A 53-year-old woman has died and hundreds of others may be risking their lives by turning to herbal diet products that contain unsafe western medical ingredients, the Department of Health has warned.

The woman died recently after using herbal health products found to contain the substances fenfluramine and propranolol.

Philippa Yu, executive officer of the Hong Kong Eating Disorders Association (HEDA), echoed the warning, saying the need to be slim has spiralled out of control in Hong Kong.

Dr Lo Kwok-wing, a member of the Hong Kong Society of Obesity, says it is hard to predict how many more dieters will fall victim to the remedies.

In addition to the death of the 53year-old woman, hundreds more may have fallen ill over the years and the numbers could soar, Lo warned.

The products are seen as a quick fix solution to dieters unwilling to lose weight the right way - exercising regularly and eating properly.

Natural or herbal health foods are not subject to the Pharmacy and Poisons Ordinance or the Chinese Medicine ordinance, which restrict the sale of drugs.

The herbal dietary products are considered to be health foods and no pre-market approval is required.

It is only when the Department of Health receives information from the general public that products are tested.

``The government needs to maintain a balance between market and public health,'' said Yu. ``I don't think the government has enough experience or policies to control the problem [of Western medicines mixed in herbal slimming products].''

Raymond Ho, representative of the engineering functional constituency of the Legislative Council, said while it is not possible to test all the health foods before they come into the SAR, ``selective testing of products from specific places could help.''

Ho also suggested collaboration between governments would help. ``We can't rely on our own government, we do not have enough resources and have to maintain close communication with other governments, including China,'' he said.

Legco passed an amendment to the Undesirable Medical Advertisements Bill last June that prohibits or restricts advertising claims of herbal or health foods which must also state the ingredients on the labels. The products are not tested before they reach Hong Kong and the government has to rely on the manufacturers to be truthful.

RS Slim & Fit, Trim Up Plus Birds Nest and other health foods have already been yanked off the shelves and banned by the Department of Health.

Fenfluramine was banned in the United States in 1997 after being linked to several deaths. Western dietary drugs can only be prescribed by doctors and are usually used to treat severe obesity.

The case of the unnamed woman who died is still being investigated. There is no English name for the product she consumed, believed to have contained fenfluramine, which is often mixed with phentermine.

The ``fen-phen'' craze in the US led to more than 50,000 product liability lawsuits filed by alleged victims.

In Hong Kong, fenfluramine was deregistered in 1998 after being linked to heart-valve disease. But slimming aids containing the drug can still be found in the territory and other parts of the world, according to health experts.

In a survey conducted by the Hong Kong Eating Disorder Association in 2003, 60 percent of 1,200 women of all ages surveyed in the SAR were considered normal weight, yet 90 percent of them said they had tried slimming products.

With increasing trade flows between Hong Kong and China, authorities are finding it difficult to control the banned products although importers, wholesalers and retailers selling unregistered pharmaceuticals face a fine up to HK$100,000 and two years in prison.

Since 2003, only 26 herbal slimming products, containing Western medicines, have been recalled.

Herbal slimming products containing Sibutramine, also known as Meridia, an appetite suppressant that causes increases in blood pressure and heart rate, are among the latest products banned in the SAR. Sibutramine was the first appetite suppressant to receive approval by the United States Food and Drug Administration after the fenfluramine ban. In 2002, 29 deaths were linked to the drug since its launch in 1998. Italy banned it in 2002 and withdrew all products that contained the ingredient after receiving 50 reports of health-related problems linked to the drug.

According to Public Citizen, a consumer advocacy group which petitioned to ban Sibutramine in the US, 19 of the deaths were caused by adverse cardiovascular effects in users of the drug. Abbott Laboratories, which produces the drug, continues to stand behind it.

In Hong Kong this year, five of the eight slimming drugs banned by the Department of Health contained Sibutramine.

In the Consumer Council survey on health foods released Monday, five percent of respondents reported side effects such as diarrhoea, insomnia, lassitude, dizziness, sweating and thirst. Some side effects were attributed to slimming or herbal tea products.

An analysis of 80 health food product labels found most of them gave no information on contra-indications and side effects.

The number of proprietary Chinese medicine samples for treatment of obesity sent to the government laboratory increased sixfold over 2003, according to a Hong Kong government laboratory report last year.

staff.reporter@singtaonewscorp.com