The Skinny on Diet Pills

With the release of Alli this past June, diet pills are once again in the spotlight. The claims are appealing: “Lose 30 lbs in 30 days” or “Melt your fat away”. But, do these pills really work? And more importantly, are they even safe? We’ve broken down for you some of the more popular over the counter and prescription diet pills on the market to let you decide for yourself. As a disclaimer, we believe that there are no magic pills to get you to your goal – changing your lifestyle is the only truly tested and effective method.

Prescription Drugs
Research regarding prescription drugs is more thorough and credible since they have to be approved by the Food and Drug Administration. Prescription weight loss drugs are intended for individuals with medically significant weight problems, and are intended to be used in conjunction with dietary, behavioral, and exercise programs. If used correctly by the intended group of users, oftentimes they can be a lifesaver. For those who do not fit the description of the intended user, or for those who simply take the pills without changing their lifestyle, expect disappointment.

Orlistat (Brand name prescription drug: Xenical; OTC drug: Alli)
How it Works: Orlistat blocks the absorption of fat by working on the digestive system. It is claimed to inhibit the action of an enzyme called lipase, which breaks down dietary fat so the body can absorb it. Orlistat blocks the absorption of up to 30% of dietary fat, and the unabsorbed fat is eliminated through the stool.

Research: According to the FDA, before orlistat was approved in 1999, it was tested in seven clinical trials, in which more than 4,000 obese individuals participated. Each of these trials used orlistat in conjunction with a low-calorie, low-fat diet, and an exercise routine. Overall, 57% of people taking orlistat lost at least 5% of their body weight as compared to 31% who took a placebo.

Side Effects: Due to the fact that unabsorbed fat will exit through the stools, many gastrointestinal side effects may exist. Perhaps most embarrassing is that users may experience oily rectal seepage and in extreme cases, may need adult diapers. Fecal urgency, gas with discharge, and frequent, oily bowel movements are also possible. In addition, orlistat interferes with the absorption of fat-soluble vitamins (A,D,E, and K) and may also limit the absorption of healthy fats like fish oil or flaxseed oil. As a result, nutritional deficiencies may occur.

Sibutramine (brand name: Meridia)
How it Works: Sibutramine is a monoamine reuptake inhibitor, which means that is blocks the reabsorption of certain neurotransmitters, or messengers to the brain. This allows the levels of these neurotransmitters to increase, which then helps to control appetite. Thus, sibutramine is mostly an appetite suppressant.

Research: Manufacturers report several double-blind, placebo controlled trials. There was evidence that various levels of sibutramine led to significantly more weight loss in obese individuals, than for those who used the placebo. As with orlistat, these studies were done in conjunction with a healthy eating and exercise plan.

Side Effects: The most common side effects are dry mouth, anorexia, headache, insomnia, and constipation. Some users also experience an increase in blood pressure and heart rate.

OTC Drugs
Over the counter weight loss drugs are not subject to approval or regulation by the FDA. As a result, we have limited research on the hundreds of OTC diet pills out there, and almost no long-term research. In addition, because these pills aren’t regulated, they may not even have the amount of an effective ingredient that is stated on the bottle. There are hundreds of diet pills out there. This is only a small sample.

Alli
The only FDA approved OTC drug. See orlistat (above).

TrimSpa X32
How it Works: Trimspa, endorsed by the late Anna Nicole Smith, has many different ingredients in it. Unfortunately, TrimSpa no longer lists each of the ingredients separately, but rather states that it has a “x32 proprietary blend”. We were able to uncover some of the ingredients. Ingredients like caffeine, bitter orange, and green tea extract are thought to work as stimulants. Hoodia, chromium, and glucomannan (fiber) are proposed to work as appetite suppressants.

Research: Clinical trials have not shown that the ingredients in TrimSpa can reduce body fat. There is some evidence that green tea extract may aid in weight loss, and there is clear evidence that fiber (i.e. glucomannan) will lead to satiety, thus decreasing one’s appetite. However, none of the ingredients have been significantly proven to lead to weight loss.

