CONSUMERLINE By Ching M. Alano Updated May 05, 2009 12:00 AM
Oh, to live and diet! The battle with the bulge rages. You’ve tried every diet program on the planet, every fat-zapping procedure and diet pills there are. But so far, the only thing they’ve successfully reduced is your hard-earned money.
Wait, did we just say diet pills? Before you pop that pill into your mouth, here’s a mouthful: The Food and Drug Administration recently warned the public against weight loss products that are tainted by potentially dangerous ingredients. Many of these products claim to be “natural” or “herbal,” when in fact, they contain drugs — and in very high doses at that. Now, that’s a bitter pill to swallow.
In its new alert, FDA lists these dangerous drugs found in weight loss products (stop, look, and see if your diet pill has them):
• Sibutramine, a controlled substance.
• Phenytoin, an anti-seizure medication.
• Phenolphthalein, a solution used in chemical experiments and a suspected cancer-causing agent.
• Bumetanide, a diuretic.
Since it made the issue public in December last year, the FDA has found 72 weight loss products, most of them imported from China, which are tainted with hidden and potentially dangerous drugs and chemicals. Among these are:
• Cetilistat — an experimental obesity drug that can cause serious health risks in certain populations.
• Fenproporex — a stimulant not approved for marketing in the US, which can cause increased blood pressure, uncontrollable movements or shaking, palpitations, arrhythmia, and possibly sudden death.
• Fluoxetine — the active pharmaceutical ingredient in Prozac, a prescription antidepressant, which can increase the risk of suicidal thinking and suicide in children, adolescents, and young adults.
• Furosemide — the active pharmaceutical ingredient in Lasix, a potent diuretic that can cause profound dehydration and electrolyte imbalance, leading to dehydration, seizures, GI problems, kidney damage, lethargy, collapse, and coma.
• Rimonabant — the active pharmaceutical ingredient in Zimulti, which has not been approved in the United States because of increased risk of neurological and psychiatric side effects, such as seizures, depression, anxiety, insomnia, aggressiveness, and suicidal thoughts among patients.
(The full list of contaminated products can be found in FDA’s web site.)
These tainted weight loss supplements on the list are not FDA-approved and available over-the-counter without a prescription, which is not to say that those that are FDA-approved or available by prescription don’t have serious side effects.
Two of the most well-known diet drugs in the United States are Xenical, a prescription-only drug, and its non-prescription version Alli. Unpublished studies on Xenical have revealed the following alarming data:
• Xenical increases the precursor markers to colon cancer by 60 percent in rats.
• When eating a high-fat diet and taking Xenical, the cancer risk increased 2.4 fold.
• Fat-soluble vitamin E depletion, due to Xenical’s fat-blocking action, raises the risk of colon cancer even further.
• Recorded adverse reactions to Xenical include: 39 cases of increased abnormal blood thinning, several cases of bleeding episodes, 10 hospitalizations (four with life-threatening reactions), and one death.
• Dangerous thinning of the blood can occur in people taking drugs like Warfarin (an anti-coagulant), or who suffer from vitamin K deficiency.
On the other hand, Alli, which blocks the absorption of about 25 percent of consumed fat, can also result in loose stools, hard-to-control bowel movements, and gas with an oily discharge. But the manufacturer calls these “treatment effects.”
Fat chance you’ll lose weight with diet pills alone. Fact is, the Mayo Clinic reports that the average weight loss for prescription-strength Xenical is only about six pounds greater than diet and exercise alone after one year. Since Alli is half the strength of Xenical, they reasoned Alli could conceivably result in an average of just three extra pounds lost in a year.
Certainly, diet pills are a big business in the US. According to health activist Dr. Joseph Mercola, who wouldn’t be tempted by the promise of shedding unwanted pounds without sweating — simply take a pill, then sit back and relax as the pounds melt away.
According to Mercola, “for the 15 percent of American adults who say they’ve used weight-loss supplements, many probably thought, ‘Why not?’ What could they lose other than the money to buy them and possibly some extra pounds?”
Here, you could lose a lot, warns Mercola, including your health, if you take many of these weight-loss supplements.
Dieting is much more than having a bikini-worthy figure, according to Mercola. “It’s about having more energy, fighting disease, protecting your heart and, above all else, choosing a lifestyle that will support your entire body and your health.”
