From the FMS Global and UK News Desk of Jeanne Hambleton
Atkins vs. Ornish, South Beach Diet vs. the Zone: Does any weight loss plan really work?
Courtesy of WebMD.com
By Peter Jaret – Reviewed by Matthew Hoffman, MD – WebMD Feature
After four years of following one diet plan after another and watching his weight yo-yo up and down, Marv Leicher finally discovered the secret formula for losing weight and keeping it off successfully.
And he is not sharing it with anyone.
“I wasted enough of my own time following somebody else’s idea of the perfect diet plan,” says Leicher, 42, an insurance claims adjuster in Iowa. “I do not want some poor fool following my advice and then wondering why it is not working for him. The real secret is that there is no one perfect diet. What works for one person would not necessarily work for someone else.”
From one diet plan to the next
Leicher began by following a low-fat diet. For a few months, the pounds dropped away. He bought a new set of pants with a slimmer waist. And before long, the numbers on the bathroom scale started climbing again. Frustrated, Leicher took a friend’s advice and started following the Atkins high-protein/low-carb diet. He started losing weight within the first week. After four months, he was back to wearing his new lean and mean wardrobe.
“I really thought, OK, this is it. I am home free.”
Then came the holidays — office parties, family dinners — and when they were over, Leicher had regained 10 pounds and was on his way back to being overweight.
“That is when I said to myself, ‘Wait a minute. I am a capable guy. This is not rocket science. I should be able to figure this out.’”
So Leicher sat down and made a list of the parts of diets that seemed to work for him. He went through all the rest of the advice that he had heard — eat breakfast, do not eat breakfast; choose healthy snacks, avoid snacks — and added the tips that seemed to help.
“I ended up with six rules. Frankly, I would be embarrassed to show them to anyone else. But they were changes I knew I could make without feeling like I was doing penance for some past sins.”
Within three months, he was back down to his college weight. This time, though, he stayed there. “It has been almost a year, and I do not even really think of myself as being on a diet. This is just the way I eat.”
How popular diet plans score
What works? What does not? With some 38,000 diet books in print — and 2,500 new ones hitting the shelves every year — not to mention magazines trumpeting the ultimate new fad diet in every monthly issue, there is plenty to choose from. Lately, even researchers have got into the act. The National Institutes of Health and university medical centers around the nation have spent many years and millions of dollars to test the Atkins diet versus the South Beach, the American Heart Association diet versus the Zone.
Along the way, there have been genuine surprises. The low-fat diet, widely endorsed by many official groups, has not turned out to be as safe or effective as most experts thought. Some people do manage to lose weight on low-fat diets, but usually weight loss is fairly slow — only a pound or two a month. And while levels of bad cholesterol (LDL) fall, studies show that levels of good cholesterol also drop. Many people on low fat diets also see a rise in triglycerides — an independent risk factor for heart disease.
To almost everyone’s surprise, low-carb/high-protein diets — Atkin’s is the model — have proved much safer and more effective than expected. Here was a diet that featured eggs and bacon and warned people away from bread. Yet study after study has shown that for people who are overweight or obese, high-protein/low-carb diets have real advantages.
“These diets push most of the numbers in the right direction,” says Ronald Krauss, MD, a senior researcher at Children’s Hospital Oakland Research Institute and a spokesperson for the American Heart Association.
“Body weight and body fat go down, triglycerides and LDL cholesterol drop, while at the same time good cholesterol levels remain up. Low-carb diets also improve insulin sensitivity even without weight loss, so they offer better protection against diabetes.”
The best news for dieters is that high-protein/low-carb dieters also shed pounds faster, on average, than low-fat dieters. In the latest of a string of studies that have pitted one popular diet against another, researchers at Stanford put the Atkins, Zone, Ornish, and LEARN diet to the test. After 12 months, volunteers on the Atkins diet had lost more weight — twice as much — as people on any of the other diets.
But if you are looking to dramatically change your shape, the numbers were not all that encouraging. The average weight loss was a scant 10.3 pounds.
In a slew of recent head-to-head studies of popular diets, in fact, the Atkins diet has pulled ahead in the first few months, resulting in more and faster weight loss. Many experts have come around to accept the notion that protein-rich foods may be more satiating than carb-rich foods.
Unfortunately, the Atkins lead typically evaporates by the end of a year. In a 2006 British study that compared four popular weight loss plans, for example, volunteers lost weight faster on the high-protein/low-carb plan. But after a year, all four diets had resulted in about the same weight loss, about 13 pounds. What is more, several studies comparing diets have seen very high drop-out rates. Even with scientists looking over their shoulders, it turns out people have trouble sticking with most diets.
The best diet plan
Disheartening? Sure. But lurking behind the generally glum news about fad diets and popular weight loss programs are individual success stories — and important information for anyone looking to lose weight.
