Obesity

Maria Teresa Guagnano et al. (2021) · Nutrients

This pilot randomised trial with 40 women who have long-standing rheumatoid arthritis (RA) explored whether cutting meat, gluten and lactose from the diet changes pain, quality of life and inflammation. RA is a chronic autoimmune condition in which the immune system attacks the joints, and diet is thought to influence it partly through gut bacteria. Meat, dairy and gluten have been suspected of worsening symptoms, so the researchers compared an exclusion diet, which they call a privative diet, with a balanced diet that kept those foods. At a rheumatology clinic in Chieti, Italy, women aged 31 to 72 on stable RA drugs, all overweight or obese, were randomly assigned to a meat-, gluten- and dairy-free diet with fish as the main animal protein, or to a balanced diet including poultry and dairy. Both diets provided about 1,500 kcal a day to lose weight. After 3 months, 28 completed the study. Pain was rated on a 100 mm visual scale, disease activity with the DAS 28, quality of life with the SF-36 and the Health Assessment Questionnaire, and blood tests tracked inflammation. On the exclusion diet, median pain dropped from 50 to 40 (p = 0.003) and the SF-36 health score rose from 42 to 59 (p < 0.001), whereas the balanced diet showed no significant change. Blood pressure fell (systolic p = 0.003, diastolic p = 0.025), and white cells, neutrophils and the inflammation marker hs-CRP decreased only on this diet. Both diets lowered weight, waist size, fat mass and leptin, but neither changed the DAS 28 joint-activity score or the cytokines measured. Nine people left because the diets were hard to keep and three because of bloating or nausea; none left because of a flare. The authors describe the study as a pilot and caution that the small sample, high dropout, all-female overweight group and lack of a mid-study check limit what can be concluded. They suggest the exclusion diet may carry benefits beyond weight loss alone, and call for larger studies.

Hadis Hooshmandi et al. (2024) · Journal of ovarian research

This 8-week randomized, double-blind, placebo-controlled trial with 66 women explored whether licorice (Glycyrrhiza glabra) root extract could ease some of the metabolic burden of polycystic ovary syndrome (PCOS), a hormonal condition marked by irregular ovulation, elevated androgen levels, and polycystic ovaries on ultrasound. PCOS frequently occurs alongside obesity and insulin resistance, the body's reduced response to insulin, which raises blood sugar and makes weight loss harder to achieve. The trial paired licorice extract with a calorie-restricted diet to test whether the herb added benefit beyond diet alone. Seventy-two overweight or obese women with PCOS, ages 18 to 45, at a clinic in Yazd, Iran, were randomly assigned to 1,500 mg of standardized licorice extract daily, taken as three capsules before meals, or a matching placebo, both alongside the same reduced-calorie diet, for 8 weeks. Sixty-six women completed the study. Body composition was measured with a bioelectrical impedance analyzer, and blood tests tracked fasting glucose, insulin, and cholesterol levels before and after treatment. Women taking licorice lost more weight than those on diet alone (82.60 kg versus 86.09 kg, a statistically significant difference at p<0.001) and showed larger drops in body mass index and body fat percentage. Their fasting blood sugar (74.0 versus 94.0 mg/dl), insulin (6.68 versus 11.06 µIU/ml), and an insulin-resistance score called HOMA-IR (1.23 versus 2.55) all improved significantly more than in the placebo group (p<0.001), as did triglycerides and total and LDL cholesterol (all lower with licorice) and HDL cholesterol (higher, the more favorable direction) (p between <0.001 and 0.01). A separate measure of insulin-producing capacity, HOMA-B, improved within the licorice group and looked better than placebo before statistical adjustment, but that edge disappeared once the analysis accounted for baseline differences and other factors, a reminder that not every raw difference holds up under closer scrutiny. Diet and activity levels were identical between the two groups throughout the study, and the low-calorie diet alone produced no measurable change in any of these markers over the 8 weeks. The authors propose that licorice's compounds act on fat metabolism, insulin signaling, and cholesterol handling through several biological pathways, though those pathways were not directly measured in this trial. The study ran for only 8 weeks, did not test licorice without the accompanying diet, and relied on 24-hour dietary recall, a self-reported method that can be imprecise. Longer trials isolating licorice's own effect and testing its proposed mechanisms, in more diverse populations than this single-center Iranian cohort, are needed to confirm these results.

Yan-Kun Chen et al. (2023) · Frontiers in endocrinology

This literature review asks two connected questions: what actually drives obesity and type 2 diabetes at a biological level, and whether Traditional Chinese Medicine has anything to offer in managing them. The two conditions are closely linked — the review notes that type 2 diabetes accounts for roughly 90% of all diabetes cases and is strongly tied to excess weight. There is a practical bind behind the question, too: several standard diabetes drugs, including insulin and sulfonylureas, make weight loss harder rather than easier. The authors searched PubMed, Scopus and Web of Science for work published between 2019 and 2023, covering molecular, cellular and clinical studies of how obesity, diabetes and TCM interact. It is important to be clear about what kind of review this is: a narrative overview rather than a systematic one. There is no count of included trials, no pooled statistics and no formal assessment of study quality, so it maps a field rather than measuring an effect. On mechanism, the review draws a useful distinction between visceral fat — stored around the liver, pancreas and kidneys, hormonally active, and the type that drives insulin resistance — and subcutaneous fat sitting under the skin. This is why apple-shaped fat distribution carries more metabolic risk than pear-shaped. The scale of the problem is stark: the World Health Organization counted 1.9 billion overweight adults in 2016, 650 million of them with obesity, and 38.2 million children under five overweight or obese in 2019. The TCM proposal is that acupuncture, herbal remedies and dietary therapy act on inflammation, oxidative stress, insulin resistance and the balance of gut bacteria. What this review does not provide is evidence of how well any of that works. No effect sizes, no confidence intervals, no trial results for any specific TCM intervention appear. The authors themselves conclude only that TCM may be promising and that well-designed studies are still needed to confirm both efficacy and safety. Read it as a map of plausible mechanisms and an argument for research, not as grounds for choosing a treatment.