Weight loss abstract
New dietary supplement compositions are disclosed that comprise
the phytochemical Diindolylmethane (DIM), as well as its precursor,
Indole-3-carbinol (I3C), and cogener, 2-(Indol-3-ylmethyl)-3,3'
diindolylmethane (LTR-1), dietary supplement acceptable carriers
and/or excipients. The use of these dietary supplement compositions
facilitate weight loss as part of a nutritional system targeting
release and metabolism of stored fat.
Weight loss claims
What is claimed is:
1. A method of promoting weight loss in a subject in need thereof
comprising administering to the subject an amount of a dietary indole
effective to promote weight loss.
2. The method according to claim 1 wherein the dietary indole is
selected from the group consisting of I3C, DIM and LTR-1.
3. The method of claim 2 wherein the dietary indole is DIM.
4. The method of claim 3, wherein the DIM is suspended as microparticles
in a starch carrier matrix.
5. The method of claim 1, further comprising limiting the carbohydrate
intake of the subject to an amount effective to promote weight loss.
6. The method of claim 1, further comprising limiting the carbohydrate
intake of the subject to less than 500 grams per day.
7. A pharmaceutical composition comprising an amount of a dietary
indole effective to promote weight loss.
8. The composition of claim 7 wherein the dietary indole is selected
from the group consisting of I3C, DIM and LTR-1.
9. The composition of claim 8 wherein the dietary indole is DIM.
10. The composition of claim 9, wherein the DIM is suspended as
microparticles in a starch carrier matrix.
11. The composition of claim 7, wherein the composition is formulated
for oral administration.
12. The composition of claim 7, wherein the dietary supplement
composition is formulated as a pill.
13. The composition of claim 7, wherein the dietary supplement
composition is formulated as a tablet.
14. The composition of claim 7, wherein the dietary supplement
composition is formulated as a capsule.
15. The composition of claim 7, wherein the dietary supplement
composition is formulated as a cream.
16. The composition of claim 7, wherein the dietary supplement
composition is formulated as a liposomal spray.
17. A method of treating weight gain in a subject in need thereof
comprising administering to the subject an amount of a dietary indole
effective to treat weight gain.
18. The method according to claim 17 wherein the dietary indole
is selected from the group consisting of I3C, DIM and LTR-1.
19. The method of claim 18 wherein the dietary indole is DIM.
20. The method of claim 19, wherein the DIM is suspended as microparticles
in a starch carrier matrix.
21. The method of claim 17, further comprising limiting the carbohydrate
intake of the subject to an amount effective to treat weight gain.
22. The method of claims 21, further comprising limiting the carbohydrate
intake of the subject to less than 500 grams per day.
23. A pharmaceutical composition comprising an amount of a dietary
indole effective to treat weight gain.
24. The composition of claim 23 wherein the dietary indole is selected
from the group consisting of I3C, DIM and LTR-1.
25. The composition of claim 24 wherein the dietary indole is DIM.
26. The composition of claim 25, wherein the DIM is suspended as
microparticles in a starch carrier matrix.
27. The composition of claim 23, wherein the composition is formulated
for oral administration.
28. The composition of claim 23, wherein the dietary supplement
composition is formulated as a pill.
29. The composition of claim 23, wherein the dietary supplement
composition is formulated as a tablet.
30. The composition of claim 23, wherein the dietary supplement
composition is formulated as a capsule.
31. The composition according to claim 23, wherein the dietary
supplement composition is formulated as a cream.
32. The composition according to claim 23, wherein the dietary
supplement composition is formulated as a liposomal spray.
33. The method of claims 1 or 17, further comprising administering
grapefruit, grapefruit concentrate, grapefruit juice, or grapefruit
juice concentrate.
34. The composition of claims 7 or 23, further comprising grapefruit,
grapefruit concentrate, grapefruit juice, or grapefruit juice concentrate.
Weight loss description
1. INTRODUCTION
The present invention relates to compositions and methods for promoting
weight loss and/or preventing weight gain in mammals by administering
phytochemicals. Among the phytochemicals useful in the compositions
and methods of the invention are dietary indole, Diindolylmethane
(DIM), as well as its precursor, Indole-3-carbinol (I3C), and cogener,
2-(Indol-3-ylmethyl)-3,3'-diindolylmethane (LTR-1). When used as
described, these natural substances, alone and in combination with
other substances, facilitate weight loss as part of a nutritional
system targeting release and metabolism of stored fat.
2. BACKGROUND OF THE INVENTION
The term "overweight" describes an excessive accumulation
of body fat or "adiposity". "Overweight" is
defined as an elevation in the Body Mass Index (BMI) beyond desirable
standards due to increased body fat. The BMI expresses an individual's
degree of overweight independent of height by dividing weight in
kilograms (Kg) by height squared (m.sup.2). In overweight men a
BMI above 25 Kg/m.sup.2 and in overweight women a BMI above 26 Kg/m.sup.2
defines a level of adiposity which negatively impacts health (Simopoulos,
A.P., Body Weight Reference Standards, In Van Itallie, T.B. and
Simopoulos, A.P. (Eds), Obesity: New Directions in Assessment and
Management, The Charles Press, Inc., Philadelphia, Pa., 1995). The
increasing prevalence of overweight is one of the major health problems
of industrialized countries. Overweight occurs as a result of an
imbalance between energy intake as food and energy expenditure through
physical activity. Most importantly, the trend to increased consumption
of sugar and refined carbohydrate in excess of energy needs results
in a metabolic and hormonal status favoring the formation and storage
of fat. Weight loss depends on mobilization and metabolism of fat
at the cellular level. This requires the metabolic process of lipolysis
and encompasses the release of stored fat from fat cells. In all
mammals the process and rate of lipolysis are highly regulated by
the system of catecholamine hormones.
