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If Americans have a New Year’s Day tradition more routine than taking aspirin on January 1st, it is making annual New Year’s resolutions to lose weight—again—and for good this time. A few short weeks ago, at the start of the 2006 calendar year, weight loss strategies were planned, high fat and high calorie holiday goodies were systematically emptied from cupboards, measurements for excess fat and inches were bravely performed, diet programs and fitness regimens were researched, new gym memberships were purchased, and over-the-counter (OTC) drugs and dietary supplements for weight loss flew off the shelves. During the holiday season, consuming anything less than excessive quantities of fattening treats was met with suspicion. But as the month of December gave way to January, rampant gluttony became less socially acceptable. Millions pledged to make lifestyle self-improvements, and practically overnight the sugar plums that danced in our heads were replaced with visions of toned bodies that did not exhibit the tell-tale signs of mincemeat pie abuse. In fact, a new survey commissioned by Weight Watchers and conducted by market research firm Harris Interactive®, reported almost half of American women (45 percent) said losing weight is one of their 2006 New Year’s resolutions. Among this group, 97 percent said they will need some assistance keeping this resolution. Because, as veteran dieters know, sticking to a weight loss strategy is harder than simply making a resolution to fit into that little black dress by Valentine’s Day.

The challenge for dieters to “stay on the wagon” has been made more difficult in the wake of growing public concern regarding the safety and efficacy of popular weight loss diets, exercise regimens, OTC drugs and dietary supplements. The ephedra controversy and the “now-you-see it, now-you-don’t” low carb craze has contributed to dieter confusion about which weight loss programs and products are safe and effective and how they fit into a long-term lifestyle of weight management. But, the medical and psychosocial impact of being overweight, as well as the difficulty in making sustained improvements in diet and physical activity, has kept dieters looking to nonprescription weight loss products for added support.

According to the Centers for Disease Control (CDC) Division of Nutrition and Physical Activity in Atlanta, “With increasing rates of obesity, nonprescription product use is likely to increase.”¹ Natural products retailers can take this key opportunity to help customers achieve their weight loss goals by educating them about supplemental nutritional aids that can help promote healthy, long-term weight management.

An estimated 127 million adults in the United States are either overweight or obese, with 64.5 percent of American adults age 20 and over above a healthy weight.² Overweight and obesity is a health problem that increases the risk for developing several medical conditions including Type II diabetes, heart disease, stroke, hypertension, gallbladder disease, osteoarthritis, sleep apnea and some cancers.³ These risks have fueled thousands of research studies focusing on the various physical and social mechanisms contributing to weight gain. As a result, the creation of diet programs, exercise regimens, prescription and OTC medications, surgery options and dietary supplement formulas purporting to promote some mechanism of weight loss have grown. According to the CDC, almost 100 million Americans—approximately 80 percent of overweight individuals and 86 percent of obese individuals—are trying to lose or maintain their weight,⁴ and many others at healthy weight levels are trying to lose additional weight in hopes of attaining a preferred body shape.⁵

Naturally, effective weight loss solutions are in high demand; according to market research firm BCC International, the total U.S. retail market for weight loss products and services is expected to grow at an average annual growth rate of 13.2 percent through 2007 to $157.6 billion, with sales of weight loss dietary supplements expected to almost double by 2007. A 2005 report titled “Weight Control-U.S.” by Mintel International Group reported the U.S. weight loss market, including eating regimens, dieting support groups, supplements, food products, meal replacements, and books and videos, will grow in demand as obesity and overweight rates continue to climb. With all the available weight loss options on the market, natural products retailers can help customers focus their weight loss strategies on programs and products that work.

The dietary supplement industry has been busy researching the effectiveness of thermogenics, insulin aids, appetite suppressants and fat-binders to help prevent weight gain or promote weight loss. To help customers achieve their weight loss goals and increase turnover of weight loss dietary supplements, retailers must identify customers’ needs and provide information detailing the weight loss actions of dietary supplements.

