Herbex Appetite Control: more Herbex nonsense?

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Posted 21 January 2014

The website (http://herbexhealth.com/shop/appetite_control_chewies/) claims that “Herbex Appetite Control Chewies are formulated to manage the appetite safely and naturally.” Really? The evidence does not really support this claim.

The claims for this product are:
* Manages Appetite
* Reduces Hunger Pangs And Cravings

Conclusion of examination of the evidence:
There is NO evidence that this product has EVER been tested in humans: you, the user, are the guinea pig. For the product as a whole, there is zero evidence that this mix of ingredients can fulfill the claims being made.

There is NO evidence for all but one ingredient to support the the claims “manages appetite and reduces hunger pangs and cravings” being made, and/or the ingredients are being used at minute dosages compared to those used in studies; for the one ingredient, the proof for the claims are inconclusive. There is NO evidence how the claims of this ingredient is influenced by the combination of the other ingredients.

If there is NO evidence to support the claims being made, is this product then simply a scam?
You be the judge after examining the evidence for this product – see below.

Deconstruction:

For the individual ingredients, this product claims:

  • L-Carnitine Tartrate: Amino acid known to assist in fat burning.
  • Garcinia Cambogia: An Asian fruit that is reputed to assist with appetite reduction, could assist fat metabolism and and assist with increased energy.
  • Green Tea extract: A very popular leaf that has been known to help burn calories. 

Each tablet contains:

  • L-Carnitine Tartrate             100 mg
  • Garcinia Cambogia 60%      10 mg
  • Green Tea extract 95%       3.30 mg
  • Chromium Polynicotinate   0.15 mg
  • Other ingredients: Mannitol, Sodium Bicarbonate, Colloidal Silicon Dioxide, Stearic Acid, Megnesium Stearate, Sorbitol, Artificial Sweetener, Nature Identical Flavourant, E122 (colourant) 

Daily: Chew one tablet half an hour before meals. As required: Chew one tablet at onset of hunger pangs. 

Proof / Evidence for the product’s claims

There are a number of sources of information for proof of the claims for the ingredients. The two most well-known are:

  1. Natural Medicines Comprehensive Database (NMCD) “Unbiased, Scientific Clinical Information on Complementary, Alternative, and Integrative Therapies”. This database, a collection of reviews of ingredients is a major source of information for “complementary medicine / alternative medicine”, and is often used by health professionals working in this field. (http://naturaldatabase.therapeuticresearch.com/)
  2. PubMed “PubMed comprises more than 23 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites”. PubMed is a valuable source of information for “mainstream/orthodox” health professionals; however PubMed has also started includigg information from alternative medicine publications. (http://www.ncbi.nlm.nih.gov/pubmed)

These are among the sources of information we use to evaluate the claims for this product.

A.      Evidence for efficacy for the whole product

There is not a single peer-reviewed published study throughout the world evaluating this combination of ingredients. There is no study demonstrating efficacy for a combination of some of these ingredients. This combination is novel.

There is no evidence that Herbex have conducted their own internal study, and if indeed conducted, proof of permission obtained from the Medicines Control Council to conduct the study needs to be offered.

B.      Evidence for efficacy for the individual ingredients.

Only the following ingredients have a therapeutic effect:

  • L-Carnitine tartrate
  • Garcinia cambogia
  • Green tea
  • Chromium polynicotinate

Herbex Appetite control main claims are claim is that the product “manages appetite and reduces hunger pangs and cravings” 

1.       L-Carnitine tartrate

L-Carnitine Tartrate is used in this ingredient at 100 mg per tablet versus between 2,000 mg to 6,000 mg/day in studies, a significant difference. There is no mention in NMCD of L-Carnitine being used to manage appetite and/or reducing hunger pangs and cravings, but it is used in anorexia!

