Friday, October 30, 2009

The Starch Blocker Diet

Offers Hope For Those Who Can't Give Up Comfort Foods

The biggest news in weight management this year is the use of starch-blocking supplements. The introduction of this approach was heralded in the important new book, The Starch Blocker Diet, released this spring by HarperCollins publishers.

The Starch Blocker Diet, by Steven Rosenblatt, M.D., Ph.D., and veteran health science author Cameron Stauth, describes an entirely new approach to weight control. In this approach, dieters take nonprescription starch blockers in order to neutralize the calories from the starchy foods they eat.

"This diet is truly revolutionary," notes Dr. Rosenblatt, one of America's most prominent physicians practicing integrative medicine. "It's the first approach that doesn't put the entire onus for success upon the patient. For once, science is doing the heavy lifting, so to speak, rather than the patients."

The starch blocking ingredient mentioned prominently in the book is Phase 2, which can now be found in a variety of weight loss products available in health food stores. A partial protein extracted from white kidney beans, Phase 2 selectively bonds with the body's starch-digesting enzyme, amylase. For approximately one hour the powerful ingredient puts the amylase in a biochemical "headlock," which prevents the amylase from bonding with starch and digesting it. Therefore, any starch that is eaten during that hour passes through the digestive system in whole-molecule form, undigested, in much the same way that the indigestible fiber from bran does. There are no significant side-effects, but there is a huge benefit in caloric reduction. Starch comprises approximately one-fourth to one-third of the average person's diet, so elimination of starch calories automatically results in the elimination of about one-fourth to one-third of all normal caloric intake.

Because Phase 2 neutralizes only starch, it doesn't stop the digestion and assimilation of all the other nutrients in starchy foods. The vitamins, minerals, enzymes and proteins in starchy foods, such as grains or vegetables, are all absorbed.

The biochemical action of the ingredient is rarely noticed by the people who take it. Less than one percent of those using Phase 2 experience minor gas or bloating and this typically ceases within about 24 hours, as the body adjusts to its new digestive pattern.

"The beauty of this approach," says Cameron Stauth, who was also coauthor of the international bestseller, Brain Longevity, "is that it respects the power of the natural human desire to eat, and does not try to subvert, alter, or deny this urge. Therefore, this is the first truly realistic weight management program--the only one that deals with people the way they are instead of the way they should be."

The Starch Blocker Diet, available now at most bookstores, states that there are five major factors that set this diet apart.

(1) This is the first nondenial diet. People can actually eat even more calories than previously because many of these calories will not be absorbed.

(2) This is the first no-hunger weight program. Abdominal fullness, caused by calorie-neutralized starchy foods, causes the neurological "stretch receptors" in the stomach to turn off hunger. In addition, insulin stability, achieved by blocking starch calories, stops blood sugar swings, which also helps prevent hunger.

(3) This is the first weight program that safely directs the body to burn stored fat. Unlike low-calorie diets, it doesn't rely upon high-fat foods, which can hurt health. Unlike low-fat diets, it doesn't require a high intake of carbohydrates, which disrupts insulin stability.

Instead, the starch blocker diet makes exercise burn body fat more efficiently by reducing stored carbohydrates in the muscles and liver, which the body must deplete before it can begin to burn fat.

(4) This is the first weight management approach that appears capable of relieving complications from diabetes. The diet has been clinically shown to arrest some of the symptoms of diabetes and it also controls the precursor conditions of diabetes, including hypoglycemia, hyperglycemia and Syndrome X.

(5) This is the first weight program that has neither physical nor psychological side effects. It doesn't employ general stimulants, metabolic stimulants or appetite suppressants. It doesn't raise cholesterol, as do some low-carb, high-fat diets. It doesn't destabilize insulin levels, as do some low-fat, high-carb diets. It doesn't create a psychological sense of deprivation caused by denial. In fact, it actually improves mood chemistry by stopping the blood sugar and hormonal fluctuations that cause mood swings.

"When I go on TV shows to talk about the book," Stauth says, "the interviewers are usually just blown away. They can't believe how different this is from the other diets that they've investigated. A lot of them say, 'It sounds too good to be true.' But it is all true, of course, as the research so abundantly indicates."

Research on starch blockers began in 1973, when legendary billionaire Howard Hughes spotted an article in an obscure scientific journal about an experiment in which a group of mice, for unknown reasons, began losing weight and even starving to death while being fed a seemingly nutritious diet--high in white kidney beans. The article speculated that perhaps some form of "antinutrient" had caused the baffling starvation.

Hughes assigned a team of researchers at Miami's Howard Hughes Medical Institute to look into the mystery. By 1982 they had isolated the specific partial-protein in white kidney beans that blocks starch digestion.

Some of the people who were researching starch blockers rushed them to market in 1982 and they quickly became a weight loss fad. However, the Food and Drug Administration ruled that there had not yet been enough research to support a claim for human weight loss so the FDA prohibited starch blockers from being marketed for weight loss. When retailers could no longer sell them for weight management, interest in them waned.

However, researchers at Mayo Clinic remained fascinated by starch blockers, particularly as an anti-diabetes substance. For the next 15 years, Mayo Clinic continued to research starch blockers, completing 13 studies that were all published in peer-reviewed scientific journals including The New England Journal of Medicine.

Over approximately the same time period other institutions also researched starch blockers, including the University of California at San Diego, the University of Illinois and universities in Germany, France, Scotland and Japan. The interest in Japan was particularly keen, resulting in 11 separate studies between 1992 and 2001.

Between 1980 and 2003 a total of 42 studies were completed by researchers in America and abroad. Virtually all of the studies had extremely positive, promising outcomes.

Even as late as the mid-1990s, however, no institution had developed a refinement process that could deliver a highly potent version of starch blockers at a price most people could afford. This problem was eventually solved though, by researchers working on behalf of Pharmachem Laboratories of New Jersey, one of the country's largest producers of bulk supplement products.

By 2000, Pharmachem researchers were satisfied with their formula. Pharmachem project director Mitchell Skop later remarked, "What we had produced was so different from the original formulas that we call it 'Phase 2'." The new ingredient was markedly stronger than the Mayo Clinic's substance. It was more concentrated, more stable in the gastrointestinal tract and was completely free of impurities.

Skop authorized an aggressive program of testing Phase 2 for weight loss in humans. The results were significant and conclusive.

Studies at the University of Scranton proved that Phase 2 reduced activity of the starch-digesting enzyme amylase by an average of 66 percent.

The most impressive study to date though, was performed by Jay Udani, M.D., director of the Integrative Medicine Program at Northridge Hospital, a U.C.L.A. affiliate. In Dr. Udani's study, patients on Phase 2 lost 230 percent more weight than patients on placebo, and lost 40 percent more in waist measurements than the patients in the control group. The Phase 2 group also had a 370 percent better reduction in triglycerides.

"Apparently," concluded Dr. Udani, "the starch blocker substance contributed to persistent and steady weight loss."

Over many years of bariatric research it has become apparent that will power alone is not a practical solution to the epidemic of obesity that has struck America. Weight management, for large scale populations, requires an approach that is scientifically sound, safe, powerful and compatible with long-term use. It has been exceptionally difficult to find a substance that provides this rare combination of factors.

Finally, though, there appears to be reason for great optimism.

THE DIET ALMANAC: FINDING THE DIET FOR LIFE, HEALTH AND COMBATING DISEASE

There are many diet books written every day, and, most of the time, they are books devoted to one diet. Each diet book often contains one diet which an author may write about for 200 pages. Usually this diet is condensable to several pages.

It is wonderful that we have so many diets, since every disease requires a specific diet. There is a diet for osteoporosis, a diet for hypertension, a diet for obesity, a diet for arthritis, a diet for heart disease, a diet for diabetes, a diet for virtually every disease. Often there are several valuable diets for one disease.

PART I: BASIC HEALTH DIET GUIDANCE
There are some basic fundamental rules for the generally healthy person to follow. These rules make up the Basic Health Diet, which is the diet of which all other diets are a variation.

ADDITIVES AVOIDED
It eliminates simple sugars, MSG, corn syrup, corn starch, flour, pickling, nitrates, or other preservatives used in food preparation.

PROTEIN FOODS
Concerning protein foods, it emphasizes fish first, for its great cardiovascular preventive benefits. Secondly, it emphasizes chicken, turkey and other fowl. Thirdly, it includes at a very reduced rate, either beef or veal once a week. Pork and shellfish are the least valuable protein sources. Pork is frequently fatty and filled with nitrates and preservatives. Shellfish is relatively high in cholesterol and low in cardiovascular protective fish oils. Shellfish also contains hepatitis A virus.

EGGS
Eggs are permitted, but generally no more than seven per week. If cholesterol is a problem, this is because, although blood cholesterol levels are not necessarily related to cholesterol intake, there is for some people a relationship between too much cholesterol intake and high serum cholesterol.

High cholesterol intake, when combined with other poor eating habits, will definitely lead to serum cholesterol build-up. Carbohydrateholics (addicted to junk food) usually have high cholesterol.

NUTS
Nuts are permitted on the diet as a basic snack, including nut butters, if they are without simple sugars like glucose. So are soy flour and textured soy products permitted. The type of nuts that need to be emphasized, however, are high in polyunsaturated oils and low in salurated fats. These include English walnuts, almonds, pecans, and sunflower seeds. While nuts that are high in salurated fats, such as pistachios and cashews are usually less healthful, except in the case of a weight-gain diet.

DAIRY PRODUCTS
For most people, dairy products are permitted, particularly milk, except in the case of lactose-intolerant individuals or individuals on a low-estrogen diet. Cheeses can be permitted, with less of the aged, salty cheeses, and more of the fresh cheeses, such as cottage cheese, ricotta, farmer cheese, etc. being emphasized. Avoid diet cheeses, cheese spreads, or cheese foods such as Velveeta, because they are generally high in carbohydrates or have additives. Cream and butter should be used at a complete minimum, since they promote cancer and heart disease. Non-dairy lighteners or creamers are completely forbidden, due to the high saturated oil and toxic aluminum content.

