100% Fad FreeHealth updates on current diet trends

Allison Brewer

May 2, 2012

Presentation OverviewHistory of Fad DietsCurrent Fad Diet OverviewDiet Programs and Systems

◦Weight Watchers◦NutriSystem

Role of the DietitianSummaryFood For Thought in Future

Practice

Learning ObjectivesAt the end of the presentation, the participants will be able to:Identify popular methods for weight loss,

interpret dietary trends, and develop the skills to identify fad diets

Discuss current trends in dietary applications for weight loss and characteristics of popular diets

Evaluate systems and programs developed for weight loss and determine efficacy

Understand the role of the Registered Dietitian in healthy weight loss and dietary interventions

Pop QuizBeverly Hills DietSleeping Beauty DietCigarette DietSacred Heart DietNegative Calorie DietTapeworm DietCheater’s DietBaby Food DietBanana DietBlood Type Diet

What is a Fad Diet?Eating patterns that promote

short term weight lossUsually have no concern for

weight maintenanceTemporary popularity and

solution to what is commonly a chronic condition

Many lack major nutrients, vitamins and minerals

Identify Fad DietsPromise a quick fix.Claims that sound too good to be true.Simplistic conclusions drawn from a complex

study.Dramatic statements that are refuted by

reputable scientific organizations.Lists of 'good' and 'bad' foods.Specialized product used in conjunction for

desired resultRecommendations based on studies published

without review by other researchers or that ignore differences among individuals or groups.

Eliminating 1 or more of the 5 food groups.

Common Fad Diets

“I’m just one stomach flu away from my goal weight…”

Which diet was originally published in 1825 but is still popular today?

A. Raw Foods DietB. Low Carbohydrate DietC. Blood Type Diet

Atkins Diet UpdateLow carbohydrate diet with

intake based on fiber rich vegetables and protein

Research supports: prevention of CVD, lowers LDL and increases HDL (although research not consistent)

Research argues: contributes to osteoporosis and kidney stones

Nutritional Concerns: restrict healthful foods and limit variety

Dukan DietProtein based (excluding pork

and lamb)Designed by French MD Pierre

Dukan4 phases with over 100 “allowed”

foods◦Attack◦Cruise◦Consolidation◦Stabilization

Analysis of Dukan DietPierre Dukan – French MD with 35

years of experience in clinical nutrition

Similar to AtkinsPromises hunger will disappear by day 3Encourages MVI with minerals

Risk of kidney issues, muscle loss, issues with electrolyte imbalances

Restrictive nature - hard to maintain lifelong

British Dietetic Association: “Do-can’t Diet”

National Agency for Food, Environmental and Work Health Safety in France – declared the diet unhealthy

Risk Factors with Dukan Diet

Myth or Fact

You should eat each food group separately for optimal digestion.

MYTH!You’re digestive system is made to handle more than one type of food at a time.

HCG DietHuman ChoriogonadotropinHormone produced by women

during early stages of pregnancyHCG hormone surge signals the

hypothalamus to move nutrients and fat into the placenta

Low calorie diet & supplemental drops or injections

Fact or Myth

Skipping meals helps cut calories and isn’t a bad way to help lose weight.

MYTH!When you skip meals, the natural tendency is to overeat and overcompensate later.

Paleo Diet“The World’s Healthiest Diet”Genetic adaptationsFoods broken down into “do eat”

and “do not eat”◦Foods focus on what humans would

have eaten during the Paleolithic era

Analysis of the Paleo DietClaims

◦Permanently free yourself from acne◦Improve athletic performance◦Slow progression of autoimmune

