The effect of glucomannan on body weight in overweight or obese children and adults: a systematic review of randomized controlled trials

Risperidone Pellets, Pycnogenol®, and Glucomannan Gummy Formulation for Managing Weight Gain and ADHD in Autistic Children

Gummy formulations are defined as gradually or slowly released solid oral dosage forms. Risperidone is an atypical antipsychotic medication used to treat schizophrenia and autism-related irritability. This study presents the development of visually appealing, patient-tailored medicated gummies that act as a novel pharmaceutical form of Risperidone for pediatrics. In this study, two gummy bases were used, one containing Glucomannan and the other containing Gelatin as a gelling agent, where these gummy bases were loaded with coated Risperidone pellets with a controlled release layer. The final products were evaluated for their pH, viscosity, content uniformity, drug content, and dissolution profile. Both formulas showed proper rheology and met content and weight uniformity standards. The release rates for F1 and F2 in the acidic media were 25% and 11%, respectively, after 2 h. At the same time, a full-release profile for Risperidone was noticed in both formulae at pH 6.8 where the release lasts for 24 h. It can be concluded that the chewable semi-solid dosages (gummies) filled with coated pellets are suitable for pediatric patients since pediatrics have drug-related problems which can be solved using high gastro-resistance coated pellets, which also shows a proper release profile for the drug.

Comparative metabolomics analysis reveals dynamic changes in carbohydrate profiles of corms during the "relay growth" of konjac (Amorphophallus muelleri)

The type and content of carbohydrates in konjac corms are an essential factors in determining the quality of konjac; however, the pattern of carbohydrate changes and the mechanism regulating the development of mother and daughter corms in the "relay growth" process of Amorphophallus muelleri remain unclear. This study aimed to investigate changes in corm carbohydrates during the growth cycle of A. muelleri and to compare the carbohydrate composition and the expression of related genes between mother and daughter corms. Integrated metabolome and RNA-seq analyses identified 37 differential metabolites as well as 8074 genes that were differentially expressed between mother and daughter corms, the majority of which were involved in starch and sucrose metabolism. More than 80% of the differential metabolites, including sucrose and starch, tended to accumulate in the mother corms; however, konjac glucomannan (KGM), as one of the most important carbohydrates and its major component of the corm, accumulated in higher amounts in the daughter corms. In addition, the expression of invertase and alpha-amylase that promote the breakdown of sucrose and starch was 351.78- and 15.63-fold higher, respectively, in the daughter corm, whereas that of the starch synthesis gene AkWAXY was only 0.096 times as high as in the mother corms. Furthermore, the level of cellulose synthase-like protein G, which promotes KGM synthesis, was 3.85 times higher in daughter corms compared to mother corms. Thus, we inferred that the daughter and mother corms had two distinct carbohydrate utilization strategies. This study provides insights into temporal changes in carbohydrates during the growth cycle of A. muelleri.

Konjac Glucomannan: An Emerging Specialty Medical Food to Aid in the Treatment of Type 2 Diabetes Mellitus

There are many factors causing T2DM; thus, it is difficult to prevent and cure it with conventional treatment. In order to realize the continuous intervention of T2DM, the treatment strategy of combining diet therapy and traditional medication came into being. As a natural product with the concept of being healthy, konjac flour and its derivatives are popular with the public. Its main component, Konjac glucomannan (KGM), can not only be applied as a food additive, which greatly improves the taste and flavor of food and extends the shelf life of food but also occupies an important role in T2DM. KGM can extend gastric emptying time, increase satiety, and promote liver glycogen synthesis, and also has the potential to improve intestinal flora and the metabolic system through a variety of molecular pathways in order to positively regulate oxidative stress and immune inflammation, and protect the liver and kidneys. In order to establish the theoretical justification for the adjunctive treatment of T2DM, we have outlined the physicochemical features of KGM in this article, emphasizing the advantages of KGM as a meal for special medical purposes of T2DM.

