IHR - July / August 2011 Issue

YOUR HEALTH CATEGORY SOURCE
For Mobile Issue!
SCAN ME
The Best of Both Worlds | $6
PUBLICATIONS MAIL 40678000 | 60 BLOOR STREET WEST SUITE 1106 | TORONTO ONTARIO, M4W 3B8
The Best of Both Worlds

Bob Mehr, of Bob Mehr Compounding Pharmacies, BC
Continuing Education:
Sponsored by Webber Naturals
Natural Health Products for Weight Loss
C.E. Credit:
1.75 CEUs
Tea Tree Oil from Holista
Tea Tree Oil is essential for a well-stocked natural health medicine cabinet. Its antiseptic, antibacterial and antifungal properties make it the ultimate product for convenient family rst aid, health, and beauty!
Potent Tea Tree Oil

Natures First Aid in a Bottle!
A potent antiseptic and germicide that can be applied to minor cuts, abrasions, acne, stings, and more. The convenient spray is perfect for freshening hands or feet, or for gently treating minor cuts, scrapes or infected areas.
Skin Health
Protect, Soothe, and Moisturize Skin
Natural antibacterial action without the negative side effects such as dryness, redness or peeling. These fresh scented lotions can be used as daily moisturizers or to help relieve acne and fungal skin infections.
Scalp & Foot Health

Combat Head Lice, Dandruff and Athletes Foot
An effective natural alternative to potentially toxic chemical lice treatments. Topical use of Tea Tree Oil can relieve athletes foot symptoms, including inammation, itching and burning.
Call today and ask about adding Canadas #1 selling Tea Tree Oil* products to your shelves! 1.800.204.4372
* Nielsen MarketTrack, National All Channels, 52 Weeks Ending June 5, 2010
For details, write #101 on Free Info Page, page 73.
New! Tea Tree Spray
New! Hand & Body Lotion
ESSENTIALS
Omega-3
softgels
100
softgels
90
softgels
100
60
softgels
90
softgels
75
90 softgels
avoured softgels
120
50
The Premium Line of Omega-3 Formulas from webber naturals

Want more information about webber naturals products? 1-800-430-7898 | www.webbernaturals.com Follow us on : @webbernaturals | Like us on : www.facebook.com/webbernaturals
Herbals and supplements from webber naturals are advertised on national television, major market radio, in consumer magazines, and daily newspapers.
Teaming up for a healthier, longer life

Our popular One-Per-Day Triple Strength Omega-3 delivers over 600 mg EPA and 300 mg DHA, doses recommended to help lower cholesterol, triglycerides, and blood pressure, and to support cognitive health. Now combined with either Coenzyme Q10 or Vitamin Din the same enteric-coated softgel this product has even greater appeal. Triple Strength Omega-3 with Coenzyme Q10 CoQ10 and Omega-3 are two evidence-based nutritional supplements that support and protect the heart by helping reduce serum triglycerides. CoQ10 is essential for cellular energy production, which is especially important in large, active muscles like the heart. It is also a powerful antioxidant and an effective preventive therapy for migraine sufferers. Triple Strength Omega-3 with BONUS D Vitamin D and sh oil have been described as the two most important supplements for health and longevity. Vitamin D is important for proper bone growth and strength, and is increasingly recommended for its role in maintaining immune function, cardiovascular health, and cancer prevention. This formula includes 1000 IU of vitamin D3, and its still just one softgel per day.
Crystal Clean from the Sea

Omega-3 ESSENTIALS contain MEG-3 sh oil, a safe and pure product from naturally sourced ocean sh. It is produced by a unique patented process, ensuring crystal clean sh oil, free of contaminants.
publishers letter
YOUR HEALTH CATEGORY SOURCE
ISSN 1197 - 1495 |
Volume 11 Issue 5
Publisher & Editor-in-Chief

Olivier Felicio
Editor
Carlos Weigle
Associate Editor
Katherine Low
Editorial Assistant
Jessica Uniac
Editorial Intern
Irina Lytchak
Art Director
Scott Jordan
Design Intern
Angie Gaal
Production Coordinator
Jacqueline DSouza
Contributors
Denise Deveau Katie Huisman John A. Macdonald Linda Miles Sarah OConnor Joel B. Taller Ken Vannucci
President
Olivier Felicio
Controller & Operations Manager

Melanie Seth
Finance Administrator
Leslie Witol
Web Programmer
Matthew Pompey
Scan this code with your cell phone to be linked directly to the Publishers letter online. Look for more of these codes in future issues. To scan the code: For BlackBerrys: Go to your BlackBerry messenger and select Scan Barcode. For iPhones: Use the App Store to download Beetagg Reader Pro.
Sales Assistant
Erin Poredos
Subscription Rates Canada $50 (gst included) for nine issues (one year) USA $60 Change of Address email: ihr@publicationpartners.com telephone: 416-203-7900 fax: 416-703-6392 or send your cover label and new address to ihr c/o Rive Gauche Media, 60 Bloor St., W., Suite 1106, Toronto, ON Canada L1V 1A1 Advertising Information Olivier Felicio telephone: (416) 203-7900 x 6107 email: olivier@rivegauchemedia.com Customer Service: Marsha Miller telephone: (416) 203-7900 x 6126 email: marsha@gorgmgo.com Published by Rive Gauche Media Inc.
livier Fe licio O
Olivier Felicio
Publisher & Editor-in-Chief
TM
Canada Post Canadian Publications Mail 4067800 The publisher does not assume any responsibility for the contents of any advertisement and any and all representations or warranties made in such advertising are those of the advertiser and not of the publisher. The publisher is not liable to any advertiser for any misprints in advertising not the fault of the publisher and in such an event the limit of the publishers liability shall not exceed the amount of the publishers charge for such advertising. No portion of this publication may be reproduced, in all or part, without the express written permission of the publisher. ihr magazine is pleased to review unsolicited submissions for editorial consideration under the following conditions: all material submitted for editorial consideration (photographs, illustrations, written text in electronic or hard copy format) may be used by ihr Media Inc. and their affiliates for editorial purposes in any media (whether printed, electronic, internet, disc, etc.) without the consent of, or the payment of compensation to, the party providing such material. Please direct submissions to the Editor, ihr magazine.
IHRmagazIne.com JULy/AUGUST 2011
Continuing Education: Keep learning new information from industry experts.
Industry News: Stay up to date with all the recent news in the industry.
Stock Reports: Stay on top of the business.
Cover Stories: Read about the dierent retailers working in Canada. Cover Contest: Vote on the latest cover selections for upcoming issues.
Banner Advertising: Attract new clients through eye-catching advertisements.
Social Media: Stay informed and in touch with your customers and collegues.
The NEW!! IHR Website

For More Information Please Contact: Customer Service marsha@gorgmgo.com 416-203-7900 ext. 6126
editorial board
We believe that you, the retailer, dictate the tone and direction of the magazine, which in turn, allows us to provide you with the most accurate information that is relevant to your business. ihr works with a knowledgeable group of industry leaders whose mandate is to ensure the relevance of the publication. Our editorial committee is comprised of thought-provokers who have shaped the industry and whose experience is vital in providing you with tools to succeed. The ihr editorial committee is led by the following individuals:
Andrew Betts Category Manager, Natural Foods Thrifty Foods
Sanjiv Jagota President Natures Source
Gilles Houde President and COO GNC Canada
Olivier Felicio President Rive Gauche Media
Aaron Skelton, BSc (NNS) Sr. Category Manager Health Food Natural Value, Soins Naturels, Loblaw Companies Ltd.
IHRmagazIne.com JUly/aUgUsT 2011
For Details, write #104 on Free Info Page, page 73
38 . EMBRACE LIFE IN A BLUR
contents
Volume 11 . Issue 5 UP FRONT PUBLISHERS LETTER .....................................................................6 EDITORIAL BOARD...........................................................................8 CONTRIBUTORS..............................................................................12 GET THE GOODS ...........................................................................13 SKU REVIEW ....................................................................................14 TOP SELLER ....................................................................................18 NEWS INDUSTRY NEWS ...............................................................................20 FEATURES COMPANY PROFILE: Lakota .........................................................24 44 . PUTTING LOYALTY TO THE TEST COVER STORY: The Best of Both Worlds .....................................28 Let Them Talk .................................................................................34 Embrace life in a blur .......................................................................38 Good Learnings ...............................................................................40 Putting Loyalty to the Test ............................................................44 Turning Back the Clock ..................................................................48 Whats On Your Label? ...................................................................52 END NOTES CONTINUING EDUCATION: Natural Products for Weight Loss .......54 RESEARCH NEWS ..........................................................................72 FAX BACK ........................................................................................73
28 . THE BEST OF BOTH WORLDS
48 . TURNING BACK THE CLOCK
GLUTEN FREE
NO SUGA R ADDED
LOW IN CALORIES
INTRODUCING INTUITION TM, THE WORLDS FIRST HERBAL INFUSED LIQUID CONCENTRATE!
KEY BENEFITS
Herbal bene ts to ne-tune the body Easy to dissolve and absorb into the system Unique, creative packaging (patent pending) Convenient, portable tube for on-the-go Low calories, gluten-free, no sugar added Refreshingly delicious!
NOW AVAILABLE: MY WAISTLINE & MY VITALITY

Intuition TM is a line of preventative products that o er a variety of health bene ts through a special blend of medicinal herbal tinctures and juice concentrates, delivered in a delicious, low calorie, add-to-water mix. This all natural beverage comes in a convenient, on-the-go tubejust peel and squeeze into hot, cold or sparkling water.
Floor Display includes 18 x My Waistline 3 pack 18 x My Vitality 3 pack 6 x My Waistline 14 pack 6 x My Vitality 14 pack Code 436910
Suggested Retail Pricing: 3 Pack - $5.99 / 14 Pack - $24.99 Great value for consumers
Now available through Purity Life Health Products. To order call 1 800-265-2615 For Product information call Mon tello Inc. 1 866-808-8889
Make a cocktail with it!
www.drinkintuition.com
contributors
John already talked about why you should be using social media (see previous issue). Now he wants you to take stock of what you have and make the most of it. Go to page 34 for all the details. John helps technology firms to grow and teaches at the Schulich School of Business. He is the co-founder of Urbis Social Media and a consultant on that subject.
Joel Taller is a partner in Gowlings Ottawa office, practising primarily in the area of product regulation. He advises a variety of clients around the world on regulatory matters ranging from labelling issues to recalls concerning food, nutritional supplements, drugs, traditional herbal medicines, Natural Health Products, cosmetics and medical devices. This time, he also helps us decipher the new labelling requirements regarding allergens. Check out the new list on page 52. Dr. Linda Miles L. Ac., D.O. M., is a Doctor of Oriental Medicine and Holistic Practitioner and a spokesperson for the natural health & beauty industry. She has developed innovative natural personal care products for over 30 years. Flip to page 48 for her expert take on the effect of antioxidants on your skin. See which ones make it to her top list.
Katie Huisman was tasked with capturing and styling Bob Mehr from Bob Mehr Compounding Pharmacies in Vancouver for our cover. She studied at the Alberta College of Art and Design, graduating and winning the Governor General Award in 2004. Katie spent two years living and working overseas, assisting and receiving mentorship from photographers such as Adam Custins and Robert Kent. She is now a commercial photographer and visual artist based in Vancouver and, although she is busy shooting advertising and editorial work, she exhibits her fine art work regularly and has shown publicly across Canada.
FROM THE PUBLISHER

The 2008 recession hurt us all, in one way or another. Most of us went into survival mode and tried to weather the storm as best as we could. Finally, after so much gloom and doom, summer 2010 is bringing us sun, warm temperatures and very good news for the natural health & beauty industry. According to a recent report by market research firm Organic Monitor, the North American natural and organic personal care market experienced a welcome rebound in 2010, with a 10 per cent growth. Sales, according to the same report have exceeded $5 billion last year and are expected to reach $8 billion annually by 2017. Its time for us to grow. Bob Mehr is a good example of someone who has always believed in the industry, even through rough times. Thats probably the reason why he managed to go from owning one pharmacy to 10 and employing 135 people, all in just 12 years. Interestingly enough, he got to where he is now without compromising his belief in combining both traditional and alternative medicines (see page 28). Courage is important in a time of crisis. Preparing yourself for whatever comes next is certainly as valuable. For instance, do you know which weight-loss supplements will soon fill the shelves? Go to our continuing education lesson (page 54) to find out. The time for fear is over. Take a summer break if you can and start thinking about getting your business back to a growing path. The opportunities are there and we need to be ready to seize them.
12
IHRmagazIne.com JULy/AUGUST 2011
GOODS
WEBBER NATURALS PEPPERMINT OIL
Peppermint Oil can be used to calm an upset stomach, cramps, nausea, vomiting, and motion sickness. It can be taken with meals as a digestive aid and is a great choice for those looking for a natural source alternative to other anti-nausea and anti-vomiting products in the market
The rst 100 retailers to FAX us at 1-888-849-0155 will get these goods for FREE
HOLISTA TEA TREE SPRAY

Tea Tree Spray is a powerful antiseptic and germicide that can be applied to minor cuts, abrasions, acne, stings and more. This convenient product is perfect for freshening hands or feet, or for gently treating minor cuts, scrapes or infected areas. Its a great addition to all rst-aid kits! .
INTUITIONTM MY WAISTLINE
My Waistline is a special blend of medicinal herbs including yerba mate and dandelion root , and other appetite suppressing and body cleansing herbs, juice concentrates and natural avours delivered in a delicious add-to-water concentrate. It works to stimulate your metabolism, suppress your appetite and facilitate the way your body processes the food you eat.
Get me these goods! Fill out the form below clearly and completely.
Name: Store: Address: City: Province: Phone: Fax: Email: Postal Code:
JULY/AUGUST 2011 IHRMAGAZINE.COM
FREE
13
GET THESE
sku review
HOLISTA TEA TREE SPRAY WEBBER NATURALS PEPPERMINT OIL
Peppermint Oil can be used to calm an upset stomach, cramps, nausea, vomiting, and motion sickness. It can be taken with meals as a digestive aid and is a great choice for those looking for a natural source alternative to other antinausea and anti-vomiting products in the market. For more information write 114 on page 73. Tea Tree Spray is a powerful antiseptic and germicide that can be applied to minor cuts, abrasions, acne, stings and more. This convenient product is perfect for freshening hands or feet, or for gently treating minor cuts, scrapes or infected areas. Its a great addition to all rst-aid kits! For more information write 115 on page 73.
ANDALOU NATURALS CITRUS VERBENA BODY LOTION

The unique Advanced Fruit Stem Cell Science renews skin at the cellular level, blending nature and knowledge for visible results. Invigorating citrus verbena, organic aloe vera, apricot and sunower oils effectively hydrate and replenish to nourish skin. For more information write 116 on page 73.
SISU STRESS RESCUE L-THEANINE

SISU Stress Rescue features L-Theanine, which has been shown to reduce anxiety and improve mental focus. It is non-sedating, non-habit forming and provides quick relief in stressful situations, with the effects lasting for hours. Stress Rescue is available in high-potency, vegetarian capsules, or great-tasting, natural cherry, low-calorie chewable tablets, in convenient take-and-go packaging with a ip-top lid. For more information write 117 on page 73.
14
IHRMAGAZINE.COM JULY/AUGUST 2011
DIET TIMETHE NEW NORDIC WAY!

NOW ER ONG STR MULA FOR
No.1 Herbal Detox in Europe
BIOFIRM
Burn off the fat with spices
CHILI BURN
Eat carbs and lose weight
MULBERRY
APPLE CIDER 600

Lose excess retained water
NEW: New Nordic products are now being distributed in Canada exclusively by Nutripur Inc!
For information or to order (with a special deal for new customers), please call Nutripur at 1-877-Nutripur or email info@nutripur.com.
sku review
Ju s t e d ch laun
GENUINE HEALTH LIVE PROBIO+ O3MEGA

Here comes the worlds rst super probiotic, the result of combining the most researched strain of probiotic with certied, superior Omega-3 sh oil. Adding Omega-3s to a probiotic can increase bidobacteria levels by up to three times, while it decreases levels of bad gut bacteria that have been linked to cancer. For more information write 118 on page 73.
SISU KIDS U.F.O ULTRA-FORTIFIED OMEGA 3

SISU Kids U.F.O is a high-potency, wild sh oil chewable, in a fun UFO shape, a natural orange avour and smooth, jelly-like texture - ideal for those who dont like liquidlled softgels or low-dose, sugary gummies. Its made in Norway by a unique emulsication process for better taste, more rapid absorption and less reux. For more information write 119 on page 73.
HOLISTA RESTORATIV VITAMIN E LOTION

This creamy lotion provides immediate moisture, soothing chamomile, and the powerful protective properties of Vitamin E to nourish the entire body with no added fragrances, and its also paraben free. Perfect for use after a summer day in the sun! For more information write 120 on page 73.
OMEGA ALPHA LUNG TONE AND E-Z MOBILITY

Omega Alpha Pharmaceuticals Inc. has two new products joining their line of herbal-based liquid nutraceutical formulations for cats, dogs and small animals. Lung ToneTM is an herbal formula of herb extracts that supports the respiratory system, which is a common need for some animal breeds. Pain and inammation are covered with E-Z MobilityTM, a formulation of herbs and essential minerals for animals of all ages with mobility issues. For more information write 121 on page 73.
16
sku review
HOLISTA RESTORATIV TEA TREE & VITAMIN E ANTISEPTIC CREAM

Holista Tea Tree and Vitamin E Antiseptic Cream can be helpful in wound healing and preventing wound infection, as a natural antibacterial, antiseptic and antifungal. It may decrease the development of ingrown hairs after shaving or waxing and helps to reduce acne of the face and body. It can also assist the healing process of chicken pox sores and insect bites. For more information write 122 on page 73.
INTUITIONTM MY WAISTLINE NORTH AMERICAN HEMP CO. AREA 369 HAIR SERUM
Hemp seed oil is the most nutritious oil on earth. It is easily absorbed into the hair with no build-up or greasy residue. Its also naturally rich in Omega fatty acids and antioxidant vitamins, to lock in moisture. Area 369 Serums unique blend of silicones, vitamin E and Omega 3, 6 & 9 seals your hairs cuticle for brilliant shine! For more information write 124 on page 73. My Waistline is a special blend of medicinal herbs including yerba mate and dandelion root , and other appetite suppressing and body cleansing herbs, juice concentrates and natural avours delivered in a delicious add-to-water concentrate. It works to stimulate your metabolism, suppress your appetite and facilitate the way your body processes the food you eat. For more information write 123 on page 73.
BOO BAMBOO HAIR STRENGTHENING SHAMPOO

Say goodbye to dry brittle hair! This bamboo extract-enriched formula drenches your hair with organic proteins and silica to help strengthen it and create brilliant shine. It gently cleanses without stripping away your colour, leaving you with incredibly soft, healthier looking hair. For more information write 125 on page 73.
17
GROCERY
top seller review

STORE INFO
HEALTH BOUTIQUES
Karma Cooperative Inc. Toronto, ON Store Size: Under 1,000 sq. ft Type: Health Food Store Optimum Health Edmonton, AB Store Size: 3,000 sq. ft. Type: Health Food Store Foods for Life Toronto, ON Store Size: 2,000 sq. ft. Type: Health Food Store Get Real Natural Fort Saskatchewan, AB Store Size: 2,220 sq. ft. Type: Health Food Store Panacea Toronto, ON Store Size: 2,000 sq. ft. Type: Health Food Store Foodsmiths Perth, ON Store Size: Over 5,000 sq. ft. Type: Health Foods Store Essence of Life Toronto, ON Store Size: 5,000 sq. ft. Type: Health Food Store
TOP THREE PRODUCTS
FOOD
Almond Milk Blue Diamond Chocolates Camino N/A
Coconut Oil Nativa Stevia Now Goji Juice Genesis Today
Goji Berries
Gluten Free
Cereal, snacks and figs Barbaras Frozen Foods Gardein
Spritzer, LemonLime flavour, 311 ml Knudsen Beer, 330 ml Becks Almond Milk, unsweetened, 946 ml Blue Diamond
Chips
Organic Quinoa
Dairy Free
Nut Butter
Chia Seed
Waldon Farms brand Pizzas, Sausages, Slices Tofurky
Honey
TOP THREE PRODUCTS
HERBS
Cilantro (fresh)
Milk Thistle Organika Coleus Enzimatic Therapy Glucomannan Organika
Maca
Oregano Oil
N/A
Orega Supreme, 15 ml Health First Menopause, 30 tablets A. Vogel Cold Defense, 60 veg tabs Health First
Oil of Oregano
Parsley (fresh)
Astragalus
Melatonin N/A
Herbal Detox Wild Rose Milk Thistle
Basil (fresh)
Artichoke
Hormonal Balance N/A
TOP THREE PRODUCTS
PERSONAL CARE
Weleda brand
Weleda brand
Avalon brand
Shampoo
Hair Care Avalon Soaps, Shaving and Oral Care KMF Oral care Jason
Soap Bar Soap Care Mint Toothpaste, 75 ml Green Beaver Very Clear skin cleanser, 180 ml derma-E Proteins+ Bar, vanilla, 50 g Genuine Health Pro 2, chocolate, 72 g Interactive Vega, natural, 1029 g Sequel Vitamin C, cranberrypomegranate, 8g Emergen-C Vitamin D, 1000 I.U., 180 tablets Health First Vitamin B-12, 1000 mcg, 90 tablets Natural Factors Kettle Chips, salted, 220 g Covered Bridge Gluten-Free Muffin Mix, 453 g Namaste MCT Oil, 500 ml Alpha
Pretty brand
Prairie Naturals line
derma-E brand
derma-E brand
Toothpaste Jason Deodorant Terra Naturals
Earth Science brand
Green Beaver line
Hauschka brand
Green Beaver brand
Weleda brand
TOP THREE PRODUCTS
ACTIVE LIFESTYLE
Vega
Protein Brad Kings Meal Replacement Vega Protein Store brand
Emergen-C brand
Protein Nutrabolics L-Arginine
N/A
N/A
Protein Powder Greens+ Hemp Pro Manitoba Harvest
Greens Supplements (liquid or powder) Coconut Water
N/A L-Glutamine N/A
N/A
N/A
TOP THREE PRODUCTS
VITAMINS/ SUPPLEMENTS
Organic Traditions brand
Immuno Multi Can Prev
Vitamin D
Active X Platinum Super Rocky Multi Albi
Now D2 Vegan DHA Northcoast Naturals Digestive Enzymes Prairie Naturals
Natural Calm brand
Omega-3 Natural Factors brand Emergen-C brand Vitamin D Carlson Coral Calcium Store brand Multivitamins
Multi for 2 New Chapter
Aa Berry capsules Albi
Vegan Protein
TOP THREE PRODUCTS
NEW PRODUCTS
Camino Juice
Coconut Milk & Cream Wilderness Family Chocolate-Covered Fruits & Nuts Next Weleda Facial Care
Krill Oil
Magnesium Bisglycinate RX Balance Sunscreen Green Beaver Buzz Away
Vegan Cheeses Daiya
N/A
N/A
Astaxanthin
Vegan Macaroni & Cheese Amys Frozen Foods Gardein
N/A
N/A
Aa
N/A
Want your store to be included in the Review? Fill in & Fax the FoRm on page 74
18
ihRmagazine.com JULY/AUGUST 2011
top seller review