“If you look at all these studies, you find that on almost any diet, some people do very well and others do not lose any weight at all,” says Janet King, PhD, professor of nutrition at the University of California, Berkeley,who chaired the 2005 Dietary Guidelines Advisory Committee for the U.S. High-protein diets may have an initial advantage in jump-starting weight loss.
But all weight loss plans have one thing in common: They restrict certain kinds of foods and thus limit calories. “Most diets work in the short-term, and the reason is that they simplify decisions about what you’re going to eat,” says King. “They take variety out of the diet. Some restrict carbohydrates. Some restrict fat. But the end result is that they offer a way to eat fewer calories.”
The reason some people succeed is also simple: motivation. “What really matters is compliance, which is another way of saying someone is motivated enough to stick with a diet,” says King.
The best diet plan, in other words, is the one that you are most likely to be able to follow for the long haul. And that is likely to be different for different people. Men who are basically vegetarians are going to have a tough time following the Atkins diet. Steak-and-eggs men are not going to stick with a low-fat, mostly veggie diet plan for long.
Kathleen M. Vohs, a psychologist at the University of Minnesota, believes choosing a regimen that most closely matches the way you like to eat is crucial. She offers a provocative reason.
“Studies show that self-control is a limited resource,” says Vohs. “People may have an easy time giving something up the first time. But when people are repeatedly asked to exhibit self-control, that ability begins to erode.”
It is easier to eat a healthy meal for breakfast, in other words, than to stick with a diet plan once dinner rolls around, especially if it means saying no to foods you love. And by extension, it is easier to stick with a diet that does not eliminate most of the foods you love.
One man’s diet plan
That is a lesson Marv Leicher took to heart when he decided to abandon popular diets and fashion his own weight loss regimen. “Basically, I picked and chose from the strategies that seemed easiest for me to follow,” he says. “It was no big deal to give up soft drinks and fruit drinks, so I did that religiously. No liquid calories. I’m not the kind of guy who can eat just half of what’s in front of him, so I gave up trying to divide portions. Instead, I decided, no desserts. At lunch, I used to go out with people from the office. Now I bring a cup of yogurt and some trail mix, and if the weather is good I take a half hour walk and eat a quick lunch. Little stuff like that.”
Little stuff. But for Leicher, it adds up to big results. Over the past year, he’s lost 30 pounds. Best of all, he’s keeping them off.
©2005-2009 WebMD, LLC. All rights reserved.
Vitamin and Mineral Supplements for Men
Why multivitamins and other dietary supplements can be hazardous to your health
By Arthur Allen -Reviewed by James E. Gerace, MD – WebMD Feature
More than half the adults in America regularly use multivitamins and other supplements to boost their immune systems and enhance nutrition, supporting an industry worth more than $20 billion annually. Grocers stock every conceivable vitamin, mineral, and herbal “boost,” and every neighborhood seems to have its own supplement store.
So are vitamins and mineral supplements for men really necessary?
Based on the current evidence, the answer is a definitive “no.” “For me,” says Christian Gluud, MD, a vitamin researcher at Copenhagen University Hospital in Denmark, “the simple answer is do not use them.”
“Except for certain defined population groups,” says Irwin H. Rosenberg, MD, director of the nutrition and NeuroCognition Laboratory at Tufts University, “there is no evidence that supplemental vitamins and minerals are beneficial for your health.”
He goes on to tell WebMD, “There is no indication that a poor diet is going to be made into a good diet by taking multivitamins.”
Vitamin and mineral supplements can lead to early death
It is not just that vitamin and mineral supplements provide little benefit for the healthy middle-aged man. Large doses of the pills can actually make you sick and reduce your lifespan. A review of 68 randomized trials of high-dose antioxidant supplements such as vitamins C and E found a 5% higherrisk of death in those who took them.
The study, published in February in the Journal of the American Medical Association (Gluud is the lead author), found an even greater risk of death for vitamin users in a subset of 47 carefully conducted trials.
At first glance, this seems contradictory. Over the past three decades, many studies have found that eating fresh fruits and vegetables, which contain high amounts of antioxidants and other vitamins and minerals, can add years to a healthy life. But there are obviously components of a healthy lifestyle that can not be bottled.
“Multivitamins are not a shortcut,” Gluud says. “You are better off eating a varied diet instead of risking the increased mortality of taking these supplements.”
Multivitamins and the middle-aged man
To be sure, vitamin supplements can be beneficial for certain groups of people. After the age of 55 or so, your body starts to lose the capacity to make vitamin D from sunshine, and adding a vitamin D pill may be a good idea.