Thermogenic weight loss supplements are hot, and coincidentally, the term literally means “heat creation”. Products in this weight loss sub-category help the body burn excess calories in its brown adipose tissue (BAT), and research suggests thermogenic products may increase weight loss and fat loss in dieting individuals. Popular thermogenic products include Citrus aurantium, 7-oxo-DHEA, Garcinia cambogia, green tea and Coleus forskohlii.

In a review of Citrus aurantium (C. Aurantium), also known as bitter orange, from Georgetown University Medical Center, researchers concluded it may be, “... the best thermogenic substitute for ephedra.”⁶ Advantra Z® is a patented C. aurantum product from Nutratech Inc. that increases metabolic rate without affecting heart rate or blood pressure, as opposed to stimulants such as ephedra and caffeine. Researchers at the McGill Nutrition and Food Science Centre at Royal Victoria Hospital in Montreal found thermic response to bitter orange (as Advantra Z) increased metabolic rate in men and women, with men showing a higher response when the supplement was taken without food and women’s rate increasing when taken concurrent with a meal.⁷ According to the study results, Advantra Z did not effect on blood pressure, confirming earlier unpublished work from the same researchers in which obese women taking bitter orange (as Advantra Z) showed a significantly greater thermogenic response to meals, with no increase in heart rate or blood pressure. A study from the University of California, San Francisco, found increases in blood pressure when C. aurantium was used in combination with caffeine but not when administered on its own, even in eightfold higher dosages.⁸

Another compound investigated for its impact on thermogenesis is a metabolite of dehydroepiandrosterone (DHEA), 3-acetyl-7- oxodehydroepiandrosterone (7-oxo-DHEA, patented as 7-Keto®, from Humanetics Corp.). Multiple clinical studies have investigated the ability of 7-Keto to support weight loss. One such study was a double blind, placebocontrolled trial of obese adults that found 100 mg twice daily of 7-Keto significantly increased the amount of body weight and body fat lost compared to taking a placebo.⁹ 7-Keto was shown in a recent study to increase the resting metabolic rate (RMR) in overweight subjects during a period of calorie restriction, whereas subjects taking placebo showed an expected decline in RMR. “7-Keto increases metabolism by 5.4 percent compared to placebo,” said Scott Steil, vice president of sales and marketing at Humanetics Corp. “Since 7-Keto is a nonstimulant, this action is both safe and unique. The clear benefit of increasing metabolism is the fact that people can maximize the results of their diet plan and efforts.”

The thermogenic properties of green tea are also of growing interest. Tea compounds including caffeine, polyphenol catechins, including epigallocatechin gallate (EGCG) and theanine, may have synergistic properties that suppress weight increases. In fact, Japanese researchers found caffeine and theanine (as Suntheanine®, from Taiyo International) helped suppress weight increases, with catechins showing synergistic abilities.¹⁰ EGCG may have weight management mechanisms of its own. German researchers have found EGCG (as TEAVIGO®, from DSM) promotes fat oxidation,¹¹ and prevents diet-induced obesity.¹²

Coleus forskohlii is being studied for its fat loss stimulating properties, and may also increase lean body mass. In a study investigating the effects of forskolin (the root of Coleus forskohlii), overweight women taking 250 mg twice daily (as ForsLean®, from Sabinsa Corp.) experienced a reduction in body fat and an increase in lean body mass.¹³ ForsLean is standardized for 10-percent forskolin and works by prompting an increase in cyclic AMP levels that eventually leads to disposal of triglycerides, the building blocks for fatty tissue. But it also works by stimulating the thyroid and contributing to an increase in metabolic rate and thermogenesis.

Another ingredient well researched for its role in appetite suppression and fat loss is the extract (-)-hydroxycitric acid (HCA), primarily sourced from the rind of the citrus fruit Garcinia cambogia. HCA appears to reduce food consumption by diverting carbohydrates away from fat synthesis and toward stored glycogen, thereby signaling satiety,¹⁴ and stimulating serotonin release to balance mood. A gene study conducted at Ohio State University Medical Center, Columbus, found HCA (as Super CitriMax®, from InterHealth Nutraceuticals) upregulated an entire family of genes involved in serotonin signaling.¹⁵ And most recently, a study presented at the Experimental Biology 2005 conference indicated HCA (as Super CitriMax) could reduce levels of a neuropeptide in the hypothalamus that is linked to increased appetite.¹⁶ “Super CitriMax helps control appetite and helps address many of the emotional issues obese people face such as binge-eating and depression,” said Debasis Bagchi, Ph.D., senior vice president of research and development at InterHealth Nutraceuticals Inc.

