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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)

1990 1999

2008

No Data < 10 % 10 %– 14 % 15 %– 19 %
20 %– 24 % 25 %– 29 % ≥ 30 %
Source: CDC Behavioral Risk Factor Surveillance System
 “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_ENU-
HTML.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
C a lo rie s ca u se w e ig h t g a in
If yo u co n su m e m o re ca lo rie s th a n yo u
exp e n d yo u w illb e g in to g a in w e ig h t

American Dietetic Association at ww.eatright.org 2009


Myth or Fact

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

Myth
M a n y cre a to rs o f th e se fa d d ie ts d o n o t
h a ve scie n tific b a ckg ro u n d

S o m e fa d d ie ts ca n b e h a rm fu lto th o se w ith
ce rta in h e a lth p ro b le m s

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?
uPromises of rapid weight loss
uEasy to follow plans
uDiets include many palatable foods
uPhysical activity not required
High-protein/Low-carbohydrate
Diets
Rapid weight-loss:
 Many low-CHO diets report greater, and more
rapid weight-loss 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
Po ssib le m eCHO
ch a ndiets.
ism s: Nordmann AJ et al. (2006) Arch Intern Med 166:
D iu re285–29.
sis
M o b ilza tio n o f g lyco g e n sto re s


C ircu la tin g ke to n e b o d ie s
S a tia tin g e ffe cts o f p ro te in
U se o f p ro te in m o re e n e rg e tica lly co stly
N o t e n o u g h e vid e n ce



Atkins Diet
T h e Pre m ise :
S e ve re re strictio n o f d ie ta ry
ca rb o h yd ra te (< 2 0 % o f d a ily ca lo ric
in ta ke ), w ith its re su ltin g ke to sis,
p ro m o te s lip id oxid a tio n , sa tie ty , a n d
in cre a se d e n e rg y exp e n d itu re , fa cto rs
th a t sh o u ld p ro m o te n e g a tive e n e rg y
b a la n ce a n d w e ig h t lo ss

C a rb o h yd ra te in ta ke cre a te s:
H ig h b lo o d su g a r
In su lin re sista n ce
In cre a se d b o d y fa t
A tkin s R , D r. A tkin s’ N e w D ie t R e vo lu tio n .
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 m o re h e a lth y ve rsio n o f th e A tkin s
D ie t th a t’ s b a cke d b y so lid e vid e n ce
o n fa ts a n d h e a rt d ise a se

T h e g o o d : D o e sn ’ t le a ve o u t a n y fo o d
g ro u p s

T h e b a d : T h e first p h a se is m u ch like
th e A tkin s d ie t, ve ry re strictive o n
CHO.

R e stricts so m e fru its a n d ve g e ta b le s


su ch a s ca rro ts.
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
oThe Master Cleanse, also known
as “The Lemonade Diet”
oThe Juice Diet
oThe Water Fast

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

o
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

“ Yo u ca n lo se w e ig h t o n virtu a lly a n y d ie t, if yo u e a t le ss, yo u


w illlo se w e ig h t. T h e q u e stio n is, ca n yo u m a in ta in a h e a lth y
life style o ve r th e lo n g te rm – yo u r life ? T h e re a lke y to
re a ch in g lo n g -te rm g o a ls is to fo cu s o n yo u r o ve ra llh e a lth .”
-Roberta Anding , registered dietitianand ADA
sp o ke sp e rso n
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

 References
1. American Dietetic Association. Position of the American Dietetic
Association: Food and nutrition misinformation. J Am Diet
Assoc.2006;106:602.
2. 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.
3. 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_HTM
, 2009.
4. American Dietetic Association. Position of the American Dietetic
Association: Weight management. J Am Diet Assoc.
2002;102:1150.
5. American Dietetic Association. Position of the American Dietetic
Association: Weight management. J Am Diet Assoc.
2009;109:335,331.
6. Atkins R 1992 Dr. Atkins’ new diet revolution. New York: Avon Books.
7. 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 DetoxDiets.
Today’s Dietitian. 2008; 34-38
5. PiccoM. 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.