Be vigilant. The food industry is out to exploit your weaknesses and destroy your defenses. You need to be smart to avoid their traps.
Keep it simple. Here’s a truism from animal research: Rats fed “rat chow” or monkeys fed “monkey chow” don’t weigh as much as animals that get to pick from a variety of foods. The same is probably true for humans. Think back to the last time you wandered through a cafeteria with great choices and you’ll probably picture a tray piled with more food than you usually eat. There’s no question that we need variety in our diets. Different foods offer different nutrients that are essential for good health. At each meal, though, simplicity may be a better strategy. You’ll probably eat less if your entire meal is a chicken dish and vegetables than if you prepare several tempting recipes. Such simplification runs counter to trends in the marketplace, as the food industry offers an ever-growing and ever-beguiling variety of foods. But it may help reverse the ever-expanding trend of your waistline.
Beware of liquid calories. Sugary sodas and fruit drinks can be a big source of invisible extra calories that you can easily cut from your diet. A small glass of juice in the morning is perfectly good for you. It offers a refreshing way to start the day and provides some vitamins and minerals. But drinking juice throughout the day can add hundreds of extra calories. Keep in mind that you would have to eat two or three oranges to get the same number of calories as you do from a glass of orange juice. Sugar-sweetened soda is worse because it gives you nothing but calories.
Make healthy cooking or eating a social activity. Your social life influences what and how much you eat. Invite your friends to prepare a healthy meal together—trying some of the recipes in this book can provide a reason to get together—or join a group already organized for this purpose. Weight Watchers has created a major industry around the use of social support and interactions to improve eating habits.
Weight control isn’t impossible, nor does it need to mean deprivation or a boring, repetitious diet. With conscious effort and creativity, most people can successfully control their weight over the long term with an enjoyable but reasonable diet and near daily exercise.
THE SKINNY ON POPULAR DIETS
Legend has it that King Arthur and his Knights of the Round Table searched fruitlessly for the Holy Grail. Today, millions of people are looking for its dietary equivalent: the one true combination of foods that will help them lose weight or stay healthy. Like Arthur, most search in vain. They are led astray by empty promises from dueling diet books and conflicting nutrition news. They try diets that work for a few weeks, then stop working, or ones that don’t work at all. They end up frustrated—and still overweight.
Disappointment with diets shouldn’t come as a surprise. Part of the problem is the notion that there’s a single diet that is right for everyone or that a diet that worked for a friend will work for you—ideas as mythical as the Grail. Genes, family, friends, the environment, and many other factors influence how, why, what, and how much you eat. A bigger problem is that anyone can cook up a diet. You don’t have to know anything about medicine, nutrition, or even physiology. All you need is an idea and the chutzpah to promote and sell it.
The graveyard of fad diets stands in silent testimony to their design flaws. Remember the cabbage soup diet, which claimed that the more cabbage soup you ate, the more weight you would lose? How about the rigid Scarsdale diet, which promised 1-pound-per-day weight loss by limiting daily intake to about 1,000 calories a day with the help of specified amounts of fruits, vegetables, and mostly lean sources of protein? The list goes on: the Hollywood 48-Hour Miracle Diet, the grapefruit diet, the Subway diet, the Russian Air Force diet, the apple cider vinegar diet, a host of forgettable celebrity diets, and countless others.
The fact is, almost any diet will work—at least for a short time—if it helps you take in fewer calories. Diets do this in two basic ways:
• defining “good” foods you should eat (like the grapefruit diet) and “bad” ones to avoid (think low fat or no carbs)
• changing how you behave and the ways you think or feel about food.
Most restrictive diets come with the seeds of failure planted and already germinating. Hunger from eating less, not to mention cutting back on common or once-favorite foods or giving them up altogether, creates cravings that can lead to “cheating.” This can trigger feelings of failure and hopelessness. These, in turn, undermine the effort and enthusiasm needed to stick with a diet.