PHARMACIES
Herbs & Nutrition Toronto, ON Store Size: Over 5,000 sq. ft. Type Health Food Store Organic Garage, Oakville, ON Store Size: 17,000 sq.ft. Type: Organic Grocery Store Nutrition House, Calgary, AB Store Size: 800 sq.ft. Type: Health Food Store Academy Clinic Pharmacy Thunder Bay, ON Store Size: 1,000-3,000 sq.ft. Type: Pharmacy The Chemist Pharmacy Markham, ON Store Size: 3,000-5,000 sq.ft. Type: Pharmacy Summerland Medicine Centre Summerland, BC Store Size: over 5,000 sq.ft. Type: Pharmacy Rideau Pharmacy Calgary, AB Store Size: 1,000-3,000 sq.ft. Type: Pharmacy Claresholm Pharmacy Claresholm, AB Store Size: over 5,000 sq.ft. Type: Pharmacy
Coconut Water
Unsweetened Original Almond Breeze Agave 1.25 KG Wholesome Sweeteners Kettlecorn Popcorn, Indiana
Apple Cider Vinegar Bragg Protein Bars EAS Flax Seed / Meal Naturally Chapman Farms
N/A
N/A
N/A
N/A
Black Cherry Juice, 946ml, Knudsen Hemp Hearts, 454g, Rocky Mountain Grain Products Organic Milk, 2L Vital Green Dairy
Almond Drink Blue Diamond Flaxseed
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Dong Quai
Cinnamon Simply Organic Turmeric Simply Organic Coriander Simply Organic
Oregano Oil
Echinacea 100 caps Webber Naturals Glucosamine 90 caps Jamieson Garlic 100 caps Jamieson
CoEnzyme Q10 60 soft gels Jamieson Echinacea 100 caps Swiss Herbal Glucosamine 120 caps Swiss Herbal
Salmon Oil, 300 caps, Medicine Centre Omega Fatty Acids, 180 caps, Medicine Centre Glucosamine Sulfate, 300 caps Medicine Centre
Ginkgo Biloba, assorted, Trophic Saw Palmetto, 60 caps, Trophic Bilberry, 60 caps, Herbal Select
Echinacea, 100 caps, Sisu Evening Primrose Oil, 90 caps, Jamieson Digestive Enzymes, 100 caps, Albi
Echinacea
Milk Thistle
Elderberry
Cleanse Renew Life
Avalon brand
Daily Essential Moisturizers Desert Essence Toothpaste, Mint Green Beaver Body Wash Jason
Deodorant Crystal Naturally Fresh Toothpaste Jason Hylauronic Acid derma-e
Alba brand
Milk & Shea Butter Body Wash, 12 fl.oz. Burts Bees Baby Bee Shampoo & Wash, 8 fl.oz. Burts Bees Beeswax Lip Balm, 15oz, Burts Bees
Colour Hair Solutions Shampoo, 375ml, Pantene Colour Hair Solutions Conditioner, 375ml, Pantene Fructis Shampoo & Conditioner, 384ml, Garnier Whey Protein 2lbs Webber Naturals, Energy Drinks, Boost, 8oz, chocolate N/A
N/A
Tea Tree Oil Soap, 60g, Soap Works Oatmeal Soap, 60g, Soap Works Full Body Shampoo, 200ml Jason Natural Whey Protein, 24 servings Hammer Nutrition Whey Protein, 2kg Kaizen Maca Energy Supplements, 100 caps, Now,
Lip Moisturizer, 4.25g, Carmex Kiwi Shampoo, 50ml, Down Under Naturals Hair Colour, LImage, kit Lean Whey Protein, 908g, Prairie Naturals Meal ReplacementHigh Protein, 235ml, Ensure Meal Replacement, 235ml, Ensure
N/A
Jason brand
N/A
Yoga Mat
Vega Berry (Large) New Zealand Whey Isolate Ergogenics Pumpkin Seed Powder Omega Nutrition Vitamin D3 Natural Factors Vegan Vanilla Protein Genuine Health Organic Rice Probiotic Bio-K
Creatine Purple K PGX Natural Factors Protein Progressive
Energy Drinks, Boost, assorted N/A
N/A
Massager
N/A
Rope
N/A N/A
Multi-Vitamins
Calcium
Multi Vita-Vim 90 tabs Jamieson Vitamin C 100 caps Jamieson Vitamin D 100 caps Jamieson
PGX Daily 60 soft gels Natural Factors Vitamin B Complex, 90 caps Jamieson Calcium, 500mg, Wampole
PGX Daily, 150 caps Webber Naturals Vitamin B, 1000 IU Medicine Centre Calcium, 200 caps Medicine Centre
Salmon Oil, 90 caps Herbal Select Omega 3-6-9, 90 caps, Herbal Select CoEnzyme Q10, 60 soft gels, Now
Vitamin E, 120 caps, Jamieson Vitamin D, 100 caps, Jamieson Super Cal-Mag, 180 caps, Seroyal
Omega-3
Fish Oil Carlson Melatonin Natures Harmony
Ester-C
N/A
Beanitos
Simply Bars
N/A
N/A
N/A
N/A
N/A
N/A
Sea Veggies YangBan Indian Ketchup Amaya
Omega Truffles Bija Udos Whole Food Supplements
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
The Top selling producTs in the review are from randomly selected retailers. The review is meant to give readers some idea of what consumers are buying most of in these selected stores. participating stores are free of any third-party influence and provide all the information. The information cannot be seen as a statistical survey or taken to reflect top-selling products on a national, regional or local level.
JULY/AUGUST 2011 IHRmagazIne.com
19
industry news
GREAT NEW PRODUCTS AND THE LATEST ON RESEARCH AND REGULATION A healthy alliance
The Canadian Health Food Association and the Canada Organic Trade Association Boards of Directors met last month to approve a new Framework Agreement on Strategic Partnering as an act of support for Canadas growing organic industry. The new agreement is a reection of the two Boards communication, joint activities and consultations that are aimed at enhancing membership values and benets. The Framework Agreement outlines a specic focus on organic retail issues, consumer research and statistics, Organic Week and public education, and the CHFA trade shows, among other topics. The CHFA and COTA will partner up in October 2011 for this years Organic Week. and the Absolute Series of All Natural Whey Protein supplements. Mike Schreck, the CEO of NutriMix, has stated that True North Nutrition has proven that they are an ideal choice to represent NutriMix products in he Canadian market. True North Nutrition, a Richmond Hill, Ontario distributor, values quality over quantity and has a reputation for introducing new product categories into the market. Directive (THMPD), which will be held at the European Court of Justice in Luxembourg. The legislation, initially proposed in London, requires that traditional herbal medicinal products must be licensed or prescribed by a registered practitioner in order to comply with a directive passed in 2004. If the new law comes to effect, the alliance fears that consumers will be driven to purchase online products that tend to be unregulated. Such restrictions havent been implemented in Canada but sources in the natural health industry expect our regulations to mimic those of the EU in the future. than 70 per cent USDA-certied organic ingredients and no prohibited ingredients. Rushing to reformulate and re-label their products, personal care manufacturers that dont meet the standards must remove organic from their labels or be thrown out by Whole Foods. Only those products that have been carefully screened and third-party certied to meet National Organic Program or NSF International standards will be allowed to place organic on their labels. The company is working on a similar structure for Canada, starting with U.S. products that are sold in Canadian stores and moving on to guring out the next steps for Canadian products.
IN THE KNOW:
Chinese medicines under the microscope

A new EU legislation is under judicial review after it challenged to ban traditional Chinese medicines that are made from gingko biloba. A spokesperson for the Britains Alliance for Natural Health said that the new legislation, which was implemented on May 1, threatens to ban thousands of traditional herbal medicines that have been used in Europe for decades. The alliance is preparing for a review of the legislation, the Traditional Herbal Medicinal Product
Organic according to Whole Foods

As of June 1, 2011, U.S. Whole Foods began strictly monitoring the use of the word organic on shampoos, soaps, cosmetics and body lotions. Products must contain at least 95 per cent USDA certied organic ingredients to use organic on their labels, and made with organic if they contain more
A weighty issue for General Mills

General Mills announced a major shift into the functional foods market using its new G-WIN platform in order to develop products that will mainly target weight management and cardiovascular issues. Statistics posted by The New York Times show that the functional foods market sales reached $37.5 billion in 2009, while UKs Leatherhead Food Research reported a 14 per cent yearly increase since 2003. Dairy products have played a dominant part in this market; however, consumers will also see a growth in baked and cereal products, a specialty of General Mills. Some major brands under the functional foods market umbrella Benecol being a major participant boast the benets of these products over conventional foods.
A new name in the mix

NutriMix Labs has announced True North Nutrition as their exclusive distributor in Canada. NutriMix Labs are the creators of Interactive Nutrition brand of Sports Nutrition products
Right on Target
In 2013, Target Corporation will formally be taking over Zellers and opening 45 stores in Ontario, 19 in Quebec, 15 in British Columbia, 13 in Alberta, ve in Manitoba, two each in Saskatchewan, Nova Scotia and Newfoundland and Labrador and one each in New Brunswick and PEI. In September, the retailer will announce a second wave of store sites. During the next decade, Target aims to open 200 new stores and generate sales of $6 billion per year. It also announced it will open its Canadian headquarters in Mississauga, Ontario, this summer.
20
For Details, write #108 on Free Info Page, page 73
industry news
A match made in green heaven
At CHFA West, SISU introduced new 100 per cent recyclable metal caps as the perfect complement to their 100 per cent recyclable glass bottles. The transition to metal caps will take place over the next few months, allowing them to not waste the current inventory of plastic lids. Re ecting SISUs mission, vision and values as a premium brand, this change also supports the companys commitment to high product quality standards and the protection of the environment. To celebrate, a contest was held to guess how many metal caps were in a large vase. The lucky retailer was Optimum Health from Edmonton, who correctly guessed 986 caps and won an Apple iPad.
Cover girls, au naturel

Cosmetic giants Covergirl and Neutrogena are addressing consumer concerns regarding cancer and carcinogenic byproducts by releasing new natural makeup lines. The NatureLuxe line from Covergirl features songstress Taylor Swift as the new face of the campaign, while the Neutrogenas Naturals line is
showcased by actress Kristen Bell. The Neutrogena Naturals line has been recently released exclusively in the United States, while Covergirls NatureLuxe is available at major Canadian cosmetics retailers. The two lines join the likes of Evian, Bare Escentuals, and Tarte to be the latest companies to market natural and organic products in the cosmetics industry.
WHAT AND WHO IS HAPPENING IN THE BUSINESS WORLD Next Pharmaceuticals go the extra mile
Regan Miles, a 30-year veteran of the health industry, was announced as the President of Next Pharmaceuticals, Inc. His latest position was as President and CEO of Univera, Inc., where he achieved signicant annual growth. In only three years, he launched 10 cutting-edge nutritional products. I am excited to be joining Next Pharmaceuticals and to be involved with such high quality, proven and patented products, said Miles. I look forward to working together with the Next team to introduce breakthrough dietary supplements that improve peoples quality of life. Co-Founder, Chairman and CEO, Charles Kosmont said, Given Regan Miles expertise and accomplishments, paired with our innovative products, we are excited to see the growth and new product development we will be able to achieve together. end of May. One of the major reasons for the price hike is the increase in the cost of crude oil, which has risen by more than 30 per cent in the past few months. The decreasing value of the U.S. dollar versus the Canadian dollar has also deeply impacted the cost of importing hemp products, which are illegal to grow in the United States. Adding to the price increase is the unstable weather patterns around the world, which has also resulted in a 36 per cent rise of food prices over the past year.
ON THE GO:
High-tech, ecofriendly money

The Bank of Canada has recently released a more advanced version of bank notes, which are printed on a unique polymer material in order to ensure the highest level of security against counterfeiting. The method of using polymer for printing bank notes has been introduced in a number of countries around the world and has been making it easier for retailers and the public to verify, yet much more difcult for counterfeiters to reproduce. Statistics have
Coffee builds villages

fewer notes to be printed and a reduction in the manufacturing and transportation of the bills, in comparison to the notes that were originally printed on cotton paper. Vancouver-based Ethical Bean Coffee not only supports the local community, it also donates to a variety of international charities such as the Child-Aids FUNDIT program. Together with customer engagement, over $64,500 has been raised and over 645 children have received an education where they normally would not. Ethical Bean Coffee also supports Project Somos, a charitable organization currently building a childrens village for orphaned and abandoned children in Guatemala.
shown that the current Canadian Journey notes, which were rst introduced in 2004, have signicantly lowered the level of counterfeiting as a result of their key holographic stripe feature. Present day numbers show that less than 50 counterfeits are detected annually for each million genuine bank notes in circulation in Canada. The latest edition of bank notes produced in Canada is expected to better the environment due to the polymer notes increased longevity in circulation by at least 2.5 times. This will require
Hemp is high
The prices of various superfood products, such as hemp and coconut oil, are showing a signicant hike as a result of several global issues. Nutiva, a major superfood supplier in the United States, announced an 11 per cent increase of its hemp and coconut oil prices by the
22
industry news
government and bank ofcials. A Nielsen survey reported that 86 per cent of Canadians are affected in the way they drive and shop for groceries as a result of the rising prices, forcing many of them to only purchase staples.
POM Vs. FTC MTB nds a new sweet spot

The Michael Theodor Brokerage Ontario ofce has relocated, allowing them to continue their consistent growth and development of the Central and Eastern Canadian marketplace. The new ofce can be found 10 minutes south of Toronto Pearson International Airport, off of the 427 highway. They are located on the 10th oor of 10 Four Seasons place in Etobicoke. On May 24, a hearing started, where administrative law judge Michael Chappell dealt with complaints from the Federal Trade Commissions (FTC) stating POM Wonderful pomegranate juice made health claims unsubstantiated by science. The FTC attacked the pomegranate juice company last fall for making claims that POM Juice and POMx prevents and reduces the risk of heart disease by lowering blood pressure and has the ability to treat prostate cancer. These claims are found in ads in high-prole publications including The New York Times along with its own websites. The FTC provides a detailed summary of the facts that prove POM Wonderfuls clinical studies do not in fact prove the various health claims that they make. The case targeting POM is perceived by some as part of a FTCs campaign aimed to hinder freedom of health speech. Furthermore, a food law attorney, Jonathan Emord, has stated that the FTC is violating the U.S. Constitution by enforcing restrictions against the juice company. POM states it spent $35 million on scientic research including more than 90 scientic investigations with over 65 studies on POM products, including 17 clinical trials. POMs attorneys have appealed to the First Amendment in their defense, emphasizing that POMs product claims are substantiated free speech.
Sears steps up
Sears Canada is preparing for a new competitor, Target Corp., by naming Calvin McDonald as the new president and chief executive ofcer. McDonald was a senior executive with Loblaw Cos. Ltd., and replaces Dene Rogers effective immediately; Rogers will be returning to the U.S., the company said. In a statement, McDonald mentioned that he believes Sears Canada, the countrys second largest department store retailer, has the potential to signicantly increase its sales and protability. McDonald brings extensive retail experience, knowledge of online and customer-relationship technologies, an energetic and engaging leadership style, and an appreciation for the opportunity that Sears Canada represents, Sears Canadas chairman William Crowley said in a statement.
Puresource has moved to a new facility in Guelph in our ongoing effort to upgrade and expand and continue to develop our quality of service. Our new head ofce and warehouse provides us with enhanced technology and space to increase our productivity and reduce errors. Their new facility opened on June 6, 2011 and will also feature a new logo that mirrors the values and strengths of Puresource going forward. As changes continue at Puresource, we have also redesigned and introduced a new logo. This logo represents that we are a distributor of natural products and our commitment to change and improvement.
Franco is dedicated to providing high-level customer service to all customers. SISU is also pleased to welcome Rachel McMann to the position of Key Accounts Manager. McMann will be responsible for assisting in the development, business planning and maintenance of SISUs corporate accounts. Educated at Royal Roads University with a Bachelor of Commerce Degree, McMann brings a wealth of experience in trade marketing, relationship building and account management.
Tough times ahead for Canadian retailers

Statistics Canada reports a tough year ahead for Canadian retailers who will have to convince cashconscious customers to spend despite rising food and gas prices. According to reports from BMO Economics, retail sales volume decreased to 0.8 per cent, reecting the fact that rising food and gas prices are exceeding slow income growth. Following the recent economic recession, consumers showed higher spending, which resulted in new and high levels of debt and a series of warnings against any more spending from
Two new managers join SISU

SISU welcomes Alex Franco as Account Manager for Central Toronto. Franco has been working in the natural health products industry for over three years and is currently pursuing a Holistic Nutritionist certicate. While with Sequel Naturals, he recently received the Jack Gahler Memorial Award for Excellence in Field Sales. Passionate about this industry,
Puresource the move
makes
Puresource has moved to a more modern facility, after over 15 years at their head ofce and Eastern Canada Distribution Centre in Guelph. President, Mark Chilvers said,
23
24
IHRmagazIne.com JUly/aUgUst 2011
company profile
Lessons of the land