NMCD states the use of L- Carnitine is mainly for treating L-carnitine deficiency. NMCD states that L-carnitine is also used for a number of other conditions and as a supplement in low birthweight and preterm infants, in strict vegetarians or vegans, and in dieters. It states that it has also used for anorexia (i.e. to STIMULATE appetite!). There is NO mention of its use for reducing appetite and/or reducing hunger pangs and cravings.

The dosage of L- carnitine in L-carnitine deficiencies in adults is around 1,000 mg two to three times per day. For severe diseases such as multiple sclerosis-related fatigue, L-carnitine has been used at 3-6 grams daily. 

2.       Garcinia Cambogia

Garcinia cambogia is used in this ingredient at 10 mg per dose versus 1,000 mg to 5,000 mg/day used in studies [i], a significant difference. There is no evidence of this ingredient being used to manage appetite and/or reducing hunger pangs and cravings. 

NMCD states that people use Garcinia for “weight loss, rheumatism, dysentery, as a purgative, and for treating worms and parasites. In foods, garcinia is used as a condiment in Thai and Indian cuisine.” However, NMCD states that its effectiveness evaluated in numerous studies has not been proven:

Appetite control is not even mentioned as an effect.

Although there are many studies that have evaluated Garcinia, only one has briefly mentioned that it may be used for appetite control but concludes that there is insufficient evidence to support this claim: The study concluded that “that many botanical species including crude extracts and isolated compounds from plants have been shown to provide potentially promising therapeutic effects including appetite control and weight loss. However, many of these crude extracts and compounds need to be further investigated to define the magnitude of the effects, optimal dosage, mechanisms of action, long term safety, and potential side effects.”[i] 

3.       Green tea

Green tea is used in this ingredient at 3.30 mg per tablet versus 270 mg to 1200 mg/day used in independent published studies [ii], a significant difference. There is only one study that suggests that it may be beneficial for appetite control, but that this effect was not adequately proven, and the dose used was massively higher.

NMCD points out that people use green tea for a range of conditions, e.g., to improve cognitive performance and mental alertness, stomach disorders, vomiting, diarrhoea, and headaches, as well as weight loss. However, the rider is that people use in attempt to lose weight but that there is no proof from many studies that it is indeed effective for weight loss.

There is only one reference to appetite: “There is also some evidence that EGCG might suppress appetite. However, there is some question about how well EGCG is absorbed orally (3922). The impact of EGCG and green tea on weight loss remains to be determined with well-designed studies in obese people.” 

Note the dose used in Herbex vs studies 3.30 mg per tablet. Dosages used in independent published studies vary between 270 mg to 1200 mg/day – how the heck does this small dose do anything at all! 

4.       Chromium Polynicotinate

Chromium polynicotinate is used in this ingredient at 0.15 mg (150 mcg) per tablet versus between 200-1000 mcg /day in studies. There is conflicting evidence whether it may affect appetite and hunger pangs.

NMCD states that people use Chromium Polynicotinate for improving glycemic control in type 1 and 2 diabetes, impaired glucose tolerance (prediabetes), polycystic ovary syndrome (PCOS), corticosteroid-induced hyperglycemia and reactive hypoglycemia, for hypercholesterolemia, etc. It is also used orally for weight loss, to increase muscle mass and fat-free mass, and decrease body fat.

However, for its effectiveness, i.e., is there proof that what people use this ingredient for, actually works when tested in studies:

LIKELY EFFECTIVE:
Chromium deficiency. Taking chromium orally is effective for preventing chromium deficiency (7135).

POSSIBLY INEFFECTIVE:
Athletic performance. Taking chromium orally doesn’t seem to enhance bodybuilding, strength, or lean body mass. There is some evidence that suggests taking chromium can increase weight loss, body fat loss, and lean body mass in people taking chromium picolinate 200-400 mcg per day in conjunction with resistance training (6860,6861,6868). But the results of these studies are unreliable due to questionable methods (6861). More reliable studies show that adding chromium picolinate or chloride 177-200 mcg daily to a weight-training program has no additional beneficial effect on body composition (6861,6862).

