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1. What is the purpose of this treatment?
The purpose of this treatment is weight loss by speeding up the metabolism. It is supposedly “ a fat loss breakthrough,” and is a state of the art thermogenic formula designed to help reduce body fat during a low-calorie diet that is combined with exercise. (http://www10netrition.com/twinlab_ultimate_diet_fuel_page.html).
2. What is the rationale behind this treatment?
Diet Fuel contains two main elements which are Chromium Picolinate and Citrimax. Chromium Picolinate is an important supplement that will help you build muscle and burn fat while Citrimax also helps increase energy (http://www.1dietproduct.com/diet_fuel.html). There are many types of Diet Fuel, but several brands. In another brand, Diet Fuel starts with a potent thermogenic blend of natural ephedrine alkaloids, as well as caffeine. It adds Citrus Aurantium, plus a proprietary metabolic and thermogenic blend to enhance fat loss. It also has a highly concentrated amount of Green tree extract, which helps stimulate thermogenesis (http://www10.netrition.com/twinlab_ultimate_diet_fuel_page.html). Thermogenesis is when “energy is neither created nor destroyed. Energy is transformed, converted, transported and stored. Thermogenesis is also the creation of heat. There are three types of thermogenesis. The first kind is work-induced from exercise. Our muscles must create heat because warm muscles work much more effectively that cold muscles. The next form is called thermo-regulatory thermogenesis. This is involved with keeping the temperature of the human body regulated. The third type of thermo genesis is called diet-induced thermo genesis. The thermogenic system of the body is triggered by the sympathetic nervous system. Under conditions of cold or eating a lot of food, the hypothalamus gland can register this and then trigger the sympathetic nervous system, which is an automatic nervous system. The sympathetic nervous system controls many things, such as heartbeat and breathing, that we are not normally conscious of (http://www.all-natural.com).
According to the manufacturers, by using Diet Fuel, you will feel stronger and burn fat faster than anything else. With the thermogenic aid, one will increase mental alertness and enhance physical performance. The debate in Diet Fuel’s validity lies in the fact that it contains 334 mg of MaHuang and 909 mg of Guarana (http://www.slimstore.com/diet fuel.htm).
3. What are the claims of MaHuang and Guarana?
MaHuang is an herbal supplement found in many forms. The Chinese have used MaHuang for over 5,000 years, particularly to treat asthma and reduce upper respiratory infections (http://www.ephedra.net). These include powder, pill, or as a liquid. Ephedrine comes from MaHuang and this is found in many medications for the treatment of colds and flu (http://www.healthdietnews.com). Natural Ephedrine is a stimulant like coffee and tea. Ephedrine stimulates the adrenal glands, ( or the sympathetic nervous system) which increases the metabolism and causes vasoconstriction of the blood vessels in the lining of the nose. It also dilates the bronchial tubes and stimulates the heart (http://www.ephedra.net). Ephedra has the ability to open up the adrenergic receptor sites found primarily in the heart and lungs, thereby increasing the metabolic rate and calorie consumption. The net results is release of fatty acids from stored fat cells and a quicker consumption of the fat into energy. When ephedrine is combined with caffeine as found in Guarana, the thermogenic effects can be improved as much as 20 percent. However, there are many young people who mix ephedrine with other stimulants , in order to get a “high”. Invariably in such cases the ephedrine is taken in combination with other drugs, such as caffeine and pseudoephrine, and in some cases it has been combined with illegal substances such as metamphetamines. This has occasionally resulted in cardiovascular accidents and even a few deaths. In such cases, the question to ask is whether these accidents occurred because of the herb or because of the drugs. Many herbal manufacturers spike their ephedrine-containing weight products such as Diet Fuel with caffeine, such as cola nuts. While the cautions for ephedrine and caffeine are similar, ephedrine causes greater cardiovascular activity than caffeine (http://www.ephedra.net).
4. What claims are made about the effectiveness of this treatment?
All websites that were used to research claimed the same effectiveness of Diet Fuel. One website (http://www.bodybuilding.com) states that Diet Fuel promotes fat reduction, is a weight loss aid, and helps preserve lean muscle mass.
While none of the websites were valid enough for one to believe the claims they state, the most valid claims that could be found were from the customers. Testimonials are the weakest forms of evidence, yet one must evaluate the validity of the sources, before believing what they have to say.
One woman claims that Diet Fuel has the “Guarana effect which triggers epinephrine and you get a high heart rate, chills and other side effects” (http://www.nutritional supplements.com).
Another woman states that she has, “tried a few fat burning supplements and the one that proved most efficient was Twinlab’s Diet Fuel” (http://www.nutritional supplements.com).
At the same website there was a range of claims, some supporting Diet Fuel, others proving that it is not an effective supplement.
One woman took Diet Fuel for 3 months during the summer, and spent six days a week in the gym. She lost 101 pounds, but gained 4 pounds in muscle, her body fat changed from 24% to 19%. However , with all these pros came many side effects. She began to feel very irritable, lost a lot of sleep, and her head was constantly turning. It got so bad that sometimes she would just want to, “pull my brain right out of my head” (http://www.nutritional supplements.com).
