There has been alot of hype and talk about Phentermine as the bes diet pill in the market. However, before taking the drug, it is important to understand some basic facts.

History of Phentermine -
In 1959 phentermine first received approval from the FDA as an appetite suppressing drug. Phentermine hydrochloride then became available in the early 1970s. It was previously sold as Fastin from King Pharmaceuticals for SmithKline Beecham, however in 1998 it was removed from the market. Medeva Pharmaceuticals sells the name brand of phentermine called Ionamin and Gate Pharmaceuticals sells it as Adipex-P. Phentermine is also currently sold as a generic. Since the drug was approved in 1959 there have been almost no clinical studies performed. The most recent study was in 1990 which combined phentermine with fenfluramine or dexfenfluramine and became known as Fen-Phen.

In 1997 after 24 cases of heart valve disease in Fen-Phen users, fenfluramine and dexfenfluramine were voluntarily taken off the market at the request of the FDA. Studies later proved that nearly 30% of people taking fenfluramine or dexfenfluramine had abnormal valve findings. The FDA did not ask manufacturers to remove phentermine from the market.

Phentermine is still available by itself in most countries, including the U.S. However, because it is similar to amphetamines, it is classified as a controlled substance in many countries. Internationally, phentermine is a schedule IV drug under the Convention on Psychotropic Substances. In the United States, it is classified as a Schedule IV controlled substance under the Controlled Substances Act.

What is phentermine?
Phentermine is a class of drugs called anorectics which decrease appetite by possibly changing brain levels of neurotransmitters associated with satiety. Phentermine is a stimulant that is similar to an amphetamine

• Phentermine Hydrochloride Oral tablet come in different commercial trade names:
  Adipex P (Immediate release)
  Anoxine-AM
  Ionamin (Slow Release Resin, Australia, discontinued in the US)
  Duromine (Slow Release Resin, New Zealand, Australia & South Africa)
  Fastin
  Mirapront
  Obephen
  Obermine
  Obestin-30
  Phentrol
  Phenterex
  Phentromin
  Pro-Fast SA
  Redusa
  Panbesy
  Phentermine Trenker
  Obenix
  Oby-Trim
  Teramine
  Zantryl
  Sinpet (MX)
  Supremin (PH)
  Umine (NZ)
  Weltmine (KP)

How does Phentermine work?
Phentermine stimulates nerves to release particular neurotransmitter called catecholamine. These include dopamine, epinephrine, (adrenaline) norepinephrine (noradrenaline). The increased levels of these chemicals appear to decrease the sense of hunger. Neurotransmitters are chemicals used to relay signal/messages in the brain.

These neurotransmitter eliminate the sense of hunger by putting your body in a small extent of “fight or flee’. This is the state your body takes when faced with danger. As you know if you see a car coming to hit you, you will not be aware of any hunger. Phentermine and other similar weight loss drugs like sibutramine and fenfluramine tend to mimic this state of “flight or flee” to some extent with their effect on neurotransmitters.

With the continued use of phentermine however, the effect of depressed appetite tend to wear off after a few weeks. This is why it is recommended for short term treatment. Some studies point to the possibility that this drug tolerance that results to reduced effect varies with individuals. One study has show phentermine to be still effective in a 3 year trial.

What is Phentermine used for?

It is a prescription weight loss pill that is used together with a Phentermine is used togther with diet and exercise to treat obesity (overweight) in people with risk factors such as high blood pressure, high cholesterol, or diabetes.

Phentermine may also be used for other purposes not listed in this medication guide.

What other information must I give my healthcare provider before taking Phentermine?

Taking phentermine together with other diet medications such as fenfluramine (Phen-Fen) or dexfenfluramine (Redux) can cause a rare fatal lung disorder called pulmonary hypertension. Do not take phentermine with any other diet medications without your doctor’s advice.

Do not take this medicine with any of the following medications:
•duloxetine
•MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
•medicines for colds or breathing difficulties like pseudoephedrine or phenylephrine
•procarbazine
•sibutramine
•SSRIs like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline
•stimulants like dexmethylphenidate, methylphenidate or modafinil
•venlafaxine

This medicine may also interact with the following medications:
•medicines for diabetes

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Tell your healthcare provider if you have any of these conditions:
•agitation
•glaucoma
•heart disease
•high blood pressure
•history of substance abuse
•lung disease called Primary Pulmonary Hypertension (PPH)
•thyroid disease
•an unusual or allergic reaction to phentermine, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
If you have any of these conditions, you may need a dose adjustment or special tests during treatment.

