.

.
marylin monroe
Showing posts with label banaba. Show all posts
Showing posts with label banaba. Show all posts

Berberine, Banaba (Corosolic Acid), Rauwolfia Serpentina, (Apple Cider) Vinegar, Chromium. Supplements to Improve and Restore Insulin Sensitivity - Serving #2

Setbacks are part of the process. Don't be mad at yourself. Get back on the wagon and identify what triggered them.
Before we tie into serving #2 of our list of insulin sensitizing supplements, let me just briefly remind you of the imperative to have your lifestyle changes in place before even thinking about spending or, in the case you did not give up the laziness and gluttony, wasting money on dietary supplements, if you ever want to send your insulin resistance, pre- or full-blown diabetes to remission. There is no way you achieve that by leading the same life that caused it, in the first place (re-read Part I).

Lifestyle changes are more powerful than supplements, and psychology more important than physiology

So, enough of the lecturing - at least as far as the lifestyle changes are concerned, let's rather check out what "must have" [A], "may have" [B], "could have" [C] and "should not have" [D] supplements have found their way into today's installment of this series (learn more about the rating system):
  • Berberine [B]: I must say that I was quite surprised that not just one but four of you insisted on including berberine in this list. Probably partly due to the fact that the euphoric reviews on some website did not take into account what a recent review rightly says about this supplement: "The evidence of berberine for treating T2DM [type 2 diabetes] should be carefully interpreted due to the low methodological quality, small sample size, limited number of trials, and unidentified risks of bias" (Dong. 2012).
    Remember: Just because it's "natural", berberine is not necessarily safe! The LD 50 (50% of animals die; please note that this is for 100% pure alkaloid content and not the amount of an extract) is 713.57mg/kg i.e. ca. 12mg/kg or <1g for human beings (Yi. 2013)! It has also been reported to cause bradycardia (Cannillo. 2013) and messes with the hepatic cytochrome metabolism (Guo. 2012) and who knows what side effects this may cause in conjunction with pharmacological drugs and other supplements. Against that background it's actually counter-intuitive that it's administration to human subjects in a 2010 study by Zhang et al. lead not just to improvements in blood glucose, but also n ALT and AST, both of which are generally regarded as markers of liver damage (Zhang. 2010)
    So while the evidence is accumulating, its quality is still questionable. This does not mean berberine does not work - on the contrary - you could even argue that this makes it "dangerous" to investigate. After all, studies like Chen (2010), Jeong (2009), Kim (2009), and Lee (2006) appear to suggest that it acts via multiple pathways including AMPK (see metforming and ALA in previous installment) to improve both the glucose and lipid metabolism in mice and men in a way that would make many of the currently available redundant.

    Insulin sensitivity is not the be-all-and-end-all of ultimate leanness. These 20 agents in this list could help you "conserve" weight loss results, keep you lean on a bulk and/or avoid the hazardous Yoyo effect. Berberine with its pronounced anti-ppar-gamma effect is one of them, check out the rest!
    What is particularly interesting for the non-diabetic user is however its suppressive effects on PPAR-gamma (learn more about PPAR-g and body fat gain), and it's direct beneficial effects on the expression of insulin receptors in type II diabetics. Just as the PPAR-gamma effect this is a berberine exclusive trick and nothing ALA or metformin - let alone of of the std. "just makes you fat" diabetes drugs could do (Zhang. 2010)

    So, although there is evidence that berberine can effectively compete with regular diabetes meds (e.g almost identical effects on HbA1c in Dong. 2010). The number of quality human studies is still low. This is particularly worrying because of the lack of reliable long-term safety studies and information on optimal dosages (currently extracts are usually administered in 2-3 doses at a total amount of 0.5g and 1.5g per day; cf. Dong. 2010).

    Berberine certainly has the potential for an "A" rating, but at the for now, it's still only a "B". Despite additional benefits on cancer and its potential ability to improve body compositon via PPAR-gamma suppression which is an effect current top dog, metformin, does not have to offer (e.g. Wei. 2012). 
  • Corosolic acid from Banaba = Lagerstroemia speciosa [C]: It is quite funny that corosolic acid, which is actually a "brother" to ursolic acid (with a 2-alpha-hydroxy attachment to it), has very much in common with berberine. It increases GLUT-4 activity + glucose activity (unfortunately not tissue specific, i.e. in fat cells, as well) and it inhibits the activity of the fattening (spec. increase in fat cells) PPAR-gamma activity (Liu. 2001) - unfortunately only in the petri dish. Still, in a study in diabetic mice its anti-diabetic qualities sucked compared to malted barley extract which had much more pronounced effects on the glucose levels of the diabetic rodents (Hong. 2004).