diseases◦Longer, healthier, more active life◦Lose weight without dieting or

exercise◦Reduce or eliminate your risk for

disease

Analysis of the Paleo DietBenefits

◦Reducing risk of chronic diseases:Risks

◦Not balanced nutrition◦Long term high protein – high

saturated fats◦Long-term maintenance difficult

Paleo Diet: Behind the ResearchType 2 Diabetes and

cardiovascular risk13 pts – 3 women, 10 menOne group on Paleo diet for 3

months, Another on usual diet for 3 months Paleo Diet

Improvements

HgbA1c -0.4%, p = 0.01

Triglycerides -0.4mmol/L, p = 0.003

Diastolic BP -4mmHg, p = 0.03

Weight -3kg, p = 0.01

BMI -1 kg/m2, p = 0.04

Waist Circumference -4cm, p = 0.02

Master Cleanse2 TB lemon juice, 1 TB maple syrup,

1/10 Tsp cayenne pepper and 2 cups water

Drink 6-12 glasses throughout the day for 10 days

Laxative therapy morning and evening

“Help you lose up to 20 pounds, look younger, ease chronic pain, cleanse your body of internal waste and boost your energy levels in 10 days”

How Master Cleanse works3 phases

◦Ease In◦The Lemonade Diet◦Ease Out

Cleanse Stack“Every day of the master cleanse

that you overcome the psychological need to eat, you feel a growing sense of control that motivates you to complete the process”

Risks of the Master CleanseDeficient in calories, vitamins,

minerals and macronutrientsFear of filling our body with

toxins drives many to these diets◦Our bodies naturally rid themselves

of undesirable substances without human intervention

Fasting can rob intestines of healthy bacteria

Laxative abuse

Match the Diet with the correct description

Master Cleanse

Paleo Diet

HCG Diet

“The Pregnancy Diet”

“Healthiest diet in the world!”

Helps you overcome the psychological need to eat

KE DietKetogenic Enteral Nutritionhttp://abcnews.go.com/Health/die

t-brides-feeding-tubes-rapidly-shed-pounds/story?id=16146271#.T58m3NnAE14

Risks of KE DietSudden weight loss often returnsOpens up other medically

“controlled” weight loss methodsEthical dilemma

KE DietA.S.P.E.N. Statement: Using this

medical therapy for weight loss detracts from the health benefit achieved by patients that require this therapy and would much rather eat by mouth◦None of the 5,500 physicians,

dietitians and other professionals in A.S.P.E.N. would support this action

Weight Loss Programs

28 day delivered meal programCatered to your meal preferencesConsider portion sizes while reducing fat and caloric intakeGlycemic Index 1200 – 1500 calories for women,

1500 – 1800 calories for menOffers money back guarantee

NutriSystem - ProsWith exercise, can lose 1-2#/weekEaseFocuses on low fat, whole grains,

fruits and vegetablesAllows for pre-established meal

patterns with snacks and dessertNo calorie countingPre-portioned mealsSocial support, nutrition education

and exercise tips available online

NutriSystem - ConsPreservatives in mealsPre-packaged meals can lack

color and varietyExpensiveCounseling education not from

health professional/RD but “Qualified Counselors”

NutriSystem – Behind the Research

Obese individuals with T2DMStudied commercial weight loss

programs and glycemic control69 patients (49 females, 20 males)

◦Mean age: 52 years, BMI 39, HcgA1C: 7.5%Random assignment to NutriSystem – D

or Diabetes Support and Education program

3 months – Support group also on NutriSystem D

Study duration – 6 months

Research ResultsAt 3 months – 7.1% weight loss from

NutriSystem group, 0.4% weight loss from Support Group, P<0.0001, statistically significant; NutriSystem HgbA1C reduction 0.88% vs 0.03% in Support Group

Show obese patients with improvements in weight and glycemic control can benefit from commercial weight management programs

Points Plus ProgramProtein and fiber-rich foods get

fewer points to encourage dieters to eat more filling foods throughout the day

Unlimited fruit and non-starchy veggies

All foods can fitNamed #1 Best Commercial Diet,

2011

Weight Watchers - ProsSuits women and menCounselingExercise regimen

recommendationsRecipe and meal ideasPartnerships40 years of experienceMobile App

Weight Watchers - ConsCounting points similar to

counting caloriesWeight Watchers for Men – online

onlyOpen-ended plan with lots of

personal controlNot a strong emphasis on fitnessPoints system based solely on

calories, total fat and dietary fiber

Weight Watchers – Behind the ResearchRandom assignment to either

WW group or Self-help group◦48 in WW group, 40 in Self-help◦Means BMI = 33.7 kg/m2◦85% women◦2 year duration

Weight Watchers Research ResultsMaximum weight loss

◦5.3 # at 26 weeks in WW group◦1.5# at 26 weeks in Self-Help group

Maintenance in 2 years◦3.2# in WW◦0# in Self Help

How do I use this information?

