Dietary supplements are frequently utilized by adults seeking to control their weight. A survey of 3,500 people trying to lose weight found 70 per cent attempt to lose weight on their own without a doctor's assistance and weight-conscious adults prefer to use supplements rather than drugs to control weight. One third of those surveyed used supplements only and just 15 per cent used prescription drugs for weight-loss management.
Some supplements users are rightly concerned about the safety of weight-loss drugs, while doctors appear to be more concerned about the safety of supplements. The withdrawal of the herbal stimulant ephedra from the marketplace gave a bad name to all supplements used for weight management or blood-sugar control.
There are more than 100 supplements that are suggested for weight loss, including natural diuretics, such as uva ursi, juniper berries and dandelion root, or other remedies that work in a variety of ways, such as chitosan, guar gum, ginseng, green tea, chromium, conjugated linoleic acid, hydroxycitric acid, psyllium, fiber and many others.
In general, dietary supplements are not highly regarded, but neither are weight-loss drugs. In fact, the short list of approved weight-loss drugs, all of which are fraught with undesirable side effects, prompts many people to search for safer alternatives.
Chromium: Chromium is a trace mineral involved in the production of glucose tolerance factor. There is considerable interest in chromium as a weight-loss remedy, but chromium supplements have often produced disappointing results in published studies.1
Most weight-loss studies last no more than a year, and after a dietary or supplement regimen is completed, patients often go back to their old habits and regain weight. But a study recently published in the Journal of Alternative and Complementary Medicine investigated the slong-term use of 14 dietary supplements marketed as weight-loss aids. The results of this study are noteworthy.2
Among overweight or obese men and women, long-term use of chromium and vitamins B6 and B12 was associated with modulating effects on weight. For example, weight gain over a 10-year period for obese men was 11.7 pounds among chromium nonusers whereas chromium users (150mcg or more per day) lost 3.1 pounds. Among obese women, chromium produced a 3.2-pound weight gain vs 14.1 pounds for the non-users.
In another recent study among overweight depressed patients, 600mcg/day chromium picolinate reduced carbohydrate craving and overall appetite increase.3
Among five obese women with polycystic ovary syndrome, 1,000mcg/day chromium picolinate given without change in diet or activity levels caused a 38 per cent improvement in the glucose disposal rate, which measures insulin sensitivity.4
Calcium/Vitamin D: A revolution in the understanding of the need for vitamin D, both from natural sunlight and dietary supplements, is now under way. Vitamin D has profound and broad influence over weight control and mood, which are intertwined. Consider these facts:
Overweight individuals are frequently depressed.5 It is not uncommon for overweight individuals to be placed on antidepressant drugs, which are generally known to increase weight gain.6
It is also widely observed that depression and carbohydrate craving risesin winter months, particularly in northern latitudes, when vitamin D levels are low. Increased appetite, carbohydrate craving and weight gain are more characteristic of winter than summertime depression.7
As the body mass of adults increases, their vitamin D levels are found to be lower. As vitamin D levels decline, waist size increases.8
Vitamin D also preferentially decreases abdominal fat.9 Obese individuals submitting themselves for weight-loss surgery are commonly vitamin D deficient.
Low vitamin D levels are even associated with obesity in children (74 per cent of obese children were found to be deficient in one study).10
Omega-3s: Inflammation is associated with insulin sensitivity.11 European researchers report that omega-3 oils reduce inflammation in fatty tissue.
When researchers at the University of South Australia divided 68 overweight and obese people into groups and assigned them small daily doses of fish oil or sunflower oil, with half of each group also participating in an exercise programme, they found that the group taking fish oil lost an average of 4.5 pounds over a three-month period vs no weight loss with safflower oil.11
A low-fat, low-calorie diet with added omega-3 oils has been shown to reduce body mass index and waist circumference among obese adults.12
Depression is a common complication of type 2 diabetes. Antidepressant drugs often don't work in diabetics. The use of omega-3 oil is believed to indirectly decrease depression in type 2 adult-onset diabetes.13
Anthocyanidins: These are found in grape seed, cinnamon, purple corn, berries and cherries, as well as other fruits and vegetables and are all iron-controlling molecules that inhibit the formation of fat within fat cells as well as have a great potential for the prevention of diabesity.14
It is not surprising to find that whole fruit powder from strawberries and blueberries had no effect upon weight gain, body weight or body fat when consumed with a low-fat diet, but consumption of purified anthocyanin extracts from strawberries and blueberries produced 13-34 per cent less body-weight gain in animals. The fruit extracts contain higher amounts of anthocyanins and less fruit sugar.15
While the weight-loss drug orlistat inhibits lipase, the fat-breakdown enzyme, so does grape seed extract, which may prove to be a safe weight-control agent. Overproduction of lipase reduces HDL cholesterol. Higher lipase activity is associated with greater abdominal fat and greater body mass.16
Cayenne pepper: This pungent spice is an overlooked metabolic booster. Adding cayenne pepper to foods can increase the sense of fullness when eating meals.17 Cayenne pepper also increases calorie burning after a meal.18 Consumption of chili peppers inhibits the rise in blood sugar after consuming a sugary drink.19
Garlic: A remarkable experiment shows a natural molecule may be able to single-handedly quell epidemic levels of obesity, high blood pressure and diabetes that now plague Western societies.
