The prevalence of extreme overweight and obesity has caused concerns of scientific community in the South East Asian population, due unhealthy diet and life style change over 2 decades of economic prosperity. Overweight and obesity have reached epidemic proportions in many Asian countries, affecting even younger age than in Western populations with economic burden in the development of Obesity-related disorders such as diabetes, hypertension, and cardiovascular diseases(1). One of six Malaysian are either extreme overweight or obese, according to Datin Paduka Santha Kumari, chairman of the Selangor branch of the Malaysian Diabetes Association and according to global health observatory, at least 2.8 million people die each year as a result of being overweight or obese, and an estimated 35.8 million (2.3%) of global DALYs are caused by overweight or obesity, worldwide(2).
Epidemiological studies, linking herbal medicine, foods and vitamins in preventing and treating these diseases have been inconclusive(a)
Some researchers insisted that using herbs and supplements to induce weight loss should be taken with care, as a considerable number of reports have been published on hepatotoxicity associated with herbal products attributed with weight-reducing properties(4)(5)(6)(7). The College of Medicine, The Ohio State University insisted that various dietary, lifestyle, and psychologic factors are involved in the etiology of Prameha, particularly in relation to disturbances in fat and carbohydrate metabolism(8), without effective management, obtaining a workable weight loss plan may be extremely difficult.
Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin, found in fresh fruits, berries and green vegetables. It is best known for its free radical scavengers activity and regenerating oxidized vitamin E for immune support.
Vitamin C deficiency and incidence of obesity
Vitamin C and other nutrient deficiency not only is associated to the risk of Obesity(15) but also enhances the risk of lipids, inflammation and insulin resistance(16).
According to the research team at Universidad Autónoma de Querétaro, there is an associated link between Obesity and Zinc and vitamins A and C concentration in in women from rural Mexico, in a fasting blood sample analysis (11).
Although genetic susceptibility to obesity is associated with gene polymorphisms affecting biochemical pathways which also impacted by specific foods and nutrients. According to Dr. Johnston CS., vitamin C depletion is associated to positively related to body mass, individuals with adequate vitamin C status oxidize 30% more fat during a moderate exercise bout than individuals with low vitamin C status(10)
Vitamin C, the protective effect against obesity
Endothelial dysfunction has found to be associated to the incidence of obesity(12). The study of 76 healthy subjects (50 men and 26 women aged 21-45 years) obese subject, showed a positive effect of vitamin C and indomethacin in reduced oxidative stress contributed to endothelial dysfunction in human obesity(13).
In the evaluation of the potential inhibitory activity on α-glucosidase and pancreatic lipase by Citrus spp. fruits of Spanish origin, grapefruit, contained higher contents of phytochemicals such as vitamin C, is found to have a great value for nutrition and treatment of diet-related diseases(14).
L-Ascorbic acid in the study, whether would facilitate the anti-obesity effects of chitosan and psyllium husk in vivo, showed addition of vitamin C in diet influenced the reduction in body weight gain and food efficiency ratio, and the increase in total fecal weight and fecal fat excretion in guinea pigs fed a high-fat diet(16).
Taken altogether, deficiency of vitamin C and other nutrient is associated to increased risk obese incidence. Vitamin C may be effective in induced weight loss for obese subjects due tom its positive interaction in inhibiting oxidative stress causes of endothelial dysfunction. Daily ingestion of high-dose vitamin C may be considered safe, but in rare incidence, overdoses in a prolonged period of time, may cause intra-renal oxalate crystal deposition, a fatal nephrotoxicity(18)(19).
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(1) Rising Burden of Obesity in Asia by Ambady Ramachandran and Chamukuttan Snehalatha(Journey of Obesity)
(2) Obesity – Situation and trends(WHO)
(3) Influence of a combination of herbs on appetite suppression and weight loss in rats by Talpur NA1, Echard BW, Manohar V, Preuss HG.(PubMed)
(4) [Hepatotoxicity induced by herbs and medicines used to induce weight loss].[Article in Spanish]by Herrera S1, Bruguera M.(PubMed)
(5) A case report of adult lead toxicity following use of Ayurvedic herbal medication by Breeher L1, Gerr F, Fuortes L.(PubMed)
(6) [Chronic lead intoxication associated with Ayurvedic medication].[Article in Dutch] by Kanen BL1, Perenboom RM.(PubMed)
(7) Potential toxicity of caffeine when used as a dietary supplement for weight loss by Pendleton M1, Brown S, Thomas C, Odle B.(PubMed)
(8) Multinutrient supplement containing ephedra and caffeine causes weight loss and improves metabolic risk factors in obese women: a randomized controlled trial by Hackman RM1, Havel PJ, Schwartz HJ, Rutledge JC, Watnik MR, Noceti EM, Stohs SJ, Stern JS, Keen CL.(PubMed)
(9) Associations between body mass index and the prevalence of low micronutrient levels among US adults by Kimmons JE1, Blanck HM, Tohill BC, Zhang J, Khan LK.(PubMed)
(10) Strategies for healthy weight loss: from vitamin C to the glycemic response by Johnston CS.(PubMed)
(11) Zinc, vitamin A, and vitamin C status are associated with leptin concentrations and obesity in Mexican women: results from a cross-sectional study by García OP1, Ronquillo D, Caamaño Mdel C, Camacho M, Long KZ, Rosado JL.(PubMed)
(12) Mechanisms of endothelial dysfunction in obesity(Science direct)
(13) Obesity and body fat distribution induce endothelial dysfunction by oxidative stress: protective effect of vitamin C. by Perticone F1, Ceravolo R, Candigliota M, Ventura G, Iacopino S, Sinopoli F, Mattioli PL.(PubMed)
(14) Phytochemistry and biological activity of Spanish Citrus fruits by Gironés-Vilaplana A1, Moreno DA, García-Viguera C.(PubMed)
(15) High-fat feeding increases hepatic vitamin C synthesis and its circulatory mobilization in mice by Tranberg B1, Hansen AK, Lykkesfeldt J.(PubMed)
(16) Zinc, iron and vitamins A, C and e are associated with obesity, inflammation, lipid profile and insulin resistance in mexican school-aged children by García OP1, Ronquillo D, del Carmen Caamaño M, Martínez G, Camacho M, López V, Rosado JL.(PubMed)
(17) Anti-obesity effects of chitosan and psyllium husk with L-ascorbic acid in guinea pigs by Jun SC1, Jung EY, Hong YH, Park Y, Kang Dh, Chang UJ, Suh HJ.(PubMed)
(18) Fatal vitamin C-associated acute renal failure by McHugh GJ, Graber ML, Freebairn RC.(PubMed)
(19) Ascorbic acid overdosing: a risk factor for calcium oxalate nephrolithiasis by Urivetzky M, Kessaris D, Smith AD.(PubMed)