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Park YJ, Kim HJ, Koh DJ, Kim E, Lim YW, An HJ. Effect and mechanisms of Gambi-jung against high-fat diet-induced cardiac apoptosis in mice. Heliyon 2024; 10:e29161. [PMID: 38644871 PMCID: PMC11031771 DOI: 10.1016/j.heliyon.2024.e29161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/23/2024] Open
Abstract
Obesity is associated with an increased risk of cardiovascular disease. Gambi-jung (GBJ), a modified herbal formula of Taeumjowi-tang, induces weight loss in high-fat diet (HFD)-fed obese mice. Meanwhile, concerns have been raised regarding Ephedra sinica Stapf (ES), the primary herb of GBJ, having potential adverse cardiovascular effects. However, there have been no reports on the effects of ES and ephedrine-containing products on obesity-induced cardiac apoptosis. Therefore, to investigated the effect of GBJ and ES on HFD-induced cardiac apoptosis, we utilized Western blot analysis, TUNEL-staining, and histological staining of heart tissues from HFD-fed obese mice. Western blot analysis showed that there were significant changes in the protein levels of anti-apoptotic markers (B-cell lymphoma (BCL) protein 2 (BCL-2), BCL-XL, and X-linked inhibitor of apoptosis protein) and pro-apoptotic markers (Fas, Fas-associated protein with death domain, BCL-2 agonist of cell death, BCL-2 associated X, cytochrome C, and cleaved caspase-9) in the heart of HFD-fed mice. In contrast administration of 250 mg/kg GBJ for 12 weeks significantly reversed the protein levels related to the apoptosis signaling pathway, which was greater than that of ES administration. Furthermore, GBJ-treated mice had markedly decreased number of TUNEL-stained apoptotic cells compared to the HFD group. Moreover, GBJ improved the mitochondrial function by regulating the genes expression of uncoupling protein 2, peroxisome proliferator-activated receptor-γ coactivator-1α, optic atrophy protein 1, and fission protein 1. Notably, hematoxylin and eosin histological staining showed no changes in the heart tissues of GBJ- and ES-treated mice, indicating that long-term administration of GBJ and ES did not exert any adverse effects on the cardiac tissue. The present study lays the foundation to support the efficacy of GBJ in protecting cardiac cell apoptosis induced by HFD feeding, as well as to verify the cardiac safety of GBJ administration.
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Affiliation(s)
- Yea-Jin Park
- Department of Rehabilitative Medicine of Korean Medicine and Neuropsychiatry, College of Korean Medicine, Sangji University, Wonju, Gangwon-do, 26339, Republic of Korea
- Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Hyo-Jung Kim
- Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Duck-Jae Koh
- Nubebe Korean Medical Clinic Jamsil Center, Seoul, 05510, Republic of Korea
| | - Eunjoo Kim
- Nubebe Obesity Research Institute, Seoul, 06634, Republic of Korea
- Nubebe Korean Medical Clinic Bundang Center, Seongnam-si, 13506, Republic of Korea
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Young-Woo Lim
- Nubebe Obesity Research Institute, Seoul, 06634, Republic of Korea
- Nubebe Korean Medical Clinic Bundang Center, Seongnam-si, 13506, Republic of Korea
| | - Hyo-Jin An
- Department of Oriental Pharmaceutical Science, College of Pharmacy, Kyung Hee University, Seoul, 02447, Republic of Korea
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Hyder A. Naturally-occurring carboxylic acids from traditional antidiabetic plants as potential pancreatic islet FABP3 inhibitors. A molecular docking-aided study. Chem Biol Interact 2023; 372:110368. [PMID: 36709838 DOI: 10.1016/j.cbi.2023.110368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023]
Abstract
The antidiabetic action of traditional plants is mostly attributed to their antioxidant and anti-inflammatory properties. These plants are still having some secrets, making them an attractive source that allows for investigating new drugs or uncovering precise pharmacologic antidiabetic functions of their constituents. In diabetes, which is a lipid disease, long-term exposure of pancreatic islet beta cells to fatty acids (FAs) increases basal insulin release, reduces glucose-stimulated insulin secretion, causes islet beta cell inflammation, failure and apoptosis. Pancreatic islet beta cells express fatty acid binding protein 3 (FABP3) that receives long-chain FAs and traffics them throughout different cellular compartments to be metabolized and render their effects. Inhibition of this FABP3 may retard FA metabolism and protect islet beta cells. Since FAs interact with FABPs by their carboxylic group, some traditionally-known antidiabetic plants were reviewed in the present study, searching for their components that have common features of FABP ligands, namely carboxylic group and hydrophobic tail. Many of these carboxylic acids were computationally introduced into the ligand-binding pocket of FABP3 and some of them exhibited FABP3 ligand possibilities. Among others, the naturally occurring ferulic, cleomaldeic, caffeic, sinapic, hydroxycinnamic, 4-p-coumaroylquinic, quinoline-2-carboxylic, chlorogenic, 6-hydroxykynurenic, and rosmarinic acids in many plants are promising candidates for being FABP3-specific inhibitors. The study shed light on repurposing these phyto-carboxylic acids to function as FABP inhibitors. However, more in-depth biological and pharmacological studies to broaden the understanding of this function are needed.
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Affiliation(s)
- Ayman Hyder
- Faculty of Science, Damietta University, New Damietta 34517, Egypt.
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3
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Song EJ, Shin NR, Jeon S, Nam YD, Kim H. Impact of the herbal medicine, Ephedra sinica stapf, on gut microbiota and body weight in a diet-induced obesity model. Front Pharmacol 2022; 13:1042833. [DOI: 10.3389/fphar.2022.1042833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Obesity is a chronic metabolic disease caused by excessive body fat and has become a global public health problem. Evidence suggests that obesity and obesity-induced metabolic disorders are closely related to gut microbiota. Bupropion (BP), an antidepressant medicine, and Ephedra sinica Stapf [Ephedraceae; Ephedrae Herba], a herbal medicine, are sympathetic stimulants and have weight loss effects. However, to our best knowledge, no studies have simultaneously assessed the effects of drugs and herbal medicines on obesity and gut microbiota. This study aimed to determine the effects of BP and ES on weight loss and re-modulation of host gut microbiota. To test this hypothesis, we fed C57BL/6J mice with a high-fat diet supplemented with bupropion (BP; 30 mg/kg/day) and Ephedra sinica Stapf extract (ES; 150 mg/kg/day) via oral gavage for eight weeks. Further, we evaluated the effects of BP and ES on body weight and fat accumulation. In addition, we evaluated the effects of BP and ES on gut microbiota using 16S rRNA amplicon sequencing. Our results showed that weight loss was confirmed in both BP and ES; however, it was more pronounced in ES. ES changed the overall composition of the gut microbiota by restoring the relative abundance of Oscillospiraceae, Lachnospiraceae, and the Firmicutes/Bacteroidetes ratio, an indicator of gut microbiota dysbiosis. Nine amplicon sequence variants (ASVs) of the gut microbiome were significantly recovered by BP and ES treatment, of which eight ASVs correlated with body weight and fat accumulation. Additionally, three ASVs were significantly recovered by ES treatment alone. In conclusion, the anti-obesity effects of BP and ES, especially fat accumulation, are related to the regulation of gut microbiota. Moreover, ES had a greater influence on the gut microbiota than BP.
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Rebello CJ, Greenway FL, Zhang D, Johnson WD, Patterson E, Raum W. Sympathomimetic increases resting energy expenditure following bariatric surgery: A randomized controlled clinical trial. Obesity (Silver Spring) 2022; 30:874-883. [PMID: 35244344 PMCID: PMC10167942 DOI: 10.1002/oby.23384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to test the hypothesis that ephedrine + caffeine (EC) reduces the fall in resting energy expenditure (REE) following bariatric surgery. METHODS This 32-week, randomized, double-blinded, placebo-controlled trial included 142 patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery. Participants were randomized to either EC or placebo for 27 weeks, beginning 5 weeks post surgery. The primary end points were change in REE (measured), percentage of predicted REE ([measured REE/Harris-Benedict equation-predicted REE] × 100), and body composition. Secondary outcomes included change in percentage of weight. Adverse events (AEs) were recorded. RESULTS The reduction in REE was smaller in the EC versus the placebo group, but it was not significant. Percentage of predicted REE was increased in the EC versus the placebo group (difference, mean [SE]: 5.82 [2.29], p = 0.013). Percentage of weight (difference: -3.83 [1.39], p = 0.007) was reduced in the EC versus the placebo group. Percentage of predicted REE was increased and body weight decreased in the EC-treated participants who underwent SG compared with those who underwent SG and were treated with placebo (difference in percentage of predicted REE = 8.06 [2.83], p = 0.006; difference in weight percentage = -4.37 [1.92], p = 0.025). Percentage of fat-free mass was increased in the SG participants treated with EC versus placebo (difference: 1.31 [0.63], p = 0.042). The most common AEs were anxiety, dizziness, insomnia, and tremors. Most AEs were not different from placebo by Week 32. CONCLUSIONS EC enhances weight loss and reduces the fall in REE following bariatric surgery. Adrenergic symptoms mostly resolve over time.
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Affiliation(s)
- Candida J Rebello
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Frank L Greenway
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Dachuan Zhang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - William D Johnson
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | | | - William Raum
- Oregon Weight Loss Surgery, LLC, Portland, Oregon, USA
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Effects of Aerobic Exercise Concurrent with Caffeine Supplementation on Weight and Body Fat Among Overweight Women. Asian J Sports Med 2022. [DOI: 10.5812/asjsm.116015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Obesity and overweight are among serious global epidemics that significantly threaten human health, especially among women. Objectives: This study aimed to assess the concurrent effects of 6-week caffeine supplementation with moderate-intensity aerobic exercise on weight and body fat among overweight women. Methods: Thirty overweight females (age: 36.47 ± 6.48 years; BMI: 27.61 ± 1.54 kg/m2; mean ± SD) with a sedentary lifestyle were recruited to the study. The participants were randomly allocated to the experimental group, EC (exercise + caffeine) group, who took 100 milligrams of caffeine of the “API” brand supplement 30 minutes before exercise training (n = 15) or control group, EP (exercise + placebo) (n = 15). All participants performed moderate-intensity aerobic exercise with an intensity of 40 to 60% of heart rate reserve based on the individual's exercise test for 30 minutes, three days a week for six weeks. Measurements, including the percentage of body fat, waist circumference, and skinfold (suprailiac, abdominal), were done two times, at baseline and after six weeks of exercising. Results: There were no significant differences between control and experimental groups related to weight (P = 0.22), percentage body fat (P = 0.88), and other measurements after six weeks. Conclusions: 6 weeks of caffeine supplementation combined with moderate-intensity aerobic exercise without dietary interventions couldn’t make a significant reduction in weight and central or total body fat among overweight women.
