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7 Weight-Loss Winners:
How to Win 'the race to lose'

By Stephen Langer, M.D., Contributing Writer

Having co-authored How to Win at Weight Loss with James F. Scheer, and having treated hundreds of overweight patients successfully, I am always on the look out for natural products that prove helpful in melting off unwanted pounds. Along with the well-established standbys, there are many new weight-loss products "gaining" in popularity today. When added to a sensible diet and exercise program, these products may enhance weight-loss efforts. These products include, HMB, pyruvate, 5-HTP, HCA, CIA, GTF chromium, and L-carnitine.

1.HMB
HMB (or beta-hydroxy beta-methybutyrate), is a supplement which is a breakdown product of the amino acid leucine, one which may play a role in protein metabolism, according to the authors of Dynamic Nutrition for Maximum Performance.

A four-week, double-blind study at Iowa State University, conducted by Steve Nissen, Ph.D., shows that HMB not only works, but works well.

Twenty-three untrained and 17 trained men received 3 g (3,000 mg) of HMB or look-alike placebo capsules in divided daily doses. All 40 of them exercised on Monday, Wednesday, and Friday during the four-week period.

As a basis for comparison, body weight was measured for lean and fat mass before and after the experiment. Four weeks later, HMB-takers had increased their lean mass by 3.10 percent, compared with a 1.92 percent increase among placebo takers. Those on HMB also experienced a dramatic decrease of fat mass - 7.2 percent, compared with 2.2 percent for those on the placebo - more than three times greater.

The HMB-takers also increased their strength, as demonstrated by ability to bench press: 10.2 kilograms compared with 6.45 kilograms for those on the placebo. Based on the study's findings, Nissen holds out hope of weight reduction to all who try the program:

"Athletes who used HMB along with exercise developed more lean body mass and lost more than three times as much fat as the placebo group . .. .HMB may have a similar impact on anyone following a regular, resistance-training program, whether they are beginners or Olympic-caliber athletes."

2. Pyruvate
Produced in the body, pyruvate is also found in such dietary sources as cheese, dark beer, red apples, and red wine. Its use as a nutritional supplenent has been shown to promote weight loss and bring about a reduction of body fat in overweight persons on low-fat diets.

Researchers R.T. Stanko, H.R. Reynolds, and R. Hoyson demonstrated this in a study published in the American Journal of Clinical Nutrition (AJCN).

In another paper published in the same issue of AJCN, weight loss and reduction of body fat were achieved by revving up the resting metabolic rate, as found in an animal study by biochemist J.L. Ivy, and associates. Clinical trials also show that pyruvate supplements may be able to enhance exercise endurance.

3. 5-HIP
5-Hydroxytryptophan (5-HIP) is a compound made by the body from the amino acid tryptophan. In his book, 5-HTP: Nature's Serotonin So' lution, Ray Sahehan, M.D., comments that "shortterm observations have shown that 5HTP (5-hydroxytryptophan), even without dietary restrictions, causes loss of interest in food, decreased food intake, and weight loss in obese individuals."

Although only a few of my patients have tried 5-HTP for weight loss, I have noted similar results. Other results reported after use of this supplement are supported by two Italian studies, as discussed by Sahehian.

In the first, 19 obese women were tested in a double-blind, crossover study by researchers at the University of Rome to evaluate the effects of 5-HTP on food intake, mood, and weight loss.

During two five-week periods, they were given an average of 8 mg of 5HTP per kilogram of body weight in three divided doses, taken 30 minutes before each meal. (As a frame of reference, Sahelian indicates that a 60-kilogram (about 132-pounds] woman would have taken about 480 mg daily.)

Fifteen of the 19 women reported loss of appetite; however, only six women taking the placebo made this claim. Prior to treatment, the average daily intake of food was 2,900 calories.

Women taking the placebo dropped to 2,300 calories - Sahelian indicates that merely being monitored on a weight-loss program motivates people to eat less. However, the big drop was seen among the 5-HTP takers - 1,100 to 1,800 calories.

During the first five weeks, the 5-HIP takers averaged a loss of five pounds. However, 60 percent of the women experienced nausea and von3iting, indicating the need to decrease the dosage to lessen or eliminate this side effect while still promoting weight loss.

A follow-up study by the University three years later differed only in that it ran for two consecutive sixweek periods. Twenty obese patients received either 300 mg of 5-HTP, or a placebo, in divided doses before each meal.

During the first six weeks, the volunteers were able to eat what they liked. However, during the second period, they were required to reduce their caloric intake moderately. During both periods, they lost significant amounts of weight. An additional factor is that they ate less carbohydrates and felt more full. Again, nausea was a commonly reported side effect, until doses were reduced.

4. HCA
Another supplement with promise in a weight-management program is hydroxycitric acid (HCA), a fruit extract similar to citric acid from oranges and grapefruit, derived mainly from a small, pumpkin-shaped fruit, the Matabar tamarind (Garcinia cambogia), a native of southeast Asia (India). Hydroxycitrate is a natural substance isolated from the fruit.

The book, The Natural Pharmacy notes that HCA can be "a useful weightloss aid." Laboratory studies indicate that it works by blocking certain enzyme processes that reduce the amount of carbohydrate converted into stored fat. They state that HCA suppresses appetite and induces weight loss.

