Truth about Fad Truth about Fad DietsDiets

Obesity, Health and the Student

GoalsGoals

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 AdultsUS Adults

Half are overweightOne-fourth are obese

Men WomenAfrican A. 56.5% 65.8%Mexican A. 63.9% 65.9%Caucasian A. 61% 49.2%

Direct medical cost >$51 billion/yr for weight-related diseases

Dollars and SenseDollars 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

men22% 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 weightHealth risk of excess weight

Heart disease, HTN, HyperlipidemiaCancer: colon, breast, endometrial, pancreas, prostate,

uterine, cervicalInfertilityVaricose veinsStrokeSnoring

And the list goes on…And the list goes on…

Kidney stonesOsteoarthritisGoutDiabetes Mellitus

Components of body weightComponents of body weight

Water 60-65% Muscle, Bones, OrgansAdipose 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 obesityAssessment of obesity

Ideal Body WeightMetropolitan 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 m2Caution with: increased muscle mass, edema

Waist-Hip ratio> 88cm women, > 102cm men for those with BMI <40

Ideal Body weight classificationsIdeal Body weight classifications

Underweight <100%Ideal 100%Overweight 110%Obese 135%Medically sig. 160%Morbidly obese 200%Super obese 225%

How to classify BMIHow to classify BMI

Underweight <18Normal 19-25Overweight 26-29Obesity 1 30-35Obesity 2 36-40Morbidly Obese >45.1

Fat distributionFat distribution

Gynoid type (pear) Thigh/buttocks Energy reserves

Android type (apple) Waist/upper abdomen HTN, Insulin resistance, Heart

disease

Recent studiesRecent 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 ObesityEtiology of Obesity

Long-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

Role of HeredityRole 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. AnimalHuman vs. Animal

Animal model of obesity are characterized by one single geneOb/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 sourceBody’s Fuel source

Primarily CHO Brain uses solely Converts protein/fat into

glucose• Gluconeogenesis

Healthy diet: CHO: 50-60% Pro: 15-20% Fat: 25-30%

CaloriesCalories

Carbohydrate 4 kcal/gm

Protein 4 kcal/gm

Fat 9 kcal/gm

Alcohol 7 kcal/gm

Food labelFood label

Common Weight Loss MethodsCommon Weight Loss Methods

Attempts to lose the weightAttempts to lose the weight

Low 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

Setting the Record Straight: The Truth About Fad Diets

ObesityObesity

Over 50 percent of Americans are overweight.One in three adults is obese. Why?

Sedentary lifestylePoor food choicesObsession with dietingLack of time

The U.S. Diet IndustryThe U.S. Diet Industry

Almost $40 billion per year industry, includes:Diet booksDiet foodsDiet programsWeight-loss gimmicks

Do You Remember?Do You Remember?

1960 Drinking Man’s Diet Steak and Wine

1967 Dr. Stillman’s Diet1972 Dr. Atkin’s Diet1973 Richard Simmons

Fitness Guru1978 Scarsdale Diet1979 Pritikin Diet

1980 Beverly Hills Diet1981Cabbage Soup Diet1988 Optifast Liquid Diet1991 Protein Power1991Fen Phen Diet Pill1995 Enter the Zone1997 Fen Phen pulled from

market

Dr. Bob Arnot’sRevolutionary WeightControl Program

TheCabbageSoup Diet

Dr. Atkin’sNew DietRevolution

SugarBusters!

Enter the ZoneProtein Power

TheAnti-AgingZone

Fad diets: The ZoneFad diets: The Zone

Claim: Boost protein, cut carbs achieve peak athletic performance

Why you lose: very low calorieDownfall: few carbs can cause fatigue, weakness in

athlete and few fiber foodsMost useful tip: Choose low fat protein sources, Eat

several meals/snacks per day

Fad diet: Sugar BustersFad 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 zincDigestive downside: constipationMost useful tip: cut back on added sugar

Tips for evaluating fad dietsTips 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 DietHow to Recognize a Fad Diet

Is the author credible?