Researchers in Israel used allicin, an active ingredient in fresh-crushed garlic cloves, and compared it with enalapril, a drug often used to treat hypertension. Rats were fed a fructose-rich diet for five weeks. During the last two weeks, groups of 10 animals received only fructose, fructose + allicin or fructose + enalapril. After two weeks, allicin lowered blood pressure from the maximal level of 153.4 to 139.7 after two weeks on allicin and insulin was reduced from 11.7 to 6.92ng per milliliter, and triglycerides were cut from 132.8 to 59.6. More remarkably, the fructose-fed rats were massively obese while the fructose plus allicin-fed animals were normal weight.20
Green tea: Components of green tea, particularly epigallocatechin gallate, or EGCG, have been demonstrated in lab dish and animal models of obesity to reduce fat mass, body weight, fat absorption, blood plasma levels of triglycerides, cholesterol, glucose and insulin.21
Green tea contains caffeine. High caffeine consumption has been shown to reduce weight, fat mass and waist circumference more than low caffeine consumption.22 However, when obese adults were given green tea providing 270mg EGCG in low and high caffeine content, the low-caffeine group still experienced significant weight loss.23 EGCG, the primary active ingredient in green tea, has been shown to be helpful in weight loss by promoting loss of body fat, independent of caffeine.24 It's possible that EGCG pills may be more beneficial than tea drinking in regard to weight control.25
An overlooked mechanism by which green tea controls weight gain is its iron-controlling capabilities. Green tea and its extracts are known to be effective in preventing iron overload.26
Resveratrol: If humans could only reduce their intake of calories, down to eating about one meal a day (about 1,500 calories), they would achieve a health and longevity enjoyed by only a very few. Aside from the senior adult population on the island of Okinawa, there is no large human population that practices what has become known as calorie restriction.
But there now may be an option to what many might perceive as a regimen of deprivation. In recent years researchers at Massachusetts Institute of Technology and Harvard Medical School have come upon a remarkable molecule that mimics calorie restriction. Resveratrol, available in 70 species of plants, but more widely known as a red wine molecule, mimics calorie restriction. That is, it switches on the same gene that calorie restriction activates — Sirtuin 1, a DNA repair gene.
Of great interest is an enzyme called fatty acid synthase. It is the key enzyme involved in the conversion of dietary carbohydrates (sugars and starches) to fat in mammals.27 Resveratrol is a potent inhibitor of fatty acid synthase.28
Resveratrol is available for dietary supplements, without the calories or alcohol included in wine. Studies indicate resveratrol in wine and animal studies has always been utilized in its trans-resveratrol form. Exposure to light, heat or oxygen may alter its molecular structure into cis-resveratrol, which does not activate the Sirtuin 1 gene.29
Resveratrol opens a new door in the metabolic battle. It could allow humans to 'eat their cake' and not pay the price of diabetes and obesity.30 Resveratrol seems to essentially mimic calorie restriction. It would produce many of the same effects as dieting without having to deprive oneself of food.31 The effect of resveratrol in limiting the production of fat in fat cells is greatly synergized by the addition of quercetin. The ability of fat cells to produce fat is inhibited by 15-18 per cent by resveratrol or quercetin alone, but when combined, this inhibitory effect climbs to 73 per cent, nearly a five-fold difference.32
Stevia: Stevioside is a natural non-caloric sweetener derived from the leaves of stevia (Stevia rebaudiana Bertoni). It has been used for many years as a sweetener in Brazil and Japan. It has traditionally been used to treat diabetes by Indians in South America. Only recently has it been demonstrated that stevia does enhance insulin secretion.31 Stevia is believed to exhibit low or no toxicity.32 However, it has been shown to reduce testosterone levels in male rats.33
Stevia is now being considered more than a sweetener. It is being given consideration as an agent for the treatment of diabetes.34
Remarkably, a single oral dose of stevia, at a human equivalent dose of about 350mg for a 160-pound adult, reversed the effects of a 60 per cent fructose diet in rats. Stevia improved insulin sensitivity (ability to enter cells and produce energy). A lower dose, the human equivalent of 14mg for a 160-pound adult taken three times a day, has been shown to increase insulin secretion and sensitivity.35
Stevia, in 500mg doses taken three times a day, has been shown to lower elevated blood pressure on par with many blood-pressure-lowering medication.36 Another study using a lower dose did not significantly lower blood pressure.37
Just how many cases of diabetes and obesity will be averted with the introduction of stevia — in carbonated beverages alone — is beyond estimation at this point.
