herbal and dietary supplements for weight loss

A May 2021 study by the University of Sydney said, 

"Over-the-counter herbal and dietary supplements promoted for weight loss are increasingly popular, but unlike pharmaceutical drugs, clinical evidence for their safety and effectiveness is not required before they hit the market", 

"Our rigorous assessment of the best available evidence finds that there is insufficient evidence to recommend these supplements for weight loss. Even though most supplements appear safe for short term consumption, they are not going to provide weight loss that is clinically meaningful."

"Herbal and dietary supplements might seem like a quick-fix solution to weight problems, but people need to be aware of how little we actually know about them”

"Very few high-quality studies have been done on some supplements with little data on long-term effectiveness. What's more, many trials are small and poorly designed, and some don't report on the composition of the supplements being investigated. The tremendous growth in the industry and popularity of these products underscores the urgency for conducting larger more rigorous studies to have reasonable assurance of their safety and effectiveness for weight loss."

Fat around the waist

A May 2021 study by Dr Alexis Elias Malavazos, I.R.C.C.S.Policlinico San Donato, San Donato Milanese, Italy, and colleagues, said, 

"Abdominal obesity might predict a high chest X-ray severity score better than general obesity in hospitalised patients with COVID-19. Therefore, in hospital, waist circumference should be measured and patients with abdominal obesity should be monitored closely."

Testosterone and Inflammatory Foods

An April 2021 study found that,

“… a pro-inflammatory diet can contribute to testosterone deficiency, among other potentially debilitating health issues," 

"Our results suggest men who eat a pro-inflammatory diet [a refined diet** that scores high on the dietary inflammatory index (DII)], particularly those who are obese, are more likely to have testosterone deficiency," 

**A refined diet includes foods that contain refined carbohydrates and sugar as well as polyunsaturated fats.

The study also said,

"Since men with obesity likely already experience chronic inflammation, physicians should be aware of contributing factors, like diet, that could likely worsen this inflammation and contribute to the risk of other health conditions, such as diabetes and heart disease.”

A more anti-inflammatory diet "could be a feasible method to reduce the accumulated inflammatory burden, [potentially] leading to an increased testosterone level.”

Weight Loss and Diabetes Risk

It appears that just a few kilograms in weight loss can significantly reduce the risk of diabetes.

A November 2020 study by the University of East Anglia said, "We have now shown a significant effect in Type 2 diabetes prevention, and we can be very optimistic that even a modest weight loss, and an increase in physical activity, in real world programmes like this have a big effect on the risk of getting Type 2 diabetes.”

"This is really great news for the eight million people in the UK with a prediabetes diagnosis. The results of this trial, show that diabetes prevention is possible in the same prediabetes populations being treated in the NHS national diabetes prevention programme.”

"This is important to know, as the clinical methods for diagnosing diabetes and prediabetes have changed a lot in recent years."

Visceral fat and cognition

A March 2020 study by Augusta University said,

• "We have moved beyond correlations saying there is a lot of visceral fat here, and there is cognitive decline here so they may be interacting with each other."

• "We have identified a specific signal [proinflammatory protein signal interleukin-1 beta] that is generated in visceral fat, released into the blood that gets through the blood brain barrier and into the brain where it activates microglia and impairs cognition."

• "Obesity-induced inflammation occurs over years and so does inflammation in some … chronic inflammatory diseases."

For visceral fat, BMI (body mass index, dividing weight by height) is inferior to the waist-hip ratio.

Attitudes to Obesity

A March 2020 study by Leeds University said,  

• "…weight stigma and discrimination are common within healthcare settings and affects the quality of care that patients receive."

• "Attributions of personal responsibility can lead to bias... with a person's health status perceived to be within an individual's control, which leads to fault and blame.

•  Obesity is "...a complex, multifaceted health condition that can be caused by, for instance, by genetics, epigenetics, biological, environmental, and societal factors."

• "The most striking difference is that the language used about cancer is positive, reflecting optimism and hope … When compared with obesity, the language is negative, reflecting pessimism, fear and unpleasantness."

The report’s proposals include

1. Using “object descriptions such as "weight" or "excess weight"”

2. Putting “people first - not using 'obese people' but 'people with obesity'”

3. Being “accurate in the description of the complex causes of weight gain”

4. No implying “there is a group of people who do not wish to manage their weight.”

Nobiletin, oranges, weight loss

A March 2020 study by the University of Western Ontaria of sweet oranges and tangerines said,

"We went on to show that we can also intervene with nobiletin,"

"We've shown that in mice that already have all the negative symptoms of obesity, we can use nobelitin to reverse those symptoms, and even start to regress plaque build-up in the arteries, known as atherosclerosis."

