"Diet and Weight Management"


    Meal Substitutes

    When used as substitutes for regular meals, meal substitutes
    are a convenient way to reduce calories as part of a low calorie
    diet plan. A typical meal substitute available in powder and liquid
    form is Slim-Fast. Ensure is another meal substitute available in
    both liquid and bars. Meal substitutes should provide protein and
    be low in fat and calories. The label should include the amount of
    calories per serving and the percentages of protein, carbohydrates,
    and fat. The total number of calories per serving is predetermined
    so it is easier to keep track of the daily consumption of calories.

    Artificial sweeteners

    Saccharin (Sweet 'N Low) and aspartame (Equal) are sugar
    substitutes that provide little or no calories. They may be used
    as a substitute for table sugar. Using saccharin instead of a
    teaspoonful of sugar eliminates 33 calories from the diet.
    People with phenylketonuria (a serious genetic disease in
    which an individual is unable to break-down and eliminate
    an amino acid, phenylalanine) should not use aspartame
    because it contains phenylalanine. Fructose, sorbitol and
    xylitol may be used as alternatives to sugar, but they provide
    more calories than saccharin and aspartame. Excessive
    use of sorbitol also may cause diarrhea.

    Over-the-Counter (OTC) weight-loss products

    Despite claims by manufacturers, the use of OTC products
    alone does not cause weight loss. Herbal weight loss products
    or preparations called "fat burners" are even more misleading.
    These products may contain a combination of ma huang
    (a botanical source of ephedrine), #016EBB willow (a source of salicin),
    and/or guarana or kola nut (a source of caffeine). These agents
    are stimulants, which theoretically increase the metabolism and
    help the body break down fat. Nevertheless, there is no evidence
    that they are effective for weight loss. In addition, ma huang has
    been linked to serious side effects such as heart attacks, seizures,
    and death. Chromium also is a popular ingredient in weight loss products,
    but there is no evidence that chromium has any effect on weight loss.

    Weight loss teas contain strong botanical laxatives (Senna, cascara sagrada) and
    diuretics (Rhamnus purshiana) cause diarrhea and loss of water from the body.
    Diarrhea and water loss lead to the depletion of sodium, potassium and can lead
    to dehydration. Although an individuals weight may decrease, the loss is fluid and
    is only temporary. Moreover, low sodium and potassium levels may cause abnormal
    heartbeats and can even lead to death.

    Guar gum preparations have also been promoted as a weight loss agent. Guar gum
    thought to work by leading to a feeling of fullness early in the meal. It has not been
    scientifically proven, and has been associated with abdominal pain, gas and diarrhea.

    All of the OTC products discussed above are not considered drugs and are therefore
    not regulated by the Food and Drug Administration (FDA). As a result, there is little
    information on their effectiveness or safety.

    Phenylpropanolamine
    The United States FDA in November 6, 2000 took steps to remove phenylpropanolamine
    (PPA) from all drug products and requested that all drug companies discontinue
    marketing products containing phenylpropanolamine. The FDA issued a public
    health advisory concerning the risk of hemorrhagic stroke, or bleeding into the brain,
    associated with phenylpropanolamine hydrochloride. For more information about the
    FDA Advisory, please read the Doctor's View, FDA Issues Public Health Warning on
    Phenylpropanolamine


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