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Boots is a large multi-national corporation working in the United Kingdom and nearby. They are owned by Walgreens, operating across the vast majority of the English-speaking world. Thus, when we look at the way that this company markets products, we have to hold it to the highest standards and scrutinise their products with extra detail.
Carb control is one such product that is deserving of intense review: the product claims to reduce the absorption of complex carbohydrates and, thus, reduce the caloric intake of foods consumed. This is achieved by inhibiting the enzymes that break complex carbohydrates down into simple carbohydrates (glucose, or sugar) during digestion, meaning that they cannot be absorbed through the digestive system and are simply excreted. Scientifically-speaking, Amylase-inhibitors like captocarb found in “carb control” are potential therapeutics for diabetes and can be made safely from plant extracts .
Boots is sceptical about making bold claims on their own website: the suggestion is that it “may help to reduce dietary carbohydrate that is digested and absorbed by the body […] take 2 tablets, if having a meal containing large amounts of complex carbohydrate”. This will allow the body to excrete the carbohydrates consumed within this meal – though only the complex ones. This product is clearly targeted at individuals who consume a large amount of starchy carbs as a cornerstone of their diet. In other words, the majority of the UK population!
The second claim of this product is that it can be used as a therapy to diabetes and insulin resistance through the reduction of glycaemic load and insulin spiking which are common after eating carbohydrates. This makes some sense: those who have type-II diabetes need to reduce their carbohydrate intake and ensure that their foods are high-quality. What concerns us, however, is that this would promote the consumption of carbohydrates among diabetes sufferers when the safest and most responsible approach would be reduction of carbohydrates (especially refined carbohydrates) and improvement of food sources. Malabsorption of carbohydrates strikes us a ‘bandage for a bullet wound’: it patches over the problem of dietary mis-management rather than seeking to alter eating habits. The best approach to diet-induced diabetes is a diet relying on a relatively small quantity (“low carb”) of low-GI carbohydrates and a variety of high quality fats and proteins .
The concern that we have is that carbohydrates, whilst associated with water retention and possible negative health effects, are not bad and starchy carbohydrates can be used as part of an effective and healthy diet. There are no foods that are bad in and of themselves, but only within the context of a whole diet. Starchy carbohydrates are often the main sources of caloric energy throughout the day for most of us, meaning that there is a large scope for reducing the intake of these calories but also reducing the positive effects: fuelling the body and providing “slow-release” energy. The simple question is, if we are aware that we are consuming a high calorie-quantity of starchy carbohydrates, why not simply eat less of these – replacing them with dietary fibre has a very similar effect with the added benefits of increasing gut health, digestive speed of other consumed foods and reducing glycaemic load .
The second problem, and perhaps the most important, is that the population has less of a problem with starchy carbohydrate consumption and more of a problem with refined carbohydrate intake. The intake of refined carbohydrates has a far more profound negative effect of health-regulating processes, contributing to inflammatory and metabolic problems . Why would we focus on reducing the absorption of starchy, lower-GI carbohydrates over those which have a more profound effect on both inflammatory and metabolic processes? This seems an unusual approach, for which there is very little justification: the malabsorption of potatoes, sweet potatoes, oats, rice and wholegrain pastas does not improve health in the same way that reduction of refined carbohydrates (through dietary choice intervention) would and some wholegrains have a protective effect against diabetes . This is tantamount to eating less fruit and vegetables because you want to reduce NET carbohydrate intake!
Simply put, then, this product may be effective in circumstances where the individual does not have sufficient willpower or education to make informed, positive dietary changes. Whilst it is marketed as a compliment to a health diet and exercise, we fail to see how this is possible: a healthy diet would have a reasonable amount of starchy carbohydrates but would reduce overall caloric intake rather than reducing such intake through the inhibition of carbohydrate absorption.
This strikes us as yet another product aimed at mitigating the need for willpower and self-control in the dieting process. The problem with this is that it will contribute to a culture of ineffective long-term dieting by promoting reliance on supplementary aids and, strangely enough, the development of willpower and self-control is an important psychological effect of diet and exercise. There are no shortcuts to dealing with the life-long concern of weight management and body composition, especially in those with type-II diabetes. Striving to improve nutritional education and alter diets for the better is actively set back by misinformation about the best approach to dieting. Whilst there are no aggressive marketing campaigns associated with this product, its very existence and description as a dietary supplement that promotes dependence and short-term weight changes are not productive.
