Centella asiatica / gotu kola: an ancient "panacea" worth it's reputation

  • The south asian medicinal herb centella asiatica (gotu kola) has been used as a cure-all for thousands of years for the treatment of hypertrophic scars (very common in Asia), wound healing  and burns.
  • The main actives compounds of the herb are asiaticoside, madecasosside, asiatic acid and madecassic acid and together they are called TTFCA (total triterpenic fraction of centella asiatica) or TECA (titrated extract of centella asiatica) and these are the types of gotu kola extract to look for when taking centella asiatica orally (food supplements) or topically (creams).
  • High quality, concentrated extracts, such as the above, do help in wound / burn / hypertrophic scar healing, facial skin anti-ageing, body and face skin firming, under eye bags, cellulite reduction and water retention / poor circulation, as multiple studies, included the one mentioned below, have shown.
  • The main mode of action of gotu kola is in the repair of connective tissue, which is implicated in all the health / aesthetic problems mentioned above. For this reason, centella is one of the key actives we use at our clinic, specialising in skin tightening, anti-ageing and cellulite, and in our anti-cellulite / leg wellness creams.
  • Source: Centella asiatica in dermatology: an overview
  • Abstract: Centella asiatica is a medicinal plant that was already used as a 'panacea' 3000 years ago. The active compounds include pentacyclic triterpenes, mainly asiaticoside, madecasosside, asiatic acid and madecassic acid. We have conducted an overview to summarize current knowledge on the results of scientific in vitro and in vivo experiments focused on the improvement of the healing process of small wounds, hypertrophic scars and burns by C. asiatica. In this paper, we discuss the data on constituents, recommended preparations and the potential side effects of C. asiatica.
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Centella asiatica / gotu kola extract found to boost collagen production in human collagen cells / fibroblasts

  • In this study on human tissue, a highly concentrated extract of the  medicinal herb centella asiatica / gotu kola was found to boost collagen turnover.
  • This indicates collagen tissue repair action, for which gotu kola is well known. Due to this connective tissue repair activity, gotu kola is ideal for use in skin anti ageing and anti cellulite creams and supplements.
  • Source: Stimulation of collagen synthesis in fibroblast cultures by a triterpene extracted from Centella asiatica
  • Abstract: The drug "Titrated Extract from Centella asiatica" (TECA), used for its stimulating properties on the healing of wounds, is a mixture of 3 terpenes extracted from a tropical plant: asiatic acid (30%, w/w), madecassic acid (30%, w/w) and asiaticoside (40%, w/w). The effects of TECA and its individual components were checked on human foreskin fibroblast monolayer cultures. TECA increased the collagen synthesis in a dose-dependent fashion whereas a simultaneous decrease in the specific activity of neosynthesized collagen was observed. Asiatic acid was found to be the only component responsible for collagen synthesis stimulation. TECA and all three terpenes increased the intracellular free proline pool. This effect was independent of the stimulation of collagen synthesis.
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Centella / gotu kola aids wound healing by boosting collagen and fibronectin production in collagen cells / fibroblasts

  • Centella / gotu kola aids wound healing by boosting collagen and fibronectin production in collagen cells / fibroblasts
  • Source: Effect of the triterpenoid fraction of Centella asiatica on macromolecules of the connective matrix in human skin fibroblast cultures.
  • Abstract: The mechanism of action of the total triterpenoid fraction extracted from Centella Asiatica (TTFCA) was evaluated using human skin fibroblast cultures as the experimental system. In particular its influence on the biosynthesis of collagen, fibronectin and proteoglycans was considered. The presence of TTFCA (25 micrograms/ml) does not seem to affect cell proliferation, total protein synthesis or the biosynthesis of proteoglycans in a significant way. A statistically important increase was observed in the percentage of collagen and, as revealed by immunofluorescence measurements, in cell layer fibronectin. This effect on collagen and fibronectin may help to explain the action of TTFCA in promoting wound healing, and suggests an interesting working hypothesis for its action on basal endothelia.
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Asiaticoside, from centella asiatica, helps wound healing by boosting the growth and function of fibroblasts / collagen cells

  • In this study asiaticoside, a natural chemical found in the herb gotu kola / centella asiatica, was found to boost the movement, adhesion and growth of collagen cells in wound sites, thereby accelerating wound healing
  • Due to their connective tissue healing / repair action, asiaticoside-rich centella asiatica extracts, are ideal candidates for anti-ageing, wound healing, stretch mark and anti-cellulite, under eye care creams.
  • Source: Asiaticoside enhances normal human skin cell migration, attachment and growth in vitro wound healing model
  • Abstract: Wound healing proceeds through a complex collaborative process involving many types of cells. Keratinocytes and fibroblasts of epidermal and dermal layers of the skin play prominent roles in this process. Asiaticoside, an active component of Centella asiatica, is known for beneficial effects on keloid and hypertrophic scar. However, the effects of this compound on normal human skin cells are not well known. Using in vitro systems, we observed the effects of asiaticoside on normal human skin cell behaviors related to healing. In a wound closure seeding model, asiaticoside increased migration rates of skin cells. By observing the numbers of cells attached and the area occupied by the cells, we concluded that asiaticoside also enhanced the initial skin cell adhesion. In cell proliferation assays, asiaticoside induced an increase in the number of normal human dermal fibroblasts. In conclusion, asiaticoside promotes skin cell behaviors involved in wound healing; and as a bioactive component of an artificial skin, may have therapeutic value.
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Centella asiatica / gotu kola boosts wound healing by activating collagen cells

