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Obesitas / Overgewicht

Fytoschema uit de cursus fytotherapie van de Herboristen Opleiding 'Dodonaeus' (volg de cursus)

Definitie
20% boven het gemiddelde gewicht wordt als overgewicht beschouwd, nauwkeuriger is de meting van het lichaamsvet, van overgewicht is dan sprake bij 25% lichaamsvet bij mannen en 30% lichaamsvet bij vrouwen. 
BMI = Body Mass Index of Quetelet-index (bij volwassenen) is het lichaamsgewicht in kg, gedeeld door het kwadraat van de lengte in meters vb 60 : (1,7 x 1,7) = 20,7. BMI 28 = overgewicht.

Soorten overgewicht
hyperblastisch: met veel vetcellen, meer bij vrouwen (gynoïd / peervorm / heupvet)
hypertroof: met grote vetcellen, meer bij mannen (androïd / appelvorm / buikvet) = ongezonder!
een combinatie van hyperblastisch - hypertroof

Mogelijke oorzaken
te veel eten, vooral verzadigde vetten en enkelvoudige suikers (veel brandstoffen die niet verbrand worden) en te weinig vezelstoffen gebruiken
te weinig beweging (te weinig verbruik van het te veel aan brandstoffen)
aanleg, verschil in stofwisseling door (1) te laag serotoninegehalte en verschil in activiteit van sympathisch zenuwstelsel (adrenaline-effect), (2) verschillen in warmteproductie, vetverbranding in de cellen (thermogenesis), (3) lichaam (cellen) streeft naar een bepaald gewicht (set-point), invloed van insuline en leptine. Hyperinsulinisme, een obese persoon maakt meer insuline aan met minder afbraak van vetweefsel (insulineresistentie) 
verkeerde voedselcombinaties? (Atkins, Montignac: eiwitten >< koolhydraten)
sociale factoren, opvoeding, eetgedrag.

Gezondheidsproblemen verbonden aan overgewicht
gewrichtsaandoeningen (artrose), ouderdomsdiabetes, sommige kankers (colon) komen meer voor bij het androïde type.

Kruiden naar werking
Combineren van vochtafdrijvende kruiden met laxerende en drainerende kruiden
  • diuretica: Taraxacum, Betula, Urtica
  • laxantia: Rhamnus, Senna (vervangen door slijmstofplanten)
  • slijmstofplanten hebben een licht laxerende werking en geven een verzadigd gevoel: Lijnzaad, Guargom, Plantago species
Planten met invloed op de stofwisseling: verhoging van serotonine (via tryptofaan) geeft verzadigd gevoel, verhoging van adrenaline veroorzaakt betere verbranding
  • methylxanthinen:  Coffea arabica, Camellia sinensis, Cola nitida, Paullinia cupana (Guarana)
  • ephedrine: Ephedra sinica
  • Catha edulis en andere stimulerende planten?

Kruiden alfabetisch
  • Aardpeer / Helianthus tuberosus: inuline (FOS) met invloed op darmflora en suikerstofwisseling?
  • Ananas / Ananas comosus : bromelaïne (koolhydraatverterend enzymcomplex)
  • Betula / Berk: blad of sap (berkenwater)
  • Boneschillen / Phaseolus: diuretisch en invloed op de suikerstofwisseling
  • Ephedra sinensis: amfetamine-achtige werking, gevaarlijk!
  • Fucus vesiculosis: jodium, lichte stimulerende werking op de schildklier, hoge voedingswaarde
  • Garcinia camboga: zou eetlust verminderen en vetverbranding versnellen (dierproeven)
  • Groene thee / Camellia sinensis
  • Konjac / Amorphophallus konjac: vulstoffen glucomannanen geven verzadigingsgevoel
  • Linum / Lijnzaad: verzadigingsgevoel (slijmstof), vetzuren (LNA alfa-linolzuur), licht laxerend
  • Oenothera biennis: in de zaden veel tryptofaan, nodig voor de aanmaak van serotonine
  • Taraxacum / Paardebloem
  • Paullinia cupana / Guarana: cafeïneplant, stimuleert de verbranding van vetten
  • Plantago psyllium: slijmstofplant, licht laxerend en geeft verzadigd gevoel
  • Stevia rebaudiana: zoetmiddel met lage calorische waarde en licht bloedsuikerverlagend

Nutritherapie
Chromium: (200 mcg daags) invloed op suikerstofwisseling (insuline aanmaak)
HTP 5-hydroxytryptofaan (100mg 1/2 uur voor de maaltijd): nodig voor de aanmaak van serotonine
Co-enzym Q10 (100 tot 300mg daags): 100 mg daags
Hydroxycitraat HCL (Garcinia cambogia): 500 mg 3x daags
CLA (geconjugeerd linolzuur): beïnvloedt de verhouding vetmassa - spiermassa.

