title: Weight loss associated with reduced intake of carbohydrate reduces the atherogenicity of LDL in premenopausal women. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. Flaxseed oil increases the plasma concentrations of cardioprotective (n-3) fatty acids in humans. Effect of green tea on resting energy expenditure and substrate oxidation during weight loss in overweight females. Carnitine does not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted, low-fat diet. The effects of 2-week ingestion of (−)-hydroxycitrate and (−)-hydroxycitrate combined with medium-chain triglycerides on satiety, fat oxidation, energy expenditure and body weight Effects of Chinese Green Tea on Weight, and Hormonal and Biochemical Profiles in Obese Patients With Polycystic Ovary Syndrome—A Randomized Placebo-Controlled Trial The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Effects of (−)-hydroxycitric acid on appetitive variables Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Effects of 2-week ingestion of (−)-hydroxycitrate and (−)-hydroxycitrate combined with medium-chain triglycerides on satiety and food intake Effects of hempseed and flaxseed oils on the profile of serum lipids, serum total and lipoprotein lipid concentrations and haemostatic factors Effects of (−)-hydroxycitrate on net fat synthesis as de novo lipogenesis Body fat loss achieved by stimulation of thermogenesis by a combination of bioactive food ingredients: a placebo-controlled, double-blind 8-week intervention in obese subjects Use of nonprescription weight loss products: results from a multistate survey.
abstract: The effect of a 3-tier intervention including dietary modifications ( ie , moderate energy restriction , decreased carbohydrate , increased protein ) , increased physical activity , and the use of carnitine as a dietary supplement was evaluated on plasma lipids and the atherogenicity of low-density lipoprotein ( LDL ) particles in a population of overweight and obese premenopausal ( aged 20 - 45 years ) women .  Carnitine or a placebo ( cellulose ) was r and omly assigned to the participants using a double-blind design . Carnitine supplementation was postulated to enhance fat oxidation result ing in lower concentrations of plasma triglycerides . Seventy women completed the 10-week protocol , which followed a reduction in their energy intake by 15 % and a macronutrient energy distribution of 30 % protein , 30 % fat , and 40 % carbohydrate . In addition , subjects increased the number of steps taken per day by 4500 . As no differences were observed between the carnitine and placebo groups in all the measured parameters , all subjects were pooled together for statistical analysis . Participants decreased ( P<.01 ) their caloric intake ( between 4132.8 and 7770 kJ ) and followed prescribed dietary modifications as assessed by dietary records . The average number of steps increased from 8950+/-3432 to 12764+/-4642 ( P<.001 ) . Body weight , plasma total cholesterol , LDL cholesterol , and triglyceride were decreased by 4.5 % , 8.0 % , 12.3 % , and 19.2 % ( P<.0001 ) , respectively , after the intervention . Likewise , apolipoproteins B and E decreased by 4.5 % and 15 % ( P<.05 ) after 10 weeks . The LDL mean particle size was increased from 26.74 to 26.86 nm ( P<.01 ) , and the percent of the smaller LDL subfraction ( P<.05 ) was decreased by 26.5 % ( P<.05 ) after 10 weeks . In addition , LDL lag time increased by 9.3 % ( P<.01 ) , and LDL conjugated diene formation decreased by 23 % ( P<.01 ) , indicating that the susceptibility of LDL to oxidation was decreased after the intervention . This study suggests that moderate weight loss ( < 5 % of body weight ) associated with reduced caloric intake , lower dietary carbohydrate , and increased physical activity impacts the atherogenicity of LDL BACKGROUND Current interest in the role of functional foods in weight control has focused on plant ingredients capable of interfering with the sympathoadrenal system . OBJECTIVE We investigated whether a green tea extract , by virtue of its high content of caffeine and catechin polyphenols , could increase 24-h energy expenditure ( EE ) and fat oxidation in humans . DESIGN Twenty-four-hour EE , the respiratory quotient ( RQ ) , and the urinary excretion of nitrogen and catecholamines were measured in a respiratory chamber in 10 healthy men . On 3 separate occasions , subjects were r and omly assigned among 3 treatments : green tea extract ( 50 mg caffeine and 90 mg epigallocatechin gallate ) , caffeine ( 50 mg ) , and placebo , which they ingested at breakfast , lunch , and dinner . RESULTS Relative to placebo , treatment with