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Tag: Metabolife

  • Ephedra-Like Weight Loss Minus the Risks  | NutritionFacts.org

    Ephedra-Like Weight Loss Minus the Risks  | NutritionFacts.org

    The diving reflex shows that it’s possible to have selective adrenal hormone effects.

    Thermogenic drugs like DNP can cause people to overheat to death; they can increase resting metabolic rates by 300 percent or more. A more physiological spread would range about ten times less, from a 30 percent slower metabolism in people with an underactive thyroid to a 30 percent higher metabolism when the part of our nervous system that controls our fight-or-flight response is activated. In response to a fright or acute stress, special nerves release a chemical called noradrenaline to ready us for confrontation. We experience this by our skin getting paler, cold, and clammy, as blood is diverted to our more vital organs. Our mouth can get dry as our digestive system is put on hold, and our heart starts to beat faster. What we don’t feel is the extra fat being burned to liberate energy for the fight.

    That’s why people started taking ephedra for weight loss—“to stimulate the release of noradrenaline from nerve endings.”

    Ephedra is an evergreen shrub. It’s been used in China for thousands of years to treat asthma because it causes that same release of noradrenaline that offers relief to people with asthma by dilating their airways. In the United States, it was appropriated for use as a metabolic stimulant, shown to result in about 2 pounds (0.9 kg) of weight loss a month in 19 placebo-controlled trials. By the late 1990s, millions of Americans were taking it. The problem is that it also had all the other noradrenaline effects, like increasing heart rate and blood pressure. So, chronic use resulted in “stroke, cardiac arrhythmia, and death.” The U.S. Food and Drug Administration warned of its risks in 1994, but ephedra wasn’t banned until a decade later after a 23-year-old Major League Baseball pitcher dropped dead. His “autopsy report revealed evidence of ephedra, which the medical examiner said contributed to his death.”

    In the current Wild West of dietary supplement regulation, not only can a supplement be “marketed without any safety data” at all, but the manufacturer is under no obligation to disclose adverse effects that may arise. No surprise, then, that online vendors assured absolute safety: “No negative side effects to date.” “No adverse side-effects, no nervous jitters or underlying anxiety, no moodiness…” “100% safe for long-term use.” “It will not interact with medications and has no harmful side effects.” The president of Metabolife International, a leading seller of ephedra, assured the FDA that the company had never received a single “notice from a consumer that any serious adverse health event has occurred…” In reality, it had received about 13,000 health complaints, including reports of serious injuries, hospitalizations, and even deaths. 

    If only there were a way to get the good without the bad. As I discuss in my video How to Get the Weight Loss Benefits of Ephedra Without the Risks, there is. But to understand it, you first have to grasp a remarkable biological phenomenon known as the diving reflex.

    Imagine walking across a frozen lake and suddenly falling through the ice, plunging into the freezing depths. It’s hard to think of a greater, instantaneous fight-or-flight shock than that. Indeed, noradrenaline would be released, causing the blood vessels in your arms and legs to constrict to bring blood back to your core. You can imagine how fast your heart might start racing, but that would be counterproductive because you’d use up your oxygen faster. Remarkably, what happens instead is your heart rate slows down. That’s the diving reflex, first described in the 1700s. Air-breathing animals are born with this automatic safety feature to help keep us from drowning.

    In medicine, we can exploit this physiological quirk with what’s called a “cold face test.” To determine if a comatose patient has intact neural pathways, you can apply cold compresses to their face to see if their heart immediately starts slowing down. Or, more dramatically, it can be used to treat people who flip into an abnormally rapid heartbeat. Remember that episode of ER where Carter dunked a patient’s face into a tray of ice water? (That show aired on TV when I was in medical school, and a group of us would gather around and count how many times they violated “universal precautions.”)