HCA is also being studied for its ability to reduce appetite and food intake by stimulating the “fullness” signal to the brain. A human study showed subjects taking 440 mg of HCA three times daily 30 minutes before meals for eight weeks experienced reduced appetite, a 68-percent increase in weight loss and greater fat loss than those taking a placebo.

The botanical compound banaba (Lagerstroemia speciosa L.) also has effects in weight management, as its ellagitannins appear to increase glucose uptake by adipocytes, lowering blood glucose levels.¹⁷ In addition, banaba extract may increase the expression of PPAR-gamma, a transcription factor that regulates the development of adipocytes.¹⁸ Studies on a specialized banaba extract (as GlucoHelp™, from OptiPure/Soft Gel Technologies) support this mechanism theory, noting the absence of adipocyte differentiation activity and inhibition of that activity suggests the compound may prevent obesity in Type II diabetics.¹⁹ In fact, in a study of genetically diabetic female mice, administration of banaba extract was found to attenuate weight gain and adipose tissue weight.²⁰

Conjugated linoleic acid (CLA) has been extensively studied for its ability to maintain lean muscle mass and promote fat loss.²¹ Researchers from North Carolina State University, Raleigh, noted CLA’s mechanisms of action are still largely unknown, although it appears to modulate energy expenditure, fatty acid oxidation, lipolysis and lipogenesis.²² In addition, reviews have noted there is marked variation in human clinicals, often with isomer-dependent influences.²³

However, intervention studies using proprietary CLA compounds have shown both short-term and long-term benefits to the use of CLA on body fat mass. In a four-week trial, men taking 4.2 g/d of CLA (as Tonalin®, from Cognis Nutrition & Health) showed a significant decrease in abdominal diameter.²⁴ Similar results were seen in a 12-week intervention in 60 overweight or obese subjects, who received 1.7, 3.4, 5.1 or 6.8 g/d of CLA (as Tonalin).²⁵ There was a significantly higher reduction in body fat mass in the CLA groups compared to placebo, with a significant reductions reported in the 3.4 and 6.8 g/d groups.

Results from a one-year study using CLA (as Tonalin) were published in the American Journal of Clinical Nutrition in early 2004.²⁶ The double blind, placebo-controlled study randomized 180 men and women with a BMI of 25 to 30 into three groups to receive a placebo or 4.5 g/d of CLA (as Tonalin) in free fatty acid or triglyceride form. Researchers found a significant decrease in body fat mass in both CLA groups by as much as 9 percent; the CLA free fatty acid group also had an increase in lean body mass compared to placebo. The results were not attributable to changes in diet or exercise, and no adverse events were reported. And in an open-label, one-year continuation of that study, researchers reported CLA supplementation helped maintain fat loss and lean body mass.²⁷ Interestingly, at the end of the two-year period, CLA was also found to lower levels of leptin, promoting better sensitivity to the hormone and helping satiety.

A relative newcomer to the weight loss category, Hoodia gordonii is a South African plant that induces satiety by suppressing appetite and thirst. There is not a great deal of published research on hoodia, though a study conducted at Brown Medical School in Providence, R.I., suggested a glycoside from hoodia may increase adenosine triphospate (ATP) content in the hypothalamus.²⁸ The interest in hoodia has been so great that there are currently supply concerns, which have caused manufacturers to urge their buyers to ensure they have certificates of analysis for the material.

