Truth about Fad Truth about Fad DietsDiets
Obesity, Health and the Student
GoalsGoals
Determine how to assess obesity and additional medical problems caused by excess weight.
Understand how to read a food label.Identify appropriate ways to incorporate healthy foods
into your diet.
US AdultsUS Adults
Half are overweightOne-fourth are obese
Men WomenAfrican A. 56.5% 65.8%Mexican A. 63.9% 65.9%Caucasian A. 61% 49.2%
Direct medical cost >$51 billion/yr for weight-related diseases
Dollars and SenseDollars and Sense
U.S. spends 33 billion annually on wt loss (6 million Americans morbidly obese)Adults trying to lose weight: 35-40% women, 20-24% of
men22% of this population get regular physical activity
39.3 million work days lost/yr 11% of youth (6-17 yrs) overweight
Health risk of excess weightHealth risk of excess weight
Heart disease, HTN, HyperlipidemiaCancer: colon, breast, endometrial, pancreas, prostate,
uterine, cervicalInfertilityVaricose veinsStrokeSnoring
And the list goes on…And the list goes on…
Kidney stonesOsteoarthritisGoutDiabetes Mellitus
Components of body weightComponents of body weight
Water 60-65% Muscle, Bones, OrgansAdipose tissue
Protection of organs/nerves, insulation, preserves body heat, maintains body temp, & vitamin absorption
Women 20-25%, essential 12%Men 12-15%, essential 4-7%
Assessment of obesityAssessment of obesity
Ideal Body WeightMetropolitan Life Insurance Co.
• Men: 106# for 5ft, 6# for each inch over• Women: 100# for 5ft, 5# for each inch over
Body Mass Index (Quetelet index)Weight in kg/Height in m2Caution with: increased muscle mass, edema
Waist-Hip ratio> 88cm women, > 102cm men for those with BMI <40
Ideal Body weight classificationsIdeal Body weight classifications
Underweight <100%Ideal 100%Overweight 110%Obese 135%Medically sig. 160%Morbidly obese 200%Super obese 225%
How to classify BMIHow to classify BMI
Underweight <18Normal 19-25Overweight 26-29Obesity 1 30-35Obesity 2 36-40Morbidly Obese >45.1
Fat distributionFat distribution
Gynoid type (pear) Thigh/buttocks Energy reserves
Android type (apple) Waist/upper abdomen HTN, Insulin resistance, Heart
disease
Recent studiesRecent studies
20% increase in wt increases risk for Type 2 DM, HTN, CAD, Lipid NHANES: Women BMI >28 had 2x risk
for disability/mobility problems
Nurses Health Study BMI 23-25 had a four-fold
increase in Diabetes BMI >35 was associated with
risk of 93.2% for Diabetes
Etiology of ObesityEtiology of Obesity
Long-term imbalance betweenEnergy intake and Energy expenditure
Must be closely related: 2% over needs (50 kcal/d) for someone who required 2500 kcal/d
If over one year weight gain: 1.5 kg
Role of HeredityRole of Heredity
Hormonal Factors determined genetically Satiety signals Feeding activity Number/size fat cells Resting metabolic rate
Studies of twins/adoptees Evidence that a Genetic
component accounted for 67%
540 Danish adoptees were found to correlate with the weight of biological parent
Human vs. AnimalHuman vs. Animal
Animal model of obesity are characterized by one single geneOb/ob mouse
• Genetic defect for coding the protein leptin• Leptin normally produced in fat cells in proportion to fat mass.
