Bodybuilding diet
Definition
The bodybuilding diet is designed to build muscle and reduce body fat. It emphasizes foods high in protein and complex carbohydrates, such as whole grain bread, pasta, and cereal. There are many variations of the bodybuilding diet but an essential component remains the same throughout, a regular strength-building exercise building program.Origins
Description
A bodybuilding diet generally contains 2,500– 5,500 calories per day for men and 1,500–3,000 calories daily for women, depending on the types and levels of exercise. The diet’s ratio of protein, carbohydrates, and fat can differ. Some programs recommend 40% carbohydrates, 40% protein, and 20% fats. Others suggest a ratio of 40% protein, 30% carbohydrates, and 30% fat. There are many variations of this diet where the calorie intake and ratios are different. Most bodybuilding diets include nutritional supplements as well as protein powders. The focus of bodybuilding has shifted away from an emphasis on health toward an emphasis on appearance at all costs. To achieve a bigger, better body, many bodybuilders have placed a huge emphasis on nutritional and other types of supplements, including the illegal use of steroids.All diets require an exercise routine of three to seven days a week, usually with weightlifting and cardiovascular exercises. The body burns up to 50 calories per day for every pound of muscle. So adding 10 pounds of muscle can burn up to 500 extra calories each day. The exact diet and exercise routine can vary greatly and can be confusing, especially to people new to bodybuilding. When it comes to either diet or exercise, no two people follow the same routine.
Basic nutrition of bodybuilding
The three main components of a bodybuilding diet are the three macronutrients: carbohydrates, protein, and fatCARBOHYDRATES. Carbohydrates are the main source of energy for the body. They are especially important in aerobic exercise and high-volume weight training, including aiding in muscle recovery. Eating carbohydrates causes the pancreas to release the hormone insulin, which helps regulate blood glucose
Carbohydrates are often referred to as either simple or complex. A bodybuilding diet contains both simple and complex carbohydrates. Complex carbohydrates have a chemical structure composed of three or more sugars. They provide energy that is sustained over time. Simple carbohydrates have a chemical structure composed of one or two sugars and provide quick but short-lasting energy. A bodybuilding diet contains mostly complex carbohydrates eaten throughout the day. Simple carbohydrates are eaten immediately after working out to aid in faster recuperation and repair of muscles. Complex carbohydrates are found in whole-grain bread, pasta, cereal, beans, and most vegetables. Simple carbohydrates are found in fruit and sugary foods such as candy, juice, and sport drinks.
There are two other ways bodybuilding diets classify carbohydrates besides the simple and complex designations: glycemic index (GI) and glycemic load. The GI measures the quality rather than the quantity of carbohydrates found in food. Quality refers to how quickly blood sugar levels are raised following eating. The standard for GI is white bread, which is assigned an index value of 100. Other foods are compared to the standard to arrive at their ratings. The higher the GI number, the faster blood sugar increases when that particular food is consumed. A high GI is 70 and greater, a medium GI is 56–69, and a low GI value is 55 or less. The GI is not a straightforward formula when it comes to reducing blood sugar levels. Various factors affect the GI value of a specific food, such as how the food is prepared (boiled, baked, sautëed, or fried, for example) and what other foods are consumed with it. Foods that are readily broken down and absorbed by the body are typically high on the GI Foods that are digested slower, such as hose high in fiber, have a lower GI value.
In 1997, epidemiologist and nutritionist Walter Willett of the Harvard School of Public Health developed the glycemic load as a more useful way of rating carbohydrates compared to the glycemic index. The glycemic load factors in the amount of a food eaten whereas the glycemic index does not. The glycemic load of a particular food or meal is determined by multiplying the amount of net carbohydrates in a serving by the glycemic index and dividing that number by 100. Net carbohydrates are determined by taking the amount of total carbohydrates and subtracting the amount of dietary fiber. For example, popcorn has a glycemic index of 72, which is considered high, but a serving of two cups has 10 net carbs for a glycemic load of seven, which is considered low.
PROTEIN. Muscle is composed primarily of protein and water. Protein builds muscle mass but not all protein consumed in the diet goes directly to muscle. Adequate consumption of protein helps preserve muscle tissue and enhance recovery from strenuous weight-bearing workouts. Since weight-bearing exercises cause significant damage to muscle tissue, the subsequent repair and growth of muscle requires a recovery period of at least 24 hours. If an inadequate amount of protein is consumed, muscle mass will suffer along with a decrease in metabolism. Most bodybuilding diets recommend 1–1.5 grams of protein per day for each pound of lean body mass (body weight minus body fat). Daily consumption of more than 3g per kilogram body mass can lead to serious health problems, especially kidney damage. Protein is found in lean meat, poultry, and fish, eggs, tofu, and soy products
FATS. Fat in a diet is needed to maintain a healthy metabolism. There are four types of fat: saturated, trans, polyunsaturated, and monounsaturated. Saturated and trans fats are limited because high consumption is a risk factor for heart disease, obesity, high cholesterol, diabetes, and some cancers. Sources of saturated and trans fats are butter, whole milk products, fried foods, shortening, and coconut, palm, and other tropical oils. Meat with visible fat is also a source of saturated fat. Monounsaturated and polyunsatu-rated fats are good fats because they lower the risks of heart disease, diabetes, high cholesterol, and obesity. These fats are derived from avocados, most nuts, fish, flax, and olive, canola, peanut, safflower, corn, sunflower, soybean, and cottonseed oils.
Two other important factors in the bodybuilding diet are water and the number and timing of meals. Bodybuilding diets suggest drinking at least eight eight-ounce glasses of water a day. In addition, bodybuilders drink about a quarter cup of water every fifteen minutes during their workout. Water helps control appetite and drinking cold water increases metabolism.
Function
The purpose of the bodybuilding diet is to gain muscle mass and lose fat. It is not a weight loss diet and most people will likely gain weight. Nutrition provides the body, especially muscles, with the raw materials needed for energy, recuperation, growth, and strength.Benefits
The benefits of the bodybuilding diet are health and appearance. The bodybuilding diet promotes increased muscle mass, which increases metabolism.Precautions
When monitored by a health professional, the bodybuilding diet can be healthy method for increasing strength and body mass. Caution should be used in regard to nutritional supplements, especially protein powders. Excess protein intake is known to cause serious health problems such as kidney damage and dehydration. Bodybuilders should discuss any supplements with their doctor, and steroids, such as human growth hormone and testosterone, should only be used for medical reasons and with a doctor’s prescription. Since exercise is a main component of the diet, people with arthritis or back, knee, or other joint problems should discuss the fitness regimen with their physicians before starting exercise. Making major changes to a person’s diet should be done in small incremental steps so the body can adapt to the changes. A sudden reduction or increase in calories can cause the body to store or hoard fat.Risks
The rigorous and regular exercise component of this diet is a risk to people with heart disease or certain other health problems. Individuals with these conditions should consult their physician before starting the diet. A bodybuilding diet is not recommended for women who are pregnant or nursing.Research and general acceptance
The bodybuilding diet is generally accepted by the medical and bodybuilding communities as being safe and effective in helping increase muscle mass and decrease fat. There is no general acceptance on the exact ratio of protein, carbohydrates, and fats.Protein is considered the basic nutrient in repairing muscle that is broken down during weightlifting and for muscle maintenance and growth. The recommended dietary allowance (RDA) per day for protein is 0.8 g/kg. However, research shows that a greater amount of protein is needed for weightlifters. Depending on a person’s level of activity, the amount of protein needed for a bodybuilder is greater than the RDA, but not more than 1.5-2 g/kg. Research indicates that muscles double the rate of protein synthesis following exercise and remains elevated for at least 24 hours.
The amount of carbohydrates in a bodybuilder’s diet can range from 40–60 percent, but such levels are not necessarily effective. An inadequate consumption of carbohydrates can have a negative effect of exercise performance and duration. Other studies have shown that the dominant factor in weight loss is a reduction of calorie intake. There has been a great deal of research on bodybuilding nutrition from the 1980s forward.
BOOKS
Campbell, Adam, and Jeff Volek. The Men’s Health TNT Diet: The Explosive New Plan to Blast Fat, Build Muscle, and Get Healthy in 12 Weeks Emmaus, PA: Rodale Books, 2007.Cordain, Loren, and Joe Friel. The Paleo Diet for Athletes: A Nutritional Formula for Peak Athletic Performance Emmaus, PA: Rodale Books, 2005.
Hofmekler, Ori. Maximum Muscle: Minimum Fat St. Paul, MN: Dragon Door Publications, 2003.
Hofmekler, Ori, and Diana Holtzberg. The Warrior Diet St. Paul, MN: Dragon Door Publications, 2003.
Kleiner, Susan, and Maggie Greenwood-Robinson. Power Eating Champaign, IL: Human Kinetics Publishers, 2006.
Larson-Meyer, D. Enette. Vegetarian Sports Nutrition Champaign, IL: Human Kinetics Publishers, 2006.
Schuler, Lou, et al. The Testosterone Advantage Plan: Lose Weight, Gain Muscle, Boost Energy New York: Fireside, 2002.
Sepe, Frank. TRUTH Body Solutions: Truthful Nutritional Strategies for a Better Body and a Better LifeCarlsbad, CA: Hay House, 2006.
PERIODICALS
Aceto, Chris. “Know the Score! Cheat Foods, When Properly Refereed, Can Help Boost Your Muscular Gains.” Flex (August 2005): 94–99.Elliott, Tabatha. “Cholesterol for Muscle.” Muscle & Fitness (October 2005): 245–246.
Schmidt, Julian. “Peels Like the First Time: Three Pros Recall Their First-Ever Bodybuilding Diet—That Worked.” Flex(September 2006): 214–218.
Stoppani, Jim. “Food Fixes: Want To Improve Your Results and Make Faster Gains? Here’s a Guide You Can Use to Upgrade Your Bodybuilding Diet, One Meal At a Time.” Flex (March 2007): 154–158.
Stoppani, Jim, and Steve Stiefel. “Strategize For Size: Looking to Bulk Up or Lean Out? Integrate the Latest Cutting-Edge Research Into Your Bodybuilding Diet With These 10 Proven Scientific Strategies.” Flex (May 2006): 96–101.
Wuebben, Joe, et al. “The Bodybuilding Foods: From the Basics for Building Muscle to On-The-Go, Gotta-Eat-Now Fast Foods, Here are 111 Superfoods Every Bodybuilder Must Have in His Eating Arsenal.” Joe Weider’s Muscle & Fitness (March 2007): 142–150.
ORGANIZATIONS
American College of Nutrition. 300 South Duncan Ave., Suite 225, Clearwater, FL 33755. Telephone: (727) 446-6086. Website: <http://www.amcollnutr.org>.American Council on Exercise. 4851 Paramount Drive, San Diego, CA 92123. Telephone: (858) 279-8227. Website: <http://www.acefitness.org>.
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>.
American Society for Nutrition. 9650 Rockville Pike, Bethesda, MD 20814. Telephone: (301) 634-7050. Website: <http://www.nutrition.org>.
Bodybuilding.com. 305 Steelhead Way, Boise, ID 83704. Telephone: (877) 991-3411. Website: <http://www.bodybuilding.com>.
Center for Nutrition Policy and Promotion. 3101 Park Center Drive, 10th Floor, Alexandria, VA 22302-1594. Telephone: (703) 305-7600. Website: <http://www.cnpp.usda.gov>.
Teen Bodybuilding.com. 305 Steelhead Way, Boise, ID 83704. Telephone: (877) 991-3411. Website: http://www.teenbodybuilding.com.
Ken R. Wells.
3-Day Diet
Definition
There are a variety of three-day diets that circulate from person to person and on the Internet. They tend to promise weight loss of 10 lb (4.5 kg) or more in just three days.Origins
The origins of the three-day diet are unclear. Some people believe that they go back to the 1980s when these kinds of diets were faxed from person to person. Three-day diets go by many different names, including the fax diet, Army diet, Navy diet, Cleveland Clinic diet, and many others. Often they are just referred to as three-day diets. Although many versions of this diet claim to have been created by one medical institution or another, no medical institutions have ever been known to come forward to claim responsibility for, or even to recommend, one of these diets. Many institutions that have these diets named after them, such as the British Heart Foundation or the Cleveland Clinic, go out of their way to inform dieters that the diet did not originate where its title claims.The most common form of three-day diet on the Internet involves eating a large quantity of tuna and various vegetables during the day, with ice cream each evening. This diet seems to be similar to, or the same
as, the three-day diet sold online by 3daydiets.net. It is unclear, however, if they are the developer of the diet, as they do not claim specifically to be.
Description
There are many versions of three-day diets circulating, all with the promise of bringing dieters significant weight loss in just three days. There are many variations in what dieters may and may not eat during these three days. One diet even calls for dieters to drink only water for the first day. On the second day dieters may eat fruit, and drink only fruit juice, and on the third day dieters may eat only vegetables, and drink only vegetable juice.The most common three-day diet, and the one that seems to be the most popular, is a three-day diet with a meal plan that instructs dieters what to eat for breakfast, lunch, and dinner. The specifics of the plan vary, as do what dieters are allowed to drink while on the plan. Some versions allow anything, others specify just water and diet soda in addition to the coffee and tea called for in the meal plan. Many require that dieters drink at least four glasses of water daily. Some allow diet soda to be substituted for the water. A common version of the three-day diet meal plan is:
Day 1
Breakfast: black tea or coffee, 1/2 a grapefruit, 1 piece of toast with 1 Tablespoon of peanut butter. Some version specify 1/3 of a grapefruit, some call for artificial sweetener to be added to the coffee, some allow grapefruit juice to be substituted for the grapefruit.Lunch: 1/2 cup tuna, 1 piece dry toast, black coffee or tea. Some versions call for tuna in water, some call for artificial sweetener with the coffee or tea.
Dinner: 3 ounces lean meat, 1 cup green beans, 1 cup carrots, 1 apple, 1 cup vanilla ice cream. Some versions specify a low fat ice cream, other do not. Some versions call for 1 cup of beets instead of carrots.
Day 2
Breakfast: 1 egg, 1 slice dry toast, 1/2 banana, black coffee or tea. Some versions require artificial sweetened in the coffee or tea. It is not generally specified how the dieter should prepare the egg. Some versions call for a whole banana.Lunch: 1 cup cottage cheese and six crackers. Some versions allow dieters to choose between 1 cup of cottage cheese and 1 cup of tuna. Some require six crackers, some allow eight. Most versions call for Saltine brand crackers.
Dinner: two hot dogs, 1 cup broccoli, 1/2 cup carrots, 1/2 banana, 1/2 cup vanilla ice cream. Some versions specify beef franks. Some call for 1 cup of cabbage instead of 1 cup of broccoli. Some versions require low fat ice cream.
Day 3
Breakfast: one apple, 1 ounce cheddar cheese, five Saltine brand crackers, black tea or coffee. Some versions allow or require artificial sweetener.Lunch: one hard-boiled egg, one slice dry toast. Some versions allow black coffee or tea (with or without artificial sweetener) with this meal, others do not.
Dinner: 1 cup tuna, 1 cup carrots, 1 cup cauliflower, 1 cup melon, and 1/2 cup vanilla ice cream. Some versions call for 1/2 a cantaloupe instead of 1 cup of melon. Some versions require low fat ice cream.
There are other versions of the above three-day diet, with some specifying even more alternatives for the dieter, including an orange instead of grapefruit, cottage cheese instead of tuna, and various vegetable substitutions. Most versions tell dieters to use lemon, salt and pepper, mustard, vinegar, herbs, soy sauce, ketchup, Worcestershire sauce, and other seasonings to add flavoring to food during the diet, but nothing containing fat, such as butter. Most versions of the diet are very specific in saying that dieters have to follow the rules exactly to see the promised weight loss.
Function
The three-day diet usually promises that dieters will be able to lose 10 pounds in three days if the diet is followed exactly. Often the diet claims that this will result because the combination of foods called for by the diet causes some kind of increased metabolism that will burn pounds of fat. It is never made clear exactly what kind of reaction this is supposed to be, or how it is supposed to work. Often the diet says the dieter can repeat the diet after a few days of regular eating. Some version of three-day diets allow for as few as two days of normal eating, others require up to four or five. The three-day diets are intended to provide a dieter with extreme weight loss in a very short time and are not intended to change the dieters lifestyle or overall eating habits. Usually the diets go so far as to tell a dieter to eat whatever he or she was eating before the diet once the diet is over. The diets only caution is not to overeat. No exercise recommendations are made with three-day diets. Weight loss is supposed to come from increased metabolism and lowered calorie intake alone.Benefits
There are many benefits to weight loss if it achieved at a moderate pace through healthy eating and exercise. Three-day diets, however, are not considered moderately paced and do not include exercise, or a well-balanced diet. Although the diets claim that a dieter can lose 10 pounds in three days, weight loss is likely to come mainly from lost water weight. There may be some psychological benefit to quick weight loss, but this is likely to be undone if the weight is gained back quickly after the diet is over.Precautions
Anyone thinking of beginning a new diet should consult a physician or other medical professional. Daily requirements of calories, fat, and nutrients can differ significantly from person to person depending on age, weight, sex, and other factors. Talking to a doctor can help a dieter determine which diet is safe for that dieter’s individual needs, and a doctor can help a dieter choose a diet that fits in well with his or her long-term weight loss goals. Pregnant or breastfeeding women should be especially cautious when thinking of beginning a new diet because when a baby is receiving nutrients from its mother, what the mother eats can have a significant impact on the growth and development of the baby.Risks
There are some risks associated with any diet, but diets that severely limit calories or the variety of foods that dieters may eat tend to be more risky than well balanced, moderately calorie-reduced diets. The most common three-day diet requires dieters to eat only about 1,000 calories a day, with some versions that have been analyzed consisting of at as few as 700 calories per day. This is too few for most people to maintain good health. A diet that contains fewer than 800 calories per day is considered a very low calorie diet. Very low calorie diets carry high risks of side effects, such as gallstones and cardiovascular problems. Very low calorie diets are only intended for the extremely obese who are experiencing significant medical problems due to obesity. These diets are carried out under the close supervision of physicians. They are not intended, or safe for, dieters to follow on their own.Dieters who follow a three-day diet may find that any weight lost is gained back as soon as the diet is over, and may even find that more weight is gained that was lost. Having a very low caloric intake makes the dieter’s metabolism slow down because the body thinks that it is starving. Then when a normal number of calories are reintroduced into the diet, the body wants to store extra fat in case there is a period of starvation again. This natural defense mechanism of the body against starvation can cause dieters who alternatively eat very few calories and then return to normal eating to gain large amounts of fat over time, even while they are trying to diet. Very low calorie diets pursued over only a few days also promote binge eating at the end of the diet.
Many of the versions of three-day diets, especially those intended for fasting, carry a high risk of vitamin and mineral deficiency. The body needs food from each of the food groups every day for good health. Drinking only fruit juices, or eating any very limited variety of foods, can make it nearly impossible for a dieter to get all of the nutrients required for good health. Any dieter considering this kind of diet should consult a physician about an appropriate multivitamin or supplement to help reduce this risk of deficiency. Multivitamins and dietary supplements carry their own risks, and can not replace a healthy, well-balanced diet.
Research and general acceptance
Three-day diets are not generally accepted as healthy, effective ways to lose weight for the long term. Although no scientific studies have been carried out to determine the effectiveness of common three-day diets, experts suggest that anything that promises dieters 10 lb (4.5 kg) of weight loss in three days is unlikely to be taking off fat. Instead, dieters are probably losing water weight, with possibly a little fat loss and some muscle mass loss through the reduced caloric intake.The United States Department of Agriculture makes recommendations for a healthy diet in its MyPyr-amid food guidelines. MyPyramid gives recommendations about how many servings of each food group are required daily for good health. These recommendations can be found at <http://www.MyPyramid.gov.> Any diet that will produce sustainable, healthy weight loss should follow these guidelines and include foods from each food group every day. Sustainable diets should not be extremely restrictive of any food group, or be extremely calorie-reduced.
Many studies have shown that exercise and diet are more effective at producing weight loss when done together than either is done alone. Three-day diets do not usually have any exercise recommendations. Instead, they generally claim that a combination of foods will magically melt away fat without the dieter having to expend any effort. Healthy weight loss plans should include both a diet and an exercise component. As of 2007, the Centers for Disease Control recommended that adults get a minimum of 30 minutes of light to moderate exercise each day for good health.
Resources top
BOOKS
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>OTHER
The Diet Channel. ‘‘3 Day Diet.’’ 2007. <http://www.thedietchannel.com/3-day-diet.htm>Tish Davidson, A.M.
3-Hour Diet
Definition
The 3-Hour diet is based on the concept that weight loss is best achieved by eating small amounts frequently, in this case, every three hours.Origins
The 3-Hour diet was originated by Jorge Cruise in the mid-2000s, Cruise was an overweight child who went on to lose weight, shape up, and become a self-proclaimed weight-loss expert. He has no formal nutrition training.Cruise is the author of the New York Times bestseller 8 Minutes in the Morning, an exercise and diet program, and The 3-Hour Diet. He is a columnist for USA Weekend Magazine and is the diet and fitness editor for Good Housekeeping magazine. Cruise has discussed his diet and fitness philosophy on many television talk shows and is the weight-loss coach on AOL. He maintains a Web site at <http://www.jorgecruise.com>
Description
The 3-Hour diet is a diet regimen based on the philosophy that the timing of meals is more important than the type of food eaten in those meals. Cruise says the body’s basal (baseline) metabolic rate (BMR) can be increased by eating every three hours. Keeping the metabolic rate high is desirable because this makes the body burn more calories.The three basic rules of the 3-Hour diet are:
- Eat breakfast within one hour of arising.
- Eat every three hours after that.
- Stop eating three hours before going to bed.
KEY TERMS
Dietary supplement—A product, such as a vitamin, mineral, herb, amino acid, or enzyme, that is intended to be consumed in addition to an individual’s diet with the expectation that it will improve health.to be drunk only rarely. However, the diet does allow occasional fast food and some frozen or processed foods. One key to success on the 3-Hour diet is planning meals and snacks ahead of time. Knowing what they will eat for the next meal helps dieters stick to the diet.
The 3-Hour diet is not a low carbohydrate, high protein, or very low fat diet. Meals are required to consist of a reasonable balance of carbohydrates, protein, and fats. The emphasis is on choosing appropriate foods and on strict portion control. Although Cruise claims people can eat anything they want and still lose weight on his diet, in reality, by following the diet correctly, an individual is limited to about 1,450 calories a day. Many nutritionists consider this an appropriate calorie intake for slow, steady weight loss. Cruise claims that people following the 3-Hour Diet will lose 2 lb (0.9 kg) per week, and that they can target the spots on the body where they can lose fat. The diet is intended to last 28 days, with a repeat cycle for people who need to lose more weight.
The exercise aspect of the 3-Hour diet is somewhat confusing. Cruise initially claims that exercise is not a part of this weight-loss program and that the 3-Hour diet is good for individuals with arthritis or limited mobility. However, he also says that building muscle mass is important in weight loss because even at rest a pound of muscle burns twice as many calories as a pound of fat. This occurs because metabolic activity is higher in muscle cells. Ultimately Cruise does suggest exercises to go along with the 3-Hour diet, and they are generally not appropriate for people with sore joints or mobility limitations.
Function
Jorge Cruise claims that his 3-Hour diet will reprogram the body’s BMR and allow people to lose 2 lb a week. According to Cruise, if the body goes too long without food, what he calls the starvation protection mechanism kicks in. When this happens, the body begins to conserve energy, use fewer calories, and burn less fat. It is true that starvation causes the body to take action to conserve metabolic fuel. However, as a review of The 3-Hour Diet on the American Dietetic Association Web site points out, there is no scientific proof that going three hours between meals causes the body to think that it is starving or that eating every three hours will change the BMR.Cruise also claims that dieters can target specific parts of the body from which to lose inches. There is no research to show that this is true, although specific exercises may build muscle and tone certain spots.
Benefits
The 3-Hour diet benefits dieters by providing a blueprint for relatively low calorie, balanced meals. People who are mindless or unconscious eaters often benefit from eating on a schedule. The 3-hour approach also helps to curb binge-eating behavior. Because they are required to eat at prescribe times, dieters do not get so hungry that they gorge themselves at the next meal. Nighttime eaters also benefit from the prohibition against eating three hours before going to bed. Another benefit of this diet is that it uses regular supermarket food, which keeps the cost reasonable. There are no required fees to participate.One common complaint about the diet is that meal plans and menus are limited unless the dieter joins the optional fee-based Web site associated with the diet. Membership to the Web site is sold in 13-week blocks. Another complaint is that the dieter is strongly encouraged to buy Jorge Cruise dietary supplements to take while on the diet.
Precautions
As with any diet, people should discuss with their physician the pros and cons of the 3-Hour diet based on their individual circumstances.Risks
There appear to be few risks to following this diet.QUESTIONS TO ASK THE DOCTOR
- Is this diet the best diet to meet my weight-loss goals?
- Would a multivitamin or other dietary supplement be appropriate for me if I were to begin this diet?
- Will this diet meet my long-term dietary needs?
- Does this diet pose any special risks for me that I should be aware of?
- Can my whole family follow this diet?
- Do you have any experience with the long-term success of this diet?
Research and general acceptance
The 3-Hour diet did not appear until the mid-2000s and as of 2007, no scholarly research has been done on it. There has been some research on the effects of eating many small meals instead of three large ones on dieting success. The results have been mildly favorable. Many weight-loss professionals support the idea of distributing calories across five or six meals during the day.No research has been done on the ‘‘resetting’’ of BMR by eating small, frequent meals. The consensus among nutritionists is that people who lose weight on the 3-Hour diet do so more because calories are restrict to under 1,500 a day than because of any specific value in the 3-hour timing of meals. The timing may, however, help people to change their eating behaviors in constructive ways.
Resources top
BOOKS
Bijlefeld, Marjolijn and Sharon K. Zoumbaris. Encyclopedia of Diet Fads. Westport, CT: Greenwood Press, 2003.Cruise, Jorge. The 3-hour Diet: How Low Carb Makes You Fat and Timing will Sculpt You Slim. New York: Har-perResource, 2005.
Cruise, Jorge. The 3-hour Diet Cookbook. New York: Collins, 2007.
Icon Health Publications. Fad Diets: A Bibliography, Medical Dictionary, and Annotated Research Guide to Internet References. San Diego, CA: Icon Health Publications, 2004.
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>JorgeCruise.com, Inc. PO Box 6220, San Diego, CA 92166. Office Telephone: 619) 523-3035 Customer Support Line: (877) 465-6743 Fax: (619) 374-2004. Website: <http://www.3hourdiet.com>
OTHER
Harvard School of Public Health. ‘‘Interpreting News on Diet.’’ Harvard University, 2007. <http://www.hsph.harvard.edu/nutritionsource/media.html>Health Diet Guide ‘‘3-hour diet.’’ Health.com. 2005. <www.health.com/health/web/DietGuide/threehr_complete.html>
United States Department of Health and Human Services and the United States Department of Agriculture. ‘‘Dietary Guidelines for Americans 2005.’’ January 12, 2005. <http://www.healthierus.gov/dietaryguidelines>
WebMD. ‘‘The Pritikin Principle.’’ <http://www.webmd.com/content/pages/7/3220_282.htm>
Tish Davidson, A.M.
Abs diet
Definition
The Abs diet is a six-week plan that combines nutrition and exercise. It emphasizes twelve power foods that are the staples of the diet. It focuses on building muscle through strength training, aerobic exercises, and a dietary balance of proteins, carbohydrates, and fat.Origins
David Zinczenko, editor of Men’s Health, developed the diet in 2004. He introduced it in the magazine and in his book, The Abs Diet: The Six-Week Plan to Flatten Your Stomach and Keep You Lean for Life. Zinczenko says he grew up as an overweight child and at age 14, he was five feet 10 inches tall and weighed 212 pounds. He learned about fitness while in the U.S. Naval Reserve and nutrition from his tenure at Men’s Health.Despite its name, the diet does not specifically target abdominal fat. Exercise helps the body burn excess fat but it is not possible to target specific areas of fat, such as the abdomen. Diet and exercise will help eliminate excess fat from all over. If the bulk of a person’s fat is around the belly, then that is where the greatest amount of fat-burning will occur. The Abs diet is designed to provide the necessary vitamins, minerals, and fiber for good health, while it promotes building muscle that helps increase the body’s fat burning process.
Description
The Abs diet developer David Zinczenko says it will allow people to lose weight—primarily fat—while developing a leaner abdomen and increasing muscle tone, strength, general health, and sexual health. The diet has two components: exercise and nutrition.There are six general guidelines that are the basic principles of the diet. These are: eat six meals a day, drink smoothies regularly, know what to drink and what not to; do not count calories; eat anything you want for one meal a week; and focus on the Abs diet twelve power foods.
The diet strongly recommends its followers eat six meals a day since it helps to maintain what researchers call an energy balance. This is the number of calories burned in an hour versus the number of calories taken in. Georgia State University researchers found that if the hourly surplus or deficit of calories is 300–500 at any given time, the body is most susceptible to burning fat and building lean muscle mass. To stay within this range, Zinczenko recommends the following daily meal schedule: breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner, and evening snack.
Another guideline is to drink smoothies regularly in place of a meal or snack. Smoothies are mixtures of low-fat milk and yogurt with ingredients such as ice, protein powder, fruits, and peanut butter, that are prepared in a blender. Although there are no definitive studies, some researchers suggest that the calcium in the milk and yogurt helps to burn body fat and restricts the amount of fat produced by the body.
A third guideline details what to drink and not drink. Drinking eight glasses of water daily is recommended. The benefits of 64-oz of water are that it helps to alleviate hunger pangs, it flushes waste products from the body, and it delivers nutrients to muscles. Other acceptable drinks are low-fat milk, green tea, and no more than two glasses of diet soda a day. Alcohol is not recommended at all since it does not help to make a person feel full. It also decreases by one-third the body’s ability to burn fat and makes the body store more of the fat from food. In addition, it decreases production of testosterone and human growth hormone that help burn fat and increase muscle mass.
KEY TERMS
Aerobic exercise—An exorcise that increases breathing and heart rates.Carbohydrates—An organic compound that is an important source of energy in humans, found in foods such as pasta, cereal, and bread.
Cardiovascular—Relating to the heart and blood vessels.
Endocrinologist—A physician who specializes in disorders of the endocrine system.
Energy balance—The number of calories burned in an hour versus the number of calories taken in.
Erectile dysfunction—The inability to get or maintain an erection.
Human growth hormone—An amino acid that stimulates growth and cell reproduction in humans.
LDL—Low-density lipoprotein (LDL), also known bad cholesterol, is a fat protein that is high in cholesterol and low in protein.
Obliques—Types of abdominal muscle.
Testosterone—A male sex hormone that is responsible for secondary sex characteristics.
Transverse abdominis—A muscle layer of the wall of the abdomen.
Urologist—A physician that specializes in disorders of the urinary tract and male genitals.
Vegan—A vegetarian who excludes all animal products from the diet.
Although burning calories is required to lose fat, Zinczenko says calorie counting makes people lose focus and motivation. The foods allowed on the diet are energy-efficient and will help dampen feelings of hunger, according to Zinczenko.
Another guideline is that dieters are allowed to cheat for one meal a week. The meal should include foods that the dieter misses most, including items high in carbohydrates and fats. This helps prevent diet fatigue that many people go though when dieting.
The last guideline is to focus on the twelve power foods of the diet to help meet core nutritional requirements. The twelve power foods are:
- almonds and other nuts (unsalted and unsmoked)
- beans (except refried and baked)
- green vegetables, including spinach, broccoli, brussels sprouts, and asparagus
- non-fat or low-fat dairy products
- instant oatmeal (unsweetened and unflavored)
- eggs and egg substitute products
- lean meats, including turkey, chicken, fish, and beef
- peanut butter
- olive oil
- whole-grain breads and cereals
- whey protein powder
- berries
Exercise
Adequate exercise is as important as good nutrition in losing fat and flattening the stomach in the Abs diet. It includes strength training three times a week, abdominal exercises two or three days a week, and optional aerobic exercises two or three times a week. There are three basic principles to the exercise program: leave at least 48 hours between weights workouts of the same body part; do no exercises one day a week; and warm up for five minutes before exercising by jogging lightly, riding a stationary bike, jumping rope, or doing jumping jacks. There are three components of the plan that target different types of exercise:- Strength training—Total-body workouts three days a week, with one workout placing extra emphasis on the leg muscles.
- Cardiovascular exercises—Do these twice a week in-between strength training days. Activities include cycling, running, swimming, brisk walking, and stair climbing.
- Abdominal (ab) exercises—Do ab exercises two or three times a week, before strength training workouts.
People who already exercise regularly should consider switching from their current workout routine to the Abs diet workout for at least the first few weeks, according to Zinczenko. For maximum results, it is best to change the workout routine every month to keep the body from adapting to a repetitious routine that can slow muscle development. The Abs diet suggests the basic workout be done on Mondays and Wednesdays, starting with one set of an ab exercise from each of the five categories of abdominal regions. Follow this with two circuits of one set of the core exercises in the order listed. On Tuesdays and Thursdays, do 20–30 minutes of cardiovascular exercise. On Friday, do the Monday through Wednesday workout but instead of the ab exercises, traveling lunges, 10–12 reps, and step-ups, 10–12 reps each leg. Do two complete circuits.
ABDOMINAL EXERCISES. These exercises strengthen.
the abdominal muscles in five regions: upper abs, 12–15 reps; lower abs, 6–12 reps; obliques, 10 each side; transverse abdominis, 5–10 reps; and lower back, 12–15 reps. The following are exercises for each of the five abdominal regions. Upper abs: traditional crunch and modified raised-feet crunch; lower abs: figure-eight crunch and bent-leg knee raise; transverse abdominis: two-point bridge and Swiss ball pull-in; obliques: medicine ball torso rotation and two-handed wood chop; lower back: twisting back extension and Swiss ball Superman.
CORE EXERCISES. These are the basic exercises that promote muscle strength: squat, 10–12 repetitions (reps); bench press, 10 reps; pulldown, 10 reps; military press, 10 reps; upright row, 10 reps; triceps pushdown, 10–12 reps; leg extension, 10–12 reps; biceps curl, 10 reps; and leg curl, 10–12 reps.
Function
The primary purpose of the Abs diet is to help people, especially men, develop a lean, flat, and hard stomach—referred to in fitness circles as a ‘six-pack’— and to maintain a healthy weight and lifestyle. The diet is designed to promote a longer and healthier life by helping prevent cancer, heart disease, high blood pressure, diabetes, and other diseases. These diseases are more prevalent in overweight and obese people compared to people who maintain a normal or below normal weight. The diet is also designed to promote a healthier sex life in men since some of the causes of erectile dysfunction are obesity, heart disease, and diabetes.Benefits
Excessive fat, especially around the belly, is a major risk factor for heart disease, high blood pressure, high LDL (bad cholesterol), diabetes, erectile dysfunction, and other diseases. By reducing or elimination excess body fat, people can live healthier and longer lives. The health benefits increase when regular exercise is added. People on the Abs diet can expect to lose up to 12 pounds in the first two weeks followed by 5–8 pounds in the next two weeks, according to Juliette Kellow, a registered dietician who reviews diets for the Website Weight Loss Resources (<http://www.weightlossresources.co.uk>).Most diets include cardiovascular (aerobic) exercise as part of a weight loss routine. Studies have shown that people who engage in aerobic exercise burn more calories than people who did strength training, or weightlifting. However, additional research indicates that the fat-burning metabolic effects of aerobic exercise lasts 30–60 minutes while the metabolic effect of strength training lasts up to 48 hours. Also, the Abs diet promotes increased muscle mass, which increases metabolism so that the body burns up to 50 calories per day for every pound of muscle. So adding 10 pounds of muscle can burn up to 500 extra calories each day.
Precautions
Overall, the diet is healthy and poses no known dangers. Some of the items listed in the 12 power foods can contain high amounts of sodium, such as canned and frozen vegetables, instant oatmeal, and peanut butter. People who want to limit salt intake or who have high blood pressure may want to avoid these food. Since exercise is a main component of the diet, people with arthritis or back, knee, or other joint problems should discuss the diet with their physicians before starting exercise. People who are allergic to peanuts or nuts should avoid food containing these products.The diet does not address if it is suitable for vegetarians or vegans. Menus in the book do not have meatless options. However, eight of the 12 power foods do not contain meat or animal products. All of the protein required in the diet can be obtained by adding more beans and legumes to the diet and replacing meat with soy protein sources, such as tofu and meat substitutes that are high in protein. Brands
QUESTIONS TO ASK YOUR DOCTOR
- Am I healthy enough to do the exercise routine required on the Abs Diet?
- Will I need any dietary supplements if I adopt the Abs Diet?
- Do you see any health risks for me in the diet?
- Are there any other diets you would recommend that would help me accomplish my goals?
- Have you treated other patients who are on the Abs Diet?If so, what has their response to the diet been?
Risks
Since the diet includes a rigorous and regular exercise program, people with heart disease or certain other health problems should consult their physicians before going on the diet. Men with erectile dysfunction should discuss their condition with their physicians, urologists, or endocrinologists. Also, one of the 12 power foods is nuts, so people with peanut or other nut allergies should eliminate or modify the nut component of the diet.Research and general acceptance
There is no specific research that proves the Abs diet delivers on what it promises: fat loss, muscle increase, increased sex drive, and six-pack abs. It is also unclear whether the diet will maintain a healthy weight once the initial weight is lost. The book contains many anecdotal stories of success but there are no scientific studies that document the claims.In an article in the October 2004 issue of Health, registered dietician Maureen Callahan comments on the merits of the Abs diet, calling it an overall good diet and exercise plan. She adds that the diet is mostly healthy but she questions its promotion of protein powder, one of the diet’s 12 power foods. She says people can get extra protein by eating low-fat cottage cheese or a few additional ounces of leanmeat or fish.
Resources
BOOKS
Zinczenko, David, and Ted Spiker. The Abs Diet: The Six-Week Plan to Flatten Your Stomach and Keep You Lean for Life Emmaus, PA: Rodale, 2005.Zinczenko, David, and Ted Spiker. The Abs Diet Get Fit Stay Fit Plan: The Exercise Program to Flatten Your Belly, Reshape Your Body, and Give You Abs for Life! Emmaus, PA: Rodale, 2005.
Zinczenko, David, and Ted Spiker. The Abs Diet Eat Right Every Time Guide Emmaus, PA: Rodale, 2005.
Zinczenko, David, and Ted Spiker. The Abs Diet 6-Minute Meals for 6-Pack Abs: More Than 150 Great-Tasting Recipes to Melt Away Fat! Emmaus, PA: Rodale, 2006.
Zinczenko, David. The Abs Diet: The Six-Week Plan to Flatten Your Stomach and Keep You Lean for Life: For Women Emmaus, PA: Rodale, 2005.
Zinczenko, David, and Ted Spiker. The Abs Diet for Women: The Six-Week Plan to Flatten Your Stomach and Keep You Leanfor Life Emmaus, PA: Rodale, 2007.
PERIODICALS
Aceto, Chris. ‘“Build Muscle, Stay Lean! Open Up Our Nutritional Toolbox and Head to the Job Site: Your Kitchen Table. This State-of-the-Art Diet Plan Will Help You Add Muscle Without Gaining Fat.” Muscle & Fitness (November 2006), 110–114.Aceto, Chris. ‘“Protein & Carbs: Carbohydrates and Protein Have Been Misunderstood For Years. Here Are the Top 10 Myths That Plague Your Diet—And Your Physique.” Muscle & Fitness (September 2005), 100–104.
Donnelly, Allan. ‘“Critical Condition: Need to Get Ripped in a Hurry? Mark Dugdale’s Fast-Track Nutritional Overhaul Will Help You Drop Body Fat in Five Easy Steps.” Flex (October 2006), 216–220.
Horn, Beth. “M & F Blueprint: 6 Weeks to a Sic-Pack; Build Awesome Abs With This Step-By-Step Training and Diet Program.” Muscle & Fitness (May 2002),142–145.
Stiefel, Steve. “Your 8000-Calorie Growth Plan: Add Up To 10 Pounds of Lean Muscle on M & S’s Turbo-Charged One-Day-A-Week Diet.” Muscle & Fitness (October 2004), 176–179.
Stoppani, Jim. “Power Abs Diet: To Build a Finely Crafted, Well-Developed and Insanely Strong Middle, You Need to Find the Balance Between Maintaining Mass While Shedding Fat. Sounds Impossible, Right?” Muscle & Fitness (July 2006), 124–129.
Vitetta-Miller, Robin. “The Flat Abs Diet: Use Our Six Eating Strategies to Get a Sleeker Belly.” Shape (August 2003),176–181.
Zinczenko, David. “Eat Right Every Time.”Men’s Health (January-February 2005), 130.
Zinczenko, David. “7 Days to a 6-Pack.” Men’s Health (September 2004), 158.
Zinczenko, David. “Abs Diet.” Men’s Health (July-August 2004), 154.
ORGANIZATIONS
American College of Nutrition. 300 South Duncan Ave., Suite 225, Clearwater, FL 33755. Telephone: (727) 446-6086. <http://www.amcollnutr.org>.American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. <http://www.eatright.org>.
American Society for Nutrition. 9650 Rockville Pike, Bethesda, MD 20814. Telephone: (301) 634-7050. <http://www.nutrition.org>.
Center for Nutrition Policy and Promotion. 3101 Park Center Drive, 10th Floor, Alexandria, VA 22302-1594. Telephone” (703) 305-7600. <http://www.cnpp.usda.gov>.
Ken R. Wells
Acne diet
Definition
The acne diet or more accurately, the acne-free diet, is simply a way of eating claims to improves or eliminates acne. There is some debate in the medical community about the impact of diet on acne; however, there is a body of evidence to support the idea that what is eaten may affect the skin.By reviewing research from over 40 years, doctors such as dermatologist, Dean Goodless have developed a set of recommendations regarding foods that may prevent acne. In his book The Acne-Free Diet Plan, Dr. Goodless presents his recommendations. He suggests eating a diet low in fat and high in fiber along with avoiding peanut product, fried foods, excessive salt, dairy products, foods that are high in refined sugars, and high carbohydrate foods.
Origins
As long as people have had pimples, there have been attempts to clear them up quickly or prevent them all together. Most cultures have folk remedies to help clear the skin. It wasn’t until the last 50 years that serious scientific research has been conducted to confirm or disprove these folk tales and myths. One of the earliest studies about food and acne focused on chocolate. This study found that chocolate did not increase acne breakouts. Other studies since have confirmed this finding.For the most part, acne treatment has been the emphasis of research; however, there have been isolated studies that explored the effect of specific vitamin and mineral supplements on acne. Other studies have investigated ethnic groups and communities from the
Possible causes of acne
- The hormone increase in teenage years (this can cause the oil glands to plug up more often)
- Hormone changes during pregnancy
- Starting or stopping birth control pills
- Heredity
- Some types of medicine
- Greasy makeup
(Illustration by GGS Information Services/Thomson Gale.).
Pacific Islands to Africa where there is little or no incidence of acne, even during puberty. When the diets of these people are compared to the typical Western diet, there are nutritionally significant differences. The ethnic groups with very low incidence of acne ate predominately plant-based diets that were low in fat and virtually sugar-free. The typical Western diet is heavy in meats, saturated fat, refined sugar, and highly processed foods. By studying these differences, doctors and researchers have developed suggestions for dietary changes to improve or eliminate acne.
Description
Integrating the results of many studies, dermatologists and nutritionists have developed a list of foods to avoid and beneficial vitamins and minerals to consume. The following acne diet has been proposed to help prevent acne breakouts:- Eat 20 to 30 grams of fiber every day–Fiber helps keep the colon clean and may remove toxins from the body before they reach the skin.
- Eat a low fat diet–The cultures whose natural diet was low in fat, had less acne, and high fat consumption may elevate hormone levels in the body that cause blemishes on the skin.
- Avoid peanut products–Peanut products were found to cause acne flare ups in a study of 500 adolescents.
- Avoid fried foods—Fried foods were found to caused break outs.
- Limit salt intake especially table salt or iodized salt– Many people with acne have elevated levels of iodine, found in table salt, in their blood stream during acne flare ups.
- Avoid highly salty sacks such as chips, lunch meats, canned foods, and salted popcorn–These foods are high in salt and, in some cases, fat.
KEY TERMS
Acne Vulgaris—An inflammatory disease of the skin characterized by pimples and cysts that may cause scarring in severe cases.Carbohydrate—An organic compound that supplies energy to the body.
Dermatologist—A doctor who specializes in the treatment of the skin.
Glycemic index—A scale for rating how quickly foods are converted to glucose or sugar by the body. It describes the impact on insulin levels of foods as they are digested.
Hormone—Substances in the body that regulate a process such as metabolism or growth.
Insulin—A hormone that regulates the conversion of food into glucose or sugar so it can be used by the body for energy.
Metabolism—The process by which food is converted into energy.
Nutritionist—A specialist in the field of diet and nutrition.
PreMenstrual—The days prior to menstruation in a woman.
Sebaceous glands—Small glands in the skin, usually part of hair follicles, that produce a fatty substance called sebum.
Sebum—The fatty substance secreted by sebaceous glands. It helps moisturize and protect skin and hair.
- Avoid dairy products such as milk, cheese and ice cream
- Avoid highly processed carbohydrates such as sodas, candy, and baked goods–High carbohydrate foods raise the level of insulin in the blood and elevated insulevel may raise the levels of acne–causing hormones in the body.
- Vitamin A (may be toxic consult your doctor first)
- Vitamin E
- Vitamin B6
- Selenium
- Zinc
- Omega-3 Fatty Acid
- Chromium
Function
Opinions vary in the medical community as to whether or not diet plays a significant role in acne. Some common misconceptions about the connection between food and acne breakouts have been disproved. For example, according to several studies, chocolate does not cause acne.. Acne is caused when glands in the skin called sebaceous glands begin to form sticky oil called sebum. These glands are stimulated by hormones that become active at puberty which is why acne occurs most often in adolescence when these hormones are produced in abundance. The oils formed by the sebaceous glands hold dead skin cells preventing them form being sloughed off. As these cells die, they create the perfect environment for bacteria to grow. When these bacteria called Acne Vulgaris become too plentiful, they will attempt to erupt from the skin causing a pimple. Sometimes, when the bacteria grow, the body sends white blood cells to fight the infection. This natural reaction can cause painful, large cysts to form in the deeper layers of skin. Chocolate may not cause acne, but the fat and sugar that usually accompanies chocolate may.Eliminating certain foods from the diet and increasing the amount of specific vitamins and minerals may help reduce the amount of sebum produced and prevent acne breakouts. However, the interaction between diet and acne is not a simple cause and effect relationship. If an oily food is eaten, the oil does not travel to the skin or cause it to be oily, but high levels of fat in the blood may effect the production of hormones such as testosterone. Higher levels of hormones may cause acne to worsen.
Many high carbohydrate foods are believed to worsen acne. Researchers have discovered that high carbohydrate foods increase the levels of insulin in the blood. High levels of insulin can raise hormone levels in the blood.
Researchers recognize that not all carbohydrates are bad. Some carbohydrates digest more slowly than others, causing a gradual rise in blood sugar after eating. Researchers have developed a glycemic index to rank carbohydrates and other foods according to the effect they have on blood sugar.
Foods that have a high glycemic index rating include: white bread, white rice, white potatoes depending on how they are cooked, beer, corn products and some products containing refined sugars. Foods with moderate glycemic index ratings include: whole grain breads and pastas, brown rice, sweet potatoes, green peas, many fruits (especially when eaten alone) and yogurt. Many of these foods are on the list of foods to avoid in the acne diet.
Low glycemic index or no GI foods include: rye grain, nuts, legumes such as black beans and lentils, green vegetables, apricots, and cherries. These foods may be enjoyed an may not worsen acne.
Foods that are high in fiber tend to have lower glycemic index numbers, because fiber takes longer to digest. Studies have shown that the presence of other foods such as fats like olive oil, can also slow digestion and keep blood sugar from rising too quickly. The glycemic index can be used along with the acne diet, to help choose which carbohydrates can be eaten with the least effect on blood sugar.
Benefits
Even if many dermatologists do not believe dietary changes will improve acne, they see little harm in adopting a diet that encourages eating fruits and vegetables and limits processed and high sugar foods.Eating foods low on the glycemic index may help prevent other medical conditions such as diabetes, heart disease, and obesity.
Precautions
Limiting the amount of dairy products in the diet may limit the amount of calcium consumed, for that reason, a calcium supplement may be needed to insure daily dietary calcium requirements are met. Poor intakes of calcium can be very damaging to one’s health.Zinc supplements can cause stomach upset. Authors of acne diet plans recommend no more than 30mg of zinc per day to avoid this.
Vitamin A is a fat soluble vitamin. That means that excess vitamin A is stored in your body rather than eliminated in your urine. Too much vitamin A can be harmful. Consult a doctor before taking vitamin A supplements.
QUESTIONS TO ASK THE DOCTOR
- What type of acne do I have?
- Will this diet improve my acne?
- Can this diet hurt me?
- Will this diet make my acne worse?
- How long do I need to follow this diet?
Risks
There are few risks associated with an acne diet. Most relate to taking zinc, vitamin A, and calcium. Zinc may prevent the body from absorbing enough copper. To avoid this, take a supplement that specifically states that it does not prevent copper absorption.High doses of vitamin A can be toxic. Many acne prescriptions contain concentrated forms of vitamin A. Consult a doctor before taking vitamin A supplements.
Limiting intake of calcium can cause deficiency and significant health problems. Supplementation may be necessary.
High doses of vitamin A can cause birth defects if taken during pregnancy. Pregnant women should, under no circumstances take vitamin A supplements or medications containing vitamin A.
Research and general acceptance
General acceptance
While most dermatologists will not confirm that altering diet may prevent acne, it is standard practice for many doctors to advice patients to avoid foods that seem to cause more severe breakouts.It is widely accepted that supplements such as zinc and vitamin A help reduce the number and severity of acne breakouts. In fact, Acutane and Retin A, popular prescription medications used to treat acne are both made from forms of vitamin A.
Research
Studies of the diets of ethnic groups that have a low incidence of acne form the basis of most of the acne diets. Studies of the diets of tribes in New Guinea, Paraguay, and the Bantu of South Africa, all of whom have little or no acne, show that they eat a primarily plant-based diet. Similarly, in other countries where the diet is plant-based such as Japan, there is a relatively low occurrence of acne.Studies have shown that half of acne patients tested had abnormal glucose levels, and in another study, 80%of premenstrual women with acne had abnormal glucose metabolism These data and others that show a high carbohydrate diet increases the levels of testosterone in the blood of both men and women, have lead to the recommendation of reducing the amount high carbohydrate foods or foods containing high levels of refined sugar to treat acne.
Researchers have developed a method for measuring how quickly carbohydrates are converted into glucose. The more rapidly a food is converted to glucose, the higher the level of insulin is secreted into the blood. The scale is called the glycemic index. Eating lower glycemic index foods may help reduce the number and severity of acne breakouts.
A large study of over 45,000 nurses found a link between the amount of dairy products these women consumed and the severity of acne they experienced. Women who reported consuming higher amounts of dairy products reported more severe acne. Similarly, the two ethnic groups with little or no acne also consumed no dairy products.
Several studies have compared the results of zinc supplementation with oral antibiotic therapy to resolved acne and found zinc to be almost as effective as the antibiotic tetracycline.
Resources top
BOOKS
Goodless, Dean R. MD. The Acne-Free Diet Celebration, FL: New Paradigm Dermatology, 2005.Perricone, Nicholas MD. The Acne Prescription: The Perri-cone Program for Clear and Healthy Skin at Every Age New, NY: HarperCollins, 2003.
PERIODICALS
Adebamowo, C. A., D. Spiegelman, F. W. Danby, A. L. Frazier, W. C. Willett, and M. D. Holmes. “High School Dietary Intake and Teenage Acne.” JAm Acad Dermatol 52 (2005): 207–14.Ayres, S. and R. Mihan. “Acne Vulgaris: Therapy Directed at Pathophysiologic Defects.” Cutis 28 (1981): 41–42.
Cordain, L., S. Lindeberg, M. Hurtado, K. Hill, S. B. Eaton, and J. Brand-Miller. “Acne Vulgaris: A Disease of Western Civilization.” Arch Dermatol 139 (2002): 1584–90.
Deplewski, D. and R. L. Rosenfield. “Growth Hormone and Insulin-like Growth Factors Have Different Effects on Sebaceous Cell Growth and Differentiation.” Endocrinology 140, no. 9 (Sept 1999): 408–994.
Gaul, L. E. “Salt Restriction in Acne Vulgaris.” Indiana State Med Assoc 58 (1965): 839–42.
Levin, O. L. and M. Kahn. “Biochemical Studies in Diseases of the Skin: II Acne Vulgaris.” Am J M Sc 164 (1922): 379–85.
Leung, L. H. “Pantothenic Acid Deficiency as the Pathogenesis of Acne Vulgaris.” Medical Hypotheses 44 (1995): 490–92.
Michaelsson, G., L. Luhlin, and K. Ljunghall. “A Double-Blind Study of the Effect of Zinc and Oxytetracycline in Acne Vulgaris.” Br JDermatol97 (1977): 561–66.
Yeh, H.P. “Acne in Taiwan.” J Formosan Med Assoc 74 (1975): 212–19.
Deborah L. Nurmi, MS
ADHD diet
ADHD diet
Definition
Attention deficit hyperactivity disorder (ADHD) is defined as the combination of inattentive, hyperactive and impulsive behavior which are severe, developmentally inappropriate, and impair function at home and in school. Common features include mood swings, anxiety, impulsivity, hostility, poor concentration and sleeping disorders, along with physical complaints such as headaches, migraines, and stomach upsets. ADHD individuals are also more likely to have been of low birth weight and to have allergies or auto-immune problems. Proportionally more males than females are affected, with inattention tending to be a more female trait and hyperactivity more common in males.ADHD does persist into adulthood, although symptoms tend to diminish with time, but the main focus relates to the problems of children with ADHD. Growing children are especially vulnerable to nutritional and environmental factors that influence brain development and function, which can have either a negative or positive impact. The symptoms of this difficult condition can also significantly compromise their education, making them challenging to teach and consequently having a deleterious effect on their
Possible causes of ADHD-like behavior
- A sudden change in the child’s life—the death of a parent or grandparent; parents’ divorce; a parent’s job loss
- Undetected seizures, such as in petit mal or temporal lobe seizures
- A middle ear infection that causes intermittent hearing problems
- Vision problems
- Medical disorders that may affect brain functioning
- Underachievement caused by learning disability
- Anxiety or depression
Behaviors associated with ADHD can be caused by other factors. It is best to consult a medical professional to rule out these possibilities. (Illustration byGGS Information Services/ Thomson Gale.).
life-potential. The daily challenges of living with ADHD place a huge strain on families and reduces overall quality of life for all involved.
Origins
Back in 1981, Colquhoun and Bunday undertook a comprehensive survey of children with ADHD and discovered that many showed physical signs of essential fatty acid (EFA) deficiency, including excessive thirst, polyuria, dry hair and skin. These authors were the first to propose that fatty acid deficiency may be a factor in ADHD, and their ground-breaking work prompted more research studies and clinical trials designed to increase understanding of those nutritional factors involved in ADHD.It has now been proposed that many developmental and psychiatric conditions, including ADHD along with dyslexia, dyspraxia, autism, depression, and schizophrenia, may involve deficiencies of certain long-chained fats, especially eicosapentaenoic acid ( EPA) and docosahexaenoic acid (DHA). Both iron deficiency and zinc deficiency have also been associated with the development of ADHD.
Description
Dietary Fats
Fats have a fundamental structural and functional role in the brain and central nervous system (CNS) and are a key factor in the development ADHD. The two fats that are thought to be especially important are EPA and DHA, not only because of their role in the brain and body but because of the relative lack of them in many people’s diets. EPA is the precursor of a complex group of substances, called eicosanoids, which perform numerous regulatory functions in the brain and body. DHA is a major ‘building block’ of brain and neuronal membranes and as such has a profound influence on cell signalling. Both EPA and DHA are omega-3 fats and can be made from the omega-3 essential fatty acid, alpha linolenic acid (ALA). However, this conversion process can be problematic as genetic and environmental factors, including diet, can cause great variation in an individual’s constitutional ability to convert ALA into EPA and DHA. Dietary factors known to adversely affect this conversion include low intakes of ALA, high intakes of omega-6 fats, saturated fat, hydrogenated fat and alcohol, in addition to vitamin and mineral deficiencies, testosterone and stress hormones. Unfortunately, many dietary surveys have revealed that a typical modern-day diet is rich in omega-6 fats, saturated fats and hydrogenated fats and often low in omega-3 fats and micronutrients. ADHD children are often found to be deficient in iron and zinc and the fact that more boys than girls tend to be affected may be partly explained by the negative effect of testosterone on this conversion process.In order to avoid a functional deficiency of these important fats, the diet should have a smaller ratio of the omega-6 essential fat, linoleic acid (LA) to omega-3 essential fat (ALA), at an ideal ratio of no more than 5:1, as well as adequate amounts of pre-formed EPA and DHA. The richest dietary sources of LA are certain vegetable and seed oils, including sunflower, safflower, soya, palm, peanut and sesame, all of which should be eaten in good amounts along with oils that are rich in ALA such as rapeseed (canola), flaxseed (linseed) and walnut oil. Olive oil is also recommended, despite having quite a low ALA content, as it is rich in beneficial monounsaturated fats. Looking at types of spreading fat available, many margarines have been specifically formulated to be rich in ALA, although some brands still contain harmful hydrogenated fats, but it is worth remembering that butter actually has a low LA content and when mixed with equal quantities of rapeseed or olive oil, the saturated fat content is much reduced. Other sources of ALA include green, leafy vegetables such as rocket, watercress and spinach as well as fresh green herbs, such as basil, coriander, mint and parsley. Consequently, the food products of animals allowed to graze on open pasture will also be rich in ALA and so organic, free-range and outdoor-reared meat, milk and eggs are the best choice.
When it comes to sources of EPA and DHA, fish and seafood are the best sources with oily fish , such as salmon, trout, mackerel, sardines, herring and anchovies, being especially rich. Fresh tuna is classed as an
Autism—Autism, or autistic spectrum disorder (ASD), is a serious developmental disorder, characterized by profound deficits in language, communication, socialisation and resistance to learning.
Auto-immunity—A response, involving the immune system, that results in a person’s own tissues being attacked.
Benzoic Acid—A type of preservative used in processed foods known to cause food sensitivity in some individuals when consumed in the diet.
Carnitine—This is a naturally occurring substance, needed for the oxidation of fatty acids, a deficiency of which is known to have major adverse effects on the CNS.
Dietitian—A Healthcare Professional, qualified to degree or post-graduate level, who advises individuals on diet and nutrition as part of a treatment strategy for particular medical conditions or for disease prevention.
Dyslexia—An inherent dysfunction affecting the language centres of the brain which results in difficulties with reading and writing.
Dyspraxia—A developmental disorder that affects co-ordination and movement.
Elimination Diet—A diet consisting of a limited range of foods, classed as low risk in terms of causing food sensitivity or allergy.
Essential Fatty Acid—A type of fat that is necessary for the normal function of the brain and body and that the body is unable to produce itself, making them ’essential’ to be taken through the diet and / or supplements.
Ferritin—Iron is stored in the body, mainly in the liver, spleen and bone marrow, as ferritin.
Functional Deficiency—The depleted state of a particular nutrient that precipitates compromised function within the brain or body.
Hydrogenated Fats—A type of fat made by the process of hydrogenation, which turns liquid oils into solid fat. Bio-hydrogenation occurs in ruminant animals (eg. cows) and so small amounts of hydrogenated fats are found in butter, dairy foods and meat but these are accepted as being harmless. The commercial hydrogenation of oils produces large quantities of hydrogenated fats and have been implicated in the development of coronary heart disease and impaired cell signalling in the brain.
Lipid Peroxidation—This refers to the chemical breakdown of fats.
Neurotoxic—A substance that has a specific toxic effect on the nervous system.
Oxidative Injury—Damage that occurs to the cells and tissues of the brain and body by highly reactive substances known as free radicals.
Polyuria—An excessive production of urine.
Sodium Benzoate—A type of preservative used in processed foods known to cause food sensitivity in some individuals when consumed in the diet.
Sodium Metabisulphite—A type of sulphite preservative used in processed foods known to cause food sensitivity in some individuals when consumed in the diet.
Sulphites—A type of preservative used in processed foods known to cause food sensitivity in some individuals when consumed in the diet.
Sulphur Dioxide—A type of preservative used in processed foods known to cause food sensitivity in some individuals when consumed in the diet.
Vanillin—A synthetic version of vanilla flavoring.
oily fish but the canning process causes a significant loss of fatty acids so tinned tuna has an EPA and DHA content comparable to white fish, such as cod, haddock and plaice. Certain varieties of fish are more likely to contain large amounts of pollutants such as mercury and lead which are known to be neurotoxic and so it is prudent for people with ADHD, and all children under 16 years of age, to avoid eating shark, marlin and swordfish. DHA can also be found in liver and egg yolks and so these foods should be incorpo rated into the diet regularly, unless you are taking a nutritional supplement that contains vitamin A in which case you should not eat liver or foods containing liver such as pâté.
Dietary Antioxidants
If intakes of long-chained polyunsaturated fats (PUFAs), such as EPA and DHA, increase then so does the risk of lipid peroxidation by the action of harmful free radicals, smoking, and pollutants, etc.; substances produced in the body by normal processes such as breathing and metabolism. PUFAs are highly susceptible to attack from these reactive substances and need the protection of antioxidants to avoid getting damaged and thus affecting the structure of the lipid membranes of the brain and CNS. When free radical production is insufficiently countered by antioxidants the resultant damage to the brain and body is termed ’oxidative injury’.Dietary antioxidants include nutrients such as vitamin E and selenium as well as biologically active substances such as flavonols, anthocyanins and carotenoids, found in highly colored fruits and vegetables, nuts, tea and red wine. Vitamin E is naturally found in PUFA-rich foods like oils and nuts whilst selenium is found in fish, seafood, liver, egg, brazil nuts, mushrooms and lentils. Eating the recommended daily minimum of 5 portions of fruit and / or vegetables should provide adequate amounts of complementary dietary antioxidants, especially if a wide range of colors and varieties are chosen.
Dietary Iron
Iron deficiency has been associated with ADHD in children and tends to be worse even when compared with iron-deficient non-ADHD controls. Lower serum ferritin levels correlate with more severe ADHD symptoms and greater cognitive deficits.Dietary sources of iron include red meat, fortified breakfast cereals, pulses and dried apricots and these foods should feature regularly in the ADHD diet. Additional supplementary iron may be required in cases of proven iron deficiency.
Dietary Zinc
Zinc has a range of important functions in the body, including the metabolism of neurotransmitters and fatty acids, with zinc deficiency possibly having an effect on the development of ADHD. Children with ADHD who have been treated with supplementary zinc have exhibited reduced hyperactive, impulsive and impaired-socialisation symptoms.Foods known to be rich in zinc include seafood, liver, pine nuts, cashew nuts and wholegrain cereals and so should be eaten regularly to help avoid deficiency.
Synthetic Food Additives
Certain synthetic food colorings, flavorings and preservatives, have been linked to increase hyperactivity in some ADHD and non-ADHD children. Many of these additives are unnecessary and are frequently used to sell poor-quality foods, that are often marketed specifically at children.The following additives have been implicated in adverse reactions:
- E102
- E104
- 107
- E110
- E122
- E123
- E124
- 128
- 133
- E142
- E150
- E151
- E154
- E155
- E180
- E221
- E222
- E223
- E224
- E226
- E227
- E228
- benzoic acid
- sodium benzoate
- sodium metabisulphite
- sulphur dioxide
- vanillin
Function
The ADHD diet works by providing the right type and amount of fats needed for the brain and CNS as well as providing sufficient amounts of iron and zinc to avoid nutritional deficiencies that are known to be associated with worsening ADHD symptoms. Nutritional supplements should be taken upon the advice of a Doctor or Dietitian and taken in addition to a healthy, balanced diet. Dietary provision of antioxidants are needed to protect the long-chained fats from breakdown which would affect brain structure and compromise signalling within the brain and CNS. Finally, the ADHD diet excludes those synthetic food additives that have been identified as having the potential to adversely affect the behavior of ADHD, and non-ADHD children alike.Benefits
The key benefit of the ADHD diet is that it provides the correct types of foods needed to support the nutritional requirements of both the brain and body. It provides the nutrients needed to sustain good growth and development in children, as well as general health promotion for all, whilst excluding potential antagonistic additives. The diet supports other treatment strategies, including stimulant medication, and so helps to improve the quality of life and educational possibilities of those individuals affected.Precautions
Detailed, personalized advice should always be sought from a suitably qualified dietitian, especially when dealing with children. Any nutritional supplements should always be taken according to the manufacturers instructions and at the prescribed dosage. IfQUESTIONS TO ASK YOUR DOCTOR
- Which nutritional supplements are recommended for ADHD?
- What are the best food choices for ADH D?
- Which food additives should be avoided?
- What are the vegetarian sources of omega 3 fats?
Risks
It has been reported that fish oil supplements when taken along side stimulant medication can exacerbate hyperactive behavior in some ADHD individuals. In these circumstances, the supplement should continue to be taken and the dosage of the medication be altered accordingly, under the supervision of a Doctor.Fish oil supplements can also reduce blood clotting times and so should not be used if anti-coagulant medication is already being taken.
There is no risk attached to the ADHD diet in terms of foods chosen and the diet can be safely followed by ADHD and non-ADHD individuals alike.
Research and general acceptance
Among the specialists working in this particular field, there is a general consensus that ADHD is a disorder that involves a functional deficiency of the long-chained fats, EPA and DHA that frequently coexists with zinc and iron deficiencies. Among the wider community there remains a great deal of scepticism about ADHD and the role that diet has in its development or management.In terms of supplementation, insufficient data is available to formulate a standardized treatment strategy and it is unclear whether the micronutrient deficiencies are a cause of, or secondary to, ADHD. Other intervention studies have looked in to carnitine supplementation and elimination diets but their findings remain inconclusive.
Resources top
BOOKS
Richardson, Alex. They Are What You Feed Them Harper Thorsons 2006Simopoulos, Artemis and Jo Robinson. The Omega Diet Harper Collins Publishers 1999
Stevens, Laura. 12 Effective Ways to Help Your ADD / ADHD Child Penguin 2000
Stordy, Jacqueline and Malcolm Nicholl. The LCP Solution Macmillan 2002.
PERIODICALS
Akhondzadeh et al. “Zinc sulphate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double-blind and randomised trial” Bio Med Central Psychiatry 2004 4:9.Antalis et al. “Omega 3 fatty acid status in attention-deficit/ hyperactivity disorder” Prostaglandins Leukotrienes and Essential Fatty Acids 2006 75 (4-5) p299-308.
Bateman et al. “The effects of a double-blind, placebo-controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of pre-school children” Archives of Disease in Childhood 2004 89 p506-511.
Bilici et al. “Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder” Progress in Neuropsychopharmacology and Biological Psychiatry 200428 (1) p181-190.
Bourre. “Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients” Journal of Nutrition, Health and Ageing 200610 (5) p377-385.
Bourre. “Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 2: macronutrients” Journal of Nutrition, Health and Ageing 200610 (5) p386-399.
Brookes et al. “Association of fatty acid desaturase genes with attention deficit/hyperactivity disorder” Biological Psychiatry 2006 epub ahead ofprint.
Colquhoun & Bunday. “A lack of essential fatty acids as a possible cause of hyperactivity in children.” Medical Hypotheses 19817 (5) p673-679.
Galler et al. “Behavioural effects of childhood malnutrition” American Journal of Psychiatry 2005 162 p1760-1761.
Georgieff. “Nutrition and the developing brain: nutrient priorities and measurement” American Journal of Clinical Nutrition 2007 85 (2) supp p614-620.
Hallahan and Garland. “Essential fatty acids and their role in the treatment of impulsivity disorders” Prostaglandins Leukotrienes and Essential Fatty Acids 2004 71 (4) P211-216.
Konofal et al. “Iron-deficiency in children with attentiondeficit/hyperactivity disorder” Archives of Pediatric and Adolescent Medicine 2004158 (12) p1113-1115.
Richardson. “Clinical trials of fatty acid treatment in ADHD, dyslexia, dyspraxia and the autistic spectrum” Prostaglandins Leukotrienes and Essential Fatty Acids 2004 70 p383-390.
Richardson. “Long-chain polyunsaturated fatty acids in childhood developmental and psychiatric disorders” Lipids 2004 39 p1215-1222.
Richardson. “Omega 3 fatty acids in ADHD and related neurodevelopmental disorders” International Review of Psychiatry 200618(2) p155-172.
Schab and Trinh. “Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind, placebo-controlled trials” Journal of Developmental and Behavioural Pediatrics 2004 25(6) p423-434.
Stevenson. “Dietary influences on cognitive development and behaviour in children” Proceedings of the Nutrition Society 2006 65 94) p361-365.
Virmani et al. “Effects of metabolic modifiers such as carnitines, coenzyme Q10 and PUFAs against different forms of neurotoxic insults: metabolic inhibitors, MPTP and methamphetamine” Annals of the New York Academy of Science 2005 1053 p183-189.
Virmani and Binienda. “Role of carnitine esters in brain neuropathology” Molecular Aspects of Medicine 2004 25 (5-6) p533-549.
ORGANIZATIONS
Brain and Body Nutrition www.brainandbody.co.uk.British Dietetic Association 5th Floor Charles House 148/9 Great Charles Street Queensway Birmingham B3 3HT www.bda.uk.com.
Food Standards Agency www.food.gov.uk.
Freelance Dietitians Group (UK) www.dietitiansunlimited.co.uk.
Emma Mills, RD
British Heart Foundation diet
Definitions
The British Heart Foundation diet is a three day diet that claims to allow dieters to lose 10 pounds in three days if they follow the diet’s specific meal plan. It was not created by nor is it endorsed by the British Heart Foundation. .Origins
The origins of the British Heart Foundation diet are unclear. It was not created by the British Heart Foundation as its name implies, and the British Heart Foundation does not endorse or recommend this diet in any way. The diet seems to circulate mainly from person to person and on the internet.It is not clear in which country the diet originated, as some versions call for Ritz Crackers (an American product), some call for Snax crackers (an Australian product), and some call for biscuits (a British term). It is probable that the diet developed in Britain because of the reference to the British Heart Foundation and because most versions call for “beetroot,” which is a British term for what Americans call beets.
Description
The British Heart Foundation diet is a diet that is intended to be done over the course of three days.During these three days the diet claims that a dieter can lose ten pounds if the diet is followed exactly. There are many variations of this diet, with the main differences being in which crackers or sausages are called for. These differences may reflect cultural food differences between the different places in the world that this diet has been circulated.
During this diet, the dieter is provided with a meal plan for three meals a day for each of three days. Amounts of food are specified in ounces, so to follow this diet effectively a dieter needs a kitchen scale or other means of accurately weighing food. The diet requires that dieters drink five eight-ounce glasses of water each day, and nothing else except the black tea or coffee specified in the meal plan. The diet says that it must be followed exactly to result in the promised weight loss. .
Day One
Breakfast: For breakfast the dieter must drink black coffee or tea, and eat 1/2 of a grapefruit, one slice of dry toast, and 2 teaspoons of peanut butter.Lunch: For lunch the dieter must again drink black coffee or tea. The dieter must eat 4 ounces of tuna and one slice of dry toast.
Dinner: For dinner the dieter must eat 2 slices of any cold meat, 1 cup of string beans, 4 ounces of beets, 1 small apple, and 4 ounces of vanilla ice cream. No specific requirement is made for a drink with this meal, so only water is allowed.
Day Two
Breakfast: For breakfast on day two the dieter may again drink black tea or coffee. Today the dieter must eat 1 egg (boiled or poached), 1 slice of dry toast, and 1/2 of a banana.Lunch: For lunch the dieter must eat 4 ounces of cottage cheese and 5 crackers. The brand of cracker varies, some versions require Ritz, Tuc, Snax, or Saltine brand crackers.
Dinner: For dinner the dieter must eat 3 ounces of broccoli, 2 ounces of carrots, 1/2 of a banana, and 2 hot dogs. Some versions call for frankfurters instead of hot dogs. Dinner is again finished with 4 ounces of vanilla ice cream.
Day Three
Breakfast: For breakfast the dieter may drink black tea or coffee and eat 5 crackers, 1 slice of cheddar cheese, and 1 small apple.Lunch: Lunch onthe third day is 1 hard boiled egg and 1 slice of dry toast. There is no specified drink so the dieter must drink water.
Dinner: Dinner on the last day of the diet is 4 ounces of tuna, 4 ounces of beets, 4 ounces of cauliflower, 1/2 of a melon, and 4 ounces of vanilla ice cream.
Some versions of the diet specify that the tuna must be the type packed in water, not oil, although some do not. This makes sense as tuna packed in oil can contain many more calories and many more grams of fat than the type that is packed in water. No specifications are made for whole grain toast, but whole grain bread is usually considered to be more healthy and to contain more vitamins and minerals than white bread.
Function
Benefits
The British Heart Foundation diet claims that it will allow dieters to lose 10 pounds in only 3 days. Many experts suggest that if weight loss does occur this quickly, the weight lost will mainly be water weight that will be gained back when the dieter begins to eat normally again. A possible benefit however, is that losing weight quickly may help give dieters the positive outlook required to help them continue to lose weight using a more balanced approach. This psychological benefit may be undone if the weight is regained quickly after the diet is completed.There are many benefits to losing weight if it is done at a safe, moderate pace through a combination of healthy eating and exercise. There are many conditions for which obesity is considered a significant risk factor, including type II diabetes and cardiovascular disease. The risk of these and other diseases may be reduced through weight loss. This is especially true for very obese people who are generally thought to be at the greatest risk. The Sacred Heart diet is not considered appropriate for long term weight loss, and losing 10 pounds in 3 days is not considered a moderate pace.
Precautions
Dieters should consult a physician or other medical professional before beginning this or any other diet. Daily requirements of vitamins and minerals can differ significantly between people, depending on age, weight, gender, and the presence of certain diseases and conditions. Getting all required nutrients can be difficult when on a diet that severely limits the types or amounts of food allowed. This diet may contain as few as 700 calories a day if followed exactly. This is not considered to be a safe number of calories for weight loss unless the diet is done under a phys-icians’s close supervision. Pregnant or breastfeeding women should be especially cautious because what is eaten by the mother can affect unborn or nursing babies.Risks
There are some risks with any diet, but following a diet that severely limits the foods the dieter is allowed to eat generally has higher risks. When a dieter consumes very few different foods it is difficult for the dieter to get all of the different vitamins and nutrients required for good health. The British Heart Foundationdiet is only intended to be done over three days. Because it is a very low calorie diet, repeating this diet frequently or over an extended period may greatly increase the risk of problems relating from deficiencies of vitamins, minerals, or calories. Pregnant or breastfeeding women should be especially cautious, because even minor deficiencies can carry risks for babies who are still receiving their nutrients from their mother. Anyone beginning this, or any other very limiting diet, should consult a medical practitioner about whether a multivitamin or supplement might be appropriate for to help reduce the risk of deficiency. Multivitamins and s! upplements have their own associated risks.
