Tuesday, December 31, 2002

Nutrition experts size up the top diets
They rate five of the most popular winners and losers

By D. PARVAZ
SEATTLE POST-INTELLIGENCER REPORTER

Hey! Put that Krispy Kreme down! We said . . . Put. That. Krispy. Kreme. Down.

Don't you know it's the season of New Year's resolutions? Promises to the self to abstain from unhealthy behavior and to be a better person? Or maybe lose a few pounds and eat healthy? Or heck, maybe just try not to gain another five pounds this year?
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Easier said than done, no doubt, especially once you brush the doughnut crumbs off the front of your shirt and take a stroll down the diet and fitness aisle of your neighborhood bookstore.

One book tells you to eat fat, the other says fat will kill you. One says to cut back on carbohydrates, the other says carbs are the only way to go.

We thought we'd take a look at five of the most popular diets (not the craziest ones -- you won't read about colonics and blood types here), take a look at who is doing them and what the experts think. Although all these diets vary in ways great and small, it's worth noting that they all stress the importance of exercise, so no tossing out the exercise bike with the doughnuts.

Dr. Adam Drewnowski, director of nutritional sciences at the University of Washington, and registered dietician Kathleen Mahan, author and personal nutritionist at Seattle's Nutrition By Design, weigh in on a handful of the most popular diets.

For the record, both believe that simply eating less and moving more will do the trick. But they're willing to indulge us here.

"The Carbohydrate Addict's Diet" by Dr. Rachael F. Heller and Dr. Richard F. Heller (Signet, 322 pages, $7.99)

Who's doing it: Oprah Winfrey.

Promises, promises: Weight loss, fewer mood swings and more energy.

The scoop: That some overweight people release too much insulin after eating high-carb meals. This increases the appetite, resulting in overeating. The idea is to eat fewer carbs at two meals and have one "reward" meal each day.

What's cool is that this is one of the few low-carb diets vegetarians can follow (tofu is accepted with open arms!).

The poop: Starches are bad, and even seemingly innocuous vegetables like broccoli and carrots are considered naughty foods and are to be consumed in moderation. What is this world coming to? Furthermore, there's no snacking at all between meals. And you have to eat your reward meal within one hour (so no splitting up that bowl of popcorn!)

Perfect for you if: You want to have your (flourless) cake and eat it too -- during your 60-minute reward meal window.

Expert opinion: Drewnowski -- First off, he said there's no way you can talk people into using up their reward meal with broccoli and such.

"You really think that's going to work?" he asked, laughing.

Even if it did, he said, basing a diet on the glycemic index (the rate at which your body converts a food into sugar) is a bad idea for two reasons.

"Number one, the glycemic index of bread and boiled carrots is higher than a Snickers bar," said Drewnowski, explaining that the fat in the Snickers bar lowers its glycemic index.

"Number two, if you eat a whole meal and everything gets all mixed up . . . the glycemic index of the whole meal will not equal the sum of its parts."

In other words, it's impossible for the average person to calculate the glycemic index of a meal. And anyway, Drewnowski said there's no scientific explanation for why high insulin levels would cause us to crave specific types of carbohydrates.

Even so, there's something to this idea of carbohydrate addiction.

"Sugar/fat mixtures, yes, these are the foods that lots of people have trouble with, interestingly enough, mostly women," Drewnowski said. Chocolate, cake and ice cream always show up on the list of foods women crave. And while chocolate does show up on the list of male cravings, they generally struggle more with protein, salt and fat mixtures -- hamburgers, pizza, meatloaf, that sort of thing. Ice cream also shows on the men's list. Male and female rats indicate similar preferences, so don't go blaming societal gender roles for this stuff.

Mahan -- "The reason that so many of us are overweight in this county is that we're living the good life and what's getting us fat is not what we're eating but how much we're eating," said Mahan, adding that this diet, like all others, is merely using a gimmick to help us eat less.

"The advantage of it is that it doesn't take things away from people. In other words, they know they can have their carbohydrates during a certain period of time in a day," said Mahan.

"The disadvantage is that I think with eating all the carbs in a short period of time, your body is going to have to release a lot insulin to deal with it."

"Eat More, Weigh Less" by Dr. Dean Ornish (Quill, 448 pages, $15)

Who's doing it: Well, no one famous has made a point of endorsing it, but the Swedish Medical Center's Heart Institute offers a Dean Ornish Program for Reversing Heart Disease. How 'bout that?

