(R)-Alpha lipoic acid: weight loss with advantages?

reference

Bobe G, Michels AJ, Zhang WJ, et al. A randomized controlled study on long-term (r) α-liponic acid supplement promotes weight loss for overweight or obese adults without changing the increased triglyceride concentrations in plasma. j Nutr . 2020; 150 (9): 2336-2345.

Study goal

primary: evaluate the effectiveness of (r) alpha-lipoic acid (R-La) when reducing increased plasmriglycerides for overweight and obesent adults

secondary: evaluate the effectiveness of alpha lipoic acid in promoting weight loss and/or improving oxidative stress and/or inflammation

draft

randomized, double blind, placebo -controlled study

Intervention

The test duration was 24 weeks. The participants received either 2 capsules with 300 mg R-LA each 30 minutes before breakfast or suitable inert tablets on an empty stomach. The researchers asked the participants not to change other aspects of nutrition or lifestyle in the course of the study.

participant

81 adults (57 % women; at the age of 21 to 60 years; body mass index [BMI] ≥ 25 kg/m 2 ).

All participants had increased plasmriglycerides (≥100 mg/dl) at the beginning of the course

study parameters evaluated

primary:

• plasma triglycerides

secondary:

• body weight and body fat mass
• Zell and plasma antioxidant pool and capacity
• gene expression antioxidant enzymes
• lipid peroxidation
• cellular and plasmatic inflammatory marker
• blood markers of immune monitoring

primary result measurements

Change of plasmetriglyceride.

important knowledge

• The plasmetriglycerides did not decrease with the R-LA supplement.
• The treatment group had a stronger reduction in the BMI after 24 weeks than the placebo group (–0,8; p = 0.04)
• After 24 weeks, women and obese participants in the treatment group (BMI ≥ 35) lost the most weight (–5.0 % or –4.8 %; both). p <0.001) and body fat (–9.4 % or –8.6 %; both p <0.005).
• gene expression of antioxidants in mononuclear cells, expressed by hemoxygenase 1 ( hmox1 ) genetic expression, was higher in the treatment group after 24 weeks.
• Several markers for evaluating oxidative stress and inflammation were lower in the treatment group after 24 weeks, including fewer F2 isoprostans in urine (–25 %; p = 0.005).

practice implications

In some people, obesity and overweight correlate with accompanying health risks, including increased triglycerides, 1,2 inflammation, 3 and oxidative stress. ⁴

The extent to which these physiological changes can affect general health 5 and mortality 6 is significant and justifies a multidisciplinary approach when working with this patient population.

After 24 weeks, women and obese participants lost the most weight in the treatment group (BMI ≥ 35).

The path to the thorough and permanent implementation of fundamental, health -promoting changes to the lifestyle can be long, tedious and tedious. Therefore, it makes sense to use additional aids to improve the BMI. If this support serves directly to improve important physiological factors that could otherwise contribute to any pathological changes, it is even more sensible.

Although this study had no effect on its primary endpoint, the effects that were observed at different secondary endpoints indicate that R-La could still fit this bill. The changes in the intervention group can make an effective contribution to health than the primary result of the result.

While this study did not show that R-La reduced the triglyceride, the clear effects on inflammation and oxidative stress that this nutrient seems to have in this patient population have clinically relevant. This applies in particular if the negative effects of inflammation and oxidative stress on the cardiovascular risk induced by hypertriglyceridemia. Theoretically, the lack of an effect that is observed in R-LAS primary result of the plasma riglycerides could be interpreted in such a way that there is no benefit when using R-La. However, triglycerides themselves are not considered to be directly atherogen, but rather as biomarkers for risks, since they often correlate with other atherogenic factors.

In fact, an increase in triglycerides can have questionable negative effects if the inflammation is under control. Some indications indicate that significant effects on endpoint markers from cardiovascular diseases can occur, even if the triglycerides increase with treatment if inflammation and oxidative stress improve.

As always, when treating patients, we should strive for a multi -track approach that is based on basic health -promoting principles (nutrition, movement, sleep, stress relief, etc.). However, various real circumstances that can come into play during the efforts of the patients can slow down or hinder their progress. Having additional tools such as R-La on board or ready can help to protect our patients in an important way while working on ever better health-promoting lifestyle and improved health.