He gives this weighty tips:
• Tailor your diet to your nutritional type. These are the foods that are right for your biochemistry, and foods that will push your body towards its ideal weight. (They may be high in fat or carbs, heavy on protein or veggies, it all depends on you.)
This is not a diet — no need to deprive yourself, no need to count calories. In fact, if you still feel hungry after eating, you are definitely not eating according to your nutritional type.
• Consider exercise as a drug. When you’re trying to lose weight, a casual walk here and there is not going to cut it. Many studies find that exercising for one hour, five days a week is actually needed — agree! Sometimes you may even need up to 90 minutes of aerobic activity every day.
Take double note: There is also strong compelling evidence that strength training and high-intensity anaerobic interval training may be especially effective for weight loss.
The safe and effective way to lose weight, according to Mercola is to eat right, exercise, and address the nagging issues, big and small, in your life. You have nothing to lose but those stubborn unwanted pounds.
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Q. I am a 36-year-old mother of two who has been waging an unending battle with my weight in the last few years. My desirable body weight is around 110 pounds, but my weight swings between 120 and 150 pounds. When I hit 150, I go on a crash diet. I usually lose 20–30 lbs in three to four weeks. The problem is I very easily gain back the weight I lose. What should I do to be able to reduce to and maintain a desirable body weight?
– Irma C., Makati City
A. Excess weight is a risk factor for many chronic diseases, that is why you will really be better off without the extra poundage that you now carry. However, your practice of repeatedly losing and gaining weight or “yo-yo” dieting may be as dangerous as being overweight. In the end, you might only lose your self-esteem instead of your unwanted pounds.
Whenever you go on your “get-thin-quick scheme” or “crash diet,” you run the risk of suffering from fluid-electrolyte imbalance and protein, calorie, and micronutrient (i.e., vitamins and minerals) deficiency, which could compromise many of your body functions and even irreparably damage some of your vital tissues and organs. You also increase your risk of developing gallstones.
Crash dieting works in that, as in your experience, one can lose as much as 20–30 lbs in just a few days or weeks. The trouble is, the weight one loses in crash dieting does not really result from the burning of fat alone; in fact, most of it is the result of dehydration and muscle waiting. Furthermore, it is next to impossible to keep the pounds that one loses by crash dieting permanently off. They promptly return, and with vengeance, when the person starts to eat “normally” again.
To lose your extra weight and to keep it off, you need to commit to certain permanent lifestyle changes—you have to modify your eating habits and to exercise.
Your diet should provide enough calories to maintain a desirable body weight, but nothing more. It should be balanced, low in fats, and high in fibers. If you weigh 20% more than your desirable body weight at the moment, this is simply because you are taking in 20% more calories than your body needs. Often, you can remove the extra calories in your diet by simply cutting down on soft drinks, desserts, and snacks. You need not give up chocolates, ice cream, and cakes forever, but you will have to reduce intake of these to occasional small servings. In addition, you can replace some of your viands and rice with a lot of leafy vegetables. If you institute these changes in your diet, you will gradually lose weight (even without the benefit of a reducing diet), one half to one pound a week, until you trim down to your desirable body weight.
Exercise, on the other hand, will raise your body’s metabolic rate and will help you burn calories more efficiently. So, in addition to modifying your diet, you need to exercise regularly.
You don’t have to engage in a structured exercise program to get the exercise you need. You simply need to adopt lifestyle changes such as taking the stairs instead of the elevator, doing household chores regularly, walking or biking in going to and from the neighborhood grocery, etc. You are getting enough exercise if these activities lead to palpable physical exertion and add up to more than 30 minutes per day.
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Obesity often goes hand in hand with the metabolic syndrome — a cluster of five factors that include high blood pressure, a large waist circumference, elevated blood sugar and triglycerides, and reduced blood levels of HDL cholesterol.
Weight reduction is one of the first lines of defense in treating the syndrome, and researchers from the University of Ulm, Germany, have found that increased amounts of protein in the diet lead to greater improvement in metabolic syndrome risk factors when compared to a standard level of protein.
The study, presented this weekend at the annual meeting of the Obesity Society in Phoenix, enrolled 110 overweight subjects with the metabolic syndrome who were randomly divided into two groups and were followed for one year.