On those lists of what things are 'in'and what things are 'out' in sweeteners, place aspartame, sucralose and saccharin on the "out" list, and "stevia" on the "in" list. It's about time.
Weight-loss supplements: A category in transition
Weight-loss supplements sales plummet after May 2009 Hydroxycut recall: sales at supermarkets, drug stores and mass merchandise outlets fell 15% from July 2008 to July 2009.
Consumer mistrust of 'magic' diet pills grows: industry insiders see a movement toward weight-loss products and ingredients that are easily understandable and paired with lifestyle changes.
Hydroxycut recall proves AERs work: recall may have provided ammo for the industry's foes, but it also showed that the tools are now in place to protect consumers.
Lessons for the industry: do your research — preferably on your finished product; be ready to be inspected by FDA; never compromise on safety; make it easy for your customers to reach you.
Weight-loss supplements SWOT analysis
Tight feedback loop
Significant consumer demand for new products
Broad awareness of obesity epidemic
Many products perceived as "dangerous"
Tarnished image/history of products
Marketers' wild claims
Changing "testimonial" guidelines
Many brands lack research on finished products
Opportunities:Discovery and commercialization of new ingredients (eg, safer thermogenics)
Technological advancements improving efficacy
Couple of recognized brands with lifestyle weight-loss programs (Zantrex, Biggest Loser)
OTC/supplement combo products
Regulatory framework revisions (eg, weight loss as a disease state)
More recalls of multi-ingredient formulations
Growing mistrust of 'magic pills'
Is obesity all about the liver?
The growing number of middle-aged and adolescent patients with abdominal obesity and diagnosed with nonalcoholic fatty liver disease (NAFLD) highlights the need for a better understanding of this condition. Recent studies have shown that obese children without a history of alcohol abuse are frequently diagnosed with NAFLD, which is linked to overeating and a Western diet. In particular, the liver can be adversely affected by a diet low in fruits, vegetables and dietary fibre, as well as ones with high-glycemic carbohydrates, trans-fats and saturated fats.
Unbalanced nutrition results in biochemical, hormonal and gut-flora changes that promote an overgrowth of gut pathogenic bacteria, causing fermentation and production of toxins. In addition, a low-fibre diet results in excessive re-absorption of bile acids, cholesterol and fatty acids into the liver. Fibre aids in the absorption of bile acids, cholesterol and triglycerides excreted from the liver into the gastrointestinal tract, so less fiber means that less of these harmful compounds are excreted from the body. This abnormal enter-hepatic circulation subsequently instigates triglyceride fat accumulation in liver cells, leading to NAFLD.
In this condition the liver has a decreased ability to metabolize fat, with excess triglyceride fats accumulating in liver cells and triggering pro-inflammatory events, insulin resistance and excessive adipose tissue, leading to obesity.
NAFLD was first described in 1980, but its significance has been recognized only recently because of its link with obesity. Improving NAFLD is an essential part of a successful weight-management programme, and potential NAFLD therapies may include compounds that improve carbohydrate and fat metabolism by the liver.
One recent study used a botanical formula (Xanthigen) composed of fucoxanthin and pomegranate seed oil. Fucoxanthin demonstrates weight-loss properties in part from its ability to suppress fat formation by regulating PPARs proteins. The punicic acid in pomegranate may have triglyceride-lowering properties and might also suppress the production of triglycerides in human liver cells.