Increased carbohydrate consumption in modern society is the result
of the introduction of refined sugar and processed carbohydrate
in various forms. The addition of high fructose corn syrup in 1967
is a prime example of this shift in dietary composition which has
contributed to the further increase of the sugar component of the
average diet to about 8% of total calories (Raper, N., and Marston,
R., "Content of the U.S. food supply (tables of nutrients and
foods)", Human Nutrition Information Service: Washington, D.C.,
U.S. Department of Agriculture, 1988). The presence of sugar and
other "high glycemic" processed carbohydrates found in
bread and pasta, increases blood insulin levels, inhibits lipolysis,
and promotes new fat synthesis. This raises serum triglycerides,
serum cholesterol, and increases the risk of atherosclerosis and
coronary heart disease. Strategies to decrease our daily intake
of processed carbohydrate and increase the release and metabolism
of stored fat are clearly needed.
Interventions to decrease appetite have focused on supporting brain
levels of the neurotransmitter serotonin which is derived from the
amino acid tryptophan. However, simply providing increased dietary
sources of tryptophan have in themselves not proven successful at
reducing appetite. Use of drugs such as fluoxetine and fenfluramine,
which raise brain serotonin levels, have proven effective in promoting
weight loss. Unfortunately, this pharmacologic approach has been
recently associated with serious cardiovascular side effects (Kolanowski,
J., "A risk-benefit assessment of anti-obeisity drugs",
Drug Safety 20(2):119-131, 1999). Use of the serotonin precursor,
L-5-hydroxy-tryptophan (5HTP) may represent a safer approach to
reducing appetite for carbohydrates. Other safe and effective means
to promote weight loss are clearly needed.
With regard to increasing fat metabolism, both caloric restricted
dieting and increased exercise promote a more active catecholamine
system which favors active lipolysis. Increasing the efficiency
of this process has been the object of much of the pharmacotherapy
of obesity.
The process of lipolysis is regulated primarily by the system of
catecholamine hormone receptors present on the surface of fat cells.
These catecholamine receptors consist of a family of membrane bound
proteins with differerent structure and activity known as the .alpha.
and .beta. receptors. The .alpha. and .beta. receptors have opposing
action on the rate of lipolysis. Predominance of activity from the
.beta. receptors favors active lipolysis and translates into weight
loss. Predominance of .alpha. receptor activity inhibits lipolysis
and favors continued fat storage. Nature has provided for an adaptive
mechanism by which activity and number of the a receptors increase
with caloric restriction. This slows continued lipolysis during
periods of fasting and results in the increased loss of muscle tissue
in addition to fat during dieting. The increased presence and activity
of .alpha. receptors and decreased overall metabolic rate which
occur during fasting has been call the "starvation response".
The starvation response reduces the efficiency of lipolysis during
weight loss.
Much of modern obesity research has concerned methods for maintaining
a hormonal balance which favors .beta. over .alpha. receptor activity
to promote more efficient and active lipolysis. The objective is
to facilitate continued lipolysis or fat loss while preserving muscle
or "lean body mass". This is achieved with exercise, a
restricted calorie but protein supplemented diet, and with the administration
of substances which mimic the .beta. receptor activity of the catecholamine
hormones. The most popular .beta. stimulating substance in use since
antiquity is ephedrine, originally discovered in the Chinese herb
"Ma Huong". Ephedrine resembles the catecholamine hormone,
epinephrine, and effectively increases the rate of lipolysis. However,
like epinephrine, ephedrine produces serious side effects related
to overstimulation of the sympathetic nervous system, including
tachycardia, hypertension, nervousness, tremor and insomnia (Cupp,
M. J., "Herbal remedies: adverse effects and drug interactions",
American Family Physician 59(5):1239-45, 1999). To offer alternatives
to the use of ephedrine and related drugs like amphetamines, the
pharmaceutical industry has attempted with little success to develop
.beta. receptor stimulants with more specific action limited to
the promotion of lipolysis in fat cells.
Another attractive approach, to increasing rates of lipolysis has
been blockade of the catecholamine .alpha. receptor system Lafontan,
M., Berlan, M., et al., "Alpha-2-adrenoceptors in lipolysis:
.alpha.2 antagonists and lipid mobilizing strategies", Am.
J. Clinical Nutrition 55:219S-227S, 1992). This has been possible
with oral use of yohimbine, another natural compound which blocks
.alpha. receptors allowing the epinephrine and norepinephrine already
present to have unopposed action at the .beta. receptors. While
theoretically an attractive approach, and successful in promoting
weight loss in dogs (Berlan, M., Galittzky, J., et al., "Anorectic
effect of alpha2-antagonists in Dog: effect of acute and chronic
treatment", Pharmacology Biochemistry & Behavior 39:313-320,
1991), the use of yohimbine has only inconsistently promoted increased
weight loss in placebo controlled studies in humans (Sax, L., "Yohimbine
does not affect fat distribution in men", International Journal
of Obesity 15:561-565, 1991, and Berlin, I., Stalla-Bourdillon,
A., et al., "Lack of efficacy of yohimbine in the treatment
of obesity", J. of Pharmarmocologie (Paris) 3:343-347, 1986).
The need thus remains to develop other approaches and applications
of safe natural substances to effectively promote lipolysis and
facilitate weight loss.
