Taking pills and supplements

Pills and supplements both have their uses, but only in moderation and only as long as strict guidelines are followed.

Over-the-counter (OTC) diet pills

The 1991/2 Weight Loss Practices Survey, sponsored by the US Food and Drug Administration (FDA) and the National Heart, Lung and Blood Institute, found that 5 per cent of women and 2 per cent of men trying to loseweight use diet pills. Products considered by the FDA to be OTC weight- control drugs are primarily those containing the active ingredient phenylpropanolamine (PPA), such as Dexatrim and Acutrim. PPA is available over the counter for weight control in a 75mg controlled-release-dosage form. The medicine should be used in combination with a restricted diet and exercise.

Using diet pills containing PPA will not make a big difference in the rate of weight loss, says Robert Sherman of the FDA's Office of OTC Drug Evaluation. 'Even the best studies show only about a half pound (250g) greater weight loss per week using PPA combined with diet and exercise,' he adds. Sherman cautions that the recommended dosage of these pills should not be exceeded because of the risk of possible adverse effects, such as raised blood pressure and heart palpitations.

Supplements

To rely on taking pills as a way of supplying nutrients is not ideal, for in a perfect world such nutrients should come from our food. But when you consider the quality of some of our food — fruit and vegetables grown in mineral-depleted soil, picked before they have ripened and shipped over vast distances in refrigeration, then put into long-term storage; meat full of hormones; grains stripped of most of their nutritional content — then taking a good multivitamin supplement and possibly extra vitamin C can benefit most people. And while you are trying to balance your blood-sugar levels, reduce body fat and rebuild lean muscle tissue, there are a few supplements that may help.

Key supplements

Magnesium

A fundamentally important mineral that counters insulin resistance.

It is hugely deficient in the Western diet. Consider taking 230-600mg per day, unless you have suffered kidney failure or have a high degree of AV heart block.

Quercetin

A flavonoid with powerful anti-inflammatory properties that helpsto control high insulin levels and inhibit fat production. Take 200-400mg three times a day before meals.

Omega-3 fats

If you don't eat fish, take 1,000-3,000mg of fish oil daily in capsule form. Vegetarians can use flaxseed oil or crushed flaxseeds instead of fish oil capsules. Try flaxseed oil in salad dressings (or even in smoothies) to ensure you get enough of this health-enhancing fat.

Chromium

A trace element that plays an important role in carbohydratemetabolism and regulating blood-sugar levels. It has proved useful in treating diabetes and shown to be effective in encouraging the body to lose fat, not muscle, when dieting. Take 400-600mcg of chromium picolinate or chromiumpolynicotinate a day.

L-carnitine

Used extensively by athletes to ensure maximum performance inendurance or aerobic sports. It is also useful for weight loss because it is involved in burning fat in muscle cells. Take 1,000-3,000mg per day.

DIETARY MYTH

Myth: I will get quicker results if I use diet pills.

Fact: there are no shortcuts — no magic pills. Losing weight sensibly and safely requires a multifaceted approach that includes setting reasonable weight-loss goals, changing eating habits and getting adequate exercise. Appetite suppressants (diet pills) may help some people in the short term, but they are not a substitute for adopting healthy eating habits in the long term.

Vitamin supplements - the facts

Most doctors and dietitians agree that an adequate diet selected from a range of foods in the Five Food Groups and taken in the recommended portion sizes, will ensure a satisfactory intake of all nutrients, including vitamins. However, it is also recognised that vitamins which are constantly needed in the metabolism can be compared to an integral part of a work force on a factory assembly line. Each worker has a specific and vitally important role to play and his absence can jeopardise the smooth running of the whole system.

In the case of an unsatisfactory vitamin intake, one should first and foremost try to rectify the situation by improving one's diet, as food sources of vitamin also include other essential nutrients - some of which may still be unknown. Incidentally, the reason for choosing a food source rather than a vitamin in pill form is not that one's system absorbs it better - the body is in fact unable to distinguish between natural and synthetic compounds in this way. Each vitamin - whether manmade or naturally available - is a very specific compound with a unique molecular structure which is handled by the body in a particular way.

Supplements should however be considered only if, for some reason, your vitamin needs exceed your dietary intake. For example, people on strict long-term weight-reducing diets, heavy smokers and drinkers, pregnant women taking a less-than-optimal diet to cover the needs of two, or people living in isolated areas (or away on expeditions) who are unable to obtain the necessary variety of foods, may all benefit from vitamin supplements. (Incidentally, a pregnant woman should always take a supplement under a doctor's supervision only.)

A recent study (by Macfarlane et al) on 774 Indian women in Durban showed that 25% had iron deficiency anaemia and an additional 17% showed sub-clinical signs of this deficiency disease. The authors concluded that South African Indian women should receive iron supplementaton during pregnancy, as their cultural dietary habits promote an inadequate intake of this important trace element.

It has also been found that heavy smokers need more vitamin C than do non-smokers, as smoking seems to reduce the availability of vitamin C in food to the body.

The dangers of the overdose

Megadoses of vitamins are a different story. Some people assume that if a small amount of a vitamin supplement is useful under certain circumstances, more would be even better, but this is not so - in fact, abnormally large quantities of the fat-soluble vitamins (A,D,E and K) can be toxic as they accumulate in the body and excesses are not immediately lost in the urine, as is usually the case with water-soluble vitamins. However, care should be taken even with the latter: cases of `rebound scurvy' have occurred in babies whose mothers have taken excessive amounts of vitamin C during pregnancy - with the result that the baby's body reacts as if deprived when it has to depend on its own food intake after birth.

A recent study (by Read et al) in which people in seven states in the USA were questioned about their health beliefs showed that regular supplement users (who were predominantly married Caucasian women between the ages of 20 and 79) believed that supplements decreased their susceptibility to health problems ranging from colds to heart attacks and cancer, and/or reduced the severity of those problems. They also found that the higher the user's level of education, the larger the number of supplements taken, but the bottom line of the study was that more non-users rated their health as 'excellent' than regular users. The authors concluded that it remains a paradox that the well-educated, settled members of the community who are in a position to obtain all their nutrient requirements from a balanced diet, continue to be the most regular users of vitamin and mineral supplements.