– Binds to receptors in hypothalamus and causes a decrease in food intake and increase in thermogenesis
– Few leptin deficient obese adults have been identified– Obese adult usually has a higher levels of leptin indicating they are resistant
to the hormone– Trials are underway
Body’s Fuel sourceBody’s Fuel source
Primarily CHO Brain uses solely Converts protein/fat into
glucose• Gluconeogenesis
Healthy diet: CHO: 50-60% Pro: 15-20% Fat: 25-30%
CaloriesCalories
Carbohydrate 4 kcal/gm
Protein 4 kcal/gm
Fat 9 kcal/gm
Alcohol 7 kcal/gm
Food labelFood label
Common Weight Loss MethodsCommon Weight Loss Methods
Attempts to lose the weightAttempts to lose the weight
Low fat dietBody weight associated to fat intakeTend to eat same amount of caloriesObese people tend to underreport their intake (30-47%)
Starvation dietsBreak down muscle and fatTend to store more when begin to eat again
Setting the Record Straight: The Truth About Fad Diets
ObesityObesity
Over 50 percent of Americans are overweight.One in three adults is obese. Why?
Sedentary lifestylePoor food choicesObsession with dietingLack of time
The U.S. Diet IndustryThe U.S. Diet Industry
Almost $40 billion per year industry, includes:Diet booksDiet foodsDiet programsWeight-loss gimmicks
Do You Remember?Do You Remember?
1960 Drinking Man’s Diet Steak and Wine
1967 Dr. Stillman’s Diet1972 Dr. Atkin’s Diet1973 Richard Simmons
Fitness Guru1978 Scarsdale Diet1979 Pritikin Diet
1980 Beverly Hills Diet1981Cabbage Soup Diet1988 Optifast Liquid Diet1991 Protein Power1991Fen Phen Diet Pill1995 Enter the Zone1997 Fen Phen pulled from
market
Dr. Bob Arnot’sRevolutionary WeightControl Program
TheCabbageSoup Diet
Dr. Atkin’sNew DietRevolution
SugarBusters!
Enter the ZoneProtein Power
TheAnti-AgingZone
Fad diets: The ZoneFad diets: The Zone
Claim: Boost protein, cut carbs achieve peak athletic performance
Why you lose: very low calorieDownfall: few carbs can cause fatigue, weakness in
athlete and few fiber foodsMost useful tip: Choose low fat protein sources, Eat
several meals/snacks per day
Fad diet: Sugar BustersFad diet: Sugar Busters
Claim: Break sugar starch habit and enjoy eggs, cheese, wine
Why you lose: Reduced total calorie, not CHO Downfall: Deprivation can set up binge mentality, low
in calcium and zincDigestive downside: constipationMost useful tip: cut back on added sugar
Tips for evaluating fad dietsTips for evaluating fad diets
Does it exclude major food groups
Does it promote supplement or pill use
Does it suggest to avoid any one certain food
How to Recognize a Fad DietHow to Recognize a Fad Diet
Is the author credible?
Diets that advocate:Magic or miracle foodsRapid weight loss/quick fixNo exerciseRigid menus, “good” vs. “bad” foods, specific food combinationsRecommendations based on a single study or studies
published without a peer reviewSounds too good to be true
Fad Diet Alert!Fad Diet Alert!
Steer clear of these claims:Fast, easy weight lossBreakthrough miracleBanish fatSecret formula, new discoveryCureBalances hormonesEnzymatic process
DIETS DON’T WORKDIETS DON’T WORK50% of Americans Diet Annually 50% of Americans Diet Annually
Average diet lasts 42 daysOnly 5 -10 percent maintain a significant weight loss
(= 10 percent or more of starting weight)No scientific data from commercial programsNo scientific data from any diet-book programsSome cause significant health problems
Source: John Foreyt, Baylor College of Medicine
Dieter Beware: Current Fad Dieter Beware: Current Fad DietsDiets
Enter the ZoneDr. Atkin’s Diet RevolutionProtein PowerDr. Arnot’s Revolutionary Weight Control ProgramSugar Busters!Eat 4 Your Blood Type
NO RESEARCH TO SUPPORT NO RESEARCH TO SUPPORT DIETSDIETS
All six diets reviewed:Lack ResearchUse testimonialsBase validity on opinions not factsLack any peer review
ENERGY 101ENERGY 101Calories are supplied by:
CarbohydratesFat Protein
Calories In > Calories Out = Weight Gain Calories In < Calories Out = Weight Loss
CARBOHYDRATESCARBOHYDRATES
Carbohydrate Intake Glucose + Insulin = Energy
Extra glucose: Glycogen storesFat stores
High Protein DietsHigh Protein DietsCommon ClaimsCommon Claims
Lose weight quicklyNever be hungryCarbohydrate intake creates:
Increased appetite Addiction to sugar High blood sugar Insulin resistance Increased body fat
INSULIN: A Closer LookINSULIN: A Closer Look
Insulin Resistance: The cells are resistant to absorbing insulin and glucose to use for energy so glucose must be stored as fat.