Research and general acceptance
There have been no significant scientific studies of the safety or effectiveness of this diet. Although it is named the British Heart Foundation diet, it was not created by the British Heart Foundation, and the Foundation does not endorse or recommend it. Instead the British Heart Foundation makes recommendations for slow, healthy weight loss and weight control that involve light to moderate exercise and a well balanced, healthy diet. The recommendations endorsed by the British Heart Foundation for a healthy diet are generally similar to those provided by the United States Department of Agriculture’s MyPyramid guide.MyPyramid recommends that adults eat the equivalent of 2 to 3 cups of vegetables each day for good health. The British Heart Foundation diet may meet this requirement. Each day requires that the dieter eat two different types of vegetables at dinner.
For many people these amounts might be enough to meet the minimum requirements. Vegetables are an especially important part of any weight loss plan, as well as part of any healthy diet, because they are often low in calories but have high volume, which can help a dieter feel full and satisfied while eating fewer calories.
The British Heart Foundation diet may also meet the recommendations for fruit. MyPyramid recommends that healthy adults eat the equivalent of 1 1/2 to 2 cups of fruit per day. 1 cup of fruit is equivalent to 1 small apple, or 1 large orange. This diet includes two different types of fruit each day, one at breakfast and one at dinner. This may meet the recommendations for most people.
Dairy products are generally considered to be part of a healthy diet. MyPyramid recommends the equivalent of 3 cups of low-fat or non-fat dairy each day for healthy adults. The British Heart Foundation Diet would not meet this recommendation. The diet provides dairy, about half of which is in the form of four ounces of ice cream eaten each night. Ice cream is not considered an optimal way to get required dairy, as it is often high in fat. The diet also does not provide enough dairy, and because the dieter is not allowed to drink skim milk while on the diet there is no way for the dieter to increase dairy intake while still strictly following to the diet.
MyPyramid recommends that healthy adults eat the equivalent of 3 to 4 ounces of grains each day, of which at least half should be whole grains. This is equivalent to about one piece of whole grain bread. The British Heart Foundation diet would provide about two servings of grains per day. These are in the form of toast and crackers, which are not specified as whole grain. This would not meet the MyPyramid recommendation.
The MyPyramid recommendation for the meat and beans group is that healthy adults eat between 5 and 6 1/2 ounces of food from this group each day. One egg or one tablespoon of peanut butter are equivalent to about one ounce from this group. The British Heart Foundation diet may provide dieters with enough servings from this food group.
The diet requires dieters to drink five eight-ounce glasses of water each day, and nothing else except for the drinks required by the meal plan. Generally it is recommended that adults drink eight eight-ounce glasses of water each day, so this diet would not meet this recommendation.
The British Heart Foundation diet does not include any recommendations for exercise. In 2007, the Center for Disease Control recommended that healthy adults get at least 30 minutes per day of light to moderate exercise. Regular exercise has been shown to have many health benefits including decreasing the risk of cardiovascular disease. Additionally, studies have shown that regular exercise can help dieters manage their weight. Plans that include diet and exercise together have been shown to help dieters lose more weight than just diet or exercise done alone.
BOOKS
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: http://www.eatright.org.OTHER
British Heart Foundation 2007. http://www.bhf.org.uk (April 7, 2007)Get the Skinny on Diets 2007. http://www.skinnyondiets.com (March 26, 2007).
Helen M. Davidson
Body mass index
Definition
Body mass index (BMI), also called the Quetelet Index, is a calculation used to determine an individual’s amount of body fat.Purpose
The BMI gives healthcare professionals a consistent way of assessing their patients’ weight and an objective way of discussing it with them. It is also useful in suggesting the degree to which the patient may be at risk for obesity-related diseases.Description
BMI is a statistical calculation intended as an assessment tool. It can be applied to groups of people to determine trends or it can be applied to individuals. When applied to individuals, it is only one of several assessments used to determine health risks related to being underweight, overweight, or obese.The history of BMI
The formula used to calculate BMI was developed more than one hundred years ago by Belgian mathematician and scientist Lambert Adolphe Quetelet (1796-1874). Quetelet, who called his calculation the Quetelet Index of Obesity, was one of the first statisticians to apply the concept of a regular bell-shaped statistical distribution to physical and behavioral features of humans. He believed that by careful measurement and statistical analysis, the general characteristics of populations could be mathematically determined. Mathematically describing the traits of a population led him to the concept of the hypothetical “average man” against which other individuals could be measured. In his quest to describe the weight to height relationship in the average man, he developed the formula for calculating the body mass index.Calculating BMI requires two measurements: weight and height. To calculate BMI using metric units, weight in kilograms (kg) is divided by the height squared measured in meters (m). To calculate BMI in imperial units, weight in pounds (lb) is divided by height squared in inches (in) and then multiplied by 703. This calculation produces a number that is the individual’s BMI This number, when compared to the statistical distribution of BMIs for adults ages 20–29, indicates whether the individual is underweight, average weight, overweight, or obese. The 20–29 age group was chosen as the standard because it represents fully developed adults at the point in their lives when they statistically have the least amount of body fat. The formula for calculating the BMI of children is the same as for adults, but the resulting number is interpreted differently.
Although the formula for calculating BMI was developed in the mid-1800s, it was not commonly used in the United States before the mid-1980s. Until then, fatness or thinness was determined by tables that set an ideal weight or weight range for each height. Heights were measured in one-inch intervals, and the ideal weight range was calculated separately for men and women. The information used to develop these ideal weight-for-height tables came from several decades of data compiled by life insurance companies. These tables determined the probability of death as it related to height and weight and were used by the companies to set life insurance rates. The data excluded anyone with a chronic disease or anyone who, for whatever health reason, could not obtain life insurance.
Interest in using the BMI in the United States increased in the early 1980s when researchers became concerned that Americans were rapidly becoming
Interpreting BMI calculations for adults
All adults age 20 and older are evaluated on the same BMI scale as follows:- BMI below 18.5: Underweight
- BMI 18.5-24.9: Normal weight
- BMI 25.0-29.9: Overweight
- BMI 30 and above: Obese
Interpreting BMI calculations for children and teens
The formula for calculating the BMI of children ages 2-20 is the same as the formula used in calculating adult BMIs, but the results are interpreted differently. Interpretation of BMI for children takes into consideration that the amount of body fat changes as children grow and that the amount of body fat is different in boys and girls of the same age and weight.Instead of assigning a child to a specific weight category based on their BMI, a child’s BMI is compared to other children of the same age and sex. Children are then assigned a percentile based on their BMI The percentile provides a comparison between their weight and that of other children the same age and gender. For example, if a girl is in the 75th percentile for her age group, 75 of every 100 children who are her age weigh less than she does and 25 of every 100 weigh more than she does. The weight categories for children are:
- Below the 5th percentile: Underweight
- 5th percentile to less than the 85th percentile: Healthy weight
- 85th percentile to less than the 95th percentile: At risk of overweight
- 95th percentile and above: Overweight
Application of BMI information
The BMI was originally designed to observe groups of people. It is still used to spot trends, such as increasing weight in a particular age group over time. It is also a valuable tool for comparing body mass among different ethnic or cultural groups, and can indicate to what degree populations are undernourished or overnourished.When applied to individuals, the BMI is not a diagnostic tool. Although there is an established link between BMI and the prevalence of certain diseases such as type 2 diabetes, some cancers, and cardiovascular disease, BMI alone is not intended to predict the likelihood of an individual developing these diseases. The National Heart, Lung, and Blood Institute recommends that the following measures be used to assess the impact of weight on health:
- BMI
- Waist circumference (an alternate measure of body fat)
- GALE ENCYCLOPEDIA OF DIETS
- Low HDL or “good” cholesterol
- High blood glucose (sugar)
- High triglycerides
- Family history of cardiovascular disease
- Low physical activity level
- Cigarette smoking
Precautions
BMI is very accurate when defining characteristics of populations, but less accurate when applied to individuals. However, because it is inexpensive and easy to determine BMI is widely used. Calculating BMI requires a scale, a measuring rod, and the ability to do simple arithmetic or use a calculator. Potential limitations of BMI when applied to individuals are:- BMI does not distinguish between fat and muscle. BMI tends to overestimate the degree of “fatness” among elite athletes in sports such as football, weightlifting, and bodybuilding. Since muscle weighs more than fat, many athletes who develop heavily muscled bodies are classified as overweight, even though they have a low percentage of body fat and are in top physical condition.
- BMI tends to underestimate the degree of fatness in the elderly as muscle and bone mass is lost and replaced by fat for the same reason it overestimates fatness in athletes.
- BMI makes no distinction between body types. People with large frames (big boned) are held to the same standards as people with small frames.
- BMI weight classes have absolute cut-offs, while in many cases health risks change gradually along with changing BMIs. A person with a BMI of 24.9 is classified as normal weight, while one with a BMI of 25.1 is overweight. In reality, their health risks may be quite similar.
- BMI does not take into consideration diseases or drugs that may cause significant water retention.
- BMI makes no distinction between genders, races, or ethnicities. Two people with the same BMI may have different health risks because of their gender or genetic heritage.
Parental concerns top
Childhood obesity is an increasing concern. Research shows that overweight children are more likely to become obese adults than normal weight children. Excess weight in childhood is also linked to early development of type 2 diabetes, cardiovascular disease, and early onset of certain cancers. In addition, overweight or severely underweight children often pay a heavy social and emotional price as objects of scorn or teasing.Both the American Academy of Pediatrics (AAP) and the United States Centers for Disease Control and Prevention (CDC) recommend that the BMI of children over age two be reviewed at regular intervals during pediatric visits. Parents of children whose BMI falls above the 85th percentile (at risk of being overweight and overweight categories) should seek information from their healthcare provider about health risks related to a high BMI and guidance on how to moderate their child’s weight. Strenuous dieting is rarely advised for growing children, but healthcare providers can give guidance on improving the chid’s diet, eliminating empty calories (such as those found in soda and candy) and increasing the child’s activity level in order to burn more calories and improve fitness.
Tish Davidson, A.M.
Body for Life diet
Definition
Body for Life is a 12-week diet and rigorous exercise program designed by former competitive bodybuilder Bill Phillips. The program promises those who follow it faithfully that after 12 weeks they will not only have lost about 25 lb (10 kg) if they areBody for Life diet
5–6 meals a day
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Foods approved
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Lean protein-rich food Portion equal to dieter’s hand
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Lean poultry, most fish and seafood, egg whites, low-fat cottage cheese, and lean beef and ham For vegetarians, approved proteins include tempeh, soy, textured vegetable protein, and seitan
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Unrefined or whole-grain carbohydrates Portion equal to dieter’s fist
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Baked potato, sweet potato, brown and white rice, pasta, whole-wheat bread, whole-wheat tortillas, dried beans, oatmeal, and whole grains such as quinoa. Approved carbohydrates include apples, melon, strawberries, oranges, and com
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Vegetable portion (eaten a least two meals)Portion equal to dieter’s fist
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Lettuce, tomato, carrots, broccoli, cauliflower, asparagus, spinach, mushrooms, zucchini, peas, bell peppers, celery, and onions. Served plain, without sauce
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Water
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10 or more glasses daily
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(Illustration by GGS Information Services/Thomson Gale.)
overweight, but they have a new shape and more muscular body.
Origins
Bill Phillips, the originator of the Body for Life program, is a former bodybuilder and was the founder of EAS, a dietary supplement manufacturer. In Body for Life, he has taken some of the principles of bodybuilding and incorporated them into a motivational program that is easily understandable to the general public. In 1996, when Phillips still owned EAS (he has since sold the company), he began the “EAS Grand Spokesperson Challenge.” The following year he changed its name to the Body for Life Challenge. This is a self-improvement competition based on the Body for Life program.The Body for Life program became widely known with the publication of Body for Life: 12 Weeks to Mental and Physical Strength in 1999. Other books, videos, and a Web site have followed. Phillips claims that in a decade more than 2 million people have successfully changed their bodies and their lives through the Body for Life program.
Description
Body for Life is both a diet and a rigorous exercise program served up with a big helping of motivational psychology. The diet part of the plan is relatively simple and offers some benefits over other plans in that it does not require calorie counting or careful measuring of food.Diet
The Body for Life diet works this way. For 12 weeks, people eat five or six small meals a day. The meals consist of a portion of lean, protein-rich food, and a portion of unrefined or whole-grain carbohydrates In addition, at least two meals daily must include a vegetable portion, and the diet should be supplemented by one tablespoon daily of oil high in monounsaturated fats A portion is defined as the being equal to the size and thickness of the dieter’s hand (protein) or fist (carbohydrates and vegetables). Dieters estimate portion size rather than measuring.Approved proteins include lean poultry, most fish and seafood, egg whites, low-fat cottage cheese, and, unlike many diets, lean beef and ham. For vegetarians, approved proteins include tempeh, soy, textured vegetable protein, and seitan. Vegetarians will have a hard time meeting the protein requirements of this diet. Vegans will most likely not be able to.
Approved carbohydrates include baked potato, sweet potato, both brown and white rice, pasta, whole wheat bread, whole wheat tortillas, dried beans, oatmeal, and whole grains such as quinoa. Also included in the approved carbohydrates list are apples, melon, strawberries, oranges, and corn. This is a much less restrictive list of carbohydrates than appears in many diets.
Approved vegetables include lettuce, tomato, carrots, broccoli, cauliflower, asparagus, spinach, mushrooms, zucchini, peas, bell peppers, celery, and onions. All are to be served as plain vegetables without sauce. The daily oil allotment can come from salad dressing.
The fats requirement of this diet can be met with unsaturated oils such as canola, olive, safflower, or flaxseed, but also through eating salmon three times a week or with avocados, natural peanut butter, or a handful of nuts or seeds daily.
In addition to allowed foods, the dieter is required to drink 10 or more glasses of water daily. The diet is to be followed rigorously for six days. On the seventh day, the dieter can eat anything he or she wants. Overall, this diet allows more different foods than many diets, but it is a high protein, low fat diet with about half the calories consumed coming from protein and very few from fats. Generally dietitians recommend a diet that is about 55% carbohydrates, with emphasis on whole-grain carbohydrates, 15–20% protein, and
KEY TERMS
Dietary supplement—a product, such as a vitamin, mineral, herb, amino acid, or enzyme, that is intended to be consumed in addition to an individual’s diet with the expectation that it will improve healthGlycogen—A compound made when the level of glucose (sugar) in the blood is too high. Glycogen is stored in the liver and muscles for release when blood glucose levels are too low.
Hormone—a chemical messenger that is produced by one type of cell and travels through the bloodstream to change the metabolism of a different type of cell
Insulin—a hormone made by the pancreas that controls blood glucose (sugar) levels by moving excess glucose into muscle, liver, and other cells for storage.
Pancreas—a gland near the liver and stomach that secretes digestive fluid into the intestine and the hormones insulin and glucagon into the bloodstream
Quinoa—a high-protein grain native to South America (pronounced keen-wah)
no more than 30% fat. On the positive side, the diet recommends unsaturated fats and restricts sweets, junk food, and empty calories that add few nutrients. One troubling thing about the diet is that Phillips repeatedly recommends dietary supplements made by his former company.
Exercise
The exercise portion of Body for Life is more complicated than the food portion. It consists of a two-week block of exercises. Forty-five minute weight-training exercises for either the upper or lower body alternate with a minimum of 20-minute aerobic exercises with every seventh day as a day of rest.Exercises are to be done at specific levels of exertion using a 10-point rating scale developed by the American College of Sports Medicine. This scale allows the level of difficulty to be personalized to the individual. Most exercises consist of multiple repetitions beginning around level 5, (hard, but with plenty of reserves to continue). They move on to a completely flat effort at level 10 where the individual is putting out the maximal effort possible. These exercises are difficult, and they are intended to be that way. Phillips believes that short bursts of maximal exercise burn more calories than longer exercise periods at lower intensities. Another drawback is that these exercises are best done in a gym with equipment and a supervised environment because of their intensity.
Motivation
Bill Phillips uses strong motivational techniques to help people succeed in the Body for Life Program. The program asks the dieter to determine his or her reasons for wanting to change and then set a goal for that change. Phillips then applies the psychology of competition by encouraging people to become involved in the Body for Life Challenge. This is a contest to see which dieter can improve his or her body the most using the program. Prizes in 2007 were substantial. The grand prize was $50,000, a home gym, and a $5,000 gift certificate for EAS supplement products. Eight category champions receive $20,000, a home gym, and a $2,500 gift certificate for EAS products. The official Body for Life Web site offers inspiring stories and pictures of former champions and plenty of tips and information on how to succeed.Function
The theory behind the Body for Life diet is that eating may small meals high in protein during the day helps keep insulin levels steady and boosts metabolism so that the body burns calories at a higher rate. Insulin is a hormone that regulates blood glucose (sugar) levels in the body. When blood glucose is too high, cells store the extra glucose as glycogen or fat. In addition, Phillips says that protein suppresses energy and is essential for building muscle mass. The goal of the Body for Life plan is not just to lose weight, but to develop a sculpted body.Benefits
With increased exercise, a low fat, high protein diet, and reduced portion sizes, Body for Life does help people lose weight rapidly. People do gain muscle and strength through exercise. The main drawback to achieving these benefits is the rigorousness of the program and the difficulty people have staying on it. Eating five or six times a day and finding time to exercise daily requires a major lifestyle change. The committed will see benefits, but this program is definitely not for everyone.QUESTIONS TO ASK THE DOCTOR
- Are there health risks to me caused by the level of exercise Body for Life requires?
- Is there another diet and exercise program that would meet my needs better?
- Will following this rigorous diet for 12 weeks help me achieve long-term weight loss?
- How much will I have to exercise to maintain my muscle mass and strength after the diet ends?
- Do I really need dietary supplements? Are EAS supplements the best for my needs?
- Would you recommend someone in your family going on this diet?
Precautions
Because of the high level of exercise involved in this program, dieters should talk to their doctor about whether their physical condition will allow them to participate. This is probably not a good program for people with heart or respiratory problems. Children and teens who are still growing, and pregnant women also are unlikely candidates for this program. People with kidney disease should discuss the diet aspect of the program with their doctor since their kidneys may not be able to handle a high protein diet. Anecdotally, the program appears to be most successful with out-of-shape athletes who want to lose weight and get back in shape.Risks
People who are not used to the level of exercise required by Body for Life are at high risk for develop injuries as a result of the exercise component of the program. In addition, many obesity experts feel that rapid weight loss, that is loss of more than 1–1.5 lb (0.5–7 kg) per week, increases the chance of weight cycling or putting the weight back on once the dieter begins eating a regular diet. Weight cycling is thought to have some harmful cardiovascular effects.Research and general acceptance
No scholarly research has been done on Body for Life. However, bodybuilders have used the diet and exercise principles behind the program for many years. Nutritionists like the idea of eating many small meals during the day and of using only unsaturated fats. They tend to dislike the high protein content of the diet. The thing nutritionists tend to criticize most strongly, however, is the need for dietary supplements in this program. Body for Life unabashedly pushes dieters to use EAS supplements. Many nutritionists feel that a good, healthy diet should not require protein shakes and other supplements beyond perhaps a multivitamin for certain dieters.Resources
BOOKS
Peeke, Pamela. Body-for-Life for Women: A Woman’s Plan for Physical and Mental Transformation Emmaus, PA: Rodale, 2005.Phillips, Bill. Body for Life: 12 Weeks to Mental and Physical Strength New York: HarperCollins, 1999.
Phillips, Bill. Eating for Life: Your Guide to Great Health, Fat Loss and Increased Energy!Golden, CO: High Point Media, 2003.
Phillips, Bill. Transformation; How to Change Everything Carlsbad, CA: Hay House, Inc., 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>Body-for-LIFE Official Web Page. <http://www.bodyforlife.com>
Body for Lifers.com Community Support Forums. <http://www.bodyforlifers.com>
OTHER
“Body for Life Diet.” Dietsfaq.com, undated, accessed April 17, 2007. <http://www.dietsfaq.com/bodyforlife.html>“Body for Life: What It Is.” WebMD, February 1, 2004. <http://www.webmd.com/content/pages/15/96036.htm>
Harvard School of Public Health. “Interpreting News on Diet.” Harvard University, 2007. <http://www.hsph.harvard.edu/nutritionsource/media.html>
Health Diet Guide “Body-for-Life.” Health.com. 2005. <www.health.com/health/web/DietGuide/bodylife_complete.html>
Tish Davidson, A.M.
Bob Greene’s diet
Definition
Bob Greene’s diet is two separate but similar programs with two different websites Get with the Program! (GWTP!) and The Best Life Diet. GWTP! is divided into four phases: Truth, commitment, and self-control; Revving up your metabolism; Getting real about emotional eating; and Securing a life of health and emotional well-being. The Best Life Diet is comprised of three phases: establishing a regular pattern of exercise and eating; exploring the physical and emotional reasons for hunger; and learning weight management for life. Both programs are moderate and nutritionally balanced weight loss regimens combined with an exercise program and psychological introspection.Origins
Greene is a personal trainer with educational and professional credentials in physical education and exercise physiology. He maintains that his interest in health and fitness began as early as seven, when he was told that the reason his great-grandmother was bedridden was her excess weight. He noticed that many of his other relatives were overweight and began to read articles about food and nutrition in the daily newspaper.After high school, Greene majored in physical education at the University of Delaware and completed a master’s degree in exercise physiology at the University of Arizona. He worked as the director of exercise physiology for a medical management company and as the manager and trainer of the fitness staff at a health spa in Telluride, Colorado.
Both GWTP! and the Best Life program were preceded by Greene’s first book, Make the Connection: 10 Steps to a Better Body—And a Better Life, which he co-authored with talk show host Oprah Winfrey and published in 1996. He met Winfrey while working at the spa in Telluride, later moving to Chicago to set up a training practice and make regular appearances on her television show.
Description
Get with the Program!
GWTP! is a four-phase program that focuses on the user’s slow and gradual development of new eating and exercise habits. Dieters proceed through the phases of the program at their own pace. GWTP! emphasizes the importance of organization in personal weight loss.PHASE 1: TRUTH, COMMITMENT, AND SELF-CONTROL. The theory behind this phase is that an individual will make healthier lifestyle choices if they care about their well-being. The program offers participants a contract they can use to make a commitment to themselves for a healthier lifestyle. The participant is encouraged to post it where it can be seen every day as a reminder of commitment. Physical exercise in this phase consists of flexibility, stretching, and range-of-motion exercises. Phase one should be completed in one to three weeks. Completion of the Phase 1 checklist signifies preparation for the next phase.
PHASE 2: REVVING UP YOUR METABOLISM. Many participants make the mistake of trying to cut back on calories too quickly rather than increasing their level of physical activity. Phase 2 introduces the participant to a physical fitness program that increases their body’s rate of food metabolism. Exercise has an effect known as after-burn— the body burns calories at a higher rate for several hours after an exercise session, not only during the workout. It also reinforces the participant’s commitment to more healthful eating because physical changes usually present fairly rapidly. Cardiovascular workouts average 50 to 75
KEY TERMS
After-burn—The increased rate of body metabolism that lasts for several hours after a session of vigorous exercise.Emotional eating—Term for eating to alter mood or relieve stress, boredom, or loneliness.
Ovolactovegetarian—A vegetarian who consumes eggs and dairy products as well as plant-based foods.
Personal trainer—An individual specializing in diet and exercise who works with clients on an individual basis.
Pesce/pollo vegetarian—A vegetarian who avoids the use of red meat but will include fish (pesce in Italian) or chicken (pollo in Italian) in the diet.
minutes per week in this phase. After one to three months, participants should be ready for Phase 3.
PHASE 3: GETTING REAL ABOUT EMOTIONAL EATING. The primary component of Phase 3 is recognizing emotional eating habits. The focus on this behavior is a distinctive feature of Greene’s overall approach to health and fitness. A participant needs to understand the distinction between physical hunger and eating for such emotional reasons as boredom, loneliness, job-related stress, or general anxiety. In order to learn how to tell the difference, the participant is asked to choose a specific day and delay their normal meal times for several hours so that they can experience real physical hunger. (Diabetics are advised to consult their physician before undertaking this step). After reestablishing an awareness of physical hunger, the participant is advised to keep a journal in which events or other stimuli (television advertising, eating out, the smell of food from a nearby restaurant, assignment deadlines at work or school, etc.) that trigger episodes of emotional eating are recorded. In time, the person is encouraged to identify counterproductive patterns and behaviors of which they were previously unaware and take steps to modify the behavior. One such behavior modification involves substituting other activities for eating. Suggested activities include reading, taking a class, working on a hobby or craft, or going for a walk. Exercise during phase three is increased to 100 to 125 minutes per week. Phase 3 typically lasts one to three months.
PHASE 4: SECURING A LIFE OF HEALTH AND EMOTIONAL WELL-BEING. Phase four is focuses on enhancing the changes in activity level and conscious food choices made in the first three phases. By phase four the participant’s exercise program has been scaled up to include weight training and advice is provided for continuing healthy eating habits. A checklist verifies that the participant met the major program goals. No specific timeline is provided for this phase since it leads to a lifetime of weight management using the tools acquired throughout the program.
GWTP! stresses many of the same themes in all four phases. Participants are continuously encouraged to increase their activity level, drink more water, become aware of what triggers their hunger, and eat sensibly. Guidelines for exercise are provided at each phase. Information about nutrition and making healthy food selections is also provided. Greene believes that many people overeat because they eat haphazardly, without any meal planning, and that this lack of structure is conducive to poor nutrition and exercise habits. He recommends a schedule of three meals and two snacks a day, with a cutoff point for stopping food consumption, namely two hours before bedtime
The Best Life diet
PHASE 1: THE REV-UP. The chief objective in the Best Life diet is to establish a regular pattern of exercise and eating. Phase 1 begins with an initial weigh-in followed by an increase in physical activity. The participant is allowed three meals plus one or two snacks daily, but no alcohol, and no eating for a minimum of two hours before bedtime. If the overall weight loss has been a pound or more per week and the daily objectives outlined in the plan are met consistently, the participant may move on to Phase 2 at the end of four weeks or continue in this phase until the objectives are met.PHASE 2: THE SWITCH. Phase 2 emphasizes significant and consistent weight loss through controlling hunger and implementing changes in eating patterns. The participant is expected to explore the physical and emotional reasons for hunger, and to use a 10-point scale to rate feelings of hunger (1=Your stomach acid is churning, 6=You feel satisfied, and 10=You are so full you feel nauseous). Participants are also expected to eat smaller food portions and remove six foods from their diet that lack nutritional value or are problem foods. Physical activity may be increased. Weight is checked every week for four weeks. When the participant is within 20 lb of their goal weight and the weight loss has stopped it is time to begin phase 3.
SAMPLE MENUS. Week 1, Day 1
- Breakfast: Skim milk, pear muffin, 1 fresh apple
- Snack: Low-fat yogurt
- Lunch: Walnut cannelini wrap + chopped green salad
- High-calcium snack: Whole-grain crackers with reduced-fat cheddar cheese
- Dinner: Pasta with chicken or shrimp + mixed green salad
- “Anytime treat”: 1 oz piece of dark chocolate Week 1, Day 2
- Breakfast: Best Life Kashi Go Lean Mix with pecans and skim milk, plus one half grapefruit
- Snack: Iced vanilla soy latte with graham cracker
- Lunch: Nut butter and pear whole-wheat sandwich + carrot sticks
- High-calcium snack: Maple-nut yogurt
- Dinner: Lemon and herb grilled trout + corn + sauteed sugar peas with ginger
- “Anytime treat”:Low-fat ice cream
The print editions of both books contain the core of Greene’s diet plan. They are roughly 300 pages long and contain recipes, meal plans, and suggestions for reexamining and making changes in one’s food choices. Many participants find the information in the books adequate for their needs. A daily journal is available for purchase with either program. Two additional books can be used with GWTP!: Get with the Program! Guide to Good Eatingcontaining supplementary recipes and menu plans, and Get with the Program! Guide to Fast Food and Family Restaurantscovering over 75 restaurants and how eat healthy off their menus.
Dieters who choose to pay a weekly fee for online membership in either GWTP!or the Best Life diet receive customized advice tailored to their age, weight, height, sex, and level of physical activity. The home page of each website invites the user to fill out an online form with this personal information as well as their goal weight. The online fee for GWTP!“Basic Training” includes the following:
- A workout plan based on the customer’s general fitness needs and current activity level.
- 3-D animated exercises.
- 24/7 advice and support from experts.
- Access to a support group moderated by eDiets.com nutrition and fitness experts.
- Menus, recipes, and shopping lists.
- Online tracking of the customer’s progress.
- Current news articles on topics related to health, fitness, diet, nutrition, and emotional well-being.
Function
The function of Greene’s diet plan is a restructuring of the participant’s present eating and exercise habits, phased in gradually at the participant’s own pace. This restructuring requires a committed intention to lose weight based on a willingness to look honestly at one’s patterns of food consumption, including emotional as well as physical reasons for eating.Benefits
The benefits of Bob Greene’s diet program are its commonsense approach to the necessity of personal commitment to change as well as lifestyle modifications if people wish to lose weight and keep it off. Many users find the plan’s emphasis on introspection and emotional honesty helpful in breaking the psychological patterns that cause them to regain the pounds after a period of successful weight loss.The flexibility of food choices built into the program makes it easier for participants with food allergies or those who must cook for or share meals with a family to use this plan. The foods Greene recommends are moderate in cost; there are no pricey recipes or ingredients in his plan. Vegetarians also find it easy to adjust for an ovolactovegetarian or pesce/pollo vegetarian diet.
Precautions
Dieters who select the individualized programs offered on Greene’s websites should check with their primary care physician to verify the physical exercises suggested for them are appropriate. Diabetics andQUESTIONS TO ASK YOUR DOCTOR
- What do you like and dislike about Bob Greene’s programs?
- What is your opinion regarding the amount of exercise recommended?
- What aspects of these programs worked for other patients?
Risks
Greene’s diet plan does not pose any risks to health for users who have had a recent medical checkup and have consulted their health care provider about specific forms of exercise.Research and general acceptance
His educational background in exercise physiology adds credibility to his insistence on physical activity as an integral part of a long-term weight loss or weight maintenance regimen.Most references to Bob Greene’s diet are in popular print media—daily newspapers and monthly women’s magazines with wide circulations—rather than medical or nutritional journals. Although Greene does not publicize his associations with celebrities, his websites as well as newspaper and magazine articles always emphasize that he is Oprah Winfrey’s personal trainer. Crediting Winfrey as the co-author of his first book is generally regarded as the key to Greene’s rapid success in the late 1990s.
There are no published reports on clinical trials of Bob Greene’s diet plan as of 2007. Reviews of the diet plan by professional nutritionists are generally favorable; they typically describe it as a simple program that establishes the groundwork for a lifetime of healthy living. The programs are easy to follow and include dietary guidelines aligned with those recommended by the USDA. Greene is realistic about the difficulty of long-term weight loss and up-front about the commitment required to make long-term changes.
On the other hand, some nutritionists point out that Greene’s diets require a greater time commitment for journaling and exercise than most people can manage on a regular basis.
Resources top
BOOKS
Greene, Bob W. The Best Life Diet New York: Simon & Schuster, 2006.Greene, Bob W. Bob Greene’s Total Body Makeover New York: Simon & Schuster, 2005.
Greene, Bob W. Get with the Program!: Getting Real about Your Health, Weight, and Emotional Well-Being New York: Simon & Schuster, 2002.
Greene, Bob W. The Get with the Program! Guide to Fast Food and Family Restaurants New York: Simon & Schuster, 2004.
Greene, Bob W. The Get with the Program! Guide to Good Eating New York: Simon & Schuster, 2003.
Greene, Bob W. Keep the Connection: Choices for a Better Body and a Healthier Life New York: Hyperion, 1999.
Greene, Bob W., and Oprah Winfrey. Make the Connection: Ten Steps to a Better Body—and a Better Life New York: Hyperion, 1996
PERIODICALS
Baldacci, Leslie. “Oprah’s Trainer Asks What Candy Means.” Chicago Sun-Times (November 21, 2006): 44.Eller, Daryn. “Food to Go: Have It Your Way; When It Comes to Restaurant Eating, Bob Greene Says the Choice Is Yours.” Muscle & Fitness/Hers (December 2003): 54
OTHER
The Best Life Diet. Website:<http://www.thebestlife.com>.Get with the Program!. Website:<http://www.getwiththeprogram.org>.
ORGANIZATIONS
American College of Sports Medicine (ACSM). P.O. Box 1440, Indianapolis, IN 46206-1440. Telephone: (317) 637-9200. Website:<http://www.acsm.org>.American Council on Exercise (ACE). 4851 Paramount Drive, San Diego, CA 92123. Telephone: (858) 279-8227. Website:<http://www.acefitness.org>.
Rebecca J. Frey, PhD
Blood type diet
Definition
The Blood Type diet is a way of eating that relies on an individual’s blood type (A, B, AB, or O) to dictate one’s diet. In his book, Eat Right for Your Blood Type, naturopathic doctor Peter D’Adamo, presents the idea that an individual’s blood type determines which foods are healthy for him and which foods are not. The book presents the anthropological origins of each of the four blood types and explains why each blood type developed specific antibodies against certain foods.Antibodies are proteins within the blood that identify and attack substances that are foreign to the body. Specific proteins called lectins are found in all foods. During digestion, lectins are released from the foods eaten. When they enter the blood stream, some of these lectins can bind to red blood cells causing them to stick together. This process is called agglutination. Dr. D’Adamo suggests this process causes many health problems such as stomach pains, poor digestion, headaches, diarrhea, liver disease, and kidney problems, and more.
The Blood Type diet includes extensive lists of foods that are beneficial for each blood type. The food lists also include foods that each blood type should avoid and foods that are neutral or benign. Dr. D’Adamo reports that following this diet will not
Purported benefits of the Blood Type diet
Blood type O
Weight loss.
Prevents blood clotting disorder and inflammatory diseases, including arthritis, hypothyroidism, ulcers, and asthma
Blood type A
Weight loss.
Reduced risk of heart disease, cancer, anemia, liver and gallbladder disorders, and type I diabetes
Blood type B
Weight loss.
Reduction of the risk of type I diabetes, chronic fatigue syndrome, and autoimmune disorders such as Lou Gehrig’s disease, lupus, and multiple sclerosis
Blood type AB
Weight loss.
Reduction in the risk of developing heart disease, cancer, or anemia.
(Illustration by GGS Information Services/Thomson Gale.)
only improve health but will help achieve an ideal weight
Origins
In 1901, Dr. Karl Landsteiner discovered that there were four types of human blood. He named them A, B, AB, and O. He discovered that blood types are not compatible with each other because of antibodies. These antibodies cause blood to clump together if a different blood type is mixed with it. According to Dr. D’Adamo, it was also discovered that foods can cause blood cells to become sticky and clump together in a process called agglutination.Dr. D’Adamo’s father, James, is also a naturopathic physician noticed that different diets worked better with some patients than others. In his book, One Man’s Food—Is Someone Else’s Poison, he attributed this to the differences in blood type.
Dr. Peter D’Adamo continued his father’s research by studying the agglutination process that occurs between specific blood types and certain foods. He believes it is the result of the evolution of the unique blood types.
Anthropologists have traced the origins of each blood type. The earliest human blood type was type O. Since these people were ancient hunter-gatherers and ate a diet dominated by meat, blood type O individuals developed antibodies against the lectins found in agricultural foods such as wheat and other grains. Dr. D’Adamo suggests that individuals with type O blood should eat a diet more similar to their ancient ancestors—that is a diet with more meats and fewer grains
KEY TERMS
Agglutination—The clumping or clotting of cells.Anthropological—Pertaining to anthropology or the study or the natural and cultural history of humans.
Antibodies—Proteins within blood that seek and destroy foreign bodies or substances in the body.
Lectins—Protein substances found in foods that bind with carbohydrates in blood causing it to clot.
Naturopathy (naturopathic)—An approach to medicine that does not use pharmaceuticals and surgery to treat disease but rather uses alternative therapies, supplements, special diets, and other natural remedies to help the body heal itself.
Rh Factor—Rh factor is a subset of blood type it may be either positive or negative.
The next blood type to evolve was type A. As the environmental conditions changed, humans began to grow food rather than hunt it. The diet shifted from predominantly meat to plant-based. As the diet changed and the blood type A evolved, antibodies for lectins to meat were formed. According to Dr. D’Adamo, individuals with blood type A have antibodies against many lectins found in meat and will benefit from a largely vegetarian or plant-based diet.
The next blood type to emerge was type B. As ancient peoples migrated and adapted to further climate change blood type B evolved. The diet included both meats and plants as well as dairy products. Dr. D’Adamo believes this is the reason individuals with blood type B developed fewer antibodies against lectins found in meat and grain. He also believes this is why people with blood type B are more tolerant of milk products than other blood types.
The final blood type to evolve was type AB. It is a rare blood type even today with fewer than 5% of the world’s population having type AB blood. Type AB evolved when the A and B blood types intermingled. Dr D’Adamo describes this blood type as a complex blood type with many strengths and many contradictions.
Description
D’Adamo divides all foods into sixteen food groups.The food groups are:
- Meats and poultry, pork, and chicken Seafood-fish and shellfish
- Dairy and eggs—milk, yogurt, ice cream, cheese, and eggs
- Oils and fats—all oils such as peanut oil, linseed oil, sesame oil, etc
- Nuts and seeds—all nuts or seeds
- Beans and legumes—all beans and peas
- Cereals—oats, barley, cream of wheat, corn flakes, puffed rice, etc
- Breads and muffins—all baked goods such as loaf breads, crackers, etc
- Grains and pasta—all flour, buckwheat, all noodles, spaghetti, etc
- Vegetables—all vegetables, olives, peppers, and avocado
- Fruit—fresh fruits, dried fruits, and canned fruits
- Juices and fluids—all fruit juices fresh and concentrate
- Spices—all spices fresh and dried, syrups, miso, soy sauce, and other sauces that are not dairy based
- Condiments—mayonnaise, mustard, ketchup, jellies and jams, pickles, pickle relish,and salad dressing
- Herbal teas—all herbal teas
- Miscellaneous beverages—coffee, black tea, green tea, seltzer waters, colas, wine, beer, and liquor
In addition to specific and detailed dietary guidelines, Eat Right for Your Blood Typealso includes advice for each blood type concerning the impact of stress on the body and strategies for coping with stress.
Dr. D’Adamo outlines the best supplements for each blood type and addresses the best form of exercise for individuals of each blood type.
Function
The Blood Type diet is based on the fact that all foods have lectins, or proteins that can interact with antibodies in blood. Dr. D’Adamo has tested most foods and determined which blood types react adversely to lectins in most foods.When a specific food’s lectin reacts with a specific blood type (A, B, AB, or O), it causes a process called agglutination to occur. In agglutination, the lectins cause the blood to become sticky. Dr. D’Adamo believes these sticky blood cells can lead to medical conditions such as impaired digestion, kidney and liver problems, headache, diabetes, obesity, and many others.
In order to reverse the problems caused by agglutination, an individual must avoid or limit the consumption of foods that cause it. Dr. D’Adamo has tested foods to determine which foods react adversely with which blood types. By following the Blood Type diet, these foods and the offending lectins may be avoided, and health may be improved.
In addition to the main blood types of A, B, AB, and O, there are many subtypes. These are other factors that are contained within your blood. These additional subtypes include secretor status and Rh. Rh is the part of blood that determines if a blood type is positive or negative. The Rh factor of blood type is not affected by diet; however, when blood type is reported, it is usually given as well.
Secretor status does influence the role diet plays in the functions of the body. Secretor status refers to whether or not blood type antigens, the part of the blood that determines type, are in other fluids of your body such as saliva and urine. Approximately 80% of all people are secretors. For these people, blood type can be determined by testing other bodily fluids. In the remaining 20% of the population, blood type antigens are found only in the blood. According to Dr. D’Adamo, secretors are more sensitive to interactions with food lectins. Secretors would have a more severe reaction over more systems in the body than non-sectretors. There is a test to determine if an individual is a secretor; however, since 80% of the population are secretors, chances are that most people who attempt the Blood Type diet are secretors.
Benefits
Dr. D’Adamo reports health benefits in his patients that follow the Blood Type diet. His official website is full of testimonials from satisfied Blood Type diet followers. Not only do they report weight loss, but, according to Dr. D’Adamo, each blood type is more susceptible to certain illnesses than the others.According to Dr. D’Adamo, the benefits of following the Blood Type diet for people with blood type A include weight loss and a reduced risk of heart disease, cancer, anemia, liver and gallbladder disorders, and type I diabetes.
For individuals with blood type B, the benefits if following the Blood Type diet include weight loss and a reduction of the risk of type I diabetes, chronic fatigue syndrome, and auto immune disorders such as Lou Gehrig’s disease, lupus, and multiple sclerosis.
People with blood type AB who follow the Blood Type diet may lose weight and have a reduction in the risk of developing heart disease, cancer, or anemia.
For individuals with blood type O, following the Blood Type diet may help them lose weight and may prevent blood clotting disorder, inflammatory diseases such as arthritis, hypothyroidism, ulcers, and asthma.
Even critics of the diet suggest that features of the diet such as limiting the amount of saturated fat and highly processed “junk foods” will benefit most people.
Precautions
Since blood type is a fixed characteristic of an individual, it never changes. Following a diet based on blood type would theoretically never need to change. However, there are many medical conditions that change as a person ages. Diseases may develop such as diabetes, hypertension (high blood pressure), and heart disease that may require an individual with type O blood to reduce consumption of meat and increase intake of fruits and vegetables. Following this diet may be harmful if variations in the diet necessary for health maintenance are not allowed.Encouraging a specific blood type to gradually increase dairy consumption may cause discomfort to individuals with a natural lactose intolerance, regardless of blood type. Conversely limiting diary can lead to poor calcium intakes and bone related diseases.
Certain individuals with protein deficiency or anemia may need to consume more meat to insure sufficient protein consumption, regardless of blood type.
Risks
Unbalanced diets put one at risk of nutritional deficiencies or long term poor intakes that will affectQUESTIONS TO ASK YOUR DOCTOR
- Is this diet appropriate for me?
- How long should I follow this diet?
- Are there any special precautions I should follow?
- What are the potential health risks, if any, for me as an individual?
- Are there any drug precautions I should be aware of while following this diet?
- Will I need any dietary supplements if I adopt a this diet?
- In light of my other medical conditions, is this diet safe for me to follow?
Research and general acceptance
General acceptance
While many followers of the Blood Type diet report improved health and weight loss, the Blood Type diet is not widely accepted. Dr. D’Adamo cites many anthropological and microbiological studies to support his theories. However, critics argue there is virtually no data to support his diet plan. They charge that he has no well designed, well control studies to validate his claims that blood type is critical to the impact of diet. Noting that he has not conducted simple before and after blood studies to demonstrate his claim that lectin protein in foods cause blood cells to agglutinate or stick together.Furthermore, they argue, if agglutination were as wide spread and common as Dr. D’Adamo claims, thousands of people would die each year from organ failure caused by this process and that pathologists would easily see evidence of this. Yet, no such evidence is presented or found in a review of the literature.
Additionally, critics argue that reducing people to a set of criteria based solely on blood type is tantamount to biological astrology. Characterizing all blood type O individuals as hunter-gatherers who need meat and blood type A individuals as more passive agrarians who will benefit most from a nearly vegetarian diet, they argue is far too simplistic for beings as genetically diverse and complex as humans.
Research
There have been no controlled studies comparing those who follow the Blood Type diet with those who do not, or those who follow other diets. Dr. D’Adamo cites studies that demonstrate the effect of specific food lectin on animals such as rabbits which develop symptoms similar to arthritis when lentil lectins are injected into the knees of those sensitive to lentil lectins.Dr. D’Adamo reports he has tested lectins from most common foods against individual blood types to determine which blood types are sensitive to the lectins of which foods.
Similarly, he reports measuring the impact of lectins on his patients by using the Indian Scale, a measure of the effectiveness of the bowels. Higher values on the Indian Scale indicate reduced function of the liver and intestines and increased levels of toxins. Dr. D’Adamo reports that the Indian Scale scores of his patients have decreased significantly after following the correct Blood Type diet.
Dr. D’Adamo cites multiple individual case studies of patients he has treated using the Blood Type diet with great success.
Resources top
BOOKS
D’Adamo, Peter M.D with Allan Richards. One Man’s Food—Is Someone Else’s Poison. Toronto, Ontario, Canada: Health Thru Herbs (1994).D’Adamo, Peter J. M.D. and Catherine Whitney. Cook Right for Your Blood Type: The Practical Kitchen Companion to Eat Right for Your Blood Type Berkley, CA: Berkley Trade, 2000.
D’Adamo, Peter M.D. with Catherine Whitney. Eat Right For your Type: The Individualized Diet Solution to Staying Healthy, Living Longer, and Achieving your Ideal Weight . New York, NY: G. P. Putnam and Sons, 1996.
D’Adamo, Peter J. M.D. and Catherine Whitney. Live Right for Your Blood Type New York, NY: Putnam Adult, 2000.
D’Adamo, Peter J. M.D. and Catherine Whitney. The Eat Right for Your Blood Type Encyclopedia New York, NY: G. P. Putnam and Sons, Riverhead Books, 2002.
Nomi, Toshitaka and Alexander Besher. You Are Your Blood Type New York, NY: St. Martin’s Press, 1983.
PERIODICALS
Muschel, L. “Blood Groups, Disease and Selection” Bacteriological Rev” 30, no. 2 (1966): 427–441Freed, D. L. F. “Dietary Lectins and Disease.” Food Allergy and Intolerance (1987): 375–400.
Freed, D. L. F. “Lectins.” British Med. J. 290 (1985): 585– 586.
Whman, L. C. and W. C. Boyd. “Human Blood Groups and Anthropology.” Amer Anthropol 37 (1953): 181.
Frazier Roberts, J. A. “Some Associations between Blood Types and Disease.” Brit Med Bull 15 (1959): 129–133.
OTHER
The Institute for Human Individuality. The official Website of the Blood Type Diet, it contains more information about the diet, forums, email access to Dr. D’Adamo, scientific data, training opportunities for nutritionists and doctors, and a listing of Blood Type Diet practitioners. April 19, 2007, URL: http://www.dadamo.com.Deborah L. Nurmi, MS.
Cabbage Soup Diet
Definition
The cabbage soup diet is a quick weight loss program intended to be followed for seven days. The centerpiece of the diet is a recipe for cabbage soup, which the dieter may consume in unlimited quantities. In addition to the cabbage soup, there are certain other foods the dieter must eat on specific days during the week. There are several versions of the diet, most of which promise a 10-17 lb weight loss during the week.The cabbage soup diet has a number of other names:
- TWA Stewardess Diet
- Model”s Diet
- Dolly Parton Diet
- Military Cabbage Soup Diet
- Mayo Clinic Diet
- Sacred Heart Hospital Diet
- Miami Heart Institute Diet
- Spokane Diet
- Fat Burning Diet
- T. J.”s Miracle Soup Diet
- The Skinny
Origins
The cabbage soup diet may be the oldest fad diet still in use; it seems to resurface with a new name every 10 to 15 years. It has been described by some historians of popular culture as a good example of an urban legend—a type of modern folklore passed from person to person via word of mouth, photocopies, or e-mail. Urban legends are often stories or anecdotes, but some can be called “widely accepted misinformation.”No one seems to know when the cabbage soup diet was first formulated or the identity of its originator. According to the American Dietetic Association”s timeline of fad diets, the cabbage soup diet originated around 1950, but it may date back even earlier. There is a recipe for “Doughboy Cabbage Soup” dating back to World War I (1914–1918), when American soldiers fighting in France had few other vegetables available and eating cabbage offered protection against scurvy, a deficiency disease caused by inadequate vitamin C in the diet. The name “Military Cabbage Soup Diet” is likely derived from the World War I soup recipe, although that early recipe lacked the tomatoes, bouillon cubes, and other seasonings included in recent versions of the diet.
After the 1950s, the cabbage soup diet was revived in the early 1980s not only as the Dolly Parton Diet but also as the Trans World Airlines (TWA) Stewardess Diet and the Model”s Diet. It acquired these names because of the belief that celebrities, models, and flight attendants had to meet rigorous periodic weight check-ins in order to keep their jobs. The cabbage soup diet was passed around from person to person in the form of photocopies during this period. It often claimed that the dieter would lose 10-17 lb during the first week either because cabbage supposedly has no calories at all or because it contains a “miracle fatburning” compound.
The cabbage soup diet reappeared in the mid-1990s, when fax machines and the Internet made it easy for people to transmit copies of the diet to friends and workplace colleagues. The diet was also published in magazines such as Cosmopolitan and Gentlemen”s Quarterly (now GQ) in 1995. The diet was attributed to health associations as well as the cardiology departments of several hospitals and medical centers in this period. These institutions supposedly gave the diet to overweight patients preparing for heart surgery to help them to lose weight quickly before their operations. Thus, the diet acquired such names as the Sacred Heart diet or the Spokane diet (from the names of hospitals in Brussels, Belgium, Montreal, Quebec, and
Description
Cabbage soup recipes
Most versions of the cabbage soup diet begin with a recipe for the soup. One change that has evolved since the diet first appeared in the 1950s is the cooking instructions; the earliest versions of the diet recommended cooking the soup for an hour, which would destroy most of the nutrients in the cabbage and other ingredients. Recent soup recipes recommend simmering the soup no more than 10 to 15 minutes after being brought to a boil.STANDARD RECIPE Ingredients:
- 6 large green onions
- 2 green peppers
- 1 or 2 cans diced tomatoes
- 1 bunch of celery
- 1 envelope of dry onion soup mix
- 1 or 2 bouillon cubes (some versions specify low-sodium vegetable flavor) if desired
- 1 large head of cabbage
- 1 8-oz can of V-8 juice (optional)
MILITARY DIET RECIPE Ingredients:
- 2 13-ounce cans of chicken broth
- 1 large bunch of celery
- 2 bunches of spring onions
- 1 large head of cabbage
- 1 large can of whole tomatoes
- 3 large bell peppers
- Salt and pepper to taste
GREEN CABBAGE SOUP RECIPE Ingredients:
- One-half of a green cabbage, chopped
- 3 large onions, diced
- 1 large green pepper, sliced
- 1 cup fresh mushrooms, washed and sliced
- 1 or 2 cups washed fresh spinach leaves
- 1 can of diced tomatoes
- 1 envelope of dry onion soup mix
- 3 vegetable-flavored bouillon cubes
- 8 to 12 cups of water
- Oregano, cilantro, garlic powder, basil, pepper, and/ or parsley to taste
Cabbage soup diet plan
Dieters are supposed to follow specific menus for each day of the diet, with the understanding that an unlimited amount of cabbage soup can be eaten each day.- Day One: Eat only the cabbage soup and all the fruit you want (except bananas). Cantaloupe and watermelon are recommended. Permissible drinks are water, black coffee, cranberry juice, or unsweetened tea.
- Day Two: No fruit. Raw or cooked vegetables can be eaten in unlimited quantity along with the soup, except for corn, peas, and beans. A baked potato with butter can be eaten at dinnertime.
- Day Three: Unlimited fruit or vegetables, but no baked potato.
- Day Four: Eat at least three and as many as eight bananas, and drink an unlimited amount of skim milk. Day Four is supposed to curb a desire for sweets.
- Day Six: Eat cabbage soup at least once during the day; otherwise, an unlimited amount of beef and vegetables can be consumed, but no baked potato.
- Day Seven: Eat an unlimited amount of brown rice and vegetables and drink an unlimited amount of unsweetened fruit juice. Cabbage soup must be eaten at least once during the day. No bread, alcohol, or carbonated beverages (including diet soda) are allowed.
Additional instructions
Some Internet versions of the cabbage soup diet include additional instructions for the dieter:- Follow the diet religiously
- Drink at least four glasses of water each day
- Only follow the diet for seven days
- Eat unlimited amounts of cabbage soup to prevent hunger
- Take a good multivitamin supplement every day
- Try different spices to liven up the soup and add variety
Cabbage soup diet pills
Diet pills available on the Internet supposedly represent the cabbage soup used in the diet in dehydrated form. Discovery of the pills is credited to a woman who works in a food processing plant that makes meals ready to eat (MREs) for the military. She is said to have tried dehydrating cabbage soup in the ovens for preparing MREs and ended up with a powder that tasted like the original soup when warm water was added. A local manufacturer of homeopathic remedies supposedly began packaging the powder in pill form. The cabbage soup diet pills claim to speed up weight loss, melt fat, curb appetite, cure depression, detoxify the digestive tract, boost the immune system, and protect against cancer.Function
The cabbage soup diet is intended only for short-term weight loss. It is usually recommended as a quick way to lose weight after holiday-related overeating or to fit into an outfit for a special occasion. A few Internet versions claim the cabbage soup diet can be used for weight maintenance or for long-term nutrition. A book published on the diet in 1997 and revised in 2004 does contain an appropriate maintenance diet intended for use after the seven-day soup diet.Benefits
The cabbage soup diet does work for some people as a short-term way to lose weight rapidly. Some people like the fact that the diet offers a break from junk food or fast food, and does not require any unusual or expensive ingredients, complex recipes, or appetite suppressants. Also, the soup can be stored in the refrigerator for convenience or frozen for later use.Precautions
The cabbage soup diet is safe for most adults in good health who follow it no longer than seven days. The diet should not be used by individuals with type 2 diabetes, eating disorders, or other disorders requiring special diets without consulting a doctor or registered dietitian. Dieters who do use this diet should be aware that most of the weight they lose during the week is water weight, and is easily regained when return to their previous eating habits.Due to the restrictive and repetitive nature of this diet, it is difficult to sustain for any length of time. Such diets are not useful for long-term weight loss and weight maintenance. Frequent use could lead to yo-yo dieting, which has been shown to be detrimental to health.
The cabbage soup diet does not include an adequate balance of nutrients and may be too low in calories to make it suitable for long-term use. Claims that the diet can be used indefinitely or repeated within three days of completing the first cycle should be ignored as they are not safe.
The diet does not require spending large amounts of time cooking or assembling ingredients, but it may be difficult to follow when cooking for a family.
Risks
Side effects from the diet may include dizziness, light-headedness, and flatulences (intestinal gas). The latter may be a social risk due to embarrassment related to passing gas in public. Common versions of the soup recipe are high in salt. Dieters who must restrict their sodium intake should discuss variations with their physician.Research and general acceptance
Basic nutritional information about cabbage
The cabbage soup diet has not been the subject of any mainstream clinical trials as of 2007, most likely because it is a classic fad diet. Cabbage by itself, however, has been studied by nutritionists and food chemists for some years, and is considered a good food to include inAccording to the U.S. Department of Agriculture (USDA) database, raw cabbage contains 20 calories per 100g (about 3-1/2 oz), 5.6g of carbohydrates, and 32mg of vitamin C—about 53% of an adult”s daily requirement. The carbohydrate content includes 3.2g of sugars per 100g, which are released during cooking, and 2.3g of dietary fiber Thus, the cabbage soup diet does make use of some scientific findings about the nutritional value and low calorie content of cabbage: the short period of cooking recommended by the soup recipe helps remove the bitter taste of raw cabbage without destroying its dietary fiber or vitamins.
Evaluations of the cabbage soup diet
The American Heart Association (AHA) and the hospitals whose names have been associated with the cabbage soup diet have issued formal disclaimers warning the public that they do not endorse this diet. The Hopital du Sacré-Coeur de Montréal states in its 2004 press release that the diet is contrary to healthy feeding patterns and even presents potential dangers to good health. The Sacred Heart Medical Center (SHMC) in Spokane requests that people do not affiliate the diet with their hospital as they do not consider it a safe or healthy method of weight loss. A SHMC disclaimer states, “This diet did not originate at SHMC and it is not endorsed by the dietitians or the staff of our cardiac rehabilitation program. One of our major concerns about this diet plan is it emphasizes the consumption of fruits and vegetables while excluding the consumption of meat or fish, cereal grains and milk products on most days. Any diet that focuses on only certain food groups will be low or deficient in essential nutrients and, therefore, lead to poor nutritional status long-term. Our experience with any low calorie diets like this one is that they do not lead to permanent weight loss. Once individuals start eating in a more normal pattern, the weight is regained. A very important factor in obtaining a healthy weight is to evaluate your physical activity and other lifestyle concerns. This is most appropriately done by consulting with a registered dietitian.”Scientific evidence is not yet available to support claims that cabbage has unique detoxifying, fat-burning, immunoprotective, antidepressant, or anticancer properties. Claims regarding the possibility of losing 17 pounds by the end of one week on this diet are exaggerated. In addition, there is no indication that the government of Australia (or any other government) has ever sponsored clinical trials of cabbage soup, whether in pill form or fully constituted.
Resources
BOOKS
Brunvand, Jan Harold. The Mexican Pet: More “New”Urban Legends and Some Old Favorites New York:W. W. Norton, 1986.Danbrot, Margaret. The New Cabbage Soup Diet, rev. ed. New York: St. Martin”s Press, 2004.
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
OTHER
American Dietetic Association (ADA). Fad Diet Timeline— Fad Diets throughout the Years Press release. February 1, 2007. [cited April 30, 2007]. <<http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/media_11092_ENU_HTML.htm>American Heart Association (AHA). Phony American Heart Association Diets: Seeking the AHA 3-Day, 7-Day, or Cabbage Soup Diet?[cited April 30, 2007]. <http://www.americanheart.org/presenter.jhtml?identifier=507>
Callahan, Maureen. “Cabbage Soup Diet Review.” Health Magazine April 2004. [cited April 30, 2007]. <http://diets.aol.com/a-z/cabbagesoup/_a/cabbage-soup-review/20050610162209990011>
Sacred Heart Medical Center (Spokane, WA). Miracle Soup Disclaimer <http://www.shmc.org/index.php/page/298> [cited April 30, 2007].
ORGANIZATIONS
American Dietetic Association (ADA). 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800): 877-1600. Website: <http://www.eatright.org>Cabbage Soup Diet Pills. P.O. Box 1388, Cordova, TN 38088. Telephone: (901) 737-4138. Website: <http://www.cabbagesoupdietpill.com/index.html>
Dietitians of Canada. 480 University Avenue, Suite 604, Toronto, Ontario, Canada M5G 1V2. Telephone: (416) 596-0857. Website: <http://www.dietitians.ca>.
Partnership for Healthy Weight Management (PHWM), c/o Federal Trade Commission (FTC), Bureau of Consume r Protection. 601 Pennsylvania Avenue, NW, Room 4302, Washington, DC. 20580. Website: <http://www.consumer.gov/weightloss/>.
Rebecca J. Frey, PhD
Beverly Hills diet
Definition
There are a variety of three-day diets that circulate from person to person and on the Internet. They tend to promise weight loss of 10 lb (4.5 kg) or more in just three days.Origins
The origins of the three-day diet are unclear. Some people believe that they go back to the 1980s when these kinds of diets were faxed from person to person. Three-day diets go by many different names, including the fax diet, Army diet, Navy diet, Cleveland Clinic diet, and many others. Often they are just referred to as three-day diets. Although many versions of this diet claim to have been created by one medical institution or another, no medical institutions have ever been known to come forward to claim responsibility for, or even to recommend, one of these diets. Many institutions that have these diets named after them, such as the British Heart Foundation or the Cleveland Clinic, go out of their way to inform dieters that the diet did not originate where its title claims.The most common form of three-day diet on the Internet involves eating a large quantity of tuna and various vegetables during the day, with ice cream each evening. This diet seems to be similar to, or the same
as, the three-day diet sold online by 3daydiets.net. It is unclear, however, if they are the developer of the diet, as they do not claim specifically to be.
Description
There are many versions of three-day diets circulating, all with the promise of bringing dieters significant weight loss in just three days. There are many variations in what dieters may and may not eat during these three days. One diet even calls for dieters to drink only water for the first day. On the second day dieters may eat fruit, and drink only fruit juice, and on the third day dieters may eat only vegetables, and drink only vegetable juice.The most common three-day diet, and the one that seems to be the most popular, is a three-day diet with a meal plan that instructs dieters what to eat for breakfast, lunch, and dinner. The specifics of the plan vary, as do what dieters are allowed to drink while on the plan. Some versions allow anything, others specify just water and diet soda in addition to the coffee and tea called for in the meal plan. Many require that dieters drink at least four glasses of water daily. Some allow diet soda to be substituted for the water. A common version of the three-day diet meal plan is:
Day 1
Breakfast: black tea or coffee, 1/2 a grapefruit, 1 piece of toast with 1 Tablespoon of peanut butter. Some version specify 1/3 of a grapefruit, some call for artificial sweetener to be added to the coffee, some allow grapefruit juice to be substituted for the grapefruit.Lunch: 1/2 cup tuna, 1 piece dry toast, black coffee or tea. Some versions call for tuna in water, some call for artificial sweetener with the coffee or tea.
Dinner: 3 ounces lean meat, 1 cup green beans, 1 cup carrots, 1 apple, 1 cup vanilla ice cream. Some versions specify a low fat ice cream, other do not. Some versions call for 1 cup of beets instead of carrots.
Day 2
Breakfast: 1 egg, 1 slice dry toast, 1/2 banana, black coffee or tea. Some versions require artificial sweetened in the coffee or tea. It is not generally specified how the dieter should prepare the egg. Some versions call for a whole banana.Lunch: 1 cup cottage cheese and six crackers. Some versions allow dieters to choose between 1 cup of cottage cheese and 1 cup of tuna. Some require six crackers, some allow eight. Most versions call for Saltine brand crackers.
Dinner: two hot dogs, 1 cup broccoli, 1/2 cup carrots, 1/2 banana, 1/2 cup vanilla ice cream. Some versions specify beef franks. Some call for 1 cup of cabbage instead of 1 cup of broccoli. Some versions require low fat ice cream.
Day 3
Breakfast: one apple, 1 ounce cheddar cheese, five Saltine brand crackers, black tea or coffee. Some versions allow or require artificial sweetener.Lunch: one hard-boiled egg, one slice dry toast. Some versions allow black coffee or tea (with or without artificial sweetener) with this meal, others do not.
Dinner: 1 cup tuna, 1 cup carrots, 1 cup cauliflower, 1 cup melon, and 1/2 cup vanilla ice cream. Some versions call for 1/2 a cantaloupe instead of 1 cup of melon. Some versions require low fat ice cream.
There are other versions of the above three-day diet, with some specifying even more alternatives for the dieter, including an orange instead of grapefruit, cottage cheese instead of tuna, and various vegetable substitutions. Most versions tell dieters to use lemon, salt and pepper, mustard, vinegar, herbs, soy sauce, ketchup, Worcestershire sauce, and other seasonings to add flavoring to food during the diet, but nothing containing fat, such as butter. Most versions of the diet are very specific in saying that dieters have to follow the rules exactly to see the promised weight loss.
Function
The three-day diet usually promises that dieters will be able to lose 10 pounds in three days if the diet is followed exactly. Often the diet claims that this will result because the combination of foods called for by the diet causes some kind of increased metabolism that will burn pounds of fat. It is never made clear exactly what kind of reaction this is supposed to be, or how it is supposed to work. Often the diet says the dieter can repeat the diet after a few days of regular eating. Some version of three-day diets allow for as few as two days of normal eating, others require up to four or five. The three-day diets are intended to provide a dieter with extreme weight loss in a very short time and are not intended to change the dieters lifestyle or overall eating habits. Usually the diets go so far as to tell a dieter to eat whatever he or she was eating before the diet once the diet is over. The diets only caution is not to overeat. No exercise recommendations are made with three-day diets. Weight loss is supposed to come from increased metabolism and lowered calorie intake alone.Benefits
There are many benefits to weight loss if it achieved at a moderate pace through healthy eating and exercise. Three-day diets, however, are not considered moderately paced and do not include exercise, or a well-balanced diet. Although the diets claim that a dieter can lose 10 pounds in three days, weight loss is likely to come mainly from lost water weight. There may be some psychological benefit to quick weight loss, but this is likely to be undone if the weight is gained back quickly after the diet is over.Precautions
Anyone thinking of beginning a new diet should consult a physician or other medical professional. Daily requirements of calories, fat, and nutrients can differ significantly from person to person depending on age, weight, sex, and other factors. Talking to a doctor can help a dieter determine which diet is safe for that dieter’s individual needs, and a doctor can help a dieter choose a diet that fits in well with his or her long-term weight loss goals. Pregnant or breastfeeding women should be especially cautious when thinking of beginning a new diet because when a baby is receiving nutrients from its mother, what the mother eats can have a significant impact on the growth and development of the baby.Risks
There are some risks associated with any diet, but diets that severely limit calories or the variety of foods that dieters may eat tend to be more risky than well balanced, moderately calorie-reduced diets. The most common three-day diet requires dieters to eat only about 1,000 calories a day, with some versions that have been analyzed consisting of at as few as 700 calories per day. This is too few for most people to maintain good health. A diet that contains fewer than 800 calories per day is considered a very low calorie diet. Very low calorie diets carry high risks of side effects, such as gallstones and cardiovascular problems. Very low calorie diets are only intended for the extremely obese who are experiencing significant medical problems due to obesity. These diets are carried out under the close supervision of physicians. They are not intended, or safe for, dieters to follow on their own.Dieters who follow a three-day diet may find that any weight lost is gained back as soon as the diet is over, and may even find that more weight is gained that was lost. Having a very low caloric intake makes the dieter’s metabolism slow down because the body thinks that it is starving. Then when a normal number of calories are reintroduced into the diet, the body wants to store extra fat in case there is a period of starvation again. This natural defense mechanism of the body against starvation can cause dieters who alternatively eat very few calories and then return to normal eating to gain large amounts of fat over time, even while they are trying to diet. Very low calorie diets pursued over only a few days also promote binge eating at the end of the diet.
Many of the versions of three-day diets, especially those intended for fasting, carry a high risk of vitamin and mineral deficiency. The body needs food from each of the food groups every day for good health. Drinking only fruit juices, or eating any very limited variety of foods, can make it nearly impossible for a dieter to get all of the nutrients required for good health. Any dieter considering this kind of diet should consult a physician about an appropriate multivitamin or supplement to help reduce this risk of deficiency. Multivitamins and dietary supplements carry their own risks, and can not replace a healthy, well-balanced diet.
Research and general acceptance
Three-day diets are not generally accepted as healthy, effective ways to lose weight for the long term. Although no scientific studies have been carried out to determine the effectiveness of common three-day diets, experts suggest that anything that promises dieters 10 lb (4.5 kg) of weight loss in three days is unlikely to be taking off fat. Instead, dieters are probably losing water weight, with possibly a little fat loss and some muscle mass loss through the reduced caloric intake.The United States Department of Agriculture makes recommendations for a healthy diet in its MyPyr-amid food guidelines. MyPyramid gives recommendations about how many servings of each food group are required daily for good health. These recommendations can be found at <http://www.MyPyramid.gov.> Any diet that will produce sustainable, healthy weight loss should follow these guidelines and include foods from each food group every day. Sustainable diets should not be extremely restrictive of any food group, or be extremely calorie-reduced.
Many studies have shown that exercise and diet are more effective at producing weight loss when done together than either is done alone. Three-day diets do not usually have any exercise recommendations. Instead, they generally claim that a combination of foods will magically melt away fat without the dieter having to expend any effort. Healthy weight loss plans should include both a diet and an exercise component. As of 2007, the Centers for Disease Control recommended that adults get a minimum of 30 minutes of light to moderate exercise each day for good health.
Resources top
BOOKS
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>OTHER
The Diet Channel. ‘‘3 Day Diet.’’ 2007. <http://www.thedietchannel.com/3-day-diet.htm>Tish Davidson, A.M.
Bernstein diet
Definition
The Bernstein diet is a low-carbohydrate, high-fat diet for people with diabetes (diabetics). It goes against the conventional high-carbohydrate, low-fat diabetic diet recommended by much of the medical community.Origins
The diet was developed by endocrinologist and Type I diabetic Richard K. Bernstein and first published in his 1997 book Dr. Bernstein’s Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars. It is intended for diabetics and people with insulin resistance syndrome. Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy. Insulin resistance often goes along with other health problems, like diabetes, high cholesterol, high blood pressure and heart attack. When a person has many of these problems together, it is called insulin resistance syndrome.Bernstein was diagnosed with diabetes in 1946 at the age of twelve. He was put on the standard low-fat, high-carbohydrate diet for diabetics. He remained on this diet, even though his condition worsened and he developed many complications of the disease, until 1969. During this time, he experienced frequent bouts of hypoglycemia (excessively low blood sugar) along with headaches and fatigue, which he said was caused by the large doses of insulin he was taking to help regulate his blood sugar levels. He blames this cycle of hypoglycemia followed by insulin injections on his high-carbohydrate diet. Doctors recommend a high-carbohydrate diet for diabetics because it raises blood sugar. When blood sugar levels get too high in Type I diabetics, they must be brought down with insulin injections. In 1969, Bernstein, an engineer, began adjusting his insulin regimen from one injection a day to two and cut down on carbohydrates in his diet. The changes had only minimal effect. In 1972, he began checking his blood sugar levels five to eight times a day, making small changes to his insulin regimen and diet to see what the effects would be. Within a year, Bernstein said he had refined his diet and insulin injection schedule to the point of having nearly constant normal blood sugar levels. His health improved considerably. He spent the next few years trying to convince the major medical journals and physicians who treated diabetes that his method of closely monitoring his blood sugar levels and maintaining a relatively constant, normal blood sugar level could help other diabetics. The attempts failed. So in 1979, Bernstein quit his engineering job and entered medical school. In 1983, he opened his own medical practice in New York. After that, he began formulating his diet plan that became the focus of his 1997 book.
Description
The Bernstein diet doesn’t recommend a specific ratio of the three main food groups: proteins, fats, and carbohydrates. Instead, he advocates an individualized approach to a diabetic’s diet. At the center of the diet is the need for diabetics to test their blood sugar levels at least five to eight times a day. On his Website, (http://www.diabetes-normalsugars.com) Bernstein states, “There is simply no way to determine objectively how any given food at any given time is going to behave in any given individual, unless blood sugar is tested before and for a number of hours after its consumption.” In his books and on his Website, Bernstein details how each of the three primary food groups, protein, fats, and carbohydrates, fit into his diet.Bernstein has three basic rules for diabetics when developing meal plans that normalize blood sugar levels. They are:
- Eliminate all foods from the diet that contain simple sugars, which are fast-acting carbohydrates. These foods include table sugar, most starchy foods such as breads and pasta, grains, and potatoes.
- Limit total carbohydrate intake to an amount that will work with insulin, either injected or produced naturally by the body. This will avoid a post-meal blood sugar increase, and will avoid any remaining insulin-producing beta cells of the pancreas.
- Stop eating when there is no longer a feeling of hunger. He says people should not leave the table while they are still hungry but should also not wait until they feel stuffed to stop eating.
The Bernstein diet recommends diabetics avoid eating the following foods: breakfast cereals, snack foods (candy, cookies, cakes, potato and tortilla chips, popcorn, and pretzels), protein bars, milk and
KEY TERMS
Carbohydrates—An organic compound that is an important source of food and energyDiabetes—A disease in which the blood glucose (sugar) levels are too high and the body does not make insulin (which helps regulate blood sugar) or does not make or use insulin well
Endocrinologist—A medical specialist who treats diseases of the endocrine (glands) system, including diabetes
Hypoglycemia—Abnormally low blood sugar levels
Insulin—A hormone that regulates the level of glucose (sugar) in the blood
Insulin resistance syndrome—A medical condition in which insulin fails to function normally in regulating blood glucose (sugar) levels
Ketoacidosis—Dangerously high blood sugar levels
Monounsaturated fat—A type of fat found in vegetable oils such as olive, peanut, and canola
Polyunsaturated fat—A type of fat found in some vegetable oils, such as sunflower, safflower, and corn.
cottage cheese (except for soy milk), fruits and fruit juices, certain vegetables (beans, beets, carrots, corn, potatoes, tomatoes (including tomato sauce and paste), canned and packaged soups, and most ‘health’ foods.
Foods that are allowed under the Bernstein diet include meat, fish and seafood, poultry, eggs, tofu, soy meat substitutes, cheese, butter, margarine, cream, yogurt, soy milk, soy flour, and bran crackers. Other food items allowed include toasted nori (seaweed), artificial sweeteners (Equal, Sweet’n Low, Nutra-Sweet, and Splenda), No-Cal brand syrups, Da Vinci Gourmet brand syrups, flavor extracts, herbs and spices, low-carbohydrate salad dressings, nuts, and sugar-free gelatin and puddings.
Function
The main function of the Bernstein diet is to help people with diabetes to maintain constant, normal blood sugar levels throughout the day. Maintaining control of their blood sugar levels can help diabetics avoid long-term complications of the disease, including neuropathy of the feet, amputation, cataracts and blindness, heart disease, erectile dysfunction, glaucoma, ulcers of the feet, high blood pressure, and high cholesterol. Since the diet is similar to the Atkins diet in that it emphasizes low-carbohydrate foods, people who are overweight or obese can lose weight on the Bernstein diet.Benefits
The primary benefits of the Bernstein diet come from diabetics being able to maintain constant, normal blood sugar levels. Doing this over the long-term can help reduce the number of diabetics who develop complications from the disease. These complications include heart disease, high blood pressure, eye problems, serious conditions affecting the feet that sometimes lead to amputation, gastroparesis (a condition in which the stomach requires significantly longer than its normal time to empty), kidney disease, and fatigue. The importance of maintaining constant, normal blood sugar levels (by checking the levels at least five to eight times a day with home glucose monitors and then adjusting insulin levels accordingly) was proven by the Diabetes Control and Complications Trial, a study of diabetics from 1983–1993, the most comprehensive large-scale diabetes study ever conducted. The study found that in diabetics who intensely controlled their blood sugar levels, the risk for eye disease was reduced by 76 percent, nerve disease by 60 percent, and kidney disease by 50 percent. The diet can also help diabetics who are overweight or obese to lose weight.Precautions
There are no major precautions associated with the diet, although it is not recommended for diabetics by major medical organizations including the American Medical Association, American Dietary Association, and American Diabetes Association. Diabetics should discuss the diet with their doctor or a specialist in diabetes called an endocrinologist, who may refer the person to a diabetic dietician or nutritionist. The diet is high in fat so people on it should use fats fromQUESTIONS TO ASK YOUR DOCTOR
- Will I need any dietary supplements if I adopt the Bernstein diet?
- Do you see any health risks for me in the diet?
- Are there any other diets you would recommend that would help me accomplish my weight loss goals?
- Have you treated other patients who are on a low-carbohydrate, high-fat diet? If so, what has their response to the diet been?
- How will the Bernstein diet affect my diabetes or insulin resistance syndrome?
- How important is it for me to maintain constant normal blood sugar levels throughout the day?