7 Steps to Successful Weight Loss1. Low-calorie, low-fat diet•To lose weight, one must create an energy deficit •Maintain consistency with weight loss program

2. Eat a consistent diet from day to day. • Encourage self-control, minimize unplanned food temptations, foster self-discipline, and increase one’s ability to persevere with the diet

3. Eat breakfast• Suppresses midmorning hunger• Produces better blood glucose control

4. Incorporate physical activity

5. Check body weight frequently•Form of accountability and self-monitoring

6. Limit TV viewing time

7. Take corrective action when weight is regained• Many formal weight loss programs report that dieters frequently regain weight 3-5 years after they achieve their goal weight loss

Role of the RD

Role of the RDSystemic review of 31 long term

diet studies◦2/3 of dieters regained more weight

within 4-5 years after the program than they initially lost

Kelly Brownell, MD◦Director of Rudd Center for Food Policy

and Obesity at Yale University◦Dieting is perceived as a threat to

survivalImmune function and decreased NK

cell activity

Role of the RD

Role of the RDNever learned skills for behavior

change200 overweight and obese

individuals◦Group 1 – weight loss program with

one hour counseling◦Group 2 – weight loss program with

one hour exercise (low intensity)Results – Group one maintained

weight after 3 year follow-up

ConclusionFad diets are eating patterns that

promote short term weight lossWhen a weight loss program

sounds too good to be true, it probably is

Effective weight loss programs can be used as primary education

RD can help process lifestyle changes and goals to making desired changes

Food For ThoughtAre we already crossing the line

of what is ethical when medical professionals recommend or endorse potentially dangerous programs?

How far will society go to make losing weight easier?

References 1. Lowe MR, Miller-Kovach K, Frye N, Phelan S. An initial evaluation of a

commercial weight loss program: short-term effects on weight, eating behavior and mood. Obesity Research 1999; 7 (1): 51-59.

2. American Council on Exercise – Weight Management. Available at www.acefitness.org

3. Fletcher, D. Fad Diets. Time Magazine: Health. 15 Dec 2009. Accessed April 27, 2012. Available at http://www.time.com/time/magazine/article/0,9171,1950931,00.html

4. Gilden Tsai A, Wadden TA. Systematic Review: An evaluation of major commerciation weight loss programs in the United States. Annals of Internal Medicine. 2005; 142 (1): 56-66.

5. WebMD – Women’s Health Weight Loss: Spotting Fad Diets. Available at http://women.webmd.com/fad-diets

6. Eat right for your type. Available at dadamo.com

7. WebMD – The Dukan Diet Review. Available at http://www.webmd.com/diet/features/dukan-diet-review?page=2

References 8. US News Health: Can the Dukan Diet do it? April 5, 2011. Available at

http://health.usnews.com/health-news/diet-fitness/diet/articles/2011/04/05/can-the-dukan-diet-do-it

9. The Dukan Diet. Available at Dietsinreview.com

10. HCG Diet. Available at Dietsinreview.com

11. WebMD – The Lemonade Diet (Master Cleanse Diet). Available at http://dadamo.com/http://www.webmd.com/diet/features/the-lemonade-diet-master-cleanse-diet?page=2

12. Weight Watchers. Available at Dietsinreview.com

13. FoxNews – Cleansing diet may be worthless, dangerous. Available at http://www.foxnews.com/story/0,2933,214802,00.html

14. Discovery Fit and Health – NutriSystem Diet: What you need to know. Available at http://health.howstuffworks.com/wellness/diet-fitness/diets/nutrisystem4.htm

15. Discovery Fit and Health – Paleo Diet: What you need to know. Available at http://health.howstuffworks.com/wellness/diet-fitness/diets/paleo-diet2.htm

Questions?