Citrus aurantium as a thermogenic, weight-reduction replacement for ephedra: an overview. J Med 33(1-4):247-264

Department of Physiology, Medicine and Pathology, Georgetown University Medical Center, Washington, DC 20057, USA.
Journal of medicine 02/2002; 33(1-4):247-64.
Source: PubMed


Obesity is a serious health problem throughout the world. More than half of U.S. adults are overweight (61%) and more than a quarter (26%) of U.S. adults are obese. The inability of many individuals to keep their weight in check by diet and exercise has created a need for additional therapeutic means to combat obesity. Despite great effort, the pharmaceutical industry has not come up with the solution; because most weight-loss drugs to date have serious adverse effects to health and well-being. The theory that beta agonists, especially beta 3 agonists, can affect body weight and fat mass is well accepted. Ephedrine has proven time and time again that it is an effective weight loss agent through its ability to increase thermogenesis and quench appetite. However, the publicity concerning adverse reactions has led to its gradual withdrawal from use by many despite the perceived consequences of obesity. Many companies are now substituting Citrus aurantium for ephedra in their formulations. Citrus aurantium, an agent containing beta agonists, has been reported to aid in weight loss in two studies and increase thermogenesis, at least to some extent, in three studies. Colker et al. (1999) reported that in a double-blind, placebo-controlled, randomized study the subjects receiving a combination of Citrus aurantium, caffeine and St John's Wort, lost significant amounts of total body weight while on a strict diet and exercise. Those in the placebo and control groups who also were on the same restricted diet did not. However, intergroup analysis showed no statistical significance among the weight changes in the three groups. In contrast, the loss of fat mass in the test group was significantly greater compared to the placebo and control groups. Jones describes an open labeled study performed on 9 women. The subjects showed a mean of 0.94 kg lost during the first week when no product was given and 2.40 kg during the second week when a Citrus aurantium product was taken. Body weight losses were statistically greater during the second week compared to the first week. Since most clinicians would agree that the most weight loss should occur initially coinciding with a greater fluid loss during the first week, these differences are even more remarkable. Three studies reported increased metabolic rates when ingesting Citrus aurantium products, however, at least two of these studies were acute. At present, Citrus aurantium may be the best thermogenic substitute for ephedra. However, more studies are needed to establish this definitively.

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    • "Two percent of respondents in a survey reported taking a dietary supplement containing bitter orange (Klonz et al., 2006), which if extrapolated nationwide would include at least several million individuals. As previously noted, no serious adverse events have been directly attributable to bitter orange or p‐synephrine (Preuss et al., 2002; Bent et al., 2004; Fugh‐Berman and Myers, 2004; Haaz et al., 2006, 2010; Stohs and Shara, 2007, 2011). A final consideration regarding the safety of p‐synephrine is the exposure of millions of people who daily consume, without ill effect, various juices and food products as marmalade from Citrus species as Seville orange, grapefruit, mandarin and other orange‐ related species that contain p‐synephrine (Pellati et al., 2002, 2004, 2005; Blumenthal, 2004; Avula et al., 2005; Mattoli et al., 2005; Dragull et al., 2008; Arbo et al., 2008; Roman et al., 2008). "

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    • "studies have provided convincing evidence that the intake of citrus fruits is beneficial to health [7] [8] [9]. Numerous prevention and treatment properties have been attributed to citrus fruits, like antioxidant, antiinflammatory, antitumor, anticardiovascular, and antiobesity properties [10] [11] [12] [13] [14]. Citrus fruits are usually consumed as fresh product or juice with peels and seeds discarded. "
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    • "Kimura, Saito, & Murata, 2001), green tea (Koo & Noh, 2007) 2 Enhancing thermogenesis sea weed (Maeda, Hosokawa, Sashima, Funayama, & Miyashita, 2005; Maeda, Hosokawa, Sashima, & Miyashita, 2007; Maeda, Tsukui, Sashima, Hosokawa, & Miyashita, 2008), bitter orange (Dallas, Gerbi, Tenca, Juchaux, & Bernard, 2008; Haaz et al., 2006; Preuss, DiFerdinando, Bagchi, & Bagchi, 2002 "
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