How does one respond to this sort of criticism? HELP!!


http://www.mayoclinic.com/invoke.cfm?id=HQ00654

Sensible diet and exercise plans seem to be losing a popularity contest with fad diets. It seems that just about everyone has tried the weight loss plans outlined in books like "The Zone" and "Sugar Busters!" Warnings abound that these diets are unwise. But many people dismiss these cautions because they know someone who's dropped significant weight, quickly, while on a fad diet.

Donald D. Hensrud, M.D., is a physician nutrition specialist at Mayo Clinic, Rochester, Minn. Dr. Hensrud helps people manage their weight and conducts research in weight management. He has some thoughts about what's wrong with fad diets, and offers sound advice on how to lose weight and maintain the loss.

What makes weight control so difficult?

Dr. Hensrud: Society is set up in a way that makes it easy to gain weight. We have very efficient transport systems, such as cars and elevators, and pastimes that promote inactivity, such as computers and TV. Also, high-calorie foods are widely available, and fatty foods taste good. To do something about it, you have to go against the grain. Applying the "eat-less-exercise-more" prescription is much more complicated than it seems. That's one of the reasons why there are so many treatments promoting easy weight loss. People want an easy fix. It's human nature.

Fad diets such as The Zone and Sugar Busters! are very popular. What's wrong with them?

Dr. Hensrud: One problem is lack of research in most of the diet books out there. I'm also bothered by the way many of them make or imply promises about weight loss — that it's easy, that you can still eat all your favorite foods and lose weight. The promise of a quick fix is a problem, as is the misinterpretation of known biochemistry and physiology. Some of the theories they promote don't hold water.

Still, even some doctors go on these diets. Why?

Dr. Hensrud: They see some weight loss, but despite what the books say, it's due to eating fewer calories and not anything magical about the diet. Take The Zone diet, which limits carbohydrates on the theory that they promote insulin production, which leads to weight gain. The recommended diet in the book has about 850 calories a day. Anyone who eats 850 calories is going to lose weight whether they're in "the zone" or not.

Not every aspect of these diets is bad. For instance, Sugar Busters! recommends decreasing sugar intake. I can't argue with that because many high-sugar foods are high in calories and low in nutrients. But it's only one aspect of a healthy diet. In general, with fad diets, the negatives outweigh the positives.

What are the worst aspects of fad dieting?

Dr. Hensrud: There are two main reasons for losing weight, both of which are valid: to improve your health and for cosmetic reasons.

You can lose weight on different diets, but the approach may not be healthy in the long run. Diets shouldn't go against what we know about improving long-term health. Many of these fad diets advise reducing carbohydrate intake, and they include very few grains, fruits and vegetables. There's a tremendous amount of evidence that increasing grains, fruits and vegetables is good for health and for prevention of diseases like cancer.

On fad diets, even if you lose weight, you may not improve your long-term health. Often, our traditional recommendations for weight management seem old and kind of boring, but those recommendations lead to many other health benefits. A less serious problem is the lack of long-term results. Most people can't stick with these diets, and they end up back where they started. The vast majority go off the diet and gain their weight back.

What do you do for people who come to you frustrated by their inability to lose weight?

Dr. Hensrud: I take a close look at what they're doing. Most people underestimate the number of calories they eat by about 20 percent — more if they're very overweight. On the other hand, they overestimate their physical activity. It's not intentional or devious, it's just that we're not good judges.

I recommend an individualized approach. For instance, a person may have physical problems that prevent him or her from doing much activity, so we have to look more at diet. Others think they have to overdo vigorous exercise. Instead, I encourage them to look for ways to increase their daily activity, such as parking farther away when they go to the store.

Another thing I talk to people about is how they go about losing weight. Rather than thinking, "I've got to go on a diet," I encourage them to approach it in a positive manner, looking at it as an opportunity to do something that can be enjoyable. I try to get them to focus on the process instead of the end result. People want to lose quickly, and they focus on the number on the scale. They need to focus on making lasting lifestyle changes. The pounds will come off as a result. Whatever changes people make, they need to be comfortable enough with them to make them permanent. If they feel restricted by something, they shouldn't do it.

Support can play a key role. Group support provided by programs such as Weight Watchers and TOPS can help. The key is changing people's attitude.

Finally, changing food choices to include foods that not only lead to fewer calories but also are healthy and tasty is important. There's a tremendous amount of wonderful food that can be truly enjoyable. We underestimate our ability for our tastes to change.

