Caterina Maci and Marco Biagi
Department of Physical, Earth and Environmental Sciences of the University of Siena
The promotion of health and the fight against obesity are at the center of scientific debates and political actions as they are elements of great impact on people’s health and on the environment. While 821 million people were starving in 2017, 672 million were obese, according to the United Nations Food and Agriculture Organization (FAO) report . In the face of greater conditions of well-being in industrialized countries, where the availability of food is greater, in fact, there is a lack of physical activity linked to sedentary habits and an incorrect diet, characterized by the introduction of an excessive amount of refined sugars and scarce fiber. food.
The perception of overweight and obesity is often linked to the only aesthetic problem that this represents in the general collective imagination, conditioning the cultural perception of this condition and the marketing strategies related to it to promote food products and more. We can also affirm that a physical condition of this type also has a considerable influence on the psychic state of the person and on his mood, conditioning the relationship with others and with himself.
From a medical and scientific point of view in general, however, it is much more : on the one hand it negatively affects man’s life, predisposing him to chronic diseases and on the other hand it is linked to problems of food safety and the health of our entire planet.
What is Obesity?
Obesity is due, in most cases, to incorrect lifestyles and diets : physical inactivity associated with a high-calorie diet. The result is excessive accumulation of body fat . Excluding the conditions for which endocrinological causes are recognized, where the use of specific drugs must necessarily be adopted, in other cases the patient’s diet and lifestyle are taken almost exclusively, given that it is a reversible condition . .
Obesity represents one of the major public health problems globally since it is constantly increasing both in industrialized and richer countries, but also in poorer countries (availability of cheap “junk food”) and is a predisposing factor to the development of chronic diseases such as type 2 diabetes , cardiovascular disease and cancer.
The International Diabetes Federation has estimated that 382 million people were affected by type 2 diabetes in 2013 alone and the number of patients is expected to double in 2035. This increase is attributable to causes such as insulin resistance and dysfunction of pancreatic beta-type cells, responsible for hyperglycemia , ie the increased level of glucose in the blood. In fact, postprandial blood glucose levels play an important role in the development and evolution of complications of type 2 diabetes.
Childhood obesity, a rampant phenomenon
In Italy, home of the Mediterranean diet, two out of 10 children are overweight and one in 10 is obese . Childhood obesity is a phenomenon that is not only rampant but also persistent: about 50% of obese adolescents are likely to be obese even as an adult ( SIP, Italian Society of Pediatrics ).
What are the risks of childhood obesity?
Beyond the high prevalence and persistence of the phenomenon, the demonstration of the physical and psychosocial complications already present in obese children and which tend to worsen in adulthood arouses alarm. More and more children and adolescents suffer from pathologies resulting from obesity hitherto unknown in childhood, such as hypertension, dyslipidemia and type 2 diabetes.
- New data on obesity complications emerge from the recent SIP-SIEDP Consensus on Diagnosis, Treatment and Prevention of Child and Adolescent Obesity :
- one obese child out of 20 has high blood sugar, a condition defined as pre-diabetes, that is, an alteration in glucose metabolism which, however, can still regress;
- more than 30% of obese children have high triglycerides and cholesterol compared to normal values, a condition that exposes them to the risk of metabolic syndrome and the onset of arteriosclerosis;
- more than 30% of obese children have fat accumulated in the liver, a clear condition of initial liver damage which, however, can progress and worsen over time;
- more than 10% of obese children have blood pressure values above normal.
These risks can be countered with weight control, through healthy lifestyles and a balanced diet, but early intervention is very important!
The role of the pediatrician is of the utmost importance in the overall strategy to combat childhood obesity, especially from a preventive point of view.
What are the therapeutic strategies?
The condition in which one begins to manifest theinsulin resistance , not yet definable as diabetes, is the one in which blood sugar tends to stabilize at high values (when fasting blood glucose levels are above 110 mg / dl); this condition is the alarm bell that should be listened to much more because here it is still possible to intervene in order to be able to reverse this imbalance and it is possible to adopt measures capable of restoring the correct glucose metabolism (Chao and Hirsch 2018). Hyperglycemia, high body weight, hypertension and dyslipidemia are very often associated in what is called metabolic syndrome (Martyn, 2014): the first element to take into consideration is to correct the lifestyle.
The area of metabolic syndrome is also increasingly taken into consideration in the field of food supplementation and phytotherapy and many indications derived from the scientific literature favorably orient towards the benefit obtainable with the use of plant products (Governa et al., 2018) . One of the important medicinal plants in the management of hyperglycemia, for example, is ginseng, the roots of Panax ginseng (CA Meyer): its active ingredients, ginsenosides modulate the absorption and utilization of glucose (Luo and Luo, 2009) with a mechanism that also involves the regulation of cortisol levels, connected above all with the known effect stress reliever of the plant.
The adrenergic activation of ginsenosides can cause a slight increase in blood pressure so ginseng is not recommended for children and people with hypertension.
The studies on ginseng have opened the interest for the study of other adaptogens for the maintenance of the metabolism and good conditions of applications are ascribable to the rhodiola (roots of Rhodiola rosea L.) .
Rhodiola rosea L. is a species of the arctic regions of Europe, Asia and North America. Its main indication is that of adaptogen and is used above all in case of psycho-physical stress symptoms.
The active components of rhodiola are numerous, but the characteristic and studied are the salidroside polyphenols and rosavins (Borgonetti et al., 2020).
Salidroside is responsible for the inhibition of gluconeogenesis, the reduction of adipogenesis (production of adipose tissue) and the reduction of inflammatory cytokines within the white adipose tissue . Furthermore, according to a study carried out on rats and published in Scientific Reports, the ability of salidroside to increase the anorectic action of the leptin protein hormone, produced by adipocytes, at the hypothalamus level was highlighted, informing the latter that there is sufficient fat in the organism, so that, at the moment, it is not necessary to feed further. (Wang et al., 2016)
A study published in Molecules (Pomari et al., 2015), demonstrated the lipolytic activity of rhodiola , i.e. the ability to dissolve and mobilize fats, and anti-adipogenic , i.e. to inhibit the transformation of preadipocytes into adipocytes. The adipose tissue is in fact made up of adipocytes, cells with the function of accumulating fats, while the preadipocytes are cells destined to become adipocytes but not yet differentiated.
The inhibition of the transformation of preadipocytes into adipocytes prevents the production of new fat cells so it can be useful in preventing obesity.
Salidroside and rosavins also act with an antidepressant effect by increasing the levels of serotonin in the hippocampus, causing psychological fulfillment and avoiding that the same fulfillment is offered by food, helping to interrupt the vicious emotional cycle, which underlies the condition. of obesity. In addition to the increase in serotonin, in damaged hippocampal neurons of rats, treatment with rhodiola showed a tendency for the proliferation and differentiation of neuronal stem cells to repair the stress damage caused by the increase in cortisol (Chen et al., 2009) .
Other monoamines in addition to serotonin, influenced by rhodiola are adrenaline, dopamine, noradrenaline for which their degradation is inhibited with consequent increase of these molecules: the result is to increase the general metabolism of the organism and the yield and intellectual concentration (Zhuang et al., 2019).
Rhodiola rosea present in Ansirens has a titration of 3% in rosavine and 1% in salidroside.
References
- Martyn, 2014
- Governa et al., 2018
- Luo and Luo, 2009
- Borgonetti et al., 2020
- Wang et al., 2016
- Chen et al., 2009
- Zhuang et al., 2019