Multi-pronged and holistic approaches help tackle the complexities of weight loss.
The percentage of U.S. adults who are obese continued to trend upward in 2014, reaching 27.7 percent. This is up more than two percentage points since 2008 and is the highest obesity rate Gallup and Healthways have measured in seven years of tracking it. More Americans who were previously overweight have now moved into the obese category, while the percentage who are at normal weight has remained stable since 2013.
For practitioners, the challenge of helping patients reach their weight-loss goals can be viewed as a driving force to aid in the battle of the bulge. The best chance of long-term success may be achieved with a “multi-pronged” approach to weight management that can be tailored to each individual, according to Emily Gonzalez, ND, senior scientific development associate with Florida-based Life Extension.
“Addressing Life Extension’s nine pillars of weight loss, including restoring insulin sensitivity and a youthful hormone balance, increasing physical activity, restoring resting energy expenditure rate and brain serotonin levels, promoting healthy adipocyte signaling, and, of course, eating in order to live a long and healthy life, is a holistic approach to weight management that can benefit many individuals struggling with extra body weight,” Dr. Gonzalez said.
Leonid Ber, MD, from Illinois-based Protocol For Life Balance, suggested similar advice: “The most holistic approach to weight management is the one that recognizes the complexity of the interaction between ‘nature and nurture,’ and takes into consideration genetic predispositions, epigenetic expressions, interplay between the hormones regulating hunger and satiety, as well as behavioral aspects, such as exercise and dietary choices, along with their hedonic value,” he said. “Clinicians no longer think of weight management as a pill or a surgical procedure solution that could produce long-standing results alone.”
For Beth Baldwin-Lien, ND, medical affairs & education with Vital Nutrients in Connecticut, natural approaches for weight management include, eating a whole food diet, regular physical activity and balancing calorie intake with calorie expenditure. “When tailoring recommendations for an individual patient,” she said, “a practitioner will first assess for and address underlying medical reasons for weight gain, such as insulin resistance, hypothyroidism or elevated cortisol levels, and review any medications that may impede weight-loss efforts. Functional medicine physicians often include assessment of endocrine-disrupting environmental toxins as a part of a weight-loss approach.”
There is a wide array of nutritional products to support healthy weight management. “Some of the most innovative include products that contain a specialized peptide complex from Saccharomyces cerevisiae that may modulate appetite-regulating hormones in the brain via their effect on neuropeptide Y and decrease the activity of enzymes responsible for the manufacturing of fat from excess energy in foods,” Dr. Gonzalez noted. “Products that contain a specialized extract of saffron may reduce the desire to snack by targeting some of the emotional factors that may cause someone to eat more when they’re trying to eat less. And a novel Italian Borlotto bean extract has been shown to help support normal levels of the gut hormones that control appetite and satiety, as well as modulate alpha-amylase, the enzyme that converts dietary starch into simple sugars.”
Dr. Ber added that perhaps the most useful framework for classifying nutrients relevant to weight management would be dividing them into modalities affecting central and peripheral mechanisms, and a combination thereof. “Getting to know your patient inside and out should allow you to concentrate on the pathways in need of most repairs.”
From a clinician’s perspective, the most significant evolution happening with dietary supplements is in the way they are being used—as a part of comprehensive nutritional and behavioral intervention protocol custom-fit to the patient’s needs, Dr. Ber noted. “This is the most important distinction between individual consumers who clearly lean toward a supplement-only-solution and natural practitioners who wholeheartedly embrace a holistic approach.”
“As overweight/obesity has become one of the most important public health issues facing our country,” said Dr. Gonzalez, “innovative products and ingredients with research to support their use for healthy weight management are an important part of the overall approach to combat this epidemic. Keeping abreast of the research to find these innovative ingredients and bring them to the consumer is one of the ways that Life Extension stays in the forefront of helping people find optimal health as they age.”
Weight-Loss Ingredient Research
Regarding recent research on weight loss, Life Extension’s Dr. Gonzalez pointed to a 2014 study in Nutrition, which showed that young to middle-aged obese men and women taking 500 mg twice daily of a specialized peptide complex from Saccharomyces cerevisiae reduced their energy intake, decreased their waist circumference, and lost body fat (while preserving lean body mass) in a 10-week period compared to placebo.1 In 2010, Satiereal, a proprietary saffron extract, was shown to reduce body weight and snacking frequency in healthy, mildly overweight women in a placebo-controlled, double-blind study without caloric restriction.2 And Beanblock, a standardized extract of the Italian Borlotto bean, was associated with a reduction in body weight, waist circumference, and oxidative stress in healthy, overweight subjects over a 12-week period in a 2014 pilot study.3
Used for healthy body weight, Dr. Ber noted that MCT, or medium-chain triglycerides from coconut oil, are glycerol esters of fatty acids with the number of carbon atoms between eight and 12. “Unlike longer chain fatty acids, they require little or no enzymatic breakdown and are easily absorbed and transported into the liver where they are rapidly used for energy production rather than being stored as fat,” he explained. “Metabolically speaking, they are processed more like carbohydrates, but without the requirement of insulin, and with no effect on blood sugar and triglycerides. Because MCT bypass peripheral tissues, it makes them less susceptible to hormone-sensitive lipase and to being deposited into adipose tissue.”
The best clinical outcomes in body weight and composition have been shown in moderately overweight individuals where MCT (about 10 g/day) isocalorically replaced long-chain triglycerides in a fat-balanced diet, reaching statistically significant difference in body weight at eight to 12 weeks, as compared to placebo.
