1.
Nutrition Intervention in Cancer.
Heber, D, Li, Z
The Medical clinics of North America. 2016;(6):1329-1340
Abstract
Nutrition intervention supports the patient with malnutrition secondary to cancer and its treatment and has been used in the primary and secondary prevention of common forms of cancer. During the emotional stress of dealing with cancer at any stage, patients derive increased quality of life and a sense of control over their lives as the result of receiving supportive advice on diet and lifestyle. Therefore, the use of nutrition intervention in cancer patients is justified in the absence of absolute proof of efficacy as long as it is done safely and with the consent of the cancer patient.
2.
Pistachio nuts reduce triglycerides and body weight by comparison to refined carbohydrate snack in obese subjects on a 12-week weight loss program.
Li, Z, Song, R, Nguyen, C, Zerlin, A, Karp, H, Naowamondhol, K, Thames, G, Gao, K, Li, L, Tseng, CH, et al
Journal of the American College of Nutrition. 2010;(3):198-203
Abstract
OBJECTIVE There is a widely held view that, due to high fat content, snacking on nuts will lead to weight gain, ultimately causing unhealthy changes in lipid profiles. This study is designed to study the effects of pistachio snack consumption on body weight and lipid levels in obese participants under real-world conditions. METHODS Participants were randomly assigned to consume 1 of 2 isocaloric weight reduction diets for 12 weeks, with each providing 500 cal per day less than resting metabolic rate. Each diet included an afternoon snack of either 53 g (240 cal) of salted pistachios (n = 31) or 56 g of salted pretzels (220 cal; n = 28). RESULTS Both groups lost weight during the 12-week study (time trend, p < 0.001), but there were significant differences in the changes in body mass index between the pretzel and pistachio groups (pistachio, 30.1 ± 0.4 to 28.8 ± 0.4 vs. pretzel, 30.9 ± 0.4 to 30.3 ± 0.5). At 6 and 12 weeks, triglycerides were significantly lower in the pistachio group compared with the pretzel group (88.04 ± 9.80 mg/dL vs. 144.56 ± 18.86 mg/dL, p = 0.01 at 6 weeks and 88.10 ± 6.78 mg/dL vs. 132.15 ± 16.76 mg/dL, p = 0.02 at 12 weeks), and there was a time trend difference between the 2 groups over the 12 weeks (p < 0.01). There were no significant differences in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, insulin, or glucose between the 2 groups. CONCLUSION Pistachios can be consumed as a portion-controlled snack for individuals restricting calories to lose weight without concern that pistachios will cause weight gain. By comparison to refined carbohydrate snacks such as pretzels, pistachios may have beneficial effects on triglycerides as well.
3.
Safety and antioxidant activity of a pomegranate ellagitannin-enriched polyphenol dietary supplement in overweight individuals with increased waist size.
Heber, D, Seeram, NP, Wyatt, H, Henning, SM, Zhang, Y, Ogden, LG, Dreher, M, Hill, JO
Journal of agricultural and food chemistry. 2007;(24):10050-4
Abstract
The consumption of pomegranate juice (PJ), a rich source of antioxidant polyphenols, has grown tremendously due to its reported health benefits. Pomegranate extracts, which incorporate the major antioxidants found in pomegranates, namely, ellagitannins, have been developed as botanical dietary supplements to provide an alternative convenient form for consuming the bioactive polyphenols found in PJ. Despite the commercial availability of pomegranate extract dietary supplements, there have been no studies evaluating their safety in human subjects. A pomegranate ellagitannin-enriched polyphenol extract (POMx) was prepared for dietary supplement use and evaluated in two pilot clinical studies. Study 1 was designed for safety assessment in 64 overweight individuals with increased waist size. The subjects consumed either one or two POMx capsules per day providing 710 mg (435 mg of gallic acid equivalents, GAEs) or 1420 mg (870 mg of GAEs) of extracts, respectively, and placebo (0 mg of GAEs). Safety laboratory determinations, including complete blood count (CBC), chemistry, and urinalysis, were made at each of three visits. Study 2 was designed for antioxidant activity assessment in 22 overweight subjects by administration of two POMx capsules per day providing 1000 mg (610 mg of GAEs) of extract versus baseline measurements. Measurement of antioxidant activity as evidenced by thiobarbituric acid reactive substances (TBARS) in plasma were measured before and after POMx supplementation. There was evidence of antioxidant activity through a significant reduction in TBARS linked with cardiovascular disease risk. There were no serious adverse events in any subject studied at either site. These studies demonstrate the safety of a pomegranate ellagitannin-enriched polyphenol dietary supplement in humans and provide evidence of antioxidant activity in humans.
4.
Herbal preparations for obesity: are they useful?
Heber, D
Primary care. 2003;(2):441-63
Abstract
The opportunities for additional research in this area are plentiful. Unfortunately, there has been relatively limited funding for research on herbal supplements compared with the amount of funding that is available for research on pharmaceuticals. Botanical dietary supplements often contain complex mixtures of phytochemicals that have additive or synergistic interactions. For example, the tea catechins include a group of related compounds with effects that are demonstrable beyond those that are seen with epigallocatechin gallate, the most potent catechin. The metabolism of families of related compounds may be different than the metabolism of purified crystallized compounds. In some cases, herbal medicines may simply be less purified forms of single active ingredients, but in other cases they represent unique formulations of multiple, related compounds that may have superior safety and efficacy compared with single ingredients. Obesity is a global epidemic, and traditional herbal medicines may have more acceptance than prescription drugs in many cultures with emerging epidemics of obesity. Several ethnobotanical studies found herbal treatments for diabetes, and similar surveys, termed bioprospecting, for obesity treatments may be productive. Beyond increasing thermogenesis, there are other biological rationales for the actions of several different alternative medical and herbal approaches to weight loss. For example, several supplements and herbs claim to result in nutrient partitioning so that ingested calories will be directed to muscle, rather than fat. These include an herb (Garcinia cambogia), and a lipid which is the product of bacterial metabolism (conjugated linoleic acid). Moreover, a series of approaches attempt to physically affect gastric satiety by filling the stomach. Fiber swells after ingestion and has was found to result in increased satiety. A binding resin (Chitosan) has the ability to precipitate fat in the laboratory and is touted for its ability to bind fat in the intestines so that it is not absorbed. In double-blind studies, however, this approach was found to be ineffective. There are two key attractions of alternative treatments to obese patients. First, they are viewed as being natural and are assumed by patients to be safer than prescription drugs. Second, there is no perceived need for professional assistance with these approaches. For obese individuals who cannot afford to see a physician, these approaches often represent a more accessible solution. Finally, for many others, these approaches represent alternatives to failed attempts at weight loss with the use of more conventional approaches. These consumers are often discouraged by previous failures, and are likely to combine approaches or use these supplements at doses higher than are recommended. It is vital that the primary care physician is aware of the herbal preparations that are being used by patients so that any potential interaction with prescription drugs or underlying medical conditions can be anticipated. Unfortunately, there have been several instances where unscrupulous profiteers have plundered the resources of the obese public. Although Americans spend $30 billion per year on weight loss aids, our regulatory and monitoring capability as a society are woefully inadequate. Without adequate resources, the FDA resorted to "guilt by association" adverse events reporting, which often results in the loss of potentially helpful therapies without adequate investigation of the real causes of the adverse events that are reported. Scientific investigations of herbal and alternative therapies represent a potentially important source for new discoveries in obesity treatment and prevention. Cooperative interactions in research between the Office of Dietary Supplements, the National Center for Complementary and Alternative Medicine, and the FDA could lead to major advances in research on the efficacy and safety of the most promising of these alternative approaches.