Availability and composition of weight‐loss supplements in Sri Lanka

The use of Caralluma fimbriata as an appetite suppressant and weight loss supplement: a systematic review and meta-analysis of clinical trials

BACKGROUND

Obesity prevalence has increased during the past few decades, causing a pandemic with an influx in other co-morbidities. Many factors influence weight gain in an obesogenic environment therefore strategies for treating obesity may vary from conventional dietary and physical activity interventions to pharamacotherapy. A shift in unconventional strategies as herbal products for treating obesity have been investigated and one such plant extract is Caralluma fimbriata (C. fimbriata). Further, the studies included were systematically reviewed to gather evidence on potential effects of C. fimbriata as an appetite suppressant and weight loss supplement.

METHODS

A systematic review of clinical trials reporting the effects of C. fimbriata as appetite suppression and anti-obesity supplement was reported according to PRISMA guidelines. Data were obtained by searching three databases: PubMed®, Web of Science® and SciVerse Scopus® for studies published until 30th April 2020.

RESULTS

A total of 7 articles studying C. fimbriata satisfied the inclusion and exclusion criteria and were sourced from various countries including Australia (3), Cuba (1), India (2) and Spain (1). Almost all studies recruited adults who were overweight or obese with a BMI > 25 kg/m² (n = 5), with the exception of two studies, one that recruited healthy adults with a BMI average of 26.5 kg/m2 and the second one utilised a population of children and adolescents with Prader-Willis Syndrome (PWS). Parameters assessing obesity, biochemical and appetite factors were analysed by carrying out a meta-analysis. Compared to placebo controlled group, C. fimbriata extract significantly reduced WC by 1.59 cm (95% CI, - 3.07 to - 0.10, p = 0.041) and WHR by 0.06 (95% CI, - 0.12 to - 0.01, p = 0.05) although no significant effects were seen on BW, BMI and HC. Biochemical and appetite parameters outcome on C. fimbriata consumption had no significant changes. Any side effects of individuals who ingested the extract were reported by few studies of which most common effects were constipation, diarrhoea, nausea and rashes.

CONCLUSION

Appetite parameters showed no significant changes and metabolic parameters did not improve with C.fimbriata supplementation therefore it is unlikely to recommend C. fimbriata as a weight loss supplement and an appetite suppressant.

Anti-Obesity and Gut Microbiota Modulation Effect of Secoiridoid-Enriched Extract from Fraxinus mandshurica Seeds on High-Fat Diet-Fed Mice

Previously we conducted a phytochemical study on the seeds of Fraxinus excelsior and isolated nine secoiridoid compounds with adipocyte differentiation inhibitory activity and peroxisome proliferator activated receptor alpha (PPARα) activation effects. However, the bioactive constituents and functions of Fraxinus mandshurica seeds have not been studied. In the present study, we investigated the secoiridoid compounds in F. mandshurica seed extract (FM) using column chromatography, 1H-NMR, 13C-NMR and HPLC-DAD methods. The pancreatic lipase inhibitory activities of isolated compounds were evaluated in vitro. Additionally, the anti-obesity and gut microbiota modulation effect of FM on high-fat diet-induced obesity in C57BL/6 mice were also studied in vivo. The results showed that 19 secoiridoids were isolated from FM and identified. The total content of secoiridoids in FM reached 181.35 mg/g and the highest content was nuzhenide (88.21 mg/g). All these secoiridoid compounds exhibited good pancreatic lipase inhibitory activity with inhibition rate ranged from 33.77% to 70.25% at the concentration of 100 μM. After obese mice were administrated with FM at 400 mg/kg.bw for 8 weeks, body weight was decreased by 15.81%. Moreover, FM could attenuate the lipid accumulation in serum and liver, relieve the damage in liver and kidney, and extenuate oxidative stress injury and inflammation caused by obesity in mice. FM could also modulate the structural alteration of gut microbiota in obese mice, increasing the proportion of anti-obesity gut microbiota (Bacteroidetes, Bacteroidia, S24-7 and Allobaculum), and reducing the proportion of obesogenic gut microbiota (Firmicutes and Dorea). This study suggests that F. mandshurica seeds or their secoiridoids may have potential for use as a dietary supplement for obesity management.

Effects and mechanisms of edible and medicinal plants on obesity: an updated review

In recent years, obesity has become a global public health issue. It is closely associated with the occurrence of several chronic diseases, such as diabetes and cardiovascular diseases. Some edible and medicinal plants show anti-obesity activity, such as fruits, vegetables, spices, legumes, edible flowers, mushrooms, and medicinal plants. Numerous studies have indicated that these plants are potential candidates for the prevention and management of obesity. The major anti-obesity mechanisms of plants include suppressing appetite, reducing the absorption of lipids and carbohydrates, inhibiting adipogenesis and lipogenesis, regulating lipid metabolism, increasing energy expenditure, regulating gut microbiota, and improving obesity-related inflammation. In this review, the anti-obesity activity of edible and medicinal plants was summarized based on epidemiological, experimental, and clinical studies, with related mechanisms discussed, which provided the basis for the research and development of slimming products. Further studies should focus on the exploration of safer plants with anti-obesity activity and the identification of specific anti-obesity mechanisms.

Obesity in South Asia: Phenotype, Morbidities, and Mitigation

PURPOSE OF REVIEW

Obesity has increased in South Asian countries that are still grappling with undernutrition. In this review, we highlight the characteristics of obesity, its relation to morbidities, and its management in South Asians. A literature search was conducted using relevant search engines and based on key words focusing on obesity in South Asians.

RECENT FINDINGS

The increasing trend in obesity prevalence is caused by imbalanced diets and physical inactivity. South Asians, in general, have higher body fat and lower skeletal muscle mass at the same or lower BMIs compared to white people ("high body fat-normal BMI-low muscle mass" phenotype). In addition, excess abdominal adiposity, typically seen in South Asians, and increased hepatic fat (non-alcoholic fatty liver disease) are associated with an increased risk for type 2 diabetes and cardiovascular disease. Challenges in treatment include lack of awareness regarding correct diets and non-compliance to diet and exercise regimens. Social and cultural issues limit physical activity in South Asian women. Finally, there is a lack of expert health professionals to deal with increased cases of obesity. Aggressive management of obesity is required in South Asians, with more intensive and earlier diet and exercise interventions (i.e., at lower BMI levels than internationally accepted). At a population level, there is no clear policy for tackling obesity in any South Asian country. Prevention strategies focusing on obesity in childhood and the creation of food and activity environments that encourage healthy lifestyles should be firmly applied. Obesity in South Asians should be evaluated with ethnic-specific guidelines and prevention and management strategies should be applied early and aggressively.