Download lesson 6.1 truth about fad diets

Truth about Fad Diets
Obesity, Health and the Student
Goals
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 Adults
Half are overweight
One-fourth are obese
Men
African A.
Mexican A.
Caucasian A.
56.5%
63.9%
61%
Women
65.8%
65.9%
49.2%
Direct medical cost >$51 billion/yr for weight-related diseases
Dollars 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
men
 22% 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 weight
Heart disease, HTN, Hyperlipidemia
Cancer: colon, breast, endometrial, pancreas, prostate,
uterine, cervical
Infertility
Varicose veins
Stroke
Snoring
And the list goes on…
Kidney stones
Osteoarthritis
Gout
Diabetes Mellitus
Components of body weight
Water 60-65%
Muscle, Bones, Organs
Adipose 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 obesity
Ideal Body Weight
 Metropolitan 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 m2
 Caution with: increased muscle mass, edema
Waist-Hip ratio
 > 88cm women, > 102cm men for those with BMI <40
Ideal Body weight classifications
Underweight
Ideal
Overweight
Obese
Medically sig.
Morbidly obese
Super obese
<100%
100%
110%
135%
160%
200%
225%
How to classify BMI
Underweight
Normal
Overweight
Obesity 1
Obesity 2
Morbidly Obese
<18
19-25
26-29
30-35
36-40
>45.1
Fat distribution
Gynoid type (pear)
Android type (apple)
 Thigh/buttocks
 Waist/upper abdomen
 Energy reserves
 HTN, Insulin resistance, Heart
disease
Recent 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 Obesity
Long-term imbalance between
Energy 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 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. Animal
Animal model of obesity are characterized by one
single gene
 Ob/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 source
Primarily CHO
Healthy diet:
 Brain uses solely
 CHO: 50-60%
 Converts protein/fat into
 Pro: 15-20%
glucose
• Gluconeogenesis
 Fat:
25-30%
Calories
Carbohydrate
 4 kcal/gm
Protein
 4 kcal/gm
Fat
 9 kcal/gm
Alcohol
 7 kcal/gm
Food label
Common Weight Loss Methods
Attempts to lose the weight
Low fat diet
 Body weight associated to fat intake
 Tend to eat same amount of calories
 Obese people tend to underreport their intake (30-47%)
Starvation diets
 Break down muscle and fat
 Tend to store more when begin to eat again
Setting the Record Straight: The Truth About Fad Diets
Obesity
Over 50 percent of Americans are overweight.
One in three adults is obese. Why?
 Sedentary lifestyle
 Poor food choices
 Obsession with dieting
 Lack of time
The U.S. Diet Industry
Almost $40 billion per year industry, includes:
Diet books
Diet foods
Diet programs
Weight-loss gimmicks
Do You Remember?
1960 Drinking Man’s Diet
Steak and Wine
1967 Dr. Stillman’s Diet
1972 Dr. Atkin’s Diet
1973 Richard Simmons
Fitness Guru
1978 Scarsdale Diet
1979 Pritikin Diet
1980 Beverly Hills Diet
1981Cabbage Soup Diet
1988 Optifast Liquid Diet
1991 Protein Power
1991Fen Phen Diet Pill
1995 Enter the Zone
1997 Fen Phen pulled from
market
Enter the Zone
Protein Power
Dr. Atkin’s
New Diet
Revolution
The
Cabbage
Soup Diet
Sugar
Busters!
The
Anti-Aging
Zone
Dr. Bob Arnot’s
Revolutionary Weight
Control Program
Fad diets: The Zone
Claim: Boost protein, cut carbs achieve peak athletic
performance
Why you lose: very low calorie
Downfall: few carbs can cause fatigue, weakness in
athlete and few fiber foods
Most useful tip: Choose low fat protein sources, Eat
several meals/snacks per day
Fad 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 zinc
Digestive downside: constipation
Most useful tip: cut back on added sugar
Tips 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 Diet
Is the author credible?
Diets that advocate:
Magic or miracle foods
Rapid weight loss/quick fix
No exercise
Rigid menus, “good” vs. “bad” foods, specific food combinations
Recommendations based on a single study or studies
published without a peer review
Sounds too good to be true
Fad Diet Alert!
Steer clear of these claims:
Fast, easy weight loss
Breakthrough miracle
Banish fat
Secret formula, new discovery
Cure
Balances hormones
Enzymatic process
DIETS DON’T WORK
50% of Americans Diet Annually
Average diet lasts 42 days
Only 5 -10 percent maintain a significant weight loss
(= 10 percent or more of starting weight)
No scientific data from commercial programs
No scientific data from any diet-book programs
Some cause significant health problems
Source: John Foreyt, Baylor College of Medicine
Dieter Beware: Current Fad Diets
Enter the Zone
Dr. Atkin’s Diet Revolution
Protein Power
Dr. Arnot’s Revolutionary Weight Control Program
Sugar Busters!