  • In a study examining the would healing activity of centella / gotu kola extract and dexpanthenol (a type of vitamin B5), it was found that both boost wound repair by activating fibroblasts, the cells that produce collagen and elastin in the body.
  • The connective tissue repair properties of centella make it an ideal anti-ageing / anti-cellulite / under-eye cream active ingredient.
  • Source: Testing Wound-healing Activity in T15 Fibroblast Cultures: A Morphometric Analysis.
  • Abstract: The purpose was to evaluate the use of mouse T15 fibroblast cell cultures for the investigation of wound-healing activity. In order to investigate their mechanisms of action, the effects of drugs with wound-healing activities were compared by using morphometric analyses by microscopy after cell staining. A number of parameters were used to evaluate the effects of titrated extracts from centella asiatica and dexpanthenol (drugs that have been used in medical practice for their wound-healing activities) on cultured mouse T15 fibroblasts. These parameters were : the total number of cells ; the number of T15 cells in mitosis ; the percentages of fusiform, polygonal, round and vacuole-containing cells ; and the number of intracellular collagen granules. The results indicate that these two drugs exhibit wound-healing activities by activating fibroblast cells, and have cytoprotective effects, although their mechanisms of action on mouse T15 fibroblasts were different. On the basis of our findings, mouse T15 fibroblast cell cultures seem to be useful for the pharmacological screening of compounds with wound-healing activity.
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Gotu kola / centella asiatica reduces leg heaviness, pain and oedema, review finds

  • In a meta-analysis of 8 randomised controlled trials assessing the efficacy of centella asiatica / gotu kola for chronic venous insufficiency (CVI) it was found that the herb significantly improves microcirculatory parameters, ankle swelling and other CVI signs such as leg heaviness, pain and oedema.
  • Multiple studies have shown that centella asiatica protects blood vessels from damage and stimulates their healing / repair, making it an identical active for use in supplements and topical creams against water retention, under-eye bags and cellulite.
  • Source: A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency.
  • Abstract: We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI). We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centellaasiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.
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Centella / gotu kola and rutin improve chronic venous insufficiency / water retention - clinical study

  • This is one of multiple clinical studies that report on the efficacy of centella asiatica and other natural vasoactive compounds (in this case, rutin, melilotus and vitamin E)
  • In this study, which was performed on patients suffering from chronic venous insufficiency / water retention without compressive stockings, the treatment group reported improved oedema, reduced cramps and overall reduced water retention symptoms, after just 30 days of treatment.
  • Rutin and centella asiatica are widely used in Europe in oral supplements against water retention, as well as anti-cellulite creams and leg wellness creams to offer relief against heavy legs
  • Melilotus is now used very little, while tocopherol seems to be unrelated to water retention improvement and unnecessary in the compound tested
  • Source: Effectiveness of the combination of alpha tocopherol, rutin, melilotus, and centella asiatica in the treatment of patients with chronic venous insufficiency
  • Abstract: BACKGROUND: The aim of this comparative clinical study was to evaluate the efficacy of the association of alpha tocopherol, rutin, melilotus officinalis, and centella asiatica with oral administration in patients with chronic venous insufficiency. METHODS: Thirty patients with chronic venous insufficiency have been randomized in two groups of fifteen subjects (control and treatment group). During the period of treatment the patients didn't wear elastocompressive stockings. The therapeutic efficacy and the clinical tolerability of this association have been valued with clinical-instrumental evaluations and by a control after 15 and 30 days. Functional bothers, cramps and the edema have been valued in function presence and of their gravity with a clinical-score between 0 and 4. RESULTS: At the end of the observation period, a significant improvement of the clinical simptomatology was obtained, characterised by a diminution of the sovrafascial edema. CONCLUSIONS: The present study confirms previous clinical experiences regarding the described treatment and suggests its application in chronic venous insufficiency
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Centella asiatica / gotu kola improves venous hypertension / water retention, placebo-controlled clinical study reports