Risks
There are no general health risks associated with the Bernstein diet. Critics of the diet say it contains too much fat, is not nutritionally balanced, and is not a long-term solution for losing weight and keeping it off. They also say it is difficult for many people to maintain a low-carb diet over the long-term. Also, people with type 1 diabetes who take insulin are at a high risk of hypoglycemia (abnormally low blood sugar levels) and ketoacidosis (dangerously high blood sugar levels) if they remove too much carbohydrate from their meals.Research and general acceptance
Critics of the Bernstein diet for diabetics are quick to point out that there are no major long-term scientific studies on the effectiveness of the low-carbohydrate, high-fat diet. However, the same can be said for the traditional low-fat, high-carbohydrate diet that has been the standard diabetic diet for more than 50 years. In one review of Bernstein’s 1997 book, Dr. Bernstein’s Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars, the diet was criticized because it required diabetics to be meticulous in self-managing the disease. But there are major long-term scientific studies that show that there is significant benefit in such meticulous self-management, including the landmark Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study.Among the critics of the Bernstein diabetic diet are the American Diabetes Association, American Dietary Association, American Medical Association, American Heart Association, United States Department of Agriculture, and the Physicians Committee for Responsible Medicine. They say that high-fat, low-carbohydrate diets are generally unhealthy because they are low in fiber, calcium, fruits, and vegetables, and high in cholesterol, fat, and saturated fat. On the surface, it would seem that a diet that is the opposite of what the world’s leading diabetes organization recommends would not be acceptable for diabetics. However, since 2002, a number of scientific studies that compared high- and low-carbohydrate diets concluded that a low-carbohydrate diet reduces blood sugars and risk factors for heart disease. That is why many practicing endocrinol-ogists endorse the Bernstein diet and other low-carbohydrate diets for their patients. They point out that the American Diabetes Association (ADA) has always been very slow in reacting and adjusting to new development in diabetes monitoring and treatment. For example, the ADA did not endorse patient blood glucose monitors until 1983, about 10 years after they were developed. What is lacking in the low-carb versus high-carb diet controversy is major long-term studies that track patients for longer than a year.
People with Type II diabetes may be able to improve control of their blood sugar levels, lose weight, and lower cholesterol levels significantly with a low-carbohydrate diet, such as the Bernstein diet, that with diets that restrict calorie intake, according to two studies presented in 2006 at the American Diabetes Association annual scientific sessions. One of the studies, conducted by Duke University researchers, was funded by the Robert C. Atkins Foundation. Atkins authored a number of popular books on the Atkins low-carbohydrate diet.
Resources top
BOOKS
Bernstein, Richard K. Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars (New York: Little, Brown and Company, 2007.Bernstein, Richard K. The Diabetes Diet: Dr. Bernstein’s Low-Carbohydrate SolutionNew York: Little, Brown and Company, 2005.
D’Adamo, Peter J. Diabetes: Fight It With the Blood Type DietNew York: Putnam Adult, 2004.
Elliot, Ross. The Vegetarian Low-Carb Diet: The Fast, No-Hunger Weightloss Diet for Vegetarians London: Piat-kus Books, 2006.
Gallop, Rick. The G.I. Diet: The Easy, Healthy Way to Permanent Weight Loss New York: Workman Publishing Company, 2003.
Scales, Mary Josephine. Diets in a Nutshell Clifton, VA: Apex Publishers, 2005.
Sears, Barry, and Deborah Kotz. A Week in the Zone: A Quick Course in the Healthiest Diet for You New York: Regan Books, 2004.
PERIODICALS
American Diabetes Association. “Nutrition Principles and Recommendations in Diabetes.” Diabetes Care (January 2004): S36–S46.Bernstein, Richard K. “Low-Carb Guru Weighs In On Controversy.” Diabetes Interview (March 2004): 28–29.
Clark, Charles. “PulseClinical: Effective Diet in Diabetes.” Pulse (November 23, 2006): 36.
Evans, Jeff. “Low-Carb Diet Trumps Caloric Restriction in Type 2 Diabetes.” Family Practice News (October 15, 2006): 21.
Govindji, Azmina. “The Role of Carbohydrates in a Healthy Diet.” Nursing Standard (September 27, 2006): 56–64.
Kendrick, Malcolm. “Kendrick On Atkins Over Complex Carbs for Diabetes.” Pulse (September 10, 2005): 64.
Mangels, Reed. “Lowfat Vegan Diet for Type 2 Diabetes.” Vegetarian Journal (January-March 2007): 12.
Vaughan, Lisa. “Dietary Guidelines for the Management of Diabetes.” Nursing Standard (July 13, 2005): 56–64.
ORGANIZATIONS
American College of Nutrition. 300 South Duncan Ave., Suite 225, Clearwater, FL 33755. Telephone: (727) 446-6086. Website: http://www.amcollnutr.org.American Diabetes Association. 1701 N. Beauregard St., Alexandria, VA 22311. Telephone: (800) 342-2383. Website: http://www.diabetes.org.
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. Website: http://www.eatright.org.
American Society for Nutrition. 9650 Rockville Pike, Bethesda, MD 20814. Telephone: (301) 634-7050. Website: http://www.nutrition.org.
Center for Nutrition Policy and Promotion. 3101 Park Center Drive, 10th Floor, Alexandria, VA 22302-1594. Telephone: (703) 305-7600. Website: http://www.cnpp.usda.gov.
Ken R. Wells.
Atkins diet
Definition
The Atkins diet is named for Robert C. Atkins, M.D., the diet’s founder. It is based on restrictions of carbohydrates and focuses on eating mostly protein and fat, along with use of vitamin and mineral supplements.The Atkins diet has been one of the most popular fad diets in the United States. It started a “low-carb revolution,” leading to development of low carbohydrate choices in grocery stores and restaurants around the world. The diet’s founder, Robert C. Atkins, died in February 2003.
Origins
Dr. Atkins introduced his Diet Revolution in 1972. From the beginning, Dr. Atkins, a cardiologist, said that limiting intake of carbohydrates (sugars and starches) would improve health and aid in weight control. The original premise for developing the diet came about because of Atkins’ frustration with the increasing rates of obesity and chronic diseases such as diabetes.Description
Throughout the diet, Dr. Atkins recommended drinking at least eight 8-oz. glasses of water each day to avoid dehydration and constipation He also recommended daily intake of nutrients through a good multi-vitamin supplement. Finally, Dr. Atkins mentioned getting plenty of exercise to speed weight loss. The Atkins diet consists of four distinct phases that participants should go through to achieve and maintain weight loss.Induction
The induction phase is not required, but that doing so jump starts weight loss as dieters cut back significantly on carbohydrate consumption. According to Atkins Advantage notes, the induction phase can make people feel revitalized, since carbohydrates cause blood sugar spikes that lead to fatigue and other symptoms. The diet also claims that the induction phase will help dieters see the benefits of fat-burning and strengthen their immune systems.This is by far the most restrictive of the four phases, allowing no more than 20 net carbohydrates per day. This equals roughly three cups of salad greens or other non-starchy vegetables. Participants can eat
Phases of the Atkins Diet
Induction—At least two weeks
No more than 20 net carbohydrates per day
Liberal amounts of protein, including meats, fish, poultry, and eggs, as well as healthy fats
Fatty condiments (mayonnaise, sour cream, guacamole, and butter) are allowed in unlimited quantities
Weight loss during the induction phase may be significant
Ongoing weight loss—Begin after two weeks
Slow introduction of foods with carbohydrates that are considered nutrient dense (green beans, Brazil nuts, avocados, berries, and whole grains)
In week one, add 25 grams of carbohydrates per day
In week two, 30 grams of carbohydrates are allowed
The addition of five grams per week continues until weight loss stalls, then drop back to the previous gram level
Pre-maintenance goal—Begin when within 5 to 10 pounds of weight-loss goal
Gradually increase carbohydrate intake by 10 grams per week until weight is gained, then drop back to the previous carbohydrate gram level
Level weight loss to less than one pound per week
Lifetime maintenance—Begin one month after weight-loss goal is achieved
May be able to consume from 90 to 120 grams of carbohydrates a day, depending on age, gender, and activity level
Maintaining weight goal is more likely if carbohydrate intake remains at the level discovered in pre-maintenance
(Illustration by GGS Information Services/Thomson Gale.)
liberal amounts of protein, including meats, fish, poultry, and eggs, as well as healthy fats. Healthy fats include vegetable and seed oils. High fat condiments such as mayonnaise, sour cream, guacamole, and butter are allowed in virtually unlimited quantities. The Atkins theory is that these high fat foods enhance the flavor of meals, making the Atkins diet easier to maintain. Atkins has reminded dieters that while unlimited quantities of fats and proteins are allowed, the advice is not a license to gorge. Dieters are said to feel hungry for the first 48 hours as their bodies adjust to the abrupt reduction in carbohydrates. Weight loss during the induction phase is said to be significant. The phase is recommended to last at least two weeks.
Ongoing weight loss
The second phase of the Atkins diet moves into ongoing weight loss. It involves slow introduction of foods with carbohydrates that also are considered nutrient dense. Most of the carbohydrate calories come from vegetables. Atkins dieters still eat a higher proportion of proteins and fat, but they gradually add more carbohydrates into the diet. According to Atkins, the purpose of the phase is to continue to burn and dissolve fat while maintaining appetite and craving control. This phase also introduces the dieter.KEY TERMS
Ketoacidosis—An imbalance in the makeup of body fluids caused by the increased production of ketone bodies. Ketones are caused by fat breakdown.to a broader range of foods and helps to determine the dieter’s threshold level of carbohydrate consumption. It is the intention of this phase to deliberately slow weight loss.
If weight loss continues, carbohydrate intake is gradually increased each week. In week one, the dieter can add 25 grams of carbohydrates per day. In week two, 30 grams of carbohydrates are allowed. This addition of five grams per week continues until weight loss stalls, then the dieter drops back to the previous gram level. Typical tolerance levels may range anywhere from 30 grams to 90 grams per day. Atkins literature says that the more a dieter exercises, the more carbohydrates he or she can tolerate. The Atkins diet recommends choosing carbohydrates first from vegetables that are low in carbohydrates, then from other sources that are fresh foods high in nutrients and fiber. Examples of low-carbohydrate vegetables are lettuce, raw celery, and cucumbers. Nutrient-rich carbohydrates are green beans, Brazil nuts, avocados, berries, and whole grains.
Pre-maintenance
The Atkins diet considers the third phase a practice for lifetime maintenance of goal weight and “healthy eating habits”. When the goal weight is within five to 10 pounds, the dieter gradually begins to increase carbohydrate intake by 10 grams per week until weight is gained, then drops back to the previous carbohydrate gram level. The purpose is to level weight loss to less than one pound per week. The dieter should continue at this rate until the goal weight is reached, then for one month past that time. The goal is to achieve a level at which weight is neither gained nor lost and to internalize the habits that become part of a permanent lifestyle.Examples of vegetables that contain about 10 grams of carbohydrates are 3/4 c. of carrots, 1/2 c. of acorn squash, 1 c. of beets, and 1/4 c. of white potatoes. Legumes and fruit are the next preferred food groups for adding 10 grams daily. One-half apple contains 10 grams of carbohydrates, as does 1/3 c. of kidney beans.
Lifetime maintenance
This final phase of the Atkins diet occurs when a dieter reaches goal weight. Although an adult may be able to consume from 90 to 120 grams of carbohydrates a day, depending on age, gender, and activity level, maintaining goal weight is more likely if carbohydrate intake remains at the level discovered in pre-maintenance. The key, according to Atkins, is never letting weight vary by more than three to five pounds before making corrections.Function
From the beginning, Dr. Atkins said that the traditional approach to weight loss of counting calories and cutting fat must not be working. He blamed carbohydrates for adding to the expanding waistlines and declining health of Americans. Through several updates of the Atkins diet, the same basic premise held with minor revisions. The function of the diet is to enjoy eating while severely limiting carbohydrates. Atkins Advantage mostly makes a distinction between trans fats and other fats. A more clear distinction also is made in the later version between carbohydrates in general and sugar in particular. All along, Atkins has emphasized that a focus on protein builds energy, repairs muscles and bones, and boosts the metabolism.Benefits
Some dieters have had at least initial success with the diet and have found the liberal rules regarding protein and fats more tasteful and filling than other diets, Advice from the Atkins plan concerning behavioral changes can be helpful, such as shopping the perimeter of the grocery store, where the unprocessed foods are located. In recent years, the program has attempted to modify some of its advice to more closely fit traditional advice from registered dieticians. For example, more clearly defining the types of fats to emphasize in the diet may help avoid mistakes by some who follow the diet to overeat unhealthy fats and increase risk for heart disease. However, experts have said that the diet still contradicts mainstream views concerning health promotion and disease prevention.Precautions
The average carbohydrate intake recommended by the Atkins diet is well below averages generally recommended by other experts. Studies have shown that even though people may lose weight on the Atkins plan, they do not necessarily keep the weight off longterm because the diet does not teach sustainable lifestyle changes.Like many fad diets, the Atkins plan produces and promotes many food products associated with its diet plan. As of 2007, these products included bars, shakes, and candy. So although the plan argues against processed foods and snacking, the company also heavily promotes use of its nutritional products to support weight loss or maintenance.
Most importantly, followers of the Atkins diet have reported suffering from muscle cramps, diarrhea, general weakness, and rashes more frequently than people on low-fat diets. Others have reported constipation, bad breath, headache, and fatigue. The American Dietetic Association has warned that any diet that severely limits one food group should raise a red flag to dieters.
Risks
Beyond the reported side effects and concerns about the diet’s long-term effectiveness, some serious problems may arise for Atkins diet followers. One problem that has been documented is called ketoacidosis. This occurs when there is a buildup of the byproducts of fat breakdown because the body does not have enough glucose available. The condition can be dangerous, resulting in cell damage, severe illness, and even death. The low carbohydrates eaten by those on the diet are below those needed to supply the brain and muscles with sugar. Critics of the diet have also long focused on the risks of unlimited fat intake that the Atkins diet allows. Eating large amounts of saturated fat, even if weight is dropping, can lead to high levels of cholesterol and heart disease. However, this is not necessarily always the case. Cholesterol levels tend to decrease in many individuals when they lose weight, even if eating an unbalanced diet. Long-term research remains to be done in this area.Research and general acceptance
Research results have varied over the years concerning the Atkins diet. The research has tended to support that Atkins followers have experienced comparable or higher weight loss than people on traditional low-fat diets with higher amounts of carbohydrates, but for only a six-month period. After 12 months, weight loss was about equal. Some research also has shown that the diet has not produced damaging cholesterol or heart effects, but these studies have not been large, long-term trials. For example, effects of increased fat consumption on diet followers’ hearts may take years toQUESTIONS TO ASK YOUR DOCTOR
- What aspects of the Atkins diet do you feel are appropriate for weight loss?
- How often would I need to be seen by a physician or registered dietitian while following the atkins diet?
In 2004, Jody Gorran, a 53-year-old businessman from Florida, sued the promoters of the Atkins diet, saying that the plan clogged his arteries and nearly killed him. Mr. Gorran claimed that he was seduced by the plan and that by eating the high levels of protein and fats touted by the plan, his cholesterol soared. His lawsuit was backed by the Washington-based advocacy group called Physicians Committee for Responsible Medicine. Mr. Gorran sought damages and to seek an injunction preventing the sale of Atkins’ books and products without fair and adequate warnings about the dangers of the diet. The lawsuit was dismissed late in 2006 by a judge, but an appeals continue.
Atkins’ company filed for Chapter 11 bankruptcy protection in July 2005. The company completed its Chapter 11 reorganization by January 2006, having streamlined some operations, and continued to operate early in 2007, making Dr. Atkins’ diet run more than 35 years long.
Controversy even surrounded Atkins’ death in 2003. Though he died when he slipped on the ice outside his office in February 2003. He spent eight days in a coma before dying, and a copy of the medical examiner’s report showed that his weight upon death was 258 pounds. Critics of Atkins’s diet said that this was considered obese for a man who was six feet tall. His allies said that most of the pounds were gained in Atkins’ time in a coma because of fluid retention. But even while Atkins was alive, he had reportedproblems with his heart, though his physician’s council said the trouble was from an enlarged heart, which had stemmed from a viral infection, not from his diet.
Though Dr. Atkins added that numerous studies pointed to the fact that carbohydrates were to blame for weight gain, an explanation for how his diet program worked was never really offered by researchers. Numerous studies continued throughout the 1990s and even after Dr. Atkins’ death. Though some studies showed that people on the Atkins diet often lost weight faster in six months than those on other weight loss programs, the long-term effectiveness and possible harmful effects of the Atkins diet required more study.
In 1992, Dr. Atkins updated his Diet Revolution and by 2004 Dr. Atkins’ New Diet Revolution had sold more than 45 million copies and been translated into 25 languages. The new plan was the same, but the maintenance portion of the diet was made a little more liberal. The diet was extremely popular, as were Atkins Nutritionals products, such as vitamin supplements and numerous food items. A later Web-based version called the Atkins Advantage emphasized the products of Atkins Nutritionals and offered additional books, software, and information on a company Website to support the program’s goals and products.
Resources top
BOOKS
Atkins, Robert C. Atkins for Life M. Evans, 2003.Atkins, Robert C. Dr. Atkins’ New Diet Revolution St. Martin’s Paperbacks, 2004. 2003.
ORGANIZATIONS
Atkins Nutritionals, Inc. New York, NY. <http://www.atkins.com>Physicians Committee for Responsible Medicine. 5100 Wisconsin Ave NW, Suite 400, Washington, D.C. 20016. 202-686-2210. <http://www.atkinsdietalert.org>
Teresa G. Odle
Asian diet
Definition
The Asian diet is an ancient and time honored way of eating. For thousands of years people of the Asian world have eaten a diet based on plant foods such as rice, vegetables, and fresh fruits. Unlike Western diets, meat is rarely the main dish of any meal but rather an accent and flavor compliment. Fish is often eaten in main courses.In many Asian cultures diet is closely related to religious practices and tradition. It is an extremely healthful diet. Asian populations who have access to a sufficient variety of traditional foods are some of the healthiest and longest lived people on Earth. Many chronic illnesses that plague Western cultures such as heart disease, cancer, and obesity occur rarely in these cultures.
Origins
Over 43 countries follow a form of Asian diet. Nearly half the world’s population may be considered Asian. Food is an important part of daily life. Religious practices often dictate the type of foods eaten and the meal is an essential part of family relationships. The diet is based on fresh food prepared primarily raw, steamed, stir-fried, or deep fried.There are four major types of Asian diets: .
East Asian Food: China, Japan, and Korea
China is the largest country in the world and has many different cuisines. Although China stretches across mid-Asia as well as to the east, Chinese food as a whole is considered East Asian food. Throughout most of China, rice is an important food staple. However, in some regions, noodles rather than rice are the foundation of the diet. Most food is prepared by mincing and cooking it, along with a small amount of oil, in a wok.
Merits of traditional Asian diets
Staple foods
|
Merits of diet
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Cambodian
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Rice
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Low in fat
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Fish
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Low in sugar
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Tea
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Chinese
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Rice
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Reduces risk for heart
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Vegetables
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disease and certain
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Green Tea
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cancers
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Filipino
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Rice
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Reduces risk for heart
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Vegetables
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disease and cancers
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Seafood
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Fruit
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Hmong
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Rice
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Low in fat
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Vegetables
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Low in sugar
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Meat
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Fish
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Asian Indian
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Cereals
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Low in fat
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Rice
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Low in sugar
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Vegetables
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Laotian
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Rice
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Low in fat
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Vegetables
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Low in sugar
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Fish
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Vietnamese
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Rice
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Low in fat
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Fish
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Low in sugar
| |
Fruit
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Within China there are three distinct regional cuisines: Shanghainese, whose regional food is known for its hot and spicy chili pepper flavoring and distinctive red-colored meats. Cantonese and Chaozhao regions associated with flavorful meat and vegetable combinations. Beijing, Mandarin, and Shandong regions serve noodles and steamed bread dumplings used instead of rice as the foundation of most meals.
Japan is an island nation and much of its food uses fish and fish-based ingredients. Rice is a staple in Japanese cooking as are sliced, salted vegetables. Soy products such as tofu, soy sauce and soy paste called miso are used in many dishes. Foods of Japan also include sushi, meats flavored with teriyaki sauce, and lightly battered and fried meats, fish, and shellfish called tempura.
Korean food is a blend of Chinese and Japanese influence, yet it has its own distinct flavors including soy sauces, garlic, ginger, chilies, pine nuts, and sesame seeds among other spices and foods. Traditional Korean meals include meats and seafood. Most meals include a vegetable dish called gimchi made of grated vegetables pickled with garlic, chili, and ginger.
Southeast Asian Food: Vietnam, the Philippines, Malaysia, and Singapore
Vietnamese cuisine relies on rice and vegetables as its foundation with meat and fish used sparingly. Fish.KEY TERMS
Antioxidants—Substances believed to protect the body from the damage of oxidation.Diabetes— A disease that causes an abnormally high level of glucose (sugar), to build up in the blood.
Hinduism—A broad group of religious and philosophical beliefs from India. It is characterized by belief in reincarnation, one God with many forms, and the pursuit of transcending the evils of earth.
Hypertension—High blood pressure.
Menopause—The time in a woman’s life when menstruation stops.
Obesity—Over weight.
Osteoporosis—A weakening of the bones that is caused by calcium deficiency.
sauces called nuocmam is the main flavoring. Fruits such as bananas, mangoes, papayas, coconut, and pineapple are also an important part of each meal.
Philippines cuisine is a unique blend of Spanish, Japanese, Chinese, Islamic, and American influences. The typical day includes four meals, three main meals and a light afternoon snack. Unlike other Asian diets, meat is very important. Favorite meats include pork, beef chicken, and water buffalo in the rural provinces. Rice and noodles are served with most meals and vegetables such as broccoli, bitter melon, mung bean, bean sprouts, and okra.
Malaysia and Singapore share a spicy cuisine incorporating Chinese, Muslim, and Indian influences. Traditional foods include meat kebabs called Satays which are served with a spicy peanut sauce. Curry is a favorite spice and is mixed with meat and marinades. Rice and Chinese noodles are eaten daily. Deserts made from coconut milk, green noodles, sugar syrup, and sweet beans are local favorites.
Southern Asian Food: India
Origins
In general, the Asian diet is not measured and does not include exact portion sizes, but rather guidelines for what should be eaten daily, weekly, and monthly. Rather than prohibitions and prescriptions, the Asian diet suggests balance. The typical daily calorie content is approximately 1200 to 1400.Suggested daily foods include:
- Grains and Breads: Grains form the basis of the Asian diet. Rice is the predominant grain and is eaten daily. Other grains include noodles, corn, millet, and bread. Also included in this category are potatoes and cereals.
- Vegetables: Many fresh vegetables are eaten daily and in large quantities. There are many vegetables to be enjoyed following the Asian diet such as carrots, cabbage, green leafy vegetables, onions, sprouts, and many others. Vegetables provide necessary daily vitamins and fiber.
- Fruit: Many fruits are used as flavoring, ingredients, deserts, and enjoyed raw. Eating a variety of fruits insures proper vitamin and minerals in the diet.
- Nuts and Legumes: In the Asian diet, nuts and legumes or beans provide the primary source of protein. Soy beans in many forms such as tofu, soy milk, and soy flour are used almost daily. Nuts and seeds also play a vital role in the diet providing necessary protein and minerals. Tofu, nuts, seeds and beans are used in soups, salads, main dishes and even deserts.
- Vegetable Oils: Essential fats come from the vegetable oils used in cooking. Some of the oils used are high is saturated fat and are a very small part of the Asian diet used primarily for cooking.
- Optional Daily Foods: Daily products that could be consumed daily are dairy products and fish. Dairy products are not a part of most Asian diets. If dairy is included on a daily diet it should be low fat and eaten in moderation.
Suggested weekly foods include:
- Sweets: Sweets are eaten rarely in the Asian diet as a treat. They are high in sugar and usually high in fat. Fruit is an excellent substitute for high fat and high sugar deserts.
- Poultry and Eggs: Eggs, chicken , and turkey are used weekly as ingredients to main dishes.
- Red Meat: Meat is eaten very sparingly in the Asian diet. It may be eaten a few times a monthly or more frequently if in small servings.
Eating the Asian way, according to Tran, involves the benefits of fresh fruits and vegetables and uses vivid flavors and spices to enhance the eating experience. Asian eating uses vegetables, broths, and spices to make the calories filling so that eating few calories is still very satisfying.
Function
Asian diets are influenced by culture, religion, and agriculture. Research has shown that this way of eating is extremely healthful. Low in fat, high in fiber and full of fresh fruits and vegetables, many believe it is the secret to a long and healthy life.By eating a diet that is predominantly plant-based, the calories are low. The spices and manner of cooking provide the palate with a stimulating eating experience and help the dieter feel satisfied.
Benefits
Antioxidants are a category of vitamins and minerals that help to prevent damage to the body caused by substances called free radicals. Free radicals are the by-products of molecular functions in the body and environmental toxins ingested such as tobacco smoke and radiation. Antioxidants are believed to reduce the negative impact of these free radicals and reduce the risk of certain forms of cancer and heart disease.Fruits and vegetables also provide fiber. Many studies have shown that adequate amounts of fiber in the diet may reduce the risk of several forms of cancer including colon cancer, the third most prevalent cancer among both men and women in the United States.
The Asian diet limits fat in general and almost completely eliminates saturated fat. A diet high in saturated fat has been shown to cause chronic illnesses such as coronary artery disease, obesity, and cancer. Many researchers believe this is the primary reason such diets are so healthy.
Precautions
Traditional Asian diets include little or no dairy products. This limits the amount of calcium consumed since milk and other dairy products contain high amounts of calcium and are the usual food group to provide this essential nutrient. Modern version of this diet presented to the Western world generally include low-fat or reduced-fat dairy products in moderation. Pregnant or nursing women will need to take calcium supplements to insure that they have enough calcium. Dieters who do not wish to consume dairy products may also decide to take calcium supplements. In Asia, most people are far more active than typical Westerners. Their activities often involve lifting heavy objects and manual labor. Weight bearing exercise has been shown to strengthen bones and my offset the lower amounts of calcium consumed.The Asian diet is a wholesome option for most healthy adults. However, children and pregnant women may not receive the proper balance of nutrition needed. Children may need the calcium dairy products provide and increased fat consumption during stages of rapid growth and development. Pregnant women need to insure sufficient intake of.
QUESTIONS TO ASK YOUR DOCTOR
- Is this diet appropriate for me?
- What are the potential benefits for a person of my age, sex, and lifestyle in adopting an Asian diet?
- What are the potential health risks, if any, of this diet for me as an individual?
- Will I need any dietary supplements if I follow the Asian diet?
- How much exercise should I do each week in conjunction with this diet?
Risks
A traditional Asian diet is low in dairy products and may, therefore, be low in calcium. Diets low in calcium can lead to osteoporosis, a weakening or the bones. Women are especially vulnerable to this disease after menopause when lower levels of hormones weaken bones as well. Similarly, pregnant women and children have higher calcium requirements. To insure that adequate amounts of calcium are in the diet, a calcium supplement may be needed or the addition of low-fat dairy products.Attempting to follow an Asian diet by eating at Asian style restaurants in the West may not be successful or healthy since many of these restaurants have adapted to Western tastes by adding high levels of fats and sodium. To enjoy the benefits of Asian style eating, it may be necessary to prepare the foods at home. Though many communities enjoy authentic Asian restaurants and it may be possible to find healthy Asian cuisine.
Research and general acceptance
General acceptance
Asian style diets are considered by many nutritionists and doctors to be the model of healthy eating. Low in fat and high in vitamins, minerals, and antioxidants, the Asian diet is believed to prevent many illnesses of the Western world such as diabetes, coronary artery disease, hypertension, cancer, and obesity.Research
In 2000, The American Heart Association issued revised dietary guidelines for reducing the risk of heart disease and stroke. These recommendations include eating a diet low in fat and full vegetables and fruits. They also recommend increasing the consumption of fish. All of these recommendations are found in the Asian diet.Many studies show the benefit of eating a diet such as the Asian diet. These studies show that lipid (fat) levels in the blood, a major risk factor for heart disease and stroke, may be dramatically reduced by following a low fat, plant-centered diet. The effects of years of unhealthy eating habits may be reversed by altering the diet to limit intake of high fat foods and increasing the amount of low fat foods, fruits, and vegetables.
In 2000, one study confirmed the results of previous research that a diet low in saturated fat and high in fruits and vegetables lowers blood pressure in patients with untreated hypertension. Doctors believe following such as the Asian diet could prevent hypertension.
Resources top
BOOKS
Hadady, Letha. Feed Your Tiger: The Asian Diet Secret for Permanent Weight Loss and Vibrant Health New York, NY: Rodale, 2007.Hodder, Mary T. The Complete Asian Health and Diet Cookbook Berkeley, CA: Heian International, 1988.
Tran, Diana My. The Asian Diet: Get Slim and Stay Slim the Asian Way Herndon, VA: Capital Books, 2002.
Yo, Linda. Asian Slim Secrets: Enjoy Food, Stay Slim Naturally! San Diego, CA: Asian Way, 2005.
PERIODICALS
American Hear Association. “AHA Dietary Guidelines” Circulation 102 (2000): 2296–2311.Jacobi, Dana. “The World’s Healthiest Diet.” Natural Health 26, no. 1 (Jan–Feb 1996): 90–107.
Krauss, R. M. and D. M. Dreon. “Low-Density Lipoprotein Subclasses and Response to a Low-Fat Diet in Healthy Men.” Am JDin Nutr 62 (1995): 478S–487S.
Marckmann, P., B. Sanatrom, and J. Jesperson. “Low-Fat, High-Fiber Diet Favorably Affects Several Independent Risk Markers of Schemic Heart Disease: Observations on Blood Lipids, Coagulation, and Fibrinolysis From a Trial of Middle-Aged Danes.” Am J Clin Nutr 59 (1994): 935–939. 90–107.
McLaughlin, Leah and Jean Kressy. “The Healthiest Cuisine in the World.” Fitness 12.10 (October 2002): 138–143.
Deborah L. Nurmi, MS.
Arthritis diet
Definition
Arthritis is the general medical term for the inflammation of a joint or a disorder characterized by suchinflammation. There are a number of different arthritides (the plural form of arthritis), and therefore there is no “arthritis diet” as such that has been proposed as a treatment for all these different joint disorders. Dietary therapies for osteoarthritis (OA) and rheumatoid arthritis (RA), the two most commonforms of arthritis, fall into three major categories: mainstream management strategies that focus on weight reduction and well-balanced diets as a way to relieve stress on damaged joints and slow the progression of arthritis; dietary supplements of various types that have been evaluated in clinical trials and have been found to benefit at least some patients; and alternative medical approaches that rely on dietary adjustments (including elimination diets) and/or traditional herbal remedies to treat arthritis.Osteoarthritis
The reader should be aware of the differences between OA and RA in order to understand both mainstream and alternative approaches to these disorders. Osteoarthritis (OA) is the more common of the two in the general North American population, particularly among middle-aged and older adults. It is estimated to affect about 21 million adults in the United States, and to account for $86 billion in health care costs each year. It is also the single most common condition for which people seek help from complementary and alternative medical (CAM) treatments. The rate of OA increases in older age groups; about 70% of people over 70 are found to have some evidence of OA when they are X-rayed. Only half of these elderly adults, however, are affected severely enough to develop noticeable symptoms. OA is not usually a disease that completely disables people; most patients can manage its symptoms by watching their weight, staying active, avoiding overuse of affected joints, and taking over-the-counter or prescription pain relievers. OA most commonly affects the weight-bearing joints in the hips, knees, and spine, although some people first notice its symptoms in their fingers or neck. It is often unilateral, which means that it affects the joints on only one side of the body. The symptoms of OA vary considerably in severity from one patient to another; some people are only mildly affected by the disorder.Differences between Osteoarthritis and Rheumatoid Arthritis
Osteoarthritis
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Rheumatoid Arthritis
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Risk factors
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Age-related
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Family history
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Overuse of joints
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Excessive weight
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Physical effects
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Affects joints
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Autoimmune disease
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Bony spurs
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Enlarged or malformed joints
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Treatment options
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Weight management
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Glucocorticoids
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Non-steroidal anti-inflammatory drugs
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MethotreXate
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Disease-modifying antirheumatic drugs
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Pain management
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Support groups
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Exercise
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Joint splitting
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Physical therapy
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Passive exercise
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Joint replacement
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Heat and cold
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Massage therapy
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Acupuncture
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Psychological approaches(relaxation, visualization)
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Tai chi
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Low stress yoga
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KEY TERMS
Arthritis (plural, arthritides)—A general term for the inflammation of a joint or a condition characterized by joint inflammation.Avocado soybean unsaponifiables (ASU)—A compound of the fractions of avocado oil and soybean oil that cannot be used in the production of soap. ASU shows promise in the treatment of OA. It is available only by prescription in France, where it was first studied, but can be purchased over the counter in the United States.
Ayurveda—The traditional system of natural medicine that originated in India around 3500 BC. Its name is Sanskrit for “science of long life.” Some people have tried Ayurvedic medicines and dietary recommendations in the treatment of arthritis.
Chondroitin sulfate—A compound found naturally in the body that is part of a large protein molecule (proteoglycan) helping cartilage to retain its elasticity. Chondroitin sulfate derived from animal or shark cartilage can be taken as a dietary supplement by people with OA.
Disease-modifying antirheumatic drugs (DMARDs)— A class of prescription medications given to patients with rheumatoid arthritis that suppress the immune system and slow the progression of RA.
Elimination diet—Adiet in which the patientexcludes a specific food (or group of foods) for a period of time in order to determine whether the food is responsible for symptoms of an allergy or other disorder. Elimination diets are also known as food challenge diets.
Glucosamine—A type of amino sugar that is thought to help in the formation and repair of cartilage. It can be extracted from crab or shrimp shells and used as a dietary supplement by people with OA.
Naturopathy—A system of disease treatment that emphasizes natural means of health care, as water, natural foods, dietary adjustments, massage and manipulation, and electrotherapy, rather than conventional drugs and surgery. Naturopaths (practitioners of naturopathy) often recommend dietary therapy in the treatment of arthritis.
Nonsteroidal anti-inflammatory drugs (NSAIDs)— A class of drugs commonly given to treat the inflammation and pain associated with both RA and OA. NSAIDs work by blocking prostaglandins, which are hormone-like compounds that cause pain, fever, muscle cramps, and inflammation. Some NSAIDs are prescription drugs while others are available in over-the-counter (OTC) formulations.
Osteoarthritis (OA)—The most common form of arthritis, characterized by erosion of the cartilage layer that lies between the bones in weight-bearing joints. OA is also known as degenerative joint disease or DJD.
Rheumatoid arthritis (RA)—An autoimmune disorder that can affect organ systems as well as the joints. It is much less common that OA but is potentially much more serious.
Rheumatologist—A physician, usually a pediatrician or internist, who has additional specialized training in the diagnosis and treatment of diseases that affect the bones, muscles, and joints.
Turmeric—A perennial herb of the ginger family used as a coloring agent as well as a spice in food preparation. It is used in some traditional Ayurvedic medicines for the relief of joint pain and inflammation.
Vegan—A vegetarian who excludes all animal products from the diet, including those that can be obtained without killing the animal. Vegans are also known as strict vegetarians. Some people believe that a vegan diet is helpful in managing arthritis.
OA, although some studies indicate that African American women have a higher risk of developing OA in the knee joints. Other risk factors for OA include osteoporosis and vitamin D deficiency.
Origins
The role of diet and nutrition in both OA and RA has been studied since the 1930s, but there is little agreement as of 2007 regarding the details of dietary therapy for these disorders. One clear finding that has emerged from seven decades of research is the importance of weight reduction or maintenance in the treatment of patients with OA, and the need for nutritional balance and healthy eating patterns in the treatment of either form of arthritis. Findings regarding the use of dietary supplements or CAM therapies will be discussed in more detail below.Various elimination diets (diets that exclude specific foods from the diet) have been proposed since the 1960s as treatments for OA. The best-known of these is the Dong diet, introduced by Dr. Collin Dong in a book published in 1975. This diet is based on traditional Chinese beliefs about the effects of certain foods inincreasing the pain of arthritis. The Dong diet requires the patient to cut out all fruits, red meat, alcohol, dairy products, herbs, and all foods containing additives or preservatives. There is, however, no clinical evidence as of 2007 that this diet is effective.
Another type of elimination diet, still recommended by naturopaths and some vegetarians in the early 2000s, is the so-called nightshade elimination diet, which takes its name from a group of plants belonging to the family Solanaceae. There are over 1700 plants in this category, including various herbs, potatoes, tomatoes, bell peppers, and eggplant as well as nightshade itself, a poisonous plant also known as belladonna. The nightshade elimination diet began in the 1960s when a researcher in horticulture at Rutgers University noticed that his joint pains increased after eating vegetables belonging to the nightshade family. He eventually published a book recommending the elimination of vegetables and herbs in the nightshade family from the diet. There is again, however, no clinical evidence that people with OA will benefit from avoiding these foods.
Description
Osteoarthritis
WEIGHT REDUCTION. The major dietary recom-mendation approved by mainstream physicians for patients with OA is keeping one’s weight at a healthy level. The reason is that OA primarily affects the weight-bearing joints of the body, and even a few pounds of extra weight can increase the pressure on damaged joints when the person moves or uses the joint. It is estimated that that a force of three to six times the weight of the body is exerted across the knee joint when a person walks or runs; thus being only 10 pounds overweight increases the forces on the knee by 30 to 60 pounds with each step. Conversely, even a modest amount of weight reduction lowers the pain level in persons with OA affecting the knee or foot joints. Obesity is a definite risk factor for developing OA; data from the National Institutes of Health (NIH) indicate that obese women are 4 times as likely to develop OA as non-obese women, while for obese men the risk is 5 times as great.Although some doctors recommend trying a vegetarian or vegan diet as a safe approach to weight loss for patients with OA, most will approve any nutritionally sound calorie-reduction diet that works well for the individual patient
DIETARY SUPPLEMENTS. Dietary supplements are.
commonly recommended for managing the discomfort of OA and/or slowing the rate of cartilage deterioration:
- Chondroitin sulfate. Chondroitin sulfate is a compound found naturally in the body that is part of a large protein molecule called a proteoglycan, which imparts elasticity to cartilage. The supplemental form is derived from animal or shark cartilage. Recommended daily dose is 1200 mg.
- Glucosamine. Glucosamine is a form of amino sugar that is thought to support the formation and repair of cartilage. It can be extracted from crab, shrimp, or lobster shells. The recommended daily dose is 1500 mg. Dietary supplements that combine chondroitin sulfate and glucosamine can be obtained over the counter in most pharmacies or health food stores.
- Botanical preparations: Some naturopaths recommend extracts of yucca, devil’s claw, hawthorn berries, blueberries, and cherries. These extracts are thought to reduce inflammation in the joints and enhance the formation of cartilage. Powdered ginger has also been used to treat joint pain associated with OA.
- Vitamin therapy. Some doctors recommend increasing one’s daily intake of vitamins C, E, A, and B6, which are required to maintain cartilage structure.
Traditional Chinese medicine (TCM) treats OA with various compounds containing ephedra, cinnamon, aconite, and coix. A combination herbal medicine that has been used for at least 1200 years in TCM is known as Du Huo Ji Sheng Wan, or Joint Strength. Most Westerners who try TCM for relief of OA, however, seem to find acupuncture more helpful as an alternative therapy than Chinese herbal medicines.
Rheumatoid arthritis
DIETARY ALTERATIONS. There is some indication that patients with RA benefit from cutting back on meat consumption or switching entirely to a vegetarian or vegan diet. One follow-up study of RA patients on a vegetarian diet showed that improvement continued after one and two years on the diet.Another dietary adjustment that appears to benefit some people with RA is switching from cooking oils that are high in omega-6 fatty acids (which increase inflammation) to oils that are high in omega-3 fatty acids (which reduce inflammation. This second group includes olive oil, canola oil, and flaxseed oil.
DIETARY SUPPLEMENTS. The most common dietary supplements recommended for patients with RA are as follows:
- Fish oil. The oils from cold-water fish have been reported to reduce inflammation and relieve joint pain in some patients with RA. The recommended daily dose is 1 to 2 teaspoons.
- Plant oils that are high in gamma-linoleic acid (GLA), which reduces inflammation in the joints. These plant oils include evening primrose oil, borage oil, and black current oil. The recommended daily dose is 200 to 300 mg.
- Green tea. Drinking 3 to 4 cups of green tea per day is thought to benefit RA patients by reducing inflammation in the joints.
Traditional Chinese medicine (TCM) uses such plants as hare’s ear (Bupleurum falcatum) and thunder god vine (Tripterygium wilfordii) to reduce fever and joint pain in patients with RA.
Function
Osteoarthritis
The function of dietary treatment for OA is to lower (or maintain) the patient’s weight to a healthy level in order to minimize stress on damaged weight-bearing joints; to maintain the structure and composition of the cartilage in the joints; to protect the general health of tissues by including bioflavonoids and antioxidants in the diet; and by conducting food challenges when appropriate to determine whether specific foods are affecting the patient’s symptoms.Rheumatoid arthritis
Dietary treatment of RA is primarily adjunctive, as the disease cannot be managed by nutritional changes alone. Patients with RA must take a combination of medications, usually a combination of disease-modifying anti-rheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), to control pain, inflammation, and slow the progression of the disease. A well-balanced and healthful diet, however, can help to offset the emotional depression that often accompanies RA and to enable patients to maintain a normal schedule of activities. It also helps to prevent nutritional deficiencies in these patients that may be caused by the use of prescription drugs to control the disease.Benefits
Osteoarthritis
The benefits of weight reduction in overweight patients with OA are a noticeable reduction in discomfort and improved range of motion in the affected joints. The benefits of dietary supplements vary from patient to patient depending on the specific joints affected and the degree of erosion of the joint cartilage.Rheumatoid arthritis
The benefits of dietary adjustments or dietary supplements for RA vary considerably from patient to patient. Maintenance of a balanced diet, however, is valuable in preventing the nutritional deficiencies that sometimes occur in patients with RA as side effects of high dosages of DMARDs and NSAIDs.Precautions
Some general precautions for all persons with arthritis:- Before beginning any form of dietary treatment for joint pain, consult a physician to obtain an accurate diagnosis of the type of arthritis that is causing the pain. When RA is suspected, it is vital to get systemic treatment as soon as possible to minimize long-term damage to health.
- Consult a physician before taking any dietary supplements, as certain OTCs and prescription medications can interact with these compounds. Chondroitin sulfate, for example, may increase bleeding time in some people, particularly if it is taken together with aspirin.
- Purchase dietary supplements only from well-established companies that can be held accountable for the quality of their products.
- Do not stop taking any medications currently prescribed by a doctor without consulting him or her.
- If maintaining a primarily vegetarian diet, be aware of the potential for iron deficiency.
Osteoarthritis
People with diabetes should monitor blood sugar levels more frequently if they are taking glucosamine, because it is an amino sugar. Similarly, persons who are taking blood thinners should have their blood clotting time checked periodically if they are taking chondroitin sulfate. ASU has not been reported tocause drug interactions as of 2007.Rheumatoid arthritis
Plant oils containing GLA have been reported to cause intestinal gas, bloating, diarrhea, and nausea in some persons. In addition, these oils may interact with other prescription medications, particularly blood thinners. Some borage seed oil preparations contain ingredients known pyrrolizidine alkaloids, or PAs, that can harm the liver or worsen liver disease. Only forms of borage oil that are certified to be PA-free should be used. Last, evening primrose oil may interact with a group of tranquilizers used in the treatment of schizophrenia known as phenothiazines. This group of drugs includes chlorpromazine and prochlorperazine.Fish oil may affect the rate of blood clotting and cause nausea or a fishy odor to the breath in some persons. Some fish oil supplements may also contain overly high levels of vitamin A or mercury. In addition, patients who take fish oil supplements must usually take them for several months before they experienceany benefits.
Risks
Osteoarthritis
Most dietary supplements for OA appear to be safe when purchased from reputable manufacturers and used as directed. Glucosamine and chondroitin sulfate have been reported to cause intestinal gas or mild diarrhea in some people. ASU causes nausea and skin rashes in some people.Cost may be a consideration for some people, as these supplements cost between $1.50 and $3 per day, and are not usually covered by health insurance.
Rheumatoid arthritis
Chinese thunder god vine is reported to weaken bone structure and increase the risk of osteoporosis in patients with RA. Fish oils with high levels of vitamin A have been reported to cause vitamin A toxicity in some people.Research and general acceptance
Osteoarthritis
No mainstream clinical studies have found that patients with OA benefit from elimination diets. With regard to dietary supplements, findings are mixed. A major 4-year study of glucosamine and chondroitin sulfate supplements, the Glucosamine/chrondoitinQUESTIONS TO ASK YOUR DOCTOR
- Would you recommend glucosamine and chondroitin supplements for mild OA?
- Have any of your other patients benefited from taking ASU or other dietary supplements for arthritis?
- What is your opinion of elimination diets as treatment for arthritis?
- Would you recommend a vegetarian diet for patients with OA as well as patients with RA?
Rheumatoid arthritis
The National Center for Complementary and Alternative Medicine (NCCAM) has noted in a recent review of alternative treatments of RA that few high-quality studies of these treatments have been published as of 2006. Several studies indicate that vegetarian or vegan diets and the Mediterranean diet do in fact benefit patients with RA. Fish oil has been reported to reduce the risk of heart attacks in patients with RA as well as reduce joint pain and inflammation. Green tea has been tested on mice with RA but has not yet been tested on human subjects. A study conducted at the University of Arizona reported in 2006 that turmeric by itself inhibits the destruction of joint tissue in rats with RA as well as reducing joint inflammation; but as with green tea, turmeric supplements have not yet been used in clinical trials with human subjects with RA.Resources top
BOOKS
Childers, Norman Franklin. A Diet to Stop Arthritis: The Nightshades and Ill Health, 2nd ed. New Brunswick, NJ: Somerset Press, 1981.Dong, Collin H., MD, and Jane Banks. New Hope for the Arthritic New York: Crowell, 1975.
Kandel, Joseph, and David B. Sudderth. The Anti-Arthritis Diet: Increase Mobility and Reduce Pain with This 28-Day Life-Changing Program Rocklin, CA: Prima Publishing, 1998. In spite of its title, this book focuses primarily on weight reduction in general as an important aspect of managing OA.
Murray, Michael, ND, and Joseph Pizzorno, ND. Encyclopedia of Natural Medicine, 2nd ed. Rocklin, CA: Prima Publishing, 1998. Includes a list of dietary supplements recommended by naturopaths to treat arthritis.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part II, “CAM Therapies for Specific Conditions: Arthritis.” New York: Fireside Books, 2002. A useful summary of the various dietary therapies that have been tried in the management of osteoarthritis and rheumatoid arthritis.
Theodosakis, Jason, MD, and Sheila Buff. The Arthritis Cure, rev. ed. New York: St. Martin’s Press, 2004.
COOKBOOKS
Adderly, Brenda, and Lissa DeAngelis. The Arthritis Cure Cookbook. Washington, DC: LifeLine Press, 1998.Flynn, John A., MD, and Lora Brown Wilder. Recipes for Arthritis Health New York: Rebus, 2003.
Haupt, Prentiss Carl, and James McKoy. The Executive Chef’s Arthritis Cookbook and Health Guide. Pukalani, HI: Arthritis Cookbook Corporation, 2001.
PERIODICALS
Ameye, L. G., and W. S. Chee. “Osteoarthritis and Nutrition. From Nutraceuticals to Functional Foods: A Systematic Review of the Scientific Evidence.” Arthritis Research and Therapy 8 (2006): R127.Berkow, S. E., and N. Barnard. “Vegetarian Diets and Weight Status.” Nutrition Reviews 64 (April 2006): 175–188.
Chopra, A., P. Lavin, B. Patwardhan, and D. Chitre. “A 32-Week Randomized, Placebo-Controlled Clinical Evaluation of RA-11, an Ayurvedic Drug, on Osteoarthritis of the Knees.” Journal of Clinical Rheumatology 10 (October 2004): 236–245.
Clark, K. L. “Nutritional Considerations in Joint Health.” Clinics in Sports Medicine 26 (January 2007): 101–118.
Clegg, D. O., D. J. Reda, C. L. Harris, et al. “Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis.” New England Journal of Medicine 354 (February 23, 2006): 795–808.
Cleland, L. G., G. E. Caughey, M. J. James, and S. M. Proudman. “Reduction of Cardiovascular Risk Factors with Longterm Fish Oil Treatment in Early Rheumatoid Arthritis.” Journal of Rheumatology 33 (October 2006): 1973–1979.
Funk, J. L., J. B. Frye, J. N. Oyarzo, et al. “Efficacy and Mechanism of Action of Turmeric Supplements in the Treatment of Experimental Arthritis.” Arthritis and Rheumatism 54 (November 2006): 3452–3464.
Lee, S., K. M. Gura, S. Kim, et al. “Current Clinical Applications of Omega-6 and Omega-3 Fatty Acids.” Nutrition in Clinical Practice 21 (August 2006): 323–341.
Morelli, Vincent, MD, Christopher Naquin, MD, and Victor Weaver, MD. “Alternative Therapies for Traditional Disease States: Osteoarthritis.” American Family Physician 67 (January 15, 2003): 339–344.
Rindfleisch, J. Adam, MD, and Daniel Muller, MD, PhD. “Diagnosis and Management of Rheumatoid Arthritis.” American Family Physician 72 (September 15, 2005): 1037–1047.
OTHER
American College of Rheumatology Fact Sheet. Herbal and Natural Remedies. Atlanta, GA: ACR, 2005. Available online at http://www.rheumatology.org/public/factsheets/herbal.asp (accessed March 20, 2007).Arthritis Research Campaign (ARC). Diet and Arthritis: An Information Booklet. ARC, 2006. A helpful 38-page summary of diet in the management of arthritis. Available online in PDF format at http://www.arc.org.uk/about_arth/booklets/6010/6010.html.
Bartlett, Susan, PhD. Osteoarthritis: Weight Management. Baltimore, MD: Johns Hopkins Arthritis Center, 2007. Available online at http://www.hopkins-arthritis.org/arthritis-info/osteoarthritis/weight-management.html (accessed March 18, 2007).
Klaper, Michael, MD. Nutritional Strategies for Inflamed Joints and Other Conditions. Manhattan Beach, CA: Institute of Nutrition Education and Research, 2005. Recommends the nightshade elimination diet. Dr. Klaper is a vegan who conducts research on the health benefits of veganism. Available online at http://www.vegsource.com/klaper/nutrition.htm.
Koch, Cheryl, CSND. Nutrition and Rheumatoid Arthritis Baltimore, MD: Johns Hopkins Arthritis Center, 2007. Available online at http://www.hopkins-arthritis.org/mngmnt/nutinra.html (accessed March 18, 2007).
National Center for Complementary and Alternative Medicine (NCCAM). Research Report: Rheumatoid Arthritis and Complementary and Alternative Medicine. Bethesda, MD: NCCAM, 2006. Available online at http://nccam.nih.gov/health/RA/ndash5.
ORGANIZATIONS
American Association of Naturopathic Physicians (AANP). 4435 Wisconsin Avenue NW, Suite 403, Washington, DC 20016. Telephone: (866) 538-2267 or (202) 237-8150. Website: http://www.naturopathic.org.American College of Rheumatology (ACR). 1800 Century Place, Suite 250, Atlanta, GA 30345-4300. Telephone:(404) 633-3777. Website: http://www.rheumatology.org.
American Vegan Society (AVS). 56 Dinshah Lane, P. O. Box 369, Malaga, NJ 08328. Telephone: (856) 694-2887. Website: http://www.americanvegan.org/index.htm.
Arthritis Foundation. P.O. Box 7669, Atlanta, GA 30357-0669. Telephone: (404) 872-7100 or (800) 568-4045. Website: http://www.arthritis.org.
Arthritis Research Campaign (ARC). Copeman House, St. Mary’s Court, St. Mary’s Gate, Chesterfield, Derbyshire S41 7TD United Kingdom. Telephone: +44 (0) 1246 558007. Website: http://www.arc.org.uk.
National Center for Complementary and Alternative Medicine (NCCAM). 9000 Rockville Pike, Bethesda, MD 20892. Telephone: (888) 644-6226. Website: http://nccam.nih.gov.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. National Institutes of Health, 1 AMS Circle, Bethesda, MD 20892-3675. Telephone: (877) 22-NIAMS or (301) 495-4484. Website: http://www.niams.nih.gov.
National Institute of Ayurvedic Medicine (NIAM). 584 Milltown Road, Brewster, NY 10509. Telephone: (845) 278-8700. Website: http://niam.com
Rebecca J. Frey, Ph.D.
Calorie Restriction
Definition
The definition of calorie restriction is when the body does not receive an adequate intake of energy. This can result as a consequence of lack of availability of adequate volumes of food. However, sometimes the failure to consume an adequate calorie intake may be a conscious and deliberate decision, for example, in individuals seeking to lose weight or people who suffer with the eating disorder, anorexia nervosa. Calorie restriction can result in malnutrition or a deficiency of one or more nutrients.Purpose
The human body requires an adequate amount of energy or calories to enable us to grow, perform daily activities, produce hormones and to minimize the risk of nutrition-related complications. Calorie requirements for individuals vary from one individual to the next and are dependent on variables including gender, age, activity levels, climate and environment and the presence or absence of medical or nutritional complications. Consequently, it is possible that individuals of similar weight and age may have different energy requirements owing to unique individual needs. In addition to the body requiring energy to perform the aforementioned tasks, energy is also required to support activity of the internal organs and to maintain body temperature. This energy is called the basal or resting metabolism. The basal metabolic rate (BMR) is determined experimentally when an individual is lying down at complete physical and mental rest under standardized environmental conditions. Research over many years has provided researchers.with guidelines on how to assess and determine an individuals BMR using specific calculations.
Description
Individuals require a certain number of calories on a daily basis, which incidentally may vary subject to activity levels and physical status but overall is within a relatively stable range. When dietary intake remains stable weight too remains unchanged. Conversely, increases or decreases in intake can result in weight changes. To clarify,.- When energy intake equals energy expenditure, weight remains unchanged.
- When energy intake exceeds expenditure, weight increases.
- When energy intake is less than expenditure, weight will decrease.
Complications
Physical effects of starvation
Malnutrition occurs when is there is a deficiency of one or more nutrients. It may be mild or severe. Severe Malnutrition is rare in developed countries but sadly remains prevalent in many developing countries. Weight loss is an obvious sign of a diet too low in calories or energy. Protein-energy malnutrition occurs when the diet provides too little energy and protein. Malnutrition is assessed in terms of degrees of weight loss in adults, whilst in children height and weight are used and compared with growth charts. Weight loss in adults and failure to thrive in children are the most obvious signs of insufficient energy intake. In adults, this is usually noticed by a drop in the body mass index (BMI), which is a method used to relate weight to height and is used as part of the process in determining an individuals’ nutritional status. In children, insufficient energy intakes are noticed when children fail to meet expected growth milestones. In the long-term, stunted growth may result as a consequence of insufficient energy requirements and children may not reached an expected height for weight ratio.It is important to remember that individuals of a healthy body weight could still be classified as malnourished.
Below is a list of some of the general effects of starvation.
- tiredness
- lethargy
- poor concentration
- weakness
- hair loss and sometimes the growth of additional hair on the arms and back. (The growth of additional hair called lanugo hair and is frequently evident on people who suffer with anorexia nervosa.)
- decreased muscle mass and tone
- weight loss
- menstruation may stop if weight loss is serious
- delayed puberty in adolescents
- iron-deficiency anemia
- poor immunity
- decrease in bone mineral density and an increased risk of osteoporosis if weight loss is not reversed
- constipation
- deficiencies of various vitamins and minerals
- delayed gastric emptying
Cognitive changes associated with starvation
As the body starts to lose weight as a as a result of insufficient energy intake, the ability of the brain to function correctly is impaired. The symptoms associated with changes in the way the brain functions are referred to as cognitive changes.The cognitive changes associated with starvation include.
- increased risk of depression-related symptoms
- poor decision making skills
- irritable
- anxiety
- very reactive
- poor concentration
Social and sexual changes associated with starvation
- withdrawal from social activities
- decreased libido
- decreased enjoyment in previously enjoyed activities
Parental concerns
As mentioned above, children who have an insufficient energy intakes over prolonged periods of time may not reach expected growth rates. Furthermore, they may lose weight and ultimately experience stunted growth and develop nutrition-related complications. Parents should ensure that a registered doctor monitors growth rates regularly or a suitably qualified professional.BOOKS
Garrow, J.S., James, W.P.T. and Ralph, A. Human Nutrition and Dietetics, 10th Edition. Churchill Livingstone.Thomas, B. Manual of Dietetic Practice, 3rd Edition. Blackwell Science Ltd.
PERIODICALS
Benedict, F.G., Miles, W.R., Roth, P. and Smith, M. “Human vitality and efficiency under prolonged restricted diet.” Cited in Garrow, J.S., James, W.P.T. and Ralph, A. Human Nutrition and Dietetics 10th Edition. Churchill Livingstone.Keys, A., Brozek, J., Hanschel, A., Mickelson, O. and Taylor, H.L. “The biology of human starvation.”The Journal of Nutrition 135, 1347(6).
ORGANIZATIONS
<http://www.http://www.b-eat.co.uk><http://www.eatright.org>
Annette Laura Dunne, BSc (Hons) MSc RD
Anti-inflammatory diets
Definition
There is no one anti-inflammatory diet, rather, there are diets designed around foods that are believed to decrease inflammation and which shun foods that aggravate the inflammatory processes. Many anti-inflammatory diets are based around whole grains, legumes, nuts, seeds, fresh vegetables and fruits, wild fish and seafood, grass-fed lean turkey and chicken which are thought to aid in the bodies healing of inflammation. They exclude foods that are thoughtAnti-inflammatory diet
Anti-inflammatory foods
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Fruits
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Fresh fruits, berries, blueberries, blackberries, and strawberries
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Legumes and beans
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Pinto, kidney, borlotti, mung, cannelloni, adzuki, fava, and black beans; soybeans; garbanzo or chickpeas
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Nuts and seeds
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Walnuts, flax seeds, pumpkin seeds (raw, unsalted)
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Oils
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Expeller pressed canola oil, extra-virgin olive oil, or rice bran, grape seed, evening primrose and walnut oil
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Poultry, lean
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Grass fed, free of preservatives, sodium, nitrates or coloring
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Soy products
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Soybeans, edemame, tofu, tempeh, soymilk, other products from soybeans
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Spices and herbs
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Replaces salt, sugar, added saturated fat
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Seafood and wild fish
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Herring, mackerel, salmon, trout
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Vegetables, fresh
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Green leafy vegetables, brightly colored vegetables
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Water
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Free of toxic chemicals
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Whole grains
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Amaranth, barley, bulgur, wild rice, millet, oats, quinoa, rye, spelt, wheat berries, buckwheat, whole wheat
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Pro-inflammatory foods
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Dairy products, high fat
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Butter, cream, sour cream, whole milk
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Processed meats
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Lunch meats, hot dogs, sausages
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Red meats
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Beef, lamb, pork
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Refined grains
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White bread, white rice, pasta (unless whole grain), chips, products made with white flour, such as cake, cookies, crackers, pretzels, doughnuts, bagels, muffins
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Saturated fats
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Meats, dairy products, eggs
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Sugars, refined, and high
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Sodas, pastries, presweetened cereals, candy, white and brown sugar, confectioners sugar, corn syrup, processed
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sugar foods
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corn fructose
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Trans fats
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In meats, dairy products, cakes, cookies, crackers, pies, bread, margarine, fried potatoes, potato chips, corn chips, popcorn, household shortening, salad dressing
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to trigger inflammation such as refined grains, wheat, corn, full-fat dairy, red meat, caffeine, alcohol, peanuts, sugar, saturated and trans-saturated fats.
The common foundation of anti-inflammatory diets is the belief that low grades of inflammation are the precursor and/or antagonizer to many chronic diseases. Once removed, the body can begin healing itself.
Origins
Beginning in the 1970s investigators began exploring physiological mechanisms of fever, weight loss, and acute phase responses to acute and chronic infection. Research results from these studies began to change the mainstream attitudes about disease pathogenesis. Accumulating evidence linked proteins, produced by macrophages and other immune cells, not pathogens, as formerly believed, to the cause of tissue damage and disease syndromes in experimental animals. Thus the medical profession began looking into original treatments for chronic diseases. Then in the 1980s, research showed that proteins, newly named cytokines, and hormone-like substances, named prostaglandins and leukotrienes, revealed that they possessed pleiotropic biological activities that were either beneficial or injurious to the bodies’ tissues.From this research emerged the cytokine theory of disease. The concept that cytokines produced by the immune system, can cause the signs, symptoms, and damaging after effects of chronic diseases. Change did not occur until the measurement of C-reactive protein (CRP), a marker of inflammation circulating in the blood, was proposed as a method to identify persons at risk of chronic diseases. As pioneering research began to show that higher levels of C-reactive protein was linked to heart disease, conventional thought among the medical profession began. Originally discovered by W. S. Tillett and T. Francis Jr. in 1930, C-reactive protein was discovered as a substance in the serum of patients diagnosed with acute inflammation that reacted with the C-polysaccharide of pneumoccocus.
Today, a growing consensus among medical professionals is that inflammation is believed to play a role in the pathogenesis of chronic diseases such as heart disease, stroke, diabetes, and colon cancer to name a few. Mainstream thinking is beginning to accept that treating the underlying cause may ameliorate cardiovascular disease, metabolic syndrome, hypertension, diabetes, and hyperlipidemia, inflammation caused by visceral adipose tissue.
Description
Inflammation
Inflammation is a localized reaction of tissue to injury, whether caused by bacteria or viral infection, trauma, chemicals, heat or other phenomenon that.KEY TERMS
Inflammation:—Swelling, redness, heat, and pain produced in an area of the body as a reaction to injury or infection.Chronic disease:—an illness or medical condition that lasts over a long period of time and sometimes causes a long-term change in the body.
C-reactive protein (CRP):—a marker of inflammation circulating in the blood has been proposed as a method to identify persons at risk of these diseases.
Flavonoid:—refers to compounds found in fruits, vegetables, and certain beverages that have diverse beneficial biochemical and antioxidant effects.
Anti-oxidant:—A chemical compound or substance that inhibits oxidation. A substance, such as vitamin E, vitamin C, or beta-carotene.
causes irritation. The ‘irritation’ causes the tissues within the body to release multiple substances that cause changes within the tissues. This complex response is called inflammation. Inflammation is characterized by such symptoms that include (1) vasodilatation of the local blood vessels resulting in excess local blood flow, (2) increases in the permeability of the capillaries with leakage of large quantities of fluid into the interstitial spaces, (3) May include clotting of the fluid in the interstitial spaces due to excess amounts of fibrinogen and other proteins leaking from the capillaries, (4) relocation of granulocytes and monocytes into the tissue in large quantities, thus (5) swelling of the tissue cells.
The common substances released from the tissues that result in inflammation are histamine, bradykinin, serotonin, prostaglandins, multiple hormonal substances called lymphokines that are released by sensitized T-cells and various other reaction products of other systems within the body. Many of these substances activate the macrophage system, which are sent out to dispose of the damaged tissue but also which further injure the still-living tissue and cells.
Conditions with chronic inflammation
Medical Anti-Inflammatory Treatments
General anti-inflammatory medical treatments include relaxation, moderate exercise such as walking, weight maintenance or loss, and medications designed to reduce the inflammation and control the pain if present.These medications may include: ibuprofen or aspirin, Non Steroidal Anti-Inflammatory Drugs (NSAIDs), or steroid medications. The NSAIDs are widely used as the initial form of therapy. Unfortunately, long-term use of these medications can irritate the stomach and lead to ulcers. And in some cases can lead to kidney, as well as other medical problems.
Function
Diet and chronic inflammation
Registered dietitians, and Naturopathic physicians often prescribe diets to lessen the inflammatory symptoms of diseases. Although these diets have not been compared to other treatments in many formal research settings to date, it is thought that anti-inflammatory diets result in a reduced amount of inflammation and a healthier response by the immune system.Adding foods that reduce inflammation is thought to improve symptoms of chronic diseases and help decrease risk for chronic diseases. These foods help in supplying the nutrients that are needed to decrease inflammation. One example is omega-3 fatty acids. The human body uses these fats to manufacture prostaglandins, chemicals that play an important role in inflammation and a healthy immune response. Another beneficial component of fish oil that plays an important role is eicosapentaenoic acid (EPA), an essential fatty acid derived from omega-3 fatty acids. EPA promotes the production of certain forms of prostaglandins having anti-inflammatory properties by reducing inflammation and decreasing the production of inflammatory substances.
Foods that reduce chronic inflammation
Whole grains
Whole grains or foods made from them, whether cracked, crushed, rolled, extruded, and/or cooked, contain the essential parts and nutrients of the entire grain seed. Research has shown that diets high in whole grain products are associated with decreased concentrations of inflammatory markers and increased adiponectin levels. The protective effects of a diet highin whole grains on systemic inflammation may be explained, in part, by reduction in overproduction of oxidative stress that results in inflammation.A whole grain will include the following parts of the grain kernel–the bran, germ and endosperm. Such whole grains are amaranth, barley, bulgur, wild rice, millet, oats, quinoa, rye, spelt, wheat berries, buckwheat, and whole wheat.
Legumes
Diets high in legumes are inversely related to plasma concentrations of C-reactive protein (CRP). Among the many varieties of legumes are; pinto beans, lentils, kidney beans, borlotti beans, mung beans, soybeans, cannelloni beans, garbanzo or chickpeas, adzuki beans, fava beans, and black beans.Nuts, seeds
Nuts and seeds are rich in unsaturated fat and other nutrients that may reduce inflammation. Frequent nut consumption is associated with lower levels of inflammatory markers. This may explain why there is a lower risk of cardiovascular disease and type 2 diabetes with frequent nut and seed consumption. With the exception of peanuts, be sure to add in walnuts, flax seeds and pumpkin seeds. Nuts and seeds are best eaten when unsalted and raw.Fresh vegetabless
Green leafy vegetables, and brightly colored vegetables provide beta-carotene; vitamin C and other antioxidants have been shown to reduce cell damage and to have anti-inflammatory effects. Aim for 3 or more servings per day.Fresh fruits
Flavonoids found in fresh fruits among other substances are thought to increase the antioxidant effects of vitamin C. research has shown that fruits have an anti-inflammatory effect. Aim for two or more servings daily. Be sure to include berries in your weekly choices of fruits such as blueberries, blackberries, and strawberries.Wildfish and seafood
Oily fish such as Herring, Mackerel, Salmon and Trout are an excellent source of omega-3 fatty acids, as are shellfish such as mussels and clams. Including fish or seafood high in omega-3 fatty acids at least three times a week is recommended.Lean poultry
Protein is used in the body to repair and manufacture cells, make antibodies, enzymes and hormones. Lean protein has been associated with lower levels of inflammatory biomarkers.When choosing poultry, choose grass-fed animals, which tend to have a higher amount of essential fatty acids. Select poultry with limited amounts of, or free of, preservatives, sodium, nitrates or coloring. Also, in an ideal diet, only 10-12% of daily calories should come from protein. On average, an adult needs 0.36 grams of protein per pound of body weight.
Soy products
Anti-inflammatory properties of the isoflavones, a micronutrient component of soy, have been reported in several experimental models and disease conditions. Data suggests the possibility of beneficial effects of isoflavone-rich soy foods when added to the diet. Soy products include; soybeans, edema me, tofu, tempeh, soymilk, as well as many other products made from soybeans.Oils
Expeller pressed Canola oil and Extra Virgin Olive oil are types of oils that have been linked to reduced inflammation. Other oils thought to aid in reducing inflammation include rice bran, grape seed, evening primrose and walnut oil. It is suggested to use these oils in moderation when cooking, baking and flavoring of foods. Also, when purchasing oils, make sure they are pure oils rather than blended oils. Blended oil usually contains less healthful oils.Water in the form offresh drinking water free of toxic chemicals
Water is an essential substance for every function of the body. It is a medium for chemical processes; a solvent for body wastes and dilutes their toxicity and aids in their excretion. Water aids in ingestion, absorption and transport of vital nutrients that have anti-inflammatory effects. Water is also needed for basic cell functioning, repairing of body tissues and is the base of all blood and fluid secretions.Herbs and Spices
A greater amount of research is emerging on the antioxidant properties of herbs and spices and their use in the management of chronic inflammation. Herbs and spices can be used in recipes to partially or wholly replace less desirable ingredients such as salt, sugar and added saturated fat, know for theirinflammatory effects, thus reducing the damaging properties of these foods.Precautions
Foods that irritate inflammation
Best referred to in research articles as ‘the western dietary pattern’, it credits a diet that is high in refined grains, red meat, butter, processed meats, high-fat dairy, sweets and desserts, pizza, potato, eggs, hydrogenated fats, and soft drinks. This pattern of eating is positively related to an increase in circulating blood CRP levels and higher risks for chronic diseases, obesity and cancers. These foods, termed ‘pro-inflammatory’ may increase inflammation, thus increasing a persons risk for chronic diseases as well as exacerbate symptoms from these chronic conditions.There is some support for the belief that food sensitivities or allergens to foods may be a trigger for inflammation. Often hard to detect with common blood tests, some people have seen alleviation of symptoms of chronic diseases, such as arthritis, when the aggravating foods are removed from their diet. Common allergic foods are milk and dairy, wheat, corn, eggs, beef, yeast and soy.
Other pro-inflammatory foods have been shown to have substances that activate or support the inflammatory process. Unhealthy trans fats and saturated fats used in preparing and processing certain foods are linked to increased inflammation. Processed meats such as lunchmeats, hot dogs and sausages contain chemicals such as nitrites that are associated with increased inflammation and chronic disease.
Saturated fats naturally found in meats, dairy products and eggs contain fatty acids called arachidonic acid. While some arachidonic acid is essential for health, excess arachidonic acid in the diet has been shown to worsen inflammation.
Research supports that diets high in sugar produce acute oxidative stress within the cells, associating it with inflammation. Elimination of high sugar foods such as sodas, soft drinks, pastries, presweetened cereals and candy has been shown to be beneficial. As well as switching from refined grains to whole grains.
Benefits
The effects of the anti-inflammatory diet are unobtrusive. There is a series of research articles that demonstrate a benefit in reduction of chronic diseases such as cardiovascular disease, neurodegenerative diseases, and cancers when following a dietary pattern associated with the anti-inflammatory diet. But theQUESTIONS TO ASK YOUR DOCTOR
- May any of my medical conditions be aided by adopting an anti-inflammatory diet?
- What foods can I eat to decrease my dosage of anti-inflammatory medications?
- How might the anti-inflammatory diet help me in reducing my risks of chronic diseases?
- Would you recommend that I adopt more anti-inflammatory foods into my diet?
It has also been documented that people who followed the anti-inflammatory diet stated they experienced loss of weight, had an elevation of energy, and reported better mental and emotional health.
Risks
The risks associated with following the anti-inflammatory diet are limited and not supported by research. The general concern associated with following any diet without the consent of a primary physician would apply. Anyone attempting to follow the anti-inflammatory diet should discuss it with their primary care physician and get a referral to see a Registered Dietitian, educated in the diet for maximal benefit and decreased risk of following a diet that eliminates certain foods from the dietary pattern to ensure proper intake of all macro and micro-nutrients.Research and general acceptance top
As stated previously, there is no one anti-inflammatory diet but rather there are foods that are thought to increase the inflammatory process and ones that are beneficial to the inflammatory processed within the body. Because of this, many medical professionals and other health providers may not support the concept of a diet that decreases the anti-inflammatory response within the body.There is substantial evidence supported through research that shows the beneficial effects on the body in reducing markers of inflammation such as CPH andreduction in chronic disease and its symptoms. Most medical professionals have an easier time accepting the Mediterranean diet which includes many of the foods found in the anti-inflammatory diet, and is the closest termed dietary eating pattern to the anti-inflammatory diet.
Megan C.M. Porter, RD, LD
Anti-aging diet
Definition
The anti-aging diet is one that restricts calorie intake by 30–50% of normal or recommended intake with the goal of increasing human lifespan by at least 30%. People on the diet also have improved health providing they consume adequate vitamins, minerals, and other essential nutrients.Origins
The idea that a calorie-restrictive diet can significantly increase lifespan has been around since the 1930s. In 1935, Cornell University food researchers Clive McCay and Leonard Maynard published their first in a series of studies of experiments in which laboratory rats were fed a diet that contained one-third less calories (compared to a control group of rats) but still contained adequate amounts of vitamins, minerals, protein, and other essential nutrients. This calorie-restrictive diet provided much less energy than researchers had previously thought rats needed to maintain growth and normal activities. The rats on the lower calorie diet lived 30–40% longer than the rats on a normal calorie diet. Since then, more thanAnti-Aging Diet
Benefits
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Risks and disadvantages
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Can improved health
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Hunger, food cravings, and obsession with food
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Research shows it adds years to the lifespan and extends youthful years
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Loss of strength or stamina and loss of muscle mass, which can affect physical activities
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Can prevent or forestall many diseases, including heart disease, cancer, stroke, diabetes, osteoporosis, Alzheimer’s, and Parkinson’s
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Decreased levels of testosterone
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Rapid weight loss (more than two pounds a week) which can have an overall negative impact on health
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Most physiologic functions and mental abilities of animals on reduced calorie diets correspond to those of much younger animals
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Slower wound healing
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Reduced energy reserves
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Shown to extend the maximum lifespan of most life forms it has been tested on
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Menstrual irregularity
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Drastic appearance changes from loss of fat and muscle, causing people to look thin or anorexic
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Problems can arise over family meals, eating in restaurants, workplace food, parties, and holidays
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Can cause psychological problems, including anorexia, binging, and obsessive thoughts about food
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2,000 studies have been done, mostly on animals, about the connection between calorie restriction and increased longevity.
A reduced calorie diet was taken a step further by the University of California, Los Angeles, pathologist Roy Walford who studied the biology of aging. In 1986 he published The 120-Year Diet and a follow-up in 2000, Beyond the 120-Year Diet in which he argued that human longevity can be significantly increased by adhering to a strict diet that contains all the nutrients needed by humans but with about one-third the calories. In 1994 he co-authored The Anti-Aging Plan: Strategies and Recipes for Extending Your Healthy Years. His anti-aging plan is based on his own research and that of other scientists. Included is his study of diet and aging conducted as chief physician of the Biosphere 2 project in Arizona in the early 1990s. Walford was one of eight people sealed in Biosphere 2 from 1991 to 1993 in an attempt to prove that an artificial closed ecological system could sustain human life. He also cofounded the Calorie Restriction Society in 1994.
Description
Anti-aging diets are regimes that reduce the number of calories consumed by 30–50% while allowingKEY TERMS
Alzheimer’s disease—A degenerative disorder that effects the brain, causing dementia and loss of memory usually late in life.Antioxidant—Substance that inhibits the destructive effects of oxidation in the body.
Body mass index (BMI)—A scale that expresses a person’s weight in relation to height.
Calorie reduction—A decrease in the number of calories that a person consumes.