INSULIN: A Closer LookINSULIN: A Closer Look
Insulin Resistance: The cells are resistant to absorbing insulin and glucose to use for energy so glucose must be stored as fat.
High Protein Diet Theory: 75% of dieters are insulin resistant. A high carbohydrate intake leads to a dramatic surge of insulin. Because of insulin resistance, the glucose cannot be used for energy so it is stored as fat. Therefore carbohydrates make you FAT!
INSULIN: The RealityINSULIN: The Reality
10-25% of dieters are insulin resistantMost with insulin resistance are:
ObeseSedentary (insulin receptor sites and glycogen stores are
full. Glucose stored as fat.)Treatment:
Increase activity and decrease weight. This will deplete glycogen stores and increase blood glucose absorption. Less insulin is needed.
High Protein DietsHigh Protein DietsThe Inefficient Energy MachineThe Inefficient Energy Machine
Protein breakdown = Energy + Nitrogen Fat breakdown (no glucose) = Energy + Ketones
Increased fluid requirements Increased electrolyte loss Increased strain on kidneys and liver Increased uric acid in blood (gout)Ketosis
Ketones in Blood = KetosisKetones in Blood = Ketosis Acidic waste from fat breakdown in the Acidic waste from fat breakdown in the
absence of carbohydrate.absence of carbohydrate. Ketosis:
DizzinessNauseaDecreased appetiteDehydrationElectrolyte Imbalance
LethargyBad Breath: acetone
evaporation in lungsBone Loss: Calcium
buffers changes in blood pH
High Protein Diets: A Closer High Protein Diets: A Closer LookLook
Low in calories; 1200 or lessHigh in protein / low in carbohydrateLow in vitamins, minerals, phytochemicals High in saturated fat and cholesterol Increased risk for:
• Cardiovascular disease• Cancer• Osteoporosis
High Protein DietsHigh Protein DietsCommon ClaimsCommon Claims
Lose weight quicklyNever be hungryCarbohydrate intake creates:
Increased appetite Addiction to sugar High blood sugar Insulin resistance Increased body fat
Dr. Bob Arnot’sRevolutionary WeightControl Program
TheCabbageSoup Diet
Dr. Atkin’sNew DietRevolution
SugarBusters!
Enter the ZoneProtein Power
TheAnti-AgingZone
Sugar Busters!Sugar Busters!H. Leighton Steward; Morrison C. Berthea, M.D.; H. Leighton Steward; Morrison C. Berthea, M.D.; Sam S. Andrews, M.D.; and Luis A. Balart, M.D.Sam S. Andrews, M.D.; and Luis A. Balart, M.D.
Premise: Sugar is toxic, causing the body to release insulin and store excess glucose as body fat. High glycemic index foods should be eliminated. Minimal fluids with meals so digestive juices are not diluted. (1200 kcal)Negative Health Implications: Kidney and liver damage, fatigue, weakness and irritability. Vitamin and mineral deficiency. Risk for heart disease.
Sugar Busters!Sugar Busters!H. Leighton Steward; Morrison C. Berthea, M.D.; H. Leighton Steward; Morrison C. Berthea, M.D.; Sam S. Andrews, M.D.; and Luis A. Balart, M.D.Sam S. Andrews, M.D.; and Luis A. Balart, M.D.
