The New Sonoma Diet is a popular American version of the Mediterranean diet that focuses on improved cardiovascular health as well as weight loss. I think this paints a bit too idealized view of the health habits of at least of Greece, where I lived for two years 30 years ago.
The Atkins plan involves the restriction of processed carbohydrates such as bread, grain, pasta, starchy vegetables and any foods high in sugar.
The second phase is called the ongoing weight loss and continues until you have between 5-10 pounds still to lose. The third stage of the plan is pre-maintenance and continues until you lose those final 5-10 pounds. The final stage of the Atkins plan is called Lifetime Maintenance and as the name suggest is supposed to carry on for the rest of your life.
There are several layers to this and, frankly, there are some things we can’t fully explain – I’ll always acknowledge this. Take a look again at the figure below, which shows you how many calories folks are consuming on each diet and, more importantly, where those calories come from.
You’ll note that people on these diets, including the strictest low-fat high-carb diets, significantly reduce their total amount of carbohydrates (therefore reducing the amount of insulin they secrete). The reason, I believe, most of these diets have some efficacy – at least in the short-term – is that they all reduce sugar and highly refined carbohydrate intake, either explicitly or implicitly. Someone made a great point in response to my post on why fruits and vegetables are not actually necessary for good health. I know a lot of people who eat this way and, I’ve got to say, these folks do not eat a lot of sugar or a lot of highly refined carbohydrates.
While I do plan to write an entire post on this topic of what one can and cannot conclude from an experiment, I do want to at least make the point here: The biggest single problem with nutrition “science” is that cause and effect are rarely linked correctly.
I am, to be clear, not implying this is the case for this trial, but I want you to understand why it’s important to read papers fully. This trial, The Lifestyle Heart Trial, prospectively randomized a group of not-so-healthy patients into two treatment groups: the control group and the experimental group (or what we’d call the “treatment” or “intervention” group). First off, and perhaps most importantly from the standpoint of drawing conclusions, compliance was reported to be excellent and the differences between the groups were statistically significant on every metric, except total average caloric intake. Take a moment to look over the rest of the table (or just skip reading it since I’m going to keep talking about it anyway).
Though not shown in this table, the experimental group also reported less chest pain severity (though chest pain frequency and duration were not statistically different). Let’s take a leap of faith and hypothesize that the dietary intervention (rather than, say, the social support) had the greatest impact on the measured parameters in the subjects. It’s certainly the most likely factor in my mind. But what, exactly, can I conclude?
People don’t like to be hungry, and if they are reducing their caloric intake by reducing fat intake, they seldom find themselves satiated. Semi-starvation reduces basal metabolic rate, so your body actually adjusts to the “new” norm and slows down its rate of mobilizing internal fat stores.
I argue that reduction of fat intake has nothing to do with it and that the reduction of total calories has a transient effect.
It’s *really* tough to study this stuff properly, especially compared to studying things blood pressure lowering pills, which are complex in their own right, but MUCH easier to control in a study. A nutrition department of a university accepts funds from a company that makes confectionery.
Do you think the Academy’s supporters want to hear that if you eliminate their products you will no longer need to rely on the products provided by the biggest supporters of the Diabetic Association?
Pretty much solely because of their report, Suzuki was forced to eventually withdraw the Samurai from production in the US although they later won the lawsuit that was filed as a result of the forged report by showing videos from the actual testing of the car conducted by CR. Ironically, the fact that CR had to admit it was faked somehow wasn’t plastered all over their magazines and the front pages of a bunch of newspapers. At that point, everything they publish became suspect and may as well line a birdcage somewhere. Peter, I have a coworker who has recently lost 80lbs over the course of a year on weight watchers.
Looking forward to your next post, and of course people's comments for the current one! I will discuss all of this in great detail, hopefully in the coming month, when I do a post on PUFA (polyunsaturated fatty acids). Anyway, it’s nice to discover someone who takes the Taubes viewpoint on things, and also takes the time to actually post online about it with some frequency, so thanks! Oh absolutely, I was mostly referring to the fact that most of the excess carbs we eat are converted to palmitic acid, which is a SFA.
There was an (1) average protein, low fat group (65% CHO), (2) High protein, low fat group , (3) Average protein, high fat, and (4) high protein, high fat (35% CHO).
Thanks very much, Bob, both for the kind comments and for sharing the other data with folks. A healthy diet is a crucial part of an overall healthy, balanced lifestyle, and over the past few years, there has been a serious shift toward focusing on internal health, rather than dieting to try to lose weight or achieve a certain look. If you’ve ever traveled to this region of the world, you know that obesity is somewhat of a problem there too. It is based on the theory that consumption of carbohydrates, in particular those which are processed and refined, is directly related to weight gain.
