Sorting Through The World of Diets: Real Nutrition for Real Health

1. Sorting Through The World of Diets: Real Nutrition for Real Health Lynn Goldstein, MS, RD, CDN The Jay Monahan Center for Gastrointestinal Health

2. Diet Statistics • 66.3% of adults over age 20 are overweight or obese • 17% of adolescents age 12-19 are overweight • 19% of children age 6-11 are overweight • 25% of American men and 45% of American women are on a diet on any given day • 95% of all dieters will regain their lost weight in 1-5 years • American spend over $40 billion on dieting and diet-related products each year .

3. Health Risks Associated with Obesity • Heart disease/stroke • High blood pressure • Diabetes • Cancer (uterine, gallbladder, ovarian, cervical, breast, colon, prostate, kidney, esophagus, stomach, liver and pancreas) • Gallbladder disease/gallstones • Osteoarthritis • Gout • Breathing problems • GERD

4. Other Nutritional Risk Factors for Cancer • High intakes of animal fat may increase the risk of breast, colon, prostate, and pancreas cancers • Increased risk for colon cancer with inactivity, diets low in fruits and vegetables, and high in red meat • High intakes of alcohol may increase cancer risk for mouth, pharynx, larynx, esophagus, liver and breast • Diets high in sodium may increase risk for stomach cancer • Smoking can increase your risk for lung and pancreatic cancer

5. Overview • Atkins • The Zone • South Beach • The Ornish Diet • Weight Watchers • USDA Food Guide Pyramid • Lynn’s Opinion on the best way to eat

6. The Zone: Dr. Barry Sears • Goal is to combat insulin resistance and alter eicosanoid levels – hormonal messengers • Eicosanoids are produced by the body and influence blood clotting, blood pressure, immunity, and inflammation • Balance insulin:glucagon ratio. These are hormones produced by the pancreas that act in opposing ways to regulate blood sugar levels. • According to Sears when theses are in balance the body is better able to burn stored calories and prevent unwanted fat deposition

7. The Zone Diet • Balance of carbohydrates, proteins, and fats to keep you in “The Zone” • The Zone means keeping ones blood insulin at a low and consistent level and this will suppress appetite and promote fat burning • 40% carb, 30% protein, 30% fat, calories are restricted • The protein to carbohydrate ratio of the diet: 0.75 or 3gm of protein for every 4gm of carb • Control eicosanoids: hormones in the body that control inflammation, immune system, and cellular activity. Affected by dietary fat

8. The Zone Plate • Divide your plate into thirds • 1/3 is low fat protein • 2/3 are fruits and vegetables • Finally add in a healthy monounsaturated fat • Each meal and snack should contain this balance • The Zone Pyramid: base is vegetables followed by fruits, low fat proteins, monounsaturated fats and at the top is grains and starches

9. The Zone Diet: Pros and Cons • No long term studies to support the theory that the 40-30-30 ratio is necessary or more beneficial • The Zone Diet is ultimately a calorie/portion controlled diet, can be a very low calorie diet • Can be confusing and complicated to follow • Does emphasize fruits, vegetables, and high fiber foods • Eliminates grains from the diet • Does encourage exercise • Does encourage multivitamins omega 3 fatty acid supplements • Does encourage healthy fats and proteins

10. Atkins Diet: Dr. Robert Atkins • High protein, very high fat and very low carbohydrate, unrestricted calories • Maintain low insulin levels, which leads to suppressed appetite, lower food consumption, and weight loss • Low insulin levels promote increased burning of fat for fuel and decrease fat storage • Leads to ketosis, burning of fat for fuel • Promotes meat, cheese, eggs, poultry, fats and limits fruit, vegetables and grains

11. Atkins Diet • High saturated fat foods are not discouraged • Low fruit and vegetable intake leading to a lack of key vitamins, minerals, and fiber • Protein/fat take longer to digest and to suppress hunger leading to lower calorie intake and therefore weight loss • Does recommend vitamins/mineral supplements • Does not address importance of regular exercise

12. The Dangers of the Atkins Diet • Harvard study indicates that regular meat consumption increased colon cancer risk by as much as 300% • Harvard study indicates that women with the highest intakes of animal fat had over a 75% greater risk for developing breast cancer • American Kidney Fund warns that high protein diets can lead to irreversible kidney damage • This type of diet can also increase your risk for constipation, diverticulosis, and colon cancer • Diets with high amounts of animal protein cause calcium loss from bone leading to osteoporosis and bone fractures

