SHAPE UP
Be wary of any claims made for supplements
By Charles Stuart Platkin
I just received an incredible e-mail — could it possibly be true?
"As seen on NBC, CBS, CNN, and Oprah! The health discovery that actually reverses aging while burning fat, without dieting or exercise!" The pitch even had a link to a study on the esteemed New England Journal of Medicine's Web site.
Many 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, which regulates the marketing of supplements, conducted a review of weight-loss product advertisements and found that 40 percent had at least one false claim, while 55 percent had assertions that couldn't be substantiated.
"Many times there actually is a grain of biological truth (in journal articles and studies) as to the effect of these supplements on weight loss, but overall these supplements don't work, and some might even be harmful to your health," says Dr. Madelyn Fernstrom, director of the University of Pittsburgh Medical Center's Weight Management Program.
Keep in mind that even if a study did prove conclusively that a supplement promotes weight loss, a single study does not prove that a supplement is effective and safe.
How can a supplement company make these unsubstantiated claims? Easily — unlike over-the-counter and prescription drugs, the U.S. Food and Drug Administration does not have to approve dietary supplements for safety or effectiveness before they go to market.
While the FDA does remove supplements from the market that are found to be dangerous or harmful, the law does not currently require manufacturers and distributors of dietary supplements to investigate or forward to the FDA any reports they receive of injuries or illnesses that may be related to the use of their products. This makes documenting these adverse events extremely difficult.
So with all of these uncorroborated claims and falsified advertisements — do any of these supplements actually work?
Experts agree that most studies investigating these products have been largely inconclusive. Hydroxycitric acid, conjugated linoleic acid, chromium picolinate and ephedra are the ingredients most commonly found alone or in combination in weight-loss supplements in your drugstore or on supermarket shelves. This list is by no means exhaustive, but one thing that all four of these popular ingredients have in common is the lack of significant evidence of their effectiveness.
But of all the weight-loss supplements out there, the granddaddy of them all has to be ephedra — an amphetamine-like substance derived from the Chinese herb ma huang. Many of the most popular weight-loss products on the market contain ephedra, including Trim Spa, Metabolife 356, Xenadrine RFA-1, Hydroxycut, and Stacker 3.
While a few studies have shown that ephedra appears to affect weight loss both as an appetite suppressant and as a metabolic enhancer, experts are apprehensive: "Sure these products suppress your appetite. That is a common stimulant effect that could also be achieved with several strong cups of coffee," says New York Nutritionist Carey Clifford, M.S., R.D. "As metabolic enhancers, the effect these products can produce is negligible."
"If you just took ephedra and made no other changes in your lifestyle, you could lose a few pounds, maximum. But this would require a reasonably high dose, and the weight would come back as soon as you stopped taking product," says Dr. Arthur Grollman, professor and chairman, Department of Pharmacological Sciences at SUNY-Stony Brook.
In a nutshell, ephedra is not the "exercise in a bottle" that we all hoped it would be. The only reliable way to speed up your metabolism and burn more calories is through good, old-fashioned strength training and cardiovascular activity. And those success stories you see of toned bodies in bikinis? If they are even real, you can bet that they used the energy boost they got from the supplement to hit the gym — and that's where the real fat burning started.
In addition to its dubious efficacy, ephedra has also been shown to cause an abundance of adverse side effects. The FDA has received more than 1000 reports linking this herb to everything from dizziness, headaches and chest pain to psychosis, seizures, strokes and death. About 100 deaths have been linked to ephedra, including Baltimore Orioles baseball player Steve Bechler, who just recently died.
In a recently published study in the Annals of Internal Medicine, Dr. Steven Bent showed that products containing ephedra accounted for 64 percent of all adverse reactions to herbs in the United States, yet these products represented less than 1 percent of herbal product sales. "We found that the relative risk for an adverse reaction from ephedra was more than 100 times higher compared with all other herbs," cautioned Bent.
In fact, the one major study that showed that ephedra has some weight-loss benefits, conducted by St. Luke's-Roosevelt Hospital New York, looked at 35 healthy people who took ephedra. Almost a quarter of the participants dropped out of the study because of side effects that included heart palpitations, chest pains and high blood pressure, yet the ephedra industry issued a press release claiming that ephedra is safe and effective, and gave no mention of the adverse side effects.
Ephedra has been banned by the NCAA, the NFL and the International Olympic Committee. Even municipalities are taking steps to speed up what many experts claim the U.S. government has failed to accomplish — Suffolk County in New York will become the first region to completely ban ephedra sales.
Even if the side effects and other potential dangers don't scare you away, it should be noted that many of the studies that show efficacy of any supplement are done in very controlled environments — not with bottles off the shelves.
Researchers are testing pure extracts and carefully prepared dosages with medically supervised usage — it's doubtful that this is what you're getting at your local drugstore.
Additionally, a recent test by consumer watchdog group Consumer Labs found that a popular chromium picolinate supplement was contaminated with Chromium VI — a known carcinogen that was responsible for the illnesses recently featured in the movie Erin Brokovich. Remember, supplements are not regulated or tested — so you never really know what you're going to get.
I guess it's back to the treadmill for me.
Charles Stuart Platkin is a syndicated health, nutrition and fitness columnist.
