There will always be bullets. The weight-loss category can't seem to
completely escape the wild claims glorified by dramatic before-and-after images
and coated in illusion. Magic bullets always promise to kill a weight problem
quickly, and the many desperate consumers that riddle the weight-loss segment
are quick to pull the trigger on hotshot products and of-the-moment diets.
Unfortunately this can be a cycle vicious to all those involved—products (and
manufacturers) come and go without any sustained, long-term sales; consumers are
often left dissatisfied and distrustful of natural weight-loss products that
didn't live up to the hype; and retailers are left dealing with the mess of
misled consumers, ever-changing products and threats to their staff's
credibility. In response, the natural products industry is continuing to move
away from magic bullets and toward science-based products that help consumers
more responsibly mange their weight and body by controlling hunger, trading fat
for lean muscle and improving overall nutrition, diet and lifestyle.
People around the world snap up natural weight-control products to the tune
of $7.5 billion each year, according to Frost & Sullivan, which noted the
category is growing almost 7 percent annually. The market research firm's
Christopher Shanahan noted while Europe is the largest market for satiety
ingredients and has tight regulatory controls of weight supplements, North
America is an established market with a few dominant ingredients, such as hoodia,
and much looser regulation that enables easier entry for new products. He added
the North American market currently faces challenges such as declining consumer
confidence in supplements following several safety-related issues in recent
years (ephedra, Hydroxycut, etc.). Among the current market drivers, according
to Shanahan, are fiber and protein for satiety; functional food and beverage
formulations; co-branded products; and scientifically supported ingredients.
Ingredients may rise and fall, products come and go, but one thing that is
becoming more consistent is the need for science, responsibility and commitment
in the weight-management category. "There is an absolute requirement for
research support for all weight-loss ingredients in today's dietary supplement
market," said Stephen Holt, M.D., Holt Institute, who noted a significant
proportion of all weight-loss supplements are sold with relatively weak evidence
of efficacy.
"This category commands the highest volume of sales in the dietary
supplements segment and, hence, is prey to many fly-by-night operators out to
make a quick buck, and who sell products with wild claims," added R.V. Venkatesh,
Gencor Pacific, who stated supporting science and research is the only way to
ensure the public gets a good product that is safe and efficacious.
"Science supporting any ingredient that plays in the weight-management sector
is a must in today's environment," said Scott Steil, NutraBridge, who agreed the
entire weight-supplement industry suffers from the actions of a few bad apples.
However, he noted the vast majority of top supplement companies do require any
weight-loss or blood-sugar management product be validated with solid human,
clinical studies. "We invest most of our resources in the science that supports
our ingredients, which has proven to be a strategy that is paying off for our
customers and consumers," he said. "In fact, last year the weight-loss
marketplace remained flat in terms of sales, yet our ingredient sales more than
doubled." He credited scientific support for this growth.
"We regard clinical research to be essential to our product," echoed Bob
Green, Nutratech, who noted even in the best-case scenarios, manufacturers and
retailers have too often focused on the "flavor of the month" new ingredients
that, in most cases, does not have substantial scientific backing. "If consumers
aren't demanding more scientific proof, they should be," he remarked, noting his
company posts all its supporting science on its Web site, as do many reputable
supplement companies. "We have no problem putting the research out there for
people to make up their own minds."
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Ingredients and Science
There may be lots of weight-management products from which retailers can
choose their store's inventory, but only certain ingredients have been studied
for mechanism of action, efficacy and safety.
For many dieters, cutting calories and increasing exercise is just not enough
to reach to their weight goals. To help them get over the hump, products that
help them burn fat are popular choices. Fortunately "burns fat" is not totally a
pipe-dream, as many thermogenic ingredients have generated positive research
results.
The theory behind thermogenesis is brown adipose tissue (BAT) more
efficiently converts nutrients into energy (i.e. heat) than other types of
tissue that are more abundant in humans. Certain natural compounds are
hypothesized to stimulate this heat-generating process via increased metabolic
rate. Caffeine is an example of a commonly consumed naturally occurring
ingredient with thermogenic actions; but, the market, in general, is moving away
from stimulants in the wake of the federal actions against ephedra, Hydroxycut
and other stimulant supplements.