  • Venous hypertension occurs when the return of blood from the lower legs towards the heart is inhibited, due to poor vein function, resulting in water retention as well as vein damage.
  • In a study which examined the effect of what is called the Total Triterpenic Fraction of Centella Asiatica (TTFCA) it was found that TTFCA does significantly improve vein function and veneers hypertension in just 8 weeks, resulting in objective improvement (better leg tissue oxygenation, better removal of carbon dioxide from tissues, improved overall circulation, reduced ankle swelling); and subjective improvement (feeling of heaviness, itching, pain, puffiness etc.) as reported by patients. The study showed that the higher dose of centella asiatica (120mg of TTFCA per day) offered the most impressive results. The placebo group experienced no results at all.
  • This is one of multiple studies about the effect of centella asiatica on circulation and vein health improvement. Centella asiatica (gotu kola) is widely used in Europe for water retention and skin firming, both as a nutritional supplement as well as an active ingredient in anti-cellulite / leg wellness creams. For cellulite / leg wellness creams, the best form of centella asiatica is one comprising 90-100% of any (or all) of the four important active molecules found in centella: pure asiatic acid, madecassic acid, madecassoside and asiaticoside, as used in this study. Creams can contain centella extracts with as little as 0.1% of those active molecules, so doing your research before choosing an anti-cellulite cream is essential
  • Source: Total triterpenic fraction of Centella asiatica in the treatment of venous hypertension: a clinical, prospective, randomized trial using a combined microcirculatory model
  • Abstract: A single-blind, placebo-controlled, randomized study was performed on the effects of different doses of the total triterpenic fraction of Centella asiatica (TTFCA) in patients with venous hypertensive microangiopathy. A combined microcirculatory model that considers laser Doppler flowmetry (LDF) and transcutaneous oxygen (PO2), transcutaneous carbon dioxide tension (PCO2) measurements was combined with the symptom evaluation. LDF tests included the baseline resting flow, the venoarteriolar reflex, and the variation of flow related to the temperature increase. All tests provided a significant difference between drug-treated groups and the placebo group, thereby allowing a distinction to be made between the higher (120 mg daily) and the lower (60 mg daily) dose of TTFCA. Transcutaneous PO2-PCO2 measurements were significantly modified by drug treatments, while no variation could be detected in the placebo group. Important symptomatologic effects (evaluated by subjective scores) followed TTFCA administration, especially at the higher dose level, while no effect was obtained with placebo. The trend of symptom evaluation paralleled the results of objective tests of our microcirculatory model, providing evidence that this model can reveal effects of venoactive drugs on venous hypertensive microangiopathy. TTFCA displays a significant activity. Doses as high as 120 mg daily may be safely used in venous hypertension.
  • Source 2: Effects of the total triterpenic fraction of Centella asiatica in venous hypertensive microangiopathy: a prospective, placebo-controlled, randomized trial.
  • Abstract 2: The aim of this study was to demonstrate whether total triterpenic fraction of Centella asiatica (TTFCA), was effective in improving the microcirculation in venous hypertension and microangiopathy. Forty patients with severe venous hypertension, ankle swelling, lipodermatosclerosis were included. After informed consent, patients were randomized into a treatment and a placebo group: those in the treatment group received TTFCA (tablets, 60 mg, twice daily for 8 weeks). The two groups of subjects were comparable for age and sex distribution. The mean age was 48 years (SD 9; M:F= 11:11) in the treatment group (22 patients) and 47.6 (SD 7; M:F= 10:8) in the placebo group (18 patients). There were no differences between placebo and treatment group at inclusion; there was no change between inclusion and measurements at 8 weeks in the placebo group. A decrease (p < 0.05) in RF (flux at rest) and RAS (rate of ankle swelling) were observed in the treatment group. The decrease in capillary filtration was associated with improvement in signs and symptoms (p < 0.05). The difference in flux, signs and symptoms, and filtration was clinically important at 8 weeks. No side effects were observed. In conclusion venous microangiopathy was improved by TTFCA treatment.
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Vegans have lower levels of vitamin D, omega-3 fatty acids EPA and DHA, ferritin and cholesterol than non-vegetarians - study

