Posts Tagged ‘diet’

Are Diet Pills Safe?

Written by Dr. Steve Chaney on . Posted in Drugs and Health, Issues, Obesity

Another Diet Pill Bites the Dust

Author: Dr. Stephen Chaney

New Year DietThe New Year is upon us, and everyone is looking for an easy way to lose weight.

Let’s face it. Losing weight is difficult. You have to give up your favorite foods. You’re often hungry and cranky. You have to change your lifestyle. And did I mention that you might need to put on your running shoes and go for a run or, heaven forbid, actually go to the gym.

It’s so much easier to take one of those diet pills. You know the ones I’m talking about. They promise to give you energyburn the fatsuppress your appetite. All you need to do is take one of those little pills every day and, voila, you’re ready to try on that bikini.

It all sounds great. But are those diet pills really safe? A few weeks ago I shared with you that the experts have warned against the use of fat burning sports supplements. They consider them unsafe. Now it’s time to turn our attention to the fat burning diet pills.

Are Diet Pills Safe?

Lots of diet pills have come and gone over the years. Some have just faded away because they didn’t work. They didn’t live up to their claims. Others have been withdrawn from the market by regulatory agencies because they were dangerous or actually killed people- Ma huang and Fen-Phen come to mind, but there have been many others.

And now it looks like yet another diet pill, one called Dexaprine, may have the same fate.

The ads make it sound like a wonder pill.

  • “With one little change…you could feel energy all day long”
  • “With one little change…you can suppress your insatiable appetite”
  • “You can try another unsuccessful diet without it, but when you’re ready…the ultimate fat burner will be waiting for you with open arms.”

The Dark Side

And yet, like most diet pills, it also has a dark side. Side effects include insomnia, sweating, heart palpitations and high blood pressure. As if that weren’t bad enough, the supplement manufacturer that makes Dexaprine conducts no clinical studies on their products, so they have no idea whether their product is safe or not.

And, it appears that it may not be safe. Dutch authorities banned Dexaprine in August after reports of 11 adverse reactions associated with Dexaprine use in Holland since March of this year, including hospitalizations and severe heart problems. British authorizes followed suit the next day and issued a warning against use of “fat burner” supplements in general. It’s probably just a matter of time before other governments step in and ban Dexaprine as well.

And, it’s not just Dexaprine. New diet pills hit the market almost every day. And, they all have those same “magical” claims.

The Only Safe Drug Is A New Drug

It reminds me of the wise advice that a physician colleague of mine gave to the medical students near the start of their first year. He told them “The only safe drug is a new drug”. He went on to say that he didn’t mean that new drugs were safer than the older drugs. It’s just that we don’t know all of their bad side effects until they’ve been on the market for a few years.

Diets pills are no different. They burst on the market full of promise. But, once they’ve been on the market for a year or two, reports of their bad side effects start to appear. We start to learn just how dangerous they are. And, one by one, they all bite the dust.

The Bottom Line

1)     There is no “Tooth Fairy”. There is no “Easter Bunny”. And, there is no magical pill that will SAFELY melt the pounds away. You simply don’t want to risk the diet pill solution – no matter how easy it sounds. No magical, “quick fix” diet solution is worth risking permanent heart damage – or worse.

2)     If you are fortunate to lose weight safely using one of those diet pills, you won’t have learned anything. You won’t have changed anything. The weight will come right back on.

3)     Permanent weight loss requires a permanent change to your lifestyle. Some of those changes will be difficult at first, but once those lifestyle changes become habits – once they become part of who you are, they will become easy.

You can achieve both the weight and the health you want!

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

The Two Biggest Misconceptions About Supplementation

Written by Dr. Steve Chaney on . Posted in Issues, Supplements and Health

Secrets You Need To Know

Author: Dr. Stephen Chaney

Nutrition MythsIn last week’s “Health Tips From The Professor” I told you the truth behind the headlines that vitamins are a waste of money. This week I’m going to be talking about the two biggest misconceptions that people have about supplementation. These are two secrets you need to know.

The Two Biggest Misconceptions About Supplementation

I won’t keep you in suspense. The answer is pretty simple. The two biggest misconceptions about supplementation that I hear over and over are:

1)     Supplementation can cure disease

2)     It doesn’t matter what you eat (or what supplements you take)

Of course, those statements don’t tell you much by themselves, so let’s delve into the subject more deeply.

