Intrebari cu raspuns – suplimente pentru slabit (Q&A – Weight loss supplements)

Dna L. are 40 de ani, este mama a doi copii si s-a luptat cu probleme de greutate timp de aproape 10 ani. A incercat tot felul de diete, niciuna nu a dat rezultate si, dupa 2-4 luni de chin, renunta. Nici sfatul dieticienilor nu a ajutat-o prea mult.

Are un indice de masa corporala de 31 kg/m2 (normal: 18 – 25 kg/m2). Are functie tiroidiana normala, colesterol LDL crescut si nivel de trigliceride normal. Nu sufera de alte boli.

Ne intreaba despre suplimentele alimentare destinata curelor de slabire si vrea sa stie daca boabele verzi de cafea, ceaiul verde, extractul cetonic de zmeur sau fructele de acai functioneaza. A citit despre ele pe Internet si se intereseaza daca sa le incerce.

Boabele verzi de cafea

Boabele verzi (neprajite) de cafea au primit multa atentie si se gasesc in multe suplimente pentru slabit. Teoretic, contin cantitati mai mici de cafeina  si cantitati mai mari de acid clorogenic (un acid polifenolic) decat boabele prajite de cafea. Se crede ca acidul clorogenic modifica metabolismul glucozei si poate inhiba acumularea de grasimi.

Studiile publicate nu sunt de cea mai buna calitate, unele descriu scaderi de 1.5-2.5 kg pe o perioada de 1-2 luni pentru doze care variaza intre 80 – 1000 mg of extract / zi. Efectele secundare care pot aparea sunt lejere si pot include dureri de cap, diureza crescuta, probleme gastrice, vomitat, insomnie, anxietate si aritmii. Se indica sa se evite consumul de alte produse care contin cafeina, de exemplu cacao sau ceai, pentru ca cresc riscul de aparitie a efectelor secundare [1].
Deci, nu exista suficiente dovezi care sa sustina utilizarea boabelor verzi de cafea ca si supliment pentru slabit.

Ceaiul verde

Dovezi mai consistente, inclusiv mai multe studii clinice de macar 12 saptamani, vorbesc despre efectele ceaiului verde in curele de slabire. 8 studii care s-au desfasurat in Japonia (1030 pacienti) si 6 conduse in alte tari (532 pacienti) au fost incluse intr-o revizie Cochrane din 2012. Pacientii fie au baut ceai verde, fie li s-a dat catechine sub forma de extract purifiat si rezultatele au fost comparate cu placebo. Chiar daca calitatea acestor studii a fost medie, se arata ca pierderea in greutate pentru pacientii obezi dupa 12 saptamani de tratament cu ceai verde este minima si nu poate fi considerata semnificativa. In concluzie, pierderea in greutate nu este importanta din punct de vedere clinic [2]. Reactiile adverse sunt usoare. Pe de alta parte, ceaiul verde a dus la alte efecte colaterale pozitive, mai ales asupra sistemului cardiovascular, datorita efectului sau antioxidant [3].

Fructele de acai

Acai-ul este un pamier care creste in America de Sud; fructele sale sunt consumate crude sau sub forma de suc. Au proprietati antioxidante puternice, chiar mai puternice decat alte fructe precum zmeura, afinile sau murele. Se crede ca ar putea avea efecte benefice in boli inflamatorii si sa previna boli cardiovasculare [4].
Ca si supliment pentru slabit, fructele de acasi se gasesc in pilule, capsule sau sucuri. Un mic studiu pilot indica ca ar putea avea efecte benefice asupra sindromului metabolic [5]. Cu toate astea, inca nu exista dovezi suficiente care sa confirme ca sunt eficiente ca si supliment alimentar pentru curele de slabire.

Extract cetona de zmeur

Cetona de zmeur este unul dintre cei mai scumpi agenti de aroma din industria alimentara si se gasesteste in cantitati mici in fructele de zmeur. Se extrage si din piersici, struguri, mere si rubarbar, in care se gaseste in cantitati mai mari. S-a raportat ca extractul cetona de zmeur are efect antioxidant la sobolani si ca promoveaza lipoliza in vivo [6]. Unele studii arata ca scade nivelul de LDL colesterol si ca creste nivelul de HDL colesterol in modele animale. Cu toate acestea, nu exista suficiente studii clinice conduse pe oameni care sa confirme aceste efecte.


