Garcinia gummi-gutta, also known as Garcinia cambogia, is a member of the Guttiferae family. Garcinia is a polygamous genus consisting 200 species of trees and shrubs. It is found in different zones of the planet including Asia’s tropical regions. In India alone, around 30 species have been discovered. They are widely used as a flavoring agent to garnish fish curry in southern India, particularly in Kerala and Karnataka. The fruit rind of G. gummi-gutta has traditionally been used to treat gastrointestinal problems, diarrhea, and ulcers. South Indian people have been
utilizing it traditionally as evidenced by its ethnobotanical properties. In vivo and in vitro effects of the crude fruit extract showed anti-inflammatory, anticancer, anthelmintic, anti-microbial, and antioxidant activities. G. gummi-gutta fruit rind is medicinally significant and is frequently used in ayurvedic and traditional medicine for many diseases. Various secondary metabolites such as organic acids-hydroxycitric acid (HCA), flavonoids, terpenes, polysaccharides and polyisoprenylated benzophenones- garcinol, xanthochymol, guttiferone, benzophenone, xanthone, biflavonoids, alkaloids, tannins, phenols, and saponins isolated from the G. gummi-gutta have diverse pharmacological activities. (1) Studies have shown that the extracts as well as hydroxycitric acid (HCA), a main organic acid component of the fruit rind,
exhibited anti-obesity activity including
reduced food intake and body fat gain by regulating the serotonin levels related to satiety, increased fat oxidation and decreased de novo lipogenesis. HCA is a potent inhibitor of adenosine triphosphate- citrate lyase, a catalyst for the conversion process of citrate to acetyl-coenzyme A, which plays a key role in fatty acid, cholesterol and triglycerides syntheses. (2)
Over weight is a state of excess adipose tissue mass. It should not be defined by body weight alone, as muscular
individuals may be overweight by arbitrary standards without having increased adiposity. The most widely used method to classify weight status and risk of disease is the body mass index (BMI), which is equal to weight/height2 in kg/m2. (3)
Prevalence of obesity in India is 40.3%.
Zonal variations were seen as follows: south highest at 46.51% and east lowest at 32.96%. Obesity was higher among
women than men (41.88% vs.
38.67%), urban than rural (44.17% vs.
36.08%), and over 40 than under 40 (45.81% vs.
34.58%). More education implied a higher obesity (44.6% college vs. 38%
uneducated), as did lowered physical activity (43.71% inactive vs. 32.56% vigorously active). The odds ratio for physical activity was 3.83, stronger than age (1.58), education (1.4), urban (1.3), and gender (1.2). (4)
ETIOLOGY:
Obesity can result from increased energy intake, decreased energy expenditure, or a
combination of the two. Excess
accumulation of body fat is the consequence of environmental and genetic factors; social factors and economic conditions also represent important influences. The recent increase in obesity can be attributed to a combination of excess caloric intake and decreasing physical activity. Poorly Understood reasons for increased food assimilation due to dietary composition have also been postulated, as have sleep deprivation and an unfavorable gut flora. (3)
CLINICAL FEATURES
Over weight has major adverse effects on health. Increased mortality from obesity is primarily due to cardiovascular disease, hypertension, gall bladder disease, diabetes mellitus, and several types of cancer, such as cancer of the esophagus, colon, rectum, pancreas, liver, and prostate, and gallbladder, bile ducts, breasts, endometrium, cervix, and ovaries in women. Sleep apnea in severely obese individuals poses serious health risks. Obesity is also associated with an increased incidence of
steatohepatitis,gastroesophageal reflux, osteoarthritis, gout, back pain, skin infections, and depression. Hypogonadism in men and infertility in both sexes are prevalent in obesity. (3)
COMPLICATIONS
Obesity has adverse effects on both mortality and morbidity. Changes in mortality are difficult to analyse due to the confounding effects of lower body weight in cigarette smokers and those with other illnesses (such as cancer). However, it is clear that the lowest mortality rates are seen in Europeans in the BMI range 18.5- 24 kg/m2 (and at lower BMI in Asians). It is suggested that obesity at age 40 years can reduce life expectancy by up to 7 years for non-smokers and by 13 years for smokers. Coronary heart disease is the major cause of death but cancer rates are also increased in the overweight, especially colorectal cancer in males and cancer of the gallbladder, biliary tract, breast, endometrium and cervix in females. Obesity has little effect on life expectancy above 70 years of age, but the obese do spend a greater proportion of
their active life disabled. Epidemic obesity has been accompanied by an epidemic of type 2 diabetes and osteoarthritis, particularly of the knee. Although an increased body size results in greater bone density through increased mechanical stress, it is not certain whether this translates to a lower incidence of osteoporotic fractures. Obesity may have profound psychological consequences, compounded by stigmatisation of the obese in many societies. (3)
References (Vancouver style)
- Amrita Thandayamparambil Anilkumar, Suryaa Manoharan, Satheeswaran Balasubramanian, Ekambaram Perumal Garcinia gummi-gutta: Phytochemicals and pharmacological applications
biof.1943
- Semwal RB, Semwal DK, Vermaak I, Viljoen A. A comprehensive scientific overview of Garcinia cambogia. Fitoterapia. 2015 Apr;102:134-48. doi: 10.1016/j.fitote.2015.02.012. Epub 2015
Feb 27.
PMID: 25732350
j.fitote.2015.02.012
- Harrison’s_Manual Of Medicine_19
Edition
- Venkatrao M, Nagarathna R, Majumdar V, Patil SS, Rathi S, Nagendra H. Prevalence of Obesity in India and Its Neurological Implications: A Multifactor Analysis of a Nationwide Cross-Sectional Study. Ann Neurosci. 2020
Jul;27(3-:153-161. doi:
10.1177/0972753120987465. Epub 2021 May 29. PMID: 34556954; PMCID: PMC8455012.
About the Author:
Dr. Raj Singh : PG Scholar, Department of Homoeopathic Pharmacy Government Homoeopathic Medical College & Hospital, Bhopal
Under the Guidance of
Prof. Dr. B.D. DWIVEDI – HOD, DEPARTMENT OF SURGERY Government Homoeopathic Medical College & Hospital, Bhopal
