GetFit.com.au

DRUG giant Roche has been banned from advertising its weight-loss pill Xenical direct to consumers because of the risk of unsafe use.

The move comes after controversial advertisements for the drug were screened during the popular youth program Australian Idol, prompting criticisms that Roche was targeting teenage girls.

The National Drugs and Poisons Schedule Committee, which made the decision yesterday, said the advertising was increasing pressure on pharmacists to sell the product and this could lead to inappropriate use.

"While acknowledging the importance of the obesity problem in Australia, the (committee) decided that, on balance, there was insufficient public health benefit associated with allowing direct-to-consumer advertising," a committee spokeswoman said.

She said the drug was appropriate only for patients who were very overweight and had a serious health problem or who were obese, but not for the general population "who might wish to manage more minor weight issues".

However, the committee rejected calls for Xenical to be sold only by prescription, so pharmacists will still be able to sell the drug over the counter.

Consumer lobby group Choice, which had been campaigning for the drug to be returned to prescription-only status, welcomed the advertising ban by the committee, but said it would be effective only if pharmacists followed the issuing guidelines.

"Our research shows that a significant number of pharmacists aren't following the Pharmaceutical Society of Australia's guidelines on how it should be sold, and we hope that those pharmacists would now pay more attention to those guidelines," Choice policy manager Gordon Renouf said.

In December, Choice tested pharmacists' adherence to the guidelines by sending a 19-year-old woman in the healthy weight range, who should not have been sold Xenical, to 30 Sydney pharmacies. The woman was sold the drug in 24 of 30 pharmacies.

Fewer than 10 pharmacists asked for her measurements, and eight of those who sold the drug gave no directions on how to use it properly. She was advised about diet and exercise in only 13 pharmacies.

Xenical costs between $120 and $180 for a four-week course and Mr Renouf said pharmacists faced a financial conflict of interest in advising customers against it.

However, Pharmaceutical Society of Australia spokesman Aaron Hall said he believed most pharmacists were following the guidelines.

"Advertising an over-the-counter drug in itself is not a bad thing. The devil is always in the detail," Mr Hall said.

"Drug companies really should think carefully about the impact of the advertising and the context in which it's shown to try and minimise perceptions of exactly what Roche has been accused of," he said.

www.smh.com.au

Posted by Dean at 12:04 AM | Permalink

It's no secret exercise is good for you, but for some breast cancer patients, group exercise can do a lot to strengthen the body and heal the spirit.
Researchers from Scotland studied more than 200 women with early stage breast cancer to find out if group exercise was beneficial

Researchers assigned one group of women to receive cancer treatment alone. The second group received cancer treatment along with a 12-week exercise program. Patients in the exercise group participated in two exercise classes a week led by trained fitness experts. They also practiced one exercise session at home each week. Researchers measured depression, quality of life, mood, shoulder mobility, walking ability and weekly levels of physical activity in all the women in the study

At the end of the 12-week study, women in the exercise group had better physical scores as well as better psychological scores than women who did not exercise. This held true when the women were again evaluated six months later. The women who exercised also made fewer trips to their doctor and spent fewer nights in the hospital than the non-exercising women.

Researchers report many rehabilitation programs for women with breast cancer focus on psychotherapy and social support, rather than the physical problems many women encounter during treatment. They say the benefits for the women in this study could be accredited to the exercise itself, the group experience, or a combination of both.

Study authors conclude: "Supervised group exercise provided functional and psychological benefit after a 12-week intervention and six months later. Clinicians should encourage activity for their patients." They go on to suggest, "Policy makers should consider the inclusion of exercise opportunities in cancer rehabilitation services."

According to the American Cancer Society, nearly 180,000 women will be diagnosed with breast cancer in 2007. More than 40,000 women will die from the disease.

SOURCE: The British Medical Journal, published online, Feb. 15, 2007

Posted by Dean at 08:51 AM | Permalink

They make big claims but with many diet supplements the only thing lighter will be your wallet.

An hour or so spent trawling the shelves of pharmacies, health food stores and supermarkets leaves you wondering why Australia has a weight problem. With so many products claiming to suppress appetite, boost metabolism and promote weight loss, dropping a dress size should be easy.

But despite their use of words such as "thermogenic" or "fat metaboliser", implying these products have the weight of science behind them, there's little solid research to match many of their claims.

There's some evidence to suggest some ingredients in weight loss products - including green tea, bitter orange and capsaicin (the active ingredient that gives chilli its bite) - can increase metabolism a little. However, this doesn't automatically translate into weight loss. The effect on metabolism is small, the evidence isn't strong and more studies are needed, says nutritionist Rosemary Stanton.

Caffeine and guarana (a plant extract containing caffeine), common ingredients in weight-loss products, can also boost metabolism slightly, she says, but again the effect is small and only lasts for a couple of weeks.

Eight years ago, Stanton co-authored a review published in the Medical Journal of Australia assessing the evidence of the effectiveness of common ingredients in non-prescription weight-loss supplements. The ingredients studied included brindleberry, chitosan, capsaicin, caffeine, L-carnitine, chromium picolinate, ginkgo biloba, a seaweed called fucus vesiculosus, fibre supplements, grape seed extract, lecithin, St John's wort, isoflavones and horse chestnut.

