The global prevalence of obesity is increasing rapidly among adults as well as among children and adolescents in places where high dietary fat intake is a major risk factor for the development of obesity [1
]. Obesity is reaching epidemic proportions worldwide; it is correlated with various comorbidities, among which the most relevant are dyslipidemia [2
], diabetes mellitus T2DM [3
], fatty liver (which can later progress to nonalcoholic fatty liver disease [4
]), cardiovascular (CV) diseases such as heart failure (HF) and coronary heart disease (CHD) [5
L-carnitine is essential for the transfer of long-chain fatty acids from the cytosol to mitochondria for subsequent beta oxidation. Its lack impairs the ability to use fat as fuel. This can result in an acute metabolic decompensation, most often early in life, with hepatic encephalopathy and hypoketotic hypoglycemia [6
Carnitine (L-beta-hydroxy-gamma-N,N,Ntrimethyl-aminobutyric acid) is one of the "nutraceuticals" that has pleiotropic biologic effects. L-carnitine administration to carnitine-deficient rats led to normalization in myocardial function including indices of contractility relaxation, systolic diastolic blood pressure [7
The liver is a central organ for carnitine metabolism; therefore it is not surprising that carnitine metabolism is impaired in patients and experimental animals with certain types of chronic liver disease. L-carnitine can have a therapeutic role in some of these conditions [8
Nowadays there is an increased demand for using plants in therapy "back to nature" instead of using synthetic drugs which may have adverse effects. Traditional medicinal plants are often cheaper, locally available, and easily consumable (raw or as simple medicinal preparations). These simple medicinal preparations often mediate beneficial responses due to their active chemical constituents.
The reason for using herbs in combination is that herbs have chemicals components which can bring strong effects on body. When herbs are used in combination it helps the body better manage potentially undesirable effects of any one and each herb in the combination/formulation plays a curative or pacifying role. It is therefore preferable to use herbal combinations instead of depending on single herbs [9
The HMF contains antioxidants, stimulant laxatives that are present in T. chebula, senna, licorice and rhubarb. The herbal supplement also includes carminatives which are represented by black cumin, aniseed, fennel, and licorice [10
]. These carminative herbs are utilized to improve digestion or to treat dyspepsia or irritable bowel symptoms of ulcerative colitis; and to treat maladies of specific organs in the digestive system, such as the pancreas, liver, stomach or large and small intestines.
Demulcents and carminatives are often used to soften and physiologically balance the harsh effects of stimulant laxatives [11
]. Both licorice and aniseed are considered to be flavors that by altering the characteristics of the solute, causing sweet and sour tanginess.
The ethanolic extract of roots of rhubarb led to the isolation of anthraquinones: chrysophanol, physcion, emodin, glucopyranoside, stilbenes: desoxyrhaponticin, rhaponticin, resveratrol, rhapontigenin, glucopyranoside, ampelopsin B and rhaponticin [12
The mechanism of rhubarb action is twofold: 1) stimulation of colonic motility, which augments propulsion and accelerates colonic transit which in turn reduces fluid absorption from the fecal mass; 2) an increase in the paracellular permeability across the colonic mucosa, probably owing to an inhibition of Na+
exchanging ATPase or to an inhibition of chloride channels. This results in an increase in the water content in the large intestine. Purgation is followed by an astringent effect owing to the tannins presence [13
Licorice root is the dried peeled or unpeeled root of Glycyrrhiza glabra
known as Spanish licorice; or of other varieties of Glycyrrhiza glabra
Constituents with antioxidant capacity were isolated from Glycyrrhiza glabra
. The isolated compounds were identified as the isoflavans, Hispaglabridin A, Hispaglabridin B, Glabridin; the two chalcones, isoprenyl chalcone derivative isoliquiritigenin; theisoflavone, formononetin. Among these compounds, Glabridin constituted the major component in the crude extract and the most potent antioxidant toward LDL oxidation [15
Glycyrrhizin inhibited histamine release from rat mast cells prevented carbon Tetrachloride-induced liver lesions and macrophage-mediated cytotoxicity. Glycyrrhizin protected the liver apparently through its membrane stabilization effects [16
]. Glycyrrhizic acid its glucoside, glycyrrhizin impart the unique licorice taste. Glycyrrhizin is 50 times sweeter than sucrose. Licorice sweetness has a slower onset than sugar so it is important for the palatability of the HMF.
Aniseed is the dried ripe fruits of the Pimpenella anisum
family, containing licorice-like components, anise
which is sweet, very aromatic and anethole, are the principal component of anise oil [17
Fennel is the ripe fruit, or seed, of Foeniculum vulgare
. It has a strongly aromatic odor somewhat bitter sweet pungent taste. The British Herbal Pharmacopoeia reported its action as a carminative is considered to be one of the best additions to purgative medicines, and it is often compounded with T. chebula, senna and rhubarb, in infusions or mixture [18
]. Fennel seed extracts may possess a radical scavenging antioxidant activity due to the occurrence of some phenol compounds in fennel being responsible for such an activity [19
Black cumin is the dried ripe seeds of Nigella sativa (NS), strongly aromatic when crushed, reminiscent of anise or nutmeg, also slightly bitter tasting at first, then spicy and somewhat pungent. It contains fixed, volatile oils which contain thymoquinone and several monoterpenes, including p-cymene a-pinene [20
]. Many therapeutic effects of NS extracts have been documented, including immunomodulative, anti-inflammatory, antitumor, antidiabetic and antiulcerogenic [21
] effects in both clinical and experimental studies.
Recently, the use of powerful drugs has become a popular means to overcome excess weight. Adverse effects may limit their overall usefulness. Accordingly, recent preliminary reports suggesting that herbs with along history of use of other natural substances is less likely to produce toxicity and might be effective in reducing food intake, promoting significant weight loss, are encouraging. Preliminary findings suggest that, at least, one formulation of herbs has such promise.
However, the effect of HMF on lipid peroxidation and antioxidant enzymes activities in obesity has not been examined and so far, little is known on the medicinal values of HMF. Thus, the present investigation was carried out in order to study the possible antiobesity, hypolipidemic, hypoglycemic and antioxidant effect of HMF. The effect was compared with L-carnitine in a model of high fat diet-induced obesity. Moreover, the extract was also tested for its hepatic cardiac and renoprotective effects in rats.