Beyond Ephedra
The truth behind nine fat-burning alternatives.

By David Kennedy

Along with Britney Spears, “Survivor,” Tae-Bo and the Backstreet Boys, go ahead and add ephedra to the list of “what’s out” in 2003. Store shelves that used to be jammed with products containing the controversial dietary supplement are filling with alternatives like CLA and green tea, as a shift in consumer demand coupled with unrelenting controversy has many supplement makers and suppliers turning their back on history’s most popular fat burner..

Last November, General Nutrition Centers (GNC), the country’s largest retailer of dietary supplements, began requiring customers to show proof they are 18 or older before buying products containing ephedra. At the same time, Twinlab Corp. announced it would discontinue the manufacture of all ephedra products, effective this spring. And earlier this year, Vitamin Cottage Natural Grocers and 7-Eleven Corp., along with supplement distributor EAS, announced they, too, are ending sales of products with ephedra.

“This is a consumer-driven decision for EAS,” says Jim Heidenreich, EAS vice president of marketing. “We believe consumers are showing a strong preference for non-ephedra weight-management products.”

Controversy over ephedra’s safety continues to swirl. Critics have asked the Food and Drug Administration to ban sales of ephedra, citing numerous adverse event reports filed with the FDA. However, experts like Columbia University researcher Dr. Carol Boozer caution against making cause and effect determinations of ephedra’s safety based entirely on FDA adverse event reports. “With millions of Americans consuming ephedra-containing products, it is obvious that some number of adverse events is expected each year regardless of consumption of these products,” Dr. Boozer says. “The real question is not whether adverse events occur in a population undergoing treatment (taking ephedra supplements), but whether these occur at a rate that is higher than that of a matched, untreated group. This is impossible to determine from adverse event reports alone. The randomized placebo-controlled trial allows evaluation of cause and effect relationships versus coincidental events.”

Last year, in the longest and most comprehensive study of ephedra’s efficacy and safety to date, Dr. Boozer, along with colleagues from Harvard University, confirmed the supplement’s fat-reducing effects and found no evidence of adverse effects. “Compared with placebo, the tested product produced no adverse events and minimal side effects that are consistent with the known mechanisms of action of ephedrine and caffeine,” Dr. Boozer says. “In total, these [results] suggest that herbal ephedra/caffeine supplements, when used as directed by healthy overweight men and women in combination with healthy diet and exercise habits, may be beneficial for weight reduction without significantly increased risk of adverse events.”

Still, consumers, perhaps wary from the negative publicity ephedra has received, are turning to non-ephedra alternatives. “I don’t know if ephedra is safe or not, but I just feel more comfortable taking something without it,” says Lisa Resseguie, 38, of Arvada, Colo., who lost 27 pounds of body fat after following the Body-for-LIFE Program and using a few of the more popular ephedra alternatives.

What are the alternatives?
While ephedra sales are slumping compared to years past, the market for non-ephedra products is taking off. According to Information Resources, Inc., sales of ephedra-free weight-loss supplements were up 255 percent in 2002 (spanning a 52-week period ending 11/20/02) from the year before. The good news is the research does indeed look promising for a few of these nutrients. The bad news is some may slim little more than your pocketbook.

Supplement Key
Green light: Research promising; may be a supplement worth trying
Yellow light: Research preliminary; proceed with caution
Red light: Research paltry; don’t waste your money

Caffeine
Caffeine is one of the more well-researched nutrients available today. Studies show it may help liberate fatty acids from body-fat stores, thus possibly increasing your body’s ability to burn fat.2,7 What’s more, studies show caffeine enhances both short-term and long-term endurance performance1,6 and seems to delay fatigue, allowing for more effective aerobic workouts (and perhaps, therefore, greater body-fat reductions).

Recommended serving: Effective doses range between 100 milligrams and 200 milligrams, two to three times per day.
Rating: Green light

Chitosan
Chitosan is popularly promoted as a “fat blocker,” with some advertisements going so far as to claim the nutrient can block the absorption of up to 120 grams of dietary fat per day. No so, according to one study recently published in the International Journal of Obesity.5 “Results showed that consumption of this chitosan supplement did not increase fecal fat content and therefore did not block fat absorption,” the researchers concluded. Bottom line: Don’t waste your money.
Rating: Red light

CLA
Numerous studies have noted CLA’s effectiveness in reducing body fat. Among the most intriguing is one published recently in the International Journal of Obesity, which found that the nutrient may be particularly effective at reducing abdominal fat.8 In all, 25 people participated in the double-blind trial—14 received 4.2 grams of CLA per day while the others received a placebo. After four weeks there was a marked decrease of abdominal diameter (1 full inch) among the CLA group.