The review concluded there was little evidence to support the use of any of them. Since then, Stanton says, not much has changed in the way of stronger evidence or promising new supplements.

An appetite suppressant extracted from an African succulent called Hoodia gordonii is one of few new developments. Traditionally used by Kalahari Bushmen to suppress appetite and thirst on hunting trips, it appears to target the brain's satiety centre. Some animal studies and one human study found that taking hoodia reduced kilojoule intake, though Stanton says there are concerns about whether it's a good thing to suppress thirst.

Unilever, together with a company called Phytopharm, is doing research in Europe to develop a commercial product but it will take a while for clinical trials to be done. As for hoodia supplements touted on the internet, there's no guarantee that they're the real thing, let alone that they work.

But the problem for consumers is that many claims for these supplements don't reflect the often flimsy or non-existent evidence that the ingredients work - even though price tags can be as high as $60.

We asked Stanton to unpick the information provided online for a Pretorius product called EstroTrim, which is described as "the first weight-loss and weight-control formula for peri-menopausal and post-menopausal women".

It states that "hormonal and metabolic changes around menopause make it harder for women to maintain their ideal weight and body shape" and that the product helps "boost metabolic rate to help burn fat faster" and "in balancing hormones and blood sugar levels to protect against weight gain and altering body shape during hormone changes".

"What's wrong with this statement is there's no evidence that hormonal changes at menopause cause weight gain but lots of evidence that they don't," Stanton says.

Hormone changes, though they can influence where older women store excess weight - around the middle rather than the hips - do not cause the extra weight.

The product contains green tea, which has a little research to back it, but Stanton says there's no evidence that its other ingredients, such as iodine or chromium, help with weight loss.

A Pretorius spokesman contacted by Essential said chromium in the product "helps you snack less and suppresses appetite"; Stanton says there's no evidence for this. Another ingredient, vitex or chasteberry, may help with premenstrual syndrome, Stanton adds, but it isn't relevant to weight loss.

According to Helen Hopkins, executive director of the Consumers' Health Forum of Australia, "The health message the community needs to hear is about changing habits but we have advertisers chipping in with these products when we should be focusing on improving our diet and lifestyles. Many of these claims make it harder for consumers to work out the best way of doing this." This is not a new problem, she says, though it's occurring in an environment where weight problems are increasing and more people are vulnerable to these claims.

Unlike prescription and non-prescription drugs, complementary medicines - including weight-loss supplements - are not evaluated for efficacy by the Therapeutic Goods Administration, the office of the Department of Health and Ageing that regulates medicines.

A strong critic of this double standard is Ken Harvey, a senior research fellow in the school of public health at La Trobe University - if it were up to him, manufacturers of complementary medicines, including weight-loss supplements, would be more accountable for their claims.

"They should have to make the evidence to support their claims publicly available on the Australian Register of Therapeutic Goods [via the TGA website]," Harvey says, "and the register should also indicate whether this information has been independently audited by the TGA.

"Alternatively, the product pack should state that the product has not been evaluated by the TGA for efficacy."

So far, that has not happened.

Before you hand over your money

* Ask your pharmacist what the evidence is to support the claims of diet supplements and if there are any side effects.

* Think about what the product information really says. Typical phrases are "may assist in weight loss" - hardly a cast-iron, money-back guarantee that it works. It may also say an ingredient has been used "traditionally" for weight loss, which does not mean it works or there's evidence to back it up.

* Claims that a product "provides weight-loss support", "helps fatigue brought about by diet and exercise" or "assists with imbalances" aren't the same as saying it will help you lose weight.

* The product is likely to say it should be used with a healthy eating and exercise plan - though this is likely to be less prominent than the claims. Better habits, not pills, are still the mainstay of weight loss.

www.smh.com.au

Posted by Dean at 04:36 PM | Permalink

DIETS and exercise may not be the future for weight loss.

A pacemaker-like device, which blocks hunger nerves, has been successfully trialled at Adelaide's Flinders Medical Centre, with stunning results.

The first person to be implanted with the device lost 20 kilograms in a year without changing her dietary habits or exercise regime.

The Adelaide medical centre was one of three in the world to trial the new device, developed by EnteroMedics Inc.

Flinders' Professor of Digestive Surgery James Toouli (Toouli) said the instrument was placed under the abdominal skin and powered by parts worn outside the body.

The device then intermittently blocked hunger signals carried by vagus nerves - two large cables which go from the brain to the gastrointestinal tract.

"The vagus are the most important nerve that go to the digestive system," Prof Toouli said today.

"These nerves control the movement of the stomach and they control some of the secretions used for digestion, and by blocking these intermittently, what it does is it slows downs the aching of the stomach so consequently people don't feel as hungry."

The theory of blocking the hunger nerves came from clinical observations from past surgery where patients had the nerves divided.

"It was noted in those people if they were overweight, they actually would lose weight," Prof Toouli said.