This is the most severe stage of the plan designed to clean your body out and eliminate your physiological dependency on sugar, white flour, alcohol and caffeine. This phase allows you to eat higher levels of carbohydrates and offers a larger variety of foods to choose from.
The purpose of this phase is to maintain your weight but gradually shed the last few kilos to reach your goal.
That said, many of the successes (at least weight-wise, though hopefully by now you realize there is much more to health than just body composition) of popular diets can be explained by a few simple observations. You can argue that those who are overweight probably consume an even greater amount of carbohydrates.
Even the Ornish diet, which is the most restrictive diet with respect to fat and most liberal with respect to carbohydrates, still reduces carbohydrate intake by about 40% from what people were likely eating pre-diet.
No one on the Ornish Diet or Jenny Craig Diet is eating candy bars and potato chips, at least not if they are adhering to it. The point was, essentially, that telling people to eat 5-6 servings per day of fruits and vegetables can hopefully drive a beneficial substitution effect.
I have no intention of engaging in a battle with proponents of plant-based eating or no-saturated-fat diets. Stated another way, it’s one thing to observe an outcome, but it’s quite another to conclude the actual cause of that outcome. In other words, for every intended difference between the groups a difference existed, except that on average they ate the same number of calories (though obviously from very different sources), which was not intended to be different as both groups were permitted to eat ad libitum – meaning as much as they wanted.
Ornish’s study? I think the reduction in sugar and simple carbohydrates played the largest single role in the improvements experienced by the experimental group, but I can’t prove it from this study any more than one can prove a low-fat vegetarian diet is the “best” diet. We can only conclude that it’s better than eating Twinkies and potato chips which, admittedly, is a good thing to know. And, the majority of the benefit folks receive comes from the reduction of sugars and highly refined carbohydrates. Case in point…they recently reported that olive oil is not good for you because it does not contain omega 6. 3, has a good point about some plans (including WW) having the advantage of group support, which I think is a very major confounder. It is wonderful to watch these people glow once they have found some sort of solution to their weight problem.
One of my favorite things to say to people who are scared of saturated fat is that even on an entirely plant based diet, (ala Ornish Diet), if they are restricting their caloric intake, their bodies will be running on the saturated (animal) fat that they have stored on themselves. For example the degree of unsaturated fatty acids in our membrane bilayer probably plays a role in our insulin sensitivity, just as one example.
However, it is important to do your research and familiarize with research from different nutritionists, doctors, and health experts.
Individuals have to create their own eating plan that keeps the pounds off but doesn't become monotonous over the long term. But for the purpose of simplicity, let’s assume even the folks who go on these diets are consuming the national average of approximately 450 grams of carbohydrate per day (in compliance with governmental recommendations, as a percent of overall intake).
If you tell someone who eats Twinkies, potato chips, and candy bars all day to eat more fruit (and they do), you’ve almost guaranteed an improvement in their health if they eat bananas and apples instead of the aforementioned junk food. I’m reasonably confident that the proponents of these diets are good people who really want to help others and have nothing but the best intentions.
Ornish was the principle investigator on a trial published in the journal The Lancet in 1990. In other words, there were not enough subjects in the study to determine a difference in these “hard” outcomes, so we can’t make a conclusion about such events, only the changes in “soft” outcomes.
Good science, bad interpretationGravity and insulin: the dynamic duoIf low carb eating is so effective, why are people still overweight? His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things.
Eg, the criticism of the Ornish Lifestyle Heart Trial is excellent (and I LOVED the kitten-stroking quip), and really could and should have stood alone. After short diologue with her on the particulars of her daily intake I quickly realized her consumption of carbohydrate was significantly reduced and eliminated almost all fructose. By relying on information that you were taught as a child, or by only following the instruction of one doctor, you might be missing out on valuable information. It is recommenced you add five grams in the first week and then see what difference this makes.
You can eat more carbohydrate and more of the tasty snacks you love just as long as your weight continues to drop. You are able to add any foods you want to your diet but you're expected to cut them out if they make you put weight on. Popularity, of course, was determined by a number of factors, including compliance with current government recommendations (sorry Atkins), number of people who have tried the diet, and reported success on the diets.
That doesn’t mean bananas and apples are “good for you” – it just means they are less “bad for you.” Here’s the kicker, though.