the green tea extract result ed in a significant increase in 24-h EE ( 4 % ; P < 0.01 ) and a significant decrease in 24-h RQ ( from 0.88 to 0.85 ; P < 0.001 ) without any change in urinary nitrogen . Twenty-four-hour urinary norepinephrine excretion was higher during treatment with the green tea extract than with the placebo ( 40 % , P < 0.05 ) . Treatment with caffeine in amounts equivalent to those found in the green tea extract had no effect on EE and RQ nor on urinary nitrogen or catecholamines . CONCLUSIONS Green tea has thermogenic properties and promotes fat oxidation beyond that explained by its caffeine content per se . The green tea extract may play a role in the control of body composition via sympathetic activation of thermogenesis , fat oxidation , or both Alpha-linolenic acid ( ALA ) is a major dietary ( n-3 ) fatty acid . ALA is converted to longer-chain ( n-3 ) PUFA , such as eicosapentaenoic acid ( EPA ) and possibly docosahexaenoic acid ( DHA ) . EPA and DHA are fish-based ( n-3 ) fatty acids that have proven cardioprotective properties . We studied the effect of daily supplementation with 3 g of ALA on the plasma concentration of long-chain ( n-3 ) fatty acids in a predominantly African-American population with chronic illness . In a r and omized , double-blind trial , 56 participants were given 3 g ALA/d from flaxseed oil capsules ( n = 31 ) or olive oil placebo capsules ( n = 25 ) . Plasma EPA levels at 12 wk in the flaxseed oil group increased by 60 % , from 24.09 + /- 16.71 to 38.56 + /- 28.92 micromol/L ( P = 0.004 ) , whereas no change occurred in the olive oil group . Plasma docosapentaenoic acid ( DPA ) levels in the flaxseed oil group increased by 25 % from 19.94 + /- 9.22 to 27.03 + /- 17.17 micromol/L ( P = 0.03 ) with no change in the olive oil group . Plasma DHA levels did not change in either group . This study demonstrates the efficacy of the conversion of ALA to EPA and DPA in a minority population with chronic disease . ALA may be an alternative to fish oil ; however , additional clinical trials with ALA are warranted We assessed the effect of ingestion of green tea ( GT ) extract along with a low-energy diet ( LED ) on resting energy expenditure ( REE ) , substrate oxidation and body weight as GT has been shown to increase energy expenditure and fat oxidation in the short term in both animals and people . Forty-six overweight women ( BMI 27.6 ( sd 1.8 ) kg/m2 ) were fed in energy balance from day 1 to day 3 , followed by a LED with GT ( 1125 mg tea catechins + 225 mg caffeine/d ) or placebo ( PLAC ) from day 4 to day 87 . Caffeine intake was st and ardised to 300 mg/d . Energy expenditure was measured on days 4 and 32 . Reductions in weight ( 4.19 ( sd 2.0 ) kg PLAC , 4.21 ( sd 2.7 ) kg GT ) , BMI , waist : hip ratio , fat mass and fat-free mass were not statistically different between treatments . REE as a function of fat-free mass and fat mass was significantly reduced over 32 d in the PLAC group ( P<0.05 ) but not in the GT group . Dietary restraint increased over time ( P<0.001 ) in both groups , whereas disinhibition and general hunger decreased ( P<0.05 ) . The GT group became more hungry over time and less thirsty , and showed increased prospect i ve food consumption compared with PLAC ( P<0.05 ) . Taken together , the ingestion of GT along with a LED had no additional benefit for any measures of body weight or body composition . Although the decrease in REE as a function of fat-free mass and fat mass was not significant with GT treatment , whereas it was with PLAC treatment , no significant effect of treatment over time was seen , suggesting that a robust limitation of REE reduction during a LED was not achieved by GT OBJECTIVES Carnitine deficiency impairs fatty acid beta-oxidation and may partly explain weight gain in valproate-treated patients . The aim of this study was to determine whether l-carnitine supplementation improves weight loss outcomes in bipolar patients taking sodium valproate .  