At least 38 million male Baby Boomers are currently facing andropause, often called “male menopause.” Although not all men experience difficulties at this stage in life, andropause is potentially associated with a host of vague and not-so-vague signs and symptoms, including decreased muscle strength, diminished energy, and lagging physical function. As if those problems weren’t enough, men of a certain age also experience reduced sexual performance, slower cognitive functioning, and depression.

“Just as women experience different psychological and physical changes as they go through hormonal changes, men do as well,” says David Foreman, RPh, ND, a retired pharmacist and naturopathic physician. “In most cases, men tend to ignore it or blame it on something else.”

Conventional treatment for troubling andropause symptoms is almost always some form of testosterone. Foreman isn’t so keen on this approach. “The body is supposed to go through this decline in hormones. To me, it’s malpractice to focus on maintaining the testosterone levels of an 18-year-old in a person who’s 65. I don’t believe the body was designed for that.”

Foreman says it’s also a big mistake for manufacturers of finished products to focus just on enhancing sexual performance and testosterone levels. “Men also produce estrogen and progesterone, as well as metabolites of sex hormones,” he explains. Additionally, cortisol, a hormone that is increased in stress also tends to increase during aging, while DHEA, the precursor for testosterone, usually decreases, he says.

Rather than aim at increasing testosterone, Foreman recommends ingredients that help manage the individual symptoms of andropause.

One of Foreman’s favorite supplements for maintaining energy levels and cognitive function in aging men is pyrroloquinoline quinone, or PQQ. “PQQ helps the body increase the numbers of mitochondria and protects them from being damaged,” Foreman says. “It increases energy without giving you a buzz.”

Although the function of PQQ in human physiology remains controversial, PQQ appears to stimulate mitochondrial biogenesis and, by this mechanism, may have possible health benefits such as improved energy utilization, at least in animal studies. Mice and rats fed diets deficient in PQQ have reduced mitochondrial content, grow poorly, fail to reproduce, and have functional deficits in connective tissue, studies show.

 Conversely, rats supplemented with PQQ demonstrate improved memory when subjected to oxidative stress compared to nonsupplemented rats or rats supplemented with COQ10.

Other animal studies suggest PQQ can help mitigate the effects of severe stroke, protect the brain against neurotoxins, and possibly protect against Parkinsonism and Alzheimer’s disease.

 Still, a rat is a rat and not a person, so until clinical trials in humans are undertaken, there’s no way to know the effects of PQQ in people and how useful it can be in enhancing health in andropause.

Bruce Abedon, director of scientific affairs at NutraGenesis LLC (Brattleboro, VT), agrees that the focus of andropause treatment shouldn’t be just sexual enhancement. To that purpose, his company developed ZTEN, a proprietary formulation composed of two multipatented ingredients-extracts of the herbs ashwagandha (

), sold under the trade name Sensoril, and 

“Sensoril has adaptogenic properties-meaning it helps bring about balance in the body, provides resistance to various stressors, and helps balance hormone levels,” he explains. Abedon says that Sensoril has been studied in eight randomized, double-blind, placebo-controlled clinical trials, which have found significant improvements in stress, concentration, memory, sleep quality, and energy. Moreover, Sensoril has been shown to reduce cortisol and improve DHEA levels. Significant improvements have also been seen in cardiovascular health in men, Abedon says.

 extract was included in the ZTEN formulation for its weight management and metabolic wellness properties, which have been proven in two clinical trials so far, Abedon says. “As men get older, they often gain weight around the abdomen, which increases the risk for cardiovascular disease, so reduction in waist size is particularly important for older people,” he says. “Also, they tend to have increased issues with blood sugar management. The 

extract helps support this area as well.”

Sexual-Enhancement Supplements: Hype or Help?

So, then, what about those sexual-enhancement supplements? Do they have a role in andropause?

“In all honesty, I am not a big fan of sexual-enhancement herbs like tongkat ali and horny goatweed,” Foreman says. “The issue of erectile dysfunction is not normally testosterone-related. If you talk to experts in that area, they will tell you that it is more related to the cardiovascular system, or between the ears, meaning there is some anxiety or stressor that keeps the man from performing. Rarely does it link back to hormone levels.”

Mark Blumenthal, executive director of the American Botanical Council (Austin, TX), is also not impressed with supplements claiming to increase sexual performance and testosterone levels. Take, for instance, horny goat weed (

). “I think the name pulls the demand for horny goat weed more than the science supports it,” Blumenthal says. Maca powder, frequently marketed for its effects on sexual performance and sex hormones, is another herb with equivocal science behind the claims, he says. If testosterone is indeed low, “most of the men that I know, frankly, are using some type of testosterone application. It’s very challenging to identify herbs that actually have proven, reliable ability to increase testosterone,” he says.