Diindolylmethane (DIM), as well as its precursor, Indole-3-carbinol
(I3C), and cogener, 2-(Indol-3-ylmethyl)-3,3'-diindolylmethane (LTR-1)
are natural phytochemicals and part of the family of dietary indoles
discovered in cruciferous vegetables. DIM and I3C are found in all
cruciferous vegetables including broccoli, cauliflower, cabbage
and Brussels sprouts (Bradfield C A and Bjeldanes L F, High performance
liquid chromatographic analysis of anticarcinogenic indoles in Brassica
oleracea, J Agric. Food Chem., 1987, 35:46-49). DIM, together with
the linear trimer, LTR-1, are formed from the precursor indole,
I3C, after the enzymatic release of I3C from parent glucosinolates
found in all cruciferous vegetables. Supplemental use of DIM and
I3C are effective in humans in adjusting the pathways of estrogen
metabolism to favor the production of 2-hydroxy estrogen metabolites
(Michnovicz, J J, et al., Changes in levels of urinary estrogen
metabolites after oral indole-3-carbinol treatment in humans, J
Natl Cancer Inst., 1997 May 21, 89(10):718-23). An increased proportion
of 2-hydroxy metabolites is correlated to protection from breast
cancer. This relationship has been documented in case-control studies
(Ho GH, et al. Urinary 2/16 .alpha.-hydroxyestrone ratio: correlation
with serum insulin-like growth factor binding protein-3 and a potential
biomarker of breast cancer risk, Ann Acad Med Singapore, 1998, 27:294-299,
and Schneider, J., et al., Abnormal oxidative metabolism of estradiol
in women with breast cancer, Proc Natl Acad Sci USA, 1982, 79:3047-3051).
The use of I3C, which converts to DIM and LTR-1 after passage through
the stomach, has been the subject of a U.S. Pat. No. 5,895,787 describing
the use of I3C and related dietary indoles to reduce the symptoms
of fibromyalgia. Use of DIM and LTR-1 in absorption enhancing formulations
for improving the balance of estrogen metabolites has been the subject
of earlier investigations and provides the basis of U.S. Pat. No.
6,086,915. No prior investigations have suggested that DIM, I3C
or LTR-1 might be potentially useful agents to promote lipolysis
or facilitate weight loss.
3. SUMMARY OF THE INVENTION
The present invention provides methods and compositions for the
promotion of weight loss and the maintenance of body weight. In
particular, the present invention relates to the administration
of phytochemicals, preferably I3C, DIM and/or LTR-1, for the promotion
of weight loss and the maintenance of body weight by preventing
weight gain. In a preferred embodiment, the dietary indole is "processed",
referring to a dietary indole that has been processed according
to the methods described in U.S. patent application Ser. No. 09/053,180.
Also according to the present invention, a pharmaceutical composition
is provided, which comprises a phytochemical, preferably I3C, DIM
and/or LTR-1, and, optionally, pharmaceutically acceptable carriers.
4. BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 depicts the dose response from processed DIM presented as
the increasing level of carbohydrate intake ("Critical Carbohydrate
Level [CCL]) associated with persisting ketosis.
FIG. 2 depicts the effect of processed DIM showing the increase
in carbohydrate intake (Max % Change in CCL ["Critical Carbohydrate
Level"] from BSL [Baseline]) and the weight loss acheived (Weight
Loss as % of pre-study weight) for each subject.
FIG. 3 depicts the statistically significant correlation of weight
loss achieved (Percent Weight Loss) and the effect of processed
DIM as measured by the increase in carbohydrate intake still associated
with ketosis (Max % Change in CCL ["Critical Carbohydrate Level"]
from BSL [Baseline])
FIG. 4 depicts the statistically significant correlation of decrease
in Body Mass Index (BMI) and the effect of processed DIM as measured
by the increase in carbohydrate intake still associated with ketosis
(Max % Change in CCL ["Critical Carbohydrate Level"] from
BSL [Baseline]). This demonstrates that the Processed DIM effect
is independent of height.
5. DETAILED DESCRIPTION OF THE INVENTION
The present invention is based upon the observation that phytochemicals,
in particular, I3C, DIM, and LT-1, have proven to be a useful and
consistent promoters of weight loss. This has facilitated weight
loss and reduction in body fat in individuals who have become resistant
to continuing weight loss from adherence to reduced carbohydrate
diets alone. DIM, I3C, and LT-1, together with other complimentary
components, like grapefruit concentrate and L-5-Hydroxy-trytophan
(5HTP), have thus been found to support more active fat metabolism.
Controlled trials of formulated DIM have produced evidence of more
active lipolysis correlated with facilitated weight loss.
Anti-lipolytic increases in both .alpha. receptor activity and
receptor number are associated with both obesity and aging (Taouis,
M., Valet, P., et al., "Obesity modifies the adrenergic status
of dog adipose tissue", J. of Pharmacology and Experimental
Therapeutics, 250(3):1061-1066, 1989, and Langin, D., Portillo,
M., et al., "Drop in the "atypical" .beta.-adrenergic
response and modification of the .beta./.alpha.2-adrenoceptor balance
in fat cells from aging rabbits", Endocrinology 130:307-315,
1992). Thus, according to the present invention, DIM alone, DIM
potentiated with grapefruit concentrate, related dietary indoles
such as LTR-1 used like DIM, and DIM and LTR-1 in combination with
.alpha. blocking products like yohimbe bark extract, are useful
for treating obesity. This phytotherapy, when combined with a prudent
carbohydrate restricted diet, defines a new nutritional system for
combating adiposity. This approach is also compatible with nutritional
support for the serotonin system which adds a component of appetite
control. This can be achieved through additions of tryptophan, and
the serotonin precursor, 5HTP, derived from Griffonia simplicifolia
extract. 5HTP alone has been recently shown to help non-insulin
dependent diabetics reduce carbohydrate intake with associated weight
loss (Cangiano, C., Laviano, A., et al., "Effects of oral;
5-hydroxy-tryptophan on energy intake and macronutrient selection
in non-insulin dependent diabetic patients.", International
J. of Obesity 22:648-654, 1998).
The facilitated delivery of DIM and related indoles may be accomplished
according to formulations and methods described in U.S. Pat. No.
6,086,915. The effectiveness of supplemental DIM is further supported
by co-administration of DIM with grapefruit concentrate, which additionally
facilitates the absorption of DIM and adds an additional fat mobilizing
action.
5.1. Promotion of Weight Loss
The invention provides compositions and methods for promoting weight
loss in a subject in need thereof through the administration of
cruciferous phytochemicals (e.g., dietary indoles) in a pharmaceutically
acceptable fashion. In a preferred embodiment, the subject is suffering
from obesity. In another embodiment, the subject is overweight and
has a BMI above 25 kg/m.sup.2 for men and a BMI above 26 Kg/m.sup.2
for women. In particular embodiments, I3C, DIM, or LTR-1, alone
or in combination with each other or other compositions, are administered
orally in, for example, the form of encapsulated dietary supplements.