    Instead of banaba, you better try "6 Bananas à day" - well at least if you are still insulin sensitive (learn why)
    Other studies, such as Park, Lee & Sung (2005), also suggest that the in vivo effects may differ from what Liu et al. observed in the petri dish (Park. 2005). The observations Park et al. made, i.e. the increase, not decrease in the pro-obesogenic PPAR-gamma activity, is however of little use, as banaba was just used as one of three compounds in their study, which shares this downside with a whole host of other studies that are often cited in support of the effects of corosolic acid.

    A study by Klein et al. from 2007 even suggests that it's not the corsolic acid in banaba, but rather one of the gallotannin from banaba water extracts, namely Penta-O-galloyl-glucopyranose (PGG) that's responsible for the anti-diabetic effects. Much more so than for berberine there is thus a lack of reliable data on the efficacy and potency of corosolic acid / banaba. In conjunction with the existing counter-evidence, Banaba is thus only a [C], as in "a candidate when you've tried all other things, already".
  • Effects of different dosages of the anti-diabetes drug gilbenclamide and rauwolfia methanol extract on haemoglobin (Hb) and HbA1C levels in rodent model of diabetes (Azmi. 2012)
    Rauwolfia serpentina [C]: While I did actually not intend to have rauwolfia in this list, I stumbled upon a pertinent study and was surprised that the purported fat burner (due to its yohimbine content) has beneficial effects on glucose metabolism, as well.

    Pretty impressive ones, as you can see in the figure on the right. It reduces the HbA1c levels in alloxan-induced diabetic Wister male mice (DIA in the figure) to (almost) normal levels and is thus exactly as potent as 5mg/kg of the FDA approved anti-diabetes drug glibenclamide.

    The mere fact that we do only have data from rodent studies (see figure above), does yet probably suffice as an explanation why the herb that is among the top 50 fundamental herbs of Chinese Traditional Medicine did only get a "C" rating. In this case probably "C" as in "compound you don't have to avoid if you get it for free as part of fat burner you use anyway ;-)
  • Vinegar (apple cidar and other) [C]: While it is one of those anti-diabetic supplements everyone knows about, it's not an insulin sensitizer or wonder drug, but a glycemic index (GI) reducer. In other words, the addition of vinegar will reduce the glycemia mainly (*) by modulating the absorption kinetics of high GI carbs. No wonder that it has no proven effect in low GI foods (Liatis. 2010).

    Glucose levels (mg/dL) of healthy normal-weight volunteers after a serving of instant mashed potatoes during oral octreotide/insulin suppression test w/ or w/out 20 mL apple cider vinegar [5% g acetic acid] (Salbe. 2009)
    If you don't believe that, because you have been exposed to Internet brain-washing for too long, check this out: In a 2009 study Salbe et al. observed that as soon as the insulin release is controlled for, the co-ingestion of vinegar loses it's effect and ...
    "[...] the rise of glucose [in response to a mashed potato meal] was modestly but significantly (P = .01) greater after vinegar ingestion compared to placebo, suggesting that vinegar does not act to decrease glycemia by interference with enteral carbohydrate absorption." (Salbe. 2009)
    Don't get me wrong that's not necessarily bad, but if you follow the advice in part I of this series, you are not consuming significant amounts of these foods (in the Liatis study, mashed potatoes with low fat milk), anyway.

    Vinegar is thus not a real means to improve insulin sensitivity, but a tool like low carbing which will simply make it less important to be insulin sensitive. Consequently, I am rating it with a "C" as in "continues to be useful, but the mechanism of action does not allow us to list it as an 'insulin sensitizer' in the narrow sense". As long as you are aware of that you can obviously still use it "strategically", whenever you are indulging a high GI meal (and actually don't want it to be high GI) - 2 tablespoons is what you see usually being used for this purpose (ca. 30ml).