Weight loss is only one spoke in the wheel of good health. You could put yourself on a hot dog diet and almost certainly lose weight. But it won’t last or be good for you in the long run. What’s really needed is a plan you can sustain for years. It should be as good for your heart, bones, brain, colon, and psyche as it is for your waistline. Its hallmarks should be plenty of choices, few restrictions, and few “special” foods—exactly what I recommend in this book.
How do current diets measure up using this yardstick? Let’s take a look at a few popular ones.
LOW-FAT DIETS
The two key ideas behind low-fat diets are: fat makes you fat and fat is bad for the heart. Neither of these is accurate.
One of the best-known low-fat diets is Dr. Dean Ornish’s Eat More, Weigh Less plan. The “eat more” idea comes from the fact that fat contains 9 calories per gram while carbohydrates contain 4 calories. By switching from fatty foods to carbohydrate-rich ones, especially fruits and vegetables, you can double your food intake without taking in more calories.
The Ornish plan got a boost from a small study that Dr. Ornish conducted among forty-eight men and women with heart disease.24 It showed that a very-low-fat vegetarian, whole-grain diet, along with exercise, stress management, and group support, reduced the narrowing of blood vessels in the heart better than less intensive changes. The improvement could have come from the low-fat diet. It could also have come from the other changes.
Keep in mind that “doing Ornish” means forgoing refined grains in favor of whole grains. It also means exercising. Eating carbohydrates without exercising can increase triglycerides and decrease protective HDL cholesterol, neither of which is good for the heart. Reducing stress is another essential part of the program.
There is no question that following a low-fat diet can aid weight loss, at least for the short term. Some people manage to stick with such a diet for the long haul. But that takes real commitment. Why? A low-fat diet tends to be less flavorful than other eating strategies and more restrictive about food choices, especially when dining out. It can also leave you feeling hungry, one reason why low-fat diets usually call for high-fiber foods that increase the sensation of fullness as well as between-meal snacks.
The reputation of low-fat diets as being good for the heart is a holdover from a time when many experts believed that all fats were bad for the heart. This belief has faded in light of findings that unsaturated fats can improve cholesterol levels, reduce blood pressure, and snuff out potentially deadly heart rhythm disturbances.
Bottom line: Some people lose weight and keep it off with a low-fat diet. Others lose weight then put it back on, or don’t lose weight at all. On average, most people do worse over the long run on low-fat diets than on higher-fat diets (see “A Low-Carb Diet May Help” on page 53).25 It can be difficult to stick with a low-fat diet for a long time because fats make food taste good and a low-fat diet limits the number and types of food you can eat. If you decide to follow a low-fat diet, choose intact or whole grains, fruits, vegetables, beans, and other slowly digested carbohydrate-rich foods.
LOW-CARB DIETS
In the 1990s, carbohydrates began to replace fats as the great dietary demon. Thanks to Dr. Robert Atkins (Dr. Atkins’ Diet Revolution) and Dr. Arthur Agatston (The South Beach Diet), millions of Americans gave up bread, pasta, rice, and other carbohydrate unmentionables in their quest to lose weight. The more recent Wheat Belly diet books (by Dr. William Davis and others), Grain Brain (by Dr. David Perlmutter), and The Dukan Diet (b
y Dr. Pierre Dukan) have continued to fuel the anti-carb fires.
Low-carb diets tend to be better than low-fat diets at helping people lose weight. The main issue with them is what to eat in place of carbohydrates. Many people choose hamburger, steak, and sausage. These deliver a lot of saturated fat, which can counterbalance the metabolic benefits of reducing carbohydrate intake. High-protein and high-fat options based on plant foods, such as beans, soy, nuts, and liquid plant oils, are better choices, and fish and poultry are fine to include.
