Ingredients for satiety are part of the strategy helping consumers do more than just control their appetites. Part I of NIE’s weight- management coverage.

The obesity epidemic has become a global issue. According to the World Health Organization (WHO), worldwide obesity has nearly doubled since 1980, and in 2008, more than 1.4 billion adults age 20 and older were overweight; of this number, more than 200 million men and 300 million women were classified as obese. The WHO also reports that more than 40 million children under the age of 5 were overweight in 2011, while 65 percent of the world’s population live in countries where being overweight and obese kills more people than being underweight.

Further, overweight and obesity are currently the fifth leading cause of deaths globally and more than 10 percent of the world’s adult population can be classified as obese. “It’s well known that the world is experiencing a global obesity epidemic. In the U.S., an estimated 68 percent of the population is overweight or obese,” said Jith Veeravalli, president of California-based Gencor. “It’s predicted that 50 to 80 million Americans will diet in 2013, contributing $60 billion to the weight-loss industry.” 

Supersized: The New Normal 

Today, the average restaurant meal is four times larger than in the 1950s, while a 2012 study published in the journal Public Health Nutrition found that 96 percent of America’s chain restaurant meals exceed dietary guidelines for sodium, fat and saturated fat.Increased portion sizes cause Americans to consume more calories, encourage them to eat more—past the point of being full, distorting the perception of what an appropriate serving size is and, in conjunction with the sedentary lifestyles many people lead, has caused Americans to pack on the pounds.

Hunger and satiety are complex functions of the body that should tell us to stop eating when we are full. “Fullness is associated with a satisfied feeling in the stomach or, if you overeat, an uncomfortable feeling,” said Jamie Spell, managing director of Nutraceuticals International Group in New Jersey.
“The feeling of fullness stimulates a signal to the brain that tells us to stop eating.Satiety is the sensation that keeps us from snacking between meals. The feeling of satiety involves a number of natural physiological actions that start in the stomach and ultimately affect the appetite center in the brain.” 

While larger meals are a factor of the American obesity epidemic, according to Barbara Davis, PhD, RD, director of medical and scientific affairs for P.L. Thomas in New Jersey, it is much more complicated than overeating simply because there is more on your plate. “Weight management is a complex issue comprised of biological, environmental, behavioral and emotional factors,” she explained. “Psychological factors are often associated with higher body weight—anxiety, depression and stress are all correlated with higher body mass index (BMI) and weight gain—especially in women. Stress induced eating and snacking are well documented and the types of foods often consumed in response to stress, namely comfort foods or calorically dense options, can lead to weight gain.Conversely, products that improve mood and reduce stress can play a role in weight management by creating a sense of satiety, which ultimately decreases hunger and snacking frequency.” 

Satiereal® from P.L. Thomas is an extract of Crocus sativus L. saffron stigmas that was developed to support weight management through satiety by improving emotional well-being and decreasing compulsive behavior toward eating. Unlike other satiety ingredients, Satiereal does not act acutely to promote a feeling of “fullness.” Rather, it induces a feeling of well-being and stress reduction over time to address the source of stress-related overeating and snacking, according to the company.

“Satiereal Saffron Extract is the only saffron-based ingredient that has clinical studies supporting its role as a satiety inducing nutritional ingredient,” said Davis.“Satiereal is a proprietary extract of saffron petals that enhances the activity of the neurotransmitter serotonin, influencing satiety, appetite, mood and behaviors relating to snacking.” 

Exploring Options 

The market for natural satiety ingredients continues to grow as consumers become more skeptical of pharmaceutical drugs. For instance, Fen-phen was once toted as the “holy grail” of weight-loss products—in 1996 alone, doctors wrote approximately 18 million prescriptions a month. A year later, it was pulled off the market after the U.S. Food and Drug Administration (FDA) estimated that up to a third of patients using fenfluramine or dexfenfluramine developed heart valve damage.

“Various types of ingredients exist in this sector. Some, such as fenfluramine, phentermine and fen-phen have been shown to have dangerous effects, such as coronary heart valve problems, dizziness, insomnia, mood swings and even death,” said Gencor’s Veeravalli. “Consumers are increasingly moving toward natural products because they are not only more readily available than pharmaceuticals, but also because they know that natural ingredients tend to have fewer side effects.” 

At the same time, while consumers are exploring natural options, they want results and they want them immediately.“In our fast-paced world, we have come to expect things now,” noted Chase Hagerman, business development and marketing manager for Chemi Nutra in Minnesota. “Other health conditions (heart health, eye health, etc.) are maintained over a long time and [the supplement’s benefits] are often not perceivable to the user. As they say, ‘perception is everything.’” 