Chitosan promotes weight loss by preventing absorption of dietary fat. Derived from the chitin found in shellfish, chitosan bonds with fat which is removed from the body as unabsorbed waste. However, whether chitosan can effect significant weight loss is inconclusive. One study of 50 obese women found consumption of 1,500 mg of chitosan before each main meal significantly improved weight loss over a placebo.²⁹ However, another study of 250 obese men and women taking 3 g/d of chitosan found no significant impact of the supplement on weight loss.³⁰ A 2005 Cochrane Database Review examined 14 different studies and concluded there is some evidence that chitosan is more effective than placebo in the short-term treatment of overweight and obesity; many trials reviewed were of poor quality, yet the data from higherquality trials suggests chitosan’s impact on weight management may be negligible.³¹

The fat binding effectiveness of prickly pear (nopal) cactus has been supported with clinical studies on the standardized prickly pear extract NeOpuntia®, from BioSerae Laboratories. In a pilot clinical study, 10 healthy volunteers received 1.6 g of NeOpuntia per meal or a placebo.³² The quantity of fat content excreted versus the quantity ingested increased by 27 percent in the treatment group compared to the placebo group. An earlier study investigating the mechanism of action in a gastrointestinal (GI) model found 2 g of NeOpuntia prevented the absorption of 2.7 g of fatty acids during a four-hour GI exposure.³³

Unlike fat binders, white kidney bean extract (Phaseolus vulgaris) is a “carb blocker” that promotes weight loss by preventing starch digestion. The majority of recent studies have used Phase 2® Starch Neutralizer, a patented ingredient from Pharmachem Laboratories. A recent clinical study investigated the effects of white kidney bean extract (as Phase 2) or placebo in 50 obese adults for eight weeks.³⁴ Researchers saw a greater weight loss (an average of 3.79 lbs.) in the group receiving Phase 2 compared to the control group (an average of 1.65 lbs.).

Dieters can profit from implementing dietary and behavior modification strategies to prevent overindulging and promote long-lasting weight management. According to a review published in the journal Physiology & Behavior, socially informed perceptions of which foods are appropriate to eat, when they should be eaten and how much should be consumed, have a greater impact on food intake than feelings of hunger or fullness.³⁵ University of Toronto psychology professors Peter Herman and Janet Polivy examined more than 30 years of research to survey the principles governing overeating and obesity. The researchers found that while medical approaches continue to emphasize hunger and satiety as the root of the obesity epidemic, these two factors are usually not the most significant causes of overeating.

The review suggested people allow environmental cues to dominate their eating choices, rather than adhering to selections that would satisfy their physical or nutritional needs. Portion size, palatability, variety and the food intake of fellow eaters are all potent influences on individual consumption. For example, an individual wishing to avoid appearing overindulgent may refuse second helpings at a formal meal but accept them when eating at an all-you-can-eat buffet or in a relaxed environment among family and close friends.

Behavior therapy involves changing diet and physical activity patterns to new behaviors that promote weight control. Tried-and-true weight loss strategies of individuals who have self-reported a weight loss of 30 lbs. or more and kept it off for at least a year have been recorded on The National Weight Control Registry (NWCR). According to the NWCR database, key weight loss strategies were:

• 89 percent changed their diets and increased physical activity (10 percent used diet modification only and 1 percent used activity only);
• 55 percent used a formal program (e.g., Weight Watchers, Jenny Craig) or professional assistance (e.g., dietitian, psychologist);
• 87.6 percent limited a type or class of food (e.g., high-fat and high-calorie foods);
• 44.2 percent limited the quantities of food they ate;
• 43.7 percent counted calories;
• 92 percent exercised at home, 40.3 percent exercised regularly with a friend, and 31.3 percent exercised regularly with a group, with walking the most common activity reported;
• 42.7 percent described losing weight as hard, 31.4 percent as moderately hard, and 25.7 percent as easy; and
• 91 percent had made previous weight loss attempts.

Comparing successful weight loss attempts to previous ones, NWCR researchers found:

• 81.3 percent engaged in more exercise.
• 63 percent implemented a stricter dietary approach.

As a result of weight loss, 85 percent reported improvements in physical health, quality of life, energy level, physical mobility, general mood and self-confidence.

