When most people think about diet, they focus on weight loss—getting rid of those extra five or ten pounds they’ve been promising to shed. A booming industry caters to this fascination with weight and appearance, offering scores of books to help people shed weight, improve their sex lives, and look younger; promoting schemes to deliver a thinner you in a matter of weeks; and hawking diet plans based on “magic” foods, “power” foods, fast foods, convenience foods, even liquid foods.
At any given time, 20 million Americans are on a diet of some kind, and another 20 million are convinced they should be. Yet most of them fail to achieve their goals, dropping out because the programs they’ve chosen are too stringent, concentrate on foods they dislike, or conflict with their lifestyle. Even those who reach their objectives usually slip back, eventually returning to their original eating patterns.
This is not the way it has to be. A diet program needn’t be a hardship, doesn’t have to include foods you hate, and shouldn’t be measured exclusively in terms of pounds lost. Instead, think in terms of your own health and enjoyment. If you simply follow what we know about nutrition today, you can protect your health, find an agreeable style of eating, and maintain a reasonable weight in the bargain.
Most experts, such as New York Times science and medical writer Jane Brody, believe that “unless you have a chronic illness like diabetes, or are genetically prone to heart disease, you need not become an extremist or an acetic, nor do you have to give up everything you love forever.”
People adopt diets for two main reasons: 1) to improve their health and prevent serious medical problems or 2) to lose weight. In many cases, the same basic food plan—low fat, moderate protein, high complex carbohydrate—will accomplish both goals. In others, a more specialized program is necessary.
But before you start any new eating program, whether it be for weight loss or health, there are a number of things you should consider. According to Stanley Gershoff, Ph.D., dean of the Tufts University School of Nutrition, you need to ask yourself:
• What is my motivation? For example, if you believe losing weight will improve your love life or assure a job promotion, you’re bound to fail. While a diet and fitness program can be a positive motivating factor, losing weight, in itself, does not guarantee your life will change.
• Why have I failed at other diets? Perhaps it was not entirely your fault. You may have tried one of many fad diets that have been proven time and again to be ineffective. By examining your diet history, you may spot a trend. For example, extremely low calorie diets or organized diet plans may not work for you.
• Am I built like other members of my family? Look at your close relatives. No matter how much you diet, you can no more change your genetically-given shape than you can change the color of your eyes.
• Do I have “special health considerations?” Are you at risk for heart disease, high blood pressure, or diabetes? Do you have food allergies? Do you have high cholesterol, high blood sugar, or other medical conditions that might make certain diets harmful to you? Are your medications compatible with the program you’re considering? If you do have a medical problem, ask your doctor to help you choose a program.
Your diet can influence your risk of developing an imposing list of life-shortening diseases, including heart disease, cancer, stroke, diabetes, and high blood pressure, not to mention the less threatening but painful problems of tooth decay, bone fractures, and excess weight.
For example, almost everyone now knows that a diet rich in saturated fat plays a central role in the development of heart disease, America’s number one killer. According to the American Heart Association, an ample body of scientific evidence shows that reducing dietary fat and cholesterol can lower the risk of heart and blood vessel disease in the general population.
Excess weight often goes hand in hand with high cholesterol. LDL, the so-called “bad” cholesterol, is known to promote atherosclerosis, the accumulation of plaque in the walls of the arteries that results in reduced blood flow and oxygen to the heart. Too much cholesterol in the blood invites this development. But, says Dr. Gershoff, for some people, slimming down to a healthy body weight will, by itself, completely correct elevated LDL concentrations.
Experts agree that any nutritional program aimed at preventing or improving heart disease should be based on a food plan that emphasizes low-fat, high-starch meals. It should also include sample menus and recipes; hints on how to eat at a restaurant, a dinner party, or a special occasion; plus information on such other risk factors as tobacco and alcohol. It should be neither so restrictive that it invites failure, nor so unstructured as to be confusing.
It should also include a medically approved exercise program. The Centers for Disease Control and Prevention warn that the sedentary life-style of many Americans may be as great a risk factor for heart disease as high cholesterol or high blood pressure. On the other hand, aerobic exercise increases the strength of the heart, raises HDL (the “good” cholesterol), and alleviates stress on the heart.
Many other health problems respond favorably to this type of heart-healthy program. Certain types of cancer—including breast, colon, rectum, stomach, and esophagus—have been linked to the high-fat, low-fiber types of food that a heart-healthy diet restricts. Excess weight can also increase the risk of developing some cancers, so, as a heart-healthy diet brings down your weight, it reduces your cancer risk as well.
