IBDanswers

By Debbe Geiger
December 30, 2003

THE PRODUCT AND WHAT IT'S MARKETED FOR: A new generation of weight loss supplements is marketed with the promise that you can eat all the starch you want while losing weight.

"Now, you don't have to give up bread and pasta," an advertisement purports for Starch Away. Taken before a meal, it and other starch blockers like Ultra Carbo Blocker 2000, Carb Cutter and Sierra Slim, say they work by blocking the body's ability to digest the starch found in rice, potatoes and other high carbohydrate foods that popular diets like Atkins and South Beach blame for weight gain.

People are buying the products in droves. According to SPINS, a San Francisco-based market research company that tracks natural and organic foods, starch blocker sales are up 900 percent in the past year. Starch blockers were introduced more than 20 years ago but were taken off the market by the Food and Drug Administration because of adverse side effects: nausea, vomiting and diarrhea. The ones being sold are a new generation, according to Dr. Steven Rosenblatt, a family practice physician in Los Angeles and president of Sierra Medicinals, which manufactures Sierra Slim.

Starch blockers are marketed as a way for dieters to have bread and pasta. Rosenblatt, author of the "Starch Blocker Diet" (HarperResource, $23.95), also recommends starch blockers as a way for people to eat starch found in fruits and vegetables, which are limited on high- protein diets. "I tell people to bring back some of the starch and carbohydrates, and use the starch blocker to block out the starch." The recommended dose is two 500 mg. starch blocker tablets a day, taken up to 30 minutes before a meal. A typical one-month supply costs $20-$30.

WHAT IS KNOWN: Starch blockers rely on an active ingredient called phaseolamin that often goes by the trade name Phase2. It is a concentrated form of the white kidney bean, said Dr. Jay Udani, medical director of the integrative medicine program at Northridge Hospital in Northridge, Calif. Phaseolamin "blocks the action of alpha amalyse, a major enzyme that breaks down starch into sugars," Rosenblatt says. That allows starch to pass through the body undigested.

Research on starch blockers offers mixed reviews. In a study Udani conducted with 27 subjects, funded by Pharmachem Laboratories, manufacturer of Phase2, "the active group lost an average of 3.79 pounds," he says, or almost a half a pound per week. Those who weren't on starch blockers lost an average of 1.65 pounds or 0.21 pounds per week. "Because this was a small pilot study, these results did not reach statistical significance," he said. Udani says other studies are more conclusive. "Scientific studies have shown that may be helpful in combination with exercise and a moderate carbohydrate diet."

When Dr. Gerard Mullin, chief of gastroenterology at North Shore University Hospital in Manhasset, reviewed medical literature, he found few studies proving starch blockers are effective for weight loss. One published in 1982 in the New England Journal of Medicine, measuring their effectiveness on a meal of spaghetti, tomato sauce and bread, found starch blocker tablets do not inhibit digestion and absorption of starch calories in humans. In a study conducted on rats, Mullin said there was 100 percent inhibition of starch but no weight loss. "One study suggested starch blockers cause you to lose copper and zinc, which are essential minerals for us."

THE BOTTOM LINE: Mullin believes starch blockers "may have an effect, but it is theoretical. Until you see studies that show they work, it's hard to encourage people to take these things with unknown risk."

Nina Wachtel, a registered dietician in East Williston and Forest Hills, is concerned that starch blockers will "give people a false sense of security that they can eat as much as they want" because they think they won't be getting the calories from starch. "People are going to end up overeating." Rosenblatt agrees that people will misuse starch blockers. But he stresses, "Those of us involved in responsible medicine are trying to encourage people to use it effectively.

"This is not the magic pill that makes weight fall to the ground. This is an effective tool that does one simple thing: It stops the breakdown of starch into sugar. By doing that, it takes away the major increase of blood glucose into the diet. It gives people's exercise a chance to burn body fat. Otherwise, most people's exercise barely gets through the morning's bagel or last night's lasagna."

Wachtel is not convinced. "There isn't research to support that it does what it says it does." And, she adds, "If they are effective, it will be minimal. These products are not regulated. They can say what they want. You don't know for sure that what the label claims is true."

Richard Cleland, assistant director for the division of advertising practices at the Federal Trade Commission, says, "We're aware of the starch blocker products being marketed, and we're aware of the claims being used to promote these products. Our view is: Those claims are scientifically infeasible . . . but there is nothing public we have at this point to announce."

Anyone who takes nutritional supplements should do so under guidance of a health care provider, Udani says. He says starch blockers are not recommended for people with inflammatory bowel disease like Crohn's or colitis because blocking starch digestion may cause larger quantities of undigested carbohydrates to pass through the bowels. "That could end up causing local irritation."

Diabetics should only take starch blockers under the supervision of a physician, he adds, because decreasing the absorption of calories from complex carbohydrates may affect sugar levels. "Doctors base diabetes medications on a normal diet," he explained.

ALTERNATIVES: The best way to control weight and maintain weight loss is by lifestyle changes including diet and exercise, Wachtel says. "Cut down on the total amount of food you consume. Treat yourself to small portions of foods and sweets that you really like, so you don't feel deprived. Include plenty of fruits and vegetables in your diet every day." And, when eating carbohydrates, look for whole grains - brown rice, whole wheat breads, pastas - to add fiber to your diet.