written by reader Your Waistline and Your Lifeline: How Strong is that Link, Really?

"Doc Gumshoe" looks at Dr. Oz, Garcinia Cambogia, and more

By Michael Jorrin, "Doc Gumshoe", July 28, 2014

[ed. note: Michael Jorrin, who I like to call “Doc Gumshoe” (he’s a longtime medical writer, not a doctor) writes about health and medicine topics for us from time to time. His words and thoughts are his own.]

Let me begin with a disclaimer: I am not skinny, but neither am I fat. This chapter in the Epistles of Doc Gumshoe is neither an apologia nor a stern lecture. True, a year or so ago, at my regular medical tune-up, a nurse erroneously subtracted a full four inches from my height, and in consequences, calculated my BMI as being just over the lower boundary for obesity. This was because she was a very, very short woman, and could not see to the top of my head. When I saw that my medical record showed that I was obese, I fussed considerably, but to no avail. What was written was written.

Perhaps because of that bit of incorrect information, which has somehow leaked out into cyberspace, I am bombarded daily – nay, hourly, it seems! – with inducements to take part in sure-fire, easy-as-pie (and twice as yummy!) programs to trim my waistline and, in consequence, extend my lifeline.

Naturally, my mean-spirited nature has led me to scrutinize these, and to seek answers to two principal questions:

One, is there a possibility that some of these weight-loss schemes might work, at least a little?

Two, is it really the case that losing weight (if one is indeed overweight or obese) will add to one’s life expectancy?

Before looking at any of these in any detail, let me offer some preliminary comments:

First, in spite of the claims that many of these weight-loss schemes make to the effect that by taking their pill you won’t have to diet, I would guess that people who adopt these plans do try to be at least a tiny bit careful about what goes in through their gullets. They don’t take their daily weight-loss supplement and then proceed to feast on Turducken and Boston Cream Pie. I think they try to diet a bit in addition to taking their magic pill.

Second, it depends on the degree of obesity. At a certain point, obesity itself is a clear and present danger, and just about anything that gets rid of some avoirdupois helps alleviate the danger.

Two birds with one stone

So let’s look at some of these weight-loss plans. The first one that I took a close look at was from an outfit called BioTrust Nutrition, whose slogan (and website) is fixyourbloodsugar.com. (I seem to remember that a former presidential candidate, with credentials in the pizza business, was sending a zillion emails to all and sundry, directing them to that website. Perhaps he was trying to compensate for having fattened people up with his pizza.)

The pleasing premise of this outfit is that all weight gain is due to insulin resistance. The reasoning goes as follows: in a healthy person with normal insulin function, all blood sugar is metabolized and converted to energy, therefore none of it is converted to loathsome fat. But, with insulin resistance, the insulin receptors are unable to utilize the circulating insulin, so then the body can’t do anything with blood sugar but convert it to fat, and there you are. (That line of reasoning omits conversion of glucose to glycogen, but so what.)

On the face of it, every single denizen of Gumshoeland sees a problem with this: energy is demand, and blood sugar is supply, and if the supply exceeds the demand, what are we going to do with it? Store it, of course.

We’ll ignore that quibble and proceed with their proposal, which is put forward by a very plausible chap named Joel Marion in an interminable video, which I watched all the way through. He starts out proclaiming that there are four foolproof ways to deal with insulin resistance and lose weight.

Three blind alleys and the True Way

Way number one is exercise. Intense, weight-bearing exercise for at least one hour a day will do the trick. Unfortunately, this is not practical for most people.

Way number two is megadoses of cinnamon. Twelve 500 mg. capsules a day will do the trick – about two teaspoonsful. Unfortunately, the cinnamon you can buy at the grocery store is usually not real cinnamon – it might even be cinnamon-flavored saw dust. Also, unfortunately, most people can’t tolerate that much cinnamon.

Way number three is a really, really strict diet – no sugar and no carbohydrates. Unfortunately, most people find it difficult to subsist on kale and quinoa.

So, after the unfortunate fact that the first three foolproof ways are just unfortunately not practical, we’re left with way number four, their special nutritional supplement, BioTrust Nutrition’s IG-5, which contains no fewer than five guaranteed substances that will address insulin resistance, and consequently, take the pounds off in double digits (possibly triple digits).