Not everyone in the industry agrees with that conclusion. Annie Eng, CEO at HP Ingredients (Bradenton, FL), says that tongkat ali, the root of the Malaysian plant 

 has been used for centuries by the aboriginal people of Southeast Asia for vitality, energy, antiaging, and, yes, sexual enhancement. HP Ingredients manufactures LJ100, a standardized extract of tongkat ali that is patented for the treatment of sexual dysfunction and male fertility. LJ100 contains 28% eurypeptides, which have been shown to have androgenic properties and are believed to be the active ingredient of tongkat ali.

Eng has the scientific data to back up her claims. “We have published 12 human clinical trials on LJ100 and have four human clinical trials that are ongoing.” Some of the studies were conducted in the United States in collaboration with the Massachusetts Institute of Technology, but most have been conducted in Malaysia. 

studies have shown that LJ100 inhibits sex hormone binding globulin (SHBG), a protein that binds testosterone and other sex steroids, making them inactive in the body, Eng says.

“LJ100 works by inhibiting SHBG, thereby releasing bound testosterone and increasing free testosterone naturally,” Eng explains.

LJ100 also catalyzes the conversion of cholesterol to pregnenolone, which then is converted to DHEA and other sex steroids. Human clinical studies have shown that LJ100 can reduce body fat, lower cortisol, increase testosterone, and improve sexual performance and satisfaction, according to Eng.

Jennifer Gu, director of R&D at AIDP Inc. (City of Industry, CA), whose company manufactures the tongkat ali extract LongJaX, also agrees that tongkat ali has a place for enhancing men’s health in andropause and has some effects on hormone levels. But, she notes, traditionally tongkat ali was used as an energy tonic, not just for sexual enhancement. “While certain individual peptides may be responsible for the effect on testosterone levels, there are probably multiple components in tongkat ali that are effective, and it’s possible they have a synergistic effect,” she says.

Another ingredient Gu says supports the aging process in men (and also in women) is cordyceps, a fungus that grows on the larvae of insects. 

are used extensively in traditional Chinese medicine, where they are considered a mild adaptogen and enhance not only hormone function but also lung function.

“There are tissue culture studies that show it can stimulate testosterone production in male cells and female hormones in female cells. It has some aphrodisiac properties, but it is not as specific as 

for this application,” Gu says. Cordyceps also demonstrates a wide range of other activities that have been demonstrated primarily in animal and tissue culture studies, including immune-enhancing properties, anticancer properties, antihyperglycemic effects, kidney protection, and energy enhancement.

) has testosterone-like properties, says Gencor Pacific’s (Irvine, CA) president Jith Veeravalli, which may be useful in andropause. Gencor Pacific manufactures the fenugreek extract Testofen. “Fenugreek contains over 100 phytochemical constituents, including furostanol saponins and steroidal saponins,” says Veeravalli, which possibly work by displacing SHBG-bound testosterone. As with LJ100, this makes testosterone more available in the body without actually raising testosterone levels.

Two recent human studies offer some evidence for these claims. A randomized, double-blind, placebo-controlled study was conducted on 60 healthy men and resulted in statistically significant improvements in overall male sexual health.

 An eight-week, placebo-controlled, human clinical study showed an increase in free testosterone levels, plus an increase in muscle mass and a decrease in body fat.

 “We are continuing to do research on Testofen in the area of sexual health and expect to present further information on its benefits by next year,” Veeravalli says.

Emphasis on sexual-performance enhancers tends to overshadow the importance of minerals in men’s reproductive health. Zinc, in particular, has been linked to male fertility.

Max Motyka, director of the human products division at Albion Minerals (Clearfield, UT), recommends Albion’s proprietary zinc arginate chelate as the best zinc chelate to include in men’s formulas because it offers a sort of a two-for-one benefit. “Both zinc and arginine play important roles in the prostate in the generation of seminal fluid,” says Motyka, “and they are also involved in the stimulation of testosterone synthesis.”

Boron also plays a role in the balance between testosterone and estrogen in the male, Motyka says, and some data suggest that inadequate selenium intake may be linked to prostate cancer. A recent systematic review showed that higher concentrations of selenium in the body were associated with a 70% reduction in prostate cancer risk; however, studies have not found that supplementation with selenium reduces risk.

As men age, maintaining muscle mass can become an uphill battle. “One of the manifestations of andropause is you’re working out just like before, but all of a sudden you can’t maintain weight and you have muscle wasting,” Foreman says.

Albion Minerals markets a proprietary, patented creatine and magnesium chelate product, Creatine MagnaPower, which has been shown to have a positive effect on intracellular protein synthesis. Although creatine products are most often used for building muscle mass, Motyka says findings in studies show that creatine/magnesium supplements may also be useful in enhancing cognitive function. One study randomized 32 elderly adults to receive either placebo or 5 g of creatine four times per day. After one week of creatine supplementation, participants scored significantly better on cognition tests than the placebo group.

Considering the sheer number of men in the United States entering middle age, you’d think the men’s health supplements industry would be racing to keep up with the latest research on new ingredients and formulations for andropause. Not so, said most of the leaders interviewed for this article. “I think research in this area is pretty slow,” says Gu, “because FDA regulation is very sensitive to anything that claims to influence hormone levels. We have some good products that we think will help people, but we worry that if we invest in extensive research, one day the FDA will say they don’t want anything that will change hormone levels.”