Recommended serving: Try taking 1 to 1.5 grams three times a day with meals.
Rating: Green light

Essential fatty acids (EFAs)
EFAs, like minerals, vitamins and essential amino acids, are essential to good health and optimal metabolism. “They act like hormones that increase fat burning and decrease fat production in the body,” says Dr. Udo Erasmus, author of the New York Times bestseller Fats that Heal, Fats that Kill. “They shift the body from carbohydrate-burning mode to fat-burning mode. They turn up heat production (thermogenesis), which keeps us warm and increases fat burn-off as heat.”

Recommended serving: Try taking between 2 to 5 tablespoons of an appropriate EFA-rich oil mixture with omega-3s and omega-6s in the right ration. Two solid choices include hemp seed oil, which, according to Dr. Erasmus, is nature’s most perfectly balanced EFA oil, and Udo’s Choice Perfected Oil Blend (www.udoerasmus.com).
Rating: Green light

Green tea extract
A 1999 study published in the American Journal of Clinical Nutrition showed green tea extract may increase 24-hour energy expenditure and fat oxidation (burning) in humans.3 Some have speculated these effects may be due to green tea’s caffeine content. However, the authors of this study found evidence to the contrary. “Green tea extract,” they write, “has thermogenic properties and promotes fat oxidation beyond that explained by its caffeine content per se.” They continue, “Green tea extract may play a role in the control of body composition via sympathetic activation of thermogenesis, fat oxidation or both.”

Recommended serving: Try taking 200 milligrams to 300 milligrams daily. Look for a standardized extract containing at least 40 percent EGCG.
Rating: Green light

Octopamine
A study published in January 2000 concluded that “octopamine could be considered as an endogenous selective beta 3-adrenergic agonist.”4 (The beta 3 is a kind of receptor on fat cells that when stimulated may increase fat loss). “For the past decade or so, studies with beta 3-adrenergic agonists have suggested that they could specifically increase metabolic rate, reduce amounts of white fat (the storage form of fat that is the majority type of fat in the body) without causing a decrease in either food consumption or lean muscle mass,” says Duke University researcher Dr. Sheila Collins, one of the world’s leading researchers in this area. “There is still great hope for beta 3-agonists as therapeutic agents to combat the epidemic of the bulge,” Dr. Collins says, “but at this point more research is needed to understand the biology of this loss of response to beta 3-agonists.”

Recommended serving: 200 milligrams one to two times daily.
Rating: Yellow light

Phosphatidylserine (PS)
Few things contribute to abdominal fat storage quite like the “stress” hormone cortisol. According to a new study out of University Hospital in the Swedish city of Gothenburg, elevated cortisol levels (provoked by both emotional stress and physical stress, like sleep deprivation and vigorous exercise) stimulates a fat-gathering enzyme, which is more easily taken up by the abdomen than other parts of the body. One nutrient that may help keep your cortisol levels in check, and thereby contribute to a slimmer waistline, is called phosphatidylserine (PS). According to several studies by Italian researcher Dr. Palmiero Monteleone, PS supplementation seems to blunt cortisol release significantly secondary to stress. In one study published in the journal Biology of Sport, PS supplementation reduced cortisol levels by 30 percent compared to a placebo following exercise.

Recommended serving: Try taking 200 milligrams right after exercise and another 200 milligrams 30 minutes before bedtime. Ask for it at specialty health-food stores like GNC and the Vitamin Shoppe.
Rating: Yellow light

Pyruvate
To date, there are over a dozen clinical research studies assessing pyruvate’s effects. And the results have been, for lack of a better term, bastardized to such a degree that the average person might be led to believe this stuff is the next best thing to the magic bullet. But nothing could be further from the truth. The fact is there isn’t a single study supporting the fact that a typical 3-gram to 5-gram daily dose of pyruvate will do much of anything. Don’t believe the advertisements that claim this nutrient can “increase fat loss by 48 percent!” Truth be known, studies showing this kind of effect used 22 grams to 28 grams of pyruvate per day. Consuming this much pyruvate would make most people sick to their stomach.