Some diseases, such as diabetes, require a more indivualized diet. A good diabetes diet, for example, groups foods according to their calories and their carbohydrate, protein, and fat content, and uses an “exchange” system to guide the dieter. With the help of a registered dietitian, these exchanges can be fine-tuned to accommodate your favorite foods while controlling blood sugar. Again, the emphasis is on weight control; a diet rich in starch and fiber, and low in fat; and regular aerobic exercise.
If you think you have allergies or food sensitivities, the first step is to get tested. Then you can work with your doctor or a dietitian to eliminate the offending foods and develop a healthy eating plan.
Whatever your goal, be certain to discuss major changes in your diet with your doctor. He or she can tell you whether your medications could react unfavorably with certain foods, whether a particular diet can create problems with any medical condition you may have, and whether a program includes all the nutrients and calories you need.
If religion or philosophy governs the type of food you eat, your choice of diet plans is automatically limited. Fortunately, there are a number of excellent programs to meet these special needs.
Since 1970, there has been a 30 percent growth in vegetarianism in this country. Vegetarian restaurants, food stores, cookbooks, and nutritional programs are plentiful.
There are many degrees of vegetarianism. Lactovegetarians eat dairy foods but no animal protein including eggs. Ovolacto vegetarians eliminate animal foods from their diets, but do eat eggs and dairy products. Other vegetarians indulge in fish as well as dairy foods and eggs. Only vegans eat absolutely nothing from a creature that flies, walks, or swims.
If you are a vegetarian, you must choose a diet rich in the nutrients most Americans get from meat, poultry, fish, eggs, milk, and cheese. Your food plan should include vegetable protein from such sources as beans and soy products; starches from whole grains and a variety of fruits and vegetables; oils low in saturated fat; and nuts and seeds. You may also want to take vitamin and mineral supplements (especially vitamins B2, B12, and D, and iron, zinc, and calcium) to restore the essential elements that may be missing from your foods.
For vegetarians, most experts favor a diet program that permits you to combine foods for adequate nutrition. For example, during the course of each day nutritionists suggest you eat beans along with grains, or nuts and seeds; and eggs or dairy products along with any vegetable protein.
A good vegetarian diet program contains all the nutrients essential to good health and enough calories to support your ideal weight. It should include meal plans that allow you to choose among a variety of foods, and—ideally—recipes to help you cook them. It should also teach you how to plan your own menus.
Few nutritionists applaud a strict macrobiotic diet. It starts out as a balanced vegetarian diet, but can progress into a limited, extremely deficient intake of brown rice (or grain) only. Extreme macrobiotic diets can lead to scurvy, anemia, and dangerously low levels of blood sugar and protein. Some nutritionists call the diet “bizarre,” and “repugnant.”
Whole grains and vegetables are the key foods in a macrobiotic diet. They are supplemented by soups, soy products, beans, fruits, nuts, seeds, fish, and sea greens. Whole grain cereals make up 50 to 60 percent of the diet, fresh vegetables 20 to 30 percent, beans and sea greens five to 10 percent, and soup another five to 10 percent. Adherents are forbidden to eat artificial or chemically-processed products; refined sugars and grains; certain vegetables, fruits, and juices; red meat, poultry, eggs, and dairy products; saturated and refined fats and oils; caffeine, and carbonated beverages.
In its initial stages, a macrobiotic diet is not dangerous, although it may be deficient in certain essential nutrients. But if you choose this way of eating, nutritionists caution it’s unwise to complete the transition to an almost complete reliance on grains. If, as its founder says, the diet’s purpose is to “ensure survival of the human race and its further evolution on this planet,” its prospects seem grim.
It’s easy to set a healthy kosher table, although it does require some tampering with traditional recipes.
Although Jewish dietary law requires separation of meat and dairy foods—they cannot be eaten at the same meals or on the same dishes—it’s still easy to maintain a balanced diet. Approved meats come only from certain portions of animals that have split hooves, chew their cud, and have been killed according to a strict set of rules, but these restrictions still leave room for plenty of variety.
If you are an orthodox Jew, or if you eat only kosher, foods there is no reason your diet cannot meet the current standards for good health: You can still increase your fruits, grains, and vegetables and cut down on saturated fats. Jews from the Mediterranean countries typically eat that way, according to Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest.
If you prefer traditional eastern European foods, even if only on holidays, you can still reduce their fat content. For example, use imitation sour cream and farmer cheese in blintzes and low- or no-fat cottage cheese in noodle pudding, defat homemade chicken soup, and make matzoh balls with egg substitute and fewer eggs.
While there are few specifically kosher diet cookbooks, you can modify recipes from a regular kosher cookbook or adapt recipes from others.
