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The South Beach diet was created in 2003 by Dr. Arthur Agatstan, a preventative
cardiologist and associate professor of medicine at the University of Miami Miller school of Medicine. The South Beach diet is meant to provide lifelong change and has been updated to incorporate daily exercise.  The diet focuses on eating low glycemic index carbohydrates, lean protein, healthy fats, and nutrient-dense, fiber rich fruits and vegetables.  The diet has three phases:  

Phase one lasts two weeks and is meant to jumpstart the diet. This is the most restrictive phase.  Almost all carbohydrates are eliminated.  Lean protein, high
fiber vegetables, low fat dairy and healthy unsaturated fats and oils are allowed.  An eight to ten pound weight loss can be expected at the end of the first phase.  If a person has ten pounds are less to lose they may skip the first phase and start the second phase.  

Phase two is a long term weight lost phase and lasts until a person’s goal weight is reached. Healthy carbohydrates such as whole-grain breads, whole wheat pasta, brown rice, fruits and vegetables are added during this phase.  Weight loss of one to two pounds is expected during phase two. 

Phase three is the maintenance phase and is meant to be a healthy way to eat for life. Although, no foods are off limits during this phase and occasional indulgences are included, a person should continue to follow the principles learned in phase one and two.  

Professionals do not seem to have too many issues with the South Beach diet. 
Cindy Moore, RD, a director of nutrition therapy at Cleveland Clinic says that although weight loss in phase one is mainly due to water loss, the diet overall meets many criteria for a healthy diet because if doesn’t leave out any major food groups and it includes fruits, vegetables, whole grains and lean proteins. The diet also promotes lifelong change.  Dawn Jackson Blatner, RD, an American Dietetic Association spokesperson agrees that the South Beach diet includes the behavioral changes necessary for a healthy lifestyle.  She also adds the most Registered Dietitians advise clients to follow weight loss plans similar to recommendations found during the second and third phases of the South Beach diet.  
 
More information on the South Beach diet can be found at:
http://www.southbeachdiet.com/sbd/publicsite/index.aspx


References:
 http://www.mayoclinic.com/health/south-beach-diet/MY00499
 http://www.webmd.com/diet/south-beach-diet-what-it-is?page=2

The Zone diet was created by Dr. Barry Sears, a former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology.  The diet is based off of his 25 years of lipids research.  Dr. Sears published The Zone diet, in June 1995. The Zone diet was a #1 best seller on the New York Times book list, sold over 2 million copies and has been translated into 22 different languages.  

The Zone diet is based on the belief that eating the wrong foods or the wrong amounts of foods will cause an imbalance of insulin and glucagon. This imbalance will cause cellular inflammation which causes cells to trap fat instead of releasing it for energy.  The lack of energy being released is said to be the underlying cause for weight gain because people always feel hungry.  If the proper foods are eaten in the proper amounts the levels of insulin and glucagon will make a person feel full and not eat as many calories so weight is lost. When in balance a person should feel full for 4-6 hours.

The Zone diet does not have any calorie restrictions.  The diet works by changing the amounts and types of food a person eats. The diet recommends that 35-45% of a person’s total calories come from carbohydrates, 25-35% from protein, and 30% or less come from fat.  This is commonly referred to at the 40:30:30 plan.  During a meal a person would fill 1/3 of their plate with 3-4oz of low fat protein and the remaining 2/3 with favorable carbohydrates such as fruits and vegetables.  Grains and starches are treated as condiments and should only be whole grains.  Small amounts of fats such as olive oil, canola oil, almonds, macadamia nuts and avocados are allowed.  Food such bread, pizza, pasta, potatoes and rice should be avoided.  There are Zone diet approved cookies, bars, cereals, bagels, bread, pasta, and pretzels for sale on the Zone diet website. Dr. Berry suggests fish oil, polyphenols, and condition specific micronutrient supplements be taken if they are lacking in the foods eaten on the diet. 

Many health professionals don’t endorse The Zone diet but find it more acceptable than some of the other fad diets because it is lower in fat and doesn’t severely restrict total calories.  One large problem health professionals have with the diet is that there is not enough evidence to back up the scientific claims of the diet that
hormones play a large role in weight reduction.  Robert H Eckel MD, the American Heart Association’s chair of the Council on Nutrition, Physical activity and Metabolism said the diet has not been proven for long term weight loss.  It restricts intake of essential vitamins and minerals and the 40:30:30 ratio is flawed. While the amount of fat is ok the protein is too high and the carbohydrates too low. Bonnie Liebman MS, the nutrition director for the Center for Science in the Public interest’s Nutrition Action Newsletter said that while the diet restricts carbohydrates more than necessary, if you ignore the unproven scientific claims the diet isn’t bad.