Shying away from whole grains, fruits, and vegetables can lead to low intake of fiber, healthy fats, vitamins, and minerals—deficits that supplements can’t possibly overcome. In the Nurses’ Health Study, the lowest risk of heart disease and diabetes was in women with diets lower in carbohydrates and higher in protein and fat from plant sources—good to keep in mind if planning to try a low-carbohydrate diet for weight control.26
Bottom line: A low-carb diet works for some people, helping them shed pounds faster than a low-fat diet and possibly keeping off the weight for longer. Low-carb diets can be expensive: following the portion sizes and ingredients in the Atkins and South Beach diets can nearly double your average grocery bill. A lower-carb diet based largely on plant sources of protein and fat can be gentler on your household budget.
RIGHT-CARB DIETS
Instead of banning carbohydrates, diets such as the Glucose Revolution, Wheat Belly, and Sugar Busters! embrace “correct” carbohydrates while shunning “harmful” ones. This means eating plenty of fruits, vegetables, and whole grains (no wheat in the case of the Wheat Belly diet) and cutting way back on refined sugars (white sugar, high-fructose corn syrup, honey, molasses, etc.) and processed grains.
Right-carb diets rely heavily on the glycemic index and glycemic load (see pages 118–122). These measure how strongly a particular food boosts blood sugar and insulin levels. Right-carb diets focus on foods that make blood sugar and insulin levels rise slowly. These foods include whole grains, beans, vegetables, and fruits. In theory, foods with a low glycemic index, which generate small but steady increases in blood sugar, help stave off hunger, while foods with a high glycemic index cause large but fleeting increases that quickly ring your internal hunger alarm. There isn’t enough solid research to confirm the effectiveness of right-carb diets for weight control. A six-month trial showed that lowering the glycemic index offers modest benefits for weight loss.27 It would be quite useful for a research team to mount a large two-year trial examining the effect of a lower glycemic diet on weight control.
Bottom line: In general, right-carb diets promote healthy eating by focusing on fruits, vegetables, and intact whole grains. Their reliance on the glycemic index can overly complicate choosing what to eat, especially when dining out. Diets that completely prohibit refined sugars also make dieting and healthy eating unnecessarily complex. Cutting back on foods made with refined carbohydrates and added sugars certainly makes sense.
Traditional Mediterranean diets have a relatively low impact on blood sugar because they use plenty of fruits and vegetables, are relatively high in healthy fats, and are relatively low in easily digested carbohydrates. So do diets like these that are in line with Harvard’s Healthy Eating Pyramid and Healthy Eating Plate (see pages 16, 19). Their benefit on weigh control likely comes from multiple factors, including low glycemic effects.
PERFECT PROPORTIONS AND CORRECT COMBINATIONS
Several popular diets are based on the notion that specific proportions of nutrients or certain combinations of foods are essential to weight loss.
According to the Zone diet, for example, achieving the right balance of carbohydrates, proteins, and fats at every snack and meal creates a hormonal balance that will lead to weight loss, improved energy, and other health benefits. You reach “the Zone” by creating meals and snacks that contain 9 grams of carbohydrate for every 7 grams of protein and 1.5 grams of fat (40 percent carbohydrate, 30 percent fat, and 30 percent protein). This might result in a healthy diet, but it might not; it depends on the sources of carbohydrate, protein, and fat. What’s more, there is little evidence that such a rigid approach to eating is necessary or even helpful for weight loss. This approach makes it difficult to eat with family members not on the program, or to dine out. But if you like structure and rules, then the Zone might be right for you.
The Eat Right 4 Your Type diet takes an odd and even less scientific tack: that your blood type determines what you should eat (not to mention how you should exercise, what supplements you need, and what type of personality you have). According to this plan, people with type O blood need a high-protein, low-carb diet that’s light on wheat and beans, while those with type A blood need a high-protein, low-carb diet that contains plenty of fish and beans but steers clear of red meat, dairy foods, and wheat. Following this diet means remembering a lot of detailed information, including lists of good and bad foods for your blood type—and the blood types of your family. It isn’t a balanced diet that gives you all the nutrients you need—something you can tell from the long list of recommended supplements. And it certainly isn’t family friendly: most families encompass more than one blood type, which means different meals for different family members.