Misconception #1: Supplementation can cure disease.

I don’t know how many times I’ve been asked “I have “disease X”. What supplements should I take? – as if supplements were drugs that can be taken to cure a disease.

We shouldn’t think of supplements as drugs that cure diseases. We should think of them as providing the nutrients that are the building blocks of health – or perhaps the ammunition that the body uses to fight diseases. Diseases, after all, are an abnormal state of being, and our bodies have an amazing capacity to fight those diseases.

When we have infections or cancer our body activates its immune system to fight it. When we have inflammation our body tries to put out the fire. When we have damage to our DNA – our genetic information – our body tries to repair it. The list is almost endless. Our bodies are wondrously designed!

Our immune systems require nutrients like protein, B vitamins, antioxidants, zinc and iron. The omega-3 fatty acids, anti-oxidants and polyphenols like resveratrol are anti-inflammatory. Nutrients like antioxidants and polyphenols support DNA repair.

So proper diet and supplementation are not “magic bullets” that cure diseases. They are simply the building blocks that allow the body to do what it does best.

And because no two of us are alike the nutrients that we need the most to allow our bodies to do their job efficiently may be different for each one of us.

So while there is no magic food or supplement that will cure a specific disease, a healthy diet and a holistic approach to supplementation can often work wonders.

Misconception #2: It doesn’t matter what you eat.

This is the flip side of the coin. I often come across people who have been told by the “experts” that the cause of their disease was not related to diet so they shouldn’t worry about what they eat. They are also usually told that supplementation will not do any good.

Let’s take the most extreme example – genetically caused diseases or serious degenerative diseases like multiple sclerosis or Parkinson’s for which the causes are still not fully understood.

It is generally true that these diseases were not caused by poor diet (MS may be the exception because there is some evidence that it can be caused by inadequate vitamin D during childhood). And I know many people who take the “expert’s” advice to heart and eat whatever they like and consider supplementation a waste of money.

Is that a sound approach? Let’s consider.

Any nutritionist will tell you that an inadequate diet can lead to malaise, low energy, inflammation, weakened immune system and impaired wound healing – just to name a few maladies. Even if you don’t end up with the symptoms of a nutritional deficiency, a poor diet can rob you of energy and vitality.

If you layer the consequences of a poor diet on top of the underlying disease, your chances of being able to cope with the disease and function optimally are greatly diminished.

I have come across many people with very serious diseases who are able to function at a very high level through proper diet and a holistic approach to supplementation.

Diet and supplementation did not cure their disease as they quickly discover if they stop supplementing and go back to the way they used to eat, but in many cases you would consider them to be perfectly healthy as long as they keep doing what they have been doing.

The Bottom Line

1) There is no perfect food or supplement that is capable of curing disease, but if you give your body the nutrients that it needs it often has the ability to heal itself.

2) Proper diet and supplementation can make a difference even if the disease was not caused by poor nutrition.

3) Each of us have unique nutritional needs so a holistic approach to diet and supplementation is best.

I didn’t specifically talk about weight control and exercise, but you should know from my previous “Health Tips From The Professor” that I consider them to be an essential part of any holistic health program.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

A Low Carb Diet and Weight Loss

Posted January 15, 2019 by Dr. Steve Chaney

Do Low-Carb Diets Help Maintain Weight Loss?

Author: Dr. Stephen Chaney

 

low carb dietTraditional diets have been based on counting calories, but are all calories equal? Low-carb enthusiasts have long claimed that diets high in sugar and refined carbs cause obesity. Their hypothesis is based on the fact that high blood sugar levels cause a spike in insulin levels, and insulin promotes fat storage.

The problem is that there has been scant evidence to support that hypothesis. In fact, a recent meta-analysis of 32 published clinical studies (KD Hall and J Guo, Gastroenterology, 152: 1718-1727, 2017 ) concluded that low-fat diets resulted in a higher metabolic rate and greater fat loss than isocaloric low-carbohydrate diets.

However, low-carb enthusiasts persisted. They argued that the studies included in the meta-analysis were too short to adequately measure the metabolic effects of a low-carb diet. Recently, a study has been published in the British Medical Journal (CB Ebbeling et al, BMJ 2018, 363:k4583 ) that appears to vindicate their position.