ur company is the only one in Canada, maybe in the world, focused solely on natural source pain relief, says Kent Pedersen. That in itself is quite an achievement. Yet, when the company in question is Lakota, thats just part of what makes it so unique. As is usually the case, Lakota was born out of necessity and curiosity. Don Pedersen, Kents father, suffered from arthritis and was tired of trying different treatments without success. Thats when he became interested in a formulation a Metis friend prepared for him with traditional ingredients Native Americans have been using for centuries. To Kents surprise, it worked! The product was first given to awardwinning horses and then to humans. After the initial success, a line of equine pain relief and human joint care was developed and Lakota was born. Anyone would think venturing into the natural products business when you have been a farmer all your life could prove to be quite intimidating. Not for the Pedersens, though. In fact, they think it was actually an asset. As Kent explains it, the farming background was a key element in our success. One thing you learn from farming is that you have to put all your seed and fertilizer in the spring, and then wait; you cant harvest before its ready. We applied that principle to Lakota and invested in doing things right from the very beginning.
Two farmers (and their native friends) created Lakota, a natural health powerhouse
By Carlos Weigle
The analogies dont stop there: When we started, we invested heavily in marketing, which was like fertilizer: it can make your crop grow thicker but it wont change a bad seed into a winner. We knew we had good products, so we poured on the fertilizer and the crop grew. Dont follow the herd That approach translated into a simple yet very effective campaign. While the experts advised them against having too much copy on their ads, the Pedersens packed them with product information. It seems thats exactly what consumers wanted. As Kent found out, sometimes its best to do things your own way: I think it was good that I didnt have any formal training. When you do, you start to think the same way as everyone else. If everyone is doing the same thing, especially in marketing, it wont work. You have to stand out in order to be noticed. Stand out they did. Their iconic TV ads with Floyd Red Crow Westermann were done in-house and with a low budget. Even so, they certainly resonated with consumers and became pop culture sensations that merited spoofs on both Royal Canadian Air Farce and This Hour Has 22 Minutes. Marketing can only take you so far; you also need a good product to keep consumers going back to your brand. In this case, the products seemed to work just fine. From the beginning, Lakota had two lines: topical roll-on pain relievers and pain-relieving supplements. This approach dealt with immediate pain relief as well as with long-term pain management.
july/august 2011 IHRmagazIne.com
25
company profile
Facts not fads The natural ingredients, such as white willow bark and yucca root, had been proven time and time again by Native Americans. However, thats not the only thing they brought to the table. As Kent explains, the other lesson we learn from native people is to respect tradition. There is a reason why their elders do things in a certain way. Too often in todays world, the latest fad is everything. At Lakota, we try to avoid fads and jumping on the latest bandwagon. We stick to what works, be that in marketing or formulations. That said, the company is also interested in improving their formulas, even with natural ingredients that were not available to native people, such as glucosamine and collagen type II. We arent going to rest on our past achievements, adds Kent. We continue to work on new products and formulations. When more people are using natural pain relievers than pharmaceutical ones, then we may slow down. Until then, we want to show people theres a better way to deal with pain.
Speaking of people, theres certainly not a bigger reward for a health-related company than to see their customers well-being improved. As Kent explains it, one of the primary motivators we have here in the office is the letters we get from customers. They often write to us to tell us how Lakota has changed their lives. People tell us they avoided surgery by using Lakota Joint Care or how they can be mobile now whereas before they could hardly move. These stories of changed lives motivate us to do more for our customers. Even though the company has grown substantially, the Pedersens still run the company themselves and do it only a few miles from the family farm. The ties they have to farming are what have kept them grounded. Says Kent: Many of the same principles apply to both farming and manufacturing hard work, integrity, treating people fairly. Sometimes I think people overcomplicate things. We treat all our customers the same way we treat our next-door neighbours on the farm, and it has worked well for us. Likewise, the companys success could have made them lose focus and start expanding into other areas, yet they stayed true to its natural pain roots. They actually dug deeper into what they knew best to explore other types of pain their products could relieve. Thats how they started developing formulas for back pain, nighttime pain and, recently, muscle pain. The Pedersens also ensured their existing products remained effective and stuck to producing standardized herbs, which are more expensive yet more reliable. Adds Kent: Some thought we were wasting money by not using cheaper versions of the ingredients, because most consumers dont know the difference. We wanted to guarantee we were making products that worked. After all, we were selling them to our friends. The lessons learned by native people and by farmers alike stay true to this date. Sticking to them is a sure way to make a lasting impression, one that will stay with people even after the marketing campaigns fade. Thats Lakotas secret.
At a Glance
Lakota Herbs Phone: 250-782-2419 Fax: 250-782-9161 Email: kentp@Lakota.ca Website: www.lakota.ca Facebook & Twitter: www.facebook.com/lakotaherbs Staff: 5 Top-selling products: joint care formula, extra-strength soft touch, arthritis roll-on Sales: Up 20% from 2010
26
IHRmAGAzInE.com JULy/aUgUst 2011
cover story
THE BEST
OF BOTH
WORLDS
Bob Mehr took his passion for traditional and alternative therapies and turned into a success story.
By Carlos Weigle Photography & Wardrobe Styling by Katie Huisman
july/auguSt 2011 IHRmagazIne.com
29
cover story
here are moments in life that define you. Leaving Iran by yourself when youre only 17 would certainly qualify as one. Thats when Bob Mehrs journey to Canada and a brand new life started. Mehr who currently owns 10 pharmacies in British Columbia knew he wanted to be a pharmacist and started to go to college to become one. In the meanwhile, he also had two jobs one of them as a salesperson at a clothing store which not only supported him but also exposed him to the nature and challenges of the retail business. When he graduated in 1995, he knew what he wanted. He told his friends he would work as a pharmacist for a few years and then open his own pharmacy which, to their surprise, he did. He also knew what aspect of the pharmacy profession attracted him the most. I was always very busy with compounding, mixing medications, recalls Mehr. He was also very green. Coming out of pharmacy school youre idealistic, then you go to the pharmacy board and see how things are not exactly the way we were taught at school. Right after college he started to learn more about what else was out there. I took courses on alternative medicine, natural products, homeopathy. I also learned about the history of compounding. He adds that by doing compounding you actually learn a lot about the different therapies available to patients because you are able to custom-make medication targeted to their specific needs. A system in crisis While he was working for a pharmacy in Northern B.C., another one of those life-changing moments happened. A patient who was complaining about chest pains called him. Even though the patient had been told his ulcer caused the symptom, Mehr sensed something more serious was going on and urged him to go to a hospital. Instead, the patient went to his family doctor and later showed up at the pharmacy with a prescription for the ulcer medicine he was already taking. All of a sudden, the man turned blue and passed out in front of Mehr. Even though the pharmacist attempted CPR and called an ambulance, he was already gone. I then realized there was something wrong with our healthcare system. If that patient had been aware of the signs and symptoms of a heart attack, then he wouldnt have gone to his doctor who wouldnt have given him just ulcer medication, explains Mehr.
30
IHRmAgAzIne.com JUly/aUgUst 2011
cover story
In life and as a healthcare professional, its your responsibility to spend time with your patients, educate them about their health and encourage them to learn more and more. Such a traumatic and at the same time revelatory event shaped the kind of pharmacy Mehr had in mind. So when he opened his first one in 1999 along with his wife, Mahtab, whom he met in college he had a vision of what he wanted to achieve. My first pharmacy was different because, first of all, I offered alternative and complementary medicine to my patients, he explains. I introduced a lot of homeopathic remedies. It was also one of the first pharmacies, at that time, to start doing consultations regarding medications, regarding hormone therapy for women and overall just spending time listening to what my patients were telling me. A pharmacy like no other Mehrs pharmacy offered patients something unique: a space where they could buy both traditional and alternative medicines yet also a place where they could ask questions and make informed decisions for themselves. Whenever I saw a
patient, I always asked them if theyd tried alternative paths, if theyd tried dieting, exercise, supplements, vitamins, says Mehr. Then I started seeing the benefits of patients who were taking conventional medicines and augmenting them with complementary medicines. The novel concept puzzled many patients at first, not used to someone telling them they could combine a traditional approach with an alternative one. They were surprised because I wasnt selling them medication. I was giving them a chance to explore an area they hadnt explored before. I would send them to yoga or meditation or I would write the name of a book for them to read. However, very soon they started enjoying the experience (and reaping the benefits). Mehr summarizes his view on the matter: Theres something wrong in the way we treat people. Were not spending time with our patients, we are not sharing enough with them to let them see the entire problem. We need to educate and empower them so they can be in charge of their own health. Thats the way I practice and the way I do business.
july/august 2011 IHRmAgAzIne.com
31
cover story
Theres something wrong in the way we treat people. We need to educate and empower them so they can be in charge of their own health.
Patients certainly agreed with Mehr: Believe it or not, after 11 years, all those patients from my first pharmacy still communicate with me; they still call me or send me an email and ask for my advice. Thats the difference theyve made in their lives, because theyve realized they can get alternatives and more answers from their pharmacy. Of course his unorthodox practice got him in trouble with a few of the more conventional doctors. Many of them, in the end, became more open-minded regarding alternative therapies. One in particular saw the benefits of a patient who was being treated with homeopathy and started prescribing those remedies himself. Pets, sauna and Chinese medicine Mehrs unique approach is apparent in all the Bob Mehr Compounding Pharmacies, seven under the Pharmasave banner and three under Pure Pharmacies. Each one has an on-site compounding area, which prepares not only customized medicines for people, but also their pets. In fact, veterinary compounding accounts for up to 20 per cent of all prescriptions. In 2009 Mehr took over Pure Pharmacy as CEO and started implementing changes. During the last two years weve been sensing a huge growth in that particular location, he says. So much so that he opened two other Pure Pharmacies in Victoria. The Pure Pharmacies offer patients a really comprehensive approach. They allow customers to find specialists in homeopathy, compounding pharmacy, herbal medicine, organic skin care and sports nutrition. Other services available at Pure are detoxification, bio-identical hormone restoration therapy, infrared sauna and complete food and allergy testing. Oh, and even jewellery! Patients will also find unique practitioners such as Jennifer Deng, who specializes in traditional Chinese medicine and is the only registered member of the International Association of Certified Thermographers in Canada. Thermographic imaging is currently being used as a risk marker for breast cancer and as an early warning system for other diseases. Deng is also trained in the use of cold-laser therapy to treat a number of ailments. Recently, in 2008, she also received her masters degree in auricular medicine. In other words, she embodies the Bob Mehr principle of combining the best of both worlds, tradition and the latest technologies. As Mehr points out, the products I offer are no different from any other natural health store or pharmacy. The only thing I have to differentiate myself is our staff and our people. At the moment, the Bob Mehr Compounding Pharmacies employ about 135 people. Every single employee is the CEO of his or her own department, highlights Mehr. They are in constant communication with each other and they all treat each other like family members. We believe in the same culture and philosophy, which is based on care and share.
32
IHRmagazIne.Com JUly/aUgUst 2011
cover story
It is obvious to anyone that, in addition to his holistic approach to pharmacy, Mehr also has a great business sense. Ive always been interested in business, he explains. However, I tell my friends that Ive got my MBA on the streets and by applying business in my practice. Mehrs passion hasnt been unnoticed. In fact, he received the 2010 Commitment to Care & Service Awards as Outstanding Pharmacy Owner or Manager. He was also named the 2005s top compounding pharmacist of the month by the Professional Compounding Centre of America (PCAA). In addition, he won the British Columbia Pharmacy Association 2008 Achievement Award. The pharmacist and business owner is frequently giving back to the community. For instance, he donated $50,000 to the B.C. Cancer Foundations Inspire the World campaign, which aims to contribute $10 million to the expansion of the B.C. Cancer Agencys Vancouver Island Centre. Mehr also supports the InspireHealth Integrated Cancer Care patients in Vancouver as a volunteer pharmacist, answering their questions in small groups and individual sessions on a regular basis. One thing Mehr has learned along the way is that there is a place and time for every single therapy out there. For some people, prescription medication may be the right approach. For others, natural medicine may be the right direction. And some need the combination of both. He also believes other factors in our lives are as important: Some patients need a combination of medication and exercise, socialization, friendship and laughter. We call it holistic healing because it comes from all different angles. It has been proven that not even cancer can be treated with chemotherapy alone. The moments that define your life, the lessons learned, the people you help, can all converge into a successful business venture. More than that, it can inspire you to get out there everyday and try to make a difference. Bob Mehr knows that very well.
At a Glance
Bob Mehr Compounding Pharmacies Locations: Ten in the Vancouver and Victoria areas Main address: 111-15388, 24th Ave, South Surrey, BC V4A 2J2 Phone: 604-542-7780 Website: www.bobmehrpharmacies.com, www.purepharmacy.com Staff: 135 Key Personnel: Bob Mehr, CEO & President Mike Grasso, Operational Manager (Vancouver) Michelle Almonte, Homeopath & Manager at Pure Pharmacy Ada Poon, Pharmacy Manager (White Rock) Lana Mitchell: Natural Cosmetic Manager Alan Hick: Pharmacist/Owner Pure Pharmacy (Victoria) Victor Chu: Pharmacist/Owner Pure Pharmacy (Victoria) Mike March: Pharmacist/Owner Pure Pharmacy (Victoria) John Butler: Operational Manager (Victoria) Top Selling Products: Vitamins: Sisu Multi Vitamin, Purica Recovery Extra Strength, Mikei Red Reishi, A. Vogel Echinaforce, Emergen-C Personal: Jason Power Smile, Dr. Hauschka Rose Day Cream, Weleda Baby Calendula Lotion, Burts Bees Shaving Cream, Seabuckthorn Shampoo Miscellaneous: The Good Seed Certified Organic De-hulled Hemp Seed, Sequel Savi Seed, Vega Whole Food Optimizer Heel-Traumeel, Bach Rescue Remedy
JuLy/AuGuST 2011 IHRMAGAzIne.CoM
33
feature
Let Them Talk
Take stock of your social media inventory before getting out there
By John A. Macdonald
s a retailer or distributor it probably goes without saying that you regularly need to take stock of your product inventory. Well, in todays socially networked business world, you should also regularly take stock of your social inventory. Many, if not most, retailers have made substantial investments in their online web presence. As a retailer. what steps can you immediately take to socialize your existing online investment? Listening is a critical point of effective online conversations.
Before you jump into blogging and adding social gadgets to your website, take a few months to listen to your customers online, prospective customers, industry trendsetters and even your competitors. You can learn about the appropriate tone and frequency for your audience by monitoring how these audiences discuss issues in existing online forums, blogs and industry social networks. Therefore, one of the first things any good marketer needs to do is to add listening tools to your kit of social media best practices. The good news is that many are effective and free tools that you can leverage.
34
IHRmagazIne.com JUly/AUgUst 2011
feature
One of the first places to start is Google Alerts. You should immediately sign up for all your major keywords and constantly monitor where your brand is being mentioned. Some of my other favourite free online tools for measuring and monitoring the social impact of your product or brand are Social Mention and Howsociable, as well as Technorati for blog measurement. Twitter is also a great monitoring tool you can quickly leverage it by creating a personal Twitter account and start following your key customers and competitors, as well as key industry influencers and consultants. If your requirements are more complex, there are many other paid monitoring products such as Radian6 and Sysomos. Lead them back to you There are a number of easy ways to leverage this existing investment and to quickly add social content to your organizations website. For example, many websites these days have taken advantage of adding in Facebook and Twitter gadgets this is a great step to begin to quickly give the appearance of a socialized website. Unfortunately, adding these gadgets really only links visitors to other social media sites it does nothing to capture them and engage your audience into a meaningful conversation. Many website platforms have widgets or plugins that can be displayed or integrated into your website. Some of the more popular implementations allow for the Facebook Like button. The Like button lets visitors selectively like a specific page on your site. It will then show on their Facebook profile with a link back to your content. This can be a great tool, especially when you have someone with several hundred friends like something on your site. It can mean quite a few potential new prospects. You might also look at plugins or widgets that retweet or tweet a page link to the visitors Twitter page. This can also be a powerful tool and a potential entry point into an authentic conversation about your product or brand. However, you or your marketer need to monitor this conversation and be ready to engage in this conversation by jumping in on those retweets. That said, using Twitter is a great way to do quick notifications and let followers know what your company is doing. Using Twitter effectively can help boost your reach to customers or interested people. Using Twitter to its full potential means that you will have to learn how to use the @ and the # symbols. Person-to-person twittering allows you to send a message directly to another Twitter user. If you enter a tweet (which is a message of 140 characters of less) with @username at the beginning it will be sent directly to that user. Placing the # symbol called a hashtag marks the word as a topic. Using the hashtag in your tweet essentially categorizes the tweet for others to find it. If we tweeted Looking for an #Omega-3 product for my kids, those hashtagged words show more easily on a Twitter search.
Be careful about being too self-promotional with your material. The more self-promotional you are the less likely the community will engage with you.
First five things to do to set up your Facebook page:

1. Set up your business as a group rather than a page for a business. 2. You will need a Facebook account to work with, so set that up first if you dont have one. 3. Make sure you add the Facebook Like button to your website and point it to the group. 4. Post to your Twitter account with your Facebook link. 5. Remember to interact with your fans/friends.
Five free ways to listen to what your customers are saying about you online
Use a social media monitoring tool. Set up Google search alerts. Set up a few blog searches. Set up Twitter searches on customers, partners and competitors. Search for your organizations name on social networks.
jULY/aUGUST 2011 IHRmagazIne.com
35
feature
Getting started on Twitter (the basics):

1. Twitter limits the Twitter name to 15 characters. If you are setting up the account for your company, use your store or business name. 2. Start by adding friends and family to your follow list to get familiar with it. Then invite your power shoppers or regulars. 3. Send tweets out on a regular basis and encourage your employees to follow the stores tweets. Consider starting a regular tweet with employees on favourite products. 4. Promote your Facebook group to your Twitter friends.
Provoke them! If you dont already have a blog, start one soon! Blogs are a fantastic way to get unique content out onto your site. It helps the search engines determine your worthiness and may potentially help increase your website ranking with Internet search engines such as Google and Bing. Make sure you allow for comments, as this is how you engage customers in meaningful two-way conversations. When it comes to content creation, surround yourself with others in the company (including the business owners and senior business leaders) to help you create and write content. Be careful about being too self-promotional with your material. The more self-promotional you are the less likely the community will engage with you. In the beginning, if you are struggling to find topics to blog about, start by asking questions. If the questions are helpful, sincere and maybe even slightly provocative you are more likely to get a reaction from the community. The other key benefit of asking questions is that it keeps your content alive and fresh for a longer period of time this is very important in the fast moving and highly cluttered online world. What if you dont have a blog or the ability to add a blog to your existing website? No problem, have a look at Wordpress.com; you can sign up for a free Wordpress site and start blogging almost immediately. You simply need to add a link to your website to your new blog.
Another tool that might be of interest is a social toolbar. Social toolbars hook into your website and consolidate the social media sites into one tool. There are many options you can find online for social toolbars, however one of the easiest to implement is the Wibiya toolbar (find it at Wibiya.com). The Wibiya toolbar, like other available options, allows you to connect your website to Facebook, Twitter and the rest of the social web. So what should you do if you have not already made an investment in a website? Well, the good news is that youre not encumbered with and committed to an existing and potentially outdated technology infrastructure; you get to take advantage of the latest technologies. Many of these new online technologies are built from the ground up to be socially enabled. For example, content management systems (CMS) such as Joomla, Drupal and Wordpress come prebuilt with embedded social capabilities and integration to other popular social media tools. The upside of these new marketing tactics are helping the best retailers attract more customers and build deep, trust-based relations with existing customers. Furthermore, they do not necessarily require an expensive investment in new social media products and expensive consultants to get started.
Six steps to optimizing your blog post:

1. Find a compelling subject that brings a fresh perspective and might even be a bit provocative. 2. Conduct a keyword research to determine whether your blog post is aligned with what people are looking for online. 3. Select keywords and limit your blog to 1-2 variations of that keyword (ie. Omega-3 products for my kids). 4. Optimize your blog page by inserting keywords in your URL, title and other key places and ensure they link back to your blog whenever you reference this topic on your website. 5. Syndicate you blog post externally by sharing it across tools like Twitter, Linkedin and Facebook. 6. Track and monitor your post in terms of rank, visits and leads from its keyword phrase use this information to learn how your blog is resonating with readers.
36
IHRmaGazIne.com JULy/aUgUST 2011
Joining Pharmasave has been one of the best business decisions I have ever made
Rosanne Currie, Pharmacist/Co-Owner Lucknow, Walkerton
Independent... But Not Alone

We will work with our members to ensure the long term success of their retail business and the Pharmasave Brand
Never before have independent pharmacy owners faced such challenges with so many factors threatening the success of their business. Now, more than ever, will a strong, well established program provide pharmacy owners with the support necessary to get through these challenging times and help owners reinvent their business model to ensure a successful future. We can help. There is an unprecedented importance to joining a group who takes care of its members first. You are guaranteed to achieve this at Pharmasave because Pharmasave is owned by its members. Pharmasave has more than 25 years of experience in building a program that works for you and has a strong team of professionals to ensure you get the most value out of your program. While being part of a strong buying group is important, and Pharmasave has the leverage of one of the largest independent pharmacy buying groups in the country, we have stayed true to our values. The strength in any program lies in the support that is provided to its members. We have remained committed to building a program around support first, which is why so many independent pharmacists have made the decision to join Pharmasave and why Pharmasave is the best option to support independent pharmacists on their path forward. Let us work with you to ensure that there will always be a place for independent pharmacy!
British Columbia Pharmasave Drugs (Pacific) Ltd. Dave Reston Direct: (604) 575-5730 Alberta Pharmasave Drugs (Western) Ltd. Vinod Thakrar Direct: (403) 255-5022 1-866-308-7779
Saskatchewan, Manitoba, North West Ontario Pharmasave Drugs (Central) Ltd. Robert Gare Direct: (204) 985-0225 Ontario Pharmasave Drugs (Ontario) Ltd. Doug Sherman Direct: 1-800-515-8620 x223
New Brunswick, Newfoundland, Nova Scotia, Prince Edward Island Pharmasave Drugs (Atlantic) Ltd. Greg Van Den Hoogen Direct: (902) 481-5175
www.pharmasave.com
Columnist
Ken Vannucci
Ken is a Merchandise Manager for London Drugs and a social media advocate.
Embrace life
in a blur
By Ken Vannucci
hat does it mean to be online, connected, or engaged? I guess it really depends on you. I know that for a lot of the people who are not participating in todays many social media, any of those words may be dissuading or literally freaking them out. Social media sounds kind of techie or maybe overwhelming, since it seems so encompassing. To participate in social media can sound like tons of work with a huge time commitment attached. I know this is the typical reaction of many of my friends, who are not participating as much as I am in the new online world. If these new labels are whats freaking them out, maybe we just use some of the old nomenclature and just say that we are going to hang out on Twitter, call up some old buddies on Linkedin, or catch up with friends on Facebook. Call it whatever you want. I would really love to get more of my friends and family online so that we can connect and/or reconnect. I think the naming of these online activities, mostly for marketing and branding reasons, is what has caused many of the issues folks my age have with signing on. We know that the fastest growing segment on Facebook today is people aged around 55. We also know that the 35 and younger crowd are on most media, and that many women and younger moms (say, 25 to 40) use Facebook and frequent blogs regularly.
The most challenged group seems to be mine, the mid-to-late 40s one. Were tech savvy, but somewhat reluctant to participate heavily in any of the social media. The perception of this huge time constraint just seems to loom heavy over my friends, I hear all the time. So, what do you do? I am sitting in day two of a personal development conference that I am attending on my own - its the 2011 Northern Voice, Personal Blogging and Social Media Conference at the UBC Health Sciences Building. I am not going to get into the nitty-gritty of any one presentation; what I wanted to share with you is a nagging point that keeps coming up, the question of, How blurry have our personal and professional online lives become? Does it matter? How far is too far? Should we care and/or fix it? This one is quite personal to me and, as I watch the room, a nagging issue for many presenters as well. This is new stuff. These communication media are new. Although most in the room(s) are social media savvy and have been doing this for at least five years, this is new in the grand scheme of things. Even the pros appear to still be learning the way these new media are interacting with society. Never in our existence as a species have we been able to individually connect with so many, so quickly, so easily, with so little training or understanding as to how, and what we are doing. We went from screaming an opinion on a street corner for maybe 50 people to hear, to clicking a send button and potentially having millions hear us! This concept is freaking out many employers and employees, parents and grandparents alike.
38
kens kool
We went from screaming an opinion on a street corner for maybe 50 people to hear, to clicking a send button and potentially having millions hear us!
To be clear, I am not talking about the usual, I hate my boss post on Facebook or the is that your wife picture that seems to find its way online. What I am talking about is situations where you have a senior management member who writes his or her own blog. Some of it is quite personal (pics, recipes, stories, etc.), and some very much work-related. This person may have Twitter, Flickr, Facebook and YouTube accounts. This individual will most definitely have their views on life and all that it encompasses. Some of the ideas will follow what his or her company stands for and believes in, and many wont. If we pretend that this person worked for a retailer, we would have to assume that, he or she, shops at many different retailers that may, or may not, carry similar or even the same merchandise; in essence, a true competitor. What happens if this person says or implies that they have made purchases elsewhere, or if they appear to be okay with other people making purchases elsewhere, what do we do about that? What happens if an article or an idea is retweeted, shared, or blogged that may challenge the direction of that company? Remember we are talking about people here, not robots. What do you do with that kind of employee? What guardrails should be in place? What are the boundaries? What should be said and what should not be said? How transparent is too transparent? Do opinions need to be censored? Does the employer have the right to censor; or if not the right to, does he
or she have the ability to, or should he or she even attempt to exercise these rights and or abilities? My feeling has always been this: I think it is awesome that many companies have become personalized. People relate to people, not to bricks and mortar, or tall glass high-rises. They get satisfaction (or dissatisfaction) out of the adventure of interacting with people: live in front of them, or live online. These new forms of communicating have just extended those feelings into more homes and offices, and many times, a half world away. I really think that the only way for any executive at any company to answer the questions posed by the new reality is to participate in the media in order to understand them. It is impossible to truly comprehend what is going on in todays world of social media and social networking without being an active participant, and not just an active bystander, or worse yet, a nay-sayer. You cant hide from this one, it isnt going away. The ones who will win are the ones who connect with people, their patrons and customers. As Dylan says, The Times, They Are A-Changing. Embrace the changes. The lines are blurring, if in fact they have not completely blurred in many respects already. Think about it and do something about it! Get on board and connect! Life is fun in a blurrrrr!
39
feature
Good Learnings
Natural and organic snacks make their way into lunch boxes
By Denise Deveau he time is fast approaching when parents will be stocking up on all the good things their kids need for the school season. at includes a good inventory of breakfast items, supplements and organic snacks and drinks to ensure a wellbalanced diet for their kids at home or at school. By all accounts, organic sales continue to rise, despite some slowdowns during recessionary times. While the global market for organic food and drink expanded by just ve per cent in 2009 after experiencing several years of double-digit growth, growth rates have been picking up since. Great things come in small packages As part of that, we are seeing an increased availability of packaged natural and/or organic snack foods and portable lunches. e Organic Trade Association reports that organic snack foods accounted for ve per cent of total organic food sales in 2009. Snacks are also showing above average growth compared to other categories. Mintel Group, Ltd. reports that as of April 2011, sales of popcorn, cheese, corn and meat snacks through natural supermarkets grew 16.7 per cent between 2008 and 2010 (according to SPINS data), while corn snacks showed strong growth at 20 per cent. e increasing demand has driven a market in which organic options can be found as readily in a mass merchandiser as a specialty retailer. Even the major commercial brands have organic/ all-natural, juice boxes, cereal bars and cheese and fruit snacks in their repertoire. Ryan Dennis, a nutritionist with Natures Emporium, conrms there are tons of dierent packaged products. With everybody
getting busier and busier theres a real push for convenience. He says the store is addressing this demand in a number of ways. One is building up the bars category. Now we have almost an entire aisle dedicated to bars. Granola bars are as popular as ever, with probiotic bars a favourite with the organic crowd. Tetrapak beverages are a perennial top seller, whether its high antioxidant juices or newer favourites such as rice, almond, quinoa and hemp milks and coconut waters. Weve got a full aisle just for juices. Id say a third of that is individual tetrapaks, Dennis reports. Smoothies are also gaining ground for their bre content. Still, even though there are more and more natural products going into lunch boxes, there is certainly room to grow. One factor where conventional items still beat their natural counterparts is convenience. at, fortunately, is changing. Several natural food manufacturers are starting to create portable school snacks, especially nut-free ones, points out Andrew Betts, natural foods category manager at rifty Foods. In that respect, nut-free butters are doing very well. Organic juice boxes are also becoming popular and so are snack bars. Parents want to provide their kids with the best possible products, but they also need convenient sizes and packaging as well as avourful foods children will actually want to eat. Another element that has slowed the advance of natural and organic snacks has always been price. at is also changing. Even with the cost of food commodities on the rise, the price of natural and organic snacks has started to shrink and the gap between them and more conventional items has narrowed, adds Betts.
Marketing
Following are some helpful reminders that can help you create a successful back-to-school marketing campaign. 1. Start your promotions around mid-August and make the most use of banners, displays and feature products. 2. Create an online checklist with snacks parents should stock up on. 3. Have a list of tips regarding peanut allergy and other food sensitivities. 4. Support your marketing efforts with social media. Post, reply and monitor your Facebook and Twitter pages often. 5. Offer nutritional support, both online and in store. 6. Set up special displays and select featured products with a back-to-school tie-in including supplements, portable snacks, yogurts, soy alternatives, nut-free butters, and single-serve organic juices and non-dairy drinks. 7. Put together your own packaged lunch combos or suggest product combinations for making healthy lunches. 8. Host in-store product sampling and demo events featuring an assortment of vendor-supported products.
41
feature
Lunch box favourites

Retailers are saying that sales for portable organic and natural foods products for kids are definitely picking up. A sampling of top selling back-to-school lunch box items in demand include: Individual packs of organic yogurts, applesauce Soy puddings Organic juices in Tetrapaks Soy milk in Tetrapaks Fruit leathers and dried fruit snacks Fruit and cereal bars Flavoured raisins Organic pastries and candies Organic fruits in squeeze tubes All-natural cookies, crackers, snack bars and trail mixes Organic fruits and vegetables (bananas, apples, plums, carrots, celery sticks, salads)
One obstacle that remains in place is that many of the snacks now available come from the U.S. and that forces prices up. When you account for shipping, duty and other costs, some products would double their retail price when you bring them to Canada, explains Betts. Some other factors, such as bilingual labelling dissuade many American manufacturers of even considering selling their products in Canada. Bring them shopping The growing interest in foods that address allergies and food sensitivities continues, with gluten and lactose ranking among the more prevalent concerns with parents. Smart retailers can do their part by helping educate them on meal preparation and appropriate food choices. Mairlyn Smith, professional home economist and author of Healthy Starts Here, notes that one way to promote healthy choices is by encouraging parents to bring their kids shopping. Since nuts are banned in many schools, she recommends finger foods such as crackers, cheese or cut-up organic oranges. (Her favourite healthy finds these days are individual packages of frozen pineapple and peaches.) She suggests that retailers could try putting together all the ingredients to make sub sandwiches or wraps, including nonpreservative meats and whole grain buns. Sometimes it helps to try creating a healthy match for whats in vogue in the fast food world. She notes that for smaller kids, smaller portion sizes for juices and drinks are ideal. Blueberry and cherry blends are a
popular choice. Just be careful that theyre not mixed with apple juice, she adds. Keeping calcium and protein levels up is also important. When you use milk substitutes, they dont have as much protein. Roasted chick pea snacks are a great way to make up for it. And any whole grain cookies provide a nice perk, adds Smith. The general rule I always give to parents is that the more you concentrate on whole foods, the better, says Doug DiPasquale, a nutritionist with The Big Carrot in Toronto. Any time there are added ingredients, youre looking at an opportunity to add something not conducive to health added sugars, colourings, additives, preservatives. Even products that are labelled healthy, organic or gluten-free (etc.) can be highly processed and not particularly good for kids. If you dont make it yourself, at least be reading labels for additives. He says parents often limit themselves to looking to the basic food groups for guidance. This can lead to accepting processed foods that, while they cover the food groups, are actually not giving the nutrition children need. For instance, those mini-pizza lunch packages: while they cover the basic food groups (bread, cheese, pepperoni or other processed meats, tomato sauce) theyve had most of the essential nutrients removed in processing and had a lot of chemical ingredients added. Furthermore, many of the ingredients are from genetically modified sources. As well, there are a lot of hidden sugars and salt that are not healthy options for children, explains DiPasquale
42
IHRmagazIne.com JUly/AUgUST 2011
ADVANCED SKIN CARE