Promises, promises: Ornish says a vegetarian (or near vegetarian) diet low in fats and high in complex carbs can reverse prostate cancer, shrink tumors and help maintain a healthy weight.

The scoop: Ornish doesn't see his diet as one of deprivation -- he touts complex carbohydrates, beans and legumes, fruits and vegetables. Fats (nuts, seeds, meats, oils) are out, as are dairy products, eggs, sugars, honey, white flour, salt, white rice and alcohol. Even non-fat dairy products and low-fat processed foods are to be eaten in moderation. You are encouraged to meditate.

The poop: One gin martini with a couple of olives and you've blown the whole thing!

Perfect for you if: You derive sustenance from your own self-righteousness.

Expert opinion: Drewnowski -- "I think it's lucky that Dean Ornish combines his diet with meditation and prayer because that will help -- it's not a very tasty diet."

"It's a rigorous, puritan, joyless diet," said Drewnowski. That said, he adds that "over-fed males of 50" with high cholesterol levels and other cardiac issues will benefit from Ornish's diet.

"This is a clinical intervention type diet which is fine if you are a cardiac patient . . . but it's not nutritionally balanced for a growing adolescent, a pregnant woman or a healthy, active adult."

Mahan -- "The problem with that diet is that it's so restrictive in fat that it causes you to restrict even good fats," says Mahan. "Not only is fat essential in the body, but the fats available in olive oil and avocados and nuts are good for you. You need more than 10 percent of fat in your diet -- not saturated fat, but the good fats."

But Mahan gives the thumbs up to Ornish's holistic approach to health. "He's talking more about healing the heart and the spiritual aspects of heart disease, not just the physical disease," says Mahan, adding that Ornish's diet, in general, is "the one approach that's actually been shown to reverse plaque buildup in the arteries."

"The Macrobiotic Way" by Michio Kushi (Avery, 251 pages, $12.95)

Who's doing it: Madonna, Gwyneth Paltrow and ex-Spice Girl Geri Halliwell.

Promises, promises: High in fiber, the diet is supposed to prevent colon cancer.

The scoop: The macrobiotic diet is based on eating whole foods (as opposed to processed foods, heavy on preservatives and additives), organic grains as well as leafy, root, ground and sea vegetables. It's the more manageable cousin to the raw food diet, in which nothing is heated to more than 116 degrees (devotees include Donna Karan and Demi Moore). Kushi recommends a diet of 50 to 60 percent whole cereal grains, 5 to 10 percent soups, 20 to 30 percent vegetables and 5 to 10 percent beans and sea vegetables (a variety of seaweed).

The poop: The no-no list is long: No dairy, red meat, poultry, cane or beet sugar, salmon, mackerel, tuna, swordfish, ginseng, commercial soy sauces and salt, mayonnaise, cashews, Brazil nuts, avocados, dates, figs, lemons, limes, oranges, mangoes, pineapple, hard liquor, wine, black tea, coffee, soda, tap water . . . plus there are specific ways to cook everything -- pressure-cooking, picking and water-sautéing among them.

Perfect for you if: You have a personal chef or have nothing better to do than fret over your next meal.

Expert opinion: Drewnowski -- "I like the soup component. But this diet would be extremely well-suited to cattle, except they have three more stomachs -- you have one," he said, referring to the high volume of grains and our difficulty in digesting them properly.

"And there's a problem with flatulence -- you don't want to be in the same room as someone on this diet."

On a more serious level, Drewnowski worried that someone on this diet is looking for something more than a nutritionally balanced diet.

"To some extent, this is not a diet, this is a monastic way of life. The people who adopt this don't do it for nutrition purposes, but for psychological reasons. They need the discipline to get on with their life," said Drewnowski, adding that seeking this sort of diet might be a symptom of an eating disorder.

"Diana Vreeland said that elegance is refusal . . . the macrobiotic diet is basically about refusal."

Mahan -- "The advantage of it is that it's so tremendously high in vegetables which are high in phytonutrients (antioxidants that stimulate the immune system) and they protect the body against oxidation," said Mahan, explaining that cells are damaged when exposed to oxygen and to free radicals (think of oxygen interacting with iron, causing it to rust).

But the diet does have its drawbacks. "It strikes me as being awfully boring, and . . . it's going to be deficient in calcium, so either you're going to have to take a supplement or you'll have to be sure to eat enough spinach. Even then, I'm not sure you could get enough."

"Enter the Zone" by Barry Sears (Harper Collins, 328 pages, $25).

