| Abstrakt: |
Obesity has been identified as a rapidly rising pandemic within the developed world, potentially increasing the risks of type 2 diabetes and cardiovascular disease. Various studies have identified a positive association between stress, elevated cortisol levels and obesity. Mechanisms of the stress response lead to hyperpalatable food preference and increased appetite through the activation of the HPA axis, elevated cortisol and the resulting interactions with the dopaminergic system, neuropeptide Y, ghrelin, leptin and insulin. The methodology of this review involved a Systematic Search of the Literature with a Critical Appraisal of papers considering ashwagandha, mediation and mindfulness in relation to mechanisms of the stress response. It incorporated 12 searches yielding 330 hits. A total of 51 studies met the inclusion criteria and were critically appraised with ARRIVE, SIGN50 and Strobe checklists. Data from the 51 studies was extracted, coded into key themes and summarized in a narrative analysis. Thematic analysis identified 4 key themes related to ashwagandha and 2 key themes related to meditation. Results provide an overview of evidence assessing the efficacy of ashwagandha and meditation in relation to weight loss interventions by supporting the stress response and the pathways highlighted. Results of Clinical studies indicate that ashwagandha supports weight loss through reduced stress, cortisol and food cravings. Pre-clinical studies also suggest that ashwagandha possesses the capacity to regulate food intake by improving leptin and insulin sensitivity and reducing addictive behaviors through dopamine regulation. Clinical studies on meditation indicate it may enhance a weight loss protocol by reducing the stress response, cortisol release and blood glucose and improving eating behaviors. Key teaching points: Chronic exposure to stress may promote obesogenic eating behaviors through the activation of the HPA axis and the resulting interactions between cortisol and the dopaminergic system, neuropeptide Y, ghrelin, leptin and insulin. Ashwagandha may support weight loss via appetite regulation through stress reduction, enhance leptin sensitivity, glucose tolerance, insulin sensitivity and dopamine regulation. Withaferin A, ashwagandha's primary withanolide, may be the active compound responsible for its capacity to regulate leptin and insulin. Meditation may support weight loss through stress and cortisol reduction, improve glucose tolerance and insulin sensitivity and regulate eating behavior. [ABSTRACT FROM AUTHOR] |