13. The South Beach Diet: Dr. Arthur Agatston • Not all carbohydrates are created equal • Emphasizes the right carbs and fats with emphasis on promoting good health not just weight loss • Main culprits in our diet are highly processed carbohydrates found in baked goods, breads, snacks, soft drinks etc., which have been stripped of their fiber and nutrients • Decrease consumption of simple carbs, insulin resistance improves, weight decreases, metabolize carbohydrates properly • Cutting simple carbs also decreases triglyceride and cholesterol levels

14. South Beach • Suggests avoiding low fat products because the fat is replaced with carbohydrate • Recommends healthy monounsaturated fatty acids such as olive oil • Promotes fruits, vegetables and grains in the final stage • 3 phases to the diet • Phase I – total elimination of fruit, bread, rice, potatoes, pasta, sugar, alcohol, and baked goods • Phase II – after 2 weeks you can begin adding back some restricted foods but in moderation • Phase III – less restrictive once the weight has been lost

15. South Beach: Pros and Cons • Studies have shown and improvement in cholesterol levels and ratios as well as weight loss • Promotes vegetables, fruits, whole grains, lean proteins and does not eliminate any food group • Teaches portion control, promotes whole unprocessed foods, and emphasizes differences amongst healthy and unhealthy proteins, fats, and carbohydrates • Promotes regular exercise

16. Why Do Low-Carb Diets Work? • Water loss = weight loss • Decreased appetite: fat metabolism creates ketones which can decrease appetite • Increased feeling of fullness: Fat and Protein take longer to digest • Reduced calories: low carb diets reduce your overall calorie intake because they strictly limit the variety of foods you can eat.

17. Weight Watchers: Jean Nidetch • Does not tell people what they can or can’t eat • Educate people about food and encourage exercise • Local support groups to help keep people motivated • Members keep track of the calories they eat in a form of points • The points allotted are assigned based on your current weight and weight goal • Foods are assigned point values, stay within your point range and you loose weight

18. Weight Watchers • Ultimately a calorie restricted diet • Promotes developing healthy eating habits • Not meant to count points for the rest of your life • Cost to the plan includes a sign up fee, $15/meeting, cost of packaged foods (optional), online service fees

19. The Ornish Diet: Dr. Dean Ornish • Author of The Reversal Diet, The Prevention Diet, and Eat More, Weigh less • Diet plan to reverse/prevent heart disease • Low fat diet/vegetarian diet • 10% of calories come from fat, excludes all animal products (except for eggs and low fat dairy), nuts, seeds, avocado, chocolate, olives, and coconuts • Oils are eliminated except a small amount of canola oil for cooking and oil that supplies omega 3 fatty acids

20. The Ornish Diet • Prohibits caffeine but allows moderate intake of alcohol, sugar, and salt • Promotes fruit, vegetables, whole grains, and high fiber foods • Diet alone is not sufficient to reverse heart disease and needs to be combined with exercise, yoga, meditation, stress reduction, and lifestyle changes

21. The Ornish Diet: Pros and Cons • AHA recommends a diet with 30% fat and the average American consumes a diet with 50% fat • Eliminates healthy fats as well as unhealthy fats • Studies show vegetarians have lower rates of disease • Studies show this approach does work to lower cholesterol, improve ratios and promote weight loss

22. The Ornish Diet: Pros and Cons • Very restrictive and difficult to maintain • Too low in fat and does not provide enough essential fatty acids • Does promote taking vitamin supplements, fish oil supplements • Promotes exercise, stress relief and lifestyle changes • Low fat products tend to be high in sugar and calories

23. USDA Food Guide Pyramid www.mypyramid.gov

24. Old Food Pyramid

26. What Are Whole Foods? • Eat foods that are closest to their natural form • Limit processed foods • Avoid sugar substitutes • Learn to read package labels; Don’t consume foods if you don’t know what the ingredients are

27. Whole Foods

28. Whole Foods

29. Exception to the Rule

30. Professional Dietary Recommendations • The number one recommendation of the AICR is a plant based diet • The number one recommendation of the World Cancer Research Fund is a plant based diet • The number one recommendation of the NCI and the WHO is eat more fruits and vegetables • The number one recommendation of the ACS is eat more plant based foods and less meat

31. Which Plan Is Right? • Include a variety of foods including vegetables, fruits, grains, lean protein sources including animal protein, soy, legumes, etc. • Include foods you like to eat • Include foods that are accessible to you • Fit your lifestyle and budget • Include the correct nutrients and calories to help you loose weight safely • Should encourage regular physical activity • Plan should not make unrealistic promises like loosing 30 lbs in 30 days

32. Questions?

33. Please Consult Your Doctor • Before beginning any new nutritional or weight loss program, please consult your doctor • For people with certain health conditions, some foods discussed in this seminar may not be appropriate.