METHODS Sixty bipolar patients with clinical ly significant weight gain thought to be related to sodium valproate , who had been taking sodium valproate for > or=6 months , were r and omized to l-carnitine ( 15 mg/kg/day ) or placebo for 26 weeks , in conjunction with a moderately energy-restricted , low-fat diet . The primary outcome measure was weight change . RESULTS l-carnitine had no effect on mean weight loss compared with placebo ( -1.9 kg versus - 0.9 kg ) ( F = 0.778 , df = 1,58 , p = 0.381 ) . The number of people in each group able to lose any weight was identical ( = 0 , p = 1.0 ) ; more patients in the carnitine group ( nine versus five ) achieved a clinical ly significant weight loss ( > or=5 % ) but this was not statistically significant ( p = 1.0 , Fisher 's exact test ) . CONCLUSIONS At the dose prescribed in this study carnitine supplementation did not improve weight loss outcomes in valproate-treated bipolar patients consuming an energy-restricted , low-fat diet OBJECTIVE : Assessment of the effect of 2-week supplementation with (−)-hydroxycitrate ( HCA ) and HCA combined with medium-chain triglycerides ( MCT ) on satiety , fat oxidation , energy expenditure ( EE ) and body weight ( BW ) loss . DESIGN : Three intervention periods of 2 weeks separated by washout periods of 4 weeks . Double-blind , placebo-controlled , r and omised and cross-over design .SUBJECTS : Eleven overweight male subjects ( mean±s.d . ; age , 47±16 y ; body mass index , 27.4 ± 8.2 kg/m2).INTERVENTION : Subjects consumed three self-selected meals and four iso-energetic ( 420 kJ ) snacks daily with either no supplementation ( PLA ) , 500 mg HCA ( HCA ) or 500 mg HCA and 3 g MCT ( HCA+MCT ) . Each intervention ended with a 36 h stay in the respiration chamber . RESULTS : There was a significant BW loss during the 2 weeks of intervention ( PLA , −1.0 ± 0.4 kg , P<0.05 ; HCA , −1.5 ± 0.5 kg , P<0.01 ; HCA+MCT , −1.3 ± 0.2 kg , P<0.001 ) , but this reduction was not different between treatments . 24 h EE  ( PLA , 11.8 ± 0.2 MJ ; HCA , 11.7 ± 0.1 MJ ; HCA+MCT , 11.5 ± 0.1 MJ ) , 24 h RQ ( 0.85 ± 0.00 in all treatments ) and the area under the curve of the appetite-related parameters were not different between treatments . CONCLUSION : Two-week supplementation with HCA and HCA combined with MCT did not result in increased satiety , fat oxidation , 24 h EE or BW loss  compared to PLA , in subjects losing BW Objectives : To study the effects of green tea on body weight , and biochemical and hormonal profiles in obese Chinese women with polycystic ovary syndrome ( PCOS ) . Methods : Thirty-four obese Chinese women with PCOS were r and omized into either treatment with green tea capsules or placebo for 3 months . The anthropomentric measurements , and biochemical and hormonal profiles before and after treatment in each group were compared . Results : The body weight of the green tea group decreased by a nonsignificant 2.4 % after treatment ; whereas the body weight , body mass index ( BMI ) , and body fat content of the control group were significantly higher after 3 months . There were no differences in any of the hormone levels measured in either group . The biochemical profiles of the two groups were also similar except that there was a small but significant rise in the triglyceride level in the green tea group . Fewer patients in the green tea group remained amenorrhoeic , but this was not significantly different from the control group . Conclusions : Green tea supplementation did not significantly reduce body weight in obese women with PCOS , nor did it alter the glucose or lipid metabolism BACKGROUND A previous study has demonstrated that L-carnitine reduces plasma lipoprotein(a ) ( Lp[a ] ) levels in patients with hypercholesterolemia . OBJECTIVE To test a tolerable Lp(a)-reducing agent in diabetic patients , we assessed the effect of a dietary supplementation of L-carnitine on plasma lipid levels , particularly Lp(a ) , of patients with type 2 diabetes mellitus ( DM ) and hypercholesterolemia . METHODS In this 6-month , r and omized , double-masked , placebo-controlled clinical trial , patients were enrolled , assessed , and followed up at the Diabetic and Metabolic Diseases Center of the Department of Internal Medicine and Therapeutics at the University of Pavia , Pavia , Italy . All study patients had newly diagnosed type 2 DM that was managed through dietary restriction alone throughout the study , as well as hypercholesterolemia . Patients were r and omized to 1 of 2 groups . One group received L-carnitine , one 1-g tablet BID . The other group received a corresponding placebo . We assessed body mass index , fasting plasma glucose , postpr and ial plasma glucose , glycosylated hemoglobin , fasting plasma insulin , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , triglycerides , apolipoprotein ( apo ) A-I , apo B , and Lp(a ) at baseline and at 1 , 3 , and 6 months of treatment . RESULTS This study included 94 patients . The treatment group included 24 men and 22 women ( mean [ SD ] age , 52 [ 6 ] years ) . The placebo group included 23 men and 25 women ( mean [ SD ] age , 50 [ 7 ] years ) . The baseline characteristics of the groups did not differ significantly . The mean ( SD ) body weight , height , and body mass index were 78.2 ( 5.8 ) kg , 1.70 ( 0.04 ) m , and 27.3 ( 2.5 ) kg/m(2 ) , respectively , in the L-carnitine group and 77.6 ( 6.4 ) kg , 1.71 ( 0.05 ) m , and 26.8 ( 2.2 ) kg/m(2 ) , respectively , in the placebo group . In the treatment group , Lp(a ) was significantly reduced at 3 and 6 months compared with baseline ( P < 0.05 ) and P < 0.01 , respectively ) . We observed a significant improvement after 6 months ( P < 0.05 ) in the Lp(a ) value in patients taking L-carnitine compared with those taking placebo . Between-group differences in other variables did not reach a level of significance at months 3 and 6 . No drug-related adverse events were reported or observed . CONCLUSION In this preliminary study , after 3 and 6 months , L-carnitine significantly lowered the plasma Lp(a ) level compared with placebo in selected hypercholesterolemic patients with newly diagnosed type 2 DM OBJECTIVE The body fat reducing effect and reduction of risks for cardiovascular disease by a green tea extract ( GTE ) high in catechins was investigated in humans with typical lifestyles . RESEARCH METHODS AND PROCEDURES Japanese women and men with visceral fat-type obesity were recruited for the trial . After a 2-week diet run-in period , a 12-week double-blind parallel multicenter trial was performed , in which the subjects ingested green tea containing 583 mg of catechins ( catechin group ) or 96 mg of catechins ( control group ) per day . R and omization was stratified by gender and body mass index at each medical institution . The subjects were instructed to maintain their usual dietary intake and normal physical activity . RESULTS Data were analyzed using per- protocol sample s of 240 subjects ( catechin  group ; n = 123 , control group ; n = 117 ) . Decreases in body weight , body mass index , body fat ratio , body fat mass , waist circumference , hip circumference , visceral fat area , and subcutaneous fat area were found to be greater in the catechin group than in the control group . A greater decrease in systolic blood pressure ( SBP ) was found in the catechin group compared with the control group for subjects whose initial SBP was 130 mm Hg or higher . Low-density lipoprotein ( LDL ) cholesterol was also decreased to a greater extent in the catechin group . No adverse effect was found . DISCUSSION The continuous ingestion of a GTE high in catechins led to a reduction in body fat , SBP , and LDL cholesterol , suggesting that the ingestion of such an extract contributes to a decrease in obesity and cardiovascular disease risks (-)-Hydroxycitric acid ( HCA ) reportedly promotes weight loss , in part , through suppression of hunger . However , this mechanism has never been evaluated in humans in a controlled study . Eighty-nine mildly overweight females were prescribed 5020-kJ diets for 12 weeks as part of a double-blind , placebo-controlled parallel group study . Forty-two participants ingested 400-mg caplets of Garcinia cambogia 30 - 60 min prior to meals for a total dose of 2.4 g/day ( 1.2 g/day HCA ) . Forty-seven participants ingested matched placebos .  Weight and body composition were assessed at baseline and every other week for 12 weeks . Food intake and appetitive variables were assessed at baseline and monthly for 12 weeks . Both groups lost body weight with the active group achieving a significantly greater reduction ( 3 . 7+/-3.1 kg versus 2.4+/-2.9 kg ) . No effects of the HCA were observed on appetitive variables . The active treatment group did not exhibit better dietary compliance or significant correlations between appetitive variables and energy intake or weight change . This study does not support a satiety effect of HCA The association of television viewing and obesity in data collected during cycles II and III of the National Health Examination Survey was examined . Cycle II examined 6,965 children aged 6 to 11 years and cycle III examined 6,671 children aged 12 to 17 years . Included in the cycle III sample were 2,153 subjects previously studied during cycle II . These surveys , therefore , provided two cross-sectional sample s and one prospect i ve sample . In all three sample s , significant associations of the time spent watching television and the prevalence of obesity were observed . In 12- to 17-year-old adolescents , the prevalence of obesity increased by 2 % for each additional hour of television viewed . The associations persisted when controlled for prior obesity , region , season , population density , race , socioeconomic class , and a variety of other family variables . The consistency , temporal sequence , strength , and specificity of the associations suggest that television viewing may cause obesity