When using oils and fats, most individuals should emphasize either polyunsaturated oils (sunflower, safflower) or monosaturated fat (olive oil). Polyunsaturated oil content is highest in safflower, then sunflower, walnut, soybean and sesame. These oils are especially good for individuals with heart disease and hypertension. Yet, olive oil is better for cholesterol lowering. Linseed oil may also serve this same purpose. Mayonnaise is a saturated fat, and is to be avoided. Fried oils as well as baked hydrogenated oils are all dangerous saturated fats.

CARBOHYDRATES: VEGETABLES & GRAINS
Complex carbohydrates are the goal. All vegetables steamed and cooked can be taken freely. Generally, there should be less use of starchy vegetables, which increase weight gain, and may increase craving for sweets. These include peas, corn, carrots and beets.

Grains should be emphasized. Fiber is an extremely important component of grains, because it lowers cholesterol which reduces heart disease as well as the risk of a variety of cancers (speeds elimination of toxins), and treats irritable bowel syndrome and constipation. All grains are allowed as whole-grains or cereals. White flour, white rice, white bread or other refined carbohydrates must be avoided. Whole grain breads, crackers, and pasta are made with yeast, and they are allowed depending on the person's diet. (Matzoh and sour-dough bread are examples of no-yeast products.) Spinach pasta may substitute for a white pasta.

Some vegetables and grains with high carbohydrate content include brown rice, kasha, oats, corn, cracked wheat, millet, peas, lentil beans, parsnips and acorn squash. These are acceptable if you are not trying to lose weight.

FRUIT
Fruit is excellent under most conditions, because its high water content is good for the skin, and it has many valuable nutrients. Excessive fruit juice-drinking can lead to sugar-cravings and mood instability. Fruit is valuable, particularly in the case of bananas and apples, for lowering cholesterol, or in the case of other high-potassium fruits, which are important in heart arrhythmia, stroke prevention, or in bowel regularity.

OTHER CATEGORIES
Lemon, lime, vegetable juice, and olives are allowed, although olives need to be removed from a low-salt diet, and avocados need to be eliminated from a low-fat diet.

The Atkins Diet Reconsidered

Back in 2000, Prevention reported on popular high-protein diets, saying that a diet higher in fat (the healthy kind such as monounsaturated fats) and protein--if these foods replaced refined carbs such as white bread and cookies--might actually be healthier for some people. But at the time, we were not convinced of the merits of the Atkins diet in particular, because of its high level of saturated fats and severe limits on certain types of vegetables, fruit, and dairy products.

What changed our minds are the many success stories that we've heard. "I saw people like Scott Case who tried to lose weight so many times and finally succeeded on the Atkins diet," says Prevention Nutrition Editor Holly McCord. "I had to ask myself--do the drawbacks of the Atkins diet really outweigh the dangers of being obese all your life?"

The American Heart Association does not support the diet because of its high fat content. But as of now, there's no clear-cut evidence that the Atkins diet is harmful for most people. That's why the National Institutes of Health is beginning a 5-year study of this diet. In the meantime, we do know that being obese contributes to many serious health problems, including diabetes, heart disease, stroke, arthritis, and some cancers.

"We'll know more in 5 years, but my guess is we'll find that most people are healthier if they lose weight and keep it off on the Atkins diet than if they stay obese," McCord says. "What Scott Case eats now is healthier than what I see many low-fat, high-carb people eat, which is tons of refined carbs such as bagels and pretzels. He's eating far more vegetables than he was before, and he isn't struggling to maintain his weight loss."

Headline-Making Diet Comparison Delivers a Mixed Message

What's the real takeaway of the recent, much-publicized study in Israel pitting the controversial Atkins diet against low-fat and Mediterranean-style plans? That depends on your point of view:

* The Atkins Research Foundation, which partly financed the study but had no role in the trial, called it "a vindication" because the Atkins group lost the most weight over two years — an average 12 pounds, compared to 10 on the Mediterranean diet and 7.3 on the low-fat diet.
* The Mediterranean Foods Alliance pointed out that the 45 women among the 322 dieters actually lost more weight on the Mediterranean diet — 14 pounds versus 5 on Atkins and less than a pound on the low-fat diet. Moreover, an Alliance statement argued, "The 'Atkins-style' low-carb diet used in the study might better be described as 'Atkins goes Med.'"
* Because all three groups showed improvements in the ratio of good (HDL) to bad (LDL) cholesterol and other health indicators, lead author Iris Shai, PhD, RD, of Ben Gurion University of the Negev emphasized, "This suggests that healthy diet has beneficial effects beyond weight loss."
* In a Reuters interview, Shai added another takeaway: "The good news is, we have alternatives." Senior author Meir Stampfer, MD, of Brigham and Women's Hospital in Boston elaborated: "The findings suggest that because Mediterranean and low-carbohydrate diets are effective alternatives to low-fat diets, individual preferences could be taken into consideration when tailoring dietary interventions for weight loss."

The study garnered headlines — and so many opinions — in part because of its unusual design: a two-year trial conducted at a remote nuclear research center in Dimona, Israel. Because of the setting, where most participants ate lunch in a cafeteria with color-coded servings to help stick to each plan, and avoidance of "extreme diet protocols," 85% stuck with their assigned diet. The lowfat and Mediterranean diets did have calorie restrictions — 1,800 calories daily for men, 1,500 for women.

Besides restricting processed carbs, Atkins dieters were counseled to choose vegetarian sources of fat and protein. "But the main sources of protein were animal origin," Dr. Stampfer notes.

Average starting weight was about 200 pounds. All three groups lost the most weight in the first five months, then regained some but not all of the lost pounds.

Published in the New England Journal of Medicine, the findings in part echo another diet "face-off" in 2007, where the Atkins plan also prevailed (see the June 2007 Healthletter). The real lesson for weight loss may be similar: The low-carb Atkins diet seems to work because it's simple. Susan B. Roberts, PhD, director of the Energy Metabolism Laboratory at Tufts' Jean Mayer USDA Human Nutrition Research Center on Aging and author of the forthcoming The Instinct Diet, says losing weight is easier for some people when they cut out whole classes of foods, like processed carbohydrates.

"Other people prefer to keep a few treats and watch what they eat," Roberts adds. "The good thing is that there are several ways to eat that work. However, simpler is definitely good. When you have simple rules about what you can and can't eat, it's simpler to stick to those rules."

IS THERE WISDOM IN THOSE WACKY DIETS?

Some pretty strange diets are getting lots of buzz. Can they make you healthier? What we learned may surprise you.

Got a health problem? Check the Internet or the next talk show, and you'll find a wacky diet to cure it. "Just stop eating the wrong stuff and start my diet," their creators assert, "and you'll lose your allergies! Overcome fatigue! Live longer! Shed pounds effortlessly!"

To be honest, the theories behind some of these diets are so intriguing (can your blood type really dictate what you should eat, for example?) that it's natural to wonder: Could they work? Especially if you've known someone-maybe it's you!-who's tried one of these diets and is convinced that it helped.

"Unless you're a scientist with courses in biology and physiology, it's hard to sort fact from fiction," says Judith Stern, ScD, professor of nutrition and medicine at the University of California, Davis, and vice president of the American Obesity Association. So we asked the experts. Surprisingly, they gave us reasons why each of the following diets has both hype and hope.

Food-Combining Diet
Two books currently on the market that espouse versions of the old diet idea of combining foods are Suzanne Somers' Eat Great, Lose Weight (Crown Publishing, 1997) and Harvey and Marilyn Diamond's Fit for Life (Warner, 1987).

The Claim Behind It

This type of diet is based on the belief that many health problems occur because we eat foods in the wrong combinations. If you eat the wrong foods together at the same meal, you confuse your body into producing the wrong digestive enzymes (chemicals that break your food into particles that your body can absorb). That leaves undigested food to rot in your intestines-and turn into poisons.

The Promise

If you stop combining the wrong foods, you'll start digesting your meals fully. The result? You'll lose weight, increase energy, and even reverse food allergies.

What You Eat

Eat fruit only by itself-and only in the morning. Eat protein and fat with vegetables, but not with carbohydrates. Eat carbohydrates with vegetables only, never with fat or protein.

The Experts' View

In fact, few foods occur as pure protein, carbohydrate, or fat, as this diet implies. Most foods are a mix, making it virtually impossible to keep components separate. Whole wheat bread, for example, isn't pure carbohydrate-it's also 15% protein and 14% fat.

What's more, it's impossible to confuse your digestive enzymes. Each has just one job to do. In a lock-and-key fashion, each enzyme pairs with the correct substance and severs its chemical bond. "Fortunately, your digestive system is quite capable of making multiple enzymes in just the right mix for what you're eating at the time," says registered dietitian Cyndi Thomson, PhD, a research instructor at the University of Arizona College of Public Health in Tucson.

The Grain of Truth

Strict rules about what-goes-with-what almost automatically limit the size of your meals. This diet emphasizes low-calorie fruits and vegetables (no soft drinks or cupcakes on the "yes" list). Smaller meals and lots of produce are both good ways to lose weight. "That's why you may lose weight practicing food combining," says Dr. Thomson.

What to Watch Out For

Short term, you'll do okay on this diet. But the structure limits your intake of calcium-rich dairy foods while opening the door to foods high in saturated fat. That's bad for your bones, blood pressure, and heart. And if you have a life-threatening food allergy, beware: The only way to control it is to avoid the offending food.

Blood-Type Diet
This diet originated with the book Eat Right 4 Your Type, by Peter D'Adamo, ND (Penguin Putnam Books, 1997).