 The Zone diet’s website:www.zonediet.com 
-The website contains more information about the diet, recipes, a journal, dining out tips, Zone food and a list of Zone certified physicians.


                                                 
References:

1. www.medicinenet.com/script/main/art.asp?articlekey=52012

 2.www.sciencedaily.com/articles/z/zone_diet.html

3.www.webmd.com/diet/zone-what-it-is

4.www.zonediet.com

This week while on the internet I came across an article from www.dailymail.co.uk
talking about the latest diet gaining popularity in Britain. The diet is the ketogenic enteral nutrition or KEN diet. The diet works by sending the body into a state of starvation that forces the body to use its own fat for energy.  A slow infusion of protein generates ketosis. The diet was started by Prof. Gianfranco Cappello, an associate professor of general surgery at the University of Rome’s La Sapienza hospital.  The diet is very popular in Italy.  There are 14 KEN centers in Italy and the diet has been used on over 33,000 people.  Dr. Ray Shidrawi, a consultant physician and gastroenterologist for Homerton University Hospital NHS FoundationTrust in London is promoting the KEN diet.  Dr. Shidrawi works with Wight Management Systems Ltd, a London based company that introduced the KEN diet to the UK and believes the KEN diet is the future for weight loss in the UK.

No foods are allowed to be eaten on the KEN diet. To receive nutrients a small
plastic tube is inserted up with nose.  Two liters of a special liquid formula are dripped down into the stomach over 24 hours. An electric pump is used to hold formula and control the release rate.  With the exception of carrying around a pump, a person can go about their normal daily activities.  One hour of being disconnected from the pump is allowed for activities such as showering. Water and plain coffee or tea are allowed at any time.  

The KEN diet lasts 10 days. Four to nine percent of total body weight loss is expected per cycle.  Multiple cycles can be done if a person wants to lose more weight. It is recommended that there should be 10 days off between each cycle. 
A healthy diet of regular food should be eaten in between the cycles.  In the UK each cycle costs about $550 plus a refundable deposit of $470 for use of the pump.

Dr. Shidrawi says the KEN diet is safe and is meant to be used for a limited time.  The only people who should avoid the diet are those with kidney failure or an allergy to milk proteins.  On the diet there is supposed to be no loss of muscle or hunger. Daily urine tests are done to monitor ketone levels. Some side effects are constipation due to the lack of fiber and feeling very tired. Laxatives are given to help with the constipation.

The British Dietetic Association says that more evidence is needed showing the KEN diet is safe. Eleanor Donaldson, a National Health Service Dietitian says that a potential danger with the diet is that if the tube becomes dislodged then food could go into the lungs.  She also notes that drastic weight lose is not good for the body. A spokesperson for the British Dietetic Association Helen Bond, RD agrees that weight should be lost slowly at a rate of 1-2 pounds per week.  She believes the KEN diet is just the latest in fad diets.  In order for long term weight loss success psychological and emotional reasons for over eating need to be addressed and the KEN diet does not do that. 

In the UK 60 patients have tried the KEN diet.  With the diet’s popularity in Italy and
now the interest in the UK, it will be interesting to see if KEN clinics will start to show up in the US.  


Dr. Shidrawi’s websites:
 http://www.shidrawi.co.uk/Weight-Loss
 http://www.weightmanagementsystems.co.uk

 Prof Gianfranco Cappello’s website:
 http://www.gianfranco-cappello.it/eindex2.html

 Articles on the KEN diet:
 http://www.dailymail.co.uk/femail/article-2110165/Ketogenic-Enteral-Nutrition-diet-NHS-specialist-recommends-fed-drip-lose-weight.html
 http://www.telegraph.co.uk/health/wellbeing/8711645/Would-you-choose-the-drip-fed-diet-to-lose-weight.html

In the past few years it has been hard to miss the advertising from Kellogg for the
Special K Challenge since it’s everywhere.  Kellogg introduced Special K cereal in
the US in the 1950’s and in recent years the Special K product line has expanded
to include multiple cereal flavors, cereal bars, meal bars, snack bars, fruit crisps, granola bars, crackers, chips, protein shakes and protein water mixes.  Special K has gone from being from just a cereal to being part of a weight loss plan. 
The Special K Challenge claims you can lose 6 pounds in two weeks by replacing two meals and two snacks with Special K products and then eating one regular meal. You are also encouraged to eat fruits and vegetables throughout the day.  The Special K diet enables people to lose weight by providing portion and calorie control.  The diet is meant to help jumpstart weight loss or to help people that just need to lose a few pounds.  It is not designed to be a long term weight loss program.  According to Kathleen M. Zelman, MPH, RD, LD, the director of nutrition
for WebMD, experts agree that there is no harm in using the Special K diet for a
couple weeks to transition into a more balanced weight loss plan. It may also be good for people to skip breakfast because eating breakfast can play an important part in being successful in controlling weight. 

