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Millions of Americans regularly use herbal supplements, but many are unaware of the potential hidden dangers. Numerous supplements have been associated with hepatotoxicity and, indeed dietary/herbal supplements represent an increasingly common source of acute liver injury. We report a case of acute liver failure requiring liver transplantation associated with the use of Garcinia cambogia, a supplement widely promoted for weight loss. When patients present with acute hepatitis or liver failure from an unknown etiology, a careful history of supplement use should be performed.

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A nutraceutical product composed of a combination of Garcinia cambogia, l-carnitine and a seaweed extract of Ascophyllum nodosum has been recently developed. The aim of the present study was to characterize its effects on subjective satiety sensations and food preferences in healthy volunteers. In a crossover design, 28 subjects (21 females and 7 males, aged 31 ± 5, BMI 22.6 ± 1.7) were randomly assigned to receive the active treatment (LIS) or placebo (PL) over one week. At the end of each treatment period, subjects were instructed to consume ad libitum a test meal. Food preferences and appetite sensations were evaluated by means of the Leeds Food Preferences Questionnaire and visual analog scales, before and after meal, over three hours. There were no differences in energy intake between study groups. LIS was associated with a reduction in subjective hunger sensations (p = 0.018) and to an increase in satiety (p = 0.02) and fullness (p = 0.01) ratings. The preference for high fat foods was reduced after consuming the test meal in both study groups. There was a significant effect of LIS treatment on food explicit liking and implicit wanting, as evidenced by an increase in preference for sweet foods (relative to savory foods; p = 0.03 and p = 0.004, respectively), but no differences were observed regarding the preference for low or high fat foods (NS). These results provide proof of principle for the satiating properties of a nutraceutical containing Garcinia cambogia, Ascophyllum nodosum extract and l-carnitine and suggest that it might be useful as an appetite modulator.

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Garcinia cambogia seems to promote weight reduction and improvement on lipid profile by its major compound, hydroxycitric acid (HCA), blocking ATP-citratelyase, potentially inhibiting lipogenesis. Furthermore, it is suggested that its extract is able to change the adipokine levels. Thus, the aim of this study was to analyse the effect of G. cambogia on the lipid profile, endocrine, calorimetric and anthropometric parameters of obese women. The women (BMI > 25 kg/m(2) ; age 25-60 years), divided in treated (n = 30) and control (n = 13) groups, received 2.4 g (800 mg 3×/day) of garcinia extract (50% of HCA) or placebo during 60 days, respectively, as well as dietary control. Weight, BMI, waist-hip ratio and percentage of fat mass, resting metabolic rate, respiratory coefficient, triglycerides (TG), total cholesterol, HDL and LDL, leptin and insulin serum levels were evaluated. TG was significantly reduced in the treated group (p = 0.0002) and the post-treatment variation was different compared to the placebo group (p = 0.04). No significant response was observed on other variables of the lipid profile, or on the anthropometric and calorimetric parameters. Leptin and insulin levels did not change significantly after the treatment. The short-term treatment with G. cambogia demonstrated a hypotriglyceridemic effect, which does not appear to be related to changes in leptinemia.

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Objetivo - Avaliar se polimorfismos nos genes CETP (proteína transferidora de ésteres de colesterol) e APOE (apolipoproteína E) influenciam no peso e na resposta do perfil lipídico ao tratamento com G. cambogia. Métodos - Trinta e três pacientes com sobrepeso ou obesidade receberam diariamente uma dose de 2,4g de extrato padronizado de G. cambogia (52,4% de ácido-hidroxicítrico). Antes do início do tratamento e após oito semanas, dados antropométricos e perfil lipídico foram obtidos. Resultados - Após o período de tratamento, não foi possível perceber diferenças na resposta sobre o perfil lipídico entre portadores e não portadores do alelo APOE*2, ou do alelo APOE*4. Uma diferença modesta, porém não significante, foi encontrada na comparação entre portadores e não portadores do alelo B2 (gene CETP) para os níveis de colesterol HDL (p=0,086) e triglicerídeos (p= 0,098). Em relação ao peso, não foram detectadas diferenças na resposta ao tratamento entre os genótipos. Conclusão - Os resultados sugerem que a variante no gene CETP pode estar envolvida na modulação dos níveis de HDL-c após o tratamento com G. cambogia. Entretanto, uma investigação em uma amostra maior será necessária para confirmar esses resultados.