"This result told us that nobiletin is not acting on AMP Kinase, and is bypassing this major regulator of how fat is used in the body,"

"What it still leaves us with is the question - how is nobiletin doing this?" [They don’t know yet].

“Obesity and its resulting metabolic syndromes are a huge burden to our health care system, and we have very few interventions that have been shown to work effectively… We need to continue this emphasis on the discovery of new therapeutics."

Pilates, Blood Pressure & Obesity

An April 2020 study "hypothesized that Mat Pilates might decrease the risk of hypertension in young obese women.”

The study found that, “Mat Pilates benefit[s] cardiovascular health by decreasing blood pressure, arterial stiffness, and body fatness in young obese women with elevated blood pressure. Because adherence to traditional exercise (both aerobic and resistance) is low in obese individuals, Mat Pilates Training might prove an effective exercise alternative for the prevention of hypertension and cardiovascular events in young obese adults."

Sugar, Longevity, Uric Acid, Gout and Stones

A March 2020 study by the MRC London Institute of Medical Sciences and Kiel University said,

• "Just like humans, flies fed a high-sugar diet show many hallmarks of metabolic disease - for instance, they become fat and insulin resistant."

• "Obesity and diabetes are known to increase mortality in humans, and so people always assumed that this was how excess sugar is damaging for survival in flies".

• "Water is vital for our health, yet its importance is often overlooked in metabolic studies. Therefore, we were surprised that flies fed a high-sugar diet did not show a reduced lifespan, simply by providing them with an extra source of water to drink. Unexpectedly, we found that these flies still exhibited the typical metabolic defects associated with high dietary sugar".

The researchers found that the excess sugar is related to a build up of uric acid but that,

• "the sugar-fed flies may live longer when we give them access to water, but they are still unhealthy. And in humans, for instance, obesity increases the risk of heart disease. But our study suggests that disruption of the purine pathway is the limiting factor for survival in high-sugar-fed flies. This means that early death by sugar is not necessarily a direct consequence of obesity itself".

• "Strikingly, just like flies, we found that dietary sugar intake in humans was associated with worse kidney function and higher purine levels in the blood."

• "It will be very interesting to explore how our results from the fly translate to humans, and whether the purine pathway also contributes to regulating human survival."

• "There is substantial evidence that what we eat influences our life expectancy and our risk for age-related diseases. By focusing on the purine pathway, our group hopes to find new therapeutic targets and strategies that promote healthy ageing".

Diabetes, Obesity and Bacteria

A March 2020 study by McMaster University, Université Laval, and the Québec Heart and Lung Institute said,

• "Our findings suggest that in people suffering from severe obesity, bacteria or fragments of bacteria are associated with the development of type 2 diabetes,"

• "We know that the intestinal barrier is more permeable in obese patients."

• "Our hypothesis is that living bacteria and bacterial fragments cross this barrier and set off an inflammatory process that ultimately prevents insulin from doing its job, which is to regulate blood glucose levels by acting on metabolic tissues."

• "Location, location location...Beyond knowing the names of bacteria, their location is key to understanding how gut microbes influence host metabolism."

• "Our next objective is to determine if the bacteria found in the liver and fat deposits of people suffering from severe obesity are also present in those who are overweight or moderately obese."

• "We also want to see if certain pathogenic bacteria found in the tissues can trigger type 2 diabetes in an animal model. And lastly, we want to find out if certain beneficial bacteria found in these tissues can be used to prevent the development of the disease. If so, they might lead us to a new family of probiotic bacteria or a source of bacteria-based treatments to help fight diabetes."

10,000 steps again

Another piece of research about the mythical 10,000 steps. A February 2020 study by Brigham Young University found that,

• “Exercise alone is not always the most effective way to lose weight,"

• "If you track steps, it might have a benefit in increasing physical activity, but our study showed it won't translate into maintaining weight or preventing weight gain."

• "The biggest benefit of step recommendations is getting people out of a sedentary lifestyle,"

• "Even though it won't prevent weight gain on its own, more steps is always better for you."

Visceral Fat, Obesity, Heart Disease and Diabetes

A January 2019 study by the Smithsonian Tropical Research Institute looked at visceral adipose tissue – visceral fat – (VAT).  