For the first three months — the weight loss phase — those in the high protein group were instructed to follow a diet that supplied about twice the protein obtained from a typical diet; they also replaced two meals a day with Herbalife’s European Formula 1, a meal replacement shake. The other group was instructed to eat a standard amount of protein from an all-food diet.
For the remaining nine months of the study — the weight maintenance phase — everyone used one meal replacement shake a day as part of their meal plan, and both groups maintained the level of protein intake in the diet they had consumed during the previous three months.
Everyone lost weight after a year, but the high protein group lost more weight (nearly 25 pounds, compared with about 14 pounds for the standard protein group) and more body fat, and preserved lean body mass. More significant, however, was the finding that at the end of the study, 64 percent of those in the high protein group no longer met the criteria for the metabolic syndrome, compared with 41percent who consumed the standard amount of protein.
“We knew that weight loss would improve risk factors for the metabolic syndrome,” said Marion Flechtner-Mors, PhD, one of the researchers on the study and head of the Obesity Research Group at the University of Ulm, Germany, “but we found that more subjects showed improvement in these risk factors when we increased the protein in the diet.”
Health and Family
No matter where they live in our vast and wonderful planet, people are people. But if all humans share a common biologic backbone, the peoples of the earth display a remarkable diversity of cultural norms. Language, religion, family structure, governance, music, dance, sports, and clothing are all subject to amazing cultural differences. And the human diet is every bit as diverse as the other cultural traditions. All people eat to live, but the foods they choose depend on complex interactions between climate, geography, national resources, religion, and tradition. Each culture has its signature dishes; for example, Asians are noted for rice, noodles, and soy; Italians for pasta and bread; Germans for meat and potatoes; the French for wine and cheese; and the Latinos for corn, beans, and rice. As migration, travel, and the global economy shrink our world, dietary diversity has diminished. But before variety becomes an exception, we should consider adopting the best nutritional traditions from other cultures, not just for the occasional pleasure of ethnic dining but as a healthful pattern for everyday life. And one of the best patterns is the traditional Mediterranean diet.
A Mediterranean eating pattern was first identified more than 50 years ago as part of a study of health and habits in seven countries — Greece, Finland, Italy, Japan, the Netherlands, the United States, and Yugoslavia. One of its most intriguing findings was that people living in Crete, other parts of Greece, and Southern Italy lived longer and had the lowest rates of heart disease in spite of a high-fat diet and limited medical care.
What Is It?
Although the Mediterranean Basin occupies only a small fraction of the earth, there is considerable dietary diversity within the region. When nutritionists speak of the traditional Mediterranean diet, though, they refer to a centuries-old dietary pattern that has flourished in Crete, various rural regions in the rest of Greece, and parts of Southern Italy and France. And that pattern has 10 characteristic features:
1) An abundance of vegetables, fruits, beans, nuts, seeds, and other plant foods.
2) An abundance of unrefined grains, such as whole grain cereals and bread.
3) Olive oil as the major source of fat.
4) Fish in moderate to high amounts.
5) Fruit as the typical dessert, with sweets containing honey or sugar consumed several times a week in low to moderate amounts.
6) Yogurt, cheese, and other dairy products consumed daily in low to moderate amounts.
7) Four or fewer eggs consumed per week.
8) Poultry consumed in moderate to large amounts and red meat in low amounts.
9) A reliance on locally grown, fresh, minimally processed foods.
10) Alcohol consumed in moderate amounts, usually as wine with meals.
Although the farmers of Crete did not analyze the nutrients in their diets, modern scientists have run the numbers. The traditional Mediterranean diet is high in complex carbohydrates and fiber but low in simple sugars, moderate in unsaturated fat, moderate in proteins, and moderate in alcohol. It’s also tasty, but does it work? Yes, it does, if we base it on the many research studies done previously in Europe.
Studies In Greece And Europe
And here are some recent studies that further prove the beneficial effects of the Mediterranean diet:
• A study of 22,043 adults in Greece found that people who adhered to the traditional Mediterranean diet enjoyed a lower mortality rate than those who did not. Compared to people with the least traditional diets, people with the best diets were 33 percent less likely to die of heart disease and 24 percent less likely to die of any cause during the 44 months of the study. And benefit depended on the overall Mediterranean dietary pattern rather than any individual nutrients; olive oil won’t help unless you include the other good stuff in your diet.
