Monday, April 30, 2012

Diet Drug Disasters

Kate Moss once said, "Nothing tastes as good as skinny feels."  Anna Nicole Smith used to lounge in cars or pose for paparazzi while promoting Trim Spa.  'Detox' pills and colon cleanse products are lining the shelves and you can never seem to avoid the latest diet pill gimmick.  

So what are a few of the latest drugs are clientele are being inundated with?

Adipex-P Oral (from WebMD): "Phentermine is used along with a doctor-approved, reduced-calorie dietexercise, and behavior change program to help you lose weight. It is used in people who are significantly overweight (obese) and have not been able to lose enough weight with diet and exercise alone. Losing weight and keeping it off can reduce the many health risks that come with obesity, including heart diseasediabeteshigh blood pressure, and a shorter life."  Some of the side effects are depression related withdraw, the usual GI issues (nausea, vomiting, diarrhea, dry mouth), headache, blurred vision, and seizures.

Qnexa (from WebMD): "Qnexa the only prescription appetite suppressant approved for long-term use available in the U.S. The only other widely marketed prescriptionweight loss drug, orlistat -- sold by prescription as Xenical and over-the-counter as Alli -- works by blocking dietary fat absorption."  Some of the side effects are  increased heart rate, heart attacks and arrhythmias.  It is not recommended for the masses ans long term use is not yet known.  It is not recommended for women of childbearing years as it can cause birth defects. 

The table shows common weight-loss pills and what the research shows about their effectiveness and safety.
ProductClaimEffectivenessSide effects
Alli — OTC version of prescription drug orlistat (Xenical)Decreases absorption of dietary fatEffective; but weight loss is even more modest than that with XenicalLoose stools, oily spotting, frequent or hard-to-control bowel movements; reports of rare, but serious liver injury
Bitter orangeIncreases calories burnedProbably ineffectiveSimilar to ephedra: raised blood pressure and heart rate
ChitosanBlocks absorption of dietary fatProbably ineffectiveUncommon: upset stomach, nausea, gas, increased stool bulk, constipation
ChromiumDecreases appetite and increases calories burnedProbably ineffectiveUncommon: headache, insomnia, irritability, mood changes, cognitive dysfunction
Conjugated linoleic acidReduces body fatPossibly effectiveUpset stomach, nausea, loose stools
Green tea extractDecreases appetite, and increases calorie and fat metabolismInsufficient evidence to evaluateDizziness, insomnia, agitation, nausea, vomiting, bloating, gas, diarrhea
Guar gumBlocks absorption of dietary fat and increases feeling of fullnessPossibly ineffectiveAbdominal pain, gas, diarrhea
HoodiaDecreases appetiteInsufficient evidence to evaluateInsufficient information available
Sources: U.S. Food and Drug Administration, 2011; Natural Medicines Comprehensive Database, 2011

Gina Lesako RD, LD is a Columbus, Ohio based dietitian.  She is the SCAN volunteer blog coordinator and also writes for her own blog, Dietitians Eat Chocolate Too

Tuesday, April 17, 2012

Organic Fitness

Just last Thursday I attended the annual NAND (Nebraska Academy of Nutrition and Dietetics) conference at the Lied Lodge in Nebraska City, Nebraska.  It was a great event - multiple knowledgeable speakers, delicious food and networking with fellow dietitians.  I wanted to share some of what I learned with you and hopefully inspire you, as I was, to make more healthy lifestyle choices. 
The speaker I enjoyed the most, was Dr. James H O'Keefe, MD a Board Certified Cardiologist at Cardiovascular Consultants and Mid America Heart Institute.  He spoke to our group about getting back to the roots of good nutrition vs. opting for fad diets or quick fixes.  

Sounds like something we have all heard over and over again right?  Well Dr. O'Keefe spoke about why he thinks we have become an obese society  in the first place and gave us his top tips for living a long, healthy life.

Over the past 50 years, our nation has turned into a country high in overweight and obese individuals.  There has been multiple theories as to why this occurred.  Is it due to our soda intake, high fructose corn syrup, or fast food?  Though it may be easier to point blame at one reason, this just isn't the case.  It really does come down to our ancestry. 

Hundreds of years ago our ancestors survived only on what they hunted and gathered.  They were often on their feet because if they didn't move they didn't eat.  Foods higher in fat and calories helped to keep them alive and therefore we evolved to seek high fat and calorie foods.  High sugar foods gave immediate energy leading to its enticing qualities as well.  However, none of them were overweight.