So, what’s in it?

  1. Cinnamonum cassia, sometimes also called Chinese or Ceylon cinnamon. Apparently (I did not know this) there are lots of kinds of cinnamon, and this is the one with allegedly medicinal properties. According to WebMD, it is “used for many conditions, but so far science has not confirmed that it is effective for any of them. Research does show that it is probably not effective in lowering blood sugar in Type 1 or Type 2 diabetes.” Among the conditions that some people use it for are impotence, high blood pressure, diarrhea, kidney disease, and bed wetting.
  2. Berberine, a plant alkaloid of the isoquinoline family. Many related substances have important medicinal qualities, and berberine also has some clear medicinal qualities. For example, it is part of standard treatment for leishmaniasis, an infection caused by a protozoal parasite. It is found in a number of related plants, including European barberry, goldenseal, goldthread, Oregon grape, phellodendron (NOT philodendron), and tree turmeric. It is also taken for heart failure, applied to the skin to heal burns, and to the eye to treat trachoma. It appears to upregulate insulin receptors, and thus have some possible use in Type 2 diabetes.
  3. Pterocarpus marsupium, also known as Vijayasar, the Indian King Tree. It appeared to lower blood glucose in rats with induced Type 2 diabetes. A clinical study in India found that it was similar in effectiveness in treating type 2 diabetes patients as the drug tolbutamide (Orinase), which was one of the very first oral drugs used in treating diabetes. Tolbutamide, like other sulfonylureas, boosts insulin release. It is seldom used these days, owing to side effects more severe than with other sulfonylureas, and it strikes me as an odd drug against which to evaluate the Vijayasar candidate.
  4. hydroxyisoleucine, which is fenugreek, familiar to many supplement advocates. There is evidence (in animal studies) that it activates an insulin receptor, phosphoinositide 3, thus reducing insulin resistance in the liver and in muscle, and also potentiates insulin release.
  5. R – alpha lipoic acid. This is the right-handed enantiomer of alpha lipoic acid, meaning that it’s chemically identical to the left-handed molecule, of which it is a mirror image; however, in many chemical reactions what’s important is the precise shape of the molecule, since the interactions are dependent on the fit of the molecule – like a key in a lock. It is a known antioxidant, and is used to treat the symptoms of diabetic nerve damage. Lipoic acid has also recently been found (by researchers at Oregon State University) to have significant effects on circadian rhythms – the physiologic changes that strongly influence our sleeping and waking cycles. Many genes are affected by circadian rhythms, and when out of balance they can play roles in cancer, heart disease, inflammation, hormonal imbalance and many other areas.

Sounds good, but will it work?

Thus, the components of IG-5 do have some potential activity in controlling insulin resistance and treating Type 2 diabetes. But, going back to the presentation by the fixyourboodsugar.com chap, is there any reason at all to suppose that taking this miraculous pill will make people lose weight without recourse to dieting? Because that’s what the presentation very strongly implies – the graphic that introduces it is a photograph of an exceedingly yummy and gooey pizza, and the presenter as good as says that trying to diet is useless – the basic message is take the pill and eat the pizza.

Granting that the ingredients in IG-5 have medicinal properties of some kind, there remain serious doubts about the efficacy and safety of this preparation.

We have no idea of what the right doses of these agents are. The effects of ingesting any substance depend greatly on the dose. At one end of the spectrum, in minuscule doses, a particular substance may not do anything at all, while at the other end it may kill you. My guess regarding the dosage of active ingredients in most supplements is that the manufacturers err on the low side. They really don’t want to poison anybody. That would not be good for business. But getting the dose right requires lots of clinical studies, and, as we know, those are expensive.

We also don’t have any idea whether taking all five of these potentially active substances together might not mean that there are dangerous interactions between them. Drug interactions are by no means uncommon; some can have quite serious consequences. For example, some antihistamines (now off the market) were metabolized and excreted via the same pathway as some common antibiotics and even some foods (e.g., grapefruit). The result was a build-up of the antihistamine concentration, to the point where it caused fatal cardiac arrhythmias. Unearthing these interactions requires diligent research beyond the capacities of most supplement manufacturers.

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