“ I have been taking Diet Fuel for about a year now and have lost over 30 pounds of fat and 4 inches in my waist line. I look great. My body is toned and my muscles are well defined. If you want to get lean, this is the supplement for you” (http://www.nutritional supplements.com).
“I started taking Diet Fuel last year and rapidly lost 20 pounds in only a few months. After a while, I began to have horrible mood swings and constant headaches. Every morning I would wake up with a nose bleed and, even worse, I developed heart palpitations. Diet Fuel was great at first but do not exceed 12 weeks” (http://www.nutritional supplements.com).
“ I have tried Diet Fuel both with and without MaHuang. Both formulas made me extremely tired” (www.nutrionalsupplements.com).
“ I have been taking Diet Fuel on and off for the past three years. I love the stuff. You have to work at finding what is right for your particular body” ( http://www.nutritional supplements.com).
Clearly, all the claims made vary in whether or not Diet Fuel is effective. We can not believe these claims, if we do not have real evidence proving that it really works.
5. What evidence is offered in support of the claim?
Throughout researching , not one of the many websites gave any evidence that Diet Fuel really did what they claimed to do. The only evidence used was the customer’s feedback. Typically, however, the reason why most people do not feel safe taking Diet Fuel is because there are too many health conditions associated with them and there are no real scientific experiments to prove that Diet Fuel really works.
One must not take Diet Fuel if they are pregnant, nursing, or if you are treated for high blood pressure, heart, liver thyroid, psychiatric disease, diabetes, pernicious anemia, nervousness, anxiety, depression, seizure disorder, stroke or difficulty in urination due to prostate enlargement. Also, one must not continue taking Diet Fuel if they experience dizziness, sleeplessness, tremors, nervousness, headaches, heart palpitations or tingling sensations(www.slimstore.com/dietfuel.htm).
FTC and FDA regulations
August 4, 1999
The General Accouting Office, and investigative arm of congress, reports that the FDA does not have the evidence to restrict ephedrine containing dietary supplements. Many efforts were made by the FDA to place severe “restrictions on the sale of MaHuang related products as dietary supplements. E’OLA along with other major companies the industry opposed such regulation considering it to be unnecessary, wrongful and unjustified or products which are considered to be safe and effective when properly used. After extensive investigation, the FDA’s reliance upon numerous adverse event reports to show that ephedrine is harmful is based upon inadequate scientific evidence. The GAO took the position that the FDA failed to show a linkage between the adverse event reports and ephedrine abuse. This announcement did not mean that the FDA would not place further regulation upon the labeling and sale of ephedrine products. But the FDA would be a lot more likely to take a much more rational approach to the issue- one that respected companies could live with, and one that is not based on innuendo, anecdotes, and hearsay of the widely publicized adverse event reports” (http://www.aloealways.com)
October 9, 2002
FTC provides testimony on the marketing of dietary supplements and weight-loss products containing ephedrine. For the past eight years there have been many disputes on whether or not these dietary supplements should remain on the market. Recently, FTC’s director of the Bureau of Consumer Protection, Howard Beales, told a senate subcommittee that, “although some dietary on inadequate supplements offer the potential for real health benefits to consumers, as the market for these products have expanded, so too have unfounded or exaggerated claims (http://www.ftc.gov). It is the FTC”s job to protect consumers from fraudulent claims of the many dietary supplements on the market. Just in the past ten years, the Commission has filed more than eighty law enforcement actions challenging claims about the safety of these products. The testimony noted that ephedrine is often marketed for use in weight loss. Last month the FTC released a report on obesity and these products and found that in the aspect of advertising, a sample of 300 ads were disseminated during the first half of 2001, including all ads from all forms of media. More than half of the ads collected contained at least one representation that was very likely to be false or to lack substantiation (http://www.ftc.gov).
According to an article, Medical Science or Political Hype? FDA’s allegations of risk are not supported by scientific or empirical data. The FDA has not cited a single article to support it’s conclusions, nor has it made an attempt to rebut the studies and over 200 articles from scientific literature supporting the safety of ephedrine herb MaHuang. A retrospective study of 230,000 subjects, who over a three-year period had used ephedrine herb supplements at single servings of about 20 mg 3-5 times per day, for periods of six to eleven weeks, revealed no serious adverse effects, including no increases in blood pressure and no increases in heart rates (http://www.thinandslimnaturally.com).
One report from a Harvard University journal, states that more than 800 dangerous reactions have been reported with ephedrine use, including heart attacks, strokes, seizures, and sudden deaths and that the National Institutes of health warn against using ephedrine and ephedrine-containing preparations (Lee, 2002).
