Dietary Supplements For Weight Loss Research Articles

FDA Warns of Hidden Prescription Drugs in Dietary Supplements.

The Food and Drug Administration has issued a warning that many products sold as dietary supplements for weight loss, sexual enhancement, or body building contain prescription drugs or other chemicals.Nurses and NPs should assess patients for use of these products and help them recognize those that are potentially tainted.

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

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

Analiza zawartości kofeiny w suplementach diety wspomagających odchudzanie

Analiza zawartości kofeiny w suplementach diety wspomagających odchudzanie

Effects of Thylakoid-Rich Spinach Extract on the Pharmacokinetics of Drugs in Rats.

Thylakoid-rich spinach extract is being used as dietary weight-loss supplements in Japan. A recent rat study has suggested that intake of thylakoid-rich spinach extract with dietary oil inhibits dietary fat absorption via binding to bile acids, which promotes excretion of bile acids in feces. While, we confirmed that a serving size of thylakoid-rich spinach extract contains a large amount of calcium (130 mg/5 g). Therefore, using rats, we evaluated whether one-time ingestion of thylakoid-rich spinach extract affects the gastrointestinal absorption of water-insoluble drugs, such as griseofulvin (GF) and indomethacin (IM), or ciprofloxacin (CPFX) that chelate with polyvalent metal cations. Pretreatment of the rats with thylakoid-rich spinach extract (100 or 300 mg/kg) for 15 min prior to oral administration of GF (50 mg/kg) or IM (10 mg/kg) did not significantly alter the pharmacokinetic properties of either drug. Meanwhile, co-administration of thylakoid-rich spinach extract (500 mg/kg) and CPFX (20 mg/kg) significantly reduced the peak plasma concentration and the area under the plasma concentration-time curve of CPFX to 25 and 40%, respectively in rats. In vitro studies demonstrated that when a mixture of thylakoid-rich spinach extract and CPFX was centrifuged, there was a significant reduction in the supernatant concentration of CPFX relative to the control. When the experiment was repeated in the presence of ethylenediaminetetraacetic acid, the concentration of CPFX was unchanged. These results suggest that the intake of thylakoid-rich spinach extract may reduce the absorption of drugs that form a chelate with polyvalent metal cations, such as CPFX.

Determination of Stimulants and Diuretics in Dietary Supplements for Weight Loss and Physical Fitness by Ion-pair Chromatography and Pulsed Amperometric Detection (PAD)

Determination of Stimulants and Diuretics in Dietary Supplements for Weight Loss and Physical Fitness by Ion-pair Chromatography and Pulsed Amperometric Detection (PAD)

Safety evidence on the administration of Fucus vesiculosus L. (bladderwrack) extract and lamotrigine: data from pharmacokinetic studies in the rat

Fucus vesiculosus is often incorporated in weight loss dietary supplements to improve weight loss in overweight adults. Obesity is a common condition in epilepsy patients and is indeed increasing in refractory epilepsy and in patients under polytherapy. Since lamotrigine (LTG) is a first-line antiepileptic drug, used in monotherapy or adjunctive therapy, the main objective of this work was to investigate the potential pharmacokinetic-based interactions between F. vesiculosus and LTG in rats. In a first pharmacokinetic study, a single oral dose of F. vesiculosus extract (575 mg/kg, p.o.) was co-administered with a single-dose of LTG (10 mg/kg, p.o.). In a second study, rats were orally pretreated with F. vesiculosus extract (575 mg/kg/day, p.o.) for 14 days and received LTG (10 mg/kg, p.o.) on the 15th day. In the control groups, rats received water instead of the extract. After LTG administration, blood samples were taken until 96 h post-dose, and LTG concentrations measured in plasma were submitted to a non-compartmental pharmacokinetic analysis. The co-administration of F. vesiculosus extract and LTG caused no significant changes in the drug kinetics. However, the repeated pretreatment with F. vesiculosus extract significantly reduced the peak concentrations of LTG and caused a slightly decrease in the extent of systemic drug exposure. Overall, based on these results, no significant clinical impact is expected from the administration of F. vesiculosus dietary supplements and LTG.