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Qu W, Chen Z, Hu X, Zou T, Huang Y, Zhang Y, Hu Y, Tian S, Wan J, Liao R, Bai L, Xue J, Ding Y, Hu M, Zhang XJ, Zhang X, Zhao J, Cheng X, She ZG, Li H. Profound Perturbation in the Metabolome of a Canine Obesity and Metabolic Disorder Model. Front Endocrinol (Lausanne) 2022; 13:849060. [PMID: 35620391 PMCID: PMC9128610 DOI: 10.3389/fendo.2022.849060] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/17/2022] [Indexed: 12/19/2022] Open
Abstract
Canine models are increasingly being used in metabolic studies due to their physiological similarity with humans. The present study aimed to identify changes in metabolic pathways and biomarkers with potential clinical utility in a canine model of obesity and metabolic disorders induced by a high-fat diet (HFD). Eighteen male beagles were included in this study, 9 of which were fed a HFD for 24 weeks, and the remaining 9 were fed normal chow (NC) during the same period. Plasma and urine samples were collected at weeks 12 and 24 for untargeted metabolomic analysis. Dogs fed a HFD showed a gradual body weight increase during the feeding period and had hyperlipidemia, increased leukocyte counts, and impaired insulin sensitivity at week 24. Plasma and urine metabonomics analysis displayed clear separations between the HFD-fed and NC-fed dogs. A total of 263 plasma metabolites varied between the two groups, including stearidonic acid, linolenic acid, carnitine, long-chain ceramide, 3-methylxanthine, and theophylline, which are mainly engaged in fatty acid metabolism, sphingolipid metabolism, and caffeine metabolism. A total of 132 urine metabolites related to HFD-induced obesity and metabolic disorders were identified, including 3-methylxanthine, theophylline, pyridoxal 5'-phosphate, and harmine, which participate in pathways such as caffeine metabolism and vitamin digestion and absorption. Eight metabolites with increased abundance (e.g., 3-methylxanthine, theophylline, and harmine) and 4 metabolites with decreased abundance (e.g., trigonelline) in both the plasma and urine of the HFD-fed dogs were identified. In conclusion, the metabolomic analysis revealed molecular events underlying a canine HFD model and identified several metabolites as potential targets for the prevention and treatment of obesity-related metabolic disorders.
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Affiliation(s)
- Weiyi Qu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Ze Chen
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xing Hu
- Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
| | - Toujun Zou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Yongping Huang
- Institute of Model Animal, Wuhan University, Wuhan, China
- College of Life Sciences, Wuhan University, Wuhan, China
| | - Yanyan Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Yufeng Hu
- Institute of Model Animal, Wuhan University, Wuhan, China
- Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
| | - Song Tian
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Juan Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Rufang Liao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lan Bai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Jinhua Xue
- Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
- Department of Pathophysiology, School of Basic Medical Sciences, Gannan Medical University, Ganzhou, China
| | - Yi Ding
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Manli Hu
- Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
| | - Xiao-Jing Zhang
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
| | - Xin Zhang
- Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
| | - Jingjing Zhao
- Department of Cardiology, Tongren Hospital of Wuhan University and Wuhan Third Hospital, Wuhan, China
| | - Xu Cheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- *Correspondence: Hongliang Li, ; Zhi-Gang She, ; Xu Cheng,
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- *Correspondence: Hongliang Li, ; Zhi-Gang She, ; Xu Cheng,
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- School of Basic Medical Science, Wuhan University, Wuhan, China
- *Correspondence: Hongliang Li, ; Zhi-Gang She, ; Xu Cheng,
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Smita RM, Shuvo APR, Raihan S, Jahan R, Simin FA, Rahman A, Biswas S, Salem L, Sagor MAT. The Role of Mineral Deficiencies in Insulin Resistance and Obesity. Curr Diabetes Rev 2022; 18:e171121197987. [PMID: 34789132 DOI: 10.2174/1573399818666211117104626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/06/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022]
Abstract
Minerals are critical for maintaining overall health. These tiny chemical compounds are responsible for enzymatic activation, maintaining healthy teeth and bones, regulating energy metabolism, enhancing immunity, and aiding muscle and brain function. However, mineral deficiency in the form of inadequate or under nourished intake affects millions of people throughout the world, with well-documented adverse health consequences of malnutrition. Conversely, mineral deficiency may also be a risk factor for Insulin Resistance (IR) and obesity. This review focuses on another, more "less discussed" form of malnutrition, namely mineral deficiency and its contribution to metabolic disorders. At the cellular level, minerals maintain not only molecular communication but also trigger several key biochemical pathways. Disturbances in these processes due to mineral insufficiency may gradually lead to metabolic disorders such as insulin resistance, pre-diabetes, and central obesity, which might lead to renal failure, cardiac arrest, hepatic carcinoma, and various neurodegenerative diseases. Here we discuss the burden of disease promoted by mineral deficiencies and the medical, social, and economic consequences. Mineral deficiency-mediated IR and obesity have a considerable negative impact on individual well-being, physical consideration, and economic productivity. We discuss possible molecular mechanisms of mineral deficiency that may lead to IR and obesity and suggest strategies to counter these metabolic disorders. To protect mankind from mineral nutrient deficiencies, the key is to take a variety of foods in reasonable quantities, such as organic and pasture-raised eggs, low fat dairy, and grass-fed and finished meats, insecticide, and pesticide-free vegetables and fruits.
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Affiliation(s)
| | | | - Sabbir Raihan
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Rajib Jahan
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Faria Anjum Simin
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Ashiqur Rahman
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Soumick Biswas
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Liyad Salem
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
| | - Md Abu Taher Sagor
- Department of Pharmaceutical Sciences, North South University, Dhaka, Bangladesh
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The Role of Bioactive Compounds from Dietary Spices in the Management of Metabolic Syndrome: An Overview. Nutrients 2021; 14:nu14010175. [PMID: 35011050 PMCID: PMC8747161 DOI: 10.3390/nu14010175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022] Open
Abstract
Metabolic syndrome (MetS) is a combination of physiologically dysregulated parameters that can include elevated fasting blood glucose, high blood pressure, central obesity, increased triglyceride levels, insulin resistance, diabetes, elevated low density lipoprotein levels, and reduced high density lipoprotein levels in the blood. Effective clinical management of MetS is critical as it is strongly associated with long lasting and fatal complications in patients. Alongside standard care of lifestyle changes and medication, dietary supplements derived from herbal resources could be an alternative therapeutic strategy that is safe, efficient, culturally acceptable, and has few side effects. Of the dietary supplements, spicy foods have always been considered a great source of functional bioactive compounds. Herbal therapy is broadly used in many countries as a treatment or as a preventive measure in the management of MetS risk factors, including blood glucose, blood pressure, and blood lipid levels. Herein, an attempt is made to evaluate the recent studies in the management of MetS with herbal alternatives, and to explore the possibility of their use as therapeutic treatments or supplements.
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9
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Effects of Ephedrine-Containing Products on Weight Loss and Lipid Profiles: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pharmaceuticals (Basel) 2021; 14:ph14111198. [PMID: 34832979 PMCID: PMC8618781 DOI: 10.3390/ph14111198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 01/15/2023] Open
Abstract
Ephedrine, the main active ingredient of mahuang, may lead to weight loss; however, it can also induce cardiovascular side effects. As ephedrine use remains controversial, this study aimed to systematically review previous studies on ephedrine-containing products and perform meta-analysis of the existing evidence on weight, blood pressure (BP), heart rate, and lipid change effects of ephedrine-containing products. We searched for placebo-controlled randomized studies in PubMed, Web of Science, and EMBASE until July 2021 using the following search terms: (ephedr* OR mahuang) AND (“weight loss” OR obes* OR overweight). Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of ephedrine-containing products on weight, BP, heart rate, and lipid profiles. A total of 10 articles were included. Compared with the placebo group, the ephedrine-containing product group was associated with greater weight loss, with an MD of −1.97 kg (95% CI: −2.38, −1.57). In the ephedrine-containing product group, the mean heart rate was 5.76 beats/min higher than in the placebo group (95% CI: 3.42, 8.10), whereas intergroup differences in systolic and diastolic BP were not statistically significant. The ephedrine-containing product group had a significantly higher mean high-density lipoprotein cholesterol level (MD: 2.74 mg/dL; 95% CI: 0.94, 4.55), lower mean low-density lipoprotein cholesterol level (MD: −5.98 mg/dL; 95% CI: −10.97, −0.99), and lower mean triglyceride level (MD: −11.25 mg/dL; 95% CI: −21.83, −0.68) than the placebo group. Compared with placebo, the ephedrine-containing products showed better effects on weight loss and lipid profiles, whereas they caused increased heart rate. The ephedrine-containing products may be beneficial to obese or overweight patients; however, close monitoring is needed, especially heart rate monitoring.
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10
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Gad MZ, Azab SS, Khattab AR, Farag MA. Over a century since ephedrine discovery: an updated revisit to its pharmacological aspects, functionality and toxicity in comparison to its herbal extracts. Food Funct 2021; 12:9563-9582. [PMID: 34533553 DOI: 10.1039/d1fo02093e] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Ephedrine, a sympathomimetic amine that exhibits several adrenaline actions, is a plant alkaloid that is a common ingredient in several cold, asthma and narcolepsy treatment preparations, and in obesity management and sport medicine. Its principal action mechanism relies on its direct adrenergic actions as well as indirect role that involves the release of epinephrine and norepinephrine, thus increasing the activity of epinephrine and norepinephrine at the postsynaptic α and β receptors. Nevertheless, its serious side effects, including stroke, heart attack, drug abuse and interactions, have never been comprehensively reviewed. We conducted a systematic review of data on ephedrine, including its occurrence in functional foods, pharmacological aspects, metabolism, pharmaco/toxicokinetics and clinical features. Furthermore, a review of ephedrine natural structural analogues with regards to their differential adrenergic receptor binding affinities, food interaction, and their impact on the pharmacokinetics and effects relative to ephedrine are presented for the first time, and in comparison to its action when present in herbs.
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Affiliation(s)
- Mohamed Z Gad
- Department of Biochemistry, Faculty of Pharmacy & Biotechnology, The German University in Cairo, Egypt
| | - Samar S Azab
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Amira R Khattab
- Pharmacognosy Department, College of Pharmacy, Arab Academy for Science, Technology and Maritime Transport, Alexandria 1029, Egypt
| | - Mohamed A Farag
- Pharmacognosy Department, College of Pharmacy, Cairo University, Kasr El Aini St, P.B. 11562, Cairo, Egypt. .,Chemistry Department, School of Sciences & Engineering, The American University in Cairo, New Cairo 11835, Egypt
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11
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Bessell E, Maunder A, Lauche R, Adams J, Sainsbury A, Fuller NR. Efficacy of dietary supplements containing isolated organic compounds for weight loss: a systematic review and meta-analysis of randomised placebo-controlled trials. Int J Obes (Lond) 2021; 45:1631-1643. [PMID: 33976376 DOI: 10.1038/s41366-021-00839-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/07/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
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.
