What’s In Your Fitness Supplement?

In today’s New York Times article, “Army Studies Workout Supplements After Deaths,” Peter Lattman and Natasha Singer write about the Defense Department’s inquiry into the safety of dimethylamylamine (also known as DMAA), a common ingredient in workout and fitness supplements sold at GNC and The Vitamin Shoppe.

The ingredient has been implicated in the sudden deaths of two young soldiers, aged 22 and 32, who died of heart attacks while exercising.  The Army’s safety review is currently underway, but the Defense Department has already removed all products containing dimethylamylamine from stores on military bases.

I admire the Army’s swift action.  When civilians question the safety of a product, their concerns are followed by debates, petitions for recall, paperwork, studies, lawsuits, and — if all goes well — eventually, action.  Military bases are a different story; the military has long functioned as more of a bureaucratic establishment. The military does not live and breathe by funding from pharmaceutical companies and food manufacturers, much like so many of our elected officials.  When the Army bans an ingredient from its military bases, the public should take note.

In addition to the untimely deaths of the two soldiers — whose toxicology reports both noted the presence of DMAA — the army had also received “reports of liver and kidney failures, seizures, loss of consciousness and rapid heartbeat in other military personnel who have used products containing DMAA,” according to the article.  USPLabs, the maker of DMAA, compared the effects to those of caffeine.

If the effects of DMAA are like those of caffeine, then why are fitness buffs and the manufacturers of fitness supplements choosing DMAA over caffeine? Here’s why:  Because the effects of DMAA are more like those of methamphetamine. DMAA was first developed my pharmaceutical company Eli Lilly.  When doctors noted that its effects were amphetamine-like — and medical literature reported that its effects were more powerful than heart-stopping ephedrine — Eli Lilly stopped marketing it as a pharmaceutical, and DMAA quietly resurfaced as a dietary supplement.

Let’s examine what went wrong here.

Who is regulating the safety of dietary supplements?  The answer, in short, is no one.  In 1994, the FDA decided to consider anything labeled a “dietary supplement” as a special category of food, not as a drug.  As the FDA explains, under the Dietary Supplement Health and Education Act (DSHEA), “the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed.”  In fact, the safety of dietary supplements is only regulated by those who stand to benefit from their sale: the manufacturers. The DSHEA was a major boon for lobbyists of the manufacturers of dietary supplements, who had engaged in a massive campaign intended to bring about this legislation.  The New York Times called the act “ill-conceived” and “a formula for covering up problems.”  A Time magazine article described the act as giving manufacturers “virtually free reign to market products defined as dietary supplements, while severely limiting the FDA’s ability to regulate them.”

Does this mean that all dietary supplements are harmful?  Absolutely not.  What this means is that you must research the safety of your dietary supplements on you own — because our government is not doing it for you.

The good news is that plenty of beneficial vitamins, minerals, and herbs fall under this category as well.  One example is Stevia.  Stevia, also called “sugarleaf” and “sweetleaf,” is an herb related to the sunflower family.  Stevia has been available as a sweetener around the world for decades, and has been widely used in Japan since the 1970s.  In powder form, the naturally sugar-free, calorie-free herb, which has little effect on blood glucose levels, was an obvious answer to the United States’ sugar addiction.  Unfortunately, due to the FDA’s close ties to the manufacturer’s of artificial sweeteners, stevia was not approved as a food additive.  However, through the DSHEA loophole, stevia was available in health food stores as a dietary supplement. (In 2008, the FDA approved a chemical extract of Stevia, known as rebaudioside A, as a food additive; the approval just so happened to coincide with Coca-Cola’s launch of Truvia and PepsiCo’s launch of PureVia, two highly-processed forms of rebaudioside A with additional non-Stevia additives and flavors.  Truvia and PureVia are extremely different from true Stevia, and many side effects have been reported.)

The onus to research dietary supplements falls on you. In the United States, the fact that you can legally purchase a substance labeled as a “dietary supplement” has absolutely nothing to do with its safety.