Cytotoxicity of Structurally Diverse Anthranoids and Correlation with Mechanism of Action and Side Effects.

The purpose of this contribution is to evaluate the cytotoxicity and apoptosis inducing ability of structurally diverse anthraquinones to establish a relationship between structure and toxicity. Besides the wide spread use of anthraquinones in pharmacological drugs for constipation and non-prescription dietary supplements for weight loss, extracts are still commercialized as crude extracts and long-term side effects are still relevant. In this work we developed a method to quantify the cascarosides isolated from Rhamnus purshiana (Cascara Sagrada) using LC-MS/MS and evaluated the effects of this extract and isolated compounds on cellular viability using NOK-SI, HeLa, and T98G cell lineages. Apoptosis inducing ability was also analyzed via evaluating key-proteins involved in apoptosis pathways. Using cascarosides isolated from bark extracts, we found that the presence of glucose moieties in the chemical structure reduced the toxicity. This communication reviewed the mechanisms of action, toxicity of anthraquinones and correlated the toxicity with chemical structures of cascarosides. Results indicate that cascarosides-enriched cascara extract, as well as glycosylated anthraquinones, may have some beneficial effects for laxative action of herbal medicines. Considering our results, a cascarosides-enrichment in cascara extract is recommended.

Novel interactomics approach identifies ABCA1 as direct target of evodiamine, which increases macrophage cholesterol efflux

Evodiamine, a bioactive alkaloid from the fruits of the traditional Chinese medicine Evodia rutaecarpa (Juss.) Benth. (Fructus Evodiae, Wuzhuyu), recently gained attention as a dietary supplement for weight loss and optimization of lipid metabolism. In light of its use by patients and consumers, there is an urgent need to elucidate the molecular targets affected by this natural product. Using a novel interactomics approach, the Nematic Protein Organisation Technique (NPOT), we report the identification of ATP-binding cassette transporter A1 (ABCA1), a key membrane transporter contributing to cholesterol efflux (ChE), as a direct binding target of evodiamine. The binding of evodiamine to ABCA1 is confirmed by surface plasmon resonance (SPR) experiments. Examining the functional consequences of ABCA1 binding reveals that evodiamine treatment results in increased ABCA1 stability, elevated cellular ABCA1 protein levels, and ultimately increased ChE from THP-1-derived human macrophages. The protein levels of other relevant cholesterol transporters, ABCG1 and SR-B1, remain unaffected in the presence of evodiamine, and the ABCA1 mRNA level is also not altered.

Chemical Analysis of Weight Loss Herbal Supplement Safe Lean™ Associated With Acute Liver Injury – A Concern for Spurious Drug, Misbranding and Adulteration

Liver injury due to herbal and dietary supplements are well described in literature and its incidence has been on the rise in the past decade. Labelling an herbal product as non-medicinal and as a supplement precludes protocols needed for testing, trials and marketing criteria. This has led to rampant use of clinically unproven multi-herb-based drugs use for a myriad of lifestyle diseases. In this report, we discuss a new dietary weight loss supplement, Safe Lean™ that was found to be the cause of liver injury in a young obese woman, that resolved after discontinuation, and discuss current literature on component, toxicology and chemical analysis of the offending drug.