For those who prefer a formal weight control program with prepared meals, the 19-year-old Start Fresh program, based in Brooklyn, has developed a kosher diet low in fat, calories and sodium; moderate in protein; and high in complex carbohydrates. Participants can buy and prepare their own food or purchase the company’s frozen meals, and snack foods.
Start Fresh also offers group, individual, and even telephone sessions that emphasize behavior modification. Participants can also join the program online at www.startfresh.com. They cover topics such as how to shop for healthy food, how to feed the children when mother is on a diet; and staying on track before, during, and after special occasions. The plan also stresses exercise.
The typical American man is now 20 to 30 pounds overweight, the typical woman, 15 to 30 pounds, and even children carry from 10 to 20 percent more weight than they should. Today’s sedentary lifestyle is largely to blame. People gain weight when they take in more food than they can burn, and store the excess as fat. Our ancestors ate a great deal more than we do, but because they were physically active, they weighed less.
Simply maintaining a weight that falls within the normal range for your height and body type can increase your life expectancy by cutting your risk of high blood pressure, heart disease, diabetes, and other weight-related problems. But how do you choose a weight loss program once you—and your doctor—decide you need to lose weight? “A good diet is something you can stay on the rest of your life,” says C. Wayne Callaway of George Washington University. “There’s no advantage to short-term austerity programs. The more the weight fluctuates, the shorter your life expectancy.” A sound program, should concentrate on behavior, not weight loss. “It should provide adequate food—not an excess—eaten in three daily meals, and include regular, moderate exercise you can live with.”
For weight loss to be lasting, it must be based on permanent lifestyle changes that you can realistically stick to. A good nutritional program teaches you to set achievable short- and long-term goals; shows you how to recognize the reasons you overeat; and gives you enough information about foods, nutrients, and calories to make the right choices. It also maximizes your chance for success by providing practical methods to help you stick to your eating and exercise plan.
Quick weight loss diets do not work in the long run, most experts agree. A sensible program helps you shed from one-half to two pounds a week. Any more than that raises your risk of failure. Research has shown that the faster you lose, the more likely you are to regain the weight and the greater the danger to your health.
Today’s best diet plans concentrate on lowering your intake of fat while raising your consumption of carbohydrates. Fat is usually limited to no more than 25 to 30 percent of total calories, and protein to 10 to 15 percent, with carbohydrates accounting for the remaining 55 to 60 percent. To lose weight safely, chose a program that recommends plenty of vegetables, fruits, and whole-grain products; and includes beans (legumes), as well as some nonfatty fish and poultry for protein and nonfat dairy products for calcium. Your meals should contain a minimum of foods high in saturated fats, such as cheeses, whole milk, beef, lamb, and pork.
That’s a far cry from the high-protein, low-carbohydrate diet of the past, now believed to be a sure path to quick fatigue and poor performance.
The consensus is that calories do count, although extremely low-calorie diets can be unproductive. Your body type and lifestyle play a large part in determining your caloric requirements, but everyone has to burn 3,500 calories to lose a pound of stored fat. While some people can shed pounds on 1,500 calories, others may do better on 1,200 or 2,000. A tall 40-year-old man who has actively participated in sports from the age of 18 needs more calories while he is still active than he will as he grows older and more sedentary. A woman who never exercises may eat less than an athlete of the same age and build and still gain weight. Your physician, or a dietitian can help you determine how many calories you should eat to lose weight while still getting the nutrition you need.
Avoid diets that make you feel deprived. Chances are you will not be able to stick to them, and any weight you lose will quickly return. There is no reason to give up everything you love to shed pounds, and guilt is unproductive. Some approaches are:
• Splurge at a special occasion and give yourself an occasional treat. If you deny yourself completely, you will be more likely to binge. Eat some of your favorite foods, but take a smaller portion or a lower fat version.
• Choose a diet that gives suggestions on what to eat at a party or a restaurant.
• Learn how to compensate or trade-off. For example, if you eat a high fat food for breakfast, choose low fat foods for the rest of your meals.
• Make sure the program allows you to select from a variety of foods within each food group. A boring repetition can quickly lead to failure.
Be certain that your diet plan includes exercise. The best way to slim down and achieve fitness is with an easy program you can stick with and work into the rest of your daily activities; one that you can enjoy no matter how unfit you are to start with. The diet you choose should emphasize regular, moderate physical activity. Most experts agree that a good exercise program should include aerobic exercise to strengthen your cardiovascular system and muscle-building exercise as well. While losing weight, you need to exercise for more than 30 minutes three or four times a week. Once you’ve reached your goal, 20 to 30 minutes will do.
