A history of obesity, or how what was good became ugly and then bad.
Chronic food shortage and malnutrition have been the scourge of humankind from the dawn of history. The current worldwide epidemic of obesity, now recognized as a public health crisis, is barely a few decades old. Only after the technological advances of the eighteenth century did a gradual increase in food supply became available. The initial effect of these advances in improved public health and amount, quality, and variety of food was increased longevity and body size. These early favorable outcomes of technological advances notwithstanding, their incremental effect since the Second World War has been an overabundance of easily accessible food, coupled with reduced physical activity, that accounts for the recent increased prevalence of obesity. Obesity as a chronic disease with well-defined pathologic consequences is less than a century old. The scarcity of food throughout most of history had led to connotations that being fat was good, and that corpulence and increased “flesh” were desirable as reflected in the arts, literature, and medical opinion of the times. Only in the latter half of the nineteenth century did being fat begin to be stigmatized for aesthetic reasons, and in the twentieth century, its association with increased mortality was recognized. Whereas early reports listed obesity as a risk factor for mortality from “chronic nephritis,” the subsequent recognition of the more common association of obesity with diabetes, hypertension, and heart disease altered the listings and questioned its being a risk factor for kidney disease. An enlarging body of evidence, accrued over the past decade, now indicates a direct association of obesity with chronic kidney disease and its outcomes.
Adv Chronic Kidney Dis. 2006 Oct;13(4):421-7
Obesity and cardiovascular disease.
Obesity is a major contributor to the prevalence of cardiovascular disease in the developed world, and yet has only recently been afforded the same level of attention as other risk factors of coronary artery disease. Obesity is a chronic metabolic disorder associated with cardiovascular disease and increased morbidity and mortality. It is apparent that a variety of adaptations/alterations in cardiac structure and function occur as excessive adipose tissue accumulates, even in the absence of comorbidities. Shifts toward a less physically demanding lifestyle are observed today throughout different populations, and this scourge associated with obesity implicates a corresponding increase in the number of individuals afflicted with the metabolic syndrome, which defines the obese patient as being “at risk.” Adipose tissue is not simply a passive storehouse for fat, but an endocrine organ that is capable of synthesizing and releasing into the bloodstream a variety of molecules that may impact unfavorably the risk factor profile of a patient. Indeed, obesity may affect atherosclerosis through unrecognized variables and risk factors for coronary artery disease such as dyslipidemia, hypertension, glucose intolerance, inflammatory markers, and the prothrombotic state. By favorably modifying lipids, decreasing blood pressure, and decreasing levels of glycemia, proinflammatory cytokines, and adhesion molecules, weight loss may prevent the progression of atherosclerosis or the occurrence of acute coronary syndrome events in the obese high-risk population.
Curr Atheroscler Rep. 2002 Nov;4(6):448-53
Blocking carbohydrate absorption and weight loss: a clinical trial using a proprietary fractionated white bean extract.
BACKGROUND: A proprietary fractionated white bean extract of Phaseolus vulgaris has been shown in vitro to inhibit the digestive enzyme alpha-amylase. This may prevent or delay the digestion of complex carbohydrates, potentially resulting in weight loss. METHODS: A 4-week randomized, double-blind, placebo-controlled study of 25 healthy subjects consuming 1000 mg of a proprietary fractioned white bean extract or an identical placebo twice a day before meals in conjunction with a multi-component weight-loss program, including diet, exercise, and behavioral intervention, was conducted. RESULTS: Both groups reduced their weight and waist size significantly from baseline. The active group lost 6.0 lbs (P=.0002) and 2.2 in (P=.0050), and the placebo group lost 4.7 lbs (P=.0016) and 2.1 in (P=.0001). The differences between groups were not significant (weight P=.4235, waist size P=.8654). Through subsequent exploratory analysis to investigate group findings further, subjects were stratified by total dietary carbohydrate intake. This probative analysis revealed that the tertile of subjects who had consumed the most carbohydrates demonstrated significant reductions in both weight (8.7 lbs vs 1.7 lbs, P=.0412) and waist size (3.3 in vs 1.3 in P=.0100) compared with placebo subjects in the same tertile of carbohydrate intake. CONCLUSION: Subjects who adhere to a program including dietary modification, exercise, and behavioral intervention can significantly reduce their weight and waist size in a short period of time. In an exploratory analysis of data, the tertile of subjects who ate the most carbohydrates experienced a significant reduction in both weight and waist size with the addition of the white bean extract compared to the placebo group of the same tertile of carbohydrate consumption. Longer studies with a larger pool of subjects are required to validate these findings.
Altern Ther Health Med. 2007 Jul-Aug;13(4):32-7
Erythrocyte membrane ATPases in diabetes: effect of dikanut (Irvingia gabonensis).