Long considered thermogenic only for its caffeine content, green tea has
recently been shown to stimulate BAT thermogenesis more than would be possible
by its caffeine content alone.1 The credit for this effect has gone
to tea catechins, primarily epigallocatechin gallate (EGCG), which affects not
only thermogenesis, but also lipogenesis (fat formation).2 Comparing
EGCG-caffeine combinations to caffeine alone revealed the catechins added
significant energy expenditure (EE) and fat oxidation (turning fat to energy).3,4
When talking increased heat, it is no surprise the pepper compound capsaicin
has been found to deliver thermogenic benefits. A handful of studies have
demonstrated capsaicin can increase fat oxidation and even decrease abdominal
adiposity.5,6,7 Piperine, an active compound in black pepper has been
found to stimulate epinephrine release, which activates the beta-receptors that
initiate thermogenesis.8 A study of piperine (as Bioperine, from
Sabinsa) and a capsicum-caffeine combo (as Capsimax™ Plus Blend, from OmniActive
Health Technologies) revealed participants taking the supplements one hour
before exercise burned three times more calories before, 3 percent more calories
during, and 12 times more calories for up to an hour after exercise.9
One of the compounds filling the void left when ephedra was banned is bitter
orange (Citrus aurantium), which contains indirect adrenergic amines that
stimulate metabolism.10 In fact, researchers discovered C. aurantium
can stimulate thermogenic beta-adrenoreceptors, without stimulating other beta-adrenoreceptors
that affect blood pressure and other side effects attributed to ephedra use.11
A wealth of research has been published since 2000 on bitter orange (as Advantra
Z, from Nutratech), either solo or in combination with other weight control
ingredients, such as green tea and natural caffeine, showing thermogenic
activity, lipolysis (fat breakdown) and fat oxidation, without negative side
effects.12,13,14,15
Hydroxycitric acid (HCA), from Garcinia cambogia, also affects
lipolysis, as well as adipogenesis (fat accumulation) and thermogenic weight
control.16,17 As Super CitriMax, from InterHealth, HCA has
demonstrated a positive effect on fat- and obesity-related genes, weight gain
and food intake.18,19,20
Another fat-burning ingredient to look for is 7-oxo-DHEA, a compound produced
naturally by the adrenal glands and known to impact three thermogenic enzymes.21,22
Deemed a safe ingredient at 200 mg/d, 7-oxo-DHEA (as 7-Keto, from Humanetics)
has increased fat and weight loss in human research, in addition to increasing
resting metabolic rate (RMR) in people on a low-calorie diet, which normally
decreases RMR.23,24
One of the recently popular thermogenic ingredients, fucoxanthin, comes from
brown seaweed. This carotenoid compound influences metabolism gene expression in
white adipose tissue (WAT), resulting in increased fat oxidation and energy
production.25 A pair of animal trials showed this mechanism of action
resulted in reduced abdominal fat weight,26,27 and researchers
suggested fucoxanthin may be ideal for humans, who tend to have more WAT than
BAT.
Carb Controllers
Brown seaweed offers more than thermogenesis, as it contains another emerging
weight-management ingredient that appears to offer benefits for those who
struggle with carbs. Derived from two species of brown seaweed, InSea2, from
innoVactiv, selectively inhibits both alpha-glucosidase and -amylase enzymes,
which are instrumental in carbohydrate absorption, and diminishes the metabolic
impact of a high-glycemic meal, such as foods rich in starch and sugar. Steil
reported the newest results from a just-completed human trial show InSea2
significantly reduced blood glucose levels by 44 percent and insulin levels by
22 percent, while increasing insulin sensitivity by 7 percent, compared to
placebo.
A standardized extract of white bean (as Phase 2, from Pharmachem) offers
additional carb-blocking benefits. This starch neutralizer increased weight loss
and decreased triglyceride levels in obese adults in 2004 research.28
A pair of recently published trials reported decreased carb absorption to
between 30 and 40 percent and normalized glucose levels more quickly than
controls.29
Hunger No More
One of the hardest parts of dieting and managing weight is controlling the
appetite. A slew of natural compounds have wooed the market by showing the
ability to curtail hunger and promote satiety.
