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A look at the science behind some of today’s most successful weight-management dietary supplement ingredients.
It didn’t take long for the headlines to surface after JAMA published the latest data on American obesity rates this March. “American Adults Just Keep Getting Fatter,” cried The New York Times. “Public Education Efforts Not Moving the Needle in Fight against Obesity,” was Kaiser Health News’ takeaway. Even the food blog Grubstreet conceded, “America’s Obesity Epidemic Is Only Getting Worse.”
The responses set a dismal tone-and for good reason. The data1 to which they respond, taken from the 2007-2008 and 2015-2016 National Health and Nutrition Examination Surveys (NHANES), paint a picture of a nation wherein 33.7% of adults are obese (defined as having a body mass index, or BMI, of 30 or more) and 5.7% are severely obese (having a BMI of 40 or more)-and they reflect an upward obesity trend that’s been in evidence for decades.
All this comes despite ongoing efforts to educate Americans about the risks of-and remedies to-obesity. And it also comes despite the earnest claims of those same Americans that they’re exercising more.
So, clearly: Something isn’t working.
Yet it’s time we find something that does. Whatever that “something” is, it’ll likely comprise dietary changes, more exercise and education, and possibly nutritional supplementation to address weight management. After all, as Joe Weiss, president, Nutrition 21 LLC (Purchase, NY), points out, “The problem surrounding obesity is only getting worse, which leads me to believe there will continue to be demand around products addressing or reducing the negative impacts of this condition.”
Cracking the Code
We’ve been down this road before, and perhaps we keep winding up here because although solving overweight and obesity may be simple in concept-eat less; exercise more-it’s much harder in fact. As Mark Cope, PhD, applied nutrition manager, DuPont Nutrition & Health (Madison, WI), says, “We all know that weight management requires lifestyle changes, but it’s these changes in diet and exercise habits that make weight management so challenging.”
Add to that the inexorable influence of genetics-and an environment apparently designed to encourage obesity-and it’s understandable why taking weight off and keeping it off is a tough code to crack. Says Mitch Skop, former senior director of new product development, Pharmachem Laboratories Inc., a division of Ashland (Kearny, NJ), “Emotionally charged mindsets often cause binge or stress eating,” and though manufacturers are making healthful choices available, “junk-food manufacturers are doing the same thing,” albeit in the equal and opposite direction.
The consequences of this “toxic food environment” extend well beyond one’s waistline. “Obesity is associated with higher death rates driven by comorbidities such as type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, certain types of cancer, steatohepatitis, gastroesophageal reflux, arthritis, polycystic ovary syndrome, and infertility2,” Cope says. “Another important point to make about obesity is reduced quality of life, even among obese individuals without associated comorbidities3.”
And don’t forget to account for obesity’s economic toll. Cope points to data4 showing that the public health burden of excess weight costs the U.S. healthcare system more than $200 billion annually. Moreover, a Johns Hopkins University study5 concluded that obese individuals who lower their BMI to what’s considered a healthy range could save $28,000 over a lifetime.
Shame on Sugar
Supplementary interventions that help keep weight in that healthy range also have the potential to ameliorate obesity’s costs. And though such products have traditionally focused on energy, thermogenesis, and metabolism, “more recently it seems a lot of formulas are catering to consumers who need help managing their sugar intake to maintain healthy blood sugar levels, reduce hunger, and increase satiety,” says Brian Appell, marketing manager, OmniActive Health Technologies (Morristown, NJ).
Indeed, “Today’s diets are loaded with sugar,” Appell observes. NPD Group research6 reveals that while a combination of sugary nonalcoholic beverages and processed grain products contribute the lion’s share of sugars in contemporary diets, “even foods many people consider healthy can contain more than 95 grams of hidden sugars,” he notes-“more than twice the maximum recommended intake.”
No wonder sugar consumption has been climbing over the past 30 years-and contributing to near-epidemic rates of elevated blood sugar and weight gain in the process. “It’s the hidden sugars that are largely responsible for this health crisis,” Appell adds. So it’s also no wonder that when an OmniActive survey7 asked consumers which single item they’d eliminate from their diets if they could, more than half cited sugar and/or carbohydrates.
Appell says that because his company’s Salacia chinensis extract-marketed as OmniLean-can “uniquely balance blood sugar and thereby control appetite,” it can help users “make healthier choices.” The randomized, double-blind, placebo-controlled three-way crossover CARBS (Carbohydrate Appetite Reduction and Blood Sugar) study8 was the first to examine the extract’s effects on postprandial glycemic indices and gut hormones, and it found that when taken with a meal, the ingredient improved glycemic response and changes in gut hormones in healthy overweight/obese individuals, reduced blood sugar spikes, and influenced appetite and satiety.