    (*) It should be mentioned though that there are a couple of rodent studies that show improved insulin release in diabetic rats after prolonged treatement (e.g. Abu-Zaiton. 2011). That is however a downstream effect that would also occur if you work out and get rid of the simple sugars in your diet. Your pancreas will after all start to heal if you stop beating it to death day in and day out.
  • Chromium [B]: Yes it helps, the evidence is there - in full-blown diabetics (!) who happen to have elevated serum, but lowered cellular chromium levels (Rükgauer. 2002). In their relatively recent review Wang et al. point out:
    I am not going to list it here, but actually all of you who have read the SuppVersity Science Round-Up Special on DHEA will know it can increase insulin sensitivity, as well (learn more).
    "[...] patient selection may be an important factor in determining clinical response, as it was concluded that a clinical response to chromium (ie, decreased glucose and improved insulin sensitivity) may be more likely in insulin-resistant individuals with type 2 diabetes who have more elevated fasting glucose and hemoglobin A(1c) levels." (Wang. 2010)
    The mechanism of action is actually a facilitative one, as trivalent chromium (that's very different from its toxic industrially used cousins that have no place in your body!) is involed in (Hua. 2012):
    • GLUT-4 expression,
    • control of oxidative damage
    • insulin action & signalling,
    • insulin receptor expression,
    • AMPK expression,
    Effective dosages range from 200mcg to 1,000mcg and I personally would suggest to start low and go for doses of max. 600mcg per day of either chromium picolinate or niacin bound chromium, which were the most potent formulations in a 2009 study by Preuss et al.

    Why not more? Well, you must have missed previous post "Chromium Picolinate Worsens Insulin Sensitivity in Healthy, Non-Diabetic, Non-Obese Individuals by Up to 25%" (learn more). You did miss it and you have been taking 2mg each day for the last 12 months? Well, at least you do now know why you're insulin resistant ;-)
    Insulin sensitivity measured in previously healthy individuals before and after the 16 week on high dose chromium (left); change in insulin sensitivity of the subjects vs. serum chromium levels (read more)
    The potential negative side effect of chromium in those who do not need it, as well as the overall mixed results from clinical trial make it a "B" choice for all of you who are actually insulin resistant. For those who want to avoid becoming insulin resistant or dream of the disproven anabolic + body composition improving effects of chromium (Vincent. 2003) it's clearly an "D" as in "DON'T take more than the RDA of 150mcg".
Yes you are right, that's not it - there is still more on the todo-list, but obviously my days have - just as yours - only 24h and since I am not willing to ruin my insulin sensitivity by working all night (there are better things to do not sleeping on the weekend, trust me), you will have to wait till next Sunday for another update - sorry ;-)