The I3C is preferably administered at a dose of 200-500 mg per
day. In alternative embodiments, I3C is administered at doses of
200-300 mg per day, 300-400 mg per day and 400-500 mg per day.
DIM is administered providing 50-500 mg per day of DIM. In preferred
embodiments, the dose of DIM, I3C or LTR-1 is 50-100 mg per day,
100-200 mg per day, 200-300 mg per day, 300-400 mg per day, and
400-500 mg per day.
In a preferred embodiment, DIM is administered in an absorption
enhancing formulation, as described in U.S Pat. No. 6,086,915, providing
50-600 mg per day of DIM suspended as microparticles in a starch
carrier matrix. In preferred embodiments, the dose of processed
DIM is 100-200 mg per day, 200-300 mg per day, 300-400 mg per day,
400-500 mg per day, and 400-600 mg per day.
The LTR-1 is preferably administered in an absorption enhancing
formulation providing 50-600 mg per day of LTR-1 suspended as microparticles
in a starch carrier matrix as previously described, however, the
present invention contemplates the administration of any preparation
of LTR-1. In a preferred embodiment, the dose of LTR-1 is 100-200
mg per day. In preferred embodiments, the dose of processed LTR-1
is 200-300 mg per day, 300-400 mg per day, 400-500 mg per day, and
400-600 mg per day.
Doses of the phytochemicals of the invention can also be calculated
based upon the body weight of the subject to be treated. Doses of
phytochemicals between 1 and 3 mg per kg of body weight per day
are preferred. In another preferred embodiment, the phytochemicals
are administered at a dose of between 1.5 and 2.5 mg per kg per
day, preferably 2.0 mg per kg per day.
Alternatively, the co-administration of grapefruit, grapefruit
concentrate, grapefruit juice, or grapefruit juice concentrate,
or other grapefruit-derived composition and/or 5-HTP along with
the indole (e.g., I3C, DIM or LTR-1) can be used to increase absorption
of the phytochemicals and promote reduced carbohydrate intake for
even more efficient weight loss.
In an alternative embodiment, the indole (e.g., DIM or LTR-1) is
administered in the form of a liposomal sublingual spray applied
directly to the oral mucosa. This liposomal suspension provides
phytochemical loaded liposomes to administer the phytochemicals
and create a sustained delivery system. Indole (e.g., DIM or LTR-1)
containing liposomes are sequestered in the oral mucosa, allowing
absorption which avoids "first pass" hepatic metabolism.
The liposomal spray uses standard liposomal preparation and structural
lipid ingredients. (Ranade, V. V., "Drug delivery systems.
1. Site-specific drug delivery using liposomes as carriers,"
J. Clin. Pharmacol. 29(8):685-94, 1989; Crommelin, D. J. A. and
Schreir, H., "Liposomes", Colloidal Drug Delivery Systems,
Kreuter, J. editor, Marcel Dekker, N.Y., 1994, p. 85).
Alternatively the indole (e.g., DIM or LTR-1) may be administered
in the form of a transdermal cream applied directly to the skin.
This cream utilizes various absorption enhancing emollients and
consists of the indole (e.g., DIM or LTR-1) in a concentration of
1-3% by weight. It is designed as a sliming cream to encourage lipolysis
and fat loss in areas of persistent adiposity such as thighs, buttocks
and abdomen. (Greenway, F. L., Bray, G. A., and Heber, D., "Topical
fat reduction," Obes. Research 3(Suppl.4):561S-568S, 1995).
In another embodiment, the method further comprises, in addition
to the administration of phytochemical, limiting the subject's carbohydrate
intake. In preferred embodiments, the subject's carbohydrate intake
is limited to 50, 100, 150, 200, 250, 300, 350, 400, 450 and 500
mg per day.
In a preferred embodiment, the subject to be treated, even though
limiting carbohydrate intake, has become resistant to losing weight
through limiting of carbohydrate intake alone. In another embodiment,
the subject is one who is already on a diet of limited carbohydrate
intake. For such a subject, the method of the invention comprises
the administration of phytochemical as described herein without
additional limitation of carbohydrate intake.
The phytochemicals of the invention may be administered in any
appropriate amount in any suitable galenic formulation and following
any regime of administration.
The actual administered amount of phytochemical, and the amount
of daily carbohydrate intake may be decided by a supervising physician
and may depend on multiple factors, such as, the age, condition,
file history, etc., of the patient in question.
The subject, or patient, to be treated using the methods of the
invention is an animal, e.g., a mammal, and is preferably human,
and can be a fetus, child, or adult. In a preferred embodiment,
the subject is a dog.
5.2. Maintenance of Body Weight by Preventing Weight Gain
The invention further provides compositions and methods for maintaining
body weight by preventing weight gain. In particular embodiments,
one or more dietary indoles (e.g., I3C, DIM, or LTR-1), alone or
in combination with each other or compositions, are administered
orally in, for example, the form of encapsulated dietary supplements.
For the maintenance of body weight, the phytochemicals of the invention
may be administered as described in section 5.1, either at the same
or lower doses. In preferred embodiments, the phytochemicals are
administered at a dose of three fourths, two thirds, one half, one
third and one fourth the doses described above used for weight loss.
Preferred doses for maintenance of weight are 200-400 mg per day
for I3C, 150-300 mg per day for processed DIM, and 150-300 mg per
day for LTR-1.
In a preferred embodiment, the method of weight maintenance further
comprises limiting dietary carbohydrate intake to the same or a
lesser extent than used for weight loss as described above. In preferred
embodiments, dietary intake is at a level 1.5 times, 2 times, 2.5
times or three times that of the amount described above used for
weight loss. In another preferred embodiment, dietary carbohydrate
intake is limited to the range of 150 to 400 grams of total carbohydrates
per day.