    What does this have to do with weight loss? The problem with noradrenaline-releasing drugs like ephedra is the accompanying rise in heart rate and blood pressure. What the diving reflex shows is that it’s possible to experience selective noradrenaline effects, raising the possibility that there may be a way to get the metabolic boost without the risk of stroking out. Unbelievably, this intricate physiological feat may be accomplished by the simplest of acts: Instead of drowning in water, simply drink it. Really? Yes, you can boost your metabolism by drinking water. Buckle your safety belts because you are in for a wild ride—one that continues next.

    This is the first in a four-part video series. Stay tuned for:

    You may also be interested in Friday Favorites: The Best Diet for Weight Loss and Disease Prevention.

    Michael Greger M.D. FACLM

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  • The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

    The Efficacy of Weight-Loss Supplements  | NutritionFacts.org

    Are there any safe and effective dietary supplements for weight loss?

    In a previous discussion, I noted that an investigation found that four out of five bottles of commercial herbal supplements bought at major U.S. retailers—GNC, Walgreens, Target, and Walmart—didn’t contain any of the herbs listed on their labels, instead “often containing little more than cheap fillers like powdered rice, asparagus and houseplants…”

    You might hope your supplement just contains houseplants. Weight-loss supplements are infamous for being “adulterated with prescription and over-the-counter” drugs. In a sampling of 160 weight-loss supplements that “were claimed as 100% natural,” more than half were tainted with drugs and active pharmacological ingredients, ranging from antidepressants like Prozac to erectile dysfunction medications like Viagra. Diuretic drugs are frequent contaminants, which makes sense. In my previous videos on ketogenic diets, I talk about rapid water loss being “the $33-billion diet gimmick” that has sold low-carb diets for more than a century. But why the Viagra?

    At least the spiked Viagra and Prozac are legal drugs. Researchers in Denver tested every weight-loss supplement they could find within a ten-mile radius. Alarmingly, they found that a third were adulterated with banned ingredients. The most common illegal adulterant of weight-loss supplements is sibutramine, which was sold as Meridia before it was yanked off the market back in 2010 for heart attack and stroke risk. Now, it is also blamed for cases of slimming supplement–induced psychosis.

    An analysis of weight-loss supplements bought off the internet that were advertised with claims like “purely natural products,” “harmless,” or “traditional herbal” found that a third of them contained high doses of the banned drug sibutramine and the rest had caffeine. Wouldn’t you be able to tell if caffeine was added to a supplement? Perhaps not, if it also had temazepam, a controlled substance (benzodiazepine) “downer” sedative found in half of the caffeine-tainted supplements.

    Doesn’t the FDA demand recalls of adulterated supplements? Yes, but they often just pop back up on store shelves. Twenty-seven supplements were purchased at least six months after recalls were released, and two-thirds still contained banned substances. That’s 17 out of 27 with the same pharmaceutical adulterant found originally, and 6 containing one or more additional banned ingredients. Aren’t the manufacturers penalized for noncompliance? Yes, but “the fines for violations are small compared to the profits.”

    One of the ways supplement makers can skirt the law is by labeling them as “not intended for human consumption because it shifts the responsibility from the seller to the user”—for example, labeling the fatal fat-burner DNP as “an industrial- or research chemical.” This is how designer street drugs can be sold openly at gas stations and convenience stores as “bath salts.” Another way is to claim synthetic stimulants added to slimming supplements are actually natural food constituents, like listing the designer drug dimethylamylamine (DMAA) as “geranium oil extract.” The FDA banned it in 2012 after it was determined that DMAA “was not found in geraniums.” Who eats geraniums anyway? Despite being tentatively tied to cases of sudden death and associated with hemorrhagic stroke, DMAA has continued to be found in weight-loss supplements with innocuous names like Simply Skinny Pollen made by Bee Fit with Trish.

    There is little doubt that certain banned supplements, like ephedra, could help people lose weight. “There’s only one problem, and it’s a big one: This supplement may kill you,” wrote a founding member of the American Board of Integrative Medicine.

