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Nutrition
Ephedra: Is It Worth the Risk?
by Denise Feeley, MS, RD, CDEMay/June 2003
For the Washington Running Report
Nutrition Advice
In February of this year, 23-year-old Baltimore Orioles pitcher Steve Bechler collapsed during practice and died later in the day. His autopsy revealed that it was likely his death was triggered by the use of the herbal supplement ephedra. This triggered a media frenzy and at the end of February the Food & Drug Administration announced that it will investigate whether dietary supplements that contain ephedra pose "significant or unreasonable risks" to users. Supplements that contain the herb are now required to display a warning label stating that use may "increase the risk for heart attack, seizures, stroke, or death." Ephedra has been linked to more than one hundred deaths in college and high school athletes and the FDA believes that ephedra accounts for approximately sixty-four percent of the reported adverse events associated with supplement use.
Ephedra, or Ma Huang, is an herb that is grown in the Far East and has been used for centuries to treat respiratory ailments such as asthma. Ephedrine or pseudoephedrine is the manmade derivative of ephedra that is found in over the counter medications (Sudafed) and is used to treat respiratory and sinus congestion. Ephedra is a powerful central nervous system stimulant that increases the release of the catecholamine epinephrine, which causes vasoconstriction, increased heart rate and blood pressure, and subsequently increases the metabolic rate. The short-term side effects include increased energy levels, nervousness, jitteriness, and headaches. These side effects can also contribute to a depression in appetite and, combined with the increase in metabolic rate, weight loss may ensue. Caffeine, which is also a stimulant, has been added to many of the supplements containing ephedra, which exacerbates the stimulatory effects as well as the side effects.
Due to these effects, ephedra (with or without caffeine) has been primarily marketed as a weight loss agent but has also been marketed to athletes as a performance enhancer. Numerous studies have been done evaluating the effects of the herb on weight loss. Most of these studies are not deemed "scientific" mainly due to either too few subjects in the studies or the studies were not long enough to demonstrate practical results. Some of these studies did show a modest short-term (over two months) weight loss in combination with diet and exercise. Some studies have also shown a modest short-term effect on performance; the effects on long term performance have not been studied and are therefore unknown at this time.
There is no doubt that the herb increases energy levels and may cause some weight loss, especially when combined with caffeine. However, the short-term benefits need to be weighed against the negative effects of the herb. The consequences of losing a few pounds or shaving a few seconds off of your 10K may be long-term and may not be worth it.
Denise Feeley is an avid runner and Registered Dietitian with more than eight years of experience counseling athletes. She is currently an adjunct professor in the Department of Exercise Science at George Washington University. She is available for nutrition counseling. For information or questions contact her atdenf44@yahoo.com.