What are some side effects of Phentermine?

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•chest pain, palpitations
•depression or severe changes in mood
•increased blood pressure
•irritability
•nervousness or restlessness
•severe dizziness
•shortness of breath
•problems urinating
•unusual swelling of the legs
•vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•blurred vision or other eye problems
•changes in sexual ability or desire
•constipation or diarrhea
•difficulty sleeping
•dry mouth or unpleasant taste
•headache
•nausea

Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other precautions:

You may have withdrawal symptoms, such as depression and extreme tiredness, when you stop using phentermine after a long period of use. Do not stop using phentermine suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

It is not known whether phentermine will harm an unborn baby. Do not take phentermine without telling your doctor if you are pregnant. It is also not known whether phentermine passes into breast milk or if it could harm a nursing baby. Do not take phentermine without telling your doctor if you are breast-feeding a baby. Do not give this medication to anyone younger than 16 years old without the advice of a doctor. Phentermine may be habit-forming and should be used only by the person it was prescribed for. Phentermine should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. This medicine is usually taken 30 minutes before or 1 to 2 hours after breakfast. Avoid taking this medicine in the evening. It may interfere with sleep. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Remember to buy drugs from reliable sources. It is not advisable to buy phentermine online without a prescription. Do not rely on the packaging or appearance of the pills, as you have no evidence that the pills contain the registered ingredients at the correct dosage and purity that is mandated by the marketing authorities. Problems with the quality of cheap phentermine ordered online and delivered to your doorstap overnight is more common than you think. You really do pay for what you get and many cases of fraud go undetected until death occurs. So better to be safe than sorry.

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When did eating become such an all-or-nothing proposition? It seems that Americans are either gorging on gigantic portions of unhealthy, highly processed foods and getting fatter all the time, or they’re starving themselves on the latest hyper-restrictive diet that no one could stay on for more than a few weeks without feeling miserable and deprived.

Whatever happened to just enjoying good food, in moderation, without guilt?

If we buy into the common-sense wisdom found in books like the bestseller French Women Don’t Get Fat by Mireille Guiliano, it’s clear that the way to be thin and still have some joy with our meals is to adopt a more traditional, and worldly, way of dining. Moderate portions, fresh whole foods, relaxing and lingering with family and friends at the table — it’s what they do not just in France, but throughout the Mediterranean, Latin America and Asia. These are places where obesity rates have historically been low (at least until the global spread of fast food and sedentary lifestyles boosted obesity everywhere). It’s where the “gym workout” was a bicycle ride to work or school, or where eating a low-fat diet meant Mom stretching the meat by stuffing cabbage or grape leaves.

This reminds us that it is possible to eat what you love without feeling guilty, deprived or going on any restrictive regimen. Here’s how:

1. Start with soup.

This Japanese tradition is one of the best weight-loss strategies. That’s because eating soup, particularly the broth-based vegetable kind, before your entrée fills you up so you eat less during the meal, explains Barbara Rolls, Guthrie professor of nutrition at Penn State University in University Park, and author of The Volumetrics Eating Plan (HarperCollins, 2005). A two-year French study of 2,188 men and 2,849 women found that those who ate soup five to six times a week were more likely to have BMIs below 23 (considered lean), compared with infrequent- or non-eaters whose BMIs tended to be in the 27 range.

2. Make lunch your main meal.

Although they do this throughout Europe, a good explanation for eating your big meal at midday comes from ayurveda, India’s 5,000-year-old approach to wellness. “According to ayurveda, we’re actually designed to eat the larger meal at lunch because our digestive ‘fire,’ called agni, is strongest between 10 a.m. and 2 p.m., so we digest more efficiently,” explains Jennifer Workman, a Boulder, Colorado-based ayurveda specialist, registered dietitian and author of Stop Your Cravings (Free Press, 2001). “I’ve seen people in my practice lose 5 to 10 pounds just by doing this.”

