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Transcript
Adkins Diet Analysis 1 Weight Management Diet Analysis Assignment Emily Lynch Sinclair Community College Dietetics 129 – Principles of Nutrition Nora Schaefer RD, LD August, 2010 Adkins Diet Analysis 2 1. List a sample day's menu this program allows and provide a nutritional analysis of the menu. (20 points). Adkins Diet Breakfast 2 medium scrambled eggs with 1 cubic inch cheddar cheese ½ cup sautéed mushrooms in olive oil and ¼ onions 1 strip of turkey bacon 1 6 oz cup of coffee with 1 oz cream and 1 packet of Splenda 8 oz of water Lunch 8 oz glass of water ½ cup cauliflower raw ½ cup broccoli raw 2 tablespoons Ranch dressing 3 oz salmon fillet cooked in 2 table spoons lemon juice, 1 garlic clove, and 1 tablespoon butter Dinner 8 oz of water 2 cups Caesar salad with 1 oz sprinkled mozzarella 1/3 tomato diced 2 tablespoons Caesar dressing Adkins Diet Analysis 3 ½ cup summer squash 1 tablespoon butter 3 oz beef Snack 1 oz cheddar cheese cube 8 oz water 2 medium celery stalks ½ cup cut pepper 2 table spoons Ranch dressing Determine if the program includes a well balanced diet? (a-f) a. Does the diet include a reasonable number of calories (not less than 1200)? There are a reasonable number of calories provided in an “induction phase” worth of dietary intake and throughout the other phases. The calorie count from the hypothetical daily intake I created from foods encouraged on this diet totaled 1977 calories. Based on the website, there is no method of limiting calories but it may be implied that dieters are encouraged to follow sample menus and recipes. The concept is to strictly limit simple carbohydrates and other carbohydrates found in most fruits, vegetables, and grains. The only method is to abide by the menu of foods that are allowed. By obeying the standardized allowances of the diet, if the dieter follows pre-determined portions on a daily menu already established that is, the calorie intake is controlled by default although it is completely possible to eat the allowed foods in excess since it is not directly advised and thus not mandatory to follow the example menus available. Generally speaking the diet plan does not stress portion size as priority but only carbohydrate limitations. Adkins Diet Analysis 4 b. Does it provide enough but not too much protein (at least the RDA)? What protein percent of the total calories does this diet plan provide? Does this percentage meet the DRI range for protein? (10 points) The Adkins diet provides an excess amount of protein compared to the recommended protein allowance. The protein intake exceeds the daily recommended intake percentage as it is at 19% of the energy intake. (A sample of a day’s menu on the Adkins site is even more…) The recommended protein intake based on the myfoodpyramid.gov website it should not exceed about 10% however; according to the Acceptable Macronutrient Distribution Range provided in the text it can be as high as 35% of energy intake (Understanding Normal and Clinical Nutrition, Rolfes, Pinna, and Whitney). c. Does it provide enough fat for satisfaction? What fat percent of the total calories does this diet plan provide? Does this percentage meet the DRI range for fat? (10 points) This diet exceeds also in the area of fat energy intake which, yes, would provide the satiety factor. The total fat intake is a whopping 74% of total energy intake. Myfoodpyramid.gov recommends no more than 76.9 grams which is 35% and the Acceptable Macronutrient Distribution Range provided coincides with this recommendation saying fat intake should be between 20-35% of total fat energy intake. It would be difficult to limit the energy intake of fat on this particular diet that restricts carbohydrate intake so much (Understanding Normal and Clinical Nutrition, Rolfes, Pinna, and Whitney). Adkins Diet Analysis 5 d. How much CHO in grams does this diet provide? How much CHO is needed to spare protein? Does this diet plan provide enough CHO to spare protein? (10 points) What CHO percent of the total calories does this diet plan provide? Does this percentage meet the DRI range for CHO? (10 points) This diet allows for no more than 20 to 30 grams of the recommended 130 grams of carbohydrate even at its most generous phase. To spare protein, one must eat between 50 to 100 grams of carbohydrate a day. The very success factor of this diet – at least in the first “induction phase” is based on inducing ketosis which of course induces body protein wasting. This diet plan is only 6% of the total energy intake requirement from carbohydrates compared to what it should be – which is at least 45%. Therefore this is not enough to spare an adequate amount of protein and keep the body from producing glucose from body protein for energy (regardless of the excess protein intake from food.) As a result, the body loses essential water and muscle protein along with fat stores which is not an efficient nor healthy weight loss method (Understanding Normal and Clinical Nutrition, Rolfes, Pinna, and Whitney). e. Does it allow for a variety of foods to choose from and offer a balanced assortment of vitamins and minerals from all food groups? (5 points) The Adkins diet encourages most of one’s intake to come from a variety of protein rich foods and a good variety of low carbohydrate vegetables. In fact they encourage the dieter to eat at least 12 to 15 grams of carbohydrates from vegetables a day. However; there are no starchy vegetables