The Effect of κ-Carrageenan Proportion and Hot Water Extract of the Pluchea indica Less Leaf Tea on the Quality and Sensory Properties of Stink Lily (Amorphophallus muelleri) Wet Noodles

The study aims to determine the effect of the proportion of κ-carrageenan and the hot water extract of pluchea leaf tea on the quality and sensory properties of stink lily wet noodles. The research design is a randomized block design with two factors, i.e., the difference in the proportion of κ-carrageenan (K) (0, 1, 2, and 3% w/w) and the addition of the hot water extract of the Pluchea indica Less leaf tea (L) (0, 15, and 30% w/v), with 12 treatment levels (K0L0, K0L1, K0L2, K1L0, K1L1, K1L2, K2L0, K2L1, K2L2, K3L0, K3L1, K3L2). The data are analyzed by the ANOVA at p < 5% and continued with the Duncan’s multiple range test at p < 5%, and the best treatment was determined by the spider web method based on sensory assay by a hedonic method. The proportions of κ-carrageenan and the concentration of pluchea tea extract had a significant effect on the cooking quality and sensory properties. However, the interaction of the two factors affected the swelling index, yellowness (b*), chroma (C), hue (h), total phenol content (TPC), total flavonoid content (TFC), and DPPH free radical scavenging assay (DPPH). The best treatment of wet noodles was K2L0, with a preference score of 15.8. The binding of κ-carrageenan and phenolic compounds to make a networking structure by intra- and inter-disulfide bind between glucomannan and gluten was thought to affect the cooking quality, sensory properties, bioactive compounds (TPC and TFC), and DPPH.

Role of Bioactive Compounds in Obesity: Metabolic Mechanism Focused on Inflammation

Obesity is a disease characterized by an inflammatory process in the adipose tissue due to diverse infiltrated immune cells, an increased secretion of proinflammatory molecules, and a decreased secretion of anti-inflammatory molecules. On the other hand, obesity increases the risk of several diseases, such as cardiovascular diseases, diabetes, and cancer. Their treatment is based on nutritional and pharmacological strategies. However, natural products are currently implemented as complementary and alternative medicine (CAM). Polyphenols and fiber are naturally compounds with potential action to reduce inflammation through several pathways and play an important role in the prevention and treatment of obesity, as well as in other non-communicable diseases. Hence, this review focuses on the recent evidence of the molecular mechanisms of polyphenols and dietary fiber, from Scopus, Science Direct, and PubMed, among others, by using key words and based on recent in vitro and in vivo studies.

Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits

Dietary supplements for weight management include myriad ingredients with thermogenic, lipotropic, satiety, and other metabolic effects. Recently, the safety of this product category has been questioned. In this review, we summarize the safety evidence as well as relevant clinical findings on weight management and metabolic effects of six representative dietary supplement ingredients: caffeine, green tea extract (GTE), green coffee bean extract (GCBE), choline, glucomannan, and capsaicinoids and capsinoids. Of these, caffeine, GTE (specifically epigallocatechin gallate [EGCG]), and choline have recommended intake limits, which appear not to be exceeded when used according to manufacturers’ instructions. Serious adverse events from supplements with these ingredients are rare and typically involve unusually high intakes. As with any dietary component, the potential for gastrointestinal intolerance, as well as possible interactions with concomitant medications/supplements exist, and the health status of the consumer should be considered when consuming these components. Most of the ingredients reviewed also improved markers of metabolic health, such as glucose, lipids, and blood pressure, although the data are limited for some. In summary, weight management supplements containing caffeine, GTE, GCBE, choline, glucomannan, and capsaicinoids and capsinoids are generally safe when taken as directed and demonstrate metabolic health benefits for overweight and obese people.

Effects of konjac glucomannan with different molecular weights on gut microflora with antibiotic perturbance in in vitro fecal fermentation

This study investigated the effect of konjac glucomannan (KGM) of different molecular weight on fecal microflora against antibiotic disturbance. KGM (~1.8 × 10⁷ Da) was partially hydrolysed with trifluoroacetic acid (TFA) for 10 and 60 min to KGM1 (~2.1 × 10⁴ Da) and KGM2 (7413 Da), respectively. The acid treatment caused significant reduction of intrinsic viscosity, average molecular weight (MW) and particle size of KGM, but brought limited change to the molecular structure. Low-MW KGM2 showed the most significant effect on fecal microflora in the presence of two common antibiotics (ampicillin and clindamycin), by increasing the relative abundance of Bifidobacteriaceae while decreasing the proportion of Enterobacteriaceae. Additionally, both the native and acid-treated KGM counteracted the adverse influence of antibiotics on the production of short chain fatty acids. The results have demonstrated the effect of KGM on gut microbiota with antibiotic disturbance.