Are low carb diets best for long term weight loss?

Low-carb enthusiasts claim the study conclusively shows that low-carb diets are best for losing weight and for keeping it off once you have lost it. They are saying that it is time to shift away from counting calories and from promoting low-fat diets and focus on low-carb diets instead if we wish to solve the obesity epidemic. In this article I will focus on three issues:

  • How good was the study?
  • What were its limitations?
  • Are the claims justified?

 

How Was The Study Designed?

low carb diet studyThe investigators started with 234 overweight adults (30% male, 78% white, average age 40, BMI 32) recruited from the campus of Framingham State University in Massachusetts. All participants were put on a diet that restricted calories to 60% of estimated needs for 10 weeks. The diet consisted of 45% of calories from carbohydrate, 30% from fat, and 25% from protein. [So much for the claim that the study showed low-carb diets were more effective for weight loss. The diet used for the weight loss portion of the diet was not low-carb.]

During the initial phase of the study 161 of the participants achieved 10% weight loss. These participants were randomly divided into 3 groups for the weight maintenance phase of the study.

  • The diet composition of the high-carb group was 60% carbohydrate, 20% fat, and 20% protein.
  • The diet composition of the moderate-carb group was 40% carbohydrate, 40% fat, and 20% protein.
  • The diet composition of the low-carb group was 20% carbohydrate, 60% fat, and 20% protein.

Other important characteristics of the study were:

  • The weight maintenance portion of the study lasted 5 months – much longer than any previous study.
  • All meals were designed by dietitians and prepared by a commercial food service. The meals were either served in a cafeteria or packaged to be taken home by the participants.
  • The caloric content of the meals was individually adjusted on a weekly basis so that weight was kept within a ± 4-pound range during the 5-month maintenance phase.
  • Sugar, saturated fat, and sodium were limited and kept relatively constant among the 3 diets.

120 participants made it through the 5-month maintenance phase.

 

Do Low-Carb Diets Help Maintain Weight Loss?

low carb diet maintain weight lossThe results were striking:

  • The low-carb group burned an additional 278 calories/day compared to the high-carb group and 131 calories/day more than the moderate-carbohydrate group.
  • These differences were even higher for those individuals with higher insulin secretion at the beginning of the maintenance phase of the study.
  • These differences lead the authors to hypothesize that low-carb diets might be more effective for weight maintenance than other diets.

 

What Are The Pros And Cons Of This Study?

low carb diet pros and consThis was a very well-done study. In fact, it is the most ambitious and well-controlled study of its kind. However, like any other clinical study, it has its limitations. It also needs to be repeated.

The pros of the study are obvious. It was a long study and the dietary intake of the participants was tightly controlled.

As for cons, here are the three limitations of the study listed by the authors:

#1: Potential Measurement Error: This section of the paper was a highly technical consideration of the method used to measure energy expenditure. Suffice it to say that the method they used to measure calories burned per day may overestimate calories burned in the low-carb group. That, of course, would invalidate the major findings of the study. It is unlikely, but it is why the study needs to be repeated using a different measure of energy expenditure.

#2: Compliance: Although the participants were provided with all their meals, there was no way of being sure they ate them. There was also no way of knowing whether they may have eaten other foods in addition to the food they were provided. Again, this is unlikely, but cannot be eliminated from consideration.

#3: Generalizability: This is simply an acknowledgement that the greatest strength of this study is also its greatest weakness. The authors acknowledged that their study was conducted in such a tightly controlled manner it is difficult to translate their findings to the real world. For example:

  • Sugar and saturated fat were restricted and were at very similar levels in all 3 diets. In the real world, people consuming a high-carb diet are likely to consume more sugar than people in the other diet groups. Similarly, people consuming the low-carb diet are likely to consume more saturated fat than people in the other diet groups.
  • Weight was kept constant in the weight maintenance phase by constantly adjusting caloric intake. Unfortunately, this seldom happens in the real world. Most people gain weight once they go off their diet – and this is just as true with low-carb diets as with other diets.
  • The participants had access to dietitian-designed prepared meals 3 times a day for 5 months. This almost never happens in the real world. The authors said “…these results [their data] must be reconciled with the long-term weight loss trials relying on nutrition education and behavioral counseling that find only a small advantage for low carbohydrate compared with low fat diets according to several recent meta-analyses.” [I would add that in the real world, people do not even have access to nutritional education and behavioral modification.]

