Slim HerbAqua

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Posted 14 February 2010 

Slim HerbAqua claims to be an effective aid for weight loss and is a mixture of 33 herbs. On the HerbAqua website it states: “Slim Herb Aqua contains a powerful herbal formula with a nine-fold action that will reduce appetite, boost metabolism and improve digestion” and “[F]or effective weight loss, drink 1 bottle a day, follow a healthy eating plan and an exercise programme.” Even if the ingredients had evidence for efficacy in weight-loss, these are the simple facts:

  • The quantity of the individual ingredients in this product is simply too minuscule to have any significant effect on appetite suppression or weight loss at any stretch of the imagination
  • There is simply no evidence in evidence-based medical texts or reputable homeopathic texts to support the claim that these ingredients have a synergistic effect
  • There is no evidence that these ingredients are bio-available in adequate therapeutic levels for even the effects claimed. Evidence for some effect in animal models has in the majority of instances either not been confirmed in appropriate human models or found to be worthless
  • There is absolutely not a shred of proof that this product has any effect on weight-loss, it is simply a theoretical model. Consumers have a right to expect a high degree of certainty that a product will fulfil the claims made for it – in this instance there is no proof that it will be even effective in 1% or 99% of consumers – no studies have been done and the ingredients have not been proven to have these effects. At best, Dr Sandell states that he is of the “opinion” that the product will result in weight-loss
  • It is significant that Dr Sandell’s substantiation of the product initially lists all the ingredients present in Slim Herb Aqua, but then only ascribes weight loss to Garcinia cambogia. However, according to homeopathic texts this ingredient, is not used homeopathically, and according to complementary medicine texts, its use in weight-loss has not been validated and its use required far greater dosages than used here
  • Dr Sandell’s substantiation claims that these ingredients used together have a synergistic effect. He states that “Herbex is the only company to have infused a unique herbal slimming formula into a mineral water base . . . “However, since this formulation is unique to this product, there is simply no evidence that this is true. How does he know this to be true? If there is a synergistic effect that proposes, how does he know for a fact that there are no similar synergistic effects resulting in side effects?

Below is a summary of the arguments made to the ASA regarding HerbAqua. The full argument can be be read here. On the Website, http://herbaqua.com/slim.php (no longer active), the ingredients and their effects are listed and these are detailed below.

The Natural Medicines Comprehensive Database is regarded by health workers in complementary and integrative medicine circles in high regard and is regularly quoted to support the use of a particular ingredient’s therapeutic use. This database monitors ALL evidence-based articles on complementary and integrative medicine ingredients and constantly reviews the evidence for the evidence and claims made for ingredients.
Significantly, according to Natural Medicines Comprehensive Database at least 8 of these ingredients is used for appetite stimulation! Even reputable homeopathic and herbal texts are contrary to Herbex’s interpretation: appetite suppression is indicated for 2 ingredients (fennel, hypericum), appetite stimulation for 5 (ginger, burdock, gentian, tumeric, Indian long pepper), and no effect on appetite for 1 (Devil’s claw).

 

A. APPETITE CONTROL – Garcinia Cambogia. a. Garcinia Cambogia (active ingredient is hydroxycitric acid) Natural Medicines Comprehensive Database states: “Effectiveness: POSSIBLY INEFFECTIVE. Obesity. Taking garcinia fruit rind extract orally doesn’t seem to help decrease weight. . . .” Note, the recommended dose suggested is “For weight loss, an extract containing 50% hydroxycitric acid, 1000 mg three times daily has been used. Hydroxycitric acid, 500 mg four times daily has also been used for weight loss.” Naturaldatabase.com has the following to say . . . : “. . nor Garcinia cambogia can be recommended for weight loss.” In fact Naturaldatabase.com says of the latter (Garcinia): “Tell patients to avoid this one.” (my emphasis) Significantly, in this product, the amount of Garcinia is used at insignificant levels when compared to studies indicated above.