The actual administered amount of phytochemical, and the amount
of daily carbohydrate intake may be decided by a supervising physician
and may depend on multiple factors, such as, the age, condition,
file history, etc., of the patient in question.
In a particular embodiment, body weight of a subject is maintained
through use of the compositions and methods of the invention after
promoting weight loss in the subject. In a preferred embodiment,
the weight loss to be maintained was accomplished through the methods
of the invention as described in section 5.1. In another embodiment,
the weight loss was accomplished through a reduction of carbohydrate
intake.
The subject, or patient, to be treated using the methods of the
invention is an animal, e.g., a mammal, and is preferably human,
and can be a fetus, child, or adult. In a preferred embodiment,
the subject is a dog.
5.3. Pharmaceutical Compositions
The pharmaceutical compositions according to the present invention
preferably comprise the active constituents and one or more carriers
acceptable in pharmaceutical compositions. The carrier(s) must be
"acceptable" in the sense of being compatible with the
other ingredients of the composition and also not deleterious to
the recipient thereof.
It will be appreciated that the amounts of phytochemical required
for said treatment or prevention will vary according to the route
of administration, the amount the subject is overweight, the degree
of obesity to be treated, the condition, age, file history of the
subject, and the galenic formulation of the pharmaceutical composition,
etc.
Preferably, the phytochemical used in the invention has been processed
to enhance bioavailability, as is described in U.S. Pat. No. 6,086,915.
So processed DIM or LTR-1 is referred to as "processed DIM"
and "processed LTR-1", respectively. However, any suitable
preparation of phytochemical can be used in the methods and compositions
of the invention.
The following is a list of ingredients useful for formulating processed
DIM or LTR-1: 1. About 10 to about 40 percent by weight of LTR-1
or DIM. 2. About 10 to about 40 percent by weight of the following,
alone or in combination: vitamin E succinate polyethylene glycol
1000; vitamin E succinate Polyethylene glycols with polyethylene
glycol (with a molecular weight range of 400-2000); other polyethylene
glycol esters such as those formed by fatty acids such as oleic
acid or stearic acid; polyvinylpyrrolidones; polyvinylpolypyrrolidones;
Poloxamer 188, Tweens; or Spans. 3. About 5 to about 20 percent
by weight of the following, alone or in combination: phosphatidyl
choline (derived from soy lecithin and supplied as Phospholipon
SOG from Rhone Poulenc Rorer); dioleoyl phosphatidylcholine; phoshatidylglycerol;
dioleoylphosphatidylglycerol; dimyristoylphosphatidylcholine; dipalmitoylphosphatidylcholine;
phosphatidylethalolamines; phosphatidylserines; or sphingomyelins;
or other sources of phospholipids as those from purified Milk Fat
Globule Membrane; glycerolesters; poly glycerol esters; or ethoxylated
castor oil. 4. About 15 to about 30 percent by weight of the following,
alone or in combination: hexanol; ethanol; butanol; heptanol; 2-methyl-1-pentanol;
various ketone solvents that would be acceptable in foods such as
methyl ethyl ketone, acetone and others; propylene glycol; and certain
ester solvents such as ethyl acetate. 5. About 20 to about 40 percent
by weight of the following, alone or in combination: modified starch
such as Capsul.TM. Starch from National Starch, Inc.; methylcellulose;
hydroxypropyl methylcellulose; hydroxyethylcellulose; hydroxypropylethylcellulose;
pectin; gum arabic; gelatin; or other polymeric matrix-forming preparation
known to those skilled in the art, soluble in water and, suitable
for spray drying. 6. About 0.5 to about 35 percent by weight of
the following, alone or in combination: aerosil 200; or any other
flow enhancing excipient from silica, or related salt, known to
those skilled in the art.
The following is a detailed method of formulating processed DIM:
1. 6.75 kg of TPGS is heated just beyond its melting point with
constant stirring in a heated vessel ("First vessel").
2. 9.38 kg of hexanol and 9.83 kg of jet milled DIM is added to
the first vessel and the mixture stirred to a uniform suspension
at 70.degree. C. 1.4 kg of phosphatidyl choline is then added. 3.
In a second larger vessel, 185 L of water and 10.7 kg of starch
are thoroughly mixed with a Cowles blade. This mixture is neutralized
to pH 7 with a small amount of sodium carbonate and then heated
to 75.degree. C. and stirred for 1 hour. 4. The contents of the
first vessel is added to the starch mixture in the second larger
vessel and thoroughly mixed with a homogenizing rotor/stator type
mixer at moderate speed for 15 minutes. 5. The mixture from step
4 is spray dried with a small amount (approximately 0.5%) of hydrophilic
silica to provide a free flowing powder of finely dispersed microparticles
containing the co-precipitated TPGS, phosphatidyl choline and DIM
in an amorphous, non-crystalline structure. 6. The flowable powder
product is collected and stored in evacuated foil sacks, after de-aerating
and flushing with nitrogen. 7. Analysis of presence of unchanged
dietary ingredient, reveals about 30 to about 33 percent by weight
of DIM.
The procedure of making processed DIM may be summarized as follows:
(a) heating one or more solubilizing emulsifiers selected from the
group consisting of vitamin E succinate polyethylene glycol 1000,
polyvinylpyrrolidone, polyoxyethylene stearate, sodium cholate,
deoxycholate and taurocholate; (b) adding to the product of step
(a) a solvent and a surfactant phospholipid selected from the group
consisting of phosphatidyl choline, dioleoyl phosphatidyl choline,
phosphatidylglycerol, dioleoylphosphatidylglycerol, dimyristoylphosphatidylcholine,
dipalitoylphosphatidylcholine, phosphatidylethanolamine, phosphatidylserine
and sphingomyelin to produce a solution; (c) dissolving in the solution
of step (b) LTR-1 and/or DIM; (d) adding to the solution of step
(c) a solution containing an encapsulator; (e) mixing the solution
produced in step (d) to produce a microdispersion with a particle
size of 5 microns or less; and (f) spray drying the resulting mixture
to leave a solid hydrophobic phytochemical composition.
