Weekly Column_120 / August 16, 2012

After Ephedra: What’s America To Do?

By Charles Platkin, PhD

Supplement companies cite study after study, often from reputable sources, to back up their claims — without regard for whether or not these claims are even legitimate. In fact, the Federal Trade Commission (FTC), which regulates the marketing of supplements, conducted a review of weight loss product advertisements and found that 40% had at least one false claim and 55% had assertions that couldn’t be substantiated.

The main problem is that many of the marketers of these supplements offer a grain of biological truth (from journal articles and studies) as to the effect of these products on weight loss, but overall these supplements are not completely effective, and some might even be harmful. Keep in mind that even if one or maybe two studies did show conclusive evidence that a supplement promotes weight loss, this does not prove that a supplement is effective and safe.

“As researchers, we are not concealing any miracle drug or supplement from the public — we would be ecstatic if something [such as a supplement or pharmaceutical product] was a panacea, but unfortunately that doesn’t currently exist,” says Judith S. Stern, Sc.D., professor of nutrition and internal medicine at the University of California, Davis. “I do believe that there must be something physiological that is causing individuals to be obese, and there is hope that it can be treated from a public health perspective similar to putting fluoride in water to prevent tooth decay.”

Yet marketers still continue to push a variety of supplements with promises of easy weight loss. And it seems there is always something new being touted as the next miracle for the waistline-disadvantaged. Here’s a breakdown of the real deal with some of the latest and greatest weight loss cures:

Bitter Orange (Seville Orange Plant) or Citrus Aurantium
Most of the ephedra-free products out there use bitter orange in their formulas because it gives a little “kick” when taken — just like ephedra. And it’s not a mystery as to why — synephrine is the active ingredient in both of these supplements.

Theory: Synephrine alone or in combination with other ingredients such as caffeine (from guarana) and aspirin (from willow bark) generally falls into the category of acting as a mild stimulant. Its alleged effect is to boost energy, increase metabolism, and suppress appetite.

Evidence: Bitter orange is not well studied, but experts who have looked at the supplement conclude that while there may be some mild weight loss effects with continued ingestion, its long-term efficacy and safety are at issue. Until more studies are conducted on the safety, pharmacology, and efficacy of bitter orange, it should be treated as an ingredient with stimulant properties, and individuals with cardiovascular and blood pressure concerns should be particularly careful.

Conjugated Linoleic Acid (CLA)
CLA is a naturally occurring fatty acid found in many meat and dairy products. CLA was discovered by Michael Pariza, Ph.D., the director of the Food Research Institute at the University of Wisconsin, Madison. Dr. Pariza has been studying CLA for more than 20 years — and recently has become an avid proponent of its potential when it comes to weight control.

“Used as part of a proper diet and exercise program, CLA can effectively aid the body in reducing fat and building lean muscle mass, giving an edge to people looking to shed excess pounds,” said Dr. Pariza. (It should be noted that the University of Wisconsin actually licenses the use of CLA for weight control under the name Clarinol.)

Theory: The idea is that CLA prevents some fat from being absorbed into the fat cells, and the excess fat is used instead as a source of energy by the body. So it prevents fat cells from filling up with fat, according to Dr. Pariza. But if you are eating too much fat and not exercising, the fat cell will be overwhelmed, and CLA will not have the appropriate effect. “CLA will help those who are already dieting, have lost weight, and want to make sure they don’t regain the weight,” says Pariza. He adds that CLA works only if you continue to exercise and eat properly.

Evidence: I was a bit surprised that there was so much research done on CLA. In fact, when I asked a few experts for their thoughts, they felt that this was one of the few supplements that had a bit of promise — but they also said they would wait for additional studies before taking it themselves. Although some studies show that CLA can assist in changing the composition of body fat, the most recent study claimed that CLA had no effect on body composition.

As a side note, after interviewing several experts I was ready to start taking CLA — what harm could it do, right? Well, there were plenty of other experts who warned convincingly that the possible mild weight loss effects don’t outweigh the possible side effects.

So the jury is still out. I would suggest waiting before ingesting.

Yes, that’s right, calcium — the stuff you get from drinking milk. I was initially skeptical about even including this, but significant research shows that it does have some effect on weight control.

Theory: There is a hormone called calcitriol that is released when individuals do not get enough calcium. This hormone acts on fat levels by converting more fat from sugar sources. By getting in enough calcium, your body will not be driven to make as much fat.

Evidence: Michael B. Zemel, Ph.D., the director of the Nutrition Institute at the University of Tennessee, has done most of the research on weight control and calcium. Although he is funded by the National Dairy Council and his findings are not conclusive, they still have validity and should not be dismissed.

“There is a substantial body of evidence that has emerged over the last few years in support of what would superficially seem to be an unlikely concept: that dietary calcium plays a significant role in the modulation of energy metabolism and, consequently, exerts an ‘anti-obesity’ effect,” says Dr. Zemel.

But don’t run out and start ingesting gallons of milk or calcium supplements. Dr. Zemel notes that there is a “plateau effect with calcium and weight loss” — meaning you can’t keep taking more and more calcium and expect to continue to lose more and more weight.

If you are not getting your “recommended” dose of dairy products, that could be one of several factors influencing your weight. Zemel recommends getting about 1000mg per day, adding that it’s better if it comes from dairy foods versus a supplement.

This is the safest of all the “new” supplements that are on the market, especially since it’s already important to get calcium in your diet. “This is the same recommendation for young adults to maximize bone mass and prevent bone loss to reduce the possibility of osteoporosis later in life. Now there is even more of a reason to meet the current recommendations of calcium intake,” says Dorothy Teegarden, Ph.D., professor of food and nutrition at Purdue University.

In addition to these newcomers, marketers also continue to hawk the old standbys, such as: guarana, which is basically a double dose of caffeine; green tea, a proven antioxidant but unproven as an appetite suppressant; chromium picolinate, which theoretically controls insulin and thus acts as an appetite suppressant; and chitosan, an alleged fat blocker made from seashells. Although all of these continue to fly off the shelves, there is disappointing research supporting their purported claims.

The bottom line is that if ANY of these supplements actually worked — well, would we really be the overweight society we have become?

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