"OxyElite Pro" Induced Fulminant Hepatotoxicity

Around 35% of adults or more are overweight according to a report by Global Health Observatory (GHO). In the absence of proven medical therapeutics, the use of dietary supplements to effect weight loss has increased and under much less scrutiny by regulatory agencies like the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA). For many, these approaches represent apparent alternatives to failed attempts at weight loss with the use of more conventional approaches [1]. Hepatotoxicity from supplements is a growing problem while the internet facilitates obtaining these agents across national regulatory boundaries. OxyElite Pro capsules are sold as a dietary supplement for weight loss and ‘’super thermogenic’’ agent (Figure1A & B). According to the manufacture, the proposed mechanism of action is ‘fat burning via the contained ingredients which are: Rauwolfia Canescens, Thyroxine (T4) and Triiodothyronine (T3), Bauhinia Purpurea Trypsin Inhibitor (BPLTI), Bacopa monnieri, Geranium which contains a powerful constituent known as 1,3-Dimethylamylamine (DMAA), Cirsium Oligophyllum, and Caffeine’. A more recent formula of OxyElite Pro released in late 2012 contained a new ingredient, Aegeline. We describe a case of acute liver failure in an otherwise young healthy female after taking the newer OxyElite Pro formula to lose weight. Keywords: OxyElite Pro, Hepatotoxicity, acute liver failure, fulminant, herbal induced liver injury

Acute Liver Failure Induced by Carthamus tinctorius Oil: Case Reports and Literature Review

BackgroundAcute liver failure (ALF) is a clinical syndrome that results from the abrupt loss of liver function in a patient without previous liver disease. The most frequent causes are viral hepatitis, drug induced, and autoimmune disease, but in 20% of cases no cause is identified. Carthamus tinctorius (safflower) oil is used as a dietary supplement for weight loss and antioxidant. There are 4 cases described in the literature of ALF induced by the use of this substance. The objective of this study was to report 3 cases of ALF treated at the Clinical Hospital of the State University of Campinas that suggest the use of C tinctorius oil as a probable etiologic factor. Case ReportsThe 3 patients had a diagnosis of ALF according to the King's College criteria. All had a history of ingestion of this oil for weight loss. During etiologic evaluation, viral hepatitis, autoimmune diseases, or any other drug cause were excluded, thus pointing to C tinctorius oil as the triggering factor. All 3 patients underwent liver transplantation: 2 had good postoperative evolution, and 1 died 12 days after the procedure. ConclusionsTwo cases are described in which the hepatic insufficiency induced by C tinctorius oil was successfully treated through liver transplantation. This highlights the risk of misuse of this substance for weight loss.

Severe non-exertional rhabdomyolysis from weight loss supplement in sickle cell trait: A perfect storm?

Exertional rhabdomyolysis from sickle cell trait has been documented. Also, cases of rhabdomyolysis from the use of weight loss supplements in the setting of sickle cell trait and exertion have been described. However, the role of sickle cell trait in non-exertional rhabdomyolysis is not clear. We present a case of severe non-exertional rhabdomyolysis from weight loss supplement in a patient with sickle cell trait.A 45-year-old African American female with sickle cell trait presented to the emergency department with two days history of fatigue and mild breathlessness. She also reported diarrhea and vomiting for five days before presentation. She admitted to taking Garcinia cambogia (a dietary supplement) for weight loss one week prior to the onset of symptoms. She denied alcohol or drug use, rigorous physical activity or trauma.She was dehydrated on examination. Laboratory values revealed markedly elevated serum creatine phosphokinase (CPK) and creatinine levels. Garcinia cambogia was discontinued and she was hydrated with intravenous fluids. Her CPK and creatinine levels significantly trended down and she was discharged home with no apparent sequelae.Our patient had multiple episodes of diarrhea and vomiting likely from the use of Garcinia cambogia. We believe she suffered non-exertional rhabdomyolysis from dehydration in the setting of sickle cell trait. Though dietary weight loss supplements are marketed as generally safe, this case suggests otherwise. We emphasize that clinicians routinely inquire about use of these supplements and provide appropriate counseling to patients on the adverse effects, especially among those with sickle cell trait.