In general, a suitable (therapeutically effective) amount of I3C
is 300-500 mg per day. DIM is preferably administered in an absorption
enhancing formulation, as described in U.S. Pat. No. 6,086,915,
at 100-200 mg per day suspended as microparticles in a starch carrier
matrix. The LTR-1 is preferably administered in an absorption enhancing
formulation at 100-200 mg per day suspended as microparticles in
a starch carrier matrix. The actually administered amounts of phytochemical
may be decided by a supervising physician. The phytochemicals of
the invention may be administered alone or in combination with one
another, and/or with other compositions. The combinations of one
or more phytochemicals and other compositions can be in the same
composition for administering in combination concurrently, or in
different compositions for administering concurrently but separately,
or sequentially.
Therapeutic formulations include those suitable for parenteral
(including intramuscular and intravenous), oral, rectal or intradermal
administration, although oral administration is the preferred route.
Thus, the pharmaceutical composition may be formulated as tablets,
pills, syrups, capsules, suppositories, formulations for transdermal
application, liposomal sprays, powders, especially lyophilized powders
for reconstitution with a carrier for intravenous administration,
etc.
The term "carrier" refers to a diluent, adjuvant, excipient,
or vehicle with which the therapeutic is administered. The carriers
in the pharmaceutical composition may comprise a binder, such as
microcrystalline cellulose, polyvinylpyrrolidone (polyvidone or
povidone), gum tragacanth, gelatin, starch, lactose or lactose monohydrate;
a disintegrating agent, such as alginic acid, maize starch and the
like; a lubricant or surfactant, such as magnesium stearate, or
sodium lauryl sulphate; a glidant, such as colloidal silicon dioxide;
a sweetening agent, such as sucrose or saccharin; and/or a flavoring
agent, such as peppermint, methyl salicylate, or orange flavoring.
Therapeutic formulations suitable for oral administration, e.g.,
tablets and pills, may be obtained by compression or molding, optionally
with one or more accessory ingredients. Compressed tablets may be
prepared by mixing phytochemicals, and compressing this mixture
in a suitable apparatus into tablets having a suitable size. Prior
to the mixing, the phytochemical may be mixed with a binder, a lubricant,
an inert diluent and/or a disintegrating agent.
In a preferred embodiment, phytochemical is mixed with a binder,
such as microcrystalline cellulose, and a surfactant, such as sodium
lauryl sulphate until a homogeneous mixture is obtained. Subsequently,
another binder, such as polyvidone, is transferred to the mixture
under stirring. This mixture is passed through granulating sieves
and dried by desiccation before compression into tablets in a standard
compressing apparatus.
A tablet may be coated or uncoated. An uncoated tablet may be scored.
A coated tablet may be coated with sugar, shellac, film or other
enteric coating agents.
Therapeutic formulations suitable for parenteral administration
include sterile solutions or suspensions of the active constituents.
An aqueous or oily carrier may be used. Such carriers can be sterile
liquids, such as water and oils, including those of petroleum, animal,
vegetable or synthetic origin, such as peanut oil, soybean oil,
mineral oil, sesame oil and the like. Formulations for parenteral
administration also include a lyophilized powder comprising phytochemical
that is to be reconstituted by dissolving or suspending in a pharmaceutically
acceptable carrier that dissolves or disperses said phytochemical.
When the pharmaceutical composition is a capsule, it may contain
a liquid carrier, such as a fatty oil, e.g., cacao butter.
Suitable excipients include starch, glucose, lactose, sucrose,
gelatin, malt, rice, flour, chalk, silica gel, sodium stearate,
glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol,
propylene, glycol, water, ethanol and the like. These compositions
can take the form of solutions, suspensions, emulsion, tablets,
pills, capsules, powders, sustained-release formulations and the
like. The composition can be formulated as a suppository, with traditional
binders and carriers such as triglycerides.
In yet another embodiment, the therapeutic compound can be delivered
in a controlled release system. In one embodiment, a pump may be
used (see Langer, supra; Sefton, CRC Crit. Ref. Biomed. Eng. 14:201
(1987); Buchwald et al., Surgery 88:507 (1980); Saudek et al., N.
Engl. J. Med. 10 321:574 (1989)). In another embodiment, polymeric
materials can be used (see Medical Applications of Controlled Release,
Langer and Wise (eds.), CRC Pres., Boca Raton, Fla. (1974); Controlled
Drug Bioavailability, Drug Product Design and Performance, Smolen
and Ball (eds.), Wiley, N.Y. (1984); Ranger and Peppas, J. Macromol.
Sci. Rev. Macromol. Chem. 23:61 (1983); see also Levy et al., Science
228:190 (1985); During et al., Ann. Neurol. 25:351 (1989); Howard
et al., J. Neurosurg. 71:105 (1989)).
Other controlled release systems are discussed in the review by
Langer (Science 249:1527-1533 (1990)).
In one embodiment of the pharmaceutical composition according to
the invention, two or more active constituents are comprised as
separate entities. The two entities may be administered simultaneously
or sequentially.
The invention also provides a pack or kit comprising one or more
containers filled with one or more of the ingredients of the pharmaceutical
compositions of the invention. Optionally associated with such container(s)
can be a notice in the form prescribed by a governmental agency
regulating the manufacture, use or sale of the pharmaceutical composition,
or biological products, which notice reflects approval by the agency
of manufacture, use or sale for human administration.
The invention is further explained by the following illustrative
examples.
6. Example: Manufacture of Processed DIM or LTR-1 for Enhanced
Oral Bioavailability
Preparation of processed DIM and LTR-1 was accomplished according
to the steps outlined in U.S. patent application Ser. No. 09/053,180.