Another version is The Answer Is in Your Bloodtype, by Steven Weissburg, MD (Personal Nutrition, USA, 1999).

The Claim Behind It

Our different blood types-O, A, B, and AB-evolved in response to the varying environments and diets faced by prehistoric man. Knowing your blood type can tell you what's the best diet (and exercise) for your digestive tract and immune system.

The Promise

If you follow the right diet and exercise for your blood type, you can stay healthy, live longer, and achieve your ideal weight.

What You Eat

Blood type O: Your Stone Age-hunter ancestry means that you need lots of meat and intense exercise, but few grains and little dairy.

Blood type A: You are descended from prehistoric farmers and require a vegetarian diet because you don't produce enough hydrochloric acid to digest meat. Do only yoga or meditation.

Blood type B: Your nomadic ancestry suggests that you need mostly dairy and a little meat, but no chicken and few grains. You need moderate exercise.

Blood type AB: You represent a merging of types A and B. You need a varied diet that emphasizes seafood, dairy, wheat-free grains, and soy foods. Do only yoga and mild aerobics.

The Experts' View

"This is pure pseudoscience," says Dr. Stern. "The blood type theory has never been tested clinically with results published in peer-reviewed journals." One clue that something's amiss: The idea that some people shouldn't get exercise flies in the face of everything we know.

Another red flag: The suggestion that people with type A don't have enough hydrochloric acid. It's true that some people's stomach produces less hydrochloric acid, but that comes with age, not blood type. And the problem with too little hydrochloric acid is that you can't absorb enough vitamin B12, not that you can't digest protein.

And just as a practical matter: How would you feed a family of four with different blood types?

The Grain of Truth

Limited food choices automatically cut calories, so you may lose weight-as long as you can stick with the limited food choices.

What to Watch Out For

No matter what your blood type, this diet sets you up to exclude too many foods. You lose fiber and vitamin E by excluding grains, fall short of carotenoids and phytochemicals when skipping vegetables, and miss out on calcium when you don't do dairy.

Candida Diet
Seems like almost everyone knows someone who's tried this one. You'll find versions of this diet in Candida: A Natural Approach, by Karen Brody (Ulysses Press, 1999) and The Candida Control Cookbook, by Gail Burton (Aslan Publishing, 1996), among many others.

The Claim Behind It

If you're always tired, bothered by allergies, or have recurrent vaginal infections, your entire body may be suffused with an overgrowth of a type of yeast called Candida albicans. If you eat foods that contain yeast, such as bread, or foods that "feed" the yeast-basically, anything containing sugar-you are strengthening the hold of the candida infection on your body.

The Promise

By eliminating sources of yeast and sugar from your diet, you can starve candida out of existence and prevent recurrent vaginal infections, chronic exhaustion, and allergies.

What You Eat

Meat, poultry, seafood, and nonstarchy vegetables are emphasized. This diet comes in three progressively restricted phases. To start with, you cut out sweets, dairy products, breads, crackers, commercial soups, white flour, mushrooms, vinegars, soy sauce, tofu, and apple cider. Later stages banish whole grains, starchy vegetables, fruits, juices, nuts, seeds, beans, herbal teas, and spices.

The Experts' View

In many healthy women, candida can be cultured from the mouth, throat, rectum, or vagina. In addition, about 90% of women will have at least one vaginal yeast overgrowth infection, which is easily cured by an antifungal agent. But about 5% of women face recurrent vaginal yeast infections that relapse after responding to antifungal medication.

In desperation, these women look for nutritional answers, says David Soper, MD, professor of obstetrics and gynecology at the Medical University of South Carolina in Charleston. The fact that recurrent vaginal yeast infections are more common in women with diabetes seems to lend credence to the idea that there is a diet connection. But there's no evidence that eliminating certain foods can cure vaginal yeast overgrowths, Dr. Soper says.

The Grain of Truth

By restricting so many foods-literally from soup to nuts-you're bound to lose weight. Along the way, you may have eliminated a food to which you have a mild allergy.

What to Watch Out For

Although you could get by with this diet for a few weeks (especially if you cheat a little), following it to the letter eliminates so many foods that you'll come up short on calcium, copper, manganese, magnesium, vitamin E, and most B vitamins. Your body deserves better than that!

The "Mayo Clinic" Diet
Before you start this diet, surf on over to the Mayo Clinic Web site at www.mayo.edu/about/mayo diet.html and read their disclaimers. This diet neither originated there nor is it approved by the famed medical center. But does it work?

The Claim Behind It

If you eat only certain combinations of foods, you'll burn more fat. Adding some grapefruit burns fat even faster.

The Promise

On this diet, you can eat as much as you want and still lose weight-permanently.

What You Eat

At every meal, eat half a grapefruit. The rest of your menu is as follows: breakfast-two eggs and two slices of bacon; lunch-salad with dressing, meat; dinner-salad with dressing, meat, and a nonstarchy vegetable cooked in butter. Drink eight glasses of water and one glass of fat-free milk or tomato juice a day. Do this for 12 days, then take 2 days off and eat anything you want. Repeat as needed. Avoid most dairy, starchy fruits and vegetables, and grains.

The Experts' View

"Clearly, there is no science to support this," says American Dietetic Association spokesperson Tammy Baker, RD. "And grapefruit is not magic." Alas.

The Grain of Truth

Why do some people lose weight on this diet? That's easy. A low-calorie menu plan puts your appetite on autopilot for awhile, and restricting food choices (did you notice that there are no desserts?) limits your calories. Men especially seem to find the high-protein diets such as this one filling and satisfying. "But people eventually get bored," says Baker. "And pretty soon you're staring wistfully at your spouse's baked potato."

What to Watch Out For

If you don't choose lean meats, eating all those foods high in saturated fat can raise your risk of heart disease. Plus, calcium is low to absent, notes Baker. Any high-protein diet is hard on the kidneys and should definitely be avoided if you are at risk of kidney disease (if you have diabetes, for example).

Maximize Good Health
Compelling passion is the hallmark of most "miracle diet" creators, and often their enthusiasm is impressive, if not their science. Luckily, following these plans for a short time won't be fatal, and some people say that they do feel better. What's interesting is that each diet has lessons that can make anyone healthier, from cutting down on sweets to eating more low-calorie vegetables to making meals smaller if you need to lose weight.

And since these diets so often result in weight loss, it would be fair to ask this question: What's the harm as long as I can drop a few pounds? "Overweight people think diets such as these can't hurt," says Dr. Stern. "But they can, because they prevent you from seeking a reasonable approach to weight management that you can sustain." Another critical drawback: If you do manage to stick with one of these diets for the long term, you'll be setting yourself up for nutrient deficiencies. Many women already face a calcium crisis-getting only half of what they need-and all these fad diets would make that worse.

THE EXERCISE DIET

I'm tired of seeing other writers get rich off diet books. Diets don't work — doesn't everyone know that? Yet, despite the presence of hundreds of diet books on the market, more such books are published on a near-daily basis — and some make best-seller lists. Even cities and towns are dragged into the diet book scam. It seems every city in America has a diet named after it, with the exception of Sheboygan. What's their problem?

"HOW sick of the diet scam mess am I," you ask?

So sick of it that I'm ready to introduce and get rich on my own diet book! No, I won't call it the "St. Petersburg Diet" or "The Wellness Diet" or even the "Don Ardell Diet for People Too Dumb To Know That Diets Don't Work" Diet."

I have a better idea. I have an idea for a diet — hold your breadth here, this is going to shock you — I have an idea for a diet THAT WORKS! Really.

My friends, I give you The Exercise Diet!

The Exercise Diet (henceforth called "TED" but not to be confused with the airline or the Senator from Massachusetts, who come to think of it could benefit from The Exercise Diet or TED), is easy to understand and even easier to sustain. Unlike all the other diets, it works.

"How do I know TED works?" you might be wondering. Have I done the requisite double-blind, crossover trials of a horizontal, longitudinal and dignified nature? No. Do I have a legion of satisfied customers who have lost tons of blubber over the years following TED while I controlled the multitudinous independent variables in their lives? No.

"Well, then how can I be so sure that TED works?" you're probably asking.

Well, actually, I'm not sure. But, I'm confident that it will work and I have an idea for a unique approach to testing TED. I plan to give TED away, initially for testing purposes, as in "free/no charge/complementary." I will describe how TED works and invite everyone who tries it to send rave reviews about weight loss, muscle gain and other benefits to me at SeekWellness.com. Testimonials and before/after photos will be welcomed. Unlike the authors of all the other diets, I will also publicize disappointing results. However, I don't expect there will be any. That's how confident I am of the power of TED.

And now, with no further ado (more ado will come later), I give you the essentials of TED, soon to be hailed as the greatest diet of all time. (This is not as impressive a claim as it might seem at first, since there have not been ANY great diets.) In fact, TED is the only diet ever devised that is worth a damn, or a bucket of warm spit or whatever metaphor you prefer to represent something worthwhile.

In time, TED will be described in a level of detail that will enable me to publish several TED anti-diet books (and make some serious big bucks). There will be TED diet centers, TED CDs, T-shirts, bumper stickers, a TV show and probably a major motion picture dramatizing the fabulous things that happened to people as a result TED, my amazing wellness breakthrough. All this will come about, in time. For now, all you need is the essence of the TED protocol. Are you ready?

Here it is: Exercise at least as long as you eat; eat no longer than you exercise. Do this on a daily basis. Don't fret or otherwise concern yourself with WHAT you eat or HOW you exercise. Just keep the two in line. You will lose weight, gain muscle and realize many health and life quality gains associated with a full-scale wellness regimen. If you are not already living a wellness lifestyle, you will soon enough adopt such an attitudinal and behavioral pattern, as the benefits of a great lifestyle will have become apparent to you.