A case of liver injury caused by Kyoukousou and Shin-Kyokubi, Chinese dietary supplements for weight loss

A case of liver injury caused by Kyoukousou and Shin-Kyokubi, Chinese dietary supplements for weight loss

USE OF DIETARY SUPPLEMENTS FOR WEIGHT LOSS IN OBESE PATIENTS IN ZONGULDAK, TURKEY

Background: Obesity is a prevalent and worldwide health problem . The most common weight loss method preferred by obese individuals is dietary supplements. This study was performed in order to determine the dietary supplements used by obese individuals for weight loss and to examine the barriers to informing health personnel on supplement use.
 Materials and Methods: This descriptive study was performed in the Endocrinology and Diabetes Polyclinic at the Endocrinology and Metabolic Diseases Department of the Health Application and Research Center of the Bulent Ecevit University. The sample consisted of 151 patients randomly selected from among the 755 people using the simple randomization method.
 Results: In the study, 33.6% of the obese individuals were found to use dietary supplements for weight loss. Women, people with no chronic diseases, people who exercised regularly, and people who underwent regular health check-ups were found to prefer dietary supplements at a greater rate (p

In Vitro Cyto-genotoxicity of Hydroxycitric Acid: A Weight-loss Dietary Supplement

The growing issue of clinical obesity has led to increased consumption of weight-loss dietary supplements containing hydroxycitric acid (HCA) derived from the fruit rind of Garcinia cambogia, a plant widely distributed in Asia and Africa. It is often consumed in an unregulated manner, beyond the permissible dose, to achieve the target weight-loss. However, its safety/efficacy is controversial and reports on cytotoxicity and genotoxicity are limited and inconsistent. Hence, we aimed to study the putative effects of HCA on genotoxicity in human peripheral blood cells.

Banned and discouraged-use ingredients found in weight loss supplements

ObjectivesTo identify banned and discouraged-use ingredients, such as ephedra, 1,3-dimethylamylamine, and beta-methyl-phenylethylamine, in readily available weight loss dietary supplements within a 10-mile radius of Regis University. MethodsA list of banned and discouraged-use ingredients was compiled with the use of the Food and Drug Administration (FDA) dietary supplement website which provides information on supplement ingredients that are no longer legal or are advised against owing to adverse event reporting. Investigators visited all retail outlet stores within a 10-mile radius of Regis University in Denver, Colorado. Retail chains were not duplicated and only one of each chain was evaluated. ResultsA total of 51 weight loss supplement products from retail stores were found with banned or discouraged-use substances listed on their labels. At least one banned ingredient was found to be listed on the product labels in 17 of the 51 studied supplements (33%). At least one discouraged-use ingredient was found in 46 of the 51 products (90%). Retail outlet stores dedicated to supplements and sports nutrition alone were found to have the greatest number of weight loss supplements that included banned and discouraged-use ingredients. ConclusionThe FDA has taken action to remove some weight loss supplements from the market that contain banned ingredients. Unfortunately, based on the findings of this study, it is evident that products containing these ingredients remain on the market today.

A clinical case of a patient with anorexia nervosa and bizarre behavior

Eating disorders (EDs) are mental illnesses, defined by abnormal eating habits. EDs are chronic, severe and difficult to treat, and cause psychological, social and physical consequences. It occurs predominantly in adolescents and young adults women (around 90%), causing severely disability, major biopsychosocial losses, and high morbidity and mortality. EDs are considered by WHO as a public health problem, affecting different ages, genres, times, regions and contexts.ObjectiveCase report of a patient with Anorexia Nervosa and bizarre behavior.MethodsClinical observation in hospital.ResultsWoman with 43 years old, with a peace of 65 years, who was hospitalized in Psychiatric Service – Eating Disorders, in August 2015, because of its extreme thinness, with difficulty to walk and with severe edema of the feet, ankles and legs. At the entrance, she weighed 29 kg, after 4 days her weight reduced to 23 kg, reaching a BMI of 8.5 kg/m2. In the first week, she showed a high cognitive impairment, confusional state and detailed and ruminative speech about food. She had developed multiple techniques to hide food and to hide and take dietary supplements for weight loss. Furthermore, she had a bizarre behavior and marked social isolation, not interacting with other patients.ConclusionAlthough the low prevalence of EDs, these have a high morbidity, and are one of the psychiatric disorders that most often leads to a fatal outcome. Treatment is lengthy and cumbersome, requiring serious investments under the personal point of view, family and clinical, yet still, these patients can have a full life and quality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prescription Drugs and Dietary Supplements for Weight Loss