5. CIA
A key nutrient for promoting weight loss is conjugated linoleic acid (CIA). The helpfulness of CLA as a supplement was discovered, by accident, by Michael W. Pariza, Ph.D., director of the University of Wisconsin-Madison's Food Research Institute some 20 years ago. In a phone interview, Pariza told ce that they were investigating muta,en formation in meats and, instead, discovered a mutagen inhibitor, CLA.

"Since then, we've discovered many applications for CLA, including [for] weight loss - particularly loss of body fat and gain of muscle mass," he told me. "CIA is an ideal supplement to prevent unwanted gain of weight - something of special importance to us as we age and become less physically active," he said.

"A six-month human research project revealed significant effects in reducing body fat. CLA stimulates metabolism through the immune system. It also makes fat cells release fat into the blood instead of letting it accumulate within them. Additionally, it contributes to increasing muscle tissue and bone density," he said.

CLA occurs naturally in beef and dairy products derived from cows whop primarily graze on grass. Today, however, many cows are fed processed foods, so the beef and dairy products which make it to our store shelves contam less CLA. Supplements of CLA made from sunflower oil are available in health food stores.

6. Chromium
A better-known supplement that is effective in promoting weight loss is GTF chromium. Robert Atkins, M.D., in his latest book, Dr. Atkins' Vita-Nutrient Solution, writes that chromium is pivotal in sugar metabolism, among other benefits. Compounding the need for chromium is the fact that more than 90 percent of Americans are deficient in this crucial trace mineral.

"Chromium deficiencies are self-perpetuating," he states. "When your body exhibits low levels of this trace mineral, your craving for sugar grows," he says. So do the numbers on your bathroom scale!

Not only does GTF chromium reduce your cravings for sugar, it also increases your total lean body mass, which also speeds up your metabolism, writes Atkins. It helps prevent the loss of lean muscle mass if you intentionally slash your caloric intake, and revs up your calorie-burning results from exercising.

7. 1-carnitine
Noted for its ability to generate energy, L-carnitine is one of the betterknown supplements with which I've had the best weight-loss results with patients. Several overweight patients have come to me for an energy and endurance boost and, after supplementing daily with 500 mg of carnitine, have lost anywhere from 10 to 15 pounds over several months.

L-carnitine is a weight-loss winner - or, a "weight loser," I should say - because it efficiently converts body fat into readily available fuel, and elevates certain enzymes essential to "burning" ugars and starches.

Best-known for preventing heart disease, it has helped my patients dissipate high levels of blood fats, including triglycerides, and raise levels of highdensity lipoprotein (HDL), the good cholesterol.

Although beef contains abundant L-carnitine, with chicken, fish, eggs, and milk having lesser amounts, the body doesn't always retain enough, inasmuch as high-fat, high-protein meals cause one to excrete much of it.

I tell my patients that, although their body synthesizes L-carnitine from the amino acid lysine, they still may need a carnitine supplement if they are deficient in nutrients needed for the synthesization of carnitine, particularly, methionine, niacin, vitamin B-6, vitamin C, and iron.

Exercise is a must. Over the years, Grant Gwinup, M.D., professor of metabolism and endocrinology at the University of California-Irvine, a worldrecognized authority on weight loss, has told me always to insist that my patients exercise regularly on their weight-control programs.

Here's the gist of his 60 publications on this subject:
"When you're not eating enough food, relying only on dieting to lose weight, your body fights back. It lowers your metabolic rate. That's why your weight tends to plateau. However, if you exercise strenuously for 30 or more minutes daily, you'll burn off fat and keep muscle. You may not even have to cut down on food."

Regular vigorous exercise works, and is a must in any weight-management program. This, plus a low-fat, low-calorie diet, and the new and better-known weight control supplements, can keep you fit and trim, and help you win the race to lose.

REFERENCES:
Atkins, Robert, M.D. Dr. Atkins' Vita-Nutrient
Solution. New York: Simon & Schuster, 1998. Gastelu, Daniel, and Hatfield, Fred, Ph.D.
Dynamic Nutrition for Maximum Performance. Garden City Park, N.Y.: Avery Publishing Group, 1997.
Gwinup, Grant. Personal communications. 19901998.
Ivy, J.L., et al. "Effects of Pyruvate Metabolism and Insulin Resistance of Obese Zucker Rats," American Journal of Clinical Nutrition 59: 3317,1994.
Lininger, Skye, D.C., ed. The Natural Pharmacy. Rocklin, Calif.: Prima Publications, 1998.
Nissen, Steve, Ph.D., et al. "Effect of 1-1MB Supplementation on Strength and Body Composition of Trained and Untrained Males Undergoing Intense Resistance Training,' presented at the Experimental Biology Conference '96, April 15, 1996.
Pariza, Michael W., Ph.D. Personal interview. October 16, 1998.
Sahelian, Ray, M.D. 5-HTP: Nature's Serotonin Solution. Garden City Park, N.Y.: Avery Publishing Group, 1998.
Stanko, R.T. "Pyruvate Supplementation on a Low Cholesterol, Low Fat Diet," Amen can Journal of Clinical Nutrition 59:423-27,1994.
Stanko, R.T. 'Enhanced Leg Exercise Endurance With a High Carbohydrate Diet and Pyruvate," Journal Applied Physiology 69(5):1651-56,1990.


Stephen Langer, M.D., practices preventive/nutritional medicine in Berkeley, Calif. He is co-author, along with Better Nutrition contributor, James F. Scheer, of Solved: The Riddle of Illness, a perennial best-seller. He's available for personal or telephone appointments at (510) 548-7384.