Foreman says that another contributor to the comparatively slow market is that women’s health always gets a higher percentage of research dollars than men’s health, mainly because women tend to buy more supplements than men.

Abedon concurs. “There’s much more interest in menopause ingredients because andropause is kind of a hidden secret-men don’t want to admit their bodies are changing.” 

Sidebar: Ingredients for a Healthy Prostate

Although not really a symptom of andropause per se, benign prostatic hyperplasia (BPH) is high on the list of issues affecting older men. And the urinary symptoms of frequency and hesitancy-not to mention not being able to get a good night’s sleep-have a major impact on men’s well being. Conventional medical intervention often falls short of producing satisfactory results.

 A host of different phytotherapies are marketed for BPH, including saw palmetto, 

 pumpkin seed, rye pollen, quercetin, and nettle root.

Mark Blumenthal of the American Botanical Council says that saw palmetto remains the unequivocal leader in this category. “There have been a couple of recently published meta-analyses that actually found equivocal support for efficacy [of saw palmetto],” Blumenthal comments, but “based on clinical research and my own experience, I am a strong believer in the use of saw palmetto extract for BPH.” Saw palmetto is believed to have anti-androgenic effects and inhibit 5-alpha reductase, and to have anti-inflammatory effects.

Blumenthal recommends a combination of saw palmetto and nettle root (not the flowering portion) to reduce the frequency of nocturia in men with BPH. This combination is manufactured in Europe by Schwabe Germany (Karlsruhe, Germany) and sold under the brand name Prostagutt Forte. In the United States, Nature’s Way (Lehi, UT) markets it as Prostol.

has anti-inflammatory and phytoestrogenic effects in BPH. A meta-analysis of 18 trials on 

 for the treatment of BPH showed moderate improvement in nocturia, flow rate, and other symptoms.

Blumenthal says that despite clinical research to support its use in BPH, sustainability issues have caused many companies to move away from pygeum. “It’s problematic, because if you gird the tree, you kill it,” he explains.

Rye pollen extract, marketed as Cernilton by Graminex LLC (Saginaw, MI), has been well researched as a therapy for BPH. A Cochrane Review meta-analysis found it to be well tolerated and to modestly improve urinary symptoms in BPH.

 Foreman is a fan of Cernilton not only for BPH but for prostatitis and bladder inflammation that occurs without bacterial infection. “Cernilton has phenomenal anti-inflammatory properties and is an antispasmodic,” he says.

Pumpkin seed is a traditional remedy for bladder ailments, and some research supports this use. A large, 2010 German study-which was conducted by GlaxoSmithKline, interestingly-found that men with BPH who took pumpkin seed extract GranuFink Prosta Forte (Deutsche Chefaro Pharma GmbH; Dusseldorf, Germany) had significant improvements in lower urinary tract symptoms and also improved their quality of life.

 Although not as widely researched as saw palmetto, “there’s a good basis for its use,” Blumenthal says. “I recommend it because it’s a food, so safety is well established, and the literature is highly suggestive that it’s effective.”

1. Killgore Jet al., “Nutritional importance of pyrroloquinoline quinone,” 

2. Ohwada Ket al., “Pyrroloquinoline quinone (PQQ) prevents cognitive deficit caused by oxidative stress in rats,” 

Journal of Clinical Biochemistry and Nutrition

3. Rucker Ret al., “Potential physiological importance of pyrroloquinoline quinone,” 

www.hpingredients.com/index.php?page=LJ100

4. Steels, E et al., “Physiological aspects of male libido enhanced by standardized 

5. Wankhede et al., “Effect of Testofen on safety, anabolic activity and factors affecting exercise physiology,” in press.

6. Hurst Ret al., “Selenium and prostate cancer: systematic review and meta-analysis.” 

7. McMorris Tet al., “Creatine supplementation and cognitive performance in elderly individuals,” 

Aging, Neuropsychology, and Cognition: A Journal on Normal and Dysfunctional Development,

8. Nickel JC et al., “Nutraceuticals in prostate disease: the urologist’s role,” 

9. Ishani A, et al., “Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis,” 

10. Wilt Tet al., “Cernilton for benign prostatic hyperplasia,” 

11. Harkenthal M et al., “Large scale multi-centre randomized placebo controlled clinical study proves the efficacy of pumpkin seed in symptomatic benign prostatic hyperplasia (BPH) – G.R.A.N.U. study,” 

Articles

Keeping aging men healthy takes more than just addressing testosterone. Why supplements are a more holistic approach.

Beyond Testosterone: Men’s Health and Dietary Supplements

Bakers like wheat for its useful gluten proteins, but just the right amount of steeping results in 

 wheat. These slightly germinated wheat grains can be milled into sprouted wheat flour, creating flour that is as functional as it is newly appealing to consumers.

What changes occur when wheat is sprouted? Some suppliers say that, depending on the sprouting method, sprouted wheat may be darker in hue than traditional, non-sprouted wheat-a difference that may or may not be detected in the final milled flour. Several other changes occur, and they should help all manufacturers.