Deoxyribonucleic acid (DNA)—A nucleic acid molecule in a twisted double strand, called a double helix, that is the major component of chromosomes. DNA carries genetic information and is the basis of life.
Free radicals—Highly reactive atoms or molecules that can damage DNA.
Osteoporosis—A disease that causes bones to become porous, break easily, and heal slowly.
Parkinson’s disease—An incurable nervous disorder marked by symptoms of trembling hands and a slow, shuffling walk.
Testosterone—A male sex hormone responsible for secondary sex characteristics.
the necessary amounts of vitamins, minerals, and other nutrients the body needs to sustain itself and grow. This calorie restriction has been shown to increase the lifespan of various animals, including rats, fish, fruit flies, dogs, and monkeys, by 30–50%. Some human studies have also been done—and longterm studies are underway— but evidence of its impact on humans is very limited compared to results available from the animal studies. The completed studies indicate that calorie restriction can increase the maximum human lifespan by about 30%. The problem preventing scientists from offering substantive proof that humans can greatly increase their lifespan by restricting calories is that the current maximum human lifespan is 110–120 years and full compliance with the diet is difficult. A 30% increase would extend the human lifespan to 143–156. This is an exceptionally long time for a scientific study and requires involvement of several generations of scientists. Only several hundred people have ever been documented to lived past age 110 and there are only two people with confirmed documentation who have lived to at least age 120: Jeanne Louise Calmet (1875–1997) of France who lived 122 years and 164 days; and Shigechiyo Izumi (1865–1986) of Japan who lived 120 years and 237 days, according to Guinness World Records.
Since 1980, dozens of books have been published offering specific calorie reduction diets aimed at increasing lifespan. The most popular diets include the Okinawa Diet, Anti-Inflammation Diet, Longevity Diet, Blood Type Diet, Anti-Aging Plan, and the 120-Year Diet.
Calorie restriction is a lifelong approach to eating by significantly lowering daily calorie intake while still getting all the body’s required nutrients. People who experience starvation or famine receive no longevity benefits since their low calorie intake contains little nutrition. The diet is believed to most benefit people who start in their mid-20s, with the beneficial effects decreasing proportionately with the age one begins the diet.
Although there are variations between anti-aging diets, most reduced calorie diets recommend a core set of foods. These include vegetables, fruits, fish, soy, low-fat or non-fat dairy products, nuts, avocados, and olive oil. The primary beverages recommended are water and green or black tea.
Guidelines on calorie reduction vary from diet to diet, ranging from a 10% reduction to a 50% reduction of normal intake. Roy L. Walford (1924–2004), author of several books on anti-aging diets, says a reasonable goal is to achieve a 10–25% reduction in a person’s normal weight based on age, height, and body frame. The Anti-Aging Plan diet recommends men of normal weight lose up to 18 % of their weight in the first six months of the diet. For a six-foot male weighing 175 lb, that means a loss of about 31 pounds. For a small-framed woman who is five-foot, six-inches tall and weighs 120 pounds, the plan recommends losing 10% of her weight in the first six months, a loss of 12 lb.
Walford’s Anti-Aging Plan is a diet based on decades of animal experimentation. It consists of computer generated food combinations and meal menus containing all of the U.S. Department of Agriculture’s Recommended Daily Allowances of vitamins and other essential nutrients using foods low in calories. On the diet, the maximum number of calories allowed is 1,800 per day. There are two methods for starting the diet: rapid orientation and gradual orientation.
The gradual orientation method allows people to adopt the diet over time. The first week, people eat a high-nutrient meal on one day. This increases by one meal a week until participants are eating one meal high in nutrients every day at the end of seven weeks. Other meals during the day are low-calorie, healthy foods but there is no limit on the amount a person can eat. After two months, participants switch to eating low-calorie, high-nutrition foods for all meals.
On his Web site (http://www.walford.com), Walford states: “Going for longevity on the Anti-Aging Plan requires caloric limitation. We advise, however, that you view this as a lifestyle change and not a quick-fix program or a diet. Any person can physiologically adapt to this level of limitation and experience no physical hunger provided that nearly every calorie eaten is a nutrient-rich calorie.”
A sample one-day low-calorie, high-nutrition menu developed by Walford is:
- Breakfast: One cup of orange juice, one poached egg, one slice of mixed whole-grain bread, and one cup of brewed coffee or tea.
- Lunch: One-half a cup of low-fat cottage cheese mixed with one-half a cup of non-fat yogurt and one tablespoon of toasted wheat germ, an apple, and one whole wheat English muffin.
- Dinner: Three ounces of roasted chicken breast without the skin, a baked potato, and one cup of steamed spinach.
- Snack: Five dates, an oat bran muffin, and one cup of low-fat milk.
Function
The goal of the anti-aging diet is to slow the aging process, thereby extending the human lifespan. Even though it is not a weight loss diet, people taking in significantly fewer calories than what is considered normal by nutritionists are likely to lose weight. Exercise is not part of calorie reduction diets. Researchers suggest people gradually transition to a reduced calorie diet over one or two years since a sudden calorie reduction can be unhealthy and even shorten the lifespan.There is no clear answer as to why severely reducing calorie intake results in a longer and healthier life. Researchers have various explanations and many suggest it may be due to a combination of factors. One theory is that calorie restriction protects DNA from damage, increases the enzyme repair of damaged DNA, and reduces the potential of genes being altered to become cancerous. Other calorie reduction (CR) theories suggest:
- CR helps reduce the production of free radicals; unstable molecules that attack healthy, stable molecules. Damage caused by free radicals increases as people age.
- CR delays the age-related decline of the human immune system and improved immune function may slow aging.
- CR slows metabolism, the body’s use of energy. Some scientists propose that the higher a person’s metabolism, the faster they age.
Benefits
The primary benefits of the anti-aging diet are improved health and prevention or forestalling diseases such as heart disease, cancer, stroke, diabetes, osteoporosis, Alzheimer’s, and Parkinson’s. Studies show that most physiologic functions and mental abilities of animals on reduced calorie diets correspond to those of much younger animals. The diet has also demonstrated extension of the maximum lifespan for most life forms on which it has been tested.Precautions
A reduced calorie diet is not recommended for people under the age of 21 since it may impair physical growth. This impairment has been seen in research on young laboratory animals. In humans, mental development and physical changes to the brain occur in teenagers and people in their early 20s that may be negatively affected by a low-calorie diet.Other individuals advised against starting a calorie-restricted diet include women who plan on getting pregnant, women who are pregnant, and those who are nursing babies. A low body mass index (BMI), which occurs with a low-calorie diet, is a risk factor in pregnancy and can result in dysfunctional ovaries and infertility. A low BMI also can cause premature birth and low birth weights in newborns. People with existing medical conditions or diseases are discouraged from reduced calorie diets. They should be especially cautious and consult with their physician before starting.
Risks
There are a wide range of risks associated with an anti-aging, reduced calorie diet. These risks include physical, mental, social, and lifestyle issues.- Hunger, food cravings, and obsession with food.
- Loss of strength or stamina and loss of muscle mass, which can affect physical activities, such as sports.
- Decreased levels of testosterone, which can be compensated with testosterone supplementation
- Rapid weight loss (more than two pounds a week), which can negatively impact health
- Slower wound healing
- Reduced bone mass, which increases the risk of fracture
- Increased sensitivity to cold
- Reduced energy reserves and fatigue
- Menstrual irregularity
- Headaches
- Drastic appearance changes from loss of fat and muscle, causing people to look thin or anorexic
Research and general acceptance
An anti-aging diet that restricts calories may slow the aging of the heart and lengthen lifespan, according to a study by Washington University School of Medicine in St. Louis, Missouri. The small study, released in 2006, followed 25 people aged 41–65 who consumed only 1,400–2,000 calories a day for six years. Results of the study showed participants had heart functions that resembled people 15 years younger and their blood pressure was significantly lower than a control group who had a calorie intake of 2,000–3,000 per day, the amount of a normal Western diet.A calorie-restrictive diet may reverse early stages of Parkinson’s disease, according to a study released in
QUESTIONS TO ASK YOUR DOCTOR
- Do I need to take any vitamin, mineral, or other nutritional supplements if I go on the diet?
- Will an anti-aging diet have any negative impacts on my health?
- Are there other diets you would recommend that would allow me to reach the same goals as the anti-aging diet?
- How will restricting my calorie intake effect my metabolism and energy level?
Resources top
BOOKS
Connor, Elizabeth. Internet Guide to Anti-Aging and Longevity. Binghamton, NY: Haworth Information Press, 2006.D’Adamo, Peter, and Catherine Whitney. Aging: Fight It With the Blood Type Diet. New York: Putnam Adult, 2005.
D’Adamo, Peter, and Catherine Whitney. Aging: Fighting It With the Blood Type Diet: The Individual Plan for Preventing and Treating Brain Decline, Cognitive Impairment, Hormonal Deficiency, and the Loss of Vitality Associated With Advancing Years. New York: Berkley Trade, 2006.
Delaney, Brian M., and Lisa Walford. The Longevity Diet. New York: Marlowe & Company, 2005.
Goode, Thomas. The Holistic Guide to Weight Loss, Anti-Aging, and Fat Prevention. Tucson, AZ: Inspired Living International, LLC, 2005.
Walford, Roy L., and Lisa Walford. The Anti-Aging Plan: The Nutrient-Rich, Low-Calorie Way of Eating for a Longer Life—The Only Diet Scientifically Proven to Extend Your Healthy Years. New York: Marlowe & Company, 2005.
Willcox, Bradley J., and D. Craig Willcox. The Okinawa Diet Plan: Get Leaner, Live Longer, and Never Feel Hungry. New York: Clarkson Potter, 2004.
PERIODICALS
Dibble, Julian. “The Fast Supper: Is a Life Lived On the Edge of Starvation Worth Living? Our Hungry Reporter Gives the Ultra-Extreme Calorie Restriction Diet a Two-Month Taste Test.” New York (October 30, 2006): 44–51.Downey, Michael. “Low-Calorie Longevity: The Anti-Aging Diet.” Better Nutrition (December 2002): 38–43.
James, Kat. “Eating for Eternal Youth: Calorie Restriction in Right Balance.” Better Nutrition (June 2004): 68–70.
Lasalandra, Michael. “Age Study Eyes Low-Calorie Diet And a Glass of Red.” The Boston Herald (August 25, 2003): 3.
Leavitt, Kathryn Perrotti. “The Live Longer Diet: Eat the Right Foods Regularly and You Can Live a Long and Vibrant Life.” Natural Health (September 2003): 54–57.
Lemonick, Michael D. “Eat Less, Live Longer?” Time (August 30, 2004): 44.
Meyer, Julie. “The Longevity Diet: Everyone Knows That Reducing Calories Can Help You Lose Weight; Members of the Calorie Restriction Society Say It Helps You Live Longer.” Natural Health (March 2007): 39–42.
Stipp. David. “Researchers Seek Key to Anti-Aging in Calorie Cutback.” Wall Street Journal (October 30, 2006): A-1.
ORGANIZATIONS
American Aging Association. The Sally Balin Medical Center, 110 Chesley Drive, Media, PA 19063. Telephone: (610) 627-2626. Website: <http://www.americanaging.org>.American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>.
Calorie Restriction Society. 187 Ocean Drive, Newport, NC 28570. Telephone: (800) 929-6511. Website: <http://www.calorierestriction.org>.
National Institute on Aging. Building 31, Room 5C27, 31 Center Drive, MSC 2292, Bethesda, MD 20892. Telephone: (800) 222-2225. Website: <http://www.nia.nih.gov>.
Ken R. Wells
Anne Collins weight loss program
Definition
The Anne Collins weight loss program is a weight loss system accessed on-line after payment of a yearly subscription fee. The system consists of nine separate diet plans plus advice regarding nutrition, exercise, and specific physical disorders; an on-line support community; and personal advice available through e-mail. There are no diet foods, nutritional supplements, appetite suppressants, exercise equipment, or any other products sold as part of the system.Origins
Anne Collins is an Irish nutritionist who says about herself, “For 24 years I have been involved in the weight loss and fitness industry as a diet consultant, nutritionist, and personal adviser. I have written for many newspapers and magazines including a weekly weight loss and health column.” She states that she first formulated her weight loss system in 1982 but does not mention the date that her Internet Web site opened.The Anne Collins Web site claims that it has had nearly 7.5 million visitors and is ranked the eighth most popular online diet Web site by Hitwise (an online competitive intelligence service that researches market trends). However, a much lower number of people have actually tried the Anne Collins system. The Web site states that it helps “over 250,000 people all over the world to lose really stubborn fat deposits and to achieve a lean body.” Therefore, it appears that most visitors to the Web site choose not to subscribe to the system.
Description
Overview
The Anne Collins system is available only through the author’s Internet Web site (URL:http://www.anne-collins.com. Some parts of the Web site are available to the public, but most pages require a $19.97 US annual subscription. The subscription fee must be paid online by credit card, as there is no telephone number on the public portion of the Web site. A comment on the Web site encourages visitors to subscribe immediately and states that rates will be increasing due to the site’s popularity. It is unknown on what date the promotion actually ends.What the dieter obtains for the subscription fee is access to the following: any and all of the e-books for the nine specific diet plans; a community forum; updates to the existing diets and any new diet plans; advice about nutrition and exercise; shopping lists; advice and tips to stay motivated; and personal support either online or by telephone available any day of the year. The e-books average 55–60 pages in length; they contain daily meal plans for a 28-day period, including options for snacks and fast foods. The motivational articles, nutrition information, and other sections of the Web site come to about 600 pages of material.
The Anne Collins weight loss system is not available in a print edition, either paperback or hardcover, even though there is an illustration of what looks like a paperback book on the Web site. In addition, neither the Library of Congress nor the British Library has a record of any book on nutrition or weight loss written by Anne Collins.
Specific diets
This diet plan includes a number of food substitutes, advice on eating in fast-food restaurants, a shopping list, and a list of acceptable snack foods.LOW GLYCEMIC INDEX DIET. The glycemic index (GI) is a measurement system devised at the University of Toronto in 1981 for ranking dietary carbohydrates. The GI measures carbohydrates in individual foods on a gram-for-gram basis in regard to their effect on blood glucose levels in the first two hours after a meal. The higher the index number, the more rapidly the carbohydrate breaks down in the digestive tract and the more rapidly it raises blood sugar levels. A lower GI number is thought to relate to a longer feeling of fullness in the stomach, better control over insulin and blood sugar levels, and lower levels of blood lipids.
The Anne Collins low glycemic index diet plan is designed for people with type 2 diabetes, insulin resistance, or women with polycystic ovarian syndrome (PCOS, an endocrine disorder associated with obesity and insulin resistance) who need or want to lose weight rapidly. Like the Anne Collins low-carbohydrate diet, the low GI diet has a 28-day cycle of meal plans and shopping lists, but is not divided into two phases. It is fundamentally a lean-protein with low-GI carbohydrate diet, intended to stabilize the dieter’s blood glucose level during weight loss. The meal plans allow about 1,100 calories per day but may be adjusted upward to 2,000 calories for men (and for dieters who wish to lose weight more slowly) by adding calorie-controlled snacks.
10-MINUTE MEALS DIET. The Anne Collins 10-minute meals diet is geared for dieters who wish to lose weight rapidly but have little time to cook. This plan is also for 28 days and is not divided into phases. The lunch menus have fast-food, brown-bag, and quick-cook options. Dinners provide fast-food, quick-cook, and two-day meal options; which are dinners intended to last for two days, thus freeing the dieter from having to cook twice.
Like the meal plans for the low GI diet, the meal plans for the 10-minute meals diet allow about 1,100 calories per day, adjustable upward to 2,000 or 2,100 calories through a choice of snacks, including fast-food options. After four weeks, the dieter can either repeat the 28-day cycle or choose another Anne Collins diet plan.
CHOLESTEROL-LOWERING DIET. This diet is intended for people who must lower blood cholesterol levels while losing weight and/or who wish to lose weight rapidly. The 28-day cycle of meal plans shows the total fat, saturated fat, and cholesterol content of every food item on the diet as well as the calorie values. The diet allows about 1,200 calories per day, with an average content of 22 g total fat, 4 g saturated fat, and 120 mg cholesterol. The meal plans are rich in dietary fiber, particularly soluble fiber, which has a number of important health benefits that include lowering blood cholesterol levels. The cholesterol and fat values of this diet plan fall within the guidelines recommended by the U.S. Food and Drug Administration (FDA). As with other Anne Collins diet plans, the calorie level can be adjusted upward for men and people who desire to lose weight more slowly.
The e-book that comes with this plan contains suggestions about and guidelines for exercise as a way to further lower blood cholesterol levels. The diet plan suggests that cholesterol levels should begin to fall within two to three weeks of beginning the diet. After four weeks, the dieter may repeat the cycle if blood cholesterol has not fallen to the desired level, or choose another diet in the program to continue losing weight
14-DAY LOW-CALORIE BOOSTER DIET. This diet plan has only a 14-day rather than a 28-day cycle. It is intended for dieters who have only a short-term weight-loss goal (such as fitting into a specific outfit for an important event) or feel unable to reach a longterm goal and want a quick breakthrough. The plan allows for six meals or snacks per day to promote rapid food metabolism. The meal plans include a number of quick-cook recipes and convenience food or fast-food options.
The basic diet plan allows about 1,000 calories a day to maximize weight loss but can be adjusted upward for men.
VEGETARIAN QUICK-START DIET. The Anne Collins vegetarian quick-start diet is a rapid weight-loss plan for committed vegetarians, those who would like to try a vegetarian lifestyle, and those who would simply like to lower their meat and poultry consumption. Technically, the diet is ovolactovegetarian, which means that it includes eggs and dairy products.
NO-NONSENSE BALANCED DIET. The no-nonsense diet plan is intended for dieters who want to lose weight rapidly but also want some flexibility in a diet plan. This diet also has a 28-day cycle, with meal plans averaging 1,100 calories per day. Flexibility includes home-cooked and convenience meal options for every lunch as well as every dinner.
As with the other Anne Collins plans, the calorie level can be adjusted upward for men. Sample menus from this diet are as follows:
- Breakfast: 2 low-fat pancakes; 1 tbsp maple syrup; 2 slices Canadian bacon; one-half cup berries. Alternate menu: 1 cup fat-free yogurt; 2 tbsp wheat germ; 1 medium banana; 1 tbsp sesame seeds.
- Lunch: Convenience option: Subway six-inch roasted chicken breast submarine sandwich and 1 serving fruit. Home-cooked option: 1 cup low-fat ready-toserve soup; 2 slices whole wheat bread spread with 2 tbsp fat-free mayonnaise and filled with chopped vegetables; 1 oz fat-free cheese.
- Dinner: Convenience meal option: Lean Cuisine angel-hair pasta meal; 2 cup salad; 1 tbsp fat-free dressing; 2 graham crackers with 1 tbsp fat-free cream cheese; 1 serving fruit. Home recipe option: 1 oz (dry weight) pasta or thin spaghetti; 3 oz very lean ground beef; one-half cup sliced bell peppers; 1 large tomato, chopped; 1 clove garlic, minced; one-half tsp oregano, one-half tsp Italian seasoning.
- Snacks: Select from list included with diet plan.
The basic calorie allowance in the diet for life is 1,300 calories per day, adjustable upward to 2,000 or 2,100 calories.
VEGETARIAN DIET FOR LIFE. The vegetarian diet for life is similar to the general diet for life plan, with a 14-day set of starter menus, a large number of easy-toprepare recipes, and advice about lifelong sensible eating habits. Like the diet for life, the vegetarian diet for life plan is low in fat and moderate in protein. The menu plans provide about 1,250 calories per day and can be adjusted upward.
QUESTIONS TO ASK YOUR DOCTOR
- What is your professional opinion of the Anne Collins weight loss system?
- Do you know of any published clinical studies of the Anne Collins program?
- Have any of your other patients tried it?
- Which of the nine diets did they use?
- Were they able to lose weight and keep it off?
Function
The Anne Collins weight loss system is intended for the dieter who is “looking for safe permanent weight loss without using pills, special foods, or gimmicks of any sort.” Most of the nine specific plans are intended for more rapid weight loss, but several are maintenance diets including a maintenance diet for vegetarians. All the specific plans can be tailored to allow higher calorie intakes for men or for dieters less concerned to about losing weight rapidly.Benefits
The system’s Web site claims the following benefits for the nine diets:- The dieter can lose weight “without going hungry.... Have you ever felt that horrible gnawing feeling on other diets when you feel that your stomach is eating itself? Well you’ll never feel this with my system. If you’re feeling hungry my advice is always to go eat.”
- The dieter will “stay motivated.... With the Anne Collins Weight Loss Program you will be supported every step of the way and if you happen to slip up at any stage I’ll be there to pick you up, dust you down and get you back on track. You can say goodbye to yo-yo dieting forever.”
- The system does not depend on appetite suppressants, dietary supplements, or other special products.
- There are no forbidden foods. The dieter can fit fast foods, chocolate, and other foods that are avoided on most diets into most of the specific diets.
- The dieter will lose the excess weight permanently. “With my system you will learn how to make realistic and sustainable changes to your eating habits for ever.”
Precautions
Although none of the Anne Collins diet plans are very low calorie diets (VLCDs) or otherwise extreme, it is always a good idea for people who need to lose 30 pounds or more; are pregnant or nursing; are below the age of 18; or have such chronic disorders as diabetes, kidney disease, or liver disease to check with a physician before starting a weight-reduction diet.Risks
There do not appear to be any significant health risks associated with any of the nine plans for dieters who have been evaluated by a physician for any previously undiagnosed disorders.Research and general acceptance
Although three physicians are listed on the Web site as approving the Collins system, two are identified only by initials. The Anne Collins system does not appear to have been used in any clinical trials reported in the medical literature, possibly because of the sheer number of different diet plans included in the program. In addition, Collins’s credentials as a nutritionist are not listed on her Web site, which makes it difficult to verify her qualifications as a weight loss expert. Existing feedback about this diet is informal as of early 2007, consisting solely of testimonials on the Web site itself and comments or reviews on various Internet diet Web sites and online chat groups.KEY TERMS
Glycemic index (GI)—A system that ranks carbohydrates in individual foods on a gram-for-gram basis in regard to their effect on blood glucose levels in the first two hours after a meal. There are two commonly used GIs, one based on pure glucose as the reference standard and the other based on white bread.Insulin resistance—A condition in which normal amounts of insulin in a person’s blood are not adequate to produce an insulin response from fat, muscle, and liver cells. Insulin resistance is often a precursor of type 2 (adult-onset) diabetes.
Lipids—Organic substances containing hydrocarbons that are relatively insoluble in water. Lipids in the blood include such substances as cholesterol and fatty acids.
Ovolactovegetarian—A vegetarian who consumes eggs and dairy products as well as plant-based foods.
Polycystic ovarian syndrome (PCOS)—An endocrine disorder characterized by irregular ovulation in women of childbearing age and excessive amounts of androgens (masculinizing hormones). It is a leading cause of infertility and thought to affect between 5 and 10% of women. PCOS is often associated with obesity and insulin resistance. PCOS is also known as Stein-Leventhal syndrome.
Soluble fiber—The part of a food plant that resists digestion and absorption in the human small intestine but is fermented partially or completely in the large intestine. This fermentation yields short-chain fatty acids, which are beneficial to health by stabilizing blood glucose levels, lowering blood cholesterol levels, and supporting the immune system.
Very low -calorie diet (VLCD)—A term used by nutritionists to classify weight-reduction diets that allow around 800 calories or fewer a day.
Resources
BOOKS
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.ORGANIZATIONS
Anne Collins Weight Loss Program. [cited April 26, 2007]. <http://www.anne-collins.com>.Rebecca J. Frey, PhD
Carbohydrate Addict’s Diet
Definition
The carbohydrate addict’s diet is an eating plan that emphasizes foods low in carbohydrates (carbs). It is based on the theory that some people develop unmanageable cravings for high-carb foods due to the pancreas producing too much insulin, leading to weight gain.Origins
American research scientists Rachel Heller and Richard Heller developed the carbohydrate addict’s diet in the early 1990s after the husband and wife lost a combined 200 lb (75 kg) on the diet. Both Hellers are professors and researchers specializing in biomedical sciences. They outlined their method in their first book, The Carbohydrate Addict’s Diet, published in 1991. They have since expanded upon the diet in subsequent books and several updates of the original book. The term “carbohydrate addiction” was coined in 1963 by Robert Kemp, a biochemist at Yale University.Description
The carbohydrate addict’s diet is a program based on the theory that balancing insulin levels in the body will lead to reduced insulin resistance and less cravings for foods high in carbohydrates. The diet has two steps: reduce the high-carbohydrate foods that are consumed, and regulate insulin levels by using dietary supplements Although the Hellers recommend an exercise program with the diet, there is not a major emphasis on exercise. The Hellers define carbohydrate addiction as a compelling hunger, craving, or desire for foods high in carbohydrates, or an escalating and recurring need for starchy foods, snack foods, junk foods, and sweets. These foods include breads, bagels, cakes, cereals, chocolate, cookies, crackers, pastry, fruit and fruit juices, ice cream, potato chips, pasta, potatoes, pretzels, rice, pies, popcorn, and sugar-sweetened beverages. The Hellers also advocate avoiding sugar substitutes (Equal, NutraSweet, Splenda), which they theorize causes the body to release insulin and the body to store fat.Up to 75% of people who are overweight are addicted to carbohydrates, according to the Hellers. Carbohydrate addiction is caused by an over-production of the hormone insulin when foods high in carbohydrates are eaten. The insulin tells the body to take in more food and once the food is eaten, the insulin signals the body to store the extra food energy as fat, the Hellers hypothesize. When too much insulin is released after eating, it is called post-prandial reactive hyperinsulinemia. Over time, some people with this condition develop insulin resistance, where cells in tissue stop responding to insulin. The body continues to produce insulin but because the tissues do not respond to it, the body is unable to use the glucose (sugar) properly. Insulin resistance is often found with other health problems, including diabetes, high cholesterol, high triglycerides, high blood pressure and cardiovascular disease. When more than one of these diseases are found together, it may be termed “insulin resistance syndrome”
There is no medical test to indicate carbohydrate addiction so the Hellers developed a self-administered quiz to determine if a person is a carbohydrate addict. The quiz, which is available in their books and on their Website, asks ten “yes” or “no” questions. They are:
- Are you hungry before lunch even if you’ve had a full breakfast?
- Is it hard to stop eating starches, snack foods, junk food, or sweets?
- Do you feel unsatisfied despite having just finished a meal?
- Do you eat when you are not hungry?
- Do you snack at night?
- Are you lethargic after a big meal?
- Are you tired and/or hungry in the afternoon without a reason to be?
- Do you continue to eat even when you are full?
- Do you yo-yo diet?
The carbohydrate addict’s diet begins with the entry plan, which allows two complementary meals and one reward meal each day for the first week. In subsequent weeks, the diet is adjusted depending on a person’s weight loss goal and amount of weight lost in the previous week. The diet also allows for a snack and salads. The complementary meal is composed of one serving of meat and two cups of low-carb vegetables or two cups of salad. There is an extensive list of meats and vegetables to choose from. The reward meal can be as large as the person wants but it must be composed of equal portions of protein, low-carb vegetables, and high-carb foods (including dessert). The reward meal must be eaten in an hour. A snack is the same as a complementary meal but half the size. The diet allows for an unlimited amount of water, diet drinks, and unsweetened coffee and tea.
Very few people need a morning breakfast to provide energy through the day, according to the Hellers. Since food takes several hours to clear the stomach and a few more hours to be processed in the small intestine, it is the food that is eaten the night before that gives a person energy for the first part of the next day, the Hellers say. For people who are not hungry in the morning, the Hellers recommend skipping breakfast and having just coffee or tea. Skipping breakfast is not a practice widely recommended among dieticians and nutritionists.
Children and teens
There are two different carbohydrate addict’s diets for children and teenagers. Both are outlined in the Hellers” book, Carbohydrate-Addicted KidsCarbohydrate addiction affects up to 74% of children and teens, according to the Hellers. It is also a problem in adolescents with behavior, motivation, concentration, and learning problems, and mood swings. On the step-by-.Function
The premise of the carbohydrate addict’s diet is to correct the body’s excess release of insulin, which occurs following consumption of foods high in carbohydrates. The excess release of insulin triggers an intense and recurring craving for more carbohydrate-rich foods. The diet, combined with exercise, is designed to correct the underlying cause of the cravings, the excess release of insulin.Benefits
Precautions
Like any strict diet, the carbohydrate addict’s diet should be undertaken with the supervision of a doctor. People with diabetes should consult an endocrinologist, who may recommend discussing the diet with a dietitian. Persons considering the carbohydrate addict’s diet should ask their doctors if they need to take any vitamin, mineral, or nutritional supplements, based on their overall health and any specific medical conditions they may have.Risks
There are no general health risks associated with the carbohydrate addict’s diet. Critics of the diet claim it contains too much fat, is not nutritionally balanced, and is not a long-term solution for losing weight and keeping it off. It may be difficult for people to maintain a low-carb diet over the long-term. The diet is not recommended for women who are pregnant or nursing. Individuals who have a history of stroke, diabetes, heart disease, high cholesterol, or kidney stones should talk to their doctor before starting any low-carb diet.Research and general acceptance
There is mixed acceptance of the carbohydrate addict’s diet and low-carb diets in general by the medical community and dietitians. Some studies have shown low-carb diets can be effective in controlling blood sugar levels in diabetics and in helping people lose weight. Other studies have contradicted these findings. No major studies or research has shown that low-carb diets are harmful to a person’s health; however most professional organizations do not support low-carb diets.A 2003 study by researchers at the University of Pennsylvania School of Medicine found that a low-carb diet produced a greater weight loss than a conventional low-calorie, low-fat diet after six months. However, after one year, the two diets produced similar weight loss results. A 2004 study by the same medical center found that both a low-carb and conventional diet produced similar weight loss results.
BOOKS
Heller, Richard F., and Rachael F. Heller. Carbohydrate-Addicted Kids: Help Your Child or Teen Break Free of Junk Food and Sugar Cravings—For Life! New York: Harper Paperback, 1998.Heller, Richard F., and Rachael F. Heller. The Carbohydrate Addict’s Carbohydrate Counter New York: Signet, 2000.
Heller, Richard F., and Rachael F. Heller. The Carbohydrate Addict’s Diet New York: Vermilion, 2000.
Heller, Richard F., and Rachael F. Heller. The Carbohydrate Addict’s Healthy Heart Program: Break Your Carbo-Insulin Connection to Heart Disease New York: Bal-lantine Books, 2000.
Heller, Richard F., and Rachael F. Heller. The Carbohydrate Addict’s LifeSpan Program New York: Signet, 2001.
Heller, Richard F., and Rachael F. Heller. The Carbohydrate Addict’s 7-Day Plan: Start Fresh On Your Low-Carb Diet! New York: Signet, 2004.
Heller, Richard F., and Rachael F. Heller. The Carbohydrate Addict’s No Cravings Cookbook New York: NAL Trade, 2006.
Scales, Mary Josephine. Diets in a Nutshell Clifton, VA: Apex Publishers, 2005.
PERIODICALS
Baron, Melissa. “Fighting Obesity: Part 1: Review of Popular Low-Carb Diets.” Health Care Food & Nutrition Focus (October 2004): 5.Bell, John R. “Jury Out on Value of Low-Carb Diets.” Family Practice News (March 15, 2006): 20. Chernikoff, Lisa. “Low-Carb Mania: A University of Michigan Expert Explains Why Low-Carb Diets are Not the Best Choice.”American Fitness (May-June 2004): 45–48.
Last, Allen R., and Stephen A. Wilson. “Low-Carbohydrate Diets.” American Family Physician (June 1, 2006):1942–48.
Marks, Jennifer B. “The Weighty Issue of Low-Carb Diets,or Is the Carbohydrate the Enemy?” Clinical Diabetes (Fall 2004): 155–156.
McVeigh, Gloria. “Why Low-Carb Diets Work.”Prevention (September 2005): 73.
Shaughnessy, Allen F. “Low-Carb Diets Are Equal to Low-Fat Diets for Weight Loss.” American Family Physician (June 1, 2006): 2020.
Sullivan, Michele G. “Teens Lose More Weight With Less Effort on Low-Carb Diets vs. Low-Fat Diets.” Family Practice News (June 15, 2004): 64.
ORGANIZATIONS
American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66207. Telephone: (800) 274-2237. Website: <http://www.aafp.org>American College of Nutrition. 300 South Duncan Ave., Suite 225, Clearwater, FL 33755. Telephone: (727) 446-6086. Website: <http://www.amcollnutr.org>
American Diabetes Association. 1701 N. Beauregard St., Alexandria, VA 22311. Telephone: (800) 342-2383. Website: <http://www.diabetes.org>
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>
American Society for Nutrition. 9650 Rockville Pike, Bethesda, MD 20814. Telephone: (301) 634-7050. Website: <http://www.nutrition.org>
Center for Nutrition Policy and Promotion. 3101 Park.Center Drive, 10th Floor, Alexandria, VA 22302-1594. Telephone: (703) 305-7600. Website: <http://www.cnpp.usda.gov>
Ken R. Wells.
African diet
Definition
Africa, the second largest continent in the world, is rich in geographic and cultural diversity. It is a land populated by peoples with histories dating to ancient times and cultures shaped by innumerable tribes, languages, and traditions. Because it is the birthplace of Homo sapiens and the land of origin for much of the world’s population, the culture of food and eating in the different regions of Africa is important to people throughout the world.Male and female life expectancy at birth in Africa, 2004
Country
|
Male
|
Female
|
Algeria
|
69
|
72
|
Angola
|
38
|
42
|
Botswana
|
40
|
40
|
Burkina Faso
|
47
|
48
|
Burundi
|
42
|
47
|
Chad
|
45
|
48
|
Congo
|
53
|
55
|
Ivory Coast
|
41
|
47
|
Ethiopia
|
49
|
51
|
Gambia
|
55
|
59
|
Ghana
|
56
|
58
|
Kenya
|
51
|
50
|
Liberia
|
39
|
44
|
Mozambique
|
44
|
46
|
Namibia
|
52
|
55
|
Nigeria
|
45
|
46
|
Rwanda
|
44
|
47
|
Senegal
|
54
|
57
|
Sierra Leone
|
37
|
40
|
South Africa
|
47
|
49
|
Uganda
|
48
|
51
|
Zimbabwe
|
37
|
34
|
Origins
Early History of Africa
The early history of man is the story of food in Africa. Homo sapiens evolved apart from other apes in Africa, and the adaptation of humans has been shaped by adaptations to diet. For example, some anthropologists believe that the selection pressure that led to bipedalism (walking on two legs) was an adaptation to changing environments that involved travel in search of tubers (rounded underground plant stems, such as potatoes). Africa’s history includes some of humankind’s earliest food production, with one of the most fertile centers located in Northern Africa, the Nile Valley. The Nile Valley historically was and continues to be a rich source of fish, animal, and plant food. In the drier African savannas, especially after the Sahara region became arid after 6000 B.C.E., nomad tribes raised cattle, goats, or sheep, which served as part of the tribes’ food source. Crops that were less affected by extreme weather like cereals (such as wheat, barley, millet, and sorghum) and tubers (such as yams) slowly became popular throughout the continent and have remained important staples in the African diet today.Description
Throughout Africa, the main meal of the day is lunch, which usually consists of a mixture of vegetables, legumes, and sometimes meat. However, though different meats are considered staples in many areas, many Africans are not able to eat meat often, due to economic constraints. Beef, goat, and sheep (mutton) are quite expensive in Africa, so these foods are reserved for special days. However, fish is abundant in coastal regions and in many lakes.The combination of various foods is called stew, soup, or sauce, depending on the region. This mixture is then served over a porridge or mash made from a root vegetable such as cassava or a grain such as rice, corn, millet, or teff. Regional differences are reflected in variations on this basic meal, primarily in the contents of the stew. The greatest variety of ingredients occurs in coastal areas and in the fertile highlands. Flavorings and spiciness have varied principally due to local histories of trade. In the traditional African diet, meat and fish are not the focus of a meal, but are instead used to enhance the stew that accompanies the mash or porridge. Meat is rarely eaten, though it is well-liked among carnivorous (meat-eating) Africans.
Traditional Cooking Methods. Traditional ways of cooking involve steaming food in leaf wrappers (banana or corn husks), boiling, frying in oil, grilling beside a fire, roasting in a fire, or baking in ashes. Africans normally cook outdoors or in a building separate from the living quarters. African kitchens commonly have a stew pot sitting on three stones arranged around a fire. In Africa, meals are normally eaten with the hands.
North Africa
The countries of North Africa that border the Mediterranean Sea are largely Muslim countries. As a result, their diet reflects Islamic traditions. The religion of Islam does not permit eating pork or any animal product that has not been butchered in accordance with the traditions of the faith. Like other regions of Africa, much of the diet is based on grains. However, cooking with olive oil, onions, and garlic is more common in the countries of North Africa. Notable spices include cumin, caraway, clove, and cinnamon. Flat breads are a common staple and can accompany any meal, including breakfast, which is usually porridgeKEY TERMS
Anemia—Low level of red blood cells in the blood.Calorie—Unit of food energy.
Famine—Extended period of food shortage.
prepared from millet or chickpea flour. Couscous (made from hard wheat and millet) is often the main dish at lunch, which is the primary meal. This may be accompanied by vegetable salads. Other main dishes include tajine, named for the conical clay pot in which a whole meal is prepared. Lamb is cooked in tajines as well as on kabobs (roasted on a skewer). Vegetables include okra, meloukhia (spinach-like greens), and radishes. Common fruits are oranges, lemons, pears, and mandrakes. Legumes such as broad beans (fava beans), lentils, yellow peas, and black-eyed peas are also important staples. Alcoholic drinks are forbidden by Islamic tradition. Mint tea and coffee are very popular beverages in this region.
West Africa
Within West Africa, there is considerable variation in the staple food. Rice is predominant from Mauritania to Liberia and across to the Sahel, a region that stretches across the continent between the Sahara and the southern savannas. Couscous is the prevalent dish in the Sahara. Along the coast from Coôte d’Ivoire (Ivory Coast) to Nigeria and Cameroon, root crops, primarily varieties of yam and cassava, are common. Cassava, imported from Brazil by the Portuguese, is boiled and then pounded into a nearly pure starch. Yam is the chief crop in West Africa and is served in a variety of dishes, including amala (pounded yam) and egwansi (melon) sauce. Millet is also used for making porridge or beer.Palm oil is the base of stew in the Gambia, southern, and eastern regions. In the Sahalian area, groundnut paste (peanut butter) is the main ingredient for stew. Other stews are based on okra (a vegetable native to the rainforests of Africa), beans, sweet potato leaves, or cassava. Other vegetables are eggplant, cabbage, carrots, chilies, french beans, lettuce, okra, onions, and cherry tomatoes. All the stews in this territory tend to be heavily spiced, often with chilies.
Protein Sources. Meat sources of protein include cattle, sheep, chicken, and goat, though beef is normally reserved for holidays and special occasions. Fish is eaten in the coastal areas. Because of the Islamic influence, pork is localized to non-Muslim areas. In these regions, “bush meat” is widely eaten, including bush rat, a large herbivorous rodent, antelope, and monkey. Giant snails are also eaten in various parts of West Africa.
East Africa
Extensive trade and migrations with Arabic countries and South Asia has made East African culture unique, particularly on the coast. The main staples include potatoes, rice, matake (mashed plantains), and a maize meal that is cooked up into a thick porridge. Beans or a stew with meat, potatoes, or vegetables often accompany the porridge. Beef, goat, chicken, or sheep are the most common meats. Outside of Kenya and the horn of Africa, the stew is not as spicy, but the coastal area has spicy, coconut-based stews. This is quite unique in comparison to the central and southern parts of Africa.Two herding tribes, the Maasai and Fulbe, have a notably different eating pattern. They do not eat very much meat, except for special occasions. Instead, they subsist on fresh and soured milk and butter as their staples. This is unusual because very few Africans consume milk or dairy products, primarily due to lactose intolerance.
The horn of Africa, which includes modern-day Somalia and Ethiopia, is characterized by its remarkably spicy food prepared with chilies and garlic. The staple grain, teff, has a considerably higher iron and nutrient content than other grain staples found in Africa. A common traditional food here is injera, a spongy flat bread that is eaten by tearing it, then using it to scoop up the meat or stew.
Southern Africa
Outside of the temperate zones, in the southern part of the continent, a greater variety of fruits and vegetables are available. Fruits and vegetables in southern Africa include bananas, pineapples, paupau (papaya), mangoes, avocadoes, tomatoes, carrots, onions, potatoes, and cabbage. Nonetheless, the traditional meal in southern Africa is centered on a staple crop, usually rice or maize, served with a stew. The most common dish made from cornmeal is called mealie meal, or pap in South Africa. Also known as nshima or nsima further north, it is usually eaten with stew poured over it. The stew may include a few boiled vegetables, such as cabbage, spinach, or turnips, or on more special occasions, fish, beans, or chicken.Risks
Nutrition and Disease
White South Africans (Dutch descendants called Afrikaaners), Europeans, and Asian Indians in Africa have diets similar to their countries of origin. In urban areas, however, the diet of (black) Africans is increasingly dependent on meat, much like the diet of some West African pastoral tribes, as well as on empty calories from prepackaged foods similar to those found in the West. The result is an unbalanced diet. In many parts of Africa, the traditional diets of indigenous peoples are often inadequate in essential vitamins, minerals, and protein, which can lead to a variety of diseases. Micronutrient deficiencies, particularly vitamin A, iodine, and iron deficiencies, which can result in vision impairment, goiter, and anemia, respectively, are prevalent throughout much of Africa, particularly in the arid areas where the soil is deficient either naturally or due to overuse.Food Security
A far greater threat comes from increasingly insecure food sources (a lack of consistent and affordable food staples) arising from adverse weather (drought and floods) and war. During the late 1900s, famine became increasingly frequent in Africa. In addition, a new threat to the food supply emerged due to the worsening HIV/AIDS epidemic. As adults fall ill and die, agricultural production declines. Rural communities are the hardest hit, and women are particularly at risk given their unique physiologic needs tied to their roles as mothers, as well as their vulnerability due to lower economic and social status.With its immense population, resources, and growing population, Africa is a continent that struggles to keep its people and cultures healthy. African history, the proliferation of foods and spices across the land, and the preservation of land that can still be farmed, will continue to be important. Weather, geography, politics, culture, and religion are forces that have caused strife within Africa for centuries, and will continue to do so. A land that was once pure and fertile can only be restored through land preservation and food availability.
Resources
BOOKS
Carr, Marilyn, ed. (199 1). Women and Food Security: The Experience of the SADCC Countries London: IT Publications.Eles, Dale, and Fitzpatrick, Mary. (2000). Lonely Planet West Africa Singapore: Lonely Planet.
Finlay, Hugh (2000). Lonely Planet East Africa. Singapore: Lonely Planet.
Fiple, Kenneth F., and Ornelas, Kriemhil Coneeè, eds. (2000). The Cambridge World History of Food, Volumes. 1 and 2. Cambridge, UK: Cambridge University Press.
Harris, Jessica B. (1998). The Africa Cookbook: Tastes of a Continent New York: Simon & Schuster.
Lentz, Carola, ed. (1999). Changing Food Habits: Case Studies from Africa, South America, and Europe Sydney, Australia: Harwood Academic Publishers.
Von Braun, Joachim; Teklue, Tesfaye; and Webb, Patrick (1999). Famine in Africa: Causes, Responses, and Prevention Baltimore: Johns Hopkins University Press.
OTHER
Haslwimmer, Martina (1996). “AIDS and Agriculture in Sub-Saharan Africa.” Available from <http://www.fao.org>Jens Levy M. Cristina F. Garces
Central American and Mexican Diet
Definition
The diets of peoples in Mexico and Central America (Guatemala, Nicaragua, Honduras, El Salvador, Belize, and Costa Rica) have several commonalities, though within the region great differences in methods of preparation and in local recipes exist. The basis of the traditional diet in this part of the world is corn (maize) and beans, with the addition of meat, animal products, local fruits, and vegetables. As in other parts of the world, the diet of people in this area has expanded to include more processed foods. In many parts of Mexico and Central America, access to a variety of foods remains limited, and undernutrition, particularly among children, is a major problem. Although access to an increased variety of foods can improve the adequacy of both macronutrient and micronutrient status, there is evidence that the use of processed foods is contributing to the rapidly increasing prevalence of obesity and diet-related chronic diseases such as diabetes.(Illustration by GGS Information Services/Thomson Gale.)
Origins
Traditional Dietary Habits
The traditional diet of Mexico and Central America is based on corn and beans, but offers a wide diversity of preparations. Coupled with locally available fruits, vegetables, meat and dairy products, the diet can be highly nutritious. However, poverty frequently limits access to an adequate variety of quality foods, resulting in malnutrition. At the same time, the increasing use of processed foods is contributing to obesity, diabetes, and other chronic conditions in this region. The balance between improving access to variety and maintaining dietary quality poses a challenge for public health.The central staple in the region is maize, which is generally ground and treated with lime and then pressed into flat cakes called tortillas. In Mexico and Guatemala, these are flat and thin, while in other Central American countries tortillas are thicker. In El Salvador, for example, small, thick cakes of maize, filled with meat, cheese, or beans, are called pupusas. Maize is also used in a variety of other preparations, including tacos, tamales, and a thin gruel called atole. The complementary staple in the region is beans (frijoles), most commonly black or pinto beans. Rice is also widely used, particularly in the southernmost countries, such as El Salvador, Honduras, Nicaragua, and Costa Rica. Historically, major changes in the traditional diet occurred during colonial times, when the Spaniards and others introduced the region to wheat bread, dairy products, and sugar. Wheat is commonly consumed in the form of white rolls or sweet rolls, or, in the northern part of Mexico, as a flour-based tortilla. Noodles (fideos), served in soups or mixed with vegetables, have also become popular.
The consumption of meat and animal products, although popular, is often limited due to their cost. Beef, pork, chicken, fish, and eggs are all used. Traditional cheeses are prepared locally throughout the region as queso del pais, a mild, soft, white cheese, and milk is regularly used in cafe´ con leche and with cereal gruels.
The region is a rich source of a variety of fruits and vegetables. Best known among these are the chile peppers, tomatoes, and tomatillos that are used in the salsas of Mexico. Avocado is also very popular in Mexican and Central American cuisines. Other commonly used vegetables include calabaza (pumpkin), carrots, plantains, onions, locally grown greens, and cacti. Fruits are seasonal but abundant in the rural areas and include guavas, papayas, mangoes, melons, pineapples, bananas, oranges, and limes, as well as less-known local fruits such as nances, mamey, and tunas (prickly pears from cacti). Traditional drinks (frescos, chichas, or liquados) are made with fruit, water, and sugar.
Description
Methods of Cooking
The traditional preparation of maize involves boiling and soaking dried maize in a lime-water solution and then grinding it to form a soft dough called masa. Soaking in lime softens the maize and is an important source of calcium in the diet. The masa is shaped and cooked on a flat metal or clay surface over an open fire. In some areas, lard or margarine, milk, cheese, and/or baking powder may be added to the tortilla during preparation. Beans are generally boiled with seasonings such as onion, garlic, and sometimes tomato or chile peppers. They are served either in a soupy liquid or are “refried” with lard or oil into a drier, and higher fat, preparation.Meat, poultry, and fish are commonly prepared in local variations of thin soup (caldo or sopa), or thicker soups or stews (cocido) with vegetables. In Mexico and
These are often served with a variety of salsas based on tomato or tomatillo with onion, chile, coriander leaves (cilantro), and other local seasonings. Tamales are made with corn (or corn and rice) dough that is stuffed with chicken and vegetables. The tamales are steamed after being wrapped in banana leaves. Salvadorian pupusas are toasted tortillas filled with cheese, beans, or pork rind eaten with coleslaw and a special hot sauce.
Central American and Mexican Dishes
Beyond the basic staples, the cuisine of Mexico and Central America is rich with many regional variations. The tortilla-based Mexican preparations familiar in the United States are generally simpler in form in Mexico. Tacos are generally made with meat, chicken, or fish grilled or fried with seasoning and served on tortillas; enchiladas are filled tortillas dipped in a chile-based sauce and fried; and tostadas are fried tortillas topped with refried beans or meat, and sometimes with vegetables and cream. Chiles rellenos are made with the large and sweet chile poblano and filled with ground meat. Examples of specialty dishes include mole, a sauce made with chocolate, chile, and spices and served over chicken, beef, or enchiladas; and ceviche, raw marinated fish or seafood made along the coast throughout Central America and Mexico.Influence of Central American and Mexican Culture
As two cultures intermingle, foods and preparations from each tend to infiltrate the other. This is clearly the case near the U.S.-Mexican border, where Mexican immigrants and return immigrants have incorporated foods from U.S. diets into their traditional diets. The result has been a modified form of Mexican cuisine popularly known as “Tex-Mex.” Beyond the border, this Americanized version of popular Mexican foods has spread throughout the United States through the popularity of Mexican restaurants. In the United States, tacos and tostadas tend to have less Mexican seasoning, but include lettuce and shredded processed cheese. Flour, rather than corn, tortillas are more widely used along the border. Many foods, such as soups and chiles, prepared along the border have become known for their spicy hotness, due to the Mexican-influenced use of chiles and chile powder.Benefits
The staple diet of the region—corn and beans, supplemented with meat, dairy products, and local fruit and vegetables—is nutritionally complete and well suited to a healthful lifestyle. The proper combination of tortilla and beans provides an excellent complement of amino acids, thus supplying the necessary amount of complex protein. The process of liming the maize makes the calcium and the niacin in the tortilla more bioavailable, and this food is a major source of these nutrients. In addition, the traditional preparation of tortillas with a hand mill and grinding stones appears to add iron and zinc to the tortilla. Beans are excellent sources of B vitamins, magnesium, folate, and fiber. The tomato and chile-based salsas, along with several of the tropical fruits such as limes and oranges are important sources of vitamin C, and the variety of vegetables and yellow fruits such as papaya, melon, and mango provide excellent sources of caro-tenoids, which are precursors of vitamin A.Risks
Unfortunately, limited financial access to this variety of foods for many people in Central America and Mexico means that the diet often does not include sufficient levels of vitamins and minerals. For low-income groups, lack of access to animal products contributes to deficiencies in iron, zinc, vitamin A, and other nutrients. When animal products are included, there has been a tendency to choose high-fat products such as sausage and fried pork rinds (chicharron). The use of lard and a preference for fried foods also contributes to high intakes of saturated fatand cholesterol among subsets of the population.Changes in Dietary Practices
These changes are more evident among immigrants to the United States, where adoption of U.S. products has been shown to have both positive and negative impacts on nutritional status. Studies that compared diets of Mexican residents to newly arrived Mexican-American immigrants and to second-generation Mexican Americans have documented both nutritionally positive and negative changes with acculturation. On the positive side, acculturated Mexican Americans consume less lard and somewhat more fruit, vegetables, and milk than either newly arrived immigrants or Mexican residents. On the negative side, they also consume less tortilla, beans, soups, stews, gruels, and fruit-based drinks, with greater use of meat, sweetened ready-to-eat breakfast cereals, soft drinks, candy, cakes, ice cream, snack chips, and salad dressings.Resources
PERIODICALS
Guendelman, Sylvia, and Abrams, Barbara (1995). “Dietary Intake among Mexican-American Women: Generational Differences and a Comparison with White Non-Hispanic Women.” American Journal of Public Health 85(1):20–25.Romero-Gwynn, Eunice; Gwynn, Douglas; Grivetti, Louis; McDonald, Roger; Stanford, Gwendolyn; Turner, Barbara; West, Estella; and Williamson, Eunice (1993). “Dietary Acculturation among Latinos of Mexican Descent.” Nutrition Today 28(4):6–12.
Romieu, Isabelle; Hernandez-Avila, Mauricio; Rivera, Juan A.; Ruel, Marie T.; and Parra, Socorro (1997). “Dietary Studies in Countries Experiencing a Health Transition: Mexico and Central America.” American Journal of Clinical Nutrition 65(4, Suppl):1159S–1165S.
Sanjur, Diva (1995). Hispanic Foodways, Nutrition, and Health Boston: Allyn and Bacon.
Tucker, Katherine L., and Buranapin, Supawan (2001). “Nutrition and Aging in Developing Countries.” Journal of Nutrition 131:2417S–2423S.
Katherine L. Tucker
Chicken Soup Diet
Definition
The chicken soup diet is a seven day diet that allows the dieter to eat one of five approved breakfasts each day and as much chicken soup as desired.Origins
The origins of the chicken soup diet are not clear. It seems to circulate mostly from person to person and on the Internet. For many years, people have believed that chicken soup has various health properties. Many different cultures give versions of chicken soup to people who are sick. This belief in the health benefits of chicken soup may have something to do with its popularity as a diet food.Description
The chicken soup diet is a diet that is designed to be followed for seven days, although many versions of the diet say that it can be followed for as long as desired, or repeated at any time. It consists of a soup recipe and five breakfast choices. After breakfast, the only thing that the dieter is allowed to eat until the next morning is the soup. This diet also tells dieters what they may or may not drink while on the diet.The Soup
- 2 tablespoons of oil (olive oil is recommended)
- 4 parsnips (about 1 pound) cut into 1/2 inch pieces
- 4 ribs of celery
- 1 turnip (about 3/4 of a pound) cut into 1/2 inch pieces
- 1 jalapeno pepper, seeded and chopped
- 1 tablespoon of chopped garlic
- 2 teaspoons of salt
- 1/2 teaspoon of cayenne pepper
- 16 cups of reduced fat, low sodium chicken broth
- 7 (5 oz.) cans of chicken or 1 1/2 pound (5 cups) cooked fresh chicken
- 1 bag (16 oz.) frozen carrots
- 1 box (10 oz.) frozen broccoli florets
- 1 box (10 oz.) frozen chopped collard greens
- 1 1/2 cups frozen chopped onions
- 1/4 cup of lemon juice
- 1/4 cup chopped fresh dill or 1 tablespoon dried dill
Breakfasts
The chicken soup diet allows the dieter to chose one breakfast each day from five possible breakfasts. Most versions of the diet encourage dieters to eat each breakfast once for the first 5 days, and then choose the breakfasts they liked best and repeat them for days 6 and 7. The breakfasts are:Breakfast 1: The dieter may eat 1 cup of nonfat vanilla yogurt and 1/2 cup of fruit salad sprinkled with wheat germ.
Breakfast 2: Breakfast 2 allows the dieter to eat 1 cup of ricotta cheese combined with 1/2 teaspoon of sugar and a dash of cinnamon. The dieter may also eat 2 pieces of toasted whole-grain bread and 3 dried figs.
Breakfast 4: This breakfast allows the dieter to eat 1 small whole-wheat bagel that is topped with 1 ounce of melted fat-free cheddar cheese, along with 1/2 cup of prune juice.
Breakfast 5: Breakfast 5 allows the dieter to eat 1 1/2 cups of cooked Wheatena brand cereal along with 1/2 cup of nonfat milk.
After the dieter eats one of these breakfasts, only the chicken soup may be consumed for the rest of the day.
Function
The chicken soup diet does not make any claims about how much weight a dieter can lose during the seven days of the diet, although it is usually implied that the dieter will be able to lose a substantial amount of weight. It does not have any exercise or healthy living recommendations. Some versions of the diet suggest that it would be a good diet to use if a dieter wanted to “jump start” a more comprehensive dieting plan, or if a dieter needed to lose a large amount of weight quickly for an upcoming special event.Benefits
There are many benefits to losing weight if it is done at a safe, moderate pace through a combination of healthy eating and exercise. There are many conditions for which obesity is considered a risk factor, including type II diabetes and heart disease. The risk of these diseases may be reduced through weight loss. This is especially true for very obese people who are generally thought to be at the greatest risk. This diet, however, is not considered appropriate for long term moderate weight loss.The chicken soup diet may have some other benefits in addition to the claim that it can allow a dieter to lose a large amount of weight in a short amount of time. The soup is usually low in calories and contains many different vegetables, which are an important part of a healthy diet. Eating a soup like the one in this diet may be able to help dieters feel more full without eating very many calories, which may make it easier for some dieters stick to a healthy reduced calorie diet.
Precautions
Anyone thinking of beginning a new diet should consult a doctor or other medical practitioner. Requirements of calories, fat, and nutrients can differ from person to person, depending on gender, age, weight, and other factors such as the presence of diseases or conditions. The chicken soup diet does not allow very many different foods, and although the soup may be healthy, it is unlikely to be able to provide all the vitamins and minerals needed for healthy adults each day. Pregnant or breastfeeding women should be especially cautious if beginning a very restricted diet like this one because deficiencies of vitamins and other nutrients can negatively impact a baby that is receiving its nutrients from its mother.Risks
There are some risks associated with any diet. The chicken soup diet does not allow the dieter to eat very many different foods each day. This means that it is unlikely that the dieter will get enough of all vitamins and minerals required each day for good health. Any dieter thinking of beginning this diet may want to consult a healthcare provider about a multi-vitamin or supplement that would be appropriate to take while on this diet to help reduce the risk of deficiencies. This is especially true for any dieter considering following a very limited diet for an extended period of time. Supplements have their own associated risks.Research and general acceptance
The chicken soup diet has not been the subject of any significant scientific studies. In 2000 researchers at the University of Nebraska Medical Center did laboratory research that showed that chicken soup may.have anti-inflammatory properties that could help reduce the symptoms of the flu and colds. This research lends credibility to what many people already believed, that chicken soup was good for people who were ill. The research done was very preliminary and was done in a laboratory, not using human subjects, so it is not clear what the effect on the immune system of a human would actually be. The soup used in the research was not made using the recipe given in this diet, although it did contain some of the same ingredients.
The United States Department of Agriculture makes recommendations for how many servings of each type of food most adults need to eat each day for good health. These recommendations are given in MyPyramid, the updated version of the food guide pyramid. The chicken soup diet is extremely limited in what foods it allows dieters to eat. This makes it unlikely that dieters following this diet would get enough of all the necessary food groups. It also makes the diet likely to be especially unhealthy if followed for a long time or repeated frequently.
The chicken soup diet would probably allow most dieters to get the recommended daily allowance of vegetables. MyPyramid, recommends that healthy adults eat the equivalent of 2 to 3 cups of vegetables each day. The soup contains many different vegetables, and because it is the only food allowed after the prescribed breakfasts, it is likely that most dieters would eat enough of the soup during the day to get the recommended amount of vegetables. These vegetables would be the same ones each day, however, and because different vegetables contain different vitamins and nutrients it is generally recommended that a variety be consumed for optimum health.
MyPyramid also recommends that healthy adults eat the equivalent of 1 1/2 to 2 cups of fruit per day. Dieters following the diet strictly would not be able to get this recommended amount of fruit each day. The soup itself does not contain any fruit, and although 4 of the 5 breakfasts do contain some fruit, 1/2 cup of fruit salad or 1/2 cup of orange juice is not enough to meet the recommendations. Because the diet does not make recommendations for what can be drank while on the diet, a dieter may decide to drink fruit juice while on the diet. This would help the dieter get enough servings of fruit each day.
Dairy products are generally considered to be part of a healthy diet. The soup in the chicken soup diet does not contain any dairy, although each breakfast option does contain dairy of some kind. MyPyramid recommends the equivalent of 3 cups of low-fat or non-fat dairy per day for healthy adults. The breakfasts prescribed by the diet do not include enough dairy to meet this requirement. The diet does not tell a dieter what to drink while on the diet. If a dieter were to choose to drink skim milk while on the diet, this requirement might be met.
The chicken soup diet does not provide many sources of starches or grains. MyPyramid recommends the equivalent of 3 to 4 ounces of grains each day for healthy adults, of which at least half should be whole grains. Although 4 of the 5 breakfasts provide a serving or more of grains, it would not be enough to meet the requirements for a full day. There are no significant sources of grains or starches in the soup.
MyPyramid recommends that healthy adults eat between 5 and 6 1/2 ounces of meat or beans each day, and specifies that lean meat is preferable. The breakfasts allowed do not provide any servings of meat or beans, but the soup does contain chicken that is a healthy lean meat. Because the amount of soup allowed to be eaten is unlimited, it is likely that a person following this diet would consume enough chicken to meet this requirement. The dieter would however only be consuming one type of meat. Variety is generally considered important for a healthy diet because different meats and beans contain different vitamins and minerals.
In 2007, the Centers for Disease Control recommended that healthy adults get 30 minutes or more of light to moderate exercise each day. The chicken soup diet does not include any recommendation for exercise. Exercise is generally accepted to be an important part of any weight loss program. Studies have shown that weight loss programs are more effective when they combine diet and exercise instead of focusing on just one aspect alone.
Resources
BOOKS
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book Detroit, MI: Omnigraphics, 2006.Willis, Alicia P. ed. Diet Therapy Research Trends New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>OTHER
“Chicken Soup Diet.” Fad Diet.com 2007 <http://www.faddiet.com/chicsoupdiet.html> (April 11, 2007).“Chicken Soup Diet.” The Diet Channel 2007 <http://www.thedietchannel.com/Chicken-soup-diet.htm> (April 9, 2007).
Get the Skinny on Diets 2007. <http://www.skinnyondiets.com>(March 26, 2007).
Helen M. Davidson
Cambridge Diet
Definition
The Cambridge diet is a commercial very-low-calorie diet (VLCD). The diet was first used only in weight-loss clinics in the United Kingdom. In the early 1980s, the products associated with the diet (powder mix, meal bars, and liquid meals) started selling commercially in the United States and the United Kingdom. Formulations of the Cambridge diet in the United Kingdom differ from that sold in the United States. In both the United Kingdom and North America, the Cambridge products are available only from distributors; they cannot be purchased over the counter at pharmacies or supermarkets.(Illustration by GGS Information Services/Thomson Gale.)
Origins
United Kingdom and Western Europe
A scientist at Cambridge University in England, Alan Howard, initiated the research that eventually lead to the development of the Cambridge diet in the 1960s. Howard became interested in obesity as an increasingly common nutritional problem. He worked together with Ian McLean-Baird, a physician at the West Middlesex Hospital, to create a formula diet food that would allow people to lose weight rapidly without losing lean muscle tissue, create a mild ketosis (a condition in which the body begins to use fat rather than carbohydrates as a source of energy), and contain enough vitamins, minerals, and micronutrients to maintain health. Howard and Mc-Lean Baird also organized the first national symposium on obesity in the United Kingdom, which was held in 1968.The formula that satisfied the researchers” goals was successful in helping people in hospital obesity clinics lose weight, but was not particularly appetizing. The researchers collaborated with food technologists to improve the flavor of the formula. After further testing with clinic patients, the Cambridge diet was marketed commercially in the United Kingdom in 1984, four years after it was available in the United States. In 1985 the Cambridge diet became available in Germany, France, and the Scandinavian countries, and in 1990 in Poland and Eastern Europe. The British company, Cambridge Manufacturing Company Limited (CMC), which manufactures the diet products as well as the Cambridge Health and Weight Plan, were owned by the Howard Foundation between 1982 and 2005, a charitable trust established by Alan Howard to offer scholarships to international students and to fund research in obesity and nutrition. In 2005 the Cambridge Manufacturing Company was sold to its three senior managers and became Cambridge Nutritional Foods Limited.
The present Cambridge diet products available in the United Kingdom are sachets (packets) of powder, Mix-a-Mousse granules, liquid meals, and meal bars. The sachets are intended to be mixed with a half-pint of water (hot or cold) to produce a shake or soup. The sachets, which provide about 138 calories, are sold in boxes of 21 servings, a week’s supply. There are 12 different flavors including banana, mixed fruit, and chicken mushroom. The dieter may also purchase Mix-a-Mousse granules that add 20 calories to the powdered formula but give it a thicker texture. The liquid formula is available in a ready-to-drink version packaged as Tetra Briks—sealed cartons with straws. Tetra Briks come in banana or chocolate flavor. There are four flavors of chocolate-covered meal bars (caramel, chocolate, orange, and toffee), one of which can be consumed each day.
Each sachet or liquid formula contains enough nutrients to be used as a complete meal. The meal bars can replace a meal as well but have extra carbohydrates and should only be eaten once a day. The Cambridge diet products can be consumed exclusively
as meal replacements or used in conjunction with regular food (e.g., sachet for breakfast, Tetra Brik for lunch, and normal dinner).
United States
Rights to the original Cambridge diet formula—a powder to be mixed in a blender with water or diet soft drinks—in the United States were obtained by Cambridge Direct Sales in 1979. After working to improve the formula’s flavor, the diet was placed on the market in 1980. It was initially quite popular. The original version of the Cambridge diet is sometimes known as the “Original 330 Formula” in the company’s promotional literature because Dr. Howard’s first rapid weight-loss program called for a total daily consumption of only 330 calories, provided by three servings of the original powder formula (110 calories per serving). The nutrient ratio of the original formula is 10–11 g of protein per serving, 15 g of carbohydrates (derived primarily from fructose or fruit sugar), and 1 g of fat.In 1984 Cambridge Direct Sales hired Dr. Robert Nesheim to develop Cambridge Food for Life products. Like the Original 330 Formula, Food for Life is a powder that comes in a can to be reconstituted with conventional foods. Food for Life is available in a super oats cereal version as well as flavor choices including tomato, potato, mushroom, chicken soup, vanilla, chocolate, strawberry, and eggnog. Nesheim was specifically asked to meet guidelines for nutrition supplements established by the U.S. Food and Drug Administration (FDA). The company states that Nesheim “increased the protein and carbohydrate content for an extra margin of safety when used as the sole source of nutrition.” Food for Life contains 140 calories per serving, 13-15 g of protein, 18 g of carbohydrates, and 1 g of fat.
The American company introduced a Cambridge nutrition bar in 1983, but was unsuccessful as the product had a short shelf life, and lacked flavor appeal. Dr. Nesheim tripled the shelf life of the nutrition bars and improved their taste. Each bar contains 170 calories, with 10 g of protein, 19-22 g of carbohydrates, and a low fat content.
Description
British version
The British version of the Cambridge diet cannot be used without the supervision of an official counselor, who “provide[s] a personal screening, advisory, monitoring and support service.” The counselors are trained and accredited by the company, and must follow a code of conduct in their dealings with customers. According to the company, most counselors are people who have successfully used the Cambridge diet themselves.The British version of the Cambridge diet is for adults over the age of 16 and has four stages:
- Preparation: The dieter is asked to reduce food intake gradually over a week to 10 days before beginning the diet.
- Stabilization: After four weeks on the Sole Source program, the dieter can add a meal of 3 oz lean white fish or poultry, cottage cheese, and a portion of green or white vegetables to the basic Cambridge meals for a total of 790 calories per day. The dieter can then return to the Sole Source regimen for further rapid weight loss. There are other options allowing the dieter 1,000-1,200 calories per day that are better suited for gradual weight loss.
- Weight maintenance: Begins at an intake of 1,500 calories per day.
American version
The American version of the Cambridge diet is divided into five separate programs:- Regular: Designed for a weight loss of 2-5 lb per week, the Regular Program provides 820 calories per day: three servings of Cambridge Food for Life formula plus one 400 calorie conventional meal. The dieter is advised to drink a minimum of 8-10 8-oz glasses of water each day. Tea and coffee are allowed, but not as substitutes for the water. There is no stipulation that the Regular program is limited to four weeks.
- Fast Start: Similar to the British Sole Source program, the Fast Start program is to be followed no longer than two weeks at a time. The dieter is advised to return to the Regular Program and contact a physician if they experience headaches, nausea, or vomiting.
- Physician-Monitored: Recommended for persons who need to lose 30 lb or more, or who are under a doctor”s care for other medical conditions. It is essentially the British Sole Source program with the added provision that the dieter should switch to the Regular Program when he or she is 10-15 lb from their goal weight.
- Maintenance: Uses the Food for Life nutrition formula as a foundation, while adding conventional foods until a caloric intake is determined to maintain an ideal weight.
- Lifetime Nutrition: The Food for Life company recommends using the Cambridge diet products as meal substitutes for one or two meals a day, or as snacks indefinitely. This maintenance program is not endorsed by any government agency.
Function
The Cambridge diet claims to be a flexible plan that can be used as a VLCD for rapid initial weight loss and then modified to serve as a maintenance diet.Benefits
The Cambridge diet offers a rapid initial weight loss that compensates (for some dieters) the low calorie intake and other food restrictions. The American version also offers a peer support network and a self-instruction program based on cognitive behavioral therapy (CBT) called Control for Life.Precautions
People under a physician’s care for high blood pressure, kidney or liver disease, diabetes, or who need to lose more than 30 lb should consult their physician before starting the Cambridge diet or any VLCD The Cambridge diet should not be used by adolescents under the age of 16, and should be used by elderly persons, pregnant women, or nursing women only with caution.Risks
VLCDs in general should not be attempted without consulting a physician, and the Cambridge diet is no exception. The diet is not suitable for people whose work or athletic training requires high levels of physical activity. One physical risk from this diet, as from other VLCDs, is an increased likelihood of developing cholelithiasis, or gallstones.There is also some financial risk to using the Cambridge diet. Although the American website states that the Physician-Monitored version is less expensive than VLCD hospital programs, all forms of the Cambridge diet cost $95–100 for a 15-day supply of the Original 330 Formula or $85–89 for a 15-day supply of the Food for Life formula. A case of six cans of the Original 330 Formula, supplying a total of 126 servings, is about $160. Although the cost per meal is between $1.25 and $1.45, the fact that the dieter must purchase at least a two-week quantity at a time is a risk for people who may not like the products well enough to remain on the diet.
A common criticism of the Cambridge diet, as of all VLCDs, is that it does not teach the dieter how to make wise food choices or the other lifestyle changes necessary to maintain weight loss. The British website states rather defensively, “To these armchair critics [the Cambridge diet] is just another fad diet. Nothing could be further from the truth as anyone can vouch.
who has used the diet as a sole source of nutrition for several weeks. For the first time one realises that vast quantities of food are not indispensable to life. It trains you to live without having food continually on your mind and the experience has a beneficial effect on most people.”
Research and general acceptance
Proponents of the Cambridge diet claim that it is scientific and has been subjected to clinical research, however, there are no recent studies in mainstream medical journals specific to this diet. The British Cambridge diet website cites research papers from the late 1990s on VLCDs as a group, most of them concerning studies conducted in England, Sweden, and Finland. In addition, neither the two British researchers who originally developed the diet nor the American scientist who reformulated the British products for the American market in 1984 began their careers as weight reduction experts. John Marks was trained as a psychiatrist and published a number of books in psychological medicine, dependence as a clinical phenomenon, and the misuse of benzodiazepine tran-quilizers as well as editing an encyclopedia of psychiatry. He wrote a book on the use of vitamins in medical practice in 1985, one year before the book he co-authored with Alan Howard on the Cambridge diet.Robert Nesheim, the American physician credited with reformulating the original Cambridge diet products for the American market, began as a researcher in agricultural medicine. Dr. Nesheim acted as chief of research and development at the Quaker Oats Company until he retired in 1983. He believed in promoting products on the basis of taste, convenience, and cost.
Opinion is somewhat divided among medical and health care professionals on the subject of VLCDs as a group of weight reduction regimens, with European researchers tending to be more favorable to these plans than physicians in North America. The first report of the National Task Force on the Prevention and Treatment of Obesity on these diets noted that “:Current VLCDs are generally safe when used under proper medical supervision in moderately and severely obese patients (body mass index 30) and are usually effective in promoting significant short-term weight loss. . . . [but] long-term maintenance of weight loss with VLCDs is not very satisfactory and is no better than with other forms of obesity treatment.”
In general, researchers in the United States and Canada maintain that VLCDs are not superior in any way to conventional low-calorie diets (LCDs). One Canadian study reported in 2005 that a history of weight cycling tended to lower the health benefits that obese patients could receive from VLCDs, while a 2006 study carried out at the University of Pennsylvania in Philadelphia found that the use of liquid meal replacement diets (LMRs) with a daily calorie level of 1000–1500 calories “provide[d] an effective and less expensive alternative to VLCDs.”The American Academy of Family Practice (AAFP), a professional association of primary care physicians, discourages the use of VLCDs in general, and categorizes the Cambridge diet in particular as a liquid “fad diet.” The only study that reported that VLCDs are “one of the better treatment modalities related to long-term weight-maintenance success” was completed in the Netherlands in 2001. The Dutch researchers added, however, that an active follow-up program, including behavior modification therapy or cognitive behavioral therapy and exercise, is essential to the long-term success that they reported.
BOOKS
Howard, Alan, ed. Nutritional Problems in Modern Society London: J. Libbey, 1981.Marks, John. The Vitamins: Their Role in Medical Practice. Lancaster, UK, and Boston: MTP Press, 1985.
Marks, John, and Alan Howard. The Cambridge Diet: A Manual for Practitioners. Lancaster, UK, and Boston:MTP Press, 1986.
PERIODICALS
Gilden Tsai, A., and T. A. Wadden. “The Evolution of Very-Low-Calorie Diets: An Update and Meta-Analysis.” Obesity (Silver Spring) 14 (August 2006): 1283–1293.Hart, K. E., and E. M. Warriner. “Weight Loss and Bio-medical Health Improvement on a Very Low Calorie Diet: The Moderating Role of History of Weight Cycling.” Behavioral Medicine 30 (Winter 2005): 161–170.
National Task Force on the Prevention and Treatment of Obesity, National Institutes of Health. “Very Low-Calorie Diets.” Journal of the American Medical Association 270 (August 25, 1993): 967–974.
Nesheim, Robert O. “Current Methods of Assessing Food Intake.” Progress in Clinical and Biological Research 67 (1981): 49–57.
Nesheim, Robert O. “Measurement of Food Consumption— Past, Present, Future.” American Journal of Clinical Nutrition 35 (May 1982): 1292–1296.
“Not by Cereal Alone.” Time, August 17, 1979. Available online at http://www.time.com/time/magazine/article/0,9171,909591,00.html (accessed March 2, 2007).
Saris, W. H“Very-Low-Calorie Diets and Sustained Weight Loss.” Obesity Research 9 (Suppl. 4): 295S–301S.
OTHER
American Academy of Family Physicians (AAFP). Fad Diets: What You Need to Know. Leawood, KS: AAFP, 2005. Available online at http://familydoctor.org/ (accessed March 2, 2007).National Digestive Diseases Clearinghouse. Gallstones. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 2006. Available online at http://www.pueblo.gsa.gov/cic_text/health/gallstones/gallstns.htm.
Partnership for Healthy Weight Management (PHWM). Weight Loss: Finding a Weight Loss Program That Works for You Washington, DC: PHWM, 2006. Available online in PDF format at http://www.ftc.gov/bcp/conline/pubs/health/wgtloss.pdf.
ORGANIZATIONS
American Academy of Family Physicians (AAFP). P.O. Box 11210, Shawnee Mission, KS 66207-1210. Telephone: (800) 274-2237 or (913) 906-6000. Website: http://www.aafp.org1.Cambridge Direct Sales, 2801 Salinas Highway, Suite F, Monterey, CA 93940-6240. Telephone: (800) 4-HEALTH. Website: http://www.cambridgedietusa.com.