Briefly, this included mixture of about 10-40% by final weight of
either DIM or LTR-1 with about 10-40% by final weight of vitamin
E polyethylene glycol 1000 succinate(Vitamin-E-TPGS, Eastman Chemical),
2-20% by final weight, phosphatidyl choline (Phospholipon 50G, Rhone
Poulenc) and 15-30% by final weight hexanol. This mixture was made
homogeneous by mixing. The homogeneous mixture of indoles and other
oil soluble substituents listed above was added to a solution of
modified starch in water (Capsul Starch from National Starch, Inc.).
The starch component forms form from 30-70% of the final dry weight
of the product. The well dispersed final combined mixture was then
subjected to spray drying. The resultant product was a fine powder
containing either DIM or LTR-1 contained within the starch particles.
7. Example: Manufacture of I3C Capsules Using Pure I3C
Pure Indole-3-carbinol (I3C) was obtained from standard suppliers
(Sabinsa, Inc or Designed Nutritional Products, Inc.). Capsules
containing 300-500 mg were manufactured by placing that amount of
I3C into opaque gelatin capsules.
Capsules containing 150-300 mg of processed DIM, as produced according
to the steps described in example 1., were made by mixing the processed
DIM with microcrystaline cellulose and placing the mixed powder
into opaque gelatin capsules.
Similarly, capsules containing 150-300 mg of processed LTR-1, as
produced according to the steps described in example 1., were made
by mixing the processed LTR-1 with microcrystaline cellulose and
placing the mixed powder into opaque gelatin capsules.
8. Example: Manufacture of DIM or LTR-1 in a Cream for Transdermal
Delivery
For the aqueous phase of the emulsion, a mixture of 70 grams of
propylene glycol and 633 grams of water is heated to 95.degree.
C. The oil phase of the emulsion is prepared by heating a mixture
of the following to 105.degree. C: 30 grams cetostearyl alcohol
(Alfol 16/18, Vista ), 30 grams hydrogenated soy monoglyceride (Myverol
18-06, Quest), 30 g of a mixture of polyoxyethylene stearic acid
ester and mono- and di-glycerides of fatty acids (Arlacel 165, ICI),
10 grams polyethylene (Epolene N-34, Eastman), and 50 g. of squalene.
The active ingredient phase is prepared separately also by gently
heating to about 63.degree. C. a mixture of the following to uniformity:
30 g d-.alpha.-tocopherol polyethylene glycol 1000 succinate (Vitamin
E TPGS, Eastman), 50 g isopropyl myristate, and 15 g of DIM or 15
g of LTR-1. The above oil phase is added to the aqueous phase using
a rotor/stator type homogenizer at moderate speed. The mixture is
cooled to 75.degree. C. and 50 grams of lemon oil is added with
low speed mixing followed by addition of the active ingredient phase.
Lastly, 2 g of a 3:1 mixture of methyl paraben to propyl paraben
is added to the emulsion. This mixture is transferred to the reservoir
of a high pressure homogenizer such as the Microfluidics % Model
110Y. The emulsion is passed through the homogenizer approximately
five times at 15,000 psi operating pressure that is sufficient to
form a cream of the desired consistency which will not separate
on standing.
9. Example: Manufacture of DIM or LTR-1 in a Liposomal Spray for
Sublingual and Oral Mucosal Delivery
A standard liposomal preparation technique was used to prepare
a liposomal suspension of DIM and separately, a liposomal preparation
of LTR-1. Briefly, propylene glycol (7.0 gms) was heated to 92.degree.
C. on a water bath, 8 grams of partially hydrogenated pure egg yolk
lecithin, and 320 mg of stearylamine were added and dissolved to
give a clear liquid. To this liquid was added 500 mg of jet milled
DIM. This translucent solution was added to 200 ml of a 1% aqueous
solution of dextran T 40 pre-warmed to 55.degree. C. and the mixture
was stirred in a propeller mixer at 50.degree. C. for 3 minutes
after which it was cooled to room temperature. This procedure yielded
an off-white, dextran T 40/liposome suspension, thus encapsulating
the DIM.
Equivalent steps were undertaken to prepare a lipsomal suspension
encapsulating LTR-1.
10. Example: Manufacture of a Food Bar Containing Grapefruit Concentrate,
Processed DIM or LTR-1, and the Serotonin Precursors, Tryptophan
and 5-Hydroxy-Trytophan (5HTP)
Food bars were manufactured by using a standard food processor
to which was added the following ingredients: organic grapefruit
rind (100 gms), organic spirulina powder (50 grams), dried Griffonia
simplicifolia extract (1 gm). 3 grams of processed DIM containing
1 gm of microencapsulated DIM by weight was then added to the mixture
and homogeneously mixed. After mixing, whey protein powder, calcium
caseinate, maltodextrin, grapefruit oil, brown sugar, and natural
flavoring were added with further mixing to provide bulk and consistency
for formation into food bars. The final mixture was extruded to
form 10 food bars each containing 100 mg of DIM.
Equivalent steps were undertaken to produce food bars containing
LTR-1. Processed LTR-1 was substituted for processed DIM, producing
10 food bars each containing 100 mg of LTR-1.
11. Example: Weight Loss with DIM
S. G. is 50 years old and weighed 213 pounds at the time of her
referral. She has been post menopausal for 2 years and takes premarin
0.625 mg/day. A carbohydrate restricted diet program including a
daily exercise component was initiated. Using urine dip-sticks for
determination of ketonuria, the daily carbohydrate intake which
allowed minimal ketosis was determined to be 20 grams. The presence
of ketones in urine is an accepted measure of active metabolism
of stored fat or "lipolysis". Glycerol released from fat
cells along with stored fatty acids during lipolysis is directly
converted into ketones which appear in the urine. (Williamson, D.
H., Postgraduate Medical Journal, June Suppl., pages 371-375, 1971;
Nosadini R, Avogaro A, et al, Diabetes Metab Rev 1989 May; 5(3):299-319).
Supplementation with bioavailable DIM was introduced at 300 mg/day
and subsequently increased to 450 mg/day.