  • In a study published today it was found that vegans have lower total and LDLD cholesterol but also lower omega-3 fatty acids (EPA and DHA), beta carotene, iodine, vitamin B12 and folic acid levels in their bloodstream; higher isoflavones (daidzein and genistein), caffeic acid and ferrulic acid. Vegans also consumed less fruits and berries than non-vegetarians. There are a few points to be made about the results of this study:
  • Vegans were severely deficient in vitamin D3, having 1/3 of the levels of non-vegetarians: 31 nmol/L falls into the severe deficiency category, which increases the risk of cancer, immune conditions and heart disease. Since adequate amounts cannot be taken by vegetarian food and are only in plentiful supply by sun exposure or by animal foods, this result simply shows that vegans (especially women) do not just avoid meat but also they neurotically avoid the sun, even the 30' per day needed to maintain healthy levels of vitamin D3. In contrast, non-vegetarians have a half-decent level of 90 nmol/L. In order to to assist with immune function and cardiovascular / cancer disease protection, 4000IU per day of vitamin D3 supplementation is recommended to vegans avoiding the sun. Actually, vegans were found to receive 50% more vitamin D supplementation than non vegetarians, but unfortunately that was at very low levels and of the wrong/inactive type (vitamin D2).
  • Vegans have 7-12x times more isoflavones than other people, due to their excessive consumption of soy products. This can help with menopausal symptoms, but in any other respect it is considered excessive.
  • Vegans have 1.5-2x times more polyphenols (caffeic acid, ferulic acid) but 2.5x times less carotenoids, such as beta carotene. This presents a mixed picture.
  • Vegans had 1/3 of the ferritin levels of non-vegetarians, indicating iron deficiency problems
  • Vegans have 60% of folic acid and vitamin B12 than non-vegetarians, despite receiving 5x times more (!) supplementation of vitamin B12 than non-vegetarians
  • Vegans had 1/4 of the EPA highly unsaturated fatty acid (HUFA) omega-3 and 1/3 of the DHA highly unsaturated fatty acid levels of non-vegetarians, who clearly either ate a lot of oily fish or took fish oil supplements. Vegans instead tried to boost their EPA and DHA HUFA omega-3 levels by taking more flaxseed/linseed oil and hoping to convert LAN found in this'll into EPA and DHA. However, as the results of the study show, this evidently and predictably did not work (the body only converts 5% of LNA into EPA or DHA). The advice for vegans is to use the now widely available vegetable source EPA and DHA, instead of expecting their body to convert 5% of LNA into EPA and DHA.
  • Vegans had the same omega-9 (oleic acid) levels as non-vegetarians, indicating the same intake of olive oil
  • Vegans eat only 1/4 of berries than non-vegetarians, the same amounts of fruits in general, 2.5x times more fruit juices, 9x times more berry juices, 3x times more margarine (probably the worst fat you can eat), 40% less coffee, , 50% more tea, twice more sugar (!), 30% less sweets, 40% more chocolate, 30x times more tofu, only 10% more vegetables and 5x times more pulses.
  • Vegans predictably had 60% of the protein intake than non-vegetarians, but it was still at adequate levels (non-vegetarians probably took too much protein); 20% less overall fat; 20% more polyunsaturated fatty acids; 50% of saturated fat; but also 50% more carbs; 30% more fibre; 30% less vitamin C (!); same amounts of calcium; 25% more iron (but they still had less ferritin, showing poor iron absorption); and the same amount of calories per day.
  • Source: Food and Nutrient Intake and Nutritional Status of Finnish Vegans and Non-Vegetarians
  • Abstract: DISCUSSION: 4.1. Plasma lipids, antioxidants, and isoflavones. Some health-related and nutritional measures were more favorable in vegans than in non-vegetarians. Most importantly, the serum total cholesterol was 20% and LDL cholesterol was 25% lower in the vegan group than in the non-vegetarian group. Furthermore, vegans showed a more favorable fatty acid profile and higher serum concentrations of certain polyphenols compared with the non-vegetarians. These findings were likely the result of high consumption of rapeseed oil and margarines as well as soy and rye products. The vegans consumed relatively small amounts of fruit, berries, nuts, and root vegetables, which was the likely cause of the lower serum concentrations of β-carotene (p = 0.001) and α-tocopherol (p = 0.003) compared to the non-vegetarians. However, after calculating the ratio of serum β-carotene and α-tocopherol to cholesterol concentration, and when adjusted to the new threshold of statistical significance obtained in Bonferroni calculation for multiple comparisons (p<0.0016) the differences in these antioxidant nutrients were not statistically significant. The poorer antioxidant vitamin status of vegans disagrees with the findings of earlier studies [35]. This is likely because the non-vegetarian subjects of this study were health conscious, as shown by their high consumption of different vitamin and mineral supplements as well as fruits and berries. 4.2. Vitamins B12 and D. Despite the use of nutritional supplements, the serum vitamin B12 concentrations in the vegans were lower compared to the non-vegetarians (p = 0.002); however, only 5% of vegans had serum vitamin B12 concentration below 140 pmol/L. It therefore appears that the consumption of vitamin B12 supplements, which 91% of the vegan subjects consumed, maintained their serum vitamin B12 concentrations within the reference limits. The onset of deficiency symptoms such as neuropsychiatric disorders and megaloblastic anemia usually occurs in 5–10 years when the serum vitamin B12 concentration is below 150 pmol/L [36]. The serum total concentration of vitamin D (25-hydroxyvitamin D2 and D3) was 34% lower in the vegans than in the non-vegetarians. However, the vegans had higher concentrations of 25-hydroxyvitamin D2 (p<0.001). The fraction of subjects having serum vitamin D concentration >75 nmol/L, which is the level proposed by some researchers to be optimal for preventing adverse health conditions [37], was 10% in vegans and 78% in non-vegetarians. In addition, more vegans had a serum vitamin D concentration ≤50 nmol/L as compared to the non-vegetarians (24% vs. 6%). The reasons for the marginal vitamin D status are presumably neglecting supplementation (23% of vegans), irregular supplementation, and, possibly, the time of sampling. 25-hydroxyvitamin D3 (calcidiol) concentrations are typically lowest during the winter [38]. Similar lower calcidiol concentrations were reported in Finnish, British, and Vietnamese vegans. [8, 9, 20, 21]. 4.3. Iodine and selenium. All vegan subjects and 91% of the non-vegetarian subjects had iodine concentrations lower than the WHO’s limit for mild iodine deficiency (<100 μg/L urine). These data indicate that iodine intake may be insufficient in the Finnish population but particularly so in vegans, who do not consume milk products, the main source of iodine in many countries. Previously, goiter caused by iodine deficiency was common in Finland. However, after the fortification of table salt and cattle feed with iodine started some fifty years ago, iodine-deficiency-related goiter was eradicated. Today, the consumption of iodized table salt has decreased, partly because the food industry does not use iodized salt. Therefore, recommendations regarding iodine intake are not met by the general population [12]. Previous studies in vegans have also reported low urinary excretion of iodine. [6, 22, 23]. The serum selenium concentrations were lower in vegans than in non-vegans, however, on the whole, the values were similar to those found in countries that do not add selenium to fertilizers. It should be noted that Finland is the only country in the world that uses this strategy for supplementing the population with selenium [39]. The selenium intake was above the current nutrition recommendations [10] in both groups. The difference between groups is likely because dietary selenium is mainly obtained from animal products, which make up over 70% of the selenium intake in Finland [39]. 4.4. n-3 fatty acids. Compared to the non-vegetarians, the proportions of C15:0, C17:0, and CLA, obtained mainly from milk products, were negligible in the vegans, indicating strict compliance with the vegan diet. The percentages of EPA and DHA of all fatty acids were respectively 0.6% and 0.9% in the vegans, and they were clearly lower than in the non-vegetarians. These differences were expected because vegans do not consume fish or fish oil products. However, the observed proportion of EPA in the vegans was still higher than expected. These results support the view that linolenic acid (LNA) is converted to EPA in humans. One may regard the vegans in this study as a high LNA population, as they consumed relatively high amounts of rapeseed oil, a common vegetable oil in the Nordic countries and a rich source of LNA. In countries consuming other types of vegetable oils, vegans would likely show even lower proportions of EPA and DHA in plasma. On the other hand, it should be noted that this issue is not straightforward, because linoleic acid (LA) and LNA compete for enzymes involved in fatty acid metabolism. A previous study among Kenyan Maasai [40] showed that despite a negligible intake of EPA and DHA, the proportion of DHA in red blood cells (RBCs) was no less than half that of a German sub-cohort. The authors speculated that a low intake of LA could also be advantageous and favor the endogenous conversion of LNA to DHA at a state of competition between n-3 and n-6 fatty acids. The serum concentrations of the isoflavones genistein (p<0.001) and daidzein (p<0.001) were considerably higher in the vegans than in the non-vegetarians.
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How low molecular weight hyaluronic acid can reduce fat and fight obesity