Basically, all you have to do with TED is "time" how long you eat. Use a stopwatch — begin when you sit down to dine, stop the clock when you get up from the table. No snacks, unless you restart the clock. You can eat whatever you choose — just make a note of the time you spend eating in a single day. Then, exercise for that amount of time the next day. Exercise time begins when you start to sweat, so don't count the minutes of stretching and easy warm-up and warm-down to whatever exercise you choose to undertake.

Naturally, you will get better results, faster, if you tweak the basic idea, getting a bit more ambitious than is required for the foundation level of TED. For example, you could realize improved results by adopting one or more of the following variations:

* Exercise twice as long as you eat.
* DO pay attention to WHAT you eat. A diet high in complex carbohydrates, fruits and vegetables with little fat will give better results than a meaty diet laden with sugar, alcohol and other high calorie food and drink.
* Eat faster. (Just kidding — I don't recommend this.)

If you wish to think in terms of formulas, I have a dandy way to help you remember how TED works. Think of eating as "inhaling" or taking IN energy; think of exercising as "exhaling" or burning off energy. Thus, you want to balance total "inhaling" or eating time (TIT) with total "exhaling" or exercise time (TAT). Think of it this way — TIT for TAT!

As noted, details will follow but that's the idea for my upcoming diet book that really works. I hope you will choose to be a part of the free testing program. If you are among the first 1000 to follow the plan and send in your results, you will get a free book and you might even be quoted, assuming you want to be. I'll even try to get you invited to my appearance on Oprah.

There you have it — my latest wellness insight — TED, The Exercise Diet.

Enjoy. Be well. Always look on the bright side of life.

GOOD NEWS ABOUT THOSE HIGH-PROTEIN DIETS

In spite of what the critics say, Prevention says that a hi-pro diet-if you do it right-may be healthier than what you're eating now

And you can bet that they're aware of the army of health experts who attack high-protein diets on TV. In fact, I used to be a critic too. No wonder all my cheeseburger junkies share this one nagging fear: "Am I damaging my health for the sake of losing weight?"

Another Look

I still believe the answer is yes-if you're following the wrong hi-pro diet. Some, like the Atkins Induction diet, just drip with artery-clogging saturated fat, yet lack the health-protective benefits of plentiful vegetables, fruits, and whole grains. You've heard these diets panned in the media, and rightly so.

But what about the more moderate hi-pro diets, including Sugar Busters! and The Zone? The truth is, I'm having second thoughts--and here's why: When I compare them to what most high-carb dieters are actually eating-tons of empty-calorie refined carbs such as white bread, fat-free cookies, pretzels, bagels, and crackers-I've started to think that the better hi-pro diets look pretty darn healthy. There's also some real scientific evidence that dieters actually need more protein.

Weight Loss Secrets Revealed!

To be sure, all the hi-pro diets are based on bogus science-the erroneous idea that carbohydrates make you fat. You think you're losing weight because you're following a "scientific" plan that focuses on "protein blocks" or "reward meals." But you're really losing weight because you're eating fewer calories, not because you're eating fewer carbohydrates. It's as simple as that.

But to follow the moderate hi-pro diets, you cut back on starchy carbohydrates and sweets, substituting meat and tons of vegetables in their place. For most people, that means trading in nutrient-empty white flour and sugar for nutrient-laden protein and produce. As a dietitian, I'd say that's a big improvement-not perfect, but a huge step in the right direction. And if it helps you achieve a healthy weight, fantastic! Just to make sure, I rechecked my facts with some top doctors-and here's the truth I now tell my clients about those "nasty" high-protein diets:

What You Hear: High-protein diets make your kidneys work harder to flush out waste products, and may also wear them out.

The Truth: "They do increase risks for people with kidney problems," says Lisa Giannetto, MD, associate in medicine at Duke University Medical Center in Durham, NC. If you have diabetes, high blood pressure, heart disease, or other risk factors for kidney disease, before considering such a diet, discuss it with your doctor and have her give you a complete physical and a blood test.

But if you have healthy kidneys, there's simply no research that says that excess protein will damage them-even though most high-protein diets call for an amount of protein about three times higher than Recommended Dietary Allowance levels. To be on the safe side, however, if you're on a hi-pro diet, your doctor should monitor you, says George Blackburn, MD, director of the Center for the Study of Nutrition and Medicine at the Beth Israel Deaconess Medical Center in Boston.

For dieters with healthy kidneys, there may actually be bonuses with higher protein levels. When it comes to satiety-keeping you satisfied longer-high-protein foods do it better than high-fat or high-carbohydrate foods.

Another hi-pro benefit for dieters: Your protein needs increase when you restrict calories. When your energy intake is restricted, some of the protein that you eat is used for energy, making it unavailable for maintaining muscle tissue and other important substances such as antibodies. On moderate-weight-loss diets such as the 1,500-calorie minimum that Prevention recommends, protein needs increase only slightly-up to about 15% of calories. But what if you go below 1,500? "The lower the calories, the higher the protein" is Dr. Blackburn's advice.

If you do follow a high-protein diet, drink at least 8 cups of fluid daily to help your kidneys flush away extra waste products.

What You Hear: High-protein diets thin your bones by raising blood acid levels, which force the bones to release calcium in order to neutralize all that acid-the same way that calcium in Tums neutralizes stomach acid.

The Truth: "Yes, excess protein increases calcium loss, but that's only a problem if your diet is calcium-poor. If you take in enough calcium, studies suggest that your bone density is maintained," says calcium expert Robert P. Heaney, MD, of Creighton University in Omaha, NE.

If you're on a high-protein diet, Dr. Heaney recommends aiming for 1,500 to 2,000 milligrams (mg) of calcium daily (slightly more than Daily Value [DV] levels) from a combination of diet and supplements.

What You Hear: High-protein diets are bad for your heart because they're high in saturated fat and raise your cholesterol.

The Truth: Some diets fit that description perfectly. One of my clients came to me after 2 months on the Atkins diet. She loved her rapid weight loss while still eating saturated-fat-laden Cheddar cheese, sausage, burgers, and ribs, but was alarmed when her total cholesterol rose to a high-risk 276 and her "good" HDL plummeted.

With a family history of heart disease, she knew that for the long term this was not good. She's now on a new eating plan low in saturated fat; her cholesterol has returned to normal and she's maintained her weight loss.

Fortunately, not all hi-pro diets are like the Atkins or Carbohydrate Addict's diets. Several, including Sugar Busters! and The Zone, focus on heart-healthy lean meat, poultry, fish, and low-fat cheese-all of which are low in saturated fat. Preferred fats include olive and canola oils, olives, nuts, seeds, avocados, and fatty fish that actually lower heart disease risk by raising HDL, lowering "bad" LDL, and controlling triglycerides.

What You Hear: High-protein diets increase cancer risk because eating lots of meat has been linked to higher rates of breast, colon, and prostate cancers and non-Hodgkin's lymphoma.

The Truth: Yes, some studies do link high-meat diets with higher cancer risk, although why isn't certain. Is it the fat? Choose lean cuts. The nitrites? Eat fewer sausages and hot dogs. The heterocyclic amines from cooking? Cook meat over low heat, don't char; and choose more vegetable proteins such as tofu, beans, and legumes. The lack of fiber? Choose one of the hi-pro diets that really maximizes your intake of fruits and vegetables, and make sure that you eat all that are allowed. Along with the fiber, you'll get phytochemicals that are known to protect against cancer.

What You Hear: High-protein diets cause a potentially dangerous condition called ketosis.

The Truth: Only hi-pro diets that are exceptionally low in carbohydrates-about 50 grams (g) or less per day, as in the Atkins plan-cause ketosis. Your brain depends on carbohydrates for its daily fuel, but in a pinch, your body will ravage fat fragments to create compounds called ketone bodies that can also be used as fuel by the brain. Ketone bodies are prized by Atkins dieters because they suppress the appetite-but they also upset the acid-base balance of your blood.

So is ketosis dangerous? In this case, no one really knows for sure. But the ketosis caused by very low carb diets is not as severe as the potentially fatal ketosis sometimes experienced by people with diabetes. Also, there is a lack of research pointing to adverse outcomes from ketosis in people who are dieting. Yet, no expert that I talked to recommends any diet that provokes ketosis.

The good news is that the better-balanced hi-pro diets, which do not restrict carbohydrates so severely, don't cause ketosis.

What You Hear: The weight that you lose on a hi-pro diet is only water, not really fat.

The Truth: It's true that your body will lose several pounds of water in the first few days of a low-carbohydrate diet. So those first few pounds that you drop in a flash at the start of a hi-pro diet are water. But that's only true in the beginning. After that, the weight that you continue to lose represents true weight loss, the same as you'd get from any low-calorie diet.

What You Hear: High-protein diets cause bad breath and constipation.

The Truth: Only the very low carb diets cause bad breath as your lungs try to blow off some of the ketones created by too much fat burning. And low-carb diets that limit high-fiber fruits, vegetables, and whole grains are responsible for constipation. So choose one of the high-protein diets that allows you more than 50 g of carbohydrates, emphasizes high-fiber foods, and reminds you to drink 8 cups of fluid daily.

Bread Made by Sugar Busters!

On the Sugar Busters! diet, bread is allowed as long as it's whole grain-the kind that Prevention recommends too. We tried Sugar Busters! 100% Whole Wheat Dinner Rolls (125 calories, 0.6 gram [g] fat, and 4 g fiber per roll) and think that they rival homemade. Call Boudreaux's Foods at (504) 866-9500 to find a store (located primarily in the southeastern US, Texas, California, and Missouri) or to order a variety of whole grain breads.

