The Battle of the Bulge

Natural Supplements that Aid Weight and Fat-Loss

With the new year upon us, millions of Americans are renewing their resolutions to lose weight. For the early part of 2002, dieting will abound, new gym memberships will be purchased and dietary supplements that aid in weight loss will be flying off the shelves. According to an article published by researchers at the Centers for Disease Control (CDC) Division of Nutrition and Physical Activity in Atlanta, "with increasing rates of obesity, nonprescription product use is likely to increase" (JAMA, 286,8: 930-5, 2001).

Weight loss supplements have been controversial among scientists and physicians because the science behind them has been lacking. Researchers in Australia, for example, published a research review, concluding that advertising may make unsubstantiated claims, and the only proof of effect on humans was when weight-loss supplements were taken in conjunction with a calorie-controlled diet and exercise program (Med J Aust, 171,11-12: 604-8, 1999).

In response, the dietary supplement industry has been busy researching the roles of supplements in weight loss, and specifically fat management. Thermogenics, insulin aids and fat-binders will all have starring roles in weight-loss efforts this year, and there is published and ongoing clinical research demonstrating these products may offer a helping hand to those in need of slimming down. The retailer's job in this effort will be to ascertain customers' needs and provide research and literature explaining each type of supplement's effect.

Thermogenics

Thermogenesis literally means "heat creation" and is the process by which the body burns excess calories in its brown adipose tissue (BAT). "Brown fat [BAT] is comprised of numerous fat-burning cells that contain large quantities of mitochondria, which actually give the fat its brown color," wrote Ann Louise Gittleman, M.S., author of Eat Fat, Lose Weight (Keats Publishing, 1999). "Researchers have discovered that thin people who have little trouble managing extra calories have activated mitochondria in their brown fat, while overweight individuals have dormant brown fat."

BAT activity can decrease through behavioral and genetic factors, making the body ineffective at burning excess calories, which are then stored as white fat, according to Daniel B. Mowrey, Ph.D., author of Fat Management: The Thermogenic Factor (Victory Publications, 1994). However, Mowrey continued, BAT activity can be restored through thermogenic dietary supplements.

Ephedra, or ma huang, is one such dietary agent that has a thermogenic effect on restoring BAT function, which may explain its current popularity in weight loss applications. The active components of ephedra include the alkaloids ephedrine and pseudoephedrine.

"In the earliest clinical trials utilizing ephedrine to help promote weight loss, the positive effect was attributed to the chemical's ability to curb appetite," Mowrey wrote. "However, it was apparent to other researchers that ephedrine administration elicited a definite thermogenic response." This thermogenic response led to weight (and fat) loss in obese individuals and a declined ability to gain fat in healthy individuals.

Taken responsibly under a physician's supervision, ephedra can assist those in their quest to lose weight. However, there are some potential adverse events that can occur with ephedra. Because its alkaloids stimulate the cardiovascular and sympathetic nervous systems, there has been some controversy over whether ephedra may be linked to strokes and heart attacks.

Industry organizations such as the American Herbal Products Association (AHPA), Consumer Healthcare Products Association (CHPA) and the National Nutritional Foods Association (NNFA) recommend that ephedra-containing products bear labels warning consumers suffering from hypertension or heart disease to avoid the supplement. Early last year, the industry released guidelines for taking ephedra, noting that individuals should not exceed 25 mg per serving and no more than 100 mg/day, and ephedra should not be taken chronically for longer than six months. (More on ephedra can be found in HSR's December 2001 issue online at www.hsrmagazine.com.)

Gamma linolenic acid (GLA) is an omega-6 fatty acid that also has thermogenic and metabolic effects. "GLA, one of the most potent omega-6 fatty acids found in evening primrose oil, borage oil and black currant oil, has been found to activate brown fat and boost the metabolic rates in healthy adults," Gittleman wrote. "GLA is the raw material needed for certain prostaglandins to ignite the mitochondria's fat-burning process in the body's brown fat."

Cayenne may also have potential in weight loss applications, although research on the topic is scarce. "Cayenne is another plant that has the potential for strongly affecting several of the events of thermogenesis, especially the flow of blood to and from BAT, and lipolysis (the conversion of fats to free fatty acids, the main fuel of thermogenesis)," Mowrey wrote. According to one study (Brit J Nutr, 80,6: 503-10, 1998), adding 10 g of cayenne to high-fat (HF), high-carbohydrate (HC) meals can enhance thermogenesis. According to authors, "Diet-induced thermogenesis was significantly higher after the HC meals than after the HF meals." Another study in a subsequent issue of the same journal (82,2: 115-23, 1999) indicated that the consumption of 10 g of cayenne with meals may also reduce subjects' appetites.

Insulin Aids

Insulin's job in the body is to regulate blood sugar, or glucose. When metabolism is working properly, glucose levels remain within normal levels, with glucose levels rising after meals. When this happens, the pancreas releases insulin. "The muscles respond to the insulin and use the excess sugar as energy or store it as glycogen," Gittleman wrote. "Muscles are only able to store a small overage of glucose as glycogen. Whatever cannot be stored as glycogen gets stored as fat."

