Part 2 of a 2-part series

The use of fat and starch blocking diet aids is insanely counter-intuitive to me. I spend my life trying to get more nutrition into people, not less. Remember, anything that blocks the digestion and absorption of a macronutrient will also tend to block the absorption of micronutrients, the vitamins and minerals.

With the fat blocker Alli, the absorption of fat-soluble vitamins A, D, E, and K is impaired. That’s why when taking it, users are instructed to be sure to take a multivitamin at night (away from the time you took the drug). If you follow the whole Alli program, you eat no more than 15 g of fat per meal.

Following a low fat diet and blocking 25% of the fat you do eat (as with Alli) may make it difficult to get enough fat in to meet your essential fatty acid needs. Anyone following the Alli program should, in my opinion, monitor themselves for signs of fatty acid deficiency (dry skin and hair, hair loss, and depression).

The potential to reduce the absorption of nutrients was just one of the concerns of a public advocacy group called Public Citizen, which has asked the FDA to recall orlistat, the drug in Alli. Another of their stated concerns is the fact that orlistat was found in studies to cause lesions in the colon called aberrant crypt foci, which some people think are pre-cancerous.^1-2

That being said, the primary nutritional concern for the newer starch blockers which contain Phaseolus vulgarus, a bean extract that inhibits your starch-digesting enzyme,is the potential to reduce the absorption of certain essential trace minerals. A study of P. vulgaris in animals found it greatly reduced the absorption of copper and zinc.³ To my knowledge, in the very few studies in humans that have been done, this effect was not evaluated, so we don’t know if it would have the same effect or not.

I doubt occasional use of a starch blocker would be a problem, and may in fact help some people if they take it with an occasional high carb meal.

However, as I stated in Part 1 of this article, the consensus is that in order for these products to be effective, you still have to lower your intake of calories and cannot eat unlimited fat or starch. So what’s the point?

A better solution is to follow a low carb eating plan. With low carb eating, there is no need for calorie restriction because the higher protein intake seems to increase satiety and leads to a natural reduction in food intake.⁴ Low carb diets have also been proven in numerous studies to be effective for controlling weight, blood sugar, and lipids.

So in my opinion, the best “diet” strategy is to keep trying to implement a low carb lifestyle until you finally become successful. My experience in working with hundreds of patients is that it is like any other lifestyle challenge — you just have to get back up on the horse and keep trying.

Here are some pointers for doing just that:

1. Reduce stress during the day with deep breathing exercises or practicing yoga. This will help keep stress hormones under control and can reduce cravings. If these measures aren’t effective, consider using a stress hormone-modulating supplement like rhodiola, Relora, or the serotonin building amino acid, 5-HTP.
2. Have a low carb food choice available for times when you still have a craving. Try a cup of tea or coffee with a small piece of low-sugar dark chocolate, or have a xylitol sweetened mint or piece of chewing gum.

References

1. http://www.citizen.org/pressroom/release.cfm?ID=2380.
2. http://www.citizen.org/publications/release.cfm?ID=7436.
3. Umoren J and Kies C. Apr. 1992, Plant foods for Human Nutr. 42(2): 135-142.
4. Nickols-Richardson SM, et al. J Am Diet Assoc. 2005;105:1433-7.

[Ed. Note: Laura B. LaValle, RD, LD is presently the director of dietetics nutrition at LaValle Metabolic Institute (formerly part of Living Longer Institute). She offers personal nutritional counseling at LMI for clients who need help with their diet in relation to illness or disease. Laura also provides educational services in the areas of health promotion, wellness, and disease prevention. To learn more click here.]