High Glycemic Index Foods:
CarrotsPotatoesBeetsPastaBread (refined flour)Rice (white)Fruit (must be eaten by itself)
Enter the ZoneEnter the ZoneBarry Sears, Ph.D.Barry Sears, Ph.D.
Premise: “Zone”: A metabolic state where the mind is
relaxed and focused and the body is fluid and strong.Follow rigid, obscure rules, such as eating in “macronutrient blocks” and limiting carbohydrates. Negative Health Implications: Nutrient deficiency, increased risk of coronary heart disease, high cholesterol.
Enter the ZoneEnter the ZoneBarry Sears, Ph.D.Barry Sears, Ph.D.
Claims:Weight easy to lose on 40:30:30 planCarbohydrates make you fat because 75% of
Americans are genetically defective and over produce insulin. We must achieve an insulin zone.
Diet lowers risk for disease by decreasing production of bad eicosanoids (hormones).
Protein PowerProtein PowerMichael Eades, M.D. and Mary Eades, M.D.Michael Eades, M.D. and Mary Eades, M.D.
Premise: Low in fiber, high in fat, claims human body has no physical need for carbohydrates; should be completely avoided. Success of diet is demonstrated by the sales and popularity of the book.Negative Health Implications: Increased risk for coronary heart disease, high cholesterol, nutrient deficiency.
Dr. Bob Arnot’s Revolutionary Dr. Bob Arnot’s Revolutionary Weight Control ProgramWeight Control ProgramRobert Arnot, M.D.Robert Arnot, M.D.
Premise: Foods are drugs: Some make you feel good and others make you feel bad (crack). Refined carbohydrates can cause rapid weight gain. A diet low in carbohydrates and high in protein will decrease hunger and lead to weight loss.
Negative Health Implications: May take a psychological toll on its followers by labeling foods “good” and “bad.” Avoiding these foods causes a person to miss out on valuable nutrients.
Fad diet: Dr. Atkins Diet Fad diet: Dr. Atkins Diet Revolution Revolution
Claim: Cut out Carbs, go into ketosis and drop the pounds
Why you lose: Leads to fluid loss, CHO is store with water
Downfalls: Associated with osteoporosis, impaired renal function, kidney stones, Colorectal cancer and cardiovascular disease (legal liability)
Most useful tip: None
Dr. Atkin’s New Diet RevolutionDr. Atkin’s New Diet RevolutionRobert AtkinsRobert Atkins
Premise: Carbohydrates make you fat, limit intake to 20g/day. Eat as much meat as you want. Never be hungry, lose weight fast.
Negative Health Implications: Increased risk for heart disease and nutrient deficiency, ketosis. Decreased benefits from plant based nutrients.
Eat 4 Your Blood TypeEat 4 Your Blood TypePeter D’AdamoPeter D’Adamo
Premise: Blood type is an evolutionary marker of which foods each person will process well and which will be useless calories or lead to illness and death.
Negative Health Implications: Promotes “good foods/ bad foods”. Nutrient deficient diet lacking carbohydrate, vitamins and minerals.
I’m Still Looking for the I’m Still Looking for the Magic!Magic!
Lifelong Healthy WeightLifelong Healthy Weight
Positive attitudeAre you ready to change?Motivation: Internal not external
Health: Healthy weight not lowest weight Increased energy Self esteem Personal control
Eat for the long haul; Choose a life-long plan
Take an Honest Look:Take an Honest Look: Why You Weigh what You Why You Weigh what You WeighWeighActivity: What and how much?Food: What and how much?Stress: Is food your answer to life’s problems?Physiologic and genetic make-upAge and health status
Here’s the Magic!!!Here’s the Magic!!! Eating for good health and Eating for good health and
eating to control weight are virtually eating to control weight are virtually the same.the same.
Incorporate regular physical activity into your schedule.
Enjoy a variety of foods from the Food Guide Pyramid.
Maintain a positive attitude.
Physical Activity = Physical Activity = Success!Success!Choose something you enjoyCombined total of 30 minutes most days Benefits:
Healthy weight! Healthy heart! Strong bones! Great sleep! Stress relief! Increased energy! Positive and confident outlook!