RENEWS DORMANT CELLS
Awakening cells to behave younger

REPAIRS DAMAGED CELLS
Increasing cell longevity and vitality

REGENERATES HEALTHY CELLS
Stimulating healthy cell production

RENEW
REPAIR
REGENERATE
Andalou Naturals are made thoughtfully and beautifully, blending natural, organic and fair-trade ingredients with advanced fruit stem cell science. We value knowing where our ingredients come from and connecting the chain of hands that make every step possible from farm to bottle, soil to skin, and botany to beauty. As a force of nature, we champion sustainability and meaningful pursuits to foster good things in the world and enrich the lives we touch with one responsible product at a time.
To learn more, please visit our website at www.Andalou.com

feature
Putting Loyalty to the Test

Get reward programs to work for you
By Sarah OConnor early three quarters of Canadians say they like or even love customer loyalty programs. According to research conducted by Leger Marketing, 86 per cent of shoppers believe they deserve to be rewarded for their loyalty, so its no surprise then that four-in-10 Canadians belong to four or more programs, with some signing up for 10 or more point collecting programs. In the competitive health retail market segment, where customers are literally entrusting brands with their well-being and vitality, staying connected to your best customers is especially important. With nearly 80 per cent of Canadians participating in a rewards program, its clear that this group wants to get the most value for every dollar spent. Earning rewards when shopping is certainly a great way to add value to every purchase, says Jennifer Hawkins, Vice President of New Product Development for American Express Canada. Canadians are miles ahead of their American counterparts in many reward-collecting and redeeming habits, she adds. Retailers have responded to the Canadian consumers enthusiasm for loyalty programs with an almost innite array of oerings, from the classic cardboard punch card to elaborate social media campaigns and everything in between. Companies such as Living Naturally, for instance, which boasts the largest online natural health network in the world, have evolved to help retailers navigate these sometimes confusing waters and develop loyalty programs that are of the appropriate size and scope for their businesses.
45
feature
Five types of loyalty programs

1. Rewards: Customers accumulate points based on purchases, which can be redeemed for products. 2. Rebate: Similar to a rewards program, rebates are based on accumulated points that can be used toward future purchases. 3. Appreciation: Less tangible than rewards or rebates, appreciation programs can take the form of bonus gifts or upgrades. 4. Partnership: Based on partnerships between businesses, these programs offer customers special deals when they shop at affiliate retailers. 5. Affinity: Targeted to high-value customers and brand advocates, these are highly personalized programs that reward long-term loyalty.
Why bother? Our primary objective, and that would be the same for any retailers that have a loyalty program, is really to understand customer behaviour, says Danielle Bussieres, Director, Customer Relationships for Rexall Pharmacies. You definitely want to reward customers for giving you their business, but fundamentally what were trying to understand is their behaviour, their wants, their purchasing habits, so we can then provide them with offers that are relevant, as opposed to an offer that makes no sense at their life stage or in their lifestyle. Rexall partners with both Aeroplan and Air Miles (in different provinces) to execute their loyalty programs, which include both mass and targeted offers and promotions. Like many health retailers and pharmacies, Rexall is particularly interested in connecting with female shoppers who make the purchasing decisions for both their children and, in many cases, their parents. Through its loyalty programs, Rexall is able to learn more about her and what she is looking for, as well as sending timely, relevant offers she can actually appreciate. We cant kid ourselves, everybodys got a loyalty program or some sort of rewards program, says Bussieres. In Canada its all about points and the accumulation of points. In our case, for example, the Air Miles and Aeroplan customers are really loyal to those two programs. Our hope is that they make the decision to
shop at Rexall because were giving them the reward that they are interested in. Theres no question that that component is added value for them because were providing them with a reward that they love, so they can get whatever they want out of it. Having said that, because everyone has a program, what you really want to do is make sure that the reward that you provide them with is meaningful. For example, if we know based on your shopping pattern that you buy diapers or whatever type of product, we try and tailor the offers to the products that you are interested in buying. We also do a lot of testing to try and understand what works, what doesnt work and what the customers will respond to. As a cutting-edge health retailer, Rexall is staying abreast of new digital channels that are offering myriad new opportunities fostering loyalty, but even Bussieres admits that the pace of change can be overwhelming. The new channels are changing rapidly and people are adapting quite rapidly to them, she says. It is very exciting because it offers us new channels and these channels give us the ability to make changes quickly. You need to manage new channels properly and you need to educate yourself because once [an offer is] out there, its out there, it cannot be retracted. We need to really make sure that if we do it, we do it right.
46
IHRmAgAzIne.com JULy/aUgUST 2011
feature
Mobile penetration is changing the face of loyalty marketing, making it possible to connect with customers anytime, anywhere, right up to the point of purchase.
The mobile revolution There is no question that mobile penetration is changing the face of loyalty marketing, making it possible to connect with customers anytime, anywhere, right up to the point of purchase. A recent study by comScore, Inc., a leader in measuring the digital world, found that 16.7 million U.S. mobile subscribers used location-based check-in services on their phones in March 2011, representing 7.1 percent of the entire mobile population. While the study focused on our neighbours south of the border, the implications for the Canadian market are clear. We are quickly catching up when it comes to mobile adoption, and this fact plus our enthusiasm for loyalty programs certainly makes for a powerful combination. Mobile check-in services offer several exciting opportunities for large retailers and small businesses alike. From customized mobile apps that send push notifications alerting customers to targeted sales and promotions, to QR codes that enhance a customers experience in-store to Foursquare mayorships that allow even the smallest business to reward their best customers however they see fit, the options are truly endless.
Although still in their relative infancy, location-based mobile check-in services are seeing rather impressive adoption among smartphone users, said Mark Donovan, comScore senior vice president of mobile. The ability to interact with consumers on this micro-local level through special offers, deals and other incentives provides brands with the real-time opportunity to engage consumers through their mobile device. Experts predict that the next big thing in mobile and loyalty programs will be near-field communication (NFC), a tiny computer chip that serves as an all-in-one debit and/or credit card, loyalty card and transmitting tool. From the customers perspective NFC is similar to MasterCards PayPass technology, in that purchases are completed by simply tapping the device on a point-of-sale machine, while making it easier than ever to take advantage of loyalty program incentives. By empowering consumers to incorporate loyalty participation in every purchase, NFC has the potential to provide marketers with a more complete understanding of consumer behaviour than ever before. Research in Motion, for instance, has announced that the new Blackberry Bold 9900 will incorporate NFC technology, and more widespread adoption is sure to follow.
Three key lessons from the Shoppers Optimum Program:

With over nine million members, the Shoppers Optimum Program is the leading health loyalty program in Canada and one of the countrys top retail loyalty programs. Make it easy: Membership is free and cashiers consistently ask customers if they collect Optimum points as they are checking out. Keep it simple: Customers earn 10 Shoppers Optimum Points for every dollar spent on almost anything in store, and every receipt includes details on how many points have been accumulated and what they can be redeemed for. Spice things up: Frequent promotions, including 20x the Points and Spend your Points events, are advertised in-store and through opt-in email newsletters, ramping up reward fervour among dedicated collectors.
july/auguSt 2011 IHRMagazIne.cOM
47
Turning
feature
48
back
Anti-aging products are ruling the cosmetics world
By Dr. Linda Miles L. Ac., D.O.M.
feature
the clock
T
he anti-aging category continues to experience rapid growth because customers are always searching for the most effective and affordable way to keep their bodies healthy and their skin smooth, radiant and younger looking. Understanding the basics of free radicals and how important antioxidants are is essential for healthy, vibrant skin. As an individual goes through the aging process, the cumulative exposure to free radicals causes visible signs of aging and the decline in skins health. Nourishing skin with powerful antioxidants from the inside and outside will help leave skin healthy, beautiful and younger looking. Pesky Free Radicals Did you know that our bodies are under continuous attack by free radicals (highly reactive atoms that damage cells in the body)? You encounter free radicals every day. For example: over-exposure to sun, toxins in food, water and air, second-hand smoke, car fumes, microwaving and even stress can create free radicals. On the inside, free radical damage is implicated in various diseases including cancers, degenerative diseases, and inflammatory illnesses, as well as the aging process itself. Free radical damage to skin causes visible signs of aging such as fine lines, wrinkles, loss of tone, hyperpigmentation and a decline in your overall skin health.
juLy/August 2011 IHRmagazIne.com
49
feature
Antioxidants Can Help Antioxidants help the body protect itself from the danger of free radical attacks. Antioxidants are specific vitamins, minerals, or nutrients that inactivate free radicals before they can damage cells. Hundreds of antioxidants exist; some, such as Alpha Lipoic Acid, the body produces, whereas others, such as vitamins E and C, we must consume. They each function slightly differently but work together to keep the body and skin healthy. How They Work To maintain healthy, youthful skin we must ensure that our skin has enough antioxidants to adequately protect itself. Because skin is fed by the blood stream, we can deliver these antioxidants through a healthy, balanced diet with plenty of fresh fruits and vegetables and taking an antioxidant supplement orally. However, according to Dr. Lester Packer, Founder of Packer Lab at UC Berkley (that specializes in antioxidant research) and author of The Antioxidant Miracle, applying antioxidants topically is the fastest way to help support and protect your skin. Although taking oral supplements will help to boost the amount of antioxidants in your skin, the direct application of antioxidants to the skin is a much faster way to increase the level of antioxidants, Dr. Packer says. Furthermore, countless studies demonstrate the protective effects of topical antioxidants. A study conducted in Germany measured the effects of antioxidants on skin structure in two groups. In the first group, volunteers applied a 3 per cent ascorbic acid (vitamin C) emulsion daily. The second group used a placebo crme containing no active ingredients. Skin analysis following one month of treatment found improved microstructure of the skin in the group using the vitamin C emulsion; after two months, a reduction of facial wrinkles was noticed in the same group. Studies in France using a 5 per cent vitamin C crme substantiate these results. In a study using green tea, topical application before UV exposure helped protect against photoaging and skin cancers. Other numerous studies have also demonstrated that topical antioxidants reduce inflammation. A Younger-Looking You Learning the basics of free radical damage and the power of antioxidants can help you and your customers defy age. Making healthy lifestyle choices and nourishing the body by eating a balanced diet with fresh fruits, vegetables and an antioxidantrich supplement is essential. For the fastest and most effective way to counteract skins age damage caused by free radicals, choose skincare products that contain effective levels of the antioxidants that meet specific skincare needs. These simple steps will promote healthy, beautiful and younger-looking skin.
DID YOU KNOW?

By 2012, anti-aging products will account for about one-quarter of the value of the global cosmetic skin care market. Global sales of antiaging cosmetic products are expected to grow to U$ 21.3 billion.*
*According to projections by Euromonitor
feature
Antioxidants Applied Topically Topical antioxidants are the fastest and most eective way to counteract skins age damage caused by free radicals. Applying crmes and serums rich in antioxidants optimize the health of the skin and help guard against environmental stress, diminish ne lines and wrinkles, soothe in ammation, even skin tone and improve texture and elasticity. Antiaging skincare products include antioxidant-rich ingredients such as Pycnogenol, Astaxanthin, Green Tea, Pomegranate, Alpha Lipoic Acid and Ester-C.
Ester-C - This stable, water-soluble, non-irritating form of vitamin C penetrates right down to the deeper layers of the skin where collagen and other important support structures are produced. Ester-C is a unique patented vitamin C complex that contains vitamin C plus minerals and bioactive metabolites to enhance the penetration and bioavailability of vitamin C. As an antioxidant, vitamin C protects the water-soluble structures of the skin from free radical damage and aids in protecting the cell membranes by recycling vitamin E. Additionally, vitamin C stimulates collagen growth to help maintain and improve skin tone, rmness, exibility, and elasticity. It also assists in modulating the inammatory response and is known for evening out pigmentation.
Pycnogenol - Harvested from the bark of the French Maritime Pine, this amazing nutrient is 50 times more powerful than vitamin E and 20 times more powerful than vitamin C as an antioxidant to neutralize free radicals. Pycnogenol also supports collagen and elastin health, enhances texture and elasticity and reduces skin irregularities for a more vibrant, youthful appearance. Pycnogenol is an ideal ingredient for all skin types as well as those with even the most sensitive skin or rosacea, helping to reduce the visible signs of aging while soothing skin.
Green Tea - When applied topically, research shows that this powerful ingredient contains strong antioxidant and anti-inammatory properties that can help slow the signs of aging. Because it is rich in polyphenols, these also help ght free radicals, prevent oxidative stress, protect skin from UVA and UVB radiation damage and reduce the number of sunburned cells. Green tea may also help prevent skin cancer.
Pomegranate - Extracts of the pomegranate contain high levels of ellagic and punicic acids, along with other polyphenols that are reported to contribute to this ingredients antioxidant, anti-inammatory and antiaging properties. Pomegranate also helps provide natural protection from the sun, protecting against the adverse effects of UV-B radiation. Additionally, this benecial fruit is reported to help boost collagen production and promote regeneration of the skins epidermis to help keep skin young and healthy.
Astaxanthin - Harvested from micro-algae and responsible for the pink colour of salmon, amingos, shrimp and lobster, Astaxanthin is the most potent antioxidant yet discovered. This amazing natural ingredient has been found to be 500 times more powerful than vitamin E in neutralizing free radicals and 1000 times more effective than both betacarotene and lutein in protecting the skin from exposure to UV light. Additionally, this antioxidant helps to reduce inammation, normalize skin function and enhance the skins defensive cells.
Alpha Lipoic Acid - As the universal antioxidant, Alpha Lipoic Acid (ALA) is capable of protecting all portions of the skins cellular structure and boosts the activity of all other antioxidants. What makes ALA special as an antioxidant is its versatility. It helps deactivate a wide array of cell-damaging free radicals and may recycle other antioxidants, making them much more effective. In particular, ALA helps protect the mitochondria and our DNA. As we age, mitochondrial function is impaired and this contributes to the adverse effects of aging.
51
feature
s on hat bel? W r la you

will labelling y ing food tr s regard products indus tion ula New reg natural health . ., M.B.A c., LL.B pact the o ns . B S im aller, H
By J oe l B. T
he federal government recently instituted new labelling requirements for allergens in foods. While the changes relate only to foods, manufacturers and importers of natural health products (NHPs) may want to take notice of the new regulatory requirements and consider adopting these changes, if not in the exact form, at the very least with the disclosure of similar information. It would appear the Natural Health Products Directorate (NHPD) has recently reacted to the change in food labelling by inquiring of applicants or those who have already received
product licenses for NHPs that may inadvertently contain milk, asking applicants or license holders to confirm if the product contained any amounts of milk. If it was determined that the product did contain even small amounts of milk, the NHPD required labelling changes to reflect language that is similar to that in the new allergen labelling regulations. The new rules The regulations will require some ingredients used in food products which were previously exempt from declaration in the list of ingredients (e.g. components of margarine, seasoning and flour)
52
IHRmagazIne.com JULy/AUgUST 2011
feature
to appear on the food label. According to the new regulations, if a food allergen or gluten is present in a prepackaged food product, the source must be shown on the label of the product in the list of ingredients or in a contains statement appearing directly after the list of ingredients (e.g. contains milk). These new food allergen labelling regulations will come into force on August 4, 2012. The new definition of food allergen includes any protein from any of the following foods, or any modified protein, including any protein fraction, that is derived from any of the following foods: (a) almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios or walnuts; (b) peanuts; (c) sesame seeds; (d) wheat or triticale; (e) eggs; (f) milk; (g) soybeans; (h) crustaceans; (i) shellfish; (j) fish; and (k) mustard seeds. The new definition of gluten includes any gluten protein from the grain of any of the following cereals or from the grain of a hybridized strain that is created from at least one of the following cereals: barley, oats, rye, triticale, and wheat. Gluten also includes any gluten protein fraction that is derived from the grain of any of the above noted cereals or from the grain of a hybridized strain. The new regulations will also require that sulphites be shown on the list of ingredients or in a contains statement, if the total amount of sulphites present in the prepackaged product is 10 parts per million or more.
The new definition of allergen includes any protein from the following foods: almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios or walnuts peanuts sesame seeds wheat or triticale eggs milk soybeans crustaceans shellfish fish mustard seeds
More under the sun

The U.S. FDA announced that sunscreen products will be labelled with new information to help consumers find sun protection products that help prevent sunburns, reduce the risk of skin cancer and early skin aging. Both UVB and UVA radiation contribute to sunburn, skin cancer and premature skin aging; however, sunburn is primarily caused by UVB radiation. Products labelled Broad Spectrum pass the FDAs test for protection against both ultraviolet A and ultraviolet B rays. Sunscreens labelled as both Broad Spectrum and SPF 15, or higher, if regularly used with other sun protection measures, will help prevent sunburn, reduce the risk of skin cancer and reduce the risk of early skin aging. Products that have SPF values between 2 and 14 may be labelled as Broad Spectrum if they pass the required test. Only products that are labelled both as Broad Spectrum with SPF values of 15 or higher may state that they reduce the risk of skin cancer and early skin aging, when used as directed. Non-Broad Spectrum products, or Broad Spectrum products with SPF between 2 to 14, will be required to have a warning stating that the product has not been shown to help prevent skin cancer or early skin aging. Regulations limit the maximum SPF value on sunscreen labels to 50 + due to insufficient data showing that products with SPF values higher than 50 provide greater protection for users. FDA reaffirmed that there are no safety issues with nanoscale titanium dioxide and zinc oxide, active ingredients in sunscreen. Regulations will be effective for most manufacturers in one year, however, manufacturers with annual sales less than $25,000 have two years to comply.
jUly/AUgUST 2011 IHRMagazIne.coM
53
1.75 CEUs
natural Health Products For Weight Loss
Questions on page 69 Answer sheet on page 70 Send your answers by fax to 416-703-6392 Continuning Education Lesson 1.75 CEUs
This month's lesson is brought to you by
54
1.75 CEUs
CCCEP File # 837-1208 Expiry Date: February 17, 2012 Number of CEUs assigned: 1.75 CEUs
NATURAL HEALTH PRODUCTS FOR WEIGHT LOSS