Maintaining your target weight is important. Yo-yo-ing up and down is unhealthy. Any good nutritional program should also help you determine why and where you overeat, so you can develop lifetime strategies to help eliminate the problem and keep off those unwanted pounds. Remember, though, not to be discouraged if a few pounds return. If you’ve taken off more than your body can handle, it will inevitably seek its natural weight.
Warning Signs of Fads and Gimmickry
“When it comes to diets . . . Americans are extraordinarily gullible,” says Jane Brody. They will “swallow anything—dozens of eggs, hundreds of grapefruits, gallons of water, even wood pulp, vinegar, and seaweed—if it will keep them away, however temporarily, from the calorie-rich foods that have made them fat.”
At best, fad diets are ineffective; at worst, they can seriously endanger your health. When choosing a program, watch out for the following danger signals:
* Excessively restrictive food choices. Unless your diet is varied, you are likely to become bored and begin overeating. In addition, restricted programs often eliminate essential nutrients.
* Unrealistic promises. “Lose 20 pounds in two weeks,” shouts one plan. “You can eat everything you want (or often as you want) and still lose weight,” claims another. There are no shortcuts when it comes to weight loss. While almost every diet works for a while, your initial weight loss is mostly water. You simply cannot lose fat quickly.
* Assertions that calories don’t count. If you consume more calories than you burn—whatever their source—you will gain weight.
* Nutritional imbalance. Stay away from any diet that does not contain all of the carbohydrates, protein, fat, vitamins, and minerals you need to sustain health. Be wary when a program asserts that one element is a “no-no.” Watch out especially for:
Low- or no-carbohydrate diets, such as the Dr. Robert C. Atkins’ plan. Without carbohydrates, your body may begin burning protein, producing toxic waste products called ketones. In large amounts, these wastes can cause brain, liver, and kidney damage; nausea; fatigue; lethargy; and, over time, heart problems. When protein must be used for energy, it cannot build and replace tissues as it should. These diets are also too high in saturated fat and too low in fiber and essential vitamins and minerals.
Crash diets. The “crash” in crash diets comes afterward, when we start gobbling food to meet the demands of our depleted bodies.
Unsupervised all-liquid diets, especially liquid protein.
Fasting. The pounds will come off quickly, but without essential nutrients, you will lose muscle as well as fat. Although a day or two probably will not hurt, you also run the risk of developing a serious, even life-threatening disease or psychological condition if the fast persists too long.
* Ineffective, or dangerous gimmicks. Over the past few years, several popular plans have sung the praises of special foods, supplements, and medications whose “magic” properties practically guarantee weight loss. Remember that shedding pounds involves sensible, healthy eating, and lifelong behavior modification, not a “miracle” potion that, at best, does not work, and at worst, could endanger your health. Be especially alert to claims made for:
—Hormones (including thyroid and human chorionic gonadotrophin [HCG])
—Certain types of fruit, especially when the dieter eats nothing else for days (or weeks) at a time
—Any diet that relies on only one food or class of foods (for instance, rice, grain, or water)
* Tie-ins with a specific manufacturer. There’s no reason to eat one company’s product if another has equivalent food value.
Good nutrition and diet programs stress self-sufficiency. Even if you choose a “structured weight control program” initially, it is likely that the more comfortable you become with selecting your own nutrition and fitness plan, the less obsessed you will become with food and the less likely you will be to binge.
Even so, dieters have different needs. Some require individual counseling and encouragement, others are more comfortable in groups; a few can diet on their own. A plan with plenty of flexibility and choice is perfect for one person, a rigid food plan is ideal for another. If your program fails to match your personality, you are less likely to achieve your goal.
Your diet plan also should be individualized to fit your special needs. In weight loss and maintainance, “one-size-fits-all” usually does not work. If you are a vegetarian or a diabetic, or if your religion places restrictions on your foods, ask a counselor to customize the standard diet for you.
Be wary of organizations that require purchase of their prepared foods unless you have neither the time nor the talent to cook your own meals. Though convenient, the products can be expensive. Some even include unhealthy ingredients, like excess salt or sugar. A reputable company gives you the option of shopping for and preparing your own food.
Also watch out for weight-loss plans that insist you buy special supplements. The popular “calories-don’t-count” diet plan Fit America, for instance, recommends that clients take its “all natural” herb and mineral preparations with each meal to control appetite and increase metabolism. When used in the quantities recommended, these products can cost up to $40.00 per week!
If you need the support and encouragement of a group of like-minded dieters, pick an organization like Weight Watchers. If you would rather work one-on-one with a counselor, turn to Diet Center, Jenny Craig, or a similar program. For more on the leading organizations, see “Best Strategies for Losing Extra Pounds.”
