In a world of fast food, desk jobs, and remote controls, it’s no surprise that more than half of America is overweight. It’s a trend, say experts at the National Institutes of Health, that can result in serious health consequences. Excessive weight can elevate serum cholesterol and blood pressure, as well as noninsulin-dependent diabetes (also known as type II diabetes mellitus). Obesity can also lead to a higher risk of developing gallbladder disease, coronary heart disease, some cancers, and osteoarthritis of the weight-bearing joints.
But at least we know we’re fat: At any given moment, three-quarters of American women and one-fourth of American men are watching their weight. Although many dieters take a healthy approach to weight loss–exercising, eating less, and opting for nutrient-rich fruits and veggies–fad diets still lure thousands with the promise of a quick fix. And, while they’re not always nutritionally sound, many of these diets do offer short-term benefits.
“But, when you go off the diet, the weight comes right back,” says Lorrie Medford, a certified nutritionist and author of Why Can’t I Lose Weight? (LDN Publishing, 1999). To tackle this yo-yo effect, many of today’s diets say they promote lifestyle changes that help to maintain weight loss. Here is the scoop on a few of the most popular.
The power of protein
Among the trendiest diets are the high-protein/low-carbohydrate diets. Based on the theory that we gain weight simply because we eat too many carbohydrates, these plans severely limit carbohydrate intake, forcing the body into ketosis. Ketosis happens when the body must rely on incompletely metabolized fats, known as ketone bodies, instead of carbohydrates for its energy source. In ketosis, hunger is suppressed. The result is rapid weight loss, but it’s mostly water, not fat. “As the body adjusts to the water deficit, weight loss slows or ceases,” says Ellen Coleman, R.D., M.P.H.
Plus, Coleman warns that ketogenic diets give dieters a distinctive breath that smells like a cross between apples and nail polish remover. Such diets, if not carefully monitored, may carry risks of dehydration, electrolyte loss, calcium depletion, nausea, and possibly kidney problems. Other critics of such diets worry that reducing carbohydrates so dramatically may cause a deficit in essential vitamins, minerals, and antioxidants. And, they say, the lack of fiber can result in constipation. Still, followers claim these diets work. Let’s look at two of today’s hottest ketogenic diets.
The Atkins philosophy
If your vision of diet nirvana is an unlimited amount of filet mignon, eggs Benedict, bacon cheeseburgers, and butter-drenched lobster, the Atkins diet would at least please your palate. The author of Dr. Atkins’ New Diet Revolution (Avon, 1998), Robert Atkins, M.D., first burst upon the diet scene in the 1970s with his high-protein/low-carbohydrate diet. The program is based on the belief that all obesity exists because of a metabolic defect that creates a glut of insulin.
“The idea that insulin makes people fat is a little simplistic,” says Judith Stern, R.D., professor of nutrition and internal medicine at the University of California, Davis.
But Atkins insists that by restricting carbohydrate calories to 20 percent of total food intake, followers can “avoid a food subdivision that causes you to be fat.” His program forbids all fruits, breads, grains, pasta, starchy vegetables, and refined sugar during the first two weeks of the diet–longer if you have a significant amount to lose. Carbohydrates are limited to 10 g per day. Then dieters switch to an “ongoing weight loss” diet, where they are allowed 20 to 30 g of carbohydrates as long as their weight loss continues. Once they’ve achieved their desired weight, long-term losers can add carbohydrate-rich fruits, veggies, and whole grains–but only to a maximum of 100 g a day.
So what can you eat? Protein, and lots of it. Fat is okay, too. In fact, one salad featured in Atkins: A Passion for Healthy Living, the diet doctor’s magazine, contained 83 g of fat. Critics cite numerous studies showing that diets high in saturated fat can promote heart disease, kidney disease, and various cancers. But a recent study of forty-one mildly obese patients by the Durham Veteran’s Medical Center in North Carolina found that not only did a high-protein/low-carbohydrate diet help participants lose an average of 21.3 pounds in four months, their total cholesterol dropped 6.1 percent and their triglycerides dropped 40 percent. Plus their HDL (the so-called good cholesterol) increased about 7 percent.
The Zone
Another diet that turns the food pyramid upside down is biochemist Barry Sears’ “the Zone.” Like Atkins, Sears believes that high insulin levels erode your overall health and well-being. But that is where the similarity ends.
In Sears’ book, The Zone (HarperCollins, 1995), he writes that insulin causes the body to make “bad” eicosanoids.
“It’s pseudo-science,” says Stern. “Eicosanoids are hormonelike compounds made from fatty acids which help regulate inflammation, blood pressure, and the immune system.”
Yet Sears maintains that these hormones are responsible for obesity, heart disease, cancer, diabetes, and even depression. He tells dieters to “treat food as if it were a medication that requires controlled dosages throughout the day.” To achieve this goal, Sears prescribes a complicated diet composed of 40 percent carbohydrates, 30 percent protein, and 30 percent fat. Food is broken into food “blocks,” which are to be eaten in the proper proportion at each meal and snack.
When it comes to carbohydrates, only approved carbs will do. Gone are breads, potatoes, rice, and bananas. And carrots, the longtime staple of dieters, are strictly a no-no. Follow this, says Sears, and you will not only lose weight, you’ll prevent disease, enhance your mental productivity, and even reset your genetic code.