Who's doing it: Jennifer Aniston, Brad Pitt, Renée Zellweger, Sandra Bullock . . . the list goes on and on.

Promises, promises: Lose weight, live longer, be fertile and pain free!

The scoop: Eat a diet consisting of 40 percent carbohydrates (veggies, not bread and pasta), 30 percent fat (the good stuff, like olive oil) and 30 percent protein (lean meats and fish) at every meal. Eat up to six meals a day rather than gorging on larger portions.

The poop: The only grain allowed is slow-cooked oatmeal (say goodbye to bread, breadsticks and breadcrumbs). Also, figuring out percentages of this and that at every meal is very tedious, and the portions are small. But compared to the macrobiotic diet, the Zone is wild and crazy in terms of what it allows you to eat.

Perfect for you if: You have time to plan your meals well ahead of time or are rich enough to have Zone meals delivered to you. (A local company called ZoneSeattle has been doing just that since August. For more information: 206-236-9663, 1-866-317-9663 or www.the-zone-diet.com.)

Expert opinion: Mahan -- "It's very popular, and that's because it's reasonable. I really think the Zone diet and that approach is a good one," said Mahan. Combining carbs, proteins and fats like the Zone causes a "lower and slower release of insulin," which she says causes less fat depositing and more fat burning.

The Zone is also good because "it forces people to look at the protein content in their diet -- and most people eat way too many carbs."

Adding a little fat to every meal balances out the meal, keeping us satisfied longer because fat stays in the stomach the longest. But, she cautioned that you can still go wrong.

"One of the problems is that you can still get too many calories -- it's not just proportion but portion control."

Drewnowski -- This is essentially a sane and balanced diet, said Drewnowski, if a little expensive.

"It's a very doable diet, but you cut out the cheap beans and grains, and your frisee lettuce and your arugula cost more," he said, adding that this is basically a diet for the upper-middle class. "But there's nothing wrong with it, nutritionally."

"Dr. Atkins' New Diet Revolution" by Dr. Robert C. Atkins (Harper Collins, 540 pages, $13.95)

Who's doing it: Dennis Franz, Al Gore, Catherine Zeta-Jones.

Promises, promises: Lose weight, burn fat, reverse Type II diabetes, and never feel hungry or deprived.

The scoop: Developed by Atkins in 1972, the diet gives you license to eat cheese, meat, eggs and, well, mostly cheese, meat and eggs. Atkins maintains that consuming sugars and other carbohydrates inhibits the body from burning fat. By depriving your body of carbs, you force it into ketosis -- the burning of stored fat.

The poop: Oh, the nasty breath that ketosis business can cause. And the diet is high in animal fat, which can be tough on the kidneys. Speaking of animals, and their fat, this diet is not doable for vegetarians. But most importantly, ask yourself: Is life without pain au chocolat worth living?

Perfect for you if: You were a Tyrannosaurus rex in a past life and have little use for vegetables.

Expert opinion: Drewnowski -- "He exaggerates the amount of fat that you can eat," said Drewnowski, pointing out that the Atkins diet includes about five time the amount of cholesterol recommended for a healthy diet.

"It has the potential to increase your cholesterol, but if you lose weight, your cholesterol could drop, so it could balance out. At what point things balance out, I don't know. There's not enough research on that," said Drewnowski, adding that whether you're talking about fats, proteins or carbs, at the end of the day, it's the calories that matter.

"The idea is that this works through reducing caloric intake through eating nothing but proteins and fat," he said, referring to the fact that proteins and fats are more filling than most carbohydrates.

"It's not what you eat, it's how much you eat."

However, adding carbs to proteins generally makes them taste better, leading us to eat more of them.

"Bitter chocolate is fat -- there's no sugar, so when you eat bitter chocolate, you're eating fat, not sugar and you don't eat so much. But the second you add sugar to it, you can eat it like bread."

Mahan -- "People do lose weight on it, and a recent study has shown that people's cholesterol doesn't go up."

She added that the diet is good because it makes people focus on the amount of protein in their diet, but ultimately, she would recommend that Atkins followers focus on lean proteins rather than steaks and full-fat cheeses.

"The fact is that people eat high-fat pork rinds -- they sell them in nine different flavors -- and the reason is the Atkins diet, because they are carbohydrate free!"

P-I reporter D. Parvaz can be reached at 206-448-8095 or dparvaz~seattlepi.com

http://seattlepi.nwsource.com/health/102063_diets.shtml