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Affiliation(s)
- Erica Bessell
- The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, Sydney, NSW, Australia.
| | - Alison Maunder
- The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, Sydney, NSW, Australia.,Western Sydney University, NICM Health Research Institute, Penrith, NSW, Australia
| | - Romy Lauche
- Southern Cross University, National Centre for Naturopathic Medicine, Lismore, NSW, Australia.,University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), School of Public Health, Faculty of Health, Sydney, NSW, Australia
| | - Jon Adams
- University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), School of Public Health, Faculty of Health, Sydney, NSW, Australia
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Faculty of Science, Perth, WA, Australia
| | - Nicholas R Fuller
- The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, Sydney, NSW, Australia
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12
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Batsis JA, Apolzan JW, Bagley PJ, Blunt HB, Divan V, Gill S, Golden A, Gundamraj S, Heymsfield S, Kahan S, Kopatsis K, Port A, Parks EP, Reilly CA, Rubino D, Saunders KH, Shean R, Tabaza L, Stanley A, Tchang BG, Gundumraj S, Kidambi S. A Systematic Review of Dietary Supplements and Alternative Therapies for Weight Loss. Obesity (Silver Spring) 2021; 29:1102-1113. [PMID: 34159755 PMCID: PMC8231729 DOI: 10.1002/oby.23110] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Dietary supplements and alternative therapies are commercialized as a panacea for obesity/weight gain as a result of the minimal regulatory requirements in demonstrating efficacy. These products may indirectly undermine the value of guideline-driven obesity treatments. Included in this study is a systematic review of the literature of purported dietary supplements and alternative therapies for weight loss. METHODS A systematic review was conducted to evaluate the efficacy of dietary supplements and alternative therapies for weight loss in participants aged ≥18 years. Searches of Medline (PubMed), Cochrane Library, Web of Science, CINAHL, and Embase (Ovid) were conducted. Risk of bias and results were summarized qualitatively. RESULTS Of the 20,504 citations retrieved in the database search, 1,743 full-text articles were reviewed, 315 of which were randomized controlled trials evaluating the efficacy of 14 purported dietary supplements, therapies, or a combination thereof. Risk of bias and sufficiency of data varied widely. Few studies (n = 52 [16.5%]) were classified as low risk and sufficient to support efficacy. Of these, only 16 (31%) noted significant pre/post intergroup differences in weight (range: 0.3-4.93 kg). CONCLUSIONS Dietary supplements and alternative therapies for weight loss have a limited high-quality evidence base of efficacy. Practitioners and patients should be aware of the scientific evidence of claims before recommending use.
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Affiliation(s)
- John A. Batsis
- Division of Geriatric Medicine, School of Medicine, and the Department of Nutrition, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John W. Apolzan
- Pennington Biomedical Research Center, Louisiana State University Sysytem, Baton Rouge, Louisiana
| | | | | | | | - Sonia Gill
- University of California, Davis School of Medicine, Sacramento, California
| | | | | | - Steven Heymsfield
- Pennington Biomedical Research Center, Louisiana State University Sysytem, Baton Rouge, Louisiana
| | - Scott Kahan
- Director, National Center for Weight and Wellness, George Washington University Milken Institute School of Public Health, Washington, DC
| | | | - Ava Port
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
| | - Elizabeth Prout Parks
- The Children’s Hospital of Philadelphia, Division of Gastroenterology, Hepatology and Nutrition, The Healthy Weight Program, Perelman Medical Center, University of Pennsylvania
| | - Clifford A. Reilly
- The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington VT
| | - Domenica Rubino
- Washington Center for Weight Management and Research, Arlington, VA
| | - Katherine H. Saunders
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, New York, NY
| | - Ryan Shean
- Dartmouth College, Hanover, New Hampshire
| | - Luai Tabaza
- Albert Einstein Medical Center, Philadelphia, PA
| | - Abishek Stanley
- Pennington Biomedical Research Center, Louisiana State University Sysytem, Baton Rouge, Louisiana
| | - Beverly G. Tchang
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, New York, NY
| | - Shivani Gundumraj
- AT Still University School of Osteopathic Medicine in Arizona, Mesa, AZ
| | - Srividya Kidambi
- Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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13
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Komolafe K, Komolafe TR, Fatoki TH, Akinmoladun AC, Brai BIC, Olaleye MT, Akindahunsi AA. Coronavirus Disease 2019 and Herbal Therapy: Pertinent Issues Relating to Toxicity and Standardization of Phytopharmaceuticals. REVISTA BRASILEIRA DE FARMACOGNOSIA : ORGAO OFICIAL DA SOCIEDADE BRASILEIRA DE FARMACOGNOSIA 2021; 31:142-161. [PMID: 33727754 PMCID: PMC7951132 DOI: 10.1007/s43450-021-00132-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/19/2021] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a virulent viral disease that has now become a public health emergency of global significance and still without an approved treatment regimen or cure. In the absence of curative drugs and with vaccines development still in progress, alternative approaches to stem the tide of the pandemic are being considered. The potential of a phytotherapeutic approach in the management of the dreaded disease has gained attention, especially in developing countries, with several claims of the development of anti-COVID-19 herbal formulations. This is a plausible approach especially with the increasing acceptance of herbal medicine in both alternative and orthodox medical practices worldwide. Also, the established efficacy of herbal remedies in the treatment of numerous viral diseases including those caused by coronaviruses, as well as diseases with symptoms associated with COVID-19, presents a valid case for serious consideration of herbal medicine in the treatment of COVID-19. However, there are legitimate concerns and daunting challenges with the use of herbs and herbal products. These include issues of quality control, unethical production practice, inadequate information on the composition, use and mechanisms, weak regulatory policies, herb-drug interactions and adverse reactions, and the tendency for abuse. This review discusses the feasibility of intervention with herbal medicine in the COVID-19 pandemic and the need to take proactive measures to protect public health by improving the quality and safety of herbal medicine deployed to combat the disease. Graphical abstract. Supplementary Information The online version contains supplementary material available at 10.1007/s43450-021-00132-x.
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Affiliation(s)
- Kayode Komolafe
- Department of Biochemistry, Faculty of Science, Federal University Oye-Ekiti, PMB 373, Oye-Ekiti, Nigeria
| | - Titilope Ruth Komolafe
- Department of Biochemistry, Faculty of Science, Federal University Oye-Ekiti, PMB 373, Oye-Ekiti, Nigeria
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
| | - Toluwase Hezekiah Fatoki
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
| | - Afolabi Clement Akinmoladun
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
| | - Bartholomew I. C. Brai
- Department of Biochemistry, Faculty of Science, Federal University Oye-Ekiti, PMB 373, Oye-Ekiti, Nigeria
| | - Mary Tolulope Olaleye
- Department of Biochemistry, School of Sciences, The Federal University of Technology, PMB 704, Akure, Nigeria
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14
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Chávez-Castillo M, Nuñez V, Rojas M, Ortega Á, Durán P, Pirela D, Marquina M, Cano C, Chacín M, Velasco M, Rojas-Quintero J, Bermúdez V. Exploring Phytotherapeutic Alternatives for Obesity, Insulin Resistance and Diabetes Mellitus. Curr Pharm Des 2021; 26:4430-4443. [PMID: 32611293 DOI: 10.2174/1381612826666200701205132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/29/2020] [Indexed: 11/22/2022]
Abstract
At present, the pathologic spectrum of obesity-insulin resistance (IR)-diabetes mellitus (DM) represents not only a pressing matter in public health but also a paramount object of study in biomedical research, as they constitute major risk factors for cardiovascular disease (CVD), and other chronic non-communicable diseases (NCD). Phytotherapy, the use of medicinal herbs (MH) with treatment purposes, offers a wide array of opportunities for innovation in the management of these disorders; mainly as pharmacological research on small molecules accumulates. Several MH has displayed varied mechanisms of action relevant to the pathogenesis of obesity, IR and DM, including immunological and endocrine modulation, reduction of inflammation and oxidative stress (OS), regulation of appetite, thermogenesis and energy homeostasis, sensitisation to insulin function and potentiation of insulin release, among many others. However, the clinical correlates of these molecular phenomena remain relatively uncertain, with only a handful of MH boasting convincing clinical evidence in this regard. This review comprises an exploration of currently available preclinical and clinical research on the role of MH in the management of obesity, IR, and DM.
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Affiliation(s)
- Mervin Chávez-Castillo
- Psychiatric Hospital of Maracaibo, Maracaibo, Venezuela,Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Victoria Nuñez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Milagros Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Ángel Ortega
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Pablo Durán
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Daniela Pirela
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - María Marquina
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Maricarmen Chacín
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
| | - Manuel Velasco
- Clinical Pharmacology Unit, José María Vargas School of Medicine, Central University of Venezuela, Caracas-Venezuela
| | - Joselyn Rojas-Quintero
- Pulmonary and Critical Care Medicine Department, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Valmore Bermúdez
- Universidad Simón Bolívar, Facultad de Ciencias de la Salud, Barranquilla, Colombia
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15
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Stohs SJ, Shara M, Ray SD. p-Synephrine, ephedrine, p-octopamine and m-synephrine: Comparative mechanistic, physiological and pharmacological properties. Phytother Res 2020; 34:1838-1846. [PMID: 32101364 PMCID: PMC7496387 DOI: 10.1002/ptr.6649] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 01/23/2023]
Abstract
Confusion and misunderstanding exist regarding the lack of cardiovascular and other adverse health effects of p-synephrine and p-octopamine relative to ephedrine and m-synephrine (phenylephrine) which are known for their effects on the cardiovascular system. These four molecules have some structural similarities. However, the structural and stereochemical differences of p-synephrine and p-octopamine as related to ephedrine and m-synephrine result in markedly different adrenergic receptor binding characteristics as well as other mechanistic differences which are reviewed. p-Synephrine and p-octopamine exhibit little binding to α-1, α-2, β-1 and β-2 adrenergic receptors, nor are they known to exhibit indirect actions leading to an increase in available levels of endogenous norepinephrine and epinephrine at commonly used doses. The relative absence of these mechanistic actions provides an explanation for their lack of production of cardiovascular effects at commonly used oral doses as compared to ephedrine and m-synephrine. As a consequence, the effects of ephedrine and m-synephrine cannot be directly extrapolated to p-synephrine and p-octopamine which exhibit significantly different pharmacokinetic, and physiological/pharmacological properties. These conclusions are supported by human, animal and in vitro studies that are discussed.
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Affiliation(s)
- Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska.,Department of Pharmaceutical & Biomedical Sciences, Kitsto Consulting LLC, Frisco, Texas
| | - Mohd Shara
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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16
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Payab M, Hasani-Ranjbar S, Shahbal N, Qorbani M, Aletaha A, Haghi-Aminjan H, Soltani A, Khatami F, Nikfar S, Hassani S, Abdollahi M, Larijani B. Effect of the herbal medicines in obesity and metabolic syndrome: A systematic review and meta-analysis of clinical trials. Phytother Res 2019; 34:526-545. [PMID: 31793087 DOI: 10.1002/ptr.6547] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 09/18/2019] [Accepted: 10/24/2019] [Indexed: 12/12/2022]
Abstract
Obesity is a medical situation in which excess body fat has gathered because of imbalance between energy intake and energy expenditure. In spite of the fact that the variety of studies are available for obesity treatment and management, its "globesity" still remains a big challenge all over the world. The current systematic review and meta-analysis aimed to evaluate the efficacy, safety, and mechanisms of effective herbal medicines in the management and treatment of obesity and metabolic syndrome in human. We systematically searched all relevant clinical trials via Web of Science, Scopus, PubMed, and the Cochrane database to assess the effects of raw or refined products derived from plants or parts of plants on obesity and metabolic syndrome in overweight and obesity adult subjects. All studies conducted by the end of May 2019 were considered in the systematic review. Data were extracted independently by two experts. The quality assessment was assessed using Consolidated Standards of Reporting Trials checklist. The main outcomes were anthropometric indices and metabolic syndrome components. Pooled effect of herbal medicines on obesity and metabolic syndrome were presented as standardized mean difference (SMD) and 95% confidence interval (CI). A total of 279 relevant clinical trials were included. Herbals containing green tea, Phaseolus vulgaris, Garcinia cambogia, Nigella sativa, puerh tea, Irvingia gabonensis, and Caralluma fimbriata and their active ingredients were found to be effective in the management of obesity and metabolic syndrome. In addition, C. fimbriata, flaxseed, spinach, and fenugreek were able to reduce appetite. Meta-analysis showed that intake of green tea resulted in a significant improvement in weight ([SMD]: -0.75 [-1.18, -0.319]), body mass index ([SMD]: -1.2 [-1.82, -0.57]), waist circumference ([SMD]: -1.71 [-2.66, -0.77]), hip circumference ([SMD]: -0.42 [-1.02, -0.19]), and total cholesterol, ([SMD]: -0.43 [-0.77, -0.09]). In addition, the intake of P. vulgaris and N. sativa resulted in a significant improvement in weight ([SMD]: -0.88, 95 % CI: [-1.13, -0.63]) and triglyceride ([SMD]: -1.67, 95 % CI: [-2.54, -0.79]), respectively. High quality trials are still needed to firmly establish the clinical efficacy of the plants in obesity and metabolic syndrome.
