College of Health and Biomedicine, Victoria University, Melbourne, Australia.
Complement Ther Med. 2013 Aug;21(4):407-16. doi: 10.1016/j.ctim.2013.05.007. Epub 2013 Jun 24.
As obesity has reached epidemic proportions, the management of this global disease is of clinical importance. The availability and popularity of natural dietary supplements for the treatment of obesity has risen dramatically in recent years.
The aim of this paper was to assess the current evidence of commonly available natural supplements used to suppress appetite for obesity control and management in humans using a systematic search of clinical trials meeting an acceptable standard of evidence.
The electronic databases PubMed, Web of Science, Google Scholar, ScienceDirect, and MEDLINE with full text (via EBSCOHost) were accessed during late 2012 for randomized controlled clinical trials (RCTs) using natural plant extracts as interventions to treat obesity through appetite regulation. A quality analysis using a purpose-designed scale and an estimation of effect size, where data were available, was also calculated. The inclusion criteria included the following: sample participants classified as overweight or obese adults (aged 18-65 years), randomized, double blind, controlled design, suitable placebo/control intervention, sample size >20, duration of intervention >2 weeks, have measurable outcomes on appetite or food intake and anthropometry, and full paper in English.
There were 14 studies that met the inclusion criteria. The findings from published double blind RCTs revealed mostly inconclusive evidence that plant extracts are effective in reducing body weight through appetite suppression. Caralluma fimbriata extract and a combination supplement containing Garcinia cambogia plus Gymnema sylvestre were the only exceptions.
According to the findings from this systematic review, the evidence is not convincing in demonstrating that most dietary supplements used as appetite suppressants for weight loss in the treatment of obesity are effective and safe. A balance between conclusive findings by double blind RCTs and advertisement is required to avoid safety concerns and dissatisfaction from consumers.
随着肥胖症达到流行程度,这种全球性疾病的管理具有临床重要性。近年来,用于治疗肥胖症的天然膳食补充剂的可用性和普及性急剧上升。
本文旨在评估目前常用的天然补充剂用于抑制食欲以控制和管理肥胖的证据,方法是对符合可接受证据标准的临床试验进行系统搜索。
2012 年底,通过 EBSCOHost 使用电子数据库 PubMed、Web of Science、Google Scholar、ScienceDirect 和 MEDLINE 全文访问了随机对照临床试验 (RCT),这些 RCT 使用天然植物提取物作为干预措施,通过调节食欲来治疗肥胖症。还使用专门设计的量表进行了质量分析,并计算了可用数据的效应量估计。纳入标准包括以下内容:将超重或肥胖成年人(年龄在 18-65 岁之间)分类为样本参与者,随机、双盲、对照设计,合适的安慰剂/对照干预,样本量>20,干预时间>2 周,对食欲或食物摄入和人体测量有可衡量的结果,以及英文全文。
有 14 项研究符合纳入标准。已发表的双盲 RCT 的结果发现,大多数植物提取物通过抑制食欲来有效减轻体重的证据尚无定论。仅 Caralluma fimbriata 提取物和含有 Garcinia cambogia 和 Gymnema sylvestre 的组合补充剂是例外。
根据这项系统评价的结果,没有令人信服的证据表明,大多数用作食欲抑制剂的膳食补充剂在治疗肥胖症中减肥是有效和安全的。需要在双盲 RCT 的结论性发现和广告之间取得平衡,以避免安全问题和消费者的不满。