Soluble Dietary Fiber Significance against Obesity in a Western China Population

Objectives

This study aimed to investigate whether soluble dietary fibers (SDFs) could protect against obesity by influencing weight, body mass index (BMI), body fat rate (BFR), visceral fat rate (VFR), or waistline.

Methods

We examined obese adult patients from western China at 0 and 3 weeks after an SDF diet. Index assessments of obesity including height, weight, BMI, BFR, VFR, and waistline were carried out. We used the Mann-Whitney U test to examine the difference between the usual diet and the SDF group.

Results

Weight, BMI, BFR, and waistline were reduced in both the control group and the SDF group (P < 0.001). The reduction of the four indices in the SDF group was significantly higher than in the control group (P < 0.001). Higher intake of various SDFs has significantly reduced the weight, BMI, BFR, and waistline than the usual diet group in obesity.

Conclusion

Our results indicated that increased intake of SDFs in the diet of obese patients would protect against obesity in the first 3 weeks.

Efficacy of dietary supplements containing isolated organic compounds for weight loss: a systematic review and meta-analysis of randomised placebo-controlled trials

BACKGROUND/OBJECTIVES

A systematic review with meta-analysis was conducted to synthesise evidence on the efficacy of dietary supplements containing isolated organic compounds for weight loss.

SUBJECTS/METHODS

Four electronic databases (Medline, Embase, Web of Science, Cinahl) were searched until December 2019. Sixty-seven randomised placebo-controlled trials of dietary supplements containing isolated organic compounds for weight loss were included. Meta-analyses were conducted for chitosan, glucomannan, conjugated linoleic acid and fructans, comparing mean weight difference post-intervention between participants receiving the dietary supplement or placebo.

RESULTS

Statistically significant weight differences compared to placebo were observed for chitosan (-1.84 kg; 95% confidence interval [CI] -2.79, -0.88; p < 0.01), glucomannan (-1.27 kg; 95%CI -2.45, -0.09; p = 0.04), and conjugated linoleic acid (-1.08 kg; 95%CI -1.61, -0.55; p < 0.01). None met our threshold for clinical significance (≥2.5 kg). There was no statistically significant effect on weight for fructans compared to placebo (p = 0.24). For dietary supplements with an inadequate number of trials for meta-analysis, a statistically and borderline clinically significant weight difference compared to placebo was found for modified cellulose, manno-oligosaccharides (in males), blood orange juice extract, and three multiple-ingredient dietary supplements. These were only reported in one trial of each. Thus, more evidence is needed before recommending them for weight loss.

CONCLUSIONS

While some dietary supplements containing isolated organic compounds warrant further investigation to determine efficacy and safety, there is currently insufficient evidence to recommend any of these dietary supplements for weight loss.

Physicochemical characteristics of green banana flour and its use in the development of konjac-green banana noodles

Asian noodles typically have high glycemic index, and an unbalanced diet heavily laden with carbohydrates has been linked to weight gain and obesity. Shirataki noodles from Japan is made from konjac glucomannan (KGM) and water and is widely known for its multiple health benefits and ability to promote satiety. However, it imparts negligible nutritional value due to its low energy content. In this study, the feasibility of making low calorie, gluten-free Shirataki noodles with improved nutritional value was shown by adding green banana flour (GBF), an underutilized subproduct of low commercial value and significance in the food industry. The optimal KGM-GBF noodles (with 6% w/w KGM, 35% w/w GBF) had 27% lower total energy content, 13% lower carbohydrate content, 5.4% higher fiber content, 2% higher ash content, and 80% hardness (as measured by texture profile analysis) when compared to commercial yellow alkaline wheat noodles. Multiple regression analysis showed that KGM level was a more influential factor than GBF level on the hardness of cooked KGM-GBF noodles (P < 0.01). The compatibility of GBF with KGM in noodle making lay in GBF's high gelatinizing and pasting temperatures, which allowed optimal KGM hydration during dough formation to develop the primary network structure in the noodles. Through this study, the potential of GBF as a functional food ingredient in product processing and nutrition enhancement was demonstrated. PRACTICAL APPLICATION: The addition of green banana flour can improve the nutritional value and sensorial properties of konjac (Shirataki) noodles. This offers a gluten-free and low glycemic index alternative to wheat and starch noodles currently available commercially. A novel method of noodle-making to create KGM noodles, without the use of high alkalinity, was developed.