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Affiliation(s)
- Moloud Payab
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Azadeh Aletaha
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of medical Sciences, Tehran, Iran
| | - Hamed Haghi-Aminjan
- Pharmaceutical Science Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Akbar Soltani
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of medical Sciences, Tehran, Iran
| | - Fatemeh Khatami
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, and Evidence-based Evaluation of Cost-Effectiveness and Clinical Outcomes Group, Pharmaceutical Science Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Shokoufeh Hassani
- Toxicology and Diseases Group (TDG), Pharmaceutical Science Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group (TDG), Pharmaceutical Science Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), and Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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17
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Abstract
OBJECTIVE A retrospective chart review was conducted to explore the effect of Gambisan, a granular extract of novel herbal medicine, for short-term (≤16 weeks) weight loss in adults who are overweight and those with obesity. METHODS Outpatients of Kyung Hee University Korean Medicine Hospital (Seoul, Korea) who took Gambisan and underwent bioelectric impedance analysis were selected (Jan 2011 to Dec 2015); their electronic medical records and clinical charts were retrospectively reviewed. The effectiveness of Gambisan was primarily evaluated by comparing body weight (BW) at baseline and endpoint, using paired t tests; the safety of Gambisan was evaluated on the basis of adverse events (AEs) experienced by patients. RESULTS Two hundred five patients were included in this study. The study population exhibited a significant reduction in BW (73.69 ± 14.49 kg to 69.01 ± 13.20 kg, P < .001) as well as percentage body fat (37.38 ± 5.38% to 34.50 ± 5.83%, P < .001). Moreover, 111 (54.1%) patients achieved modest weight loss (≥5%), while 35 (17.1%) achieved ≥10% weight loss. Furthermore, Gambisan induced significant reduction of BW in all subgroups (body mass index, sex, prescribed duration, and dosage). Among 139 patients with available data, 79 (56.8%) reported loss-of-appetite. In addition, 120 (mostly mild) AEs were reported in 69 (49.6%) patients, and the most frequent AEs were nausea, palpitation, and insomnia. DISCUSSION Despite limitations in interpreting the results of this retrospective medical record review, Gambisan induced statistically and clinically meaningful weight loss with a tolerable level of AEs. Based on the findings of this review, further well-designed clinical trials are warranted.
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Affiliation(s)
- Dae-Hyun Jo
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University
- Department of Korean Medicine, Geumwang Health Subcenter, Bureau of Health Policy, Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Seunghoon Lee
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University
| | - Jae-Dong Lee
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University
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18
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Stuby J, Gravestock I, Wolfram E, Pichierri G, Steurer J, Burgstaller JM. Appetite-Suppressing and Satiety-Increasing Bioactive Phytochemicals: A Systematic Review. Nutrients 2019; 11:nu11092238. [PMID: 31533291 PMCID: PMC6769678 DOI: 10.3390/nu11092238] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022] Open
Abstract
The prevalence of obesity is increasing worldwide. Bioactive phytochemicals in food supplements are a trending approach to facilitate dieting and to improve patients' adherence to reducing food and caloric intake. The aim of this systematic review was to assess efficacy and safety of the most commonly used bioactive phytochemicals with appetite/hunger-suppressing and/or satiety/fullness-increasing properties. To be eligible, studies needed to have included at least 10 patients per group aged 18 years or older with no serious health problems except for overweight or obesity. Of those studies, 32 met the inclusion criteria, in which 27 different plants were tested alone or as a combination, regarding their efficacy in suppressing appetite/hunger and/or increasing satiety/fullness. The plant extracts most tested were derived from Camellia sinensis (green tea), Capsicum annuum, and Coffea species. None of the plant extracts tested in several trials showed a consistent positive treatment effect. Furthermore, only a few adverse events were reported, but none serious. The findings revealed mostly inconclusive evidence that the tested bioactive phytochemicals are effective in suppressing appetite/hunger and/or increasing satiety/fullness. More systematic and high quality clinical studies are necessary to determine the benefits and safety of phytochemical complementary remedies for dampening the feeling of hunger during dieting.
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Affiliation(s)
- Johann Stuby
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, 8032 Zurich, Switzerland; (I.G.); (G.P.); (J.S.); (J.M.B.)
- Correspondence: ; Tel.: +41-44-255-7503
| | - Isaac Gravestock
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, 8032 Zurich, Switzerland; (I.G.); (G.P.); (J.S.); (J.M.B.)
| | - Evelyn Wolfram
- ZHAW Life Sciences und Facility Management, Phytopharmacy & Natural Product Research Group, 8820 Waedenswil, Switzerland;
| | - Giuseppe Pichierri
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, 8032 Zurich, Switzerland; (I.G.); (G.P.); (J.S.); (J.M.B.)
| | - Johann Steurer
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, 8032 Zurich, Switzerland; (I.G.); (G.P.); (J.S.); (J.M.B.)
| | - Jakob M. Burgstaller
- Horten Centre for Patient Oriented Research and Knowledge Transfer, University of Zurich, 8032 Zurich, Switzerland; (I.G.); (G.P.); (J.S.); (J.M.B.)
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19
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Tabrizi R, Saneei P, Lankarani KB, Akbari M, Kolahdooz F, Esmaillzadeh A, Nadi-Ravandi S, Mazoochi M, Asemi Z. The effects of caffeine intake on weight loss: a systematic review and dos-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2018; 59:2688-2696. [PMID: 30335479 DOI: 10.1080/10408398.2018.1507996] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Reza Tabrizi
- Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- Food Security Research Center, Department of Community Nutrition School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamran B Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Akbari
- Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariba Kolahdooz
- Indigenous and Global Health Research, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Department of Community Nutrition School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayyeh Nadi-Ravandi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Majid Mazoochi
- Department of Cardiology School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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20
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Haghighatdoost F, Nobakht M. Gh BF, Hariri M. Effect of green tea on plasma leptin and ghrelin levels: A systematic review and meta-analysis of randomized controlled clinical trials. Nutrition 2018; 45:17-23. [DOI: 10.1016/j.nut.2017.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 06/26/2017] [Accepted: 06/30/2017] [Indexed: 01/22/2023]
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21
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Gallien G, Bellar D, Davis GR. The Efficacy of a Pre-Workout Vegan Supplement on High-Intensity Cycling Performance in Healthy College-Aged Males. J Diet Suppl 2017; 14:697-705. [PMID: 28429998 DOI: 10.1080/19390211.2017.1310780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a limited supply of sport nutrition supplements currently available for vegan or vegetarian athletes. In addition, the efficacy of a vegan or vegetarian pre-workout supplement that does not contain any processed ingredients or stimulants is currently unknown. The purpose of the current study was to examine the effects of an unprocessed vegan pre-workout supplement on high-intensity cycling performance. Participants completed three separate cycling trials following the consumption of a vegan pre-workout supplement, an isocaloric processed supplement, or a zero-calorie placebo supplement. Each supplement was consumed 30 minutes prior to each trial, and each cycling trial was separated by a minimum of 72 hours. Supplements were administered using a randomized, double-blind cross-over design. Each cycling trial was performed at a workload equal to 80% VO2peak until exhaustion. The average time in seconds (s) until exhaustion values for the vegan, isocaloric, and zero-calorie supplements were 482 ± 163, 480 ± 157, and 496 ± 238, respectively. Consumption of the vegan supplement did not significantly improve performance compared to an isocaloric and zero-calorie supplement (F = 0.12, p =.89). The results of this study indicate that individuals who choose a vegan pre-workout supplement (over an isocaloric or zero-calorie product) will not experience any acute decrements or ergogenic benefits in cycling performance. Although the present study does not support performance benefits of the tested vegan pre-workout supplement before cycling, additional research examining various exercise intensities and modalities is warranted.
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Affiliation(s)
- Gabrielle Gallien
- a School of Kinesiology , University of Louisiana at Lafayette , Lafayette , LA , USA
| | - David Bellar
- a School of Kinesiology , University of Louisiana at Lafayette , Lafayette , LA , USA
| | - Greggory R Davis
- a School of Kinesiology , University of Louisiana at Lafayette , Lafayette , LA , USA
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22
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Serrano J, Casanova-Martí À, Blay MT, Terra X, Pinent M, Ardévol A. Strategy for limiting food intake using food components aimed at multiple targets in the gastrointestinal tract. Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2017.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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23
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Haghighatdoost F, Nobakht M Gh BF, Hariri M. Effect of Green Tea on Plasma Adiponectin Levels: A Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials. J Am Coll Nutr 2017; 36:541-548. [PMID: 28853999 DOI: 10.1080/07315724.2017.1333470] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Our objective was to perform a systematic review and meta-analysis on randomized controlled trials (RCTs) assessing the effect of green tea on serum adiponectin concentration. METHOD We searched PubMed, ISI Web of Science, Scopus, and the Google Scholar databases up to November 2016. RCTs conducted among human adults studied the effects of green tea and green tea extract on serum adiponectin concentrations as an outcome variable was included. The weighted mean differences and standard deviations (SD) of change in serum adiponectin levels were calculated. The random effects model was used for deriving a summary of mean estimates with their corresponding SDs. The protocol was registered with PROSPERO (No. CRD42017057716). RESULT Fourteen RCTs were eligible to be included in the systematic review and the meta-analysis. Our analysis showed that green tea did not significantly affect adiponectin concentrations in comparison with placebo (weighted mean difference = -0.02 µg/ml, 95% confidence interval [CI], -0.41, 0.38; p = 0.936). There was a substantial heterogeneity between studies (I2 = 91.7%; p < 0.0001). Subgroup analyses based on sex, type of intervention, continent, and body mass index (BMI) could not explain the sources of heterogeneity. Metaregression analyses revealed that the dose and duration of green tea ingestion did not have any effect on adiponectin concentrations. CONCLUSION Green tea could not change the circulatory adiponectin levels. The dose and duration of green tea could not change the result. RCTs with longer follow-up periods and higher doses are needed to replicate our results.
