Nutritionist and obesity

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683127/

 

Nutritionist and obesity:brief overview on efficacy, safety, and drug interactions of the main weight-loss dietary supplements

Table 1

Brief overview on compound, mechanism of action, main clinical studies, adverse effects, and drug interactions of the main weight-loss dietary supplements

CompoundMechanism of actionMain clinical studiesAdverse effectsDrug interactionsUsefulness

β-glucans	Increases satiety and total gastrointestinal transit time; slow cholesterol and glucose absorption	[19]	Abdominal pain, bloating, and disturbed defecation, such as urgent diarrhea and/or episodes of chronic constipation	Interaction with immunosuppressants, non-steroidal anti-inflammatory, and antihypertensive drugs	Not significant weight loss
Bitter orange	Increases energy expenditure and lipolysis, acts as a mild appetite suppressant	[25, 26]	Chest pain, tachycardia, anxiety, dyspnea; increases the risk for hypertension and cerebrovascular diseases when taken with stimulants such as caffeine or caffeine-containing herbs	Increase in blood levels of immunosuppressants, antiretroviral agents, drugs metabolized by the liver (CYP3A4); additive effect with antidepressant depression (MAOIs) and anti-diabetic drugs	Not enough evidence to recommend the consumption as an adjuvant in weight-loss management
Caffeine	Stimulates thermogenesis and central nervous system, increases fat oxidation and decreases the energy intake	[32, 33]	Nausea, vomiting, tachycardia, seizures, and cerebral edema	Toxic effects for the concomitant administration of caffeine and other drugs metabolized by the CYP1A2, including selective serotonin reuptake inhibitors, antiarrhythmics, MAOIs, lithium, bronchodilators, and quinolones; decrease the effectiveness of alendronate	The effect of caffeine alone on body weight are missing and further research is needed to confirm these findings
Calcium	Increases lipolysis and fat accumulation, decreases fat absorption by increasing fecal fat excretion	[38–41]	Constipation, increased risk of kidney stones, and interference with zinc and iron absorption	Reduces the absorption of bisphosphonates, levothyroxine, and antibiotics; induces hypercalcemia in association with thiazides cardiotoxicity in association with digoxin	Calcium supplementation did not significantly affect body weight or body fat
Capsaicin	Increases thermogenesis and energy expenditure; enhances lipolysis in adipocytes, glycogenolysis in the liver, and fat oxidation in muscle; increases satiety by increasing GLP-1 secretion, and reduce energy intake	[46]	Gastrointestinal distress, sweating, flushing, and rhinorrhea	Interferes with antihypertensive, anti-diabetic, anti-anticoagulant drugs, and simvastatin; reduces the efficacy of drugs metabolized by CYP2C19 and CYP3A4	Its consumption may contribute to weight management through reductions in total energy intake
Carnitine	Increases mitochondrial β-oxidation of fatty acids and lipolysis; reduces adipogenesis	[53]	Muscle weakness in patients with uremia and seizures in those suffer of epilepsy	Decreases the effectiveness of the supplemented thyroid hormone; increases anticoagulant effects of warfarin	Its consumption may temporarily contribute to weight loss
Chitosan	Prevents fat absorption, decreases cholesterol absorption, and increases fecal fat excretion	[60, 61]	Allergic reactions, flatulence, bloating, constipation, indigestion, nausea, and heartburn	Potential increase of the anticoagulants; reduces the absorption of fat-soluble vitamins (A, D, E, and K)	Considering the limited studies available, chitosan supplementation cannot be recommended at this time for weight loss
Chromium	Increases the activity of insulin, regulates eating behavior, mood and food cravings, and stimulates thermogenesis	[65, 66]	Skin irritation, headaches, dizziness, nausea and vomiting, mood changes, watery stools, and weakness	Decreases the serum thyroxine concentration; aspirin and non-steroidal anti-inflammatory drugs increase the risk of adverse effects; potentiates insulin or anti-diabetic drugs	Not enough evidence to recommend the consumption as an adjuvant in weight-loss management