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Mrs. L. is 40 years old, the mother of two children and she has been fighting obesity for almost 10 years, trying all kind of diets. None of them was successful and after 2-4 months of misery, she used to give up, frustrated. The advice of dieticians didn’t help too much either.
Her BMI (body mass index) is 31 kg/m2 (normal: 18 – 25 kg/m2). She has normal thyroid function, high LDL and normal triglyceride level. She doesn’t suffer from any other disease.
She asks if she should try alimentary supplements and if any of them work, such as green coffee beans, green tea, raspberry ketone, or acai berry, all of which she read on the Internet.

Green Coffee Beans

Green (unroasted) coffee beans received plenty of attention and are found in many weight-loss supplements. In theory, they have lower levels of caffeine and higher amounts of chlorogenic acid (a polyphenolic acid) than roasted coffee beans. Cholorogenic acid is believed to modify glucose metabolism and to inhibit fat accumulation.
Published studies are of poor quality, some report a 1.5-2.5 kg lost in 1-2 months in humans for doses ranging from 80 – 1000 mg of extract / day. Side effects are mild and may include headeache, diuresis, gastric distress, vomiting, insomnia, anxiety and arrhythmias. It is not advised to use green coffee beans concomitantly with other caffeine-containing products such as cocoa or tea, which may increase the risk of adverse effects [1].
In conlusion, there is insufficient evidence supporting the use of green coffee beans to lose weight.

Green Tea

More robust evidence, including clinical trials of at leat 12 weeks, talk about the effects of green tea in weight loss. 8 studies conducted in Japan (1030 patients) and 6 conducted in other countries (532 patients) are included in a Cochrane review from 2012. Patients either drank green tea or they were given the catechins as a purified extract and results were compared with placebo. Even though of moderate quality, the studies show that after 12 weeks of daily ingestion of green tea, the weight loss in obese patients was minimal and not significant. In conclusion, it is not clinically important [2]. Adverse effects were mild. However, green tea brought other beneficial outcomes, especially cardiovascular, due to its antioxidant effect [3].

Acai Berry

Acai is a palm tree that grows in South America; its berry is consumed raw or as a juice. It is a powerful antioxidant, more so that other berries, such as strawberries, blackberries and blueberries. It is thought it could be beneficial in inflammatory conditions and to prevent cardiovascular diseases [4].
As a weight-loss supplement, acai berry comes in the form of pills, capsules or juice. A small pilot study indicates that it has a benefit for metabolic syndrome [5]. Yet, there is no clinical evidence that it is efficient in weight loss.

Raspberry Ketone

Is one of the most expensive flavoring agents in the food industry and it is found in low concentrations in red raspberry fruits. It is also extracted from peaches, grapes, apples and rhubarb, which have higher concentrations.
It has been reported that it has antioxidant effects in rats, and that it promotes lipolysis in vivo [6]. Some studies show that it reduces LDL cholesterol and it increases HDL cholesterol in animal models. However, there is no clinical study conducted on humans to confirm these effects.


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References:

1. Vinson JA ea. Randomized, double-blind, placebo-controlled, linear dose, crossover study to evaluate the efficacy and safety of a green coffee bean extract in ov… – PubMed – NCBI. Diabetes Metab Syndr Obes, 5, 21-27 (2012).
2. Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E. Green tea for weight loss and weight maintenance in overweight or obese adults. Cochrane Database Syst Rev, 12, CD008650 (2012).
3. Zaveri NT. Green tea and its polyphenolic catechins: medicinal uses in cancer and noncancer applications. Life Sci, 78(18), 2073-2080 (2006).
4. De Souza MO, Souza e Silva L, de Brito Magalhães CL et al. The hypocholesterolemic activity of açaí (Euterpe oleracea Mart.) is mediated by the enhanced expression of the ATP-binding cassette, subfamily G transporters 5 and 8 and low-density lipoprotein receptor genes in the rat. Nutrition Research, 32(12), 976-984 (2012).
5. Udani JK, Singh BB, Singh VJ, Barrett ML. Effects of Açai (Euterpe oleracea Mart.) berry preparation on metabolic parameters in a healthy overweight population: a pilot study. Nutr J, 10, 45 (2011).
6. KS P. Raspberry ketone increases both lipolysis and fatty acid oxidation in 3T3-L1 adipocytes. – PubMed – NCBI. Planta Med, 15(76), 1654-1658 (2010).


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