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Affiliation(s)
- Fahimeh Haghighatdoost
- a Food Security Research Center , Isfahan University of Medical Sciences , Isfahan , Iran.,b Department of Community Nutrition, School of Nutrition and Food Science , Isfahan University of Medical Sciences , Isfahan , Iran
| | - B Fatemeh Nobakht M Gh
- c Department of Basic Medical Sciences , Neyshabur University of Medical Sciences , Neyshabur , Iran
| | - Mitra Hariri
- c Department of Basic Medical Sciences , Neyshabur University of Medical Sciences , Neyshabur , Iran
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Garcia-Alvarez A, Mila-Villarroel R, Ribas-Barba L, Egan B, Badea M, Maggi FM, Salmenhaara M, Restani P, Serra-Majem L. Usage of Plant Food Supplements (PFS) for weight control in six European countries: results from the PlantLIBRA PFS Consumer Survey 2011-2012. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:254. [PMID: 27465483 PMCID: PMC4964311 DOI: 10.1186/s12906-016-1227-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 07/19/2016] [Indexed: 01/27/2023]
Abstract
Background Obesity is increasing worldwide and weight-control strategies, including the consumption of plant food supplements (PFS), are proliferating. This article identifies the herbal ingredients in PFS consumed for weight control and by overweight/obese dieters in six European countries, and explores the relationship between their consumption and their self-reported BMI. Methods Data used were a subset from the PlantLIBRA PFS Consumer Survey 2011-2012, a retrospective survey of 2359 PFS consumers. The survey used a bespoke frequency-of-PFS-usage questionnaire. Analyses were performed in two consumer subsamples of 1) respondents taking the products for “body weight reasons”, and 2) “dieters for overweight/obesity”, to identify the herbal ingredients consumed for these reasons. The relationship between the 5 most consumed herbal ingredients and self-reported BMI in groups 1 and 2 is explored by comparing BMI proportions of consumers vs. non-consumers (using Chi-squared test). Results 252 PFS (8.8 %) were consumed for “body weight reasons” (by 240 PFS consumers); 112 PFS consumers (4.8 %) were “dieting for overweight/obesity”. Spain is the country where consuming herbal ingredients for body weight control and dieting were most popular. Artichoke was the most consumed herbal ingredient. Considering only the 5 top products consumed by those who responded “body weight”, when using the total survey sample, a greater proportion of BMI ≥ 25 was observed among consumers of PFS containing artichoke and green tea as compared to non-consumers (58.4 % vs. 49.1 % and 63.2 % vs. 49.7 % respectively). Considering only the 5 top products consumed by “dieters” and using only the “dieters” sample, a lower proportion of BMI ≥ 25 was observed among pineapple-containing PFS consumers (38.5 % vs. 81.5 %); however, when using the entire survey sample, a greater proportion of BMI ≥ 25 was observed among artichoke-containing PFS consumers (58.4 % vs. 49.1 %). Conclusions A comparison of results among the scarce publications evaluating the use of weight-loss supplements at the population level is limited. Nevertheless every hint is important in finding out which are the self-treatment strategies used by overweight/obese individuals in European countries. Although limited by a small sample size, our study represents a first attempt at analysing such data in six EU countries. Our findings should encourage the conduction of further studies on this topic, long-term and large sample-sized studies, ideally conducted in the general population.
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Stohs SJ, Badmaev V. A Review of Natural Stimulant and Non-stimulant Thermogenic Agents. Phytother Res 2016; 30:732-40. [PMID: 26856274 PMCID: PMC5067548 DOI: 10.1002/ptr.5583] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 01/11/2016] [Accepted: 01/14/2016] [Indexed: 01/19/2023]
Abstract
Obesity and overweight are major health issues. Exercise and calorie intake control are recognized as the primary mechanisms for addressing excess body weight. Naturally occurring thermogenic plant constituents offer adjunct means for assisting in weight management. The controlling mechanisms for thermogenesis offer many intervention points. Thermogenic agents can act through stimulation of the central nervous system with associated adverse cardiovascular effects and through metabolic mechanisms that are non-stimulatory or a combination thereof. Examples of stimulatory thermogenic agents that will be discussed include ephedrine and caffeine. Examples of non-stimulatory thermogenic agents include p-synephrine (bitter orange extract), capsaicin, forskolin (Coleus root extract), and chlorogenic acid (green coffee bean extract). Green tea is an example of a thermogenic with the potential to produce mild but clinically insignificant undesirable stimulatory effects. The use of the aforementioned thermogenic agents in combination with other extracts such as those derived from Salacia reticulata, Sesamum indicum, Lagerstroemia speciosa, Cissus quadrangularis, and Moringa olifera, as well as the use of the carotenoids as lutein and fucoxanthin, and flavonoids as naringin and hesperidin can further facilitate energy metabolism and weight management as well as sports performance without adverse side effects. © 2016 The Authors Phytotherapy Research published by John Wiley & Sons Ltd.
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Affiliation(s)
- Sidney J. Stohs
- School of Pharmacy and Health ProfessionsCreighton UniversityOmahaNE68178USA
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Balaji M, Ganjayi MS, Hanuma Kumar GEN, Parim BN, Mopuri R, Dasari S. A review on possible therapeutic targets to contain obesity: The role of phytochemicals. Obes Res Clin Pract 2015; 10:363-80. [PMID: 26740473 DOI: 10.1016/j.orcp.2015.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/26/2015] [Accepted: 12/08/2015] [Indexed: 12/15/2022]
Abstract
The prevalence and severity of obesity has increased markedly in recent decades making it a global public health concern. Since obesity is a potential risk factor in the development of hypertension, type-2 diabetes, cardiovascular diseases, infertility, etc., it is no more viewed as a cosmetic issue. Currently, only a few FDA-approved anti-obesity drugs like Orlistat, Lorcaserin and Phentermine-topiramate are available in the market, but they have considerable side effects. On the other hand, bariatric surgery as an alternative is associated with high risk and expensive. In view of these there is a growing trend towards natural product-based drug intervention as one of the crucial strategies for management of obesity and related ailments. In Asian traditional medicine and Ayurvedic literature a good number of plant species have been used and quoted for possible lipid-lowering and anti-obesity effects; however, many of them have not been evaluated rigorously for a definite recommendation and also lack adequate scientific validation. This review explores and updates on various plant species, their used parts, bioactive components and focuses multiple targets/pathways to contain obesity which may pave the way to develop novel and effective drugs. We also summarised different drugs in use to treat obesity and their current status. Nature is future promise of our wellbeing.
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Affiliation(s)
- Meriga Balaji
- Animal Physiology & Biochemistry Laboratory, Department of Biochemistry, Sri Venkateswara University, Tirupati 517502, Andhra Pradesh, India.
| | - Muni Swamy Ganjayi
- Animal Physiology & Biochemistry Laboratory, Department of Biochemistry, Sri Venkateswara University, Tirupati 517502, Andhra Pradesh, India
| | - Gali E N Hanuma Kumar
- Animal Physiology & Biochemistry Laboratory, Department of Biochemistry, Sri Venkateswara University, Tirupati 517502, Andhra Pradesh, India
| | - Brahma Naidu Parim
- Animal Physiology & Biochemistry Laboratory, Department of Biochemistry, Sri Venkateswara University, Tirupati 517502, Andhra Pradesh, India
| | - Ramgopal Mopuri
- Department of Biochemistry, School of Life Science, University of KwaZulu Natal, Durban 4000, South Africa
| | - Sreenivasulu Dasari
- Animal Physiology & Biochemistry Laboratory, Department of Biochemistry, Sri Venkateswara University, Tirupati 517502, Andhra Pradesh, India
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Aliko A, Wolff A, Dawes C, Aframian D, Proctor G, Ekström J, Narayana N, Villa A, Sia YW, Joshi RK, McGowan R, Beier Jensen S, Kerr AR, Lynge Pedersen AM, Vissink A. World Workshop on Oral Medicine VI: clinical implications of medication-induced salivary gland dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:185-206. [DOI: 10.1016/j.oooo.2014.10.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/12/2014] [Indexed: 10/23/2022]
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Gurley BJ, Steelman SC, Thomas SL. Multi-ingredient, Caffeine-containing Dietary Supplements: History, Safety, and Efficacy. Clin Ther 2015; 37:275-301. [DOI: 10.1016/j.clinthera.2014.08.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/19/2014] [Accepted: 08/23/2014] [Indexed: 02/07/2023]
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Kazemipoor M, Cordell GA, Sarker MMR, Radzi CWJBWM, Hajifaraji M, En Kiat P. Alternative Treatments for Weight Loss: Safety/Risks and Effectiveness of Anti-Obesity Medicinal Plants. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2014. [DOI: 10.1080/10942912.2014.933350] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Taghizadeh M, Samimi M, Kolahdooz F, Tabassi Z, Jamilian M, Asemi Z. Effect of multivitamin versus multivitamin-mineral supplementation on metabolic profiles and biomarkers of oxidative stress in pregnant women: a double-blind randomized clinical trial. J Matern Fetal Neonatal Med 2014; 28:1336-1342. [PMID: 25115164 DOI: 10.3109/14767058.2014.954241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study was designed to determine the favorable effects of received multivitamin versus multivitamin-mineral supplements on metabolic profiles and biomarkers of oxidative stress among Iranian pregnant women. METHODS This double-blind randomized-controlled clinical trial was conducted among 70 pregnant women, primigravida, aged 18-35 years old between 16 and 37 weeks gestation. Subjects were randomly assigned to receive either the multivitamin (n = 35) or multivitamin-mineral supplements (n = 35) for 20 weeks. Fasting blood samples were taken at baseline and after a 20-week intervention to measure lipid profiles and biomarkers of oxidative stress. RESULTS After 20 weeks of intervention, multivitamin-mineral supplementation resulted in a significant difference on serum triglycerides levels (changes from baseline in multivitamin-mineral group: +6.1 versus in multivitamin group: +45.9 mg/dl, p = 0.04) compared with the multivitamin group. In addition, increased concentrations of serum HDL-cholesterol (changes from baseline in multivitamin-mineral group: +0.1 versus in multivitamin group: -7.4 mg/dl, p = 0.02) and total glutathione (GSH) levels (changes from baseline in multivitamin-mineral group: +151.09 versus in multivitamin group: -116.21 µmol/l, p = 0.003) were also seen in the multivitamin-mineral group compared with the multivitamin group. CONCLUSION Supplementation of multivitamin-mineral compared to multivitamin supplementation for 20 weeks during pregnancy had beneficial effects on triglycerides, HDL-cholesterol and GSH levels.