In addition to behavior modification strategies, natural products retailers should become familiar with popular diet programs to promote further communication with customers regarding their weight loss goals.

High Protein/Low Carbohydrate diet: The Atkins’ Diet Revolution is perhaps the most popularly known high protein/low carbohydrate diet. Such diets promote weight loss by reducing carbohydrates (carbs) including sugars, refined carbohydrates and starches, forcing the body to burn fat for energy while balancing insulin levels. A common ratio in low carb diets is 15-35 percent carbs to 30-45 percent protein to 30-50 percent fat.

Like the Atkins diet, the South Beach Diet restricts simple sugars and refined carbs. But unlike Atkins, this diet recommends liberal consumption of complex carbs such as those found in whole grains and legumes. The South Beach Diet also recommends low fat sources of protein. Diets high in protein that limit or exclude simple sugars and refined carbs promote weight loss by balancing insulin levels and increasing satiety, a term that refers to the feeling of fullness and disappearance of appetite after a meal.

Satiety is controlled by the hypothalamus and triggered by various hormones. For example, leptin levels increase when the stomach is full, while ghrelin levels increase when the stomach is empty, triggering the desire to eat and appears linked to the rationale behind the success of high protein/low carb diets. Researchers at the University of Washington, Seattle, sequentially placed overweight subjects on diets differing in protein and carbohydrate content, and found increasing dietary protein from 15 percent to 30 percent of energy produced an ad libitum caloric intake decrease that participants attributed to an increased sense of satiety.³⁶ The study reported participants’ leptin levels were significantly decreased, which the researchers said suggested a link between higher protein intake and a greater body sensitivity to leptin, resulting in weight loss.

Low-Fat, Vegetarian-Based: A low fat, plant-based diet, such as the Dr. Dean Ornish program suggests a dietary intake of about 75-percent carbs, 15-percent protein and 10-percent fat. Weight loss may be achieved on such diets simply by reducing fat intake. Because each gram of fat contains nine calories and each carb or protein gram contains four calories, reducing fat intake of an otherwise normal diet would automatically decrease caloric intake and promote weight loss. Low fat diets such as the Ornish program typically recommend consumption of complex carbohydrates such as grains, beans, vegetables and fruits, and avoid sources of highly saturated fats including avocados, nuts and seeds.

The Ornish diet is also high in fiber, which prompts feelings of fullness and helps move waste through the digestive system. A review from the University of Minnesota, St. Paul, noted there is strong epidemiologic support that fiber intake can prevent obesity by promoting satiety, decreasing absorption of fat and altering secretion of gut hormones.³⁷

The Zone: Created by Dr. Barry Sears, The Zone diet does not restrict caloric intake and purportedly keeps the body in a fat burning “zone” by maintaining balanced insulin levels. Like the Atkins diet and South Beach Diet, The Zone recommends a diet containing carbs, protein and fats. However, the ratio of carbs to protein to fat ratio in The Zone is 40-30-30, and emphasizes polyunsaturated fats high in omega-3 fatty acids.

Retailers can help customers reinforce their annual New Year’s weight loss goals by suggesting safe and effective dietary supplements, and should familiarize themselves with the clinical research results of the scientific mechanisms of natural dietary supplements that have been shown to aid in fat loss and the development of lean muscle. “The retailer must try to understand that customer’s weight gain triggers such as overeating, slow metabolism, water retention, unregulated blood glucose levels, inability to metabolize fat, low serotonin levels and more,” said Bill Arthur, of Nutraceutical Solutions Consulting, marketing consultant to Nutratech Inc. “With that understanding, the retailer can guide the consumer to products geared to address his or her specific weight gain trigger. Additionally, retailers should read the industry publications so they can educate their customers. In the publications they will find plenty of articles on new research that shows efficacy and safety, new ingredients in the market, new products being manufactured and educational pieces.” Retailers have more educational materials than ever to learn from in support of safe and effective weight loss products, and can directly help the growing number of customers interested in losing weight achieve a healthier physique.

For a complete list of references to this story, visit www.hsrmagazine.com after February 1st, or e-mail hgranato@vpico.com.

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