Cambridge Health and Weight Plan, Clare House, Hunter”s Road, Corby, Northants, NN17 5JE. Telephone: (44) 1536-403344. Website: http://www.cambridge-diet.co.uk.
Partnership for Healthy Weight Management (PHWM), c/o Federal Trade Commission (FTC), Bureau of Consumer Protection. 601 Pennsylvania Avenue, NW, Room 4302, Washington, DC. 20580. Website:http://www.consumer.gov/weightloss/.
U.S. Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857. Telephone: (888) INFO-FDA [(888) 463-6332]. Website: http://www.fda.gov.
Rebecca J. Frey, PhD
Dietary Guidelines
Definition
Description
Early Dietary Advice in the United States
The first half of the twentieth century was a period of enormous growth in nutrition knowledge. The primary goal of nutrition advice at this time was to help people select foods to meet their energy (calorie) needs and prevent nutritional deficiencies. During the Great Depression of the 1930s, food was rationed and people had little money to buy food. They needed to know how to select an adequate diet with few resources, and the USDA produced a set of meal plans that were affordable for families of various incomes. To this day, a food guide for low-income families—the Thrifty Food Plan—is issued regularly by the USDA and used to determine food stamp allotments. In addition to meal plans, the USDA developed food guides—tools to help people select healthful diets. Over the years the food guides changed, based on the current information available.Food Guides versus Dietary Guidelines
Food guides are practical tools that people can use to select a healthful diet. Food guide recommendations, such as how many servings of grains to eat, are based on dietary guidelines that are overall recommendations for healthful diets. For example, the Dietary Guidelines for Americans include the recommendation that Americans “choose a variety of grains daily, especially whole grains.” To help people reach this goal, the USDA”s Food Guide Pyramid is built on a base of grain foods and recommends six to eleven servings daily with several servings from whole grains. Thus, the Food Guide Pyramid supports the recommendations of the Dietary Guidelines.Evolution of the Dietary Guidelines
During the 1970s, scientists began identifying links between people’s usual eating habits and their risk for chronic diseases such as heart disease and cancer. They realized that a healthful diet was important not only to prevent nutrient deficiencies, but because it might play a role in decreasing the risk for chronic diseases. Since heart disease and cancer were, and still are, major causes of death and disability in the United States, there was a need to help Americans select health-promoting diets.The first major step in federal dietary guidance was the 1977 publication of Dietary Goals for the United States by the Senate Select Committee on Nutrition and Human Needs, which recommended an increased intake of carbohydrates and a reduced intake of fat, saturated fat, cholesterol, salt, and sugar. There was heated debate among nutrition scientists when the Dietary Goals were published. Some nutritionists believed that not enough was known about effects of diet and health to make suggestions as specific as those given.
In 1980, the first edition of Dietary Guidelines for Americans was released by the USDA and HHS. The seven guidelines were: (1) Eat a variety of foods; (2) Maintain ideal weight; (3) Avoid too much fat, saturated fat, and cholesterol; (4) Eat foods with adequate starch and fiber; (5) Avoid too much sugar; (6) Avoid too much sodium; and (7) If you drink alcohol, do so in moderation. The second edition, released in 1985, made a few changes, but kept most of the guidelines intact. Two exceptions were the weight guideline, which was changed to “Maintain desirable weight” and the last guideline, in which “alcohol” was changed to “alcoholic beverages.”
Following publication of the second edition of the Dietary Guidelines, two influential reports concerning diet and health were issued. The Surgeon General’s Report on Nutrition and Health was published in 1988, and the National Research Council’s report Diet and Health—Implications for Reducing Chronic Disease Risk was published in 1989. These two reports supported the goal of the Dietary Guidelines to promote eating habits that can help people stay healthy. In 1990, the third edition of the guidelines took a more positive tone than previous editions, using phrases such as “Choose a diet...” or “Use ... only in moderation,” rather than “Avoid too much...” This was seen as a positive step by many nutrition educators.
The fourth edition was the first to include the Food Guide Pyramid, which had been introduced in 1992. It also was the first edition to address vegetarian diets and the recently introduced “Nutrition Facts” panel for food labels. The fifth edition, issued in 2000, expanded the number of guidelines to ten and organized them into three messages: “Aim for Fitness, Build a Healthy Base, and Choose Sensibly” (ABC).
The 2000 Dietary Guidelines for Americans
Aim for Fitness.- Aim for a healthy weight
- Be physically active each day Build a Healthy Base
- Let the Pyramid guide your food choices
- Choose a variety of grains daily, especially whole grains
- Choose a variety of fruits and vegetables daily
- Keep food safe to eat
- Choose a diet that is low in fat and cholesterol and moderate in fat
- Choose beverages and foods to moderate your intake of sugar
- Choose and prepare foods with less salt
- If you drink alcoholic beverages, do so in moderation
BOOKS
National Research Council (1989). Diet and Health: Implications for Reducing Chronic Disease Risk Washington, DC: National Academy Press.U.S. Department of Agriculture, and U.S. Department of Health and Human Services (1980). Nutrition and Your Health: Dietary Guidelines for Americans. (Home and Garden Bulletin 232.) Washington, DC: U.S. Government Printing Office.
U.S. Department of Agriculture, and U.S. Department of Health and Human Services (2000). Nutrition and Your Health: Dietary Guidelines for Americans, 5th ed. Washington, DC: Government Printing Office.
U.S. Department of Health and Human Services, Public Health Service (1988). The Surgeon General’s Report on Nutrition and Health. (DHHS “PHS’ Publication No. 88-50210.) Washington, DC: U.S. Government Printing Office.
PERIODICALS
Cronin, Frances J., and Shaw, Anne M. (1988). “Summary of Dietary Recommendations for Healthy Americans.” Nutrition Today 23:26-34.Linda Benjamin Bobroff
Cancer-Fighting Foods
Definition
It appears more than ever, that there is a great deal of truth to the philosophy of eating fruits and vegetables to maintain optimum health. It is not only because of the nutrients they contain in the form of vitamins and minerals, also because of the chemicals found in these foods. Scientists continue to extensively study the nutrient quality and quantity of foods we consume. Although scientists are still not certain about the specifics, they’re beginning to close in on the healthful constituents of plant-based foods. In particular, they’re looking closely at two components: phytochemicals and antioxidants The goal is to determine precisely how and why these substances in fruits and vegetables can prevent or stop the development of tumors and cancer When animals are given vegetables and fruits before being exposed to carcinogen (cancer-causing agents), they are less likely to develop cancer. Although additional experimental data needs to be collected in humans, there is evidence to suggest that consuming generous amounts of fruits and vegetables plays an important role in preventing cancer.Purpose
Phytochemicals, are plant chemicals that are naturally occurring substances in plants. Several hundred types of phytochemicals have been identified, but many more likely remain to be identified. Some examples include indoles in cabbage or cauliflower, saponins in.(Illustration by GGS Information Services/Thomson Gale.)
peas and beans, genstain in soybeans and isoflavones in soy milk and tofu. Over the past 20 years, nutrition scientists have consistently found that individuals that eat greater amounts of vegetables and fruits have lower rates of cancer. It has been only recently that the mechanism(s) by which phytochemicals assist the body in resisting cancer have begun to be understood. The phytochemicals present in fruits and vegetables protect the body by stunting the growth of malignant cells. Investigators have only an inkling of how many phytochemicals exist and how they work. They are confident, however, that an individual can get a basketful of anti-cancer nutrients by mixing and matching at least five servings a day of fruits and vegetables with seven or more starchy or protein-rich plant foods such as grains, peas and beans, and potatoes.
Supplements containing vitamins and minerals can help an individual gain some of the benefits of these substances. However, vitamin and mineral supplements are not a total replacement for real food.
This is because vitamin and mineral supplements, though very beneficial, do not supply the thousands of phytochemicals that might be present in fruits and vegetables, according to the Cleveland Clinic Foundation in Ohio. For example, eating a sweet potato with its skin, which is a great source of both beta carotene and fiber, provide at least 5,000 phytochemicals that are not present in a beta carotene supplement. That’s an extremely important difference. Isolating a few compounds in a pill will not provide you with the hundred of protective benefits that plant food provide. The best advice is to obtain phytochemicals by eating a good variety of plant foods every day. Whether fruits and vegetables are consumed in raw or cooked form does not really matter with regard to phytochemical content. Even canned, frozen and juiced fruits and vegetables pack a phytochemical punch. However, raw or steamed vegetables would provide the best nutrient value.
The antioxidants found in fruits, vegetables, and other plant-based foods fight free radicals, which are compounds in the body that attack and destroy cell membranes. The uncontrolled activity of free radicals is believed to cause many cancers. Examples of antioxidants include carotenoids, such as beta carotene, lycopene, and vitamins C and E.
The carotenoids, in particular, which give fruits and vegetables their bright yellow, orange, and red colors, are now gaining recognition for their nutritional worth. Numerous studies have extolled the virtues of lycopene (the carotenoid that makes tomatoes red) in preventing prostate cancer. One such study at Harvard University found that men who include tomato products in their meals twice a week could reduce their risk of developing prostate cancer by one-third compared with men who do not consume tomatoes.
Other lycopene-rich foods, such as watermelon, red grapefruit, and guava, are now piquing the interest of researchers. Watermelon not only yields more lycopene per serving (15 mg in 11/2 cups) than raw tomatoes (11 mg per 11/2 cups), but it’s also a rich source of vitamins A and C.
Whether antioxidants can reduce the incidence of cancer is still uncertain at this point because of the lack of sufficient studies. However, research data obtained thus far indicates that antioxidants do appear to provide health benefits.
The National Cancer Institute estimates that roughly one-third of all cancer deaths may be diet related. Scientists have recently estimated that approximately 30 to 40% of all cancers could be averted if people ate more fruits, vegetables, and plant-based foods and minimized high-fat, high-calorie edibles.
that have scant nutritional value. What you eat can hurt you, but it can also help you. In the past, researchers had linked fat consumption with the development of cancers, but they currently believe that eating fruits, vegetables, and grains may be more important in preventing the disease than not eating fat. Many of the common foods found in grocery stores or organic markets contain cancer-fighting properties, from the antioxidants that neutralize the damage caused by free radicals to the powerful phytochemicals that scientists are just beginning to explore. There isn’t a single element in a particular food that does all the work. The best thing to do is eat a variety of foods.
Description
There are a number of foods that have been demonstrated to have the ability to help stave off cancer and some can even help inhibit cancer cell growth or reduce tumor size. The following is a list of foods that because of the nutrients they contain, have been determined to be the best cancer fighters:Avocados: They are rich in glutathione, a powerful antioxidant that attacks free radicals in the body by blocking intestinal absorption of certain fats They also supply even more potassium than bananas and are a strong source of vitamin E Scientists also believe that avocados may also be useful in treating viral hepatitis (a cause of liver cancer), as well as other sources of liver damage.
Beans: Beans contain a number of phytochemicals, which have been shown to prevent or slow genetic damage to cells. While this makes beans beneficial for helping to reduce your risk of many types of cancer, specific research has suggested they are especially potent in preventing prostate cancer. As an added bonus, the high fiber content of beans has been connected with a lower risk of digestive cancers.
Cabbage, and cauliflower: All cruciferous vegetables including cabbage and cauliflower, are rich in a variety of compounds that have been shown to slow cancer growth and development in a number of laboratory studies. These vegetables contain a chemical component called indole-3-carbinol that can combat breast cancer by converting a cancer-promoting estrogen into a more protective variety. Other larger human studies have shown that cruciferous vegetables can help to reduce the risk of lung, prostate, and bladder cancers.
Broccoli: Broccoli, which is also a cruciferous vegetable, contains the phytochemical sulforaphane, a product of glucoraphanin, that is believed to aid in preventing some types of cancer, like stomach, colon and rectal cancer. Sulforaphane induces the production of certain enzymes that can deactivate free radicals and carcinogens. The enzymes have been shown to inhibit the growth of tumors in laboratory animals. However, be aware that the Agriculture Department studied 71 types of broccoli plants and found a 30-fold difference in the amounts of glucoraphanin. It appears that the more bitter the broccoli is, the more glucoraphanin it has. Broccoli sprouts have been developed under the trade name BroccoSprouts that have a consistent level of sulforaphane that is as much as 20 times higher than the levels found in mature heads of broccoli.
Carrots: They contain a plentiful amount of beta carotene, which may help reduce a wide range of cancers including lung, mouth, throat, stomach, intestine, bladder, prostate and breast. Some research indicated beta carotene may actually cause cancer, but this has not proven that eating carrots, unless in very large quantities i.e. 2 to 3 kilos a day, can cause cancer. In fact, a substance called falcarinol that is found in carrots has been found to reduce the risk of cancer, according to researchers at Danish Institute of Agricultural Sciences (DIAS). It has been demonstrated that isolated cancer cells grow more slowly when exposed to falcarinol. This substance is a polyacethylen.
Chili peppers and jalapenos: They contain a chemical, capsaicin, which may neutralize certain cancercausing substances called nitrosamines and may help prevent cancers such as stomach cancer.
Cruciferous vegetables - broccoli, cauliflower, kale, Brussels sprouts, and cabbage contain two antioxidants, lutein and zeaxanthin that may help decrease prostate and other cancers.
Dark Green Leafy Vegetables: Leafy-green vegetables-like romaine lettuce, mustard greens, chicory, and Swiss chard-are rich sources of antioxidants called carotenoids. These compounds scavenge dangerous free radicals from the body before they can promote cancer growth. The vegetables are also rich in folate, a vitamin shown to reduce the risk of lung and breast cancer.
Figs: Apparently figs contain a derivative of ben-zaldehyde. It has been reported by investigators at the Institute of Physical and Chemical Research in Tokyo that benzaldehyde is highly effective at shrinking tumors, though further experiments need to be conducted. In addition, the U.S. Department of Agriculture says figs, which contain vitamins A and C, and calcium, magnesium and potassium, may curtail appetite and improve weight-loss efforts. Fig juice is also a potent bacteria killer in test-tube studies.
Flax: Flax contains lignans, which may have an antioxidant effect and block or suppress cancerous changes. Flax is also high in omega-3 fatty acids, which are thought to protect against colon cancer and heart disease. Flaxseed in the form of oil and meal contains phytoestrogens believed to reduce the risk of breast, skin, and lung cancer. Research on the potency of flaxseed as an anti-cancer food is still ongoing. A specialized diet called the Budwig diet, which has been used by some cancer patients, uses the combination of flax seed oil and cottage cheese. When these two foods are consumed simultaneously, it is said that they increase the levels of substances called phosphatides and lipoproteins in the blood. Dr. Johanna Budwig, the creator of the diet claims that the diet is both preventative and curative in regard to cancer.
Garlic: This herb has immune-enhancing allium compounds (dialyl sultides) that appear to increase the activity of immune cells that fight cancer and indirectly help break down cancer causing substances.
These substances also help block carcinogens from entering cells and slow tumor development. Diallyl sulfide, a component of garlic oil, has also been shown to render carcinogens in the liver inactive. Studies have linked garlic as well as onions, leeks, and chives to lower risk of a variety of cancers including stomach, colon, lung and skin cancer. Dr. Lenore Arab, professor of epidemiology and nutrition at the UNC-CH (University of North Carolina at Chapel Hill) schools of public health and medicine and colleagues analyzed a number of studies and reported their findings in the October 2000 issue of the American Journal of Clinical Nutrition. According to the report, individuals who consume raw or cooked garlic regularly face about half the risk of stomach cancer and two-thirds the risk of colorectal cancer as individuals who eat little or none. Their studies did not show garlic supplements had the same effect. It is believed garlic may help prevent stomach cancer because it has anti-bacterial effects against a bacterium, Helicobacter pylori, found in the stomach and known to promote cancer there.
Grapefruits: Like oranges and other citrus fruits, grapefruits contain monoterpenes, that are believed to help prevent cancer by sweeping carcinogens out of the body. Some studies show that grapefruit may inhibit the proliferation of breast-cancer cells in vitro. Grapefruits also contain vitamin C, beta-carotene, and folic acid.
Grapes: Particularly red and purple grapes, are a rich source of resveratrol, a potent antioxidant and anti-inflammatory agent, which inhibits the enzymes that can stimulate cancer-cell growth and suppress immune response. Resveratrol is thought to work by preventing cell damage before it begins. Grapes also contain ellagic acid, a compound that blocks enzymes that are necessary for cancer cells. Ellagic acid also appears to help slow the growth of tumors. Red grapes also contain bioflavonoids, which are powerful anti-oxidants that work as cancer preventives.
Kale: This cruciferous vegetable contains indoles, which are a nitrogen compound that may help stop the conversion of certain lesions to cancerous cells in estrogen-sensitive tissues. In addition, isothiocya-nates, phytochemicals found in kale, are thought to suppress tumor growth and block cancer-causing substances from reaching their targets.
Licorice root: It has a chemical, glycyrrhizin, that blocks a component of testosterone and therefore may help prevent the growth of prostate cancer. However, excessive amounts can lead to elevated blood pressure.
Mushrooms: There are a number of mushrooms that appear to help the body fight cancer and build the immune system. They include Shiitake, maitake, reishi, Agaricus blazei Murill, and Coriolus Versicolor. The active ingredient in medicinal mushrooms are polysac-charides called beta-glucans. These beta-glucans are powerful compounds that help in building immunity. Examples of beta-glucans include Lentinan and a unique beta-glucan called D-fraction, that is found in the Maitake mushroom. This D-fraction is believed to be responsible for the many health benefits of Maitake. These mushrooms also have a protein called lectin, which attacks cancerous cells and prevents them from multiplying. They also contain Thioproline. These mushrooms can stimulate the production of interferon in the body. Extracts from mushrooms have been successfully tested in recent years in Japan as an adjunct to chemotherapy.
Nuts: Many nuts contain the antioxidants quercetin and campferol that may suppress the growth of cancers. Brazil nuts contain 80 micrograms of selenium, which is important for those with prostate cancer.
Oranges and lemons: They both contain Iimonene which stimulates cancer-killing immune cells like lymphocytes that may also function in breaking down cancer-causing substances.
Papayas: They have vitamin C that works as an antioxidant and may also reduce absorption of cancer-causing nitrosamines from the soil or processed foods. Papaya contains folacin (also known as folic acid), which has been shown to minimize cervical dysplasia and certain cancers.
Red wine: Even without alcohol, red wine has polyphenols that may protect against various types of cancer. Polyphenols are potent antioxidants, compounds that help neutralize disease-causing free radicals. Also, researchers at the University of North Carolina’s medical school in Chapel Hill found the compound resveratrol, which is found in grape skins. It appears that resveratrol inhibits cell proliferation and can help prevent cancer. However, the findings didn’t extend to heavy imbibers, so it should be used in moderation. In addition, alcohol can be toxic to the liver and to the nervous system, and many wines have sulfites, which may be harmful to your health. Since some research indicates that alcohol is considered a class “A” carcinogen that can actually cause cancer, it is probably best to consume non-alcoholic wines.
Rosemary: This herb may help increase the activity of detoxification enzymes. An extract of rosemary, termed carnosol, has inhibited the development of both breast and skin tumors in animals. We haven’t found any studies done on humans. Rosemary can be used as a seasoning and it can also be consumed as a tea.
Seaweed and other sea vegetables: They contain beta-carotene, protein, vitamin B12, fiber, and chlorophyll, as well as chlorophylones, which are important fatty acids that may help in the fight against breast cancer. Many sea vegetables also have high concentrations of the minerals potassium, calcium, magnesium, iron, and iodine.
Soy products like tofu: These contain several types of phytoestrogens which are weak, nonsteroidal estrogens that resemble some of the body’s natural hormones. These compounds could help prevent both breast and prostate cancer by blocking and suppressing cancerous changes. There are a number of isoflavones in soy products, but research has shown that genistein is the most potent inhibitor of the growth and spread of cancerous cells. It appears to lower breast-cancer risk by inhibiting the growth of epithelial cells and new blood vessels that tumors require to flourish and is being scrutinized as a potential anti-cancer drug. However, there are some precautions to consider when adding soy to the diet. Eating up to 4 or 5 ounces of tofu or other soy a day is probably fine, but research is being done to see if loading up on soy could cause hormone imbalances that stimulate cancer growth. As a precaution, women who have breast cancer or are at high risk should talk to their doctors before taking pure isoflavone powder and pills, extracted from soy.
Sweet potatoes: They contain many anticancer properties, including beta-carotene, which may protect DNA in the cell nucleus from cancer-causing chemicals outside the nuclear membrane.
Teas: Green tea and Black tea contain certain antioxidants known as polyphenols (catechins) which appear to prevent cancer cells from dividing. Green tea is best, followed by our more common black tea (herbal teas do not show this benefit). According to a report in the July 2001 issue of the Journal of Cellular Biochemistry, these polyphenols that are abundant in green tea, red wine and olive oil, may protect against various types of cancer. Dry green tea leaves, which are about 40% polyphenols by weight, may also reduce the risk of cancer of the stomach, lung, colon, rectum, liver and pancreas, study findings have suggested.
Tomatoes: Tomatoes contain lycopene, an antiox-idant that attacks roaming oxygen molecules, known as free radicals, which are suspected of triggering cancer. Lycopene appears to be more easily absorbed if the tomatoes are eaten in processed form—eitherastomato sauce, paste, or juice. It appears that the hotter the weather, the more lycopene tomatoes produce. Lycopene, has been shown to be especially potent in combating prostate cancer and may also protect against breast,lung, stomach, and pancreatic cancer. Scientists in Israel have shown that lycopene can kill mouth cancer cells. An increased intake of lycopene has already been linked to a reduced risk of breast, prostate, pancreas and colorectal cancer. Recent studies indicate that for proper absorption, the body also needs some oil along with lycopene. Tomatoes also have vitamin C, an anti-oxidant that can prevent cellular damage that leads to cancer. Watermelons, carrots, and red peppers also contain these substances, but in lesser quantities. It is concentrated by cooking tomatoes.
Tumeric: A member of the ginger family, that is claimed to have medicinal properties. Tumeric appears to inhibit the production of the inflammation-related enzyme cyclo-oxygenase 2 (COX-2), which reaches abnormally high levels in certain inflammatory diseases and cancers, especially bowel and colon cancer. A pharmaceutical company Phytopharm in the UK hopes to introduce a natural product, P54, that contains certain volatile oils, which greatly increase the potency of the turmeric spice.
Whole Grains: Whole grains contain a variety of anti-cancer compounds, including fiber, antioxidants, and phytoestrogens. When eaten as part of a balanced diet, whole grains can help decrease the risk of developing most types of cancer.
A considerable amount of information and knowledge has been accumulated regarding the cancer fighting foods. No single food or food substance alone can protect an individual against cancer, but the right combination of plant-based foods in the diet can greatly increase the chances of avoiding cancer. Evidence is mounting that the minerals, vitamins, antioxidants and phytochemicals in many plant foods interact to provide extra cancer protection by working synergisti-cally in the body. For this reason, many nutrition scientists recommend that at least 2/3 of the diet should consist of vegetables, fruit, whole grains and beans.
Precautions
In some cases, high intakes of individual vitamins can be harmful. An example of this is the risk of high levels of beta-carotene increasing the risk of lung cancer in smokers.Parental concerns
Resources
BOOKS
Greenwood-Robinson, Maggie. Foods That Combat Cancer: The Nutritional Way to Wellness New York: Avon Books, HarperCollins, 2003.Varona, Verne. Nature’s Cancer-Fighting Foods. New York: Penguin Putnam Inc., 2001.
OTHER
American Institute for Cancer Research. 1759 R Street NW,Washington, DC 20009. Telephone: 1-800-843-8114 Website: http://www.aicr.org/site/ PageServer?page name=dc_foods_home. American Institute for Cancer Research. 1759 R Street NW,Washington, DC 20009. Telephone: 1-800-843-8114.Website: http://www.aicr.org/site/ PageServer?page name=dc_foods_home.The Cancer Cure Foundation. P.O. Box 3782, Westlake Village, California 91359. Telephone: 1-800-282-2873.Website: http://www.cancure.org/cancer_fighting_foods.htm http://www.cancure.org/acancer_fighting_foods.htm
Thomas Prychitko
African-American diet
Definition
The 2000 U.S. Census revealed that there were almost 35 million African Americans, or about 13%of the total U.S. population. This small percentage of the populace has had a significant influence on American cuisine, not only because African-American food is diverse and flavorful, but also because of its historical beginnings. Despite their cultural, political, economic, and racial struggles, African Americans have retained a strong sense of their culture, which is, in part, reflected in their food.Origins
The After effects of Slavery
The roots of the diversity of African-American cuisine may be traced back to 1619, when the first African slaves were sold in the New World. In a quest to build new cities in America, Europeans actively transported Africans and West Indians (people from the West Indies) to the new land. The West Indies (in the Caribbean Sea) was part of the slave route to
Increase in overweight and obesity prevalence among U.S. adults* by racial/ethnic group
| ||||
Overweight (BMI ? 25) prevalence (%)
|
Obesity(BMI ? 30)prevalence (%)
| |||
Racial/ethnic group
|
1988 to 1994
|
1999 to 2000
|
1988 to 1994
|
1999 to 2000
|
Black (non-Hispanic)
|
62.5
|
69.6
|
30.2
|
39.9
|
Mexican American
|
67.4
|
73.4
|
28.4
|
34.4
|
White (non-Hispanic)
|
52.6
|
62.3
|
21.2
|
28.7
|
SOURCE: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Flegal et. al. JAMA. 2002; 288:1723-7 and IJO. 1998; 22:39-47.
(Illustration by GGS Information Services/Thomson Gale.)
America. Because the West Indians’ skin color was similar to that of Africans, they were not treated any differently. As a result, some West Indian food traditions are similar to those of African Americans.
It is not surprising that African-American food has a distinctive culinary heritage with diverse flavors, as it includes traditions drawn from the African continent, the West Indies, and from North America. While the European nations were busy establishing new societies, they did not realize that the African and West Indian slaves who worked for them brought their own vibrant and and rich culture—a culture that would withstand and adapt to the harsh centuries of slavery.
Food historian Karen Hess writes about the struggle of African Americans to maintain some of their original culture through food. ‘The only thing that Africans brought with them ‘from Africa’ was their memories.’ Slave traders attempted to craft culturally sensitive rations for the Africans by including yams, rice, corn, plantains, coconuts, and scraps of meat in the slaves’ provisions.
Southern slaves established their own cooking culture using foods that were similar to foods that were part of their African and West Indian heritages, and many popular foods in the African-American diet are directly associated with foods in Africa. For instance, the African yam is similar to the American sweet potato. White rice is also popular because it was a major part of the diet in West Africa. African Americans infuse plain rice dishes with their own savory ingredients (popular rice dishes include gumbo and ‘hoppin’ John,’ a dish made with rice, black-eyed peas, and salt pork or bacon).
KEY TERMS
Nutrient—Dietary substance necessary for health.Type II diabetes—inability to regulate level of sugar in the blood due to a reduction in the number of insulin receptors on the body’s cells
The Legacy of African-American Cuisine
Popular southern foods, such as the vegetable okra (brought to New Orleans by African slaves), are often attributed to the importation of goods from Africa, or by way of Africa, the West Indies, and the slave trade. Okra, which is the principal ingredient in the popular Creole stew referred to as gumbo, is believed to have spiritual and healthful properties. Rice and seafood (along with sausage or chicken), and file´ (a sassafras powder inspired by the Choctaw Indians) are also key ingredients in gumbo. Other common foods that are rooted in African-American culture include black-eyed peas, benne seeds (sesame), eggplant, sorghum (a grain that produces sweet syrup and different types of flour), watermelon, and peanuts.Though southern food is typically known as ‘soul food,’ many African Americans contend that soul food consists of African-American recipes that have been passed down from generation to generation, just like other African-American rituals. The legacy of African and West Indian culture is imbued in many of the recipes and food traditions that remain popular today. The staple foods of African Americans, such as rice, have remained largely unchanged since the first Africans and West Indians set foot in the New World, and the southern United States, where the slave population was most dense, has developed a cooking culture that remains true to the African-American tradition. This cooking is aptly named southern cooking, the food, or soul food Over the years, many have interpreted the term soul food based on current social issues facing the African-American population, such as the civil rights movement. Many civil rights advocates believe that using this word perpetuates a negative connection between African Americans and slavery. However, as Doris Witt notes in her book Black Hunger (1999), the ‘soul’ of the food refers loosely to the food’s origins in Africa.
In his 1962 essay ‘Soul Food,’ Amiri Baraka makes a clear distinction between southern cooking and soul food. To Baraka, soul food includes chitterlings (pronounced chitlins), pork chops, fried porgies,potlikker, turnips, watermelon, black-eyed peas, grits, hoppin’ John, hushpuppies, okra, and pancakes. Today, many of these foods are limited among African Americans to holidays and special occasions. Southern food, on the other hand, includes only fried chicken, sweet potato pie, collard greens, and barbecue, according to Baraka. The idea of what soul food is seems to differ greatly among African Americans.
General Dietary Influences
In 1992 it was reported that there is little difference between the type of foods eaten by whites and African Americans. There have, however, been large changes in the overall quality of the diet of African Americans since the 1960s. In 1965, African Americans were more than twice as likely as whites to eat a diet that met the recommended guidelines for fat, fiber, and fruit and vegetable intakes. By 1996, how- ever, 28 %of African Americans were reported to have a poor-quality diet, compared to 16% of whites, and 14% of other racial groups. The diet of African Americans is particularly poor for children two to ten years old, for older adults, and for those from a low socioeconomic background. Of all racial groups, African Americans have the most difficulty in eating diets that are low in fat and high in fruits, vegetables, and whole grains. This represents an immense change in diet quality. Some explanations for this include: (1) the greater market availability of packaged and processed foods; (2) the high cost of fresh fruit, vegetables, and lean cuts of meat; (3) the common practice of frying food; and (4) using fats in cooking.Regional differences. Although there is little overall variability in diets between whites and African Americans, there are many notable regional influences. Many regionally influenced cuisines emerged from the interactions of Native American, European, Caribbean, and African cultures. After emancipation, many slaves left the south and spread the influence of soul food to other parts of the United States. Barbecue is one example of Africaninfluenced cuisine that is still widely popular throughout the United States. The Africans who came to colonial South Carolina from the West Indies brought with them what is today considered signature southern cookery, known as barbacoa, or barbecue. The original barbecue recipe’s main ingredient was roasted pig, which was heavily seasoned in red pepper and vinegar. But because of regional differences in livestock availability, pork barbecue became popular in the eastern United States, while beef barbecue became popular in the west of the country.
Other Ethnic Influences. Cajun and Creole cooking originated from the French and Spanish but were transformed by the influence of African cooks. African chefs brought with them specific skills in using various spices, and introduced okra and native American foodstuffs, such as crawfish, shrimp, oysters, crabs, and pecans, into both Cajun and Creole cuisine. Originally, Cajun meals were bland, and nearly all foods were boiled. Rice was used in Cajun dishes to stretch out meals to feed large families. Today, Cajun cooking tends to be spicier and more robust than Creole. Some popular Cajun dishes include pork-based sausages, jambalayas, gumbos, and coush-coush (a creamed corn dish). The symbol of Cajun cooking is, perhaps, the crawfish, but until the 1960s crawfish were used mainly as bait.
More recently, the immigration of people from the Caribbean and South America has influenced African-American cuisine in the south. New spices, ingredients, combinations, and cooking methods have produced popular dishes such as Jamaican jerk chicken, fried plantains, and bean dishes such as Puerto Rican habichuelas and Brazilian feijoada.
Holidays and Traditions. African-American meals are deeply rooted in traditions, holidays, and celebrations. For American slaves, after long hours working in the fields the evening meal was a time for families to gather, reflect, tell stories, and visit with loved ones and friends. Today, the Sunday meal after church continues to serve as a prime gathering time for friends and family.
Kwanzaa, which means ‘first fruits of the harvest,’ is a holiday observed by more than 18 million people worldwide. Kwanzaa is an African-American celebration that focuses on the traditional African values of family, community responsibility, commerce, and self-improvement. The Kwanzaa Feast, or Karamu, is traditionally held on December 31. This symbolizes the celebration that brings the community together to exchange and to give thanks for their accomplishments during the year. A typical menu includes a black-eyed pea dish, greens, sweet potato pudding, cornbread, fruit cobbler or compote dessert, and many other special family dishes.
Folk beliefs and remedies. Folk beliefs and remedies have also been passed down through generations, and they can still be observed today. The majority of African-American beliefs surrounding food concern the medicinal uses of various foods. For example, yellow root tea is believed to cure illness and lower blood sugar. The bitter yellow root contains the antihistamine berberine and may cause mild low blood pressure. One of the most popular folk beliefs is that excess blood will travel to the head when one eats large amounts of pork, thereby causing hypertension However, it is not the fresh pork that should be blamed for this rise in blood pressure, but the salt-cured pork products that are commonly eaten. Today, folk beliefs and remedies are most often held in high regard and practiced by the elder and more traditional members of the population.
Risks
Effects of Socioeconomic Status: Poverty and Health
Many of the foods commonly eaten by African Americans, such as greens, yellow vegetables, legumes, beans, and rice, are rich in nutrients. Because of cooking methods and the consumption of meats and baked goods, however, the diet is also typically high in fat and low in fiber, calcium, and potassium. In 1989, 9.3 million of the black population (30.1%) had incomes below the poverty level. Individuals who are economically disadvantaged may have no choice but to eat what is available at the lowest cost. In comparison to other races, African Americans experience high rates of obesity, hypertension, type II diabetes, and heart disease, which are all associated with an unhealthful diet.Obesity and hypertension are major causes of heart disease, diabetes, kidney disease, and certain cancers. African Americans experience disproportionately high rates of obesity and hypertension, compared to whites.
High blood pressureand obesity have known links to poor diet and a lack of physical activity. In the United States, the prevalence of high blood pressure in African Americans is among the highest in the world. The alarming rates of increase of obesity and high blood pressure, along with the deaths from diabetes-related complications, heart disease, and kidney failure, have spurred government agencies to take a harder look at these problems. As a result, many U.S. agencies have created national initiatives to improve the diet quality and the overall health of African Americans.
Looking Forward to a Healthier Tomorrow
Resources
BOOKS
Foner, Eric, and Garraty, John A., eds. (1991). The Reader’s Companion to American History Boston: Houghton Mifflin.Genovese, Eugene D. (1974). Roll, Jordan, Rol: The World the Slaves Made New York: Vintage.
Harris, Jessica (1995). A Kwanzaa Keepsake: Celebrating the Holiday with New Traditions and Feasts New York: Simon & Schuster.
Harris, Jessica (1999). Iron Pots and Wooden Spoons: Africa’s Gift to the New World Cooking New York: Simon & Schuster.
Thompson, Becky W. (1994). A Hunger So Wide and So Deep: American Women Speak Out on Eating Problems Minneapolis: University of Minnesota Press.
Wilson, C. R., and Ferris, W. (1989). The Encyclopedia of Southern Culture. Chapel Hill: University of North Carolina Press.
Witt, Doris (1999). Black Hunger New York: Oxford University Press.
Zinn, Howard (1980). ‘Drawing the Color Line.’ In A People’s History of the United States New York: HarperCollins.
PERIODICALS
Basiotis, P. P.; Lino, M; and Anand, R. S. (1999). ‘Report Card on the Diet Quality of African Americans.’ Family Economics and Nutrition Review 11:61–63.de Wet, J. M. J. (2000). ‘Sorghum.’ In The Cambridge World History of Food, Vol. 1, ed. Kenneth F. Fiple and Kriemhil Conee Ornelas. Cambridge, UK: Cambridge University Press.
Dirks, R. T., and Duran, N. (2000). ‘African American Dietary Patterns at the Beginning of the 20th Century.’ Journal of Nutrition 131(7):1881–1889.
Kittler, Pamela Goyan, and Sucher, Kathryn, eds. (1989). ‘Black Americans.’ In Food and Culture in America New York: Van Nostrand and Reinhold.
Popkin, B. M.; Siega-Riz, A. M.; and Haines, P. S. (1996). ‘A Comparison of Dietary Trends among Racial and Socioeconomic Groups in the United States.’ New England Journal of Medicine 335:716–720.
OTHER
Centers for Disease Control and Prevention, National Center for Health Statistics (2002). ‘Monitoring the Nation’s Health.’ Available from <http://www.cdc.gov/nchs/>U.S. Census Bureau (2001). ‘General Demographic Characteristics for the Black or African American Population.’ Available from <http://www.census.gov>
U.S. Census Bureau (2001).‘Profile of General Demographic Characteristics.’ Available from http://factfinder.census.gov>
U.S. Department of Health and Human Services. Healthy People 2010. Available from http://health.gov/healthypeople.gov
M. Cristina F. Garces
Lisa A. Sutherland
Dr. Phil’s Diet
Definition
Dr. Phil’s diet is named for Dr. Phillip C. McGraw, Ph.D., the psychologist and life strategist seen on syndicated television. Popularly known as “Dr. Phil’ he developed a line of “Shape Up!’ weight loss products and simultaneously developed and published a book titled “The Ultimate Weight Loss Solution: The 7 Keys to Weight Loss Freedom.”The Ultimate Weight Loss Solution was promoted as a combination of healthy diet, exercise, behavior modification, and thinking differently about food.
Origins
Dr. Phil was a private practice psychologist in Wichita Falls, Texas, before starting a trial consulting firm. It was in this business that he worked with television star Oprah Winfrey, consulting with her during a 1995 trial brought against Ms. Winfrey by members of the beef industry. Shortly after, Dr. Phil began appearing on Ms. Winfrey’s syndicated television show. By 2002, he was hosting his own syndicated daily television show and had become a well-known author and popular figure.Dr. Phil has said that for 30 years, he counseled people battling weight problems and obesity He has said that he wanted to more widely address the problem of obesity with a behavioral and nutritional approach. In 2003, he introduced the book and a line of nutritional products. The diet products were marketed by CSA Nutraceuticals, along with involvement of companies that have produced similar health and nutrition products. At the same time that the products and book were being marketed, Dr. Phil focused on weight loss themes on his television show. However, he did not refer to the weight loss products on the show. He introduced his diet on a nationally broadcast television special featuring Katie Couric and 13 weight loss challengers.
Dr. Phil’s son Jay McGraw followed in his father’s footsteps and authored a book with a similar plan written specifically for teenagers. This book also was published in 2003.
Description
Dr. Phil’s diet involved a book outlining a diet plan and a line of diet food products and supplement pills. The food products included flavored shakes and snack bars. The shakes and snack bars were fortified.with 24 vitamins and minerals The products’ supplements were geared toward helping people with apple or pear body shapes. The products were only on the market for about one year.
The introduction to Dr. Phil’s book follows his “down-to-earth’ delivery style. He tells readers that he is not going to tell them what they want to hear. He says that seven critical pieces, or keys, help achieve long-term weight loss. The book is filled with personal anecdotes, self-assessment quizzes, and chapters on each key. Dr. Phil writes that those who have kept their weight off use all seven keys. The seven keys are described below.
Right thinking
Dr. Phil refers to a person’s personal truth, or whatever it is about one’s self and the weight problem that a person has come to believe. He says that part of learning to lose weight is learning to get rid of thoughts that don’t work for weight loss and instead gain access to inner power and self-control. Dr. Phil says this helps people break the negative cycle of failed weight loss efforts and negative momentum. In the chapter, Dr. Phil lists 10 self-defeating messages that people often think about weight and weight control. For example, those who have problems with weight may label themselves or be labeled by others.Healing feelings
This key refers to the way that some people eat to medicate themselves. Dr. Phil says that often people eat in response to negative emotions such as loneliness, stress, or boredom. Dr. Phil says that admitting to emotional triggers for overeating and learning to overcome the connection between emotions and food helps gain control over eating. The key helps to identify a process that is broken down into five manageable steps. Dr. Phil talks about forgiving one’s self and about learning to cope without food.A no-fail environment
This key helps people manage the environment so that they can be more successful when trying to lose weight. The book provides advice on how to prevent needless snacking, overeating, and bingeing by removing tempting foods from the home, then from other environments such as work. He talks about shopping strategies, bringing healthy food choices into the environment, and even removing large-size clothes from the closet.Mastery over food
Dr. Phil’s fourth key advises people to control habits by gaining mastery over food and through impulse control. The fourth key focuses on wiping bad, weight-gaining habits from their lives and replacing them with healthier behaviors. He lists weight-gaining behaviors and various pay-offs they offer to people. The chapter concludes with suggested behaviors to replace the weight-gaining behaviors, as well as the payoffs from the healthier behaviors.High-response, high-yield foods
In this key, Dr. Phil discusses the nutritional value of various foods by describing a “high-response cost, high-yield food’ plan. Instead of offering meal plans or calorie-cutting, Dr. Phil’s diet talks about and lists foods that take longer to prepare and eat, and therefore are healthier. He contrasts these foods with those that take little time to prepare and eat, which normally offer higher calories and less nutritional value. He also mentions vitamin and mineral supplements in addition to high-yield foods.Exercise
Dr. Phil calls his sixth key to weight loss intentional exercise. He says that instead of becoming obsessed about exercise, people need to take a balanced approach of regular strength-building and heart-conditioning activities to burn calories. Dr. Phil says that intentional exercise can open the door to body control, a state where the body can better metabolize energy for losing weight and keeping weight off. He breaks exercise into categories of moderate activities and vigorous activities. In addition, the book lists the physical and psychological benefits of exercise.Support
The book concludes with several appendices, such as food lists, a workout diary, and a sample exercise for stress relief and relaxation. Dr. Phil reminds readers that weight is managed, not cured. He explains danger zones that allow people to drift off course in managing their weight, then discusses avoiding these danger zones.Function
Dr. Phil’s weight loss solution is for people who want to lose or manage weight. He presents the diet as an alternative to crash and fad diets As a psychologist, Dr. Phil approaches the diet from behavioral aspects as well as from the nutritional aspects.Benefits
Dr. Phil says that in typical diets, the emotion fades soon after starting the diet. In interviews about his weight loss solution, Dr. Phil said that people have better chances of succeeding on weight loss efforts if they reprogram their lives and follow the seven keys to success. He said that fear keeps people from addressing the emotions involved in overeating. The diet also focuses on being healthy and having realistic expectations for a person’s age.Precautions
Some nutritionists and scientists have questioned the evidence quoted by Dr. Phil for the success rate of his plan and nutritional products. Following any particular diet plan should be done only after consultation with a physician and/or licensed dietician. The advice of involving a nutritionist comes late in Dr. Phil’s book.Risks
Among concerns was the nutritional balance of some of the Shape Up food products. Although Dr. Phil’s diet does not lean toward one food group and advises generally traditional diet advice of balanced diet mixed with exercise, it is best to involve a health care professional or registered dietary professional to ensure that the strategies are healthful and successful.Research and general acceptance
In the book, Dr. Phil cites a bibliography, a consulting nutritionist, and an 80% success rate. But there are no specific scientific studies published or referred to that prove the success of the program or its individual.strategies. After developing the Shape Up products, which consisted of herbal supplements, shakes, and snack bars, a lawsuit was filed stating that Dr. Phil had made false claims about their benefits. Reports showed that although the nutrition shakes were in good ranges for carbohydrates and fat, the nutrition bars were in relatively high carbohydrate and fat ranges. The lawsuit was filed in 2004 on behalf of three disappointed consumers. They said that that Dr. Phil had defrauded fans, making false statements about the supplement pills. CSA Nutraceuticals agreed to stop making the supplements in early 2004 when it faced an investigation from the Federal Trade Commission concerning false-advertising claims. The plaintiffs sought class action status for the lawsuit and reached a $10.5 million settlement in September 2006.
In an article in Food Processing magazine, a diet expert at the University of California at Berkeley was quoted as saying that Dr. Phil’s diet advice was not innovative. Yet she added that the advice was common sense. A review in the Tufts University Health & Nutrition Letter said there were several flaws with the book’s advice and that some of the advice contradicted other points in the book or did not make sense. The review listed some good points, including the fact that a dieter does not have to be strong 24 hours a day, seven days a week.
An American Dietetic Association fact sheet said that some of the book’s advice is good, such as behavior modification strategies that have been used in weight control programs for many years. But the review said that the book also contained nutrition and dietary recommendations that were mistaken or outdated. The review also stated that the advice for dealing with complicated emotional and other eating-related issues is made seemingly simple, but that managing these issues alone is not easy.
BOOKS
McGraw, Phillip C. The Ultimate Weight Solution: The Seven Keys to Weight Loss Freedom The Free Press, 2003.McGraw, Phillip C. The Ultimate Weight Solution Cook Book.The Free Press, 2004.
McGraw, Phillip C. The Ultimate Weight Solution Food GuidePocket Books, 2005.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000. Chicago, IL 60605. (800) 877-1600. <http://www.homefoodsafety.org >Teresa G. Odle
Elimination diets
Definition
Elimination diets are diets in which people stop eating specific foods for a period and then challenge their body by adding the food back into their diet and evaluating how the body responds. Elimination diets are used to detect food allergies and food intolerances. They are not nutritionally balanced and are intended to be used only for diagnostic purposes.Origins
For centuries it has been known that some people develop unpleasant symptoms (adverse reactions) to certain foods that other people can eat without any problems. However, it was not until the 1900s that food allergies began to be investigated in rigorous and scientific ways, and studies on food allergies started appearing in reputable medical journals. Elimination diets developed out of this scientific interest in the effects of food on the body.Description
Adverse reactions to food fall into two main categories, food allergies, and food intolerances. Food allergies cause a response by the immune system. When a person has a food allergy, his or her body responds to something in food by treating it like a threatening foreign material. Immune system cells produce proteins called antibodies that act to disable this material. This process often causes inflammation and results undesirable symptoms that range from mild and annoying to life threatening. The reason why some people respond to certain foods and others do not is probably genetically basedFood intolerances, on the other hand, also cause adverse reactions, but these reactions do not involve the immune system and are not life threatening. Lactose (milk sugar) intolerance is an example of a food intolerance. It is caused by the body producing too little of the enzyme needed to digest lactose. Interestingly, although surveys show that in the United States up to 30% of families believe they have at least one
member with a food allergy, the actual documented rate of food allergies is about 6% in infants and children and 3.7% in adults. On the other hand, in Hispanic, Jewish, and Southern European populations, the rate of lactose intolerance is about 70%, and it reaches 90% or more in Asian and African populations. Food intolerances are much more common, but true food allergies tend to be much more severe. In this article, food sensitivities are used to include both food allergies and food intolerance
The most common symptoms of food sensitivities are nausea, diarrhea, bloating, excessive gas, hives, rashes, eczema, headaches, migraine, asthma, wheezing, and hay fever-like symptoms. These symptoms may occur immediately after eating the trigger food or may not develop for hours. Most immediate reactions are severe allergic responses that can result in anaphylactic shock, a condition in which the airways swell shut and the person cannot breathe. One study found that in about one-third of individuals in anaphylactic shock who were brought for treatment to the emergency room at the at the Mayo Clinic in Minnesota, the shock trigger had been a food. Foods most likely to cause immediate reactions are peanuts, tree nuts, and shellfish
Delayed symptoms are difficult to detect and are sometimes called “maskedrdquo; food sensitivities. The most common causes of delayed sensitivities are dairy products, egg, wheat, and soy, however, sensitivities vary widely and can be caused by many foods. The amount of a trigger food that it takes to cause a response varies considerably from person to person
A true elimination diet is very rigorous and needs to be implemented under the direction of a physician often in consultation with a dietitian or nutritionist. For the elimination diet to be useful, the patient must follow the diet strictly. Cheating invalidates the results
For 2–3 weeks, a person on the elimination diet eats only the following foods (This list may be modified by the physician):
- grains: rice and rice products, sago, tapioca, buckwheat products, millet products
- proteins: veal, lamb, chicken, turkey, rabbit, tuna, bream, whiting, dried peas, lentils
- fruit: peeled pears, peeled apples, pawpaw
- vegetables: potatoes, sweet potatoes, lettuce, parsley, bamboo shoots, celery, cabbage
- sweeteners and seasonings: sugar, maple syrup, sunflower oil, safflower oil, salt, garlic
- beverages: water, fresh pear juice
Function
Elimination diets are the first part of a diagnostic technique for determining what foods are causing undesirable symptoms. Their purpose is to prepare the patient for the second part of the diagnostic process, the food challenge by cleansing the body of all possible foods that could be causing the symptoms. During the challenge phase, the patient eats the suspect food and waits to see if symptoms reappear. Elimination and challenge give healthcare professionals a way to reproducibly pinpoint exactly which foods are causing an adverse reactions so that the patient can exclude these foods from their diet.Benefits
People with symptoms that interfere with their daily life benefit greatly from pinpointing which foods are causing the symptoms so that these foods can be eliminated from the diet. People with less severe symptoms may find the process of elimination and challenge too costly and disruptive to make it worthwhile.Precautions
Many people who suspect that certain foods are causing their symptoms try modified elimination dietsfound on the Internet or elimination diets they devise themselves. These diets have varying degrees of success. For example, many people try eliminating all dairy products to see if their symptoms of lactose intolerance—bloating, cramping, diarrhea, and gas—improve. This do-it-yourself approach may be adequate for people with mild sensitivities to only one food or food group, but it is risky for people with severe intolerances. People with moderate to severe sensitivities need professional guidance to eliminate non-obvious sources of the potential problem food.
Risks
One risk of all elimination diets is that they are not nutritionally balanced. They increase the risk that vitamin and mineral deficiencies will develop. Anyone going on a full elimination regimen needs to consult a dietitian or nutritionist about how to use dietary supplements to assure adequate, balanced nutritionA second risk is that people who self-diagnose symptoms as food intolerances using a non-medically-supervised elimination diet may be ignoring symptoms of more serious and progressive diseases such as celiac disease, Crohn’s disease, gastroesophageal reflux disease, irritable syndrome, and other health problems that need medical treatment
Finally, anyone suspected of having a moderate to severe food allergy should be under the care of a physician. Any food challenging must be done in a healthcare setting, as severe reactions can cause anaphylactic shock and death.
Research and general acceptance
The medical community accepts elimination diets as a standard way to diagnose food sensitivities. A true elimination diet is quite restrictive, takes a long time to implement, and should be supervised by a healthcare professional. Many short cut do-it-yourself elimination-style diets are available on the Internet. Although people who believe they have a food intolerance often try these diets, they are not accepted by healthcare professionals as diagnostically accurate, and they may cause short-term vitamin and mineral deficiencies.BOOKS
Carter, Jill and Alison Edwards. The Allergy Exclusion Diet: The 28-Day Plan to Solve Your Food Intolerances Carlsbad, CA: Hay House, 2003Carter, Jill and Alison Edwards. The Elimination Diet Cookbook Rockport, MA: Element,1997
Scott-Moncrieff, Christina. Overcoming Allergies: Home Remedies-Elimination and Rotation Diets-Complementary Therapies. London : Collins & Brown, 2002.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: http://www.eatright.org>Chronic Fatigue and Immune Dysfunction Syndrome Association of America (CFIDS). P. O. Box 220398, Chapel Hill, NC 20222-0398. Website: http://www.cfids.org>
OTHER
Atkins, Dan. “Food Allergies.” eMedicine.com, June 13, 2006. http://www.emedicine.com/med/topic.htm>Harvard School of Public Health. “Interpreting News on Diet.” Harvard University, 2007. http://www.hsph.harvard.edu/nutritionsource/media.html>.
Manners, Deborah. “The Elimination Diet The Detection Diet.” Foodintol.com, February 11, 2006. http://www.foodintol.com/eliminationdiet.asp>.
Meyers, Suzzanne. “The Elimination Diet.” undated, Accessed April 24, 2007. http://www.eliminationdiet.com/>.
WebMD. “Allergies: Elimination Diet and Food Challenge Test.” http://www.webmd.com/allergies/allergies-elimination-diet>
Whfoods.org. “Allergy Avoidance Diet. Worlds Healthiest Foods,” undated, accessed April 21, 2007. http://www.whfoods.com/genpage.php?tname=diet=7>.
Tish Davidson, A.M.
Fit for Life Diet
Definition
Fit for Life is a combination diet diet that emphasizes eating foods in the correct combination and avoiding the wrong combinations of foods rather than counting calories or controlling portion size. Several aspects of this diet have been disputed by dietitians and nutritionists.Origins
Fit for Life is the creation of Harvey and Marilyn Diamond. The diet first came to the attention of the public in the mid-1980s with the publication of the book Fit for Life, which has sold millions of copies. On the official Fit for Life website, Diamond claims that the diet “spawned juice and salad bars, fruit sellers on the streets of New York, and the juice industry.” He also claims the book “launched a nutritional awakening in the United States and other Western countries.”These are impressive claims for a book written by a man whose “doctoral degree” came from the American College of Life Science, a non-accredited correspondence school founded in 1982 by a high school dropout.Diamond has appeared on dozens of television talk shows explaining his theories on how eating foods in the correct combination and avoiding the “wrong”combinations of food can bring about weight loss without calorie counting or exercise. In the 2000s, the Fit for Life system added the Personalized FFL Weight Management Program. This program uses what they call Biochemical Analyzation, Metabolic Typing and Genetic Predispositions to individualize and personalize the dietary protocols. The resulting diet is said to be effective only for one specific.
individual and can be used for that person’s entire life. Diamond has also begun selling nutritional supplements, many of which are strongly recommended in his newest version of the Fit for Life system.
Description
Fit for Life is a food combining diet based on the theory that to lose weight, one must not eat certain foods together. The philosophy behind the diet comes from Diamond’s interest in natural hygiene, an offshoot of naturopathic medicine. In his original book, Diamond claimed that if a person ate foods in the wrong combination, they would “rot”in the stomach. He also categorized foods as “dead foods”that “clog”the body and “living foods” that cleanse the body. The newest version of Fit for Life talks less about rotting, dead, and living foods and more about “enzyme deficient foods.”However, the general message about food combining is the same.According to Diamond, dead foods are meats and starches. Living foods are raw fruits and vegetables. His diet plan requires that these foods not be eaten together. Some of the Fitness for Life rules include:
- Only fruit and fruit juice should be eaten from the time one awakes until noon. Fruits cleanse the body
- Fruits are good for health only if they are eaten alone.They should never be eaten with any other food
- Lunch and dinner can consist of either carbohydrates and vegetables or proteins and vegetables
- Carbohydrates and proteins should never be put in the stomach at the same time
- No dairy foods should ever be eaten
- Water should never be drunk at meals
- One day each week (the same day every week) is a free day, when the individual can eat whatever he or she wants.”
Function
The goal of the Fit for Life diet is to help people lose weight and keep their body healthy through diet. Diamond states that people do not gain weight because they eat too many calories and exercise too little. Instead, he considers the cause of weight gain to be eating protein-rich foods at the same time as carbohydrate-rich foods. He argues that enzymes that digest proteins interfere with enzymes that digest carbohydrates, and therefore, these two foods should not be eaten together. His program makes little mention of the role of different types of fats—saturated, unsaturated, and transfat—in diet, dietary fiber, the role of water in health, or of the need to exercise.The Fit for Life program says it is a lifestyle program that will teach people to be healthier. Along with the personalized diet program, dieters get a “Clinical Manual”that claims to teach them how their body works, what is healthy for them, and what is not. The program is heavily infused with an alternative medicine approach to health and diet, and many of the explanations it gives for the way the body works are scientifically questionable and not accepted by practitioners of conventional medicine.
Benefits
The benefits claimed by Fit for Life are not supported by any scholarly research and are, in fact, refuted by some research (see below). The main claim, supported by testimonials and before and after pictures, is that people who follow Fit for Life will lose weight and keep it off. Along with weight loss will come a gnereral improvement in health. The official Fit for Life Website claims an “86% success rate”and mentions “clinical trials”without providing any details.Some benefits of the plan are that it encourages people to increase their consumption of fresh fruits and vegetables. Unlike some diets, Fit for Life that it does not require dieters to buy special foods, keeping food costs moderate. It does, however, encourage dieters to purchase enzyme supplements from Fit for Life Industries.
Precautions
The Fit for Life Web site is heavy on the theory behind the Fit for Life diet, but give few specifics on how the diet cam be put into effect in daily life. Sample meal plans and approved food lists are not available until the dieter signs up for the program at a substantial fee. This is very different from programs such as Body for Life or Weight Watchers which give potential program participants very specific information about diet, menus, and exercise before they pay for the plan.Fit for life claims that their rules for eating benefit everyone from young children to pregnant women to older adults. Their personalized diet is intended to be a diet for a lifetime, but it does not take into account changes in lifecycle nutrition.
Risks
Nutritionists feel that the Fit for Life diet can lead to serious vitamin and mineral deficiencies. Banning dairy products makes it extremely difficult for dieters to get the recommended daily allowance of calcium Calcium is needed to keep bones strong and in many metabolic reactions in the body. Other potential vitaminResearch and general acceptance
Many professionals in the nutrition community consider Fit for Life an unhealthy fad diet. The concept behind food combining was tested in a study published in the April 2007 issue of the International Journal of Obesity In this study, participants were fed a 1,100 calorie a day diet to promote weight loss. One group ate balanced meals containing all the major food groups. The other group ate a similar diet, but tested the food-combining theory by avoiding eating certain food groups at the same time. At the end of six weeks, the blood sugar, cholesterol, insulin, and blood fats were the same for each group. The balanced-meal group had lost an average of 16.5 lb and the food-combining group had lost 13.6 lb. This strongly suggests that eating a low calorie diet is much more important than eating foods in certain combinations.Resources
BOOKS
Bijlefeld, Marjolijn and Sharon K. Zoumbaris. Encyclopedia of Diet Fads Westport, CT: Greenwood Press, 2003.Diamond, Harvey and Marilyn Diamond. Fit for Life New York, NY: Fine Communications, 2002.
Diamond, Harvey. Fit for Life: A New Beginning: Your Complete Diet and Health Plan for the Millennium New York, NY: Kensington Books, 2000.
Icon Health Publications. Fad Diets: A Bibliography, Medical Dictionary, and Annotated Research Guide to Internet References San Diego, CA: Icon Health Publications, 2004.
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
PERIODICALS
Callahan, Maureen. “Fit for Life Diet Review.” Health Magazine April 2004. <http://diets.aol.com/a-z/fitforlife_diet/_a/fit-for-life-review/20050610162209990028>ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>Fit For Life Online Wellness Center. <http://www.fitforlife.com>
OTHER
Coleman, Ellen. “Fit for Life: Review by a Registered Dietitian.” ChaseFreedom.com, undated, accessed. April 17, 2007. lt;<http://www.chasefreedom.com/fitforlife.html>“Fit for Life FAQ.” fitforlife.com, undated, accessed April 22, 2007. <http://www.fitforlife.com/faqs.html>
Harvard School of Public Health. “Interpreting News onDiet.”Harvard University, 2007. <http://www.hsph.harvard.edu/nutritionsource/media.html>
Health Diet Guide “Fit for Life.” Health.com. 2005.<www.health.com/health/web/DietGuide/fitlife_complete.html>
Kenney, James J. “Fit for Life: Some Notes on the Book and Its Roots.” Quackwatch.com, November 12, 1999. <http://www.quackwatch.org/11Ind/fitforlife.html>
Mann. Denise. “It”s the Calories That Count, Not the Food Combinations.” WebMD, April 7, 2000. <http://www.webmd.com/news/20000407/diets-combination-balanced>
United States Department of Health and Human Services and the United States Department of Agriculture.“Dietary Guidelines for Americans 2005.”January 12,2005. <http://www.healthierus.gov/dietaryguidelines>
Tish Davidson, A.M.
Fruitarian diet
Definition
A fruitarian diet is a strict form of a vegetarian diet that is generally limited to eating fresh fruits.Origins
The fruitarian diet has been around for hundreds of years and probably longer. In his writings, artist, scientist, and inventor Leonardo da Vinci (1452–1519) indicated he was a fruitarian. Despite the popular view that.(Illustration by GGS Information Services/Thomson Gale.)
early man was primarily meat-eaters, there is some scientific evidence to indicate that they ate a diet composed primarily of fruits, nuts, and berries. Some religious scholars argue that the original fruitarians were Adam and Eve in the Garden of Eden. There are a number of historical references to a fruitarian diet in the 1800s and 1900s. In much of the historical documentation, people who became fruitarians switched to a more accepted diet after a few months or years, often renouncing the diet. Indian spiritual and political leader Mahatma Gandhi (1869–1948) was a fruitarian for six months in the early 1900s before going back to a vegetarian diet.
Description
Fruitarians can choose from seven basic fruit groups:- Acid fruits: Citrus, pineapples, strawberries, pomegranates, kiwi, cranberries, and sour apples
- Subacid fruits: Sweet apples, sweet cherries, raspberries, blackberries, blueberries, peaches, pears, cheri-moyas, papayas, figs, apricots, and mangos
- Sweet fruits: Bananas, grapes, melons, and persimmons
- Nuts: Pecans, almonds, Brazil, cashews, walnuts, macadamias, pistachios, pine nuts, hazelnuts, beechnuts, and hickory
- Seeds: Sunflower, sesame, squash, and pumpkin
- Dried fruits: Dates, figs, apricots, apples, raisins, cherries, prunes, bananas, and cranberries
Many fruitarians believe the quality of fruit available in most commercial supermarkets is poor. This is due to hybridization, chemical fertilization, chemical pesticides, and harvesting before the fruit is at the peak of ripeness. They suggest buying certified organic fruit, preferably heirloom, often found at farmers’ markets and health food stores.
Fruitarian and author David Wolfe says it is best to eat one type of fruit at a time and wait 45 minutes before another type of fruit is eaten. The Fruitarian Foundation recommends waiting at least 90 minutes between fruit types. If a person still is hungry after eating one type of fruit, they should eat more of the same type of fruit until their hunger is satisfied. People on the diet should eat only when hungry and then eat as much as they want until their hunger is satisfied. Those on a diet where only one type of fruit is eaten at a time will know when they have eaten enough, according to Wolfe. Their appetite will turn off and they will suddenly feel like they have eaten too much. Once satiated they will not gain the same satisfaction from the fruit. This is a signal from the body to stop eating, Wolfe states. The signal to stop eating is not as strong in people who eat more than one type of fruit at the same time. For a person who eats only fruit, there is no need to drink water. All the water the body needs is contained in the fruits. People whose diet is less than 100% fruit should supplement it with water. Some fruitarians fast one day a week. People fasting must drink a normal amount of water, usually eight to 10 glasses a day.
One-day meal plan
The following is a typical one-day meal plan from the Fruitarian Foundation for a fruitarian diet:- Early morning (6-9 a.m.): The juice of three to five lemons immediately upon waking, raisins, and an unlimited amount of melon or melon juice
- Midmorning (9 a.m. to 12 p.m.): An unlimited amount of apples, pineapple, figs, pears, grapes, yellow plums, lima beans, kiwi, and cucumber
- Noon (12-3 p.m.): Oranges or tangerines, peaches, apricots, and papayas in any amount desired
- Midafternoon (3-6 p.m.): Mango, cherries, strawberries, red plums, persimmons, pomegranates, watermelon, and tomatoes
- Evening 6-9 p.m.): Grapes, blackberries, and raspberries
- Late evening (9 p.m. to 12 a.m.): Mango, cherries, strawberries, red plums, persimmons, pomegranates, watermelon, and tomatoes
Social implications
Most Websites about fruitarianism emphasize that there are social concerns associated with a fruitarian diet. Much of this is because many fruitarians adopt the diet as part of a larger philosophical shift that is outside the mainstream of Western society. This includes animal rights and environmental activism, New Age spiritualism, meditation, and pacifism. In the United States, becoming or being a fruitarian or vegetarian is often seen as both a social and political statement. This can sometimes lead to conflict with family, friends, and even society at large.“Those who live on their own and don’t have any friends will have no problem changing their diet, though they may lead a bit of a lonely life,’ write fruitarians Lawrence and Michael Sartorius on the Website The New Earth (http://www.thenewearth.org). ‘For most of us, however, eating with families and friends is a daily experience and we need to consider how best to interact with them so that at the very least we do not cause a lot of inconvenience or appear cranky and antisocial with others. Younger readers especially may find themselves in conflict with their families and friends, putting them under severe pressure to ‘give up this nonsense and eat sensibly like everybody else”.
For people facing these problems, the Sartorius’ recommend explaining a decision to become a fruitarian with clear facts and strongly expressing personal views. This includes explaining that there is a growing trend towards healthier foods. Also, point out the growing health problems in the United States, including obesity, heart disease, cancer, diabetes, high blood pressure, and high cholesterol, which are often related to a bad diet and bad eating habits. Explain to friends the specific benefits of being a fruitarian or vegetarian, which includes living a longer, healthier life.
Function
There are as many reasons for being a fruitarian as there are variations of the fruitarian diet. One reason is the opposition to killing animals for food, another is opposition to consuming any products that come from animals. Other reasons include opposition to killing any plant for food, health benefits, environmental concerns, and spiritual beliefs. The primary function of a fruitarian diet is to promote health and energy. Once someone adopts a fruit diet, they become physically, mentally, emotionally, and spiritually healthier, according to the Fruitarian Foundation (http://www.fruitarian.com). The foundation’s philosophy states that fruitarians develop a fine-tuned body and experience few or no headaches, develop a greater resistance to illness, pain, and aging, and need less sleep. ‘The proper application of fruitarian dietary and lifestyle is calculated to allow the human to produce healthy offspring, live more than 100 years of age, be free of all disease, and only Lsquo;mature’ while not aging, as most people think of it, and die a natural death in their sleep,’ according to a statement on the foundation’s Website. ‘Man cannot eat of everything and maintain his good health. Man was created to eat of the fruits of the trees.’.Benefits
The benefits of a fruitarian diet are mostly promoted by people on the diet, rather than scientific research. These benefits include increased mental power and clarity, creativity, happiness, energy, confidence, self-esteem, and concentration. Physical health benefits, according to the Fruitarian Foundation, include preventing and curing cancer, constipation, insomnia, depression, and digestive problems, weight loss, wound healing, strengthening the immune system, reducing or eliminating menstruation, increasing sexual vitality, improvements in the health and appearance of skin, hair, eyes, and nails, improving muscle coordination, and the ability to control addictions to alcohol, drugs, and tobacco. The United States Department of Agriculture recommends fruit be included in daily meal planning, although the amount depends on age, gender, weight, height, level of physical activity, and weight loss goals. It must be noted that there is no scientific evidence that eating a fruit-only diet can cure any disease.Tom Billings, a writer and long-time vegetarian, was a self-described fruitarian for about 10 years. His experiences as both a vegetarian and fruitarian are chronicled on the Website Beyond Vegetarianism. He lists the benefits of a fruitarian diet as including:
- Fruit is the best tasting raw food and eating fruit is a pleasant experience.
- It helps cleanse the body of toxins.
- Fruit grown and sold locally is environmentally friendly.
- It promotes weight loss
- It can improve the function of the respiratory system.
- It sharpens the senses, especially those of taste and smell.
- It reduces the amount of water a person needs to drink since most fruit has a high water content
Precautions
To get all of the vitamins, minerals, and nutrients that a body needs, a fruitarian must eat a wide variety of fruit and in many cases, large quantities. Very little protein can be obtained from fruit. To obtain the necessary amounts, fruitarians must include in their diet fruits and nuts that are highest in protein, including avocados, nuts, and dates. Still, it will be difficult to get the amount of protein the body needs on a daily basis. Vitamin, mineral, and other nutritional supplements can be taken to insure that a person is getting the recommended amounts. However, this does not fit into the nature-only philosophy of many fruitarians. Doctors strongly recommend that women who are pregnant or nursing not be on a fruitarian diet. Doctors also say children should not be on a fruitarian diet because their bodies require extra nutrients to sustain normal growth along with mental and physical development.Risks
There are many risks associated with a fruitarian diet and the risks grow as the degree of fruitarianism increases. That is, a person whose diet is 75% fruit is likely to have more health issues that a person on a diet consisting of 50% fruit. There are serious risks associated with the diet for diabetics, since fruit has a high sugar content. People with diabetes and insulin resistance syndrome should not go on an all-fruit diet. There are also the risks of serious nutritional deficiencies, including vitamin B12, calcium, iron, zinc,.omega-3 and omega-6 amino acids, and protein. There is also the risk of severe weight loss, which can lead to anorexia and other health problems.
In 2001, a husband and wife from Surrey, England, were convicted of child cruelty in the death of their nine-year-old daughter. A pediatrician had testified in court that the infant, who died from a chest infection caused by malnutrition, was not developing properly because the mother’s breast milk was nutritionally deficient. The couple ate a diet of only raw vegetables, fruits, and nuts.
Research and general acceptance
There is little, if any, scientific research that supports fruitarianism as a healthy lifestyle, especially over the long-term, unless foods such as beans, green vegetables, soy, and whole grains are included in the diet. However, there is much scientific documentation on the benefits of a vegetarian diet. There is general and widespread disapproval of an all-fruit diet by the medical, scientific, fitness, and vegetarian communities. Many people experience positive results after initially going on a fruitarian diet but over time develop health problems, including emaciation, constant hunger, weakness, and fatigue.Resources
BOOKS
Carrington, Hereward. The Fruitarian Diet Kila, MT: Kessinger Publishing, 2005.Durette, Rejean. Fruit: The Ultimate Diet Black Canyon City, AZ: Fruitarian Vibes, 2004.
Morse, Joseph Stephen Breese. The Evolution Diet: What and How We Were Designed to Eat Seattle: Code Publishing, 2006.
Robb, Jay. Fresh Fruit DetoxCarlsbad, CA: Loving Health Publications, 2005.
Rose, Natalia. The Raw Food Detox Diet: The Five-Step Plan for Vibrant Health and Maximum Weight Loss New York: Regan Books, 2006.
Stoycoff, Cheryl. Raw Kids: Transitioning Children to a Raw Food Diet Stockton, CA: Living Spirit Press, 2004.
PERIODICALS
Graff, Jackie. ‘The Benefits of Raw Food’New Life Journal (May 2006): 13–15.Kiser, Sherry. ‘Avocado Lovers: Dig In! New Reasons and New Ways To Enjoy This Creamy, Rich Disease Fighter’Prevention (June 2002): 152–153.
Lofshult, Diane. ‘Focus on Fruit: Think Outside the Fruit Bowl for New Ways To Enjoy Nature’s Sweetness’ Diabetes Forecast (June 2006): 51–53.
Lofshult, Diane. ‘Tempting Young Adults With Fruit’ IDEA Fitness Journal (February 2007): 67.
Mangels, Reed. ‘Raw Food Diets Have Positives and Negatives’Vegetarian Journal (May-June 2006): 12.
Sare, Chris. ‘Color Code: Looks Can Be Revealing When It Comes to the Shade of Veggies’Muscle & Fitness (July 2004): 248–249.
Walker, Vrinda. ‘Attitudes, Practices, and Beliefs of Individuals Consuming a Raw Foods Diet’ Vegetarian Journal (July-August 2006): 27–29.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>.Calorie Restriction Society. 187 Ocean Drive, Newport, NC 28570. Telephone: (800) 929-6511. Website: <http://www.calorierestriction.org>
North American Vegetarian Society. P.O. Box 72, Dolge-ville, NY 13329. Telephone: (518) 568-7970. Website: <http://www.navs-online.org>
Vegetarian Union of North America. P.O. Box 9710, Washington, DC 20016. Website: <http://www.ivu.org/vuna>
OTHER
Beyond Vegetarianism. <http://www.beyondveg.comFruitarian Foundation. <http://www.fruitarian.com
The New Earth. <http://www.thenewearth.org
Ken R. Wells.
Gout diet
Definition
A gout diet is a nutritional routine that includes eating foods low in purines to help reduce the occur-ance and severity of gout attacks. Gout is a form of arthritis with symptoms of sudden and severe pain, redness, and tenderness in joints.Origins
There has been an association between gout and diet for at least two thousand years. It is the oldest known type of arthritis and was described by Greek physican Hippocrates 2,500 years ago. It subsequently became known as the disease of kings due to its association with eating rich foods and alcohol consumption, a lifestyle only the wealthy had access to. The association between gout and the production of uric acid has been known since the 1800s. In his 1861 medical book, Gunn’s New Domestic Physician: Home Book of Health, American physician John Gunn describes gout as, “a peculiar disease, somewhat resembling rheumatism, affecting the joints, most generally those of the foot or toes.” It states the cause of gout is excess uric acid in the blood. That description is generally accurate today, although much more is know about gout, including how it develops, what causes it, and how it can be treatedIt wasn’t until the 1960s that researchers developed an accurate understanding of the biochemistry of uric acid production in the human body. With this understanding came effective medical and dietetic therapy for
(Illustration by GGS Information Services/Thomson Gale.)
the condition. In the 1800s, a rudimentary gout diet was developed that recommended avoidance of “rich foods” generally defined as cream and other high-fat dairy products and alcoholic beverages. In the 1960s and 1970s, as more become known about gout and uric acid production, the diet was revised and refined. It encouraged avoiding high-fat and high-protein foods, alcohol, coffee, and soft drinks, along with anchovies, asparagus, legumes, mushrooms, meat, animal organ meat such as heart and liver, and shellfish.
Description
A gout diet is low in purines (part of what makes up DNA), especially those from red meat and seafood. Traditionally, doctors have recommended people avoid or limit eating foods high in purines. Foods that are highest in purines include sardines, mackerel, organ meats (such as brains, kidneys, and liver), scallops, mussels, goose, caviar, and yeast extract. Foods that are high in purines that can be eaten in moderation include, crab, shrimp, red meat, poultry, trout, legumes, beans, lentils, peas, asparagus, cauliflower, mushrooms, spinach, wheat germ, and bran. There are no restrictions on eating foods low in purines, including dairy products, nuts, eggs, pasta, non-whole grain breads and cereals, chocolate, and fats (such as butter, margarine, and cooking oils). Medical research released in 2004–2006 suggest vegetarian diets that are high in purines from vegetables and soy products are less likely to lead to gout than diets containing meat and seafood.By eating less meat, poultry, and seafood while taking in more low-fat or non-fat dairy products, men can cut their chances of getting gout by 50 percent, according to the results of a 12-year study of nearly 50,000 men who had no history of gout. The study is the most definitive and comprehensive research done on gout. It was conducted by rheumatologist Hyon K. Choi and other researchers at Massachusetts General Hospital in Boston. The study followed men aged 40–75 years. During the study, the men, all health care professionals, were quizzed periodically on how much of 130 foods and beverages they had eaten along with questions on weight, medications they had taken, and their medical condition. At the end of the study, 730 (about 2 percent) of the men had developed the condition.
The study found that men with the highest consumption of seafood were 51% more likely to develop gout than those who consumed the least amount of seafood. It also found that men with the highest consumption of beef, pork, and lamb had a 41% higher incidence of gout than those who ate the least amount of these meats. Men who had the highest consumption of low-fat dairy products had a 42% lower rate of developing gout compared to those who consumed the least amount of dairy products. Vegetables that are high in purines that were previously associated with an increased risk for developing gout were found to not increase the risk of getting the disease. These vegetables include peas, beans, mushrooms, cauliflower, asparagus, and spinach.