A Study of the Synergistic Interaction of Konjac Glucomannan/Curdlan Blend Systems under Alkaline Conditions

To improve the gelation performance of konjac glucomannan (KGM) thermo-irreversible gel in the condition of alkaline, this study investigated the interactions between KGM and curdlan (CUD) in terms of the sol state and gelation process. The apparent viscosity, rheological properties during heating and cooling, thermodynamic properties, gelation properties and water holding capacity of KGM/CUD blend systems in an alkaline environment were studied using physical property testing instruments and methods. The results showed that the viscosity of the KGM/CUD blended solution was greater than the value calculated from the ideal mixing rules in the condition of alkaline (pH = 10.58). As the proportion of CUD in the system increased, the intersection of storage modulus (G') and loss modulus (G") shifted to low frequencies, the relaxation time gradually increased, and the degree of entanglement of molecular chains between these two components gradually increased. The addition of CUD helped decrease the gelation temperature of KGM, increased the gelation rate and inhibited the thinning phenomenon of KGM gels at low temperatures (2-20 °C). The addition of CUD increased the hardness and gel strength of KGM but did not significantly improve the water holding capacity of the KGM/CUD blend gel. The process of mixing KGM and CUD improved the thermal stability of the gel. In summary, KGM/CUD exhibited excellent compatibility under alkaline conditions, and the blend systems produced a "viscosifying effect". KC8 and KC5 show better thermal stability, low temperature resistance and gel strength compared to KGM. This blended gel can be used as a structural support material to provide reference for the development of konjac bionic vegetarian products.

No Effect of Glucomannan on Body Weight Reduction in Children and Adolescents with Overweight and Obesity: A Randomized Controlled Trial

OBJECTIVE

To assess the efficacy of water-soluble dietary fiber, glucomannan supplementation, on the body mass index (BMI) in children with overweight or obesity.

STUDY DESIGN

In this randomized, double-blind, placebo-controlled trial, we enrolled 96 children aged 6-17 years with overweight or obesity based on the World Health Organization growth criteria (>+1 SD or >+2 SD, respectively). Participants were assigned to receive glucomannan or placebo (maltodextrin), both at a dose of 3 g/d for 12 weeks and were followed up for the next 12 weeks. Concomitant care included dietary and lifestyle advice. The primary outcome was the difference in the BMI-for-age z score change between the groups at 12 weeks.

RESULTS

Compared with the placebo, glucomannan had no effect on the BMI-for-age z score at 12 weeks (mean difference: 0.0, 95% CI -0.1 to 0.1). Compared with the placebo, the glucomannan group had lower total and low-density lipoprotein cholesterol concentrations at 12 weeks. In addition, the blood pressure was greater at 12 weeks (systolic) and at 24 weeks (diastolic) in the glucomannan group. No differences between the groups in adverse events and other secondary outcomes were observed.

CONCLUSIONS

Glucomannan supplementation compared with placebo had no effect on weight reduction in children with overweight and obesity.

TRIAL REGISTRATION

ClinicalTrials.govNCT02280772.

