Fad Diets

Fad Diets

Katie Bohannon, Britnie Delozier, Lindsey French, Andrea Meiring, Jennifer Tallent

How much $ does the United States spend on weight loss products per year?

30
Billion
 dollars!

 http://www.youtube.com/watch?v=98_5OgZieUA American Dietetic Association. J Am Diet Assoc.2006;106:602

Obesity Trends* Among U.S. Adults BRFSS, 1990, 1999, 2008 (*BMI ≥30, or about 30 lbs. overweight for 5’4” person) 1999

1990

2008

No Data

<10%

10%–14%

15%–19%

20%–24%

Source: CDC Behavioral Risk Factor Surveillance System

25%–29%

≥30%

“With rising rates of obesity, new and questionable diets appearing on the market almost everyday, and the current trend toward marketing huge portions, is it possible to control one’s weight with a nutritionally sound, emotionally healthy, common-sense-based approach?” Hannah Fiske. Today’s Dietitian. 2003;45

 Today people are more susceptible

to false claims of weight loss companies   We are more health conscious and thus more susceptible to

misinformation

 People are looking for fast, simple

and quick ways to lose weight   “Lose 30 pounds in 30 days!”   “Eat as much as you want and still lose weight!”   “Try the thigh buster and lose inches fast!”

American Dietetic Association. J Am Diet Assoc. 2006;602

Fad Diet Misinformation  Misinformation leads people to be

confused about food  People may lose weight with these diets

but it is only short term and not because of what the companies claim   Low in energy   Do not provide a good balance   May be nutrient deficient

 Scientific research reports American Dietetic Association. J Am Diet Assoc. 2006;601

ADA “unreasonable or exaggerated beliefs that eating (or not eating) specific foods, nutrient supplements or combination of certain foods may cure disease, convey special benefits or offer quick weight loss.”

http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/media_10819_ENUHTML.htm.

The Source of Information

  Media   47% Magazines   34% Television   29% Books   28% Newspaper

  Nutrition information and physicians   21% Internet   19% Product labels   18% Friends and family   13% Dietetic professionals American Dietetic Association. J Am Diet Assoc. 2006;603

Myth or Fact

Carbohydrates cause weight gain

Myth Calories cause weight gain •  If you consume more calories than you expend you will begin to gain weight

American
Diete4c
Associa4on
at
ww.eatright.org
2009


Myth or Fact

Occasionally following a fad diet is a safe way to quickly lose weight

Myth • Many creators of these fad diets do not have scientific background • Some fad diets can be harmful to those with certain health problems • You will lose weight quickly but it is most likely going to come back within months American Dietetic Association. J Am Diet Assoc. 2006; 601

Myth or Fact

Snacking does not ruin a healthful diet

Fact   Healthy snacks and small frequent meals are a

good way to control weight and food cravings   Pay attention to the foods you choose, the size of your portions, how frequently you snack, and the total amount of calories you consume

Myth or Fact

There are certain foods that can make or break a healthful diet

Myth  The most important thing to watch

is your overall pattern of eating  A wide variety is best if consumed in

moderation  Appropriate proportions  Regular physical activity Starkey J, Dombrowski J, Ryan T. www.eatright.org 2007

Myth or Fact

In order to write a diet or food related book you must have appropriate credentials

Myth -  Most of the food and diet books

are written by -  Celebrities -  Fitness experts -  psychologists

Myth or Fact

Certain foods, like grapefruit, celery, or cabbage soup, can burn fat and make you lose weight

Myth There are no foods that can burn fat -  Physical activity is needed to burn fat -  Eating a variety in moderation is the key to losing weight -

Starkey J, Dombrowski J, Ryan T. www.eatright.org 2007

Myth or Fact

Natural or herbal weight-loss products are safe and effective

Myth  Just because it says “natural” or

“herbal” does not prove it to be safe  Many products are not scientifically tested or proven to work before they hit the shelves National Institute of Diabetes and Digestive and Kidney Disease at http://win.niddk.nih.gov 2009

Myth or Fact

Eating after 8pm does not mean you will gain weight

Fact -  The time of day is not what matters

most

-  Watch WHAT you eat -  Watch HOW much you eat

-  If you consume extra calories they

will be stored as fat

Starkey J, Dombrowski J, Ryan T. www.eatright.org 2007

Fad Diet Myths Why do people buy into these myths? -  All people have to eat -  We live in a society focused on being thin -  Celebrity role models

-  People may have a false sense of security about

their health

American Dietetic Association. J Am Diet Assoc. 2006;603

As Dietitians

  Nutrition professionals need to be aware

of the misinformation that is out there

 Misinterpreted research   Work with the media to communicate science based nutrition information to consumers   Stay on top of current research  Be aware of a decrease in a person’s self-

efficacy  The public’s view of health professionals American Dietetic Association. J Am Diet Assoc. 2006;604