The study also looked at the role alcohol consumption plays in gout. The risk of gout increased by 30% by consuming one drink a day, compared to people who did not drink alcohol at all. Two drinks a day increased the risk to 50% and three drinks a day increased the risk by 100 percent. There were some differences in the types of alcohol consumed. Two glasses of wine a day did not increase the risk of gout at all when compared to men who drank no wine. Alcohol other than beer or wine increased the risk by 15% per serving. Beer increased the risk by 49 % per serving. Researchers are uncertain why the risk of gout varies depending on the type of alcohol consumed. Some suggest that other non-alcoholic ingredients in beer that are not found in wine or spirits may be responsible for increased risk of gout.
What is gout?
Gout, also called gouty arthritis, is a painful but treatable form of arthritis that affects up to five million Americans, primarily men over the age of forty. The disease is characterized by sudden and severe pain, redness, swelling, heat, stiffness, and inflammation in one or more joints. It most commonly affects the big toe first. Subsequent attacks of gout, usually limited to a single joint at a time, can occur in the instep, ankles, heels of the feet and hands, knees, wrists, fingers, and elbows.Gout is caused by needle-like crystals of uric acid, a substance that results from the metabolic breakdown of purines, which are found in many foods and are part of normal human tissue.. Uric acid is normally dissolved in the blood and filtered through the kidneys into the urine. If uric acid production is increased by the body or it is not sufficiently eliminated from the kidneys, it can build up in the blood., resulting in a condition called hyperuricemia (high uric acid). This can lead to gout. High amounts of uric acid can also collect in the kidneys, causing kidney stones.
General dietary guidelines
People with gout should consult their doctors about developing individualized meal plans. Diets should take into account all aspects of medical nutrition therapy, especially for people with heart disease, high blood pressure, or diabetes. General dietary guidelines for people with gout include:- Limit protein consumption from meat and replace it with low-fat or non-fat dairy products and soy products, such as soybeans and tofu.
- Consume dairy products low in fat rather than those high in fat.
- Fat consumption should be limited to 30% of total calories consumed.
- Cholesterol intake should be limited to 300 milligrams (mg) per day.
- Maintaining a healthy body weight is essential.
- Alcohol, especially beer, should be avoided.
- It is important to stay hydrated by drinking eight to ten eight-ounce glasses of fluids, preferably water, every day.
Laura Rall, a nutrition researcher at Tufts University in Boston, advocates the trial and error method of developing a gout diet. “Begin by eliminating foods in the high-purine category, while reducing your intake of foods in the moderate-purine category, If you don’t have gout attacks after trying this, you may add more foods from the moderate category, or occasionally try a food from the high category. Using these guidelines, you may be able to determine a safe level of purine consumption and enjoy some of your favorite foods without experiencing (gout) attacks.”.
Function
The function of a gout diet is to lower uric acid levels in the blood by eating less meat that is high in purines, which increase uric acid levels in the blood. Uric acid is a waste product formed as purines breakdown in the body. By reducing uric acid levels in the blood, people with gout usually experience a decrease in pain and swelling in joints afflicted with the disease. Without treatment, gout can lead to joint damage and disability. Gout is also associated with an increased risk of heart disease and kidney disease., according to the American College of Rheumatology.Benefits
The main benefit of a gout diet is a decrease in the pain, tenderness, swelling, redness, warmth, and inflammation of joints associated with the condition, and prevention of joint damage and disability. It also improves the quality of life in gout sufferers by helping prevent repeat attacks.Precautions
The gout diet is designed for people who have gout or who may be prone to developing gout since it can be genetically inherited. People who do not have gout or have no predisposition to the condition do not need to be on the diet. There are no precautions associated with the diet. However, since the diet recommends a severe curtailment or elimination of meat and seafood from the diet, people on or planning to go on the diet should consult a dietician in addition to their physician or rheumatologist. People who eliminate meat and seafood from their diets should make sure they are getting adequate protein and other nutrients found in meat. This may include adding vitamin, mineral, and other nutritional supplements to the diet, similar to those taken by non-vegan vegetarians. These may include iron, calcium, zinc, vitamin D, riboflavin, vitamin B-12, vitamin A, iodine, and Omega-3 and Omega-6 amino acids derived from non-fish sources, such as flaxseed oil, evening primrose oil, and borage oil.Risks
There are no known risks associated with a gout diet.Research and general acceptance
There is general acceptance among health care professionals of the low-purine diet for people with gout or those who have a family history of the disease.Diets that are high in purines and high in proteins had long been thought to cause an increased risk of gout. For that reason, a gout diet was more about what foods to avoid rather than what foods to eat. However, in the March 11, 2004 issue of The New England Journal of Medicine, gout researcher Hyon Choi reported on the results of a 12-year study of nearly 50,000 men comparing those who got gout with those who didn’t. It confirmed conventional medical opinion that eating meat, especially red meat, significantly increased the risk of gout and that eating seafood carried the greatest risk for getting gout. However, the study disproved previously held assumptions that gout was also associated with eating vegetables high in purines, such as asparagus, having a high body mass index, or eating high-protein foods. The study also found that consuming beer poses a greater risk for gout that drinking wine or other types of alcohol.
A 2004 study by the Arthritis Foundation concluded that drinking alcohol and eating any food high in purines increases the risk of repeat gout attack. The study was conducted by Dr. Yuqing Zhand, professor of medicine and public health at Boston University School of Medicine and was reported at the American College of Rheumatology Annual Scientific Meeting on Oct. 17, 2004 in San Antonio.
Statistics show that African American men have twice the risk of getting gout compared to Caucasian men, according to the Arthritis Foundation.
Resources
BOOKS
Boers, Maarten, et al. Evidence-Based Rheumatology Oxford, United Kingdom: Blackwell Publishing Limited, 2005.Craggs-Hinton, Christine. Coping With Gout: Overcoming Common Problems London: Sheldon Press, 2004.
Emmerson, Bryan. Getting Rid of Gout New York: Oxford University Press, USA, 2003.
Grahame, Rodney, et al. Gout: The At Your Fingertips Guide London: Class Publishing, 2003.
Schneiter, Jodi. Gout Hater’s Cookbook I Palm Coast, FL: Reachment Publications, 2004.
Schneiter, Jodi. Gout Hater’s Cookbook III Palm Coast, FL: Reachment Publications, 2003.
The 2002 Official Patient’s Sourcebook On Gout: A Revised and Updated Directory for the Internet Age San Diego: Icon Health Publications, 2002.
PERIODICALS
Environmental Nutrition. “Meds Offer Main Gout Relief, But Diet Plays Role” Environmental Nutrition (July 2001): 7.Environmental Nutrition. “International Study Backs Diet For Treating Gout” Environmental Nutrition (August 2006): 3.
Choi, Hyon, et al. “Meat, Seafood, and Little Dairy Are Risk Factors For Gout” Journal of the American Academy of Physicians Assistants (July 2004): 40.
Krishnan, Eswar. “Gout and the Risk Of Acute Myocardial Infarction”Arthritis & Rheumatism (July 26, 2006): 2688–2696.
Moon, Mary Ann. “It’s Confirmed: Meat and Seafood Raise Risk of Gout, Dairy Foods Lower It” Internal Medicine News (June 1, 2004): 18.
Snaith, Michael L. “Gout: Diet and Uric Acid Revisited” The Lancet (August 18, 2001): 525.
ORGANIZATIONS
American College of Rheumatology. 1800 Century Place, Suite 250, Atlanta, GA 30345-4300. Telephone: (404) 633-3777. Website: http://www.rheumatology.orgAmerican Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800) 877-1600. Website: http://www.eatright.org
Arthritis Foundation. P.O. Box 7669, Atlanta, GA 30357-0669. Telephone: (800) 568-4045. Website: http://www.arthritis.org
National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Building 31, Room 4C02, 31 Center Drive, MSC 2350, Bethesda, MD 20892-2350. Telephone: (301) 496-8190. Website: http://www.niams.nih.gov
The Arthritis Society. 393 University Ave., Suite 1700, Toronto, ON M5G 1E6, Canada. Telephone: (416) 979-7228. Website: http://www.arthritis.ca
Ken R. Wells
Grapefruit diet
Definition
There are several diets or approaches to dieting that have been referred to as the “grapefruit diet.” The first two are fad diets that have been circulating via chain letters, photocopies, faxes, and e-mail since the 1930s. The third form might be better described as the regular use of grapefruit or grapefruit juice as part of a general approach to weight reduction. It received considerable attention following the 2004 publication of a study conducted at the Scripps Clinic in California.Origins
According to the American Dietetic Association, the fad type of grapefruit diet began in the 1930s, when it was also known as the Hollywood diet. There were two regimens, a 7-day and a 21-day version, both of which were very low-calorie diets or VLCDs. The dieter consumed little except black coffee and half a grapefruit at each meal, with small amounts of salad and lean meat. This Depression-era version of the “Hollywood diet” was quite different from the Hollywood diet offered online as of 2007, which amounts to a 24- or 48-hour juice fast intended to detoxify the dieter’s body as well as promote rapid weight loss.In the 1940s, the VLCD grapefruit diet reappeared under the name of the Mayo Clinic Diet—a name that has also been attached to several other so-called mono diets, one based on eggs and the other on meat. The Mayo Clinic has issued a disclaimer regarding the use of its name in connection with the grapefruit diet as well as other fad diets that have used the clinic’s name. It is also possible that the VLCD form of the grapefruit diet may have influenced Herman Tar-nower’s first version of the Scarsdale diet in the 1960s. The original mimeographed diet sheet that the doctor gave his overweight cardiology patients specified 18 servings of grapefruit—14 at breakfast and 4 for dessert in the evenings—over the two-week period of the diet, and some of his patients referred to the Scarsdale diet informally as a grapefruit diet.
The VLCD grapefruit diet has also been recommended since the 1970s as a detoxification diet. Some writers recommend taking apple cider vinegar along with the grapefruit in order to “flush the system of impurities.” The fact that the fiber in grapefruit speeds up the passage of foods through the intestine and eases constipation is another reason why some advocates of detoxification diets design their regimens around grapefruit.
The high-protein version of the grapefruit diet began to circulate at some point during the 1970s and has reappeared at various intervals since then. It is the variation most commonly found on Internet sites that post fad diets. Some forms of this diet claim that it works because grapefruit supposedly contains special “fat-burning” enzymes.
The term grapefruit diet has also been used by journalists since 2004 to refer to the findings of a 12-week research study conducted at the Scripps Clinic in California in 2003. The term diet is a bit of a misnomer, because the study was designed to measure the effectiveness of grapefruit and grapefruit products in treating insulin resistance as well as lowering weight in 91 overweight subjects who were not otherwise trying to diet. The study received considerable publicity and revived interest in incorporating grapefruit into nutritionally sound weight reduction diets. Its use of grapefruit in capsule form as well as fresh grapefruit, however, also prompted the development of several new lines of over-the-counter “miracle diet aids.”.
Description
Very low-calorie grapefruit diet plan
The basic menu plan is the same for each day of the week:- Breakfast: 1/2 grapefruit +2 slices of bacon +2 boiled eggs +black coffee (no sugar) or unsweetened tea.
- Lunch: 1/2 grapefruit +1 cup of salad with low-calorie dressing +8 ounces of lean chicken or water-packed tuna fish +black coffee (no sugar) or unsweetened tea.
- Dinner: 1/2 grapefruit +as much salad with low-calorie dressing as desired +8 ounces of lean chicken, lean beef, or fish +black coffee (no sugar) or unsweetened tea.
- No snacks are allowed, and the only seasonings permitted for the meat or fish are herbs; no soy sauce, mustard, catsup, or other condiments are allowed.
High-protein grapefruit diet plan
This version of the grapefruit diet has been described as “just plain weird” because it comes with a curious set of rules as well as lists of foods that the dieter may or may not have. It also promises a weight loss of 52 pounds over 2-1/2 months.“The Rules”:
- You must drink eight 8-ounce glasses of water every day (64 ounces total).
- At any meal you may eat until you are full.
- You must eat the minimum of each food listed at each meal.
- You cannot eliminate any item from the diet, especially the bacon at breakfast and the salads. You MUST eat the bacon and the salads. These combinations of food burn the fat; omitting one part of the combination will cause the whole thing not to work.
- The grapefruit or fruit juice is important because it acts as a catalyst that starts the burning process. Don’t add to or reduce the amount of grapefruit or juice.
- Cut down on coffee because it affects the insulin balance that hinders the burning process. Try to limit yourself to 1 cup of coffee at meal time.
- Don’t eat between meals. If you eat the suggested foods, you will not get hungry.
- You can fry food in butter and use generous amounts of butter on the vegetables.
- Do not eat desserts, bread, or white vegetables or sweet potatoes.
- You may have double or triple helpings of meat, salad, or vegetables.
- Eat until you are stuffed. The more you eat, the more weight you will lose.
- Stay on the diet 12 days, then stop the diet for 2 days and repeat.
- Breakfast: Either 1/2 grapefruit or 8 ounces of unsweetened fruit juice (any fruit) +2 eggs any style +2 slices of bacon.
- Lunch: Either 1/2 grapefruit or 8 ounces of unsweetened fruit juice (any fruit) +salad with any dressing +meat any style and any amount.
- Dinner: Either 1/2 grapefruit or 8 ounces of unsweetened fruit juice (any fruit) +salad with any dressing or a red or green vegetable cooked in butter or spices +meat or fish any style cooked any way +coffee or tea (1 cup).
- Bedtime snack: 8 ounces of tomato juice or skim milk.
2004 grapefruit research diet
The 91 subjects in this 12-week study were randomly assigned to four groups: one group received a placebo capsule plus 7 ounces of apple juice before each meal, the second group received grapefruit capsules plus 7 ounces of apple juice, the third group received 8 ounces of grapefruit juice plus a placebo capsule, and the fourth group received 1/2 of a fresh grapefruit plus a placebo capsule. At the end of the 12 weeks, the subjects in the three groups that had received some form of grapefruit had lost significantly greater amounts of weight than those in the group that had received only the placebo, with those who received the fresh grapefruit losing the most weight. The patients were not asked to make any other changes in their food intake, but they were required to take 30-minute walks three times a week.Grapefruit diet capsules
As of 2007 there are two types of grapefruit pills or capsules sold over the Internet, both claiming to help people lose weight. The “grapefruit pectin diet tablets” are said to “help release fat deposits“that the dieter already carries on the stomach and hips. “They can also prevent new fat from penetrating the cells by redirecting it to the muscles where it is burned off, thereby eliminating fat deposits.” The pills contain 200 mg of grapefruit pectin, plus cellulose and fiber. Given the high fiber content of these pills, it is most likely that they simply speed up the dieter’s digestion and elimination.The Grapefruit Solution Natural Diet, based on a book published in 2004, makes use of capsules that contain “pure, organic whole grapefruit. .. . Five years of study and research has gone into developing and perfecting the technique of taking whole grapefruit and converting it into concentrated power while retaining all the benefits of the entire grapefruit.” In addition to the capsules, however, this diet does emphasize the importance of exercise as well as a balanced diet of complex carbohydrates and protein foods.
Function
The fad versions of the grapefruit diet are intended for rapid weight loss. They are usually recommended as a good way to lose weight after holiday-related overeating or to fit into a special outfit for an important occasion. Several of the versions available on the Internet, however, claim that the grapefruit diet can be used for weight maintenance or for long-term nutrition on a twelve-days-on, two-days-off schedule.The 2004 research version of the diet is intended to assess the effectiveness of grapefruit in counteracting metabolic syndrome (a group of risk factors for heart disease related to insulin resistance) as well as its usefulness in weight reduction diets. Preliminary results indicate that regular inclusion of grapefruit in the diet is effective in helping patients lose weight at a moderate rate and in improving their response to insulin.
Benefits
The fad versions of the grapefruit diet should be avoided in spite of their promises of rapid weight loss. The VLCD version does not allow enough calories to supply the daily energy needs of even a moderately active adult and is nutritionally unbalanced. The high-protein version is highly unlikely to help anyone lose weight, since its allowance of “meat any style and any amount” and “double or triple helpings” of meat and vegetables could easily encourage overeating.Using grapefruit as an adjunct to a balanced weight-reduction diet by eating half a grapefruit before meals, however, appears to be helpful in reducing hunger cravings. It also contributes fiber and vitamins to the dieter’s daily intake.
Precautions
General precautions
A general precaution for anyone seeking to lose weight is to consult a physician before trying any specific diet. This precaution is particularly important for adolescents, women who are pregnant or nursing, people with kidney or liver disorders, people with eating disorders, anyone who has had recent surgery, and anyone who needs to lose more than 30 pounds.Drug interactions
Here is a list of families of medications known to interact with grapefruit juice. Readers should consult their doctor or a pharmacist if they are taking a specific medication that belongs to any of these groups:- Calcium channel antagonists (given to treat high blood pressure).
- Immunosuppressants (given to control autoimmune diseases).
- Statins (given to reduce blood cholesterol levels)
- HIV protease inhibitors (given to treat HIV infection).
- Antihistamines (given to treat seasonal allergies)
- Antiarrhythmics (given to control irregular heartbeat).
- Sedatives, sleep medications, and benzodiazepine tranquilizers
- Birth control pills
- Selective serotonin reuptake inhibitors (given to treat depression)
- Drugs given for male impotence
- Some anti-migraine drugs
Risks
The risks of using the fad versions of the grapefruit diet include nutritional imbalance (for both versions) and weight gain (for the high-protein version). The researcher who designed and conducted the Scripps.Clinic trial has specifically warned people against the fad grapefruit diets, saying that both are unhealthy.
The risk of a severe interaction between grapefruit and prescription drugs can be minimized by checking with a physician or pharmacist before adding large amounts of grapefruit or grapefruit juice to the diet.
Research and general acceptance
Basic nutritional information about grapefruit
Unlike some other fruits, such as apples, grapes, and lemons, that have figured in mono diets, grapefruit is a relatively new addition to the human table. It was not known to the ancient world and was first encountered by Europeans in the 1750s on the island of Barbados in the West Indies. Grapefruit (Citrus paradisi) developed as a hybrid of the pomelo (Citrus maxima), a large citrus fruit with a sour taste, and the sweet orange (Citrus sinensis). It is not known whether the hybridization occurred spontaneously in the citrus groves on the island or was carried out by native fruit growers.The grapefruit was originally called the shattuck or shaddock until the 1820s. The name came from a Captain Shaddock, a 17th-century Englishman who had brought the first pomelo seeds to Barbados in 1693. In 1823 the new hybrid was brought to Florida by a Frenchman named Odette Philippe; it was first cultivated only as an ornamental plant. By the 1880s, however, grapefruit were being shipped from Florida to New York and Philadelphia. It was not until the 1940s that improved methods of packaging and faster transportation made grapefruit a household favorite in the Northeast as well as in Florida and the Southwest. As of 2007, the United States produces 41% of the world’s grapefruit.
Evaluations of grapefruit in weight reduction diets
Grapefruit is considered a good food choice for people watching their weight because it is relatively filling thanks to its fiber content. It also has a low glycemic index (GI), which is a measurement of the rate at which carbohydrates in the food affect a person’s blood glucose level within two hours after eating the food. Foods with low GI scores break down slowly in the digestive tract and thus prevent sudden changes in the blood sugar level—an important consideration for persons with metabolic syndrome or type 2 diabetes and possibly for those watching their weight for other reasons. Grapefruit has a GI of 25 (pure sugar is 100), which is lower than the GI scores of apples (40), oranges (51), and bananas(51).According to the research team at Scripps Clinic, it is not yet known as of 2007 why grapefruit appears to improve insulin response in overweight people or why it assists weight loss. Ongoing research may help to answer this question, but one finding at least is clear: grapefruit does not contain any miracle fat-burning enzymes.
Resources
BOOKS
Dunford, Randall Earl The Grapefruit and Apple Cider Vinegar Combo Diet. McKinney, TX: The Magni Company, 2002.Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
Thompson, Daryl L., and M. Joseph Ahrens. The Grapefruit Solution: Lower Your Cholesterol, Lose Weight and Achieve OPtimal Health with Nature’s Wonder Fruit. n.p.: Linx Corporation, 2004.
PERIODICALS
Bakalar, Nicholas. “Experts Reveal the Secret Powers of Grapefruit Juice.” New York Times, March 21, 2006. Available online at http://www.nytimes.com/ (accessed March 20, 2007).Cunningham, E., and W. Marcason. “Is It Possible to Burn Calories by Eating Grapefruit or Vinegar?” Journal of the American Dietetic Association 101 (October 2001): 1198.
Doheny, Kathleen. “Grapefruit Lowers Weight, Fights Cancer.” Drug Digest, August 25, 2004. Available online at http://www.drugdigest.org/DD/Articles/News/0,10141,520829,00.html (accessed March 20, 2007).
Fujioka, K., F. Greenway, J. Sheard, and Y. Ying. “The Effects of Grapefruit on Weight and Insulin Resistance: Relationship to the Metabolic Syndrome.” Journal of Medicinal Food 9 (Spring 2006): 49–54.
“Grapefruit and Weight Loss.” Medical News Today, January 24, 2004. Available online at http://www.medical-newstoday.com/medicalnews.php?newsid=5495(accessed March 20, 2007).
OTHER
American Dietetic Association (ADA). Fad Diet Timeline— Fad Diets throughout the Years. Press release, February 1, 2007. Available online at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/media_11092_ENU_HTML.htm.Enbysk, Liz. “It’s NOT Your Grandma’s Grapefruit Diet.” MSN Health and Fitness, n.d. Available online at http://health.msn.com/dietfitness/articlepage.aspx? cp-documentid=100096310 (accessed March 20, 2007).
Mayo Clinic. Mayo Clinic Diet—Myth vs. Reality. Available online at http://www.mayoclinic.org/healthinfo/mayoclinicdiet.html (accessed March 21, 2007).
U.S. Department of Agriculture (USDA), Agricultural Research Service. USDA National Nutrient Database for Standard Reference, Release 18. Available online at http://www.nal.usda.gov/fnic/foodcomp/Data/SR18/sr18.html.
ORGANIZATIONS
American Dietetic Association (ADA). 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800): 877-1600. Website: http://www.eatright.org.Dietitians of Canada/Les dietetistes du Canada (DC). 480 University Avenue, Suite 604, Toronto, Ontario, Canada M5G 1V2. Telephone: (416) 596-0857. Website: http://www.dietitians.ca.
Grapefruit Pectin Diet Tablets. [No other contact information] Website: http://ordertron.stores.yahoo.net/grdipl.html (accessed March 21, 2007).
Grapefruit Solution Dietary Supplement. [No other contact information] Website: http://www.grapefruitsolution.com/index.asp (accessed March 21, 2007).
National Institutes of Health, Office of Dietary Supplements (ODS). 6100 Executive Blvd., Room 3B01, MSC 7517, Bethesda, MD 20892-7517. Telephone: (301) 435-2920. Website: http://dietary-supplements.info.nih.gov/index.aspx.
Rebecca J. Frey, PhD.
Healthy Heart Diet
Definition
A healthy heart diet is an eating plan designed to keep blood cholesterol low and prevent the risk of heart disease. This is usually achieved by eating foods that are low in saturated fat, total fat, cholesterol, and sodium. Some diets help people lower their cholesterol levels.Origins
The healthy heart diet is the result of ongoing nutrition research by organizations including the United States Department of Agriculture (USDA) and the American Heart Association (AHA). The department first issued dietary recommendations for Americans in an 1894 Farmer’s Bulletin, according to the 1996 USDA report Dietary Recommendations and How They Have Changed Over Time.The 1894 recommendations came from W.O. Atwater, first director of the USDA’s Office of Experiment Stations. He proposed a diet for American men based on protein, carbohydrate, fat, and mineral matter. In a 1902 Farmer’s Bulletin, he warned about the danger of a dieting consisting of too much protein or fuel ingredients (carbohydrates and fat). “The evils of overeating may not be felt at once, but sooner or later they are sure to appear—perhaps in an excessive amount of fatty tissue, perhaps in general debility, perhaps in actual disease,” Atwater cautioned.
More was known about nutrients in 1941 when the USDA first issued the Recommended Dietary Allowances (RDAs). The allowance allowances covered areas like calorie intake and nine essential nutrients: protein, iron, calcium, vitamins A and D, thiamin, riboflavin, niacin, and ascorbic acid (Vitamin C). The USDA also released national food guides during the 1940s. The guides provided a foundation diet with recommendations for foods that contained the majority of nutrients. The guide was modified in 1956 with recommended minimum portions from food groups that the USDA called the “Big Four”: milk, meats, fruits and vegetables, and grain products.
The guides remained in effect until the 1970s when an increasing amount of research showed a relationship between the over-consumption of fat, saturated fat, cholesterol, and sodium and the risk of chronic diseases such as heart disease and stroke. In 1979, the USDA guide included the Big Four and a fifth category that included fats, sweets, and alcoholic beverages.
The following year, the USDA and the Department of Health and Human Services (HHS) issued the first edition of Nutrition and Your Health: Dietary Guidelines for Americans. The recommendations for healthy Americans age 2 and older included consuming a variety of foods, avoiding too much fat, saturated fat, cholesterol, and sodium. Those guidelines were recommended for people older than age 2 because younger children need more calories and fat in their diet to aid in their growth and development.
The USDA and HHS update the federal guidelines every five years. The 1990 edition recommended a diet low in fat, saturated fat, and cholesterol. Salt and sugars were to be consumed in moderation. In Dietary Guidelines for Americans 2005, the federal departments featured more specific recommendations.
The recommendations for healthy Americans came from two departments that are part of the National Institutes of Health (NIH). Within NIH is the National Heart, Lung, and Blood Institute (NHLBI), which was formed by Congress in 1948. In the 21st Century, the institute’s focus on heart disease included the creation of a Heart Healthy Diet to keep cholesterol low and the Therapeutic Lifestyles Changes (TLC) Diet to help people lower their blood cholesterol.
Furthermore, the American Heart Association (AHA)has long been concerned with educating the public about the relationship between diet and heart health. The association started in 1924 as an outgrowth of local organizations including the Association for the Prevention and Relief of Heart Disease in New York City. That group was founded in 1915 and consisted of physicians and social workers.
The national organization’s public education activities include issuing nutritional guidelines that are periodically revised. The title of the association’s “2006 Diet and Lifestyle Recommendations” reflected the importance of diet and physical activity on health,
A comparisonofthe dietary guidelines of the Healthy Heart diet, the Therapeutic Lifestyle Changes diet, and the American Heart Association diet. (Illustration by GGS Information Services/Thomson Gale.)
a combination endorsed by the medical community and public health organizations.
Description
Healthy heart diets share fundamental elements about how to prevent heart disease. The process starts with an understanding of why some foods should be avoided and others are beneficial to the heart. The first step is for the person to be aware of how food affects heart health.An internal delivery system
The heart is a muscle, and the body’s muscles require a steady supply of oxygen and nutrients. This supply is brought to the heart by blood in the coronary arteries. Healthy heart diets are designed to keep the coronary arteries open for the delivery of oxygen and nutrients. When the arteries become narrow or clogged, the heart will not receive enough blood. This blockage causes coronary heart diseases. If the heart doesn’t receive enough of the blood containing oxygen, the person feels a chest pain, which is known as angina. If the coronary artery is totally blocked off and no blood reaches the heart, the person experiences a heart attack.The narrowing or clogging of the arteries is designated as atherosclerosis when the blockage is caused by deposits of cholesterol and fat. Cholesterol is a soft, waxy substance that is similar to fats (lipids). Cholesterol occurs naturally and is found throughout the body in the bloodstream and cells.
Cholesterol’s functions
Cholesterol is used by the body to produce VitaminD, hormones, and the bile acids that dissolve food, according to NHBLI. However, the body doesn’t need much cholesterol to perform those functions, and the extra cholesterol is deposited in the arteries.Cholesterol and fats don’t dissolve in the bloodstream and are moved through the body by lipoproteins. These are a combination of a lipid (fat) surrounded by a protein, according to the American Heart Association. Total cholesterol consists of low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very-low density lipoprotein (VLDL).
VLDL carries triglycerides, a form of blood fat that could affect the heart. LDL is known as “bad” cholesterol, and HDL is called “good” cholesterol. HDL may help the body by clearing fat from the blood and removing extra cholesterol, according to the AHA.
The body produces LDL and receives more of it from food. When foods rich in cholesterol and some fats are consumed, the body creates more LDL. The dietary cholesterol comes from animal products such as meat. Also contributing to the LDL build-up are foods that are high in trans fats and saturated fats.
Fat facts
Food contains three types of fats that should be monitored on a healthy heart diet:- Saturated fat is the popular term for saturated fatty acid. Saturated fat tends to raise cholesterol levels and is found in meat, poultry, whole-milk dairy products including cheese and butter, cocoa butter, lard, and tropical vegetable oils like coconut and palms oils. Saturated fat remains solid at room temperature.
- Trans fat is a type of vegetable oil that was processed to make the liquid more solid. The process called hydrogenation produces hydrogenated and partially hydrogenated vegetable oils. These oils are found in stick margarine, vegetable shortening, commercial fried food, and baked goods such as cookies and crackers.
- Unsaturated fats include polyunsaturated fats and monosaturated fats. Polyunsaturated fats are found in fish, walnuts, corn oil, and safflower oil. Mono-saturated fats are found avocadoes, olives, olive oil, canola oil, and peanut oil.
Sodium
Sodium and salt are sometimes used interchangeably in information about healthy heart diets. The AHA recommends that people consume less than 2,300 milligrams of salt per day. This amounts to about 1 teaspoon of salt. Some organizations recommend a slightly higher amount of less than 2,400 milligrams. The recommended amount is for healthy people and may be lower for people with some health conditions.The diets of most Americans contain too much salt, and processed foods are generally the source of this sodium. A diet high in salt tends to raise blood pressure, and this could lead to heart disease, stroke, and kidney damage.
Reducing the amount of sodium in a diet will lower blood pressure, and aid in reaching healthy cholesterol levels. In addition, foods high in potassium counteract some of the effect of sodium on blood pressure, according to the USDA guidelines.
Creating a healthy heart diet
The federal government and the American Heart Association are among the organizations that provide recommendations for a healthy lifestyle. The recommendations frequently parallel those of the healthy heart diet, a plan that emphasizes the consumption of less fat, less cholesterol, and less sodium. There is also agreement that diets should include fiber-rich foods like fruits, vegetables, and whole-grain products.Guidelines also focus on the importance of regular physical activity to prevent or lower the risk of conditions like heart disease. Generally, people are advised to exercise at least 30 minutes most days of the week. While some recommendations are designed for healthy people, the guidelines also apply to a healthy heart diet. There may be more specific instructions in plans to lower cholesterol levels.
DIETARY GUIDELINES FOR AMERICANS 2005. Nutrition and Your Health: Dietary Guidelines for Americans defines a healthy eating plan as one that:
- Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
- Includes lean meats, poultry, fish, beans, eggs, and nuts.
- Is low in saturated fats, trans fats, cholesterol, salt, and added sugars.
- The total fat intake should be between 20% to 35% of the daily calories consumed.
- A variety of vegetables and fruits and unrefined, whole-grain food.
- Fish at least twice a week. Oily fish such as salmon, trout, and herring contain omega-3 fatty acids. These acids may help reduce the risk of fatal coronary disease.
- Lean meats and poultry without skin. These proteins should be prepared them without added saturated and trans fat.
- Less than 300 milligrams of cholesterol each day.
- A moderate amount of alcohol, with one drink per day for women and two drinks per day for men.
- Dairy products that are fat-free, 1% fat, and low-fat dairy.
- Food containing little or no salt. The association advises the public to cut back on:
- Foods containing partially hydrogenated vegetable oils to reduce trans fat in their diets.
- Foods high in dietary cholesterol.
- Beverages and foods with added sugars.
THE NHBLI HEART HEALTHY DIET. The NHBLI website in the spring of 2007 featured heart healthy diet guidelines and an online tool to create a personal eating plan. The online activity starts with the person providing information about height, weight, gender, age, and level of physical activity. This action generates a recommendation for a daily calorie allowance. That allowance is used to determine the percentage of total fat and saturated fat permitted at that calorie level. The consumer then receives prompts to select food choices for three meals and a snack.
As information is received, the person sees the amounts of calories, fat, total fat, cholesterol, and sodium that would be consumed. After the final entry is made, the nutritional information is totaled. The total is compared with the recommended amounts. Along with that data are recommendations on how to modify the meal plan to lower fat and cholesterol consumption.
Meal planning on the heart healthy diet is based on these guidelines:
- A person should eat just enough calories to achieve or maintain a healthy weight and reduce blood cholesterol level. A doctor or registered dietitian can determine what a reasonable calorie level.
- Saturated fat should account for 8 to 10% of the day’s total calories.
- Total fat should be 30% or less of the day’s total calories.
- Dietary cholesterol should be limited to less than 300 milligrams per day.
- Sodium intake should be limited to 2,400 milligrams a day.
- The person should eat just enough calories to achieve or maintain a healthy weight and reduce the blood cholesterol level.
- Saturated fat should account for less than 7% of the daily total calorie total.
- Fat consumed amounts to 25 to 35%% of the day’s total calories.
- The person should eat less than 200 milligrams of dietary cholesterol per day.
- Sodium intake should be limited to 2,400 milligrams per day.
Function
A healthy heart diet helps people age 2 and older reduce the risk of cardiac disease. This is achieved by the consumption of foods that keep total cholesterol and LDL cholesterol at healthy levels. A healthy heart diet may involve lowering cholesterol levels by reducing the amount of foods high in cholesterol, fat, and sodium. At the same time, people work to increase HDL levels through diet and exercise.The healthy heart diet is a lifelong process that starts with education about the effects of food on the heart. People on this diet learn to make wise food choices, relying on information including the nutritional labels on processed food. The labels provide information about the calories, fats, sodium, and sugar in a single serving of the product.
Benefits
The benefits of a healthy heart diet are that people lower their cholesterol levels and reduce their risks of cardiovascular disease. A healthy heart diet is a preventive plan for people age 2 and older since high cholesterol could become an issue in childhood. Parents who place their children on healthy heart diets not only help them with physical health, they give their children with the basics for a lifetime of healthy habits.Diet and regular physical activity keep cholesterol at healthy levels. The healthy heart diet that is also a weight loss plan will help obese and overweight people shed excess pounds. Smoking is another risk factor that will be lowered when people stop smoking. Diabetes and high blood pressure also put people at risk for heart disease. Both may be treated with medication, and people diagnosed with those conditions will benefit from a healthy heart diet.
Factors like heredity can’t be changed, so people with a family history of high cholesterol or early heart disease should prescribe to a heart healthy diet. The NHLBI defined the person at risk as someone with a father or brother diagnosed with this condition before the age 55. There is also a risk to someone with a mother or sister with this condition before age 65.
Furthermore, cholesterol levels rise as a person ages. The level rises in men at age 45 and older. For women, the increase is generally seen at age 55 and older, according to NHLBI.
Precautions
A healthy heart diet is safe for people age 2 and older. However, some people may to consult with their doctor before eating some foods such as fish. The United States Food and Drug Administration and the Environmental Protection Agency in 2004 warned pregnant women and nursing mothers to limit their consumption of fish and shellfish to 12 ounces (340.2 grams) per week. The warning was issued because of the risk that toxins in seafood would cause developmental problems in babies and children. Furthermore, women who are pregnant or nursing should not eat shark, marlin, and swordfish because of the high mercury content in these fish.Risks
When following a healthy heart diet, people need to be aware of the nutritional content of the foods they consume. They need to evaluate that information and make wise food choices. For example, the AHA points out that nuts and seeds are cholesterol-free sources of protein and a source of unsaturated fat. However, nuts and seeds are high in calories. Furthermore, frozen meals that are low in calories and fat should be examined for their sodium content.Those foods can be part of a healthy heart diet. However, people need to observe nutritional recommendations for daily fat, sodium, and calorie allowances. Otherwise, their diet will aggravate a condition like high blood pressure or obesity.
Research and general acceptance
More than a century ago, W.O. Atwater of the UDSA cautioned about the dangers of overeating. His warning proved accurate. Cardiovascular disease (CVD) was the leading cause of death in the United States in each year since 1900, with the exception of 1918, according to the American Heart Association’s Heart Disease and Stroke Statistics—2007 Update. The heart association compiles that report in conjunction with government agencies.According to the report, nearly 2,400 Americans die of CVD each day. That amounts to an average of one death every 36 seconds. In addition, an estimated 79,400,000 American adults (one in three) have one or more types of cardiovascular disease. Of those, 37,500,000 were estimated to be age 65 or older.
By the 1970s, research showed the link between chronic diseases like heart disease and stroke and a diet high in fat, saturated fat, cholesterol, and sodium. Research in the decades since then has affirmed the connection between poor diet and disease.
During those years, Americans ate more of the foods that put them at risk for heart disease. The average calorie consumption rose 16% between 1970 and 2003, according to USDA figures cited in the heart association report.
Information from the National Health and Nutrition Examination Survey for 1999-2000 indicated that Americans have not yet accepted the nutritional guidelines of a heart health diet. According to the report:
- The average daily intake of total fat in was 79 grams, with men averaging 91 grams and women averaging 67 grams.
- The average daily intake of saturated fat was 27 grams, with 31 grams for men and 23 grams for women.
- The average amount of dietary fiber consumed was 15.6 grams, below the recommended amount of 25 grams or more. Men ate 17.8 grams of fiber and women consumed 13.6 grams.
Resources
BOOKS
American Heart Association. The new American Heart Association Cookbook. Clarkson Potter/Publishers, 2004.ORGANIZATIONS
American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606. (800) 877-1600. <http://eatright.org>American Heart Association National Center, 7272 Greenville Ave., Dallas, TX 75231. (800) 242-8721. < http://www.americanheart.org>.
WEBSITES
National Heart, Lung, and Blood Institute. Choosing Foods on the Heart Healthy Diet.<http://www.nhlbisup-port.com/cgi-bin/chd1/diet1.cgi> (April 21, 2007).National Heart, Lung, and Blood Institute. Introduction to the TLC Diet. <http://www.nhlbi.nih.gov/cgi-bin/chd/step2intro.cgi> (April 21, 2007).
United States Department of Agriculture. MyPyramid Plan. <http://www.mypyramid.gov/mypyramid/index.aspx> (April 21, 2007).
OTHER
American Heart Association. American heart Association’s Heart Disease and Stroke Statistics— 2007 Update <http://www.americanheart.org/presenter.jhtml?identifier=1200026> (April 9, 2007).Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion. Physical Activity and Good Nutrition: Essential Elements to Prevent Chronic Diseases and Obesity At A Glance 2007. <http://www.cdc.gov/nccdphp/publications/aag/dnpa.htm> (April 9, 2007).
Davis, Carole and Sallo, Etta; U.S. Department of Agriculture Dietary Recommendations and How They Have Changed Over Time. <http://www.ers.usda.gov/publications/aib750/aib750b.pdf> (April 21, 2007).
U.S. Department of Agriculture and the Department of Health and Human Services. Dietary Guidelines for Americans 2005. <http://www.health.gov/dietaryguidelines/dga2005/document> (April 9, 2007).
Liz Swain.
Hollywood Diet
Definition
Origins
The Hollywood diet products were created by Jamie Kabler. He is a self-proclaimed “diet counselor to the stars.” According to the Hollywood diet website, Kabler invented the Hollywood 48 Hour Miracle Diet after visiting a European health spa. He was at the spa to help him manage his own weight, and afterwards decided that he wanted to help people lose weight and detoxify their bodies by creating a product that everyone could afford. The Hollywood 48 Hour Diet was first available in December of 1997. According to its website, more than 10 million people have used the product since then. The Hollywood 48 Hour Miracle Diet was the first of the Hollywood Diet products, but since that time the line has been expanded to include the Hollywood 24 Hour Miracle Diet, the Hollywood Daily Miracle Diet Drink Mix Meal Replacement, and various dietary supplements.Description
The Hollywood 48 Hour Miracle Diet is probably the best known of the various Hollywood products. It is an orange colored drink that is intended to be a complete food replacement for a 48 hour period. Dieters are instructed to shake the bottle well and then mix four ounces of the drink with four ounces of water (bottled water is recommended) and sip this mixture over the course of four hours. This is to be repeated four times each day. The dieter is instructed to drink eight glasses of water each day while on this diet.For the two days that the dieter is following the Hollywood 48 Hour Miracle Diet, the drink mixture and water are all that the dieter is allowed to consume. The dieter cannot eat or drink anything else. This restriction even includes drinks that have no calories, such as diet sodas and chewing gum. During this time the dieter is told that for optimal results he or she cannot have any caffeine or alcohol while on the diet, and cannot smoke.
The Hollywood 24 Hour Miracle Diet is largely the same as the 48 Hour formulation, except that is intended only for one day use. The same restrictions about food, caffeine, and alcohol intake apply, as does the ban on smoking. The website recommends that dieters use one version of the diet or the other at least one time per month, and says that it many people choose to do the 48 Hour Diet once a week.
Both Hollywood diet formulations are made mainly of fruit juice concentrates. They do contain a significant number of vitamins. The 24 hour version of the diet contains 100% of the daily recommended value of vitamins A, B6, B12, C, D, and E, as well as thiamin, riboflavin, niacin, folic acid, and panto-thenic acid in each four ounce serving. The 48 hour formulation contains 75% of the daily required value of these vitamins and nutrients. Both formulations contain 25 grams of carbohydrates, 20 milligrams of sodium, 22 grams of sugar, and no protein ineach four ounce serving.
Each four ounce serving of the Hollywood diet contains 100 calories. This means that if a dieter follows the diet’s instructions and drinks four four-ounce servings over the course of the day, he or she will be ingesting 400 calories. Because no other food or drink products are allowed during this diet this means that anyone following it will only consume 400 calories per day. This qualifies the diet as a very low calorie diet. Very low calorie diets are usually used to treat extremely obese patients with more than 30% excess body fat, and are only administered under the supervision of a doctor or other trained medical professional. If either Hollywood diet formulation were to be used regularly or for an extended period of time this would be considered a traditional very low calorie diet and would require medical supervision.
The Hollywood diet website also includes an alternative diet plan that is more comprehensive than either the 48 or 24 Hour diets. This diet plan is called the 30 Day Miracle Program. It suggests that this program be followed to help the dieter maintain the positive results achieved during the 48 or 24 Hour Diets.
The first step of the 30 Day Miracle Program is for the dieter to do the 24 or 48 Hour Diet. After this diet is finished, and the dieter returns to eating solid foods, the second step is to replace one meal per day with another Hollywood Product, the Hollywood Daily Miracle Diet Drink Mix Meal Replacement. It is suggested that the dieter replace dinner for the most successful outcome. The dieter is also encouraged to avoid foods that are high in fat or salt, that contain sugar, and to avoid dairy products, red meat, and diet sodas.
The diet also recommends that the dieter take another Hollywood product, Hollywood Meta Miracle, twice each day. This product is supposed to be able to help dieters not feel hungry, boost their metabolism, and give them more energy. The other supplement recommended by the diet is the Hollywood Mega Miracle 75 nutritional supplement. The diet instruct that it be taken twice every day. This product supposedly contains 75 different nutrients needed by the body for good health.
The diet also suggests that dieters eat a healthy breakfast and lunch, do not eat after six pm each day, and eat fruits and vegetables as snacks. The diet recommends that a dieter take a brisk walk for 30 minutes or more each day. The final instruction of the diet is to repeat either the Hollywood 48 Hour Diet or the Hollywood 24 Hour diet on a regular basis. Once a month or each weekend are suggested.
Function
Hollywood 48 Hour Miracle Diet and Hollywood 24 Hour Miracle Diet are intended to produce large amounts of weight loss in very short times. The 48 hour diet claims that dieters can lose up to 10 pounds in just two days. The 24 hour diet claims that dieters can lose up to 5 pounds in just one day. These diets suggest that they be repeated often until the desired weight loss has been achieved. These diets also claim that they will detoxify the body and rejuvenate the dieter. The 30 Day Miracle Diet is intended to provide more long term weight loss over a period of one moth. The amount of weight that dieters can expect to lose during that time period is not specified.The Hollywood 48 and 24 Hour Diets are not intended to be lifestyle changing diets. They do not provide recommendations for exercise, and they do not provide the dieter with any other forms of healthy lifestyle support, such as stress reduction techniques. The 30 Day Miracle Diet encompasses the 48 and 24 Hour products, but is intended to be a lifestyle program for more long term weight loss. It does provide healthy eating and exercise recommendations for the dieter to follow during the course of the diet.
Benefits
The Hollywood 24 and 48 Hour diets do contain fruit products and many vitamins and minerals that are part of a balanced diet. Drinking the diet product instead of a higher calorie, sugary drink such as soda, may have some health benefits. Used as a diet however the benefits are unclear. The dieter may lose weight on the diet, but it is likely to return quickly after the diet is stopped if old eating habits are resumed. There may be some psychological benefit to quick weight loss but this are likely to be undone if the weight is regained.The 30 Day Miracle Program may have some benefits. The suggestions for helping dieters maintain the weight loss achieved by the 24 or 48 Hour Diets follows many guidelines for healthy eating and moderate exercise. Following these suggestions, such as avoiding sugar, red meat, and fatty foods, are more likely than the 24 and 48 hour diets to result in moderate, sustainable weight loss. Weight loss can have many health benefits if achieved through healthy eating and exercise. Obesity is a risk factor for many diseases and conditions, such as type II diabetes and heart disease. Weight loss can reduce this risk. Following the diet’s recommendation for 30 minutes or more per day of brisk walking may also have health benefits. Regular exercise has been shown to reduce the risk of cardiovascular disease.
Precautions
The Hollywood 24 and 48 Hour Diets specify that they should not be undertaken by pregnant or breastfeeding women, nor by people with diabetes, who are taking medication, or with any medical conditions. People without any of these conditions should also be extremely cautious about beginning this diet because of its very low calorie content. Anyone thinking of beginning this or any other diet should consult a physician or other medical professional.Risks
Although the 24 and 48 Hour diets may provide many essential vitamins and minerals, there are many substances necessary for good health that they do not provide. They do not provide significant amounts of protein or fat. Protein is a very important part of a healthy diet, and some fat is required for the body to function properly. The 24 and 48 Hour diets also do not contain other nutrients that are important for good health. This means that dieters who followthese diet plans have a high risk of nutrient deficiencies. Dieters considering this diet should consult a doctor about an appropriate multivitamin or supplement to help reduce this risk. Vitamins and supplements have their own associated risks and are not regulated by the Food and Drug Administration in the same way as medicines.
There may be some negative side effects from following the 24 or 48 Hour diets. Some dieters who have tried them reported intestinal cramping, light headedness, and generally not feeling well. The website suggests that the first time a dieter try these products it be done on a day off or a weekend.
Repeating this diet frequently or for an extended period could have serious consequences. Very low calorie diets can have many negative side effects. For extremely obese people these risks of side effects can be reduced by proper medical supervision, and may be outweighed by the benefit of significant weight loss. Very low calorie diets are usually only prescribed for people who are suffering serious medical consequences from obesity. Very low calorie diets can result in many different side effects including gallstones and cardiovascular problems. Very low calorie diets are not appropriate for people who are not extremely obese, and are never appropriate without medical supervision.
Research and general acceptance
There have been no significant scientific studies of Hollywood 24 or 48 Hour Diets, or any of the other Hollywood products. The use of very low calorie starvation type diets is generally accepted to be negative for the health. Some people do advocate the use of juice fasting as a way to detoxify the body, but this is extremely controversial, and there is no research on the Hollywood diets being safe or effective for this kind of use. It is generally recommended that for safe, effective, long term weight loss and maintenance dieters follow a reduced calorie diet full of fruits and vegetables and get regular exercise.Resources
BOOKS
Downing, Frank and O. Bardoff. The Hollywood Emergency Diet. Montclair, NJ: Millburn Book Corp, 1979.Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.
Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
PERIODICALS
Larhammar, Dan. “Fakes and Fraud in Commercial Diets.” Scandinavian Journal of Food and Nutrition (June 2005): 78-80.ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>.OTHER
Hollywood Diet.com 2004. <http://www.hollywooddiet.com> (April 2, 2007).Helen M. Davidson.
Irritable Bowel Syndrome Diet
Definition
The irritable bowel syndrome diet is a set of recommendations designed to reduce the symptoms of both constipation and diarrhea that are common with irritable bowel syndrome (IBS). It is not a diet designed for weight loss.Origins
No specific person or organization originated the irritable bowel syndrome diet. Instead, it has developed out of research, observations, and trial and error by gastroenterologists and their patients with IBS.Description
Irritable bowel syndrome is a disorder in which the intestine (bowel) appears normal, but does not function correctly. The disorder is very common, but its cause is not known. About one of every five Americans has symptoms of IBS, ranging from mild and annoying to severe and lifestyle-altering.The main symptoms of IBS are pain or discomfort in the abdomen, feeling bloated, having a lot of gas (flatulence), diarrhea, constipation, or alternating periods of both. Symptoms come and go, and over time they can vary in severity in a single individual. Although diet does not cause IBS, certain foods can trigger symptoms. These foods differ from person to person. Common food triggers include alcohol, dairy products, beverages that contain caffeine, and the artificial sweeteners sorbitol and mannitol. The IBS diet is designed to avoid foods that will trigger symptoms and encourage the consumption of foods that help correct diarrhea and constipation and reduce gas.
Function
The function of the irritable bowel syndrome diet is to give the individual more control over his or her symptoms of IBS and thus improve the quality of live.The challenge of this diet is twofold. First, constipation and diarrhea are opposite in their effect, yet they can appear in the same individual as part of the same disorder. Constipation occurs when food stays in the large intestine (colon) too long. Too much water is reabsorbed into the body, and the stool (waste) in the large intestine becomes hard, dry, and difficult or painful to eliminate. With diarrhea, food moves too quickly through the large intestine. Not enough water is reabsorbed. Stools are loose and watery, and the individual may feel extreme urgency to have a bowel movement.
The second challenge to this diet is that individuals with IBS may respond to the same food in different ways. The IBS diet is not a list of “must eat” and “must not eat” foods, but rather a group of suggested foods that the individual must personalize through trial and error. Keeping a food journal often helps the person with IBS to pinpoint which foods are beneficial and which worsen symptoms.
High-fiber/low-fat IBS diet
Dietary fiber is the collective name for a group of indigestible carbohydrate-based compounds found in plants. They are the materials that give the plant rigidity and structure. The IBS diet is a high fiber/ low fat diet. The role of fiber is crucial in controlling the quality of stool in the colon, while reducing the consumption of fat is both healthful and avoids counteracting the actions of fiber. Fiber is also called roughage or bulk.Two types of fiber are important to human health, insoluble fiber and soluble fiber. Insoluble fiber is fiber that moves through the digestive system essentially unchanged. It is not digested, and it does not provide energy (calories). What fiber does is provide bulk to stool that helps it move through the large intestine. It also traps water, which helps the stool remain soft and easy to eliminate. In people with diarrhea, it can help trap excess water.
Studies find that the average American eats only 5-14 grams of fiber daily, but the recommended amounts are much higher. The United States Institute of Medicine (IOM) of the National Academy of Sciences has issued the following daily Recommended Dietary Intakes (RDIs) for fiber.
- men age 50 and younger: 38 grams
- women age 50 and younger: 25 grams
- men age 51 and older: 30 grams
- women age 51 and older: 21 grams
- children: 5 grams plus at least one gram for every year of age
- whole grains and foods made of whole grains, such as whole wheat bread and whole wheat pasta, couscous, or bulgur
- bran and bran breakfast cereals
- brown rice
- carrots
- cucumbers
- oatmeal and foods made with oats
- foods such as chili or split pea soup that contain dried beans and peas
- lentils
- apples
- pears
- citrus fruits
People who have trouble consuming enough fiber and are still having difficulty with IBS symptoms can ask their doctor about bulk-forming or fiber supplement laxatives. These supplements are quite safe, although they should not be used for long periods unless directed by a doctor because the colon will become dependent on them to move stool. Some common brand names of fiber-supplement laxatives are Metamucil, Citrocel, Fiberall, Konsyl, and Serutan.
These must be taken with water. They provide extra fiber that absorbs intestinal water and helps keep the stool soft. The extra bulk also helps move materials through the colon.
Low residue/low fat IBS diet
For some people, the high fiber/low fat diet controls both constipation and diarrhea. For others, the high fiber foods trigger diarrhea. These individuals may have better control of diarrhea on the low fiber/ low residue diet. This diet substitutes cooked fruits and vegetables for raw ones and reduces the amount of whole-grain products. Along with these changes, the individual chooses a variety of low-fat foods.Some foods that help control diarrhea on the low residue IBS diet include:
- applesauce
- low-fat mashed potatoes
- grated apples without the skin
- avocado
- cream of rice
- smooth peanut butter
- tapioca
- Consume food and drink at room temperature rather than at hot temperatures
- Drink liquids between meals rather than with meals
- Limit dairy products
- Rest after meals. This slows down the digestive process
Benefits
In addition to controlling symptoms, the IBD high fiber/low fat diet has several other benefits.- A high fiber/low fat diet has been proven in large studies to lower cholesterol levels. High cholesterol levels are directly related to heart disease
- A high fiber diet appears to help prevent type 2 diabetes
- A high fiber diet helps prevent diverticulitis. In this disease, sections of the intestine bulge out to form pockets called diverticuli that can collect food and become infected. Increased fiber helps materials
- The increased bulk of high-fiber foods helps people feel full faster, so they may eat less, resulting in weight loss
Precautions
This diet is safe for anyone, although it may not control the symptoms of IBS for every individual. Symptoms may worsen while the individual is experimenting with personalizing the food plan.Risks
Individuals who do not drink enough water on a high-fiber diet may develop abdominal pain and constipation.The amount of fiber in the diet should be increased gradually. Increasing fiber too rapidly can result in abdominal pain and large amounts of gas.
Research and general acceptance
This diet is accepted as healthy and often helpful in controlling the symptoms of IBS by almost all gastroenterologist. High-fiber diets are endorsed as having health benefits by the American Heart Association, the American Dietetic Association, the United States Department of Health and Human Services, and many individual healthcare organizations.Resources
BOOKS
Braimbridge, Sophie and Erica Jankovich. Healthy cooking for IBS New York: Stewart, Tabori & Chang, 2006.Dean, Carolyn and L. Christine Wheeler. IBS for Dummies. Hoboken, NJ: Wiley Pub., 2006.
Koff, Ashley Recipes for IBS: Great-Tasting Recipes and Tips Customized for Your Symptoms. Beverly, MA: Fair Winds Press, 2007.
Peikin, Steven R. Gastrointestinal Health: The Proven Nutritional Program to Prevent, Cure, or Alleviate Irritable Bowel Syndrome (IBS), Ulcers, Gas, Constipation, Heartburn, and Many Other Digestive Disorders, rev ed. New York, NY: Perennial Currents, 2004.
Van Vorous, Heather. Eating for IBS: 175 Delicious, Nutritious, Low-Fat, Low-Residue Recipes to Stabilize The Touchiest Tummy. New York: Marlow & Co., 2000.
ORGANIZATIONS
IBS Self Help and Support Group 1440 Whalley Avenue, ndash145, New Haven, CT 06515. Website: <http://www.ibsgroup.org>.International Foundation for Functional Gastrointestinal Disorders. P. O. Box 170864, Milwaukee, WI 53217, Telephone: (888) 964-2001. Fax: (414) 964-7176. Website: <http://www.iffgd.org>.
OTHER
Cleveland Clinic Staff “Foods to Choose if You Have Mixed Irritable Bowel Syndrome.” The Cleveland Clinic, 2007. <http://www.clevelandclinic.org/health/health-info/docs/4000/4060.asp?index=13096>.Harvard School of Public Health. “Interpreting News on Diet.” Harvard University, 2007. <http://www.hsph.harvard.edu/nutritionsource/media.html>.
International Foundation for Functional Gastrointestinal Disorders “Dietary Measures.” April 16, 2007. <http://www.aboutibs.org/site/about-ibs/management/dietary-measures>.
Jackson Siegelbaum Gastroenterology. “High Fiber Diet.” 2006. <http://www.gicare.pated/edtgs01.htm>.
University of Pittsburgh Medical Center. “Irritable Bowel Syndrome Diet.” University of Pittsburgh Health System, undated, accessed April 18, 2007. <http://patienteducation.upmc.com/Pdf/IrritableBowelDiet.pdf>.
Monique Laberge, Ph.D.
Jillian Michaels Diet
Definition
The Jillian Michaels diet focuses on self, science, and sweat to help dieters achieve weight loss, toning, and increased health and fitness.Origins
Jillian Michaels is best known as one of the stars of the popular television program “The Biggest Loser.” “The Biggest Loser” aired on NBC, and pitted two teams of significantly overweight individuals against each other to see who could lose the most weight. Jillian Michaels was the strength trainer and life coach for one of the teams of contestants. The strategies that she used to help her contestants lose weight are some of the techniques that inspired her diet and exercise program.In addition to being a television personality, Jillian Michaels is also the co-owner of the Sky Sport and Spa fitness club in Beverly Hills, California. She is certified by two programs that certify personal trainers, the National Exercise and Sports Trainers Association, and the American Fitness Association of America. She also has been doing martial arts since the age of 14, and is experienced in Muay Thai and Akarui-Do, two forms of martial arts. She has achieved the status of black belt in Akarui-Do. Michaels believes that she brings a special understanding of the needs of people struggling with their weight to her program because she has not always been fit herself. At one time she reports that she was 50 pounds overweight. She used her own experiences becoming fit and healthy to help her design a program that would help other people reach their weight and fitness goals.
Description
Jillian Michaels’ diet begins with a very basic premise. This premise is that for weight loss to occur calories going out have to be greater than calories coming in. Calories out include all calories lost through basic day to day activities and the calories burned providing energy to the body’s cells during the day. This base line caloric use is added to the number of calories that are burned during exercise. Calories in include all calories from any food and drink consumed during the day. To lose weight the calories out need to be greater than the calories coming in. This way fat will be broken down to provide the additional calories needed by the body.The diet can be customized to allow a dieter to determine how many calories should be consumed each day based on how many calories are being expended during the day generally, how many are being used through exercise, and what a person’s specific weight loss goals are. A pound of fat is comprised of about 3500 calories. That means that to lose a pound each week a dieter would have to use up 3500 more calories than are taken in that week. Spread evenly thought the week this means that each day 500 more calories should be used than are taken in. So if a dieter calculates that he or she is using 2000 calories a day that person should consume 1500 each day to lose one pound per week.
Jillian Michaels breaks her diet down into three parts: self, science, and sweat. Each of these parts comprises one of the parts she feels is important for successful, long-term weight loss and better health. Her diet provides information, recommendations, and opportunities for the dieter to customize their program in each of these areas.
By “self” Michaels means all of the psychological and emotional issues and problems associated with eating, bad habits, and being overweight. She shares many of her own insights that she gained from when she was overweight, and ways that she managed to overcome her own problems.
Michaels focuses largely on ways to change problem behaviors. Problem behaviors include any kind of eating behaviors that stem from reasons other than hunger or necessary nutrition. These include eating when a person feels stressed or upset instead of when they are hungry. Michaels believes that it is important to identify and change these problem behaviors because these are often the reasons that people have difficulty controlling their calorie intake. She provides suggestions for ways to change these behaviors, and offers alternative ways to deal with the underlying issues such as stress. She also deals with issues like the emotional aspects of being overweight. Throughout all of her diet and exercise program she provides inspiration to help the dieter overcome any setbacks and find the inner force to keep going and meet their goals.
“Science” means information about basic nutrition and how the body uses food and calories. Michaels believes that the reason many diets do not work for most people is that they are general, and not designed to meet the individual needs of the dieter. To this end she believes that there are three different ways that people metabolize food, and that the diet cannot be successful unless it is specifically designed for the dieter’s metabolic type. The three types she identifies are fast oxidizers, slow oxidizers, and balanced oxidizers.
Michaels believes that dieters with different metabolic types need different combinations of fats, protein, and carbohydrate to make their meals the most efficient for that dieter. Fast oxidizers change the carbohydrates in their food to energy very quickly, and so tend to have spikes of blood sugar right after meals. Because of this Michaels says that people who are fast oxidizers should eat meals that have higher levels of protein and fats, which are converted to energy more slowly, and lower amounts of carbohydrates, so that the energy levels are more stable during the periods after and between meals.
Slow oxidizers are the opposite of fast oxidizers, and they have metabolisms that break down carbohydrates into energy very slowly. Michaels suggests that slow oxidizers should eat meals that contain large percentages of carbohydrates, and lower amounts of fats and proteins. Balanced oxidizers should eat balanced amounts of all three, fats, proteins, and carbohydrates. This is because their metabolism converts food neither very quickly nor very slowly. Michaels provides a detailed quiz to determine what kind of metabolizer a dieter is so that menus can be customized effectively.
Michaels believes in a balanced combination of cardiovascular exercises and strength training. She suggests exercising for 60 minutes a day, with five minutes at the beginning and the end being used for stretching, warm up and cool down, and 50 minutes being used for the rigorous exercise. She provides many different exercises and routines that be customized for the fitness level of the dieter. She also provides information about how muscles work, what the main muscle groups are, and which exercises are best for training which areas of the body. Her exercises and routines draw from many different areas of fitness such as Pilates, yoga, kickboxing, weight lifting, and traditional aerobics. One aspect of her exercise routines that she finds very helpful to many dieters is that her exercises are designed to be done at home, and she says that there is no need to join a gym.
Function
Jillian Michaels’ diet and exercise program is intended to allow people to lose weight, become more fit, and achieve better overall health and well being. She also intends it to give people the ability to feel better and more empowered in their daily lives as they take control of their weight, appearance, and health.Benefits
There are many benefits to losing weight and being more fit. The benefits of weight loss can be very significant, and are even greater for people who are the most obese. People who are obese are at higher risk of diabetes, heart disease, and many other diseases and disorders. The risk and severity of these disorders is generally greater the more obese a person is. Weight loss, if achieved at a moderate pace through a healthy diet and regular exercise can reduce the risk of these and many other obesity-related diseases. Increased exercise can also reduce the risk of cardiovascular and other diseases.Precautions
Anyone thinking of beginning a new diet and exercise regimen should consult a medical practitioner. Requirements of calories, fat, and nutrients can differ significantly from person to person, depending on gender, age, weight, and many other factors such as the presence of any disease or conditions. Pregnantor breastfeeding women should be especially cautious because deficiencies of vitamins or mineralscan have a significant negative impact on a baby. Exercising too strenuously can cause injury, and exercise should be started gradually until the dieter knows what level of intensity is appropriate. It is especially important with this diet to remember that the contestants on “The Biggest Loser” did work out many hours a day and adhere to strict diets, and that although they lost a lot of weight in a relatively short amount of time this will not necessarily be the result for all dieters. Contenstants on the show were were closely monitored by physicians and other professionals, and had diet and exercise plans were specifically tailored to their dietary needs and level of fitness.
Risks
With any diet or exercise plan there are some risks. It is often difficult to get enough of some vitamins and minerals when eating a limited diet. Anyone beginning a diet may want to consult their physician about whether taking a vitamin or supplement might help them reduce this risk. Injuries can occur during exercise, such as strained or sprained muscles, and proper warm up and cool down procedures should be followed to minimize these risks. It is often best to begin with light or moderate exercise and increase the intensity slowly over weeks or months to minimize the risk of serious injury that could occur if strenuous exercise is begun suddenly and the body is not sufficiently prepared.Research and general acceptance
Although this diet has not been studied specifically, limiting caloric intake, eating a diet low in fats and carbohydrates and high in vegetable and plant products is generally accepted as a healthy diet for most people. As of 2007 the U.S. Center for Disease Control recommended a minimum of 30 minutes per day of light to moderate exercise for healthy adults. Following Michael’s fitness and exercise program would exceed these minimum recommendation.Resources
BOOKS
Michaels, Jillian. Making the Cut: The 30-day diet and fitness plan for the strongest, sexiest you. New York: Crown, 2007.Michaels, Jillian. Winning by Losing: Drop the weight, change your life. New York: Collins, 2005.
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detriot, MI: Omnigraphics, 2006.
Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>.OTHER
Michaels, Jillian. “Jillian Michaels: Real Weight Loss for Real People.” Waterfront Media Inc. 2007. <http://www.jillianmichaels.com> (March 20, 2007).The Biggest Winner - How to Win by Losing: Cardio Kickbox. DVD. Genius Entertainment, 2005.
Helen Davidson.
Kidney Diet
Definition
The kidney diet, also known as the renal diet, is a set of guidelines for people with kidney disease. The types of foods prescribed depend on the level of kidney failure the patient is experiencing, but generally the diet involves controlling the amount of sodium, potassium, phosphorus, protein, and fluid that a person ingests. People with kidney disease should be in consultation with a renal dietitian.Origins
The kidney diet has been developed and refined by the medical science community, including doctors and hospitals, who have worked with patients with kidney disease. It is based upon scientific research done by many professionals in many different settings, including laboratories, clinics, and hospitals. This research in combination with other available information has been used to develop a set of guidelines to allow patients with kidney failure to eat and drink in a way that helps to manage their disease most effectively.Description
There is no single kidney diet. The kidney diet is a set of guidelines for patients experiencing some level of kidney failure. Because every kidney patient is unique, each kidney diet may be slightly different. People who have been diagnosed with kidney failure should see a renal dietician to determine the exact specifications of the kidney diet they should follow. Whether a person is experiencing early or late stages of kidney failure, whether they are receiving dialysis treatment and which type, as well as regular nutritional factors such as height, age, and weight will play a role in determining what sort of diet should be followed. In any case, renal patients must be very careful and take their diet seriously. Careful adherence to a kidney diet can lessen the symptoms of kidney failure and prolong the usefulness of the kidneys.Sodium
Sodium is a mineral found in many foods and is important to many different bodily functions. One of the most important functions of sodium involves maintaining fluid levels. If too much sodium builds up in the body it causes thirst and fluid buildup. Normally functioning kidneys help to maintain proper levels of sodium in the body. If the kidneys begin to fail however, it becomes more important to maintain appropriate levels of sodium intake.The easiest way to avoid excess sodium intake is to eliminate putting extra salt on foods. People frequently add salt during cooking and at the table. Even just topping these behaviors will usually cut back significantly on the amount of sodium ingested. It is also important to avoid particularly salty foods such as theater popcorn, potato chips, salted pretzels, bacon and other cured meats, and processed cheese. Checking the ingredients list of processed, frozen, and canned foods is a good way to see how much sodium the product contains. Canned soups are often surprisingly high in salt, but often times there are low-sodium alternatives available.
Because salt contributes so much to the flavor of foods, it may be helpful to find replacements for it. Using lemon juice or herb mixtures can add flavor without adding sodium, however mixtures such as garlic salt should not be used because they still have contain a high level of sodium. Artificial salt substitutes should also be avoided because these usually contain high levels of potassium, another mineral that people following a kidney diet need to monitor.
Potassium
Potassium is a mineral found in varying amounts in almost all foods, including fruits, vegetables, meat, and dairy products. The body uses potassium for a variety of important functions such as maintaining fluid and electrolyte balance, sending nerve impulse to muscles, and aiding in metabolic processes. When a person’s kidneys are functioning normally they filter out excess potassium, helping to maintain the proper amount in the body. Without properly functioning kidneys, patients need to control their potassium intake.Avoiding foods with high levels of potassium, while maintaining a healthy diet, can be quite difficult because many fruits and vegetables are high in potassium. Oranges, broccoli, tomatoes, potatoes, and carrots are all high in potassium. Apples, blueberries, grapes, strawberries, lettuce, and onions are all relatively low in potassium. Canned vegetables and the juices they are usually canned are particularly high in potassium. For patients with kidney problems who want to eat certain high potassium vegetables, there is one method for removing some of the potassium, called leaching. This process varies depending on the vegetable, but generally it involves repeatedly rinsing and boiling the vegetable in a large amount of water.
Phosphorus
Phosphorus is another mineral found in many foods. The body must maintain a proper balance of phosphorus and calcium in order to build and preserve healthy bones. Normally, the kidneys help to maintain this balance by removing excess phosphorus from the bloodstream. However, patients with kidney disease may need to take steps to maintain this balance by watching what they eat, because their kidneys are no longer able to do this important job. If too much phosphorus builds up in the body it can pull calcium out of the bones, making them weak and easily breakable.People following a kidney diet may be told to avoid foods that are high in phosphorus, such as beer, soda, cheese, milk, yogurt, oysters, beans, peas, nuts, and many whole grain products. A renal dietician may also prescribe a phosphate binder, which can help control the amount of phosphate that the body absorbs.
Protein
Proteins are complex organic molecules made of amino acid chains. The body uses these chains to build and maintain muscles, organs, and glands. When the body breaks down protein it produces a waste product called urea. This waste product is usually filtered out by the kidneys and expelled from the body in urine. Patients experiencing kidney failure must be careful about the amount and type of protein they consume because the kidneys are no longer doing a good job of removing urea. If too much urea builds up in the body it can cause serious illness. Patients must be sure to get enough protein however, because without protein the body is not abletoperform proper muscle maintenance.Fluid Intake
When patients are experiencing kidney failure, their kidneys are no longer removing water from the body with proper efficiency. The worse that the kidneys are functioning, the more important it is for patients to monitor their fluid intake. Water retention can cause swelling in the feet and ankles, as well as other parts of the body. The most recommended method for preventing water retention is to monitor salt intake, as recommended above.Function
The function of the kidney diet is to help patients with kidney disease to feel better, limit their symptoms, and slow the development of kidney failure. For people with kidney disease, it is important to maintain the proper balance of electrolytes, minerals, and fluid in the bloodstream. For patients undergoing dialysis treatments, this becomes even more important. This is because the kidneys work to rid the body of excess electrolytes, minerals, and fluid by filtering the blood. When a person’s kidneys are not functioning properly, these substances can build up in the body and cause symptoms such as nausea, vomiting, tiredness, weakness, sleepiness, and other problems. If patients lower their intake of certain substances they can help to control these problems, but if they limit these same substances too severely, they can suffer from malnutrition. The kidney diet is designed to help patients find the best balance for their body.Benefits
The benefits of the kidney diet are enormous. Patients who have been diagnosed with early to late kidney failure must follow a special diet in order to slow deterioration and lessen their symptoms. Patients who do not follow a special diet will inevitably see their disease become worse more quickly. Patients who do follow this diet usually feel better and can prolong the use of their kidneys.Precautions
People with any level of kidney failure should be under medical supervision. Patients will usually need to work closely with a renal dietician who can monitor important levels of electrolytes, minerals, and fluids to make sure that patients are maintaining proper nutrition while limiting the load on their kidney and other bodily systems. The diet for dialysis patients is especially strict and should be taken extremely seriously in order avoid further complications.Risks
While there are risks to following the kidney diet guidelines, they are usually far outweighed by the risks of not following the guidelines. Patients should work with a renal dietician to determine their specific requirements. Dietary supplements will usually be needed to maintain proper nutrition.A concern for kidney patients is that they maintain proper protein levels. Kidneys, when functioning normally, remove urea, a waste product of protein, from the bloodstream. When kidneys are not functioning properly, urea can build up in the system and make patients ill. Because of this patients with kidney failure need to limit the amount of protein in their diets. However, it is important for patients to not be over-zealous in their limiting of protein, because too getting too little protein can also have serious health consequences.
Patients with kidney disease also run the risk of losing bone calcium due to high phosphorus levels. If patients do not take a phosphate binder, phosphorus in the blood will pull calcium from the bones, making them weak and brittle.
Potassium levels are also important to people with kidney disease. This mineral affects the steadiness of the heartbeat and its level in the bloodstream is normally kept steady by the kidneys. If there is too much potassium in the blood it can be very dangerous for the heart, and possibly even fatal.
Maintaining daily calorie intake is a concern for patients following a kidney diet. With the great number of restrictions placed on the kinds of foods a person can eat it can be difficult for a patient to eat enough calories each day. However if overall caloric intake is not maintained at high enough levels the patient can suffer body tissue breakdown.
If patients with later stages of kidney disease do not pay close attention to their sodium and fluid intake they have a serious risk of retaining water. Fluid can build up and cause painful swelling and weight gain. It also can cause blood pressure to rise which can adversely affect the heart. Kidney disease patients also have a greater risk of heart disease. Following a low-fat diet will usually be necessary.
Research and general acceptance
The kidney diet is the accepted diet for people with kidney disease, especially those patients who are on dialysis. The is little or no debate that it is essential for patients experiencing kidney failure to closely monitor their diet. A doctor may also prescribe other treatments in addition to a special diet.Resources
BOOKS
Mitzimberg, Judy. Dialysis Diet. Glendale, AZ: Omni-graphics, 2006.Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.
Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org> National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. Telephone: (800) 622-9010. Website: <http://www.kidney.org>.OTHER
Culinary Kidney Cooks 2007. <;http://www.culinarykidneycooks.com> (April 7, 2007).Helen Davidson.
Low-Protein Diet
Definition
A low protein diet, a diet in which people are required to reduce their intake of protein, is used by persons with abnormal kidney or liver function to prevent worsening of their disease.Origins
The low protein diet was developed by dietitians and nutritionists in response to adverse effects that protein can have on persons with kidney or liver disease. Proteins are required for growth, upkeep, and repair of body tissues. They also help the body fight infections and heal wounds. Protein contains 16% nitrogen, which the body eliminates in the urine as urea. In cases where liver or kidney function is impaired, urea, ammonia or other toxic nitrogen metabolites may build up in the blood. The low protein diet is designed to reduce these nitrogen metabolites and ammonia in individuals with liver disease or kidney failure and to reduce the workload on the kidney or liver. If the kidneys, which are responsible for excretion of urea, are not functioning properly (renal failure), or if high levels of protein are continually present in the diet, urea and other toxic nitrogen compounds build up in the bloodstream, causing loss of appetite, nausea, headaches, bad taste in the mouth, and fatigue as well as possibly further adversely affecting the kidney or liver.Description
The low protein diet focuses on obtaining most of a person’s daily calories from complex carbohydrates rather than from proteins. There are two main sources of protein in the diet: higher levels are found in animal products, including fish, poultry, eggs, meat, and dairy products), while lower levels are found in vegetable products (breads, cereals, rice, pasta, and dried beans). Generally foods in the high protein food group contains about 8 grams of protein per serving. Cereals and grains have about 2 grams of protein in 1/2 cup or 1 slice. Vegetables have about 1 gram of protein in 1/2 cup, while fruits have only a trace amount of protein in 1/2 cup. To control protein intake, foods such as starches, sugars, grains, fruits, vegetables, fats, and oils should be eaten at levels sufficient to meet daily energy needs. If a person has diabetes, the diet must also be designed to control blood sugar.Protein should never be completely eliminated from the diet. The amount of protein that can be
included in the diet depends on the degree of kidney or liver damage and the amount of protein needed for an individual to maintain good health. Laboratory tests are used to determine the amount of protein and protein waste breakdown products in the blood. A suggested acceptable level of protein in a low-protein diet is about 0.6g/kg of body weight per day, or about 40 to 50 grams per day. A person suffering from a kidney disease such as nephrotic syndrome, where large amounts of protein is lost in the urine, should ingest moderate levels of protein (0.8 kg per kg of body weight per day).
