OPINION: Lifestyle Medicine – Does nicotine have any benefits?

Back in the early ’70s, when I was a young medical student, Groote Schuur Hospital was still basking in the acclaim of being the site of the world’s first heart transplant.

Prof Christiaan Barnard became an instant celebrity.

I was shocked when a local newspaper reported he had advised his daughter to take up smoking to control her weight gain.

But I guess that was typical of the trend amongst clinicians in those days to dissociate lifestyle behaviours from medical interventions.

However, one would have expected someone of Barnard’s stature to acknowledge the dangers of smoking, when he was dealing with its consequences on a daily basis.

It is well known that nicotine has effects in controlling weight.

Many ex-smokers have discovered, to their chagrin, the problem of weight gain after conquering addiction to tobacco. Why is this?

Dr Michael Greger, in his masterpiece How Not To Diet, explains the science.

The energy source for all living things is the conversion of adenosine tri-phosphate (ATP) to adenosine mono-phosphate (AMP).

This releases two phosphate molecules, which can then be re-incorporated to ‘charge up the battery’ by the mitochondria in the cell when we eat more food, (or when plants are exposed to sunlight).

ALSO READ: OPINION: Lifestyle Medicine: A planetary diet for health of people and the environment.

When we are not eating, an enzyme called AMP kinase (AMPK) directs the body to burn up fat – which is great news for people trying to lose weight.

Problem is, AMPK also stimulates the appetite to recharge the fat stores. Here is where nicotine comes in. It blocks the appetite stimulation by AMPK.

How do we get around the negative effects of the main source of nicotine – tobacco smoking – but still get the benefits of AMPK blockage of the appetite centre?

Botanists tell us tobacco plants are part of the nightshade family – which includes tomatoes, potatoes and peppers.

It so happens that all of these plants have small amounts of nicotine.

So, apart from peppers being an excellent source of vitamin C, they also can help with obesity control.

Other foods having a similar effect on AMPK include pomegranate seeds, goji berries, and a food I am unfamiliar with, but popular in the Middle East – barberries.

Evidently they are available in South Africa.

Another readily available AMPK modulator is vinegar.

A Japanese study showed that taking two tablespoons of apple cider vinegar per day (or 2 tsp per meal) resulted in 2,3 kg weight loss over three months, and 1 tablespoon resulted in 1,4 kg, compared to weight gain in the placebo group.

But when the study was stopped, the weight gained back. So, keep taking the vinegar.

Evidently there are a host of different flavours, even strawberry or chocolate vinegar – or, you can just feed your gut bacteria with plenty of plant fibre, and they will make the vinegar for you.

Does nicotine have any benefits? Yes, but definitely not through smoking.

Dr Dave Glass
MBChB, FCOG(SA), DipIBLM.