Lenore S. Greenstein: Why fad diets do, or don't , work

Tuesday, October 1, 2002

By LENORE S. GREENSTEIN, Special to the Daily News

The most common question I am asked still revolves around fad diets, and whether I approve of the Atkins plan and similar high-protein diets. Although I have written many times in the past about the dangers as well as limited efficacy of such quick roads to weight loss, the advocates of these programs are both vocal and vociferous.

Instead of listing all of my reasons not to engage in this, or any kind of dietary plan that restricts healthy food and important nutrients, I would like to quote many responses by esteemed researchers and health professionals.

In the New York Times recently, an article entitled "Stop Blaming Carbohydrates Or Fat, And Start Counting Calories," the author stated that the Atkins diet helped people lose weight because "If you cannot eat bread, bagels, cake, cookies, ice cream, candy, crackers, muffins, sugary soft drinks, pasta, rice, most fruits and many vegetables, you will almost certainly consume fewer calories. Any diet will result in weight loss if it eliminates calories that previously were overconsumed. This diet seems easy because it places no limits on the amounts of meats, fats, eggs, cheese and the like you can eat. These foods digest slowly, making you feel satisfied longer. Also, a diet without carbohydrates causes the body to make substances called ketones that may create a mild nausea, suppressing hunger."

A panel of 21 researchers from The Institute of Medicine of the National Academies of Science recently emphasized the importance of a balance of nutrients, with carbohydrates — starches and sugars — making up 45 to 65 percent of daily calories, while fats should only account for 20 to 35 percent. They also urged Americans to keep their consumption of saturated fats as low as possible. These saturated fats come from meats and full-fat dairy products, which are just the foods Atkins recommends as his diet's main components. With so few carbohydrates, the weight initially comes off in the form of body water, which accounts for the first 5 to 10 pounds of weight loss. After that, the going is much slower, and as soon as those missing carbohydrates are added back, so are some of the pounds.

In a study by Dr. Chia-Ying Wang at the University of Texas Southwestern Medical Center in Dallas, reported last August in The American Journal of Kidney Diseases, just six weeks of a low-carbohydrate, high-protein diet greatly increased the risk of developing kidney stones. "This study shows that this is not a healthy way to lose weight," Wang said.

In truth, the Atkins Diet has yet to be tested for its long-term safety and effectiveness. One reason that was cited for lack of government testing is because this type of high-fat-high protein diet is unlikely to be approved by any review committee. There are already many studies on the negative effects of animal fats and cholesterol on the risk of heart disease, strokes and some cancers. I have often cited evidence that diets unlike Atkins, which are rich in fruits and vegetables and moderate in protein and fat, can help prevent diseases like high blood pressure, prostate cancer, heart disease and diabetes.

The Atkins diet is also low in vital nutrients, including the B vitamins and vitamins A, C and D, antioxidants that slow the effects of aging. Calcium is also missing, and a diet rich in animal protein can draw calcium from the bones, increasing the risk of osteoporosis and hip fractures.

At the end of the day it is still calories that count. Eat more calories than you expend and you are sure to gain weight. A well-balanced dietary plan that includes a variety of foods, and has less calories taken in than calories out (or expended in physical activity), is the best way to ensure a slow but steady weight loss. The bottom line is always the same - cut calories or increase physical activity to achieve that equation, and you will be successful in dropping those extra pounds for good.

Lenore S. Greenstein is a registered and licensed dietitian in private practice in the Naples area, and can be reached online at naplesnutrition~aol.com


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