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Which diet works best?

Dr. David L. Katz, MD, MPH
Preventive Medicine
U.S. News & World Report released a list of best diets, and I was privileged to be one of the 22 judges. I get the sense we agreed more than we disagreed and am fairly comfortable with most of the outcomes.

The results were an endorsement of balanced, sensible approaches to weight control. No diet based on a gimmick or on wild distortions of a healthful dietary pattern scored well. Those diets that did score well were generally conducive both to losing weight and finding health. Big winners included Weight Watches, which came in first for both weight loss and ease, and DASH, a diet developed at the NIH for blood pressure control and since shown to confer other health benefits. The Mediterranean diet and the low-fat, plant-based diet developed by my friend Dean Ornish, placed highly as well.

However, different diets did come in first for health, weight loss, diabetes, and heart disease -- and personally, I find that a bit silly. Weight loss, by healthy means, is among the most important ways of reducing risk for diabetes and heart disease. A diet that reduces diabetes risk reduces heart disease risk. A diet that reduces risk of heart disease and/or diabetes, two of the leading public health perils of our time, is obviously good for health. A diet cannot be good for health unless it reduces the risk of heart disease and diabetes.

I trust you see where this logic leads. A good diet is a good diet, period. But is there a best diet?

I have weighed in on that topic and basically said no. We have abundant evidence to support a basic theme of healthful eating and almost none to say which of the several reasonable contenders (Asian, vegan, Mediterranean, etc.) is truly best.

That’s good, because it means we have an evidence-based theme of healthful eating -- conducive to weight control -- and variations on that theme allowing for customization and the indulgence of your personal preferences and priorities.

I am a proponent of Weight Watchers; their programming clearly works for weight loss, is sensibly aligned with healthful eating, and provides the structural support many people need. I believe, however, we can do even better -- building skill power systematically to facilitate lifelong health and weight control, while addressing the needs of all family members at once. A program I have helped develop, Weigh Forward, is an example. I also see opportunities for customizing variations on the theme of weight control based on genetic testing.
Rose Reisman
Nutrition & Dietetics

When you decide that you’re ready to lose weight which diet is best to follow? Naturally this is a personal decision but the key is to select a diet that is balanced with the four food groups and includes 3 meals and 2 snacks daily, whereby you’re never hungry. And don’t forget to exercise daily to help boost your metabolism and burn calories quicker. The combination is essential.

So which one shall you select? Jenny Craig, Weight Watchers, Slim Fast, Nutrisystem, Atkins or shall you just cut back on your intake?

Jenny Craig: Rated number one has 1300 calories daily, branded food products and counseling sessions. The food costs approx. $160 per week plus yearly fees. Clients have kept off their weight for longer than other diet plans.

Weight Watchers: At about 1900 calories, it is based on a maximum of daily points for specific foods, not necessarily healthy choices. The cost is based on monthly meetings. You can also purchase their meals in the grocery store or online.

Slim Fast: An 1100 calorie day consisting of a bar or shake for breakfast and lunch and a 500 calorie homemade dinner with the allowance of plenty of fruits and vegetables. Most consumers complain of hunger and not eating enough “real” food. There’s also no real support except for their website.

Nutrisystem: On the Nutrisystem diet, you eat branded single-serving breakfast, lunch and dinner entrées, all ordered online and delivered to your door. There are 1270 calories a day costing $350- $430 a month for food with support available at an additional cost. More like “space food” with everything vacuum sealed and freeze dried. The meals tend to be high in sodium and lack any natural flavor.

Atkins: This has been around for decades. This is the easiest diet ever since you can eat up to 2000 calories daily which consists of any source of protein, not having to pay attention to the amount of fat. Fatty meats, butter, whipped cream and cheese are all on the list! Come on! How healthy does this sound? But it’s the most inexpensive diet since you do it all on your own. Heart attack, stroke and high cholesterol are also part of the plan!

The diet that works best is the one where you keep off the weight for the long term! Remember, calories in, calories out.