As far as published studies are concerned, sprouted wheat grains show nutritional superiority over non-sprouted wheat grains. Sprouted wheat is associated with higher levels of vitamins (especially B vitamins) and minerals. More recent studies suggest higher levels of phenolic compounds and antioxidant activity in both sprouted wheat grains and flour. As enzymes activate the growth of nutrients during the sprouting phase, non-fibrous carbs are also lost, making room for higher portions of fiber and protein.

The nutritional content of sprouted wheat will likely vary from one supplier to another, as results can depend on factors such as time and temperature sprouted, and even the quality of the starting seed material.

Thanks to the wonders of science, sprouting can even improve the taste of wheat flour.

Gang Guo, wheat research and quality manager at Horizon Milling (Wichita, KS), explains that the endosperm portion of the grain undergoes significant change during sprouting. Enzymes will convert some of the endosperm starch into simple sugars, and this results in an increase in sweetness. Bitter tannins from the grain are also removed because of steeping and the biological changes that occur during sprouting.

These pleasant taste changes were detected in a Horizon Milling consumer taste test on bread made with sprouted or non-sprouted wheat flour, and they have been reported elsewhere within industry.

Shoppers should enjoy the improved nutrition and taste of sprouted wheat flour, but bakers can benefit, too. Sprouted wheat flour offers several functional benefits over non-sprouted flour, and some of them relate to that increase in sugars.

When sugars are more readily available, yeast can start digesting them quicker, says Colleen Zammer, director of product marketing for Bay State Milling Company (Quincy, MA). Quicker digestion means quicker production of CO

. The results can include quicker proof times for bread and potentially greater loaf volume, as higher retention of CO

In bake lab experiments conducted by Horizon Milling, proof times decreased by 10% and bread loaf volumes increased 10%–20% when sprouted whole wheat flour was used to bake whole wheat bread. In those same experiments, sprouted whole wheat flour actually improved flour stability compared to non-sprouted flour. Flour stability-which can be measured using a sophisticated tool called a farinograph-is an indication of how much time flour can withstand mixers before the flour softens. In Horizon Milling’s tests, flour stability increased from 6.7 minutes to 11.7 minutes thanks to sprouting.

The latest findings on sprouted wheat flour should be comforting to manufacturers who already use wheat, because times have been tough for this grain. With gluten sensitivity and potential overconsumption of wheat at the top of many shoppers’ minds, sprouting can give wheat products a whole new healthy image and an easier time in the factory.

But keep your eyes open, because wheat isn’t the only grain being sprouted.

Baking With Sprouted Wheat Flour

Of all the neologisms that shape and mirror our age-locavore, crowdsource, 

-none may resonate more profoundly, or regrettably, than 

. It’s a term that pediatric endocrinologist and researcher Francine R. Kaufman, MD, applied to the conflation of type 2 diabetes and obesity. Alas, the word all too aptly describes the collection of ills that characterize both epidemics: excess abdominal fat, high blood sugar, generalized inflammation, etc.

These truly are epidemics. The American Diabetes Association says that close to 10% of the U.S. population is diabetic, a diagnosis given to those with fasting blood glucose levels topping 126 mg/dL in at least two tests. The toll on our economy associated with diagnosed cases, to say nothing of undiagnosed cases, amounts to fully $245 billion annually.

Meanwhile, nearly 35% of adult Americans meet the Centers for Disease Control and Prevention’s definition of 

-an adult with a body mass index of 30 or above-with repercussions ranging from conditions like heart disease, stroke, and some forms of cancer to-not coincidentally-type 2 diabetes.

The hybrid nature of diabesity underscores a fundamental link between the two conditions it describes-a link that not only reflects similarities in their causes, but suggests novel interventions for mitigating them. The more we learn about the relationship between the disordered glucose metabolism at the heart of diabetes and the weight gain that leads to obesity, the more it appears that supplements designed to control the former may help control the latter, as well.

Of course, researchers and clinicians have long known that obesity, overweight, and physical inactivity are risk factors for type 2 diabetes, which accounts for almost 95% of the nation’s cases, including in children, as more young people edge over into overweight territory. These associations notwithstanding, it’s worth noting that not all overweight or obese people are diabetic-nor are all diabetics, type 2 or otherwise, overweight or obese. But about 80% of type 2 diabetics 

 overweight or obese, which raises the question: What is it about excess weight and diabetes that bind the two in a sort of chicken-and-egg interdependence?

Researchers are still sorting out all the puzzle pieces, but we have some ideas as to where and how they fit. To bring that picture into better resolution, it helps to understand a bit about energy, its metabolism, and the hormones that make energy.

A healthy body harvests the energy it needs from the foods and drinks it eats. More specifically, the body breaks down fats, proteins, carbohydrates, and even alcohol to the simple sugar glucose, which is an easily convertible “energy currency” for the cells. The body does this with the help of the hormone insulin, which the pancreas continually secretes but really starts pumping out once glucose levels in the blood rise, such as after a meal or snack.

