Demystifying Fad Diets

Transcription

1 Demystifying Fad Diets 1 E R U M J H U M R A, MSC. R D. P A K I S T A N N U T R I T I O N A N D D I E T E T I C S O C I E T Y C O N T I N U I N G N U T R I T I O N E D U C A T I O N S E M I N A R F E B R U A R Y 2 3,

2 There is more misinformation pretending to be fact in this field than any other I can think of Dr. Jeffery M. Friedman Rockerfeller University Obesity Researcher New England Journal of Medicine Jan 31,

3 Body Composition 3 Fat Free Mass Fat Mass Total Body weight

4 Distribution of Weight 4 MALES FEMALES Total fat 8 to 24% Storage fat 5-21% Essential fat 3% Muscle 44.8% Bone 14.9% Remaining % Total fat 21-35% Storage fat 9-23% Essential fat 12% Muscle 38% Bone 12% Remaining 15-29% Krause s Food and Nutrition Therapy 2008

5 What Regulates our Body Weight? Resting Metabolic Rate: 60 70% of total energy used. energy restriction and age (2-3% per decade) 5 Energy used in voluntary activity: 15 30% includes AT and NEAT Regulatory Systems: e.g. hormones and neurotransmitters

6 Factors Affecting Weight Gain 6 Genes, Metabolism, Physiology, Disease Diet, Quality and Quantity Obesity Physical Activity and Exercise Sleep and Stress

7 A Fad Diet Short term diet plans. List can vary. Claims are too good to be true - weight loss at an unrealistic pace. Refers to foods as good or bad. Recommendations are extreme. Personal testimonials used to sell the diet. Recommendations based on a single study or no research at all. Statements are refuted by reputable organizations. 7

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9 MODE OF ACTION The HCG Diet 9 Regular injections of HCG (human chorionic gonadotropin) derived from pregnant women's urine. Simultaneously follow diet

10 The HCG Diet - Reality 10 Cortisol and insulin ovarian stimulation & testosterone produced Immunity against pregnancy? Risk of headaches, blood clots and fatigue Discredited by FDA & researchers in 1970 s. Near starvation, 500 kcal for 6 weeks Placebo

11 Detox /Master Cleanse/ Green Smoothies 11 MODE OF ACTION ANALYSIS Drink for a week to several weeks: juice/water or green smoothies Detoxification? Intake of fruits and vegetables.

12 Detox, Master Cleanse, Green Smoothies 12 CLAIM REALITY Flushes toxic chemicals Body functions better Metabolism soars and sheds pounds Might include pills, powders, enemas, colon cleansers e.g. sea salt Liver, kidneys and colon detoxify Extreme low calorie

13 General Motors* Diet, 7 Day Diet MODE OF ACTION No alcohol, 10 glass water a must, only black tea/coffee allowed 1. All fruits, no banana 2. Start with a potato, but rest all vegs day 3. Veg & fruits no banana or potato 4. Upto 8 bananas and 3 glasses LF milk 5. Upto 20 oz beef and 6 tomatoes 6. All beef & veg 7. Brown rice, veg & fruit 13

14 General Motors* Diet, 7 Day Diet 14 CLAIM REALITY Unlimited wonder soup Lose 10-17lbs/week Cleansing effects Emotional fulfillment Vegetarian version Optional exercise 10 mins Repeat at intervals to maintain low cal veggies for filler Quick result repeat Sudden muscle weakness, headache, irritability, malaise, hunger. Restricted choice, nutritionally def.

15 What is wrong with semi starvation? 15 When the body is suddenly deprived of adequate energy, such as with involuntary or deliberate starvation or semistarvation,the RMR adapts to conserve energy against an unpredictable future by dropping rapidly, by as much as 15% in 2 weeks. When adequate food intake is restored, the RMR returns to baseline levels Krause s Food and Nutrition Therapy 2008 Page 535

16 CASE STUDY Your client, Rizwan s details are as follows: Age: 40 years Height: 5 10 Weight: 200 lbs Body fat: 28% of total weight (56 lbs. of fat) Daily intake: 3,000 calories (2 big meals, lunch & dinner) Reduces his intake to 2,000/day through lots of meat, eggs & milk, no carbs. Drops to 190 lbs. in 2 weeks and only feels slightly sluggish. After three weeks: Weight loss stops Cuts calories to 1,500/day Weight drops to 180 lbs Needs more sleep, has occasional headaches and craves sugars and bread. After 10 weeks: Achieved his goal weight of 170 lbs. & has a body fat of 27%. Calculate his fat in lbs and fat free mass in lbs. What s wrong with these results? 16