Related Information
Orlistat: Medication for obesity
Mayo Clinic diet: No such thing
Food & Nutrition Center


HQ00654

August 24, 1999

Question:
What do you think of the Atkins diet?

Answer:
Having seen what a powerful difference changes in diet and lifestyle can make, it makes me want to pull out what's left of my hair when I see the renewed interest in high-protein, low-carbohydrate diets. These diets are hazardous to your health. They were first popularized by an undertaker in the 1800s -- maybe he needed more business.

Telling people that pork rinds and sausage are good for you is a great way to sell books, but it is irresponsible and dangerous for those who follow their advice. I would like to be able to tell you that these are health foods, but they're not. Fortunately, there is a way to safely lose even more weight while eating great foods in abundance.

Here's the real skinny on fat:

There is a large body of scientific evidence from epidemiological studies, animal research, and randomized controlled trials in humans showing that high-protein foods, particularly excessive animal protein, dramatically increase the risk of breast cancer, prostate cancer, heart disease, and many other illnesses. In the short run, they may also cause kidney problems, loss of calcium in the bones, and an unhealthy metabolic state called ketosis in many people. The American Dietetic Association recently condemned high-protein diets as being dangerous, "a nightmare of a diet."

In contrast, whole foods such as fruits, vegetables, grains, and beans contain literally thousands of other substances that are protective, having anti-aging, anti-cancer, and anti-heart disease properties. These include fiber, isoflavones, carotenoids, bioflavonoids, retinols, lycopene, geninstein, on and on.

However, most people don't really think anything bad will ever happen to them. They think prevention is borrrrr-ing: "I don't care if I die sooner, I want to enjoy my life."

So do I. But how much fun are you having if you're feeling tired, lethargic, and impotent? Or dead?

When you go on a high-protein diet, you may get less blood flow to your most important organs. When you get less blood flow to your brain, you may feel more tired and you think less clearly. (Think about a time when you had a rich Thanksgiving feast, and how you felt afterwards.) When you get less blood flow to your heart, you increase your risk of chest pain or a heart attack. And when you get less blood flow to your sexual organs, your sexual prowess decreases.

When I was in medical school, we were taught that most impotence began in your brain -- psychological. We now know it usually begins in your arteries -- physiological. The reason that Viagra is one of the best-selling drugs of all time is that so many people need it. Impotence, also called "erectile dysfunction," is a silent epidemic, present in at least one-half of men over the age of 40. But did you know you're much more likely to be impotent if your cholesterol level is elevated? Knowing this is a lot more motivating for many men than telling them they're going to live to be 86 instead of 85 -- even when they're 85!

Not to mention bad breath and body odor. Your body excretes toxic substances like excessive amounts of meat in your breath, perspiration, and bowels. When you eat a lot of meat, it takes a long time for it to make its way through your digestive tract. As it putrefies and decays, your breath smells bad, your sweat smells bad, and your bowels smell bad. Not very attractive. You may want to lose weight to attract people to you, but when they get too close, it becomes counterproductive.

Yet many people do lose weight on high-protein diets, and cholesterol levels may even decrease. How can this be?

The important distinction to make is between simple carbohydrates and whole foods, also called complex carbohydrates. The dangerous half-truth is this: simple carbohydrates cause you to gain weight, but complex carbohydrates help you lose weight. The goal is not to switch from simple carbohydrates to a diet consisting mainly of high-protein foods like meat but from simple carbohydrates to whole foods, while reducing your intake of high-protein animal foods.

Simple carbohydrates -- sugar and other concentrated sweeteners, and alcohol, which your body converts to sugar -- are absorbed quickly, causing your blood sugar to rapidly increase. White flour (including foods like white flour pasta) and white rice are also absorbed quickly, because the fiber and bran have been removed. In response, your body secretes insulin to lower your blood sugar levels to normal. However, chronically elevated insulin levels also accelerate the conversion of calories into fat, raise your cholesterol level, and have other harmful effects. Over time, like the boy who cried "wolf," the insulin receptors say, "Oh, not more insulin!" and become less sensitive to its effects, causing your body to secrete even more insulin in a vicious cycle.

The high-protein authors advise us to avoid all carbohydrates and eat high-protein foods because these are less likely to provoke an insulin response. This is not smart.