Diets that advocate:Magic or miracle foodsRapid weight loss/quick fixNo exerciseRigid menus, “good” vs. “bad” foods, specific food combinationsRecommendations based on a single study or studies

published without a peer reviewSounds too good to be true

Fad Diet Alert!Fad Diet Alert!

Steer clear of these claims:Fast, easy weight lossBreakthrough miracleBanish fatSecret formula, new discoveryCureBalances hormonesEnzymatic process

DIETS DON’T WORKDIETS DON’T WORK50% of Americans Diet Annually 50% of Americans Diet Annually

Average diet lasts 42 daysOnly 5 -10 percent maintain a significant weight loss

(= 10 percent or more of starting weight)No scientific data from commercial programsNo scientific data from any diet-book programsSome cause significant health problems

Source: John Foreyt, Baylor College of Medicine

Dieter Beware: Current Fad Dieter Beware: Current Fad DietsDiets

Enter the ZoneDr. Atkin’s Diet RevolutionProtein PowerDr. Arnot’s Revolutionary Weight Control ProgramSugar Busters!Eat 4 Your Blood Type

NO RESEARCH TO SUPPORT NO RESEARCH TO SUPPORT DIETSDIETS

All six diets reviewed:Lack ResearchUse testimonialsBase validity on opinions not factsLack any peer review

ENERGY 101ENERGY 101Calories are supplied by:

CarbohydratesFat Protein

Calories In > Calories Out = Weight Gain Calories In < Calories Out = Weight Loss

CARBOHYDRATESCARBOHYDRATES

Carbohydrate Intake Glucose + Insulin = Energy

Extra glucose: Glycogen storesFat stores

High Protein DietsHigh Protein DietsCommon ClaimsCommon Claims

Lose weight quicklyNever be hungryCarbohydrate intake creates:

Increased appetite Addiction to sugar High blood sugar Insulin resistance Increased body fat

INSULIN: A Closer LookINSULIN: 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 LookINSULIN: 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 RealityINSULIN: The Reality

10-25% of dieters are insulin resistantMost with insulin resistance are:

ObeseSedentary (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 DietsHigh Protein DietsThe Inefficient Energy MachineThe 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 = KetosisKetones in Blood = Ketosis Acidic waste from fat breakdown in the Acidic waste from fat breakdown in the

absence of carbohydrate.absence of carbohydrate. Ketosis:

DizzinessNauseaDecreased appetiteDehydrationElectrolyte Imbalance

LethargyBad Breath: acetone

evaporation in lungsBone Loss: Calcium

buffers changes in blood pH

High Protein Diets: A Closer High Protein Diets: A Closer LookLook

Low in calories; 1200 or lessHigh in protein / low in carbohydrateLow in vitamins, minerals, phytochemicals High in saturated fat and cholesterol Increased risk for:

• Cardiovascular disease• Cancer• Osteoporosis

High Protein DietsHigh Protein DietsCommon ClaimsCommon Claims

Lose weight quicklyNever be hungryCarbohydrate intake creates:

Increased appetite Addiction to sugar High blood sugar Insulin resistance Increased body fat

Dr. Bob Arnot’sRevolutionary WeightControl Program

TheCabbageSoup Diet

Dr. Atkin’sNew DietRevolution

SugarBusters!

Enter the ZoneProtein Power

TheAnti-AgingZone

Sugar Busters!Sugar Busters!H. Leighton Steward; Morrison C. Berthea, M.D.; H. Leighton Steward; Morrison C. Berthea, M.D.; Sam S. Andrews, M.D.; and Luis A. Balart, 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!Sugar Busters!H. Leighton Steward; Morrison C. Berthea, M.D.; H. Leighton Steward; Morrison C. Berthea, M.D.; Sam S. Andrews, M.D.; and Luis A. Balart, M.D.Sam S. Andrews, M.D.; and Luis A. Balart, M.D.

