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Scientists Weighing The Worth Of Diets
Cycle goes 'round, and we get rounder
By Rosie Mestel, LOS ANGELES TIMES, January 13, 2004
Dieting has consumed Americans for more than a century, even as the collective girth of the nation has increased and a steady stream of dieting books has rolled off the presses: Scarsdale, Beverly Hills, Zone, South Beach, and on and on. Like a circle in a spiral, diet fads have come and gone, then come back again - sometimes with new frills and usually with more sophisticated marketing, but often barely changed.
The high-protein diet (currently incarnated as the Atkins diet) has risen phoenix-like from the ashes at least half a dozen times.
Restricted-food diets have had endless reiterations, be they focused on lollipops, grapes, Brussels sprouts or beef.
And the importance of proper food combining has often been stressed: Proteins and carbohydrates should never be eaten together; melons should always be eaten alone; lamb chops should be paired with pineapples for powerful, pound-burning potency.
Only recently have scientists begun trying to figure out which diets work. Low-carbohydrate, high-protein diets are receiving much of the attention, along with the low-fat diet espoused by such mainstream organizations as the American Heart Association.
The need to determine the effectiveness of the diets has become more pressing as American obesity rates rise, and Type 2 diabetes - once an obesity-associated disease of adulthood - is increasingly being diagnosed in children.
There is no mystery behind the endless carousel of quick-fix solutions, experts say, just a list of mundane causes.
Americans live in a land bursting with food, inside bodies biologically designed to pack on pounds in times of plenty and conserve energy in times of want (i.e., when we're dieting). Weight-gain has never been easier.
Dieting is hard. Obesity treatments usually yield only modest weight loss - 5 percent of a person's starting weight.
Keeping weight off is harder still. So it's easy to see why there will always be an appetite for more books, more plans, more promises.
Some scientists even believe that the act of repeated dieting contributes directly to a lifetime of weight problems, by molding the mind to be fixated on food.
It's trickier to figure out how to stop the carousel. "Every single time, people have felt, 'Finally, this is the answer, this is the diet that's going to solve the problem.' And none ever do," says James Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver.
Sporadic, documented cases of dieting stretch back 1,000 years or more. But in America, dieting only took off with a vengeance at the end of the 19th century.
The stage was set by the early 1800s. Americans were bolting their food in great quantities. (As a consequence of this new nutrition, they were several inches taller than Europeans. Foreigners were apt to exclaim at the size, frequency and speed of American meals; one Russian visitor likened Americans' eating habits to those of sharks.) Health reformers began railing against gluttony and the endless, immoral procession of pies, cakes and meats. They wrote treatises lashing out at Sunday lunches and Thanksgiving tables.
Chief among these was the Rev. Sylvester Graham, creator of the famous Graham cracker. He preached that gluttony not only led to sinful sexual practices but also to such maladies as constipation and indigestion (or "dyspepsia," as people then termed it). Americans flocked to water cures, mercury-based laxatives and Graham's pure-food, brown-bread diet in order to settle their stomachs.
The goal of Graham's earliest followers was not shedding pounds. Then, plumper bodies were fashionable, even a symbol of success. Businessmen joined the Fat Men's Club of Connecticut. "Thin girls" wrote tearful letters to the Ladies' Home Journal for weight gain advice. Women padded clothing to look like well- rounded actress Lillian Russell.
As the century bore on, interest in weight loss grew. A succession of figures proffered their surefire solutions with confidence and authority.
Then came the explosive sea change. Dieting became a widespread national preoccupation - and no one knows quite why, says historian Peter N. Stearns, provost and professor of history at George Mason University and author of "Fat History" (New York University Press, 1997).
"You could say that, well, people started getting increasingly concerned about dieting right around the time they should have," he says. Food was abundant. Public transportation and sedentary jobs were on the rise. Yet there is little evidence to suggest people were getting much fatter at that time, he adds.
Fashion played its part in the dieting phenomenon. Corsets became unstylish, and natural slenderness gained ascendancy. The life insurance industry contributed, too. Early actuarial tables revealed that fat people, on average, lived shorter lives than slimmer people.
In addition, distaste for obesity had slowly, and inexplicably, been growing, and a list of derogatory words had been invented to describe it: "porky" in the 1860s, "jumbo" in the 1880s, "butterball" in the 1890s. By 1903, plumpness was so out of favor that the Fat Men's Club of Connecticut shut its doors forever. By World War I, being fat was deemed more than unattractive; it was unpatriotic.
The carousel was picking up speed.
As the years rolled on, new products and discoveries sharpened America's focus on body weight and shaped the recommendations of diet mavens. Weight monitoring became central in the 1920s, with the rise of Health-O-Meter and Detecto private bathroom scales.
Studies on the calorie content of foods were smoothly incorporated into a long succession of books, starting with the 1918 blockbuster bestseller "Diet and Health With a Key to the Calories," by Dr. Lulu Hunt Peters, who counseled her adherents to worship their kitchen scales and forever forget about "slices" of bread, and think only of calories in bread.
If the past century's diet themes appear surprisingly repetitive, there are good, even rational reasons why. Any diet that limits calorie intake, by whatever means, will help promote weight loss, provided one sticks to that diet.
Any diet that forces people to eat limited types of foodstuffs is likely to make them eat less, because human appetites thrive on variety. We can engulf astounding quantities of food, lickety-split, at a buffet. A body can bear only so many lamb chops and pineapples.