By Joyce Johnson, B.Sc., N.D. and Stephanie Rubino, B.Sc., N.D.
Learning Objectives: After completing this session, the pharmacist should be able to: 1. Explain the role of the following weight loss products: Conjugated Linoleic Acid, Green Tea, Coleus forskohlii, Garcinia cambogia, Paullinia cupana, Citrus aurantium, Yerba Mate, Cayenne, Ginger, Chitosan, Viscous Fibre Blend (commercially known as polyglycoplex), Chromium, Gymnema sylvestre, Apple Cider Vinegar, 5-HTP, and Hoodia gordonii. 2. Describe the appropriate prescribing of the above natural health products (NHP) for weight loss. 3. Explain the safety and efficacy of NHPs in weight loss, and provide general guidelines to patients regarding their use. 4. Apply the knowledge learned in this lesson to provide general guidelines to patients regarding their safe use and efficacy. Instructions 1. After carefully reading this lesson, study each question in the post-test and select the answer which you believe to be most correct. Although more than one option may be considered acceptable, only one option is the best answer. 2. To successfully pass this lesson, a grade of 70% (14 out of 20) is required. If you pass, your CEU(s) will be recorded with the relevant provincial authority(ies).
Introduction Obesity is a result of energy intake being greater than energy expenditure resulting in a positive energy balance. The standard measurement for weight status is the Body Mass Index (BMI). The BMI = Weight (kg) / Height (m)2 Underweight: BMI of 18.5 or less Acceptable weight: BMI of 18.6 to 24.9 Overweight: BMI of 25 to 29.9 Obesity: BMI 30 30.0 to 34.9 (Obese Class I - High Risk) 35.0 to 39.9 (Obese Class II - Very High Risk) 40.0 (Obese Class III - Extremely High Risk) The validity of using BMI as a marker for obesity has recently been challenged in the scientific literature. Measurements of central adiposity such as waist circumference, hip: waist ratios and hip: height ratios have been proposed as better predictors of the pathological consequences of obesity. The National Heart, Lung,
and Blood Institute Clinical Guidelines recommend the use of waist circumference in addition to BMI in clinical screening of adults. Overweight and Obesity Rates Statistics Canada reports an increase of just 9% in the rate of measured obesity among adults aged 18 years from 1978 (14%) to 2004 (23%). In 2004, statistics indicated that approximately 58.8% of Canadian adults (65.2% of men and 52.4% of women) were either overweight or obese.ii The cost of obesity and physical inactivity in Canada ranged from between $1.8 billion to $5.3 billion, based on stats from 1997 and 2001. This included direct costs, such as cost of hospital care, drugs, physician care, care in other institutions, and additional direct health expenditures. It also included indirect costs such as those measured in terms of the value of years of life lost due to premature death and the value of activity days lost due to shortand long-term disability.ii
JULY/AUGUST 2011 IHRmagazIne.cOm
55
Healthy weight loss can be achieved by reducing energy intake or increasing energy expenditure. Several studies have demonstrated that just losing 7% to 10% of initial body weight is sufficient to have improvement in waist circumference, dyslipidemias (elevated triglycerides and low levels of high-density-lipoprotein cholesterol), trunk fat, and plasma glucose. The Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults convened by the National Institutes of Health/ National Heart, Lung, and Blood Institute recommended a 500to 1000-kcal/d deficit diet for obese persons, which will initially result in a weekly weight loss of 1 to 2 lb (0.45 to 0.9 kg). Lifestyle Considerations for Obesity A safe and effective rate of weight loss is approximately 1lb per week. A deficit of 3500 calories per week needs to be created to achieve this (1lb=3500 calories). Reducing calorie intake by this much can be very difficult, even unhealthy, thus exercise along with healthy eating is required to create such a deficit. Strength training is extremely important as muscle has a higher metabolic rate than fat. This is the reason why men in general have higher metabolic rates and therefore tend not to gain weight as easily as women. Men generally have greater muscle mass (therefore lower % body fat) compared to women. Strength training (machines, free weights, free body exercises like yoga/push ups/ pilates) can increase muscle mass and therefore metabolic rate. Recommended Physical Activity Program: Cardiovascular Training: Running, walking, bicycling, swimming 4 times per week for 30 to 40 minutes Strength Training: Free weights, machines, free body exercises (yoga and pilates) 2-3 times per week for 30 to 40 minutes Sleep is also a very important key factor to effective weight loss. Sleep deprivation increases cortisol, causing increased appetite, cravings for sugar and weight gain. It also slows down metabolism and increases inflammatory markers. Sleep deprivation elevates ghrelin (an appetite stimulating hormone from the stomach) and reduces leptin (released by fats cells to promote satiety). Stress also increases cortisol levels causing an increase in appetite and an increase in the amount of abdominal fat. Cortisol also promotes the craving of carbohydrates (CHO) by lowering serotonin levels. Excess CHO elevates insulin release insulin will then store excess CHO as fat. Natural Health Products for Weight Loss Natural health products can play a role in weight loss by addressing the following objectives: Detoxification - toxins are stored in our fat cells, and as the body grows more toxic (due to exposure to environmental pollutants, dietary additives (colouring, hormones, drugs), more fat is produced
to store the additional toxins. This is the bodys way of protecting the organs from being damaged by the toxins. From Dr. Elson Haas, MD Detoxification is also an important component in treating obesity. Many of the toxins we ingest or make are stored in the fatty tissues: hence, obesity is almost always associated with toxicity. When we lose weight, we reduce our body fat and thereby our toxic load. However, during weight loss we also release more toxins and need to protect ourselves from nutrient depletion through extra supplementation, including taking additional antioxidants to balance these toxins. Exercise will also promote the loss of excess pounds and help further detoxification. Other reasons for detoxification: enhanced functioning of metabolic enzymes and control of glycogen release in the liver; lower levels of substances that are potentially increasing inflammation; better elimination. Improve digestion. Enhance metabolism. Aid in controlling hunger signals. Maintain glucose and insulin levels. Support mental health and well-being. Note: Supplements are always used in conjunction with a healthy diet & lifestyle plan. Apple Cider Vinegar Apple cider vinegar comes from fermented juice from crushed apples. It is used for weight loss, leg cramps and pain, upset stomach, sore throats, sinus problems, high blood pressure, arthritis, to help rid the body of toxins, stimulate thinking, slow the aging process, regulate blood pressure, reduce cholesterol, fight infection, and osteoporosis.ix It is common for patients with diabetes in Sweden to drink vinegar daily because of its positive effect on blood glucose. Apple cider vinegar contains significant quantities of acetic acid and citric acid, which are known to be the active ingredients.ix Acetic acid has been shown to suppress disaccharidase activity and raise glucose-6-phosphate concentrations in skeletal muscle. It might possess physiological effects similar to acarbose or metformin. Apple cider vinegar also contains pectin, vitamins B1, B2, and B6, biotin, folic acid, niacin, pantothenic acid, and vitamin C. Small amounts of the minerals sodium, phosphorous, potassium, calcium, iron, and magnesium are also found in apple cider vinegar.lxxii It is thought that apple cider vinegar might have beneficial effects on blood glucose levels. It can delay gastric emptying, reduce postprandial blood glucose levels, improve insulin sensitivity, and has lowered the postprandial blood glucose and insulin levels in insulin-resistant subjects.x,xi Currently, there is insufficient reliable information available about the safety of apple cider vinegar. Long-term use or high doses may theoretically cause osteoporosis and might increase potassium loss of individuals using insulin based on one case report.ix
CONTINUING EDUCATION
56
IHRmAgAzINe.COm JUly/aUgUst 2011
Due to effects on potassium levels, it is advised to use caution when used in conjunction with digoxin (overuse of apple cider vinegar could decrease potassium levels, increasing the risk of toxicity for cardiovascular drugs), diuretic drugs (overuse of apple cider vinegar might compound diuretic-induced potassium loss), and insulin (theoretically, overuse of apple cider vinegar concomitantly with insulin might cause hypokalemia).ix In a randomized, cross-over trialxi, insulin-sensitive (n=8), insulin-resistant (n=11), and Type 2 diabetes patients (n=10) were given either 20g apple cider vinegar mix or placebo. After a 2-min delay, they were fed the test meal, which was composed of a white bagel, butter, and orange juice. Results of vinegar use demonstrated increased insulin sensitivity during the 60min postmeal interval in insulin-resistant subjects, a slight improvement in this parameter in subjects with type 2 diabetes, decreased postprandial fluxes in insulin in control subjects, and decreased postprandial fluxes in both glucose and insulin in insulin-resistant subjects. This data indicates that vinegar can significantly improve postprandial insulin sensitivity in insulin-resistant subjects. Hippocrates used apple cider vinegar for general health and healing.ix There is currently an insufficient number of human trials available to confidently recommend apple cider vinegar as a weight loss agent. Recommended dosage: 1 oz. (2 Tablespoons) in warm water before each meal, however not an established dosage. Bitter orange (citrus aurantium) Citrus aurantium is used in Asian herbal medicine to treat digestive problems. It has been incorporated into weight loss supplements as its MOA is similar to ephedra. In response to the ban of ephedra, many manufacturers changed their supplement formulations to ephedra- free products by eliminating ephedra and substituting with the herb Citrus aurantium (also known as bitter orange and sour orange). The active ingredients in Citrus aurantium include synephrine (also called p-synephrine or oxedrine), octopamine, N-methyltyramine, flavonoids, and furanocoumarins. xliv,ix It is believed that the mechanism of action of Citrus aurantium is due to synephrine, which stimulates alpha-adrenergic receptors (similar to ephedra) and activates -3 adrenoreceptors, and octopamine, a selective -3 adrenoreceptor agonist.ix, xiv Both of these compounds inhibit cAMP production. Alpha and betaadrenergic receptor agonists are expected to potentially increase energy expenditure and decrease food intake.xiv Adrenergic agonists decrease food intake by reducing gastric motility. Adverse effects that are associated with Citrus aurantium include potential sympathomimetic effects and inhibition of CYP3A4 in culture intestinal epithelial cells. It is contraindicated with
patients with ulcers (stomach, intestinal), and it can increase the risk of cardiovascular events as it causes vasoconstriction, resulting in increased blood pressure and heart rate.ix,xliv Due to the inhibition of CYP3A4, Citrus aurantium can result in increased drug levels in more than a quarter of pharmaceuticals such as indinavir, felodipine, dextromethorphan.ix In a RCT of 6 weeks, blinded parellel groups were given a combination supplement of 975mg Citrus aurantium, + 528mg caffeine and 900mg St Johns Wort (n=9), a placebo (n=7) or no pills at all (n=4). The supplement group lost more fat (3.1kg; P<0.05) than other groups and increased resting metabolic rate 2-3%. Citrus aurantium may assist individuals in losing body fat, attributed to increased energy and reduced energy intake expenditure. No adverse events were reported in this study. Another study conducted was an open-labelled trial of 2 weeks duration with 9 overweight/obese women. For 1 week they followed a low-energy diet followed by 1 week administration of 325mg C. aurantium +125mg day, Paullinia cupana + 5mg day Ginkgo biloba (2768mg of alkaloids). This product contained 5mg synephrine. After one week 0.94kg weight loss was noted with the supplement and after 2 weeks2.4kg weight loss (P < 0.05) was noted with supplement. C. aurantium may assist individuals in losing bodyweight. A prospective, randomized double blind trial of 8 weeks duration followed 30 overweight subjects with BMIs > 27 were given ephedrine and synephrine alkaloids (5mg twice daily)-based product vs. placebo with exercise and diet. Results demonstrated a 3.4kg weight loss in experimental group vs. 2.05 kg in placebo group (P<0.05). No adverse events were noted and findings indicate apparent short-term safety and efficacy of ephedrine and synephrine-based compound. In a randomized study of 44 days that remains unclear if was blinded, followed 5 overweight men and 14 overweight women. They were assigned an exercise program with assignment to drug (Ma Huang, bitter orange and guarana) or placebo. Bitter orange was standardized for 5mg synephrine. The supplement increased fat loss (2.5kg; P=0.033) more than placebo (0.5 kg). The results provided low statistical power and no marked side effects. Overall, the studies that examined weight loss reported a loss of 2.43.4 kg among participants using synephrine alkaloids, while placebo groups lost 0.942.05 kg, over a period of 2 to 8 weeks. Few clinical trials have examined the effects of bitter orange alone or in combination with other ingredients on body weight and/or body composition. Trials that have been conducted are of short duration and sample sizes are frequently inadequate, however overall, they indicate body weight and/or fat loss can be enhanced.
57
There is no evidence that synephrine and octopamine in levels that would be found in weight-loss products would have any lipolytic effect in human adipocytes. The effects that are seen may be due to a suppressing effect of appetite and/or a moderate increase in resting energy expenditure. Further testing on safety and efficacy is warranted.ix, xiv Recommended dosage: Citrus aurantium extract has been standardized to 4%-6% synephrine for its thermogenic effect, although a recommended dosage has not been established. cayenne (capsicum frutescens) Cayenne is also known as Capsicum frutescens. The active ingredient is capsaicin and the extract comes from the fruit. The effects indicated are due to lipid metabolism, diabetic control, digestive function, and oxidative potential. Cayenne is believed to increase energy expenditure and basal metabolic rate. By increasing energy and lipid metabolism, the result is an increase in catecholamine (epinephrine and norepinephrine) secretion from the adrenal medulla through activation of the SNS, as well as by -adrenergic stimulation. Cayenne also has the potential ability to increase number or affinity of hepatic insulin receptors leading to an increase in insulin clearance. Research suggests that cayenne also delays gastric emptying and increases transit time. xl,xv The long-term use of cayenne is limited due to its strong pungency effects (sharp sensory impression). These pungency effects can act as a topical irritant, can increase gastric acid production and bleeding (dose and time-dependent), can cause a burning feeling, may inhibit platelet aggregation and enhance intestinal motility (caution in IBS), and can result in acute effects of bronchoconstriction. Cayenne also has the potential to interact with antacids, theophylline, blood thinners, hexobarbital and barbiturate pentobarbital. xvi In a randomized, crossover, intervention study, xv the effects of a chili meal (30 g/d of chili blend; 55% cayenne chilli) was observed. In one group the effects were observed after 4 weeks of a spicefree diet and in the other, a chili meal after 4 weeks of regular consumption of chili. The study looked at levels of plasma glucose, serum insulin, C-peptide and energy expenditure (EE). There were no significant differences in BMI and fasting plasma glucose. The following was observed: decreased insulin need to control postprandial rise in glucose with regular chili consumption; decreased C-peptide and insulin secretion; increased hepatic insulin clearance (larger effect if chili is eaten regularly); and a decrease in energy expenditure. Subjects with BMI 26 had lower EE possibly due to reduced and improved profile of postpradial insulin. Anecdotal evidence and the findings from studies in lean, young persons suggest that meals containing chili increase EE and may help reduce body weight.
Another RDBPC trial is notable that involved two phases. Following 120 individuals with a BMI of 25-35, the first 4 weeks they had a very-low-energy diet intervention, followed by a 3-month weight-maintenance period with random assignment of capsaicin (135mg/d) or placebo. The results of phase I included a decrease of 7.8% body mass for both groups (p<0.001). There was also a decrease in waist circumference, resting EE, resting quotient (RQ), total EE, glucose, insulin, triacylglycerol and leptin levels. Phase II results showed no difference with percentage weight regain (p=0.09), along with an increase in fat oxidation (p<0.05) and an increase resting EE (p<0.005). Cayenne might be used for weight loss for its ability to increase energy expenditure and fat oxidation. Although effective, strong compliance is not always possible due to difficulties with tolerance. xiii Recommended dosage: 1-2 capsules (450mg-500mg per capsule), 2 or 3 times daily before meals. chitosan Chitosan is a cationic polysaccharide produced from chitin, found in the shells of crustaceans.lxvi, It is shown to increase lipid excretion in feces and has demonstrated a hypocholesterolemic effect. Chitosan has been promoted to reduce fat absorption; and has been marketed as fat blockers or fat trappersxviii, similar to Orlistat (Xenical). It also possesses anti-bacterial and anti-yeast properties. There are claims that chitosan blocks the absorption of 120g of dietary fat per day to promote weight loss.xviii Chitosan carries a positive charge, and attracts negatively charged bile acids and fats (increasing excretion of bile acid into feces).xix, It forms a gellike complex in the intestinal tract which entraps lipids and other nutrients.xx There are potential adverse effects which include gastrointestinal symptoms (constipation, diarrhea, nausea, flatulence). Chitosan might affect absorption of fat-soluble vitamins and aggravate the symptoms of mild steatorrhea.lxvi There are no known drug interactions with chitosan. In a RDBPC trial, 250 individuals with a BMI of 2850, received either 3g/d of chitosan or placebo, combined with dietary and lifestyle advice. The results demonstrated a decrease in weight by 0.4% versus an increase in weight by 0.2% in the placebo group (p=0.03). Results were not clinically significant. Another RDBPC trial with 150 people over 60-days, received either 3g/d of chitosan, placebo or control (weight loss program of choice).xxi The treatment group had a decrease in mean scale weight (p< 0.001) and a decrease in fat mass (p=0.006) compared to the control group. The treatment group also had a decrease of 2.8lbs body weight versus an increase of 0.8lbs in the control group.
58
Comparing the treatment group to the placebo group demonstrated a decrease in scale weight (2.8lbs vs 0.6lbs, p=0.03), a decrease in % fat (0.8% vs 0.4%, p=0.003), a decrease in fat mass (2.6lbs vs 0.6lbs, p=0.001), and an increase in Body Composition Improvement index (2.4 lbs vs 1.9 lbs, p = 0.002). A meta-analysis that included 14 randomized placebo-controlled trials, involving 1071 participants showed chitosan use resulted in a small but statistically significant greater reduction in body weight (weighted mean difference -1.7 kg, p < 0.00001) compared with placebo. Chitosan is promoted extensively in the United States as a dietary fiber for weight reduction. At this time, there is insufficient evidence to indicate chitosan is effective for reducing body weight in humans.lxvi Additional studies are needed to determine the effects of chitosan for weight loss. Recommended dosage: 1-3 grams for up to eight weeks however not an established dosage. chromium Chromium is an essential trace element required for carbohydrate, lipid and protein metabolism. It may improve impaired glucose tolerance and decrease elevated blood lipid concentrations. Chromium supports weight loss and improves body composition by increasing muscle mass and reducing body fat in obese individuals. It is also used to improve insulin sensitivity and facilitate blood glucose clearance in varying degrees of glucose intolerance. Approximately 90% of the US population does not meet the adequate daily amount similar findings have noted this deficiency in Canada, Britain and Finland. This is due to higher consumption of refined foods, including simple sugars, which increase urinary chromium losses by 10-300% and food processing methods that often remove naturally occurring chromium. Aging, pregnancy, strenuous exercise, infection, and physical trauma can further increase chromium loss from the body.xxiv Chromium is distributed to various tissues, in particular the kidney, muscle and liver. It potentiates the action of insulin and is a cofactor for insulin function. Chromium increases insulin binding, thereby improving glucose uptake, increases the number of insulin receptors, increases insulin receptor phosphorylation [results in enhanced glucose transport into liver, muscle and adipose tissue (primary mechanism)], and improves insulin sensitivity.xxiv,xxv Trivalent chromium is well-tolerated. There is the potential for gastrointestinal upset at high doses. Very rarely, skin rashes, insomnia or sleep disturbances, headaches, mood changes, muscle damage, or anemia may occur. Chromium is safe during pregnancy and breastfeeding.
Concurrent use with insulin and other hypoglycemic agents might cause additive hypoglycemia. NSAIDs might increase chromium levels by increasing absorption and retention. Antacids, H2 blockers and proton pump inhibitors might inhibit the absorption of chromium, while corticosteroids increase urinary chromium excretion.xxvii A meta-analysis that was conducted included RDBPC human trials of chromium picolinate with reports on body weight . There was a significant reduction in body weight in patients receiving chromium picolinate compared to placebo. Another metaanalysis of eight other trials used in a secondary analysis found no significant effect for lean body mass and a significant effect for % body fat. The results suggest a relatively small reduction of 1.11.2 kg (ie, 0.080.2 kg/wk) compared with placebo during an intervention period of 614wk in patients with an average BMI of 2833 (37). By comparison, a diet with a provision of 3300 kJ/d achieves a mean weight loss of 1.52.5 kg/wk, and a more moderate energy restriction to 5000kJ/d results in a weight loss of 0.50.6 kg/wk (49). Therefore, it seems that the observed effect with chromium picolinate is, although statistically significant, not clinically meaningful. A 12-week RDBPC trial followed 44 females with a BMI between 27-41. They randomly received chromium picolinate (400g/d) or placebo, and participated in weight-training and walking program 2 days per week. They found no significant changes in % body fat, LBM, fat mass, body weight, resting metabolic rate, or lipid values. The chromium group tendency was to lower % body fat. Percent BF was reduced as well as fat mass (p<0.05), along with an increase in LBM (p<0.05) due to exercise training.xxv Chromium potentiates the action of insulin and is involved in the metabolism of carbohydrates, lipids, and proteins. Diets consumed by the general population might not provide adequate amounts of chromium, and exercise can increase chromium loss from the body. Chromium supplementation does not appear to increase LBM or decrease fat mass, even when combined with resistive training. Consuming chromium-rich foods or supplements may be beneficial for those deficient in chromium. Health Canada is considering limiting the use of chromium picolinate as an acceptable source of chromium and limiting dose to less than or equal to 500 micrograms per day. Recommended dosage: 200-1000g daily in divided dosages. coleus (coleus Forskohlii) Coleus forskohlii is a plant that is native to India. The root of the plant is traditionally used in the treatment of disorders of the cardiovascular, respiratory, gastrointestinal, and central nervous systems. The active ingredient in Coleus forskohlii is forskolin, a diterpene. Other constituents such as volatile oils, diterpenoids and coleonols, may contribute to the activity and absorption of forskolin.ix
59
Forskolin directly activates adenylate cyclase which increases cAMP, leading to an inhibition of basophil and mast cell degranulation and histamine release, a decrease in blood pressure and intraocular pressure, platelet aggregation inhibition, vasodilation and bronchodilation, increased thyroid hormone function (increase T4 and T3) , and positive inotropic action on cardiac tissue. xix The role that forskolin has in weight and body fat management includes promoting the breakdown of stored fats, regulating thermogenic responses to food, increasing the basal metabolic rate, increasing the utilization of body fat and lipolysis, and increasing the release of fatty acids from adipose tissue which results in increased thermogenesis, decreased body fat, and increased lean body mass. There are no known toxicity or side effects of taking Coleus forskohlii at the recommended dosages.ix Forskolin can increase stomach acid levels, and decrease blood pressure and platelet aggregation, therefore use caution in cases of ulcer, hypotension and bleeding disorders. Coleus forskohlii may potentiate actions of anticoagulant and antihypertensive medications if used conjunctively.ix It does not interact with adrenergic receptors and, thus, does not result in excessive stimulation of cardiac tissue and does not raise blood pressure. Therefore, forskolin is not a sympathomimetic drug; it exhibits a vasodilatory effect, and a decrease in blood pressure is expected. A RDBPC 12-week study xi showed that Coleus forskohlii did not promote weight loss, but helped mitigate weight gain. Nineteen females, age 18-40, with BMI between 25-35 randomly received ForsLeanTM (250mg of 10%CF extract), twice daily. The Coleus group had decreased fatigue (p=0.07), hunger (p=0.02) and fullness (p=0.04) and no clinical side-effects were observed in any of the participants. An open-field trial for 6-weeks duration was conducted on 6 females of unknown age. It demonstrated a decrease in weight (p<0.05) and body fat (p=0.02), and an increase in lean body mass (p<0.02). Another 12-week RDBPC trial involving 30 males, age 18-40 with a BMI 26 randomly received 250mg of 10% forskolin extract twice daily (ForsLeanTM) or placebo. The Coleus group lost 4.52 5.74 kg of fat mass while concurrently gaining 3.71 4.07 kg of LBM. The placebo group lost 0.51 1.91 kg of fat mass and gained 1.57 2.56 kg of LBM. The reductions in fat mass as shown in the forskolin group may be attributed more toward forskolins ability to directly activate adenylate cyclase within adipose tissue, resulting in a greater release of free fatty acids (although FFA were not measured in this study). The Coleus group also had an increase in total and free testosterone (p 0.05). This increase in serum total testosterone and free testosterone may be another and/or a contributing factor for the reductions in body fat percent and fat mass seen in the
forskolin-treated group. Both groups had an increase in lean body mass (p 0.05) with no significant change in metabolic rate. Forskolin bypasses the adrenergic activation step and increases cAMP levels by either stimulating adenylate cyclase or by increasing the cAMP accumulating properties of catecholamines. It is possible that Forskolin could be used for long periods of time without diminished lipolytic effects in conjunction with increasing lean body mass. Future research is warranted due to Coleus forskohlii`s possible influence on weight loss. Recommended dosage: 100-250mg twice daily (extracts standardized to 10% forskolin) but not established.ix conjugated Linoleic acid (cLa) Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of linoleic acid with conjugated double bonds (i.e. two double bonds are separated by one single bond). Dietary supplements contain 60-90% CLA in either a free fatty acid or triglyceride form, containing a mixture of isomers, commonly cis-9, trans-11 (c-9, t-11) and trans-10, cis12 (t-10, c-12). Meat (beef, lamb) and dairy products are major sources of CLA (c-9, t11 isomer predominates). CLA is shown to have many biological effects, including anticarcinogenesis, antiatherogenesis, antidiabetic, immune modulation, and changes in body composition. x , Animal studies have shown that t-10, c-12 has the greatest effect on decreasing body fat. xi Changes in body composition due to CLA have been linked to: induction of adipocyte apoptosis; increased lipolysis in adipocytes by inhibiting prostaglandin E2; enhanced fatty acid oxidation in adipocytes and skeletal muscle cells; reduced accumulation of fatty acids due to inhibition of lipoprotein lipase and increase in carnitine palmitoyl-transferase activity; binding to peroxisome proliferators-activated receptor in fat tissue and modification of the signalling cascade to downregulate the expression of leptin; and modification of energy expenditure, the metabolic rate or both. x According to the Natural Health Product Directorate (NHPD), several areas of concern have been raised about CLA supplementation. These include lipodystrophy, insulin resistance, inflammation and oxidative stress, and vascular endothelial dysfunction. The evidence for harm is not strong but has been reported. There might soon be warning statements with regards to taking CLA in certain populations: Do not use if you have diabetes. Consult a health care practitioner prior to use if you have heart disease, high blood pressure, high cholesterol and/or high triglycerides, or history of cardiovascular disease or stroke. Common adverse effects may include fatigue and gastrointestinal symptoms, such as diarrhea, nausea and abdominal
60
discomfort. xii,xiii CLA has been shown to increase C-reactive protein, white blood cell counts, and blood urinary isoprostanes. xi Reports of increased insulin resistance, mostly seen in studies of short duration, use of single isomer, or both. xi CLA does not have any known drug interactions as seen in animal studies. Feeding of CLA to different animals including mice, pigs, hamsters, rats, chickens and dogs, has shown a decrease in body weight and fat mass, along with an increase in lean body mass. Human trials have produced mixed results - studies have differed with respect to isomer, dose and study duration. In a 12-month randomized double-blinded, placebo-controlled trial (RDBCP), 180 patients with a BMI of 25-30 were randomly assigned to 3 groups: CLA-free fatty acid, CLA-triacylgycerol, or placebo. xiii Both CLA groups demonstrated a decrease in body weight and BMI while there was no change in the placebo group. The decrease in body fat mass (BFM) above, was significantly (p<0.05) lower in both CLA groups (observed after 6 months) and was progressively higher through the last 6 months of the study (p<0.05). Body fat mass/ body fat percentage is simply the percentage of fat your body contains. There was no change in the placebo group. The best responders to CLA (4.5% BFM reduction) were women. An increase in lean body mass (LBM) in the CLA-FFA group was observed (p<0.05), whereas LBM in the CLA-triacylglycerol group did not differ significantly from placebo (p0.05). The effects were independent of diet and exercise. It is unknown whether age was a factor. The same researchers then conducted a 12-month open-study extension of the original RDBCP trial. All remaining 134 participants received CLA-triacylglycerol (3.4g of CLA isomers). Results demonstrated a decrease in serum leptin levels from 20-35%, directly correlated to BFM reduction (p<0.0001). There was a decreased BFM of 6% in previous placebo subjects now taking CLA and there were no fat or body weight changes in previous CLA groups. Overall, a 6-8% decrease of BFM was observed and a maintenance of LBM suggested a sustained effect of CLA over a long period of time. Patients also had an increase in lipoprotein (a), thrombocytes, and aspartate amino transferase, a decrease in plasma total cholesterol and LDL cholesterol, and a normalisation of glycosylated haemoglobin. A meta-analysis was conducted which included 18 longitudinal RDBPC human trials of CLA in normal weight, overweight and obese individuals of any age.xi Results showed that CLA causes a modest, but significant reduction, in fat loss of about 0.09kg/ wk (p<0.001) compared to placebo. Studies included were from different researchers. The average dietary intake of CLA is 150-200mg/day with the standard North American diet, however with increased consumption of high-fat animal products (meat and dairy), CLA
intake can increase to 650mg/day.ix Diets with an increased consumption of high-fat animal products can increase CLA consumption up to 650mg/day. Studies conducted in experimental animals and humans demonstrate that the physiological effects of CLA are attributable to the synthetic mixture of isomers (predominantly c-9,t-11-CLA and t-10,c12-CLA).x CLA has shown to decrease body fat mass, increase LBM, and is well-tolerated, however exercise caution due to the concerns noted by the NHPD. Recommended dosage: Health Canada has recently reviewed CLA and made the conclusion that the evidence is not strong enough to support a health claim for weight loss. Although animal studies indicate it is possible for doses higher than 6.8 grams of CLA to produce additional decreases in fat mass, insufficient human data is available to confirm this. garcinia cambogia (Hca) Garcinia cambogia is grown in Southeast Asia. The herbal extract is derived from the fruit and traditionally, the rinds are used in cooking and are reported to make meals more filling. The active ingredient, (-)-hydroxycitric acid (HCA), comprises up to 30% of the fruit by weight. xxii Garcinia cambogia inhibits ATP-citrate-lyase required for lipogenesis. It also decreases de novo fatty acid synthesis, increases rates of hepatic glycogen synthesis, decreases food intake, decreases body weight gain, and increases the availability of serotonin in isolated rat brain cortex. Trials and case reports of Garcinia cambogia use detail few and mild adverse events (ex: headache, nausea, gastrointestinal symptoms, with no statistical significance between groups) and no known drug interactions. Although not proven, potential caution should be considered with individuals taking SSRIs. Human trials have produced inconsistent findings on Garcinias effect on weight loss, however the reported decrease in waist circumference is significant. A RDBPC, 12-week trial with a daily dose G. cambogia 3000mg and HCA 1500mg failed to produce significant weight loss and fat mass loss in the Garcinia group compared to placebo. Another RDBPC, parallel 12-week group study with a daily dose of G. cambogia 2400mg and HCA 1200mg did not demonstrate significant weight loss, decrease in fat mass, or a decrease in energy consumption between groups. However, it did demonstrate a significant decrease in waist circumference (p=0.008) between groups. HCA found in Garcinia cambogia might promote weight loss by inhibiting ATP citrate lyase, leading to decreased fatty acid synthesis and lipogenesis. HCA may also encourage weight loss through suppression of appetite. Further research is recommended. Recommended dosage: 1,500mg of HCA per day.
61
ginger (zingiber officinale) Ginger, or Zingiber officinale, has a long history of use in China and India for lack of appetite, headaches, nausea, motion sickness, dyspepsia and flatulent colic (carminative), rheumatism, and colds. The active ingredients of ginger come from the essential oil (1-3%) including zingiberene, sesquiphellandrene and beta-bisabolene. xlix The pungent, or hot, principles provide 1-2.5% gingerols, and shogaols. Gingerol is the most potent thermogenic component. xlv The pungent principles of ginger provide thermogenic properties that may aid in weight loss. It is also shown to increase catecholamine secretion from the adrenal medulla. xvi Ginger is usually well tolerated. In doses greater than 5 grams per day there might be an increased risk of side-effects and decreased tolerability. Common side effects of ginger include abdominal discomfort, heartburn, diarrhea, and a pepper-like irritant effect in the mouth and throat. , Use caution with gastric ulcers or reflux or gallstones . It is advisable to discontinue use of high dose ginger supplements (>10g) 1 week before major surgery. xli Ginger has the potential to interact with anticoagulants/ antiplatelets, thus increasing the risk of bleeding. Ginger has been shown to inhibit thromboxane formation and inhibit platelet aggregation xxxviii, however this effect appears dependent on dose and formulation (e.g. dried, fresh, or extract). There is also the potential for interaction with H2-blockers/Proton pump inhibitors through a possible antagonizing activity by increasing stomach acid production. xliii Lastly, ginger may potentiate antihypertensives and hypoglycemics/insulin. xliii Ginger has the potential to aid in weight loss due to potential effects on satiety, thermogenesis and fat oxidation. However, insufficient research is available on the effects of ginger in a weight management program. Additional studies are needed where ginger can be examined as a monotherapy for reducing weight. Recommended dosage: up to 4 grams daily in divided dosages, however dosage is not established. glucomannan (Konjac root) Glucomannan is a natural constituent of Amorphophallus konjac. It is a soluble fiber shown to have the greatest gel volume and viscosity properties.li Resaerch on glucomannan has shown to reduce appetite, decrease glucose and insulin response to meals and promote satiety.li Investigators have indicated that glucomannan appears to be the fiber best suited for use as a dietary supplement in the treatment of excess weight, constipation, hyperlipidemia and diabetes. It is available as a bulk powder and used in capsule form or added to food. Commercially it can be found in products such as PGX and PropolTM.
Glucomannan has exceptionally high viscosity. 1% solutions of glucomannan are 10 times more viscous than comparable solutions of guar gum, and greater than 100 times more viscous than pectin solutions.lii Bulk-forming properties in the stomach result in decreased appetite and decreased caloric intake.li,lii A decreased in the rate that food exits the stomach and enters the intestine for absorption leads to a decrease in the rate of nutrient absorption, glucose and insulin response to meals by 50%, and promotes satiety.li LDL-cholesterol levels were lowered by up to 22% lii due to decreased intestinal cholesterol absorption and increased fecal bile and sterol excretion.li A delay in gastric emptying, as well as slowing the degradation and absorption of carbohydrates, accounts for the reduction in the glycemic index of a meal, post-prandial insulin surge and peak insulin response.lii When glucomannan is taken before meals, it slows the rate at which the food is broken down into glucose. This eliminates blood sugar roller-coaster and improves the bodys use of insulin. Glucomannan does not cause malabsorption, compared to -glucosidase inhibitors such as acarbose which frequently induce malabsorption-related side-effects. lii Glucomannan is entirely degraded and metabolized by gut bacteria.lii Although it results in stool volume increases, there is little increase in flatus or other undesirable gastrointestinal symptoms.lii It is important to not take glucomannan at the same time as medications as it can delay their absorption. Monitor blood glucose and lipid levels, and adjust drug dosages appropriately. Randomized controlled trials suggest that glucomannan in dosages of 3-4 grams per day may be well-tolerated and result in modest weight loss. Trials are small and have methodologic limitations. A double-blind placebo-controlled crossover design trial of 11 people with high-risk coronary heart disease patients with type 2 diabetes was conducted. They maintained their medications during the study. They began with 8-week baseline period where participants followed National Cholesterol Education Program (NCEP) Step 2 diet (low-fat, high-fiber), after which participants were randomly assigned to take glucomannan-biscuits or wheat bran biscuits during two 3-week treatment phases separated by 2-week washout period. The results indicated that glucomannan significantly reduced serum fructosamine[a short-term marker of glycemic control (5.7%, p=0.007)], reduced total:HDL cholesterol ratio (10%, p=0.03) and reduced systolic blood pressure (6.9%, p=0.02). There were non-significant changes with body weight, total cholesterol, LDL and HDL cholesterol, triglycerides, apolipoproteins A-1, B and their ratio, glucose, insulin and diastolic blood pressure.
62
TABLE 1: Results
Men
No-Exercise BMI (kg/m )
2
Women
Exercise -0.9 -2.9* -3.7 -4 -18.8 -15.2 -15* No-Exercise -0.9 -1.9 -3.3 -2 -9.3 -6.9 -9.3 Exercise -1.3 -2.8* -3.5 -5 -10.2 -13.6 -26.2*