High Glycemic Index Foods:

CarrotsPotatoesBeetsPastaBread (refined flour)Rice (white)Fruit (must be eaten by itself)

Enter the ZoneEnter the ZoneBarry Sears, Ph.D.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 ZoneEnter the ZoneBarry Sears, Ph.D.Barry Sears, Ph.D.

Claims:Weight easy to lose on 40:30:30 planCarbohydrates 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 PowerProtein PowerMichael Eades, M.D. and Mary Eades, M.D.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 Dr. Bob Arnot’s Revolutionary Weight Control ProgramWeight Control ProgramRobert Arnot, M.D.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 Fad diet: Dr. Atkins Diet Revolution 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 RevolutionDr. Atkin’s New Diet RevolutionRobert AtkinsRobert 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 TypeEat 4 Your Blood TypePeter D’AdamoPeter 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 I’m Still Looking for the Magic!Magic!

Lifelong Healthy WeightLifelong Healthy Weight

Positive attitudeAre 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:Take an Honest Look: Why You Weigh what You Why You Weigh what You WeighWeighActivity: What and how much?Food: What and how much?Stress: Is food your answer to life’s problems?Physiologic and genetic make-upAge and health status

Here’s the Magic!!!Here’s the Magic!!! Eating for good health and Eating for good health and

eating to control weight are virtually eating to control weight are virtually the same.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 = Physical Activity = Success!Success!Choose something you enjoyCombined 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 PyramidFood Guide Pyramid

High Carbohydrate DietHigh Carbohydrate Diet

Increases intake of: FiberCalciumVitaminsMineralsAntioxidantsPhytochemicals

Lowers risk for:Heart DiseaseCancerOsteoporosisDiabetesHigh Blood Pressure

Diets that WorkDiets that Work

Weight Watchers Intuitive 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

Lifestyle ChangeLifestyle Change

Be realistic - Small changes over timeBe adventurous - Expand your tastesBe flexible - Balance food and activity over several

daysBe sensible - Enjoy all food in moderationBe active - Walk the dog, don’t just watch the dog walk

The Student DietThe Student Diet

Problems with student dietProblems with student diet

Study long hoursNo time to cook healthy mealsDo not have time to grocery shopEasier to eat out or drive thruVery little exercise= Sedentary lifestyle

Eating outEating out

1 of 3 mealsDrinks: High kcalAppetizer: 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 BeveragesAlcoholic 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 How to eat out sensibly

Avoid all-you-can eat buffetsChoose baked or grilledAvoid white or cheese

saucesAsk for dressing or

condiments on the sideRequest a take-home

container

Look for light or heart healthy menu

Order calorie free beveragesWatch for key words

signaling high kcal: Fried, creamed, pan-fried,

sautéed, alfredo, or gravy

Caffeine and CalciumCaffeine 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 homeIdeas at home

Prepare meals and freezeGo in with a friendDon’t keep trigger foods in the houseAlways eat at the tableSlow down

Myths about dietingMyths about dieting

Eating late at night is sure to pack on the pounds

You can lose weight by eating fewer calories

Never have secondsDeny cravings; they are all in

your head

Don’t eat between mealsEating breakfast makes you

hungry all dayTo lose weight, become a

vegetarianYou can eat anything you

want as long as it is fat free

Tips for successTips for success

Regular exercisePermanent changesAvoid skipping mealsDo not eat while

studying/watching t.vEat only when hungry

Do not use food as a rewardDrink only calorie-free

beveragesDo not grocery shop when

hungryNO fad dietsChoose a variety of foods

GoalsGoals

Decrease Regular soda intake

Decrease caffeineLimit meat servings Increase fruits/vegetables

fiber

Increase calciumMultivitamin

Healthy snacks when you have Healthy snacks when you have the munchiesthe munchies

Fresh, frozen, canned fruitLight or low fat yogurtString cheeseLow fat cheese and wheat

crackersVanilla wafers & skim milk

Baked chipsLow fat popcornSugar free hard candyFrozen fruit bars