Because simple sugars and starches break down easily into glucose-that is, they have a high glycemic index-the more sugary or starchy the meal or snack, the more rapidly glucose floods the bloodstream in a state known as postprandial hyperglycemia. When we’re in that state, says Mitch Skop, senior director, new product development, Pharmachem Laboratories Inc. (Kearny, NJ), “the pancreas releases more insulin to escort glucose into the cells” where the glucose supplies immediate energy or goes into storage as fat in the liver. Given glucose’s ability to trigger this response, those of us fond of sweetened beverages and an abundance of starchy and sugary foods run the risk of drowning our cells in glucose-

insulin-every time we eat. And, sure enough, cells that have bathed too long in insulin soon grow desensitized to the hormone’s signals.

This desensitization more properly goes by the name 

. It means that much of that glucose in the blood winds up stuck outside the cells’ doors “with essentially nowhere else to go,” Skop says. This deprives the cells of valuable energy while causing a host of other problems down the line. “So it stands to reason,” he continues, “that a poor diet high in starch and sugar calories will, over time, cause insulin resistance, which itself may lead to diabetes.”

So, to recap: Excess sugar in the blood leads to insulin resistance, which leads to diabetes. And excess dietary energy (calories)-these days, that often means sugar-leads to overweight and obesity. Overweight and obesity themselves promote diabetes by making it harder for cells to pay attention to insulin’s glucose-management cues. And now we’re learning that simply having diabetes can make it harder for diabetics to manage their weight, as the insulin they take to treat the disease allows more glucose to enter the cells where-absent sufficient energy demand-it’s stored as fat.

This complicated relationship doesn’t surprise Mohammad Rafi, president of Bioactive American Corp. (Highland Park, NJ), who points out that “healthy blood sugar can help maintain normal body weight in healthy adults, and diabetic patients will often lose or gain weight based upon the antidiabetic drugs they’re taking.”

Further, he notes that both diabetes and obesity share an oxidative and inflammatory component in the sense that high blood sugar can promote inflammation. “There is a direct correlation to inflammation and issues that cause weight gain, such as blood sugar,” he says. In the words of a recent study in 

, all these elements are part of an “overlapping pathophysiology” that underlies both excess weight and poor glucose control.

Granted, there’s nothing inevitable about being overweight or diabetic, as both conditions are largely preventable-even reversible-through sensible diet and exercise. Pharmaceuticals have also stepped in to combat the diseases’ progression, but we’ve already seen the unintended consequence insulin has on weight gain. Diabetes medications may present other drawbacks, as well, including their cost: the American Diabetes Association estimates that 18% of diabetes’ $245 billion price tag goes toward prescriptions to treat its complications.  As for pharmaceutical attempts at addressing obesity, they have an even poorer track record, with the safety-driven withdrawals of fenfluramine/phentermine (better known as fen-phen), sibutramine, and others still fresh in mind.

Does this open a door for supplementary interventions? Rafi thinks it may. “The supplement industry needs to be proactive, advocating for healthy lifestyles that include a good diet, exercise, and stress reduction,” he says. But also “there is data that certain ingredients can prevent excess absorption of carbohydrates from foods to curb obesity, diabetes, and other chronic disorders.”

Indeed, Skop says, “Action has been taken for quite some time in the research and formulation of products for healthy blood sugar support”-products that could also encourage healthy weight loss. And though blood sugar management would be a new weight-control angle for the industry, it may be one whose time has come.

“Thermogenic fat burners, satiety enhancers, and metabolism boosters have all worked to a certain extent in weight loss or weight management and have been accepted by consumers,” says Xiaoming “Sandy” Chien, PhD, vice president, innovative products, HORN Nutraceuticals (La Mirada, CA). Blood sugar management may be “a less direct approach,” she says, but “it addresses the bottom line of weight management: excess glucose being stored as fat.”

Among the ingredients recognized for managing blood sugar are the South Asian botanical 

, banaba leaf extract (popular in the Philippines), bitter melon extract, cinnamon extract, and others. “Many of these products, such as the cinnamon extracts currently on the market, work with the beta cells in the pancreas to increase insulin production, and therefore help clear out blood glucose,” Chien says. “Some of the products can also increase insulin sensitivity, which helps cells take up blood glucose.”

Some of the ingredients attracting the most attention, both for their blood glucose and weight management potential, fall within the category of starch or carb blockers. Historically made from proteinaceous extracts of the white bean, 

, they suppress the enzymes that break down starches and other polysaccharides into the simpler sugars that cells use for energy or store as fat.

More specifically, they target the enzymes alpha-amylase, which turns starches into oligosaccharides, and alpha-glucosidase, which breaks oligosaccharides further into monosaccharides like glucose. The theory is that by inhibiting the enzymatic release of these simple sugars, starch blockers make it harder to transform calories into pounds.

