By Kerry Bone, BSc (hons.), Dip. Phyto

Metabolic syndrome, or metabolic syndrome X, is now a recognized medical condition. The clinical features of this disorder typically include abdominal obesity and visceral fat, fatty liver, elevated hepatic transaminases (liver enzymes), dyslipidemia and, eventually, hypertension.

In the United States, the incidence of metabolic syndrome has reached epidemic proportions, with somewhere between 30 percent to 40 percent of adults said to suffer from this condition.^3,4 Insulin resistance is probably the most significant underlying event in metabolic syndrome. This, in turn, is thought to be closely linked to abdominal obesity and visceral fat.^5,6 Hence, any treatment capable of addressing this fundamental issue of excess body fat will be a useful tool in the management of metabolic syndrome, together with other treatments and appropriate dietary and lifestyle modification.

Recent research on the ayurvedic herb Coleus forskohlii suggests it could be such an agent. Controlled clinical trials with a standardized extract of Coleus have shown that it particularly seems to address the issue of excess body fat, as well as cause modest reductions in total body weight.

The exact mechanisms behind the reduction in body fat caused by Coleus are not known. However, it is widely recognized that forskolin from Coleus activates the production of cyclic AMP (cAMP). There are many physiological and biochemical effects of raised intracellular cAMP, which include inhibition of platelet activation, increased force of contraction of heart muscle, relaxation of smooth muscle, increased insulin secretion, increased ACTH release by the pituitary, increased thyroid function and increased lipolysis in adipocytes (fat cells). Many of the actions of the sympathetic nervous system are ultimately mediated by cAMP.

Despite this evidence, the value of Coleus is not fully appreciated. This contrasts with the cactus Hoodia gordonii from southern Africa, which has received significant publicity as a weight-loss herb. Is Hoodia a significant development in our fight for weight loss, or is it more hype than hope? In my view, the jury is still out; it could prove to be a very useful herb. Although it is not as well-known as Hoodia in terms of general use, and especially for metabolic syndrome, Coleus stacks up well against it for a number of practical reasons. Let me explain.

Hoodia is an endangered species and hence in a fragile state, ecologically. To legally export Hoodia, you need the appropriate documentation that proves it has been legally harvested from the wild or otherwise cultivated. Recently, thousands of Hoodia shipments ordered from the United States by Canadians were stopped at the border by officials. To protect the scarce stands of Hoodia, Environment Canada is requesting that consumers ensure the product has a valid environmental permit. The permit status of products sold in the United States can be uncertain. Contrast this with Coleus, which is cultivated and readily available.

The research on Hoodia has focused on a patented appetite-suppressing component (phytochemical) known as P57. When a variety of Hoodia products were tested from the U.S. market, the majority was found to contain either no P57, or very low levels. In fact, five different batches of the one product were all found to be missing this important active compound.⁷ How could this be? The authors of the study suggested that other species of cactus, especially Opuntia (prickly pear), were being substituted for Hoodia. In contrast, provided the Coleus has a declared amount of forskolin (which is its important active component) on the label, you can be assured of its quality and authenticity.

But the most compelling aspect for the use of Coleus as a supplement for metabolic syndrome is the clinical evidence. No controlled clinical trials on Hoodia have ever been published. In contrast, there have been three randomized controlled clinical trials that support the value of Coleus, especially for reducing body fat (the most important health aspect of weight loss).

In the United States, a randomized, double-blind, 12-week trial observed that although there was no difference in food intake, overweight female volunteers taking Coleus extract (50 mg/day of forskolin) experienced weight loss (average 1.5 lbs), while the placebo group actually gained weight (an average of 2.2 lbs).⁸

A trial of similar design, conducted in India with obese men and women, found that at the end of the trial, the difference in body weight between the groups was significant. Coleus-treated patients lost an average of 4 percent of total body weight (3.8 lbs), compared to a gain of 0.3 percent (0.55 lbs) in the placebo group. The effect on body fat and lean body mass was also statistically significant. The loss of body fat in the Coleus-treated group was replaced with lean body mass, while those on placebo gained body fat and experienced a decrease in lean body mass.⁸

Finally, in a double-blind clinical trial conducted in the United States, 30 overweight/obese male volunteers were randomized to receive Coleus extract (containing 50 mg/day of forskolin) or a placebo for a period of 12 weeks. Administration of Coleus resulted in a significant decrease in fat mass and body fat. The reduction in fat mass from baseline to after treatment with Coleus was an incredible 9.9 lbs.⁹

This is truly good evidence and shows that the best aspect of Coleus is the loss of body fat, which means loss of inches. This is exactly what is needed to correct the main health problems associated with being overweight, namely insulin resistance and metabolic syndrome. Make sure that the Coleus product contains the extract used in the clinical trials (ForsLean) and delivers a dose of at least 50 milligrams of forskolin per day.

References

1. Scheen AJ, Luyckx FH. Rev Med Liege, 2003;58(7-8):479-84.
2. Grundy SM, Cleeman JI, Daniels SR, et al. Circulation, 2005;112(17):2735-52.
3. Cheung BM, Ong KL, Man YB, et al. J Clin Hypertens (Greenwich), 2006;8(8):562-70.
4. Ford ES. Diabetes Care, 2005;28(11): 2745-9.
5. Despres JP, Lemieux I. Nature, 2006; 444(7121):881-7.
6. Chan JC, Tong PC, Critchley JA. Semin Vasc Med, 2002;2(1):45-57.
7. Avula B, Wang Y-H, Pawar RS. J AOAC Int, 2006;89(3):606-11.
8. Sabinsa Corporation. ForsLean® Product Information. Available from www.forslean.com. Accessed May 2007.
9. Godard MP, Johnson BA, Richmond SR. Obes Res, 2005;13(8):1335-43.