-0.8 -1.4 -2.1 -2 -17.9 -16.1 -5.4
Body fat (%) Abdominal fat (%) Waist circumference (cm) Total cholesterol (mg/dL) LDL (mg/dL) Leptin (ng/mL)
*p < .05, significant effect of time and exercise; all other values p < .05 significant effect of time.
Another study examined the effect of adding a total-body exercise program to an 8-week diet supplemented with glucomannan.li 22 men (age: 18-57 ) and 20 women (age: 18-52) with BMIs > 25 completed one of two experimental conditions: No-exercise: a diet with glucomannan (1500mg before 2 largest meals every day for 8 weeks). Exercise: A diet with glucomannan combined with a resistance and endurance exercise training program. See Table 1 for Results Dietary intervention with glucomannan alone promoted weight loss, fat loss and improvement in cholesterol and LDL levels, however results were augmented with the addition of exercise. Decreased daily caloric (p < .05) intake due to decreased total fat (p < .05) and decreased carbohydrate (p < .05) intake in both groups (no major effects from exercise) resulted in decreased body mass and BMI. There was also a significant decrease in leptin levels in both groups (however with a significant decrease in the exercise group). Placebo-controlled studies have shown 1-4 grams of glucomannan can enhance weight loss with calorie restricted and non-calorie restricted diet.li Glucomannan has been beneficial for those who need to decrease their risk of developing diabetes and/or cardiovascular disease, decrease their potential for metabolic syndrome or prediabetes, decrease insulin resistance, better manage blood glucose levels, especially in Type 2 diabetes, lower moderate-high cholesterol levels, with or without cholesterol-lowering medication, decrease appetite and reduce intake of extra calories. Recommended dosage: 1-4 grams of glucomannan per day can enhance weight loss with calorie restricted and non-calorie restricted diets.li green Tea (camellia sinensis) Green tea is derived from Camellia sinensis. Green tea is produced
by lightly steaming the freshly cut leaf. Oxidation of enzymes within the leaf does not take place (the opposite occurs for black tea), allowing for a high content of polyphenols. Green tea is widely consumed in China and Japan. It is used for the reduction and maintenance of weight and body fat, and to increase energy expenditure as well as many other therapeutic properties. Green tea contains high quantities of polyphenolic components (flavonoids)xviii such as epicatechin, epicatechin gallate, epigallocatechin, and epigallocatechin gallate (EGCG). EGCG comprises 50% of the total amount of tea catechins and is the most pharmacologically active compound. Catechins may stimulate thermogenesis and fat oxidation through inhibition of catechol O-methyl-transferase (COMT), the enzyme that degrades norepinephrine (NE), leading to a prolonged effect on NE on thermogenesis and fat metabolism. xviii Caffeine also plays a role in stimulating thermogenesis by inhibiting the phosphodiesterase-induced degradation of intracellular cyclic adenosine monophosphate (cAMP).xviii,xx,xxi EGCG has demonstrated antiangiogenic effects. It is theorized that the growth of adipose tissue is dependent on angiogenesis and mediated by leptin. The modulation of angiogenic factors during development of adipose tissue plays an important functional role in prevention of obesity. This is important because of the phenomenon that angiogenic factors are elevated in overweight and obese individuals. In vitro studies have shown green tea to be more effective than an equivalent amount of caffeine in stimulating peripheral tissue thermogenesis.xx Green tea is not associated with any significant side-effects or toxicity. xvii,xviii Overconsumption may produce a stimulant effect due to caffeine content (nervousness, anxiety, insomnia, etc.). xvii A component of green tea, L-theanine, has been shown to counteract the stimulatory effect of caffeine.
july/august 2011 IHRMAgAzINE.coM
63
Since the best types of green tea also have higher levels of L-theanine, the side-effects of caffeine are not as apparent but it is still important to note that green tea drinking can contribute to anxiety and insomnia in susceptible individuals. Minor, short-term, increases in blood pressure have been noted, with no increase in heart rate.xviii There are potential additive effects with other stimulants due to caffeine content. Health Canada has recently released an updated monograph on Green tea extracts that include some warning labels based on a few case reports of putative liver toxicity at higher levels. These are: Consult a health care practitioner prior to use if you have a liver disorder or develop symptoms of liver trouble (such as abdominal pain, dark urine or jaundice) Consult a health care practitioner prior to use if you are pregnant or breastfeeding. Consult a health care practitioner prior to use if you have an iron deficiency. To support the use of green tea, a randomized trial of 3 treatments which included green tea extract (caffeine 50mg, EGCG 90mg), caffeine (50mg) and placebo was conducted with 10 men that had a body fat percentage ranging from 8-30%.xx Results from the green tea group indicated an increased 24-hour energy expenditure by 4% (p<0.01) over placebo or caffeine. Two studies both with counter-balanced crossover design were conducted. xix Each participant completed two trial days separated by 1 week. During a 24-hour period before the trials, participants ingested 3 capsules containing either green tea extract (GTE) (total: 89013mg polyphenols and 3665mg EGCG) or a corn-flour placebo. The first study investigated whether acute ingestion of GTE can increase fat oxidation rates during moderate-intensity exercise. Twelve men with an average BMI 23.90.8, performed a 30-minute cycling exercise at 60% of maximal oxygen consumption before and after supplementation of GTE. The results indicated a 17% increased average fat oxidation rate with GTE (p < 0.05). The second study investigated the effects of acute ingestion of GTE on glucose tolerance as assessed by a 2-hour oral-glucose-tolerance test (OGTT). Eleven men with an average BMI 24.1 1.1 were given an OGTT before and after supplementation of GTE. The results of this study indicated an increase AUC for serum insulin by 15% (p < 0.01) and increased insulin sensitivity by 13% (p < 0.05). Acute GTE ingestion can increase fat oxidation during moderate-intensity exercise and can improve insulin sensitivity and glucose tolerance in healthy young men. There have been several small human studies addressing the use of green tea in weight loss, or as part of a weight maintenance program of reduced intake of dietary calories and increased physical activity. The recommended extracts provided on average 136-300mg of (-)-epigallocatechin-3-gallate (EGCG) and 75-150 mg of caffeine, with an EGCG:caffeine ratio of 1.8:1 to 4:1, per day.
Additional research on green tea for weight loss is warranted. Recommended dosage: There is no established dosage for effective weight loss, however general recommendations range from 250mg-500mg, as long as the 150mg of caffeine per day is not exceeded. guarana (Paullinia cupana) Paullinia cupana is a shrub native to Brazil that grows in the Amazon region. Its therapeutic properties have been known since the seventeenth century and it has been used as a stimulant, aphrodisiac, antidiarrheal, antiaging agent, and weight loss agent. , Popular motivations for consuming guarana extracts as dietary supplements are: weight loss, energy boost, improvement of fitness and sexual performance, and increase of cognitive capacity. Guarana contains high levels of caffeine, ranging from 3-5% of dry weight. xxxx It also contains tannic acid, catechutannic acid, and a greenish essential oil. xxxv In comparison, coffee beans contain approximately 1 to 2% caffeine, and dried tea leaves contain 1 to 4% caffeine. Spiced foods and herbal drinks such as capsaicin, black pepper, ginger, mixed spices, green tea, black tea and caffeine have the potential to produce significant effects on metabolic targets such as satiety, thermogenesis, and fat oxidation. xxi Methylxanthines, such as caffeine and its metabolite theobromine, are known to affect almost every physiological system of the body, with special stimulatory effects on the brain, the heart, gastric secretion, and urine flow. The effects of caffeine include irritability, heart palpitations, increased blood pressure, anxiety and other central nervous system events. xxxii,xxxvii Caffeine also prolongs the speed of gastric emptying and decreases tension in the lower esophageal sphincter (LES). Guarana should be avoided in hypertension and other cardiac conditions, and it potentially has additive effects with other stimulants due to the caffeine content. Caffeine acts as a central nervous system stimulant. In addition, it increases blood pressure and stimulates the release of catecholamines. Guarana in combination with drugs targeting the sympathetic nervous system, such as alpha-adrenergic agonists and pseudoephedrine, or with other caffeine containing substances, may have additive effects on blood pressure elevation. In a double-blind, placebo-controlled parallel trial, 47 patients were given 3 capsules of a combination preparation (yerba mate, guarana, damiana) for 45 days. Results observed included an increase in gastric emptying time (p=0.025), a decrease in body weight of 5.10.5kg (vs 0.30.8kg placebo), and weight maintenance over 12 months (73kg vs 72.5kg). These results cannot be attributed to guarana alone.
64
Another trial which was a RDBPC, cross-over design with each subject spending 24-hours in a metabolic chamber on 5 separate occasions was conducted evaluating the effectiveness of a mixture of various strengths of green tea extracts in combination with guarana extracts compared to placebo. 14 individuals with BMIs of 20-27 were given: 1.Mixture of green tea and Guarana extracts: 200 mg caffeine (600 mg/d) + 90 mg EGCG (270 mg/d); 2.Mixture of green tea and Guarana extracts: 200 mg caffeine (600 mg/d) + 200 mg EGCG (600 mg/d); 3.Mixture of green tea and Guarana extracts: 200 mg caffeine (600 mg/d) + 300 mg EGCG (900 mg/d); 4.Mixture of green tea and Guarana extracts: 200 mg caffeine (600 mg/d) + 400 mg EGCG (1200 mg/d); 5.Placebo: inert filler of cellulose. Results demonstrated an increase in 24-hour energy expenditure with all mixtures, with no statistically significant differences among the mixtures with the different amounts of EGCG (p<0.005). There was also no effect on fat oxidation and an increase of 7mmHg systolic blood pressure (SBP) along with an increase of 5mmHg diastolic blood pressure (DBP) (p<0.005) was observed. Guarana has only been studied in combination with other active NHPs (such as yerba mate and green tea) for its weight loss effects, but not in isolation. Although there is evidence to support the use of caffeine in weight loss due to its thermogenic effects, there is insufficient evidence to support Guarana specifically. Caution must also be used to avoid the potential risks of too much caffeine consumption. Recommended dosage: 200mg-800mg in divided daily doses, based on evidence provided, however dosage is not established. gumar (gymnema sylvestre) Gumar is native to Central and Western India, tropical Africa and Australia. It has been used in the treatment of diabetes mellitus in India for over 2000 years. The Hindi name gumar means destroyer of sugar. The use of gumar is indicated in hyperglycemia, insulin-dependent and non-insulin dependent diabetes mellitus, reduction of sweet cravings and appetite, weight loss, and it may benefit hyperlipidaemia.lxxv The active ingredient in gumar is gymnemic acid, a mixture of at least 17 different saponins. lxxvi The antisweet principles are due to gymnemic acids, gymnemasaponins and gurmarin. lxxv Gymnemic acid reduces intestinal absorption of glucose and may stimulate pancreatic -cell growth.lxxvi Gumar stimulates insulin release from pancreatic islets of Langerhans. It has been found to show improvements in hepatic and muscle glucose uptake. Gumar also increases glycolysis and normalizes gluconeogenesis, delays the glucose absorption in the blood, has an antagonistic effect on somatotropin-,
corticosteroid-, and adrenaline-induced hyperglycemia, attenuates the insulinotropic action of gastrointestinal hormones, increases peripheral insulin sensitivity, and has a hypolipidemic effect. lxxv,lxxvi Gymnemic acid molecules fill the receptor locations on the taste buds thereby preventing its activation by sugar molecules present in the food, thereby curbing the sugar craving. It also curbs the binding of carbohydrates to the receptors in the intestine. lxxv No adverse effects have been reported with using gumar. lxxvi It might cause additive hypoglycemia, and there is a possible interaction with lipid lowering agents due to cholesterol lowering effect. Currently, there is insufficient evidence available for the use of Gymnema sylvestre for weight loss. Preliminary human evidence suggests that Gumar may be efficacious for the management of blood glucose levels in type 1 and type 2 diabetes, as an adjunct to conventional drug therapy, for up to 20 months. There is early evidence suggesting the possible efficacy of Gumar as a lipidlowering agent. Gymnema has a potential role in obesity due to the action of gymnemic acids in influencing carbohydrate and lipid metabolism. lxxviii Recommended dosage: not established. Hoodia (Hoodia gordonii) Hoodia gordonii grows in the Kalahari Desert. It is claimed that the San bushmen ate Hoodia to stave off hunger during long hunts (dating back possibly 40,000 years ago). The stems and roots are used as an appetite suppressant for obesity and weight loss. The active ingredients in Hoodia are steroidal glycosides. lxxxiii,lxxxv The precise mechanism of action is not known. lxxxiii It possibly affects the CNS pathways mediated by a variety of neuropeptides. Neuropeptides serve as messengers, facilitating communication between the brain and the rest of the body. There are over 100 of these small molecules with specific roles in regulating body processes such as mood, sleep, wakefulness, and hunger. Extracts of H. gordonii have been shown to have a satiety enhancing activity in animal studies. When the extract was injected into the central nervous system of mice, it seemed to lower food intake by as much as 40% to 60% over the next 24 hours. lxxxv Preliminary unpublished evidence suggests that overweight men who consume extracts of H. gordonii have significantly lower calorie intake than those on placebo. In this 15-day RDBPC trial of 18 individuals, a decreased average daily calorie intake of the Hoodia group (p= 0.014) was noted as well as a decreased body fat content (p=0.035).
65
Product testing has shown that not all Hoodia supplements contain the active ingredients, or contain little to no Hoodia extract. Reports on Health Canada websites caution about Hoodia imports due to the fact that Hoodia is listed as an endangered plant and there are many potential adulterated and fake products sold on the market. Hoodia is believed to have appetite suppressant properties, but studies on its effectiveness and safety are still missing. Hoodia capsules are standardized to contain 20:1 concentrate of pure Hoodia.lxxxi,lxxxiii Currently there is insufficient reliable information available about the safety of Hoodia.lxxix Recommended dosage: 400-800 mg daily, however not an established dosage. Yerba Mate (Ilex paraguariensis) Yerba mate comes from Ilex paraguariensis, a native South American tree. It is an herbal tea beverage widely consumed in southern Latin American countries (southern Brazil, Argentina, Paraguay, and Uruguay). The reported health benefits and actions of yerba mate are that it is hypocholesterolemic, hepatoprotective, a central nervous system stimulant, diuretic, an antioxidant, a protector of DNA oxidation and in vitro LDL lipoperoxidation, and is involved in the management of obesity. The active ingredients responsible for these proposed actions include polyphenols (chlorogenic acid), xanthines (caffeine and theobromine), purine alkaloids, flavonoids, amino acids, minerals (P, Fe and Ca), and vitamins (C, B1, B2). xlix The mechanism of action is not directly known, but is possibly due to prolonged gastric emptying time, delayed intestinal absorption of fat, a thermogenic effect, and a lipolytic effect. Epidemiological data suggest that the habit of ingesting hot mat drinks over long periods of time is linked to various types of cancer, such as oral, esophageal, laryngeal and bladder. xliii However, it should be noted that this seems to be related to chronic thermal injury rather than to a pharmacological effect. It should also be noted that the case studies of Mate consumption and increased cancer incidence also include individuals that consume black tobacco and alcohol, namely, wine. There are no known drug interactions associated with yerba mate. In a double-blind, placebo-controlled parallel trial, 47 patients were given 3 capsules of a combination preparation of yerba mate, guarana, and damiana for 45 days. xxxix Results demonstrated an increase in gastric emptying time (p=0.025), a decrease in body weight of 5.10.5kg (vs 0.30.8kg placebo) (p value not reported), and weight maintenance over the course of 12 months (73kg vs 72.5kg). Yerba mate has a higher antioxidant capacity than green tea. Further research is needed to determine the exact role and mechanism of yerba mate in weight loss and weight management.xlix Recommended dosage: not yet established.
5-HTP 5-HTP is commercially obtained from the seeds of the African plant, Griffonia simplicifolia. It is a precursor of the neurotransmitter serotonin. Serotonin plays a role in the regulation of sleep, depression, anxiety, aggression, appetite, temperature, sexual behaviour, and pain sensation. Research supports its use in the treatment of depression, psychiatric disorders, fibromyalgia, headaches, and as an appetite suppressant or weight-loss agent. Serotonin has an inhibitory influence on eating behaviour. , It activates satiety neurons localized in the medial hypothalamus, has an antagonistic action against noradrenaline, and plays a role in macronutrient selection, in particular carbohydrate consumption in obese individuals. Mild nausea may occur with initial use therefore it is recommended to start with a low dose and increase gradually. lxxxv Theoretical caution when used in combination with either a selective serotonin reuptake inhibitor (SSRI) antidepressants or an MAOI antidepressants as conjunctive use may cause serotonin syndrome (characterized by agitation, confusion, delirium, tachycardia, diaphoresis, and blood pressure fluctuations). lxxxv In a randomized double-blinded lxxxvi placebo-controlled trial of 28 females with a BMI between 30-40 over 2 consecutive 6-week study periods, results showed a weight loss of 5% of basal body weight. Patients were randomly assigned to receive 900mg/day 5-HTP or placebo.The first period had no dietary restrictions, and the second period had 5040kJ/d diet comprised of 53% carbohydrate, 29% fats, 18% proteins. At the end of first period significant weight loss was reported, carbohydrate intake was reduced by 50%, and early satiety was reported in 100% of patients. At the end of the second period, a greater reduction of body weight was achieved, further carbohydrate intake was reduced, and early satiety was reported in 90% of patients. Use of the placebo showed no significant change in body weight during either study period. Another randomized double-blinded, placebo-controlled trial with 25 patients with a BMI of 25-30 over a 2-week treatment period were given either 250mg 5-HTP tid or placebo. Results demonstrated a decreased mean daily energy intake (2,903kcal/d 825 to 1,819kcal/d 324, p<0.01) and decreased weight (1.4kg loss for 5-HTP vs 0.4 kg for placebo, p<0.01) in the treatment group. Manipulation of brain serotonin concentrations with serotoninactive agents such as dexfenfluramine and fluoxetine, has been reported to control food intake and reduce body weight in obese patients. Concerns arise over the potentially high incidence of side-effects of these medications. 5-HTP from Griffonia
66
IHRMagazIne.coM JUly/aUgUst 2011
simplicifolia provides an alternative with possibly less adverse reactions. Recommended dosage: 50mg three times per day with meals. If the clinical response is inadequate after two weeks, dosage may be increased to 100 mg three times per day. lxxxv conclusion Obesity can have long-term health complications such as heart disease, high blood pressure and diabetes, among others. Weight loss programs should be multi-faceted, including a healthy diet and exercise program. A variety of herbal medicines and nutrient supplements have been shown to aid in weight loss, their effects being demonstrated through traditional use, and/or through scientific evidence. Table: Possible Effects demonstrated by natural health products for weight loss include: Increased lipolysis and fatty acid oxidation (CLA, coleus, guarana, bitter orange, mate, cayenne) Increased thermogenesis (green tea, coleus, guarana, mate, ginger) Increased basal metabolic rate (coleus)
Increased satiety (guarana, PGX, 5HTP) Increased serotonin levels (coleus, 5HTP) Prolonged gastric empyting (mate, cayenne, apple cider vinegar) Increased catecholamine secretion (ginger) Blocked fat absorption (chitisan) Control of blood sugar levels (PGX, chromium, gymnema, apple cider vinegar) Improved insulin function (PGX, chromium, gymnema, apple cider vinegar) Appetite suppression (hoodia) It is very important that every client is counselled individually before using natural health products to ensure the NHP is appropriately indicated and does not interact with any medications that a client may be taking. Appropriate instruction also allows for safe use, in order to avoid any potential sideeffects which could otherwise be avoided. Although many NHPs have been marketed for weight loss, few have been appropriately evaluated in rigourous trials. Larger trials with proper design must be conducted in order to obtain more knowledge on potential therapies to prevent and/or treat the rising epidemic of obesity.
References i Nestmann E, Harwood M, and Martyres S. An innovative model for regulating supplement products: Natural health products in Canada. Toxicology. 2006;221: 50-58. ii Starky, S. The Obesity Epidemic in Canada (15 July 2005). Library of Parliament. Available at: http://www.parl.gc.ca/information/library/prbpubs/prb0511-e.htm. Accessed August 14, 2008. iii Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008 Jul;61(7): 646-53. iv National Institutes of Health National Heart, Lung and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obese Adults the Evidence Support. No 98-4083. Available at: http://www.nhlbi.nih.gov/ guidelines/obesity/ob_gdlns.pdf. Accessed December 11, 2008. v Canadian Institute for Health Information. Improving the Health of Canadians: Promoting Healthy Weights. Available at: http://secure.cihi.ca/cihiweb/products/ healthyweights06_e.pdf. Accessed December 10, 2008. vi Fernandez, ML. The Metabolic Syndrome. Nutrition Reviews. June 2007; 65(1);30-34(5). vii Klein S, Burke L, Bray G, Blair S, Allison D, Pi-Sunyer X, Hong Y, Eckel R. Implications of Obesity With Specific Focus on Cardiovascular Disease A Statement for Professionals From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2004;110: 2952-2967. viii Elson, H. Weight Loss. Available at: http://www.detox.org/weightloss.html. Accessed December 21, 2008. ix Natural Standard Monograph Apple Cider Vinegar. Available at: www.naturalstandard. com. Accessed July 29, 2008. x Hlebowicz J, Darwiche G, Bjrgell O and Almr L. Effect of apple cider vinegar on delayed gastric emptying in patients with type 1 diabetes mellitus: a pilot study. BMC Gastroenterology. 2007 Dec; 7: 46. xi Johnston C, Kim C, Buller A. Vinegar Improves Insulin Sensitivity to a HighCarbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes. Diabetes Care. 2004 Jan;27(1): 281-282. xii Fugh-Berman A, Myers A. Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: current status of clinical and basic research. Exp Biol Med (Maywood). 2004 Sep;229(8): 698-704. xiii Bent S, Padula A, Neuhaus J. Safety and efficacy of citrus aurantium for weight loss. Am J Cardiol. 2004 Nov 15;94(10): 1359-61. xiv Colker CM, Kalman DS, Torina GC, Perlis T, Street C. Effects of Citrus aurantium extract, caffeine, and St. Johns Wort on body fat loss, lipid levels, and mood states in overweight healthy adults. Current Therapeutic Res. 1999;60: 145153. Original Reference. xv Jones D. Regulation of Appetite, Body Weight, and Athletic Function with Materials Derived from Citrus Varieties. Patent 6224873. May 2001. Original Reference. xvi Kalman DS, Colker CM, Shi Q , Swain MA. Effects of a weight-loss aid in healthy overweight adults: double-blind, placebo-controlled clinical trial. Current Therapeutic Res. 2000;61: 199205.Original Reference. xvii Armstrong WJ, Johnson P, Duhme S. The effect of commercial thermogenic weight loss supplement in body composition and energy expenditure in obese adults. Journal of Exercise Physiology. 2001;4: 2835.Original Reference.
xviii Ahuja KD, Robertson IK, Geraghty DP, Ball MJ. Effects of chili consumption on postprandial glucose, insulin, and energy metabolism. Am J Clin Nutr. 2006 Jul;84(1): 63-9. xix Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Eclectic Med. Publications, 2001. xx Lejeune MP, Kovacs EM, Westerterp-Plantenga MS. Effect of capsaicin on substrate oxidation and weight maintenance after modest body-weight loss in human subjects. Br J Nutr. 2003 Sep;90(3): 651-59. xxi Gades, MD and Stern JD. Chitosan supplementation does not affect fat absorption in healthy males fed a high-fat diet, a pilot study. International Journal of Obesity. 2002;26: 119122. xxii Deuchi K, Kanauchi O, Imasato Y, Kobayashi E. Decreasing effect of chitosan on the apparent fat digestibility by rats fed on a high-fat diet. Biosci Biotech Biochem. 1994;58: 1613-1616. xxiii Koide, S. Chitin-chitosan: properties, benefits and risks. Nutrition Research. 1998;8(6): 1091-1101. xxiv Kaats GR, Michalek JE, Preuss HG. Evaluating efficacy of a chitosan product using a doubleblinded, placebo-controlled protocol. J Am Coll Nutr 2006;25: 389-394. xxv Mhurchu CN, Poppitt SD, McGill AT, Leahy FE, Bennett DA, Lin RB, Ormrod D, Ward L, Strik C, Rodgers A. The effect of the dietary supplement, Chitosan, on body weight: a randomised controlled trial in 250 overweight and obese adults. Int J Obes Relat Metab Disord. 2004 Sep;28(9): 1149-56. xxvi Mhurchu CN, Dunshea-Mooij C, Bennett D, Rodgers A. Effect of chitosan on weight loss in overweight and obese individuals: a systematic review of randomized controlled trials. Obes Rev. 2005 Feb;6(1):35-42. xxvii Cefalu W, Hu, F. Role of Chromium in Human Health and in Diabetes. Diabetes Care. 2004; 27(11):2741-2751. xxviii Volpe SL, Huang HW, Larpadisorn K, Lesser II. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. J Am Coll Nutr. 2001 Aug;20(4):293-306. xxix Broadhurst, C.L., & Domenico, P. Clinical Studies on Chromium Picolinate Supplementation in Diabetes Mellitus A Review. Diabetes Technology & Therapeutics, 2006;8(6): 677-687. xxx Natural Standard Monograph - Chromium. Available at: www.naturalstandard.com. Accessed February 2, 2008. xxxi Pittler MH, Stevinson C, Ernst E. Chromium picolinate for reducing body weight: meta-analysis of randomized trials. Int J Obes Relat Metab Disord. 2003 Apr;27(4): 522-9. xxxii Kobla HV, Volpe SL. Chromium, exercise, and body composition. Crit Rev Food Sci Nutr. 2000 Jul;40(4):291-308. xxxiii Coleus forskohlii. Monograph. Altern Med Rev. 2006 Mar;11(1):47-51. xxxiv Laurberg P. Forskolin stimulation of T4 and T3. FEBS Letter. 1984 May 21;170(2): 273-6. xxxv Henderson S, Magu B, Rasmussen C, Lancaster S, Kerksick C, Smith P, Melton C, Cowan P, Greenwood M, Earnest C, Almada A, Milnor P, Magrans T, Bowden R, Ounpraseuth S, Thomas A, Kreider RB. Effects of coleus forskohlii supplementation on body composition and hematological profiles in mildly overweight women. J Int Soc Sports Nutr. 2005 Dec 9;2: 54-62.
67
xix Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Eclectic Med. Publications, 2001. xx Lejeune MP, Kovacs EM, Westerterp-Plantenga MS. Effect of capsaicin on substrate oxidation and weight maintenance after modest body-weight loss in human subjects. Br J Nutr. 2003 Sep;90(3): 651-59. xxi Gades, MD and Stern JD. Chitosan supplementation does not affect fat absorption in healthy males fed a high-fat diet, a pilot study. International Journal of Obesity. 2002;26: 119122. xxii Deuchi K, Kanauchi O, Imasato Y, Kobayashi E. Decreasing effect of chitosan on the apparent fat digestibility by rats fed on a high-fat diet. Biosci Biotech Biochem. 1994;58: 1613-1616. xxiii Koide, S. Chitin-chitosan: properties, benefits and risks. Nutrition Research. 1998;8(6): 1091-1101. xxiv Kaats GR, Michalek JE, Preuss HG. Evaluating efficacy of a chitosan product using a doubleblinded, placebo-controlled protocol. J Am Coll Nutr 2006;25: 389-394. xxv Mhurchu CN, Poppitt SD, McGill AT, Leahy FE, Bennett DA, Lin RB, Ormrod D, Ward L, Strik C, Rodgers A. The effect of the dietary supplement, Chitosan, on body weight: a randomised controlled trial in 250 overweight and obese adults. Int J Obes Relat Metab Disord. 2004 Sep;28(9): 1149-56. xxvi Mhurchu CN, Dunshea-Mooij C, Bennett D, Rodgers A. Effect of chitosan on weight loss in overweight and obese individuals: a systematic review of randomized controlled trials. Obes Rev. 2005 Feb;6(1):35-42. xxvii Cefalu W, Hu, F. Role of Chromium in Human Health and in Diabetes. Diabetes Care. 2004; 27(11):2741-2751. xxviii Volpe SL, Huang HW, Larpadisorn K, Lesser II. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. J Am Coll Nutr. 2001 Aug;20(4):293-306. xxix Broadhurst, C.L., & Domenico, P. Clinical Studies on Chromium Picolinate Supplementation in Diabetes Mellitus A Review. Diabetes Technology & Therapeutics, 2006;8(6): 677-687. xxx Natural Standard Monograph - Chromium. Available at: www.naturalstandard.com. Accessed February 2, 2008. xxxi Pittler MH, Stevinson C, Ernst E. Chromium picolinate for reducing body weight: metaanalysis of randomized trials. Int J Obes Relat Metab Disord. 2003 Apr;27(4): 522-9. xxxii Kobla HV, Volpe SL. Chromium, exercise, and body composition. Crit Rev Food Sci Nutr. 2000 Jul;40(4):291-308. xxxiii Coleus forskohlii. Monograph. Altern Med Rev. 2006 Mar;11(1):47-51. xxxiv Laurberg P. Forskolin stimulation of T4 and T3. FEBS Letter. 1984 May 21;170(2): 273-6. xxxv Henderson S, Magu B, Rasmussen C, Lancaster S, Kerksick C, Smith P, Melton C, Cowan P, Greenwood M, Earnest C, Almada A, Milnor P, Magrans T, Bowden R, Ounpraseuth S, Thomas A, Kreider RB. Effects of coleus forskohlii supplementation on body composition and hematological profiles in mildly overweight women. J Int Soc Sports Nutr. 2005 Dec 9;2: 54-62. xxxvi Badmaev V, Majeed M, Conte A, Parker JE. Diterpene forskolin: a possible new compound for reduction of body weight by increasing lean body mass. Townsend Lett. 2001;June: 115. xxxvii Godard MP, Johnson BA. Richmond SR. Body Composition and Hormonal Adaptations Assocatied with Forskolin Consumption in Overweight and Obese Men. Obesity Research. 2005;13: 1335-1343. xxxviii Larsen T, Toubro S, and Astrup A. Efficacy and safety of dietary supplements containing CLA for the treatment of obesity: evidence from animal and human studies. Journal of Lipid Research. 2003 Dec;44: 2234-2241. xxxix Belury, MA. Dietary conjugated linoleic acid in health: physiological effects and mechanisms of action. Annu Rev Nutr. 2002;22: 505-531. xl Whigham LD, Watras AC, Schoeller DA. Efficacy of conjugated linoleic acid for reducing fat mass: a meta-analysis in humans. Am J Clin Nutr. 2007 May;85(5): 1203-11. xli Blankson H, Stakkestad JA, Fagertun H, Thom E, Wadstein J, Gudmundsen O. Conjugated linoleic acid reduces body fat mass in overweight and obese humans. J Nutr. 2000;130: 2943-8. xlii Gaullier JM, Halse J, Hoye K, Kristiansen K, Fagertun H, Vik H, Gudmundsend O. Conjugated linoleic acid supplementation for 1 y reduces body fat mass in healthy overweight humans. Am J Clin Nutr. 2004;79: 1118-25. xliii Katzman MA, Jacobs L, Marcus M, Vermani M, Logan AC. Weight gain and psychiatric treatment: Is there a role for green tea and conjugated linoleic acid? Lipids Health Dis. 2007 May 3;6: 14. xliv Gaullier JM, Halse J, Hye K, Kristiansen K, Fagertun H, Vik H, Gudmundsen O. Supplementation with conjugated linoleic acid for 24 months is well tolerated by and reduces body fat mass in healthy, overweight humans. J Nutr. 2005 Apr;135(4): 778-84. xlv Gaullier JM, Halse J, Hivik HO, Hye K, Syvertsen C, Nurminiemi M, Hassfeld C, Einerhand A, OShea M, Gudmundsen O. Six months supplementation with conjugated linoleic acid induces regional-specific fat mass decreases in overweight and obese. Br J Nutr. 2007 Mar;97(3): 550-60. xlvi Cherniak EP. Potential applications for alternative medicine to treat obesity in an aging population. Altern Med Rev. 2008 Mar;13(1): 34-42. xlvii Preuss HG, Bagchi D, Bagchi M, Rao CV, Dey DK, Satyanarayana S. Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss. Diabetes Obes Metab. 2004 May;6(3): 171-80. xlviii Pittler MH, Schmidt K, Ernst E. Adverse events of herbal food supplements for body weight reduction: systematic review. Obes Rev. 2005 May;6(2): 93-111. xlix Heymsfield SB, Allison DB, Vasselli JR, Pietrobelli A, Greenfield D, Nunez C. Garcinia cambogia (hydroxycitric acid) as a potential antiobesity agent: a randomized controlled trial. JAMA. 1998 Nov 11;280(18): 1596-600. l Mattes R, Bormann L. Effects of (-)-hydroxycitric acid on appetitive variables. Physiol Behan. 2000;71(1-2): 87-94. li Zingiber officinale Monograph. Alternative Medicine Review. 2003;8(3): 331-335. lii Mills S and Bone K. Principles and Practice of Phytotherapy. Churchill Livingstone, 2005. liii Srivastava KC. Isolation and effects of some ginger components on platelet aggregation and eicosanoid biosynthesis. Prostaglandins Leukot Med. 1986;25: 187-98. liv Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol. 2001;97: 577-82. lv Grontved A, Brask T, Kambskard J, Hentzer E. Ginger root against seasickness: a controlled trial on the open sea. Acta Otolaryngol. 1998;105: 45-9. lvi Braun L, Cohen M. Herbs and Natural Supplements: An evidence-based guide. Elsevier Australia, Marrickville, NSW, 2005. lvii Boon H, Smith M. The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs. Robert Rose, Toronto, 2004. lviii Brinker F. Herb Contraindications and Drug Interactions, 2nd ed. Sandy (OR) Eclectic Med. Publications, 1998. lix Lumb AB. Effect of dried ginger on human platelet function. Thromb Haemost. 1994;71:110-1.
lx Kraemer WJ, Vingren JL, Silvestre R, Spiering BA, Hatfield DL, Ho JY, Fragala MS, Maresh CM, Volek JS. Effect of adding exercise to a diet containing glucomannan. Metabolism. 2007 Aug;56(8): 1149-58. lxi McCarty MF. Glucomannan minimizes the postprandial insulin surge: a potential adjuvant for hepatothermic therapy. Med Hypotheses. 2002 Jun;58(6): 487-90. lxii Saper RB, Eisenberg DM, Phillips RS. Common dietary supplements for weight loss. Am Fam Physician. 2004 Nov 1;70(9): 1731-8. lxiii Vuksan V, Jenkins DJ, Spadafora P, Sievenpiper JL, Owen R, Vidgen E, Brighenti F, Josse R, Leiter LA, Bruce-Thompson C, Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care. 1999; 22(6): 913-919. lxiv Murray, Michael. Textbook of Natural Medicine. California: Prima Health, 2000. lxv Diepvens K, Westerterp KR, Westerterp-Plantenga MS. Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physiol Regul Integr Comp Physiol. 2007 Jan;292(1): R77-85. lxvi Venables MC, Hulston CJ, Cox HR, Jeukendrup AE. Green tea extract ingestion, fat oxidation, and glucose tolerance in healthy humans. Am J Clin Nutr. 2008 Mar;87(3): 778-84. lxvii Dulloo AG, Duret C, Rohrer D, Girardier L, Mensi N, Fathi M, Chantre P, Vandermander J. 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 Nutr. 1999 Dec;70(6): 1040-5. lxviii Westerterp-Plantenga M, Diepvens K, Joosen AM, Brub-Parent S, Tremblay A. Metabolic effects of spices, teas, and caffeine. Physiol Behav. 2006 Aug 30;89(1): 85-91. lxix L-theanine Monograph. Alt Med Rev. 2005;10(2): 136-138. lxx Green Tea Extract Monograph. Health Canada. Available at: http://www.hc-sc.gc.ca/dhp-mps/ prodnatur/applications/licen-prod/monograph/mono_greentea-thevert-eng.php. Accessed December 19, 2008. lxxi Green Tea Extract Monograph. Health Canada Compendium of Monographs. Available at: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/applications/licen-prod/monograph/mono_greenteathevert-eng.php. Accessed September 24, 2008. lxxii Pagliarussi RS, Bastos JK, and Freitas L. Fluid Bed Drying of Guarana (Paullinia cupana HBK) Extract: Effect of Process Factors on Caffeine Content. AAPS PharmSciTech 2006;7(2)-Article 54: E2-E7. lxiii Angelo PC, Nunes-Silva CG, Brgido MM, Azevedo JS, Assuno EN, Sousa AR, Patrcio FJ, Rego MM, Peixoto JC, Oliveira WP Jr, Freitas DV, Almeida ER, Viana AM, Souza AF, Andrade EV, Acosta PO, Batista JS, Walter ME, Leomil L, Anjos DA, Coimbra RC, Barbosa MH, Honda E, Pereira SS, Silva A, Pereira JO, Silva ML, Marins M, Holanda FJ, Abreu RM, Pando SC, Gonalves JF, Carvalho ML, Leal-Mesquita ER, da Silveira MA, Batista WC, Atroch AL, Frana SC, Porto JI, Schneider MP, Astolfi-Filho S; Brazilian Amazon Consortium for Genomic Research (REALGENE). Guarana (Paullinia cupana var. sorbilis), an anciently consumed stimulant from the Amazon rain forest: the seeded-fruit transcriptome. Plant Cell Rep. 2008 Jan;27(1): 117-24. lxxiv Morelli V, Zoorob RJ. Alternative therapies: Part I. Depression, diabetes, obesity. Am Fam Physician. 2000 Sep 1;62(5): 1051-60. Review. lxxv Hess AM, Sullivan DL.Potential for toxicity with use of bitter orange extract and guarana for weight loss. Ann Pharmacother. 2005 Mar;39(3): 574-5. lxxvi AndersenT, Fogh J. Weight loss and delayed gastric emptying following a South American herbal preparation in overweight patients. Journal of Human Nutrition and Dietetics. 2001;14(3): 243-250. lxxvii Brub-Parent S, Pelletier C, Dor J, Tremblay A. Effects of encapsulated green tea and Guarana extracts containing a mixture of epigallocatechin-3-gallate and caffeine on 24 h energy expenditure and fat oxidation in men. Br J Nutr. 2005 Sep;94(3): 432-6. lxxviii Bone K. Gymnema: A Key Herb in the Management of Diabetes. Townsend Letter for Doctors & Patients.2002; 233:28-30. lxxix Leach, M. Gymnema sylvestre for Diabetes Mellitus: A Systematic Review. x The Journal of Alternative and Complementary Medicine. 2007;13(9):977-983. lxxx Kimura, I. Medical Benefits of Using Natural Compounds and Their Derivates Having Multiple Pharmacological Actions. The Pharmaceutical Society of Japan. 2006;126(3):133-143. lxxxi Kanetkar P, Singhal R, Kamat M. Gymnema sylvestre: A Memoir. J Clin Biochem Nutr. 2007 Sep;41(2): 77-81. lxxxii Wang LF, Luo H, Miyoshi M, Imoto T, Hiji Y, Sasaki T. Inhibitory effect of gymnemic acid on intestinal absorption of oleic acid in rats. Can J Physiol Pharmacol. 1998;76: 1017-1023. lxxxiii Natural Standard Monograph Hoodia gordonii (Hoodia). Available at: www. naturalstandard.com. Accessed July 29, 2008. lxxxiv van Heerden FR, Marthinus Horak R, Maharaj VJ, Vleggaar R, Senabe JV, Gunning PJ. An appetite suppressant from Hoodia species. Phytochemistry. 2007 Oct;68(20): 2545-53. lxxxv Lee RA, Balick MJ. Indigenous Use of Hoodia gordonii and Appetite Suppression. EXPLORE: The Journal of Science and Healing. Jul-Aug 2007;3(4): 404-406R. lxxxvi DallAcqua S, Innocenti G. Steroidal glycosides from Hoodia gordonii. Steroids. 2007 Jun;72(6-7): 559-68. lxxxvii Janssen HG, Swindells C, Gunning P, Wang W, Grn C, Mahabir K, Maharaj VJ, Apps PJ. Quantification of appetite suppressing steroid glycosides from Hoodia gordonii in dried plant material, purified extracts and food products using HPLC-UV and HPLC-MS methods. Anal Chim Acta. 2008 Jun 9;617(1-2): 200-7 lxxxviii Successful Completion of Proof of Principle Clinical Study P57 for Obesity. Available at: http://www.phytopharm.co.uk/news/newsreleases/?filterType1=text&dateMode=years&year=all&filt erArg1=p57&y=0&range=today&filterType2=date&id=1749&x=0. Accessed August 26, 2008. lxxxix Environment Canada. New Release: Thousands of Hoodia Diet Pills Stopped at the Border by Federal Wildlife Enforcement Officers. http://www.ec.gc.ca/default.asp?lang=En&n=714D9AAE1&news=F79FB524-8B9A-4324-B748-6F92231F410D. Accessed December 20. 2008 xc Heck CI, de Mejia EG. Yerba Mate Tea (Ilex paraguariensis): a comprehensive review on chemistry, health implications, and technological considerations. J Food Sci. 2007 Nov;72(9): R138-51. Review. xci Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr. 2004 Apr;79(4): 529-36. xcii Birdsall, T. 5-Hydroxytryptophan: A Clinically-Effective Serotonin Precursor. Alternative Medicine Review. 1998;3(4): 271-280. xciii Cangiano C, Ceci F, Cascino A, Del Ben M, Laviano A, Muscaritoli M, Antonucci F, RossiFanelli F. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J Clin Nutr. 1992 Nov;56(5): 863-7. xciv Ceci F, Cangiano C, Cairella M, Cascino A, Del Ben M, Muscaritoli M, Sibilia L, Rossi Fanelli F. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. J Neural Transm. 1989;76(2): 109-17. xcv Cangiano C, Laviano A, Del Ben M, Preziosa I, Angelico F, Cascino A, Rossi-Fanelli F. Effects of oral 5-hydroxy-tryptophan on energy intake and macronutrient selection in non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord. 1998 Jul;22(7): 648-54.
68
Natural Health Products for Weight Loss- Review Questions

