Fad Diets

1. Fad Diets By: Sheila Mulhern

2. 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

3. Names: ThePaleo 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

4. 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

5. 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.

6. 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 Low Carbohydrate Diet

7. Dukan Cultural 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 Atkins Cultural 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 vs. Atkins

8. The Claim: Eat whatever you want and never gain a pound The Phases: 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) 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. Dukan Diet

9. Comparison 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 Studies

10. 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

11. 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 Low Carb Diet Health Risks

12. 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

13. Food Combining Diet

14. Meal 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

15. 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

16. 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

17. 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

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

19. Food Combining Diet

20. 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

21. 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. DASH Diet TLC Diet Mayo Clinic Diet Mediterranean Diet Weight Watchers Diet Volumetrics Diet Jenny Craig Diet Biggest Loser Diet Ornish Diet Vegetarian Diet Slim-Fast Diet Flat Belly Diet Nutrisystem Diet Abs Diet South Beach Diet Vegan Diet Eco-Atkins Diet Glycemic-Index Zone Diet Macrobiotic Diet U.S. News Best Diets Overall

22. 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)

23. 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/

24. Resources Food 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