But that doesn’t mean we can or should overlook the errors being made in drawing their conclusions. I’m not discounting soft outcomes, only pointing out the distinction for folks not familiar with them. They never factor in that the chicken was breaded or that when someone ate steak or fish they had a large amount of bread of potatoes along with it. If you have still lost weight you can add some more carbs the next week and so on until you identify the maximum number of carbohydrates you can eat and still lose weight.
At the onset of the pre-maintenance phase you should add 10 grams of carbohydrate each week until you stop losing weight. We’re led to believe that the reason such folks get leaner and more healthy is because they are eating more fruits or more vegetables or more grains or more [fill-in-the-blank], rather than because they eliminated the most egregious offenders from their diet. Ornish personally, and I can only assume that he is a profoundly caring physician who has dedicated his life to helping people live better lives. But as always, I STRONGLY encourage folks with access (or folks who are willing to purchase it) to read the paper in its entirety. Yogurt, milk, juice, breakfast cereal, and other products that are advertised as having extra added Omega 3s, Vitamin C, Calcium, or antioxidants are popular choices among people who want to eat only healthy foods and meals. This is the period where most users will experience noticeable weight loss because you are not giving the body the carbohydrates it needs for energy so it begins to burn your excess fat. The second phase also allows you to start eating fruits, seeds and nuts, cheese, wine and spirits, starchy vegetables and whole grains. For people who don’t want to read the study completely, or who may not have much experience reading clinical papers, I want to devote some time to digging into this paper. The end conclusion is the whole thing must be bad and therefore needs to be reduced or outright expunged from the diet. I recall hearing Gary talking about his discussion with a participant from the Biggest loser on Larry King and the rapant weight gain after the show. It’s hard to tell if this change was statistically significant by inspection, so you glance at the p-value which tells you it was not. That is one big difference I’ve noticed between studies cited by writers who want to condemn the entire diet consumed by Americans vs those who look at it with a more in depth eye and realize that certain components are the problem not the whole diet across the board. For example, drinking orange juice that has extra added calcium might seem like a great way to achieve your recommended calcium intake; however the calcium that is added to orange juice isn’t always the type or strength you need, and orange juice does not make it easy for your body to absorb.
Why did the people in the China Study who ate more plants do better than those who ate more animals (assuming they did)? Well, for starters, reading abstracts, hearing CNN headlines, or reading about studies in the NY Times doesn’t actually give you enough information to really understand if the results are applicable to you.
Most vitamins and minerals have specific foods or other nutrients that need to be taken with them in order for optimum absorption, so throwing added nutrients into everything usually isn’t very effective. Parenthetically, if you actually want the answer to this question, beyond my peripheral address, below, please read Denise Minger’s categorically brilliant analysis of the study.
Beyond this reason, and let me be uncharacteristically blunt, just because a study is published in a medical journal it does not imply that is worth the paper it is printed on. It’s just messing with nature.Natural Food for Better HealthIf you really want to eat healthy foods and meals, your best bet is to eat natural, unprocessed food. If vitamins and minerals are what you seek, it’s best to get them from their natural sources, rather than as supplements tacked on to other processed foods.
Steve Rosenberg, once told me that a great number of published studies are never again cited (I forget the exact number, but it was staggering, over 50%).
Vitamins and minerals in their natural forms (in the foods they naturally occur in) are made to be easier to absorb, so they will be more effective and have a better and more positive impact o your body and overall health.
Translation: whatever they published was of such little value that no one ever made reference to it again. The thing is, it is possible to eliminate wheat and still eat way too many carbs (can we say ice cream?).
Take some time to learn about what combinations of foods are the most powerful and will benefit your body the most, and plan your meals accordingly. There aren’t heavy legal restrictions on what can be classified as organic, and many brands will use the organic label simply to sell their products, even if they don’t quite fit the organic description. You should always do a little research on the brands you are interested in buying to decide if they really are free of chemical pesticides, genetic modification, and other potentially harmful procedures. I’m now happily in ketosis, and the best part is, I know the WHY of weight loss now, how totally liberating and hope giving.
You might also want to look at the organic regulations in your area to determine just how easy it is for companies to earn that designation for their products.If you aren’t certain that the produce you are buying actually lives up to its organic title, there is a simple solution to ensure that you are getting the wholesome, organic food that you need: grow it yourself!
If you have space for a garden, you should take advantage of it and try growing your own vegetables. You’ll know where they came from and will feel more comfortable eating them, and will be saving money and trips to the grocery store as well.Eating healthy foods and meals is a noble goal, but if you are not careful, you can easily be fooled into eating things that aren’t the best for your health. Chief editor and author at LERAblog, writing useful articles and HOW TOs on various topics. Particularly interested in topics such as Internet, advertising, SEO, web development and business.Do you like this post?
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