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Affiliation(s)
- Mohsen Taghizadeh
- a Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R. Iran
| | - Mansooreh Samimi
- b Department of Gynecology and Obstetrics , School of Medicine, Kashan University of Medical Sciences , Kashan , I.R. Iran
| | - Fariba Kolahdooz
- c Aboriginal and Global Health Research Group, Department of Medicine , University of Alberta , Edmonton , Canada , and
| | - Zohreh Tabassi
- b Department of Gynecology and Obstetrics , School of Medicine, Kashan University of Medical Sciences , Kashan , I.R. Iran
| | - Mehri Jamilian
- d Department of Gynecology and Obstetrics , School of Medicine, Arak University of Medical Sciences , Arak , Iran
| | - Zatollah Asemi
- a Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences , Kashan , I.R. Iran
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Outlaw JJ, Wilborn CD, Smith-Ryan AE, Hayward SE, Urbina SL, Taylor LW, Foster CA. Acute effects of a commercially-available pre-workout supplement on markers of training: a double-blind study. J Int Soc Sports Nutr 2014; 11:40. [PMID: 25302053 PMCID: PMC4190923 DOI: 10.1186/s12970-014-0040-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pre-workout supplements containing numerous ingredients claim to increase performance and strength. Product-specific research is important for identifying efficacy of combined ingredients. The purpose of this study was to evaluate the effects of a proprietary pre-workout dietary supplement containing creatine monohydrate, beta-alanine, L-Tarurine, L-Leucine, and caffeine, on anaerobic power, muscular strength, body composition, and mood states. METHODS In a double-blind, randomized, matched-pair design, twenty male subjects (mean ± SD; 22.4 ± 9.5 yrs, 76.9 ± 11.2 kg, 22.7 ± 9.5% body fat), consumed either 30 g of a pre-workout supplement (SUP) or maltodextrin placebo (PLC) 30 minutes before a resistance training workout, after completing baseline testing. Body composition was determined via dual-energy x-ray absorptiometry (DEXA). Subjects completed 12 vertical jumps for height (VJ) and one repetition maximum (1RM) and repetitions to failure lifts on bench (BPM) and leg press (LPM). Finally, subjects completed a Wingate power test on a cycle ergometer [mean power (WMP) and peak power (WPP)]. After baseline testing, participants completed eight days of supplementation and four split-body resistance-training bouts. Side effect questionnaires were completed daily 30 minutes after consuming the supplement. Subjects completed post-supplement testing on Day 8. Data were analyzed utilizing a 2 × 2 repeated measures ANOVA [treatment (PLC vs SUP) × time (T1 vs T2)] and ninety-five percent confidence intervals. RESULTS There were no significant treatment × time interactions (p > 0.05). There were no significant changes in %body fat (%BF; ∆-0.43 ± 0.58; p = 0.920), fat mass (∆-2.45 ± 5.72; p = 0.988), or lean body mass (LBM; 10.9 ± 12.2; p = 0.848). 95% CI demonstrated significant LBM increases for both groups. There was a main effect for time for WPP (∆100.5 ± 42.7W; p = 0.001), BPM (∆8.0 ± 12.9 lbs; p = 0.001), and LPM (∆80.0 ± 28.8 lbs; p = 0.001), with no significant differences between treatments. There was no significant difference in mood states between groups or over time. CONCLUSION The proprietary pre-workout blend combined with eight days of training did not significantly (ANOVA) improve body composition or performance. While not significant, greater gains in LPM were demonstrated in the SUP group for lean body mass and lower body strength. Future studies should evaluate more chronic effects of proprietary pre-workout blends on total training volume and performance outcomes.
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Affiliation(s)
- Jordan J Outlaw
- Human Performance Lab, University of Mary Hardin-Baylor, 900 College Street, Belton 76513, TX, USA
| | - Colin D Wilborn
- Human Performance Lab, University of Mary Hardin-Baylor, 900 College Street, Belton 76513, TX, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina Chapel Hill, 209 Fetzer Hall, CB# 8700, Chapel Hill 27599, NC, USA
| | - Sara E Hayward
- Human Performance Lab, University of Mary Hardin-Baylor, 900 College Street, Belton 76513, TX, USA
| | - Stacie L Urbina
- Human Performance Lab, University of Mary Hardin-Baylor, 900 College Street, Belton 76513, TX, USA
| | - Lem W Taylor
- Human Performance Lab, University of Mary Hardin-Baylor, 900 College Street, Belton 76513, TX, USA
| | - Cliffa A Foster
- Human Performance Lab, University of Mary Hardin-Baylor, 900 College Street, Belton 76513, TX, USA
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Effects of anti-obesity drugs, phentermine and mahuang, on the behavioral patterns in Sprague-Dawley rat model. Lab Anim Res 2014; 30:73-8. [PMID: 24999361 PMCID: PMC4079834 DOI: 10.5625/lar.2014.30.2.73] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 05/12/2014] [Accepted: 05/21/2014] [Indexed: 02/02/2023] Open
Abstract
According to WHO global estimates from 2008, more than 1.4 billion adults were overweight and among them, over 200 million men and 300 million women were obese. Although the main treatment modalities for overweight and obese individuals remain dieting and physical exercise, the synthetic anti-obesity medications have been increasingly used due to their perceived convenience. Generally, anti-obesity medications are classified as appetite suppressants or fat absorption blockers. In the present study, we examined the adverse side-effects in respect of behavior changes of phentermine and Ephedra sinica (mahuang) that are anti-obesity drugs currently distributed to domestic consumers. Phentermine is mainly classified as an anorexing agent and mahuang a thermogenic agent. Because phentermine and mahuang are considered to display effectiveness through the regulation of nerve system, their potential influences of on behavioral changes were examined employing animal experiments. From the results of experiments testing locomotor activity through the use of treadmill, rota-rod, and open field system, phentermine and mahuang were commonly revealed to induce behavioral changes of rats by reducing a motor ability, an ability to cope with an external stimulus, and a sense of balance or by augmenting wariness or excitement. These adverse effects of phenternime and mahuang in behavioral changes need to be identified in humans and anti-obesity medications such as phentermine and mahuang should be prescribed for only obesity where it is anticipated that the benefits of the treatment outweigh their potential risks.
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Kim BS, Song MY, Kim H. The anti-obesity effect of Ephedra sinica through modulation of gut microbiota in obese Korean women. JOURNAL OF ETHNOPHARMACOLOGY 2014; 152:532-539. [PMID: 24556223 DOI: 10.1016/j.jep.2014.01.038] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 01/30/2014] [Accepted: 01/30/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ephedra sinica (Ma Huang) has been used in traditional Chinese medicine for more than 5000 years for treatment of various conditions, including modern-day obesity. Ephedra has been used as a supplement for weight loss and its effects have been reported. The current study investigated the influence of ephedra on the composition of gut microbiota, and its correlation with weight loss. MATERIALS AND METHODS Clinical data of subjects were measured at pre- and post-intake of ephedra (4g of water extract, roughly equivalent of 24g of crude herb), and analysis of the alteration of gut microbiota was performed simultaneously using 16S rRNA gene based pyrosequencing. RESULTS Body weight (BW), body mass index (BMI), and body fat percentage of subjects were reduced after intake (p<0.05). In correlation analysis, Subdoligranulum, Oscillibacter, and Akkermansia showed an association with changes of BW and BMI (p<0.05). However, the alteration of gut microbiota varied by indigenous microbiota of each subject, and the dissimilarity between microbiota of subjects at pre- and post-intake were different. CONCLUSIONS The influences of gut microbiota are unique according to indigenous microbiota and differences in individual sensitivity to ephedra. Alteration of gut microbiota by ephedra intake showed correlation with loss of BW and BMI.
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Affiliation(s)
- Bong-Soo Kim
- Chunlab Inc., Seoul National University, Seoul 151-742, Republic of Korea
| | - Mi-Young Song
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University, 707 Seokjang-dong, Gyeonsangbuk-do, Republic of Korea
| | - Hojun Kim
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University, 814 Siksa-dong, Gyeonggi-do 410-773, Republic of Korea.
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Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol 2014; 4:177. [PMID: 24454289 PMCID: PMC3887317 DOI: 10.3389/fphar.2013.00177] [Citation(s) in RCA: 1215] [Impact Index Per Article: 121.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 12/23/2013] [Indexed: 12/11/2022] Open
Abstract
The use of herbal medicinal products and supplements has increased tremendously over the past three decades with not less than 80% of people worldwide relying on them for some part of primary healthcare. Although therapies involving these agents have shown promising potential with the efficacy of a good number of herbal products clearly established, many of them remain untested and their use are either poorly monitored or not even monitored at all. The consequence of this is an inadequate knowledge of their mode of action, potential adverse reactions, contraindications, and interactions with existing orthodox pharmaceuticals and functional foods to promote both safe and rational use of these agents. Since safety continues to be a major issue with the use of herbal remedies, it becomes imperative, therefore, that relevant regulatory authorities put in place appropriate measures to protect public health by ensuring that all herbal medicines are safe and of suitable quality. This review discusses toxicity-related issues and major safety concerns arising from the use of herbal medicinal products and also highlights some important challenges associated with effective monitoring of their safety.
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Affiliation(s)
- Martins Ekor
- Department of Pharmacology, School of Medical Sciences, University of Cape Coast Cape Coast, Ghana
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Habibi Asl B, Vaez H, Imankhah T, Hamidi S. Impact of caffeine on weight changes due to ketotifen administration. Adv Pharm Bull 2013; 4:83-9. [PMID: 24409414 DOI: 10.5681/apb.2014.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/27/2013] [Accepted: 11/26/2013] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Prescription of ketotifen as an effective antihistamine in asthma and allergic conditions is associated with side effect of weight gain. Caffeine is an agent which increases thermogenesis and improves energy expenditure and also effective in asthma. The aim of current study was to evaluate caffeine impact in reducing weight gain side effect of ketotifen. METHODS Male mice at the weight limit of 20-30 gr in 8 groups were randomly chosen and injected following drug dosages for 45 days intraperitoneally: control group (normal saline 10 ml/kg), three groups of ketotifen (4, 8, 16 mg/kg), three groups of caffeine (4, 8, 16 mg/kg) and one group of ketotifen (4 mg/kg) in combination with caffeine (4 mg/kg). Weight changes have been recorded and assessed every 3 days for 45 days. RESULTS The results showed that in all dosages of the two drugs, significant weight loss occurred in comparison with the control group. CONCLUSION The effect of caffeine on weight loss according to our results, matches with human studies, while ketotifen contradictory to our assumption, resulted in weight loss which probably was related to the difference in metabolic pathways in mice and humans, or maybe the used doses of ketotifen in this study were insufficient to reduce TNF-α production or influence in serotonin release and be effective on appetite or weight gain.
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Affiliation(s)
- Bohlool Habibi Asl
- Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haleh Vaez
- Department of Pharmacology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. ; Student Research Committee, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Turan Imankhah
- Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samin Hamidi
- Student Research Committee, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. ; Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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Lee SR, Schriefer JM, Gunnels TA, Harvey IC, Bloomer RJ. Acute oral intake of a higenamine-based dietary supplement increases circulating free fatty acids and energy expenditure in human subjects. Lipids Health Dis 2013; 12:148. [PMID: 24139127 PMCID: PMC4016229 DOI: 10.1186/1476-511x-12-148] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/15/2013] [Indexed: 12/17/2022] Open
Abstract
Background Higenamine, also known as norcoclaurine, is an herbal constituent thought to act as a beta-2 adrenergic receptor agonist—possibly stimulating lipolysis. It was the purpose of this study to determine the impact of a higenamine-based dietary supplement on plasma free fatty acids and energy expenditure following acute oral ingestion. Methods Sixteen healthy subjects (8 men; 26.1 ± 2.5 yrs; 8 women 22.4 ± 3.1 yrs) ingested a dietary supplement containing a combination of higenamine, caffeine (270 mg), and yohimbe bark extract or a placebo, on two separate occasions in a double-blind, randomized, cross-over design, separated by 6–8 days. Blood samples were collected immediately before ingestion, and at 30, 60, 120, and 180 minutes post ingestion, and analyzed for plasma free fatty acids (FFA) and glycerol. Breath samples were collected at the same times for a measure of kilocalorie expenditure and respiratory exchange ratio (RER) using indirect calorimetry. Heart rate and blood pressure were recorded at all times. Data collection occurred in the morning following a 10 hour overnight fast. Results A condition effect was noted for both FFA (p < 0.0001) and kilocalorie expenditure (p = 0.001), with values higher for supplement compared to placebo at 60, 120, and 180 minutes post ingestion. No statistically significant effects were noted for glycerol or RER (p > 0.05). A condition effect was noted for heart rate (p = 0.03) and systolic blood pressure (p < 0.0001), with values higher for supplement compared to placebo. Conclusion Ingestion of a higenamine-based dietary supplement stimulates lipolysis and energy expenditure, as evidenced by a significant increase in circulating FFA and kilocalorie expenditure. The same supplement results in a moderate increase in heart rate (~3 bpm) and systolic blood pressure (~12 mmHg), which is consistent with previous studies evaluating moderate doses of caffeine and yohimbine, suggesting that higenamine contributes little to the increase in these hemodynamic variables. These findings are in reference to young, healthy and active men and women.