There are some problems that experts see with the diet. The Special K diet does not provide any guidance on exercise or building long term healthy eating habits.
 The Special K diet can also be high in carbohydrates and low in fiber and protein. Kellogg did recently introduce a Special K Protein Plus cereal that provides 10g of protein per ¾ cup serving.  However, with other products being lower in protein and fiber dieters may tend to be very hungry while on the diet and could be tempted to overeat.  One example of where a person could follow the diet but still overeat would be on the third meal where there is freedom in the foods that can be
eaten.    

To help dieters make more healthful choice during their third meal Special K provides recipes on their website www.specialk.com.  I did find it nice that they provide the options of easy, adventurous, and vegetarian recipes.  The website allows you to create a free online profile where you can track weight loss progress, share stories, and get suggestions of what to eat for each meal and snack for each day of the two week diet.  I found two things really interesting while playing around on the website.  First I noticed that if a person was to follow the meal and snack
suggestions exactly as given a person would consume between 1200-1300 calories per day.  1200 calories a day is usually the lowest a health professional would recommend consuming. The second thing I found interesting was that the Special K instruction page on their website says that a person can drink beverages like normal.  I thought it was strange that there was no suggestion of limiting or cutting out high calories beverages.  Too many sugary drinks like soda could hinder weight loss.

This is an example taken from the Special K website of what you would eat in a day on the Special K diet:


·         
Breakfast Special K® Original Cereal Breakfast with Milk and Fruit 
        
Morning Snack Special K™ Fruit Crisps: Strawberry

Lunch Special K™ Honey Almond Protein Meal Bar Lunch 
         
AfternoonSnack Special K™ Multi-Grain Cracker Snack 

Dinner Grilled Salmon with Leek Risotto Dinner

A serving of cereal on the diet is usually ¾ to 1 cup with ¾ cup of nonfat
milk

Overall, the Special K diet has easy to follow instructions provides some freedom in food choices, and while it may not be the most nutritionally balanced diet it does
not seem to be quite as dangerous as some of the other fad diets out there if it
is followed only for the intended two weeks. 



References:
 www.webmd.com/diet/features/the-special-k-challenge
 www.mayoclinic.com/health/speical-k-diet/AN02094
 www.speicalk.com

The Dukan Diet

While the Dukan Diet has been popular in France for almost a decade it has only recently gained popularity in the United State in the past year.  The rise in popularity can be linked to Kate Middleton who was rumored to have been on the diet to help slim down for the royal wedding in April 2011.  By May 2011 The Dukan Diet book was #1 on the New York Times Best Seller list. 

The Dukan Diet was created ten years ago by the French medical doctor Dr. Pierre Dukan.  The diet is a high protein, low fat and low carbohydrate diet.  The diet consists of four phases:

1.       Attack phase:  The first phase is used to instill lasting motivation by eating pure protein which results in a 1 or 2 pound weight loss per day.  This phase last about one to ten days and allows to you to choose from 68 high protein foods.

2.       Cruise phase: The second phase adds vegetable into the diet.  The dieter will alternate pure protein days and protein with vegetables days.  This phase can last for months depending on the about of weight loss desired.  The average weight loss is 2 pounds per week.

3.       Consolidation phase:  The third phase allows two celebration meals per week.  During the celebration meals a person may eat whatever they like.  During this phase no weight loss is expected.   A person stays in the Consolidation phase 5 days for every pound lost in the Cruse phase.

4.       Permanent Stabilization phase:  Phase four is the maintenance phase that lasts for life. A person is to follow three rules:

            1. Consume three Tablespoons of oat bran a day

            2. Choose to take the stairs and walk whenever possible

            3. Have a pure protein day once a week

Unlike other diets, the Dukan Diet does not require any counting, is low fat, and you can eat as much of the diet approved food as you wish until you feel satisfied.  The diet does acknowledge that there can be negative side effects such as bad breath, constipation, dry mouth and fatigue. 

The critics of this the Dukan Diet claim that the diet can be dangerous because it doesn’t include all the nutrients required  for good health and can lead to nutrient deficiencies and kidney problems.  Karen Ansel, MS, RD, CDN with the American Dietetic Association agrees that the Dukan Diet is not the healthiest diet.  She states that although the diet does recommend several healthful practices, it is hard to recommend the diet because the first two phases are highly restrictive and raise health concerns. 