A sample menu for one day might include:
Breakfast: 1 orange, 1 egg or egg substitute, 1/2 cup rice or creamed cereal, 1 slice whole wheat bread (toasted), 1/2 tablespoon margarine or butter, 1/2 cup whole milk, hot, non-caloric beverage, 1 tablespoon sugar (optional).
Lunch: 1 ounce sliced turkey breast, 1/2 cup steamed broccoli, 1 slice whole wheat bread, 1/2 tablespoon margarine or butter, 1 apple, 1/2 cup gelatin dessert, 1 cup grape juice, hot, non-caloric beverage, 1 tablespoon sugar (optional).
Mid-Afternoon Snack: 6 squares salt-free soda crackers, 1/2 tablespoon margarine or butter, 1 to 2 tablespoons jelly, 1/2 cup apple juice.
Dinner: 1/2 cup tomato juice, 1 ounce beef, 1 baked potato, 1 teaspoon margarine or butter (optional), 1/2 cup steamed spinach, 1 slice whole wheat bread, 1/3 cup sherbet, 4 apricot halves, hot, non-caloric beverage.
Evening Snack: 1 banana.
This sample menu contains about 1850 calories, with a protein content of 8%.
Special, low protein products, especially breads and pastas, are available from various food manufacturers for persons who need to follow a low protein diet. Specific information on the protein content of foods can be found on food labels. Books that list protein contents of various foods as well as low protein cookbooks are also available.
In addition, it is recommended that fat calories be obtained from monounsaturated and polyunsaturated fats. In order to be effective, some persons may also be required to reduce their sodium and potassium ingestion in foods. Sodium restriction improves the ability to control blood pressure and body fluid build-up as well as to avoid congestive heart failure. Foods with high sodium contents, such as processed, convenience and fast foods, salty snacks, and salty seasonings, should be avoided. Potassium is necessary for nerve and muscle health. Dietary potassium restriction is required if potassium is not excreted and builds to high levels in the blood, which may result in dangerous heart rhythms. At very high levels, potassium can even cause the heart to stop beating.
As kidney function decreases, the kidneys may reduce their production of urine, and the body can become overloaded with fluids. This fluid accumulation can result in swelling of legs, hands and face, high blood pressure, and shortness of breath. To relieve these symptoms, restriction of fluids, including water, soup, juice, milk, popsicles, and gelatin, should be incorporated into the low protein diet. Liver disease may also require dietary fluid restrictions.
Tyrosinemia is a rare but serious inherited disease that may also require the use of a low-protein diet. Tyrosinemia is an inborn error of metabolism in which the body can not effectively break down the amino acid tyrosine.
Function
The purpose of a low protein diet is to prevent worsening of kidney or liver disease. The diet is effective because it decreases the stress on the kidney or liver.Benefits
Protein restriction lessens the protein load on the kidney or liver, which slows down the continued development of disease.Precautions
A person requiring a low protein diet should consult a dietitian familiar with liver or kidney diseases to provide guidance on developing an appropriate diet as well as to learn how to follow the diet effectively. The diet must meet the person’s nutritional needs, cut down the work load on the kidneys or liver, help maintain the kidney or liver function that is left, control the build-up of waste products, and reduce symptoms of the kidney or liver disease. Strict adherence to the diet can be difficult, especially for children. Small amounts of protein-containing food combined with larger amounts of low or no-protein foods can be used to make the diet more acceptable. Some persons eliminate meat, eggs, and cheese from their diets rather than measure the amounts of protein from these foods. However, care must be taken to make sure that adequate protein is included in a vegetarian diet to provide for growth and development, including building muscles and repairing wounds. Another approach, since it is difficult to manage portion sizes of foods other than milk, is to omit meats, fish, and chicken from the diet and use milk as the primary source of protein.A person with both kidney disease and diabetes must be careful to eat only low-to-moderate amounts of carbohydrates along with monounsaturated and polyunsaturated fats.
The human body reacts to protein deficiency by taking amino acids (the building blocks of proteins) away from muscle tissue and other areas of the body. The process, in which the body basically metabolizes itself, is called catabolism and leads to muscle loss and weakness. The use of exercise and strength training is recommended to counter the effects of muscle loss.
Risks
The levels of calcium and phosphorus must be monitored closely, for in persons with kidney disease, phosphorus levels can become too high, while levels of calcium can become too low. Monitoring of these two minerals may require an adjustment in dietary intakes of these minerals. Phosphorus is a mineral that helps to keep bones strong. Too much phosphorus, however, may cause itchy skin or painful joints. Calcium is required to maintain bone density and vitamin D isnecessary to control the balance of calcium and phosphorus. If changes to add these nutrients to the diet are not adequate, then supplements and medications may be required. If phosphorus levels are too high, a person may have to take phosphorus binders that reduce the amount of phosphorus that enters the blood stream from the intestine. Dairy products as well as seeds, nuts, dried peas, beans, and processed bran cereals, are high in phosphorus, so the use of these food sources may need to be limited.
A low protein diet may also be deficient in some of essential amino acids (which are the building blocks of protein), the vitamins niacin, thiamine, and riboflavin, and the mineral iron (most people with advanced kidney disease have severe anemia). Vitamin supplementation is dependent on the amount of protein restriction, the extent of kidney damage, and the vitamin content of food that is eaten. A person with kidney failure may have decreased urine output. The amount of fluids a person needs to drink is based on the amount of urine produced daily, the amount of fluid being retained, the amount of sodium in the diet, the use of diuretics, and whether the person has congestive heart failure.
In persons with advanced kidney disease, a low protein diet may lead to malnutrition. The person may lose muscle and weight, lack energy, and have difficulty fighting infections. Daily calorie intake is dependent on the amount needed to prevent breakdown of body tissues. Body weight and protein status should be monitored periodically, which in some cases may be daily. Extra calories can be added to the diet by increasing the use of heart-healthy fats, eating candy and other sweet foods, such as canned or frozen fruits in heavy syrup.
Research and general acceptance
However, it is known that although the low-protein diet may help those with chronic kidney or liver disease, the diet is also known to lead to muscle loss. In 2004 researchers in the Nutrition, Exercise Physiology, and Sarcopenia Laboratory of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (HNRCA) in Boston, Massachusetts, reported on a study involving a group of volunteers with chronic kidney disease who consumed a low protein diet. About half the group engaged in resistance training, while the other half served as a control group. Among the strength-trained participants who exercised for 45 minutes (including warm-up and cool-down) three times per week for 12 weeks, measurements showed that, on average, total muscle fiber increased by 32 percent, and muscle strength increased by 30 percent. Those who did not exercise lost on average about 3% of their body weight, or about 9 pounds.Researchers studying a group of vegetarians who had maintained a diet relatively low in protein and calories found that they had lower blood levels of several hormones and other substances that have been tied to certain cancers. Additionally it has been shown that a low protein diet protects against gout, which is caused by too much uric acid in the blood. The excess uric acid forms crystal deposits in joints, particularly in the big toe, feet and ankles, resulting in episodes of pain.
A low protein diet has also been shown to help persons with Parkinson’s disease. In this disease, dop-amine-secreting neurons in the brain die-off, leading to tremors, slowness, and rigidity. The most common treatment is a dopamine precursor called levodopa. However, the effects of this drug can decrease over time, resulting in ‘on’ periods when the person exhibits few symptoms and other ‘off’ periods when the person suffers from high and often debilitating symptoms. A research team in Italy showed that lowering the protein content of the diet can improve levodopa therapy and reduce the number and length of the “off periods.” Additional studies are needed to confirm these results.
Resources
BOOKS
Harum, Peggy. Marina Del Ray, CA: R & D Laboratories, Inc., 1999. .
The Cleveland Clinic Foundation Creative Cooking for Renal Diets Willoughby, OH: Senay Publishing, Inc., 2006. .
Walser, Mackenzie. Coping with Kidney Disease: A 12-Step Treatment Program to Help You Avoid Dialysis Hoboken, NJ: John Wiley and Sons, Inc., 2004.
The Cleveland Clinic Foundation Creative Cooking for Renal Diets Willoughby, OH: Senay Publishing, Inc., 2006. .
Walser, Mackenzie. Coping with Kidney Disease: A 12-Step Treatment Program to Help You Avoid Dialysis Hoboken, NJ: John Wiley and Sons, Inc., 2004.
ORGANIZATIONS
National Kidney Foundation, 30 East 33rd Street New York, NY 10016. Telephone: 800-622-9010. Website: kidney.orgAmerican Liver Foundation, 75 Maiden Lane, Suite 603, New York, NY 10038. Telephone: 800-465-4837 Email: info@liverfoundation.org Website: www.liverfoundation.org.
Tish Davidson, A.M.
Low-Sodium Diet
Definition
A low sodium diet is a diet that is low in salt, usually allowing less than 1 teaspoon per day. Many diseases, including kidney disease, heart disease, and diabetes, require a patient to follow a low sodium diet.Origins
There is no single origin for the idea behind low sodium diets. Many hospitals and health centers have long recommended that people with diseases that are affected by sodium intake lower the amount of salt in their diet.Description
The Role of Sodium
The majority of sodium consumed comes from sodium chloride (NaCl), better known as salt. Salt has many useful properties, both in food preservation and for the body. It helps to prevent spoilage by drawing the moisture out of foods. This helps to keep bacteria from growing in the food. It can also kill bacteria that are already growing on the surface of foods. Before refrigeration technology was developed,salting was one of the few methods available for preserving foods, such as meat, through the winter. Salt also dissolves into the electrolytes Na+ and Cl1 that help maintain the right balance of fluids in the body, transmit signals through the nervous system, and cause muscles to contract and relax.
The kidneys are responsible for regulating the amount of sodium in the body. When the body has too much sodium, the kidneys filter some out and the excess amounts are excreted from the body in the urine. When the body does not have enough sodium, the kidneys help to conserve sodium and return the needed amount into the bloodstream. When a person eats too much salt, however, and the kidneys are not able to filter enough out, sodium begins to build up in the blood. In the same way that salt pulls water out of foods, sodium in the blood pulls out and holds water from cells in the body. This increases the volume of the blood and puts strain on the heart and circulatory system.
Ways to Reduce Salt Intake
According to a study done by the Mayo Clinic, the average American gets only 6% of their total salt intake from salt that is added at the table. Only 5% comes from salt that is added during cooking, and natural sources in food makeup only another 11 percent. The remaining 77% comes from processed or prepared foods. Many packaged meats, as well as canned and frozen foods, contain a surprising amount of salt. Salt is used so heavily by manufacturers because it acts as a preservative, adds flavor to foods, helps to keep foods from drying out, and can even increase the sweetness in desserts. Soups are often especially high in salt because salt helps to disguise chemical or metallic aftertaste.One of the best ways to reduce salt intake is to cut back on heavily processed and prepared foods. Hot dogs, sausages, ham, and prepackaged deli meats usually contain much more salt than freshly sliced lean meats, such as chicken or fish. Most canned vegetables also have a much higher salt content than the same vegetable found in the fresh produce section. Frozen prepared meals should be avoided for the same reason, and canned soups usually contain much more salt than soups made a home. By reading the Nutrition Facts label on the side of commercially manufactured foods, dieters can determine how much sodium is in the food they are considering.
When choosing canned or frozen foods, dieters who wish to reduce their salt intake can often find a ‘low sodium’ option. The Food and Drug Administration (FDA) sets legal standards for how much sodium can be contained in a product that is labeled ‘low sodium.’ Products labeled as such may not contain more than 140 milligrams of sodium per serving, while products labeled as ‘reduced sodium’ need only contain 25% less sodium than the usual amount found in that product.
Meals served in restaurants are also often high in salt. Most restaurant kitchens use a great deal of processed foods. To this they often add salt because it is an inexpensive way to improve the taste. Recently, some chain restaurants have begun providing dietary information about their meals. Usually this is printed in a pamphlet that is separate from the menu, so customers may need to ask for it. Some restaurant chains even provide this information on their websites so that customers can decide on a low-sodium meal before they visit the restaurant. If this information is not available, dieters can use the same ideas for avoiding salt at the restaurant that they do at the supermarket. Salads and other foods made with fresh vegetables will usually have less salt than soups. Appetizers and meals with sauces should generally be avoided.
The most obvious way to reduce salt intake is to cut back on the amount of salt added at the table. Since salt is an acquired taste, many doctors recommend simply removing the salt shaker from the table altogether. Most condiments like ketchup, mustard, and pickle relish are also high in salt. Eliminating these can also be a significant help. Many commercially available sauces, dips, and salad dressings also contain a lot of salt. By checking the labels on these condiments before purchasing, consumers can often find options with less sodium.
Sodium Content of Popular Foods
Many people are unaware of just how much sodium is in some of the most popular foods. A low sodium diet generally consists of 1500 to 2400 milligrams of sodium each day. Some foods contain almost half of this in a single serving. The following is a list of foods and the approximate amount of sodium in one serving of each of them.- 1 large cheeseburger: 1,220 mg
- 1 cup canned soup: 800 mg
- 1 hot dog: 650 mg
- 12-ounce can of soda: 25 mg
- 1/2 cup cottage cheese: 425 mg
- 1 Tablespoon soy sauce: 800 mg
- 1 bean burrito: 920 mg
- 1 Saltine cracker: 70 mg
- 1 frozen enchilada: 680 mg
Function
The low sodium diet is designed to lower the amount of sodium that a person consumes. While this is generally considered healthy for most Americans, a low sodium diet is particularly important for people suffering from certain conditions and diseases.For kidney patients, reducing sodium is important because the kidneys are no longer capable of effectively filtering sodium out of the body. If these patients do not reduce their sodium intake, the buildup of sodium will cause fluid retention, which can cause swelling in the lower extremities. A low sodium diet will help to prevent this problem. For heart patients, a low sodium diet is important to help reduce strain on the heart. Excess sodium in the bloodstream means that excess fluid is kept suspended, which increases the volume that the heart must pump.
Benefits
There are benefits of a low sodium diet for people suffering from many different diseases and even for those who are not. A diet that is low in sodium can help to reduce blood pressure and the risk of heart disease and stroke. People who have a family history of heart problems, people of African decent, smokers, those who frequently drink alcohol, people who are overweight or do not exercise regularly, and people who live with a lot of unmanaged stress are all at higher risk for increase blood pressure and should consider a low sodium diet. For heart disease patients, a low sodium diet can be part of a plan to reduce their blood pressure and reduce the strain on their heart in order to slow the progress of current conditions and prevent future problems. For kidney patients, a low sodium diet is necessary to prevent fluid retention.Precautions
Anyone thinking of significantly altering their regular diet should talk to their physician. Each person has different dietary needs, which should be considered. In general, moderately lowering sodium intake is considered safe for most people. Dieters should be careful to not severely and abruptly increase their level of exercise and fluid intake while severely and abruptly lowering their sodium intake to avoid hyponatremia.Risks
The risks of following a low sodium diet are very low. Many experts believe that most Americans could benefit from following a low sodium diet, even if they do not yet suffer from any of the conditions that might require them to do so. Most Americans consume between 3000 and 5000 milligrams of sodium per day, and a low sodium diet reduces this to a healthier level of between 1500 and 2400 milligrams per day. Since the physiological requirement for sodium for adults is only 500 milligrams daily, there is little danger that a person following a low sodium diet will consume so little sodium that it will endanger their health.Some athletes and others who exercise frequently and ingest very little sodium yet drink a lot of water may be at risk of hyponatremia, a condition that occurs when the body does not have enough sodium. Though rare, low sodium levels can cause headache, nausea, lethargy, confusion, muscle twitching, and convulsions.
Research and general acceptance
Low sodium diets are generally accepted as part of many programs that are aimed at lowering the serious risks posed by certain diseases, such as kidney and heart disease. Most health professionals agree that a low sodium diet is not only necessary for patients suffering from these diseases, but would also be healthy and beneficial for most Americans. There is a great deal of scientific research that supports a direct link between salt intake and blood pressure.Resources
BOOKS
American Heart Association American Heart Association Low-Salt Cookbook. New York: Clarkson Potter, 2006.
Gazzaniga, Donald A. and Maureen A. Gazzaniga. The No-Salt, Lowest Sodium Light Meals Book. New York: Thomas Dunne Books, 2005.
James, Shelly V, The Complete Idiot’s Guide to Low-Sodium Meals. Indianapolis, IN : Alpha Books, 2006.
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.
Willis, Alicia P. ed. Diet Therapy Research Trends New York: Nova Science, 2007.
Gazzaniga, Donald A. and Maureen A. Gazzaniga. The No-Salt, Lowest Sodium Light Meals Book. New York: Thomas Dunne Books, 2005.
James, Shelly V, The Complete Idiot’s Guide to Low-Sodium Meals. Indianapolis, IN : Alpha Books, 2006.
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.
Willis, Alicia P. ed. Diet Therapy Research Trends New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association.120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>.American Heart Association. 7272 Greenville Avenue, Dallas, TX 75231. Telephone: (800) 242-8721. Website: <http://www.americanheart.org>.
International Food Information Council. 1100 Connecticut Avenue, NW Suite 430, Washington, DC 20036. Telephone: 02-296-6540. Fax: 202-296-6547. Website: <http://ific.org>.
OTHER
American Heart Association. ‘Sodium.’ undated, accessed April 27, 2007, <http://www.americanheart.org/presenter.jhtml?identifier=4708>.Mayo Clinic Staff. ‘Sodium: Are You getting Too Much?’ MayoClinic.com, May 24, 2006. <http://www.mayo-clinic.com/health/sodium/NU00284>.
Mayo Clinic Staff. ‘Low-Sodium Diet: Why is processed food so salty?’ Mayo Clinic.com, 2006. <http://www.mayoclinic.com/health/food-and-nutrition/AN00350>.
Medline Plus. ‘Dietary Sodium.’ U. S. National Library of Medicine, April 23, 2007. <http://www.nlm.nih/gov/medlineplus/dietarysodium.html>.
Tish Davidson, M.A.
Mayo Clinic Diet (Fad Diet)
Definition
The Mayo Clinic diet (fad diet) is a popular diet that was neither created by nor endorsed by the Mayo Clinic, an internationally respected medical research facility headquartered in Rochester, Minnesota. The fad diet promises a weight loss of 10 pounds (4.5kilo-grams) for the person who follows the plan for 12 days. The dieter wanting to lose more weight takes two days off from the regimen and then starts the diet again. A person supposedly could lose more than 50 pounds (22.7 kilograms) within several months, according to the diet plan. The diet is low in carbohydrates, high in fat, and restricts the consumption of fruits, breads, and dairy products.Origins
Details are vague about how a grapefruit-based diet became known as the Mayo Clinic fad diet. Not even the Mayo Clinic knows how its name became associated with the popular diet, according to the medical facility’s web site. The Mayo Clinic fad diet is believed to date back to the 1930s, when it was known as the Hollywood diet. It may be that the public thought that following the diet would quickly lead a dieter to have a slender figure like those of the movie stars. The Hollywood diet was a three-week plan that called for the dieter to eat grapefruit with every meal. Small amounts of other food were allowed, with the calories consumed each day totaling less than 800.Grapefruit was eaten three times daily because the citrus fruit was said to contain enzymes that burned fat. Because of this special property, the weight-loss plan was also known as the ‘‘Grapefruit Diet’’ or the ‘‘Grapefruit and Egg Diet.’’ The grapefruit diet was spoofed in the 1933 movie ‘‘Hard to Handle,’’ a comedy starring actor James Cagney. He played a con man who promoted various money-making schemes during the Great Depression. While in prison, Cagney’s character came up with a grapefruit diet that lasted 18 days.
Some Cagney fans said that the choice of fruit was a reference to ‘‘The Public Enemy,’’ a 1931 movie where the actor smashed a grapefruit into actress Mae Clarke’s face. However, grapefruit was a key element in various diets at the time. By the 1940s, one version of the fad diet was known as the Mayo Clinic Diet, according to dietitians at the Mayo Clinic.
It may be that promoters of the high-fat, low-carbohydrate diet thought that using the Mayo Clinic’s name would lead dieters to believe that the food plan was medically sound. The Mayo Clinic disputes this label and refers to the fad weight-loss plan as a ‘‘diet myth.’’
Although the creator of the Mayo clinic fad diet is not known, the weight loss plan is known internationally. The bogus Mayo Clinic diet has been circulated by various methods over the decades. People typed copies of it for their friends during the 1950s. They duplicated it on office copiers during the 1970s, sent by it fax during the 1980s, and posted online versions of it that could be found on the Internet in 2007.
Over the years, variations of the fad diet have focused on grapefruit, meat, or eggs, according to the Mayo Clinic. Furthermore, the Mayo Clinic fad diet could be the inspiration for the Atkins diet. That plan named for cardiologist Robert Atkins was first described in his 1972 book, Dr. Atkins’ Diet Revolution. Twenty years later, he updated the plan in his book, Dr. Atkins’ New Diet Revolution. Atkins maintained that people could lose weight by eating meat and cheese, foods that are high in fat. The diet starts with a two-week ban on starchy items like potatoes, food made from white flour like pasta, fruit, and most vegetables.
While the Atkins diet remained popular in 2007, the Mayo Clinic continued to receive numerous calls about the Mayo Clinic fad diet. Most people phoned during the spring, according to the clinic web site. The callers may be motivated by the desire to quickly shed pounds before summer. The Mayo Clinic was not associated with a fad diet, and the medical facility developed a program of ‘‘healthy-eating principles.’’ The program was detailed in the book Mayo Clinic Healthy Weight for Every Body.
Published in 2005, the book provided information on developing a personalized weight-loss plan. The Mayo Clinic program called for a combination of nutritional eating and exercise. This regimen generally resulted in a weight loss of 1 to 2 pounds (0.45 to 0.90 kilograms) per week. The book also advised readers that maintaining a healthy weight was a lifelong process involving a nutritious diet and physical activity.
Description
The fad Mayo Clinic diet is also referred to as the grapefruit diet because grapefruit or unsweetened grapefruit juice is consumed at every meal. Diet promoters claimed that grapefruit burned fat, resulting in weight loss. Some diets also called for the consumption of eggs, so the diet was referred to as the grapefruit and egg diet. Other elements of the diet included proteins like meat. The diet specified portion sizes for some foods. For other foods, dieters could eat as much as they wanted. Fried food was allowed in most plans.The fad diets promised that the person could eat until full and would not experience hunger. For that to occur, the dieter had to follow diet instructions that included not eating between meals and avoiding all fruit except grapefruit. The diet also limited the consumption of vegetables. The Mayo Clinic fad diet is believed to have originated as the Hollywood Diet of the 1930s.
The Hollywood Diet
The weight loss plan followed for three weeks consisted of the daily consumption of grapefruit. For 21 days, dieters followed a meal schedule of:- A breakfast of half of a grapefruit and black coffee.
- A lunch of a half-grapefruit, an egg, cucumber, a piece of melba toast, and coffee or plain tea.
- A dinner of a half of a grapefruit, two eggs, half of a head of lettuce with a tomato, and coffee or tea.
The Mayo Clinic Diet
The Hollywood Diet evolved into the weight-loss plan known as the Mayo Clinic diet or the grapefruit diet. The citrus fruit remained a key element of the numerous versions of the fad diet. Dieters could eat meat and fats, items that were said to produce the sensation of feeling full. Fruits and vegetables were restricted, and the diet was a temporary plan that generally lasted 12 days.In one version of the diet, people followed this plan:
- Breakfast consisted of a half-grapefruit or 8 ounces (0.24 liters) of grapefruit juice, two eggs, two slices of bacon, and black coffee.
- Lunch was a grapefruit half or 8 ounces (0.24 liters) of grapefruit juice, salad and salad dressing, and as much meat as the person wanted to eat.
- Dinner consisted of a half-grapefruit or 8 ounces (0.24 liters) of grapefruit juice, salad or green and red vegetables, and unlimited meat.
- The evening snack consisted of 8 ounces (0.24 liters) of skim milk or 8 ounces of (0.24 liters) tomato juice.
Most versions of the Mayo Clinic fad diet are based on a 12-day cycle. For the dieter wanting to lose more weight, the person diets 12 days, takes two days off, and then starts the cycle again. Some plans recommended starting the plan on a Monday so the dieter would have the weekend off to indulge in forbidden items. Some dieters satisfied their cravings for pastries; others enjoyed alcoholic beverages.
The New Mayo Clinic fad diet
The Internet in 2007 was among the sources of the New Mayo Clinic Diet, a plan that expanded on the original diet with more food choices. The new version contained the information that the diet was not created by the Mayo Clinic and was not approved by the medical facility. Some sites carried evaluations of the risks and benefits of the diet. Most advised the public to consult a doctor before starting a weight-loss program. Some versions advise people to exercise.The dieter follows the plan for 12 days and is off the diet for two days. The weight-loss plan consists of:
- A breakfast of a half-grapefruit or 8 ounces (0.24 liters) of unsweetened grapefruit juice, two eggs prepared any way, two slices of bacon, and black coffee or tea.
- A lunch of a half-grapefruit or 8 ounces (0.24 liters) of unsweetened grapefruit juice, salad or raw vegetables from the allowed list, salad dressing that was not fat-free or low-fat, and meat that was prepared any way. Foods could be fried in butter.
- Dinner of a half-grapefruit or 8 ounces of (0.24 liters) unsweetened grapefruit juice, salad with dressing or allowed vegetables, and meat. Vegetables could be cooked in butter and meat could be cooked any way.
- An optional evening snack of 8 ounces (0.24 liters) of tomato juice or skim milk.
Not allowed on the diet are white vegetables such as potatoes and white onions, corn, sweet potatoes, other starchy vegetables, breads, pasta, rice, and snack foods such as potato chips and pretzels. Also forbidden are fruit and desserts.
People are advised to follow the all of the diet rules because the combination of food supposedly burns fat. The diet regulations are:
- The amount of coffee or tea consumed should be restricted to one cup with the meal because drinking more could affect the fat-burning process.
- No foods should be eliminated, and dieters should eat the bacon at breakfast and salad during the other meals.
- The dieter must eat at least the minimum amount required for each meal. When no amount is specified, the person is may eat as much as needed until she or he feels full.
- The dieter should avoid eating between meals. If the diet is followed, the person is not supposed to experience hunger between meals.
Function
Benefits
The primary benefit of the Mayo Clinic fad diet is that a person quickly loses weight. For some people, a diet of several weeks is easier to follow than one that could last months or one described as a lifetime of healthy eating. On the fad plan, dieters do not have to count calories or track the fat and fiber of content of foods. People follow a plan consisting of several basic foods. The diet is more affordable than some weight-loss plans that require the purchase of meals.Furthermore, dieters could feel that they aren’t depriving themselves because they’re allowed to eat as much as they want of meat and other high-fat proteins. People fond of fried foods will be happy that they don’t have to give up those items.
The plan consists of a limited selection of food so it will be easy for dieters to shop and to know what to eat. While the repetitive nature of the diet may become monotonous, that sameness may help curb dieters’ appetites. The monotony for some dieters is endured by the knowledge that the diet is short-term.
Precautions
People taking certain medications should not prescribe to the Mayo Clinic fad diet because grapefruit and grapefruit juice could interact with those medications. Moreover, the general public should avoid the popular diet because it is not nutritionally balanced. According to the Mayo Clinic, the fad diet could be dangerous because some versions restrict calorie consumption to 800 per day.Organizations including the clinic and the American Heart Association maintain that 1,200 calories per day is the minimum amount that should be consumed unless a dieter is following a medically supervised weight-loss plan.
Some versions of the diet are low calorie; others permit the dieter to eat unlimited amount of proteins. The fad diet severely restricts other food groups. Dieters miss out on the nutrients and fiber in fruits and vegetables, and the calcium found in dairy products. At the same time, they eat foods that often contain more calories, fat, and sodium.
The appeal of the Mayo Clinic fad diet is that it is a short-term plan. However, people often gain back more weight after they stop dieting.
Risks
Risks associated with the fad diet range from the medication-grapefruit interaction to the potential for complications related to a high-fat diet. The Mayo Clinic in 2006 cautioned that cmicals in grapefruit and grapefruit juice interfere with the body’s process of breaking down drugs in the digestive system.. The interference could produce excessively high levels of the drug in the blood. The interaction could occur with some medications to treat high blood pressure, HIV, high cholesterol, arrhythmia (abnormal heart rhythm), and erectile dysfunction. There is also a potential for interaction with some anti-depressants, anti-seizure medications, tranquilizers, immunosup-pressant drugs and the pain relief drug Methadone.The issue of this interaction was subject to some debate, with the Florida Department of Citrus in 2003 advising the public that the use of alternate medications would allow people to continue drinking grapefruit juice. In a related matter, the University of Florida served a key role in the establishment in 2003 of the Center for Food-Drug Interaction Research and Education. The center focuses on interactions with grapefruit. It is accessible to the public through a website.
People with concerns about grapefruit should ask their physician or pharmacist about possible drug interactions or alternative medications.
Furthermore, the combination of a high-protein diet with unlimited fat and the restriction on carbohydrates puts dieters at risk for conditions such as high blood pressure, heart disease, strokes, and diabetes. According to the American Heart Association, the risk is caused by increased cholesterol levels. This rise in cholesterol is brought on by the increase in fat and the decrease in fiber from fruits, vegetables, and whole-grain products. These foods are complex carbohydrates, and eliminating them causes the body to burn stored fat. While this process causes a weight loss, it triggers a reaction called the ‘‘starvation mode.’’
When the person ends the diet and again eats carbohydrates, the body responds by converting food into fat. This protection against starvation results in a weight gain.
Research and general acceptance
Grapefruit is a source of vitamin C and fiber, but the citrus fruit does not have the capacity to burn calories. That’s one of the misconceptions about the fad diet that the Mayo Clinic called a ‘‘hoax’’ because it limits the variety of food and promises a dramatic weight loss. Research by the clinic and organizationsincluding the United States Department of Agriculture (USDA) concluded that a healthy weight loss is based on a nutritionally balanced diet with selections from the five food groups.
Furthermore, healthy selections for all people are recommended in the nutritional guidelines issued jointly by the USDA and Department of Health and Human Services. Dietary Guidelines for Americans 2005 recommends a diet that emphasizes fruits, vegetables, whole grains, and fat free or low-fat milk and milk products. Selections from the protein food group should include lean meats, poultry, fish, beans, eggs, and nuts. In addition, the diet should be low in saturated fats, trans fats, cholesterol, salt, and added sugars.
Moreover, much of the Mayo Clinic fad diet conflicts with the American Heart Association’s ‘‘2006 Diet and Lifestyle Recommendations.’’ The nutritional guidelines for preventing cardiovascular disease include a diet of:
- Less than 300 milligrams of cholesterol each day. An egg yolk contains approximately 200 milligrams of cholesterol. Egg whites are cholesterol-free and rated by the association as a good source of protein.
- A variety of fruits and vegetables. These foods could help control weight and blood pressure.
- I Meats and poultry without skin. They should be prepared without added saturated fat.
- Less than 2,300 milligrams of sodium each day. This is the equivalent of 1 teaspoon of salt. High-sodium foods on the Mayo Clinic diet include: bacon, ham, sausage, hot dogs, lunch meat, and salad dressings.
General acceptance
Versions of the Mayo Clinic fad diet have been in circulation since the 1930s. The weight loss plan’s popularity was related to the fact that people rapidly lost weight by eating foods not ordinarily on a diet. The popularity of the diet seemed to lessen when the public discovered the Atkins diet, a weight-loss plan with some similarities.Resources
BOOKS
Hensrud, Donald (ed.) Mayo Clinic Healthy Weight for Every Body. Mayo Clinic, 2005.ORGANIZATIONS
American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606. (800) 877-1600. <http://eatright.org>.American Heart Association National Center, 7272 Greenville Ave., Dallas, TX 75231. (800) 242-8721. <http://www.americanheart.org.>.
Center for Food-Drug Interaction Research and Education (grapefruit only), website. <http://www.druginterac-tioncenter.org/index.php>.
Mayo Clinic, 200 First St. S.W.,Rochester, MN 55905. (507) 284-2511. <http://www.mayoclinic.com>
OTHER
Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion. Physical Activity and Good Nutrition: Essential Elements to Prevent Chronic Diseases and Obesity At A Glance 2007. <http://www.cdc.gov/nccdphp/publica-tions/aag/dnpa.htm> (April 9, 2007).Mayo Clinic. Grapefruit juice: Can it cause drug interactions?<http://www.mayoclinic.com/health/food-and-nutrition/AN00413> (April 12, 2007).
Food and Nutrition Information Center National Agricultural Library/USDAWeight Control and Obesity Resource List for Consumers<http://www.nal.usda.gov/fnic/pubs/bibs/topics/weight/consumer.html> (April 11, 2007).
Mayo Clinic. Mayo Clinic Diet: A weight-loss program for life (2006). <http://www.mayoclinic.com/health/mayo-clinic-diet/WT00016> (April 7, 2007).
U.S. Department of Agriculture and the Department of Health and Human Services. Dietary Guidelines for Americans 2005 <http://www.health.gov/dietaryguidelines/dga2005/document> (April 9, 2007).
Zelman, Kathleen M. ‘‘The Grapefruit Diet. ’’WebMD <http://www.webmd.aol.com/diet/features/the-grapefruit-diet?page=1> (February 20007).
Liz Swain
Negative Calorie Diet
Definition
The Negative Calorie diet is based on the theory that some foods use more calories to digest than are contained in the foods and that this can be used to produce weight loss.Origins
The origins of the idea of negative calorie foods are not clear. For many years some people have speculated that if a dieter were to eat foods that were hard for the body to break down, but did not contain very many calories, that it would take more energy for the body to process the food than were acquired through the breakdown of the food.As of 2007, the Negative Calorie diet is available as an 80 page downloadable e-book from the website www.negativecaloriediet.com. It is put out by The Equilibria Group, and is not available as a traditional book. Dieters must purchase the right to download the book to their personal computer and then can view the book on the computer or print it out if they choose. According to the website the diet has been available since 1997 and has been followed by thousands of dieters around the world.
Description
The Negative Calorie diet is based on the idea that some foods are negative calorie foods. The diet does not claim that the foods actually contain negative calories, instead the idea is that some foods take more calories for the body to process and digest than are contained in the foods themselves.When a person eats a piece of food the first thing that happens is chewing and this action consumes energy. Foods that are higher in stringy fibers, such as celery, generally require more chewing, and hence more energy expenditure, than other foods such as cake which do not require as much chewing. After chewing, the food is moved down the esophagus and into the stomach, where it begins to be broken down as it mixes with stomach acid. Then it is moved into the small intestine where it is liquefied and absorption into the body begins. Then the mass moves into the large intestine where fluids are absorbed and then the residual mass is excreted.
The Negative Calorie diet believes that this entire process of digestion uses many calories, and so by eating foods that are low in calories, and take longer to digest, the body will actually be using more calories than are taken by processing the foods. The diet claims that these extra calories required for digestion are taken from fat stores in the body, and that the more of these negative calorie foods the dieter eats, the more weight will be lost.
The Negative Calorie diet gives, as an example, the net calorie consumption from eating broccoli. It says that if you eat a serving of 100 grams of broccoli, which contains 25 calories, it will take the body 80 calories worth of energy to digest it. This results in a negative net calorie use of 55 calories which are supposed to be taken from fat stores on the body. As a counter example the diet says that if a dieter eats a piece of cake that contains 400 calories, it will take the
body 150 calories to digest it, and the net 250 calories taken into the body will be stored as fat.
The Negative Calorie diet contains more than 100 foods which are considered negative calorie. These are mostly fruits and vegetables that are high in fiber. Some of the vegetables include: asparagus, beets, broccoli, cabbage, celery, chilies, garlic, lettuce, spinach, and zucchini. Some fruits considered negative calorie include: apples, grapefruits, lemons, oranges, and pineapple.
There are 3 diet plans that a dieter can select from, depending on how fast the dieter wants to lose weight. Also provided are a variety of recipes and suggestions for how to continue to include negative calorie foods in the diet once the desired weight loss has been achieved.
The diet says that eating these negative calorie foods can actually increase the body's metabolism. The e-book also includes other suggestions for how the dieter can increase his or her metabolism. One suggestion is breathing better and more deeply. The diet says that this will increase metabolism and let the body rid itself of toxins. The diet also provides a set of exercises. It claims that the three exercises provided will tone 85% of the body's muscles. These exercises are recommended to be done for 15 minutes, three times a week.
Function
The Negative Calorie diet is intended to help dieters lose a lot of weight very quickly. It says that dieters can lose up to 14 pounds in 7 days by following the diet strictly. It also includes exercise recommendations that are intended to help the dieter tone their body. After the dieter has reached their desired weight the Negative Calorie diet suggests that it be repeated as needed to help maintain weight loss. It also says that during this period the negative calorie food should be included into the dieters usual diet to help promote continued health and ensure that the weight is not regained.Benefits
The Negative Calorie diet claims that dieters can lose up to 14 pounds in 7 days. Although this has not been proven, there are many benefits to a diet that includes many of the foods on the negative calorie list. Eating a diet that includes many different fruits and vegetables will provide a dieter with many vitamins and minerals that are important to good health.Including many of the foods listed as negative calorie foods may be able to help promote weight loss if part of an otherwise balanced and healthy diet. This is because foods that are low in calories, but full of fiber, can make the dieter feel fuller after eating fewer calories, and because fibrous foods may take longer for the stomach to break down, they may help the dieter to feel full longer. There are many benefits to losing weight if it is done at a moderate pace through healthy eating and increased exercise. Obesity is associated with an increased risk of type II diabetes, cardiovascular disease, and many other diseases and conditions. Losing weight can reduce the risks of these and other obesity-related diseases as well as may be able reduce the severity of the symptoms if the diseases have already occurred.
Precautions
Risks
There are some risks with any diet, and these risks are often especially great when the diet severely limits the foods that can be eaten. It is often difficult to get enough of some vitamins and minerals when eating a limited variety of foods. The Negative Calorie diet limits the dieter mainly to the list of foods that are believed to be negative calorie. Although these foods are fruits and vegetables, which are good sources of many important vitamins and minerals, they are not enough to maintain good health.The Negative Calorie diet limits dairy products, as they are not considered to be negative calorie. Because these foods are excellent sources of calcium, it is possible that people who do not eat any of these foods may not get enough calcium in their diet. Lack of calcium can lead to many different disease and conditions such as osteoporosis and rickets. Anyone considering this diet might want to consider taking a supplement or vitamin to help reduce the risk of this and other similar deficiencies.
Protein and fat are also not included in any of the foods that are considered to be negative calorie. Although too much fat in the diet can be harmful, some is required to maintain good health. Protein is also necessary for good health. Not getting enough protein can have many negative effects on the body and people considering this diet should closely monitor their intake to make sure that they are getting enough.
Research and general acceptance
There have been no scientific studies of the Negative Calorie diet. Although it is generally accepted that food does require energy for the body to digest, the amount of energy expended depends very heavily on the body's metabolism, and there is no way for dieters to accurately measure how much energy their body is expending to digest any given food. The diet also claims that these foods will increase the dieter's metabolism, which has not been scientifically proven.Following the diet's recommendations for breathing has not been scientifically proven to increase metabolism, or rid the body of toxins.
The United States Department of Agriculture's MyPyramid, the updated version of the Food Guide Pyramid, recommends that healthy adults eat the equivalent of 2 to 3 cups of vegetables each day. The Negative Calorie diet would more than adequately meet these requirements for most people because the majority of the foods considered to be negative calorie are vegetables.
MyPyramid recommends that healthy adults eat the equivalent of 1 1/2 to 2 cups of fruit per day. 1 cup of fruit is equivalent to 1 small apple, 1 large orange, or 1 cup of pineapple cubes. Because these and many other fruits are considered to be negative calorie, it is likely that a person following the negative calorie diet would consume the recommended daily amount of fruit.
The Negative Calorie diet severely limits the intake of dairy products for dieters. Dairy products are generally considered to be part of a healthy diet. MyPyramid recommends the equivalent of 3 cups of low-fat or non-fat dairy per day for healthy adults. Following the Negative Calorie diet would generally not meet this recommendation.
Starches and grains are also severely restricted on the Negative Calorie diet. Whole grains are generally considered a necessary and important part of any healthy diet. MyPyramid recommends that healthy adults eat the equivalent of 3 to 4 ounces of grains each day, of which at least half should be whole grains. The Negative Calorie diet would not generally meet this recommendation.
As of 2007, the Center for Disease Control recommends 30 minutes of light to moderate exercise each day for healthy adults. Because this diet includes exercise recommendations that are only require performing the exercises three times a week, for 15 minutes each workout, following this diet alone without additional exercise does not meet these minimum recommendations. Regular exercise is generally accepted as an excellent way of improving health, reducing the risk of disease, and managing weight.
Resources
BOOKS
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>OTHER
“Negative Calorie Diet” The Diet Channel 2007.<http://www.thedietchannel.com/Negative-calorie-diet.htm> (April 6, 2007).“The Negative Calorie Diet” Get the Skinny on Diets 2007.<http://skinnyondiets.com/TheNegativeCalorieDiet.html> (April 6, 2007).
Negative Calorie Foods and Recipes eBook 2005.<http://www.negativecaloriefoods.com> (April 6, 2007).
Helen M. Davidson
Organic Food
Definition
Organic foods are not specific foods, but are any foods that are grown and handled after harvesting in a particular way. In the United States, organic foods are crops that are raised without using synthetic pesticides, synthetic fertilizers, or sewage sludge fertilizer, and they have not been altered by genetic engineering. Organic animal products come from animals that have been fed 100% organic feed and raised without the use of growth hormones or antibiotics in an environment where they have access to the outdoors. Standards for organic foods vary from country to country. The requirements in Canada and Western Europe are similar to those in the United States. Many developing countries have no standards for certifying food as “organic.”Purpose
The organic food movement has the following goals:- improve human health by decreasing the level of chemical toxins in food
- decrease the level of agricultural chemicals in the environment, especially in groundwater
- promote sustainable agriculture
- promote biodiversity
- promote genetic diversity among plants and animals by rejecting genetically modified organisms (GMOs)
- provide fresh, healthy, safe food at competitive prices
Description
Organic farming is the oldest method of farming. Before the 1940s, what is today called organic farming was the standard method of raising crops and animals. World War II accelerated research into new chemicals that could be used either in fighting the war or as replacements for resources that were in short supply because of their usefulness to the military. After the war ended, many of the new technological discoveries were applied to civilian uses and synthetic fertilizers, new insecticides, and herbicides became available. Fertilizers increased the yield per acre and pesticides encouraged the development of single-crop mega-farms, resulting in the consolidation of agricultural land and the decline of the family farm.Organic farming, although only a tiny part of American agriculture, originally offered aniche
(Illustration by GGS Information Services/Thomson Gale.) market for smaller, family-style farms. In the early 1980s this method of food production began to gain popularity, especially in California, Oregon, and Washington. The first commercial organic crops were vegetables that were usually sold locally at farmers’ markets and health food stores.
By the late 1980s interest in organic food had reached a level of public awareness high enough that the United States Congress took action and passed the Organic Food Production Act of 1990. This act established the National Organic Standards Board (NOSB) under the United States Department of Agriculture (USDA). NOSB has developed regulations and enforcement procedures for the growing and handling of all agricultural products that are labeled “organic.”These regulations went into effect on October 21, 2002.
Since the 1990s, the market for organic food has expanded from primarily fruits and vegetables to eggs, dairy products, meat, poultry, and commercially processed frozen and canned foods. In 2000, for the first time, more organic food was purchased in mainstream supermarkets than in specialty food outlets. By 2005, every state had some farmland that was certified organic, and some supermarket chains had begun selling their own brand-name organic foods. The demand for organic food is expected to continue to grow rapidly through at least 2010.
Organic certification is voluntary and applies to anyone who sells more than $5,000 worth of organic produce annually. (This exempts most small farmers who sell organic produce from their own farm stands). If a product carries the USDA Organic Seal indicating that it is ‘‘certified organic’’ it must meet the following conditions:
- The product must be raised or produced under an Organic Systems Plan that demonstrates and documents that the food meets the standards for growing, harvesting, transporting, processing, and selling an organic product.
- The producer and/or processor are subject to audits and evaluations by agents certified to enforce organic standards.
- The grower must have distinct boundaries between organic crops and non-organic crops to prevent accidental contamination with forbidden substances through wind drift or water runoff.
- No forbidden substances can have been applied to the land organic food is raised on for three years prior to organic certification.
- Seed should be organic, when available, and never genetically altered through bioengineering.
- Good soil, crop, and animal management practices must be followed to prevent contamination of groundwater, contamination of the product by living pathogens, heavy metals, or forbidden chemicals, and to reduce soil erosion and environmental pollution.
Selecting organic food
The USDA allows three label statements to help consumers determine if a food is organic.- Labels stating “100% organic”indicate that all of the ingredients in the product are certified organic. These items have the USDA Organic Seal on the label.
- Labels stating “organic”indicate that at least 95% of the ingredients are certified organic. These items also carry the USDA Organic Seal on the label.
- Labels stating “made with organic ingredients”indicate that at least 70% of the ingredients are certified organic. These items are not permitted to have the USDA Organic Seal on the label.
- Items that contain fewer than 70% organic ingredients are not permitted to use either the word “organic” or the USDA Organic Seal on the label.
Debate continues about the exact requirements to label animal products “cage-free,”“free-range,”or “open pasture.” Cage-free simply means the animals were not kept caged, but does not necessarily mean that they were raised outdoors or allowed to roam freely. There is no certification process for the designation “cage-free.”Animals can spend as little as five minutes per day outdoors and still be considered “free-range.”Animal rights organizations are working to clarify these designations and improve the conditions under which all animals, are raised.
Organic food and health
Certified organic food requires more labor to produce, which generally makes it more expensive than non-certified food. Some consumers buy organic food primarily because the way it is raised benefits the environment. Others believe absolutely in the health benefits of organic food. A larger group of consumers are uncertain if organic food offers enough health benefits to justify the additional cost.Discussions of the health benefits of organic food can become quite heated and emotional. Advocates of buying organic foods firmly believe that they are preserving their health by preventing their bodies from becoming receptacles for poisonous chemicals that can cause cancer, asthma, and other chronic diseases. Non-organic food buyers take the position that the level pesticide and fertilizer residue in non-organic food is small and harmless. Neither side is likely to change the other’s view. However, below are some conclusions from studies done comparing organic and non-organic foods.
- The food supply in the United States, whether organic or non-organic, is extremely safe.
- Fresh organic and non-organic produce are equally likely to become contaminated with pathogens such as E. coli that cause health concerns.
- Many, but not all, chemical contaminants can be removed from non-organic food by peeling or thorough washing in cool running water.
- Organic foods are not 100% pesticide and chemical free. However, their chemical load appears to be lower than that of non-organic foods.
- The nutrient value of identical organic and nonorganic foods is the same.
- The long-term effect on humans of trace amounts of hormones, antibiotics, and drugs found in milk, meat, and other non-organic animal products is unclear.
- The long-term effect of genetically modified foods on both humans and the environment cannot yet be known.
Precautions
Individuals should be informed about food labeling requirements and read food labels carefully so that they can make informed decisions about their purchases.Interactions
Organic food does not interact with drugs or other foods in a way that is different from non-organic foods.Complications
No complications are expected from eating organic food.Parental concerns
Chemicals found in foods may have a greater effect on the growth and development of younger children than older ones. Young children are rapidly growing while still developing their nervous system, immune system, and other organs. Chemicals may have a greater effect on these developing tissues than on adult tissues.Resources
BOOKS
Meyerowitz, Steve. The Organic Food Guide: How to Shop Smarter and Eat Healthier Guilford, CT: Globe Pequot Press, 2004.Fromartz, Samuel. Organic, Inc.: Natural Foods and How They Grew. Orlando, FL: Harcourt, 2006.
Goodman, Myra, with Linday Holland, and Pamela McKinstry, Pamela. Food to Live By: The Earthbound Farm Organic Cookbook New York: Workman Pub.,2006.
Lipson, Elaine. The Organic Foods Sourcebook. Chicago, IL:Contemporary Books, 2001.
ORGANIZATIONS
National Organic Program. USDA-AMS-TM-NOP,ROOM 4008 s. Bldg, Ag Stop 0268, 1400 Independence Avenue, S.W., Room 1180, Washington, DC 20250. Telephone: (202)720-3252. Website: “http://www.ams.usda.gov/nop>Organic Trade Association. PO Box 547, Greenfield MA 01302. Telephone: (413) 774-7511. Fax: (413) 774-6432. Website: “http://www.ota.com>
OTHER
Barrett, Stephen. “Organic’ Foods: Certification Does Not Protect Consumers.”Quackwatch, July 17, 2006. “http://www.quackwatch.org/01QuackeryRelatedTopics/organic.html>Mayo Clinic Staff. “Organic Foods: Are They Safer? More Nutritious?”MayoClinic.com, December 26, 2006. “;http://www.mayoclinic.com/health/organic-food/NU00255>
National Organic Program. “Organic Food Standards &Labels: The Facts.” United States Department of Agriculture, Agricultural Marketing Service, January 2007. <http://www.ams.usda.gov/nop/Consumers/brochure.html>
Nemours Foundation. “Organic and Other Environmentally Friendly Foods.” March 2007. <http://kidshealth.org/teen/food_fitness/nutrition/organics.html>
“Organic Foods in Relation to Nutrition and Health Key Facts.” Medical News Today. July 11, 2004. <http://www.medicalnewstoday.com/medicalnews.php?newsid=10587>
Organic Trade Association. “Questions and Answers About Organic.”2003. <http://www.ota.com/organic/faq.html>
Pames, Robin B. “How Organic Food Works.” How Stuff Works, undated, accessed April 26, 2007. <http://home.howstuffworks.com/organic-food.htm;>
Helen M. Davidson
Personality Type Diet
Definition
The personality type diet is a diet developed by Dr. Robert Kushner that helps dieters identify what kind of eating, exercising, and coping habits they have to help dieters achieve weight loss and better health through personalized incremental change.Origins
The personality type diet was developed by Dr. Robert Kushner. Dr. Kushner is a practicing physician who specializes in nutrition and weight loss. He developed the diet to meet the needs of the average dieter with a busy schedule. He used the information and insights he gained during many years of helping people lose weight. Dr. Kushner designed the diet to be a long term aid in the fight against obesity that was personalized enough to be meet each dieters unique needs.Dr. Kushner attended medical school at the University of Illinois Medical School in Chicago, Illinois. During this time he became interested in obesity and weight loss. After completing his medical degree in 1979 he completed his residency at Northwestern Memorial Hospital and specialized in internal medicine. He also completed a fellowship in clinical nutrition at the University of Chicago in 1984. He is the Medical director of the Northwestern Memorial Hospital Wellness Institute and the president of the American Board of Nutrition Physician Specialists. He authored the American Medical Association’s “Obesity Treatment Guide for Physicians,” as well as numerous scientific papers on obesity, weight loss, and nutrition. Dr. Kushner is also the head of the expert support team for Diet.com. His book “The Personality Type Diet” was written with his wife Nancy Kushner who is a registered nurse.
(Illustration by GGS Information Services/Thomson Gale.)
Description
The personality type diet is designed to be useful to normal people who are trying to lose weight, but have very busy schedules and do not have the time or energy to devote many hours each day to weight loss. Before beginning the diet there is a 66 question questionnaire that the dieter takes to determine what type of dieter, exerciser, and coper the dieter is. The questions address eating and exercise habits, as well as stress and coping mechanisms. Dr. Kushner believes that identifying the way that a person eats, exercises, and deals with problems is the first step to successful weight loss and healthy living. He provides information directed at particular types, as well as general information and tips. The seven types of eaters are:Unguided grazer
Unguided grazers tends to not think about food very much. They will eat at various times during the day but rarely stop to have a meal or think about what they are eating. Usually eating is an afterthought to a very busy schedule, so foods tend to be whatever is around and easily available. Often this person eats while doing other things, so portion size can vary drastically depending on what is available or what size package is sold.Nighttime nibbler
Nighttime nibblers eat more than half of their food intake at dinner or even later. Instead of eating regularly throughout the day they might not eat at all until dinner time. Sometimes the nighttime nibblerdoesn’t even eat dinner, he or she just snacks after work until going to sleep.
Convenient consumer
Convenient consumers may eat regular meals, but they barely ever cook. Because they don’t cook meals at home, most of the foods that they eat are packaged or are from restaurants, often fast food chains. Convenient consumers may also eat a lot of microwave meals.Fruitless feaster
Fruitless feasters may eat regular meals, but they tend to leave out two important food groups, fruits and vegetables. Instead the fruitless feaster eats lots of meat and carbohydrates.Mindless muncher
The mindless muncher snacks constantly throughout the day, usually in addition to eating a full breakfast, lunch, and dinner. Often the snacking is done without actually being hungry, and is done instead out of habit or for emotional reasons.Hearty portioner
The hearty portioner may eat three meals a day, but tends to eat far too much at any given sitting.Sometimes this may occur because they let eating go for too long and then are ravenous when they sit down to eat, and end up eating too much.
Deprived snacker
Deprived snackers are often people who are constantly on diets. They crave foods that they feel like they shouldn’t eat, and then overeat alternative foods instead. This is often a vicious cycle of making resolutions and then eating in ways that may fit the specific rules, but violate the spirit of the diet.Dr. Kushner believes that helping people to identify the ways in which they eat is an important first step in helping them change their eating behaviors. Paying attention to what is being eaten may even help to reduce negative patterns on its own. Dr. Kushner suggests specific techniques to help each type of eater overcome their specific type of problem. For example, for the healthy portioner, learning the basics of how much should be eaten at each meal can be very helpful. Also, adding a small snack or two throughout the day can help to ensure that the dieter is not so hungry by mealtime that he or she overeats.
There are also different types of exercisers, such as the hate-to-move struggler and the no-time-to exercise protester. Dr. Kushner provides ideas for making incremental changes to help achieve regular healthy exercise habits. There are also different types of copers, including cant’t-say-no pleaser, and the emotional stuffer. There are suggestions about ways to put better coping mechanisms in place, and to deal with the problems that the dieter encounters.
Function
The personality type diet is intended to help the dieter make incremental changes that are sustainable for a lifetime. Although weight loss is the primary function of the diet, it is only a secondary concern and is expected to take place as a natural consequence of the incremental changes for better eating and health that take place during the diet. Better eating, exercising, and coping strategies are expected to lead to weight loss and better health and well being that lasts a lifetime.Benefits
There are many benefits to losing weight and being more fit. The benefits of weight loss can be very significant, and are even greater for people who are obese. People who are obese are at higher risk of diabetes, heart disease, and many other diseases and disorders. The risk and severity of these disorders is generally greater the more obese a person is. Weight loss, if achieved at a moderate pace through a healthy diet and regular exercise, can reduce the risk of these and many other obesity-related diseases. Increased exercise can also reduce the risk of cardiovascular disease and other diseases. An additional benefit of the Personality Type Diet is that it may lead to a perception of increased control over life in general as the dieter learns to identify and correct problem behaviors and patterns and take more active control of his or her eating and weight.Precautions
Anyone thinking of beginning a new diet should consult a medical practitioner. Requirements of calories, fat, and nutrients can differ significantly from person to person, depending on gender, age, weight, and many other factors such as the presence of diseases or conditions. Pregnant or breastfeeding women should be especially cautious because the diet of the mother influences the nutrients that the baby receives.Risks
There are some risks to following any diet. The Dr. Kushner diet encourages the dieter to eat a wide variety of healthy foods, and does not completely restrict any food group. For this reason the risks associated with this diet are probably not as significant as with many other diets. However, a multivitamin or supplement may help ensure that the dieter receivesall the necessary nutrients and vitamins required each day for good health. A dieter my want to ask his or her physician about an appropriate vitamin or supplement before beginning the diet. Vitamins and supplements have either own risks and women who are pregnant or breastfeeding should be especially cautious. There are no known risks specifically associated with the personality type diet as it suggests slow, incremental change and a balanced diet.
Research and general acceptance
Although the personality type diet has not been studied specifically, there is a wealth of scientific evidence that suggests that a diet low in fat and high in vegetable and plant products is healthful. There is also a large quantity of evidence that suggests a generally balanced diet is important for weight loss and good overall heath.It is also generally accepted that weight loss can significantly improve overall health. Obesity is associated with many different health problems. These include diabetes, sleep apnea, and cardiovascular disease. Studies have shown that the more overweight a person is, the more likely they are to have these and other obesity related health problems. Losing weight can significantly reduce these risks and may reduce the severity of the symptoms if the problems have already occurred.
Dr. Kushner has authored many scientific papers about obesity and weight loss. He is the author of the American Medical Association’s “Obesity Treatment Guide for Physcians”. His views on what constitutes a healthy diet and what the best ways to help patients control their weight are generally accepted by the medical community, and in some cases have set the standard in care for treating obese patients seeking to lose weight.
Resources
BOOKS
Kushner, Robert and Nancy Kushner. Dr. Kushner’s Personality Type Diet. New York: St. Martin’s Press, 2003.Kushner, Robert. Evaluation and Management of Obesity. Daniel Bessesen ed. Philadelphia: Hanley and Belfus, 2002.
Kushner, Robert and Marty Becker. Fitness Unleashed!: A dog and owner’s guide to losing weight and gaining health together. New York: Three Rivers Press, 2006.
Kushner, Robert and Daniel Bessesen eds. Treatment of the Obese Patient. Totowa, NJ: Humana Press, 2007.
Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detriot, MI: Omnigraphics, 2006.
Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>OTHER
Kushner, Robert. “Dr. Kushner’s Personality Type Diet.” drkushner.com 2007. <http://www.doctorkushner.com> (March 22, 2007).Helen M. Davidson
Raw Foods Diet
Definition
The raw food diet is a lifestyle diet where at least 75% of all food consumed eaten raw and never commercially processed or cooked.Origins
Raw food has its origins in prehistory. As humans gradually developed tools and learned to control fire, a raw food diet gave way to a diet of cooked food. Modern interest in a raw food diet began in the 1930s. Ann Wigmore (1909–1994) was an early pioneer in using raw or “living” foods to detoxify the body. Herbert Shelton (1895–1985) was another early advocate of the health benefits of raw foods.Shelton founded a school and clinic in Texas that promoted the practice of Natural Hygiene. Natural Hygiene is an offshoot of naturopathic or alternative medicine. Shelton believed that conventional medicines were poison, fasting would cleanse the body, and that only one type of food should be eaten at each meal. Shelton's philosophy has influenced both the raw food movement and Harry Diamond, founder of the Fit for Life diet.
Since the 1980s, several raw food diets have been promoted as cures for cancer. However, although the American Cancer Society and the National Cancer Institute support a diet high in vegetables, including raw vegetables, they do not support a raw foods diet as prevention or a cure for cancer. Raw food began to develop a more high-profile following in the 1990s, as celebrities such as Demi Moore and Woody Har-relson embraced a raw food diet, and in the 2000s raw food restaurants and cafes began showing up in some trendy urban areas, especially in Northern California.
Description
The raw food diet is more of a philosophy and lifestyle choice than a conventional weight-loss diet. A raw food diet is one in which 75% or more of the food a person eats is uncooked. Generally, raw foodists believe that the closer a person can come to eating a diet that is 100% raw, the better that person's health will be.Raw food, as defined by many raw foodists, is unprocessed food whose temperature has never reached above 116° F (47° C). Some raw foodists make a distinction between “raw” and “living” foods. Raw foods, they define as uncooked foods, while living foods are uncooked foods that contain more enzymes because they have been “activated.” As an example, an unsprouted almond would be considered raw, but an almond soaked in water that has begun to sprout would be considered living. For discussion here, raw and living are used interchangeably to mean food that has not been processed or heated above 116° F (47° C).
Raw foodists can be vegans and eat no animal products, vegetarians, who eat dairy products and eggs but no meat, or omnivores who eat both vegetables and meat, so long as their food is raw. The majority tend to be vegetarians or vegans who prefer to eat uncooked, unheated, unprocessed organic food. Some go so far as to advocate that the raw foodist grow his or her food instead of purchasing it from commercial growers.
Some foods that are mainstays of the raw food diet include:
- fresh fruits and vegetables
- seeds
- nuts
- legumes (dried beans and peas)
- whole grains
- dried fruits and vegetables
- unpasteurized fruit and vegetable juices
- young coconut milk
- seaweed and sea vegetables (not acceptable to all raw foodists)
- wheatgrass
- sprouts of all kinds
- purified or bottled water
- unpasteurized milk and dairy products made with unpasteurized milk (non-vegans)
- raw eggs (non-vegans)
Function
Although weight loss is not a goal of a raw food diet, weight loss inevitably occurs because this diet is very low in fats, protein, and calories. More importantly, raw food tends to be part of a lifestyle choice that involves a desire for purity, rejection of conventional medicine, and an effort to be closer to nature.Raw foodists believe that raw food contains enzymes that help digestion. In their vies, cooking inactivates or kills (denatures) these enzymes, making it harder for the body to digest cooked food. Some raw foodists go so far as to claim that cooked foods are toxins. Raw foodists also believe that living food contains bacteria and microorganisms that are beneficial to digestion and that raw foods contain more nutrients than cooked foods.
Benefits
Raw foodists claim that the raw food diet offers the following benefits:- weight control. It is difficult, if not impossible, to become obese on a raw food diet
- increased energy
- better digestion
- a stronger immune system
- more mental clarity and creativity
- improved skin
- a reduced risk of heart disease and other chronic diseases
Precautions
Some foods are unsafe to be eaten raw.- Buckwheat greens are poisonous if eaten raw and cause photosensitivity in fair-skinned people.
- Rhubarb leaves can be poisonous if eaten raw. The stalks can be toxic if they are not harvested when they are young.
- Raw kidney beans and kidney bean sprouts are poisonous.
- The greenish skin that develops on some potatoes is poisonous. The toxin is neutralized by cooking at high temperatures.
- Raw foods, especially meats and seafood, can be contaminated with bacteria and parasites that would be killed with cooking.
Risks
eating ‘proper,’ ‘pure,’ or ‘superior’ foods.” People with orthorexia allow their fixation with eating the correct amount of properly prepared healthy foods at the correct time of day to take over their lives.This interest in correct eating only becomes an eating disorder when the obsession interferes with relationships and daily activities. For example, an orthorectic may be unwilling to eat at restaurants or friends’ homes because the food is “impure” or improperly prepared. The limitations they put on what they will eat can cause serious vitamin and mineral imbalances. Orthorectics are judgmental about what other people eat to the point where it interferes with personal relationships. They justify their fixation by claiming that their way of eating is healthy. Some experts believe orthorexia may be a variation of obsessive-compulsive disorder.
In addition potential psychological harm, without rigorous meal planning, raw foodists are at high risk of developing certain vitamin deficiencies, depending on whether they follow a vegan, vegetarian, or meat-eating raw food diet. Vegans are at highest risk. The most common deficiencies are of vitamin B12 and protein.
Research and general acceptance
The public does not generally accept a diet of raw food. Many medical practitioners and nutritionists also express skepticism about the ability of people on the raw food diet to get an adequate balance of vitamins, minerals, and protein to maintain long-term health. However, this diet undeniably reduces many of the risks (e.g. obesity, high cholesterol, high trigly-cerides) associated with the development of cardiovascular disease.standard American diet. They found that the raw foodists were thinner and had a lower average body mass index(BMI) than volunteers and that their bones were lighter. However, they found no sign that the bones of the raw foodists were more likely to fracture or that they had a greater degree of osteoporosis than those of people on the standard diet. The researchers concluded that the bones of the raw foodists were lighter because they ate fewer calories and had lower body weights, but that they were healthy bones.
Other research shown that some nutrients, such as carotenoids in carrots and lycopene from tomatoes, are absorbed into the body much more easily from cooked foods than from raw foods. The enzyme theory of digestion promoted by some raw foodists is also not substantiated by any scholarly research, nor are claims that a raw food diet will prevent cancer.
Resources
BOOKS
Alt, Carol with David Roth. Eating in the Raw: A Beginner's Guide to Getting Slimmer, Feeling Healthier, and Living Llonger the Raw-food Way. New York: Clarkson Potter, 2004.Bijlefeld, Marjolijn and Sharon K. Zoumbaris. Encyclopedia of Diet Fads. Westport, CT: Greenwood Press, 2003.
Icon Health Publications. Fad Diets: A Bibliography, Medical Dictionary, and Annotated Research Guide to Internet References. San Diego, CA: Icon Health Publications, 2004.
Rose, Natalie.The Raw Food Detox Diet: The Five-step Plan to Vibrant Health and Maximun Weight Loss. New York: ReganBooks, 2005.
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets fromAto Z.Clifton, VA: Apex Publishers, 2005.
PERIODICALS
Nick, Gina L. “Consuming Whole Foods in Their Raw, Uncooked State: A Personal Interview with Raw Food Nutrition Expert, David Wolfe.” Towsend Letter.240 (2003):50-2. <http://findarticles.com/p/articles/mi_m0ISW/is_2003_July/ai_104259135>ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>Living and Raw Foods Support Groups. <http://www.living-foods.com/resources/support.html>
Living Nutrition. <http://www.livingnutrition.com>
OTHER
Brotman, Juliano. “The Living and Raw Foods F.A.Q.” LivingFoods.com, undated, accessed April 20, 2007. <http://www.living-foods.com/faq.html>Harvard School of Public Health. “Interpreting News on Diet.” Harvard University, 2007. <http://www.hsph.harvard.edu/nutritionsource/media.html>
Hobbs, Suzanne H. “Raw Food Diets: A Reviews of the Literature.” Vegetarian Resource Group October 28, 2002. <http://www.vrg.org/journal/vj2002issue4/rawfoodsdiet.htm>
“The Raw Food Diet.” iVillage.com <http://www.ivillage.co.uk/dietandfitness/experts/nutrexpert/articles/0,,282_598387,00.html>
“Raw Food Eaters Thin but Healthy.” BBC News, March 29, 2005. <http://news.bbc.co.uk/g0/pr/fr/-/1/hi/health/4389837.stm>
Wong, Cathy. “The Raw Food Diet.” About.com, March 31, 2006. <http://altmedicine.about.com/od/popularhealthdiets/a/Raw_Food.htm>
Tish Davidson, A.M.
South American diet
Definition
Description
Eating Habits and Meal Pattern
South Americans typically eat three meals and one or two snacks daily. Milk is usually not consumed as a beverage but used in fruit-based drinks and coffee, and milk-based desserts are popular. Fruits, vegetables, and nuts are eaten in abundance. Cassava flour and meal are common in many areas.Coffee is a major beverage throughout the continent, and South American countries now produce most of the coffee consumed worldwide; Brazil alone produces about a third of the world’s coffee. Coffee usually is served concentrated, then diluted with evaporated milk or water. Coffee is consumed heavily in Argentina, Colombia, Ecuador, and Brazil, while tea is popular in Chile and Uruguay. Herbal teas are used as remedies throughout the continent.
Yerba mate (pronounced ‘yerba mahtay’) is a caf-feinated, tea-like beverage that is consumed for its ‘medicinal’ properties. Its many health claims include energizing the body, stimulating mental alertness, strengthening the immune system, and aiding weight loss. Mate is consumed mainly in Argentina, Uruguay, Paraguay, and southern Brazil. It is brewed from the dried leaves and stemlets of the perennial tree Ilex para-guarensis. The bombilla is a special metal straw used to drink this brew.
Breakfast is normally a light meal with coffee or tea; bread with butter and jam; and sometimes fruit or fruit juice. Meat and cheese are usually eaten in Brazil and Chile. Lunch is traditionally a heavy meal, and it is followed by a siesta (nap), which helps one recover from both the food and the heat. The siesta is still common among many locals, but the tradition is disappearing from the business day. Appetizers such as fritters and turnovers may start the lunch meal, followed by grilled meat, rice, beans, cassava, and greens. Dinner is another heavy meal, and it often lasts several hours. Dinner usually begins late in the evening, sometimes as late as 9:00 P.M. Desserts are usually simple.
Typical desserts are fresh or canned fruits with cheese, a custard called flan, and a milk cake called tres leches. Snacks are readily available from street vendors and bakeries. Popular snacks include turnovers filled with spicy meats, seafood, and vegetables; hot dogs; and steak or meat sandwiches.
Traditional Cooking Methods and Food Habits
The cuisine of South America varies from country to country and region to region. The cuisine tends to be a blend of cultural backgrounds, available foods, cooking styles, and the foods of colonial Europeans. Some regions have a largely maize-based diet (often spiced with chili peppers), while other regions have a rice-based diet. Grilled meats are popular. Traditionally, sides of beef, hogs, lamb, and goats are grilled slowly for hours. Another cooking method is to steam foods in a pit oven. For example, in Peru, a pachamanca typically includes a young pig or goat (as well as chicken, guinea pig, tamales, potatoes, and corn) cooked under layers of hot stones, leaves, and herbs. Clambakes are popular in Chile.Quinoa, the seed of the Chenopodium, or goose-foot plant, has been a staple food of millions of native inhabitants, but production declined for centuries after the Spanish conquest in the 1500s. It is used as a grain and substituted for grains because of its cooking characteristics. It became a minor crop due to its decline, and at times it has been grown only by peasants in remote areas for local consumption. In Peru, Chile and Bolivia, quinoa is widely cultivated for its nutritious seeds, which are used in creating various soups and bread, and it is also fermented with millet to make a beer-like beverage. A sweetened concoction of quinoa is used medicinally.
Regional Food Habits
Colombia and Venezuela. Venezuelan and Colombian foods have Spanish influences. Many foods are cooked or served with olive oil, cheese, parsley, cilantro, garlic, and onions. Hot chile peppers are served on the side of most dishes. Local fruits and vegetables are abundant, and tropical fruits are often dried to make fruit leather. In Columbia, chicken stew and sancocho (a meat stew with starchy vegetables) are popular. One of the most unusual specialties of Columbi is hormiga, a dish made from fire ants. Toasted ants are also a favorite treat during the insect season in June. In Venezuela, cornmeal bread, or arepa, is a staple food. Arepa is cooked on a griddle and is sometimes stuffed with meat or cheese before it is fried. Pabellon caraqueno is also popular. This dish consists of flank steak served on rice with black beans, topped with fried eggs and garnished with plantain chips. Coffee, rum, and beer are common beverages.Argentina, Chile, Bolivia, Uruguay, and Paraguay. These southern countries are major beef producers. Argentineans eat more beef per capita than any other country in the world. Argentina is famous for asados, restaurants specializing in barbecued and grilled meat dishes—mainly beef, but also pork, lamb, and chicken. The national dish of Argentina is matambre, which is herb-seasoned flank steak rolled around a filling of spinach, whole hard-boiled eggs, and whole or sliced carrots. It is then tied with a string and either poached in broth or baked.
Citizens of these southern states enjoy hearty soups and stews daily. Fish soups and stews are popular in coastal Chile. Stews in Argentina often combine meats, vegetables, and fruits. The soups of Paraguay have heavy European influences and include bori-bori, which is a beef soup with cornmeal and cheese dumplings. Pizza, pasta, and meat dishes are popular in these countries. Wines from the midlands of Chile are considered to be some of the best produced on the continent.
Guyana, French Guiana, and Suriname. Guyanese cuisine is a culinary hybrid with African, East Indian, Portuguese, and Chinese influences. Guyanese usually cook three full meals every day. Rice and roti (flat bread) are staples at lunch and dinner. Fresh cow’s milk may be part of the morning or evening meal. A favorite dish is pepper pot, a stew made with bitter cassava juice, meat, hot pepper, and seasoning. Other popular foods are roti and curry, garlic pork, cassava bread, chow mein, and ‘cook up,’ a one-pot meal that can include any favorite meats or vegetables. Popular homemade drinks are mauby, made from the bark of a tree, sorrel, made from a leafy vegetable used in salads, and ginger beer. People in French Guiana enjoy an international cuisine, as well as Chinese, Vietnamese, and Indonesian dishes. Imported soft drinks and alcoholic drinks are popular but expensive. Suriname’s cuisine has heavy Javanese, Dutch, Creole, Chinese, and Hindustani influences. Beer and rum are popular alcoholic drinks.
Peru and Ecuador. The cuisine of Peru and Ecuador is typically divided into the highland foods of the Andes and the lowland dishes of the tropical coastal regions. The cuisine in the mountain areas is the most unique in South America, preserving many dishes of the Inca Indians. Potatoes are eaten at nearly every meal, including snacks. More than 200 varieties of potato can be found in the Lake Titicaca region. They range in color from purple to blue, and from yellow to brown. Size and texture vary as well—some are as small as nuts, while others can be as large as oranges. The foods of Peru and Ecuador feature an abundant use of chile peppers. Salsa de aji, a mixture of chopped chile, onion, and salt is served at most meals. The coastal region is famous for its cerviches, a method for preparing seafood in which the main ingredient is marinated in lime or sour orange.
Risks
Nutritional Status
A high percentage of South Americans live in extreme poverty. Parasitic infection, protein-calorie malnutrition, iron-deficiency anemia, iodine deficiency, and vitamin-A deficiency are common nutritional problems in the rural and urban areas in many South American countries. Heart disease, hypertension, and obesityare also on the rise.Precautions
The natural beauty of South America makes it a popular ecotourism destination. Food-borne and water-borne diseases are the number one cause of illness in travelers. Visitors are therefore advised to wash their hands often and to drink only bottled or boiled water or carbonated drinks in cans or bottles. They also should avoid tap water, fountain drinks, and ice cubes.Resources
BOOKS
Kittler, P. G., and Sucher, K. P. (2001). Food and Culture, 3rd edition. Stamford, CT: Wadsworth.OTHER
U.S. Centers for Disease Control and Prevention. ‘Health Information for Travelers to Temperate South America.’ Available from <http://www.cdc.gov/travel/temsam.htm>Hamre, Bonnie. ‘South America for Visitors.’ Available from <http://gosouthamerica.about.com/cs/cuisin1/>
Delores C. S. James
TLC Diet
Definition
Although there are several diets that will result in lowered LDL cholesterol, the National Cholesterol Education Program (NCEP) set forth guidelines for medical professionals to follow when instructing patients on a medical nutrition option for lowering cholesterol. Termed the TLC diet or the Therapeutic Lifestyle Changes Diet it emphasizes heart healthy lifestyle choices.The Therapeutic Lifestyle Changes diet (TLC) is a cholesterol lowering diet that refers to a cholesterol-lowering treatment that lowers a person’s low-density lipoprotein (LDL) level and raises their high-density lipoprotein (HDL) level enough to reduce their risk of a heart attack or other chronic disease caused by hardening of the arteries.
The TLC diet follows the
se dietary guidelines
- Less than 7% of the day’s total calories from saturated fat.
- 25-35% of the day’s total calories from fat.
- Less than 200 milligrams of dietary cholesterol a day.
- Limit sodium intake to 2400 milligrams or less per day.
- Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level.
The NCEP classifies blood cholesterol levels as:
- Total Cholesterol less than 200 mg/dL, desirable; 200-239 mg/dL borderline-high; 240 mg/dL and above high.
- HDL Cholesterol less than 40 mg/dL as a major heart disease risk factor; 60 mg/dL and above gives some protection against heart disease.