  • Hyaluronic acid is now well-known for it's skin moisturising, joint lubricating and anti-ageing benefits. However, what is not known that depending on the size of the hyaluronan molecule, it can have different effects on the body.
  • Low molecular weight hyaluronic acid of around 50,000 Dalton (50kDa) size is already known to inhibit fat cell growth in the lab
  • Now a new study has shown that oral ingestion of such hyaluronic acid actually decreases body weight, fat tissues, LDL cholesterol triglycerides, leptin fatty liver in mice, indicating a direct anti-obesity effect.
  • The researchers have found that 50kDa hyaluronate inhibits the proteins PPAR-gamma and FAS, which have a "fattening" effect and boosts UCP2 and PPAR-alpha, which have a "slimming" effect.
  • This anti-adipogenic effect on fat cells means that low molecular weight hyaluronic acid may be an ideal ingredient for anti-cellulite creams
  • Source: Anti-obesity potential of enzymatic fragments of hyaluronan on high-fat diet-induced obesity in C57BL/6 mice.
  • Abstract: Hyaluronan has diverse biological activities depending on its molecular size. The hyaluronan fragments (50 kDa) can decrease adipogenic differentiation in vitro. However, in vivo anti-obesitic effects of hyaluronan fragments have not been elucidated. Therefore, we examined the anti-obesity effects of hyaluronan fragments on high-fat diet induced obesity in in C57BL/6 mice. Oral administration of hyaluronan fragments (200mg/kg for 8 weeks) decreased body weight, adipose tissues, serum lipid (low-density lipoprotein cholesterol, triglyceride), and leptin level. Hyaluronan fragments decreased the hypertrophy of adipose tissue and ameliorated liver steatosis. The mRNA expression of leptin was reduced in adipocyte by treatment with hyaluronan fragments. Additionally, hyaluronan fragments enhanced the mRNA expression of PPAR-α and its target genes UCP-2 and decreased mRNA expression of PPAR- γ and fatty acid synthase in liver. In conclusions, hyaluronan fragments had marked effects on inhibiting the development of obesity in obese mice fed the high-fat diet. It suggested that enhancing PPAR-α and suppressing PPAR-γ expression are two possible mechanisms for the anti-obesitic effect of hyaluronan fragments.
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How curcumin helps reduce blood sugar levels and fat accumulation

  • Curcumin, the anti-inflammatory, anti-ageing and anti-cancer compound from turmeric, is well-known for it's anti-adipogenic / slimming activity and thereby it's usefulness in anti-cellulite creams
  • Turmeric acts via various pathways to inhibit growth of fat cells and in a recent study yet one more fat accumulation inhibiting pathway has been discovered: turmeric inhibits glucose absorption by intestinal cells, by blocking the protein GLUT1
  • This leads to blood sugar reduction and fat reduction and is in addition to turmeric's inhibiting effect on GLUT4, which blocks glucose absorption by fat cells
  • The researchers state that due to the blockage of GLIT1 turmeric may also compromise cancer cells that depend on GLUT1 for glucose absorption
  • Source: Curcumin directly inhibits the transport activity of GLUT1.
  • Abstract: Curcumin, a major ingredient in turmeric, has a long history of medicinal applications in a wide array of maladies including treatment for diabetes and cancer. Seemingly counterintuitive to the documented hypoglycemic effects of curcumin, however, a recent report indicates that curcumin directly inhibits glucose uptake in adipocytes. The major glucose transporter in adipocytes is GLUT4. Therefore, this study investigates the effects of curcumin in cell lines where the major transporter is GLUT1. We report that curcumin has an immediate inhibitory effect on basal glucose uptake in L929 fibroblast cells with a maximum inhibition of 80% achieved at 75 μM curcumin. Curcumin also blocks activation of glucose uptake by azide, glucose deprivation, hydroxylamine, or phenylarsine oxide. Inhibition does not increase with exposure time and the inhibitory effects reverse within an hour. Inhibition does not appear to involve a reaction between curcumin and the thiol side chain of a cysteine residue since neither prior treatment of cells with iodoacetamide nor curcumin with cysteine alters curcumin's inhibitory effects. Curcumin is a mixed inhibitor reducing the Vmax of 2DG transport by about half with little effect on the Km. The inhibitory effects of curcumin are not additive to the effects of cytochalasin B and 75 μM curcumin actually reduces specific cytochalasin B binding by 80%. Taken together, the data suggest that curcumin binds directly to GLUT1 at a site that overlaps with the cytochalasin B binding site and thereby inhibits glucose transport. A direct inhibition of GLUT proteins in intestinal epithelial cells would likely reduce absorption of dietary glucose and contribute to a hypoglycemic effect of curcumin. Also, inhibition of GLUT1 activity might compromise cancer cells that overexpress GLUT1 and be another possible mechanism for the documented anticancer effects of curcumin.
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Lactobacillus probiotics, combined with ultrasound cavitation treatment, reduce body weight!