The key to satiety is the hunger hormone ghrelin, as well as various peptides
that help signal satiety and fullness. A satiating diet tends to contain more
protein, according to a number of reviews.30,31,32 Whey, casein and
soy protein all contribute to satiety to some degree.33,34,35 Many
researchers have focused on glycomacropeptide (GMP) from whey and casein,
finding this constituent decreased energy (food) intake and affected key hormone
peptides.36,37
A potato extract (Slendesta, from Kemin Health) appears to affect the same
peptide (cholecystokinin, CCK) in managing hunger, satiety and weight. A pair of
Iowa State University trials confirmed increased fullness, decreased hunger and
recued weight following Slendesta supplementation.
In addition to protein, fiber and fats can promote satiety. While insoluble
fiber such as FOS (fructooligosaccharide) and soluble fiber such as beta-glucan
have been shown to affect fullness, appetite and weight,38,39,40 a
soluble fiber from the fenugreek plant is making some headway in recent
research. In a 2009 trial, Galactomannan (as FenuLife, from Frutarom) given to
obese subjects led to significant increases in measurements of satiety and
fullness, while also reducing hunger and food consumption.41
Early unpublished trials on a combination of oat and palm oils (as Fabuless,
from DSM Food Specialities) found decreased energy intake (carbs, fats and
proteins) due to the slowing down of fat absorption in the small intestines, a
process called the ileal brake. Subsequent published studies showed Fabuless
supplementation in obese subjects could impact satiety, appetite and weight
gain.42,43 The most recent trial in men with healthy body mass index
(BMI) revealed Fabuless delayed food absorption as much as 45 minutes.44
Korean pine nut oil might also favorably influence satiety and hunger.
Pinolenic acid (as PinnoThin™, from Lipid Nutrition) is known to act on hunger
peptides including CCK. One trial noted 3 g Pinnothin affected CCK and led to
reduced appetite and food intake.45
From the arsenal of botanicals, Caralluma fimbriata is drawing
attention as an appetite suppressant. Glycosides in C. fimbriata may inhibit the
hunger sensory mechanism of the hypothalamus, according to researchers who found
a Caralluma extract (as Slimaluma, from Gencor Pacific) given to adults with BMI
over 25 helped reduce hunger levels and waist circumference. Glycosides are also
the target of research on hoodia and appetite control. The ever-popular herbal
hunger inhibitor has been linked to decreased food intake and body weight.46
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Hyperdrive Can Be Dangerous
Hoodia might be a prime example of what can go wrong when irresponsible
companies seize a market opportunity due to skyrocketing popularity for a new,
hot ingredient with demand that overwhelms both supply and science. As hoodia
became the latest star in the weight and diet market, entrepreneurs came out
with all kinds of products, many which suffered from poor quality materials, if
they even contained any real hoodia at all. While there has been some research
in the past on hoodia and, more specifically, on a particular compound, p57,
many new hoodia products manufacturers made wild claims, often for the
low-quality product. Often, product was adulterated.
"The dietary supplement industry should be ashamed of circumstances where
lack of authenticity resulted in the decline of interest in what has been
described as one of the most important ethno botanical discoveries of the 20th
century," Holt lamented, adding FTC has taken appropriate action against
individuals who have provided adulterated product. "The problems have been
largely identified as improper activity by bulk suppliers of ingredients."
Of greater concern to Susan Knightly, Desert Labs: "Low-quality hoodia in the
marketplace has resulted in ineffectual results for the consumer." She added
Desert Labs uses a special tissue propagation technique with the mother plant to
ensure the original DNA of the hoodia and its active ingredients.
The demand for hoodia resulted in depleted supply globally, and the
sustainability of hoodia was in question. Holt reported Global Healthcare LLC
entered into direct agreements with South African suppliers of hoodia who are
engaged in controlled growing operations that do not damage the ecology and work
to protect this valuable dietary supplement.
Describing the long-term supply feeding Desert Labs, Knightly noted the
hoodia plant was brought from its native Kalahari Desert in South Africa to the
Negev Desert in Israel, where the climate is almost identical to the Kalahari.
She advised retailers to look for the freshest whole food hoodia products from
mature plants with strong finger lab analysis to ensure customer satisfaction.
"It is also helpful to know the production chain," she said, noting Desert Labs
maintains control of the entire production of its Ice Cube Diet product, from
planting and harvesting through freezing to packaging and shipping.