The 16-week, randomized study gave 200mg Xanthigen three times daily to 151 obese, nondiabetic female volunteers with (NAFLD) or normal liver fat (NLF) content. It resulted in statistically significant reductions of body weight (5.5kg NAFLD group vs 4.9kg NLF group), liver fat content, liver enzymes (NAFLD group only), serum triglycerides, and C-reactive protein vs placebo. Weight loss and reduction in body and liver fat content occurred earlier in patients with NLF than in patients with NAFLD. In both Xanthigen-receiving groups, loss of liver fat occurred one week prior to statistically significant loss in body fat and body weight.
1. Angulo P. Non-alcoholic fatty liver disease. N Engl J Med 2002 Apr 18;346(16):1221-31.
2. Seo YS, et al. PPAR agonists treatment is effective in a nonalcoholic fatty liver disease animal model by modulating fatty-acid metabolic enzymes. J Gastroenerol Hepatol 2008 Jan;23(1):102-9.
3. Abidov M, et al. The effects of Xanthigen in the weight management of obese premenopausal women with non-alcoholic fatty liver disease and normal liver fat. Diabetes Obes Metab 2010 Jan;12(1):72-81.
4. PL Thomas
5. Polifenoles Naturales, Spain
6. Sochim Intl, Italy
7. Mivalied Rohstoffhandel, Germany
Select suppliers: Weight-management ingredients span spectrum
Vitamin D2 in crystalline form and vitamin D3 in resin, oil, crystalline and powder forms. Concentrations range from 100,000IU/g to 1,000,000IU/g.
Superba brand krill oil provides omega-3s in phospholipid form. Aker's Antarctic harvest has received Marine Stewardship Council sustainability certification.
Resveratrol is available at 20%, 50%, 95% and 99%.
Omega-3, omega-6 and omega-9 oils; fatty acid concentrates; specialty nutritional oils; and food products from both plant and marine sources.
Good & Sweet brand 99 per cent Reb-A stevia was GRAS confirmed by FDA in July 2009 for general diet products, sports nutrition, desserts, yoghurts, gum and more.
Truvia brand Reb-A broke open the stevia market. Cargill received an official FDA response in December 2008 to support published safety findings.
Tonalin brand CLA from safflower oil in various forms for food and supplements. Lipoec brand 99 per cent ALA in crystalline powder form for foods and supplements.
US distributor of Salba, a Salvia hispanica supplement rich in omega-3s, fiber and antioxidants. Available in whole and ground seed, oils, and gelcaps.
Denomega Nutritional Oils
Omega-3 supplier for food, beverage, supplements, medical foods and pet/animal nutrition.
resVida is a 99% pure form of trans-resveratrol that is self-affirmed GRAS.
Supplies omega-3 supplements with condition-specific ratios of EPA to DHA. Sourced from sustainable anchovy fisheries.
Exclusive North American supplier of NeuVia brand stevia from Shandong QianQian Pharmaceuticals in China.
GAT Food Essentials
Microencapsulation specialist focusing on the stabilization of sensitive active ingredients such as omega-3s.
ChromeMate is the brand name for a niacin-bound chromium complex.
Resveratrol is available at varying purity specifications.
Advantra-Z is the leading thermogenic ingredient, derived from bitter orange (Citrus aurantium).
Chromax brand chromium picolinate is marketed for weight loss and sports nutrition. Chromax is GRAS for use in foods and is backed by substantial research.
Ocean Nutrition Canada
Meg-3 brand fish oils provide EPA and DHA; and come with Powder-loc double-hulled protection for food and beverage applications.
Grape-seed extract is 95% polyphenols, while resveratrol from giant knotweed is a minimum of 50%.
High-quality company supplies a full line of standardized fruit and botanical extracts from top suppliers including Proliant of Spain, Polyphenolics of the US and Isocell of France.
Line includes MegaNatural BP, an extract from white wine grape seeds; and MegaNatural Gold Grape Seed extract that guarantees a minimum 90% polyphenols. These are GRAS for beverages.
PureVia brand Reb-A led the way in the opening up of the stevia market in the US through partnerships with Cargill, Coke and Pepsi.
Capsaicin from Capsicum annuum, a pepper species native to Mexico, is standardized at 40% and 75% pure capsaicinoids. Resevenox is a 95% resveratrol.
Stauber Performance Ingredients
Offers 97% Rebaudioside-A. GRAS approved and stable for all applications.
Sunwin International Neutraceuticals
Stevioside wholesale supplier with a production capacity of more than 600 metric tonnes annually.
Distributes a wide range of products from suppliers like DSM, Polyphenolics and Sabinsa.
