DEAR DR. BLONZ: I wanted your take on the Alli diet pill, which I understand is based on the prescription drug Xenical. It is a product that prevents you from absorbing fat? What is your opinion about this type of product? -- F.S., Sacramento, California
DEAR F.S.: Alli is the only over-the-counter (OTC) weight-loss product; the fact that it is OTC means it has established safety and efficacy with the Food and Drug Administration (FDA). Consider it another soldier in the battle against obesity. Alli is a half-strength version of the prescription drug Xenical (Orlistat). These drugs work by inhibiting the action of lipase, a key fat-digesting enzyme that breaks apart the fat in the food we eat before absorption. When lipase is inhibited from doing its job, fats remain in your GI tract and are eventually eliminated. With Xenical, approximately 1/3 of the fat consumed is not absorbed; with Alli, the OTC version, only 1/4 of dietary fat is affected. There is no evidence that either will have any significant effect on calories from carbohydrates or proteins. A side-effect of unabsorbed fats is that they continue all the way though, and that can mean undesirable consequences. Something that allows fat to pass through undigested can also affect fat-soluble vitamins and certain medications, so be sure to check with your physician to see if there are specific cautions for you to consider.
I am not a fan of such drugs as a primary effort against obesity, but I recognize that they might be appropriate as part of a multifaceted effort. For anyone considering Alli, I encourage you to read all the information before you start. Once you purchase an Alli starter pack, you can access a free online counseling service at myalli.com and receive a personalized action plan and answers to your questions. More about this and other diet drugs at tinyurl.com/yb2gndyv.
DEAR DR. BLONZ: I needed to reduce sodium, which I have done. For seasoning, I use various salt substitutes, but I have found it to be a bit of a zoo out there with many products containing various herbs, while others have potassium chloride to provide pseudo-saltiness of a sort. I would like to know whether any of the ingredients or the potassium chloride are harmful. -- H.T., Dallas, Texas
DEAR H.T.: As you have discovered, there are different takes on the concept of the “salt substitute.” Some rely on herbs and spices, and they should be thought of as “salt-free seasoning blends.” Others rely on potassium chloride, which provides a salty, but slightly bitter, taste that many characterize as metallic. There are formulations designed to eliminate the bad taste. But there is no standard formulation, the only shared trait being the absence or very low level of sodium. This leaves it up to you, the consumer, to sample and find which one works with which dishes. You may be able to get product samples by contacting manufacturers. Also, consider checking among the many low-sodium cookbooks to provide additional guidance. I am not aware of any general safety issues with the herbal components of the seasoning blends.
The potassium-based salt substitutes should not represent a health risk when used sparingly. They should, however, be used with caution by anyone with kidney or other health problems that involve the way the body handles potassium. Ask your health professional if you have questions. Those taking diuretics or medications that prevent potassium from being eliminated through the urine should also speak with their physician before they use this type of product.
Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to firstname.lastname@example.org. Due to the volume of mail, personal replies cannot be provided.