Fad DietsBy: Sheila Mulhern

Fad Diets

Taking a look at fad diets and their inadequacies so we can become familiar with them and how to advise clients with accuracy

Diets often resurface over time with refreshed models but shared principles

• Paleo Diet• Low Carbohydrate• Food Combining

Paleo Diet

Names: The Paleo Diet (2010) by Loren Cordain, Caveman Diet (1985)

The Claim: Our bodies are genetically and evolutionary designed to survive and thrive on the foods that were available to our early Paleolithic ancestors

The Rules: Eat only foods that can be mainly hunted or gathered that were prior to the development of agriculture– Meat, chicken, fish, eggs, fruit,

vegetables, nuts and seeds

Sample Diet:• Breakfast: scrambled eggs

with a side of fresh berries• Lunch: green salad topped

with grilled chicken breast or shrimp

• Dinner: beef tenderloin, raw or steamed vegetables & stewed fruit for dessert.

• Snacks: raw nuts, veggies, hard-boiled eggs and fresh fruit

Paleo Diet

Pros: • Objects to processed foods and promotes fresh fruits,

vegetables, lean meats• Restricts salt, refined sugar and processed oils

Limitations: Lacks variety, can lead to nutritional inadequacies with eliminated food groups (grains, dairy, beans, legumes, flours) has inconsistencies in theory and practice

• Evolutionary theory: Diet discourages grain intake yet scientists have found evidence of wild grains and seeds which emerged 55-65 million years ago

• Diet is high in animal protein (saturated fats) and argues strongly against vegetarianism

Paleo Diet• Academy of Nutrition and Dietetics says:

– Spokeswoman Heather Mangieri, MS, RD, says, "This diet has some great aspects, but the limitations make it another diet that people go on but can’t sustain for a number of reasons, including a lack of variety, [cost], and potential nutrient inadequacies" due to the elimination of certain food groups.

Low Carbohydrate Diet• Origins: 1825 in “The Physiology of

Taste” by Jean Brillat-Savarin

• Typically set up a system of stages to follow

• First stage follows ketogenic diet: low/no carbs cause body to use stored fat for energy

• Blood glucose levels decrease to less than 3.58 mmol/L for glucagon and hormones to be released to maintain energy metabolism

• Pros: Has structure and rapid initial weight loss

• Cons: Rapid weight loss unsafe, lack of variety and nutritional balance, difficult to comply, evidence of severe medical complications

• Examples

– Dukan Diet

– Atkins Diet

– The Zone Diet

– South Beach Diet

Dukan vs. AtkinsDukanCultural Impact Rumored diet of Kate

Middleton before the royal wedding; Over 5 million copies of the book sold worldwide

Diet: Low carbohydrate, high protein, limited fat only oil, fish and eggs

Phases: Attack, Cruise, Consolidation, Stabilization

Long term: Anything 6 days a week, protein only once a week

AtkinsCultural Impact: Caused large declines

in sales of heavy carb items like pizza, rice and Krispy Cream; most popular in 2003, 2004

Diet: Low carbohydrate, high protein, allows any fat sources

Phases: Induction, Ongoing Weight Loss, Pre-Maintenance, Lifetime Maintenance

Long term: Lifetime of low carbs

Dukan DietThe Claim: Eat whatever you want

and never gain a pound

The Phases:1. Attack phase (1-10 days) Eat as

much lean protein and nonfat dairy products with no calorie restrictions (carbs won’t spike glucose) Secret weapon is oat bran (1 tbs./day) to feel full (lose up to 10 lbs in a week) ketosis, dehydration from water weight loss; For example if you want to lose 25 lbs aim for 7 days

2. Cruise phase: Add non-starchy vegetables every other day lasts until you reach goal weight (10 weeks plus)

3. Consolidation phase: Add small amounts of simple carbs back fruit, whole grains, cheese; 2 celebration meals (no binge) example slice of pizza and glass of wine; if lose control and eat too many carbs go back to phase 2

4. Stabilization phase: Eat what you want with these 3 rules to live by

• One day a week eat just eat protein. It must be the same day each week.

• Eat 3 tablespoons of oat bran a day for the rest of your life.

• Never take elevators or escalators. Walk 20 minutes a day.

Low Carb Diet StudiesComparison of the Atkins, Ornish,

Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial.

Journal of American Medical Association, Division of Endocrinology, Tuft-New England Medical Center, Boston, MA, Jan. 5, 2005

Patients: Mean BMI 35, aged 22-72 with known hypertension, dyslipidemia or fasting hyperglycemia

Design: Assigned to diet randomly Atkins (carbohydrate restriction), Zone (macronutrient balance), Weight Watchers (calorie restriction), or Ornish (fat restriction) diet groups.

After 2 months of maximum effort, participants selected their own levels of dietary adherence and were evaluated after a year.

Results: Each diet modestly reduced body weight, reduced cholesterol ratio by approx 10% with no significant effects on blood pressure or glucose. Adherence to diets was low but those who followed had better results

Low Carb Diet Health Risks

Physiologic Response• Ketoacidosis

• Hepatic

• Gastrointestinal

• Endocrine

Corresponding Complication• Hyperuricemia, gout, renal stones,

anorexia, mausea, vomiting, dysphoria

• Increased serum bilirubin and serum glutamic oxaloacetic transaminase concentrations

• Diarrhea, constipation

• Amenorrhea, cold intolerance, dry skin, hair loss, muscle cramps

Low Carb Diet Health Risks

• USDA established conclusive evidence that there is an increased risk of death as a direct consequence of high protein, low-energy diets

• Received reports by Dec. 1977 of 44 deaths in association with high protein diet intakes

Medical Complications of protein diets

• Death: Cardiac (arrhythmias, myocardial infarction), cerebral ischemia, pancreatitis

• Cardiac conditions• Neuromuscular disorders• Gastrointestinal• Renal Stones

Food Combining/Hay Diet

• Hay Diet (1930); Nutripathy (1970s); Alkaline-Acid Diets

The Claim: It’s easier to digest carbohydrates and proteins when the are eaten separately. It rids toxins easier, increases metabolic rate, stores less fat, counteracts digestive problems and weight gain.

