By Suheil Khuri M.D.
There are so many diet plans that claim great results. This makes it difficult to know which ones to trust and which ones will be helpful to follow. It is also critical to be able to maintain most of the lost weight for the long term.
Long-term success requires not only diet compliance but also a lifestyle change that includes behavior/
habit changes as well as a commitment to an active exercise program.
The following review examines several popular diet plans. Most diets emphasize the restriction of one macronutrient (Carbohydrate, Fat, and Protein) as the basis for that plan. The other nutrients are allowed in variable quantities, depending on the plan.
Weight loss is impossible without a calorie restriction. Each diet should provide fewer calories than your body needs to decrease your weight. Otherwise a diet without a calorie restriction will end up causing weight gain.
I- Reduced-Fat Diets
A. Very-Low-Fat Diets. Provide 10% – 20% fat.
They are primarily plant-based diets (fruits, vegetables, whole grains, beans and soy) including limited amounts of reduced–fat dairy, eggs, lean meat, and fish. Dietary fat is needed to transport the fat-soluble vitamins A, D, E, and K. Without fat to transport them; they will not be able to serve their functions in your body.
1) Ornish Diet. Created by: Dean Ornish, M.D. Is a very high carbohydrate vegetarian diet that is extremely low in fat and moderate in protein. The primary goal of this diet was to reverse heart disease. Fat intake is only 6% of your total calories.
It advises the consumption of unlimited quantities of low-fat, high fiber, complex carbohydrate foods, such as beans, legumes, fruits, vegetables, and grains. Low fat dairy products are allowed in moderation. Meats, eggs, nuts, oil, seeds, alcohol, and high fat fruits and vegetables are prohibited. Physical activity and stress management are also emphasized.
2) The Pritikin Diet. Created by Nathan Pritikin & revised by: Robert Pritikin. Is a very low-fat, high-carbohydrate diet. The focus is to eat vegetables, fruits, and high-fiber grains. Fats should not exceed 10% of total daily calories. The revised Pritikin diet includes a “Calorie Density (amount of calories in a given weight) Solution:” Consume low-calorie dense foods (apples, brown rice,..) 6-7 times per day. Theorizes that eating low-calorie density foods throughout the day will reduce hunger and cause weight loss.
B. Low-Fat Diets. Provide 20% – 35% fat.
This diet is the cornerstone of most mainstream dietary recommendations.
1) DASH (Dietary Approaches to Stop Hypertension) Diet. Is a balanced diet with no extreme percentages of macronutrients; low in sugar, salt, alcohol and saturated fat, with moderate levels of total fat, and a high level of mono-unsaturated fats. It emphasizes helpful minerals and antioxidants to lower blood pressure.
It emphasizes vegetables, fruits, low-fat dairy products, whole grains, poultry, fish, and nuts, limited amount of red meat, sweets, and sugar-containing beverages. Limits the amount of total fat, saturated fat and cholesterol.
2) American Diabetes Association (ADA) Diet. Is composed of: 60% Carbohydrates, 20% Proteins, and 20% Fat. Is based on “exchange units”. For a 1600-calorie diet, it includes: 9 starch, 4 fruit, 4 vegetables, 5 meat, and 6 fat exchanges.
3) Jenny Craig Diet. Has become best known for the celebrities who followed it. This diet provides you with your foods and snacks to ensure you consume the exact amount of calories your body needs to lose weight. You add fresh produce and dairy. You meet with a consultant regularly. Physical activity is emphasized.
4) Weight Watchers. Has been around for many years. There have been changes to the program, but weekly meetings have remained a part of the plan.
There are two diet options:
1. Flex Plan. The points value for foods is calculated based on the food’s calories, fat, and fiber.
2. Core Plan. Is based on energy density (the amount of calories in a given weight of food). Encourages low energy dense foods as in: vegetable soups, vegetables, and fruit.
5) NutriSystem. Provides prepackaged food that has a low glycemic index, high-fiber and high protein. You add fresh produce and dairy. This system does address the three important components for successful weight loss and maintenance: diet, behavior and physical activity.