Aromatherapie (etherische olie en hydrolaten)
Rosmarinus ct verbenon: lipolytisch
Citrus sp. / Citroen
Hydrolaten: Rozemarijn + Brandnetel + Moerasspiraea

Voeding
Meer vezelstoffen: volkorenproducten zoals brood, muesli en fruit vooral appel en ananas
Minder verzadigde vetten en enkelvoudige suikers
Veel drinken: water, kruidenthee (berkeblad + brandnetel + moerasspiraea), soep met selder, venkel, peterselie, lavas, prei, wilde planten  zoals brandnetel en teunisbloemblad

Leefstijl
Meer bewegen, 3 x per week 30' wandelen met 100 / 120 hartslag.

Mijn recept
Theemengsel: Berkenblad + Paardebloem + Brandnetel (drainage) eventueel met Groene thee
Lijnzaad 2x daags één eetlepel 1/2 uur voor de maaltijd met veel water
tinctuur Ephedra + Guarana combineren met 
wandelen, elke dag 1/2 uur stevig (hartslag min.120) doorstappen

Literatuur
Murray - Encycopaedia of Natural Medicine
Nieuwenhuis - Handboek vitamines en zelfzorg. Elmar 1997
Moatti _ Maigrir par les plantes et les oligo-élements. Marabout  1987
Studie over doeltreffendheid van een voedingsaanvulling Bio-Slim op gewichtsverlies. FS 52
Garcinia-50, een natuurlijk middel bij overgewicht. Orthica.
Soy, Flaxseed can help fight diabetes and obesity.  www.NutraIngredients.com

'Dodonaeus' Herboristen Opleiding (fytoschema overgewicht) - Maurice Godefridi.



 A Novel Herbal Preparation Reduces Body Weight and Several Parameters Associated with Obesity 
Sengupta K, Mishra AT, Rao MK, Sarma KVS, Krishnaraju AV, Trimurtulu G. Efficacy and tolerability of a novel herbal formulation for weight management in obese subjects: A randomized double blind placebo controlled clinical study. Lipids Health Dis. September 20, 2012;11:122. doi: 10.1186/1476-511X-11-122.

Obesity is a major health concern in many developed and developing countries. Some of the pathological disorders linked to obesity include diabetes, hypertension, and cardiovascular disease. Obesity is associated with increased volume and number of mature adipose cells that result from lipid accumulation and from the increased number of adipocytes arising from differentiation of adipose precursor cells. Several treatments used to overcome obesity include diet, exercise, behavior therapy, and surgical intervention. In need of more effective treatments, many people also turn to pharmacological therapies; however, high costs and safety concerns do not always make this an attractive option. Thus, for many people, traditional healing methods, such as plant-based therapies, are an appealing treatment alternative.

The herbal formulation LI85008F, also known as Adipromin™ (P.L. Thomas & Co., Inc.; Morristown, New Jersey), has been shown to have potent antiadipogenic activity in mice adipocytes in vitro. LI85008F has also been shown to enhance triglyceride mobilization from fat cells (lipolysis) and has demonstrated broad-spectrum safety in various animal models. Furthermore, preliminary research suggests that LI85008F inhibited lipogenesis in adipocytes, as well as antagonized peroxisome proliferator-activated receptor γ (PPARγ) and other lipogenic factors. Therefore, this study evaluated the weight loss effects of the herbal formulation LI85008F in obese humans in an 8-week randomized, double-blind, placebo-controlled study.