Coleus forskohlii	Stimulates cAMP levels, fat oxidation, and thermogenesis, activates the hormone-sensitive lipase, reduces appetite	[71, 72]	Increased frequency of bowel movements and loose stools, headache	Decreases the effect of anticoagulant drugs; potentiates the effects of hypotensive drugs; stimulates metabolism of CYP3A substrate drugs	Not enough evidence to recommend the consumption as an adjuvant in weight-loss management
Conjugated linoleic acid	Increases lipolysis and fatty acid oxidation in skeletal muscle, reduces lipogenesis, promotes apoptosis in adipose tissue, increases UCP-1 and energy expenditure	[79]	Abdominal discomfort and pain, constipation, diarrhea, loose stools, nausea, vomiting, and dyspepsia	Potential interactions with anticoagulant drugs	Not enough evidence to recommend the consumption as an adjuvant in weight-loss management
Fucoxanthin	Increases energy expenditure, fatty acid oxidation and thermogenesis, inhibits adipocytes differentiation	[84]	Potential risk of thyroid disorders	No drug interactions have been reported	Considering the limited studies available, fucoxanthin cannot be recommended at this time for weight loss
Garcinia cambogia	Exerts anorexigenic effects, stimulates fatty acid and inhibits cholesterol synthesis	[86–89]	Headache, nausea, upper respiratory tract, and gastrointestinal symptoms	Interacts with anti-diabetic, serotonin-norepinephrine reuptake inhibitors and CYP2B6 substrate drugs; increases risk of rhabdomyolysis with HMG-CoA reductase inhibitors	Garcinia cambogia did not significantly affect body weight or body fat
Glucomannan	Promotes satiety, delays gastric emptying, and reduces small-bowel transit and cholesterol absorption	[95–97]	Abdominal discomfort, bloating, flatulence, diarrhea, loose stools, and belching and flatulence	Reduces with absorption of antihypertensives, antilipemics, antidiabetics, liposoluble vitamins and anti-obesity agents; increases the enterohepatic circulation of thyroid hormones	Not enough evidence to recommend the consumption as an adjuvant in weight-loss management
Guar gum	Reduces dietary lipids absorption and gastric emptying, increases satiety	[100]	Abdominal pain and cramps, nausea, diarrhea, flatulence, and increased number of bowel movements	Decreases the absorption of digoxin, aspirin, paracetamol, rosuvastatin, anti-diabetic drugs, corticosteroids, and multivitamins	Guar gum did not significantly affect body weight
Hoodia Gordonii	Suppresses appetite and adrenal steroidogenesis, exerts antinflammatory	[105]	Dizziness, nausea, disturbance of skin sensation, headache, hypertension, tachycardia, electrocardiogram abnormalities, and blood chemistry abnormalities	Interactions with anti-diabetic drugs and anticoagulants; inhibits CYP3A4 substrate drugs	Hoodia Gordonii did not significantly affect body weight
Irvingia gabonensis	Reduces fat storage, food intake and gastric emptying; inhibits adipogenesis	[106, 109]	Headache, xerostomia, gastrointestinal complaints, sleep disorder, and flu-like symptoms	May enhance the side effects of anti-diabetic drugs and statins	Considering the limited studies available, Irvingia gabonensis cannot be recommended at this time for weight loss
Phaseolus vulgaris	Reduces food intake, gastric emptying, carbohydrate digestion and fat storage; stimulates cholecystokinin and GLP-1 release	[110, 111]	Flatulence, constipation or soft stools and headaches	Interactions with anti-diabetic drugs and insulin	Phaseolus vulgaris supplementation showed statistically significant effects on body weight and body fat
Pyruvate	Increases lipolysis, energy expenditure, thyroxine levels, and ‘futile’ cycling in glycolytic pathways	[116]	Gas, bloating, and diarrhea	Not available	Not enough evidence to recommend the consumption as an adjuvant in weight-loss management
Raspberry ketone	Reduces adipogenesis, fat storage and appetite	[122]	Cardiotoxicity as well as a teratogenic effect	Interactions with anti-diabetic drugs and anticoagulants	Considering the limited studies available, raspberry ketone cannot be recommended at this time for weight loss