Ah, and in case you missed either Part I or Part II of this series, this would be the right moment to go back and read them.
References:
  • Abu-Zaiton AS. Effect of apple vinegar on physiological state of pancreas in normal and alloxan induced diabetic rats. World Journal of Zoology. 2011; 6(1), 7-11.
  • Azmi MB, Qureshi SA. Methanolic Root Extract of Rauwolfia serpentina Benth Improves the Glycemic, Antiatherogenic, and Cardioprotective Indices in Alloxan-Induced Diabetic Mice. Adv Pharmacol Sci. 2012;2012:376429. doi: 10.1155/2012/376429. Epub 2012 Dec 18.
  • Cannillo M, Frea S, Fornengo C, Toso E, Mercurio G, Battista S, Gaita F. Berberine behind the thriller of marked symptomatic bradycardia. World J Cardiol. 2013 Jul 26;5(7):261-4.
  • Chen C, Zhang Y, Huang C. Berberine inhibits PTP1B activity and mimics insulin action. Biochemical and Biophysical Research Communications. 2010;397(3):543–547.
  • Golubnitschaja O, Yeghiazaryan K. Opinion controversy to chromium picolinate therapy's safety and efficacy: ignoring 'anecdotes' of case reports or recognising individual risks and new guidelines urgency to introduce innovation by predictive diagnostics? EPMA J. 2012 Oct 7;3(1):11.
  • Dong H, Wang N, Zhao L, Lu F. Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. Evid Based Complement Alternat Med. 2012;2012:591654.
  • Guo Y, Chen Y, Tan ZR, Klaassen CD, Zhou HH. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol. 2012 Feb;68(2):213-7. 
  • Hong H, Jai Maeng W. Effects of malted barley extract and banaba extract on blood glucose levels in genetically diabetic mice. J Med Food. 2004 Winter;7(4):487-90. 
  • Hua Y, Clark S, Ren J, Sreejayan N. Molecular mechanisms of chromium in alleviating insulin resistance. J Nutr Biochem. 2012 Apr;23(4):313-9.
  • Jeong HW, Hsu KC, Lee JW, et al. Berberine suppresses proinflammatory responses through AMPK activation in macrophages. American Journal of Physiology. 2009;296(4):E955–E964. 
  • Kim WS, Lee YS, Cha SH, et al. Berberine improves lipid dysregulation in obesity by controlling central and peripheral AMPK activity. American Journal of Physiology. 2009;296(4):E812–E819.
  • Klein G, Kim J, Himmeldirk K, Cao Y, Chen X. Antidiabetes and Anti-obesity Activity of Lagerstroemia speciosa. Evid Based Complement Alternat Med. 2007 Dec;4(4):401-7.
  • Lee YS, Kim WS, Kim KH, et al. Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006;55(8):2256–2264. 
  • Liatis S, Grammatikou S, Poulia KA, Perrea D, Makrilakis K, Diakoumopoulou E, Katsilambros N. Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal. Eur J Clin Nutr. 2010 Jul;64(7):727-32.
  • Liu F, Kim J, Li Y, Liu X, Li J, Chen X. An extract of Lagerstroemia speciosa L. has insulin-like glucose uptake-stimulatory and adipocyte differentiation-inhibitory activities in 3T3-L1 cells. J Nutr. 2001 Sep;131(9):2242-7.
  • Park MY, Lee KS, Sung MK. Effects of dietary mulberry, Korean red ginseng, and banaba on glucose homeostasis in relation to PPAR-alpha, PPAR-gamma, and LPL mRNA expressions. Life Sci. 2005 Nov 12;77(26):3344-54.
  • Preuss HG, Echard B, Perricone NV, Bagchi D, Yasmin T, Stohs SJ. Comparing metabolic effects of six different commercial trivalent chromium compounds. J Inorg Biochem. 2008 Nov;102(11):1986-90. doi: 10.1016/j.jinorgbio.2008.07.012. Epub 2008 Jul 31. 
  • Rükgauer M, Zeyfang A. Chromium determinations in blood cells: clinical relevance demonstrated in patients with diabetes mellitus type 2. Biol Trace Elem Res. 2002 Jun;86(3):193-202.
  • Salbe AD, Johnston CS, Buyukbese MA, Tsitouras PD, Harman SM. Vinegar lacks antiglycemic action on enteral carbohydrate absorption in human subjects. Nutr Res. 2009 Dec;29(12):846-9. 
  • Stearns DM, Silveira SM, Wolf KK, Luke AM. Chromium (III) tris (picolinate) is mutagenic at the hypoxanthine (guanine) phosphoribosyltransferase locus in Chinese hamster ovary cells. Mutation Research/Genetic Toxicology and Environmental Mutagenesis. 2002; 513(1), 135-142.
  • Wang ZQ, Cefalu WT. Current concepts about chromium supplementation in type 2 diabetes and insulin resistance. Curr Diab Rep. 2010 Apr;10(2):145-51. doi: 10.1007/s11892-010-0097-3. Review.
  • Wei W, Zhao H, Wang A, Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012 Jan;166(1):99-105. 
  • Vincent JB. The potential value and toxicity of chromium picolinate as a nutritional supplement, weight loss agent and muscle development agent. Sports Med. 2003;33(3):213-30.
  • Yi J, Ye X, Wang D, He K, Yang Y, Liu X, Li X. Safety evaluation of main alkaloids from Rhizoma Coptidis. J Ethnopharmacol. 2013 Jan 9;145(1):303-10.
  • Zhang H, Wei J, Xue R, Wu JD, Zhao W, Wang ZZ, Wang SK, Zhou ZX, Song DQ, Wang YM, Pan HN, Kong WJ, Jiang JD. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression. Metabolism. 2010 Feb;59(2):285-92.

Can An OTC Supplement Quadruple Your Weight Loss Success? Recent Study Says: Yes It Can! But The Absolute Improvements in Body Composition Are Still Pathetic

I am sorry, but I have to tell you: Significant weight loss does not happen without effort. Even if you take a pill that comes with just this promise.
I guess you will not have heard about "IQP-GC-101", before - right? Well, me neither, but it is obviously a patented blend of a bunch of very familiar weight loss adjuvants, namely Garcinia cambogia, Camellia sinensis, unroasted Coffea arabica (aka green coffee bean extract), and Lagerstroemia speciosa. All of them were pressed into tablets, the scientists from InQpharm, the producer and patent owner handed to 92 German subjects who had volunteered to participate in a double-blinded randomized study in the course of which they had to (a) adhere to a -500kcal/day energy deficit and (b) consume three tablets of either IQP-GC-101 or an identically looking placebo twice a day - once 30min before breakfast and once 30 minutes before lunch.
The "lose fat effortlessly"-myth is not the only one, learn more about Myths & Truths 

Pasta "Al Dente" = Anti-Diabetic

Vinegar & Gums for Weight Loss

Teflon Pans Will Kill You!

