WEIGHT CONTROL: A TIME FOR REAPPRAISAL

Transcription

1 WEIGHT CONTROL: A TIME FOR REAPPRAISAL Embracing the Key Public Health Initiative of Western Society Stephen Holt MD, LLD (Hon.) ChB., PhD, DNM, FRCP (C), MRCP (UK), FACP, FACG, FACN, FACAM, OSJ Distinguished Professor of Medicine, NYCPM, Scientific Advisor, Natural Clinician LLC

2 FACTS Obese people die young Obese people develop premature disability Obese people are modern, metabolic dinosaurs Obese people are generally mismanaged in clinical practice

3 FACT OBESE KIDS BECOME UNHAPPY, UNHEALTHY OBESE ADULTS

4 BACKGROUND Studies imply that the physically active person of normal body weight outlives the overweight, inactive individual Obese related disease, most notably Metabolic Syndrome X, presents unifying concepts of premature aging Retention of body functions and survival are clearly associated with partial food restrictions, at least in rodents

5 SUPER-SIZING AMERICA Americans exude complacency about their overweight status Obesity is part of a metabolic syndrome Syndrome X is under diagnosed and often mistreated by conventional and alternative medicine

6 THE UNKNOWN EPIDEMIC

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8 REDEFINING SYNDROME X Classic Definition: Obesity, Hypercholesterolemia, High Blood Pressure, Linked by Insulin Resistance. Syndrome X, Y and Z.., an expanded definition incorporating a novel unifying concept of common diseases

9 THE PUBLIC HEALTH RISK Syndrome X increases risk for : Type 2 Diabetes Mellitus Cardiovascular Disease Cardiovascular Deaths Deaths from ALL CAUSES Am.J.Epidemiol, 148, 958, 1998.

10 INTEGRATIVE MEDICINE FOR SYNDROME X While proper management of the individual abnormalities of this syndrome can reduce morbidity and mortality, it seems unlikely that management of the individual abnormalities of this syndrome provides better outcomes than a more integrated strategy CDC, Atlanta, Ga.

11 SYNDROME X NUTRITIONAL FACTORS Soluble fiber eg oat beta glucan Soy Protein 25 g/day Omega 3 Fatty acids (EPA) Chromium Alpha lipoic acid Vanadium Antioxidants e.g. ellagic acid, bioflavonoids Starch blockers Cinnamon Maitake Green coffee bean extract Hoodia gordonii

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13 Unrealistic weight loss expectation

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15 WEIGHT MANAGEMENT NOT ONLY A FUNCTION DIET CALORIE CONTROL BEHAVIOR MODIFICATION EXERCISE MANAGEMENT OF SYNDROME X TREATMENT OF OBESITY RELATED DISEASE OBESITIS RESTORATION OF BIORHYTHM BALANCING DIGESTIVE FUNCTION HORMONAL FACTORS

16 OBESITIS Obesity is an inflammatory disorder 30% of blood cytokine IL-6 from adipose tissue, decrease CRP and IL- 18 with weight loss Naïve Zones, but EPA valuable Adipocytokines [leptin, adiponectin and visobesein], adiponectin lowers TNFalpha Final common pathway oxidative stress

17 OBESITIS [A Missing Link] Imbalances of pro-inflammatory and anti-inflammatory cytokines exist in Obesity Free radical generation and reduced antioxidant defenses contribute Oxidative stress promotes the clinical course of Syndrome X and Diabetes Management of obesity is incomplete without addressing antioxidant profiles

18 WHICH ARE QUICK FIX PROMISES? Drugs: Phentermine, Fen-phen, Sibutramine, Orlisat OTC: Phenylpropanolamine Dietary Supplements: Pyruvate, Chromium Picolinate, Conjugated Linoleic Acid, Hydroxycitric Acid, Omega 3 Fatty Acids, GLA, Hoodia Gordonii etc? [SYNERGY] ALL OF THE ABOVE!

19 HOODIA GORDONII

20 HOODIA REVIEW ARTICLES NOV. AND DEC TOWNSEND LETTER, HOLT AND TAYLOR

21 THE SAN BUSHMEN

22 THE SUCCULENT PLANT

23 CONTRARIAN MODERN USE OF HOODIA

24 REPORTED EFFECTS OF HOODIA Hunger and thirst suppression Energizing effects Aphrodisiac effects Suppression of gastric acid Contention effective as extract containing steroidal glycosides or effective as a dietary supplement?

25 PROPERTIES OF HOODIA Folklore use Ethnobotanical facts Whole plant/ plant extracts Steroidal glycosides Animal studies Human studies

26 HOODIA: ANIMAL STUDIES FREE FEEDING RATS, obese/lean Whole plant and extract Feeding reduction and weight loss EFFECTS ON CNS IN RATS Extracts: steroidal glycosides Increase ATP in hypothalamus

27 HOODIA Human Studies Approx 3000 Kcal Placebo Daily Energy (calorie) intake Approx 2000 Kcal Start Hoodia Approx Approx Approx Day 4 Day 9 Day 14 Time (days) Adapted from Research by Phytopharm PLC using P57

28 Hoodia Lab analysis (IRS) South African Hoodia Gordonii Chinese Hoodia Gordonii Stella Hoodia Sample 1 Another companies Hoodia Stella Hoodia Sample 2 Stella Hoodia Sample New Absorbance o.o Wavelength (nm) Infrared Spectroscopy Property of Holt MD Labs

29 Hoodia Lab analysis (Chemistry) Chemical Analysis: Hoodia Gordonii, Average of two batches Analyte Alpha-formyl-pyrroidone N-carbamylputracenen P57-isoberberine alkaloid Steroidal glycosides Result 0.025/ / / /0.125 Unit % wt/wt % wt/wt % wt/wt % wt/wt Independent Laboratory Analysis Property of Holt MD Labs

30 HOODIA COMBINATION SUPPLEMENTS Hoodia plus coffee bean extract, chlorogenic acid and other metabolic enhancers (Patent Pending, Holt S, 2006) A novel biopharmaceutical approach is to suppress appetite while altering metabolic disturbances associated with obesity, e.g. insulin resistance, hepatic glucose synthesis and increasing basal metabolic rate, without cardiovascular risk

31 COMMON CAUSES OF OBESITY The Double Whopper Brain Sedentary Lifestyle Genetic Tendency Insulin Resistance Social Glutton (Appetite) Sleeplessness Infection?

32 EMERGING CONCEPTS Sleeplessness causes Obese Average sleep duration fallen Study, December 7, 2004, Ann. Int. Med Decrease leptin, increased ghrelin Carbohydrate craving with sleep loss The Sleep Naturally Plan A new innovation in weight loss

33 THE GLYCEMIC INDEX Calculations of the glycemic index of food is probably a waste of time. Understanding factors that control gastric emptying rate can result in inference about the glycemic index. Slowing gastric emptying slows glucose absorption relevance in acute dosing

34 GLUCOSE TOLERANCE WITH SOLUBLE FIBER Holt S, et al Effect of Gel Fiber Lancet, March 24th, 1979.

35 DIETARY PRINCIPALS CALORIES DO COUNT WATCH MACRONUTRIENTS CHO, FAT, PROTEIN HEALTHY FATS (EPA) SALT RESTRICTION FIBER INTAKE

36 CONCLUSIONS Weight management involves holistic medicine There is no successful, sustainable stand alone intervention for weight control Failing to manage obesity related disease or metabolic disorder is malpractice Sleep and inflammation must be addressed Nutraceuticals are preferred first line adjunctive options