"Instead of dividing the nerves we now block them with this pacemaker-type device.

"And the reason why this is better than dividing them ... is the body always recuperates if we do something permanent and those nerves do regenerate in time.

"So if you can just block them intermittently but not destroy them, then the effects are most likely to last for a long time."

Flinders trialled the device on 10 people including 32-year-old Sarah Polkinghorne, who lost 20kg in a year after having her vagus nerves blocked for a total of 12 hours a day.

The group was told not to alter their exercise or dietary habits.

A smaller improved version of the device is now being trialled.

"The idea is that this will be implantable, the whole thing," Prof Toouli said.

"At the moment what we call the neuroregulator is implantable but the person has to actually apply an external device in order to send messages to the nerves.

"Ultimately what we are working towards is a fully implantable thing just like a pacemaker so it would be put in and left there for a number of years with a rechargeable battery.

"These early trials are geared towards trying to work out the dosage and how often this thing needs to be turned on so that it will optimise the fully implantable device, which is still very much in a prototype stage."

Prof Toouli hoped the device would be widely available in the future.

"That is certainly our view," he said.

"As always with these things, cost comes into it and these things have not been worked out yet, but it's really very promising."

www.news.com.au

Posted by Dean at 06:16 AM | Permalink

If you enjoy good fresh food then summer is a time of plenty, especially if you love the fruit and vegetables that are in abundance right now.

When it comes to delicious, nutritious summer fare it's hard to go past a salad – you can almost feel every cell in your body sing after eating a bowl full of brightly-coloured vegetables.

But if constipation is an issue for you then maybe you should reach for the potato salad or sushi in addition to your more traditional salad favourites.

Why – it's all to do with resistant starch and dietary fibre both of which, the Gut Foundation says in its latest booklet Constipation and Bloating, are important when it comes to maintaining regular and healthy bowel activity.

Resistant starch is starch from cereals, fruits and vegetables that isn't digested by enzymes in the small intestine but broken down by bacteria in the large intestine instead. Dietary fibre is the remains of plant foods that – like resistant starch – passes undigested through the small intestine and is mostly broken down by bacteria in the colon.

How we cook starch determines which part of the digestive system breaks it down. This brings us to potato salad and sushi – if you cook starchy food like a potato and eat it hot, it's digested in the small intestine, but if you allow the potato to cool and then eat it, the starch ends up in the large bowel as resistant starch. Rice cooked by the Asian absorption-method – commonly used in sushi and many Asian restaurants – also contains more resistant starch.

While both resistant starch and dietary fibre ferment in the bowel, resistant starch can produce more volatile fatty acids than dietary fibre. These fatty acids can protect against colon cancer. Both dietary fibre and resistant starch contribute to faecal bulk, which has a significant role in normal bowel movements.

Are you getting enough fibre?
We all need at least 30 grams of dietary fibre each day, recommends the Gut Foundation. So while the healthy salad your slim workmate just had for lunch – the one with lettuce, tomato, cucumber and celery – does contain significant amounts of vitamins and minerals, it's not the perfect meal after all.

Unless we eat wholegrains we're not getting enough dietary fibre. And in bad news for all those on the Atkins and South Beach diets: high fibre bread isn't fattening, it's just what you put on it that can be, says the Gut Foundation's president Professor Terry Bolin.

But veggie-lovers don't despair; some of your favourites such as asparagus, broccoli, potatoes, corn and spinach all contain amounts of dietary fibre similar to brown rice.

Other sources of dietary fibre include: muesli, bran, wholemeal pasta, legumes, dried fruits, nuts and seeds (especially pumpkin seeds). But you'll need to cut out the white bread, cornflakes and biscuits – it's better to reach for wholegrain options.

A healthy embarrassment
For those plagued by another sensitive issue, digestively speaking, Bolin offers comfort. If you're passing wind then chances are your diet is pretty good, he says. Foods well known for producing gas – such as legumes, broccoli, cabbage and pears – also contain significant levels of dietary fibre.

One way of preventing flatulence is to make dietary changes slowly, Bolin says it gives your body a better chance of adapting to the new amount of fibre in your diet and perhaps lessen the amount of gas your gut produces.

However, if you're eating a diet high in dietary fibre and feeling very uncomfortable, full of gas and bloated then Bolin says it's not unreasonable to cut back a bit on dietary fibre and consider using laxatives.

The new guidelines have debunked some common myths about the use of laxatives. For example there's no evidence to indicate that laxatives will damage the bowel, they're not addictive and they're safe to use under medical supervision, he says.

The guidelines also address other commonly believed misconceptions about constipation. For example, clinical studies have found no evidence that moderate exercise helps people suffering mild constipation and other experiments have found drinking more water than normal doesn't overcome constipation.

Now's the time to enjoy the bounties of summer, so next time you tuck into a bowl of fruit salad for breakfast why not add some muesli? And when you pack that salad for lunch put it between two slices of wholegrain bread, your gut will be glad you did.

ABC Health

Posted by Dean at 10:00 AM | Permalink