Weight ManagementSession Three:

Supplemental Support

Supplements

Dietary supplements can be botanically based or formulated from non-botanical substances and are ingested in addition to a healthy diet.

Dietary supplements for weight loss are often dangerous and pose health risks.

Fiber

Fiber

Fiber is a type of carbohydrate that the body can’t digest. Though most carbohydrates are broken down into sugar molecules, fiber cannot be broken down into sugar molecules, and instead it passes through the body undigested. Fiber helps regulate the body’s use of sugars, helping to keep hunger and blood sugar in check.

Soluble

Soluble fiber, which dissolves in water, can help lower glucose levels as well as help lower blood cholesterol. Foods with soluble fiber include oatmeal, nuts, beans, lentils, apples and blueberries.

Insoluble

Insoluble fiber, which does not dissolve in water, can help food move through your digestive system, promoting regularity and helping prevent constipation. Foods with insoluble fibers include wheat, whole wheat bread, whole grain couscous, brown rice, legumes, carrots, cucumbers and tomatoes.

Yunsheng et al 2015

Researchers compared the effectiveness of two diets with help from 240 volunteers. Half were asked to follow the American Heart Association’s (AHA) diet for preventing heart disease, in which you try to eat more fruits, vegetables, high-fiber foods, fish, and lean protein but also cut back on salt, sugar, fat, and alcohol. The other half were asked to follow a diet in which the only goal was to eat 30 grams or more of fiber each day. Neither group received advice or recommendations for exercise. All of the volunteers had metabolic syndrome — that is, all of them had high blood pressure, high blood sugar, and high cholesterol, and were overweight. This cluster of health issues greatly increases the risk for developing diabetes, heart disease, and stroke.

Results

The participants in each group averaged 19 grams of fiber a day. Both groups lost weight, lowered their blood pressure, and improved their response to insulin. Those following the AHA diet lost a bit more weight (5.9 pounds) than those on the high-fiber diet (4.6 pounds), but both groups were able to maintain their weight loss for 12 months.

Karl et al 2017

The effect of whole grains on the regulation of energy balance remains controversial.Objective: We aimed to determine the effects of substituting whole grains for refined grains, independent of body weight changes, on energy-metabolism metrics and glycemic control.Design: The study was a randomized, controlled, parallel-arm controlled-feeding trial that was conducted in 81 men and postmenopausal women [49 men and 32 women; age range: 40-65 y; body mass index (in kg/m2): <35.0]. After a 2-wk run-in period, participants were randomly assigned to consume 1 of 2 weight-maintenance diets for 6 wk. Diets differed in whole-grain and fiber contents [mean ± SDs: whole grain-rich diet: 207 ± 39 g whole grains plus 40 ± 5 g dietary fiber/d; refined grain-based diet: 0 g whole grains plus 21 ± 3 g dietary fiber/d] but were otherwise similar.

Findings

These findings suggest positive effects of whole grains on the RMR and stool energy excretion that favorably influence energy balance and may help explain epidemiologic associations between whole-grain consumption and reduced body weight and adiposity.

Fiber

Psyllium Husks

Flaxseeds

Chia Seeds

Probiotics

Bacteria

The human gut harbors more than 100 trillion microbial cells, which have an essential role in human metabolic regulation via their symbiotic interactions with the host. Altered gut microbial ecosystems have been associated with increased metabolic and immune disorders in animals and humans. Molecular interactions linking the gut microbiota with host energy metabolism, lipid accumulation, and immunity have also been identified. - Boulange et al 2016

Risk FactorsAlthough genetic variants have been associated with susceptibility to developing obesity and type 2 diabetes, the heritability of these variants is fairly modest. The gut microbiota has recently been recognized as a key environmental factor driving metabolic diseases. In fact, the gut microbiota is even seen as a separate endocrine organ, which is involved, through a molecular crosstalk with the host, in the maintenance of host energy homeostasis and in the stimulation of host immunity.

Impact Germ-free mice have 40 % less total body fat than conventional mice although they ingest 29 % more calories than their conventionally raised littermates . Germ-free mice also gain less weight than conventionally raised mice and they are protected against diet-induced glucose intolerance and the development of insulin resistance. In addition, fecal microbiota transplanted from conventionally raised mice to germ-free mice triggered a 57 % increase in the amount of body fat and a dramatic increase in hepatic triglyceride levels and insulin resistance without modifying the amount of food consumed.

Probiotics in Research

Majid et al 2016

We compared the effect of the PY with LF yogurt consumption on body weight and cardiometabolic risk factors in women during a weight-loss program.