• A study of 74,607 men and women, aged 60 or older, in nine European countries found that following the principles of the Mediterranean diet was associated with increased survival and longevity. Protection was consistent in Mediterranean as well as in non-Mediterranean countries.
• A study of 2,339 people between the ages of 70 and 90 in 11 European countries linked the Mediterranean diet to a 23-percent reduction in the overall mortality rate. And when exercise, moderate alcohol use, and avoidance of tobacco were added to the diet, the death rate was reduced by more than 50 percent.
• A study of 1,302 Greek patients with heart disease found that greater adherence to the traditional Mediterranean diet was associated with a lower death rate during nearly four years of observation.
• A study of 1,926 Greek adults found that people who followed a Mediterranean diet enjoyed a 27-percent decrease in the likelihood of acute coronary artery syndrome.
• A study of 11,323 Italian heart attack survivors found that patients who succeeded in adopting a Mediterranean diet were only half as likely to die during 6.5 years of observation as patients who did not succeed in improving their diets.
More Support From U.S. Studies
There was more encouraging news a little more than a year ago, when the Archives of Internal Medicine issue of December 10/24, 2007, published results from an American study. In a long-term investigation of 400,000 men and women, the results confirmed the beneficial effects of the Mediterranean diet. Those whose eating patterns closely matched the Mediterranean diet were about 20 percent less likely to have died of heart disease, cancer, or any cause, over a five-year follow-up period.
In addition, a Mediterranean-type diet seems to be as good for treating heart disease as it is for preventing it. In the Heart Institute of Spokane Diet Intervention and Evaluation Trial (THIS-DIET), heart attack survivors following this type of diet were less likely than their counterparts on a more typical American diet to have died or suffered a second heart attack, a stroke, or an episode of unstable angina over a two-year period. The study was published in the June 1, 2008 issue of the American Journal of Cardiology.
Are you trying to lose weight? A Mediterranean diet trumps a low-fat diet. Results of a two-year head-to-head comparison study, published in the July 17, 2008 issue of the New England Journal of Medicine showed that the Mediterranean diet yielded greater weight loss and was better at easing low-grade inflammation, a process linked to heart disease. Among the volunteers with diabetes, the Mediterranean diet yielded better fasting blood sugar and insulin levels.
How It Works
The Mediterranean diet works because it has lots of the things that can protect you from heart disease, diabetes, and other chronic illnesses; the list includes dietary fiber, vitamin-rich fruits and vegetables, and fish, as well as the moderate amounts of alcohol that also appear to protect the heart. At the same time, it shuns items that are harmful, including saturated fat from animal sources, trans fat from partially hydrogenated vegetable oils, salty processed foods, and rapidly absorbed simple carbohydrates. The net results include lower levels of LDL (“bad”) cholesterol, higher levels of HDL (“good”) cholesterol, lower levels of blood sugar and insulin, and lower blood pressure readings.
In addition, a randomized clinical trial of 180 patients with the metabolic syndrome, a major precursor of cardiovascular disease, found that the Mediterranean diet reduced body weight, improved arterial function, and lowered levels of C-reactive protein and other markers of vascular inflammation. Researchers have also demonstrated that the Mediterranean diet produces similar risk factor improvements even in healthy adults.
When doctors prescribe the Mediterranean diet, they are advising the traditional diet present in Crete and certain other rural areas in Southern Greece, Italy or France. But with globalization, the traditional dietary pattern is eroding. In the Mediterranean, as in much of the world, the Western preference for processed foods that are high in fat, salt, sugar, and calories but low in fiber, is taking hold. Olive oil and wine are still in vogue, but exercise is not. Over the past 30 years, the Greek waistline has expanded drastically; the prevalence of obesity is now as high or higher than any area of the world except certain Pacific islands. Diabetes is also rampant, and an epidemic of heart disease may just be a heartbeat away.
So, here’s the take-home advice: When in Greece, do as the Greeks used to do!
AN APPLE A DAY
By Tyrone M. Reyes, M.D.
Updated February 17, 2009 12:00 AM