3. Think quality, not quantity.

The French snub processed “diet foods” not found in nature, opting instead for high-quality meats, fish, produce, dairy, even desserts. When food is fresh and flavorful, you can be satisfied with smaller portions. This is the opposite of the American approach, which is to fill up on bland diet foods, then gorge on sweets later. “The French set the standard for small portions with their haute cuisine,” says David Katz, MD, author of The Way to Eat (Source Books, 2002). “If we consider that part of eating is to induce pleasure, if you can get there with quality of choice, you get there in fewer calories.”

4. Mix up the flavors.

In ayurveda, including the six basic tastes — sweet, sour, salty, bitter, pungent and astringent — is the key to a satisfying meal that won’t leave you craving junk food later.

Not sure where to start? This will cover all the flavor bases: Try salmon with yogurt dill sauce along with some sautéed kale topped with mango chutney, a sweet potato sprinkled with sea salt and a little clarified butter, and finish with a cup of chai and a small piece of dark chocolate.

5. Go for color.

The Japanese have a saying: “Not dressing up the meal with color is like going out without clothes.” Not only does color make food more attractive, but consciously seeking out colorful foods is a great way to bulk up your meals without a lot of calories. A Cornell University study of 6,500 adults in rural China found that while the Chinese ate about 30 percent more than the average American male, they weighed about 25 percent less, largely because they ate a lot of plant-based foods. The Japanese aim for five colors at each meal: red, blue-green, yellow, white and black, including things like red peppers, squash, broccoli, onions, black beans or black olives. “We’re variety seekers, so instead of seeking a variety of, say, cookies, get the variety from these low-energy-dense foods,” Rolls says.

Enjoy Yourself
Drizzle on the healthy oils. Healthy fats like olive oil, a staple of the Mediterranean diet, and canola oil, a staple of Okinawans, make vegetables tastier, so you’re likely to eat more of them. According to data from the Catalan Nutrition Survey done in Spain, people who ate the most olive oil also consumed more vegetables than those who consumed the least olive oil. And, as we know, eating a diet rich in produce is key to maintaining a healthy weight. In a study of more than 74,000 female nurses conducted over 12 years, Northwestern and Harvard University researchers discovered that those who added the most fruits and vegetables to their diets lowered their risk for major weight gain by 28 percent.

When you’re eating, just eat.

No other culture multitasks meals the way Americans do with our TV dinners, fast-food drive-throughs and grab-’n-go food that’s designed to fit into a car cup holder and be eaten with one hand. In Japan, it’s considered rude to eat while walking. And you’ll never catch the French gulping coffee in the car. “In France, there are no car cup holders because you don’t drink coffee while driving,” explains Will Clower, PhD, author of The Fat Fallacy: The French Diet Secrets to Permanent Weight Loss (Three Rivers Press, 2003). “Eating and drinking aren’t errands. It’s not what you do on the way to something else.” Good advice. When you’re distracted by work, traffic or the TV, you’re apt to overeat without even realizing it, notes Dean Ornish, MD, author of Eat More, Weigh Less (Perennial Books, 2001). “If you really pay attention to what you’re eating, you enjoy it more fully and don’t need as much food.”

Enjoy regular meals.

One reason French women don’t get fat is because French women eat three meals a day. You may think skipping meals cuts calories, but all it does is evoke a primal “fear of hunger response” that causes overeating later, explains Dr. Katz. “Throughout most of our history, we had too little to eat. So when you go for long periods without eating, you stir up all that native programming, which says eat like crazy when you can, because all too often you can’t.” Start with breakfast. Studies show that breakfast-eaters are slimmer than skippers.

Stop eating before you’re full.

The Okinawans, whose average BMI is 21.5 for those who eat a traditional diet, call this hara hachi bu, or eating till you’re 80 percent full. Of course, we’re not suggesting that you leave the table hungry. But eating until the buttons pop stretches the stomach by about 20 percent each time you do it, so you inevitably need more food to feel satisfied, explains Bradley Willcox, MD, co-author of The Okinawa Diet Plan (Random House, 2004). He says that putting your fork down “when you feel that first twinge of fullness” gives your brain a chance to realize that you are full before you overdo it.

Chow down only when you’re hungry.

Americans eat for all sorts of reasons besides hunger, especially from boredom, loneliness, stress or fear, a foreign concept in other cultures. “You can’t make food the solution to every issue in your life and expect to be thin,” says Dr. Katz. “If you eat from boredom, find a hobby. If you eat to relieve stress, learn meditation or yoga.”

Dine with others.