Nutritionist and obesity: brief overview on efficacy, safety, and drug interactions of the main weight-loss dietary supplements

Over the past 20 years the use of dietary supplements as adjuvant therapy for weight loss gained growing favor among consumers and dietician-nutritionists, with the subsequent astounding increase in health costs. Despite the reassuring label of natural remedy for losing weight, dietary supplements contain a wide variety of ingredients on which available information is rather scanty and scientifically incomplete. Currently, there is little evidence that weight-loss supplements offer effective aids to reduce weight and meet criteria for recommended use. Robust, randomized, placebo-controlled studies to provide clear-cut scientific evidence of their efficacy and potential side effects in clinical practice are still lacking. Understanding the evidence for the efficacy, safety, and quality of these supplements among nutritionists and physicians is critical to counsel patients appropriately, especially considering the risk of serious adverse effects and interference with concomitant therapies. Detailed information on the efficacy and safety of the most commonly used weight-loss dietary supplements has been recently published by the National Institutes of Health (NIH). However, in this report the thorny issue that may result from drug interactions with weight-loss dietary supplements has been not sufficiently addressed. The aim of this review was to provide a synthetic, evidence-based report on efficacy and safety of the most commonly used ingredients in dietary supplements marketed for weight loss, particularly focusing on their possible drug interactions.

The safety and effectiveness of commonly-marketed natural supplements for weight loss in populations with obesity: A critical review of the literature from 2006 to 2016

Objective: To evaluate the evidence published from 2006 to 2016 on the effectiveness and safety of commonly used natural supplements for weight loss in individuals with obesity.Methods: Amazon and Google were searched for names of mono-agent natural supplements marketed for weight loss and a list of the 10 supplements was created. Google Scholar, Pubmed, Science Direct, and the Cochrane Library were searched for articles that met inclusion.Results: At least one article was published on the effectiveness or safety of bitter orange, capsinoid, carnitine, chromium picolinate, Coleus forskohlii, conjugated linoleic acid, glucomannan, green tea and psyllium for weight loss in populations with obesity from 2006 to 2016. There was insufficient evidence to suggest that the natural supplements examined contribute to significant weight loss, with the exception of perhaps glucomannan in the form of PGX. In general, the majority of side-effects reported were minor to moderate, and gastrointestinal-related. However, in some cases extreme side-effects such as liver and kidney failure were observed.Conclusion: Contrary to popular belief, results of this review suggest that the use of natural supplements for weight loss are unlikely to contribute to meaningful weight loss and in some cases may contribute to harm.

Effects of Ultrasonication on the Conformational, Microstructural, and Antioxidant Properties of Konjac Glucomannan

This study aims to evaluate the effects of ultrasonication (US) on the conformational, microstructural, and antioxidant properties of konjac glucomannan (KGM). US treatment with a 20-kHz and 750-W ultrasonic processor at 60% amplitude was applied for partial degradation of KGM with an average molecular weight (MW) of 823.4 kDa. Results indicated that the US treatment caused dramatic reduction in the MW, apparent viscosity, hydrodynamic radius, and z-average mean radius of gyration. The flexibility of chain conformation of native KGM was slightly increased during the US treatment. According to electronic microscopic imaging, the compact, smooth, and orderly fibrous strings formed by KGM were changed to amorphous, porous flakes and globular particles after US treatment. KGM and its US-treated fractions showed moderate radical-scavenging and ferric-reducing antioxidant activity. US degradation of KGM affected these activities either positively or negatively, depending on the US treatment period. In summary, ultrasonic degradation of KGM caused changes in its conformation characteristics, microstructure, and antioxidant activities.

Scientific rigor and credibility in the nutrition research landscape

Scientific progress depends on the quality and credibility of research methods. As discourse on rigor, transparency, and reproducibility joins the cacophony of nutrition information and misinformation in mass media, buttressing the real and perceived reliability of nutrition science is more important than ever. This broad topic was the focus of a 2016 plenary session, "Scientific Rigor and Competing Interests in the Nutrition Research Landscape." This article summarizes and expands on this session in an effort to increase understanding and dialogue with regard to factors that limit the real and perceived reliability of nutrition science and steps that can be taken to mitigate those factors. The end goal is to both earn and merit greater trust in nutrition science by both the scientific community and the general public. The authors offer suggestions in each of the domains of education and training, communications, research conduct, and procedures and policies to help achieve this goal. The authors emphasize the need for adequate funding to support these efforts toward greater rigor and transparency, which will be resource demanding and may require either increased research funding or the recognition that a greater proportion of research funding may need to be allocated to these tasks.