You Can Drum Yourself Lean

You Can Wash Pesticides Away

Milk = Poisonous Hormone Cocktail
Now, it goes without saying that this is not the first sponsored weight loss study. So you may be asking yourselves rightly, why this one made it into the SuppVersity news while most of the other trash did not, right?  Well, there are actually a handful of reasons, of which I consider the following two to be most significant:
  • The study design: Double-blinded, an impressive number of subjects (n=91; one subject was "lost to follow up after randomization"; Chong. 2014), all caucasian with a mean age of 42.8 ± 11.2 years (31.9% were male), and full details on the ingredients of the supplement - that's nothing you will see with the average "pimp my product" study
  • The supplement ingredients: Garcinia cambogia aka HCA, camelia sinensis aka green tea, coffea arabica aka green coffee bean extract and lagerstroemia speciosa aka Banaba are all ingredients you will find in many of the currently available supplements.
I guess, I could add that interesting supplement news are slow, these days and that I am so freaking busy that I had to pick the next best study from my "could be something to write about in the future" folder, but I am not sure how relevant that would be ;-)

Apropos "relevant", what certainly is relevant is the ingredient profile each of the 6 tablets (2x3) the subjects consumed on a daily basis:
  • Table 1: Subjects' demographics at baseline - age (years), height (cm), body weight (kg; from Chong. 2014)
    G.cambogiaextract (650 mg) – standardized to at least 60% HCA; 
  • C.sinensis extract (100 mg) – at least 15% epigallocatechin-3-gallate and 11% caffeine;
  • unroasted C.arabica extract (75 mg) – at least 25% chlorogenic acid and 5% caffeine; and 
  • L. speciosa extract (25 mg) – at least 5% corosolic acid in a standardized extract
The "at least..." indicates that the producer guarantees a certain level of active ingredients. That's the case for most of the reputable companies, but in view of the fact that there are more than enough snake oil vendors out there, I think it may be prudent to repeat my advice: Whenever you look at the ingredient level make sure the producer declares the level of active ingredients.
Do not buy non-standardized herbal / natural supplements! You could not only be wasting your money on products without active ingredients, you could - in the worst case - end up with a sloppily produced extract that contains all the bad stuff from the raw material (e.g. all the heavy metals from Chinese green tea | learn more) and not a single microgram of the of the active ingredient.
You don't want "green tea" in your fat burner, you want a green tea extract with a standardized amount of catechins in it and if the bottle doesn't say anything about "standardization" / "standardized for", etc. you can be sure that what you are buying is hardly different from the content of the contents of the cheapest tea bags from the supermarket next door - the only difference being: It did not have to pass the rigorous quality control of the supermarket chain!

But let's get back to the study at hand. The subjects consumed what I would call a pretty lame iteration of the SGD, the "standard German diet". It's not as "SAD" as the standard American one, but my fellow countrymen and -women have gained some ground in terms of eating unhealthy over the past two decades; and the fact that "[t]he diet plans were compiled by a dietician and ensured a balanced diet providing 30% of the ingested energy as fat," (Chong. 2014) does not increase my confidence in the overall quality of the foods the subjects consumed at one out of five distinct energy equivalents, i.e. 1500, 1800, 2000, 2200, and 2500 kcal per day - obviously calculated based on the theoretical energy requirements of the subjects.
The kcal-display lies to her!
SuppVersity Suggested Reads: "Predictive Value of Equations to Calculate Your Resting Metabolic Rate (RMR) Flawed: Results Can Be 14-29% Off" | read more - At this point I would like to invite you to take a look at the real-world validity and the corresponding "value" of calculated energy requirements. In the corresponding article, as well as in a more detailed follow up that includes 9 Tips to Optimize Fat Loss and successfully manage your weight, I outline a couple of commonly known but often overlooked principles that facilitate real and lasting fat, not weight loss.
If we rely on the messed up 3,500kcal per pound of fat calculation I've debunked years ago (read the corresponding article "Busting the 3,500kcal = 1lbs Weight Loss Myth!"),  the "diet" alone should have yielded a net reduction in body fat of ~1lbs per week and thus a total fat loss of 12weeks x 1lbs per week = 12lbs or ~6kg of pure fat!