The elderly also lose the ability to absorb vitamin B12 from their diet, and some of this deficiency can be met by taking a B12 supplement. Cancer patients, or people eating fewer than 1,000 calories a day, may have vitamin deficiencies. Vegans may need some B vitamins and iron unless they are meticulous about getting these nutrients from their diet.
“There really is no strong evidence to support the need of the average 35- to 55-year-old man to take a multivitamin,” says Cheryl Rock, MD, professor of nutrition in the Department of Family and Preventive Medicine at the University of California, San Diego, School of Medicine.
“If you’re concerned about your nutritional levels, a doctor can order tests. It is quite easy to find out, for example, if you are deficient in B12 or vitamin D. And usually one visit with a dietician will be covered by health insurance.”
So far, the evidence of benefit, and harm, from supplements comes from careful studies of large doses of particular vitamins and minerals. There is almost no evidence of health effects from multivitamins. Taking a once-a-day vitamin pill is probably as harmless as it is pointless, except for the manufacturer that can produce a bottle of pills for a few cents and market it for $9.99, nutrition experts say.
Do multivitamins work if you think they do?
There can be, of course, a placebo benefit from a multivitamin or other supplement — the benefit of feeling in control of your health and hopeful of the results. “Even in the face of evidence that multivitamins lack efficacy, people are still going to take them,” says Marion Nestle, PhD, professor of nutrition at New York University and author of What to Eat.
“You’re dealing here with something that goes beyond science and has to do with belief systems.”
Nestle notes that when the recent JAMA study came out, many scientists interviewed about its findings said they would still keep taking vitamins. (Nestle, for one, does not regularly take supplements: “Sometimes when I need a placebo, I’ll pop one.”)
An unhealthy dose of heavy metal
But buyers beware. Some pills contain less or more of a vitamin than promised, and it is not unusual to find heavy metals like lead in the pills, according to chemical analyses by the commercial laboratory ConsumerLab.com, which tests vitamins for sports teams and others.
To be sure, the existence of a vast industry selling products that are potentially dangerous and probably of marginal value strikes some as troubling. We have Congress to thank for the virtually unregulated state of the supplement industry.
The 1994 Dietary Supplement Health and Education Act effectively handcuffed regulation of dietary supplements by the Food and Drug Administration. The term “supplements” includes everything from vitamins and minerals to herbal supplements such as ephedra, saw palmetto, ginkgo biloba, and other substances, some of which have powerful pharmacological effects. Purveyors of these substances are not required to prove their efficacy, and the FDA must show they are dangerous before removing them from the market. The supplement maker has no obligation to test the safety of the product.
Since passage of the bill, the market in vitamin and mineral supplements has ballooned from an estimated $3.3 billion in 1990 to well over $20 billion.
How did vitamin and mineral supplements get such a good rep?
A body of research conducted in the 1980s and 1990s seemed to show benefit from vitamin and mineral supplements in preventing chronic diseases like cancer and osteoporosis and heart disease. But reviews of these studies showed that much of the benefit attributed to supplements was actually attributable to the overall better health practices of those who took them. In other words, people who took vitamin supplements also tended to eat better, smoke less, and get more exercise, says Rosenberg.
Many people have started taking supplements containing antioxidants because of research gathered over the past three decades showing these compounds help slow cell damage. But a well-fed population is already ingesting enough to overcome oxidative stress, and adding more antioxidants probably would not lower the risk of chronic diseases, says Rock.
Foods rich in antioxidizing compounds range from walnuts, blackberries, artichokes, and pecans to brewed coffee and chocolate cupcakes. Yet these products are not equally good for you, and you obviously would not want to build a diet exclusively around antioxidants.
SOURCES: Bjelakovic, G. et al., Journal of the American Medical Association, Feb. 28, 2007; vol 297(8): pp 842–57. Huang et al., American Journal of Clinical Nutrition, 2007; vol 85 (suppl): pp S265–S268. Gad, S.C. and S.E., International Journal of Toxicology, 2003; vol 22: pp 381–385. Fletcher, F., JAMA, June 19, 2002; vol 287(23): 3116–3126. Halvorsen, B. et al., American Journal of Clinical Nutrition, 2006; vol 84: pp 95–135. Morris, M.C. et al., Archives of Neurology, April 2005; vol 12: pp 641–645. Christian Gluud, MD, Copenhagen University Hospital. Irwin H. Rosenberg, MD, director, Nutrition and NeuroCognition Laboratory, Tufts University. Cheryl Rock, MD, professor of nutrition, Department of Family and Preventive Medicine, University of California, San Diego, School of Medicine. Marion Nestle, PhD, professor of nutrition, New York University; author of What to Eat (North Point Press, 2007). Paul M Coates: testimony before the Committee on Government Reform, US HR, March 9, 2006. ConsumerLab.
©2005-2009 WebMD, LLC. All rights reserved.