As they are watching their waistlines, Americans are on the go and want their weight-loss products to be easy and portable—hence the proliferation of bars, snacks and beverages. According to Veeravalli, weight-management bars are popular options for meal replacement and between-meal snacking.Consumers are also looking for beverages that offer better alternatives to sugary sodas and juices.

Illinois-based FutureCeuticals has focused on developing functional fibers from oats, barley, amaranth, quinoa and ancient grains. The company’s patented shearing technology increases the soluble fiber beta glucan content in healthy grains and provides a creamy “fat mimetic” mouth feel that pairs very well with whey and plant based proteins.

“Our most successful ingredient in the weight-loss category is our patented Nutrim Oat Bran,” said Hartley Pond, vice president of technical sales. “It has been used primarily as a healthy grain that is paired with proteins in leading meal replacement products. While most of the research on Nutrim has been focused on heart health, its creamy textural properties are a key attribute to meal replacements, and its high soluble fiber content provides satiety.” 

Nutraceuticals International Group’s satiety ingredient, Slimpro (patentpending), is a fish peptide fortified with BCAAs (branched-chain amino acids).Derived from blue whiting fish caught off the banks of Newfoundland, Canada, Slimpro works naturally with the human physiology by increasing CCK (cholecystokinin) and GLP-1 (glucagon-like peptide-1) production, which sends messages to the brain to control hunger, eating less and nibbling.CCK is the most studied satiety signal, which is stimulated in the intestine, in response to a meal stimulation. It contributes in regulation of the daily energy intake and maintaining an appropriate meal size, which helps to manage body weight for long term, according to the company.

“GLP-1 is a type of glucagon that is secreted from the intestine while eating and suppresses the appetite. It has been said to decrease food intake by increasing satiety in the brain,” explained Spell. “This direct action on the hunger process targets many different subjects for weight control such as new moms, recent non-smokers and individuals who simply want to manage their weight and stop snacking.” 

Slimpro can be used in a number of applications including: tablets, capsules, soft gels, stick packs, protein shakes, soft beverages and baked goods.

Backed By Science 

Due to the influx of negative reports regarding weight-loss products, many Americans are becoming wary if there’s no science to back up claims. “Unfortunately, consumers generally Don’t trust marketers, especially when it comes to weight management where there is an abundance of over exaggerated and unrealistic claims,” said Chemi Nutra’s Hagerman. “This approach tends to have the opposite effect, that being reducing the credibility of a product.” 

It is up to ingredient suppliers and their manufacturing partners to be transparent and offer access to research. For instance, a study published last year in the journal Lipids in Health and Disease showed that Chemi Nutra’s PhosphoLean NOPE+EGCG, combined with dieting, appears to have a positive benefit on both diet compliance and mood. The randomized, placebo-controlled, double- blind study involved 34 healthy male and female subjects, aged 18-46, who participated in an eight-week diet compliance study. One subject group consumed three capsules (300 mg; PhosphoLean NOPE+EGCG), while the other subject group consumed three capsules of a placebo on a daily basis.BMI values of the subjects ranged from 25-39, and each subject visited the investigators six times during the study.

Subjects were instructed to complete a three-day dietary recall and a total energy expenditure (TEE) value was determined by a formula that used age, height, weight and reported physical activity. A recommended caloric intake was provided that was 30 percent or 500 kcals per day (whichever was greater) less than what had been consumed, not to exceed 1,000 kcal per day.

While it was evident that almost all of the subjects failed to achieve expected weight-loss results, due to insufficient calorie restriction, the PhosphoLean NOPE+EGCG group had a greater decrease in total mood (a favorable response), as well as similar positive outcomes for both fatigue and confusion vs. the placebo group.

Another satiety ingredient is Gencor’s Slimaluma. The product features Garcinia cambogia and Caralluma fimbriata, which help curb hunger cravings, therefore moderating eating habits by allowing the person to eat more by choice than compulsion, according to the company. “For centuries, an extract of the herb Caralluma fimbriata has been used to alleviate hunger pangs,” said Veeravalli. “For example, tribal hunters in indigenous parts of India have traveled into the forest for days at a time carrying only a few pieces of this plant. They sustained themselves simply by chewing and eating the plant’s stems. Gencor developed and patented a standardized extract of Caralluma fimbriata to create Slimaluma.” 

