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."
Showing posts with label Atkins Diet. Show all posts
Showing posts with label Atkins Diet. Show all posts
Friday, October 30, 2009
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."
* 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."
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.
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.
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 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.
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.
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.
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.
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