Side Effects: Due to the fact that many of the ingredients have been insufficiently tested, there is concern that in large doses, some of these ingredients may be harmful. Bitter orange (naringin) may interfere with many common prescription drugs such as antiarrhythmics, anticoagulants, statins, immunosuppressants, calcium channel blockers, and protease inhibitors. Ingredients in TrimSpa may lead to insomnia, anxiety, palpitations, and restlessness. TrimSpa may also cause migraines in susceptible people since it contains cocoa extract which contains tyramine. Hoodia, a popular ingredient on its own, and thought to suppress appetite, is also still in the beginning research stages. There is a possibility that it can lead to liver toxicity. Moreover, Hoodia is a protected plant, and because OTC diet pills are not regulated, most of the pills don’t have as much Hoodia as is stated on the packaging.

Xenadrine EFX
How it Works: As with the TrimSpa, Xenadrine has a long list of ingredients. These include green tea leaf extract, bitter orange, caffeine, cocoa extract, grapeseed extract, ginger root, and guarana. These ingredients are purported to speed up the metabolism.

Research: Though proponents of Xenadrine claim numerous clinical trials have been completed, it was hard for us to find any. The two we did find were extremely small studies of six and ten subjects. In addition, we found it dodgy that the Xenadrine website listed “returning shortly…” under the tab for clinical studies. When we called the company, they could not elaborate.

Side Effects: The same side effects noted for specific ingredients in TrimSpa are noted here. In addition, people taking Xenadrine have noticed nausea and upset stomachs, anxiety, shaking, cramps, increased heart rate, and increased sweating.

There are hundreds of other diet pills out on the market. Most of the OTC diet pills rely on the fine print that states it must be combined with a low-calorie diet and exercise. In reality, if you followed the healthy diet and exercise portion, you would lose weight. However, in certain cases, prescription drugs may be helpful and/or necessary, but that must be determined by your physician. With all diet pills remember - if it sounds too good to be true, chances are it is.

Red, White, and Blue Trifle

It’s summertime, and though we all may “scream for ice cream”, our waistlines are begging us to lighten up. Luckily, summertime is also chock full of fresh fruit, a naturally sweet dessert, which provide us with many important vitamins, minerals, fiber and water.
In fact, we need at least 2-4 servings of fruit per day. The following recipe combines 2 of these delicious fruits in a satisfying and low-calorie dessert.

Serves 15

1 package prepared low-calorie instant vanilla pudding
1- 8-ounce container fat-free or light whipped topping, ½ cup divided
2 ¼ cups sliced fresh strawberries, divided (2 cups & ¼ cup)
2 ¼ cups blueberries, divided (2 cups & ¼ cup)
1 prepared (10 ounces) angel food cake, cut into 1-inch cubes

1. Fold the vanilla pudding into the whipping topping (minus the reserved ½ cup of whipped cream).
2. Combine the 2 cups of strawberries and 2 cups of blueberries.
3. Place half the cake cubes in the bottom of a 2- to 3- quart trifle dish or straight-sided glass serving bowl. Top with half of the fruit mixture and then half of the whipped cream mixture. Repeat layers with remaining cake and fruit mixture. Spoon remaining whipped cream mixture over the fruit mixture. Place reserved ½ cup of whipped cream on top.
4. Arrange reserved strawberry slices and blueberries over the whipped cream.
5. Cover and chill in refrigerator for at least 2 hours before serving.

Calories per serving: ~170

Flavonoids and Cognitive Decline

Flavonoids are powerful antioxidants that are found in fruits, vegetables, tea, and red wine. The benefits of flavonoids have been highly touted, especially as it relates to cancer prevention. In a study published this year by the American Journal of Epidemiology, researchers found that flavonoids may also help with cognitive function. Over 1600 subjects, age 65 and over, were followed for 10 years. At baseline, all participants were evaluated and found to be free from dementia. In addition, information on dietary flavonoid intake was collected at baseline. Over the 10 year period, participants were cognitively evaluated four times. The researchers found that those participants who consumed the most flavonoids from food did significantly better on the mental examinations 10 years later than those who consumed the least amount of flavonoids. Just one more reason to visit your Farmer’s Market and load up on fresh produce…

