Electroacupuncture and Cholesterol Levels
Electroacupuncture and Cholesterol Levels
By Yoon Hang Kim, MD, MPH, DABMA, ABHM, Dean of Integrative Medicine, AIMC Berkeley, Berkeley, CA. Dr. Kim reports no consultant, stockholder, speaker's bureau, research, or other financial relationships with companies having ties to this field of study.
Source: Cabioglu M, Ergen N. Electroacupuncture therapy for weight loss reduces serum total cholesterol, triglycerides, and LDL cholesterol level in obese women. Am J Chin Med 2005;33:525-533.
Abstract: The purpose of this study was to investigate the effect of acupuncture therapy on body weight and on levels of the serum total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol in obese women. Fifty-five women were studied in three groups: control group (n = 12, mean age = 43.3 yrs ± 4.3, and mean body mass index [BMI] = 32.2 kg/m2 ± 3.4); electroacupuncture (n = 22, mean age = 39.8 yrs ± 5.3, and BMI = 34.8 kg/m2 ± 3.3); and diet restriction (n = 21, mean age = 42.7 yrs ± 3.9, and BMI = 34.9 kg/m2 ± 3.3). Electroacupuncture was performed using the ear points, Sanjiao (hungry) and Shen Men (stomach), and the body points, LI 4, LI 11, St 25, St 36, St 44 and Liv 3, once daily for 30 minutes for 20 days. Patients on diet restriction followed a 1,425 Kcal diet program for 20 days. There was a 4.8% weight reduction in patients with electroacupuncture application, and a 2.5% weight reduction in patients on diet restriction. There were significant decreases in total cholesterol and triglyceride levels in electroacupuncture and diet groups compared to the control group (P < 0.05 in both cases). Furthermore, there was a decrease in LDL levels in the electroacupuncture group compared to the control group (P < 0.05). No significant changes could be found in HDL levels among the three groups. The results suggest that electroacupuncture application in obese women may decrease the serum total cholesterol, triglyceride, and LDL cholesterol levels by increasing the serum beta endorphin level. This lipolytic effect of electroacupuncture also may reduce the morbidity of obesity by mobilizing the energy stores that result in weight reduction.
Comments
Obesity is on the increase in the united states, as confirmed by two Journal of the American Medical Association studies documenting increased prevalence of overweight in U.S. adults from 1960 to 1998.1,2 The morbidities related to obesity include hypertension, coronary artery disease, Type 2 diabetes, and gallbladder disease.3 Treatment options for obesity include a reduced-calorie diet, increased activity, behavior modification, pharmacotherapy, and surgery.4 The treatment of obesity is estimated to be approximately $99 billion per year with additional consumer spending on weight-reduction products and services in excess of $33 billion annually.5,6
One recent review demonstrates that acupuncture plays a therapeutic role in the treatment of obesity.7 Specific acupuncture protocols include body acupuncture, electroacupuncture, and auricular acupuncture. A study comparing different protocols of acupuncture for treating obesity concluded that a combination approach of auricular and body acupuncture yielded superior results compared to auricular or body acupuncture alone.8 Furthermore, another study documented possible mechanisms of action for electroacupuncture in the treatment of obesity in lipoprotein lipase activity, regulation of leptin, and insulin level in the animal model.9
Cabioglu and Ergen conducted an intervention study in 55 subjects, who were assigned to one of three groups: no intervention control group, electroacupuncture group, or calorie restriction group.10 Acupuncture consisted of a combination of auricular and body acupuncture points with electric stimulation performed once daily for 30 minutes for 20 days. The calorie restriction group received 1,425 Kcal diet program for 20 days. The research findings are summarized below:
- The results showed a statistically significant weight reduction in both the electroacupuncture group (4.8%) and the calorie restriction group (2.5%) compared to the control group at the end of intervention (P < 0.05). The weight reduction in the electroacupuncture group was significant compared to that of both the diet and the control groups (P < 0.05).
- Significant decreases in total cholesterol and triglyceride levels were observed in both the electroacupuncture and the calorie restriction groups compared to the control group.
- A decrease in LDL level was observed only in the electroacupuncture group compared to the control group (P < 0.05).
- No significant increases in the HDL were observed in the three groups.
The electroacupuncture group achieved a 4.8% reduction of body weight, which is clinically significant in many illnesses including hypertension and diabetes. The decrease of total cholesterol and triglycerides achieved by electroacupuncture group is statistically significant only when compared to the control group but not statistically relevant when compared to the diet group. This indicates that the effect of electroacupuncture is strongest for weight loss and offers comparable benefits to calorie restriction for LDL and triglyceride reduction.
A design strength of this study is the use of two control groups consisting of non-intervention control and calorie restriction control. The use of two controls assists in elucidating the effect of acupuncture for treating obesity compared to non-intervention and to calorie restriction, a common way to treat obesity. A unique feature of the protocol employed by this study is the integration of body and auricular acupuncture and electrical stimulation.
A potential weakness of the study includes the fact that there was no sham acupuncture group documenting non-specific effects of needling sham points on weight loss. Sham acupuncture allows investigators to compare the effect of random needling vs. true needling. There is an increasing body of literature demonstrating that sham acupuncture has treatment benefits sometimes rivaling true needling.11
In addition, the lack of randomization description in the article makes it difficult to tell whether the study was a randomized controlled trial of three groups or a comparison study of three groups. Randomization is a powerful clinical research tool allowing for control of both known and unknown potentially confounding factors. Direct communication with the author has clarified that this study is a randomized controlled trial; however, such information should be self-evident in the publication. Finally, the three-week study duration may be too short for a chronic condition such as obesity.
Even with its limitations, this study lends support to the growing evidence that acupuncture can play a role in treating obesity. Further trials should investigate integration of different modalities such as diet and acupuncture to investigate potential synergistic relationships.
References
1. Kuczmarski RJ, et al. Increasing prevalence of overweight among U.S. adults: The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 1994;272:205-211.
2. Mokdad AH, et al. The spread of the obesity epidemic in the United States, 1991-1998. JAMA 1999;282:1519-1522.
3. Wadden TA, et al. Benefits of lifestyle modification in the pharmacologic treatment of obesity: A randomized trial. Arch Intern Med 2001;161:218-227.
4. National Institutes of Health. Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults: The evidence report. Obes Res 1998;6(suppl 2):51S-209S.
5. Colditz GA. Economic costs of obesity. Am J Clin Nutr 1991;55(Suppl 2):503S-507S.
6. Wolf AM, Colitz GA. Current estimates of the economic cost of obesity in the United States. Obes Res 1998;6:97-106.
7. Yin LL, et al. Advances of clinical studies on acupuncture and moxibustin for treatment of obesity in recent 10 years [in Chinese]. Zhongguo Zhen Jiu 2005;25:517-519.
8. Qunli W, Zhicheng L. Acupuncture treatment of simple obesity. J Tradit Chin Med 2005;25:90-94.
9. Wang SJ, et al. Effect of electroacupuncture on metabolism of lipids in rats of obesity induced by sodium glutamate [in Chinese]. Zhongguo Zhen Jiu 2005;25:269-271.
10. Cabioglu M, Ergen N. Electroacupuncture therapy for weight loss reduces serum total cholesterol, triglycerides, and LDL cholesterol level in obese women. Am J Chin Med 2005;33:525-533.
11. Goddard G, et al. Acupuncture and sham acupuncture reduce muscle pain in myofascial pain patients. J Orofac Pain 2002;16:71-76.
Kim YH. Electroacupuncture and cholesterol levels. Altern Ther Womens Health 2006;8(2):13-15.Subscribe Now for Access
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