It is not the diet that works. You have to educate yourself on what foods do and don't do for you. When you discover or uncover what is not working you have to make a conscious decision to improve your choices. Honestly we can tell you what to eat and it would not work. I find that walking my clients through is and holding them accountable once educated works.

Randolph P. Martin, MD
Cardiology (Cardiovascular Disease)
People are always saying should I be on a high protein low saturated fat diet or a high carbohydrate diet?  What is the best diet? There is unequivocal proof, based on studying over 1.5 million people for an 18 to 20 year period that clearly shows that eating like citizens of the Mediterranean countries (places like Italy, Spain, Portugal, France and Greece) lead to a decrease in the risk of heart attacks and strokes, a decreased risk of developing certain cancers, and a decreased risk of developing Alzheimer’s.  In fact, this type of diet can lead to a 23% lower risk of dying from all causes. Unfortunately, people who live in the Mediterranean countries now have become westernized and are eating an American-type diet, which is high in red meats, saturated fats, salts and sugars. The concept of a Mediterranean diet is a diet for life – it’s not a fad diet. It consists of a lot of fruits and vegetables of color, legumes, whole grains—especially whole grains of wheat in bread products and cereals, olive oil, fish in moderation especially the oily fishes like sardines, salmon and mackerel and a little bit of red wine in moderation. This type of diet is rich in antioxidants and in fact is low in saturated fats. The olive oil is an excellent source of the right kind of fats. So the Mediterranean Diet is one where a lot of fresh fruits, a lot of fresh vegetables especially vegetables of color and very little red meat is consumed along with complex carbohydrates. This diet has the right type of fats in it, the mono saturated and polyunsaturated fats and is rich in omega-3 fatty acids, which have clearly been shown to be beneficial. So the bottom line is eat like you live in the Mediterranean countries but eat like they did in the 1930s not in the year 2010.

The key to losing weight on any diet is burning more calories than you consume. It doesn’t matter which diet you are on – if you are successful in losing weight it is because you are burning more calories than you are consuming on that diet. With that said, you should choose a diet that you can easily fit into your lifestyle. You won’t be successful in the long run if you are on a diet that you are not able to maintain. With regard to specific diets I think are most healthy, my favorite has to be the Mediterranean diet. It is full of healthy fruits, vegetables, whole grains and healthy fats. It has also been shown to lower risks of many diseases including heart disease and cancer.

I believe there is not just one "set in stone" rule of what you can or cannot eat to lose weight and be healthy. Successful weight loss using any dietary plan means finding healthful foods that work to keep you well and at an ideal weight and then integrating these foods into your daily menu plan.
Diet for a Pain-Free Life: A Revolutionary Plan to Lose Weight, Stop Pain, Sleep Better and Feel Great in 21 Days, ADA...sound nutritional advice...do-able, delicious..a godsend to pain sufferers.

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Let's take a moment to look at the definition of the word diet (via thefreedictionary.com):

  1. The usual food and drink of a person or animal.
  2. A regulated selection of foods, as for medical reasons or cosmetic weight loss.
  3. Something used, enjoyed, or provided regularly

Most of us only identify with the second portion of that definition - "a regulated selection of foods, as for medical reasons or cosmetic weight loss".  

In order for a diet to work, I believe that it has to embrace all three of the above definitions.   While you will need to be mindful of your food choices and portions, in order to consume less calories than you expend, you also need to make those choices part of your lifestyle.  And, most importantly, you need to enjoy what you eat.

The only diet that will work for any of us is the one that we can sustain for our entire lives. 
Karen Diaz
Nutrition & Dietetics

I believe none. Diets don't work. Give yourself permission to eat any food available.  Most people would believe that they would then sit around eating chocolate and french fries all day.  Not true.  If you think about the idea of food habituation, the more you have something the less you want it.  It does not feel good to sustain yourself on foods that taste good but do not make you feel good. 

Once you let go of the belief that there are all these foods you love that you cannot have, you can focus on what kind of nutrition philosophy works best for you.  In order to discover whether being vegetarian, eating organic, eating less processed, or finding moderation works best; you will need to make sure you have a healthy relationship with food.  There is no such thing as eating perfect.  Normal eating involves overeating sometimes but you need to look at the situation and say that did not feel good instead of "I was so bad I need to make up for it." 

