Thursday, October 29, 2009

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; 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

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.

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