The other problem with hoodia—outrageous and unsupported weight-loss
claims—is a problem in the entire diet category. "Hyperbole consisting of wild
claims (e.g., lose weight while you sleep, etc.) and before/after tall tales are
the marketing hallmark of many [weight-management] products," said Paul Dijkstra,
InterHealth, who added the hype, combined with negative media coverage, has made
many consumers wary. "Reputability, efficacy and safety are bigger issues in
this category than any other." In the end, he said products that over-promise,
under-deliver and do not have the proper clinical trials to support product
efficacy can damage the entire industry. "Product claims should be backed by
well-designed clinical studies so as to not mislead consumers of any expected
benefits," Dijkstra said.
Steil noted, "FDA and FTC are closely monitoring the weight-loss market and
vow to take action against any product that is unsafe or not able to support
claims."
Venkatesh confirmed FDA and FTC are targeting this segment stringently to
ensure claims are backed by proper science. "Quite a big proportion of the
weight-loss supplements industry is tainted by products with poor science and
quality control, and this has definitely resulted in a lot of negative publicity
for this segment of the market," he said.
Despite this growing problem, Russell Grossman, BNG Enterprises, reported,
"We have noticed throughout the years that consumer demand for weight-loss
products has grown despite vast negative media and government attention. It
appears consumers want to find products that work and will keep looking until
they find it."
However, Sunil Kohli, Health Plus, expressed concern on the impact
irresponsible weight-loss marketers can have on the legitimate industry. "Their
shadows do loom darkly over the legitimate companies who have legitimately
effective products that help accelerate the goal of healthy weight loss in
tandem with exercise and eating right."
Holt supported this notion of a well-rounded weight management approach.
"Weight-loss tactics must be holistic and include appropriate diet, behavioral
change and exercise," he said.
Contributing to the prevalence of wild claims is a customer base vulnerable
to the quick-fix marketing ploy. "Many are obese and desperate; they try
everything, thinking that one magic easy thing will make them look like gods or
goddesses without having to change their eating or lifestyle habits," Kohli
reasoned. "Numerous companies that lack any moral fiber get out there with wild
claims and commercials and hook these people like fish. It's ‘catch and
release'—they're on their own after they buy the product." He suggested
educating and counseling consumers will help address these marketing issues.
Dijkstra agreed on the importance of educating consumers on responsible
weight management, saying, "Consumers will start to become informed as to the
safety and efficacy of each and every ingredient in the product they are
taking."
Marketing Weight Control at Retail
The concept of educating consumers on the science and quality of the best
products, and recommending exercise, dietary restriction and other lifestyle
changes is a popular theme among responsible companies in the industry. "FTC
requires all marketing companies to recommend weight-loss supplements be used in
conjunction with a sensible diet and exercise program; it is critical that
clinical studies include diet and exercise as part of the protocol," Stiel
reported. "When we design a weight-loss study, the placebo arm always involves
diet and exercise."
Grossman said in addition to science and other information, convenience is a
big factor for consumers. "They don't want to follow a complicated plan where
they have to buy special foods or remember to take three capsules in the
morning, three at lunch and none at dinner," he reasoned. "Who can remember how
many and when?" He further noted while beverages are becoming a popular delivery
form, consumers increasingly favor premix products rather than something they
have to manually prepare.
"Beverages are an excellent fit for delivering weight-management products
since they naturally fit within consumers' normal lifestyles," agreed Dijkstra.
"It is a significant advantage if they can consume products with functional
ingredients without having to make changes in their daily activities or remember
taking supplements."
Another trend evident in a review of the research supporting quality
weight-control products is the growing presence of branded ingredients. "Branded
ingredients are often supported by years of science—a powerful tool in promoting
a product," Dijkstra noted, adding retailers will see an increase in displaying
a specific branded ingredient on the front of a package. "In the wake of quality
and adulteration issues, consumers are more likely to trust the quality of
branded ingredients."
Dijkstra also said branded ingredients are increasingly being incorporated
into functional products, especially beverages. He stressed the importance of
conducting research to ensure the use of branded ingredients in various
products—from ready-to-drink beverages and single-use packets to snack
foods—doesn't compromise taste, odor, color, feel or bioavailability of a
finished product. GRAS (generally recognized as safe) status is also a key
requirement for an ingredient to be used in a food and beverage.