Origins
Cholesterol is a waxy substance found only in foods of animal origin such as poultry, beef, fish, eggs, and dairy products. Cholesterol can be made from the liver and thus is not needed in the diet for normal cellular processes. Cholesterol must be combined with fats, proteins, and lipoproteins, before it can be transported through the body within the blood. There are many different lipoproteins that vary in size, function and composition. One of which is low-density lipoprotein (LDL). Commonly referred to as the “bad” cholesterol, it composes relatively two-thirds of total circulating blood cholesterol. Because the LDL transports cholesterol through the bloodstream, in high levels, it is associated with plaque deposits on the walls of the arteries resulting in a higher risk for cardiovascular events. High-density lipoprotein (HDL) referred to as the “good” cholesterol, scavenges excess cholesterol from the blood and brings it back to the liver for excretion. Research! shows that higher levels of HDL levels are related to lower levels of certain cardiovascular events. Another class of lipoproteins, the very-low-density-lipoproteins (VLDL), is responsible for carrying triglycerides through the bloodstream.Evidence is clear that the major dietary contributors to elevated cholesterol are saturated fat, trans fat, dietary cholesterol, and an imbalance in caloric intake and energy expenditure resulting in weight gain. In some cases elevated cholesterol may be due to an underlying medical condition or certain prescribed medications as listed below, but not limited to:
- Hypothyroidism
- Nephrotic syndrome
- Chronic liver disease
- Cholestasis
- Monoclonal gammopathy
- Cushing’s syndrome
- Oral contraceptive use
- Anorexia nervosa
- Acute intermittent porphyria
- Protease inhibitor use
- Heredity. Genetic factors play a large role in the amount of cholesterol in a person’s blood.
- Age.As a person ages, their cholesterol level tends to rise gradually.
- Sex. Men tend to have higher LDL and lower HDL than premenopausal women.
- Menopause. After menopause, estrogen levels fall and women’s LDL cholesterol levels tend to rise.
- Weight. As weight rises, so does cholesterol. Usually LDL levels rise as HDL levels lower.
- Smoking. Smoking can lower a persons HDL levels.
- Exercise. Regular exercise raises a persons HDL levels. As well as help in weight loss or maintenance.
- Alcohol. Studies suggest that no more than one drink for women and two drinks for males may help in raising HDL levels.
In their first approach, the NCEP designed the Step 1 and Step 2 diet to lowering cholesterol. Designed as an initial diet for people with high dietary cholesterol, the Step I diet restricted total fat to no more than 30% of total calories, saturated fat to no more than 10% of total calories, and cholesterol to less than 300 mg/day. If this approach did not result in a lowering of cholesterol or for people post-myocardial infraction or at high risk of one, the Step II diet goals were instituted. They recommended less than 7% of total calories for saturated fat and less than 200 mg/ day of cholesterol.
For the general population, the NCEP still recommends a diet following the Step 1 recommendations. However, in May of 2001, the NCEP issued the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]) which recommended the new TLC dietary therapy for subgroups of people with specific medical conditions and risk factors listed below:
High LDL cholesterol or other lipid disorders, coronary heart disease or other cardiovascular disease diabetes mellitus, insulin resistance or metabolic syndrome.
Soon after the report was issued, health organizations such as The American Heart Association (AHA) began to accept and endorse these recommendations. Now a majority of organizations have incorporated the TLC diet into materials on dietary and lifestyle change for people with high blood cholesterol.
Description
The three cornerstones of the TLC lifestyle modification diet are:- Dietary Changes. Reduction of saturated fat, trans-fat, and cholesterol within the diet. Addition of plant stanols and sterols. Increased consumption of soluble fiber.
- Weight Management. Weight loss can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels. For those with a large waist measurement (more than 40 inches for men and more than 35 inches for women) it is important to lose weight to decrease the risk for developing heart disease.
- Physical Activity. Regular physical activity, at least 30 minutes on most, if not all, days is recommended every day of the week. Physical activity can help raise HDL and lower LDL and is important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement
The TLC Program is adjusted using a set of four categories that are based on ones heart disease risk profile to set LDL goals and treatment steps. For a person who has heart disease or diabetes, they are considered a category I, carrying the highest risk. For persons free of those conditions, their needs are based upon their personal risk of having a heart attack in the next 10-years based upon the Framingham Heart Study. The higher a persons risk category, the more important it is for them to lower their LDL and control any other heart disease risk factors (including smoking and high blood pressure) they have.
Function
The TLC diet is prescribed for people who need to reduce their risk for heart disease. The main goal in treating high cholesterol via the TLC program is to lower a persons LDL level. Research has proven that a lowering of LDL levels can prevent or decrease the risk of heart attacks and reduce deaths from heart disease in both men and women. The TLC program can decelerate, stop, or reverse the buildup of plaque. When followed, it can also lower the cholesterol content in unstable plaques, making them less likely to burst and cause a heart attack. For those who have already experienced a myocardial infraction, the diet can reduce the risk of another heart attack, possibly prolonging life.Benefits
Precautions
Along with a qualified physician, making sure that qualified professionals who can assist with safe dietary and lifestyle changes should include registered dietitians, doctors, nurses, psychologists, and exercise physiologists.Risks
According to the NCEP Guidelines, all adults 20 years of age and older should have their total cholesterol as well as HDL-cholesterol measured every five years.Positive Risk factors for heart disease:
- Male greater than 45 years of age
- Female greater than 55 years of age
- Female with premature menopause without estrogen replacement
- Family history of premature coronary heart disease having definite myocardial infarction or sudden death before age 55 in father or other first-degree male relative, or mother before age 65 years of age
- Currently smoking or history of cigarette smoking
- Blood pressure greater than 140/90 mmHg or on antihypertensive medications
- HDL cholesterol less than 35 mg/dl
- LDL cholesterol greater than 130 mg/dl
- Diabetes Mellitus
Research and general acceptance
Scores of research articles support a direct relationship between LDL cholesterol levels and the rate of coronary heart disease (CHD) in a person. Within-population studies such as the Framingham and MRFIT studies and between-population studies, most notably the Seven Countries study support this research as well. Studies on familial Hypercholesterolemia, a genetic disorder characterized by high levels of LDL cholesterol, have an exceedingly high rate of premature atherosclerosis. The majority of research from experimental animals, laboratory investigations, epidemiology, and genetic forms of hypercholesterolemia indicate that elevated low-density lipoprotein (LDL) cholesterol is a major cause of CHD. In addition, clinical trials demonstrate a reduction of coronary heart disease risk when low-density lipoprotein-lowering therapy is instituted. For these reasons, the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood cholesterol in Adults (Adult Treatment Panel III) continues to identify elevated low-density lipoprotein cholesterol as the primary target of cholesterol-lowering therapy.
Resources
BOOKS
Hark, Lisa and Gail Morrison. Medical Nutrition & Disease: A Case-based Approach, 2003.Marian, Mary J., Pamela Avonne Williams, and Jennifer Muir Bowers. Integrating Therapeutic and Complementary Nutrition , 2006.
Meskin, Mark S. et al. eds. Phytochemicals: Mechanisms of Action 2003.
Stamford, Bryant A. and Robert J. Moffrat. Lipid Metabolism and Health 2006
Stanfield, Peggy S. and Yiu H. Hui. Nutrition and Diet Therapy, 2003.
ORGANIZATIONS
National Cholesterol Education Program NHLBI Information Center. P.O. Box 30105 Bethesda, MD 20824-0105 <http://www.nhlbi.nih.gov>.National Diabetes Information Clearinghouse http://diabetes.niddk.nih.gov/
Tobacco Information and Prevention Source TIPS. <http://www.cdc.gov/tobacco/index.htm>.
Megan C.M. Porter, RD, LD
USDA Food Guide Pyramid (MyPyramid)
Definition
The United States Department of Agriculture (USDA) food pyramid, called MyPyramid to distinguish it from earlier versions, contains recommendations on diet and exercise based on the Dietary Guidelines for Americans 2005.Purpose
MyPyramid is intended to help Americans become more aware of what they eat and what their nutrient requirements are. It is designed to help people learn how to eat a healthy diet, live an active lifestyle, and maintain or gradually move in the direction of a healthy weight that will reduce the risk of weight-related diseases. Unlike earlier diet and nutrition guidance, MyPyramid can personalize dietary recommendations based on the individual’s height, weight, age, gender, activity level and weight goals.Description
MyPyramid, released in 2005, is the most recent in a series of publications designed to provide Americans with broad dietary recommendations that will promote health. More than one hundred years ago in 1894, the USDA published its first set of national nutrition guidelines. The first food guide followed this in 1916. In this first food guide, the author, a nutritionist, introduced the idea of food groups. The five food groups defined in the food guide were milk and meat, cereals, fruits and vegetables, fats and fatty foods, and sugars and sugary foods. The guide made recommendations about eating food from each food group to remain healthy.In 1941, the Food and Nutrition Board of the National Academy of Sciences published the first Recommended Dietary Allowances (RDAs). The RDAs were based on the amount of each vitamin or mineral that was needed to prevent symptoms of the corresponding nutrient-deficiency disease. Two years later, the United States was in World War II. During this time certain foods (e.g. butter, sugar) were rationed and others were scarce. In order to help people eat a healthy diet during rationing, the USDA published new nutritional guidelines. Not long after World War II ended, the guidelines were again modified. The post-World War II guidelines introduced the basic four food groups: milk, meats, fruits and vegetables, and grains. These four food groups served as the foundation for nutrition education until the 1970s. During the 1970s, the USDA added a fifth dietary category, foods that should be used in moderation. This new restricted foods category included fats, sweets, and alcoholic beverages.
The first pyramid graphic designed to explain the concepts behind the basic food groups appeared in 1988. It was intended show graphically that people
should eat a variety of foods in differing amounts of food from all of the four groups and consume only small amounts from the fifth group of restricted foods. The need for physical activity was not illustrated anywhere in this pyramid, nor was it shown in the 1992 version called the Food Guide Pyramid.
The 2005 MyPyramid was a major revision of the Food Guide Pyramid. It was designed to illustrate recommendations found in the Dietary Guidelines for Americans 2005 released by the USDA in January 2005. MyPyramid introduced both new graphics and the previously ignored concept that physical activity had to be taken into account when planning a healthy diet. On one side of the pyramid, each food group is represented by a vertical band of color ascending to the peak of the pyramid. The bands are of varying width, illustrating the relative proportions of each food group that should be consumed daily. On the other side of the pyramid, a figure climbs stairs, illustrating the intercon-nectedness between diet and exercise.
These were not the only changes incorporated into MyPyramid. There were other new features.
- Fruits and vegetables are listed as separate categories.
- Emphasis is placed on eating whole grains rather than highly processed refined grains.
- Quantities of food are defined in familiar measures such as cups or ounces, rather than as serving sizes.
- Physical activity is incorporated into a healthy eating plan.
- One-size-fits-all dietary guidance was abandoned. A Web-based feature allows individuals to personalize dietary recommendations by entering their height, weight, age, gender, and level of daily physical activity. The program then calculates how many calories should be consumed daily and makes recommendations on how these should be distributed among the different food groups.
- A new category called discretionary calories was introduced. These are calories that can be consumed after other food group requirements have been met.
- A Web-based tracker allows individuals to assess their food intake and physical activity level and track their energy balance (calories taken in compared to calories burned) for an entire year.
- Educational information is available on three levels: child, adult, and healthcare professional.
Using personalized MyPyramid recommendations
To make use of the information in MyPyramid, individuals must first know whether they are considered thin, average, overweight, or obese. The National Institutes of Health and the World Health Organization classify weight based on body mass index (BMI). For instructions on how to calculate BMI, and adiscussion of its limitations, see the body mass index entry.
For adults of both genders over age 20, weight is classified as follows:
- BMI below 18.5: Underweight
- BMI 18.5-24.9: Normal weight
- BMI 25.0-29.9: Overweight
- BMI 30 and above: Obese
- Below the 5th percentile: Underweight
- 5th percentile to less than the 85th percentile: Healthy weight
- 85th percentile to less than the 95th percentile: At risk of overweight
- 95th percentile and above: Overweight
MyPyramid recommendations
MyPyramid makes recommendations in seven categories: grains, vegetables, fruits, milk, meat and beans, oils, discretionary calories, and physical activity. MyPyramid assumes that people will eat from all food categories. The personalized recommendations about quantities to eat for each group do not take into consideration special diets for people with diabetes or other diseases.GRAINS. Wheat, rice, oats, barley, and cornmeal are common grains in the American diet. Less familiar grains include buckwheat (also called kasha), amaranth, quinoa, sorghum, millet, rye, and triticale. Pasta, bread, oatmeal, breakfast cereals, grits, crackers, tortillas and other foods made from grains are part of this group.
Grains are divided into two categories, whole grains and refined grains. MyPyramid recommends that at least half of the grains an individual eats daily are whole grains. In whole grain, the whole kernel including bran and germ of the grain seed, is used or ground into flour. Examples of whole-grain products include whole-wheat flour, cracked wheat (bulgur), brown rice, wild rice, whole cornmeal, oatmeal, whole wheat bread, whole wheat pasta, whole wheat cereal such as muesli, and popcorn.
Refined grains have the bran, or seed coating, and the germ, or center of the kernel, removed during processing. This produces softer flour and removes oils from the grain. This slows the spoilage process and increases the shelf life of refined grain products. However, refining also removed dietary fiber, iron, and B-complex vitamins. Products made with refined grain often have B vitamins and iron added to replace some of what was lost by removing the germ and bran. These products are labeled ’’enriched.‘‘ Examples of refined grain products include white flour, degermed cornmeal, white rice, couscous, crackers, flour tortillas, grits, pasta, white bread, and corn flake cereal. Some products are made with a mixture of whole grain and refined grain flours too improve texture and taste but retain some nutrients.
VEGETABLES. Any vegetable or any 100% vegetable juice is part of the vegetable group. This group is subdivided into different types of vegetable. MyPyra-mid recommends that people eat vegetables from all five subgroups over the course of a week. The subgroups are:
- dark green vegetables-spinach, kale, watercress, turnip greens, bok choy, broccoli, collard greens, and similar vegetables.
- orange vegetables-carrots, sweet potatoes, butternut squash, pumpkin, acorn squash, etc.
- dry beans and peas-black beans, navy beans, pinto beans, kidney beans, lima beans, black-eyed peas, chickpeas, lentils, tofu (bean curd), etc.
- starchy vegetables-potatoes, corn, fresh lima beans, green peas.
- other vegetables-artichokes, cauliflower, mushrooms, bean sprouts, onions, eggplant, peppers, tomatoes, celery, iceberg lettuce, and vegetables not other categories.
MILK. Non-fat, low-fat, and whole milk all have about the same amount of calcium, the most important mineral in milk. Non-fat and low fat milk are the preferred choices in this group. Other foods in the milk group include yogurt, cheese, and desserts made with milk such as ice cream and pudding. When foods like ice cream or full-fat cheese or sweetened yogurt are chosen, the extra calories from fat and sugar should be subtracted from the daily discretionary calories. People who are lactose intolerant can choose lactose-reduced and lactose-free products. Cream cheese and butter contain only small amounts of calcium and are not part of this group.
MEAT AND BEANS. This group provides most of the protein in diet. Vegetarians and vegans can choose plant-based sources of protein. However, people who do not eat meat need to make sure they are getting adequate amounts of iron. See the entry on iron for more information. The meat group contains several subgroups. People should try to eat less red meat and more fish, poultry, and dried beans. Meat should be trimmed of all visible fat and baked, broiled, or grilled. If fat is added in cooking, it should be counted as oil or discretionary calories. This group includes:
- meat-beef, pork, lamb, game meats such as venison and rabbit, organ meats such as liver and kidney, and lean cold cuts.
- poultry-chicken and ground chicken, turkey and ground turkey, duck, goose, and pheasant.
- eggs-all types. Egg yolks are high in cholesterol, but egg whites are not.
- Dry beans and peas. This is the same as the list under vegetables. Dried beans and peas can be counted either in the vegetable group or the meat group.
- fish and shelfish-catfish, salmon, halibut, tuna, and all other finned fish, shellfish such as clams, shrimp, crabs and lobster, canned fish such as sardines and anchovies.
- seeds and nuts- almonds, peanuts, walnuts, and all other nuts, sunflower seeds, sesame seeds, pumpkin seeds.
Oils come from plant sources and include olive oil, canola oil, corn oil, safflower oil, and oil blends. Fats come mainly from animal sources and include butter, lard (pork fat), tallow (beef fat), and chicken fat. Stick margarine and shortening are made of vegetable oils that are treated to make them solid. This process, called hydrogenation, increases the amount of saturated fat and trans fat they contain, making them less desirable sources of fat. Also palm oil and coconut oil, although liquid at room temperature, are not recommended because they are unusually high in saturated fat and trans fat. Avocados, nuts, olives, and some fish, such as salmon, are high in oils. Processed foods such as mayonnaise, salad dressings, and oil-packed tuna are also high in oil. See the entry on fat replacers for more information about fats and oils in processed foods.
DISCRETIONARY CALORIES. Discretionary calories are extra calories that remain after all the food group requirements have been met. The amount varies depending on how active a person is and their age and gender. MyPyramid calculates discretionary calories based on the personalized information each individual enters in the Web-based MyPyramid Plan. These calories can be used to increase the amount of food eaten in any group or for things like sugary treats, sauces, or alcoholic beverages that are not included in any of the food groups. Be aware, however, that the number of discretionary calories is usually small, especially for people who are not very active.
PHYSICAL ACTIVITY. MyPyramid recommends at least 30 minutes of moderate or vigorous physical activity every day in addition to a person’s normal daily routine. Moderate and vigorous activity will increase the heart rate. Movement, such as casual walking while shopping, that does increase heart rate does not count toward the 30 minutes of activity.
Moderate activity includes:
- brisk walking
- hiking
- year work and gardening
- dancing
- golfing while not using a golf cart
- easy bicycling
- light weight training Vigorous activity includes:
- running or jogging
- brisk or hard bicycling
- lap swimming
- aerobic exercising
- power walking
- many competitive sports (tennis, basketball, etc.)
- heavy yard work such as chopping wood
- heavy weight training
Precautions
MyPyramid is designed for healthy people. It does not take into account special diets for people who have diabetes, hypertension, gluten intolerance, or other allergies, or those who have diseases such as cancer or AIDS that alter the nutrient requirements of the body. People with special conditions should follow the advice of their healthcare provider.Parental concerns
MyPyramid is designed to apply only to children over age two. Because they are growing so rapidly, children younger than that have special dietary needs, including increased fat intake. Parents of children age two and younger should follow the dietary advice of their pediatrician.Resources
BOOKS
Faiella, Graham Faiella. The Food Pyramid and Basic Nutrition: Assembling the Building Blocks of a Healthy Diet. New York: Rosen Pub. Group, 2005.Ward, Elizabeth M. The Pocket Idiot’s Guide to the New Food Pyramids.: New York, NY: Alpha, 2005.
PERIODICALS
Macready, Norra. ‘‘ New Pyramid Reflects Preventive Role of Nutrients: Food and Supplements for Older Adults.’’ Family Practice News. 33, no. 17 (September 1, 2003): 29. Wendling, Patricia. ‘‘New Food Pyramid Draws Mixed Reviews.’’ Family Practice News. 35, no.10 (May 15, 2005): 5.ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>American Council for Fitness and Nutrition. P.O. Box 33396, Washington, DC 20033-3396. Telephone: (800) 953-1700 Website:<http://www.acfn.org>
United States Department of Agriculture. 1400 Independence Avenue, S.W., Room 1180, Washington, DC 20250. Website: <http://www.usda.gov/wps/portal/usdahome>
OTHER
Lewis, Jaye. ‘‘The Food Pyramid: It’s History, Purpose, and Effectiveness.’’ Healthlearning.com, undated, accessed March 26, 2007. <http://health.learninginfo.org/food-pyramid.htm>United States Department of Agriculture. ‘‘Finding the Way to a Healthier You: Based on the Dietary Guidelines for Americans,’’ 6th ed. 2005. <http://www.healthierus.gov/dietaryguidelines>
United States Department of Agriculture. ‘‘My Pyramid: Steps to a Healthier You.’’ 2005. <http://www.mypyramid.gov>
United States Department of Health and Human Services and the United States Department of Agriculture. ‘‘Dietary Guidelines for Americans 2005.’’ January 12, 2005. <http://www.healthierus.gov/dietaryguidelines>
United States Department of Agriculture. ‘‘My Pyramid for Kids.’’ 2005. <http://www.mypyramid.gov/kids/index.html>
Tish Davidson, A.M.
Vegetarianism
Definition
Vegetarianism refers to the practice of excluding meat, poultry, and fish from the diet. The word was coined in 1847, when the Vegetarian Society of the United Kingdom—the oldest organized vegetarian group in the world—was founded in Ramsgate, Kent. The Society, which has included George Bernard Shaw and Mahatma Gandhi among its members, chose the word vegetarian for its name because it is derived fromBased on the 2003 American Dietetic Association pyramid and the Dietitians of Canada rainbow. The recommended servings and foods are intended to accommodate the needs of vegans as well as those of less strict vegetarians. (Illustration by GGS Information Services/Thomson Gale.)
the Latin vegetus, which means “lively” or “vigorous,” and because it suggests the English word vegetable. Vegetarianism is better understood as a lifestyle rather than a diet in the strict sense, as there are many specific plant-based diets that could be called vegetarian.
There are several distinctive subgroups of vegetarians:
- Vegans: Sometimes called strict vegetarians, vegans are people who exclude all animal products from their diet or clothing, whether or not they involve the death of an animal. Vegans will not use honey or dairy products, for example, and will not wear clothing made of wool, silk, fur, or leather, or use bedding stuffed with down.
- Ovolactovegetarians: Vegetarians in this category will use eggs, milk, and other dairy products on the grounds that these foods are not obtained by killing animals.
- Ovovegetarians: Vegetarians who will include eggs in the diet but not milk or milk products.
- Lactovegetarians: Vegetarians who will use milk and milk products but not eggs.
- Semivegetarians or pesce/pollo vegetarians: People who include fish or chicken in the diet but also seek to minimize their consumption of animal protein.
- Fruitarians: Vegetarians who eat only fruits, nuts, seeds, and other plant matter that can be harvested without harming the plant.
- Flexitarians: Persons who prefer a vegetarian diet but are willing to eat meat, fish, or chicken on exceptional occasions.
- Freegans: Anti-consumerist vegans who seek to avoid participating in any practices they regard as exploitative of other people or the environment, in addition to excluding meat and animal products from their diet. Freegans obtain their food by growing it themselves, by barter, or by foraging in refuse bins and restaurant trash receptacles for discarded food. This practice is called “dumpster diving” in the United States and “skipping” in the United Kingdom.
Origins
Religious vegetarianism
Religious belief is the oldest historical motive for vegetarianism. Hinduism is the earliest of the world's major religions known to have encouraged a vegetarian lifestyle. As of the early 2000s, Hinduism accounts for more of the world's practicing vegetarians—70 percent— than any other faith or political conviction. Different Hindus, however, explain their commitment to vegetarianism in different ways. Some associate vegetarianism with the doctrine of ahimsa, or nonviolence, which forbids the shedding of animal as well as human blood. Others believe that animals have souls, and that those who kill them will acquire bad karma and suffer in their next reincarnation. Last, some Hindus believe that their gods will not accept nonvegetarian offerings.The Jain religion, which is an ascetic offshoot of Hinduism that began in the sixth century BC, requires followers to adopt a vegan diet; they may also not eat roots because to do so kills the plant. Most Jains fast on holy days and at other times throughout the year, as they believe that fasting strengthens self-control as well as protecting the believer from accumulating bad karma.
In ancient Greece, the followers of the philosopher and mathematician Pythagoras (c. 582–507 BC) practiced an ascetic lifestyle that included a vegetarian diet and abstaining from animal bloodshed, including sacrifices to the Greek gods. Neoplatonist philosophers of the third and fourth centuries AD revived the Pythagorean notion that vegetarianism helps to purify the soul. As a result of the association of a plant-based diet with Pythagoras, European Christians in the sixteenth and seventeenth centuries who practiced vegetarianism were often called Pythagoreans.
Mainstream Christianity in both its Eastern and Western forms has never made year-round vegetarianism mandatory for laypeople; however, there is a long tradition of monastic vegetarianism going back at least as far as the Desert Fathers in the third and fourth centuries AD. In addition, many Christians abstain from meat during certain seasons of the church year (Lent and Advent). One reason for vegetarian diets in some of the monastic orders is the belief that eating meat increases temptations to anger and violence. Another reason, found more commonly among evangelical Protestants, is the interpretation of Genesis 1:29 and other Bible passages as meaning that God originally intended humans to be vegetarians, and that God wants his present-day followers to be responsible stewards of the earth. The Christian Vegetarian Association (CVA), which welcomes Roman Catholics as well as mainstream and evangelical Protestants, was founded in 1999.
One Christian denomination that was formed in the United States in the nineteenth century, namely the Seventh-day Adventist Church, has expected its members to be vegetarians since its beginning. Members of the church have been studied by the National Institutes of Health (NIH) and the National Cancer Institute (NCI) since 1960. NIH findings indicate that Adventist men live on average seven years longer than men in the general population, and Adventist women eight years longer than their non-Adventist counterparts.
Many members of New Age groups, as well as some atheists and agnostics, practice vegetarian or vegan lifestyles out of respect for nature or for the earth, even though they would not consider themselves religious in the conventional sense.
Environmental vegetarianism
The application of scientific methods to agriculture in the eighteenth and nineteenth centuries also allowed people to calculate for the first time the cost to the environment of raising animals for meat. As early as the 1770s, the English clergyman William Paley had already urged a vegetarian lifestyle on the grounds that an acre of land used to raise fruits and vegetables could support twice the number of people as an acre used to graze animals. A common ethical argument for vegetarianism in the early 2000s is that 40% of the world's grain goes to feed animals raised for meat rather than to feed people, and that world hunger could be eliminated if even half this grain could be redistributed to undernourished populations. According to the North American Vegetarian Society (NAVS), 15 vegans can be fed on the same amount of land needed to feed one person consuming a meat-based diet.Animal rights vegetarianism
Commitment to a vegetarian diet as a way to reduce the suffering of animals—sometimes called compassion-based vegetarianism—emerged during the mid-nineteenth century, a period that also witnessed the foundation of the first groups devoted to animal welfare. The Royal Society for the Prevention of Cruelty to Animals (RSPCA) was given its charter byQueen Victoria in 1840, seven years before the organization of the Vegetarian Society. The American Society for the Prevention of Cruelty to Animals (ASPCA) was founded in New York City by Henry Bergh in 1866. In addition to ongoing concern about maltreatment of household pets and working animals, the advent of so-called factory farming in the twentieth century has intensified the revulsion many people feel regarding the use of animals for human dietary consumption and clothing.
Description
The 2003 vegetarian food guide
- Grains: The foundation of the vegetarian diet. Whole grains are best, but enriched refined grains are also acceptable.
- Vegetables and fruits: The ADA and DC recommend that vegetarians choose both vegetables and fruits rather than using only one or the other.
- Legumes, nuts, and other protein-rich foods: Legumes include soy milk and tofu. Dairy products used by ovo-and lactovegetarians also fall into this category, as do meat substitutes.
- Fats: Vegetarians who do not eat fish require plant-based sources of n-3 fats.
- Calcium-rich foods: Adult vegetarians require eight servings from this category each day. Each serving, however, counts toward one of the other food choices, as calcium-rich foods can be found across the other food groups.
Dietary supplements are recommended for vegetarians over 50 and for vegans, based on studies conducted by the Institute of Medicine (IOM). These guidelines are described more fully under Risks below.
Some specific vegetarian diets
Vegetarian diets can accommodate a wide variety of regional and ethnic cuisines as well as different philosophical or religious approaches. The following are only a few of the possible choices:MEDITERRANEAN DIET. In its origin, the Mediterranean diet was not a purely vegetarian diet. It is, however, sparing in its use of red meat and eggs, and low in its use of fish and poultry. It can thus be easily adapted to a vegetarian or pesce/pollo vegetarian diet. The Mediterranean diet is high in its use of whole grains, fruits, nuts, and high-fiber vegetables; it appeals to many people because of its wide choice of flavorful foods.
MACROBIOTIC DIET. The macrobiotic diet, which was brought to Europe and North America from Japan in the 1960s, is associated with the Eastern concepts of yin and yang as well as with the elimination of animal products from the diet. This diet also involves such changes in eating habits as chewing each mouthful of food at least 50 times, drinking liquids only when thirsty, avoiding the use of aluminum cook-ware, and cooking foods on a wood stove rather than using electrical appliances.
ORNISH DIET. Developed by a medical doctor to reverse the signs of heart disease, the Ornish diet has also been popularized as a weight-loss program. It is a strict low-fat, high-fiber diet that excludes red meat, poultry, and fish, although persons following this diet may use limited amounts of egg whites, fat-free milk, and other fat-free dairy products.
SEVENTH-DAY ADVENTIST DIET. Seventh-day Adventists (SDAs) have followed vegetarian dietary regimens since the denomination was first organized in 1863. The diet recommended by the church's General Conference Nutrition Council (GCNC) in the early 2000s is an ovolactovegetarian diet high in whole-grain breads and pastas, fresh vegetables and fruits; moderate use of nuts, seeds, and low-fat dairy products; and limited use of eggs. Some SDAs prefer a vegan diet. The church has its own professional organization for dietitians, which is affiliated with the ADA, and encourages all its members to follow the ADA guidelines for vegetarians.
Tips for starting a vegetarian diet
The ADA offers the following suggestions for persons considering vegetarianism:- List all the meatless dishes that you already like to eat. Pizza, chili, vegetable soups, salads, bean casseroles, Oriental stir-fried vegetables, and pasta dishes are common favorites.
- Look through some vegetarian cookbooks and copy the recipes that appeal to you.
- Check out natural food stores and try some of their products.
- Visit ethnic restaurants—Chinese, Japanese, Thai, Indian, Vietnamese, or Middle Eastern are good choices—and sample some of their meatless dishes.
- Try meat substitutes (sometimes called meat analogues or “mock meat”) made from textured vegetable protein (TVP) or tofu (bean curd). Veggie burgers, veggie hot dogs, and imitation sausage are popular items of this type.
Function
Vegetarian diets are adopted by people in developed countries primarily for ethical or religious reasons rather than economic necessity—although some nutritionists do point out that plant-based foods are usually easier on the household food budget than meat. Another more recent reason is the growing perception that plant-based diets are a form of preventive health care for people at increased risk of such diseases as heart disease, type 2 diabetes and some forms of cancer. Adolescents, however, are more likely to adopt vegetarian diets as a weight reduction regimen.Benefits
The long-term NIH study of Seventh-day Adven-tists began to report in the 1970s and 1980s that lowered blood pressure, lower rates of cardiovascular disease and stroke, lower blood cholesterol levels, and lowered risks of colon and prostate cancer are associated with a vegetarian diet. In particular, SDAs were only half as likely to develop type 2 (adult-onset) diabetes as were nonvegetarian Caucasians. Although it is possible to gain weight on a vegetarian diet, most people lose weight, especially in the first few months; and most vegetarians have lower body mass indices (an important diagnostic criterion of obesity) than their meat-eating counterparts.Several studies carried out in Germany and Austria reported in 2006 that vegetarian diets appear to be effective in lowering the risk of rheumatoid arthritis, osteoporosis, kidney disease, gallstones, diverticulitis, and dementia as well as heart attacks, stroke, and diabetes.
In addition to lowering the risk of chronic degenerative diseases, vegetarian diets have also been shown to be useful in treating constipation in adults and children, and dysmenorrhea (painful menstrual periods) in women of childbearing age.
Precautions
The ADA strongly recommends that people consult a registered dietitian as well as their primary physician before starting a vegetarian diet. The reason for this precaution is the variety of vegetarian regimens as well as the variations in height, weight, age, genetic inheritance, food preferences, level of activity, geographic location, and preexisting health problems among people. A nutritionist can also help design a diet that a new vegetarian will enjoy eating as well as getting adequate nourishment and other health benefits.Risks
The longstanding concern about vegetarian diets is the risk of nutritional deficiencies, particularly for such important nutrients as protein, minerals (iron, calcium, and zinc), vitamins (vitamin D, riboflavin, vitamin B12, and vitamin A), iodine, and n-3 fatty acids. The 2003 vegetarian food guide recommends that vegetarians over 50 years of age as well as vegans in all age groups should take supplements of vitamin B12 and vitamin D, or use foods fortified with these nutrients. Vitamin D supplements are particularly important for vegans living in northern latitudes or other situations in which they receive little sun exposure.In addition to nutritional concerns, there is some evidence that vegetarian diets may actually increase the risk of breast cancer in women, particularly in those who use large amounts of soy-based products. Soybeans contain phytoestrogens, or plant estrogens, which have been implicated in breast cancer. The plant estrogens in soy-based products may also explain why vegetarians have a disproportionate number of female babies, and why these girls have a higher rate of precocious puberty than girls born to nonvegetarian mothers.
General acceptance
The ADA has a professional subgroup called the Vegetarian Nutrition Dietary Practice Group, or DPG, which publishes a quarterly newsletter called Vegetarian Nutrition Update, available to nonmem-bers of the ADA for an annual subscription fee of $25. The Vegetarian Nutrition DPG also has its own website at http://www.vegetariannutrition.net/index.htm, with articles available to the public on vegetarian diets and cancer prevention, treatment of rheumatoid arthritis, sports nutrition, pregnancy, and vegan diets for children.Once considered an eccentricity, vegetarianism is widely accepted by the general public in developed countries as a legitimate dietary option in the early 2000s. The ADA and DC state that about 2.5% of adults (defined as people over 18 years of age) in the United States and 4% of Canadian adults follow vegetarian diets. The Vegetarian Resource Group (VRG), a nonprofit research organization, conducted a poll in 2006. It estimated that 2.3% of adults in the United States—4.7 million people—are vegetarians, with a third to a half of this group being vegans. In addition, the VRG notes that 30 to 40% of American adults choose vegetarian dishes over meat dishes at least some of the time. Other interesting details from the 2006 poll:
- People between 45 and 54 years of age are almost twice as likely to be vegetarians as people between 18 and 24 years of age.
- The Northeast has the highest percentage of vegetarians in the general population, with the South having the lowest.
- People who have graduated from college are twice as likely to be vegetarians as those who did not complete high school.
- Hispanics are more likely to be vegetarians than either Caucasians or African Americans.
- There is no correlation between household income and a vegetarian lifestyle as of the early 2000s; people at all income levels seem to be equally likely to become vegetarians.
Research
As has been noted in Europe as well as the United States, the emphasis in medical research on vegetarian diets has shifted in the early 2000s from concern about nutritional deficiencies in people following these diets to the role of vegetarianism in preventing or treating chronic diseases. It was the NIH's studies of Seventh-day Adventists that first indicated that vegetarian diets lower the risk of heart disease, stroke, and type 2 diabetes. The Adventist Health Study received new funding in 2003 for its continuation. As of early 2007, the NIH is conducting five additional clinical trials to evaluate the advantages of vegetarian diets in managing uremia in the elderly, cardiovascular disease, type 2 diabetes, high blood pressure, and postmenopausal disorders in women as well as treating obesity.One area of concern, however, is in veterinary medicine—namely, the trend among some pet owners to put dogs and cats on vegetarian diets, often with homemade foods. Cats in particular are at risk of malnutrition and eventual blindness on a vegetarian or vegan diet because they are obligate carnivores (must have meat in the diet). Their bodies cannot form taurine (an amino acid), thiamine, retinol (a form of vitamin A essential to healthy eye tissue), and vitamin B12—all micronutrients found primarily in meat. The Vegetarian Society (UK) has an information sheet warning against putting cats on a vegetarian diet, while the American Veterinary Medical Association (AVMA) strongly urges vegetarian pet owners to consult their veterinarian before offering either dogs or cats vegetarian pet food.
Resources
BOOKS
Colbert, Don. What Would Jesus Eat? Nashville, TN: T. Nelson Publishers, 2002. A conservative Christian attempt to prove that Jesus was a vegetarian.
Harris, William, MD. The Scientific Basis of Vegetarianism. Honolulu, HI: Hawaii Health Publishers, 1995.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Chapter 3, “Food for Thought.” New York: Fireside Books, 2002. A good summary of recent studies of the health benefits of vegetarianism.
Stepaniak, Joanne. The Vegan Sourcebook, 2nd ed., with nutrition section by Virginia Messina. Los Angeles: Lowell House, 2000.
Stuart, Tristan. The Bloodless Revolution: A Cultural History of Vegetarianism from 1600 to Modern Times. New York: W. W. Norton &Co., 2006.
Harris, William, MD. The Scientific Basis of Vegetarianism. Honolulu, HI: Hawaii Health Publishers, 1995.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Chapter 3, “Food for Thought.” New York: Fireside Books, 2002. A good summary of recent studies of the health benefits of vegetarianism.
Stepaniak, Joanne. The Vegan Sourcebook, 2nd ed., with nutrition section by Virginia Messina. Los Angeles: Lowell House, 2000.
Stuart, Tristan. The Bloodless Revolution: A Cultural History of Vegetarianism from 1600 to Modern Times. New York: W. W. Norton &Co., 2006.
PERIODICALS
American Dietetic Association and Dietitians of Canada. “Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets.” Canadian Journal of Dietetic Practice and Research 64 (Summer 2003): 62–81.Key, T. J., P. N. Appleby, and M. S. Rosell. “Health Effects of Vegetarian and Vegan Diets.” Proceedings of the Nutrition Society 65 (February 2006): 35–41.
Leitzmann, C. “Vegetarian Diets: What Are the Advantages?” Forum of Nutrition 57 (2005): 147–156.
Michel, K. E. “Unconventional Diets for Dogs and Cats.” Veterinary Clinics of North America, Small Animal Practice 36 (November 2006): 1269–1281.
Shapin, Steven. “Vegetable Love.” New Yorker, January 22, 2007. Available online. URL: http://www.newyorker.com/critics/content/articles/070122crbo_books_shapin This article is a review of Stuart's book.
Stahler, Charles. “How Many Adults Are Vegetarian?”. Vegetarian Journal, no. 4 (2006). Available online at http://www.vrg.org/journal/vj2006issue4/vj2006issue4poll.htm.
Willett, Walter, MD. “Lessons from Dietary Studies in Adventists and Questions for the Future.” American Journal of Clinical Nutrition 78 (September 2003): 539S–543S.
OTHER
Indian Vegetarian Cooking Videos, vol. 1 and vol. 2. Simple step-by-step demonstrations of vegetarian cooking in the Indian tradition by a registered dietitian. Nutritional information is provided for the recipes in the videos. To order, call (757) 464-0786 or e-mail Vegdiets@AOL.com.Mayo Clinic Staff. Vegetarian Diet: A Starter's Guide to a Plant-Based Diet. Rochester, MN: Mayo Clinic Foundation, 2006. Available online at http://www.mayoclinic.com/health/vegetarian-diet/HQ01596.
North American Vegetarian Society (NAVS). Vegetarianism: Answers to the Most Commonly Asked Questions. Dolgeville, NY: NAVS, 2005. Available online at http://www.navs-online.org/frvegetarianism.html.
Prieur, Ran. “How to Drop Out.” Ran Prieur.com, April 2, 2004. URL: http://ranprieur.com/essays/dropout.html. Personal essay explaining freeganism.
Seventh-day Adventist Dietetic Association (SDADA). A Position Statement on the Vegetarian Diet. Orlando, FL: SDADA, 2005. Available online at http://www.sdada.org/position.htm.
ORGANIZATIONS
American Dietetic Association (ADA). 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800): 877–1600. Website: http://www.eatright.org.American Vegan Society (AVS). 56 Dinshah Lane, P. O. Box 369, Malaga, NJ 08328. Telephone: (856) 694–2887. Website: http://www.americanvegan.org/index.htm.
Christian Vegetarian Association (CVA). P.O. Box 201791, Cleveland, OH 44120. Telephone: (216) 283–6702. Website: http://www.all-creatures.org/cva/.
Dietitians of Canada/Les diététistes du Canada (DC). 480 University Avenue, Suite 604, Toronto, Ontario, Canada M5G 1V2. Telephone: (416) 596–0857. Website: http://www.dietitians.ca.
North American Vegetarian Society (NAVS). P.O. Box 72, Dolgeville, NY 13329. Telephone: (518) 568–7970. Website: http://www.navs-online.org.
Seventh-day Adventist Dietetic Association (SDADA). 9355 Telfer Run, Orlando, FL 32817. Website: http://www.sdada.org SDADA is an official affiliate of the ADA.
Vegetarian Resource Group (VRG). P.O. Box 1463, Dept. IN, Baltimore, MD 21203. Telephone: (410) 366-VEGE. Website: http://www.vrg.org/index.htm Publishes Vegetarian Journal, a quarterly periodical.
Vegetarian Society of the United Kingdom. Parkdale, Dunham Road, Altrincham, Cheshire, England WA14 4QG. Telephone: 0161 925 2000. Website: http://www.vegsoc.org The oldest organized vegetarian group, founded in 1847.
Rebecca J. Frey, PhD
Warrior Diet
Definition
The Warrior diet is perhaps better described as a total exercise, nutrition, and fitness program; a diet regimen is only one part of the program. The diet is controversial on account of its proposal of a daily undereating/overeating cycle. The author of the diet claims that this daily undereating/overeating pattern is a natural biological tendency that modern humans ignore to the detriment of their long-term health. The diet's slogan is “It's when you eat that makes what you eat matter.”Origins
The Warrior diet was designed by Ori Hofmekler (b. 1952), a former member of the Israeli Defense Force (IDF), an artist, and a contributing editor of Penthouse magazine for 17 years. He was health editor of Penthouse from 1998 to 2000. Hofmekler created the Warrior diet on the basis of his own experiences in the Israeli army and his own theories about how such warriors in ancient history as the Roman legionaries ate and trained. He stated in an interview with a bodybuilder named Mike Mahler that “I did not really come up with the idea [for the diet]; the idea came to me. It really started when I was in the Israeli Special Forces. I found out that some of my friends and I were doing much better when we reduced the eating during the day, or active time, and ate during the time when we knew that we could rest. I realized that when I ate the traditional 6 to 7 army meals plus snacks, I got more exhausted than ever. I suffered from energy crashes and my brain was not as focused and alert as I wanted it to be. . . . I felt a tremendous difference when I reduced drastically the amount of food I consumed during the day. Later when I went on to university and started my career as an artist, I realized that when I minimize eating during the day and have one main meal, I feel much more creative; much more alert. . . . After doing some research, I found out that other warriors of the past used to live like this and that is where I really got intrigued.”As Hofmekler's biography indicates, he is an artist who specializes in political satire as well as the author of a diet book. According to his art website, he graduated from the Bezalel Academy of Art and Design in Jerusalem after his army service and has received study grants from the Israel Museum and the American Israel Foundation.
Description
Nutrition
Hofmekler bases his concept of a daily cycle of undereating and overeating on what he calls instinct rather than control. He has criticized other diets for being “designed according to some kind of theme or a goal that's based on control. . . . Just about every diet you can think of is about control. This [Warrior] diet is based on the assumption that your body has the instinct, like any other instinct, to control itself and to manipulate it very well.” The basic human instinct, according to Homekler, is survival. The Warrior diet website states at the top of the home page, “The Warrior Diet is based on one master biological principle: Human Survival.”This human survival instinct, according to Hofmekler, was well served by the eating and exercise patterns of Paleolithic (Stone Age) people. Hofmekler believes that “The current epidemic of obesity, diabetes and impotence bears testimony to the fact that humans today have betrayed their biological destiny.” He maintains that there are four reasons why modern people “fail to maintain primal health”: they eat too many meals during the day; they eat when they are not hungry; they make poor food choices; and they do not keep a proper balance between physical activity and relaxation.
According to Hofmekler's theory, a daily cycle of undereating and overeating, during which the dieter consumes no more than light snacks of raw fruits or vegetables or a light protein food like yogurt for 10 to 18 hours a day, exercises during this undereating period, and eats one large meal at night, awakens the basic human survival instinct. Evolution supplies the reason why people should have their daily physical workout during the undereating period, which is supposed to begin about 4 hours after the nightly main meal has been consumed. Hofmekler says that both Stone Age people and ancient cultures performed most of their physical labor during the day, ate very little until the evening, and were mentally sharper as well as in better physical condition: “Hunger is part of life and they accepted it. Some ancient cultures such as the Greeks and Romans used to train their children to go through hunger. It was something that they felt it was important to be able to handle. Even when I was in the army, I was told that I need to learn how to handle hunger. It is critical for your body to feel hungry at least once a day from both a physical, emotional, and mental standpoint. Thus, people would go through long periods without eating and maybe have small meals of fruit and veggies during the day. Then they would have a big cooked meal in the evening, which was usually a social occasion. They ate as much as they wanted from all the food groups and stayed in great shape. That is what happened and that was the warrior way.”
The overeating part of the cycle allows the parasympathetic nervous system (PSNS), the other major component of the autonomic nervous system, to take over and regulate digestion, elimination, and other metabolic activities that slow people down and prepare them to sleep. Hofmekler believes that people do not need to count calories for their nighttime meal; rather, their instincts will tell them how much to eat. In an article titled “Your Warrior Diet Questions Answered,” he states, “The Warrior principles are very simple: one meal a day at night. The Warrior diet is based on instinctual principles in which one does not have to check exact times, or for that matter, count calories or restrict macronutrients.” In an interview from 1999, he told the reporter, “Your body... will tell you exactly what it needs [in terms of protein]. ... It's not a diet that's ketogenic or based on suffering and you count the hours. With the Warrior diet, every day has a happy ending.”
Hofmekler does not, however, trust people's instincts completely. His diet has a fairly long list of dos and don'ts:
- Avoid processed foods.
- Eat only organic foods, because ordinary supermarket produce and dairy products contain estrogens.
- Drink only filtered water, and use only filtered water in cooking.
- Minimize the consumption of foods that are wrapped or bottled in plastic containers, particularly soft plastics. Do not store food in plastic containers at home. Plastic fibers contain “estrogenic chemicals that are dangerous to our health.”
- Minimize alcohol consumption because alcohol compromises the liver's ability to rid the body of estrogens.
- Eat carbohydrates last during the evening meal in order to stabilize the level of insulin in the blood.
- Cycle between high fat and high carbohydrate days in order to maximize the body's fat burning during exercise.
Exercise
Hofmekler considers exercise an important part of fat burning during the undereating part of the daily cycle. He recommends whole-body workouts (squats, chin-ups, high jumps, frog jumps, kicks, sprints, and presses) rather than exercises aimed at only one part of the body, such as the abdomen or upper arms. Based on his notion that Roman soldiers had to carry 40 to 60 pounds of arms and equipment on the back and shoulders while marching 30 to 40 miles a day, he maintains that exercise should focus on building strong joints and a strong back. He also thinks that workouts should be short and intense, no longer than 20 to 45 minutes.A key part of the Warrior diet exercise regimen is what Hofmekler calls Controlled Fatigue Training or CFT. Basically, CFT means that the person continues to exercise when they already feel fatigued, using workout sets that mimic the fight-or-flight responses that prehistoric people needed when they had to hunt or fight while they were hungry. Hofmekler maintains that humans have inherited so-called thrifty genes from their Stone Age ancestors that make them better able to survive under conditions of biological stress, and that CFT activates those genes. The slogan for CFT is “If you are not actively surviving, you are passively dying.”
Nutriceuticals and dietary supplements
Hofmekler markets a number of protein powders, protein bars, and dietary supplements intended to help the body burn fat, detoxify, rid itself of estrogenic compounds from the environment, and maintain a normal hormonal balance. Warrior Milk is a protein powder intended to be mixed with water or milk to form a pudding-like “treat.” These products, some of which are sold through a website called Defense Nutrition, are said to be free of chemical additives, alcohol, food coloring, preservatives, or fillers.Estrogen inhibitors
Training programs and certification
Since 2005 Hofmekler has begun to offer certification programs in the Warrior diet itself and in CFT training. One seminar offered is five days in length but the website gives no details of the course contents or qualifications needed for certification.Function
The function of the Warrior diet is not weight loss per se, but rather improving fitness through eating patterns supposed to reduce fat, boost the immune system, stimulate the synthesis of muscle tissue, and slow down the aging process, combined with an exercise regimen focused on power and endurance. In terms of bodybuilding, Hofmekler has stated repeatedly that the goal of his diet is to make the body leaner, not necessarily more muscular. In speaking to Mahler, he noted, “…the ‘Warrior Diet’ was never meant to be a bodybuilding diet. It is meant to get you in much better shape. If your goal is to gain muscle, it can be done on the ‘Warrior Diet.’ However, it will be much more gradual…part of being a warrior is having functional strength. You do not want to have quads that get in the way of running or impede fighting ability. Running is the first line of defense and should not be impeded by your thighs chaffing. Also keep in mind that women are more attracted to the lean and athletic build rather than the behemoth bodybuilding physique.”Benefits
The Warrior diet's emphasis on “going down to the bottom of the food chain,” that is, eating raw vegetables, fresh fruits, and unprocessed foods, is in line with the advice of many nutritionists. It is also possible that the exercise regimen recommended by Hofmekler might help some dieters adapt more effectively to the high stress level of modern life by becoming more physically active. The diet's claims, however, to anti-aging and “brain powering” as well as fat-burning properties have not been proven. The Warrior diet might conceivably be useful to committed bodybuilders.Precautions
Although it is always a good idea for people to consult a physician and a nutritionist before starting a diet, particularly if they are pregnant or nursing, below the age of 18, or have more than 30 pounds of weight to lose, consultation with a health professional is particularly important before beginning a diet that has such an unusual pattern of food intake as the Warrior diet. In addition, anyone considering an exercise program as rigorous as Hofmekler's should make sure that they do not have any previously undiagnosed cardiovascular or musculoskeletal conditions that might make the specific exercises recommended in the Warrior diet inadvisable.Another precaution to consider is the impact of the Warrior diet's daily undereating/overeating cycle on other members of the dieter's household. A common observation among people who have tried this diet is that the meal schedule works only for people who either live alone or share housing with other people using the Warrior diet.
Risks
Vigorous exercise during a period of minimal food intake may not be sustainable for some people. In addition, the specific exercises recommended by Hofmekler would be too strenuous for people who are not already used to some form of athletic activity.Another risk is that those who may need to lose weight will not see any weight reduction on this diet. Since the Warrior diet emphasizes freedom from calorie counting and portion size, some people might well continue to consume more calories during the one evening meal than they can burn off during the under-eating part of the daily cycle. The diet's alternation between undereating and overeating also seems inappropriate for people struggling with bulimia, binge eating, and other eating disorders, and could possibly trigger relapses.
One risk mentioned by some people who have tried this diet is its potentially high cost. The protein powders, dietary supplements, Warrior bars, and other products sold online through the Warrior diet and Defense Nutrition websites are expensive. For
example, a 30-day supply of EstroX capsules, an anti-estrogen product, costs $40 as of 2007, while a 16-day supply of Warrior Milk is $24.
Research and general acceptance
The Warrior diet is controversial even among the bodybuilding community. With regard to research, there are no clinical studies of this diet reported in mainstream medical journals as of 2007. Hofmekler's own attitude toward scientific research is a curious mixture of skepticism about standard views of nutrition, a skewed view of history, and selective citation. In an interview from 1999, he remarked that his diet “is more of an opinion or a concept rather than completely [emphasis in original] scientific research, but it's based on opinions and a lot of science, which I hope to verify in the future. The idea is very simple. It's based on my own experience and somehow, because I was so interested in the effect, I did my own historical, anthropological, and scientific research. It's largely based on the romantic notion of the warrior.”One factor that inhibits Hofmekler's acceptance by the general public as well as by healthcare professionals is the poor quality of his printed materials and the many spelling and grammatical errors to be found in them. Several people who purchased The Warrior Diet noted not only that the paper and binding are not the best, but also that some paragraphs are printed twice. Other examples of uncorrected typos and usage problems can be found on Hofmekler's websites; the Warrior Diet site, for example, refers to Hofmekler as a “reknowned nutrition expert,” while the Defense Nutrition website claims that his diet and training methods have been endorsed by “marshal artists.” While it may be argued that errors of this type do not automatically invalidate Homekler's theories, they certainly do not add to his credibility.
While estrogen levels in the body are known to stimulate the growth of about 80% of breast cancers and to increase the risk of some forms of uterine cancer, it is doubtful that these hormones are responsible for the range of problems Hofmekler attributes to them, or that such substances as plastics can significantly affect estrogen levels in adults. In addition, some of the word-of-mouth advertising for Hofmekler's books has a macho tone that makes the reader wonder whether his concern about estrogen is symbolic. A typical example reads as follows: “Are you sick of diets that are made for forty-year-old women? When is the last time that you read a diet book that was made for men and got you excited?” Although Hofmekler claims that the Warrior diet can help women as well as men improve their physical health, it is difficult to imagine very many women finding this diet useful.
Hofmekler's use of the thrifty gene hypothesis as an explanation for the presumed eating habits of Stone Age people and ancient warriors is a weakness rather than an advantage, in that scientists have increasingly questioned whether humans have ever had a thrifty gene. To begin with, no specific candidate genes have been proposed as of 2007; recent research suggests that numerous genes, each one having only a modest effect, combine to determine a person's susceptibility to obesity. Second, most people who die during a famine die of disease rather than starvation, thus there would be little difference in mortality between lean and obese persons. Third, famines are a relatively recent phenomenon and occur only once every 100—150 years; thus most human populations would have experienced at most only 100 famines during their evolutionary history. Last, the increase in mortality during a famine rarely exceeds 10 percent. In short, famines do not provide enough of a selective advantage for a single thrifty gene to be widespread among modern humans.
Resources
BOOKS
Hofmeckler, Ori. The Anti-Estrogenic Diet: How Estrogenic Foods and Chemicals Are Making You Fat and Sick. Berkeley, CA: North Atlantic Books, 2007.Hofmeckler, Ori, with Diana Holtzberg. The Warrior Diet: How to Take Advantage of Undereating and Overeating. St. Paul, MN: Dragon Door Publications, 2001.
Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
PERIODICALS
Anderson, R. M., and R. Weindruch. “Metabolic Reprog—ramming in Dietary Restriction.” Interdisciplinary Topics in Gerontology 35 (2007): 18—38.Damcott, C. M., P. Sack, and A. R. Shuldiner. “The Genetics of Obesity.” Endocrinology and Metabolism Clinics of North America 32 (December 2003): 761—786.
Hofmekler, Ori. “Excess Estrogen and Weight Gain.” Warrior Newsletter 32, December 5, 2006. Available online at http://www.dragondoor.com/warriornews_archive.html (accessed March 15, 2007).
Masoro, E. J. “Overview of Caloric Restriction and Ageing.” Mechanisms of Ageing and Development 126 (September 2005): 913—922.
Speakman, J. R. “Thrifty Genes for Obesity and the Metabolic Syndrome—Time to Call Off the Search?”Diabetes and Vascular Disease Research 3 (May 2006): 7—11.
VIDEOS
Hofmekler, Ori. The Warrior Workout, Part One. Running time: 54 minutes. Both videos can be purchased at the Warrior Diet website, http://www.warriordiet.org/tek9.asp?pg=wdvideos.Hofmelker, Ori. The Warrior Workout, Part Two. Running time: 54 minutes.Both videos can be purchased at the Warrior Diet website, http://www.warriordiet.org/tek9.asp?pg=wdvideos.
OTHER
Bass, Clarence. The Warrior Diet & Workout. Available online at http://www.cbass.com/warrior_diet.htm (accessed March 14, 2007).Hofmekler, Ori. “New Studies Support the Warrior Diet's Brain Powering and Anti-Aging Effects.” Chet Day's Health and Beyond Online, available online at http://chetday.com/warriordietantiaging.htm (accessed March 15, 2007).
Hofmekler, Ori. Your Warrior Diet Questions Answered— Part 1. Available online at http://www.dragondoor.com/articler/mode3/155/ (accessed March 14, 2007).
Mahler, Mike. “Conversation with a Modern-Day Warrior—Ori Hofmekler.” http://BodyBuilding.com. Available online at http://www.bodybuilding.com/fun/mahler49.htm (accessed March 15, 2007).
“The Warrior Diet: An Interview with Penthouse Editor Ori Hofmekler.” Testosterone Nation, posted August 5, 1999. Available at http://www.t-nation.com/findArticle.do? article=body_64war (accessed March 15, 2007).
ORGANIZATIONS
Defense Nutrition, LLC. P. O. Box 5028, Woodland Hills, CA 91365-5028. Telephone: (866) 927-3438. Website: http://www.defensenutrition.com/.Dragon Door Publications. P.O. Box 4381, St. Paul, MN 55104. Telephone: (651) 487-2180. Website: http://www.dragondoor.com/.
Hofmekler's art website: http://www.orihofmekler.com. [No mailing address] Telephone: (917) 767-7983 or (212) 909-2793.
Warrior Diet. P. O. Box 5028, Woodland Hills, CA 91365-5028. Telephone: (866) WAR-DIET (927-3438). Website: http://www.warriordiet.com.
Rebecca J. Frey, PhD
Zone Diet
Definition
The Zone diet is a high protein, low carbohydrate diet. It is based on the concept that if people eat an ideal balance of carbohydrates, proteins, and fats at every meal and snack, they will achieve hormonal balance. This will control insulin levels and result in weight loss and health benefits.Origins
The Zone diet was developed by Barry Sears. Sears has a Ph. D. in biochemistry, but no special training in nutrition. He began working on this diet in the 1970s. After his father died prematurely of a heart attack at age 53, Sears began studying the role of fats in the development of cardiovascular disease. In 1995, his book Enter the Zone, became a bestseller. Since then he has written a dozen books and cookbooks about the Zone diet, established a Web site, and developed a program of home-delivered Zone meals, turning the Zone diet concept into a multi-million dollar business.Description
The Zone diet is designed to promote fat loss and weight loss, but its developer also claims that the diet brings about substantial health benefits. This diet is highly structured. Participants in the Zone diet are instructed that every meal and every snack should consist of 40% carbohydrates, 30% protein, and 30% fats. This produces what Sears considers the ideal ratio of protein to carbohydrate. The protein to carbohydrate ratio of .75, Sears says, allows the body to function at optimal level. He refers to this optimal functioning as being “in the Zone.” Being in the Zone claims TO boosts energy, delays signs of aging, helps prevent certain chronic diseases and allows the body to function at peak physical and mental levels. The Zone diet is less concerned with people reaching a specific weight than with reducing body fat. The goal is for men to have only 15% body fat and women 22% body fat.The amount of food a Zone dieter consumes is based on that person's protein needs. Protein needs are calculated based on height, weight, hip and waist measurements, and activity level. The amount of carbohydrates and fats allowed on the diet derives from the calculation of protein needs. The result is a daily diet that usually ranges from 1,100–1,700 calories. Dietitians consider this a low calorie diet. To simplify meal planning, portions of proteins, carbohydrates, and fats are divided into Zone Food Blocks. Instead of eating a certain number of calories, the dieter eats a specific number of Zone Blocks in the required proportions.
On the Zone diet, foods are either “good” or “bad.” Some “good” foods that are allowed (in the proper ratios) include:
- proteins: lean chicken, turkey, and other poultry, seafood, egg whites, and low-fat/non-fat dairy products.
- carbohydrates: fruit, non-starchy vegetables, oatmeal, barley, very small amounts of grains
- fats: small amounts of canola and olive oil.
- red meat and organ meats such as liver
- egg yolks
- fruits and vegetables: carrots, corn, raisins, bananas, papaya, mango, most fruit juices and many fruits
- bread, cereal, rice, bagels, most baked goods
- potatoes
- whole milk dairy products
- red meat or fatty meats
- caffeinated coffee
- alcohol
- diet soft drinks
- Eat three meals and two snacks daily, all of which meet the 40:30:30 ration of carbohydrates to proteins to fats.
- Eat the first meal of the day within one hour of arising.
- Never allow more than five hours to pass without eating.
- Drink more than 8 cups (64 oz or almost 2 L) of water daily.
- Exercise moderately every day.
- Meditate daily.
Function
The science behind the Zone diet can be quite complicated and intimidating to someone not trained in biochemistry or nutrition. The explanation Sears gives of why the Zone diet works is based on an interplay of foods, the hormones insulin and glucagon, and hormone-like substances called eicosanoids.The simplified explanation goes like this. When people eat, the level of glucose (sugar) in their blood increases. How much it increases depends on the foods they eat. “Good” foods with a low glycemic index (below 50) raise blood sugar less quickly than “bad” foods with a high glycemic index (above 65). When blood glucose levels increase, cells in the pancreas release the hormone insulin. This signals cells to convert glucose into a compound called glycogen that is stored in the liver and muscles and facilitates the storage of fat, stored in fat cells. When blood glucose levels go down, different cells in the pancreas release the hormone glucagon. Glucagon signals cells in the liver and muscle to release glycogen, which is converted back into glucose and is burned by the body. If glucose levels continue to be low, fat is also burned for energy.
According to Sears, carbohydrates, especially those with a high glycemic index (e.g. bread, cereal, sweets), cause the pancreas to release a lot of insulin, which in turn causes the body to store a lot of glycogen. Proteins, on the other hand, stimulate the body to release glucagon and burn stored glycogen, so that the body uses more calories.
Sears also says that another group of hormonelike compounds called eicosanoids comes into the food-insulin-glucose-glycogen equation. Eicosanoids are hormone-like substances that affect the immune system, nervous system, and cardiovascular system. “Good” eicosanoids reduce inflammation (irritation) in the walls of the blood vessels and help keep blood cells from clotting. This helps blood vessels stay open and prevents stroke and heart attack. “Bad” eicosanoids do the opposite. They cause inflammation and help blood to clot. Sears believes that increasing the amount of “good” eicosanoids to improve health can be done by following his diet. His books give a more complex explanation of the biochemistry involved in the process of regulating “good” and “bad” eicosanoids. Ultimately, he says that staying “in the Zone” by eating foods in the ideal proportions promotes both burning fat and cardiovascular health.
Benefits
Barry Sears, developer of the Zone diet says that the makes the following claims for the Zone diet:- weight loss of 1-1.5 lb (.6-.7 kg) per week
- permanent weight loss
- improved physical and mental performance
- prevention of chronic cardiovascular diseases
- improved immune system functioning
- decreased signs of aging and increased longevity
- no need to count calories (count Zone Food Blocks instead)
Precautions
People with reduced kidney function should discuss this diet with their doctor because of the high level of protein. Severely reducing the amount of grains eaten, especially whole grains, may lead to not getting enough dietary fiber. Dietary fiber plays an important role in maintaining bowel function. Too little fiber can result in constipation.Risks
Research and general acceptance
The core of the Zone diet is that everything a person eats should have a balance of 40% carbohydrates, 30% protein, and 30% fats. The 30% fats fits in well with what many dietitians and nutritionists recommend, and Sears emphasizes the use of olive oil and canola oil, both high in monounsaturated fats which are considered good for the body. However, 30% protein is considered high by many nutritionists and 40% carbohydrates is considered low. The federal health guidelines, Dietary Guidelines for Americans 2005, recommend consuming food in the proportions of 55% carbohydrates, 15% protein, and no more than 30% fats. These guidelines also recommend substantial consumption of whole grain products that are severely limited on the Zone diet.In a review of the Zone diet published in Journal of the American College of Nutrition in 2003, the author questions the emphasis placed on the hormonal control of weight. He argues that although it is well documented that carbohydrates stimulate the production of insulin and proteins stimulate the production of glucagon, this occurs only when single nutrients are consumed. In a mixed meal consisting of protein, carbohydrates, and fats, such as those required by the Zone diet, the situation is much more complex and Sear's conclusions about hormonal response are simplistic. In the same article, the author questions the emphasis put on the role of controlling the production of eicosanoids through diet.
The claim that the Zone diet allows individuals to perform at peak physical performance is refuted by several studies by sports nutritionists who feel that limiting carbohydrates can harm athletic performance, especially among endurance athletes.
In an effort to determine which of several popular diets helped people keep weight off, researchers at Tufts-New England Medical Center in Boston assigned a group of volunteers to one of four diets: Atkins, Dean Ornish, Weight Watchers, and Zone diet. The found that regardless of the initial amount of weight lost, after one year, losses were only about 5% in all programs, meaning that these diets were all equally ineffective in helping most people keep weight off. These results were published in 2005 in the prestigious Journal of the American Medical Association.
In general, dietitians and nutritionists believe that any benefit from the Zone diet comes from the
reduction of calories and subsequent weight loss. They tend to feel that the same result can be achieved with a less complicated diet low in fats and high in fruits, vegetables, and whole-grain carbohydrates. They also question whether individuals on the Zone Diet get enough B-complex vitamins (found in large quantities in whole grains) without supplementation.
Resources
BOOKS
Sears, Barry. A Week in the Zone. New York: Regan Books, 2004.Sears, Barry. What to Eat in The Zone: The Quick & Easy, Mix & Match Counter for Staying in The Zone. New York: Regan Books, 2004.
Sears, Barry and Lynn Sears. Zone Meals in Seconds: 150 Fast and Delicious Recipes for Breakfast, Lunch, and Dinner. New York: Regan Books, 2004
PERIODICALS
Cheuvront, Samuel N. “The Zone Diet Phenomenon: A Closer Look at the Science Behind the Claims.” Journal of the American College of Nutrition. 22, no. 9 (2003): 9-17 <http://www.jacn.org/cgi/content/full/22/1/9>ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: <http://www.eatright.org>DrSears.Com Official Zone Web Page. Website: <http://www.drsears.com/>
OTHER
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Tish Davidson, A.M.
Protein
(Illustration by GGS Information Services/Thomson Gale.)
protein's role and function in the human body, it is important to understand its basic structure and composition.
Amino Acids
atom (H), and a fourth group, referred to as the R-group, that determines the structural identity and chemical properties of the amino acid. The first three groups are common to all amino acids. The basic amino acid structure is R-CH(NH2)-COOH.There are twenty different forms of amino acids that the human body utilizes. These forms are distinguished by the fourth variable substituent, the R-group, which can be a chain of different lengths or a carbon-ring structure. For example, if hydrogen represents the R-group, the amino acid is known as gly-cine, a polar but uncharged amino acid, while methyl (CH3) group is known as alanine, a nonpolar amino acid. Thus, the chemical components of the R-group essentially determine the identity, structure, and function of the amino acid.
The structural and chemical relatedness of the R-groups allows classification of the twenty amino acids into chemical groups. Amino acids can be classified according to optical activity (the ability to polarize light), acidity and basicity, polarity and nonpolarity, or hydrophilicity (water-loving) and hydrophobicity (water-fearing). These categories offer clues to the function and reactivity of the amino acids in proteins. The biochemical properties of amino acids determine the role and function of protein in the human body.
Of the twenty amino acids, eleven are considered nonessential (or dispensable ), meaning that the body is able to adequately synthesize them, and nine are essential (or indispensable), meaning that the body is unable to adequately synthesize them to meet the needs of the cell. They must therefore be supplied through the diet. Foods that have protein contain both nonessential and essential amino acids, the latter of which the body can use to synthesize some of the nonessential amino acids. A healthful diet, therefore, should consist of a sufficient and balanced supply of both essential and nonessential amino acids in order to ensure high levels of protein production.
Protein Quality: Nutritive Value
The quality of protein depends on the level at which it provides the nutritional amounts of essential amino acids needed for overall body health, maintenance, and growth. Animal proteins, such as eggs, cheese, milk, meat, and fish, are considered high-quality, or complete, proteins because they provide sufficient amounts of the essential amino acids. Plant proteins, such as grain, corn, nuts, vegetables and fruits, are lower-quality , or incomplete, proteins because many plant proteins lack one or more of the essential amino acids, or because they lack a proper balance of amino acids. Incomplete proteins can, however, be combined to provide all the essential amino acids, though combinations of incomplete proteins must be consumed at the same time, or within a short period of time (within four hours), to obtain the maximum nutritive value from the amino acids. Such combination diets generally yield a high-quality protein meal, providing sufficient amounts and proper balance of the essential amino acids needed by the body to function.Protein Processing: Digestion, Absorption, and Metabolism
The cells of the small intestine actively absorb the amino acids through a process that requires energy. The amino acids travel through the hepatic portal vein to the liver, where the nutrient are processed into glucose or fat (or released into the bloodstream). The tissues in the body take up the amino acids rapidly for glucose production, growth and maintenance, and other vital cellular functioning. For the most part, the body does not store protein, as the metabolism of amino acids occurs within a few hours.Amino acids are metabolized in the liver into useful forms that are used as building blocks of protein in tissues. The body may utilize the amino acids for either anabolic or catabolic reactions . Anabolism refers to the chemical process through which digested and absorbed products are used to effectively build or repair bodily tissues, or to restore vital substances broken down through metabolism. Catabolism, on the other hand, is the process that results in the release of energy through the breakdown of nutrients, stored materials, and cellular substances. Anabolic and catabolic reactions work hand-in-hand, and the energy produced in catabolic processes is used to fuel essential anabolic processes. The vital biochemical reaction of glycolysis (in which glucose is oxidized to produce carbon dioxide, water, and cellular energy) in the form of adenosine triphosphate, or ATP, is a prime example of a catabolic reaction. The energy released, as ATP, from such a reaction is used to fuel important anabolic processes, such as protein synthesis.
The metabolism of amino acids can be understood from the dynamic catabolic and anabolic processes. In the process referred to as deamination, the nitrogen-containing amino group (NH2) is cleaved from the amino acid unit. In this reaction, which requires vitamin B6 as a cofactor, the amino group is transferred to an acceptor keto-acid, which can form a new amino acid. Through this process, the body is able to make the nonessential amino acids not provided by one's diet. The keto-acid intermediate can also be used to synthesize glucose to ultimately yield energy for the body, and the cleaved nitrogen-containing group is transformed into urea, a waste product, and excreted as urine.
Vital Protein Functions
Proteins are vital to basic cellular and body functions, including cellular regeneration and repair, tissue maintenance and regulation, hormone and enzyme production, fluid balance, and the provision of energy.Cellular and tissue provisioning. Protein is an essential component for every type of cell in the body, including muscles, bones, organs, tendons, and ligaments. Protein is also needed in the formation of enzymes, antibody, hormones, blood-clotting factors, and blood-transport proteins. The body is constantly undergoing renewal and repair of tissues. The amount of protein needed to build new tissue or maintain structure and function depends on the rate of renewal or the stage of growth and development. For example, the intestinal tract is renewed every couple of days, whereas blood cells have a life span of 60 to 120 days. Furthermore, an infant will utilize as much as one-third of the dietary protein for the purpose of building new connective and muscle tissues.
Hormone and enzyme production. Amino acids are the basic components of hormones, which are essential chemical signaling messengers of the body. Hormones are secreted into the bloodstream by endocrine glands, such as the thyroid gland, adrenal glands, pancreas, and other ductless glands, and regulate bodily functions and processes. For example, the hormone insulin, secreted by the pancreas, works to lower the blood glucose level after meals. Insulin is made up of forty-eight amino acids.
Enzymes, which play an essential kinetic role in biological reactions, are composed of large protein molecule. Enzymes facilitate the rate of reactions by acting as catalysts and lowering the activation energy barrier between the reactants and the products of the reactions. All chemical reactions that occur during the digestion of food and the metabolic processes in tissues require enzymes. Therefore, enzymes are vital to the overall function of the body, and thereby indicate the fundamental and significant role of proteins.
Energy provision. Protein is not a significant source of energy for the body when there are sufficient amounts of carbohydrate and fats available, nor is protein a storable energy, as in the case of fats and carbohydrates. However, if insufficient amounts of carbohydrates and fats are ingested, protein is used for energy needs of the body. The use of protein for energy is not necessarily economical for the body, because tissue maintenance, growth, and repair are compromised to meet energy needs. If taken in excess, protein can be converted into body fat. Protein yields as much usable energy as carbohydrates, which is 4 kcal/gm (kilocalories per gram). Although not the main source of usable energy, protein provides the essential amino acids that are needed for adenine, the nitrogenous base of ATP, as well as other nitrogenous substances, such as creatine phosphate (nitrogen is an essential element for important compounds in the body).
Protein Requirement and Nutrition
The recommended protein intake for an average adult is generally based on body size: 0.8 grams per kilogram of body weight is the generally recommended daily intake. The recommended daily allowances of protein do not vary in times of strenuous activities or exercise, or with progressing age. However, there is a wide range of protein intake which people can consume according to their period of development. For example, the recommended allowance for an infant up to six months of age, who is undergoing a period of rapid tissue growth, is 2.2 grams per kilogram. For children ages seven through ten, the recommended daily allowance is around 36 total grams, depending on body weight. Pregnant women need to consume an additional 30 grams of protein above the average adult intake for the nourishment of the developing fetus.Sources of protein. Good sources of protein include high-quality protein foods, such as meat, poultry, fish, milk, egg, and cheese, as well as prevalent low-quality protein foods, such as legumes (e.g., navy beans, pinto beans, chick peas, soybeans, split peas), which are high in protein.
Protein–Calorie Malnutrition
The nitrogen balance index (NBI) is used to evaluate the amount of protein used by the body in comparison with the amount of protein supplied from daily food intake. The body is in the state of nitrogen (or protein) equilibrium when the intake and usage of protein is equal. The body has a positive nitrogen balance when the intake of protein is greater than that expended by the body. In this case, the body can build and develop new tissue. Since the body does not store protein, the overconsumption of protein can result in the excess amount to be converted into fat and stored as adipose tissue. The body has a negative nitrogen balance when the intake of protein is less than that expended by the body. In this case, protein intake is less than required, and the body cannot maintain or build new tissues.A negative nitrogen balance represents a state of protein deficiency, in which the body is breaking down tissues faster than they are being replaced. The ingestion of insufficient amounts of protein, or food with poor protein quality, can result in serious medical conditions in which an individual's overall health is compromised. The immune system is severely affected; the amount of blood plasma decreases, leading to medical conditions such as anemia or edema; and the body becomes vulnerable to infectious diseases and other serious conditions. Protein malnutrition in infants is called kwashiorkor, and it poses a major health problem in developing countries, such as Africa, Central and South America, and certain parts of Asia. An infant with kwashiorkor suffers from poor muscle and tissue development, loss of appetite, mottled skin, patchy hair, diarrhea, edema, and, eventually, death (similar symptoms are present in adults with protein deficiency). Treatment or prevention of this condition lies in adequate consumption of protein-rich foods.
Resources
BOOKS
Berdanier, Carolyn D. (1998). CRC Desk Reference for Nutrition. Boca Raton, FL: CRC Press.Briggs, George M., and Calloway, Doris Howes (1979). Bogert's Nutrition and Physical Fitness, 10th edition. Philadelphia, PA: W. B. Saunders.
Robinson, Corrinne H. (1975). Basic Nutrition and Diet Therapy. New York: Macmillan.
U.S. Department of Agriculture (1986). Composition of Foods. (USDA Handbooks 8–15.) Washington, DC: U.S. Government Printing Office.
Wardlaw, Gordon M., and Kesse, Margaret (2002). Perspectives in Nutrition, 5th edition. Boston: McGraw-Hill.
OTHER
Institute for Chemistry. “Amino Acids.” Available from <http://www.chemie.fuberlin.de>Jeffrey Radecki
Susan Kim