High-protein/Low-carbohydrate Diets Some familiar fads…

  All of these popular high-protein/low-carbohydrate

diet books have reached The New York Times bestseller status. -Amazon.com

High-protein/Low-carbohydrate Diets   What makes these diets so appealing?  Promises of rapid weight loss  Easy to follow plans  Diets include many palatable foods  Physical activity not required

High-protein/Low-carbohydrate Diets   Rapid weight-loss: Many low-CHO diets report greater, and more rapid weightloss when compared to other higher CHO diets.   The reality: This is short term (<6 months). After 12 months, this weight-loss dissipates, and total weight-loss is no more than traditional higher CHO diets. Nordmann AJ et al. (2006) Arch Intern Med 166: 285–29.

• Possible mechanisms: • Diuresis • Mobilzation of glycogen stores • Circulating ketone bodies

• Satiating effects of protein • Use of protein more energetically costly • Not enough evidence

  Atkins Diet

The Premise: Severe restriction of dietary carbohydrate (<20% of daily caloric intake), with its resulting ketosis, promotes lipid oxidation, satiety, and increased energy expenditure, factors that should promote negative energy balance and weight loss Carbohydrate intake creates: • High blood sugar • Insulin resistance • Increased body fat Atkins R, Dr. Atkins’ New Diet Revolution. 1992.

High-protein/Low-carbohydrate Diets   Atkins Diet

The good: Initial rapid weight loss can be motivating.

The bad: Long-term CVD risks need to be better studied Nutrient deficiencies

Effects of prolonged ketosis

High-protein/Low-carbohydrate Diets   The South Beach Diet A more healthy version of the Atkins Diet that’s backed by solid evidence on fats and heart disease The good: Doesn’t leave out any food groups The bad: The first phase is much like the Atkins diet, very restrictive on CHO. Restricts some fruits and vegetables such as carrots.

High-protein/Low-carbohydrate Diets   Atkins vs. South Beach

A study done on the effects of three popular diets on lipids, endothelial function, and C-reactive protein during weight maintenance found that the Atkins diet was associated with higher total cholesterol and LDL cholesterol compared to the South Beach diet, which lowered overall cholesterol and LDL cholesterol during the maintenance period. Moreover, saturated fat intake correlated inversely with endothelial function as assessed by brachial artery reactivity testing. M. Miller et al, J Am Diet Assoc 109 (2009), pp. 713–717.

High-protein/Low-carbohydrate Diets

Malik et al. Cardiovascular Medicine. 2007.

What are Meal Replacements?   Beverages, prepackaged or frozen entrees, and

meal or snack bars that are designed to take the place of one or two meals

  Contain a known energy and macronutrient

content

  Objective is to attain a 500 to 1,000 kcal/day

energy deficit

  The Slimfast diet plan is an example

Meal Replacements   Convenient   Good for portion and calorie control   In some cases can improve a person’s nutritional

status

How effective are meal replacements?   Several studies have shown a greater weight loss

efficacy with structured meal replacement plans than compared to reduced calorie diet treatments

  In a randomized controlled trial by Rothacker in

2001 a meal replacement diet was compared to a low-fat diet

  After one year, the meal replacement group

maintained their initial weight loss, while the other group regained most of the initial weight loss back

J Am Diet Assoc 2001; 101(3): 345-347

Meal Replacements   May not be a long-term solution   Encourages “eating on the run”   Concerns of nutritional inadequacies   May still feel hungry or may not be satisfying   Does not teach good eating habits or choices

What ADA says about meal replacements   Advise on how to optimize the overall nutrient

content   Must be careful selection of the conventional

foods that make up the non-meal replacement portion of the diet plan

Detox Diets   What is a Detox Diet   Popular Detox Diets o The Master Cleanse, also known as

“The Lemonade Diet” o The Juice Diet o The Water Fast

http://vids.myspace.com/index.cfm?fuseaction=vids.individual&videoid=6518245

Pro’s of Detox Diets   Beneficial in treating the side effects of

chronic diseases   Stepwise detox program used to eliminate bad eating habits, and reduce smoking and drinking addictions   Detoxing used as a “motivational tool”

Con’s of Detoxing   Lack of scientific research supporting

detox diets   Nutrient deficiencies and electrolyte imbalances   Detoxing is extremely dangerous for certain groups of people   Negative physical effects

How Dietitians Feel About Detoxing   Stress the importance of being under the

supervision of a dietitian while detoxing   Feel that more research needs to be done: which toxins are being removed from the body?   Believe in using detox diets to motivate people to lose weight and live healthier lifestyles   Important for patients to remember that it is what they eat after the cleanse is complete

  “The best diet is one you can stick too”

-  Michael Dansinger -  Director of Diabetes, New England Medical Center, Boston

•  ADA believes weight management to improve

overall health requires a lifelong commitment to healthy lifestyle behaviors emphasizing sustainable and enjoyable eating practices and daily physical activity.