Food Guide PyramidFood Guide Pyramid
High Carbohydrate DietHigh Carbohydrate Diet
Increases intake of: FiberCalciumVitaminsMineralsAntioxidantsPhytochemicals
Lowers risk for:Heart DiseaseCancerOsteoporosisDiabetesHigh Blood Pressure
Diets that WorkDiets that Work
Weight Watchers Intuitive Eating by Evelyn TriboleOutsmarting the Midlife Fat Cell by Debra WaterhouseOutsmarting the Female Fat Cell by Debra WaterhouseThin for Life. 10 Keys to Success from People Who Have
Lost Weight and Kept it Off by Anne FletcherThe Solution: Winning Ways to Permanent Weight Loss by
Laurel Mellin
Lifestyle ChangeLifestyle Change
Be realistic - Small changes over timeBe adventurous - Expand your tastesBe flexible - Balance food and activity over several
daysBe sensible - Enjoy all food in moderationBe active - Walk the dog, don’t just watch the dog walk
The Student DietThe Student Diet
Problems with student dietProblems with student diet
Study long hoursNo time to cook healthy mealsDo not have time to grocery shopEasier to eat out or drive thruVery little exercise= Sedentary lifestyle
Eating outEating out
1 of 3 mealsDrinks: High kcalAppetizer: Onion mum (1/2
= 20 oz steak with 80 gm fat & 1000 kcal)
Salad: Caesar salad 300 kcal, 25 gm fat
Steak: 16 oz prime rib 1300 kcal, 94 gm fat
Dessert: Cheese cake 500 kcal, 30 gm fat
3100 kcal, 229 gm fat ( not counting drinks)
Alcoholic BeveragesAlcoholic Beverages
70-200 kcals/drink 12 oz serving Mainly fat & some CHO
Linked to many forms of Cancer Esophageal GI cancer
Red pigmentation Anthocyanin Antioxidant Same pigment in grape skins
How to eat out sensibly How to eat out sensibly
Avoid all-you-can eat buffetsChoose baked or grilledAvoid white or cheese
saucesAsk for dressing or
condiments on the sideRequest a take-home
container
Look for light or heart healthy menu
Order calorie free beveragesWatch for key words
signaling high kcal: Fried, creamed, pan-fried,
sautéed, alfredo, or gravy
Caffeine and CalciumCaffeine and Calcium
Caffeine beverages High Mg & Phos Pulls Vit D from bones Increases heart rate Limit to 1-2 per day
Calcium (1000mg/d) Required for
• Nerve conduction, muscle contraction, blood clotting, Prevent osteoporosis
Impairs absorption• Fiber, high protein diets, High
Na diets, soybeans• Take separately from MVI b/c
impairs iron & zinc
Ideas at homeIdeas at home
Prepare meals and freezeGo in with a friendDon’t keep trigger foods in the houseAlways eat at the tableSlow down
Myths about dietingMyths about dieting
Eating late at night is sure to pack on the pounds
You can lose weight by eating fewer calories
Never have secondsDeny cravings; they are all in
your head
Don’t eat between mealsEating breakfast makes you
hungry all dayTo lose weight, become a
vegetarianYou can eat anything you
want as long as it is fat free
Tips for successTips for success
Regular exercisePermanent changesAvoid skipping mealsDo not eat while
studying/watching t.vEat only when hungry
Do not use food as a rewardDrink only calorie-free
beveragesDo not grocery shop when
hungryNO fad dietsChoose a variety of foods
GoalsGoals
Decrease Regular soda intake
Decrease caffeineLimit meat servings Increase fruits/vegetables
fiber
Increase calciumMultivitamin
Healthy snacks when you have Healthy snacks when you have the munchiesthe munchies
Fresh, frozen, canned fruitLight or low fat yogurtString cheeseLow fat cheese and wheat
crackersVanilla wafers & skim milk
Baked chipsLow fat popcornSugar free hard candyFrozen fruit bars