The Healthy Way to Go Hi-Pro

If you do decide to follow a high-protein diet, here are rules to help you use-but not abuse-the staying power of protein:

* Have your doctor test your kidney function before you start a hi-pro diet to make sure that your kidneys are healthy.
* Choose a diet that maximizes yourintake of high-fiber, brightly colored veggies-and be sure to eat all the veggies that are allowed.
* Select a diet that emphasizes low-saturated-fat meat and poultry. Trim fat. Don't char.
* Pick a diet that includes at least 50 grams (g) of carbohydrates daily to prevent ketosis.
* Drink 8 cups of fluid daily to help your kidneys.
* Select whole grain breads and cereals when possible.
* Opt often for soy-based foods, legumes, and fish for your protein choices.
* Choose low-fat dairy foods and calcium supplements to reach 1,500 to 2,000 milligrams (mg) of calcium daily.
* Take a standard (not high potency) multivitamin/mineral supplement daily.

The Best and Worst

Prevention says that the healthiest weight loss diet is one that's based on plant foods-about 15% protein, 25% fat, and 60% mostly unprocessed carbohydrates (vegetables, fruits, and whole grains). But if you want to go high-protein, we surveyed an array of popular hi-pro diets to zero in on what we think is the best-and the worst. We've also included a "fix" to make the best even better.

Sugar Busters!

Food focus: Lean protein; legumes; low-fat dairy foods; high-fiber fruits, vegetables, whole grain breads and cereals

Calorie control: Small portions, no seconds

Considered the enemy: All sugars, sweets, corn, carrots, beets, and white potatoes/rice/bread

Sample Menu

* Breakfast: OJ, wheat bran cereal, fresh strawberries, fat-free milk
* Lunch: Lean roast beef on whole wheat with lettuce and tomato
* Snack: Kiwifruit, 6 walnut halves
* Dinner: Turkey breast, baked sweet potato, steamed green beans
* Dessert: 2 thin slices of cheese

Risks: You get obsessed with every grain of sugar-unnecessarily. A few healthy foods such as carrots are demonized. It's a little low in calcium, folate, and iron.

Benefits: Provides a great array of healthy choices, including whole grains. Rich in fiber, vitamins A and C, the B vitamins, and zinc

The fix: Choose calcium-fortified orange juice and take a daily multivitamin/mineral supplement.

Dr. Atkins's New Diet Revolution

Food focus: Bacon, fried eggs, fried pork rinds, high-fat cheese, butter, cream

Calorie control: Limits carbohydrates to 20 grams (g) to provoke ketosis, which inhibits hunger Considered the enemy: Most breads and cereals, fruit, and starchy vegetables are severely limited. Milk and sugars are forbidden.

Sample Menu

* Breakfast: Fried eggs with sugar-free sausage
* Lunch: Bacon cheeseburger (no bun), small tossed salad
* Dinner: Shrimp cocktail with mustard and mayo, clear consomme, steak, tossed salad with dressing, diet Jell-O with artificially sweetened heavy cream

Risks: Bad breath, constipation, and elevated cholesterol. Oozes saturated fat and limits many foods known to protect your health

Benefit: Rapid weight loss

The fix: Honor your body enough to choose a different diet.

Practice Variety, Not Restriction, for a Healthy Diet Says University of Arkansas Researcher

Fad diets that restrict the types of food we eat may actually jeopardize our overall health. Such weight loss schemes are based on the erroneous notion that eating only a few specific foods can lead to better health. On the contrary, says University of Arkansas anthropologist Peter Ungar — humans evolved to consume the widest possible range of foods, and limiting that variety can lead to serious health risks.

Rather than whittling your diet down to a select group of foods, a healthier approach to nutrition is to expand the variety of foods you eat. After all, says Ungar, that's what four million years of evolution has designed the human body to do.

"Americans assume that their diets are varied because of the seemingly infinite array of foods available to us," Ungar said. "But if you look at the average American diet, it consists mainly of fat and starch. Occasionally, we throw in some tomatoes.

"Diets that purport to solve that problem by cutting out entire categories of food are taking the wrong approach," he added. "The modern risk, at least in part, is that our diets aren't varied enough."

Experts across the nation agree. In a new book titled "Human Diet: its Origin and Evolution" Ungar and co-editor Mark Teaford of Johns Hopkins University gathered leading experts in health, nutrition and human evolution to produce a comprehensive review of the human diet. Published by Bergen & Garvey, it represents one of few books to address the topic of diet using insights and evidence from multiple fields.

By combining the expertise of physicians, anthropologists, nutritionists and paleontologists, the book examines human diet from the eating habits of our earliest ancestors to the diet-related health problems that plague our world today. Each chapter cites evidence from the latest research in those fields, and each contributes to the overall message: that human beings evolved to eat the most varied diet of any species and that the limited nature of our modern diet can lead to chronic health problems.

In the preface to the book, Ungar and Teaford write that "diet changes have far outstripped the capacity of genetic evolution to keep pace with changes in what we eat today." The discrepancy between our modern eating habits and the metabolic functioning of our bodies has given rise to such diseases as diabetes, cancer and heart disease. Further restriction of food intake, as prescribed by fad diets, has been shown to promote kidney failure, enlargement of the pancreas and iron deficiency.

"Human Diet" begins with two chapters that examine the link between diet and health. In the first of these chapters, a physician of evolutionary medicine and two of his colleagues assess how excessive consumption of saturated fats, simple sugars and sodium impact human health. They then compare the nutritional content of our modern diet to that of our ancestral diet.

In the second chapter, a bioarcheologist examines the shift from hunter-gatherer societies to agricultural settlements. He states that the effects of that transition on diet content immediately resulted in a decline in health. Bones and teeth from that transitional period show increased infection, dental disease and physiological stress. The researcher then emphasizes that the agricultural foundation of our modern food supply continues to deteriorate human health.

While the opening chapters of "Human Diet" assess modern health concerns, subsequent chapters trace the trail of evidence back, hoping to illuminate the health and habits of human ancestors. The authors of these chapters — including Ungar and Teaford — attempt to reconstruct early hominid diet through observation of modern hunter-gatherer societies and primate models, or through evidence found in the fossil record.

By understanding the diet of our earliest ancestors, these researchers hope to identify how modern eating habits have diverged and to assess the physiological consequences of that divergence. These latter chapters drive home the point that diet has profoundly influenced the design and function of the human body.

In an unpredictable environment, the ability to consume and digest whatever foods were available meant the difference between survival and extinction for many species. Early hominids coped with an uncertain food supply by adapting to eat as many different foods as possible. These adaptations included changes in tooth and jaw morphology, in digestive functioning and metabolic processes. Contributors to the book explore the development and consequence of each of these adaptations.

But the features that allowed our ancestors to adopt such a varied diet were not just physiological. They were also mental. According to Ungar, the capacity for innovative thinking led to tool use and methods of external food preparation. By cooking and cutting, early hominids gained access to foods that otherwise would have been inaccessible.

"We are unique in the broad spectrum of foods we take. Primates have a much broader diet than other animals, but we're like super-primates," Ungar explained. "We can eat almost anything we want. That's thanks to our fairly simple gut, our cultural ability to cook and detoxify foods and to our tools, which enable us to break down material that our teeth can't handle."

Nutritional quality has long been inadequate in the modern human diet. But by demonstrating that the human body is designed to consume the broadest possible range of foods, "Human Diet" suggests that nutritional variety is also lacking. As the medical field continues to find links between diet and disease, it becomes evident that the survival of our species may once again hinge on our ability to consume the right foods.

How I Did It

I was a former collegiate athlete and coach. I maintained an adequate level of fitness, but not to the same degree as an athlete. After joining a gym in May '04 and getting a membership that included five training sessions, I remember thinking, I don't need a trainer. But after seeing the physiques produced by trainer Jolene Carter, I agreed to sign up to train and compete in my first figure competition.

The training regimen and work ethic were not new — but the diet was. I began my transformation at 148 pounds and 21% bodyfat. I ate six clean meals daily, incorporating one hour of weight training five days per week and one hour of cardio six days per week. I included a lot of plyometrics and track workouts. The changes in my physique were immediate and amazingly gratifying. I felt good, looked awesome and the diet was great. The key is to find foods you enjoy, and then learn to prepare them healthfully.

During my competition diet, I eat chicken and shrimp fried rice, Southern-style potatoes, steak fries, crab cakes, chicken fajitas and twice-baked potatoes — but I know how to prepare them the right way.

Sixteen weeks after my journey began, I was 128 pounds, 6% bodyfat, and the winner of my class in my first figure competition: the 2004 NPC John Sherman Classic. I have been competing ever since, including several national-level NPC contests.

I have since learned how to successfully maintain, adjust and manipulate my body type through proper diet and exercise. The secret? There is none. There is no magic pill. There is no quick fix. There is only hard work, dedication and education.

FLEX welcomes letters from readers. Send them to talkback@flexmagazine.com or to Talkback, FLEX, 21100 Erwin St., Woodland Hills CA 91367. Include your name, city, state, phone number and age. We welcome photos, but no cell phone pictures, please. To be our inspirational "How I Did It" story, include an essay of 250 words or less, detailing what training and nutrition methods you used to make the transformation and how you were inspired to do so, plus the above basic information and "before" and "after" photos. FLEX reserves the right to edit and condense for publication.

THE WORD ON WHEAT

IS A VOLUNTARY GLUTEN-FREE DIET A GOOD CHOICE FOR CYCLISTS?

ONE IN 133 PEOPLE — OR 1.5 million Americans — may suffer from a sensitivity to gluten, a protein found in wheat grain, a group of researchers at the University of Maryland discovered in 2003. Fast-forward six years: Grocery aisles now burst with gluten-free alternatives to wheat-based staples such as pasta, bread, cookies — even beer. High-profile athletes such as Garmin-Slipstream rider Christian Vande Velde openly ascribe to a gluten-free diet. And the FDA is now developing standards for voluntary gluten-free labeling, similar to those used for organic foods.