How can you avoid dimethylamylamine and DMAA?  In a health safety alert to athletes, the U.S. Anti-Doping Association warns of the effects of dimethylamylamine and advises athletes to:

  • Avoid the following substances: methylhexaneamine, a 1,3-dimethylamylamine (DMAA), dimethylpentylamine (DMP) 4-methylhexan-2-amine, Geranamine, geranium oil, geranium extract, geranium stems, geranium leaves
  • Avoid the following products: Jack3d (USP Labs), Lipo-6-Black and Hemo-Rage Black (Nutrex), Spriodex (Gaspari Nutrition), F-10 (Advanced Genetics), Clear Shot (E-Pharm), 1.M.R. (BPI Sports), and many others.
  • Avoid products with names or marketing performance terms such as “stacked,” “muscle,” “mass,” “tren,” “bol,” “anabolic steroid,” “legal steroid,” “power,” “blast,” “energy,” “stimulant,” and others.
  • Use your best judgement.  Unfortunately, due to the extremely permissive regulation of dietary supplements, the U.S. Anti-Doping Association notes multiple “instances where a supplement actually contained ingredients that were not listed on the label.”

If you must supplement your workout, keep it simple: Drink a cup of coffee.  Since we know the human body responds differently to extracts than to ingredients in their natural form, avoid caffeine-containing supplements as well.  Better yet, let the workout itself raise your heart rate, and skip the stimulants altogether.  Your only have one heart; your next fitness shake, drink, pill, or supplement, could be your last.

Still unconvinced? Visit Supplement Safety Now.

Photo Credit: William P. O’Donnell for The New York Times

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Soft Drinks and Sports Drinks: Would You Drink Flame Retardant?

If you drink soft drinks or sports drinks, such as Mountain Dew or Gatorade, keep reading.  Since the Environmental Health News published this story last month, it has been picked up by Gizmodo (you can read that story here), The Huffington Post (you can read that story here), Scientific American, and many others.

Our story begins with the chemical element called bromine.  Bromine is a toxic, corrosive liquid named after the Greek word for stench (“bromos”).  Pure bromine is a dark red color and gives off an extremely unpleasant odor.  It is considered a hazardous material because it causes severe burns to the skin and its vapor is a strong irritant to the eyes, nose, throat.  Although free bromine doesn’t occur on its own in nature, stores of it exist in the ocean, and it can be extracted through a chemical process.

To “brominate” something is to combine it with bromine.   Somewhere along the line, scientists decided to “brominate” vegetable oil and found that the resulting compound — brominated vegetable oil — worked really well as a flame retardant for plastics, a lead-eating additive for gasoline, a swimming pool sanitizer, etc.

Around the world, the use of brominated vegetable oil (BVO) as a flame retardant is raising health concerns.   Research shows that mammals exposed to brominated vegetable oil store up bromine in fat and muscle tissue.  A study of 20 American mothers found that all had detectable levels of brominated flame retardant in their breast milk.

Because bromine is a member of the halogen group, it displaces iodine.  Iodine is a requirement to human life, and especially important in thyroid functioning.  A deficiency of iodine is considered one of the leading causes of preventable mental disability.  In animal studies, BVO exposure has caused reproductive damage; neurological damage; severe behavioral problems; and permanent organ damage to the heart, kidneys, and testicles.

Most countries are clear on the fact that BVO is NOT a food. More than 100 countries have banned its use in food, including Europe, Japan, and India, and many are working to ban its use altogether — as a flame retardant in plastics, etc.  The United States missed the memo and approved BVO as a food additive.

In 1970, unable to ignore serious health concerns, the FDA pulled brominated vegetable oil from it’s GRAS (Generally Regarded As Safe) food list and placed the substance on a special “Interim” list.  According to the FDA, the Interim list was designed for cases when “new information raises a substantial question about the safety [of a substance].”  The substance in question would remain on the list “while the question raised is resolved by further study.”

What happened next?

Nothing.

The FDA never revisited brominated vegetable oil, never took into account the countless new studies that have emerged since the 1970s, including reports of its horrifying side effects on the unfortunate humans who have consumed too much Ruby-Red Squirt, and never re-evaluated the safety of brominated vegetable oil.  As a result, since 1970, brominated vegetable oil has been hanging out on the FDA’s Interim list and added to American soft drinks and sports drinks.