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Affiliation(s)
| | | | | | | | - Richard J Bloomer
- Department of Health and Sport Sciences, Cardiorespiratory/Metabolic Laboratory, University of Memphis, 106 Roane Field House, Memphis, TN 38152, USA.
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Astell KJ, Mathai ML, Su XQ. A review on botanical species and chemical compounds with appetite suppressing properties for body weight control. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2013; 68:213-21. [PMID: 23666454 DOI: 10.1007/s11130-013-0361-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
As obesity has reached epidemic proportions, the management of this global disease is of clinical importance. The availability and popularity of natural dietary supplements for the treatment of obesity has risen dramatically in recent years. The purpose of this paper was to review the effect of commonly available over the counter plant-derived supplements used to suppress appetite for obesity control and management. The data were obtained from the electronic databases PubMed, SpringerLink, Google Scholar, ScienceDirect, and MEDLINE with full text (via EBSCOHost) and the databases were accessed during late 2012 - early January 2013. The botanical species discussed in this review include Camellia sinensis, Caralluma fimbriata, Citrus aurantium, Coleus forskohlii, Garcinia cambogia and Phaseolus vulgaris. This review found that many botanical species including crude extracts and isolated compounds from plants have been shown to provide potentially promising therapeutic effects including appetite control and weight loss. However, many of these crude extracts and compounds need to be further investigated to define the magnitude of the effects, optimal dosage, mechanisms of action, long term safety, and potential side effects.
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Affiliation(s)
- Katie J Astell
- College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
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Efficacy and Safety of Taeeumjowi-tang in Obese Korean Adults: A Double-Blind, Randomized, and Placebo-Controlled Pilot Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:498935. [PMID: 24062784 PMCID: PMC3770019 DOI: 10.1155/2013/498935] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/05/2013] [Indexed: 11/17/2022]
Abstract
Objective. The purpose of this study was to assess the efficacy and safety of Taeeumjowi-tang (TJ001) as well as to estimate obesity-related factors. Methods. This was a 12-week trial with 5 visits. A total of 102 participants of both genders were randomized to either TJ001 (n = 57) group or the placebo group (n = 55). Subjects were administered 7 g of either TJ001 or placebo 3 times a day. The primary outcome was a rate of subjects who lost 5% or more of initial weight. Secondary outcomes included anthropometric parameters, lipid profiles, and body fat composition. Results. The subject response rate of ≥5% weight loss compared to baseline was similar in both groups, and no statistically significant difference was observed (P = 0.87). Changes in anthropometric parameters were greater during the first 4 weeks in the treatment group (P < 0.0001). There were no significant changes in both within groups and between groups for lipid profile and body fat composition. No adverse event was reported in either group. Conclusion. Although the difference between the groups regarding a rate of subjects who lost 5% or more of initial weight did not show statistical significance, TJ001 appears to be beneficial in safely controlling weight.
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Astell KJ, Mathai ML, Su XQ. Plant extracts with appetite suppressing properties for body weight control: a systematic review of double blind randomized controlled clinical trials. Complement Ther Med 2013; 21:407-16. [PMID: 23876572 DOI: 10.1016/j.ctim.2013.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/08/2013] [Accepted: 05/22/2013] [Indexed: 11/18/2022] Open
Abstract
OVERVIEW As obesity has reached epidemic proportions, the management of this global disease is of clinical importance. The availability and popularity of natural dietary supplements for the treatment of obesity has risen dramatically in recent years. AIMS The aim of this paper was to assess the current evidence of commonly available natural supplements used to suppress appetite for obesity control and management in humans using a systematic search of clinical trials meeting an acceptable standard of evidence. METHODS The electronic databases PubMed, Web of Science, Google Scholar, ScienceDirect, and MEDLINE with full text (via EBSCOHost) were accessed during late 2012 for randomized controlled clinical trials (RCTs) using natural plant extracts as interventions to treat obesity through appetite regulation. A quality analysis using a purpose-designed scale and an estimation of effect size, where data were available, was also calculated. The inclusion criteria included the following: sample participants classified as overweight or obese adults (aged 18-65 years), randomized, double blind, controlled design, suitable placebo/control intervention, sample size >20, duration of intervention >2 weeks, have measurable outcomes on appetite or food intake and anthropometry, and full paper in English. RESULTS There were 14 studies that met the inclusion criteria. The findings from published double blind RCTs revealed mostly inconclusive evidence that plant extracts are effective in reducing body weight through appetite suppression. Caralluma fimbriata extract and a combination supplement containing Garcinia cambogia plus Gymnema sylvestre were the only exceptions. CONCLUSION According to the findings from this systematic review, the evidence is not convincing in demonstrating that most dietary supplements used as appetite suppressants for weight loss in the treatment of obesity are effective and safe. A balance between conclusive findings by double blind RCTs and advertisement is required to avoid safety concerns and dissatisfaction from consumers.
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Affiliation(s)
- Katie J Astell
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
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Kim EJY, Chen Y, Huang JQ, Li KM, Razmovski-Naumovski V, Poon J, Chan K, Roufogalis BD, McLachlan AJ, Mo SL, Yang D, Yao M, Liu Z, Liu J, Li GQ. Evidence-based toxicity evaluation and scheduling of Chinese herbal medicines. JOURNAL OF ETHNOPHARMACOLOGY 2013; 146:40-61. [PMID: 23286904 DOI: 10.1016/j.jep.2012.12.027] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 12/19/2012] [Accepted: 12/19/2012] [Indexed: 05/19/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE While there is an increasing number of toxicity report cases and toxicological studies on Chinese herbal medicines, the guidelines for toxicity evaluation and scheduling of Chinese herbal medicines are lacking. AIM The aim of this study was to review the current literature on potentially toxic Chinese herbal medicines, and to develop a scheduling platform which will inform an evidence-based regulatory framework for these medicines in the community. MATERIALS AND METHODS The Australian and Chinese regulations were used as a starting point to compile a list of potentially toxic herbs. Systematic literature searches of botanical and pharmaceutical Latin name, English and Chinese names and suspected toxic chemicals were conducted on Medline, PubMed and Chinese CNKI databases. RESULTS Seventy-four Chinese herbal medicines were identified and five of them were selected for detailed study. Preclinical and clinical data were summarised at six levels. Based on the evaluation criteria, which included risk-benefit analysis, severity of toxic effects and clinical and preclinical data, four regulatory classes were proposed: Prohibited for medicinal usage, which are those with high toxicity and can lead to injury or death, e.g., aristolochia; Restricted for medicinal usage, e.g., aconite, asarum, and ephedra; Required warning label, e.g., coltsfoot; and Over-the-counter herbs for those herbs with a safe toxicity profile. CONCLUSION Chinese herbal medicines should be scheduled based on a set of evaluation criteria, to ensure their safe use and to satisfy the need for access to the herbs. The current Chinese and Australian regulation of Chinese herbal medicines should be updated to restrict the access of some potentially toxic herbs to Chinese medicine practitioners who are qualified through registration.
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Affiliation(s)
- Ellie J Y Kim
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia
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The Extract of Herbal Medicines Activates AMP-Activated Protein Kinase in Diet-Induced Obese Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:756025. [PMID: 23533517 PMCID: PMC3606713 DOI: 10.1155/2013/756025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/06/2013] [Accepted: 02/06/2013] [Indexed: 11/17/2022]
Abstract
Our study investigated whether the extract of six herbal medicines (OB-1) has an inhibitory effect on obesity. High-fat diet-(HFD-) induced rats and controls were treated with 40 mg/100 g body weight of OB-1 or saline once a day for 5 weeks. After significant changes in body weight were induced, OB-1 and saline were administered to each subgroup of HFD and control groups for additional 5 weeks. No statistically significant decrease of body weight in OB-1-treated rats was found compared to controls. However, OB-1-treated rats were found to be more active in an open-field test and have a reduction in the size of adipocytes compared to controls. We observed no changes in the mRNA expressions of leptin and adiponectin from adipocytes between OB-1- and saline-treated rats with HFD-induced obesity group. However, OB-1 treatments were shown to be inversely correlated with accumulation of lipid droplets in liver tissue, suggesting that OB-1 could inhibit a lipid accumulation by blocking the pathway related to lipid metabolism. Moreover, the phosphorylation of AMP-activated protein kinase (AMPK) was significantly increased in OB-1-treated rats with HFD compared to controls. These results suggest that OB-1 has no direct antiobesity effect and, however, could be a regulator of cellular metabolism.
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Sherafat-Kazemzadeh R, Yanovski SZ, Yanovski JA. Pharmacotherapy for childhood obesity: present and future prospects. Int J Obes (Lond) 2013; 37:1-15. [PMID: 22929210 PMCID: PMC3522799 DOI: 10.1038/ijo.2012.144] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Pediatric obesity is a serious medical condition associated with significant comorbidities during childhood and adulthood. Lifestyle modifications are essential for treating children with obesity, yet many have insufficient response to improve health with behavioral approaches alone. This review summarizes the relatively sparse data on pharmacotherapy for pediatric obesity and presents information on obesity medications in development. Most previously studied medications demonstrated, at best, modest effects on body weight and obesity-related conditions. It is to be hoped that the future will bring new drugs targeting specific obesity phenotypes that will allow clinicians to use etiology-specific, and therefore more effective, anti-obesity therapies.