For the average cyclist, gluten-free eating may not offer any benefits over a healthy, well-rounded diet. In fact, according to Julie Miller Jones, PhD, a nutritionist and advisory board member of the Grain Foods Foundation, gluten-free diets often lack a host of nutrients typically found in whole-grain wheat products such as vitamins B and D, calcium, iron, zinc, folate and magnesium. And because cyclists rely on the carbohydrates found in many wheat-based foods to pound out miles, it's important to know if you're a good candidate to go gluten free, or if you should just keep digging into that linguini.

Gluten sensitivity is an umbrella term for three distinct wheat-related ailments: celiac disease, wheat allergies and nonceliac gluten intolerance, says Cynthia Keefer of the Gluten Intolerance Group. Celiac disease is a genetically predisposed condition in which gluten causes an inflammatory reaction, often resulting in gastrointestinal distress. A blood test can diagnose that problem.

People who suffer from a wheat allergy, one of the eight most common food allergens, produce a histamine response that can result in a skin rash, breathing difficulty and nausea. A standard allergy test clears most people of a potential reaction to wheat.

While nonceliac gluten intolerance has yet to gain widespread recognition, it's commonly accepted as a treatable condition among alternative practitioners such as chiropractors. (Vande Velde's gluten-free diet originated with his chiropractor.) Currently, the only way to determine if you suffer from nonceliac gluten intolerance is by eliminating gluten from your diet.

Celiac disease can present itself at any age, and symptoms range from severe to hardly noticeable. Pro triathlete Desiree Ficker started having stomach problems in her early 20s while running track at the University of Alabama — "During an Ironman I'd have to stop up to six times," she says — but she wasn't diagnosed with celiac disease until she was 29.

That year, 2006, Ficker had her best season yet, placing second in the Hawaii Ironman World Championships. Ficker says she thinks the gluten-free diet might benefit even people without a diagnosed medical condition. "It does end up being a lot healthier because it forces you to stay away from overly processed foods," she says. "I learned how to cook for myself so things don't taste like sawdust. I don't know if I lost any weight on the scale, but I definitely got a lot leaner."

The truth about diet pills

Here's the scoop on 6 promising supplements--and 6 to avoid.

The sales pitches are irresistible: "Lose 2 Pounds a Day!" "Burn Fat Round the Clock!" "Learn the Amazing Weight-Loss Secret of Hollywood's Sex Symbols!" OK, maybe that's pushing it. But if diet pills could give you Eva Longoria's body, would you bother with the salads and stair-climbing?

Truth is, lifestyle changes are the key to healthy weight loss. Without them, you won't get anywhere. But the 6 diet-pill ingredients listed here just might help, according to experts at Georgetown University, the University of Mississippi, and the University of California, Los Angeles. Want to try one? Check labels to see if they contain these ingredients, avoid "proprietary blends" that don't reveal their contents, and discuss your weight-loss game plan with your doctor.

Caffeine

What it is: The wake-you-up chemical in your coffee appears to be the most effective weight-loss ingredient.

Why try it: A stimulant, caffeine speeds up metabolism and can ward off listlessness from dieting. It may suppress appetite. too, and boost the power of other weight-loss ingredients.

Why not: More than 400 milligrams per day (equivalent to three to four cups of coffee) won't help you lose more weight and could bring on jitteriness, headaches, and insomnia. Unfortunately, most products don't reveal their caffeine quantities in easy-to-understand terms; a typical daily dosage of some supplements might have as much caffeine as 30 cans of Coke (1,200-plus milligrams). Skip it if you have high blood pressure or heart disease, or if you're pregnant or nursing.

EGCG

What it is: It's green tea's main antioxidant--the same stuff that may protect against cancer and heart disease--and is available in green tea supplements. The effective dosage seems to be 90-plus milligrams per day. Or just drink four cups of green tea. Vitamins with EGCG typically don't contain enough of the antioxidant to be useful.

Why try it: EGCG appears to work synergistically with the caffeine in green tea to boost metabolism. And a few small studies suggest it'll help you burn about 4 percent more calories (about 80) a day and specifically burn fat.

Why not: EGCG has no risks, but the caffeine in green tea may lead to jitters if you drink coffee or take a caffeine supplement, too.

Chromium

What it is: Your body needs this mineral for the hormone insulin (which lets cells turn sugar into fuel) to work effectively. Insulin resistance, linked to diabetes, is thought to make you fat. The effective dosage seems to be 200 micrograms per day.

Why try it: Chromium seems to slightly limit weight gain in people with diabetes or pre-diabetes. And in one study, people who didn't have insulin trouble lost about 3 pounds more in 10 weeks using chromium than those who didn't. But experts say the mineral may be most useful for people with insulin resistance.

Why not: Years ago, there were health concerns about one form: chromium picolinate. Later studies found it to be safe, though, says Adriane Fugh-Berman, MD, associate professor in the complementary and alternative medicine master's program at Georgetown. But case reports have linked chronic use of 600 micrograms or more per day to kidney and muscle damage.

Conjugated Linoleic Acid (CLA)

What it is: This fatty acid is a natural substance found in meat and dairy products. The effective dosage used in studies is 3,000 milligrams per day; most supplements contain 1,000 to 1,200 milligrams per pill.

Why try it: In one trial women lost 9 percent of their body fat in a year--and gained muscle, too. In another study, men and women lost about 6 percent of their fat after 6 months. Losing fat can make weight maintenance easier, because you burn more calories when you have less of it.

Why not: CLA may raise cholesterol and worsen insulin resistance.

5-HTP

What it is: Sometimes called Griffonia simplicifolia, 5-hydroxytryptophan is an amino acid that your body eventually converts into serotonin, the brain chemical thought to be lacking in people with depression. It's shown promise as a natural antidepressant. The usual dosage: 100 milligrams, three times a day.

Why try it: 5-HTP may increase levels of a hormone that tells your brain when you're full.

Why not: If you're also taking antidepressants or migraine drugs called triptans, 5-HTP may overstimulate your nervous system and lead to muscle spasms or tremors.

L-dopa or L-tyrosine

What it is: Your body turns the amino acid L-tyrosine into L-dopa and then turns L-dopa into dopamine, another brain chemical linked to cravings and pleasure. A common daily dosage is 500 milligrams.

Why try it: Low dopamine levels may lead to overeating, says John Williamson, PhD, of the National Center for Natural Products Research at the University of Mississippi. And researchers discovered years ago that Parkinson's patients given L-dopa lost weight. What's more, L-dopa may trigger production of human growth hormone, which builds muscle and reduces fat.

Why not: Some people experience nervousness, palpitations, and tremors after even low doses.

What not to buy

• Cascara. This is a natural laxative--not a safe way to shed pounds.

• Dandelion. It's a natural diuretic, so you lose only water weight.

• Ephedra. The Food and Drug Administration banned it in 2004; now, court challenges hope to put it back on the shelf. Ephedra increases the risk of heart problems and stroke.

• Garcinia. There are possible links to liver damage.

• Hoodia. There's been lots of hype about hoodia gordonni, a cactuslike South African plant with appetite-suppressing chemicals (in one study, people who took it ate 1,000 fewer calories a day). But the hoodia in that test isn't available right now, says University of California, Los Angeles, expert and Health Advisory Board member David Heber, MD, PhD. He says the hoodia products in stores or online probably contain other hoodia types that don't work--or none at all. The British company Phytopharm, which has a global patent on hoodia for weight loss, says real products are years away. Bottom line: The available hoodia products may be safe, but they're useless.

• Usnic acid. Found in some bodybuilders' formulas, it's been linked to severe liver damage.

Thursday, October 29, 2009

Halt hunger with HOODIA?

That second piece of cake looks appealing. You know you shouldn't, but you're not quite full, What if you could take a safe, natural pill to blunt your appetite? The herb hoodia might be the answer.

Fans of the herb say that it provides that extra bit of willpower needed to avoid
snacking, and it keeps them feeling full for longer periods of time. These reported
benefits address one of the most critical aspects of weight loss—limiting calories.

Shut off the Hunger Switch
For centuries, the Kalahari Bushmen in the southern African desert have relied on a cactuslike succulent, Hoodia gordonii, as a "famine" food—used to curb hunger during long desert treks. The plant looks and tastes like a spiny cucumber. Hoodia indeed appears to have appetite suppressant properties, and unlike other weightloss aids, it is not a stimulant.

Hoodia contains a steroidal glycoside molecule, dubbed P57, that is thought to be 10,000 times more active in the brain than glucose. The compound appears to work by tricking the body into feeling full. Brown University scientists found that P57 reduces daily food intake by 40-60 percent and helps increase brain ATP (the body's energy molecule) by 50-150 percent. In clinical trials in Britain, obese people taking hoodia ate about 1,000 calories a day less than the control group.

How to Use Hoodia
The fresh plant may cut your appetite immediately, but some people might need up to two weeks of regular supplementation before noticing results.

Start with 500mg one hour before lunch and again before dinner for two weeks. As the effects kick in, reduce the dosage to 500mg total daily. While thought to be a safe herb (no side effects have been noted), hoodia has not undergone studies to establish its safety profile.

Finding a Quality Product
Since hoodia's introduction to the US market, concerns have been raised about product quality. Some have speculated that certain brands don't contain true Hoodia
gordonii but rather other hoodia species or even other succulents. There currently is
no way to measure the quality of hoodia and/or P57 in products; however, attempts
are being made to change that. For now, use a brand that you trust and that clearly
lists Hoodia gordonii on the label.

A weight loss “secret”: Calories matter

Diet gurus have long promoted weight-loss strategies that fiddle with the form of calories. Avoid fat. Avoid carbs. Eat lots of protein. Balance carbs, fats, and protein. The only thing that really matters, though, is taking in fewer calories
than you burn. That’s the conclusion from the latest trial comparing weight loss across four popular diet strategies: low fat, average protein; low fat, high protein; high fat, average protein; high fat, high protein. Each diet met the American Heart Association’s recommendations for cardiovascular health.