B. METABOLIC ENHANCERS Guarana Naturaldatabase.com states“INSUFFICIENT RELIABLE EVIDENCE to RATE”, and “Obesity. Guarana taken orally might cause weight loss when used in combination with mate and damiana. . . . . More evidence is needed to rate guarana for this use.” Significantly, in this product, the amount of guarana is used at insignificant levels when compared to studies indicated above. Green Tea Naturaldatabase.com states: “INSUFFICIENT RELIABLE EVIDENCE to RATE”, and “Obesity. Preliminary evidence suggests that a specific green tea extract . . . . might help reduce weight in moderately obese patients. However, other evidence suggests that taking a green tea extract plus caffeine does not help maintain weight following a period of weight loss.” Significantly, in this product, the amount of green tea is used at insignificant levels when compared to studies indicated above. Cayenne (capsicum)

Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Ginger Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for appetite stimulation Kelp Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer.

C. DIGESTIVES Berberis Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Burdock Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for appetite stimulation Fennel Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for mild appetite suppression. Wilde Als Naturaldatabase.com does not specifically list Wilde Als except for the close relative, Wormwood, and states that “[O]rally, wormwood is used for loss of appetite . . . There are no reports on the effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Hypericum (St John’s Wort) Naturaldatabase.com states that “[O]rally, St. John’s wort is used for depression, dysthymia, anxiety . . . It is also used orally for secondary symptoms associated with depression such as fatigue, loss of appetite, insomnia, and anxiety.” Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for appetite suppression. Cayenne See above Gentian Naturaldatabase.com states that “[O]rally, gentian is used for digestive disorders, such as loss of appetite, fullness, flatulence . . .” Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for appetite stimulation. Devil’s Claw Naturaldatabase.com states that “[O]rally, devil’s claw is used for arteriosclerosis, osteoarthritis . . . . It is also used for . . . loss of appetite . . .” Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites have no reference to this product having any effect on appetite. Ginger See above Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Turmeric Naturaldatabase.com states that “[O]rally, turmeric is used for dyspepsia, abdominal pain . . . loss of appetite . . .” Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for appetite stimulation Indian Long Pepper Naturaldatabase.com states that “[T]he fruit is used orally to stimulate menstrual flow, appetite, and bile flow . . .” Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Homeopathic and herbal sites claim this product is used for appetite stimulation

D. FAT REDUCERS / METABOLISERS Turmeric See above Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. Indian Myrrh Naturaldatabase.com reports no effectiveness or reference to burning of fat, use in weight loss, or as a metabolic enhancer. E. OTHER INGREDIENTS Diuretics or laxatives as useful agents in weight control – there is simply no evidence that frequent use of diuretics or laxatives is an appropriate or effective strategy in weight-loss. Weight-loss due to these agents is at best temporary and at worse dangerous. DIURETICS Juniper, Cornsilk, Cleavers, Indian Celery Seed, Buchu, Uva-Ursi. LAXATIVES – Cascara, Dandelion, Haritaki, Amla NERVINES Hypericum, Guarana, Siberian Ginseng, Gotu Kola, Schisandra, Milk Thistle, Haritaki. NUTRITIONAL All herbs have some nutritional value, these being the most outstanding – Alfalfa, Dandelion, Kelp, Gotu Kola, Green Tea, Burdock, Amla. LIVER TONICS / PROTECTORS Milk Thistle, Dandelion, Turmeric, Hypericum, Devil’s Claw, Schisandra. BLOOD PURIFIERS Burdock, Devil’s Claw, Dandelion, Echinacea, Gotu Kola. ADAPTOGENS Siberian Ginseng, Schisandra. IMMUNOSTIMULANTS / PROTECTORS Siberian Ginseng, Echinacea, Turmeric, Hypericum, Ginger, Green Tea.

Other matters On the Herbex Website, it states “No caffeine”. However, guarana’s active metabolite is in fact caffeine.

Conclusion It is evident that there is insufficient scientific and homeopathic evidence to suggest that this product has any efficacy in weight loss (or even for the other “health benefits” claimed, e.g., appetite suppression, immunostimulants / protectors). Not a single study can confirm the claims made by this product for this product. There is on the other hand, overwhelming evidence that claims for individual ingredients are simply incorrect or exaggerated (based on scientific evidence and the dosage used).