Eating Seasonally

No longer do you have to drive to rural areas for the fresh vegetables, fruits, flowers, and seasonal culinary creations of the farms. In the last few years, Farmer's Markets have been popping up and becoming increasingly popular in both urban and suburban neighborhoods. Towns and cities alike have happily sectioned off streets monthly, or even weekly, for nearby farms to provide residents access to locally grown food. While many look at jaunts to the Farmer's Market as occasional quaint outings, however, there are major benefits to regularly frequenting the local markets and to eating seasonally.

Health
Whether or not we realize it, the foods that are grown locally are essentially preparing us for the days ahead. Spring vegetables, like lettuce, kale, asparagus, and spinach, help to clean us out after a long winter. The summer harvest of grains and fruit helps to give us energy for the long days. The produce of autumn, including squash, apples, carrots, and beets, provide warmth and sweetness to help nourish us prior to the long winter. And finally, the winter foods, which generally are stored, like dried fruits, nuts, and other, heavy, dense foods, help to provide resilience.

Intact Nutrients
As soon as a piece of fruit (or any produce) is plucked from the tree, the nutritional breakdown begins. Certain vitamins, particularly vitamin C, are very unstable and though they may be present fresh off the vine, are largely depleted after a few days. Supermarket produce may be shipped from a thousand (or more) miles away. As a result, the produce sits around for many days constantly losing some of the key nutrients.

Since local farms must adjust to the seasonal weather, the fields are also turned over more frequently. Thus, a patch of land that held cucumbers in the summer may hold root vegetables in the fall and winter. This turnover encourages a more nutrient-rich soil, which translates into a more nutrient-dense product (not to mention a tastier product).

Freshness
Locally grown produce is typically picked the day before arriving at the Farmer's Market. As a result, the produce is picked ripe or at its peak. Moreover, after a day at the Farmer's Market, leftover produce is generally not saved to be sold the next day. Instead it is used for jams and baked goods. On the other hand, supermarket produce is harvested well before ripeness so that it can withstand bulk handling and long range shipping. That means that when supermarket produce first hits the shelf, it is at least a week old. In fact, the automatic spraying of the produce section every few minutes is mainly done to perk up the week-old vegetables. It doesn't help that nutrients of the produce leach out at each spraying.

Fewer Preservatives
Many of the small growers at Farmer's Markets are organic growers, which mean they do not use any synthetic compounds on their fields. Even for those local farmers who do use some chemicals, however, the amount which they use is far less than large commercial farms. Moreover, because local farms pick their produce at its peak, they do not use any chemical ripening agents. And because they get their produce to market almost immediately, they do not need to coat their produce in wax or add any other preservative.

Variety
Nowadays, when you walk into a supermarket, you may never know the season. Due to global trade, the supermarkets will always have melon, tomatoes, and tropical fruit. Without any new options, we can easily encounter food fatigue. And when we tire of fruits and vegetables, it is too easy to fall into the rut of treating ourselves with high-fat and high-sugar foods to perk up our food repertoires. However, when we eat seasonally, we can look forward to the juicy summer watermelon or the savory autumn artichokes. Plus, by purchasing seasonal foods, and not splurging on that $10 clamshell of blueberries in the dead of winter, you can also save money.

Incorporating seasonal eating into your lifestyle demands a bit more time, thought, and commitment. As a result, however, you will be rewarded with more robust flavors and loads more nutrients – your body, your palette, and the Earth will definitely thank you!

Seasonal Produce Calendar (New York)

This chart, adapted from the Greenmarket NYC chart, will help you determine the seasonality of your favorite fruits and vegetables.