Gittleman added, "The pancreas ... is constantly working to maintain healthy glucose levels in the bloodstream. All too often, however, this system of checks and balances fails to work properly, and a condition called 'insulin resistance' develops." When insulin resistance develops, the pancreas releases large amounts of insulin to the muscles to convert sugar to glycogen, which is a suspected precursor to obesity, high blood pressure and Type II diabetes.

In order to combat weight gain associated with insulin resistance, the body's metabolism must be repaired. "Omega-3 oils have been clearly demonstrated to help combat the scourge of insulin resistance," Gittleman wrote. "They will help restore the healthy functioning of the metabolism in order to burn fat calories for energy rather than storing them as fat."

Conjugated linoleic acid (CLA) is an omega-3 that may be useful for reducing fat through improving insulin resistance. According to Susie Rockway, Ph.D., director of scientific and clinical affairs for Lake Bluff, Ill.-based Pharmanutrients CLA is appropriately used for weight maintenance and fat loss. She directed a small pilot study using Pharmanutrients' proprietary CLA ingredient, CLA One^™, that involved six people who took 3 g/d of the ingredient (225 mg CLA) for six weeks, while incorporating diet and exercise into their regimen. "We saw fat loss, increase in lean body mass, significant difference in cholesterol and triglycerides, weight circumference--all the parameters you want to see in people who should be losing weight and gaining muscle," Rockway said. She went on to add that one subject who forewent the exercise regimen also saw a loss in body fat, although he demonstrated no increase in lean body mass. "You can get fat loss without exercising or dieting," Rockway added. "But you need to have a healthy diet. [CLA] is not a magic pill."

Published research has also demonstrated CLA's role in weight maintenance and fat loss. For example, a 12-week, randomized, double blind study involved 60 subjects with a body mass index (BMI) of 25 to 35 (overweight to obese) who were divided into five daily supplement groups: 1.7 g, 3.4 g, 5.1 g or 6.8 g of CLA or placebo. Researchers noted a significant reduction in body fat in groups taking more than 3.4 g of CLA, although no significant difference was found in lean body mass, BMI or blood lipids (J Nutr, 130,12: 2943-8, 2000).

In another study investigating the effects of CLA in abdominally obese humans, researchers gave 25 men with a waist-to-hip ratio of 1.0 (a healthy ratio is 0.9 or below) either 4.2 g/d of CLA or placebo. On average, the CLA-supplemented group lost one inch around the waist compared to men in the placebo group (Intl J Obes, 25,8: 1129-35, 2001). The study was sponsored by Vernon Hills, Ill.-based Natural Inc., which also provided the product, Tonalin^® CLA.

A subsequent study (Lipids, 36,8: 773-81, 2001), also using Tonalin CLA, involved 53 Swedish patients who were randomly assigned to take either CLA (4.2 g) or placebo for 14 weeks. Patients were instructed to maintain their diet and refrain from adding supplements. Results showed that subjects in the CLA group experienced body fat reductions of 3.8 percent.

Chromium, another insulin aid, is an essential trace mineral that improves the efficacy of insulin by assisting in the metabolism of carbohydrates, lipids and proteins. In addition, chromium is also necessary for the cellular uptake of glucose. Deficiency can cause insulin resistance as well as diabetes-like symptoms. Supplementation with chromium may be able to reverse this situation.

The regulation of insulin and fat loss are related, according to James Komorowski, director of technical services for Purchase, N.Y.-based Nutrition 21, manufacturer of Chromax^®, a proprietary chromium picolinate ingredient. "Chromium is needed for insulin-mediated metabolism, but when your body secretes insulin, it's telling your cells to store energy, sugar and fat," he explained. "So it's not uncommon for people who have high insulin levels to become obese. If you can make that metabolism more efficient, that's where the impact can be on lowering body fat."

One study (Diabetes Obes Metab, 1,6: 331-7, 1999) following overweight African-American women in Washington, D.C., indicated that niacin-bound chromium supplementation in combination with a dieting/exercising regimen led to a significant loss of fat, while sparing muscle, as compared to placebo.

Gilbert Kaats, Ph.D., of the Health and Medical Research Foundation in San Antonio conducted another study that had positive results and used chromium picolinate (Curr Ther Res, 59,6: 379-88, 1998). The randomized, double blind, placebo-controlled study involved 122 subjects who took 200 mcg/d chromium, and all subjects' caloric intake and exercise were controlled. Subjects in the supplement group demonstrated a more significant loss of weight and fat mass as compared to placebo. Kaats concluded that daily supplementation with chromium picolinate can lead to significant improvements in body composition, particularly when the changes are corrected for differences in caloric intake and exercise.