One theory, the "VAT prioritization hypothesis", suggests that a fetus that is undernourished makes the decision to store fat (energy) in visceral fat instead of in fat under the skin – subcutaneous fat.  Visceral fat (VAT) is designed to protect from infection. This prioritizing has a major impact on later life obesity, diabetes, blood pressure. VAT is, in part, stored in the omentum (we wrote about that recently).

An increase in visceral fat causes inflammation. This can lead to insulin resistance. A feed-back loop starts: even more visceral fat is stored.

The researchers said,

• “Trying to understand diseases related to obesity without understanding the abdominal structures [the omentum] that become obese is like trying to understand circulatory diseases without knowing the functions of the heart,"

• "The fact that visceral fat tissue evolved to fight visceral infections provides a causal hypothesis for how high fructose sweeteners and saturated fats contribute to chronic diseases such as type 2 diabetes,"

• "They influence which bacteria grow inside the intestines [called the microbiome], making the intestinal walls more permeable and releasing more toxins into the bloodstream, stimulating the visceral immune system and potentially leading to chronic inflammatory disease."

• "I think the combination of malnutrition early in life coupled with modern diets of saturated and trans-fats and high-fructose foods available on a global scale is leading to a situation that is toxic for individuals in many different cultures."

• "People's body shape--apple versus pear--is based on the way their bodies allocate fat. Even in ancient societies, poor nutrition leading to investment in VAT contributed to apple-shaped bodies, versus more 'beautiful,' voluptuous, pear-shaped bodies associated with SAT fat storage by better-nourished babies. Social upheaval (war, conquest and disease) would have favored flexibility in fat allocation because social rank and food availability would occasionally have changed."

Proposal for a Scientifically Correct and Medically Actionable Disease Classification System (ICD) for Obesity

Obesity Society: “Objective: Obesity is responsible for a huge burden of suffering and social costs, and yet many patients lack access to evidence-based therapies. The diagnostic term "obesity" and inadequate International Classification of Diseases (ICD) codes contribute to suboptimal efforts to prevent and treat obesity as a chronic disease. The goal of this review is to develop a medically actionable classification system based on the diagnostic term "adiposity-based chronic disease" (ABCD) that reflects disease pathophysiology and specific complications causing morbidity and mortality.

Methods: A coding system based on the diagnosis of ABCD with four domains is proposed: A codes reflect pathophysiology, B codes indicate BMI classification, C codes specify specific biomechanical and cardiovascular complications remediable by weight loss, and D codes indicate the degree of the severity of complications. Supplemental codes identify aggravating factors that complicate care and that are relevant to a personalized therapeutic plan.

Results: The coding system addresses pathophysiology and therapeutic goals and differential risk, presence, and severity of specific complications that are integral to ABCD as a chronic disease.

Conclusions: The scientifically correct and medically actionable approach to diagnosis and disease coding will lead to greater acknowledgement of ABCD as a disease and accessibility to evidence-based therapies on behalf of patients across the life cycle.”

Sources

About the journal - Obesity is the peer-reviewed, scientific journal of The Obesity Society.

Proposed Coding System Addresses Pathophysiology, Therapeutic Goals, W. Timothy Garvey, garveyt@uab.edu, and Jeffrey I. Mechanick (http://onlinelibrary.wiley.com/doi/10.1002/oby.22727)

Also see accompanying commentary by Johannes Hebebrand (http://onlinelibrary.wiley.com/doi/10.1002/oby.22740), posting online on Feb. 24, 2020

https://www.eurekalert.org/pub_releases/2020-02/tos-rpn022120.php

Big Breakfasts Good

A February 2020 study by University of Lübeck found, “that a meal eaten for breakfast, regardless of the amount of calories it contains, creates twice as high diet-induced thermogenesis as the same meal consumed for dinner,"

"This finding is significant for all people as it underlines the value of eating enough at breakfast."

"We recommend that patients with obesity as well as healthy people eat a large breakfast rather than a large dinner to reduce body weight and prevent metabolic diseases."

Visceral Fat and Exercise

It is worth revisiting the July 2019 study by the University of Texas Southwestern Medical Center which said,

• "Visceral fat can affect local organs or the entire body system. Systemically it can affect your heart and liver, as well as abdominal organs.”

• "When studies use weight or body mass index as a metric, we don't know if the interventions are reducing fat everywhere in the body, or just near the surface."

• "The location and type of fat is important. If you just measure weight or BMI, you can underestimate the benefit to your health of losing weight,"

• "Exercise can actually melt visceral fat."

• "Some people who are obese get heart disease, diabetes, or metabolic syndrome - and others don't."

• "Our study suggests that a combination of approaches can help lower visceral fat and potentially prevent these diseases."