and virtually neither fruits nor grains in any of the recipes provided for this diet. This diet is not based on the goal of variety nor does it focus even on moderation. (In fact the website suggests to, “Eat liberally of combinations of fat and protein” and “Eat absolutely no fruit, bread, pasta, grains, starchy vegetables or dairy products other than cheese, cream or butter” Adkins Diet Analysis 6 http://www.the-atkins-diet.info/atkins-induction-phase.htm). In other online sources such as Wikipedia, Adkins diet experts claim they do not encourage “binging” but there is little suggest otherwise in their other online publications with regard to an affirmed protein and fat calorie limit – regardless if there is a calorie limit or not, however; the percentage from protein and fat grossly exceeds what they should be. This means total fat, cholesterol, and sodium are at least double the recommended amounts and other vitamins and minerals that would be derived from grains and fruits are less than half of what they should be. And where there is an excess of these items that should be kept to a minimum, there is poor vitamin and mineral absorption through supplementation. (Where there is excess sodium, calcium absorption falters, for example.) f. Does it consist of ordinary foods that are available locally at a price people Ordinarily pay? (5 points) The foods on the diet are normal but it can be expensive if one purchased only “Adkins” brand name labeled varieties to ease the burden and time spent of trying to figure out what is allowed and what isn’t on the actual diet. The product and the name tailored just to market this diet costs more than just buying the specified foods that are always available at a normal cost at any local grocery store. 2. Does it provide for behavior modification? (5 points) a. Are clients taught how to identify their individual behavior and help them develop personalized strategies for changing that behavior? There doesn’t seem to be a personalized councilor assigned to a dieter advocating correct consumption, providing accountability or otherwise regarding the safety, health, nor results of the diet plan. There are a few tips and suggestions in the fine print (for anyone caring to read Adkins Diet Analysis 7 them or daring to follow the diet plan) that point toward individualistic behavior such as caffeine addictions and alcohol drinkers encouraging them that they should sustain from these things while on the diet and that since the diet is based on low carbohydrate/high protein concept, vegans and vegetarians will have a hard time with the diet since they provide no menu option to accommodate them specifically. Therefore, vegans and vegetarians are told they have to start accepting at least fish into their daily regimen. It also provides a comment encouraging adjusting portion sizes to suit one’s individual appetite but again there is no portion control other than advise not to eat to the point of feeling “stuffed.” There is also a list of up to 10 different ways to customize the diet to meet your needs in such areas as starting at the phase of your choice and moving at the right pace for you, for example. It also advertises that the Adkins diet is all about learning how different foods affect you. I suppose this can be another example of how they accommodate for individualizing the diet while encouraging the dieter to explore the options and recipes of the diet plan. 3. Does the program include a component of exercise: (5 points) After searching long and hard for any exercise tips the Adkins Diet professionals may have all I found was one comment on their “Adkins Diet Lifetime Maintenance” list which provided a tip as the very last bulleted item stating, “Make exercise a regular part of your life” and “Being active has numerous benefits from improving mood and mental focus to managing weight and preventing chronic health conditions” (http://www.atkins.com/Science/UnderstandingNutritionAndExercise/Activity.aspx ).Then the website offers a “more information” button that explains the generic “common sense” review of what activity is suggested for anyone and everyone. None of the information, however; refers directly to its relationship between activity and the Adkins diet program specifically. Of course, Adkins Diet Analysis 8 given the body protein wasting affect and the slowing of metabolism this diet has on the body doesn’t exactly equip the body to perform well in the area of energy expenditure since the body protein and intake is sacrificed to sustain energy (as opposed to the proper major protein sparing energy of carbohydrates) for normal body processes instead of performing its other important roles (Understanding Normal and Clinical Nutrition, Rolfes, Pinna, and Whitney). So I understand why they wouldn’t go out of their way to advocate a lot of exercise while on the diet. Not only is the body using protein inefficiently but it is also working hard to metabolize the excess through the liver and kidneys trying to cleanse the body of the nitrogen which creates toxic ammonia, diluting it as urea and excreting it through the urine. A very busy process if the majority of what is eaten is protein. a. What type of exercise is recommended? Is the client examined by their personal physician to determine the appropriateness of exercise? There is no specification regarding what type of exercise is recommended. It simply states to “make exercise a regular part of your life.” From what I can find there is