Bottom line: Exact proportions or specific food combinations may help you lose weight. Any success is almost certainly because such diets force you to focus on what you are eating and to eat less each day, not because of any nutritional or physiological secret the diet developers have uncovered. Their long-term health effects have not been studied.
WHAT ABOUT ENERGY DENSITY?
Another approach to losing weight takes aim at energy density, the concentration of calories in each portion of food (see “Energy Density Isn’t a Reliable Guide” on page 55). The Volumetrics Weight-Control Plan tries to manipulate satiety, the body’s signals that it has gotten enough food by recommending foods that fill the belly without adding too many calories. These tend to be water-rich foods such as fruits, vegetables, low-fat milk, cooked grains, beans, lean meats, poultry, and fish. Soups, stews, casseroles, pasta with vegetables, and fruit-based desserts get the thumbs-up, while high-fat foods like potato chips and dry, calorie-dense ones like pretzels, crackers, and fat-free cookies get the thumbs-down.
Bottom line: The strategy of eating foods that fill you up without delivering many calories probably helps people lose weight the same way most other diets do: it narrows your choices so you take in fewer calories each day. Although the Volumetrics idea is appealing, and many of the foods included would be part of a healthy diet, it is much too simplistic. For example, a can of Coca-Cola has a low energy density but it contributes plenty of calories that do little to fill you up or delay hunger. White bread made from highly processed wheat that has been stripped of many vitamins, minerals, and fiber has low energy density, while a high-fiber crisp bread has high energy density. But the energy density concept doesn’t take into account how rapidly a food is digested and absorbed, which can have a big impact on the return of hunger.
EAT LIKE IT’S 100,000 B.C.
“Paleo” diets are a relatively new entry into the diet scene. They encourage you to eat as your Paleolithic ancestors did, thousands of years before the advent of agriculture. Following a paleo diet means eating anything that an early human could have found or hunted down—greens, root vegetables, berries and fruits, nuts, seeds, meat, birds, and fish—and staying away from processed grains, milk and dairy foods, refined sugar, processed foods and oils, and salt.
A diet that keeps you away from refined grains, sugar, and processed foods is a step in the right direction toward healthy eating. However, a “hunter” paleo approach that recommends you eat a lot of red meat isn’t good for your long-term health or the health of the planet (see chapter twelve). If everyone tried to eat such a diet, most of the earth’s 7.5 billion inhabitants would go hungry: it takes so much land and energy to produce meat that it would be impossible to feed even a billion earthlings on a paleo diet.
BEHAVIOR CHANGE
Some weight-loss strategies focus as much on how, why, and when you eat as on what you eat. The attention isn’t entirely misplaced. Some people use food for comfort. They overeat because they are sad, lonely, frustrated, nervous, bored, depressed, or due to any number of other triggers. Breaking an unhealthy relationship with food can help such individuals lose weight.
Bottom line: There is no question that habits, behaviors, and relationships with other people and with food influence the ability to lose weight or maintain a steady weight. Some people can benefit from recognizing these issues and getting counseling for these underlying problems. But not all overweight people have dysfunctional habits or relationships. The truth is, everyone, overweight or not, needs to watch what and how much they eat and to exercise.
THE EVIDENCE ON DIETS
Although the glut of unsubstantiated diet plans shows no signs of abating, we have learned quite a bit over the last fifteen years about strategies for weight control. Two things we know for sure about weight-loss diets:
• Almost any type of diet works for a while.
• No single diet works for everyone.
As mentioned earlier, anyone can concoct and peddle a diet. No laws mandate that it be tested first. Some diet promoters try their plans on themselves, their families, and their friends. Those who lose weight become the success stories hyped in the books. But in most cases there’s no hard-nosed evaluation of what percentage of people who start the diet stick with it or how many lose weight and keep it off.
Eat, Drink, and Be Healthy Page 9