Patrick Holford has sent his latest email on weight-loss to our faithful reader, Precious Ramotswe. Mma Ramotswe has written to Holford Watch to ask for our advice.
Dear Holford Watch,
I am a traditionally-built lady, as you know. Most of the time, this is of great advantage to me (e.g., snakes know where I am and I can cast shade for small children), but I am subject to much advice on the topic of weight-loss. Patrick Holford has sent me an email about his eating programme. I have looked through it but there is no mention of cake which makes me a little sad. However, it may be possible to put something together from oats and fruit, although that may make me sadder as it does not resemble cake.
As part of his GL Diet Patrick Holford recommends that I should take some pills. Here in Botswana, we grow and sell the best-quality food, not like some other countries. Do you think that I need to take these pills
4. Supplement your efforts – there are all sorts of diet pills out there which are for the large part totally ineffectual and which may in some instances actually cause harm. There are three supplements that I do recommend however, which are well-researched and safe, as well as being extremely helpful for anyone following a low GL diet:
First, try supplementing 5-Hydroxytryptophan (5-HTP) to ensure your brain has adequate serotonin (the feel good factor) to control appetite and carbohydrate cravings, so you have less desire to eat in excess. The brain converts 5-HTP into serotonin to top up your levels.
Second, take a chromium supplement to keep your blood sugar level stable and insulin release even. This mineral works with insulin to help balance your blood sugar levels. Look for a supplement which contains chromium in the polynicotinate form.
Third, Garcinia cambogia (the tamarind fruit) has been shown to help weight loss as the body continues to burn calories as fuel rather than storing them as fat.
I thought that it might be difficult to locate such things in Botswana but Patrick Holford has kindly put them into a convenient pill to meet my needs.
I look forward to your comments – Precious Ramotswe (Private Detective)
We are delighted to hear from you, Mma Ramotswe. Holford Watch can not give any advice on weight loss (as you know) but we can comment on some of the research behind the recommended supplements and maybe that will assist you in your decisions. As a private detective, you are very used to gathering the evidence and then weighing it before acting, so we hope that this will be helpful.
In general, there are very few, high-quality long-term studies that show any particular diet programme is more successful than others in losing body fat and then sustaining weight-loss, Mma. Recently, researchers published a paper that looked at the long-term effects of both a high-GL and low-GL diet to promote weight loss. The researchers say that the outcome at the end of 6 months was equivalent and neither diet was better than the other. It did not seem to matter whether you ate foods with a high glycaemic load or a low one.
Now for the supplements.
5-HTP is sometimes promoted as a ‘natural anti-depressant’. You seem to be a naturally happy lady, Mma, especially since you married Mr J.L.B. Matekoni and whenever you eat cake, so this might be treating you for a serotonin deficiency that you don’t have. I have looked for evidence as to why it might be useful in weight-loss but couldn’t find any on Entrez Pubmed. Although I did find people who intended to study whether or not a combination of 5-HTP with chromium and other substances would aid weight-loss but they do not seem to have reported the results of that study. Some older papers suggest that this substance might be helpful but there have not been long-term, high-quality investigations of the sort that you might expect.
We have already written about the fact that a review of the clinical evidence does not support the use of chromium to modify glucose metabolism in people without diabetes. You are not diabetic are you, Mma?
As for HCA, the tamarind fruit extract, there are several reviews that do not find that this is helpful for weight loss, Mma. Prof. Ernst and a colleague looked at a number of dietary supplements for body-weight reduction. They concluded that:
[o]verall, the evidence for G. cambogia is not compelling.
Another team of doctors looked at the evidence for HCA and other common dietary supplements. They report that there are very few trials (I would add that none of them is long-term, Mma) and:
[a]lthough HCA appears to be well tolerated, the evidence for efficacy currently is contradictory.
Dr Saper (the lead doctor for the last paper, Mma) was interviewed for the New York Times for an article, Weight-Loss Drugs: Hoopla and Hype. He said: “Over-the-counter dietary supplements to treat obesity appeal to many patients who desire a magic bullet for weight loss”. He was sad to report that there is no such magic bullet.
Patrick Holford wrote, there are:
all sorts of diet pills out there which are for the large part totally ineffectual…There are three supplements that I do recommend however, which are well-researched…
All of these doctors and researchers would agree that most diet pills are “totally ineffectual” and from what they have written they seem to indicate that this would include the supplements like the ones that Patrick Holford recommends.
That is the evidence that we could find, Mma. As you say, Mma, there is good quality food in Botswana and you are careful to provide healthy food for yourself and your household. As Michael Pollan recently said, the best diet advice seems to be “Eat food. Not too much. Mostly plants“.
If we might express our own opinion, it does not seem as if it would be worth selling any cattle to fund the purchase of these supplements but we are sure that you will make up your own mind on this matter. Whatever you decide, we wish you well and hope to hear from you again.