C. Moderate-Fat Diets. Provide 35% – 45% fat.
Contain a high proportion of unsaturated fatty acids primarily from monounsaturated fatty acid oils and emphasizes high intake of plant foods (fruits, vegetables, whole grains, legumes, and nuts) and fiber and limited amounts of saturated fat from animal foods.
>> Mediterranean Diet: Has become a popular diet and is composed of: 40% Carbohydrates, 17% Proteins, and 43% Fat. It has a high amount of mono-unsaturated fats. The diet contains: vegetables, fruits, cereals, dairy products, meats and poultry, fish, wine, legumes and olive oil.
II- High-Protein Diets
Those are diets with protein intake that is greater than 25% of total energy or 1.6 gms/kg per day. A key difference between high protein and low carbohydrate diets is that high protein diets are typically low in fat.
>> The Zone Diet. Is composed of: 40% Carbohydrates, 30% Proteins, and 30% Fat. When this ratio is achieved, this diet claims that the body is working within the “zone” leading to maximum energy and weight loss.
It focuses on lean meats (especially poultry), avoids high-fat animal products (fatty meats, dairy products, eggs) as well as most grain products, starchy vegetables, and some fruits. It promotes eating a balance of each nutrient, without severely restricting calories. Protein increases your feeling of fullness, helping you to avoid eating between meals. Healthy unsaturated fats are encouraged in place of the saturated and trans fats.
Poor long-term compliance has been reported in several studies comparing high protein and low fat diets.
III- Low Carbohydrate Diets
Consist of limited amounts of carbohydrate (20 – 50 grams/day or about 10% – 30% Carbohydrate). This amount is gradually increased over time. Those diets have relatively high amounts of fat (about 60% fat), which differentiates Low Carbohydrate diets from High Protein Diets.
1) Atkins Diet. Created by Robert Atkins M.D. is a well-known diet. It restricts carbohydrates to 6%, and has 35% Proteins, and 59% Fat.
The basis for this plan is: the significant decrease in carbohydrate intake leads to a reduced appetite, and the body will use stored fat for energy leading to weight loss.
This diet has been around for decades and has undergone many revisions.
The most recent version of this diet is much more nutritionally balanced and does emphasize the need to consume unsaturated fats as well as allows the use of good carbohydrates instead of restricting all carbohydrates. These newly allowed foods provide the previously lacking vitamins, fiber, and minerals in this diet.
2) South Beach Diet. Created by: Arthur Agatston M.D. is composed of: 28% Carbohydrates, 33% Proteins, and 39% Fat. It emphasizes healthy carbs, such as whole grains, certain fruits and vegetables, mono-unsaturated fats, such as olive and canola oil and nuts, and lean source of protein.
It is divided into different phases. The first phase is to eliminate cravings and quick start weight loss; the second phase is to induce a steady weight loss; and the third phase is to achieve and maintain your weight goal.
Low Carbohydrate diets have been associated with lower reductions in Total Cholesterol and LDL cholesterol, greater reductions in Triglycerides and larger increases in HDL cholesterol when compared to Low Fat diets.
All diets mentioned above lead to some weight loss but the ability to adhere to a diet for the long term and maintain the weight loss is the main problem in all diets.
The composition of the most healthful diet is not known. However, our diets are meant to have a balance of all three nutrients (protein, carbohydrates, and fat).
The Dietary Reference Intake (DRI) established the need for each one of the three nutrients based on research for optimal health and weight. It set the dietary goals at 45% – 65% from carbohydrates, 20% – 35% from fat and 10% – 35% from protein.
You need to be an educated consumer when it comes to weight loss. It takes lifestyle changes and modifications in behavior, diet, and physical activity to succeed at weight loss. It also takes long term commitment and adherence to whichever diet plan you follow.
Answering the question:
“Which diet is best for you?”
“The best diet for you is the one that you will and can commit to and follow regularly for the long term.” There is no one diet that is the answer for everyone.
If you are having difficulties with weight loss, consult your physician. Dieting is a complex issue with multifactorial causes and ongoing professional support may be needed for success. Never give up hope, because it is possible to lose weight and keep it off.
Always remember that Weight Loss of 5% – 10% can reduce several risk factors for cardiovascular disease, stroke, hypertension, and many other diseases associated with obesity, even if the optimal weight is not achieved.
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