    Are there any safe and effective dietary supplements for weight loss? As I discuss in my video Friday Favorites: Are Weight-Loss Supplements Safe and Effective?, when popular slimming supplements were put to the test in a randomized placebo-controlled trial, not a single one could beat out placebo sugar pills. “A systematic review of systematic reviews” of diet pills came to a similar conclusion: None appears to generate appreciable impacts “on body weight without undue risks.” That was the conclusion reached in a similar review out of the Weight Management Center at Johns Hopkins, which ended with: “In closing, it is fitting to highlight that perhaps the most general and safest alternative/herbal approach to weight control is to substitute low-energy density [low-calorie] foods for high-energy density and processed foods, thereby reducing total energy intake.” In other words, eat more whole plant foods and fewer animal foods and junk. “By taking advantage of the low-energy density [low-calorie] and health-promoting effects of plant-based foods, one may be able to achieve weight loss, or at least assist weight maintenance without cutting” down on the volume of food consumed or compromising its nutrient value.

    Learn more about the risks of supplements in my video Are Weight Loss Supplements Safe?.

    I referred to a keto diet video I did, check out the related posts below the links to other videos and blogs in that series.

    Learn more about optimal weight loss in my book, How Not to Diet

    Michael Greger M.D. FACLM

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  • The Safety of Weight-Loss Supplements  | NutritionFacts.org

    The Safety of Weight-Loss Supplements  | NutritionFacts.org

    Only 2 out of 12 supplement companies were found to have weight-loss products that were even accurately labeled.

    According to a national survey, one-third of adults who have made serious attempts at weight loss have tried using dietary supplements, for which Americans spend billions of dollars every year. Most people mistakenly thought that over-the-counter appetite suppressants, herbal products, and weight-loss supplements had to be approved for safety by a governmental agency, like the U.S. Food and Drug Administration (FDA), before being sold to the public or at least include some kind of warning on the label about potential side effects. Nearly half even thought they had to demonstrate some sort of effectiveness. None of that is true.

    As I discuss in my video Friday Favorites: Are Weight Loss Supplements Safe and Effective?, the “FDA has estimated that dietary supplements cause 50,000 adverse events annually,” most commonly liver and kidney damage. Of course, prescription drugs don’t just have adverse effects; they kill more than 100,000 Americans every year. But, you at least notionally have the opportunity to parse out the risks versus benefits of prescription drugs, thanks to testing and monitoring requirements typically involving thousands of individuals.

    When the manufacturer of Metabolife 356, a supplement containing ephedrine, had it tested on 35 people, only minor side effects were found, such as dry mouth, headache, and insomnia. However, once unleashed on a broad population, nearly 15,000 adverse effects were reported, including heart attacks, strokes, seizures, and deaths, before it was pulled from the market.

    Given the lack of government oversight, there is no guarantee that what’s on the label is even in the bottle, as you can see in the graph below and at 1:55 in my video. FDA inspectors have found that 70 percent of supplement manufacturers violated so-called Good Manufacturing Practices, which are considered the minimum quality standards. This includes things like basic sanitation and ingredient identification. Not 7 percent in violation, but 70 percent.

    DNA testing of herbal supplements across North America found that most could not be authenticated. In a significant percentage of the supplements tested, the main labeled ingredient was missing completely and substituted with something else. For example, a so-called St. John’s wort supplement contained nothing but senna, a laxative that can cause anal blistering. Only 2 out of 12 supplement companies had products that were accurately labeled.

    This problem isn’t limited to fly-by-night phonies in some dark corner of the internet either. The New York State Attorney General commissioned DNA testing of 78 bottles of commercial herbal supplements sold by Walgreens, Walmart, Target, and GNC “and found that four out of five…did not contain any of the herbs on their labels.” Instead, the capsules “often contained little more than cheap fillers like powdered rice, asparagus and houseplants…”

    What about weight-loss medications? See Are Weight Loss Pills Safe? and Are Weight Loss Pills Effective?. Also, see related posts below.

    Take a deep dive into the best way to lose weight with my book How Not to Diet

    Michael Greger M.D. FACLM

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