The levels of the three ATPases found in the erythrocyte membrane of diabetic patients were significantly lower than normal subjects. The distribution of the enzymes was also different. Na+,K+-ATPase and Mg2+-ATPase reflected the status of blood glucose more than Ca2+-ATPase. The ratio between two of the ATPases was sensitive to glycemic response. When dikanut, a viscous preparation, was fed to diabetics for 4 weeks, blood glucose became normal and the activities of the three ATPases increased significantly. The ratio among the enzymes also approached that of normal subjects. A relationship was found between the blood glucose level and erythrocyte membrane ATPases which, if linked to insulin binding or level, may provide a rapid inexpensive assay in diabetes research.
A supplement of Dikanut (Irvingia gabonesis) improves treatment of type II diabetics.
The effects of Dikanut (Irvingia gabonensis), an African viscous preparation, as supplement (4g/day) in the diet of eleven Type II diabetics were studied. Levels of plasma lipids, glucose and erythrocyte ATPases were monitored for one month. The dikanut supplement elicited hypolipidemic activity. The reduction in plasma lipids was primarily due to a decrease in LDL + VLDL-cholesterol and triglycerides levels. HDL-cholesterol was increased. The three ATPases of the erythrocyte membrane of the diabetic patients were significantly lower than in normal subjects. When dikanut was consumed by the diabetics for four weeks, the activities of the enzymes increased significantly. The increases correlated well with significant reduction of plasma glucose levels. These desirable biochemical effects mediated by ingestion of a naturally-occurring dietary fibre were accompanied by improved clinical states.
West Afr J Med. 1990 Apr-Jun;9(2):108-15
Digestive and hepatic enzymes in streptozotocin-induced diabetic rats fed supplements of dikanut (Irvingia gabonensis) and cellulose.
In a feeding trial involving dikanut (an African viscous fibre) and cellulose (a particulate fibre), diabetic rats were maintained for 4 weeks on each of the test fibres. The levels of digestive and membrane-bound enzymes of the intestine, and hepatic glycolytic enzymes were determined. The effect of the supplements on intestinal morphology was also assessed. The two types of dietary fibre caused a general reduction in the levels of all the intestinal enzymes assayed with the effect of dikanut supplementation resulting in more drastic reductions. Evidence was obtained for a marked alteration in the intestinal morphology. It was concluded that the reduced absorption of glucose resulted in its lowered level in the blood and urine. The disruption of the mucosal membrane may also curtail the absorption of glucose. On the other hand, the activities of hepatic glycolytic enzymes became elevated to efficiently utilize the low substrates reaching the liver. The dietary fibres caused a shift away from the depletion of glycogen by the diabetic rat to synthesis of the storage polysaccharide. The long-term effects of the several adaptive responses resulting in lowered blood glucose from feeding these dietary fibre supplements to the diabetic rat requires further research.
Ann Nutr Metab. 1993;37(1):14-23
Original study of the biochemical and oil composition of the Cambodia nut Irvingia malayana.
Analysis of the biochemical composition of Irvingia malayana was carried out. This Cambodian nut contains 7.5% water and 70% oil. Most of the fatty acids are saturated and include 42% C12:0 and 41.8% C14:0; the sterol composition is similar to that of other vegetable oils. This oil is less rich in alpha-tocopherol than in gamma-tocopherol. Analysis of the solid content of the oil with respect to the temperature by NMR shows a fast fall of solid content around its fusion range at 38-39 degrees C. The main differences in the properties of the indigenous Cambodia nut from other known oleaginous seeds are in its selenium content, fatty acid composition, fusion temperature profile, and content of antioxidants. These important characteristics can soon make possible its application in pharmacology, cosmetics, the margarine industry, etc.
J Agric Food Chem. 2002 Mar 13;50(6):1478-82
The effect of Irvingia gabonensis seeds on body weight and blood lipids of obese subjects in Cameroon.
Dietary fibres are frequently used for the treatment of obesity. The aim of this study was to evaluate the efficacy of Irvingia gabonensis seeds in the management of obesity. This was carried out as a double blind randomised study involving 40 subjects (mean age 42.4 years). Twenty-eight subjects received Irvingia gabonensis (IG) (1.05 g three time a day for one month) while 12 were on placebo (P) and the same schedule. During the one-month study period all subjects were on a normocaloric diet evaluated every week by a dietetic record book. At the end, the mean body weight of the IG group was decreased by 5.26 +/- 2.37% (p < 0.0001) and that of the placebo group by 1.32 +/- 0.41% (p < 0.02). The difference observed between the IG and the placebo groups was significant (p < 0.01). The obese patients under Irvingia gabonensis treatment also had a significant decrease of total cholesterol, LDL-cholesterol, triglycerides, and an increase of HDL-cholesterol. On the other hand, the placebo group did not manifest any changes in blood lipid components. Irvingia gabonensis seed may find application in weight lose.