Effects of isolated soluble fiber supplementation on body weight, glycemia, and insulinemia in adults with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials

Background: There is strong epidemiologic evidence that dietary fiber intake is protective against overweight and obesity; however, results of intervention studies have been mixed. Soluble fiber beneficially affects metabolism, and fiber supplementation may be a feasible approach to improve body composition and glycemia in adults with overweight and obesity.Objective: We evaluated randomized controlled trials (RCTs) of isolated soluble fiber supplementation in overweight and obese adults on outcomes related to weight management [body mass index (BMI; in kg/m²), body weight, percentage of body fat, and waist circumference] and glucose and insulin metabolism (homeostasis model assessment of insulin resistance and fasting insulin) through a systematic review and meta-analysis.Design: We searched PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature and Cochrane Library databases. Eligible studies were RCTs that compared isolated soluble fiber with placebo treatments without energy-restriction protocols. Random-effects models were used to estimate pooled effect sizes and 95% CIs. Meta-regressions were performed to assess outcomes in relation to the intervention duration, fiber dose, and fiber type. Publication bias was assessed via Begg's and Egger's tests and funnel plot inspection.Results: Findings from 12 RCTs (n = 609 participants) from 2 to 17 wk of duration are summarized in this review. Soluble fiber supplementation reduced BMI by 0.84 (95% CI: -1.35, -0.32; P = 0.001), body weight by 2.52 kg (95% CI: -4.25, -0.79 kg; P = 0.004), body fat by 0.41% (95% CI: -0.58%, -0.24%; P < 0.001), fasting glucose by 0.17 mmol/L (95% CI: -0.28, -0.06 mmol/L; P = 0.002), and fasting insulin by 15.88 pmol/L (95% CI: -29.05, -2.71 pmol/L; P = 0.02) compared with the effects of placebo treatments. No publication bias was identified. Considerable between-study heterogeneity was observed for most outcomes.Conclusions: Isolated soluble fiber supplementation improves anthropometric and metabolic outcomes in overweight and obese adults, thereby indicating that supplementation may improve fiber intake and health in these individuals. However, the interpretation of these findings warrants caution because of the considerable between-study heterogeneity. This trial was registered at clinicaltrials.gov as NCT03003897.

A Review on Konjac Glucomannan Gels: Microstructure and Application

Konjac glucomannan (KGM) has attracted extensive attention because of its biodegradable, non-toxic, harmless, and biocompatible features. Its gelation performance is one of its most significant characteristics and enables wide applications of KGM gels in food, chemical, pharmaceutical, materials, and other fields. Herein, different preparation methods of KGM gels and their microstructures were reviewed. In addition, KGM applications have been theoretically modeled for future uses.

Re-evaluation of konjac gum (E 425 i) and konjac glucomannan (E 425 ii) as food additives

The present opinion deals with the re-evaluation of konjac (E 425), comprising konjac gum (E 425 i) and konjac glucomannan (E 425 ii) when used as food additives. Following the conceptual framework for the risk assessment of certain food additives re-evaluated under Commission Regulation (EU) No 257/2010, the Panel considered that current use of konjac (E 425) was limited in all food categories to maximum permitted level (MPL) of 10 g/kg, and that the calculated indicative refined exposure assessment for all population groups was below 0.1 mg/kg body weight (bw) per day for the general population (mean and high level). Konjac gum and konjac glucomannan were unlikely to be absorbed intact and were significantly fermented by intestinal microbiota. The available database on toxicological studies was considered limited, however, no relevant adverse effects were seen in rats and dogs in 90-day feeding studies according to the SCF, the no-observed-effect level (NOEL) in rats being 1,250 mg konjac glucomannan/kg bw per day. Konjac gum and konjac glucomannan were of no concern with respect to the genotoxicity. After a daily dosage of 3,000 mg in adults for 12 weeks, several individuals experienced abdominal discomfort including diarrhoea or constipation. The Panel concluded that there was no need for a numerical acceptable daily intake (ADI) and that there was no safety concern for the general population at the refined exposure assessment for the reported uses of konjac gum (E 425 i) and konjac glucomannan (E 425 ii) as food additives under the current conditions of use of 10 g/kg. The Panel agreed with the conclusions of the SCF (1997) that the uses of konjac (E 425) as an additive at the levels up to 10 g/kg in food are acceptable, provided that the total intake from all sources stays below 3 g/day.