Noting that “industry cannot change people’s stress or behavior, but we can help them lessen the impact of a carb-laden diet,” Skop explains that Pharmachem’s white kidney bean extract-brand named Phase 2 Carb Controller-helps delay digestion and absorption of dietary starches by temporarily inhibiting salivary and pancreatic alpha-amylase enzyme. Carbohydrates that thus resist digestion in the small intestine can travel to the large intestine where they act like dietary fiber, feeding microbiota and upregulating the hormone GLP-1 (glucagon-like peptide-1), which promotes satiety signaling, among other metabolic effects.
Four placebo-controlled human studies published between 2001 and 2004 showed significant weight and inch loss with the product’s use. The most recent study9 on the ingredient-and the largest human trial on it to date-showed that after 12 weeks of supplementation, those taking the extract lost an average of 7 lb more than the placebo group and experienced a statistically significant decrease in the desire, frequency, and strength of cravings for chocolates and other sweet foods; meanwhile the placebo group saw a significant increase in the difficulty of resisting particular types of food. After 24 weeks, 73.5% of participants in the weight-management phase had successfully maintained their body weight.
An earlier review10 of more than a dozen studies also concluded that Pharmachem’s kidney-bean extract could potentially induce weight loss and reduce blood sugar spikes caused by carbohydrates. The study’s coauthor wrote that the ingredient demonstrated the ability to cause weight loss “with doses of 500 to 3,000 mg per day, in either a single dose, or in divided doses. It also has the ability to reduce the postprandial spike in blood glucose levels.”
All of which suggests that it may play a role in addressing blood sugar management and diabetes. And as far as Weiss is concerned, any supplement capable of doing that is just what we need. He cites World Health Organization numbers estimating that 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. “This increasing incidence of diabetes, as well as complications correlating with poor blood sugar, is likely due to an increase in the associated risk factors in individuals, such as being overweight or obese,” he says.
Chromium “is commonly regarded as effective in helping control blood sugar and carbohydrate cravings, as well as in fighting body fat and assisting in weight management,” notes Jim Komorowski, chief science officer at Nutrition 21. The trace mineral appears to improve insulin’s action, boosting the body’s ability to manage blood sugar levels. “People often struggle to lose weight even when dieting and exercising due to impaired insulin resistance,” he notes. “If the body is successfully keeping blood sugar levels in check, managing weight and appetite is a bit more simplified.”
His company’s patented Chromax chromium picolinate supplement was the focus of a new 2018 review that the company recently publicized in a white paper, comparing it to other weight-loss products and programs, the conclusion of which was that the supplement yielded the greatest percentage of fat loss and smallest percentage of lean body mass loss relative to total weight loss. As Komorowski notes, “Chromax positively impacts body composition by enabling individuals to lose fat while retaining muscle.”
Fat Still Matters
A signal implication of the study is that notwithstanding the current fixation on carbohydrates and sugar, fat-or, more specifically, adipose tissue-still matters.
Why? When a body loses primarily lean body mass and not fat in its efforts to shed pounds, it suppresses its metabolic rate, setting up conditions for the subsequent accumulation of more fat. Lean body mass also generates energy, and thus its excess loss can trigger fatigue, poor neuromuscular function, and injury risk. “Therefore,” Komorowski says, “satiety promoters and other low-calorie diets may fall in favor over time compared to products and programs that enhance body composition by increasing fat loss while preserving lean body mass.”
Because the body requires a controlled insulin response to convert food to energy rather than store it as fat, Komorowski adds, “having a controlled insulin response is very important” to keeping body composition in healthy balance during any weight-loss program.
Johanna Maukonen, global health and nutrition science lead at DuPont Nutrition & Health, notes that the results of a double-blind, placebo-controlled weight-management trial11 credited her company’s Howaru Shape probiotic (10 billion-CFU Bifidobacterium lactis B420 strain)-either alone or administered with 12 g of the company’s branded Litesse Ultra polydextrose fiber-with controlling body fat mass, core fat mass, waist circumference, and calorie intake in overweight and obese adults. Subjects supplementing with the probiotic/fiber combination had 4.5% less total body fat mass, 6.7% less trunk fat, and a 2.6-cm/1.02-in. smaller waist circumference after six months of supplementation relative to the placebo.
The supplement’s mechanism of action appears to relate to improvements in intestinal integrity, as well as anti-inflammatory effects and, potentially, beneficial changes to the gut microbiota’s composition. “Moreover,” Maukonen says, “the unique results were obtained with no changes to diet or exercise habits. And there were no stimulants added, so participants felt like themselves while controlling body fat mass and improving body composition.”
Bye to the Bad Old Days
Going forward, clinically substantiated evidence like this will become more important than ever. As Appell says, “Science on efficacy and safety drive the market by keeping consumers both realistic and optimistic. They want to know how their supplements work and what they can expect. Sound research and messaging that’s easy to understand help them gain the knowledge they need to make educated purchases.”
In other words, “Gone are the days of ‘magic bullet’ pills boasting unfounded claims or using questionable ingredients with potential side effects,” he says. Weight management has undergone a much-needed market correction as manufacturers lean less on sensationalism and more on real, live effects, he adds, and “that can only lead to better formulas that can prosper in this growing market.”