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Green Tea Effects on Weight Reduction
Green tea has been studied for its beneficial effects on cardiovascular and metabolic diseases. Epigallocatechin gallate (EGCG) is the most abundant green tea catechin and is considered the most bioactive constituent that can reduce body weight by decreasing fat cell differentiation and proliferation. One study has demonstrated that green tea extracts and drinks could reduce body weight and body mass index in obese individuals in 2 months.1 On the other hand, a previous study by those authors found that 302 mg of EGCG daily did not reduce weight in obese women.2 The currently published study set out to increase the concentration of EGCG to a daily dose of 856.8 mg/day to see if this increased amount would result in weight loss in obese individuals.
This randomized, double-blind trial was conducted in 115 women with central obesity with 102 of them having a body mass index (BMI) ≥27 kg/m2 and a waist circumference ≥80 cm. Women were randomized to either a high-dose green tea group or placebo group for 12 weeks. One capsule of green tea or placebo was given 3 times per day, 30 minutes after meals for a total daily dose of 856.8 mg EGCG.
Body weight decreased from 76.8 kg to 75.7 kg after 12 weeks in the EGCG group. BMI and waist circumference were reduced from 31.0 cm to 30.6 cm and 95.1 cm to 92.8 cm respectively. In the placebo group, only waist circumference and hip circumference reached significant reduction, from 95.7 cm to 91.5 cm and 107.2 cm to 103.7 cm respectively. No differences were seen in weight or BMI.
The study also demonstrated a trend of decreased total cholesterol and decreased LDL cholesterol. Significantly lower ghrelin levels and elevated adiponectin levels were also seen in the green tea group than in the placebo group.
Comment: Obesity is one of the most challenging issues in women's health care. No one strategy produces consistent results in all women. Nutritional modifications, exercise programs, behavioral therapy, and agents that can affect insulin resistance, fat burning, fat oxidation, and metabolic rates occupy central roles in efforts. Green tea and its main components, the catechins, including EGCG, are thought to influence body weight through mechanisms of thermogenesis and fat oxidation. The results of the current study with significant weight reduction and decreased ghrelin levels after EGCG treatment implies that a high dose of EGCG might increase energy metabolism and interrupt lipid accumulation and directly inhibit ghrelin secretion.
For perspective on dosing, one might look for a capsule of green tea extract of approximately 300 mg of EGCG. If 1 capsule 30 minutes after each meal (3 times per day), this would then be 900 mg of EGCG per day, slightly more than the 856.8 mg in the current study.
Chen I, Liu C, Chiu J, Hsu C. Therapeutic effect of high-dose green tea extract on weight reduction: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr. 2015:1–8 (in press).
1. Basu A et al. Green tea supplementation affects body weight, lipids, and lipid peroxidation in obese subjects with metabolic syndrome. J Am Coll Nutr. 2010;29:31–40.
2. Hsu C, Sai T, Kao Y, et al. Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr. 2008;27:363–370.
Comparison of Myo-Inositol and D-Chiro-Inositol in PCOS Women
Both myo-inositol and D-chiro-inositol have been shown to affect ovarian function and metabolic factors in women with polycystic ovarian syndrome (PCOS). They have been shown to improve androgen levels, increase the action of insulin, reduce systolic blood pressure, and more.
The purpose of the current study was to compare the effects of myo-inositol and D-chiro-inositol in women with PCOS. Fifty women with a diagnosis of PCOS according to the Rotterdam criteria were enrolled. They were randomized into two groups; 25 were treated with 4 g of myo-inositol plus 400 mcg of folic acid daily for 6 months, and the other 25 were treated with 1 g of D-chiro-inositol plus 400 mcg/folic acid per day.
In the myo-inositol group, there were statistically significant reductions of diastolic and systolic blood pressure; lowering of luteinizing hormone (LH); lowering of the LH/FSH (follicle stimulating hormone) ratio; and lowering of total testosterone and free testosterone, androstenedione, prolactin, and the HOMA (homeostatic model assessment) to check for insulin resistance. These same patients also had a statistically significant increase of sex hormone binding globulin (SHBG) and the glycemia/immunoreactive insulin ratio.
In the D-chiro-inositol group, there was a statistically significant reduction of systolic but not diastolic blood pressure and a statistically significant reduction of the Ferriman-Gallwey Score (a measure of hirsutism), LH, LH/FSH ratio, total testosterone, free testosterone, androstenedione, prolactin, and the HOMA.
Both inositols reduced systolic blood pressure, LH, LH/FSH ratio, circulating androgens, and prolactin, and increased insulin sensitivity and SHBG. Myo-inositol may decrease the LH/FSH ratio, total testosterone, and the HOMA in a more statistically significant way. D-chiro-inositol is likely to reduce mostly, but not statistically significantly, the LH and free testosterone levels and may increase, but not significantly, the glycemia/IRI ratio.