By paying stricter attention to the science behind products and their
ingredients, retailers can stock only the best products that have substantiated
efficacy in the area of weight control, whether thermogenesis, appetite control
or satiety. While the feds are focused mostly on manufacturers and marketers,
especially online, it is important retailers maintain responsible marketing in
their stores by avoiding the wild claims that trouble the marketplace, and drive
doubt and mistrust into the customer base. "Exaggerated or false claims might
generate sales in the short term," Grossman conceded, "But if our industry is to
build real credibility and staying power, ingredient suppliers, manufacturers
and retailers must work together to break the myth that there could be a magic
bullet out there for weight loss."
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catechin-polyphenols, caffeine and sympathetic activity.” Int J Obes Relat Metab
Disord. 2000 Feb;24(2):252-8.
2. Wolfram S, Wang Y, Thielecke F. “Anti-obesity effects of green tea: from
bedside to bench.” Mol Nutr Food Res. 2006 Feb;50(2):176-87.
3. Boschmann M, Thielecke F. “The effects of epigallocatechin-3-gallate on
thermogenesis and fat oxidation in obese men: a pilot study.” J Am Coll Nutr.
2007 Aug;26(4):389S-395S.
4. Dulloo AG et al. “Efficacy of a green tea extract rich in catechin
polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation
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5. Shin KO, Moritani T. “Alterations of autonomic nervous activity and energy
metabolism by capsaicin ingestion during aerobic exercise in healthy men.” J
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7. Lejeune MP, Kovacs EM, Westerterp-Plantenga MS. “Effect of capsaicin on
substrate oxidation and weight maintenance after modest body-weight loss in
human subjects.” Br J Nutr. 2003 Sep;90(3):651-59.
8. Kawada T et al. “Some pungent principles of spices cause the adrenal
medulla to secrete catecholamine in anesthetized rats.” Proc Soc Exp Biol Med.
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9. Unpublished trial.
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11. Preuss HG et al. Ibid.
12. Gougeon R et al. “Increase in the thermic effect of food in women by
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13. Haller CA, Benowitz NL, Jacob P 3rd. “Hemodynamic effects of ephedra-free
weight-loss supplements in humans.” Am J Med. 2005 Sep;118(9):998-1003.
14. Sale C et al. “Metabolic and physiological effects of ingesting extracts
of bitter orange, green tea and guarana at rest and during treadmill walking in
overweight males.” Int J Obes. 2006. DOI:10.1038/sj.ijo.0803209.
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DOI:10.1111/j.1365-2125.2008.03144.x
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functional supplements for weight management.” Curr Genomics. 2008
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17. Kim KY et al. “Garcinia cambogia extract ameliorates visceral adiposity
in C57BL/6J mice fed on a high-fat diet.” Biosci Biotechnol Biochem. 2008
Jul;72(7):1772-80.
18. Roy S et al. “Transcriptome of primary adipocytes from obese women in
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2007 Sep;26(9):627-39.
19. Hayamizu K et al. “Effect of Garcinia cambogia extract on serum leptin
and insulin in mice.” Fitoterapia. 2003 Apr;74(3):267-73.
20. Preuss HG et al. “An overview of the safety and efficacy of a novel,
natural(-)-hydroxycitric acid extract (HCA-SX) for weight management.” J Med.
2004;35(1-6):33-48.
21. Lardy H et al. “Ergosteroids: Induction of thermogenic enzymes in liver
of rats treated with steroids derived from dehydroepiandrosterone.” Proc Natl
Acad Sci. 1995;92:6617-19.
22. Lardy H et al. “Ergosteroids II: Biologically active metabolites and
synthetic derivatives of dehydroepiandrosterone.” Steroids. 1998;63:158-65.
23. Kalman DS et al. “A randomized, double-blind, placebo controlled study of
3-acetyl-7-oxo-dehydroepiandrosterone in healthy overweight adults.” Curr Ther
Res. 2000;61:435-442.
24. Zenk JL et al. “HUM5007, a novel combination of thermogenic compounds and
3-acetyl-7-oxo-dehydroepiandrosterone: Each increase the resting metabolic rate
of overweight adults.” J Nutr Biochem. 2007;18:629-34.
25. Maeda H et al. “Seaweed carotenoid, fucoxanthin, as a multi-functional
nutrient.” Asia Pac J Clin Nutr. 2008;17 Suppl 1:196-9.
26. Maeda H et al. “Effect of medium-chain triacylglycerols on anti-obesity
effect of fucoxanthin.” J Oleo Sci. 2007;56(12):615-21.