Any diet that focuses primarily on limiting food intake is likely to work better than one centered on exercise.
"It's a matter of magnitude," says Hill. "You could reduce your energy intake easily by 1,000 calories a day. You couldn't do 1,000 a day with exercise." There are also reasons why low-carbohydrate, high-protein diets have repeatedly sprung to the fore: Doctors once believed that proteins could not be converted into fat. (Not true!) Protein is satiating; it satisfies the appetite, hence the popularity of such diets (although that could decline if mad cow hysteria takes hold). Eating a lot of protein can lead to water loss, because the body flushes out the waste left over from protein digestion in the form of urine.
Some scientists say avoiding carbs can curb the appetite, because this practice avoids spikes in insulin and crashes in blood sugar that may get people feeling hungrier sooner.
While some fad diets are silly and others nutritionally inadequate and downright irresponsible, a lot of them could work, nutrition scientists say. But there is no reason to proclaim one vastly superior or possessed of any magical power, especially given the dearth of proper, scientific tests of diets.
"If you lined up all the diets in the world in a multimillion-dollar clinical trial and fired the starting gun, and lots of people started each of these diets, my prediction is early on there might be some separation, with some of these diets showing bigger weight loss than others," says Kelly Brownell, director of the Yale Center for Eating and Weight Disorders in New Haven, Conn. "But in the long term, they'd probably work the same overall."
Most experts believe stopping the mad procession of diet books will require changes: health insurance coverage for weight-loss programs, more scientific studies of different diets, altered attitudes toward norms of weight and attempts to clean up an environment awash in high-calorie snacks and drinks.
Diet Trends Through the Years
1087 - William the Conqueror tries a liquid diet for weight loss, taking to his bed and consuming only alcohol.
1600s to early 1700s - Dr. George Cheyne, author of "An Essay of Health and Long Life," writes that a milk diet renders him "lank, fleet and nimble."
1811 - Lord Byron douses his food in vinegar to lose weight, dropping from 194 pounds to less than 130.
1860s - William Banting loses 50 pounds on a high-protein regimen of lean meat, dry toast, soft-boiled eggs and vegetables; Dr. James Salisbury promotes a diet of hot water and minced meat patties.
1876 - Dr. John Harvey Kellogg crusades for vegetarianism, pure foods, slow chewing, calorie counting, colon cleansing and individualized diets.
1898 - Businessman Horace Fletcher drops 40 pounds through a strategy of chewing each mouthful of food to liquid before swallowing it.
1910 onward - Food scales, developed for diabetics, and calories become central to diet plans.
1920s - Dr. William Howard Hay's "medical millennium" plan holds that dieters must not combine starches, fruits and proteins in the same meal; the very-low-calorie Hollywood 18-day diet allows 585 calories daily, mostly grapefruit.
1928 - Low-calorie diets of 600 to 750 calories daily are introduced by doctors for severely obese patients.
1932 - Dr. Stoll's Diet Aid meal substitute powder goes on sale.
1948 - Take Off Pounds Sensibly, the first national group-dieting organization, is formed.
1950 - Reducer's Cookbook, the first dieter's cookbook from commercial publishers, is published.
1960 - Diet support groups grow; Overeaters Anonymous founded.
1961 - Bestselling "Calories Don't Count" by Herman Taller espouses a high-fat, high-protein, low-carb diet; Dr. Irwin Stillman publishes "The Doctor's Quick Weight Loss Diet," a low-carb, high-protein diet.
1961-63 - Weight Watchers is born.
1972 - "Diet Revolution" by Robert Atkins advocates plenty of meat and fat, no carbohydrates.
1976 - "The Last Chance Diet" by osteopath Robert Linn relies on a mix of fasting and liquid-protein drinks made from animal tendons and hides. Fifty-eight deaths are associated with these and similar diet drinks, which lack key nutrients.
1978 - Herman Tarnower publishes the high-protein Scarsdale diet, 700 calories daily.
1979 - Very low-fat diets emerge after Nathan Pritikin's "Pritikin Program for Diet & Exercise" ispublished.
1981 - Diet counselor and avid dieter Judy Mazel publishes "The Beverly Hills Diet," a fruit-heavy food- combining regimen; the Cambridge diet peddles low-calorie liquid-protein drinks sold through a pyramid scheme. Thirty people die of heart attacks before the nutritionally inadequate drinks are banned.
1983 - Jenny Craig weight-loss company is formed.
1992 - Atkins publishes "Dr. Atkins' New Diet Revolution," espousing his low-carb, high-fat, high-protein approach.
1993 - Low-fat diets re-emerge: "Eat More, Weigh Less" by Dean Ornish is a low-fat vegetarian diet.
1995 - Low-carb, high-protein diets return with the publication of Barry Sears' "The Zone."
1996 - Mazel's "The New Beverly Hills Diet" is a revised version of the old fruit-rich diet.
1998 - One of many resurfacings of Lord Byron's strategy, "Lose Weight With Apple Vinegar," claims vinegar consumption burns body fat.
1999 - Atkins publishes a revised version of his book.
2003 - "The South Beach Diet" is published by Miami doctor Arthur Agatston. It falls midway between low-fat, high-carb and low-carb, high-protein diets.
-LOS ANGELES TIMES
"Scientists Weighing The Worth Of Diets"
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