“Technically,” Chien says, “products that block starches actually delay their digestion and absorption, which allows the body fully to process the resulting glucose in a more sustained way, leaving little excess to be stored as fat.” Even better, she adds, starch blockers “will have some effect on postprandial glycemia, depending on how efficacious they are.” In fact, Skop says, “a wonderful side effect” of blocking carbohydrate absorption is that it puts “less stress on the pancreas, insulin, and blood sugar systems.”

In the 1990s, Skop’s company, Pharmachem, developed the first standardized starch blocker extracted from the white kidney bean-Phase 2 Carb Controller (known as StarchLite in the functional foods market). He says studies show significantly more “weight, fat, and inches lost” following Phase 2 intake.

reported that after 12 weeks of taking the extract, subjects lost 7 lb more on average-including significantly more body fat and waist circumference-than those taking a placebo. After 24 weeks, almost three-quarters of subjects in the weight-management phase of the trial had maintained their body weight.

While white beans provide the starting material for many starch blockers, it’s not the only source. According to Rafi, 

“is a safe, nontoxic herbal extract that has been used for thousands of years in ayurvedic medicine for the oral treatment of diabetes by helping naturally regulate blood sugar and insulin.” His company produces a branded 

extract, Salsulin, that inhibits alpha-glucosidase, preventing the enzyme’s hydrolysis of starch into glucose.

Rafi points to human clinical studies that indicate 

 is a safe and effective blood sugar regulator. In one randomized, double-blind crossover study

, 61 patients with type 2 diabetes consumed one of three high-carbohydrate meals: a standard control meal, the control meal plus 240 mg 

. Serum glucose and insulin samples taken at baseline and up to three hours postprandially showed that both doses of 

 extract significantly lowered the postprandial positive area under the glucose curve-a measure that indicates reduced postprandial glycemia-Rafi says. Plus, he adds, both doses of 

 extract lowered “the adjusted peak glucose response compared to the control meal, with the higher dose performing even better.”

Chien points to her company’s patented extract of 

, or Ceylon cinnamon. A product of HORN’s partnership with French-based biotechnology company Dialpha, the cinnamon extract, branded MealShape, inhibits alpha-amylase when taken 20 to 30 minutes before a starchy meal to delay the digestion and absorption of carbohydrates. This “reduces the post-meal glucose spike to allow for a slower and more controlled rise in blood sugar,” she says. “Body fat storage is also reduced as the rate of glucose entering the body drops.” Chien cites a 2013 randomized, crossover, double-blind, placebo-controlled clinical trial, still in peer review, involving 18 healthy subjects. The study validated the extract’s ability to lower blood sugar by more than 20% after a standard meal. “Plasma glucose and insulin levels were checked at regular intervals, demonstrating reduced postrandial glycemia via area-under-the-curve calculations,” she says. “This innovative approach to postprandial glycemia reduction offers potential global health benefits for diabetes, cardiovascular health, and weight management.”

But inhibition of digestive enzymes-the bailiwick of classic starch blockers-isn’t the only game in town. Skop notes that another product in the Pharmachem arsenal combines the starch blocker L-arabinose (a simple sugar extracted from corn that inhibits the digestive enzyme sucrase) and chromium picolinate ingredient Chromax.

Chromium has long been known to aid insulin regulation and improve blood sugar balance, and many glucose-management supplements-including the Pharmachem one Skop speaks of, called Prenulin-include it. A 2011 study published in 

, found that, compared to a placebo, the Pharmachem product significantly lowered both circulating glucose and insulin levels following consumption of a 70-g sucrose challenge.

Chromium polynicotinate appears in InterHealth Nutraceuticals’ (Benicia, CA) product ChromeMate, which, company CEO Paul Dijkstra, says “has been shown to support healthy weight in clinical studies.” The supplement works, he explains, “by supporting balanced blood sugar levels, increasing fat loss, and maintaining lean body mass.”

And combining ChromeMate with InterHealth’s 

 extract Super CitriMax-a patented double salt bound to calcium and potassium for enhanced bioavailability-appears to have “a greater effect on weight loss than just Super CitriMax” or the chromium supplement alone, Dijkstra says, citing several published studies, including one published in 2004 in 

help with carbohydrate metabolism? As Melony Fuller, director of marketing for National Enzyme Co. (NEC; Forsyth, MO), explains, “One of the most notable active ingredients in 

is hydroxycitric acid (HCA). HCA competitively inhibits the enzyme ATP citrate lyase by competing with citrate. This slows the conversion of sugars to fatty acids, and fewer fatty acids results in less excess energy being stored as fat in adipose tissue.” NEC’s H3XG weight-management ingredient includes 400 mg of HCA from 

The company also offers its Enzymolic CarbBlocker Support, whose primary active ingredient is the enzyme transglucosidase. Unlike an enzyme like alpha-amylase that promotes conversion of starch to simple sugars, transglucosidase “converts easy-to-digest starches, such as white rice or white potatoes, to complex polysaccharides that are actually more difficult to digest,” Fuller says.

Using enzymes for healthy starch metabolism is a relatively new interest area, “within the last decade,” she adds. “Until transglucosidase came along, most enzymes actually sped up the transition from starch to sugar during digestion.”