17 CASE STUDY Post diet: Total weight: 170 lbs. Body fat: 27% (46 lbs. of fat) Weight lost: 30 lbs (20 lbs. of lean tissue and 10 lbs. fat) Primary loss = Lean mass, metabolism. Poorly balanced diet = immune suppressed. Difficult to follow same pattern for long What will happen when he goes back to usual eating pattern? After 1 year (Now 41 years old): Weight: 203 pounds Body fat: 32% (70 lbs.of fat) Intake: Approx. 2,000 calories (2 big meals, lunch & dinner Remembers he lost weight on that diet and plans to do it again. About to become a yo-yo dieter. 17

18 The Dukan Diet MODE OF ACTION: Different phases Attack : 1-10 days unlimited lean protein/dairy Cruise : alternate pure protein veg and protein. Introduce unlimited (allowed) vegetables Consolidation: add 1 fruit, 2 slice bread, 1 piece cheese. 2 free meals allowed in a weak Stabilization: eat what you like, but protein only thursdays forever. 18

19 The Atkins Nutritional Approach An evolving approach. Has been around since The New Atkins For a New You (2010) Phases: 2 week Induction: high protein, high fat, low carb Ongoing Weight loss: tiny increase in carbs Pre maintenance: 10 gms increase/week (identify optimum) Life time maintenance: with option to drop back 19

20 The Atkins and Dukan Diets 20 OVERVIEW Low carb diet after about 48 hours, ketones are burnt for energy. Glucose is reserved only for absolute need. ANALYSIS Hunger is controlled by less changes in blood sugar levels. Not sustainable long term. Protein should be lean High fat a concern Lower triglycerides

21 Low CHO & High Protein Restricting all CHO is unhealthy 1 Ketosis is a biochemical process in fat burning state 2 Systematic Review of data 3 : n= 229 hunter-gatherer societies Information on Anthropological and nutritional data 21 Results: 76% of the societies derived >50% of their subsistence from animal foods. The rest gathered plant foods 1. Karra,C ; Shape Up America Reveals The Truth About Dieters, Volek, J.; Stephen D.(2011). Beyond Obesity. pp. 302, Cordain, L., J. B. Miller, S. B. Eaton, N. Mann, S. H. Holt, and J.D. Speth. American Journal of Clinical Nutrition, 2000

22 The Good and the Bad Carbohydrate Is there such a thing as a good CHO? For weight loss, a good CHO is one with lower calorie density Fruits and vegetables have lesser calories per bite as opposed to other CHO Healthy intake of CHO between 45% to 65% 22

23 The Paleo Diet 23 OVERVIEW ANALYSIS Includes only things you can hunt, gather and grow e.g. fish, meat, veg, fruits and nuts. No dairy Restricts most grains. sugar, refined CHO, processed foods. risk of heart disease, due to better fat metabolism. Calcium deficiency.

24 The Macrobiotic Diet 24 OVERVIEW ANALYSIS Use of grains, supplemented by vegs. Avoid processed foods Avoid red meat Fish, seafood, nuts, fruits allowed 2-3 times/wk Not a cure for cancer as advocated Severe forms very restrictive

25 Why Conventional Weight Loss Diets Fail 25 They focus on weight loss not fat loss. Starvation lowers energy expenditure Don't encourage lifestyle modification or exercise. Demand drastic changes in eating patterns Most often result in weight regain plus more

26 Nutritionally Sound Diets That Work 26 The DASH Diet The Mediterranean Eating Pattern

27 Which Weight Loss Diet Works Best? You can choose any diet for weight loss as long as you take in fewer calories than you burn. 1 n= 800 volunteers Assigned to one of four diets : average protein, low fat; high protein, low fat; average protein, high fat; high protein, high fat. 27 Results: At 2 years, weight loss across the four plans was similar (7 to 9 lbs) There was no difference in feelings of hunger, satiety, satisfaction or other markers of cardiovascular risk. 1. Sacks, FM, Bray GA, Carey VJ, et al. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. N Engl. J Med.2009

28 Which Weight loss Diet Should I Choose? 4 Simple Questions 1. Will this diet teach you to eat right in the long term? 2. Does it involve modification of behavior that caused weight gain to begin with? 3. Can you follow this diet for an extended period of time? 4. Does this diet offer sensible advice on exercise? 28

29 Successful Weight loss Exercise Diet Behavior 29

30 The Qur an: Al Ma idah ayah 87 O you who believe! Make not unlawful the good things which Allah has made lawful for you, but commit no excess; for Allah loves not those given to excess ي ا أ ي ه ا ال ذ ين آم ن وا ال ت ح ر م وا ط ي ب ات م ا أ ح ل ه للا ل ك م و ال ت ع ت د وا إ ن ه للا ال ي ح ب ال م ع ت د ين 30

31 31 A Balanced Diet Still the Best Approach clients' history.do cx