In November 2011, the British Dietetic Association listed the Dukan Diet on their Top 5 Worst Celebrity Diets to Avoid in the New Year because there is no solid science to back up clams the diet makes.  The BDA states the diet works by restricting foods, calories and portion control.   

http://www.eatright.org/Media/content.aspx?id=6442464088

http://www.bda.uk.com/news/111117CelebDiets.html

http://www.ducandiet.com

In this blog I am going to take a closer look at fad diets.  The first fad diet I want to explore is the HCG diet.  I had never heard of the HCG diet until a few years ago when some of my family members started the diet.  HCG is the human chorionic gonadotropin hormone produced during pregnancy.  HCG is commonly used to treat fertility issues in woman and can be used to increase low testosterone levels in males. 

Using HCG for weight loss was first introduced in the early 1950’s by a British endocrinologist, Dr. ATW Simeons. Dr. Simeons noticed that when he treated young males with low testosterone by giving them injections of HCG their appetite decreased and they lost abdominal weight. After doing some research he found that HCG injections along with a restricted diet of 500 calories lead to a pound a day weight loss.  He then came up with a HCG weight loss plan and wrote the book Pounds and Inches:, A new approach to obesity.  Dr. Simeons intended for the HCG diet to be done under the supervision of a physician and warned that people should not try it on their own.  The HCG diet was popular from the 1950’s up until the 1970’s.  In 2007, Kevin Trudeau wrote The weight loss cure, what they don’t want you to know which introduced an updated version of Dr. Simeons's weight loss plan and lead to the more recent popularity of the HCG diet.  With the recent rise in popularity has come the current discussion of whether or not the HCG diet is safe. 

While the FDA has approved the use of HCG injections for fertility treatment, they have banned homeopathic HCG from being sold. Homeopathic HCG is usually found in the form of oral drops, pellets and sprays.  On December 6, 2011, the FDA advised consumers to avoid over the counter HCG weight loss products and sent notices to sellers saying their products are illegal. The products are illegal because HCG has not been FDA approved for weight loss. Also, there is no data to support the claims that HCG is responsible for weight loss since the weight loss is most likely coming from the strict calorie restriction. Dr. Pieter Cohen, MD of Cambridge Health Alliances, Harvard Medical School has commented that since the 1950’s over a dozen trials have been done and have showed that HCG doesn’t provide any positive results over given placebos.    According to the Mayo Clinic and the FDA, the calorie restriction suggested during the HCG diet (500-800 calories a day) is dangerous without medical supervision and could be fatal.  There is also the risk of irregular heartbeat, electrolyte imbalance, and the formation of gallstones.

There is also a concern the diet can cause a deficiency in vitamins, minerals and proteins.  People can still get HCG for weight loss under physician supervision in some states.  However, just last month in Mississippi, the Mississippi State Board of Medical Licensure informed physicians that they could no longer prescribe HCG to patients for the off label use of weight loss.  There seems to be a concern among some health professions that HCG diets don’t work and aren’t safe.    

The HCG diet usually involves restricting calories to 500 a day and taking HCG which results in the weight loss of 1-2 pounds a day.  Below is an example of what someone on the diet might eat in a day.

The HCG Diet; Sample used on Dr. Oz (weight loss controversy HCG diet pt.1)

Breakfast – Coffee, then a snack of fruit
Lunch – 3.5 oz. Protein and lettuce
Snack – Melba toast or two
Dinner – 3.5 oz. protein with a vegetable
Snack – Fruit

Although, many medical professionals say the HCG diet is dangerous and doesn’t work, many dieters still swear by it.  I think it will be a while before the popularity of the HCG diet fades away again despite its health risks.  My family members who followed the diet did lose a significant amount of weight; however, they gain it back not too long after they stopped the diet. 

One interesting fact to note is that while on the HCG diet women are not to use certain cosmetics because fats, oils, creams and ointments that are applied to the skin are said to be absorbed into the body as if they were eaten and will interfere with weight loss by reacting with the HCG.  I would never have thought that face cream could count as fat while on a diet. 

For anyone interested in more information I found this episode of Dr. Oz to be interesting because it gives both the pros and cons of the HCG diet. 

http://www.doctoroz.com/videos/weight-loss-controversy-hcg-diet-pt-1

References:

www.doctoroz.com/videos/hcg-diet-fact-vs-fiction

www.doctoroz.com/videos/weight-loss-controversy-hcg-diet-pt-1

www.familyphysicianinc.com/hcgdiet.html

www.fda.gov/forconsumers/consumerupdates/ucm281333.htm

www.mayoclinic.com/health/hcg-diet/an02091

http://www.wreg.com/wreg-mississippi-bans-hcg-prescriptions-for-weight-loss-20120125,0,3534348.story