Question: Can PEMT genetics cause fat malabsorption, mineral deficiencies, and oxalate problems?

First of all, saponification of minerals, the point here is that if you have malabsorption of fat, the fatty acids are going to bind to any positively charged minerals in your diet. This has been particularly well studied in preterm infants where the poor absorption of fatty acids causes the fatty acids to bind to the calcium that have lower bioavailability. Yeah. If you surpass your ability to absorb the fat, the fatty acids can bind minerals and induce mineral deficiencies. I agree with this.

PEMT polymorphism is a marker of poor synthesis of phosphatidylcholine. That will impair export of fat from the liver. Low phosphatidylcholine synthesis due to PEMT. I was thinking of it as a direct marker. It's not a direct marker, but it could theoretically impact. This is probably especially true if you have a low phosphatidylcholine intake. Probably eating phosphatidylcholine protects against this. But yeah, low phosphatidylcholine levels in the liver partly as an interaction between low activity in the PEMT enzyme and low intake of phosphatidylcholine from food could cause bile acid issues, which could in turn cause fat malabsorption.

If you have fat malabsorption and you have enough digestion of the fat to release the free fatty acids from triglycerides, but you don't have enough absorption of those fatty acids, the fatty acids will bind calcium. They won't bind oxalate, they can't. Binding the calcium will lower the calcium absorption, and it will also prevent the calcium from binding oxalate. Calcium binding oxalate is what prevents oxalate absorption, so yes, I would think that would increase oxalate absorption.

This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/09/06/ask-anything-nutrition-march-8-2019

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