Products that can both aid weight loss and even out blood sugar pose an opportunity for what Skop calls “twofer solutions.” Namely, he suggests, “Formulate a healthy weight-loss product and a healthy blood sugar–management product and shrink-wrap them with a well-written booklet explaining why the conditions are so intimately intertwined.”

He may not be far off the mark. Metabolic disorders are much in the news these days, as is the fact that obesity is straining the fabric of our nation’s healthcare system. Now may be the best time to capture consumers’ attention with products that can move them to a better place metabolically.

Education, Dijkstra says, is key. “It’s important to educate consumers so they recognize that even if they don’t have any form of diabetes, it’s still critical to manage blood sugar levels to help interfere with metabolic pathways that may lead to excess body weight or cardiovascular problems,” he says. “Being physically active, making healthy food choices, and reaching and maintaining a healthy weight can help decrease insulin resistance and maintain a healthy blood sugar level.”

“As consumers become more informed on how the body uses glucose and its effect on weight management, increased focus on how to aid in this process will make its way into mainstream channels, elevating awareness,” says NEC’s Fuller.

Scheen AJ. “Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes.” 

. Published online ahead of print February 19, 2014.

Grube B et al. “Weight reduction and maintenance with IQP-PV-101: a 12-week randomized controlled study with a 24-week open label period.” 

Williams JA et al. “Extract of Salacia oblonga lowers acute glycemia in patients with type 2 diabetes.” 

The American Journal of Clinical Nutrition

Kaats GR et al. “A combination of l-arabinose and chromium lowers circulating glucose and insulin levels after an acute oral sucrose challenge.” 

Preuss HG et al. “Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss,” 

Controlling blood sugar is a newer tactic for weight management.

New Tactic for Weight Management: Blood Sugar Control

), also known as hedgehog mushroom, has been used for centuries in traditional Chinese medicine and as a food in Asia. In China, it is known as hou tou gu, and in Japan as yamabushitake. The mushroom has a distinctive appearance, with what appears to be a large mass of long tendrils similar to a shaggy lion’s mane. (The entire length of each tendril is attached to the mushroom’s body.) Other names for this mushroom may refer to its similar shape or appearance to a pom pom or a monkey’s head.

Lion’s mane mushroom is white in color when fresh, but turns a rusty brown or creamy color when dried. In culinary use, it’s sometimes compared to lobster or crab in taste and texture, with a mild sweetness.

 The mushroom is commercially grown on oak logs, miller’s bran, beech sawdust, and soybean substrates.

In traditional medicine, lion’s mane mushroom is used for promoting digestive health, including improving stomach and liver function, liver protection, and helping with peptic and duodenal ulcers and chronic gastric inflammation. It is also used for alleviating mental apathy (neurasthenia) and as a restorative health tonic.

In modern clinical use, lion’s mane mushroom is known as a dietary supplement based on positive human clinical studies for brain health, memory, and mood.

 Lion’s mane mushroom has been shown to increase neurotrophic activities by stimulating nerve or brain cell growth, which could possibly be responsible for the mushroom’s purported brain-strengthening and antidepressant effects.

The body’s nerve growth factor (NGF) system produces proteins that help to maintain the central nervous system’s cholinergic system in the forebrain. The forebrain is where most decision-making, memory, and higher thinking take place. Research shows that the forebrain size decreases in cases of Alzheimer’s disease. The bioactives in lion’s mane mushroom known as hericenones (aromatic molecules) and erinacines (diterpene compounds) can spur production of NGF in nerve cells, thus helping to maintain the cholinergic system and forebrain function.

 study found that lion’s mane extract at a concentration of only 0.0001%, when added to NGF in brain cell cultures, stimulated the production of more NGF and caused specialized nerve cells to increase their growth by 60%.6 This effect may pose potential for neurodegenerative diseases such as amyotrophic lateral sclerosis (Lou Gehrig’s disease), Parkinson’s disease, multiple sclerosis, and Alzheimer’s disease.

When the effects of lion’s mane and more than 20 other brain-improving culinary–medicinal mushrooms (including the 80 different bioactive secondary metabolites they contain) were tested on brain biochemical pathways, numerous protective and regenerative effects were found. These effects included reductions in beta-amyloid–induced neurotoxicity (the toxic protein implicated in Alzheimer’s disease–related dementia); acetylcholine neurotransmitter–protective effects; stimulation of neurite outgrowth; increased NGF synthesis; as well as neuroprotective, antioxidant, and anti-inflammatory effects.

Moreover, animals given lion’s mane extract that had nerve crush injury exhibited recovery of hind-limb function and normal toe-spreading. They also showed regeneration of axons (nerve fibers) and re-innervation of motor endplates/neuromuscular junction in extensor digitorum longus muscle (in the front of the leg) in the early stages of recovery.

 One of the pathways was modulating the MAP kinase (MAPK) enzyme.

While the cognitive benefits of lion’s mane mushroom have been better studied, newer animal studies and 

 studies hint that there could possibly be other potentially associated health benefits.

