Pittler Max H, Ernst Edzard
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, United Kingdom.
Am J Clin Nutr. 2004 Apr;79(4):529-36. doi: 10.1093/ajcn/79.4.529.
Compliance with conventional weight-management programs is notoriously poor, and a plethora of over-the-counter slimming aids are sold with claims of effectiveness.
The objective of the study was to assess the evidence from rigorous clinical trials, systematic reviews, and meta-analyses on the effectiveness of dietary supplements in reducing body weight.
The study was a systematic review. Literature searches were conducted on Medline, Embase, Amed, Cinahl, and the Cochrane Library until March 2003. Hand searches of medical journals, the authors' own files, and bibliographies of identified articles were conducted. There were no restrictions regarding the language of publication. The screening of studies, selection, validation, data extraction, and the assessment of methodologic quality were performed independently by the 2 reviewers. To be included, trials were required to be randomized and double-blind. Systematic reviews and meta-analyses of dietary supplements were included if they were based on the results of randomized, double-blind trials.
Five systematic reviews and meta-analyses and 25 additional trials were included and reviewed. Data on the following dietary supplements were identified: chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba maté, and yohimbe. The reviewed studies provide some encouraging data but no evidence beyond a reasonable doubt that any specific dietary supplement is effective for reducing body weight. The only exceptions are E. sinica- and ephedrine-containing supplements, which have been associated with an increased risk of adverse events.
The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.
众所周知，人们对传统体重管理计划的依从性很差，而且大量非处方减肥辅助产品打着有效宣称进行销售。
本研究的目的是评估来自严格临床试验、系统评价和荟萃分析中关于膳食补充剂在减轻体重方面有效性的证据。
本研究为一项系统评价。截至2003年3月，在Medline、Embase、Amed、Cinahl和Cochrane图书馆进行了文献检索。还对手工检索医学期刊、作者自己的文档以及已识别文章的参考文献进行了检索。对出版物的语言没有限制。由两位评审员独立进行研究筛选、选择、验证、数据提取以及方法学质量评估。纳入的试验要求为随机双盲试验。如果膳食补充剂的系统评价和荟萃分析基于随机双盲试验的结果，则予以纳入。
纳入并评审了5项系统评价和荟萃分析以及另外25项试验。识别出了以下膳食补充剂的数据：壳聚糖、吡啶甲酸铬、麻黄、藤黄果、葡甘露聚糖、瓜尔胶、羟基甲基丁酸、车前草籽、丙酮酸、马黛茶和育亨宾。所评审的研究提供了一些令人鼓舞的数据，但没有超出合理怀疑的证据表明任何特定膳食补充剂对减轻体重有效。唯一的例外是含麻黄和麻黄碱的补充剂，它们与不良事件风险增加有关。
大多数膳食补充剂作为减肥辅助手段的证据并不令人信服。所评审过的膳食补充剂均不推荐非处方使用。