Eat 4 Your Blood Type
NO RESEARCH TO SUPPORT DIETS
All six diets reviewed:
 Lack Research
 Use testimonials
 Base validity on opinions not facts
 Lack any peer review
ENERGY 101
Calories are supplied by:
 Carbohydrates
 Fat
 Protein
Calories In > Calories Out = Weight Gain
Calories In < Calories Out = Weight Loss
CARBOHYDRATES
Carbohydrate Intake  Glucose + Insulin = Energy
Extra glucose:
 Glycogen stores
 Fat stores
High Protein Diets
Common Claims
Lose weight quickly
Never be hungry
Carbohydrate intake creates:
 Increased appetite
 Addiction to sugar
 High blood sugar
 Insulin resistance
 Increased body fat
INSULIN: 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 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 Reality
10-25% of dieters are insulin resistant
Most with insulin resistance are:
 Obese
 Sedentary (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 Diets
The 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 = Ketosis
Acidic waste from fat breakdown in the absence of
carbohydrate.
Ketosis:
 Dizziness
 Nausea
 Decreased appetite
 Dehydration
 Electrolyte Imbalance
 Lethargy
 Bad Breath: acetone
evaporation in lungs
 Bone Loss: Calcium
buffers changes in
blood pH
High Protein Diets: A Closer Look
Low in calories; 1200 or less
High in protein / low in carbohydrate
Low in vitamins, minerals, phytochemicals
High in saturated fat and cholesterol
Increased risk for:
• Cardiovascular disease
• Cancer
• Osteoporosis
High Protein Diets
Common Claims
Lose weight quickly
Never be hungry
Carbohydrate intake creates:
 Increased appetite
 Addiction to sugar
 High blood sugar
 Insulin resistance
 Increased body fat
Enter the Zone
Protein Power
Dr. Atkin’s
New Diet
Revolution
The
Cabbage
Soup Diet
Sugar
Busters!
The
Anti-Aging
Zone
Dr. Bob Arnot’s
Revolutionary Weight
Control Program
Sugar Busters!
H. Leighton Steward; Morrison C. Berthea, 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!
H. Leighton Steward; Morrison C. Berthea, M.D.;
Sam S. Andrews, M.D.; and Luis A. Balart, M.D.
High Glycemic Index Foods:
Carrots
Potatoes
Beets
Pasta
Bread (refined flour)
Rice (white)
Fruit (must be eaten by itself)
Enter the Zone
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 Zone
Barry Sears, Ph.D.
Claims:
 Weight easy to lose on 40:30:30 plan
 Carbohydrates 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 Power
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
Weight Control Program
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 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 Revolution
Robert 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 Type
Peter 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 Magic!
Lifelong Healthy Weight
Positive attitude
Are 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:
Why You Weigh what You Weigh
Activity: What and how much?
Food: What and how much?
Stress: Is food your answer to life’s problems?
Physiologic and genetic make-up
Age and health status
Here’s the Magic!!!
Eating for good health and eating to
control weight are virtually 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 = Success!
Choose something you enjoy
Combined 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 Pyramid
High Carbohydrate Diet
Increases intake of:
Fiber
Calcium
Vitamins
Minerals
Antioxidants
Phytochemicals
Lowers risk for:
Heart Disease
Cancer
Osteoporosis
Diabetes
High Blood Pressure
Diets that Work
Weight Watchers
Intuitive Eating by Evelyn Tribole
Outsmarting the Midlife Fat Cell by Debra Waterhouse
Outsmarting the Female Fat Cell by Debra Waterhouse
Thin for Life. 10 Keys to Success from People Who Have
Lost Weight and Kept it Off by Anne Fletcher
The Solution: Winning Ways to Permanent Weight Loss by
Laurel Mellin
Lifestyle Change
Be realistic - Small changes over time
Be adventurous - Expand your tastes
Be flexible - Balance food and activity over several
days
Be sensible - Enjoy all food in moderation
Be active - Walk the dog, don’t just watch the dog walk
The Student Diet
Problems with student diet
Study long hours
No time to cook healthy meals
Do not have time to grocery shop
Easier to eat out or drive thru
Very little exercise
= Sedentary lifestyle
Eating out
1 of 3 meals
Drinks: High kcal
Appetizer: 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 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
Avoid all-you-can eat buffets
Choose baked or grilled
Avoid white or cheese
sauces
Ask for dressing or
condiments on the side
Request a take-home
container
Look for light or heart
healthy menu
Order calorie free beverages
Watch for key words
signaling high kcal:
 Fried, creamed, pan-fried,
sautéed, alfredo, or gravy
Caffeine 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 home
Prepare meals and freeze
Go in with a friend
Don’t keep trigger foods in the house
Always eat at the table
Slow down
Myths about dieting
Eating late at night is sure to
pack on the pounds
You can lose weight by
eating fewer calories
Never have seconds
Deny cravings; they are all in
your head
Don’t eat between meals
Eating breakfast makes you
hungry all day
To lose weight, become a
vegetarian
You can eat anything you
want as long as it is fat free
Tips for success
Regular exercise
Permanent changes
Avoid skipping meals
Do not eat while
studying/watching t.v
Eat only when hungry
Do not use food as a reward
Drink only calorie-free
beverages
Do not grocery shop when
hungry
NO fad diets
Choose a variety of foods
Goals
Decrease Regular soda
intake
Decrease caffeine
Limit meat servings
Increase fruits/vegetables
 fiber
Increase calcium
Multivitamin
Healthy snacks when you have the
munchies
Fresh, frozen, canned fruit
Light or low fat yogurt
String cheese
Low fat cheese and wheat
crackers
Vanilla wafers & skim milk
Baked chips
Low fat popcorn
Sugar free hard candy
Frozen fruit bars