I hope you are not surprised to see that this was exactly not what happened. In fact, after the first four weeks, when the subjects in both groups should have had lost roughly 2kg of body fat, the average study participants in the active and the placebo arm of the study had lost only ~1lbs of body fat and a total of ~1.5lbs of weight.
Figure 1: Absolute changes in body weight (kg) and body fat (kg) over the 12-week study period (Chong. 2014)
Now, in all fairness, it should be said that the 4-week margin was actually the 2-week margin for the active treatment. There was a 2-week run-in, after which 10 non-compliant subjects were removed and the rest of the subjects were randomized to receive either the placebo or active treatment. Against that background, it makes sense to isolate the body weight and body fat trajectory from week 2 to week 12 ... et voilá! The result does already look much more promising. Still, in spite of the fact that the subjects in the active arm lost almost 4x more body fat, the overall result, i.e. -1.21kg of fat over 12 weeks in overweight subjects, is still pretty pathetic.

Programming a 500kcal deficit based on calculated energy expenditure is stupid

Moreover, the fact that the subjects in the placebo arm gained almost 1lbs of body fat does not speak to either, the competence of the "registered dieticians" who compiled their diets, or the subjects' ability to stick to their alleged 500kcal deficit.

2x-3x higher than RDA protein help men and women lose fat, not weight, but there is a limit to wheer more is actually better | learn more
If you have not read it, already, this would be a good time to read my previous article on the "validity" *rofl* of the currently available equations to calculate your energy requirements (read more). And remember, while I personally don't believe that there is such a thing as diet induced "metabolic damage", it's a scientifically validated matter of fact that there are normal-, hyper- and hypometabolizers. And people with a mean BMI of 28+kg/m² (see Table 1) who belong to the sedentary average of the German society and are thus not just by definition "overweight" are probably more likely to be hypo- than normal- let alone hypermetabolizers.

This means, compared to the average for whom the equations the dietitians used to calculate their baseline intake may be more or less accurate, their real energy expenditure would be lower than what the equation says.

It's thus not impossible that their weight and fat gain (see Figure 1) was a simple result of the dieticians' stoic over-reliance on unreliable math and a minimal real-world calorie deficit (probably way below 500kcal) that was further reduced by non-adherence - especially in the placebo group.
Is garcinia or hydroxycitric acid aka HCA even safe? Ever since the FDA report about Hydroxycut(TM) (FDA. 2013). Most people think garcina was not safe. If you look at the evidence, it's yet not as "black" as the FDA has painted it in their warning against Hydroxicut(TM). If you look at some of the latest studies, you will even find conclusions such as the following statement from a well-referenced letter to the editor of the World Journal of Gastroenterology:
"In both animal and clinical literature, elevated intakes of HCA per se have not led to signs of inflammation or hepatotoxicity. The compound has been found to reduce markers of inflammation in brain, intestines, kidney and serum."(Clouatre. 2013) 
In the study at hand, the researchers did likewise not observe any liver problems or similar allegedly HCA-related side effects. In view of the rather mediocre results, the safety question may yet be more or less irrelevant, anyway.
 Bottom line: Specifically in view of the last remarks on dietary adherence, the significant inter-group differences speaks in favor of the the use of the patented weight loss formula in an average Joe's messed up diet scenario with a focus on food and macronutrient quantities, instead of qualities, a low protein intake (learn more about 2xRDA protein intakes, while you're dieting | here) and no exercise component, which would steer the total weight loss away from lean and towards fat mass.

