Body Composition

Effects of Berberine, White Mulberry Leaf Extract and Chromium Picolinate on Body Composition and Insulin Resistance in Adults with Obesity: A Randomized Controlled Trial.

TL;DR

A fixed-dose combination of berberine, white mulberry leaf extract, and chromium picolinate produced significantly greater reductions in BMI, total body fat mass, and visceral fat rating, and a 28% greater improvement in insulin sensitivity compared with placebo over 12 weeks in adults with obesity.

Key Findings

The active intervention produced significantly greater reductions in body mass index compared with placebo over 12 weeks.

  • Adjusted mean difference in BMI: -1.24 kg/m² (95% CI: -2.15 to -0.33)
  • 93 participants were randomized: 46 to active intervention, 47 to placebo
  • The trial was 12 weeks in duration, randomized, double-blind, and placebo-controlled
  • Intervention consisted of berberine (1000 mg), white mulberry leaf extract (400 mg standardized to 5% 1-deoxynojirimycin), and chromium picolinate (0.644 mg) administered in two daily doses before main meals

Total body fat mass was significantly reduced in the active intervention group compared with placebo.

  • Adjusted mean difference in total body fat mass: -2.35 kg (95% CI: -4.12 to -0.58)
  • Body fat mass was assessed using bioelectrical impedance analysis (BIA)
  • This was a pre-specified secondary outcome of the trial
  • Participants were community-dwelling Greek adults with obesity and no diagnosed chronic disease

Visceral fat rating was significantly lower in the active intervention group than in the placebo group.

  • Adjusted mean difference in visceral fat rating: -0.92 units (95% CI: -1.74 to -0.10)
  • Visceral fat rating was assessed via BIA-derived measures
  • This was a pre-specified secondary outcome
  • The confidence interval narrowly excludes zero, indicating a statistically significant but modest effect

Insulin sensitivity improved significantly more in the active intervention group than in the placebo group.

  • Adjusted geometric mean ratio for insulin sensitivity: 1.28 (95% CI: 1.14 to 1.44), representing a 28% greater improvement in the active group
  • Insulin sensitivity was assessed using the Matsuda Composite Insulin Sensitivity Index derived from a 75-g oral glucose tolerance test (OGTT)
  • The Matsuda Index was the primary outcome of the trial
  • A geometric mean ratio was used due to the skewed distribution of insulin sensitivity values

The trial did not include single-agent arms, leaving individual component contributions and potential synergy among the three ingredients undetermined.

  • The fixed-dose combination included berberine, white mulberry leaf extract, and chromium picolinate administered together
  • The authors note: 'Because no single-agent arms were included, individual component contributions and synergy remain undetermined'
  • The authors call for 'confirmatory trials using direct metabolic and imaging methods'
  • Body composition was measured by BIA rather than imaging methods such as DXA or MRI, which is noted as a limitation

The study population consisted of Greek community-dwelling adults with obesity who had no diagnosed chronic disease.

  • Total randomized sample: 93 participants (46 active, 47 placebo)
  • The study was conducted in Greece
  • Inclusion required obesity status but exclusion of diagnosed chronic disease
  • The trial was 12 weeks in duration with a double-blind, placebo-controlled design

What This Means

This research suggests that taking a daily supplement combining berberine, white mulberry leaf extract, and chromium picolinate for 12 weeks may meaningfully improve several markers of metabolic health in people with obesity. Compared to a placebo, people taking the supplement lost more body fat (about 2.35 kg more), showed greater reductions in BMI (about 1.24 kg/m² more), had lower visceral fat ratings, and showed 28% greater improvement in how well their bodies respond to insulin. These results were seen in a relatively well-designed study — randomized, double-blind, and placebo-controlled — involving 93 adults in Greece who were obese but otherwise healthy. However, there are important limitations to keep in mind. Because all three ingredients were given together in a single combination product, the study cannot tell us which ingredient (or combination of ingredients) was responsible for the benefits seen, or whether the ingredients work better together than individually. Additionally, body composition was measured using bioelectrical impedance analysis (a common but less precise method) rather than gold-standard imaging techniques like MRI or DXA. The study also only lasted 12 weeks and was conducted in a specific population, so it is unclear whether the findings would hold over longer periods or in more diverse groups. This research adds to a growing body of evidence suggesting that these natural compounds may support metabolic health, but the authors themselves emphasize that larger confirmatory trials using more precise measurement tools are needed before strong conclusions can be drawn.

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Citation

Xenos K, Chalkias K, Chryssou G, Alexandrou E, Vassilopoulou E. (2026). Effects of Berberine, White Mulberry Leaf Extract and Chromium Picolinate on Body Composition and Insulin Resistance in Adults with Obesity: A Randomized Controlled Trial.. Nutrients. https://doi.org/10.3390/nu18172801