The Rules: Separate foods into groups (alkaline, acidic, neutral), don’t combine carbohydrates and proteins, use meal intervals

Food Combining Diet

Food Combining DietMeal Intervals • Breakfast until morning

snack: 1 – 2 hour break

• Morning snack until lunch: 0.5 – 1.5 hour break

• Lunch until afternoon snack: 3 – 4 hour break

• Afternoon snack until dinner: 1.5 – 2 hour break

• In general fruit should be eaten before and not after the meal. Eat fruit separately as meal or snack. If you snack on fruit you can have a meal already 30 minutes later.

Food Combining Diet

Myths: • If you eat steak and then fruit it will ferment in your stomach.

– Avoid highly acidic foods (coffee) and foods without a dominant nutrient (legumes, lentils, beans, peas) because they are more difficult to digest

• The body produces toxins because it can’t break down carbs, proteins and fats at the same time

Food Combining Diet

Facts and Studies:

• The pancreas secretes digestive enzymes simultaneously regardless of whether the food eaten is a carbohydrate or protein– Demonstrated by Dr. Stewart Baxter 1935,

pancreas secretes both acidic and alkaline mediums in parallel concentrations

– Analyzed three principle enzymes of pancreatic juice trypsin, amylase, lipase

Food Combining Diet

Facts and Studies:• The International Journal of Obesity study comparing a

balanced diet with the food combining diet shows no difference in weight loss and metabolism

• 6 week period at in-hospital setting with 54 obese patients Obesity Outpatient Clinic of the Department of Medicine at Geneva University Hospital

• No significant difference in weight loss, decrease in total body fat and waist to hi circumference. Both diets had reduced (similar) fasting plasma glucose, insulin, cholesterol, lower systolic and diastolic blood pressure

• Both overall diets had similar weight loss; balanced diet had higher total fat weight loss

                                                    

Changes in body weight & body fat (a) In dissociated diet group (square); (b) In

balanced diet group (circle).

Food Combining Diet

Food Combining Diet

• Additional considerations– Breast milk easily digested by babies which contains all of the

macronutrients– Most foods are a combination of carbohydrates, protein and fat

• Broccoli (1 cup) 2.6  grams of protein, 4.6 grams of carbohydrate and 0.3 grams of fat

U.S. News Best Diets Overall

• U.S. News evaluated and ranked the 25 diets below with input from a panel of health experts. To be top-rated, a diet had to be relatively easy to follow, nutritious, safe, and effective for weight loss and against diabetes and heart disease. The government-endorsed Dietary Approaches to Stop Hypertension (DASH) snagged the top spot.

1. DASH Diet2. TLC Diet3. Mayo Clinic Diet4. Mediterranean Diet5. Weight Watchers Diet6. Volumetrics Diet7. Jenny Craig Diet8. Biggest Loser Diet9. Ornish Diet10. Vegetarian Diet11. Slim-Fast Diet12. Flat Belly Diet13. Nutrisystem Diet14. Abs Diet15. South Beach Diet16. Vegan Diet17. Eco-Atkins Diet18. Glycemic-Index 19. Zone Diet20. Macrobiotic Diet

More Fad Diets!

• Cigarette Diet (1925)• The Chewing Diet: Horace Fletcher (1909):

Chew food 32 times• Bananas & Skim Milk Diet (1934)• Grapefruit Diet/Hollywood Diet (1950)• Cabbage Soup Diet (1950/1990)• Calories Don’t Count Diet (1961)• Sleeping Beauty Diet (1976): • Blood Type Diet (1996)

Resources• Paleo

– http://thepaleodiet.com/– Environmental Nutrition. The Modern Take on the Paleo Diet: Is it Grounded in

Science? January, 2010.– Amidor, Toby. Popular Fad Diets. Today’s Dietitian. Jan., 2012. p. 10.

• Low Carb– Pittier A, Corrigan F, (2001). "The ketogenic diet: healthy or harmful? a review in

light of its renewed popularity". Trinity Student Medical Journal 2 (5): 39–41. – Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of

the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. Journal of the American Medical Association. Division of Endocrinology, Diabetes, and Metabolism, Atherosclerosis Research Laboratory, Tufts-New England Medical Center, Boston, MA. 2005 Jan 5;293(1):43-53.

– Marliss, Errol. Protein diets for obesity: metabolic and clinical aspects. Canadian Medical Association Journal. Dec. 1978. Vol 119. p 1413-1421. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1818596/?tool=pubmed

– Moore, Shelley. What are the Dangers of Ketogenic Diets?. LIVESTRONG.com. May 21, 2010. http://www.livestrong.com/article/128113-dangers-ketogenic-diets/

ResourcesFood Combining

– American Journal of Digestive Diseases. The parallel concentration of enzymes in the pancreatic juice, Stewart G. Baxter, January 25, 1935, http://www.springerlink.com/content/31j7472670571764/ http://resources.metapress.com/pdf-preview.axd?code=31j7472670571764&size=largest

– International Journal of Obesity, Similar Weight Loss with Low-Energy Food Combining or Balanced Diets.April 2000, Volume 24, Number 4, Pages 492-496 http://www.nature.com/ijo/journal/v24/n4/full/0801185a.html

Diet Timelines http://www.eatright.org/nnm/games/timeline/index.html