What do the nutritionists say? Entering “the Zone” may not transform you into the perfect human being, but you probably will lose weight. Behind the Zone’s hype and complexity lies a low-calorie diet based on lean protein, nonstarchy fruits and vegetables, and healthy monounsaturated fats. But, if you do the math, you’ll find the average Zone dieter consumes 800 to 1,200 calories per day–hardly enough to make the Zone a dietary roadmap for life.
Carbohydrate heaven
On the flip side of these carnivore carnivals are high-carbohydrate/low-fat diets. Primarily plant based, these diets were originally designed to reduce the risk of heart disease. The most well-known proponent of the high-carb habit is Dean Ornish, M.D., author of Eat More, Weigh Less (Harper, 1997).
Ornish puts dieters on a very low-fat, lacto-ovo vegetarian diet (one that includes dairy and eggs) chock full of complex carbohydrates such as brown rice, oats, legumes, fruits, and vegetables. Although the American Heart Association and the U.S. Department of Agriculture’s (USDA’s) food pyramid recommend getting 30 percent of your dietary calories from fat, Ornish confines followers to a daily fat intake of 10 percent–a mere 22 g. Such fat must come from the food itself; the diet forbids added fats or oils.
In addition to forgoing meat and oils, dieters must also avoid avocados, olives, nuts and seeds, sugar, and alcohol. Soy products get the green light, as do fat-free dairy products. With so many restrictions, dieters find eating out difficult, and the recipes Ornish includes in his book are both complicated and time-consuming.
On the up side, the diet does live up to many of its health claims. A study done at University of California, Los Angeles, found that this type of diet may help prevent breast cancer. Researchers at St. Michael’s Hospital in Toronto, confirmed that a low-fat diet rich in soy, vegetable protein, and soluble fiber cuts risk for heart disease.
Stricter still is the McDougall program, which starts dieters off on an extremely regimented twelve-day diet–no meat, no dairy, not even soy. The good news? You can eat as much of the approved foods (legumes, fruit, vegetables, and whole grains) as you desire. Created by John McDougall, M.D., author of The McDougall Program (Plume, 1991), this vegan diet claims to take off the pounds while reducing cholesterol, lowering blood pressure, decreasing or eliminating the need for medication, and helping followers avoid unnecessary surgery.
Although both of these diets require dieters to make major changes in the way they eat, they do reduce girth and boost energy. But critics charge that this type of diet is too low in fat to be effective long-term. Making their claim more credible is a recent study by Brigham and Women’s Hospital in Boston, which found that a moderate-fat diet not only helps dieters lose weight, but helps keep it off.
And the health benefits may not be as far-reaching as proponents claim. A recent study by the Nutrition and Wellness Center at the University of Illinois, Chicago, found that a diet high in carbohydrates delays the clearance of LDL (the so-called bad cholesterol). Another study of 2,079 men and women by the National Cancer Institute, discovered that a low-fat, high-fiber diet doesn’t influence the recurrence of colon and rectal polyps or the risk of developing colon cancer.
The complicated combos
When you think low-cal, do you picture a salad, lean steak, and a baked potato sans the butter? Well, think again, says Judy Mazel, author of The New Beverly Hills Diet (Health Communications, 1996), who believes that it isn’t the steak that makes you fat but how that steak interacts with everything else on the plate.
Mazel and her followers insist that improper food combinations impair the natural digestive process, leaving food to ferment and rot in your stomach and intestines. The end result is fat. Eating fruits, starches, and proteins separately, says Mazel, can alleviate the problem and leave you svelte and energetic.
According to Stern, however, there is no scientific basis for eating foods separately. In fact, she says, “combining protein with carbohydrates makes for better utilization of the protein.”
But if quick weight loss is your goal, this thirty-five-day plan may help. Why? The plan only allows you to eat pineapple, corn on the cob, prunes, strawberries, and lettuce during the first two days. On day three you can eat grapes–just grapes–all day. Besides hunger, dieters can suffer from diarrhea on this modified fast. For advanced combiners, Mazel promises steak and lobster and restructures the food pyramid into three main groups–protein, carbohydrates, and fruit–to allow for these goodies. This creative manipulation goes even further, counting ice cream as a protein and wine as a fruit. Despite the fact that clinical research supporting food combining is sorely lacking, the diet ultimately offers more variety than Atkins or Ornish and helps followers become more aware of their food choices.
Old-fashioned calorie counting
So–book sales and marketing ploys aside–what is the smartest way to shed excess weight? Stern advises picking a diet you can live with for the rest of your life. “Fasting, skipping meals, or consuming less than 800 calories a day is a bad idea,” she warns. Instead, dieticians suggest a daily minimum of 1,200 to 1,500 calories. Stern also recommends following the USDA’s food pyramid, which offers a lot of variety. But pyramid detractors note that, without a thorough study of the recommendations, it’s easy to assume that all proteins, fats, and carbs are equal. They point out that dieters have to make smart choices. If you are a carnivore, they say, opt for lean chicken or fish. When you’re eating carbs, ditch the white bread and Twinkies in favor of fiber-rich legumes and whole grains. Choose healthy fats such as olive and flaxseed oils.
“And,” says Stern, falling back on some words that diet veterans sometimes dread, “don’t forget to incorporate exercise into your overall plan.”
Kim Erickson writes frequently on natural health and environmental issues and is the author of a book on nontoxic beauty products due for publication later this year.
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