Eating with family or friends vs. alone in your car, at your desk or on the couch is part and parcel of traditional cultures. Not only does camaraderie make the meal more enjoyable, it’s slimming. “Eating with others restrains your own behavior,” notes Dr. Katz. “You eat more slowly, which increases the likelihood that you’ll register when you’re full before you’ve eaten more than you should.”

Have a glass of wine.

A staple of French and Mediterranean tables, wine adds joie to the meal, and because it contains potent antioxidants, is at least partly responsible for why these cultures traditionally have lower rates of cardiovascular disease and mortality despite their higher-fat diets. And while some studies show that we tend to eat more when we imbibe, a Finnish study actually found that male drinkers were leaner than abstainers.

Get moving.

People in Asian countries, France and the Mediterranean tend to be slim because they’re more active. Not that they spend hours at the gym; they simply walk a lot. It can work for Americans too. A study of 200,000 Americans at Rutgers University in New Brunswick, New Jersey, found that city dwellers were six pounds lighter than their suburban counterparts, largely because, instead of driving, they walked more. “You’re not working out,” says Dr. Clower. “You’re just moving.”

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The Food Pyramid, with its recommended servings, represents what the diet and nutrition experts consider to be the most solid, reliable, well-researched thinking to date. It provides a good model for healthy eating.

The basic pyramid, developed by the USDA and the U.S. Department of Health and Human Services, is only one model. However, this pyramid has been adapted for ethnic preferences and there are now pyramids for the Mediterranean diet, the Asian diet and the Latin American diet. Other diets, such as the Hawaiian diet, can also be placed on a food pyramid.
How the Food Pyramid is constructed:

The food pyramid has four levels.

1. At its base, the foundation of a healthy diet, are bread, grains, and cereals. They should compose the largest percentage of what you consume.

2. Next come two food groups (vegetables and fruits) which, together, occupy the second tier of the pyramid.

3. On an even higher, smaller level you find the next two food groups: the milk and meat groups.

4. In the small triangle at the top of the pyramid sit fats and oils and sugars.
How to use the Food Pyramid:

Follow these simple steps.

1. Determine your calorie requirement

2. Translate your calorie requirement into daily food group allowances

3. Use the food group allowances to help you plan your meals and snacks

4. Record what you eat and check it against your daily allowances for each group

5. Use the Food Diary to record the areas where you are typically over your daily allowances

6. Try to alter the diet to be closer to your target
Here are a few simple practices to help get or keep you on track:

1. Choose a variety of foods from each major food group. This ensures that you get all of the calories, protein, vitamins, minerals and fiber you need. Choosing a wide range of foods also helps make your meals and snacks more interesting.
2. Adapt the plan to your specific tastes and preferences. For example, a serving of grains doesn’t only mean a slice of wheat bread. It can be wild rice, whole-wheat pasta, grits, bulgur, cornmeal muffins or even popcorn.
3. Combine foods from each major group however you like. For example, you might make a meal of tortillas (grain group) and beans (meat and beans group). Or you could top your fish with fruit salsa or serve steamed vegetables over pasta. The possibilities are endless.
4. Select your meals and snacks wisely. Make the most of what you eat by choosing nutrient-rich foods within each group. And if you need to avoid foods from one or more food groups — for example, if you don’t consume dairy products because of lactose intolerance — choose other foods that are good sources of the nutrients found in those foods.

How to fine-tune the Food Pyramid:

There are some challenges to using the USDA Food Pyramid. The first is that you need to put some distinction in your food choices, according to your particular dietary goals. For instance, if you are concerned about your weight, you will want to make your choices in the meat group from among those with lower fat content. The food pyramid doesn?t distinguish between hot dogs and lean chicken breast, so these distinctions are up to you.

After you have gone through this exercise a few times, you may find there are some foods that do not fit your diet plan. For instance, pizza may not be the best choice if you are trying to cut down on carbohydrates and fat, because it takes up too much of your daily allowance of each. If you don?t want to consume milk products, you may want to substitute additional carbohydrates.

Food pyramid differences:
Although food pyramids reflect the same general principles of healthy eating, they demonstrate different food choices. These differences reflect dietary preferences, food availability and cultural eating patterns. For example, the Latin American Diet Pyramid might include tortillas and cornmeal within the grains food group, whereas the Asian Diet Pyramid might emphasize noodles and rice.