  • It is now well known that chronic low grade inflammation contributed obesity and lactobacillus probiotics inhibit weight gain caused by inflammation, by regulating the immune system.
  • On the other hand, ultrasound cavitation treatment is a well-known spot fat reduction technique.
  • In this study, researchers combined ultrasound treatment with probiotic ingestion and found that overall full body weight loss in mice after 8 weeks of treatment was 69% in the ultrasound/lactobacillus group, in comparison to 52% in the lactobacillus-only group and 37% in the ultrasound-only group. So for overall full body weight loss lactobacillus was more effective than ultrasound, and the combination of the two was more effective than each of them separately.
  • On the other hand, on the specific fat tissue where ultrasound cavitation treatment was directly applied, cavitation was clearly superior to lactobacillus bacteria, while the combination of the two was still better than each treatment alone, but only slightly so, showing the superior effectiveness of ultrasound for spot fat removal. The fat tissue thickness after 8 weeks of treatment was as follows:
    • No treatment: 1150 μm
    • Lactobacilli treatment: 1060 (very slight improvement at local level)
    • Ultrasound treatment: 370μm (huge improvement at local level)
    • Ultrasound + lactobacilli treatment: 340μm (small improvement at local level, in relation to ultrasound-only)
    • So in summary, this study showed that lactobacillus probiotics help with whole body fat loss but not local fat loss; that ultrasound helps with local body fat loss but not much for overall fat loss; and that the combination produces maximum results on whole body levels but not much better than ultrasound on local fat tissue. Fat cell size and blood lipids also improved due to the combination treatment.
    • Of course, when it comes to slimming, results in mice are always much more pronounced than in humans, so expectations should be more conservative when it comes to humans. But the overall tendency is correct and it clearly applies to humans. ultrasound cavitation has been effectively used for more than a eat now to reduce local body fat, while probiotics also seem to modestly help with whole body weight loss. Combining the two could help maximise the results of ultrasound cavitation treatment, and most probably that of radiofrequency fat / cellulite treatment too, as they work in the same way.
    • Source: Combining ultrasound and lactobacilli treatment for high-fat-diet-induced obesity in mice
  • Abstract: Chronic systemic lipopolysaccharide-induced inflammation can cause obesity. In animal experiments, lactobacilli have been shown to inhibit obesity by modifying the gut microbiota, controlling inflammation and influencing the associated gene expression. A previous study found that high-fat-diet-induced (HFD) obesity was suppressed by lactobacilli ingestion in rats via the inhibition of parasympathetic nerve activity. This study explored the combined use of lactobacilli ingestion and ultrasound (US) to control body weight and body fat deposition in HFD mice over an 8-week experimental period. Male C57BL/6J mice received an HFD during treatment and were randomly divided into four groups: (i) control group (H), (ii) lactobacilli alone (HB), (iii) US alone (HU) and (iv) lactobacilli combined with US (HUB). The US was targeted at the inguinal portion of the epididymal fat pad on the right side. At the 8th week, body weight had decreased significantly in the HUB group (15.56 ± 1.18%, mean ± SD) group compared with the HU (26.63 ± 0.96%) and H (32.62 ± 5.03%) groups (p < 0.05). High-resolution microcomputed tomography (micro-CT) scans revealed that the reduction in total body fat volume was significantly greater in the HUB group (69%) than in the other two experimental groups (HB, 52%; HU, 37%; p < 0.05). The reductions in the thickness of the subcutaneous epididymal fat pads were significantly greater in the HUB group (final thickness: 340 ± 7 μm) than in the H (final thickness: 1150 ± 21 μm), HB (final thickness: 1060 ± 18 μm) and HU (final thickness: 370 ± 5 μm) groups (all p < 0.05). Combination therapy with lactobacilli and US appears to enhance the reduction in body weight, total and local body fat deposition, adipocyte size and plasma lipid levels over an 8-week period over that achieved with lactobacilli or US alone in HFD mice. These results indicate that US treatment alone can reduce hyperlipidemia in HFD mice.
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Why most cellulite creams don’t work?

  • If you have used cellulite creams before, you would know that most of them don't do much (if anything) or at best they offer a short-term effect. This is because most creams contain very little in the way of active ingredients and aim for a quick short-term effect (gimmick) based on functional ingredients (the "base" of the cream). 
  • The problem with cellulite is that, as we mentioned elsewhere on this website, it is a complex aesthetic problem. So by definition, an anti-cellulite cream that "works" must contain high concentrations of several high purity active ingredients, which act on many or all the aspects of cellulite, as mentioned above. However, out of ignorance and/or for reasons of keeping costs low and profits high, most anti-cellulite creams contain one, two or three active ingredients, of low specification and at low concentrations, hence the complaints by the public about cellulite creams.
  • Another reason is the use of the cellulite cream for too short a time for it to create any real changes. Adipose tissue and connective tissue take several weeks to respond to any anti-cellulite cream or treatment. So a 2-3 week use before holidays of even the best cream will not produce anything other than a short-term result based on water retention (puffiness) reduction.
  • Furthermore, for cellulite to be reduced, a healthy lifestyle must be maintained, which means exercise and avoidance of sweets, fried food, fatty food, excessive carbs, smoking and alcohol. It is unrealistic to indulge on all the above and then expect from a cream - or even a treatment - to offer any results. Unfortunately, in the fight between chocolate muffins and anti-cellulite creams the muffins win.
  • And finally, genetics and the overall health of the user has to be taken into account. A young, healthy woman with good genes will react faster and better than an older one, or one who suffers from different health/metabolic problems, or one who has "fat" genes, even if they have an identical lifestyle. In the latter case, more discipline with lifestyle and more perseverance with cellulite reduction methods (treatments, creams) will be needed.
  • So, in summary, there are three reasons why cellulite creams do not work: cream quality; lifestyle; genetics / overall health. A cream manufacturer has the responsibility to offer a quality, multi-ingredient cream that offers the user the best chances of reducing her cellulite, if she follows a healthy, cellulite-busting lifestyle. The rest really is up to nature!
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What is cellulite and what kind of cellulite creams can help reduce it?