Visceral Fat, Cognition and Diabetes

In a February 2020 study it was said, "Preserved cognitive functioning is important in the execution of complex task such as diabetes self-care management. Therefore, assessment of visceral adiposity and interventions that target visceral adiposity may help to prevent cognitive decline in older patients with diabetes and reduce the global burden of dementia in ageing populations,"

Alternating Keto Diet – “Starving-Not Starving”

A January 2020 study (on mice) by Yale University found mixed results by following a ketogenic diet.  Short term health benefits were followed by some negative effects.  There appears to be some benefit in lowering inflammation and reducing the risk of diabetes. Researchers said, “Obesity and type 2 diabetes are lifestyle diseases … Diet allows people a way to be in control … Our findings highlight the interplay between metabolism and the immune system, and how it coordinates maintenance of healthy tissue function,"

The Omentum

“The Omentum (Latin for "apron") is a medical term referring to layers of peritoneum that surround abdominal organs … The greater omentum … is a large apron-like fold of visceral peritoneum that hangs down from the stomach … The greater omentum is larger than the lesser omentum, which hangs down from the liver to the lesser curvature.” (Wikipedia)

“The common anatomical term "epiploic" derives from "epiploon", from the Greek epipleein, meaning to float or sail on, since the greater omentum appears to float on the surface of the intestines.” (Wikipedia)

There’s an interesting, graphic, comparison of a healthy omentum and a not-so-healthy one here:

The omentum has, amongst other things, immune functions using white filters called milky spots for the surrounding fluids. These milky spots are very small white-coloured areas of lymphoid tissue.

A June 2017 review by the University of Alabama reported that, “the fluid around the abdominal organs doesn't just sit there, it circulates through the milky spots …Milky spots collect cells, antigens, and bacteria before deciding what's going to happen immunologically."

Galen states, “It is in this way, therefore, that the stomach, when it is in need of nourishment and the animal has nothing to eat, seizes it from the veins in the liver. Also in the case of the spleen we have shown in a former passage[384] how it draws all material from the liver that tends to be thick, and by working it up converts it into more useful matter. There is nothing surprising, therefore, if, in the present instance also, some of this should be drawn from the spleen into such organs as communicate with it by veins, _e.g._ the omentum, mesentery, small intestine, colon, and the stomach itself. Nor is it surprising that the spleen should disgorge its surplus matters into the stomach at one time, while at another time it should draw some of its appropriate nutriment from the stomach.” (our italics)

Ayurvedic medicine has it as secondary tissue, upadhaatu, as part of fat tissue, medodhatu, that which supports and nourishes the fatty tissue, as part of lubrication and energy storage. Part of the element of water.

Dr Louis Gordon ventured that the omentum may the gut of the brain.  In Traditional Chinese Medicine the brain is the “sea of marrow”.  It may be possible to see the omentum as the stomach’s “sea of marrow” and also connected to the Triple Warmer meridian.

Image

Dr. Johannes Sobotta [Public domain]

Bread Products – the Glycemic Index (GI)

This is a way of measuring how the food that you eat affects the amount of sugar in your blood.  This is important for a number of reasons.

A food with a GI value of 55 or less is labelled “Low GI”.  The food will have a slower, longer impact on you, energy-wise.  High GI foods (those with a GI above 70) will be used by your body before any stored energy like body fat. And this may make weight loss more difficult.

French Baguette - 95

Bagel - 72

White Bread - 71

Croissant - 67

Wholemeal Rye - 62

Hamburger Bun - 61

Pitta - 57

__________________________

Sourdough Wheat - 54

Whole Wheat - 49

Sourdough Rye - 48

Pumpernickel - 46

Heavy Mixed Grain - 45

Soya and Linseed - 36

Source

http://www.the-gi-diet.org/lowgifoods/

Weight Loss Using Different Diets and Fasting

A January 2020 study by the University of Otago found that for some, certain types of diet and fasting can be, “healthful, beneficial ways to eat". The researchers said, “This work supports the idea that there isn't a single 'right' diet - there are a range of options that may suit different people and be effective. In this study, people were given dietary guidelines at the start and then continued with their diets in the real world while living normally. About half of the participants were still following their diets after a year and had experienced improvements in markers of health.”

"Like the Mediterranean diet, intermittent fasting and paleo diets can also be valid healthy eating approaches - the best diet is the one that includes healthy foods and suits the individual."

“Our participants could follow the [Mediterranean] diet's guidelines more closely than the fasting and paleo diets and were more likely to stay with it after the year, as our retention rates showed."