no personal physician or advocate available through the website information or weight loss program unless you personally decide to inform and recruit your personal physician to aid you with the best personalized feedback possible. When you start this diet, whether you buy all the products and read all the books or not, you are virtually on your own with little to no support. The support you do have is from others who are advocates, testimonials, or fellow dieters that can be easily reached through an online discussion forum. Perhaps the in depth literature and publications on the Adkins diet would best describe what exercise is appropriate but it certainly wouldn’t be personalized so basically, one would have to Adkins Diet Analysis 9 consult their personal physician as far as getting advice on what exercise, if any, would be appropriate while on this diet. b. Are the "counselors' qualified to provide these services? What are their qualifications? From what I’ve seen on the web in relation to the Adkins program providing support by counselors or physicians of any kind other than simply stating that you should potentially inform your personal physician especially if you have any health conditions that could be impacted by the low-carb diet. Therefore, there is no qualified counselor (since most support that can be found is from others just like you…) to help you along unless you recruit your own personal physician. 4. Does this program provide any support system for the client? (2 points) a. Who provides the support? How often? There is a support group via an online forum if and when a dieter chooses to participate. 5. Misc. questions: (8 points) a. Is the program medically supervised? Does the physician regularly see the client and does the physician know the client well enough to be safe? It is not medically supervised unless the dieter decides to be under the regular care of their own personal physician or dietitian. There are similar low carbohydrate diets (the Ketogenic diet) that is used mostly for epileptic patients where ketosis keeps seizure activity to a minimum or otherwise completely eliminates it. In such cases a dietitian not only supervises their intake regularly but plans their intake and portion sizes strictly keeping a tight rein on the regimen along with strong support and accountability while watching other health risks closely (such as Adkins Diet Analysis 10 cardiovascular disease) as to keep them at bay. The Adkins Diet, however; has no such supervision. b. Does the program promote the use of special dietary supplements, such as vitamin and mineral tablets, pills, weight loss aids? The Adkins diet does recommend a daily multi-vitamin supplement to make up for the loss of nutrients such as potassium, magnesium and calcium, but without iron. They also provide fortified snack bars and shakes that offer these vitamins and minerals in the form of supplementation though they may not be as bio-available as they do not come from the foods that naturally supply them. c. Does the program offer unproved testing or analysis, such as hair or breath analysis? There is a breath analysis instruments referred to as Ketostix which reveal and measure ketones in a low carbohydrate dieter’s breath verifying when, if and at what degree ketosis occurs. This is a proven test and does actually monitor ketosis but has nothing to do with monitoring neither health nor success of the diet. The advocate’s proof of success is primarily in the weight loss results. That’s all the “proof” they need. c. What claims are made that are just too good to be true? Weight loss is the primary promise and yes it has definite results but it implies that one must stay on the weight loss maintenance program for good if they don’t want their weight to be gained back while discouraging a simple low calorie diet as it would not be as “successful.” Staying on the diet long term can cause serious cardiovascular diseases and all the other similar associated complications. The weight loss promise through the Adkins diet also claims that the body will turn the body into a “fat burning machine” but in actuality the abundance of the weight loss is from water and body protein as well as body fat which is an expensive and inefficient use Adkins Diet Analysis 11 of protein to achieve weight loss – not fat loss. There are many claims that the diet prevents cardiovascular disease, lowers the low density lipoprotein (LDL) cholesterol, and increases the amount of HDL cholesterol but other studies concluded that the diet contributes to cardiovascular disease, coronary heart disease, arrhythmia, osteoporosis, and kidney stones (http://en.wikipedia.org/wiki/Atkins_diet). It is also stated, “Low-carbohydrate diets like the Atkins diet are often touted for their ability to reduce LDL and triglycerides, but this effect is caused by the initial weight loss, Tallmedge said. ‘Once the weight loss has stopped, they often go higher than ever before.’” (http://www.weight-loss-institute.com/atkins_diet.htm). Adkins Diet Analysis 12 References Adkins Nutritionals, www.atkins.com (Copyright 2010). Rolfes, Sharon R., M.S. Pinna, Kathryn, M.S., PhD., Whitney, Ellie, B.A, Ph.D. Understanding Normal and Clinical Nutrition, Eighth Edition, (2009). Weight loss Institute, Inc. http://www.weight-loss-institute.com/atkins_diet.htm Copyright (2002-2010). Wikimedia Foundation, Inc . http://en.wikipedia.org/wiki/Atkins_diet Copyright (2010). Adkins Diet Analysis 13 Adkins Diet Analysis 14