in at least some children and adolescents . The potential effects of obesity on activity and the consumption of calorically dense foods are consistent with this hypothesis The aim of this study was to assess the effects of 2 weeks of supplementation with (-)-hydroxycitrate ( HCA ) and HCA combined with medium-chain triglycerides ( MCT ) on satiety and energy intake . The experimental design consisted of three intervention periods of 2 weeks separated by washout periods of 2 or 6 weeks in a double-blind , placebo-controlled , r and omized , and crossover design . Seven male and 14 female normal to moderately obese subjects ( mean+/-S.D. ; age , 43+/-10 years ; body mass index , 27.6+/-2.0 kg/m(2 ) ) participated in this study . Subjects consumed three self-selected meals and four isoenergetic snacks daily with either no supplementation ( PLA ) , with 500 mg HCA ( HCA ) , or 500 mg HCA and 3 g MCT ( HCA+MCT ) . Each intervention period ended with a test day , consisting of a st and ardized breakfast and ad libitum a lunch and a dinner . There was a significant body weight ( BW ) loss during the 2 weeks of intervention ( PLA , -0.5+/-0.3 kg , P<.05 ; HCA , -0.4+/-0.2 kg , P<.05 ; HCA+MCT , -0.7+/-0.2 kg , P<.01 ) , but this reduction was not different between treatments . Twenty-four-hour energy intake ( PLA , 8.1+/-0.3 MJ ; HCA , 8.3+/-0.3 MJ ; HCA+MCT , 8.4+/-0.3 MJ ) and the area under the curve of the appetite-related parameters during the test day were similar for all treatments . Two weeks of supplementation with HCA and HCA combined with MCT did not result in increased satiety or decreased energy intake compared to placebo in subjects losing BW Summary Background Both hempseed oil ( HO ) and flaxseed oil ( FO ) contain high amounts of essential fatty acids ( FAs ) ; i.e. linoleic acid ( LA , 18:2n-6 ) and alpha-linolenic acid ( ALA , 18:3n-3 ) , but almost in opposite ratios . An excessive intake of one essential FA over the other may interfere with the metabolism of the other while the metabolisms of LA and ALA compete for the same enzymes . It is not known whether there is a difference between n-3 and n-6 FA of plant origin in the effects on serum lipid profile . Aim of the study To compare the effects of HO and FO on the profile of serum lipids and fasting concentrations of serum total and lipoprotein lipids , plasma glucose and insulin , and haemostatic factors in healthy humans . Methods Fourteen healthy volunteers participated in the study . A r and omised , double-blind crossover design was used . The volunteers consumed HO and FO ( 30 ml/day ) for 4 weeks each . The periods were separated by a 4-week washout period . Results The HO period result ed in higher proportions of both LA and gamma-linolenic acid in serum cholesteryl esters ( CE ) and triglycerides ( TG ) as compared with the FO period ( P < 0.001 ) , whereas the FO period result ed in a higher proportion of ALA in both serum CE and TG as compared with the HO period ( P < 0.001 ) . The proportion of arachidonic acid in CE was lower after the FO period than after the HO period ( P < 0.05 ) . The HO period result ed in a lower total-to-HDL cholesterol ratio compared with the FO period ( P = 0.065 ) . No significant differences were found between the periods in measured values of fasting serum total or lipoprotein lipids , plasma glucose , insulin or hemostatic factors . Conclusions The effects of HO and FO on the profile of serum lipids differed significantly , with only minor effects on concentrations of fasting serum total or lipoprotein lipids , and no significant changes in concentrations of plasma glucose or insulin or in haemostatic factors (-)-Hydroxycitrate ( HCA ) might promote weight maintenance by limiting the capacity for de novo lipogenesis ( DNL ) . It was investigated whether HCA may reduce DNL in humans during a persistent excess of energy intake as carbohydrate . In a double-blind , placebo-controlled , r and omized and cross-over design , 10 sedentary lean male subjects ( mean+/-S.D. , age : 24+/-5 years , BMI : 21.8+/-2.1 kg/m2 ) performed a glycogen depletion exercise test followed by a 3-day high-fat diet ( F/CHO/P , 60/25/15 % energy ; 100 % of energy expenditure ( EE ) ) and a 7-day high-CHO diet ( F/CHO/P , < 5/>85/10 % energy ; 130 - 175 % of EE ; overfeeding ) . During overfeeding , they ingested 3 x 500 mg/day HCA or placebo ( PLA ) . Each intervention ended with a 60-h stay in the respiration chamber ( days 9 and 10 ) . Body weight increased during overfeeding ( mean+/-S.E. , HCA : 2.9+/-0.2 kg , PLA : 2.8+/-0.2 kg ) . Respiratory quotient ( RQ ) was > 1.00 in all subjects indicating that DNL was