"Whenever you conduct a weight loss study and you're looking at a dietary supplement or even a drug, you need to control diet and exercise because those things have such a big impact," Komorowski said. "If everyone keeps the same regimen and you add chromium, people are going to get additional results, including lower body fat."

Not only is monitoring insulin levels important, but also carbohydrate intake, which affects insulin levels. A standardized extract made from Phaseolus vulgaris (Northern white kidney bean) may be effective in weight loss efforts because of its ability to reduce absorption of carbohydrate calories, according to a pilot study conducted at the University of Scranton. For the study, subjects (five male, five female) were randomly split into two diet groups: 1) four slices of white bread (60 g carbohydrate), 42 g soybean oil margarine and 4 g Sweet'N Low; or 2) bread plus 1.5 g of the proprietary Phaseolus vulgaris extract called Phaseolamin. Subjects' plasma glucose was measured at baseline and every 30 minutes for four hours.

"Phaseolamin showed almost a 60-percent decrease in the change in plasma glucose levels, which indicates that it neutralized much of the carbohydrate in the gastrointestinal tract," said Dennis Meiss, Ph.D., medical spokesperson for Kearny, N.J.-based Pharmachem Laboratories, which provided the supplement for the study.

A second clinical trial sponsored by Pharmachem that involved 60 Italian subjects demonstrated that taking 500 mg of the same supplement with one primary meal containing complex carbohydrates led to an average weight loss of 6.5 lbs. after 30 days. "The significant part was that researchers showed there was a significant decrease in the body fat content, with no decrease in the lean muscle mass content," Meiss said.

Fat-Binders

Chitosan is a polymer of glucosamine that is derived from chitin, a fiber taken most often from the exoskeletons of shellfish. It can also be derived from fungal chitins. According to Rockway, chitosan has a unique positive charge that allows it to draw negatively charged fat molecules to it and draw them through the gastrointestinal tract before they can be absorbed. The one drawback to this mechanism of action is that negatively charged fat-soluble vitamins can also be caught and excreted before they are absorbed.

Because of chitosan's propensity for drawing fatty molecules to itself, this soluble fiber has been recommended for lowering cholesterol as well as for weight loss applications. However, research on chitosan's effects is conflicting. In a United Kingdom study (Eur J Clin Nutr, 53,5: 379-81, 1999), researchers followed 34 overweight volunteers who were assigned either four capsules of chitosan or placebo twice daily for 28 consecutive days. BMI, serum cholesterol, triglycerides and other measurements were taken at the end of the study. Testing results indicated that the only difference between the chitosan and placebo groups was a rise in vitamin K seen in the supplement group. There was no noted weight loss difference.

Conversely, rapidly soluble chitosan was shown to be effective in facilitating weight loss and reducing body fat in another study (JANA, 4,1: 42-9, 2001). Researchers, led by Rebecca Schiller, M.S., C.N., studied 59 overweight, otherwise healthy women who had a history of daily dietary fat consumption greater than or equal to 30 percent of total calories. During the randomized, double blind, placebo-controlled trial, subjects received either three capsules of rapidly soluble chitosan (a total of 1.5 g) or placebo twice daily for eight weeks. No food restrictions or modifications were assigned, and subjects were instructed to continue their regular caloric intake.

Subjects in the treatment group experienced decreased mean body weight and BMI as compared to baseline, while subjects in the placebo group increased mean weight, BMI and percent body fat, as well as decreased lean body mass. Researchers concluded that rapidly soluble chitosan is effective for facilitating weight loss and reducing body fat in overweight and mildly obese individuals. The product used in this trial, Liposan Ultra^™, was provided by Redmond, Wash.-based Vanson Inc.

In a small, double blind, crossover study led by Pharmanutrients' Rockway, chitosan was seen to lower LDL and reduce fat in six subjects who took two 500 mg pills of chitosan prior to meals, twice daily for 12 days. "What we were doing was proving that what we have seen in the laboratory, we can now show in the human body as well," she said. "Our conclusion was that chitosan does decrease fat absorption."

Psyllium husk is sometimes added to chitosan products to enhance their effects because of its laxative action. Derived from the seed of the Plantago ovata plant, psyllium husk is a bulk fiber useful in digestive health (Am J Clin Nutr, 72,3: 784-9, 2000). In addition, there is research indicating that fiber may reduce appetite by providing a "full" feeling, thereby reducing caloric intake (Am J Clin Nutr, 37: 763-7, 1983).

Slowly, but surely, more clinical trials are offering scientific proof that elucidate the mechanisms of action behind natural weight loss products. As the science behind natural medicine becomes more abundant, retailers will have additional educational materials to offer in support of these products. The preliminary results of recent research indicates that many dietary ingredients can aid in fat loss and the development of lean muscle, a result which is enhanced by a healthy diet and exercise program. Throughout this new year and new years to come, consumers will constantly be striving to find that one product that will help them achieve a fitter physique. Retailers are able to help in this healthy quest, and will be able to do so more effectively as more research becomes available.

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