Overweight and obese women [body mass index (in kg/m(2)): 27-40; age: 18-50 y) who usually consumed standard LFs were asked to consume either PY or LF every day with their main meals for 12 wk while following a weight-loss program.

ResultsA statistically significant reduction in anthropometric measurements and significant improvements in cardiometabolic risk characteristics were observed over the 12 wk in both groups. However, no significant differences in weight loss and anthropometric measurements were seen between groups after the intervention. Compared with the LF group, the PY group had a greater (mean ± SD) decrease in total cholesterol (PY = -0.36 ± 0.10 mmol/L, LF = -0.31 ± 0.10 mmol/L; P = 0.024), low-density lipoprotein cholesterol (PY = -0.35 ± 0.10 mmol/L, LF = -0.31 ± 0.11 mmol/L; P = 0.018), homeostasis model assessment of insulin resistance (PY = -0.55 ± 0.32, LF = -0.42 ± 0.20; P = 0.002), 2-h postprandial glucose (PY = -0.61 ± 0.24 mmol/L, LF = -0.44 ± 0.19 mmol/L; P < 0.001), and fasting insulin concentration (PY = -1.76 ± 1.01 mU/mL, LF = -1.32 ± 0.62 mU/mL; P = 0.002), as secondary endpoints after the study.

Garlic

Garlic has been found to have temporary positive effects on the growth of beneficial lactobacilli which populate the gut.

Ingestion of the herb in both culinary and supplemental doses may provide a positive influence on overall gut health. (Filocamo, et al, 2012)

Iron

Iron and Weight Gain

Obesity is a risk factor for iron-deficient anemia but once anemia is present, its symptom of fatigue creates a negative cycle in which fatigue prevents physical activity, further reducing iron stores.

According to the WHO, global prevalence of anemia is 47.5% for preschoolers, 25.4% for school age children and nearly 42% of pregnant women.

Anemia and Obesity

Increasing obesity is a major global health concern while at the same time iron-deficiency anemia remains common worldwide. Although these two conditions represent opposite ends of the spectrum of over- and under-nutrition, they appear to be linked: overweight individuals are at higher risk of iron deficiency than normal-weight individuals.

Low iron status in overweight individuals may result from a combination of nutritional (reduced absorption) and functional (increased sequestration) iron deficiency.- Cepeda-Lopez et al 2010

Gong et al 2014

To assess the effect of a weight-loss program on improving iron status in overweight and obese school-aged children.

The data were analyzed in overweight and obese children (7-11 years of age; 114 girls and 212 boys) with body mass index-for-age z-scores (BAZ) >1 from a weight-loss program. Schools were randomly divided into 2 groups: intervention and control. Children in the intervention group underwent a 1-year, nutrition-based comprehensive intervention weight-loss program. Anthropometric, dietary intake, and physical activity data were collected at baseline and follow-up (1 year). Iron status and inflammatory markers were assessed within a month.

ResultsIn the intervention group, BAZ decreased more than that in the control group (-0.4 ± 0.7 vs -0.1 ± 0.6, P < .0001); and iron profiles and inflammation status were improved at follow-up. In multivariable linear regression models, a greater decrease of BAZ and inflammation factors predicted a better improvement of iron status.

Iron status and inflammation were improved by weight reduction. The improvement in inflammatory markers during weight reduction was independently associated with improvements of iron status.

”Many Americans have low levels of iron, resulting in varying degrees of fatigue. This fatigue inhibits physical activity and

leads to greater fuel intake for energy.

Other Options

ChromiumChromium is a mineral that you need to regulate your blood sugar levels. It’s claimed to increase muscle mass and fat loss and decrease appetite and food intake.

Chromium might help you lose a very small amount of weight and body fat.

Chromium in food and supplements is safe at recommended amounts, which range from 20 to 35 micrograms a day for adults. In larger amounts, chromium can cause watery stools, headache, weakness, nausea, vomiting, constipation, dizziness, and hives.

Garcinia cambogia

This is a tree that grows throughout Asia, Africa, and the Polynesian islands. Hydroxycitric acid in the fruit is claimed to decrease the number of new fat cells your body makes, suppress your appetite and reduce the amount of food you eat, and limit the amount of weight you gain.

Garcinia cambogia has little to no effect on weight loss.

Garcinia cambogia seems to be fairly safe. But it can cause headache, nausea, and symptoms in the upper respiratory tract, stomach, and intestines. A few people who were taking weight-loss supplements containing Garcinia cambogia developed liver damage. But experts don’t know whether this ingredient or the combination of ingredients in the weight-loss supplements was responsible.

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