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Affiliation(s)
- Roya Sherafat-Kazemzadeh
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development
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Song MY, Bose S, Kim HJ, Lee MJ, Lim CY. The impact of Ephedra and green tea combination mesotherapy on localized fat: A randomized-controlled clinical trial. Eur J Integr Med 2012. [DOI: 10.1016/j.eujim.2012.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Sui Y, Zhao HL, Wong VCW, Brown N, Li XL, Kwan AKL, Hui HLW, Ziea ETC, Chan JCN. A systematic review on use of Chinese medicine and acupuncture for treatment of obesity. Obes Rev 2012; 13:409-30. [PMID: 22292480 DOI: 10.1111/j.1467-789x.2011.00979.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Obesity is a major health hazard and despite lifestyle modification, many patients frequently regain any lost body weight. The use of western anti-obesity drugs has been limited by side effects including mood changes, suicidal thoughts, and gastrointestinal or cardiovascular complications. The effectiveness and safety of traditional Chinese medicine including Chinese herbal medicine (CHM) and acupuncture provide an alternative established therapy for this medical challenge. In this systematic review, we used standard methodologies to search, review, analyse and synthesize published data on the efficacy, safety and relapse of weight regain associated with use of CHM and acupuncture. We also examined the rationale, mechanisms and potential utility of these therapies. A total of 12 electronic databases, including Chinese, English, Korean and Japanese, were searched up to 28 February 2010. Randomized controlled trials (RCTs) for CHM and/or acupuncture with comparative controls were considered. We used the Jadad scale to assess methodological qualities, the random effect model in the pooled analysis of therapeutic efficacy to adjust for heterogeneity and funnel plots to explore publication bias. After screening 2,545 potential articles from the electronic databases, we identified 96 RCTs; comprising of 49 trials on CHM treatment, 44 trials on acupuncture treatment and 3 trials on combined therapy for appraisal. There were 4,861 subjects in the treatment groups and 3,821 in the control groups, with treatment duration ranging from 2 weeks to 4 months. Of the 77 publications written in Chinese, 75 had a Jadad score <3, while 16 of the 19 English publications had a Jadad score of >3. Efficacy was defined as body weight reduction ≥ 2 kg or body mass index (BMI) reduction ≥ 0.5 kg/m(2) . Compared with placebo or lifestyle modification, CHM and acupuncture exhibited respective 'risk ratio' (RR) of 1.84 (95% CI: 1.37-2.46) and 2.14 (95% CI: 1.58-2.90) in favour of body weight reduction, with a mean difference in body weight reduction of 4.03 kg (95% CI: 2.22-5.85) and 2.76 kg (95% CI: 1.61-3.83) and a mean difference in BMI reduction of 1.32 kg m(-2) (95% CI: 0.78-1.85) and 2.02 kg m(-2) (95% CI: 0.94-3.10), respectively. Compared with the pharmacological treatments of sibutramine, fenfluramine or orlistat, CHM and acupuncture exhibited an RR of 1.11 (95% CI: 0.96-1.28) and 1.14 (95% CI: 1.03-1.25) in body weight reduction, mean difference in body weight reduction of 0.08 kg (95% CI: -0.58 to 0.74) and 0.65 kg (95% CI: -0.61 to 1.91), and mean difference in BMI reduction of 0.18 kg m(-2) (95% CI: -0.39 to 0.75) and 0.83 kg m(-2) (95% CI: 0.29-1.37), respectively. There were fewer reports of adverse effects and relapses of weight regain in CHM intervention studies conducted in China than studies conducted outside China. CHM and acupuncture were more effective than placebo or lifestyle modification in reducing body weight. They had a similar efficacy as the Western anti-obesity drugs but with fewer reported adverse effects. However, these conclusions were limited by small sample size and low quality of methodologies.
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Affiliation(s)
- Y Sui
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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Park S, Park JS, Cheon C, Yang YJ, An C, Jang BH, Song YK, Go H, Lee JA, Shin Y, Ko SG. A pilot study to evaluate the effect of Taeumjowi-tang on obesity in Korean adults: study protocol for a randomised, double-blind, placebo-controlled, multicentre trial. Trials 2012; 13:33. [PMID: 22483238 PMCID: PMC3362753 DOI: 10.1186/1745-6215-13-33] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 04/07/2012] [Indexed: 12/25/2022] Open
Abstract
Background Obesity, which is described as excessive or abnormal body fat, increases the risk of diet-related diseases. In Korea and around the world, the prevalence of obesity has grown annually from 1998 to 2008. This growth has continued despite various therapeutic efforts. The discovery of new and alternative treatments for obesity should be considered an important priority. Taeumjowi-tang (TJ001), a traditional Korean medicinal extract consisting of eight herbs, is a widely used herbal remedy for obesity in Korea. However, the efficacy and safety of TJ001 have not been fully investigated in a clinical trial. The purpose of this pilot study is to estimate obesity-related parameters and to assess the efficacy and safety of TJ001. Methods Our study is a randomised, double-blind, placebo-controlled, multicentre clinical trial of Taeumjowi-tang (TJ001). For this study, we will recruit obese Korean patients of both sexes, ages 18 to 65 years, from four university hospitals. A total of 104 subjects will be recruited. The participants will receive either 7 g of TJ001 or a placebo three times daily for 12 weeks. The primary end point will be the rate of subjects who lose at least 5% of their baseline body weight. The secondary end points will be changes in body weight, body mass index, waist circumference, hip circumference, waist/hip circumference ratio, lipid profiles, body fat composition, blood pressure, fasting glucose concentration, C-reactive protein and questionnaires related to the quality of life. The outcomes will be measured every 4 weeks. The study period will be 12 weeks and will include a total of five visits with each subject (at screening and at 0, 4, 8 and 12 weeks). Conclusions The results of our study will inform various estimates of TJ001 and will serve as the basis for a larger-scale trial. This study will assess the efficacy and safety of TJ001 as an alternative herbal remedy for obesity. Trial registration Current Controlled Trials ISRCTN87153759
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Affiliation(s)
- Sunju Park
- Center for Clinical Research and Genomics, College of Oriental Medicine and Institute of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea
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Song MK, Um JY, Jang HJ, Lee BC. Beneficial effect of dietary Ephedra sinica on obesity and glucose intolerance in high-fat diet-fed mice. Exp Ther Med 2012; 3:707-712. [PMID: 22969956 DOI: 10.3892/etm.2012.462] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 12/30/2011] [Indexed: 12/12/2022] Open
Abstract
Obesity is a major contributor to both glucose intolerance and metabolic syndrome. In this study, we investigated the anti-obesity and anti-hyperglycemic effects of Ephedra sinica on high-fat diet-fed mice. Male ICR mice were divided into four groups; the normal group, the obese and diabetic control group treated with a high-fat diet, the positive control group treated with a high-fat diet containing acarbose, and the experimental group treated with a high-fat diet containing Ephedra sinica. The effects of Ephedra sinica on obesity and glucose intolerance were measured by an oral glucose tolerance test (OGTT), plasma biochemistry, body and epididymal fat weight; the expression of adiponectin, peroxisome-proliferator-activated receptor α (PPAR-α), tumor necrosis factor α (TNF-α) and leptin was also determined. Ephedra sinica reduced weight gain and epididymal fat accumulation, improved glucose intolerance on the OGTT, decreased triglycerides and increased high-density lipoprotein cholesterol compared to the controls. Moreover, it reduced weight gain and fasting glucose levels and improved HDL-cholesterol levels more than acarbose. Gene expression analysis revealed that Ephedra sinica upregulated the expression of adiponectin and PPAR-α, and downregulated the expression of TNF-α. From these results, we suggest that Ephedra sinica may reduce obesity and hyperglycemia by increasing PPAR-α and adiponectin and reducing TNF-α, and that it may have the potential to be used clinically as an ingredient in food or drugs effective in obesity-related glucose intolerance treatments.
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Abstract
This article presents an overview of the current knowledge, status, and use of supplements by patients before surgical operations, together with the benefits expected of the supplements by the patients. The indications, potential advantages and disadvantages, and the relationships with various aspects of the preoperative preparation and postoperative management of surgical patients are discussed, with emphasis on the significant percentage of this population that is deficient in fundamental nutrients. Recent revisions and recommendations for some of the macronutrients are presented, together with a summary of federal regulations and an oversight of supplements.
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Myslobodsky M, Eldan A. Winning a won game: caffeine panacea for obesity syndemic. Curr Neuropharmacol 2010; 8:149-60. [PMID: 21119886 PMCID: PMC2923369 DOI: 10.2174/157015910791233213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 02/20/2010] [Accepted: 02/23/2010] [Indexed: 02/08/2023] Open
Abstract
Over the past decades, chronic sleep reduction and a concurrent development of obesity have been recognized as a common problem in the industrialized world. Among its numerous untoward effects, there is a possibility that insomnia is also a major contributor to obesity. This attribution poses a problem for caffeine, an inexpensive, “natural” agent that is purported to improve a number of conditions and is often indicated in a long-term pharmacotherapy in the context of weight management. The present study used the “common target” approach by exploring the tentative shared molecular networks of insomnia and adiposity. It discusses caffeine targets beyond those associated with adenosine signaling machinery, phosphodiesterases, and calcium release channels. Here, we provide a view suggesting that caffeine could exert some of its effects by acting on several signaling complexes composed of HIF-1α/VEGF/IL-8 along with NO, TNF-α, IL1, and GHRH, among others. Although the relevance of these targets to the reported therapeutic effects of caffeine has remained difficult to assess, the utilization of caffeine efficacies and potencies recommend its repurposing for development of novel therapeutic approaches. Among indications mentioned, are neuroprotective, nootropic, antioxidant, proliferative, anti-fibrotic, and anti-angiogenic that appear under a variety of dissimilar diagnostic labels comorbid with obesity. In the absence of safe and efficacious antiobesity agents, caffeine remains an attractive adjuvant.
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Smith AE, Lockwood CM, Moon JR, Kendall KL, Fukuda DH, Tobkin SE, Cramer JT, Stout JR. Physiological effects of caffeine, epigallocatechin-3-gallate, and exercise in overweight and obese women. Appl Physiol Nutr Metab 2010; 35:607-16. [DOI: 10.1139/h10-056] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the combined effects of a 10-week exercise program with ingestion of caffeine and epigallocatechin-3-gallate (EGCG) on body composition, cardiovascular fitness, and strength in overweight and obese women. In a double-blind, placebo-controlled approach, overweight and obese women (n = 27) were randomly assigned to treatment groups with exercise (an active-supplementing group with exercise (EX-Act) and a placebo group with exercise (EX-PL)) or without exercise (an active-supplementing group without exercise (NEX-Act) and a placebo group without exercise (NEX-PL)). All participants consumed 1 drink per day for 10 weeks; EX-Act and EX-PL participated in a concurrent endurance and resistance training program. Changes in body composition were assessed using a 4-compartment model. Changes in muscle mass (MM) were evaluated using a DXA-derived appendicular lean–soft tissue equation. There was a significant time × treatment interaction for MM (p = 0.026) and total cholesterol (TC) (p = 0.047), and a significant time × training interaction for peak oxygen consumption (p = 0.046) and upper-body and lower-body strength (p < 0.05). Significant differences between the EX groups and NEX groups for percentage change in MM and peak oxygen consumption, and upper-body and lower-body strength, were revealed. Clinical markers for hepatic and renal function revealed no adverse effects. TC significantly decreased for the active-supplementing groups (EX-Act, NEX-Act). The current study suggests that implementing a caffeine–EGCG-containing drink prior to exercise may improve MM, fitness, and lipid profiles in overweight women.
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Affiliation(s)
- Abbie E. Smith
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - Christopher M. Lockwood
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - Jordan R. Moon
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - Kristina L. Kendall
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - David H. Fukuda
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - Sarah E. Tobkin
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - Joel T. Cramer
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
| | - Jeffrey R. Stout
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK 73019, USA
- Department of Sports Fitness and Health, United States Sports Academy, One Academy Drive, Daphne, AL 36526, USA
- College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73126, USA
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