A cell wall polysaccharide produced by a special, submerged culture of lion’s mane mushroom was found in an animal study to lower cholesterol by 32%, LDL cholesterol by 45.4%, and triglycerides by 34.3%, and to raise the “good” HDL cholesterol by 31%.

 The researchers proposed that the mushroom’s constituents helped to lower cholesterol production via the hepatic HMG-CoA reductase pathway, reducing the amount of this enzyme by 20%.

Although an animal study examining the antibacterial effects of lion’s mane extract against 

 bacteria did not find a direct effect, researchers did find, in the two-part study’s cell culture portion, that lion’s mane extract indirectly reduced mortality by increasing host resistance to infection and increasing white blood cell uptake of bacteria.

 This immune-boosting effect happened by increasing the macrophage cells’ ability to engulf the bacteria for subsequent destruction, as shown by higher colony-forming unit (CFU) counts inside the macrophage cells. Within cell culture, bacterial counts increased after 4 and 8 hours of the initial infection, but when the cells were treated with lion’s mane extract, they exhibited greater activity against the bacteria compared to control. Researchers looked at parameters such as greater inducible nitric oxide synthase mRNA activity. Beta-glucan is one of the actives in the mushroom extract known to stimulate innate immune cells.

 and animal studies suggest that lion’s mane mushroom extract may have potent anti-cancer effects. These effects were found to be stronger against three gastrointestinal cancers compared to effects from a common chemotherapy drug, 5-FU (fluorouracil), when lion’s mane extract was used at its maximum tolerated dose (25–30 mg/kg/day). Liver, colorectal, and gastric cancers were tested as cell lines and implanted in tumor xenografts.

The study revealed 22 different phytocompounds found in the active cancer cell–killing lion’s mane extract, including cyclic dipeptides, indole alkaloids, pyrimidines, flavones, anthraquinones, amino acid derivatives, and phenolic compounds. In the 

 tumor xenograft studies, significant antitumor efficacy was shown, without toxicity to the host.

A rat study on the effects of lion’s mane water extract on alcohol-induced ulcers showed a significant reduction of the ulcer area, as well as protection against gastric mucosa injury by maintaining levels of antioxidant enzymes.

 study found that lion’s mane mushroom extract was active against nine clinical strains of 

, the bacteria implicated in the cause of 85% of ulcers. A mere 0.02% concentration was needed to cause 50% bactericidal activity.

In streptozotocin (STZ)-induced diabetic rats whose pancreases were damaged by a toxic agent, a water extract of lion’s mane given for several weeks caused a significant decrease in serum glucose level and a significant rise in serum insulin levels. The extract also reduced blood lipid abnormalities while increasing antioxidant enzymes in the liver.

An animal study used a topical application of a water extract of the mushroom at concentrations of 20, 30, and 40 mg/ml (between 2%-4% concentration). Control groups were topically applied with 0.2 ml of sterilized distilled water or the mushroom extract on a 2-cm-diameter neck wound. The lion’s mane groups had less scar tissue area at wound enclosure, and the healed wounds had fewer white blood cells (indicating less infection or pus formation) and greater levels of collagen. They also contained a greater density of new blood vessels.

Lion’s mane mushroom extract is an exciting new nutraceutical that may have many potential health benefits. Some of the health effects, such as memory enhancement and mood improvement, are demonstrated in human clinical studies, while numerous animal and test tube studies point to a wide range of other potential health benefits. Further studies based on a human clinical design are needed to ascertain more precisely efficacy and proper dosages.

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2. G Halpern, Healing Mushrooms: Effective Treatments for Today's Illnesses Square One Publishers, Jan 1, 2007, p. 155

3. R Rogers, The Fungal Pharmacy: The Complete Guide to Medicinal Mushrooms and Lichens, North Atlantic Books 2011, p. 212.

4. M Nagano et al., “Reduction of depression and anxiety by 4 weeks 

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5. K Mori et al., “Improving effects of the mushroom Yamabushitake (

) on mild cognitive impairment: a double-blind placebo-controlled clinical trial,” 

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6. PL Lai et al., “Neurotrophic properties of the lion's mane medicinal mushroom, 

 (Higher Basidiomycetes) from Malaysia." 

International Journal of Medicinal Mushrooms

7. CW Phan et al., “Therapeutic potential of culinary-medicinal mushrooms for the management of neurodegenerative diseases: diversity, metabolite, and mechanism.” 

ogy. Published online ahead of print Mar 24, 2014. 

8. KH Wong et al., “Neuroregenerative potential of lion's mane mushroom, 

 (Bull.: Fr.) Pers. (higher Basidiomycetes), in the treatment of peripheral nerve injury (review),” 

9. BK Yang et al., “Hypolipidemic effect of an Exo-biopolymer produced from a submerged mycelial culture of 

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11. G Li et al., “Anticancer potential of 

Lion's mane mushroom, also known as hedgehog mushroom, has been used for centuries in traditional Chinese medicine.

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