In the United States, food manufacturers found a special role for brominated vegetable oil in citrus-flavored soft drinks and sports drinks.  Lightweight citrus flavors tend to float to the top of a drink, but bromine atoms are very heavy and help weight down the lightweight citrus flavors, so BVO is used a stabilizer that helps citrus flavors stay suspended in the drink for an even distribution of flavor.  BVO also helps maintain the cloudy appearance of artificial citrus drinks that consumers equate with fresh-squeezed lemons.  Even I have fallen to prey to believing that the lemon-colored haze of sodas has something to do with citrus juice.  In actuality, that’s the magic of brominated vegetable oil.

In fairness, when elements are combined, the properties of the individual elements may change; theoretically, harmful elements can become tolerable compounds and harmless elements can become dangerous compounds.  Still, if we know bromine is harmful, who wants bromine atoms in their body?

The same manufacturers using BVO as a food additive in the United States have found alternatives to brominated vegetable oil — better or worse, we don’t know — which are currently used in Europe.  The decision to continue using brominated vegetable oil in the United States is a blatant disregard for public health.

My prediction is that American soft drink companies will find a replacement for BVO very soon — not because new studies will surface that are any more damning than those already in existence, but because anyone who does a quick Google search of brominated vegetable oil will probably stop drinking citrus-flavored soft drinks and sports drinks.  With the recent coverage of BVO gaining maintstream publicity so swiftly, that’s going to hurt sales.  Cast your vote next time you go to the grocery store.

Here are some alternatives to consider:

Need your caffeine fix?  Brew a cup of organic coffee.  (Yes, tea is probably healthier than coffee, but if you’re used to soft drinks, the level of caffeine in coffee will give you a more comparable caffeine kick.)

Like the sweet taste of sports drinks?  Add a splash of 100% fruit juice to your good old H20.

Do you prefer drinks with carbonation?  Add carbonated water to your 100% fruit juice.

Worried about electrolyte balance?  Although electrolyte balance may become important in extreme cases (marathons, ultramarathons, Ironman competitions, etc.), many sports drinks don’t have the appropriate ratio of electrolytes to effect levels of electrolytes anyway.  Good news: Your body is designed to balance its own electrolyte levels.  In fact, some of the so-called “performance boost” athletes find from sports drinks may come from the brain’s response to the taste of sugar.  If you’re an extreme athlete, consult with your coach, but remember, humans got along just fine before Gatorade.

Just can’t give up sweetened drinks?  At the very least, check the label. Don’t buy drinks with brominated vegetable oil (or BVO) listed as an ingredient. Even better, choose all-natural and organic drink brands.

Drinks to Avoid: Mountain Dew, Squirt, Fanta Orange, Sunkist Pineapple, Gatorade Thirst Quencher Orange, Powerade Strawberry Lemonade and Fresca Original Citrus.

Update: This issue is finally gaining mainstream attention!  Read the New York Times article “Drink Ingredient Gets A Look,” published Dec. 13, 2012.

Welcome!

The United States is facing an unprecedented crisis in public health. Americans are more ill than they have ever been in history. Recent studies predict that by 2020, more than 80 percent of American men and more than 70 percent of American women will be overweight or obese. Not only are Americans as a population more ill than they have ever been, but the neediest among us are suffering most of all.

The disparity in health among social classes is growing rapidly. The gap in premature death rates between the poorest and richest Americans has almost doubled since 1980.  This disparity begins in the womb — low socioeconomic status is strongly linked to low birthweight — and the disadvantages continue throughout life. In 2009, 600,000 of Chicago’s 3 million residents lived in urban neighborhoods with limited or no access to fresh fruits and vegetables. Fortunately, new studies are pulling back the curtain on food deserts, and challenging the old assumption that poor people choose unhealthy food voluntarily.  In reality, they often do not have access to healthier options. In America today, the best predictor of health is social class.

Food is one part of the health equation, but it is only one part. Wellness is about more than diet and exercise. It’s about our daily patterns and activities. It’s about exposure to toxins and chemicals. It’s about education, and awareness.

WELLNESS & EQUALITY is a progressive health blog.  Health, at it’s core, is simple. Our modern world, however, is complex; simple, natural living has become nearly impossible without thoughtful effort. The goals of this blog are to bring awareness to contemporary health concerns, including health-related inequalities, and to encourage a conversation about how we can alter the fate of millions of Americans — including ourselves.