  • Cellulite is scientifically defined as Oedematous Fibrosclerotic Superficial Panniculitis (OFSB). In plain English this means: inflammation of the excessive superficial deposits of fat, accompanied by water retention and connective tissue deformity / scar tissue. Cellulite has also been likened to hypodermal stretch marks, i.e. stretch marks of the deeper layers of the skin (hypodermis).
  • Since in most cases cellulite is accompanied by skin and connective tissue looseness, we should add that component to the official definition. In most cases, oxidation, glycation and capillary weakness / excessive permeability are also contributors to cellulite and integral aspects of this complex aesthetic condition.
  • Regarding cellulite creams, it is evident by the complex nature of cellulite that one, two, or even three active ingredients cannot be of much help. A multi-pronged approach that tackles all aspects of cellulite is needed: fat accumulation, skin/connective looseness/injury, circulation, glycation, oxidative damage, inflammation.
  • Therefore, an effective cellulite cream is one that contains multiple active ingredients that act on all aspects of cellulite, in high concentrations.
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Is it the cellulite cream that works or the massage action by which the cream is applied?

  • This is yet another urban myth propagated by ignorant people who know nothing about anti-cellulite massage, or cellulite reduction in general, for that matter.
  • The one-minute amateur light massage needed to apply a cream is 60x times less effective than a light sixty-minute anti-cellulite massage. And it is probably 180x times less effective than a proper, full-on, strong anti-cellulite massage.
  • Now, if you have had one of the light cellulite massages before, you would already know that these don't do anything for cellulite. And if you were lucky enough to have found a specialist therapist who offers the super-strong variety, you would also know that at least six sessions of that super-strong, skilled, sixty-minute massage is necessary to see some good results, with twelve sessions being ideal.
  • So in summary, the one-minute amateur massage applied every day to help absorb the cream is 1,080 times less effective than a course of six proper anti-cellulite massages, that are needed for some decent results and decent customer satisfaction. So if any results that are produced by an anti-cellulite cream are definitely down to the cream and not to the little massage needed to absorb the cream.
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Do cellulite creams get absorbed?

  • The myth that creams do not get absorbed is propagated by ignorant people who have never bothered to read a science paper on this matter. Creams do get absorbed and there are thousands of science papers dedicated to transdermal absorption of creams - just have a look at this list for a start. Last time we checked there were 16,072 science papers on the subject: http://www.ncbi.nlm.nih.gov/pubmed/?term=transdermal+absorption.
  • There are also entire textbooks written on the subject of increasing transdermal / percutaneous absorption of creams containing cosmetic active ingredients or even drugs into the skin:
    • http://www.amazon.co.uk/Topical-Transdermal-Drug-Delivery-Principles/dp/0470450290
    • http://www.amazon.co.uk/Percutaneous-Penetration-Enhancers-Second-Edition/dp/0849321522
    • http://www.amazon.co.uk/Transdermal-Drug-Delivery-Systems-Pharmaceutical/dp/082470861X
    • http://www.amazon.co.uk/Transdermal-Drug-Delivery-Adrian-Williams/dp/0853694893
    • http://www.amazon.co.uk/Skin-Barrier-Principles-Percutaneous-Absorption/dp/3805563264
  • In fact, since July 2013 the effect of skin absorption of active and functional ingredients of cosmetics is regulated by law in the EU, according to "EU Cosmetics Regulation 2009", with very strict guidelines on the level at which different substances can be absorbed into the body (of course our products fully comply with these very strict EU laws).
  • All in all, creams do get absorbed and there are multiple ways to maximise and also speed or delay absorption, depending on the intended effect of the cream.
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Critique of a 30% vitamin C facial care regimen

  • A facial care regimen based on HUGE amounts of vitamin C (30%), retinol (0.5%), bakuchiol, CoQ10, vitamin E and herbal extract of ophiopogon japonica improved pigementation and overall facial condition in 12 weeks, as was found by a recently published study, but also increased skin dryness for 8 weeks
  • However, the use of 30% (!) vitamin C is quite pointless in order to improve pigmentation, as the same result can be achieved by 1-2% curcumin or resveratrol, which in addition have more potent anti-ageing effects than vitamin C. To be honest, I really fail to understand why such mega doses need to be used...
  • The use of multiple actives is commendable, however, and it is a nice departure from creams containing only a couple of actives. However, it would be nice if the formulators used the 28% of the excess vitamin C (2% is absolutely fine, more is not needed) to add other more advanced actives, for better synergy, better results and higher customer satisfaction.
  • Retinol contributed to the anti-ageing effect but also to skin dryness
  • Vitamin E, bakuchiol and CoQ10 also contributed to anti-ageing
  • Source: An Open Label Clinical Trial to Evaluate the Efficacy and Tolerance of a Retinol and Vitamin C Facial Regimen in Women With Mild-to-Moderate Hyperpigmentation and Photodamaged Facial Skin.
  • Abstract: A 12-week open-label, single-center clinical usage trial was conducted to determine the effectiveness of a dual product regimen consisting of a 0.5% retinol treatment and an anti-aging moisturizer with 30% vitamin C in women with mild to moderate hyperpigmented and photodamaged facial skin. Clinical grading of several efficacy parameters, tolerability evaluations, subject self-assessment questionnaires, and digital photography were completed at baseline and at weeks 4, 8, and 12. A total of 44 women completed the study. Effective ingredients incorporated into the 0.5% retinol treatment included encapsulated retinol for a retinol concentration of 0.5%, bakuchiol, and Ophiopogon japonicus root extract. The anti-aging moisturizer with 30% vitamin C contained 30% vitamin C in the form of tetrahexyldecyl ascorbate (THD ascorbate), alpha-tocopheryl acetate (vitamin E) and ubiquinone (coenzyme Q10). The facial regimen produced a statistically significant decrease (improvement) in clinical grading scores for all parameters assessed at weeks 8 and 12 when compared with baseline scores. In addition, the majority of these parameters were improved at week 4. The test regimen was well-perceived by the subjects for various inquiries regarding facial skin condition, product efficacy, and product attributes. Several tolerability parameters were assessed with no statistically significant increase except for dryness. A statistically significant increase in clinical grading scores for dryness on the face occurred at weeks 4 and 8 when compared to baseline scores. The increase in dryness is expected when introducing a retinol product to a facial regimen and the dryness did not persist to the week 12 time point.
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Can deep tissue massage reduce my cellulite?

