with the euglycemic glucose clamp), by a decrease in fasting blood glucose,plasma cholesterol and triglycerides as well as a decrease in diastolic blood pressure. In the DHT group an increased visceral mass was detected. No other changes in these variables were found in the DHT and P groups."

http://www.ncbi.nlm.nih.gov/pubmed/15525599

"Transcripts involved in adipogenesis, and cell cycle and cell shape organization, such as DDX5, C/EBPalpha, cyclin I, procollagen types I, III, IV, V and VI, SPARC and matrix metalloproteinase 2, were upregulated by DHT"


I think that DHT and T have different effects on where fat is deposited in the body. While both tend to lower intramuscular and subcutaneous fat (noticeably reduced in balding scalps), DHT tends to cause an increase in visceral abdominal fat, the kind that is hormonally active and secretes all kinds of inflammatory cytokines.

More than likely for some of these individuals, testosterone is actually low to low-normal and you're seeing an increase in estradiol and DHT.

I wonder also if internal visceral fat packed around the organs contributes to core overheating?

ETA: since exposing myself to colder temps, I have started to burn up fat stores very rapidly (with the help of a low cal ketodiet too). I wonder if this also helps deplete visceral fat around the organs?

Some interesting info:

"Now, it has been shown that brown fat not only persists into adulthood, but that it could help people to lose weight and keep it off. Three separate studies published in the New England Journal of Medicine (NEJM) also suggested that boosting brown fat stores helped the body to burn off ‘bad’ fat - the more familiar ‘white’ fat that stores up calories and settles stubbornly on the waistline and thighs. Brown fat is also thought to play a role in diseases like diabetes that are linked to obesity and energy balance.

So how does it work? Brown fat, which is also found in small mammals like rats and mice, becomes activated naturally only when people are cold and on the verge of shivering. Chilly temperatures simulate the conditions that lead to the evolution of brown fat - namely, life threatening cold in babies that do not possess the means to keep themselves warm. Scientists are now investigating whether is it possible to reproduce the body’s internal calorie burning furnace in a test-tube. But could there be a simpler solution?

According to Professor Mike Cawthorne, director of metabolic research at the University of Buckingham who has researched the effects of brown fat, says warmer temperatures, abundant food and too little activity have effectively ‘switched off’ brown fat’s usefulness in the modern world. “Even 30 years ago it was more difficult to stay warm than it is now,” he says. “Today, our homes, cars, offices and shops and almost everywhere we go is warm.” Just turning off the central heating or going running in the cold could help spur brown fat into action. “If we were to expose ourselves to cooler temperatures more often, then a lot of people would probably lose weight,” he says. “Either that or plunge into icy water or a very cold shower. We need to activate brown fat and there are simple ways to do it.”

http://www.mensrunninguk.co.uk/toxicwaist.obyx

Interesting. That visceral fat can cause all sorts of problems. One of the big things it does also is effects both posture and breathing. It expands out on your internal and external oblique muscles (gives that dome shape to a chubby stomach). But muscles in the body operate on a line of pull, if you take them off that line of pull without introducing something to change that line (like wrapping around a bone or something) the muscle is less effective. You lose core stability, your weight isn't properly distributed over the feet, knee joints, femur and pelvis. You'll usually compensate in some muscles and others get weak. Basically it can just about ruin your entire kinetic chain and lead to knee, back, and foot problems.

Not to mention that it can impinge on the organs themselves, effect digestions, change the normal hormonal secretions in response to meals. Overall its just asking to die younger. Unfortunately the signalling that goes into its development is confusing.

Overall though I think you make a good point. While we can get into very specific detail about the human energy system and how to correct problems. There seems to be a very simple set of key principles that have a huge impact here.

1) Cold Exposure
2) Caloric Restriction
3) Intermittent Bouts of Intense Exercise

"above average amount of body hair"

this really interests me, as although on here it is argued body hair
isn't linked to hairloss... i can't help but notice that a lot of hairy bodied
men are bald/balding.
when i see a man in his 50s with full hair, I usually notice
they dont seem to have much body/facial hair.

but yes, I suppose i do see a lot of bald men with little body hair
too.

but the key for me is noticing the full heads of hair are usually
the ones who don't look hairy.

For me it highlights the fact that there are probably different hormonal patterns that can promote baldness. This particular one just happens to be a common one that I'd associate with a particular hormonal pattern. Of course, not every guy has a pudgy belly and body hair. There are guys here who are relatively low in body fat, not much body hair, and are still losing. I think you can look at that and point to a difference in the unique picture of their hormones, but ultimately they are having the same response at the end organ, the hair bulb. But I think we all know the body type I'm talking about there. The guy who tends to grow facial hair and lots of body hair, puts on belly fat very easily, also tends to be prone to gynecomastia or pseudogyno. It seems often times they also have more pronounced sexual secondary characteristics besides just the body hair, like deeper voices. When I look and see that, I think yup, DHT and estrogen high relative to testosterone (or at the very least a huge dose at puberty). Probably low SHBG.

Live forever wrote:"......

I totally agree. Most. people with full head of hair have unnoticeable body hair and even facial hair. !IMHO! there are some men that have increased body hair and facial hair although they have full head of hair. These men are usualy smokers (- because of the lack of stress ?). Look at this https://www.youtube.com/watch?v=0qJA8R444X0 , these guys are an example of full head of hair/no body hair guys.

Definitely agree there isn't one thing fits all, magic bullet.
But if we look at those with excessive body hair only, rarely do I see men
In their 50s with excessive body hair that aren't high on the Norwood scale.

This is very observational though.

And also it seems that it's excessive 5ar that is the problem,
So does this mean someone who is really hair have
Excessive 5ar?

Live forever wrote:Definitely agree there isn't one thing fits all, magic bullet.
But if we look at those with excessive body hair only, rarely do I see men
In their 50s with excessive body hair that aren't high on the Norwood scale.

This is very observational though.

And also it seems that it's excessive 5ar that is the problem,
So does this mean someone who is really hair have
Excessive 5ar?

This may be partially related to protein synthesis within the liver and of course how efficiently the liver is functioning, not to mention how much protein we incorporate into our diets. When you think about it, androgenic hair must use up a shitload of protein in order to form terminal hair, so I think that the liver would have to be performing optimally in order to synthesize enough protein for all of these hairs.

The beard is in a continual state of growth too. I find it particularly interesting that hairline recession normally occurs when the side burns develop, so androgenic hairs may well use up a great deal of protein to form keratin.

I don't know how concrete this is, but I've read that many Asian men -- particularly Japanese have little body and facial hair, yet are reported to have some of the best heads of hair in the world. But incidences of MPB have been on the rise since they started eating more saturated fatty foods since WW2.

Perhaps too much cholesterol forms around the liver and prevents it from functioning 100% Of course I'm not citing this as the main cause of MPB, but may definitely be involved.

Also, I've read many reports about fin users and how their androgenic hairs began to thin. So... downregulation of DHT receptors in androgenic hair may suggest that there is enough protein / keratin for head hair.

Just a thought.