1. A safe and effective rate of weight loss is approximately ____ lb per week. a. 1 b. 5 c. 10 d. 15 2. Major sources of CLA include: a. Beans and legumes b. Whole grains c. Meat and dairy products d. All of the above 3. The most pharmacologically active compound of green tea is: a. Epicatechin gallate b. Epicatechin c. Epigallocatechin d. Epigallocatechin gallate 4. Garcinia cambogia promotes weight loss by: a. Decreasing the rate of hepatic glycogen synthesis. b. Increasing thermogenesis through the presence of caffeine. c. Inhibiting ATP citrate lyase. d. Decreasing the availability of serotonin. 5. Guarana contains high levels of: a. Hydroxycitric acid b. Caffeine c. 5-HTP d. L-theanine 6. Choose the natural health product that does not increase thermogenesis. a. Green tea b. Yerba mate c. Ginger d. 5-HTP 7. Ginger has been shown to interact with all of the following except: a. Anticoagulants b. Proton pump inhibitors c. Hypoglycemics d. Antidepressants 8. Chitosan increases the excretion of _____________ from the body. a. Lipids b. Proteins c. Carbohydrates d. None of the above 9. The active ingredients in Hoodia gordonii are: a. Catechins b. Flavonoids c. Polysaccharides d. Steroidal glycosides 10. Extracts of this natural health product have shown to have satiety enhancing activity in animal studies. a. Hoodia gordonii b. Conjugated linoleic acid c. Chromium d. Apple cider vinegar 11. 5-HTP, commercially obtained from the seeds of the African plant, Griffonia simplicifolia, acts as a precursor for: a. Dopamine b. Serotonin c. GABA d. Epinephrine 12. Use of this natural health product has been shown to lower post-prandial blood glucose and insulin levels in insulin-resistant subjects. a. Citrus aurantium b. Coleus forskohlii c. Apple cider vinegar d. Chitosan 13. Which of the following statements is TRUE regarding Gymnema sylvestre? a. Its active compound is gurmarin. b. It enhances the cravings for sugars. c. It reduces intestinal absorption of glucose. d. It decreases peripheral insulin sensitivity. 14. Chromium potentiates the action of insulin and is involved in the metabolism of carbohydrates, lipids and proteins. a. True b. False 15. The mechanisms of green tea in weight loss include all of the following except: a. Inhibition of catechol O-methyl-transferase (COMT) b. Anti-angiogenic effects c. Increase of cAMP d. Elevation of ghrelin 16. ____________ has been shown to counteract the stimulatory effect of caffeine in green tea. a. L-tryptophan b. L-theanine c. L-arginine d. L-histidine 17. In response to the ban of ephedra, manufacturers changed their products to ephedra-free by substituting with this natural health product: a. Citrus aurantium b. Ilex paraguariensis c. Zingiber officinale d. Gymnema sylvestre 18. Synephrine primarily stimulates _____________ receptors. a. Adrenergic b. Nicotinic c. Muscarinic d. Opioid 19. Although cayenne has been shown to be effective for weight loss, compliance is not always possible due to its_______ effect. a. Carminative b. Laxative c. Pungent d. Hypnotic 20. A key feature of highly viscous fibre is its capacity to capture and suspend nutrients. a. True b. False
Answering Options Mail or Fax to: ihr magazine, 60 Bloor St., West, Suite 1006, Toronto, ON M4W 3B8 Phone: 416-203-7900 | Fax: 416-703-6392
jULY/AUGUST 2011 IHRmagazINe.com
69
Integrated Health Retailers Continuing Education Lesson