In another web journal titled, The Safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent, states that since passage of the Dietary Supplement Health and Education Act of 1994, the sale of herbal dietary supplements containing caffeine and ephedrine became widespread in the United States. Restriction on these products should be based on clinical trials. Caffeine and Ephedrine give equivalent weight loss to Diethylpropion and superior weight loss compared to dexfenfluramine. Caffeine and Ephedrine reach and remain at placebo levels after 4-12 weeks of continuous treatment, but data from randomized trials up to 6 months only are available. Obesity is chronic, requires chronic treatment, it’s incidence is increasing and it has few effective treatments. The benefits of caffeine and ephedrine in treating obesity appear to outweigh the small associated risks. Restriction of dietary supplements containing caffeine and ephedrine, often with other ingredients, should be based on controlled clinical trials of these products” (Greenway, 2001).
One study published in the web journal International Journal of Obesity, examined the long-term safety and efficacy for weight loss of an Herbal MaHuang and Kola nut supplement. It was a six month randomized, double-blind placebo controlled trial. There were a total of 167 subjects randomized to placebo(84) or herbal treatment (83) at two outpatient control weight control research units. The Primary outcome measurements were changes in blood pressure, heart function and body weight. Secondary variables included body composition and metabolic changes. As a result, by last observation carried forward analysis, herbal vs. placebo treatment decreased body weight and increased cholesterol. Herbal treatment produced small changes in blood pressure variables and increased heart rate, but cardiac arrhythmias insomnia were not increased. By self report, dry mouth, heartburn, and insomnia, were increased and diarrhea decreased. Irritability, chest pain and palpitations did not differ, nor did numbers of subjects who withdrew. The Conclusion of this test was that in the six month placebo-controlled trial, herbal ephedrine/caffeine promoted body weight and body fat reduction and improved blood lipids without significant adverse events
( Boozer, 2002).
6. Who is presenting this information and why are they presenting it?
People in the nutrition market present this information about Diet Fuel, because they are willing to take that risk. Diet Fuel, as well as many other diet pills are not regulated carefully by the FDA. These marketers are only interested in making money, and are not concerned about the health of their consumers or else they would not distribute contents such as MaHuang and Guarana, which have horrible side effects.
We live in a society where appearance is everything and our body images are very distorted. Our picture of a “normal” looking girl is a size 0-2, which in reality is below average. When these marketers try to find what products appeals to Americans the most, they find that any sort of product related to appearance, whether it be cosmetics, hair tools, or diet pills, will be a hit on the market. After they realize this, they try to advertise their product as much as they can, whether it be on television, internet or by radio, even if this means lying to the consumer. They only tell the consumer what they want to hear; which is that Diet Fuel really works and that it is safe to use.
It is surprising after researching about the side effects that some people claim to get from Diet Fuel, to know that people would insist on taking this pill. There are many other ways to lose weight, and to risk your health, for such a superficial purpose seems unethical to me. Recently, more and more deaths have been linked to products containing Ma Huang and Guarana, and I think in the future there will be a lot more clinical trials on products such as Diet Fuel, and people will become a lot aware on it’s harm on the body.
Androgen Supplement Marketers to Settle FTC Charges. 16 Nov. 1999. 9 Oct. 2002 <http://www.ftc.gov/opa/1999/9911/astmetrx.htm>.
Arditti, J., Bourdon, J.H., Spadari, M., Richard, N., Valli, M. ( 2002) MaHuang, from dietary supplement to abuse. NCBI, 1,34-36.
Boozer, C.N.,Daly, P.A., Homel, P., Solommon, J.L., Blanchard, D., Nasser, J.A., Strauss,R., & Merideth, T. (2002). Herbal Ephedra/Caffeine for weight loss: a 6 month randomized safety and efficacy trial. International Journal of Obesity, 26, 593-604.
Chinese Ephedra. 13 Oct. 2002 <www.aloealways.com>.
Crabtree, Jeannie. Ma Huang, The Chinese Herb Used for Weight Loss-AnyDanger? 13 Oct. 2002 www.health-doc.com/healtharticles/Mahuang.html
Does Diet Fuel by Twin Lab, sold at GNC, Cause Side Effects? 11 Sep. 2002 <http://www.nutritionalsupplements.com/dietfuel123q.html>.
Greenway, F.L. (2001). The safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent. NCBI, 3, 199-211.
Kalman, D., Incledon, T., Gaunaurd, I., Schwartz, H., & Krieger, D. (2002). An acute clinical trial evaluating the cardiovascular effects of an herbal ephedrine-caffeine weight loss product in healthy overweight adults. International Journal of Obesity, 26,1363-1366.
Lee, Thomas. (2002) Is ephedrine safe for losing weight? Harvard Health Publications.
Ma Huang. 11 Sep. 2002 <http://www. Ephedra.net>.
Spencer, Fred. Thermogenesis. 1998. 16 Aug. 2002 <http://www.all- natural.com/thermo.html>.
TwinLab Diet Fuel. 11 Sep. 2002 <http://www.1dietproduct.com/diet-fuel.html>.
Ultimate Diet Fuel. 11 Sep. 2002 <http// www10.netrition.com/twin lab_ultimate_diet_fuel_page.html>.
Urquhart, Judie. The Ma Huang Myth. 1999. 11 Sep. 2002 <http://www.healthdietnews.com/Mahuang.htm>.
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