present . On day 9 , 24-h EE was lower with HCA compared to PLA ( P < 0.05 ) . On day 10 , resting metabolic rate and RQ during night were lower ( P < 0.01 and P < 0.05 , respectively ) . Non-protein RQ , fat balance and net fat synthesis as DNL tended to be lower ( P < 0.1 ) with HCA compared to PLA indicating lower DNL ; activity-induced EE was higher with HCA ( P < 0.05 ) indicating the urge to eliminate the excess of energy ingested . We conclude that an experimental condition result ing in DNL in humans was created and that treatment with HCA during overfeeding with carbohydrates may reduce DNL Background : A combination of tyrosine , capsaicin , catechines and caffeine may stimulate the sympathetic nervous system and promote satiety , lipolysis and thermogenesis . In addition , dietary calcium may increase fecal fat excretion . Objective : To investigate the acute and subchronic effect of a supplement containing the above mentioned agents or placebo taken t.i.d on thermogenesis , body fat loss and fecal fat excretion . Design : In total , 80 overweight – obese subjects ( ( body mass index ) 31.2±2.5 kg/m2 , mean±s.d . ) underwent an initial 4-week hypocaloric diet ( 3.4 MJ/day ) . Those who lost>4 % body weight were instructed to consume a hypocaloric diet ( −1.3 MJ/day ) and were r and omized to receive either placebo ( n=23 ) or bioactive supplement ( n=57 ) in a double-blind , 8-week intervention . The thermogenic effect of the compound was tested at the first and last day of intervention , and blood pressure , heart rate , body weight and composition were assessed . Results : Weight loss during the induction phase was 6.8±1.9 kg . At the first exposure the thermogenic effect of the bioactive supplement exceeded that of placebo by 87.3 kJ/4 h ( 95%CI : 50.9;123.7 , P=0.005 ) and after 8 weeks this effect was sustained ( 85.5 kJ/4 h ( 47.6;123.4 ) , P=0.03 ) . Body fat mass decreased more in the supplement group by 0.9 kg ( 0.5 ; 1.3 ) compared with placebo ( P<0.05 ) . The bioactive supplement had no effect on fecal fat excretion , blood pressure or heart rate . Conclusion : The bioactive supplement  increased 4-h thermogenesis by 90 kJ more than placebo , and the effect was maintained after 8 weeks and accompanied by a slight reduction in fat mass . These bioactive components may support weight maintenance after a hypocaloric diet CONTEXT Lifestyle changes to lose weight can be difficult ; hence , both prescription and nonprescription diet products are appealing . Usage patterns of the nonprescription products phenylpropanolamine ( PPA ) and ephedra are of particular interest because of recent safety concerns . OBJECTIVE To estimate the prevalence of overall and specific  nonprescription weight loss product  use by demographic characteristics , prescription diet pill use , diabetic status , and lifestyle choices . DESIGN AND SETTING The Behavioral Risk Factor Surveillance System , a r and om-digit telephone survey conducted in 1998 in 5 states : Florida , Iowa , Michigan , West Virginia , and Wisconsin . PARTICIPANTS Population -based sample of 14 679 noninstitutionalized adults 18 years or older . MAIN OUTCOME MEASURES Prevalence of nonprescription weight loss product use in 1996 - 1998 . RESULTS Seven percent reported overall  nonprescription weight loss product use , 2 % reported PPA use , and 1 % reported ephedra product use . Overall use was especially common among young obese women ( 28.4 % ) . Moreover , 7.9 % of normal-weight women reported use . There was no difference in  nonprescription weight loss product use by daily consumption of fruits and vegetables ; however , more users than nonusers reported being physically active ( for those who exercised > /=30 minutes 5 times per week , odds ratio , 1.5 ; 95 % confidence interval , 1.2 - 2.0 ) . Among prescription weight loss product users , 33.8 % also took nonprescription product .  CONCLUSIONS With increasing rates of obesity ,  nonprescription product  use is likely to increase . Clinicians should know about their patients ' use of both prescription and nonprescription weight loss products
target: There was no significant difference between the groups in the studies regarding L-carnitina and flaxseed .
  There is a lack of evidence regarding quality studies justifying the use of alternative products for weight loss
background: OBJECTIVE The high dem and for obesity treatment and conventional therapies ' lack of effectiveness increases the use of alternative products .
  This study was aim ed at assessing evidence from r and omised clinical trials regarding the effectiveness of alternative weight-loss products ' ingredients .