Jump ahead to present day and we still crave high fat, high sugar foods.  This is because our DNA has not changed much from the days of the hunters and gatherers.  In fact, Dr. O'Keefe pointed out that it takes thousands and thousands of years for our DNA to change even a little bit.  So, therefore, we are left with the DNA of a hunter but the lifestyle of someone much different.  We don't need to hunt our food.  We can drive through a fast food restaurant and take in 1,000 calories easily in five minutes.  So you can see how all of our convenience and low-activity lifestyle all contributes to the current weight battle many of us fight.

Dr. O'Keefe presented us all with his tips for a healthy life.  Many you have heard of and may even already follow yourself.  However, there were a couple of tips that were even intriguing to me.

*Incorporate vegetarian protein into your diet.  Examples include tofu, seitan, tempeh, beans & nuts.  I am a big fan of at least trying to do one vegetarian meal a week such as a meatless Monday.

*Increase your fruit and vegetable intake to 9 servings per day.  One serving of fruit is a small piece of fruit, half a cup of low-sugar canned fruit, or 1 cup chopped fruit or berries.  One serving of vegetables is 1 cup cooked greens, 2 cups raw greens or 1 cup raw vegetables.

* Drink 3 cups of green tea per day.

* Fast for 12 hours at least 4 days per week.  Dr. O'Keefe recommends to stop eating after dinner and just have tea, water or sparkling water until breakfast the next morning.

*Aim to eat as close to the earth as possible.  In other words, try to avoid long ingredients lists and keep packaged food intake to a minimum.

*Increase your fiber intake.  If you are eating 9 servings of fruits and vegetables per day, however, you shouldn't have much trouble.

*Exercise, but not too much.  Dr. O'Keefe advocates getting out and moving for an hour a day most days of the week.  But he is not a big proponent of constant marathons or ultra-marathons.  Even with exercise there such a thing as too much of a good thing.

*Dr. O'Keefe believes in avoiding gluten.  He suggested checking out the book "Wheat Belly" which overviews the toxic effect of wheat.  He tends to only eat barley, quinoa, steel cut oats and wild rice for grains.

Don't overdo supplements.  Get 1,000 mg EPA and DHA in a fish oil capsule and 2,000 IU Vitamin D3 especially during the winter months.

I really wish I had a recording of Dr. O'Keefe's talk because he told a lot of interesting stories about his family's health history.  Hopefully, though, this overview will give you some good insight into how you can improve your own nutrition and wellness for a long, happy & healthy life.

[Editor's note: For more information please see Dr. O'Keefe's original article here]

--Lindsay Lannan

Lindsay was awarded her bachelor’s degree in nutrition and food science with a dietetic specialization from South Dakota State University. She completed an internship program at the University of Nebraska Medical Center and experienced many areas of dietetics including intensive care, solid organ transplant, weight loss and management, and long-term care. She is an active member of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association). She can be followed at:  

Saturday, April 7, 2012

Is Sugar Toxic?

A recent study led by a California endocrinologist has once again thrust sugar into the limelight. Why? Because this doctor claims that sugar is toxic. WOW. Bold statement? Apparently he thinks so too, but has evidence to support his argument.
                Dr. Lustig, who led the research and has published scientific work on sugar, was interviewed for the CBS article. Lustig says the American lifestyle is killing us and 75% of the diseases in this country linked to sugar are preventable.
                In short, Lustig is reporting that sugar is evil yet Americans continue down the path of obesity, type II diabetes, hypertension and heart disease by consuming more than 130 pounds of refined sugar, per person a year.
                The rest of the article is interesting and insightful into Dr. Lustig’s theory of sugar. Another study at the University of California is highlighted in the article, which links excess high fructose corn syrup to increased risk for heart disease and stroke. Kimber Stanhope, a nutritional biologist, leads the study and her work rejects the age-old statement that ‘a calorie is a calorie’. In a tightly controlled environment, Stanhope completely decreased sugar levels and then slowly increased consumption of sugary beverages. Her interview included some of these statements:
Kimber Stanhope: ‘We found that the subjects who consumed high fructose corn syrup had increased blood levels of LDL cholesterol and other risk factors for cardiovascular disease.”
Dr. Sanjay Gupta: How quickly did these changes occur?
Kimber Stanhope: Within two weeks.
Kimber Stanhope's study suggests that when a person consumes too much sweet stuff, the liver gets overloaded with fructose and converts some of it into fat. Some of that fat ends up in the bloodstream and helps generate a dangerous kind of cholesterol called small dense LDL.                

The purpose of sharing this article is not to say that I too, think sugar is evil. BUT, I do think that the average American consumes too much refined sugar (baked goods, sugary beverages and processed junk food). This study poses an extreme perspective, and yet there is a hint of truth. This doctor is just trying to help people, especially children as he is a pediatrician.

Take home message: Watch your intake, cut the sugary beverages and be aware of the research developments. Stay informed.

Have a great day!
Sara Shipley
University of Central Oklahoma
Nutrition and Dietetics Student