On November 9, the 2011 Weight Management Virtual Conference and Expo took place online. Speakers from around the globe, from both academia and industry, presented an informative overview of some the trends and challenges in the world of weight management. Here we highlight a few of the issues discussed.

The first speaker was Tom Vierhile, Director of Datamonitor’s Product Launch Analytics, who presented a broad array of interesting and thought-provoking data on the weight management market. For example, in a 2011 survey that asked US consumers about their 3 top health concerns, weight came in second (32%), behind only cardiovascular disease (46%), but ahead of all other categories, including cancer, aging, diabetes, and mental health (ranging from 15-22%). Over half of all Americans are trying to lose weight, and another 22% are trying to maintain weight. The main strategy people use to do this is by trying to eat smaller amounts of food (69%) or different types of food (63%). Only 22% of consumers mention diet foods or low-calorie sweeteners as strategies they are pursuing to lose weight, and an even smaller percentage (19%) try to count calories. As is well-known, however, these efforts are not paying off – Americans remain as overweight as ever, and obesity rates continue to rise (also, almost 8% of the US population has Type 2 diabetes).

While the provocative question of who should be responsible for nutritious eating resulted in most consumers (82%) identifying themselves as the key party, almost half (48%) also said that food manufacturers play an important role – a 6% increase over the response to the same question in 2010. Companies can therefore expect to see increasing pressure, both from consumers as well as from regulators, to provide healthier food choices to consumers. However, only 22% of consumers trusted commercial players in the weight loss industry – a result that should not come as a surprise, given the predominance of unfounded health claims associated with weight loss products or ingredients that ultimately do not survive closer scrutiny.

Innovative products

Looking towards the future, Vierhile identified two important factors affecting new product development trends – namely, that portion control trumps dieting, and that declining consumer interest in counting calories will spur development of new products aiming for satiety and appetite control instead. Examples of innovations in the area incude:

• WH2Ole functional water in New Zealand – water fortified with 5g protein and 1.5 fibre per 500ml serving, designed to "bridge the hunger gap" between meals;

• Simply Fuller Longer Salad from Marks & Spencer in the UK – part of an extensive line of high-protein meals for better control of hunger;

• Slimming Muesli from My Muesli in Germany – containg Plantago ovata as a source of dietary fibre (from psyllium seed husks;

• Stay Full soup from Baxters in the UK – containing high protein vegetables, meats, and pulses, with independent consumer testing indicating that respondents felt fuller for an additional 3 hours compared to standard soups;

• Glucerna Hunger Smart from Abbott Nutrition in the US – snack bars and shakes containing Carb Steady, slowly digestible carbohydrates that minimize glucose peaks and valleys.

Vierhile also highlighted several ingredients are receiving increased attention for their potential to contribute to weight management, including oats, L-carnitine, CLA (conjugated linoloeic acid), viscous fibres (including pectins, guar gum, and beta-glucans), whey protein, and konjac powder. The latter is derived from Amorphophallus konjac, a plant in tropical eastern Asia, and is used as a vegan substitute for gelatin. Konjac flour or jelly is low-calorie and high-fibre, containing high levels of the polysaccharide glucomannan. Glucomannan is a soluble, fermentable, and highly viscous dietary fibre that has been shown in some clinical studies to be associated with moderate weight loss. There is increasing evidence that this fibre exerts its beneficial effects by promoting satiety, and also some evidence that glucomannan improves lipid and lipoprotein parameters and glycemic status. Nevertheless, the FDA does currently not allow functional claims to be made for glucomannan, so further data will be needed to build a more convincing case for this ingredient.

Botanicals

Mark Blumenthal, founder & executive director of the American Botanical Council, outlined the role of botanicals in weight management, highlighting the hoodia controversy and the lessons that can be drawn from that experience. Hoodia gordonii, a succulent plant used traditionally by the San people of southern Africa to suppress hunger pangs during multi-day hunting expeditions with little or no food, has been shown in some animal studies to decrease food intake and body weight. Human data, on the other hand, has been much less convincing.

The most recent study was published by scientists with Unilever Research & Development in the November 2011 issue of the American Journal of Clinical Nutrition, and involved healthy, overweight women consuming a purified extract of H. gordonii repeatedly over 15 days (2 servings/day of 1g hoodia extract or placebo in a yogurt drink 1 hour before breakfast and dinner). Not only did this treatment reveal a lack of efficacy (as measured by the lack of significant effects on ad libitum energy intakes or body weights compared to placebo) but a number of unpleasant side effects as well (nausea, emesis, and disturbances of skin sensation, in addition significant adverse changes in some vital signs and laboratory parameters including blood pressure, pulse, heart rate, bilirubin, and alkaline phosphatase levels). These results clearly played into Unilever’s decision in 2008 to terminate their collaboration with Phytopharm for the commercial development of hoodia as an appetite suppressant.

In drawing lessons from the hoodia experience, Blumenthal emphasized three problems that led to its demise: (1) the lack of published human clinical trials to support safety and efficacy, (2) the extensive marketing and media hype that greatly exceeded existing scientific support for claims, both then and now, and (3) probable widespread adulteration (e.g. using Opuntia, or prickly pear cactus) that also may have contributed to the relative lack of effective results for consumers, leading to a significant lack of confidence in this herb category.

Needed: more research

Looking towards the future, Blumenthal highlighted several plant-derived products and ingredients that are currently being investigated as to their potential effects on weight management. One of these stood out – green coffee extract, which in two recent trials using overweight patients resulted in decreases in body weight, BMI, and fat mass, suggesting that green coffee extract can enhance the beneficial effects of a low-calorie diet in overweight individuals. Nevertheless, in a recent review, in an advance online edition of Gastroenterology Research & Practice, researchers from the Peninsula Medical School of the University of Exeter reported their findings from a meta-analysis of several previously published trials, concluding that while the evidence indeed suggests at least a moderate effect on weight loss, "more rigorous trials are needed to assess the usefulness of [green coffee extract] as a weight loss tool."

While promising, the situation of green coffee extract is typical of ingredients and/or products for weight management or weight loss: more research is needed for making a convincing case – both for consumers as well as for regulators. Manufacturers should heed the lessons of hoodia (too much hype, too early, not enough convincing data), but as the size of the market continues to grow, companies who develop a product that actually works will of course be rewarded all the more.