As if we needed even more reason to focus on diet rather than supplementation, there are concerns about the possible laxative effects of the product. Whilst dietary fibre itself may have a laxative effect (primarily in those who suffer from constipation or poor digestive health), it is a healthy alternative and does not have the same stool-softening effects. Rather, sufficient dietary fiber, as opposed to altering digestive enzymes, will improve stool regularity and constitution. This is not a popular topic, but promoting effective absorption of all nutrients and supplying the body with the proper food sources will improve digestive function whereas Amylase-inhibitors have generally-negative effects on digestive health. The suggestion that eating less carbohydrates is preferable to interfering with your digestive enzymes should not be revolutionary.
One final concern about the effects of the product is that they are incredibly dose-dependent. Even the original study providing credence to the effects of Captocarb shows that there is very little effective difference between 50mg and 200mg/kg – even more of a concern when we consider that this test was performed on rats . The amount necessary to generate an equivalent effect in humans (off-setting bodyweight gain by almost 50%) would be in the realm of several grams a day. The content of the boots carb control pills, by contrast, are dosed at around 100mg per pill and the prescription of 2 tablets with a meal brings us out at 200mg. Assuming an average body mass of 70kg (a generous estimate based on the averages in the UK population), this would work out to less than 1mg/kg – clearly this is not a sufficient dose to have an effect on the human body as in the original experiment.
When looking at supplement dosing, it is important to consider the scaling of these effects according to body mass. When we observe the positive effects of Amylase-inhibitors on the markers associated with diabetes and metabolic syndrome, the evidence suggests some statistically-significant effects  but there is no evidence to tie this effect to the purported effects on weight loss associated with the boots product. As a weight management product, there is no real evidence for the suggestion that it will reduce calorie absorption to the “200kcal” claimed in the product description – the clinical evidence does not support this kind of dose-response and Boots does not actively cite any support for their claims. In fact, they make no attempt to provide scientific evidence for any of the product’s claims, despite it being a self-titled product and having very few analogues on the market.
We can’t say much against the carb control product but we can say even less in favour of it. It seems that it will do what it says – a rarity in the supplement industry – but it will not do very much. This product seems to be directed towards people who are ignorant of nutritional basics and promotes a poor list of priorities. We say it often, but supplements should either replace or improve a balanced diet and this product seems to do neither: in the first instance it is more expensive and complicated than simply reducing carbohydrate intake and making sure we eat good carbs, whereas if we are already supplementings this as part of a balanced diet it has almost no benefits. The scientific evidence does not bare out the supposed benefits – this seems to be a severe oversight for a company as large as Boots – we said at the start that we need to hold large pharmaceutical and dietary supplement companies to higher standards. Throughout this article we have attempted to do this and found that the Carb control product falls far short of these standards.
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 Marshall and Lauda (1975): ‘Purification and properties of phaseolamin, an inhibitor of alpha-amylase, from the kidney bean, phaeolus vulgaris’. Journal of biological chemistry, 250(20), 8030-7
 Feinman et al (2015): ‘Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base’. Nutrition, 31(1), pp.1-13
 Anderson et al (2009): ‘Health benefits of dietary fiber’. Nutrition reviews, 67(4), pp.188-205
 Meyer et al (2000): ‘Carbohydrates, dietary fiber and incident type 2 diabetes in older women’. American journal of clinical nutrition, 71(4), pp.921-930
 Anderson et al (2011): ‘Fructose and non-fructose sugar intakes in the US population and their associations with indicators of metabolic syndrome’. Food and chemical toxicology, 49(11), pp.2875-2882
 URL: http://www.captocarb.com/the-effectiveness.htm
 Puls and Keup (1973): ‘Influence of alpha-amylase inhibitor (BAY d 7791) on blood glucose, serum insulin and nefa in starch loading in rats, dogs and man’. Diabetologia, 9(2), pp.97-101
Steven has researched over 500 weight-loss programs, pills, shakes and diet plans. He has also worked with nutritionists specializing in weight loss while coaching people on how to transform their physiques and live healthy lives. You can contact him via the "About Us" page.
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