Season	Vegetables	Fruit
Winter	Dried beans, beets, carrots, collard greens, leeks, onions, parsnips, potatoes, winter squash, turnips	Apples, pears
Spring	Asparagus, dried beans, cabbage, carrots, beet greens, mesclun, onions, parsnips, potatoes, radishes, rhubarb, scallions, spinach, zucchini, turnip greens	Apples, pears
Summer	Asparagus, snap beans, dried beans, beets, beet greens, broccoli, cabbage, carrots, cauliflower, celery, collard greens, corn, cucumbers, eggplant, herbs, lettuce, leeks, mesclun, onions, peas, peppers, potatoes, radishes, rhubarb, scallions, spinach, swiss chard, tomatoes, turnips, turnip greens, winter squash, zucchini	Apples, blackberries, blueberries, cantaloupe, cherries, currants, peaches, plums, strawberries, raspberries
Fall	Snap beans, dried beans, beets, beet greens, broccoli, Brussels sprouts, cabbage, carrots, cauliflower, celery, collard greens, corn, eggplant, fennel, herbs, kale, lettuce, leeks, lima beans, mesclun, onions, parsnip, potatoes, pumpkin, scallions, spinach, swiss chard, tomatoes, turnips, winter squash, zucchini	Apples, blueberries, cantaloupe, grapes, peaches, pears, plums, raspberries, watermelon

Caffeine and Weight

The findings regarding caffeine and weight loss seem to change daily. While nothing is conclusive, a recent study shed some light on caffeine intake and long term weight change in both men and women. The study, published in the American Journal of Clinical Nutrition in 2006, followed 18,416 men and 39,740 women from 1986 to 1998. Caffeine intake was initially assessed in 1986 and then reassessed every two to four years. Weight for each participant was recorded at baseline and then again in 1998. The study did find a lower mean weight gain in participants who increased, rather than decreased, their caffeine consumption. However, due to the nature of the study, it is impossible to assume that higher caffeine consumption actually causes weight loss as many other factors may have been involved; rather caffeine is simply associated with weight loss. Moreover, in men, the association between caffeine intake and weight was mostly present in younger participants. In women, the association was stronger in those who had a higher body mass index (>=25), who were less physically active, or who were current smokers. This study does lay the groundwork for future research, but for now there is no reason to run out and load up on caffeine. The best advice is to stay active and eat a balanced diet.

Coffee Beverages Exposed

With spring in full swing, and summer just a few short weeks away, we now find ourselves strolling outside as we delight in the beautiful weather. Oftentimes, these strolls are accompanied by jaunts into a coffee shop or an ice cream store to get a frosty treat. While many may feel that opting for the coffee is the healthier or least caloric choice, many times this is not the case. A serving of vanilla ice cream (which is ½ a cup) is only 145 calories, while a serving of a blended coffee beverage (16 oz) can range anywhere from 180 to 580 calories! The following chart gives a breakdown of some of your favorite coffee treats:

Product	Serving Size(oz)	Calories	Total Fat(g)	Saturated Fat(g)	Carbs(g)	Sugars(g)	Protein(g)
Starbucks Coffee Frappuccino Blended Coffee – no whip	16	260	3.5	2	52	44	5
Starbucks Double Chocolate Chip Frappuccino - whip	16	580	22	13	86	65	14
Dunkin Donuts Coffee Coolatta with Milk	16	210	4	2.5	42	40	4
Cosi Arctic Latte	16	530	16	unknown	94	unkown	6
The Coffee Bean & Tea Leaf Ice Blended, Mocha, with non-fat milk and regular powder	16	390	7	4.7	58	39	11
Caribou Coffee Coffee Cooler	16	220	4	4	46	40	2

Luckily, you can mimic some of these frosty beverages while also cutting down on the calories.

Basic Blended Coffee Base*
Serves 2

1¼ cup strong coffee, chilled
1 cup skim milk
3 packets artificial sweetener (i.e. splenda, equal, etc.)
2 Tablespoons sugar
2 cups ice

1. Put everything in a blender and blend until desired consistency.
2. Serve.

Calories per serving: ~95

*To flavor your blended coffee, try adding a teaspoon of sugar-free vanilla, hazelnut, chocolate, or caramel syrup. These flavorings will provide additional sweetness, so you may want to decrease the amount of artificial sweetener or sugar in the recipe.