Whole foods (complex carbohydrates) -- such as whole wheat, brown rice, and fruits, vegetables, grains, beans, and soy products in their natural form -- are rich in fiber, which slows their absorption. Because they are absorbed slowly, your blood sugar does not spike and so your body does not need to produce elevated levels of insulin. Instead of the rapid swings in blood sugar, you experience a more constant feeling of energy throughout the day. You become more sensitive to insulin rather than resistant to it; diabetics often are able to reduce or discontinue insulin under their doctor's supervision when they eat a low-fat, whole foods diet. Even white flour pasta is OK in moderation if you eat it with lots of veggies or legumes on top, as the fiber from these foods will slow their absorption. A recent article in the Journal of the American Medical Association clearly documented that high-fiber diets lower insulin levels. In contrast, meat has virtually no dietary fiber.

So why do some people lose weight on the high protein diets? Most people in this country eat a lot of simple carbohydrates. A recent study showed that one-third of the vegetables eaten in the United States are either French fries or potato chips. And consumption of sugar, white flour, and processed foods has increased significantly in the past two decades, along with obesity. Eating a lot of meat instead of all those simple carbohydrates will help lower their insulin response, causing them to lose weight. But they're mortgaging their health in the process.

There is a better way. If you switch from simple carbohydrates to a whole-foods, low-fat, plant-based diet, then you don't provoke an insulin response -- so you get the insulin benefit similar to being on a diet high in animal protein without the many harmful effects. Also, you are eating whole foods that are much lower in fat and cholesterol, so you lose even more weight than on a high-protein diet and your cholesterol levels come down even further. In our studies, for example, we found a 40% average reduction in LDL-cholesterol without using drugs. And you're getting thousands of substances that are protective rather than harmful.

You can lose weight on just about any diet. Keeping it off is a lot harder. A few years ago, the government reviewed all of the different weight loss plans. They found that two-thirds of people gained back all of the weight they'd lost within a year, and 97% gained it all back within five years.

However, we found in our research that the average person lost 24 pounds in the first year and kept off more than half that weight five years later, even though they were eating more food, and more frequently, than before. Without hunger or deprivation. Simply. Safely. Easily. They not only felt better, they were better. We also found that they had even more reversal of heart disease after five years than after one year, and 2.5 times fewer cardiac events such as heart attack, stroke, bypass surgery, and angioplasty. The more closely people followed the program, the better they were. Clearly, if you can reverse heart disease by eating this way, then you can help prevent it.

Most weight-loss plans are based on deprivation: counting calories, restricting portion sizes, and eating less food. Sooner or later, people get tired of feeling hungry, so they get off the diet, regain the weight, and usually blame themselves for not having enough discipline, willpower, or motivation, when the real problem is that they were going about it in the wrong way.

Here's a better way: if you change the type of food, you don't have to reduce the amount of food. Fat has nine calories per gram, whereas protein and carbohydrates have only four calories per gram. So if you go from a 40% fat diet to a 10% fat diet, even if you eat the same amount of food, you consume far fewer calories. You feel better and you become healthier. You really can eat more and weigh less if you know what to eat.

In short, when you switch from a diet based on animal protein and simple carbohydrates to a whole foods, plant-based diet, you get a quadruple benefit:

the high fiber content of fruits, vegetables, grains, and beans reduces insulin levels, so you lose weight and lower cholesterol levels;
when you eat less fat, you eat fewer calories without eating less food;
you avoid the animal-based products rich in substances that cause illnesses;
you get thousands of other substances that are protective.
To the best of my knowledge, none of the high-protein diet authors have ever published any studies in any peer-reviewed journals documenting that their approach can help people lose weight safely and keep it off. In contrast, my colleagues and I at the nonprofit Preventive Medicine Research Institute have published our findings in the Journal of the American Medical Association and other well-respected peer-reviewed journals. Part of the value of science is to help you sort out conflicting claims, to distinguish fact from fancy, what sounds good from what is real. I'm not trying to tell you what to eat; just to provide scientifically based information so that you can make more informed and intelligent choices.

If you eat a low-fat diet based on whole foods, you are likely to lose even more weight than on a high-protein diet, your cholesterol levels may come down even more, and you will feel better, look better, love better, taste better, and smell better. It's not all or nothing -- the more you move in this direction, the more benefits you receive. And you will significantly reduce the risk of heart disease, cancer, and other illnesses rather than increasing it. You can lose weight and gain health.

here is the link to the post above:

http://content.health.msn.com/content/article/3079.233

hi Laura,

I've redirected your posts to the Research/Media forum. I'll review the first article you posted later, but I recognised the second MSN article right away ... It was posted here some months ago, and we had an interesting discussion debunking the theories .. That thread is also here in the Research forum .. look for "Article on MSN-Health" posted by madpiano .. or click here to open in a new window.