Another noteworthy dietary ingredient used in a Protocol for Life Balance product is commonly known as 7-Keto, a naturally occurring metabolite of dehydroepiandrosterone (DHEA), but unlike DHEA it does not result in formation of androgenic or estrogenic hormones, Dr. Ber stated. 7-Keto has a unique mode of action via optimizing the rate of mitochondrial substrate oxidation, and support of triiodothyronine (T3) levels. Typical clinically validated amount of 7-Keto is 200 mg/day. It results in statistically significant uptick in the normal energy expenditure, and is strongly recommended when combined with a personalized diet and exercise regimen.
Dr. Baldwin-Lien recommended Vita Nutrient’s 7-KETO DHEA, Vital Clear, protein powders, multi nutrients, vitamin D and berberine.
“7-Keto, also known as 3-acetyl-7-oxo dehydroepiandrosterone or 7-oxo DHEA, is a naturally occurring metabolite of DHEA, which cannot be converted back to DHEA in the body,” she explained. Like DHEA, 7-Keto production declines with age. 7-Keto may enhance the activity of thermogenic enzymes that support the body’s ability to utilize fat for energy. Studies suggest that 7-Keto may provide non-stimulatory support in improving RMR (resting metabolic rate) and promoting weight loss when combined with exercise and a calorie restricted diet. Vital Nutrients’ 7-Keto DHEA is derived from a plant source that has been purified to match the substance naturally produced in the body.
Vital Clear is a high-quality source of naturally pure macro- and micronutrients. Vital Clear is comprised of rice and pea protein, vitamins, minerals, trace elements, amino acids, herbs and essential fatty acids. A full range of vitamins, minerals, and trace elements support all the body’s systems. Optimal nutrient levels combine with cinnamon and glucomannan to maintain healthy blood sugar levels. The unique blend of botanicals and amino acids promote normal detoxification, while simultaneously suppressing inflammation.
In addition, Life Extension’s weight-loss products include: Waist-Line Control; Optimized Saffron with Satiereal; Advanced Natural Appetite Suppress; and Advanced Anti-Adipocyte Formula.
When combined with diet, exercise and lifestyle strategies, Dr. Baldwin-Lien said nutritional supplements could help:
• Increase resting metabolic rate
• Attain ‘quick wins’ to increase feelings of self-efficacy
• Promote satiety
• Fill nutritional gaps in SAD (standard American diet), low-calorie or restrictive diets
• Support healthy blood sugar, insulin sensitivity and cortisol levels
• Aid in detoxification of accumulated environmental toxins that may be impeding fat loss and/or mobilized during fat loss
• Decrease inflammation to improve pain/exercise tolerance and lower diabetes risk
Her other recommendations are:
• Eat breakfast (including protein) within one hour of waking, to avoid cortisol surge and compensatory overeating later in the day
• Eat every three hours during the day
• Focus on whole foods: lean proteins; high-fiber, low-glycemic index vegetables, fruits and whole grains; omega-3/monounsaturated fats
• Avoid high-glycemic index foods and caloric drinks
• Correct “portion distortion:” occasionally weigh/measure servings as a reality check; eat off of smaller plates; box up half of a restaurant meal to take home
One of the most scrutinized categories of nutritional supplements is weight loss. In fact, recently the FDA (U.S. Food and Drug Administration) has warned consumers to avoid any weight-loss pills that contain BMPEA. BMPEA or beta-methylphenethylamine is something of a “super caffeine,” but FDA researchers are concerned that the substance may be more closely related to amphetamine.
“Quality is always important when it comes to dietary supplements,” Dr. Gonzalez said, adding that Life Extension meets the highest standards of good practices for quality assurance and control, as certified by NSF International, an organization that provides third-party GMP (good manufacturing practice) certification programs. “This means that the label accurately reflects exactly what is in each product, and does not contain any traces of drugs or other adulterants,” Dr. Gonzalez explained. “This is particularly important in the weight management category, as there have been issues with drugs, such as sibutramine and fluoxetine showing up in weight management supplements.”4
Dr. Ber agreed: “Safety and quality of dietary supplements have been undermined by some of the unsavory flight-by-night players in the industry,” he noted, “as documented by a steady flow of warning letters being issued by the FDA identifying adulterated weight-loss products, often containing undeclared drug ingredients. When it comes to dietary supplements, know your manufacturer, have a relationship with your brand, this step is as important as the intervention choices you make for your patients.”
1 Jung EY, Cho MK, Hong YH, et al. Yeast hydrolysate can reduce body weight and abdominal fat accumulation in obese adults. Nutrition. 2014 Jan;30(1):25-32.
2 Gout B, Bourges C, Paineau-Dubreuil S. Satiereal, a Crocus sativus L extract, reduces snacking and increases satiety in a randomized placebo-controlled study of mildly overweight, healthy women. Nutr Res. 2010 May;30(5):305-13.
3 Luzzi R, Belcaro G, Hu S, et al. Beanblock (standardized dry extract of Phaseolus vulgaris) in mildly overweight subjects: a pilot study. Eur Rev Med Pharmacol Sci. 2014 Oct;18(20):3120-5.
4 Dunn JD, Gryniewicz-Ruzicka CM, Mans DJ, et al. Qualitative screening for adulterants in weight-loss supplements by ion mobility spectrometry. J Pharm Biomed Anal. 2012 Dec;71:18-26.