The Lowdown on Energy Drinks

In 1997, with the introduction of Red Bull, energy drinks began as a significant category in the US market. Since then, the market has grown by 50% almost yearly, and the energy drink market now totals more than four billion dollars. Clearly, this indicates that many Americans are consuming these caffeine laden trendy beverages, but are they really that good for us?

What is an Energy Drink?
Energy drinks, such as Red Bull, Monster, Cocaine, and Hype Energy, are beverages that contain large doses of caffeine, sugar, taurine, and other legal stimulants like ephedrine, guarana, and ginseng. These energy drinks may contain anywhere from 80mg of caffeine for 8 oz (about the equivalent of a strong cup of coffee) to 250mg. Energy drinks purport to have “functionality”, including increasing concentration and cognitive performance of the consumer. The basis of these statements, however, lies in inconclusive data, from a limited number of studies. To de-bunk some of these claims, we will breakdown the most common ingredients.

Caffeine
Caffeine is one of the main active ingredients found in energy drinks. In spite of extensive research, the evidence with regard to the health implications of caffeine is inconclusive. There is, however, some evidence that high acute intakes of caffeine are associated with tachycardia (fast heart beat) and acute increases in blood pressure. Too much caffeine may also cause nervousness, irritability, and insomnia. The longer term risks, or possible benefits, of caffeine on cardiovascular disease and diabetes, are less known.

Guarana
Guarana, a native South American plant, contains guaranine, a substance that is chemically similar to caffeine with likely comparable stimulant effects. There is very little information regarding the effects of guarana, and in the US, it is unregulated. As a result, many health professionals are wary of guarana-containing products.

Taurine
Taurine is a normal metabolite in the body that is synthesized from the amino acid cysteine or other sulphur or cysteine containing compounds. Taurine, which is naturally present in the diet, has been shown to have beneficial health effects, including decreasing blood pressure. No published studies have found any negative physiological effects of high intakes of taurine in healthy adults. However, there have been no conclusive studies regarding taurine’s interaction with the other stimulants in energy drinks.

The Dangers of Energy Drinks
While none of the common active ingredients in energy drinks seem to be particularly harmful alone, there has been limited research studying the combination of these ingredients on health. Energy drinks’ stimulating properties have been anecdotally reported to increase heart rate and blood pressure, dehydrate the body, and prevent sleep. These effects may be particularly harmful if the drinks are used in sporting contexts. Sports drinks, such as Gatorade and Vitamin Water, have certain compositional requirements with regard to carbohydrates, electrolytes, and osmolarity. Energy drinks, on the other hand, do not have these requirements and because they contain caffeine, a known diuretic, they can greatly dehydrate an individual, whereas in sporting events or exercise, they would be needed to rehydrate. In addition, socially energy drinks are now used as mixers for alcoholic cocktails. The danger in this lies in the fact that energy drinks are stimulants and alcohol is a depressant. As a result, the stimulant properties of the energy drinks can mask the feeling of intoxication and can lead a person to drink well beyond the safe limit. Finally, though not necessarily dangerous, energy drinks contain loads of sugar, and therefore contain numerous calories. Thus, consuming energy drinks, especially in place of water, can lead to weight gain.

Healthier Alternatives
Instead of relying on energy drinks to wake you up, there are numerous lifestyle changes you can make to boost your energy naturally.

1. Eat breakfast. Eating something in the morning can rev up your metabolism and start your day out right.
2. Eat every few hours. Oftentimes we get tired because our blood sugar drops too low. To prevent the drop, try and eat a healthy meal or snack every few hours.
3. Drink water. If you’re dehydrated, you will feel fatigued. Get your 8-10 8 oz glasses to keep you awake.
4. Decrease sweets. Consuming products high in sugar will lead to a peak in blood sugar and then a major drop. The drop is what leads to feelings of fatigue. If you cut out sweets, you’ll avoid the blood sugar swings.
5. Exercise! Getting your blood flowing and getting into shape will increase your metabolism and stamina.
6. Sleep. You’ll always feel tired if you don’t get your Z’s. Try to slow down and aim for at least 7 hours of sleep per night.