INSUFFICIENT RELIABLE EVIDENCE to RATE:
Obesity. There is conflicting evidence about the effect of chromium on weight loss and obesity. Some clinical research shows that taking chromium picolinate orally might produce modest weight loss of about 1.1 kg compared to placebo when taken over 72-90 days (11962). But other research has found no benefit (6860,13727,17224). Two clinical studies show that taking chromium picolinate 400 mcg/day for 12 weeks does not significantly affect body composition, resting metabolic rate, plasma glucose, serum insulin, or serum lipids in overweight military personnel or obese women (6860,13727). Another preliminary clinical study shows that overweight adults taking 1000 mcg/day do not have significantly reduced body mass index (BMI) or central adiposity compared to placebo after 24 weeks (17224).

IN NMCD the conclusion therefore is that there is simply insufficient evidence to confirm that Chromium polynicotinate is effective to manage appetite and/or reducing hunger pangs and cravings, and in particular when combined with these ingredients.

NMCD states that Chromium Polynicotinate is used up to 400 mcg per day certain diseases, e.g., in diabetes, dyslipidemia, corticosteroid-induced hyperglycemia or exacerbation of pre-existing diabetes, etc. NMCD states that there is insufficient information to establish safe and tolerable upper intake levels of chromium; however, daily adequate intake (AI) levels for chromium have been established: men 14 to 50 years, 35 mcg; men 51 and older, 30 mcg; women 19 to 50 years, 25 mcg; women 51 and older, 20 mcg. In other words, for individuals without these pre-existing diseases, i.e., normal but overweight individuals, that this product may contribute to excessive levels of chromium in the body!

Searching PubMed is even more interesting. (Search yourself for Chromium AND (Appetite OR Hunger)): Few studies found. This recent one published in J Psychosom Res in 2013 tested 24 patients who were given 1,000 mcg chromium/day (compared to 150 mcg per Herbex chew) and found that numerically, but not significantly, greater reductions in among other, binge frequency, but recommended further studies before one could make this conclusion. In 2012, a study published in the Journal of Alternative Complementry Medicine, found that “Supplementation of 1,000 mcg of chromium picolinate alone, and in combination with nutritional education, did not affect weight loss in this population of overweight adults”. A study published in Diabetes Technol Ther reported on 42 overweight adult women with carbohydrate cravings that received 1,000 mg (versus 0.15 mg per Herbex tab) of chromium picolinate or placebo for 8 weeks, did report that patients showed reduced food intake, hunger levels, and fat cravings and tended to decrease body weight. Herbex Appetite Control uses 0.15 mg per tab. 

Yes, you read that correctly, the study used 1,000 mg versus Herbex Appetite Control that uses 0.15 mg per tab.

Conclusion

It is clear that there is NO evidence that this product has EVER been tested in humans: you, the user, are the guinea pig. There is evidence that the individual ingredients have been tested in humans but bar one ingredient, the claims that the individual ingredients “manages appetite and reduces hunger pangs and cravings” has never been associated with the ingredient, or not with the dose. Only one ingredient has very iffy evidence that it may have some effect for the claims being made in one study but not backed sufficiently by others. Will the other ingredients influence the effect of the one ingredient? Who knows, will be simply a thumb suck: they may increase or decrease or simply cancel out the effects for the one ingredient.

Some references

[i] Astell KJ, Mathai ML, Su XQ. A review on botanical species and chemical compounds with appetite suppressing properties for body weight control. Plant Foods Hum Nutr. 2013 Sep;68(3):213-21. doi: 10.1007/s11130-013-0361-1. http://www.ncbi.nlm.nih.gov/pubmed/23666454

[ii] Rains TM, Agarwal S, Maki KC. Antiobesity effects of green tea catechins: a mechanistic review. J Nutr Biochem. 2011 Jan;22(1):1-7. doi: 10.1016/j.jnutbio.2010.06.006. Epub 2010 Nov 5. http://www.ncbi.nlm.nih.gov/pubmed/21115335

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