Welcome to our Health Newsletter!

I hope you find this information helpful in your quest for weight loss, fitness, and better health. Use the quick navigation menu to the left to move to topics quickly. If you have questions or topics that you would like to see in our newsletter, please let me know!

The Buzz on Ephedra

Ephedra, or Ma-Huang, has been in the press a lot lately, and is commonly available at many drug stores and health food stores to help promote weight loss. The branches of this shrub, which grows predominantly in Mongolia and China, are harvested, dried, and processed for medicinal use. The active ingredients in Ephedra are ephedrine and pseudoephedrine, which are also common ingredients found in over the counter cold remedies, such as Sudafed or Dimetapp. Ephedra has been commonly used for treating bronchitis, sinus congestion, and asthma. It has also been promoted as an appetite suppressant and diet aid.

There have also been some recent medical publications which have looked at how effective ephedra is for weight loss.¹ This article in the Journal of the American Medical Association was a summary of over 20 published studies using ephedra for weight loss. The authors concluded that in the short term (up to 6 months), those patients that used ephedra had a greater weight loss (about an one extra pound per month) compared to those people that took a placebo (sugar pill). However, there were also a much greater number of side effects seen in those people that took ephedra. The bad effects included agitation and anxiety, tremors, difficulty sleeping, palpitations, headaches, and high blood pressure, just to name a few. Other research has implicated ephedra as potentially causing stroke and heart attack in some people.

Now let's not kid ourselves, either. Ephedra is a drug. Any "supplement" that you take, whether it is a vitamin, mineral, or herb, is a drug, you just don't need a prescription for it. There is no question that supplements may be helpful and beneficial to your health, but they most certainly have side effects and bad effects as well. For instance, vitamin A in large quantities can cause severe liver disease and be quite toxic. Even modest doses of niacin (vitamin B3) can cause palpitations and flushing. Iron supplements over time can be harmful to the liver, heart, and kidneys. Hemlock has been used to commit suicide for eons. Certain herb combinations have been used to induce abortions in certain cultures. Remember, just because it's "natural" doesn't mean it's safe and without side effects.

So Doc, what's the big deal about ephedra? The first issue is that there is no standardization of the raw herb. That means that if you took 10 tablets of ephedra from 10 different manufacturer's, or even 10 different bushes, you might have 10 different levels of the active ingredients. You are at risk of overdosing on the amount of ephedrine, even if you are taking the "recommended" number of tablets or capsules because you really don't know just how much drug is in each capsule. Finally, what happens when you want to stop the drug? If you haven't changed the way you eat or exercise, you'll eventually gain the weight back. Welcome to the "Yo-Yo" effect. In order for you to lose the weight and keep it off you need to modify the type of foods you eat, the amount you eat, and your activity.

By the way, I am not a big fan of prescription weight loss pills either. Medications like Meridia and Xenical have plenty of potential side effects. I think it comes down to the same issue: you have to make up your mind that you are going to change the way you eat and your level of activity. No pill, potion, or supplement is going to help you make that decision, it has to be done on your own, by yourself, and for yourself. This is not something you decide to do for 6 weeks, 6 months, or 6 years. This decision must last for the rest of your life!      Back to the top.

¹ JAMA, March 26, 2003; 289:1537-1545.

Your Weight Loss Questions

A reader asks about the nutritional value of her homemade smoothie:

I'm a 42-yr-old, healthy female, good fitness, but about 15 lbs over-weight. I LOVE food and I try very hard (without really 'dieting') to cook/eat sensibly, believing strongly that moderation and good nutrition is key to everything healthwise. Now, to the point....each day I use my VitaMixer to make a particular drink which I take to work for a mid-day snack. It contains all or any variation of the following ingredients: a handful of walnuts, handful of carrots, handful frozen spinach and/or mixed greens, lo-acid orange juice, banana, plain soy-milk and/or plain yogurt...sometimes a few frozen blueberries/strawberries and maybe even a handful of raw oatmeal....whatever of these I have on hand, usually a little of all. My VitaMixer purees it all down to a completely smooth drink, if too thick, I thin it down with a little water or extra juice. It sounds absolutely awful, but actually 'tastes' good, really.