Bottom line:

1.  Eat when hungry
2.  Stop when full
3.  Be aware when you turn to food for emotional reasons
4.  Discover how food affects your hunger and fullness, ie  higher fiber foods keep you satisfied longer
5. Once you have that down, fine tune your nutrition to optimize health. 

Judith Beck, PhD
Psychiatry

It is the healthiest diet (that also includes your favorite foods) that you can sustain for your whole life.

Research to date shows that people’s weight loss is roughly the same no matter what diet they’re on.


But even if it turns out that one particular diet leads to greater weight loss, it doesn’t mean that it’s the best diet for you. Sure, you may be able to initially lose more weight by following it than another diet. But if you can’t stay on this diet for life, you’ll just gain weight back.


Many of my dieters do well by emphasizing lean protein, moderate fat, and plenty of fruits and vegetables for their meals and snacks. Fruits and vegetables fill you up and protein and fat keep you feeling satiated for longer than most carbs.


On the other hand, it’s completely unrealistic for most dieters to say that they will never have chips, fries, pretzels, ice cream, candy, and other treats long term. The best diet for you, as I discuss in The Complete Beck Diet for Life allows you to have a favorite (less healthy) food once a day, so you don’t get in the position of saying to yourself: “I can’t believe I ate that cupcake. I’m never supposed to have cake. Oh, well, I might as well eat whatever cake or other junk food I want today because I’m never going to let myself have it again. I’ll just start following my diet again tomorrow.”


Instead, when you make a mistake and have an extra treat you hadn’t planned to have, you’ll be able to say, “Big deal. I made a mistake. If I stop now, it won’t even show up on the scale at the end of the week. And besides, I can always plan to have another cupcake tomorrow and the next day and the next, if I want.”

Samuel M. Warren, MD
Anesthesiology

For weight loss, I agree with Andy (above). Weight loss boils down to calories consumed versus calories burned. I cannot think of a healthy way to loose weight that does not prioritize physical activity. Aerobic physical activity is an excellent appetite suppressant as well.

To learn the first principles of healthy eating, I recommend starting with Michael Pollan's In Defense of Food or Food Rules: An Eater’s Manual. In addition to helping us learn about real food, In Defense of Food also discusses nutrition science, nutrition policy, and the corporate food market. Michael Pollan helps us see through some of the myths that distract us from our goal to eat healthy and tasty food.   

If you have coronary heart disease, or are at high risk for getting it, Dean Ornish offers an approach to diet and living that can change your life.

As for diets that charge you a lot of money to participate, I recommend a healthy degree of skepticism. You don't need me to point out the diet industry is famous for false advertisements. I bet you can find something healthier to spend your money on – like real food and physical activity!

Lastly, food is best as a social activity. Remember to share your table and knowledge with your friends.

If you google the word diet, in .24 seconds you'll receive about 165 million results.  While there aren't 165 million actual diet plans in the world, there is an over abundance of information that will confuse just about anyone.  What makes this question so interesting is despite thousands of diets and millions of bits of information out there, the actual formula is very simple.  Each and every diet out there has one basic commonality in that they require the dieter to reduce their calories while increasing their activity.  They keep this rather quiet, because if you figure it out yourself, you won't need to purchase their diet plan.

The diet that works best is burning more calories that you consume or doing our best to eat less and move more.

Let's try to remove the word "diet" from our lives and begin thinking about reasonably sized portions made up of healthy food choices.  Combined with an active lifestyle and exercise, and you'll find what you're looking for without any need for 165 million google results.

Be kind to yourselves!
Pam Grout
Alternative & Complementary Medicine
There are more theories on dieting than there are on the Kennedy assassination. One diet swears by loading up on protein. The next says, “Oh, horror, avoid protein at all costs. Focus instead on carbs." And still another claims, "Eat whatever you want, and just makes sure you wash it all down with papaya." Wading through the mire of diet ideas is enough to drive a sane person straight to the edge.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.