Wisdom Natural Brands
SweetLeaf Stevia was first in market, having been introduced into the US in 1982. It is extracted entirely with water and a proprietary filtration process, so no solvents, enzymes or alcohols ever touch the stevia leaves or products. Company says no masking agents needed.
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3. Docherty JP, et al. A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. J Psychiatric Prac 2005;11:302-14.
4. Lydic ML, et al. Chromium picolinate improves insulin sensitivity in obese subjects with polycystic ovary syndrome. Fertility Sterility 2006;86:243-6.
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8. Konradsen S, et al. Serum 1,25-dihydroxy vitamin D is inversely associated with body mass index. Eur J Nutr 2008;47:87-91.
9. McGill AT, et al. Relationships of lower serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutr J 2008;7:4.
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11. Alemzadeh R, et al. Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism 2008;57:183-91.
12. Todoric J, et al. Adipose tissue inflammation induced by high-fat diet in obese diabetic mice is prevented by n-3 polyunsaturated fatty acids. Diabetologia 2006;49:2109-19.
13. Jenkins R. Fish oil boosts exercise benefit, trims pounds. Daily News Central, 2006, Jul 30.
14. Haugaard SB, et al. Dietary intervention increases n-3 long-chain polyunsaturated fatty acids in skeletal muscle membrane phospholipids of obese subjects. Implications for insulin sensitivity. J Endocrinol 2006;64:169-78.
15. Pouwer F, et al. Fat food for a bad mood. Diabetic Med 2005;22:1465-75.
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25. Westerterp-Plantenga MS, et al. Body weight loss and weight maintenance in relation to habitual caffeine intake and green tea supplementation. Obes Res 2005;13:1195-204.
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27. Lin J, et al. Green tea polyphenol epigallocatechin gallate inhibits adipogenesis and induces apoptosis in 3T30L1 adipocytes. Obes Res 2005;982-90.
28. Wolfram S, et al. Anti-obesity effects of green tea: from bedside to bench. Molecular Nutr Food Res 2006;50:176-87.
29. Srichairatanakool S, et al. Iron-chelating and free-radical scavenging activities of microwave-processed green tea in iron overload. Hemoglobin 2006;30:311-27.
30. Menendez JA, et al. Obesity, fatty acid synthase, and cancer: serendipity or forgotten causal linkage? Molecular Genetics Metab 2005;84:293-5.
31. Tian WX. Inhibition of fatty acid synthase by polyphenols. Curr Med Chem 2006;967-77.
32. Wang Z, et al. Dealcoholized red wine containing known amounts of resveratrol suppresses atherosclerosis in hypercholesterolemic rabbits without affecting plasma lipid levels. Int J Molec Med 2005;165:533-40.
33. Banini AE, et al. Muscadine grape products intake, diet and blood constituents of non-diabetic and type 2 diabetic subjects. Nutrition, 2006 Oct online.
34. Lie Y, et al. Study on thermostability and photo-isomerization of trans-resveratrol by high performance liquid chromatography and liquid chromatography-electrospray ionization-mass spectrometry. Se Pu 2004;22:583-8.
35. Spinney L. Gerontology: eat your cake and have it. Nature 2006;441-807-9.
36. Zhang J. Resveratrol inhibits insulin responses in a SirT1-independent pathway. Biochem J 2006;397:519-27.
37. Yang JY, et al. Enhanced inhibition of adipogenesis and induction of apoptosis in 3T3-L1 adipocytes with combianation of resveratrol and quercetin. Life Sci 2008;82:1032-9.
38. Jeppesen Pb, et al. Stevioside acts directly on pancreatic beta cells to secrete insulin. Metabolism. 2000;49:208-14.
39. Geuns JM. Stevioside. Phytochemistry 2003;64:913-21.
40. Melis MS. Effects of chronic administration of Stevia rebaudiana on fertility in rats. J Ethnopharmacology 1991;67:157-61.
41. Chang JC, et al. Increase of insulin sensitivity by stevioside in fructose-rich chow-fed rats. Hormone Metab Res 2005;37:610-6.
42. Hsieh MH, et al. Efficacy and tolerability of oral stevioside in patients with mild essential hypertension; a two-year, randomized, placebo-controlled study. Clinic Therapy 2003;25:2797-808.
43. Ferri LA, et al. Investigation of the antihypertensive effect of oral crude stevioside in patients with mild essential hypertension. Phytotherapy Res 2006;20:732-6.
44. Chen TH, et al Mechanism of the hypoglycemic effect of stevioside, a glycoside of Stevia rebaudiana. Planta Medica 2005;71:108-13.