Chitosan for overweight or obesity

Jull AB, Ni Mhurchu C, Bennett DA, Dunshea-Mooij CAE, Rodgers A

Published Online:

July 16, 2008

Overweight and obesity are common health conditions worldwide but there are few effective treatments. Chitosan is a widely available dietary supplement that claims to aid weight loss and blood cholesterol levels. Fifteen studies which lasted between 4 to 24 weeks including a total of 1219 participants were analysed. Trials of chitosan to date have varied considerably in terms of quality. The review suggests that chitosan may have a small effect on body weight but results from high quality trials indicate that this effect is likely to be minimal.

Abstract (click to read)

Background:

Chitosan, a deacetylated chitin, is a dietary supplement reported to decrease body weight. It is widely available over the counter worldwide and although evaluated in a number of trials its efficacy remains in dispute.

Objectives:

To assess the effects of chitosan as a treatment for overweight and obesity.

Search strategy:

We searched electronic databases (MEDLINE, EMBASE, BIOSIS, CINAHL, The Cochrane Library), specialised web sites (Controlled Trials, IBIDS, SIGLE, Reuter's Health Service, Natural Alternatives International, Pharmanutrients), bibliographies of relevant journal articles, and contacted relevant authors and manufacturers.

Selection criteria:

Trials were included in the review if they were randomised controlled trials of chitosan for a minimum of four weeks duration in adults who were overweight or obese. Authors of included studies were contacted for additional information where appropriate.

Data collection and analysis:

Details from eligible trials were extracted independently by two reviewers using a standardised data extraction form. Differences in data extraction were resolved by consensus. Continuous data were expressed as weighted mean differences and standard deviations. The pooled effect size was computed by using the inverse variance weighted method.

Main results:

Fifteen trials including a total of 1219 participants met the inclusion criteria. No trial to date has measured the effect of chitosan on mortality or morbidity. Analyses indicated that chitosan preparations result in a significantly greater weight loss (weighted mean difference -1.7 kg; 95% confidence interval (CI) -2.1 to -1.3 kg, P < 0.00001), decrease in total cholesterol (-0.2 mmol/L [95% CI -0.3 to -0.1], P < 0.00001), and a decrease in systolic and diastolic blood pressure compared with placebo. There were no clear differences between intervention and control groups in terms of frequency of adverse events or in faecal fat excretion. However, the quality of many studies was sub-optimal and analyses restricted to studies that met allocation concealment criteria, were larger, or of longer duration showed that such trials produced substantially smaller decreases in weight and total cholesterol.

Authors' conclusions:

There is some evidence that chitosan is more effective than placebo in the short-term treatment of overweight and obesity. However, many trials to date have been of poor quality and results have been variable. Results obtained from high quality trials indicate that the effect of chitosan on body weight is minimal and unlikely to be of clinical significance.

This record should be cited as:

Jull AB, Ni Mhurchu C, Bennett DA, Dunshea-Mooij CAE, Rodgers A. Chitosan for overweight or obesity. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD003892. DOI: 10.1002/14651858.CD003892.pub3

Assessed as up to date:

September 1, 2007

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Primary Review Group:

Metabolic and Endocrine Disorders Group

Health topics:

Endocrine & metabolic > Obesity > Treatment

Complementary & alternative medicine > Endocrine & metabolic > Obesity

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Chitosan for overweight or obesity

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