On the other hand, the absolute amount of fat the subjects lost even when they were using the "fat burner" was pathetic. Any appetite suppressing or fat burning effects the formula may have are thus not pronounced enough to produce meaningful, or at least statistically significant weight, let alone fat loss. With standard deviations of 1.84 kg and thus 150% of the statistically mean in the active arm of the study, there were more than enough subjects who gained body fat in spite of the fact that they (supposedly) consumed less energy than they needed and were taking a patented weight loss adjuvant. A weight loss adjuvant with "proven" ingredients.... or should I say, with ingredients for which you can cherry pick evidence that they may increase fatty acid oxidation, inhibit lipid synthesis, decrease inflammation, increase insulin sensitivity and reduce food intake - in many cases even in human studies (see References). The fact that this does not necessarily mean that you will experience significant and visible fat loss effects, is thus probably the actual bottom line to the study at hand; and that's a bottom line that's valid irrespective of all declared conflicts of interest.
Reference:
  • Acheson KJ, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jequier E. 1980. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. Am J Clin Nutr33(5): 989–997. 
  • Chong, P. W., Beah, Z. M., Grube, B., & Riede, L. (2014). IQP‐GC‐101 Reduces Body Weight and Body Fat Mass: A Randomized, Double‐Blind, Placebo‐Controlled Study. Phytotherapy Research
  • Clouatre, Dallas L., and Harry G. Preuss. "Hydroxycitric acid does not promote inflammation or liver toxicity." World journal of gastroenterology: WJG 19.44 (2013): 8160.
  • Deocaris CC, Aguinaldo RR, dela Ysla JL, Asencion AS, Mojica ERE. 2005. Hypoglycemic activity of irradiated Banaba (Lagerstroemia speciosaLinn.) leaves.J Appl Sci Res1(1): 95–98
  • Dulloo AG, Duret C, Rohrer D,et al. 1999. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans.Am J Clin Nutr70(6): 1040–1045
  • Hayamizu K, Ishii Y, Shigematsu N,et al. 2003. Safety ofGarcinia cambogiaextract in healthy men: high doses administration study I.J Oleo Sci52(9): 499–504
  • Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C. 1998.Garcinia cambogia(Hydroxycitric acid) as a potential antiobesity agent.JAMA280(18): 1596–1600.
  • Hursel R, Viechtbauer W, Westerterp-Plantenga MS. 2009. The effects of green tea on weight loss and weight maintenance: a meta-analysis.Int J Obes (Lond) 33(9): 956–961.
  • Jayaprakasha GK, Sakariah KK. 1998. Determination of organic acids inGarcinia cambogia(Desr.) by high-performance liquid chromatography.J Chromatogr A806(2): 337–339.
  • Klein G, Kim J, Himmeldirk K, Cao Y, Chen X. 2007. Antidiabetes and anti-obesity activity ofLagerstroemia speciosa.Evid Base Compl Alternative Med4(4): 401–407.
  • Liu S, Kim J, Li Y, Liu X, Li J, Chen X. 2001. An extract of Lagerstroemia speciosa L. has insulin-like glucose uptake– stimulatory and adipocyte differentiation–inhibitory activities in 3T3-L1 cells. J Nutr131(9): 2242–2247.
  • Ohia SE, Opere CA, LeDay AM, Bagchi M, Bagchi D, Stohs SJ. 2002. Safety and mechanism of appetite suppression by a novel hydroxycitric acid extract (HCA-SX).Mol Cell Biochem 238 (1–2): 89–103.
  • Onakpoya I, Terry R, Ernst E. 2011b. The use of green coffee extract as a weight loss supplement: a systematic review and meta-analysis of randomized clinical trials.Gastroenterol Res Pract. DOI: 10.1155/2011/382852.
  • Satomi T, Seigo K, Masaki M, Haruki M. 2006. An inhibitory effect on the increase in the postprandial blood glucose by Banaba extract capsule enriched corosolic acid.J Integr Study Dietary Habits17(3): 255–259.
  • Shimoda H, Seki E, Aitani M. 2006. Inhibitory effect of green coffee bean extract on fat accumulation and body weight gain in mice. BMC Complement Altern Med6:9.
  • Stobs SJ, Miller H, Kaats GR. 2012. A review of the efficacy and safety of banaba (Lagerstroemia speciosaL.) and corosolic acid.Phytother Res26: 317–324.
  • Sullivan AC, Triscari J, Hamilton JG, Miller ON, Wheatley VR. 1974. Effect of ( )-Hydroxycitrate upon the accumulation of lipid in the rat II: appetite. Lipids9(2): 129–134.
  • Sullivan AC, Singh M, Srere PA, Glusker JP. 1977. Reactivity and inhibitor potential of hydroxycitrate isomers with citrate synthase, citrate lyase and ATP citrate lyase.J Biol Chem 252(21): 7583–7590.
  • U.S. Food and Drug Administration. Warning on Hydroxycut prod ucts. http://www.fda.gov/forconsumers/consumerupdates/ ucm152152.htm [Accessed 20 August 2013].