By Chris Mohr, PhD, R.D., CSSD
A: That's a very timely question as it was approved to go over the counter June 15, meaning it's available now. Orlistat, also known by its brand name Xenical, works by reducing the absorption of some of the fat consumed in the diet. Of course, if you decrease your absorption of dietary fat, you decrease the amount of calories you eat. This in turn should enhance weight loss efforts. It is the first FDA-approved, over- the-counter fat loss product and will go by the name, Alli. Alli contains half the dose of its prescription counterpart — Orlistat. The data with Orlistat itself is not tremendously strong, in my opinion. Of course there are some studies that show it may enhance weight loss above and beyond diet alone, but there also are some potential side effects including:
Pleasant, right? Now the key with this particular drug, or the over-the-counter version, Alli, is that you must follow a low-fat die t. If you don't follow those “rules,” you will have a higher likelihood of having some of the side effects listed above. Glaxo SmithKline, which is marketing this product, has done a fantastic job at providing sufficient educational information on following a low-fat nutrition plan. My concern is that people may not heed these warnings because they associate over the counter with safe. All it takes is one dietary ‘flub' to have some very serious side effects. All in all, what we know is that weight loss requires a number of factors:
Once all of those are in place, if a person feels that Alli would benefit them above and beyond those three factors alone, they should speak with their physician and understand the lifestyle changes that need to be made. This is not a quick fix, magic pill by any means. Just because it is over the counter, does not necessarily mean it is safe. We do know all three of those factors above are safe and effective in the long term! Please talk with your physician about this or any other over-the-counter product you are considering.
Publisher's note : Walgreen's sent a flyer about Alli in our neighborhood which includes $1 off the book called Are you losing it? and also a $2 off coupon for Theragram-M vitamins. Diarrhea can cause a lose of nutrients.
I get this question often. First and foremost, make sure your diet is in order. All too often people turn immediately to supplements to improve their health, yet they are eating no fruits and vegetables, they are not eating breakfast, and they are having fast food several times each week, for example. Dietary supplements are intended to supplement a diet; not make up for what you're lacking from foods! With over 30,000 available supplements, though, it's hard to sort through the hype to dig up the truth.
Fish oil is surely making waves (pardon the pun) lately and for a good reason. The scientific evidence is clearly mounting for healthy fish oils, known as omega-3 fats. Omega 3 fats are known as essential fats, meaning you must consume them through the diet; your body cannot make them on its own.
Research has suggested that those who have higher omega-3 fat intakes have a decreased risk of inflammatory diseases, such as heart disease, Alzheimer's, rheumatoid arthritis, and many others. High omega-3 consumption is one of the major explanations why Eskimos, who eat an extremely high fat diet, still have low levels of heart disease.
Omega 3 fats help reduce inflammation — they are anti-inflammatory. In fact, recent research out of the University of Pittsburgh actually demonstrated that fish oil is effective for reducing the symptoms of chronic neck and low back pain (again, which can stem from inflammation). This particular study included 250 patients who were given 1.2-2.4 grams of Nordic Naturals Pro EPA fish oil. After an average of 75 days of fish oil supplementation, 60 percent of respondents reported significant improvements, including reduction in overall pain, and 59 percent were able to stop taking other pain medicine (NSAIDs). None of the patients experienced significant side effects and 88 percent of the respondents planned to continue using the fish oil supplements. That's pretty impressive data. And think about the carry over to life; most Americans do experience back pain in their lives. Rather than looking at simple, safe ways to reduce this pain, they often turn to over the counter NSAID's (think aspirin) or get prescriptions from their doctors for anti-inflammatory agents. Neither of these are the safest when used consistently over time. Fish oil, and of course proper exercise, is a much smarter and healthier alternative. And the data doesn't just end. There is a whole slew of other supportive data for everyone from infants and pregnant women to the elderly.
With that said, it is very important to make sure you choose the highest quality fish oil supplement. You have likely heard about the concern over mercury and other contaminants in fresh fish. Well of course it is important that your fish oil be free from all of those as well. I mentioned that the study above used Nordic Naturals, which is the brand I recommend — they have a very pure, high quality product that can be verified through third party testing, to make sure what you are taking is safe. Another testament to the Nordic Naturals quality is that they have been used in several research studies, including the one I mentioned above — if they're being used as the benchmark, you know they're good!
I of course absolutely recommend eating plenty of cold-water fish to meet the American Heart Association Guidelines of 12 ounces of fish per week. A favorite of mine is Wild Alaska Salmon, since it's both high in omega-3 fats and lower in contaminants. And this is salmon season, so you can buy it locally at many stores throughout the area. The nice thing about fish is that it provides a bevy of other nutrients, above and beyond just omega-3 fats, including protein, zinc, iron, and many others.
Fish oil should not be a substitution for including fish in the diet; it should merely be an adjunct after speaking with your physician and letting him/her know you are interesting in taking it. With all the mounting research in this area, some may call omega 3 fats the “panaSEA”.
I highly suggest you do some of your own investigative research. One Web site that I like is www.omega-research.com . This site has done a nice job of summarizing a lot of the research using fish oil for different needs and individuals.
Always think about the exact definition of dietary supplement—it should be used to supplement the diet. Keep those simple ground rules in mind that I mentioned above and then, once you speak with your physician, determine if you should consider supplementing your diet.