1.75 CEUs
70
Natural Health Products for Weight Loss
Date of course: July/August 2011 CCCEP File # 837-1208 Number of CEUs assigned: 1.75 CEUs Expiry Date: February 17, 2012
This month's lesson is brought to you by
Complete questionnaire in full and mail or fax to: ihr magazine, 60 Bloor St., West, Suite 1006, Toronto, ON M4W 3B8 Phone: 416-203-7900 | Fax: 416-703-6392
Circle the ONE best answer

1 a 2 a 3 a 4 a 5 a
b b b b b
c c c c c
d d d d d
6 a 7 a 8 a 9 a 10 a
b b b b b
c c c c c
d d d d d
11 a 12 a 13 a 14 a 15 a
b b b b b
c c c c c
d d d d d
16 a 17 a 18 a 19 a 20 a
b b b b b
c c c c c
d d d d d
Last Name: Licensing Province: Licensing Province: Address home business: City: Phone: ( ) Province: Fax: ( )
First Name: Licensing #: Licensing #:
Postal Code: Email Address:
Type of practice:
Retail (independent) Retail (chain/franchise) Other (specify) Owner Full-time employee Part-time employee
Assessment/Evaluations Questions: 1. Did the program meet the learning objectives for you? Yes 2. Do you now have a better understanding of this topic? Yes
No No No No Too Difficult
3. Was the information in the lesson relevant to your practice? Yes 5. The information in this lesson was: Too Basic 6. Were you satisfied with our program? Yes
Appropriate No
4. Will you be able to incorporate the information from this lesson into your practice? Yes
7. What topic would you like to see covered in the future?
We are considering applications for the following Management position at various locations in Ontario, Quebec and Atlantic stores
Natural Value/ Natures Treasure Department Manager

Interested candidates must be available to work varied shifts, including weekdays, weeknights and weekends on a regular basis. The successful candidate will be responsible to oversee the operations of the Natural Value department including: Ensuring budgets are met Inventory control and selection Motivation and development of the department team The ideal candidate will have: Retail experience and/or education in Alternative Medicine, Herbology, Vitamins & Minerals, as well as an interest and knowledge of Food and Nutrition; The ability to work in a fast paced environment and the ability to multitask and prioritize; Excellent communication skills and exemplary customer service skills. If you are interested in this opportunity, please submit a detailed resume and cover letter to: Ordering Merchandising Labour scheduling
HEAD OFFICE
1135-13560 Maycrest Way Richmond BC V6V 2W9 PHONE: 604.288.0017 - TOLL FREE: 1.800.668.3008 FAX: 604.273.3417
EASTERN REGIONAL OFFICE

10 Four Seasons Place 10th Floor Etobicoke ON M9B 6H7 PHONE: 416.649.5735 - TOLL FREE: 1.800.668.3008 FAX: 416.649.5701
Senior Category Merchandising Manager (905) 861-2627
NEW FAX!
ihr MARKET PLACE

If Youre Reading It, You Know It Works! To Advertise in Marketplace
(416) 203-7900 ext. 6126
Thank you for your interest, however only those selected for an interview will be contacted.
CANADIAN REGULATORY SERVICES

Preparation of compliant Canadian label text for food products, supplements, skin care and drugs Preparation of Drug Identification Number (DIN) and Natural Health Product (NHP) Number submissions Preparation and management of GMP, SOP and Quality Control programs within the guidelines of the Natural Health Products Directorate Formulating and contract packaging available for Canada and the U.S.A Warehousing services and order fulfillment
Regional Sales Managers John Tivadar - West 403.620.6950 or john@mtbi.ca Gary Davis - East 647.962.2884 or gary@mtbi.ca Account Managers Darlene Costello - BC Mainland 604.220.2962 or darlene@mtbi.ca Anne Hume-Smith - BC Interior 250.499.9589 or anne@mtbi.ca Mandi Zolkowski - AB & Prairies/Van Island 403.702.4324 or mandi@mtbi.ca Owen Simms - BC Mainland 604.263.7140 or owen@mtbi.ca Brian Asttaria - BC Mainland 778.938.5361or brian@mtbi.ca Melissa RussoGreater Toronto Area 647.382.1252 or melissa@mtbi.ca
SERVING THE NATURAL PRODUCTS INDUSTRY SINCE 1981

MMP ENTERPRISES LTD., 130 Industry St., Units 31-34 Toronto, Ontaro, Canada M6M 5G3 Phone (416) 604-7604 Fax (416) 604-7605
Call:
HIRING DEMO STAFF

Puresource Naturals is currently hiring part time demo staff for Ontario, specifically, SW, GTA, and Niagara Region. A fun and fantastic opportunity to subsidize your income! Must have education in nutrition, naturopathic, or similar alternative background. Please forward resumes to: emma.mcfarlane@puresource.ca. Only qualified candidates will be contacted.
Vik Saini - South Western Ontario 519.267.2191or vik@mtbi.ca Helene Huot - Ottawa/W Que/Maritimes 613.224.4983 or h.huot@rogers.com Marjolaine Martel - Quebec 514.929.3952 or marjolaine@mtbi.ca Andrea Leduc- Quebec 514.743.6213 or andrea@mtbi.ca
MICHAEL THEODOR CHFA HALL OF FAME AWARD WINNER
research news
ARTHRITIS
Vitamin B6 displays positive effects on rheumatoid arthritis
The effect of vitamin B6 on inflammation was investigated in randomized controlled trial of patients with rheumatoid arthritis (RA). A total of 35 patients were randomly allocated to receive either 5 mg folic acid only, or 100 mg vitamin B6 plus 5 mg folic acid daily for 12 weeks. The following parameters were measured at baseline and after 12 weeks: Plasma pyridoxal 5-phosphate (PLP), serum folate, inflammatory parameters (hsCRP, ESR, IL-6, TNF-alpha), and immune parameters (WBC count, total lymphocytes, T-cells (CD3), B-cells (CD19), T-helper cells (CD4), and T-suppressor cells(CD8)). In the vitamin B6 group, plasma IL-6 and TNF-alpha levels significantly decreased at week 12. There were no significant changes with respect to immune responses in either group, except for the percentage of total lymphocytes in the vitamin B(6) group compared to baseline. Plasma IL-6 level were significantly inversely related to plasma PLP after adjusting for confounders (P=0.01). High dose vitamin B6 suppresses proinflammatory cytokines IL-6 and TNF-alpha in patients with RA. (Eur J ClinNutr. 2010 Sep;64(9):1007-13.) PMID: 20571496
AMINO ACIDS
Amino acids may help children with behavioural problems
Increasing numbers of children are at-risk for behavioural and emotional disorders, a phenomenon contributing to increased use of pharmacological interventions for pediatric clients. Adverse side effects and other risks associated with pharmacological approaches have helped fuel interest in nutritional interventions for behaviourally at-risk children. The current randomized clinical trial evaluated the efficacy of a neurochemical intervention involving the glutamine and glutamate analogue L-theanine and 5-hydroxytryptophan, the precursor for serotonin, with children adopted from traumatic backgrounds. Results include significant increases in urinary levels of the biomarkers for serotonin and gamma-aminobutyric acid, coupled with significant decreases in parent reports of the childrens behaviour problems. While further research is needed, these initial findings are encouraging and are consistent with a growing number of studies indicating the efficacy of nutritional approaches to help behaviourally at-risk children. (Child Care Health Dev. 2010 Dec 20) PMID: 21166834
FISH OIL
Fish oil proves to have positive effects in treating depression
A total of 241 studies were identified, of which 28 were included for meta-analysis. Overall standardized mean depression scores were reduced in response to fish oil supplementation as compared with placebo (standardized mean difference -0.291, 95 per cent CI -0.463 to -0.120, p = 0.001). Subgroup analyses showed significant effects for: (1) diagnostic category (bipolar disorder and major depression showing significant improvement with omega 3 LC-PUFA supplementation versus mild-to-moderate depression, chronic fatigue and non-clinical populations not showing significant improvement); (2) therapeutic as opposed to preventive intervention; (3) adjunctive treatment as opposed to monotherapy; and (4) supplement type. Symptoms of depression were not significantly reduced in three studies using pure DHA (p= 0.997) or in four studies using supplements containing greater than 50% DHA (p = 0.417), but were significantly reduced in 13 studies using supplements containing greater than 50 per cent EPA (standardized mean difference -0.446, 95 per cent CI -0.753 to -0.138, p = 0.005) and in eight studies using pure ethyl-EPA (standardized mean difference -0.396, 95% CI -0.650 to -0.141, p = 0.002). The current meta-analysis provides evidence that EPA may be more efficacious than DHA in treating depression. (J Am Coll Nutr. 2009 Oct;28(5):525-42.) PMID: 20439549
72
IHRmAgAzIne.com JULy/AUgUST 2011
pAGE
73
GET FREE INFORMATION!

1. See product you want info on 2. use this quick reference list below to find out its free info number (its also on the ad) 3. Write the number(s) on the attached free info card
On any product advertised in this issue
SEE A pROducT yOu lIkE? WANT MORE INFORMATION, ABSOluTEly FREE?

4. Mail or fax us at 1-888-849-0155 or 416-703-6392 5. Receive free info, direct from as many advertisers as you like
By FAx OR MAIl
cONNEcT WITH
Holista Tea, Tree Oil Webber Naturals, Omega-3 IHR magazine, Website North American Herb Spice, SinuOrega Intuition New Nordic North American Herb Spice, pom-o-power lakota pharmasave Andalou Naturals Aubrey Organics, lumessence Webber Naturals, Mulberry
page
write #
cONNEcT WITH
Webber Naturals, peppermint Oil Holista, Tea Tree Spray Andalou Naturals, Body lotion SISu, Stress Rescue Genuine Health, live probio O3mega SISu kids, u.F.O. Holista, Restorativ Vitamin E Omega Alpha, lung Tone & E-Z Mobility Holista, Tea Tree Oil & Vitamin E Intuition, My Waistline
page
write #
2-3 4-5 7 9 11 15 21 27 37 43 75 76
101 102 103 104 105 106 108 109 110 111 112 113
14 14 14 14 16 14 16 16 16 18 18 18
114 115 116 117 118 119 120 121 122 123 124 125
North American Hemp, Area 369 Hair Serum Boo Bamboo, Hair Strengthening Shampoo
*
STEp 1 STEp 3 STEp 4
FREE!
STEp 2
Info card & Subscription

To receive free information you must print clearly and fill out form completely
Yes! Please send me or continue to send me ihr magazine
No dont send
To qualify check ovals

Approximate annual sales volume m under $500,000 m $500,000 - $1 million m $1 million - $5 million m $5 million - $10 million m $10 million - $20 million m over $20 million Number of Employees in your location: m 1-3 m 4-8 m 9-12 m 13+ Number of locations: ________________ categories you personally manage m herbs m personal care m sports nutrition m vitamin/supplements m other _______________________________
Signature: ___________________________ date: ________________ Your Name: __________________________ title: _________________ company Name: ___________________________________________ address: ____________________________________________________ city: _________________________________ Province: _____________ Postal code: ________________________________________________ Phone: ______________________________ Fax: __________________ email address (optional): ______________________________________
Which category best describes your business classification? m health and diet foods-retail m pharmacies-retail m naturopathic physician m holistic practitioner m homeopathic practitioner m vitamin store m grocery-retail m chain-retailer m manufacturer/distributor m other Selling area of your store m under 1,000sq.ft m 1,001 to 3,000sq.ft m 3,001 to 5,000sq.ft m over 5,000sq.ft
Reserved exclusively for retailers

Example
julY/auguSt 2011 write iN the NuMBerS here For each Product You waNt More detailed iNForMatioN oN
101
uSe Quick reFereNce guide oN toP oF Page
Fax Now to: 1-888-849-0155 or 416-703-6392 | or Mail card todaY to: 60 Bloor St. west, Suite 1106, toronto, oN, M4w 3B8
july/August 2011 IHRmagazIne.com
73
Top Seller revieW

July/August 2011
YoUr STore MATTerS
>
Take a moment to fill out this questionnaire and your store may be among those highlighted in the Top Seller review Section of the next issue of ihr. The number of units sold determines the top sellers. To be included in the review, products mentioned must be classified as natural health products not standard consumer brands.
Store Name__________________________________________________ city ______________________________________ province ___________ date ___________ Name ____________________ Title _________ Address __________________________________________________________ phone ___________________________ Fax _____________________________ email __________________________________________________ Store Size: under 1,000sq.ft. 3,000-5,000sq.ft. 1,000-3,000sq.ft. over 5,000sq.ft $20,000-$40,000 Approximate Age of Store customers: under 25 25-40 40-65 over 65
Approximate income of Store customers:
$40,000-$60,000
over $60,000
>Food Top SellerS product: Size: product: Size: product: Size: >HerBS Top SellerS product: Size: product: Size: product: Size: Brand: Flavour: Brand: Flavour: Brand: Flavour: Brand: Flavour: Brand: Flavour: Brand: Flavour:
>SporTS NUTriTioN Top SellerS product: Size: product: Size: product: Size: Brand: Flavour: Brand: Flavour: Brand: Flavour:
>viTAMiNS/SUppleMeNTS Top SellerS product: Size: product: Size: product: Size: Brand: Flavour: Brand: Flavour: Brand: Flavour:
>perSoNAl cAre Top SellerS product: Size: product: Size: product: Size: Brand: Flavour: Brand: Flavour: Brand: Flavour:
>NeW prodUcTS Top SellerS product: Size: product: Size: product: Size: Brand: Flavour: Brand: Flavour: Brand: Flavour:
FAX: 1-888-849-0155 or (416)703-6392

74
IHRmagazIne.com JUly/AUGUST 2011
MAil:
ihr Magazine 60 Bloor St. West, Suite 1106, Toronto, oN, M4W 3B8
Protect the Earth Promote the well-being of people Nourish the Spirit
Our mission is to provide all-natural, safe and effective personal care and lifestyle products to our customers. We offer a true and authentic alternative to many of the massproduced synthetic products on the market today. We craft only the highest quality allnatural products without compromise as to ingredients, packaging or cost. We believe in education and transparency. A customer is best able to make an educated and correct purchasing decision only when armed with true and valued information not marketing fluff and puffery. Part of our core purpose is to provide that information as best as we can.
Lumessence Skin Care
A unique blend of all-natural ingredients and advanced skincare science that helps to minimize signs of aging, for a younger, rejuvenated look.
In better natural product retailers throughout Canada. For more information, call Purity Life at 1-800-265-2615 or Tall Grass Distribution at 1-800-616-5900, or New Age Marketing at 1-888-868-0127.
2HR1
Natural Balance
GLUCOSE BALANCE
Blood sugar balance is essential if we want to prevent diabetes, metabolic syndrome, and insulin resistance. Keeping blood sugar levels even throughout the day is critical also to weight loss and maintainence. If any of these issues are of concern to your customers, theres a powerful new tool in our Glucose Balance line that may help. Mulberry PLUS Chromium from webber naturals provides support for healthy glucose metabolism, helps the body metabolize carbohydrates and fats, and helps prevent chromium deciency. Mulberry has signicant blood sugar lowering effects and has been shown to lower triglycerides and harmful cholesterol, too. It also inhibits the absorption of complex carbohydrates and sugars.1 Combined with the insulinbalancing mineral chromium,2 this dynamic duo may be ideal for natural, daily blood sugar balance.
We want
1. Murray, Michael, N.D. and Michael Lyon. How to Prevent and Treat Diabetes with Natural Medicine. 2003. Riverhead Books 2. Sharma S, Agrawal RP, Choudhary M, Jain S, Goyal S, Agarwal V. Bene cial effect of chromium supplementation on glucose, HbA(1)C and lipid variables in individuals with newly onset type-2 diabetes. J Trace Elem Med Biol. 2011 May 11. [Epub ahead of print] PubMed PMID: 21570271.
Want more information about webber naturals products? 1-800-430-7898 | www.webbernaturals.com Follow us on : @webbernaturals | Like us on : www.facebook.com/webbernaturals
Herbals and supplements from webber naturals are advertised on national television, major market radio, in consumer magazines, and daily newspapers.

IHR - July / August 2011 Issue

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

IHR - July / August 2011 Issue

Uploaded by

Copyright:

Available Formats

YOUR HEALTH CATEGORY SOURCE

For Mobile Issue!

The Best of Both Worlds | $6

The Best of Both Worlds

Natural Health Products for Weight Loss

Tea Tree Oil from Holista

Potent Tea Tree Oil

Scalp & Foot Health

* Nielsen MarketTrack, National All Channels, 52 Weeks Ending June 5, 2010

For details, write #101 on Free Info Page, page 73.

New! Tea Tree Spray

New! Hand & Body Lotion

The Premium Line of Omega-3 Formulas from webber naturals

Teaming up for a healthier, longer life

Crystal Clean from the Sea

ISSN 1197 - 1495 |

Publisher & Editor-in-Chief

Controller & Operations Manager

Publisher & Editor-in-Chief

IHRmagazIne.com JULy/AUGUST 2011

Continuing Education: Keep learning new information from industry experts.

Stock Reports: Stay on top of the business.

Banner Advertising: Attract new clients through eye-catching advertisements.

The NEW!! IHR Website

Andrew Betts Category Manager, Natural Foods Thrifty Foods

Sanjiv Jagota President Natures Source

Gilles Houde President and COO GNC Canada

Olivier Felicio President Rive Gauche Media

IHRmagazIne.com JUly/aUgUsT 2011

For Details, write #104 on Free Info Page, page 73

38 . EMBRACE LIFE IN A BLUR

28 . THE BEST OF BOTH WORLDS

48 . TURNING BACK THE CLOCK

NOW AVAILABLE: MY WAISTLINE & MY VITALITY

Make a cocktail with it!

FROM THE PUBLISHER

IHRmagazIne.com JULy/AUGUST 2011

HOLISTA TEA TREE SPRAY

JULY/AUGUST 2011 IHRMAGAZINE.COM

ANDALOU NATURALS CITRUS VERBENA BODY LOTION

SISU STRESS RESCUE L-THEANINE

IHRMAGAZINE.COM JULY/AUGUST 2011

DIET TIMETHE NEW NORDIC WAY!

No.1 Herbal Detox in Europe

Burn off the fat with spices

Eat carbs and lose weight

APPLE CIDER 600

For details, write #106 on Free Info Page, page 73.

GENUINE HEALTH LIVE PROBIO+ O3MEGA

SISU KIDS U.F.O ULTRA-FORTIFIED OMEGA 3

HOLISTA RESTORATIV VITAMIN E LOTION

OMEGA ALPHA LUNG TONE AND E-Z MOBILITY

IHRMAGAZINE.COM JULY/AUGUST 2011

HOLISTA RESTORATIV TEA TREE & VITAMIN E ANTISEPTIC CREAM

BOO BAMBOO HAIR STRENGTHENING SHAMPOO

JULY/AUGUST 2011 IHRMAGAZINE.COM

top seller review

TOP THREE PRODUCTS

Almond Milk Blue Diamond Chocolates Camino N/A

Coconut Oil Nativa Stevia Now Goji Juice Genesis Today

Cereal, snacks and figs Barbaras Frozen Foods Gardein

Waldon Farms brand Pizzas, Sausages, Slices Tofurky

TOP THREE PRODUCTS