Objective - To investigate the influence of polymorphisms of the CETP (cholesterol ester transfer protein) and APOE (apolipoprotein E) genes on weight changes and lipid levels during the treatment with G. cambogia. Methods - Thirty three patients with overweight or obesity received a daily dose of 2.4 grams of a standardized extract of G. cambogia (52.4% hydroxycitric acid). Before the start of treatment and after eight weeks, lipid profile and anthropometric data were obtained. Results - After the treatment, there were no significant differences in the response of serum lipids between carriers and noncarriers of the allele APOE*2 and APOE*4. A slight difference, but not significant, was observed in the comparison between carriers and noncarriers of allele B2 (CETP gene) for HDL cholesterol levels (p=0,086) and triglycerides levels (p= 0,098). There were no significant differences in the weight after treatment according to genotypes. Conclusion - The results suggest that the variant in the CETP gene may be associated with levels of HDL-c after treatment with G. cambogia. However, an investigation in a larger sample is needed to confirm these results.

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Inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis are chronic enteropathies that probably result from a dysregulated mucosal immune response. These pathologies are characterized by oxidative and nitrosative stress, leukocyte infiltration and up-regulation of pro-inflammatory substances. Current IBD treatment presents limitations in both efficacy and safety that stimulated the search for new active compounds. Garcinia cambogia extract has attracted interest due to its pharmacological properties, including gastroprotective effects. In this study, the antiinflammatory activity of a garcinia extract was assessed in TNBS-induced colitis rats. The results obtained revealed that garcinia administration to colitic rats significantly improved the macroscopic damage and caused substantial reductions in increases in MPO activity, COX-2 and iNOS expression. In addition, garcinia extract treatment was able to reduce PGE(2) and IL-1beta colonic levels. These antiinflammatory actions could be related to a reduction in DNA damage in isolated colonocytes, observed with the comet assay. Finally, garcinia extract caused neither mortality nor toxicity signals after oral administration. As such, the antiinflammatory effects provided by the Garcinia cambogia extract result in an improvement of several parameters analysed in experimental colitis and could provide a source for the search for new antiinflammatory compounds useful in IBD treatment.

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Hydroxycitric acid (HCA), the main compound of Garcinia cambogia extract, is a competitive blocker of ATP-citrate-lyase, presenting a potential inhibition of fatty acid biosynthesis. Glucomannan fibers, abundant in Amorphophallus konjac, seem to reduce the absorption kinetics of dietary fat. Therefore, the aim of this double-blind randomized study was to evaluate the pharmacotherapeutic efficacy of standardized extracts of G. cambogia (52.4% HCA) plus A. konjac (94.9% glucomannan) in the treatment of obesity. Fifty-eight obese subjects (BMI 30.0-39.9 kg/m(2)) were assigned to the placebo group (n = 26) or the treatment group (n = 32); no dietary restrictions were applied. Over a 12-week period, subjects were given daily doses of either Garcinia (2.4 g) plus Konjac (1.5 g) or placebo prior to their main meals (3 times/day). Before the start of treatment, and every 4 weeks thereafter, the following were recorded: height, weight, circumferences and body composition, resting energy expenditure (REE), lipid profile and glucose levels. The treatment had no significant effect on anthropometric parameters, REE, triglycerides or glucose levels. However, a significant reduction was observed in total cholesterol (-32.0 +/- 35.1 mg/dL) and LDL-c levels (-28.7 +/- 32.7 mg/dL) in the treated group, the final levels being significantly lower than those of the placebo group (p = 0.008 and p = 0.020, respectively). The results obtained suggest that the treatment had a significant hypocholesterolemic effect, without influencing the anthropometric or calorimetric parameters tested.

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