Despite much advertising to the contrary, there are no dietary supplements that safely and effectively cause weight loss. Moreover, some of them are adulterated with banned prescription drugs as well as narcotics, stimulants, antidepressants, anorectics, laxatives and diuretics. There are several analytical methods, including LC-MS/MS and NMR that can be used to analyze dietary supplements for adulterants. Such methods can be used to detect and quantify them at physiologically relevant concentrations of >1%. Even though many supplements don’t contain any of these potentially deadly adulterants, many do contain caffeine and/or green tea extract at such high concentrations that they can also be quite toxic. On the other hand, there are five prescription drugs that are FDA-approved as an adjunct to counseling, diet and exercise for maintaining weight loss. They are orlistat (Xenical® or Alli when sold over-the-counter), lorcaserin (BELVIQ®), phentermine plus extended-release topiramate (Qsymia®), naltrexone plus bupropion (Contrave®) and liraglutide (Saxenda®). Unlike dietary supplements, they were all developed in research programs that were conducted through good laboratory practices (GLP) and manufactured by current good manufacturing practices (cGMP). So, they have been shown to be safe and effective. Moreover, every step in the manufacturing process is monitored and documented to ensure the purity of the drugs. Finally, post-market monitoring of potential adverse side effects is done on these drugs.

The Dangerous Mix of Adolescents and Dietary Supplements for Weight Loss and Muscle Building: Legal Strategies for State Action.

Adolescents use dietary supplements marketed for weight loss or muscle building, but these are not recommended by physicians. These products are often ineffective, adulterated, mislabeled, or have unclear dosing recommendations, and consumers have suffered injury and death as a consequence. When Congress passed the Dietary Supplement Health and Education Act, it stripped the Food and Drug Administration of its premarket authority, rendering regulatory controls too weak to adequately protect consumers. State government intervention is thus warranted. This article reviews studies reporting on Americans' use of dietary supplements marketed for weight loss or muscle building, notes the particular dangers these products pose to the youth, and suggests that states can build on their historical enactment of regulatory controls for products with potential health consequences to protect the public and especially young people from unsafe and mislabeled dietary supplements.

A study on verifying the effectiveness of 4-week composite weight-loss dietary supplement ingestion on body composition and blood lipid changes in middle-aged women.

PurposeThe purpose of this study was to investigate the effectiveness of a composite weight-loss dietary supplement on body composition and blood lipid changes in middle-aged women.MethodsThirty seven middle-aged women living in the Kyunggi area participated in this study and they were randomly divided into 2 groups (Dietary supplement ingestion group; DG, n = 20 and Placebo group; PG, n = 17). Blood draw and dual energy x-ray (DEXA) measurements were conducted to examine changes in body composition and blood lipids.ResultsThere were no significant changes in weight and BMI in both groups. There was an interaction between the composite weight-loss dietary supplement intake and lean body mass in DG and there was a significant decrease in percent body fat in DG. Blood lipid changes in the study results showed that there was no significant difference in TC, TG, and LDL in both groups; however, there was a significant interaction between the composite weight-loss dietary supplement intake and HDL-C as well as an increase in the HDL-C of DG.ConclusionIn conclusion, it seems that 4-week ingestion of the composite weight-loss dietary supplement decreased body fat, increased lean body mass, and increased HDL-C. Therefore, the composite weight-loss dietary supplement is expected to prevent obesity and induce health improvements in middle-aged women.