LI85008F consists of an ethanol extract of horseradish tree (Moringa oleifera) leaves, an aqueous alcohol extract of curry tree (Bergera koenigii syn. Murraya koenigii) leaves, and an ethanol extract of turmeric (Curcuma longa) rhizomes (standardized to 95% total curcuminoids), mixed in a ratio of 6:3:1, respectively. The trial took place at Alluri Sitarama Raju Academy of Medical Sciences (ASRAM) in Eluru, Andhra Pradesh, India. Through questionnaire-based screening, 50 obese but otherwise healthy, non-pregnant subjects aged 21-50 years and with a body mass index (BMI) from 30 to 40 kg/m2 were selected for this study. In addition, health conditions that would confound the study were excluded. After recruitment, subjects were distributed (via block randomization) into placebo (n=25) and treatment groups (n=25). All study investigators were blinded in this study.

Each subject was advised to consume capsules consisting of either 300 mg of LI85008F with 200 mg of excipient or a placebo with 500 mg of excipient (3 capsules/day, 30 minutes before a meal, for both treatments). Subjects were also given compliance cards, instructed to perform moderate exercise, and told to consume a diet of 2000 calories/day. In addition, subjects filled out questionnaires, providing details about various demographics, medical history, and nutritional status at the baseline evaluation and at 14, 28, and 56 days. During each of these time points, body measurements, vital signs, and various parameters of serum biochemistry, hematology, and urine were obtained from the subjects. In addition, adipogenesis markers were assessed in vitro by allowing mouse embryo fibroblasts (3T3-L1) to differentiate for 5 days in the presence or absence of 50 µg/mL of LI85008F or 0.1% (v/v) dimethyl sulfoxide (DMSO) vehicle (control). Adipokine (cell-signaling proteins from adipose tissue) expression profiling was performed on each of the cell lysates of treated 3T3-L1 mouse adipocytes.

Overall, the group supplemented with LI85008F and the placebo group had similar demographics and BMI at baseline. LI85008F supplementation resulted in a statistically significant body weight reduction (P<0.001). Body weight was reduced in the LI85008F group by 3.97 kg (4.6%) more than the placebo group. This amount of weight loss would be predicted to be 9.2% greater than placebo at the 6-month plateau which is a clinically significant weight loss that would be sufficient to meet the US Food and Drug Administration (FDA) standards for an obesity medication. BMI was reduced in the LI85008F group by 1.2 kg/m2 more than the placebo group (P<0.001).

After 8 weeks, LI85008F supplementation resulted in a 21.26% (P=0.012) increase compared to the placebo in serum adiponectin concentration, a protein that breaks down fatty acids and is involved in glucose regulation. Analysis of adipokines indicated that LI85008F upregulated adiponectin, pentraxin, and preadipocyte factor 1(Pref-1); and downregulated monocyte chemoattractant protein-1 (MCP-1), resistin, and plasminogen activator inhibitor-1 (PAI-1) in 3T3-L1 adipocytes. These adipokines are involved in the regulation of adipogenesis and insulin sensitivity linked with obesity.

There were no major adverse events observed during the 8-week study. However, there were some reports by a few subjects of minor adverse effects such as gastric irritation, abdominal pain, and back pain, but these events were evenly distributed between the placebo and treatment groups. There were also 4 subjects from the LI85008F group that were excluded due to their lack of availability for the study, and 5 subjects from the placebo group were excluded because of noncompliance with the study.

The authors conclude that the natural weight loss formula LI85008F, administered at a dose of 900 mg daily to obese humans, results in a significant reduction in body weight and an increase in adiponectin, a critical biomarker associated with obesity and type 2 diabetes. Adipokine profiling also revealed that LI85008F modulates key factors of adipogenesis and insulin sensitivity (adiponectin, Pref-1, and resistin). Although the authors mention other clinical studies of herbal supplements that reduce body weight, such as soy (Glycine max) extract,1 green tea (Camellia sinensis) extract,2 and winged treebine (Cissus quadrangularis) extract,3 there were no comparisons made with LI85008F. Thus, this study could have been improved by including comparisons with other weight loss treatments, including standard pharmacological therapies. All in all, the safety profile and the antiobesity effects of LI85008F indicate a promising weight loss therapy; however, bioavailability studies are still needed to identify the active components of this herbal preparation, and larger trials with longer treatment periods are also warranted.

References
1Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. N Engl J Med. 1995;333(5):276-282.
2Dulloo AG, Duret C, Rohrer D, et al. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. Am J Clin Nutr. 1999;70(6):1040-1045.
3Oben J, Kuate D, Agbor G, Momo C, Talla X. The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome. Lipids Health Dis. September 2, 2006;5:24. doi: 10.1186/1476-511X-5-24. 
  
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