  • This is a common question: "I have tried various types of massage to reduce my cellulite but it seems they don’t really work. At the gym I was advised that deep tissue massage can reduce cellulite - is that true?"
  • The short answer is "no". The long answer follows:
  • Deep tissue massage is a technique specific to muscles, deep fascia and other deep tissues of the body, under the skin, where cellulite is found. It improves muscle circulation and muscle lymph drainage as well as reducing tension in the muscles and deep fascia. It is essential for sportspeople and sedentary people alike in the prevention and treatment of muscular tension
  • However, cellulite is a superficial tissue, found at the bottom layer of the skin, called the hypodermis, which is way above the muscles on which deep tissue massage acts
  • In deep tissue massage (also called sports massage or remedial massage) the pressure of the therapist is not applied on the cellulite layer in any specific way that will offer appreciable results in cellulite reduction, and therefore most of the benefits of this massage technique are seen on the muscles - not the “cellulite layer”
  • Furthermore, cellulite, being a complicated aesthetic condition can not be expected to respond to any simplistic, non-specific massage measures, including deep tissue massage.
  • Consequently, I can safely say that deep tissue massage is a waste of time as a cellulite reduction method and you should consider cellulite-specific massage or other more effective cellulite treatments, such as high power monopolar radiofrequency.
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How gotu kola can boost skin firming and help reduce cellulite

  • Asiaticoside is one of the four main chemicals responsible for the tissue repair activity of the Indian herb gotu kola (centella asiatica)
  • Asiaticoside is already known to boost the production of collagen type I (the skin firming protein) in collagen cells, and in this study it was found that asiaticoside exerts this effect without causing fibrosis.
  • This is very useful in cellulite reduction, strecth mark healing and wound healing, where we need to boost collagen levels but without causing fibrosis
  • So in practice, gotu kola extracts rich in asiaticoside can aid in wound healing, stretch mark reduction and cellulite reduction / prevention, as active ingredients in creams or even taken orally
  • Source: Asiaticoside induces human collagen I synthesis through TGF-beta receptor I kinase (TbetaRI kinase)-independent Smad signaling
  • Abstract: Skin aging appears to be principally related to a decrease in the levels of type I collagen, the primary component of the skin dermis. Asiaticoside, a saponin component isolated from Centella asiatica, has been shown to induce type I collagen synthesis in human dermal fibroblast cells. However, the mechanism underlying asiaticoside-induced type I collagen synthesis, especially at a molecular level, remains only partially understood. In this study, we have attempted to characterize the action mechanism of asiaticoside in type I collagen synthesis. Asiaticoside was determined to induce the phosphorylation of both Smad 2 and Smad 3. In addition, we detected the asiaticoside-induced binding of Smad 3 and Smad 4. In a consistent result, the nuclear translocation of the Smad 3 and Smad 4 complex was induced via treatment with asiaticoside, pointing to the involvement of asiaticoside in Smad signaling. In addition, SB431542, an inhibitor of the TGFbeta receptor I (TbetaRI) kinase, which is known to be an activator of the Smad pathway, was not found to inhibit both Smad 2 phosphorylation and Type 1 collagen synthesis induced by asiaticoside. Therefore, our results show that asiaticoside can induce type I collagen synthesis via the activation of the TbetaRI kinase-independent Smad pathway.
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Gotu kola improves microcirculation and blood vessel function / health

  • In this study on 87 patients over two months it was found that concentrated gotu kola / centella asiatica extract improves circulation and tissue oxygen levels and reduces venous hypertension, venous inflammation and carbon dioxide levels, with higher doses poroducing better results.
  • Gotu kola is very well established as a circulation-boosting, vein health-protecting active, and due to these properties it is used in both food supplements and leg wellness / anti-cellulite creams.
  • Source: The microcirculatory activity of Centella asiatica in venous insufficiency. A double-blind study
  • Abstract: In 87 patients with chronic venous hypertensive microangiopathy the efficacy of oral FTTCA (Centella asiatica) administered for 60 days was tested. The microcirculatory effects of two dosages (30 mg bid and 60 mg bid) versus placebo was assessed in a double blind study. The compound was well tolerated and no unwanted effects were observed. Microcirculatory parameters--peri-malleolar skin flux at rest (RF) and transcutaneous PO2 and PCO2--improved as did the abnormally increased RF, PCO2 decreased and PO2 increased in comparison with values measured at inclusion. These results confirm the efficacy of FTTCA in venous hypertensive microangiopathy. Furthermore the effects of FTTCA appear to be dose-related.

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