truth about fad diets - veteranscaucus.org
TRANSCRIPT
Truth About Fad DietsObesity, Health and the Student
Presented By:Maria Kobylinski, MD
Goals
2
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
Half are overweight
On-fourth are obese
Direct Medical Cost >$51 billion/year for weight-related diseases
US AdultsMen Women
African American
56.5% 65.8%
Mexican American
63.9% 65.9%
Caucasian American
61% 49.2%
3
Dollars and SenseU.S. spends 33 billion on weight loss (6 million Americans morbidly obese)
Adults trying to lose weight: 35-40% of women and 20-24% of men22% of this population get regular physical activity
39.3 million workdays are lost/year
11% of youth (6-17 years) overweight
4
Health Risk of Excess WeightHeart Disease, HTN, HyperlipidemiaCancer: Colon, Breast, Endometrial, Pancreatic, Prostate,
Uterine, CervicalInfertilityVaricose VeinsStrokeSnoring
5
And The List Goes On…
Kidney StonesOsteoarthritisGoutDiabetes Mellitus
6
Components of Body WeightWater 60-65%
Muscle, bones, organs
Adipose Tissue Protection of organs/nerves, insulation, preserves body heat,
maintains body temp and vitamin absorption Women 20-25%, essential 12% Men 12-15%, essential 4-7%
7
Assessment of ObesityIdeal Body Weight
Metropolitan Life Insurance Company Men: 106# for 5ft, 6# for every inch over Women: 100# for 5ft, 5# for each inch over
Body Mass 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
8
9
Ideal Body Weight Classifications
Underweight <100%Ideal 100%Overweight 110%Obese 135%Medically Significant 160%Morbidly Obese 200%Super Obese 225%
10
How to Classify BMI
Underweight <18Normal 19-25Overweight 26-29Obesity1 30-35Obesity 2 36-40Morbidly Obese >45.1
Fat Distribution
Gynoid Type (Pear) Thigh/Buttocks Energy Reserves
Android Type (Apple) Waist/Upper Abdomen HTN, Insulin Resistance, Heart
Disease
11
Recent Studies
20% Increase in Weight 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
12
Etiology of ObesityLong-term Imbalance BetweenEnergy 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
13
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
14
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.
15
Body’s Fuel Source Primarily CHO Brain uses solely Converts protein/fat into glucose
Gluconeogenesis
Healthy DietCHO 50-60%Pro 15-20%Fat 25-30%
16
Calories Carbohydrate 4 kcal/gm
Protein 4 kcal/gm
Fat 9 kcal/gm
Alcohol 7 kcal/gm
17
Food Guide PyramidA Guide to Daily Food Choices
18
19
Common Weight Loss Methods
20
Attempts to Lose the WeightLow Fat DietBody weight associated to fat intakeTend to eat same amount of caloriesObese people tend to underreport their intake (30-47%)
Starvation DietsBreak down muscle and fatTend to store more when begin to eat again
21
22
ObesityOver 50 percent of Americans are overweightOne in three adults is obese – why?Sedentary lifestylePoor food choicesObsession with dieting Lack of time
23
The U.S. Diet IndustryAlmost $40 billion per year industry, includes: Diet books Diet foods Diet programs Weight-loss gimmicks
24
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 1991 Fen Phen Diet Pill 1995 Enter the Zone 1997 Fen Phen – Pulled
From Market
25
26
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
27
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
28
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
29
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
30
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
31
DIETS DON’T WORK50% 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
32
Dieter Beware: Current Fad Diets Enter the Zone Dr. Atkin’s Diet Revolution Protein Powder Dr. Arnot’s Revolutionary Weight Control Program Sugar Busters! Eat 4 Your Blood Type
33
NO RESEARCH TO SUPPORT DIETS All Six Diets Reviewed Lack Research Use testimonials Base validity on opinions not facts Lack any peer review
34
ENERGY 101
Calories are supplied by: Carbohydrates Fat Protein
Calories In > Calories Out = Weight Gain Calories In < Calories Out = Weight Loss
35
CARBOHYDRATES
Carbohydrate Intake ⇒ Glucose + Insulin = Energy
Extra Glucose: Glycogen stores Fat stores
36
High Protein DietsCommon Claims
Lose weight quickly Never be hungry Carbohydrate intake
creates Increased appetite Addiction to sugar High blood sugar Insulin resistance Increased body fat
37
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.
38
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!
39
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.
40
High Protein DietsThe 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
41
Ketones in Blood = KetosisAcidic 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
42
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
43
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
44
45
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.
46
High Glycemic Index Foods
Sugar Busters!H. Leighton Steward; Morrison C. Berthea, M.D.; Sam S. Andrews, M.D.; and Luis A. Balart, M.D.
Carrots Potatoes Beets Pasta Bread (refined flour) Rice (white) Fruit (must be eaten by itself)
47
Enter the ZoneBarry 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.
48
Enter the ZoneBarry 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).
49
Protein PowerMichael 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.
50
Dr. Bob Arnot’s Revolutionary Weight Control ProgramRobert 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.
51
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
52
Dr. Atkin’s New Diet RevolutionRobert 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.
53
Eat 4 Your Blood TypePeter 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.
54
I’m Still Looking for the Magic!
55
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
56
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
57
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.
58
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!
59
High Carbohydrate Diet
Increases Intake Of: Fiber Calcium Vitamins Minerals Antioxidants Phytochemicals
Lowers Risk For: Heart Disease Cancer Osteoporosis Diabetes High Blood Pressure
61
Diets that WorkWeight WatchersIntuitive Eating by Evelyn TriboleOutsmarting the Midlife Fat Cell by Debra WaterhouseOutsmarting the Female Fat Cell by Debra WaterhouseThin for Life. 10 Keys to Success from People Who Have
Lost Weight and Kept it Off by Anne FletcherThe Solution: Winning Ways to Permanent Weight Loss
by Laurel Mellin
62
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
63
The Student Diet
64
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
65
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: Cheesecake 500 kcal, 30 gm fat 3100 kcal, 229 gm
fat (not counting drinks)
66
Alcoholic Beverages 70-200 kcals/drink 12 oz serving Mainly fat & some CHO
EsophagealGI cancer
Linked to Many Forms of Cancer
Anthocyanin AntioxidantSame pigment in grape skins
Red Pigmentation
67
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
68
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 & zinc69
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
70
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
71
Tips For Success Regular exercise Permanent changes Avoid skipping meals Do not eat while
studying/watching TV 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
72
Goals Decrease Regular soda intake Decrease caffeine Limit meat servings Increase fruits/vegetables Fiber
Increase calcium Multivitamin
73
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
74
Thank you