 

low carb diet and youWhat Does This Study Mean For You?

  • This study shows that under very tightly controlled conditions (dietitian-prepared meals, sugar and saturated fat limited to healthy levels, calories continually adjusted so that weight remains constant) a low-carb diet burns more calories per day than a moderate-carb or high-carb diet. These findings show that it is theoretically possible to increase your metabolic weight and successfully maintain a healthy weight on a low-carb diet. These are the headlines you probably saw. However, a careful reading of the study provides a much more nuanced viewpoint. For example, the fact that the study conditions were so tightly controlled makes it difficult to translate these findings to the real world.
  • In fact, the authors of the study acknowledged that multiple clinical studies show this almost never happens in the real world. These studies show that most people regain the weight they have lost on low-carb diets. More importantly, the rate of weight regain is virtually identical on low-carb and low-fat diets. Consequently, the authors of the current study concluded “…translation [of their results to the real world] requires exploration in future mechanistic oriented research.” Simply put, the authors are saying that more research is needed to provide a mechanistic explanation for this discrepancy before one can make recommendations that are relevant to weight loss and weight maintenance in the real world.
  • The authors also discussed the results of their study in light of a recent, well-designed 12-month study (CD Gardener et al, JAMA, 319: 667-669, 2018 ) that showed no difference in weight change between a healthy low-fat versus a healthy low-carbohydrate diet. That study also reported that the results were unaffected by insulin secretion at baseline. The authors of the current study noted that “…[in the previous study] participants were instructed to minimize or eliminate refined grains and added sugars and maximize intake of vegetables. Probably for this reason, the reported glycemic load [effect of the diet on blood sugar levels] of the low-fat diet was very low…and similar to [the low-carb diet].” In short, the authors of the current study were acknowledging that diets which focus on healthy, plant-based carbohydrates and eliminate sugar, refined grains, and processed foods may be as effective as low-carb diets for helping maintain a healthy weight.
  • This would also be consistent with previous studies showing that primarily plant-based, low-carb diets are more effective at maintaining a healthy weight and better health outcomes long-term than the typical American version of the low-fat diet, which is high in sugar and refined grains. In contrast, meat-based, low-carb diets are no more effective than the American version of the low-fat diet at preventing weight gain and poor health outcomes. I have covered these studies in detail in my book “Slaying The Food Myths.”

Consequently, the lead author of the most recent study has said: “The findings [of this study] do not impugn whole fruits, beans and other unprocessed carbohydrates. Rather, the study suggests that reducing foods with added sugar, flour, and other refined carbohydrates could help people maintain weight loss….” This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.

The Bottom Line

 

  • A recent study compared the calories burned per day on a low-carb, moderate-carb, and high-carb diet. The study concluded that the low-carb diet burned significantly more calories per day than the other two diets and might be suitable for long-term weight control. If confirmed by subsequent studies, this would be the first real evidence that low-carb diets are superior for maintaining a healthy weight.
  • However, the study has some major limitations. For example, it used a methodology that may overestimate the benefits of a low-carb diet, and it was performed under tightly controlled conditions that can never be duplicated in the real world. As acknowledged by the authors, this study is also contradicted by multiple previous studies. Further studies will be required to confirm the results of this study and show how it can be applied in the real world.
  • In addition, the kind of carbohydrate in the diet is every bit as important as the amount of carbohydrate. The authors acknowledge that the differences seen in their study apply mainly to carbohydrates from sugar, refined grains, and processed foods. They advocate diets with low glycemic load (small effects on blood sugar and insulin levels) and acknowledge this can also be achieved by incorporating low-glycemic load, plant-based carbohydrates into your diet. This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.
  • Finally, clinical studies report averages, but none of us are average. When you examine the data from the current study, it is evident that some participants burned more calories per hour on the high-carb diet than other participants did on the low carb diet. That reinforces the observation that some people lose weight more effectively on low-carb diets while others lose weight more effectively on low-fat diets. If you are someone who does better on a low-carb diet, the best available evidence suggests you will have better long-term health outcomes on a primarily plant-based, low-carb diet such as the low-carb version of the Mediterranean diet.

For more details read the article above.

 

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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