Other differences include:

-Food groups. The food groups among food pyramids may vary somewhat. For example, some might group plant-based proteins — soybeans, beans and nuts — separately from animal proteins found in meat, poultry, eggs and dairy products. This is because animal proteins are often higher in fat and cholesterol, and some diets limit or avoid animal proteins.

-Serving recommendations. How food pyramids address servings also varies. The Mayo Clinic Healthy Weight Pyramid, for example, recommends a daily number of servings from each food group. And it specifically defines serving sizes; for example, a serving of cooked brown rice is 1/3 cup and a serving of milk is 1 cup. But other plans offer more general guidelines, such as eating particular foods at every meal, or on a weekly or monthly basis. For example, the Latin American Diet Pyramid recommends that you eat whole grains, vegetables and fruits at every meal but eat red meat, sweets and eggs once a week or less.

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The U.S. FDA has issued an alert on 19 Marc 09 o remind the public that Insulin Pens and Insulin Cartridges Must Not Be Shared.

Originally, this alert was sent to health care professionals reminding them that single-patient insulin pens and insulin cartridges should not be used to administer medication to multiple patients due to the potential risk of transmitting blood-borne pathogens such as HIV and the hepatitis viruses. However, I felt that this is something all diabetic patients should be aware of, so that if it happend to them, they are also well aware of the risks.

What’s the rationale for this alert?
Well, insulin pens are pen-shaped injector devices that contain a disposable needle and either an insulin reservoir or an insulin cartridge. The devices typically contain enough insulin for a patient to self-administer several doses of insulin before the reservoir or cartridge is empty. All insulin pens are approved only for single-patient use (one device for only one patient).

Apparently, the FDA was aware of incidents at two undisclosed hospitals involving more than 2,000 people in which the cartridge component of the insulin pens were used to administer insulin to multiple patients, although the disposable needles were reportedly changed among patients.

“Insulin pens are designed to be safe for one patient to use one pen multiple times with a new, fresh needle for each injection,” said Amy Egan, M.D., deputy director of safety at the FDA’s Division of Metabolism and Endocrinology Products in the Center for Drug Evaluation and Research. “Insulin pens are not designed, and are not safe, for one pen to be used by more than one patient, even if needles are changed between patients due to the risk of transmitting blood-borne pathogens.”

Patients exposed to shared insulin pens are being contacted by the two hospitals and are being offered testing for hepatitis and HIV. Some of the potentially exposed patients have reportedly tested positive for the hepatitis C virus, although it is not known if the virus was spread as a result of insulin pen sharing.

The FDA is working with the Centers for Disease Control and Prevention and professional organizations to address infection control issues related to insulin pens.

For us, as Diabetes patients, please be aware of the risks of sharing insulin catridges. If you see it being done at health care centres, stop the staff immediately and report the incident to the FDA. Also, don’t share the catridges amongst family members. Better safe than sorry!

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There are some foods that you must avoid to eat because they make you fat. In this article I give you a list of high fat foods. Perhaps you don’t know it but fat and fat is not the same.

Goods fats vs. bad fats. You need to eat fats they are required for your health. Dr Udo Erasmus has said it already there are fats that heal and fats that kill. The problem is that most people are not aware of this and they choose for 100% fat free foods. A word of caution here the food can be 100% free but at the same time it can contain a lot of sugar.

Bad fats are:
- Trans fats.
- Saturated fats

Good fats are:

- Monounsaturated fats.
- Polyunsaturated fats.

In this article we concentrate us on a list of foods that contain bad fats.

High fat foods that are bad for you. Saturated fats. Studies have shown that diets high in saturated fats increase the risk of hart disease. They also increase the level of LDL (bad) cholesterol in your blood. Products that are high in saturated fats are.

- Butter
- Ice cream (contains milkfat)
- Cheese
- Chicken fat
- Meat fat
- Palm oil
- Coconut oil - Beef
- Lamb
- Pork
- Veal
A lot of animal products contain saturated fats and in some cases foods from plants.

Trans fats. Just like saturated fats there is a relationship between trans fats and bad cholesterol level. Products that contain trans fats are.
- Some margarines
- Cookies
- Crackers
- Snack foods
- Shortening
- Doughnuts
- Cake
- Frozen foods
- Potato chips
- Candy

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