Lipids Health Dis. 2005 May 25;4:12
The use of a Cissus quadrangularis/Irvingia gabonensis combination in the management of weight loss: a double-blind placebo-controlled study.
AIM: To evaluate the effects of two formulations, Cissus quadrangularis-only and a Cissus quadrangularis/Irvingia gabonensis combination, on weight loss in overweight and obese human subjects. METHODS: The study was a 10 week randomized, double-blind, placebo-controlled design involving 72 obese or overweight participants (45.8% male; 54.2% female; ages 21-44; mean age = 29.3). The participants were randomly divided into three equal (n = 24) groups: placebo, Cissus quadrangularis-only, and Cissus quadrangularis/Irvingia gabonensis combination. Capsules containing the placebo or active formulations were administered twice daily before meals; no major dietary changes nor exercises were suggested during the study. A total of six anthropomorphic and serological measurements (body weight, body fat, waist size; total plasma cholesterol, LDL cholesterol, fasting blood glucose level) were taken at baseline and at 4, 8, and 10 weeks. RESULTS: Compared to the placebo group, the two active groups showed a statistically significant difference on all six variables by week 10. The magnitude of the differences was noticeable by week 4 and continued to increase over the trial period. CONCLUSION: Although the Cissus quadrangularis-only group showed significant reductions on all variables compared to the placebo group, the Cissus quadrangularis/Irvingia gabonensis combination resulted in even larger reductions. This apparently synergistic formulation should prove helpful in the management of obesity and its related complications.
Lipids Health Dis. 2008 Mar 31;7:12
Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea.
The global prevalence of obesity has increased considerably in the last decade. Tools for obesity management, including caffeine, ephedrine, capsaicin, and green tea have been proposed as strategies for weight loss and weight maintenance, since they may increase energy expenditure and have been proposed to counteract the decrease in metabolic rate that is present during weight loss. A combination of caffeine and ephedrine has shown to be effective in long-term weight management, likely due to different mechanisms that may operate synergistically, e.g., respectively inhibiting the phosphodiesterase-induced degradation of cAMP and enhancing the sympathetic release of catecholamines. However, adverse effects of ephedrine prevent the feasibility of this approach. Capsaicin has been shown to be effective, yet when it is used clinically it requires a strong compliance to a certain dosage, that has not been shown to be feasible yet. Also positive effects on body-weight management have been shown using green tea mixtures. Green tea, by containing both tea catechins and caffeine, may act through inhibition of catechol O-methyl-transferase, and inhibition of phosphodiesterase. Here, the mechanisms may also operate synergistically. In addition, tea catechins have antiangiogenic properties that may prevent development of overweight and obesity. Furthermore, the sympathetic nervous system is involved in the regulation of lipolysis, and the sympathetic innervation of white adipose tissue may play an important role in the regulation of total body fat in general.
Am J Physiol Regul Integr Comp Physiol. 2007 Jan;292(1):R77-85
Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults.
This study evaluated the influence of a green tea catechin beverage on body composition and fat distribution in overweight and obese adults during exercise-induced weight loss. Participants (n = 132 with 107 completers) were randomly assigned to receive a beverage containing approximately 625 mg of catechins with 39 mg caffeine or a control beverage (39 mg caffeine, no catechins) for 12 wk. Participants were asked to maintain constant energy intake and engage in >or=180 min/wk moderate intensity exercise, including >or=3 supervised sessions per week. Body composition (dual X-ray absorptiometry), abdominal fat areas (computed tomography), and clinical laboratory tests were measured at baseline and wk 12. There was a trend (P = 0.079) toward greater loss of body weight in the catechin group compared with the control group; least squares mean (95% CI) changes, adjusted for baseline value, age, and sex, were -2.2 (-3.1, -1.3) and -1.0 (-1.9, -0.1) kg, respectively. Percentage changes in fat mass did not differ between the catechin [5.2 (-7.0, -3.4)] and control groups [-3.5 (-5.4, 1.6)] (P = 0.208). However, percentage changes in total abdominal fat area [-7.7 (-11.7, -3.8) vs. -0.3 (-4.4, 3.9); P = 0.013], subcutaneous abdominal fat area [-6.2 (-10.2, -2.2) vs. 0.8 (-3.3, 4.9); P = 0.019], and fasting serum triglycerides (TG) [-11.2 (-18.8, -3.6) vs. 1.9 (-5.9, 9.7); P = 0.023] were greater in the catechin group. These findings suggest that green tea catechin consumption enhances exercise-induced changes in abdominal fat and serum TG.
J Nutr. 2009 Feb;139(2):264-70