Low carbing, put simply, is NOT a fad diet. The Cabbage Soup Diet, the Grapefruit Diet, the so-called Mayo Clinic Diet ... those are fads. The solid low carb programs such as Atkins, Protein Power, Dr. Bernstein's Diabetes Solution, Schwarzbein and many others .. are backed by decades of scientific research and medical testing. Fad diets are short-term quick "fixes" where no lifestyle changes are made, and there's no plan for lifetime maintenance. That's why longterm low carbers call this a Way of Life.

Doreen

I am not trying to upset anyone by asking these questions!

I went to my doctor yesterday and she said that "Atkins is OK short term, but is unhealthy long term." The only concrete reason she gave was because high protein diets are really hard on your kidneys, even if you dring lots of water

I am so sick of people doubting this WOL. I have been on low carb diets before, and it seemed like everyone was so *worried* about me - .....was it worry or were people (even unconciously) trying to undermine me?

My eating disorder is something I have suffered from for easily 18 years (I am 31 now and my earliest memory was when I was 13). I am so sick and tired of being sick and tired I am sick of people appeasing me "Oh, you look fine" - I feel like screaming at them "YOU DON'T HAVE TO LIVE INSIDE MY HEAD, do you????!" You have no idea how exhausting and depressing food addiction can be.

I want a solution!! The solution for smoking is unambiguous, simply stop. The solution for drug and alchohol addiction is obvious, STOP! But with food, everyone has a damn opinion and everyone thinks they are right.

I am just so discouraged, frustrated and angry. Everytime I think I have the solution (low carb, no sugar) and I feel RELIEF, some jerk like my doctor feels the need to CONFUSE ME again. I really do feel like crying

When I said "You have no idea how exhausting and depressing food addiction can be. " I referring to the people who try to belittle my food obsession, not you all

No need to apologise Laura We've all been frustrated by the nay-sayers and "experts" who try to convince us that we'll rot our kidneys and livers if we follow a low carb way of eating.

There's an great discussion in the "Best of" forum ... Need advice on what to tell others. I think you'll find it reassuring, from the experiences of other low carbers.

take care,

Doreen

The next time someone chides you for eating a "high protein" diet ask them to define how much protein constitutes "high". Is it 8 ounces a day? How about 12? Sometimes people (even "experts") seem to have the mistaken notion that we are scarfing down 3 t-bones a day along with a dozen eggs and a pound of bacon and nothing else. Atkins could better be defined as a "high fat" diet since fat comprises roughly 60-70% of our daily caloric intake. As for lacking fruits...so what? I get my 5 servings of veggies a day and still stay at 30 grams of carb or less. Something the experts fail to point out or just don't recognize is that the vegetables that are lowest in carb are often highest in fiber and all those antioxidents that they seem to think we are lacking. The numbers don't lie. I'm loosing weight and my bloodwork looks better on this WOE, not to mention that I'm rarely hungry and I haven't felt this good in years. Oh yeah...kindey function? After almost a year on this WOL, it's still perfect.

I was reading this thread and thought I would post the following:

Today as I was walking to my classroom (I am in education) I was stopped by my boss who pulled me into her office and closed the door. She very excitedly inquired to how I have been able to lose so much weight in the last several months (down almost 70 lbs since 11/01). She explained that she was upset by her upward spiraling weight and has been very impressed at my apparent success in weight loss. I took about 20 minutes and explained to her the basics of low carbing and gave her a few resources to "go after".

My boss has never made these comments like this in public, but it was clear after our talk that she cleary envied my success and wanted to copy it for herself. I think alot of the negative crap we get from people is they are a bit jealious in themselves. It is hard to see a person day in and day out be successful in something that you have failed at so many times (ie weight management).

Besides guys, it is YOUR body. I mean do you tell them what they should put in their mouth <grin>. It really is your own personal business afterall, and in time when they see your success they will "come around". I am at a point now that when I tell people I am on a high fat low carb diet the "used to be critics" can only say nothing for the results are no obvious. Sometimes they do not believe I was ever that obese (when that happens I show them my driver's license taken last October) and many ask me for help on getting them started.

So hang in there and remember it is YOUR body, YOUR life, YOUR dreams.