Participants in each group quickly lost weight, then gradually regained some. After two years, weight loss was similar across the four plans, on the order of 7 to 9 pounds. Feelings of hunger, of being satisfied, and of satisfaction with the diet were the same across the board. So were cholesterol levels and other markers of cardiovascular risk (New England Journal of Medicine, Feb. 26, 2009).

If you want to lose weight, find a diet that appeals to your taste buds. Cutting back by 250 calories a day, and exercising long enough to burn an extra 250 calories a day (walk an extra two miles, for example) will help you lose a pound a week. You can calculate the calories in your food, or the calories you burn, at www.mypyramidtracker.gov.

Instead of a catchy name, this kind of do-it-yourself diet has something better—a proven track record.

On a Diet? Avoiding the Scales? Think Again

Most advice says to weigh yourself no more than once a week when trying to lose weight. But two new studies have found that daily weighing may actually be beneficial for both weight loss and weight maintenance.

Weighing Daily Pays Off. The first study, from the University of Minnesota, followed more than 3,000 overweight or obese people for two to three years. More than half the participants were in a weight-loss program; the rest were in a program designed to keep them from gaining weight. Those in the weight-loss program who weighed themselves daily lost twice as much weight as those who weighed themselves only once a week (12 pounds versus 6 pounds).

The 20% of participants who reported that they never weighed themselves fared worst of all, gaining about four pounds over the two years. In contrast, even those enrolled in the weight maintenance program who weighed themselves daily lost weight.

Scales Supersede Support. A second, smaller study, from researchers at the Weight Control Center at Brown University Medical School in Providence, Rhode Island, followed 291 people on a weight-maintenance program for 17 months, after each had lost at least 10% of body weight. During that time, they participated in an Internet support group, a face-to-face support group or they received a monthly newsletter for support.

While support groups helped the dieters lose weight and keep it off, the researchers found that how often participants stepped on the scales had even more of an impact on weight loss than the kind of support they were receiving. Of those who weighed themselves less than once a day, 68% regained at least five pounds, while only 39% of
daily weighers regained that much.

The Bottom Line. Researchers from both studies say that while weighing yourself daily doesn't work for everyone (e.g., those who get discouraged easily or who only have a few pounds to lose), it offers a way to realize your weight is creeping upwards before it gets out of control. This allows you to get back on track quicker with your weight loss.

Choosing the Best Diet Plan for You Navigating the myriad of choices

If you’re like most people, you’ve tried a few different weight-loss diets in your life. Some worked, some didn’t. Some you liked, some you hated. Some were well-balanced, some were faddish. And there’s the rub: Weight-loss plans—and there are scores of them out there—are as individual as you are. You have to find the one that best fits you, your personal preferences, and your lifestyle.

The question is: Are some diet plans better than others? From a health standpoint, the faddish plans—for example, the grapefruit diet or the cabbage soup diet—are
definitely not a good choice because they are dangerously low in calories and essential nutrients. But when it comes to the established popular plans, the answer to that question is unclear, simply because most haven’t been studied well enough.
The one exception, however, is the Weight Watchers diet.

Research on Weight Watchers

A recent review of 9 major commercial and self-help weight-loss programs in the United States found that only Weight Watchers had good scientific evidence to support its weight loss claims.

The evidence comes from 2 studies in which overweight people were randomly assigned to regularly attend Weight Watchers meetings or try to lose weight on their own
(although in 1 study these people had the help of a dietitian). In the end, the Weight Watchers group lost approximately 5% of total body weight (about 10 lbs.) over 3–6 months, and in 1 of the studies the Weight Watchers dieters had kept off 6 of those 10 lbs. after 2 years. Dieters who tried to lose weight on their own in these 2 studies lost significantly less weight and were less successful in keeping that weight off over the long term. Although modest, a weight loss of 10 lbs. is still enough to reduce the risk of diabetes and heart disease.

Research on Other Diet Plans

The reviewers weren’t able to find high-quality research about the other large commercial diet plans they looked at (Jenny Craig and L.A. Weight Loss) or for the following diet plans: the medically supervised diets Health Management Resources, Optifast, and Medifast/Take Shape for Life; the Internet-based eDiets.com; and the organized self-help programs Take Off Pounds Sensibly (TOPS) and Overeaters Anonymous. This doesn’t mean that these diets don’t work, but rather that good scientific studies—randomized, controlled, clinical trials comparing 1 plan to
another or to losing weight without outside help—have not yet been conducted to determine how much weight you can expect to lose.

A Direct Comparison

Luckily, another trial published after the review took a different tact, and thus was able to shed some light on the relative effectiveness of 4 popular diet plans. The trial randomly assigned 160 overweight people to either the low-carbohydrate Atkins diet; the moderate carbohydrate, moderate protein Zone diet, the balanced
Weight Watchers diet, or the very-low-fat Ornish diet. The participants were asked to adhere strictly to their assigned diet for 2 months, and then to decide for themselves if they wanted to continue with their assigned diet plan for another 10
months.

Many didn’t; by 1 year, 42% of the people enrolled in the study had dropped out. The dropout rates were somewhat higher (but not significantly higher) among those assigned to the Ornish and Atkins diets, which were the most restrictive in terms of
food choices. (Adherence to the diets might have been higher if the participants had been allowed to choose which diet they went on, the researchers say.)

But the most important finding of the study was that all 4 diet plans produced similar rates of weight loss after 1 year—4.6 lbs. for Atkins, 7 lbs. for the Zone, 6.6 lbs. for Weight Watchers, and 7.3 lbs. for the Ornish diet. All of the diets also reduced the participants’ risk factors for heart disease, primarily by improving the ratio of LDL (“bad”) cholesterol to HDL (“good”) cholesterol.

The weight loss seen in this study was not achieved by diet alone, however. Many of the participants also increased their exercise level while dieting, which likely helped them lose weight.

Finding Your Best Diet

The limited research on popular weight-loss plans drives home 2 messages:

• weight loss is hard;

• finding the optimal diet for you as an individual is the only way to succeed.

Long-term weight control is based on changing your eating patterns (and your physical activity habits) for a lifetime. Anyone can go on a diet for a couple of weeks, or even a couple of months, but those who lose weight and keep it off adopt a diet plan they can sustain (with some calorie adjustments) for years. Here, then, are some tips on how to choose a diet that suits you:

• Do a self-assessment. Most overweight people eat out of habit and in response to emotions rather than because they’re hungry. For instance, they may use food to comfort themselves, to relieve anger, stress, or boredom, or as a reward. And they may not be aware of these behaviors and habits.

To learn what leads you to overeat, observe your usual diet for a week: Keep track of what you eat, when and where you eat, who you’re with when you eat, and how you’re feeling when you eat. Also make note of your portion sizes (many overweight people eat larger portions and more calories than they think).

This process will give you an idea of your trouble spots and help you decide what diet plan will work best for you. For example, if your portion sizes are too large, you might find that a diet program that provides prepackaged or prepared meals will
work best for you, because you won’t need to make decisions about portion size and will learn what a healthy portion is. These types of diet plans are also good for people who don’t have time to prepare healthy meals. If you are an emotional eater, a diet plan that offers counseling or support groups might be best for helping you
cope with the emotional issues that are driving you to overeat. And at a support group, you might make new friends who you can call to go for a walk, see a movie, or just talk, when boredom tempts you to overeat.

• Find a diet that fits your personality and lifestyle. You might be the type of person who is most comfortable with a diet that provides daily menus and recipes—or you might prefer a plan that offers
lists of foods from which you can pick and choose (or even provides prepackaged foods). You might do well with a diet that recommends 3 square meals a day, or alternatively, a diet that advises 6 small meals. You might require a plan that addresses some of your health concerns—the need to lower your sodium, cholesterol,
or fat intake—or allows you to eat meals away from home because you travel a lot for business or pleasure. Or you may be looking for a program that offers support from other dieters or guidance from a medical professional such as a registered dietitian. Determine your personal preferences and then find a diet plan that matches them.

• Choose a diet that is wellbalanced.
Trendy diets such as the Atkins plan may produce quick weight loss, but they don’t offer the full complement of vitamins, minerals, and other nutrients your body needs
to stay healthy—and they typically lead to weight regain when you go off the diet. They’re also hard to stay on for the long term because they strictly limit the types of foods you can eat.

The best strategy is to go on a calorie-controlled plan that includes all of the food groups and doesn’t deprive you of your favorite foods. You can do this by following a well-balanced, commercial diet plan—or you can devise the plan on your own.

Evaluating 4 Diets From Atkins to Zone

Trendy low-carb weight-loss plans, like the Atkins and Zone diets, have been duking it out for years, each claiming to be the best for weight loss. But a new study gives the Atkins Diet a leg up.

Experts have long voiced concerns that low-carb plans, especially the Atkins Diet, wreak havoc with blood cholesterol levels, because they are high in fat. But in the latest showdown of the weight-loss plans, the Atkins diet came out on top for both weight loss and effect on blood cholesterol levels.

Diets vs. Diets. In the study, researchers from Stanford University Medical School
recruited 311 overweight and obese women, ages 25 to 50, randomly assigning them to follow one of four diets:

• The Atkins Diet group aimed for no more than 20 grams of carbohydrates a day for two to three months and no more than 50 grams a day after that.

• The LEARN Diet (Lifestyle, Exercise, Attitudes, Relationships and Nutrition) group followed a "prudent" diet of 55% to 60% calories from carbohydrates and less than
10% from saturated fat.

• The Ornish Diet group aimed to get no more than 10% of calories from fat.

• The Zone Diet group followed a 40%-30%-30% (carbohydrate-protein-fat) distribution of calories.