Furthermore, the Medicines act, in specific that pertaining to Slimming agents, states: the Drugs Control Council established in terms of section 2 of the Drugs Control Act. 1965 (Act 101 of 1965), has by virtue of the powers vested in it by section 14 (2) of the said Act, by a resolution approved by the Minister of Health, determined that (a) drugs in the pharmacological classifications 11 and 24 and all slimming agents under classification 34 of Category A of tile regulations promulgated by Government, Notice R. 2025, dated 15 December 1967, which were available fur sale in the Republic or in the Territory of South West Africa immediately before the publication of this resolution; and, (b) also all slimming agents under pharmacological classification n 34 of Category A of the regulations promulgated by Government Notice 8.2025, dated 15 December 1967, which were not available for sale in the Republic or in the Territory of South West Africa immediately m immediately before the publication of this resolution, are subject to registration in terms of the said Act.


Additional comments to the ASA from the independent credible expert in support of the request for arbitration. . . . the dosage of the “tincture” used to “infuse” the mineral water is miniscule, and unlikely to have any effect at all on weight loss or appetite suppression. . . . . it appears that less than 1 ml of the tincture is to “be used per 500 ml of Herbex Slim Aqua Water” and less than 1 ml of the tincture is to “be used per 250 ml of Herbex Slim Ice Tea”.

From a simple calculation, assuming that the tincture was in fact 1 ml, the amount of herbal formulation within Herbex Slim Aqua Water is 0.2 % of the product (in other words 2 ml per 1000 ml). . . . 34 ingredients are in fact listed. It appears as if 3 of these are possibly not herbs at all, but water and two different concentrations of alcohol. If this is so, then there are in fact only 31 herbs in the tincture . . . It appears as if the combined water and alcohol amounts may form at least half the total amount of the tincture.

Assuming that the herbal components form half of the tincture, and that the amount of each of the herbs is equal (although clearly they are not), it would mean that in 500 ml of the product, each of 31 herbs contributes about 0.00323 % – which truly is . . . miniscule. There is no evidence that this is a homeopathic product, prepared according to homeopathic principles.

According to Dr JP Prinsloo (Chairperson of the Homeopathic Society of South Africa):

Homoeopathy is a system of medical practice based on three principles ; 1) Drugs are tested on healthy human subjects, 2) The Law of Similars, 3) The Individual Disease Picture. It is not necessary that the dilution of the medicine be infinitely diluted. However, what is important in every individual case, is the homoeopathicity of the prescription. Homoeopathicity meaning that the medicine or remedy prescribed should be in accordance with the Homoeopathic principle of similimum (individualised to the condition as presented in the patient). Prinsloo JP. Homeopathy in Perspective. http://www.homeopathy.org.za/hom_in_per.htm (accessed 14 March 2007)

A commercial product such as Slim Herb Aqua cannot claim to be “individualised to the condition as presented in the patient”.

Dr Sandell prefaces his list with the statement that it is in his opinion that the doses will be therapeutically effective in providing the health benefits. Nothing beyond his “opinion” is given to support the efficacy of the combination formula for weight loss and the other advertising claims made.

This surely does not constitute “substantiation”. . . . milk thistle . . . contains a substance, silymarin – which is a Schedule 3 Substance in terms of the Medicines and Related Substances Act. This is referred to as Silybum marianum (Carduus marianus) by Dr Sandell.

Schedule 3 substances require a prescription, may not be sold in a supermarket or health shop, and may not be advertised to the general public. In the category “Metabolic Enhancers”, guarana (referred to as Paullinia sorbilis by Dr Sandell) is listed on the webpage. Guarana contains a substance, theophylline – which is a Schedule 2 substance in terms of the Medicines and Related Substances Act. In the category “Metabolic Enhancers”, kelp (referred to as Fucus vesiculosus by Dr Sandell) is listed.

In a recent arbitration related to a product containing kelp (also known as bladderwrack), the arbitrators stated: “Theoretically, thyroid stimulation from bladderwrack may increase metabolism and cause weight loss.

However safety and effectiveness have not been studied in humans (Grade C – Unclear Scientific Evidence for this use) (NIH, 2005).” There is no evidence that kelp will assist in weight loss. . . . . Dr Sandell has not provided any evidence of “synergy” between these ingredients.

In fact, in pharmacodynamic terms Dr Sandell seems to have ignored that apart from possible synergistic effects between ingredients in a “combination formulation”, additive effects and antagonistic effects are also possible. Usually in determining the synergistic/additive/antagonistic effects of the ingredients within a combination formulation, one would require information concerning the absorption, distribution, metabolism and excretion of the ingredients individually and in combination. No such evidence has been provided. The full argument can be read here.

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