•  American Dietetic Association. J Am Diet Assoc.

2009;109:335,331.

FAD Diets  Loss of Nutrients  No emphasis on physical

activity

Healthy Weight Loss and Management   More than just a number on a scale!!   Can be complex   Nutritional intake   Physical Activity   Psychological Status   Social and Cognitive Function   Emotional factors   Food access   Environment and Environmental triggers   Functional capacity for food preperation

Nutrition Care Process

Assessment, Diagnosis, Intervention, Monitoring and Evaluation

•  Baseline weight and health indexes which will

guide weight management goals •  Health risks involved before starting exercise plan •  In addition to medical assessment a psychiatric evaluation for * Post-tramatic stress disorder * Depression * Binge eating disorder * Bulemia Studies show increased frequency in people with excessive eating problems May require medicine and/or behavioral therapy

Ready…set…go!          

Team Realistic goals and expectation Realistic expectations about time to achieve goals Emphasize health rather than cosmetic goals Portion control   Portion distortion   Eat more low energy dense foods

       

Know what’s in the foods your eating Don’t skip breakfast Triggers Physical Activity 30 -60 minutes moderate-vigerous activity most days of the week

Food Guide Pyramids Variety, Proportionality, and Moderation   RD’s rely on this everyday   Low fat   Fat is the most energy dense macronutrient but is

known to have a weak effect on both satisfaction and making you feel full   Instead of all fats being bad…eat healthy fats.   Instead of focusing only on complex carbs…limit

sugar and emphasize benefits of whole grains.   2005 first to emphasize physical activity.   Mypyramid.gov   Interactive website with educational modules

Follow up   Monitor   Evaluate   Modify plans to…   Prevent weight gain   Long term weight management

“Slow and steady wins the race!”

ADA National Nutrition Month 07’

American Dietetics Association: www.eatright.org

“You can lose weight on virtually any diet, if you eat less, you will lose weight. The question is, can you maintain a healthy lifestyle over the long term – your life? The real key to reaching long-term goals is to focus on your overall health.” -Roberta Anding, registered dietitian and ADA spokesperson

Key messages to enjoy a 100% Fad Free lifestyle:   Develop an eating plan for lifelong

health.   Choose foods sensibly by looking at the big picture.   Find your balance between food and physical activity   Learn how to spot a food fad.   Food and nutrition misinformation can have harmful effects on your health and well-being.

American Dietetics Association: www.eatright.org

1. 

2. 

3. 

4.  5.  6.  7. 

References American Dietetic Association. Position of the American Dietetic Association: Food and nutrition misinformation. J Am Diet Assoc. 2006;106:602. American Dietetic Association. Nutrition: Fact vs. Fiction. 2009. Available at: http://www.eatright.org/ada/files/Nutrition_Fact_vs_Fiction.pdf. Accessed September 26, 2009. Starkey J, Dombrowski J, Ryan T. Quick Fixes Aren’t the Answer for Healthful Weight Control: Learn to Spot Fads and Steer Clear – Then Seek Proven, Long-Term Solutions. 2007. Available at: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/ media_10819_ENU_HTML.htm. Accessed September 26, 2009. American Dietetic Association. Position of the American Dietetic Association: Weight management. J Am Diet Assoc. 2002;102:1150. American Dietetic Association. Position of the American Dietetic Association: Weight management. J Am Diet Assoc. 2009;109:335,331. Atkins R 1992 Dr. Atkins’ new diet revolution. New York: Avon Books. Levine M.J., Jones J.M., Lineback D.R.Low-Carbohydrate Diets: Assessing the Science and Knowledge Gaps, Summary of an ILSI North America Workshop (2006) Journal of the American Dietetic Association, 106 (12), pp. 2086-2094

References: 1. 

M. Miller, V. Beach, J.D. Sorkin, C. Mangano, C. Dobmeier, D. Novacic, J. Rhyne and R.A. Vogel, Comparative effects of three popular diets on lipids, endothelial function, and C-reactive protein during weight maintenance, J Am Diet Assoc 109 (2009), pp. 713–717.

2. 

Jackson, D. The Skinny on Meal Replacements for Weight Management. Today’s Dietitian. July 2004;23-24

3. 

Sherer, E. Examining the most popular weight loss diets: How effective are they? JAAPA. November 2008;31-34.

4. 

Spring Cleansing: Assessing the Risks and Benefits of Detox Diets. Today’s Dietitian. 2008; 34-38

5. 

Picco M. Nutrition and Healthy Eating: Do detox diets offer any health benefits? MayoClinic.com. 2008:1. Available at http://www.mayoclinic.com/health/detox-diets/AN01334. Accessed September 29, 2009.