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FDA Panel Gives Diet Pill the Thumbs-Down 2010-07-16
By Meagan Johnson

Health Buzz: FDA Panel Gives Diet Pill the Thumbs-Down

An advisory panel to the Food and Drug Administration voted against approving Qnexa, a weight-loss drug, for safety reasons. Studies suggest that Qnexa may increase the risk of depression, kidney stones, and certain heart problems among other possible side effects, the New York Times reports. But evidence also suggests that the drug can help people lose weight and may work better than approved weight-loss drugs. A study found that those taking high doses of Qnexa for about a year lost nearly 11 percent of their body weight versus slightly less than 2 percent for those taking a placebo (almost 30 pounds versus less than 5 pounds for someone initially weighing 250 pounds). The FDA could still go against the panel's recommendation, but the agency has not approved an obesity drug in at least a decade, according to the Times.

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What Now for the Diabetes Drug Avandia?

In a surprising turn of events, an expert panel convened by the Food and Drug Administration voted to keep the diabetes drug Avandia on the market, leaving many to wonder why a drug that seems to raise the risk of heart problems should continue to be a treatment option.

For the past three years, the evidence against Avandia has been building, U.S. News's Deborah Kotz writes. A 2007 study found a 43 percent increase in heart attacks and a 64 percent spike in heart disease deaths in diabetics taking Avandia (meaning the absolute risk of a heart attack or cardiovascular death would rise from roughly 2 percent a year to 3 percent) compared to those who took other drugs. A later study by an FDA researcher reached similar conclusions. The manufacturer's own safety study revealed no increased heart risk, but the FDA found that the study had wrongly excluded a number of patients who had heart complications or who died during the study. If they had been included, Avandia would have been deemed heart damaging. Manufacturer GlaxoSmithKline also appears to have deliberately hid safety data, according to internal company documents released by the Senate, leading the panel of experts to question the company's trustworthiness.

Yet even with all the growing evidence—and the negative press and growing calls for Avandia to be yanked from the market—the FDA panel of outside experts voted against a ban. Only 12 of the 33 members voted to withdraw Avandia, while an additional 10 voted to allow the drug to be prescribed only with severe limitations such as requiring physicians and patients to be educated about its risks. The panel, like the FDA itself, was largely divided over what to make of Avandia's potential health risks. The problem? Most of the panel members weren't satisfied with the quality of the studies conducted since the drug was approved 11 years ago, and some said they couldn't conclude from the evidence that Avandia was any riskier than Actos, its major rival in the same drug family. [Read more: What Now for the Diabetes Drug Avandia?]

Butter or Margarine? Experts Reveal What's in Their Grocery Cart

Legend has it that grocery shopping used to be a one-hour gig. Now it's full of nutrition decisions: skim or whole? Fresh or frozen? Good fat, bad fat? U.S. News's Hanna Dubansky asked two nutrition experts to dish about what they put in their carts and why.

While canola has been touted in recent years as superior to olive oil, both have high proportions of polyunsaturated and monosaturated fatty acids (good fats) and are heart healthy when consumed in moderation. "Although both are relatively low in saturated (bad) fat, the debate arose when olive oil was found to contain a slightly higher amount," says Karen Congro, a registered dietician and director of the Wellness for Life Program at Brooklyn Hospital Center. While Congro prefers olive oil for everyday use because of its higher level of monounsaturates, it does have a distinctive flavor and is significantly more expensive than canola.

For those who believe butter is healthier because it's "natural," Congro has bad news. "It's made from animal fat, [so it] contains cholesterol and very high levels of saturated fat," she says. Margarine is made from vegetable oils, and plant products contain no cholesterol. It's also higher in "good" fats than butter. But some kinds of margarine may be even worse than butter because of their content of trans fats, a particular heart risk. In general, the more solid the margarine, the higher the proportion of trans fat. Steer clear of stick margarine, advises Congro: "Go for the tubs of heart-healthy margarine made with omega-3 oil," such as Promise or Smart Balance. [Read more: Butter or Margarine? Experts Reveal What's in Their Grocery Cart.]

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