If you have trouble making choices when it comes to food, your program should include preplanned menus complete with portion sizes and recipes. Duke University Medical Center provides meal plans, shopping lists, and recipes for the entire four weeks of its maintenance program.
If you like to cook, or if you are adventurous, you’ll want more flexibility. The Tufts University School of Nutrition, for example, offers sample menus, but does not insist you eat specific foods at specific meals. It does, however provide helpful information on subjects such as ways to balance your diet, methods of reducing the fat in your food, the nutrients in fresh vegetables and fruits, and the sodium and fat content of various cheeses.
If you are severely overweight and at risk for serious health problems, your doctor may recommend a medically supervised liquid diet regimen. Optifast, Medifast, HMR, and other similar products, unlike the liquid proteins that caused deaths in the 1970s, include both high-quality protein and necessary amounts of vitamins and minerals. More than 300,000 people, including television talk show host Oprah Winfrey, have chosen this type of weight-loss program.
Like any dieting plan, a liquid protein regimen is not for everyone. You must be at least 50 pounds overweight or 30 percent above your ideal weight range on the Metropolitan Life Insurance Company charts. If your physician puts you on a strict liquid protein diet, you will need to be under the supervision of a clinic or hospital. Although you need not be an in-patient, you may require frequent—even daily monitoring. Five times a day for 12 weeks you will drink a beverage consisting of protein/nutrient powder mixed with water—and eat or drink nothing else. After the initial period, solid, healthy foods will be reintroduced. While you are dieting, you will also be taught to modify your eating behavior so that you will not regain weight when you return to normal meals.
The good news is: Four out of five people who complete this kind of program lose an average of 40 pounds.
The bad news is: One-half of those who start the plan drop out, and most of those who make it through eventually regain the weight they lose, just as Oprah did. According to Tufts nutritionist Stanley Gershoff, if you lose weight this fast you are three times more likely to regain it than if you go more slowly. A second drawback is that while some dieters lose fat, others lose lean muscle tissue. A third problem is the cost: This kind of diet program is expensive. However, some health insurance plans will pick up the charges.
A second type of liquid diet is less expensive, does not require supervision, and, when used for a short period of time (e.g., 10 days) or to replace one meal a day, is not considered to be dangerous. Products such as Slimfast and Sweet Success are available in supermarkets and pharmacies at reasonable prices. However, if you consume only liquid, you are not learning how to cope with real food in the real world.
A good nutrition plan not only helps you lose excess pounds, but also teaches you how to set your own goals and take lifetime responsibility for your weight and your health. Your program should contain the following features:
• Easy-to-follow instructions. If the instructions are too complex, you will never stick to the plan. Your diet should fit easily into your life, not take it over.
• A healthy, balanced diet. Nowadays the emphasis is on complex carbohydrates; fat is a “no-no.” While we all should cut down or eliminate saturated fats, we do need some fat or oil in our diet—up to a recommended limit of 30 percent. We must also consume vegetable or animal protein and essential vitamins and minerals. Your diet should not eliminate any of these elements.
• Sufficient calories. Different people require different numbers of calories to lose weight. The calorie count of your diet depends on your build, your level of activity, your lifestyle, and the number of pounds you need to shed. While you should not consume more calories than you can burn, you must have enough to maintain your health. Remember: Extremely low-calorie diets never work in the long run, and can be dangerous.
• A variety of foods. If you stick to one food or group of foods (fruits, for example) to the exclusion of others, your boredom may lead you to binge or to quit the diet completely. It may also be unhealthy.
• Readily-available foods. Unless you enjoy browsing in specialty gourmet shops, choose a diet that lets you shop in your neighborhood supermarket. You do not need persimmons and jicama to lose weight.
• Meal plans and recipes. It is helpful to know how to combine foods and when to eat them. And recipes are wonderful when you are learning how to cook a new, healthy way.
• An exercise plan. Aerobic and muscle-building exercise are an important part of any weight-loss program. A good diet book or counselor should include exercise in the program, helping you plan a regular program of activity for the rest of your life. (See “Exercise: The Other Half of Weight Control” for more on exercise.)
• Behavior modification. You are bound to gain back the weight you have lost unless you understand why you overeat and learn how to change your habits permanently.
The array of diet books available to you—if you choose the do-it-yourself approach—is truly staggering. The brief “Buyer’s Guide” that follows will give you an overview of today’s leading titles.
Buyer’s Guide to Diet Books
Here’s a sampling of some of the more notable diet books vying for your attention today. Inclusion here does not necessarily imply a recommendation. See the individual descriptions for further details and caveats.