Could you please assess the nutritional value and/or health benefit of this 'smoothie'. It is extremely satisfying, really picks me up, and makes me feel good. Also, you should know that my regular 'meals' are usually well-balanced...a small portion of meat and larger portion of veggies(usually steamed or sauteed). We do not substitute these drinks for regular meals. Thanks so much.

Answer:

Your "smoothie" contains a great deal of important vitamins and nutrients (especially in the blueberries and spinach) and includes omega 3 fatty acids in the walnuts (which can lower cholesterol, especially in combination with the oatmeal). As a snack, you are correct that this concoction is far healthier than anything you can buy, and sounds like a wonderful supplement to your health.

My only caution is about the potential for added calories if you are trying to lose weight. It may be difficult to estimate the total calories in your drink since it is "a handful" here and a "pinch" there. Overall, your drink is relatively high in carbs (both simple and complex), low in fat, and high in nutrition (no empty calories). I favor your drink far more than an handful of vitamin pills or supplements. I am not against vitamins or supplements, but think that if you get the important nutrients in your diet rather than a pill, they are better complemented by other substances in foods and vegetables that the pills don't have. Frankly, I wouldn't change a thing if it satisfies you and makes you feel good. It would be an excellent snack prior to exercise, and I absolutely think that it adds to your overall health.   Back to the top.

This Month's Recipe

Vegetarian Fajitas

A simple, satisfying, and easy meal to anticipate the warm spring and summer evenings. Low in fat (only 27% of this dish's calories come from fat), tasty and very satisfying.

Ingredients

2 teaspoons vegetable oil
1 cup quartered, sliced onion
1/2 cup sliced mushrooms
1/2 cup red bell pepper strips
1/2 cup green bell pepper strips
1 can (15-oz.) pinto beans, drained
1/2 cup whole kernel corn
1 package (1.25-oz.) taco seasoning mix
1/3 cup water
1/4 cup chopped fresh cilantro
6 (6-in.) flour tortillas, warmed
1 cup cheddar cheese, shredded.
6 tbsp sour cream (one per fajita)

Sauté onion, mushrooms, and peppers in vegetable oil in large skillet over medium-high heat. Stir until vegetables are tender (about 3-4 minutes).

Add in beans, corn, fajita seasoning mix and water; bring to a boil. Reduce heat to low; stirring occasionally, for 3 to 4 minutes or until mixture thickens. Remove from heat; stir in cilantro. Add 1/2 cup of this fajita mixture to each tortilla and top with 1 tbsp of sour cream; fold in half and serve. Makes 6 fajitas (per fajita, including sour cream: Calories 252, Protein 8.2 g, Total Fat 7.5 g, Carbohydrate 36.7 g, Sodium 781 mg).   Back to the top.

Site News

The Smart Calorie Health and Nutrition Support Forum is up and running! You can now ask general weight loss and diet questions to a community with similar goals and philosophies. Though this will be a public forum, there is also a method to send private messages to individuals as well. Access the public discussion boards and sign up for free. The more who join, the better the discussions!

If you have found My Deluxe Calorie Diary, My Recipe Diary, or the Body Fat Calculator helpful, consider donating here. With a minimum donation of $15 for the programs, you will gain access to a private Support Board at the Smart Calorie Health and Nutrition Support Forum. I will be moderating this private board and answering your specific weight loss and nutrition questions.

In next month's newsletter we'll have a guest author, Phillip Candito. Mr. Candito is a frequent speaker on exercise and fall prevention, and is a member of the American Physical Therapy Association. He will be writing on how to take your first steps into the world of regular exercise and activity. Stay tuned...   Back to the top.

If you have comments about this month's newsletter, feel free to e-mail me. If you know someone who would enjoy this newsletter, feel free to forward a copy to them! They can also sign up for their own copy here.

©2003 TMM Medical Consultants