27. Maeda H et al. “Dietary combination of fucoxanthin and fish oil
attenuates the weight gain of white adipose tissue and decreases blood glucose
in obese/diabetic KK-Ay mice.” J Agric Food Chem. 2007 Sep 19;55(19):7701-6.
28. Udani J et al. ““Blocking Carbohydrate Absorption and Weight Loss: A
Clinical Trial Using Phase 2 Brand Proprietary Fractionated White Bean Extract.”
Alt Med. Rev. 2004;9(1):63-69.
29. Vinson JA et al. “Investigation of an Amylase Inhibitor on Human Glucose
Absorption after Starch Consumption.” Open Nutraceutical J. 2009;2(4):88-91.
30. Smeets AJ et al. "Energy Expenditure, Satiety, and Plasma Ghrelin,
Glucagon-Like Peptide 1, and Peptide Tyrosine-Tyrosine Concentrations following
a Single High-Protein Lunch." J Nutr. 2008;138:698-702.
31. Blom WA et al. "Effect of a high-protein breakfast on the postprandial
ghrelin response." Amer J Clin Nutr. 2006; 83(2):211-20.
32. Leidy HJ et al. "Increased dietary protein consumed at breakfast leads to
an initial and sustained feeling of fullness during energy restriction compared
to other meal times." Br J Nutr. 2009 Mar;101(6):798-803.
33. Bowen J et al. "Appetite regulatory hormone responses to various dietary
proteins differ by body mass index status despite similar reductions in ad
libitum energy intake." J Clin Endocrinol Metab. 2006;91(8):2913-9.
34. Bowen J et al. "Energy intake, ghrelin, and cholecystokinin after
different carbohydrate and protein preloads in overweight men." J Clin
Endocrinol Metab. 2006 Apr;91(4):1477-83.
35. Hochstenbach-Waelen A et al. "Effects of high and normal soyprotein
breakfasts on satiety and subsequent energy intake, including amino acid and
'satiety' hormone responses." Eur J Nutr. 2009 Mar;48(2):92-100.
36. Hochstenbach-Waelen A et al. "Effects of complete whey-protein breakfasts
versus whey without GMP-breakfasts on energy intake and satiety." Appetite. 2009
Apr;52(2):388-95.
37. Burton-Freedom BM. "Glycomacropeptide (GMP) is not critical to
whey-induced satiety, but may have a unique role in energy intake regulation
through cholecystokinin (CCK)." Physiol Behav. 2008 Jan 28;93(1-2):379-87.
38. Samra RA and Anderson GH. "Insoluble cereal fiber reduces appetite and
short-term food intake and glycemic response to food consumed 75 min later by
healthy men." Am J Clin Nutr. 2007 Oct;86(4):972-9.
39. Parnell JA and Reimer RA. "Weight loss during oligofructose
supplementation is associated with decreased ghrelin and increased peptide YY in
overweight and obese adults." Am J Clin Nutr. 2009 Apr 22. Epub ahead of print.
40. Peters HP et al. "No effect of added beta-glucan or of
fructooligosaccharide on appetite or energy intake." Am J Clin Nutr. 2009
Jan;89(1):58-63.
41. Mathern JA et al. “Effect of Fenugreek Fiber on Satiety, Blood Glucose
and Insulin Response and Energy Intake in Obese Subjects.” Phytother Res.
2009;23(11):1543-48.
42. Burns AA et al. "Short-term effects of yoghurt containing a novel fat
emulsion on energy and macronutrient intakes in non-obese subjects." Int. J
Obesity. 2000; 24(11):1419-25.
43. Burns AA et al. "The effects of yoghurt containing a novel fat emulsion
on energy and macronutrient intakes in non-overweight, overweight and obese
subjects." Int J Obesity. 2001; 25(10):1487-95.
44. Haenni A et al. “Effect of fat emulsion (Fabuless) on orocecal transit
time in healthy men.” Scandanavian J Gastroentrol. 2009;44(10):1186-90.
45. Einerhand AW et al. "Korean pine nut fatty acids affect appetite
sensations, plasma CCK and GLP1 in overweight subjects." FASEB Journal.
2006;20:A829.
46. Hursel R and Westerterp-Plantenga MS. "Green tea catechin plus caffeine
supplementation to a high-protein diet has no additional effect on body weight
maintenance after weight loss." Am J Clin Nutr. 2009 Mar;89(3):822-30.
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