It could be concluded from this comparison that both the inositol isoforms are effective in improving the ovarian function and metabolism of women with PCOS, although myo-inositol showed the greater impact on the metabolic profile and D-chiro-inositol affected more positively the hyperandrogenism measurements. In comparing the two products pre- and posttreatment, there was a higher regularization of menstrual cycles in those treated with D-chiro-inositol compared with those with myo-inositol, although this was not statistically significant.
Comment: PCOS is one of the most common endocrine disorders in reproductive-aged women. The majority of women with PCOS (about 74%) do not ovulate, almost half (about 42%) have insulin resistance, and almost half (48%) have hyperandrogenism. It's important to remember that PCOS is a syndrome – and not all women with PCOS have any one sign or symptom. Not all actually have multiple cysts on the ovaries, not all have excess body hair, and not all have abnormal menstrual cycles. In women with PCOS, though, the insulin resistance is commonly associated with hyperinsulinemia, which then enhances the production of androgens by the ovarian theca cells, leading to a reduction in circulating levels of SHBG, which leads to increased levels of free testosterone. Nutritional, lifestyle, supplemental, and pharmaceutical strategies try to address the syndrome by targeting this core issue of improving insulin sensitivity, which thereby addresses the signs and symptoms of PCOS. Both myo-inositol and D-chiro-inositol, in the doses used in this study, improve ovarian function and metabolism in PCOS, but myo-inositol showed the most effect on the metabolic profile and D-chiro-inositol reduced the hyperandrogenism better.
Pizzo A, Lagana A, Barbara O. Comparison between effects of myo-inositol and D-chiro-inositol on ovarian function and metabolic factors in women with PCOS. Gynecol Endrocrinol. 2014;30(3):205–208.
Vulvar Lichen Sclerosus: Treatment with Topical Avocado and Soybean Extracts
Lichen sclerosus is a chronic inflammatory dermatosis condition that has no certain etiology. Treatment options are few, and topical corticosteroid creams are the mainstay of conventional treatment, although not the only treatment. Evidence-based natural treatments are essentially nonexistent, although many anecdotal and case reports reflect attempts at reducing inflammation with dietary changes, supplements, and topical herbal preparations such as licorice, MSM, and others. None of the natural medicine approaches has a very robust track record. Topical steroids are often needed to reduce itching and/or pain, reduce ulcerations/fissures, and slow or halt the progression of the disease.
The current single-center, prospective cohort, open-label study was designed to assess the efficacy of a topical product containing avocado and soybean extracts (ASE) along with several antioxidant, softening, and emollient ingredients. Patients in the study were those with mild to moderate disease-related clinical signs of lichen sclerosus, lichen sclerosus relapse, or recurrence after at least one previous treatment with topical steroids, or intolerance to topical corticosteroids. Patients were excluded if they were taking systemic and/or topical lichen sclerosus treatments during the 4 weeks before enrollment, or had active vulvar infections or other vulvar dermatoses or cancer. Women were also excluded if pregnant or breast-feeding.
After screening, 23 women met the eligibility criteria and entered the study, applying ASE cream on the affected vulvar area twice daily for 24 weeks. The ASE cream used was Repasine cream (Pharmaday, Italy). It contains extracts of avocado and soybean, hyaluronic acid, vitamin E, sodium carboxymethyl beta glucan, dimethylmethoxy chromanol, and trimethylglycine. During the first 12 weeks, patients also took two ASE capsules daily between meals, containing 300 mg extracts of avocado, soybean, vitamin E, para-aminobenzoic acid, and phytosterols.
By the end of the 24 weeks of treatment, 12 (70.5%) of symptomatic patients, and 13 (72.2%) of asymptomatic patients but those who had objective signs of lichen sclerosus achieved an improvement of at least 75% in subjective and objective global scores, respectively.
Comment: The authors of this study reported in the discussion that the rates of partial to complete symptom and sign remission is not easily comparable to rates with topical corticosteroids. But, while the ASE-containing products did not achieve as rapid a response of at least 75% as is seen with topical steroids, after the 24 weeks, the improvement attained was essentially the same as a 12-week course of the potent topical corticosteroids. Of note though is that the patients in this study were those with mild to moderate disease.
It appears that the topical and oral ASE products exerted anti-inflammatory, antifibrotic, emollient, and soothing effects on patients with mild to moderate lichen sclerosus.
Borthi A, Corazza Mingheti G, Toni G, Virgili A. Avocado and soybean extracts as active principles in the treatment of mild-to-moderate vulvar lichen sclerosus: results of efficacy and tolerability. J Eur Acad Dermatol Venereol. 29;2015:1225–1230.
Dr. Tori Hudson graduated from the National College of Naturopathic Medicine (NCNM) in 1984 and has served the college in many capacities over the last 28 years. She is currently a clinical professor at NCNM and Bastyr University; has been in practice for over 30 years; and is the medical director of the clinic A Woman's Time in Portland, Oregon, and director of research and development for Vitanica, a supplement company for women. She is also a nationally recognized author, speaker, educator, researcher, and clinician.
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