Beneficial health characteristics of native and hydrolysed konjac (Amorphophallus konjac) glucomannan

The impact of ingesting glucomannans on health is not limited to colonic-focused fermentation into short-chain fatty acids (SCFAs), which might have some local health benefits; it also helps in treating disease states and enhancing the body's immune system, both within the gut and in/on other parts of the body. The local and systemic roles of hydrolysed glucomannans, especially konjac glucomannans, in the mouth, oesophagus, stomach, small intestine, large intestine, gut-associated lymphoid tissue (GALT), skin and vagina, are highlighted. Therapeutic applications are discussed. © 2015 Society of Chemical Industry.

Konjac glucomannan, a promising polysaccharide of Amorphophallus konjac K. Koch in health care

In recent year, konjac glucomannan (KGM) has attracted more attention due to its non-harmful and non-toxic properties, good biocompatibility, biodegradability and hydrophilic ability. Moreover, KGM and their derivatives have several importances in the multidirectional research areas such as nutritional, biotechnological and fine chemical fields. In the previous article, we have reviewed the nutritional aspects of KGM covering the various aspects of functional foods, food additives and their derivatives. This review aims at highlighting the diverse biomedical research conducted on KGM in the past ten years, covering therapies for anti-obesity, regulation in lipid metabolism, laxative effect, anti-diabetic, anti-inflammatory, prebiotic to wound dressing applications. Moreover, this review deals with global health aspects of KGM and the disparate health related factors associated with diseases and their control measures.

Lipids, blood pressure and kidney update 2015

The most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2015 were reviewed. In lipid research, the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial revalidated the concept "lower is better" for low density lipoprotein (LDL)-cholesterol as a target for therapy, increasing the necessity of treatment the high-risk patients to achieve LDL-C goals. After these results, ezetimibe might become the preferred additional drug in the combination therapy of lipid disorders because of oral dosage form and lower acquisition cost. However, for the statin-intolerant patients and those patients requiring essential reductions in LDL-C to achieve their goals, new therapies, including PCSK9 inhibitors remain promising drugs. In blood pressure research, American Heart Association (AHA)/American College of Cardiology (ACC) 2015 guidelines recommended a target for blood pressure below 140/90 mmHg in stable or unstable coronary artery disease patients and below 150/90 mmHg in patients older than 80 years of age, however the recent results of the Systolic Blood Pressure Intervention Trial (SPRINT) trial have suggested that there might be significant benefits, taking into account cardiovascular risk, for hypertensive patients over 50 without diabetes and blood pressure levels <120/80. In kidney research, reducing the progression of chronic kidney disease and related complications such as anemia, metabolic acidosis, bone and mineral diseases, acute kidney injury and cardiovascular disease is still a goal for clinicians.

Effect of glucomannan supplementation on body weight in overweight and obese children: protocol of a randomised controlled trial

INTRODUCTION

Glucomannan (GNN), a water-soluble dietary fibre derived from the plant Amorphophallus konjac, is marketed for weight reduction. The exact mechanisms by which GNN might exert its actions are unclear. However, it has been shown that GNN slows gastric emptying by forming a viscous gel of large volume, which increases the feeling of satiety. Current evidence on the effectiveness of GNN for weight reduction is sparse, and well-designed trials performed in children are needed to assess the efficacy of this modality. We aim to systematically evaluate the efficacy of GNN consumption for the management of children who are overweight or obese.

METHODS AND ANALYSIS

Children aged 6-17 years who are overweight or obese (based on the WHO growth criteria) will be randomly assigned to receive GNN or placebo (maltodextrin) (both at a dose of 3 g/day) for 3 months and will be followed-up for 3 months. Before the intervention, all children will receive dietetic advice, and they will be encouraged to engage in physical activity. The primary outcome measure will be the body mass index-for-age z-score difference between the groups at the end of the intervention.

ETHICS AND DISSEMINATION

The study was approved by the Bioethics Committee of the Medical University of Warsaw. The findings of this trial will be submitted to a peer-reviewed journal (paediatric, nutrition or gastroenterology). Abstracts will be submitted to relevant national and international conferences.

TRIAL REGISTRATION NUMBER

NCT02280772.