Rating: Red light

Synephrine
One of the most popular alternatives to ephedra, synephrine is said to be ephedrine’s “calmer chemical cousin,” meaning it may have ephedrine’s beta agonistic (thermogenic/body-fat reducing) effects while being less stimulating to the central nervous system. One 1999 study published in the journal Current Therapeutic Research showed that a combination of citrus aurantium extract, caffeine and St. John’s wort caused significant reductions in body fat in overweight healthy adults.2 Other research has looked at the thermogenic properties of compounds found in citrus aurantium, including synephrine, and the results look promising.

Recommended serving: 20 milligrams of active synephrine, in combination with caffeine, may be helpful.
Rating: Green light

Buyer beware: Don’t get taken by these “red light” specials

Hot Mommies™ Essential 3™
One of the most ridiculous infomercials on the tube these days is for a product called “Hot Mommies Essential 3.” The marketers of this product are pitching it to new mothers and go so far as to actually call it a “miracle pill.” Among the numerous claims, they say this product will help you “quickly and effectively eliminate unwanted body fat,” and “increase physical vitality” by “boosting chi.”

“First of all, this product contains a lot of herbs that really don’t make any logical sense to take together,” says biochemist Rehan Jalali, president of the Supplement Research Foundation. It is a kitchen sink of various herbs at inefficacious doses. What’s more, these doses are not standardized, according to the label. When an herb is not standardized for the active ingredient, it shows me that it is lower quality and you may not be getting enough of the active ingredient.

“One of the ingredients in this blend is licorice root, which has actually been shown to increase water retention—not something any woman or ‘mommy’ I know wants,” Jalali says.

Rating: Red light

Peel away the pounds
Another infomercial getting a lot of airplay of late is for a system called “Peel Away the Pounds,” which includes a product called “Pound A Patch.” This is a patch where you “simply apply the one-of-a-kind patch on your arm, follow the program and excess weight disappears!”

“This ‘wonder patch’s’ main ingredient is called fucus vesiculosus, which is a type of seaweed,” Jalali says. “It also has an undisclosed amount of the herb garcinia cambogia. But I want to know how they think they can transfer an herb and a seaweed across the skin in efficacious doses to have any effects. What’s more, for those keeping score, fucus vesiculosus does not have any peer-reviewed, published studies showing that it causes fat loss or appetite suppression. In fact, one clinical study published in 1996 actually suggests that this ingredient has no effect whatsoever on fat loss.”

Rating: Red light

References cited
1C. Bruce, et al., “Enhancement of 200-m Rowing Performance After Caffeine Ingestion,” Med. Sci. Sports Exerc. 32.11 (2000) : 1958-1963.
2C. Colker, et al., “Effects of Citrus Aurantium Extract, Caffeine and St. John’s Wort on Body Fat Loss, Lipid Levels and Mood States in Overweight Healthy Adults,” Curr. Ther. Res. 60.3 (1999) : 145-153.
3A.G. Dulloo, et al., “Efficacy of a Green Tea Extract Rich in Catechin Polyphenols and Caffeine in Increasing 24-h Energy Expenditure and Fat Oxidation in Humans,” Am. J. Clin. Nutr. 70.6 (1999) : 1040-1050.
4E. Fontana, et al., “Effects of Octopamine on Lipolysis, Glucose Transport and Amine Oxidation in Mammalian Fat Cells,” Comp. Biochem. Physiol. C. Pharmacol. Toxicol. Endocrinol 125.1 (2000) : 33-44.
5M.D. Gades and J.S. Stern, “Chitosan Supplementation Does Not Affect Fat Absorption in Healthy Males Fed a High-Fat Diet, A Pilot Study,” Int. J. Obes. Relat. Metab. Disord. 26.1 (2002) : 119-122.
6T. Graham, “Caffeine and Exercise: Metabolism, Endurance and Performance,” Sports Med. 31.11 (2001) : 785-807.
7M. McCarty, “Optimizing Exercise for Fat Loss,” Med. Hypotheses 44.5 (1995) : 325-330.
8U. Riserus, et al., “Conjugated Linoleic Acid (CLA) Reduced Abdominal Adipose Tissue in Obese Middle-Aged Men with Signs of the Metabolic Syndrome: A Randomised Controlled Trial,” Int. J. Obes. Relat. Metab. Disord. 25.8 (2001) : 1129-1135.