Slimaluma’s mechanism of action has been tested by invitro as well as invivo studies. Both showed that Slimaluma causes reduction in hunger and, according to Veeravalli, the principle hypothesis suggested for the mechanism of action for hunger control is that Slimaluma regulates the signaling mechanism of the enzyme cholecystokinin from the stomach to the brain, signaling fullness.

The in-vitro study done on cell lines showed that Slimaluma inhibited differentiation of adipocytes (fat cells), meaning it prevented fat cells from multiplying, thus reducing their formation, so both body fat and waist circumference is reduced. The in-vivo study showed that Slimaluma reversed dietinduced obesity in animal models and also had anti-atherosclerotic activity.The animals lost body weight and body fat, plus cholesterol and glucose levels came down. Arterial thickness and plaque formation was also reduced.

Challenges 

While there have been advancements in the weight-management market regarding satiety, some believe the name itself is a hindrance—consumers don’t understand the term. “We actually are steering away from the word ‘satiety’ as we have found it to be a weak descriptor when targeting the consumer,” explained Chemi Nutra’s Hagerman.“We prefer the more ‘digestible’ term ‘hunger’ (i.e., hunger reducing, hunger inhibiting).” 

Other setbacks for ingredient suppliers and manufacturers include convincing consumers to get past negative reports in the media and scam products.Here, transparency is key—offering documentation, and proving safety and efficacy.

“Safety is the core concern consumers have with weight-management products,” said Hagerman. “Sadly, when the nutraceutical industry is brought up in mainstream media, it is when there are safety issues and product recalls. Generally the story goes on to state the supplement industry is ‘not regulated’ by the FDA.” 

While the elusive magic diet pill is still yet to be discovered, ingredient suppliers and manufacturers are still contending with consumers who have unreasonable expectations. But compliance is the key, said FutureCeutical’s Pond.“Losing weight is about adopting a lifestyle that can be maintained, and this includes lowering calorie intake, consuming good and healthy foods and meal replacements and increasing one’s calorie burn through exercise.

“Clearly consumers come to the challenge of weight loss from many perspectives and with a wide range of knowledge regarding nutrition,” Pond concluded. “There are still many consumers who are seeking a ‘magic bullet,’ a supplement that enhances satiety and thermogenesis, while blocking fat and carbohydrates uptake. However, more consumers now view diet and weight loss as components of an overall strategy for health and wellness and are concerned with the safety of supplements aimed at weight loss. Consumers are focusing on healthy foods, particularly vegetables, dietary fiber and proteins as key components of weight loss.”

Study Suggests Effect of Fructose on Brain May Promote Overeating

The brain processes fructose and glucose, the two forms of simple sugars, differently—impacting appetite, feelings of satisfaction, fullness and potential weight gain, according to a study by Yale School of Medicine researchers, published in the Journal of the American Medical Association.

Glucose, but not fructose, suppresses brain activity in regions that promote the desire to eat, whereas fructose feeding may promote overeating through its inability to effectively suppress food-seeking behavior, the scientists found.

Glucose and fructose are found in many fruits and vegetables, and they combine in table sugar. Fructose, however, is also found in another common sweetener, high-fructose corn syrup, which can be found in certain soft drinks and processed foods. Fructose consumption has increased over the past few decades, as have rates of obesity.

The researchers, led by corresponding author Dr. Robert Sherwin, professor and section chief of endocrinology at Yale School of Medicine, conducted functional magnetic resonance imaging studies of healthy non-obese participants’ brains to assess relative changes in cerebral blood flow in the brain after glucose or fructose ingestion.They found that ingestion of glucose reduced cerebral blood flow and activity in brain regions that regulate appetite, but fructose did not. Ingestion of glucose also produced increased feelings of satisfaction and fullness, but fructose did not.

“Glucose but not fructose ingestion reduced the activation of the hypothalamus, insula, and striatum—brain regions that regulate appetite, motivation, and reward processing; glucose ingestion also increased functional connections between the hypothalamic- striatal network and increased satiety,” wrote the study authors.

“Increases in fructose consumption have paralleled the increasing prevalence of obesity, and high-fructose diets are thought to promote weight gain and insulin resistance,” they added. “Fructose ingestion produces smaller increases in circulating satiety hormones compared with glucose ingestion, and central administration of fructose provokes feeding in rodents, whereas centrally administered glucose promotes satiety. Thus, fructose possibly increases food-seeking behavior and increases food intake.” 

For more information, visit www.medicine.yale.edu.