The Results Weigh In. After following the plans for one year, the Atkins dieters
lost the most weight—10 pounds; Zone dieters lost the least—3.5. But the biggest
surprise was that the Atkins diet showed no unhealthy effects on blood cholesterol
levels. In fact, high-density lipoprotein (HDLs or "good") cholesterol actually increased and triglycerides decreased among Atkins dieters, both favorable responses.

EN's Take. So, does this mean Atkins is the best way to lose weight? Not necessarily.
There were no significant differences in weight loss among the Atkins, Omish and LEARN diets (the Zone diet lagged behind all three). Moreover, the longer participants followed Atkins, the less effective it was; they lost more weight at the start, but began putting pounds back on as time passed. And the study didn't look at men or older people.

Still, it does lay to rest fears that the Atkins Diet increases cardiovascular disease risk by raising cholesterol levels.

The Atkins Diet May Not Be So Unhealthy After All — A Comparison Trial with Three Other Diets

In a head-to-head comparison trial of four weight-loss diets, the Atkins diet came out on top. The findings, though modest and preliminary, appear to challenge the prevailing medical wisdom
about the best diet as one that is low in fat and high in carbohydrate. The study was led by Christopher D. Gardner, PhD, Stanford University Medical School, and published in the March 7, 2007 issue of the Journal of the American Medical Association.

The 249 participants in this trial were overweight or obese women under the age of 50 without diabetes. All had been randomly assigned to follow one of these four diets for one year: The Atkins (high protein, very low in carbohydrate), Zone (low in carbohydrate with emphasis on fruits and vegetables), Ornish (high in complex carbohydrate, extremely low in fat) and LEARN (low in fat, high in carbohydrate).

The first three are diets popularized via the media and books, two of them by physicians—Dr. Robert Atkins and Dr. Dean Ornish. LEARN is a diet/lifestyle program central to the national guidelines. It involves a “prudent diet that included 55% to 60% energy from carbohydrate and less than 10% energy from saturated fat.”

Weight Loss Modest for All

After one year the amount of weight lost was: 10.4 lbs. for Atkins, 3.5 lbs. for Zone, 5.7 lbs. for
LEARN, and 4.8 lbs. for Ornish. Initially, the women on the Atkins diet lost weight faster but in
time the things began to even out across the four groups. Something that showed up in previous
studies of the Atkins diet.

The women received weekly instructions about the assigned diet for two months and at 10 months. In keeping with the fact that most Americans follow diets from a book, each woman received a copy of one of the four following books, according to her
assigned diet: Dr. Atkins’ New Diet Revolution, Enter the Zone, The LEARN Manual for Weight Management or Eat More, Weigh Less by Dean Ornish.

Heart Risk Factors Checked

Before and after the trial, the women’s cholesterol and levels of insulin, glucose and blood pressure were measured. Results for the women who had been on the Atkins diet were either comparable with or better than those of the women on the other diets.

Dr. Gardner and colleagues noted, “Many concerns have been expressed that low-carbohydrate weight-loss diets, high in total and saturated fat, will adversely
affect blood lipid levels and cardiovascular risk. These concerns have not been substantiated.” In fact, the authors cite five trials published in the last four years that produced findings similar to their own—in terms of triglycerides, high-density lipoproteins (“good cholesterol”) and blood pressure—that favor very-low-carbohydrate diets.

The researchers, however, state that they are not able to determine whether these favorable metabolic effects are attributable to the low-carbohydrate intake or other aspects of the Atkins diet, such as the high protein intake.

Dr. Gardner and colleagues concluded, “While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.” This study was funded by grants from the U.S. National Institutes of Health.

Diets, diets everywhere — but which one really works? Now, we've got the answer.

When Contributing Editor Christie Aschwanden first proposed we do a pioneering, massive Diet Face-Off project, I thought she was very smart. And crazy. "Smart" because this would be a scientific study unlike any other. It would be designed to find out which diet works best — not in a lab, not with researchers holding participants' hands, not with incentives to keep people in the study. We would find out what works best in the real world. Your world.

"Crazy" because this would be the biggest project Health has undertaken in its 18 years. It involved 1,000 women, four popular diets, more than a year of intensive
work, and so many dollar signs that my vision would blur every time we talked about it.

Christie and Deputy Editor Lisa Davis pursued the Face-Off doggedly. They chose the diets to test: lowcarb, low-fat, low-calorie, and lifestyle-changing. They teamed with David Katz, MD, director of the Yale-Griffin Prevention Research Center, to develop a scientifically sound way to randomly assign women to the diets and track their progress. Then they recruited 1,000 women who wanted to lose some weight—and, not incidentally, help solve the mystery of which diets really work, one of the most frustrating conundrums of modern life. Can you imagine just how many e-mails 1,000 women might send in 6 months? At last count, 15,000-plus. Assistant Editor Amanda Storey handled them all with aplomb. "It was our first time doing this, and some of the technical glitches were frustrating," Amanda says. "But it was so exciting when we started to hear from women. It wasn't just the weight loss; some said their whole lives had changed because of the study. It was fabulous."

We think so, too. Take a look: The results of our Diet Face-Off start on page 104.

Wednesday, October 28, 2009

Is there an MS diet?

There are low-cal diets and low-carb diets, liquid diets, vegan diets, diets that claim to fight aging, arthritis, autism, and anxiety - and that's only the "A"s.

For people with MS, many doctors recommend a traditional low-cal, low-fat diet; others promote strict limits on certain food groups. Or they emphasize certain
foods such as fatty fish, apples, blueberries, broccoli or almonds.

The varied recommendations and the lack of a distinct game plan can leave people with MS just plain confused.

"While it is unlikely that a simple diet will be therapeutic in MS, recent data regarding the roles of vitamins such as vitamin D and niacin in maintaining a healthy immune and nervous system suggest that we should pay more attention to nutrition," said Dr. Peter Calabresi, who heads the Multiple Sclerosis Center at Johns Hopkins Hospital in Baltimore.

"No one is completely sure what works and what doesn't," said Dr. Heidi Crayton, director of the MS Center of Greater Washington, DC. "There are guidelines for
smart eating, but there is no fail-safe plan. I tell my patients with MS that
it's really important to have a healthy diet.

That includes two liters of water and 30 grams of fiber every day, a palate with bright, colorful foods, and foods that have high nutritional value. Decrease fats and refined sugar," Dr. Crayton added.

Some doctors who look to a more aggressive eating plan to deal with MS support the Swank Diet, a stringet low-fat diet developed by Dr. Roy Swank more then 30 years ago. It bans all dairy products, glutens (found in wheat), legumes (meaning beans and peas) and virtually all saturated fat from animal sources. It stresses fish and
fish oils.

Dr. Swank reported that 95% of patients who adopted this very low-fat diet following an early diagnosis of MS had a remarkably good chance of remaining free from
further disability.

"They have to follow the diet strictly because even small amounts of fat make a big difference," Dr. Swank said. He asserted that patients who had a daily intake of eight grams of saturated fat (one hamburger or two ounces of cheddar cheese) significantly increased their risks. Dr. Swank published his study in the British
medical periodical The Lancet in 1990. "Most people in this country expect to be cured by a pill, and to have a cure that is almost instantaneous. With the
low-fat diet, people actually have to work to get better," Dr. Swank told Dr. John A. McDougall, founder and medical director of the McDougall Program, which promotes this very low-fat approach. The problem is other researchers have not duplicated Dr. Swanks results, and there is no generally accepted proof that the Swank diet really controls MS. There is anecdotal evidence from people with MS who say this diet makes them feel better.

Dr. Vijayshree Yadav, a neurologist at the Oregon Health & Science University MS Center in Portland, Oregon, said there is litde current research on the Swank diet. In fact, "diet has not been paid that much attention," she said. "But diet can make
a difference."

She advises her MS patients to go low-fat: "It's healthy. And it's such a low-risk intervention that I don't see any reason not to recommend it." She also said a new study is expected to get underway next year at the Oregon facility to take a hard clinical look at the impact of diet on MS.

"Diets have been used for MS from time immemorial. If they worked, we wouldn't be still talking about them," said Dr. Randall T. Schapiro, the director of the Schapiro Center for Multiple Sclerosis in Minneapolis. Like many other MS specialists. Dr. Schapiro recommends a healthy diet that is low in saturated fat.
Other than that, he said no specific diet has shown any long-term benefit.

According to Dr. Allen Bowling, director of the Complementary and Alternative Medicine Program at the Rocky Mountain MS Center in Englewood, Colo., it may be reasonable for some people with MS to take a fish oil supplement that includes one to
two grams of EPA plus DHA. He also notes that it's wise to beware of overstated claims either for or against specific foods or supplements. He agrees with Dr. Yadav that research on MS and diet is very limited.

All these doctors agree that while there is no concrete evidence that a specific diet controls MS, there is every good reason to eat a healthy diet and avoid things that are known to be bad for everybody. So while there is no true consensus, an MS plan might look like this:

• Cut back on saturated fat. That means avoiding highly marbled red meat, butter, cheese and other full-fat dairy products.

• Use oils from vegetables, seeds, and fish. Try butter substitutes, such as soft or tub margarine, but use sparingly and look for "0 trans fats" on the label.

• Eat fish regularly, especially salmon, herring, mackerel, tuna, sardines and lake trout.

• Eat skinless chicken or turkey, lean meats trimmed of visible fat, or go meatless with vegetable proteins from beans, lentils, soy or nuts.

• Consume five servings of fruits and vegetables a day, choosing the brightly colored fiber-rich varieties.

• Eat three to four servings of whole-grain products daily. There is no concrete evidence that gluten has any impact on MS.

• Exercise to stretch muscles affected by MS, stay in shape, manage mood, fight fatigue, promote bone health, and maintain a healthy weight.

• Be cautious with caffeine and alcohol.