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
Calories cause weight gain

•  If you consume more calories than you expend

you will begin to gain weight

American
Diete4c
Associa4on
at
ww.eatright.org
2009

Myth or Fact

Occasionally following a fad

diet is a safe way to quickly
lose weight
Myth
• Many creators of these fad diets do not have
scientific background

• Some fad diets can be harmful to those with

certain health problems

• 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?
 Promises of rapid weight loss
 Easy to follow plans
 Diets include many palatable foods
 Physical 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 CHO diets. Nordmann AJ et al. (2006) Arch
Intern Med 166: 285–29.
• Possible mechanisms:
• Diuresis
• Mobilzation of glycogen stores
• Circulating ketone bodies
• Satiating effects of protein
• Use of protein more energetically costly
• Not enough evidence
  Atkins Diet
The Premise:
Severe restriction of dietary carbohydrate
(<20% of daily caloric intake), with its
resulting ketosis, promotes lipid
oxidation, satiety, and increased energy
expenditure, factors that should promote
negative energy balance and weight loss

Carbohydrate intake creates:

• High blood sugar
• Insulin resistance
• Increased body fat
Atkins R, Dr. Atkins’ New Diet Revolution. 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 more healthy version of the Atkins Diet

that’s backed by solid evidence on fats
and heart disease

The good: Doesn’t leave out any food

groups

The bad: The first phase is much like the

Atkins diet, very restrictive on CHO.

Restricts some fruits and vegetables such

as carrots.
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
o The Master Cleanse, also known as
“The Lemonade Diet”
o The Juice Diet
o The Water Fast
http://vids.myspace.com/index.cfm?fuseaction=vids.individual&videoid=6518245
 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

“You can lose weight on virtually any diet, if you eat less, you will
lose weight. The question is, can you maintain a healthy lifestyle over
the long term – your life? The real key to reaching long-term goals is
to focus on your overall health.”
-Roberta Anding, registered dietitian and ADA spokesperson
 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_HTML.htm. Accessed September 26, 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 Detox Diets.
Today’s Dietitian. 2008; 34-38
5.  Picco M. 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.