After the introduction of DIM, carbohydrate consumption was able
to be increased to 50 gms/day and still be associated with ketosis.
Without instituting caloric restriction in addition to the elimination
of carbohydrates, the patient proceeded to lose 10% of her body
weight over a period of 6 weeks. Following this weight loss of 21
pounds, she reduced her supplemental use of DIM to 300 mg/day and
liberalized her carbohydrate intake to 150 grams per day. This allowed
for a significant increase in high fiber vegetables. A continued,
though more gradual, weight loss has been noted during her maintenance
regimen.
Ketosis (Urine Dipstick Reading) Carbohydrate Intake Diet plus
Subject (gm/day) Diet Alone processed DIM S.G. 20 + ++ 50 - +
12. Example: Processed DIM used on Combination with Grapefruit
Concentrare by Overweight Men
Subjects RB and PS are middle aged men troubled by persistent overweight.
Each had adhered to a low carbohydrate diet and achieved and initial
weight loss of approximately 10 pounds. This was followed by resistance
to further weight loss despite adherence to the diet and regular,
moderate aerobic exercise.
Addition of processed DIM capsules resulted in a resumption of
weight loss in both cases. Monitoring lipolysis as reflected in
urine dipsticks for ketones demonstrated increased ketosis at a
given carbohydrate intake and persisting ketosis at increased carbohydrate
intake for both subjects. These results are summarized in the following
charts.
Subsequent to these observations addition of grapefruit concentrate
in the form of reconstituted grapefruit juice (Minute Maid) was
added to the subjects weight loss dietary regimen. In each case,
the addition of one eight ounce glass of grapefruit juice twice
daily together with two capsules of processed DIM (300 mg of total
supplement weight) resulted in further weight loss and a further
increase in the degree of ketosis documented on urine dipstick testing.
These results are summarized in the following chart.
Level of Ketosis (Urine Dipstick Reading) Carbohydrate Intake Diet
Diet and Diet, GFJ, Subject (gms/day) Alone DIM and DIM P.S. 50
+ ++ 100 0 + ++ R.B. 20 + ++ 40 0 + ++
After cessation of the weight loss program, dietary carbohydrate
intake was increased to typical amounts and processed DIM was continued
at one half the dose used during the weight loss program. The increased
carbohydrate intake corresponded to 40-50% of total daily calories
from carbohydrate sources. This use of processed DIM resulted in
maintenance of a stable weight at the level achieved following the
weight loss program.
13. Example: Weight Loss Study Demonstrating Statistically Significant
Association Between DIM Effect of Ketosis and Weight Loss Acheived
by Volunteer Subjects
A 6-week study was conducted by 18 moderately overweight individuals
who consumed 150-600 mg of a processed DIM supplement containing
30% DIM by weight. Processed DIM was prepared as described in U.S.
patent application Ser. No. 09/053,180, and as briefly described
in section 6. Subjects were on a monitored, carbohydrate restricted
diet. Each subject documented all carbohydrates consumed and the
presence and level of ketosis based on daily urine dipstick testing
for ketones. (Keto-Diastix, Bayer Corp.)
In this study individuals on a carbohydrate restricted diet first
determined their Critical Carbohydrate Level (CCL). This was established
by first demonstrating ketosis with at least a small reading on
urine dipsticks following at least 3 days of documented carbohydrate
intake and daily urine testing. (Readings include: Negative; Trace;
Small; Moderate; Large; Largest) Following this, carbohydrate intake
was increased by 10-15 grams per day until a negative urine test
was obtained. This defined an individuals CCL with a subject-specific
carbohydrate intake just sufficient to eliminate ketosis and lipolysis.
This process was repeated over a period of days to confirm the accuracy
of an individual's CCL in grams of carbohydrate ingested per day.
Following the determination of an individuals CCL, processed DIM
was started at 2 caps (300mg) per day for one week and carbohydrate
intake was held constant at close to the CCL level for each individual.
After one week on processed DIM, every individual showed positive
urine strips indicative of active lipolysis and daily carbohydrate
intake was increased by 10-15 grams per day. This was continued
until a negative urine test was again demonstrated and confirmed
at the higher carbohydrate level. This determined each subject's
CCL on processed DIM. The CCL on processed DIM was determined again
after increasing the processed DIM dose to 3 caps and then to 4
caps in a few of the subjects. Body weights were followed by weekly
weighing using a qualified office scale.
The documented increase in CCL for each subject was standardized
as the Maximum % Change in CCL from Baseline by computing the percent
increase in CCL while taking processed DIM over the baseline value.
Data from two individuals is resented in FIG. 1. This figure demonstrates
that increased doses of processed DIM allow for progressively greater
levels of carbohydrate intake to be associated with ketosis. The
data from all subjects is presented in FIG. 2, showing both the
maximal percentage increase in CCL for each subject and associated
weight loss for each subject during the 6 weeks of the study. When
results for all subjects were analyzed, the correlation of percent
increase in CCL and percent change in body weight was significant
at p=0.05, confirming the contribution of processed DIM to enhanced
lipolysis and weight loss. This is shown in FIG. 3. This correlation
of the effect from processed DIM (% Change in CCL) to weight loss
as reflected in the observed decrease in Body Mass Index (The decrease
in BMI from baseline [BSL]) remained significant as shown in FIG.
4. FIG. 4 demonstrates that the processed DIM effect in promoting
weight loss was independent of each subject's height.
The dose of processed DIM used in the study ranged from about 3-4
mg/kg/day at 2 caps to 4.5-6.4 mg/kg at 3 caps. Since processed
DIM is 30% DIM by weight, this dosage range employed extended from
about 1 to 2.1 mg/kg/day of DIM.
In summary, these results demonstrate both a dose related and statistically
significant action of processed DIM in promoting weight loss. Further,
these results document an effect of processed DIM which promotes
weight loss at progressively increased carbohydrate intakes and
which is associated with active lipolysis. |