Demystifying Fad Diets
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ERUM JHUMRA, MSC. RD.
PAKISTAN NUTRITION AND DIETETIC SOCIETY
CONTINUING NUTRITION EDUCATION SEMINAR
FEBRUARY 23, 2013
“There is more misinformation
pretending to be fact in this field than
any other I can think of”
Dr. Jeffery M. Friedman
Rockerfeller University Obesity Researcher
New England Journal of Medicine
Jan 31, 2013
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Body Composition
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Fat
Free
Mass
Fat
Mass
Total
Body
weight
Distribution of Weight
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MALES
FEMALES
 Total fat 8 to 24%
 Storage fat 5-21%
 Essential fat 3%
 Total fat 21-35%
 Storage fat 9-23%
 Essential fat 12%
 Muscle 44.8%
 Muscle 38%
 Bone 14.9%
 Bone 12%
 Remaining 16.3-32.3%
 Remaining 15-29%
Krause’s Food and Nutrition Therapy 2008
What Regulates our Body Weight?
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 Resting Metabolic Rate: 60 – 70% of total energy
used. energy restriction and age (2-3% per decade)
 Energy used in voluntary activity: 15 – 30%
includes AT and NEAT
 Regulatory Systems: e.g. hormones and
neurotransmitters
Factors Affecting Weight Gain
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Genes, Metabolism,
Physiology, Disease
Diet, Quality and
Quantity
Obesity
Sleep and Stress
Physical Activity
and Exercise
A Fad Diet
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 Short term diet plans. List can vary.
 Claims are too good to be true - weight loss at an
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
unrealistic pace.
Refers to foods as “good” or “bad.”
Recommendations are extreme.
Personal testimonials used to “sell” the diet.
Recommendations based on a single study – or no
research at all.
Statements are refuted by reputable organizations.
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The HCG Diet
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 MODE OF ACTION
 Regular injections of HCG (human chorionic
gonadotropin) derived from pregnant women's
urine.
 Simultaneously follow diet
The HCG Diet - Reality
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Cortisol and insulin
ovarian stimulation & testosterone produced
Immunity against pregnancy?
Risk of headaches, blood clots and fatigue
Discredited by FDA & researchers in 1970’s.
Near starvation, 500 kcal for 6 weeks
Placebo
Detox /Master Cleanse/ Green Smoothies
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MODE OF ACTION
 Drink for a week to
several weeks:
juice/water or green
smoothies
 Detoxification?
ANALYSIS
 Intake of fruits and
vegetables.
Detox, Master Cleanse, Green Smoothies
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CLAIM
REALITY
 Flushes toxic
 Might include pills,
chemicals
 Body functions better
 Metabolism soars and
sheds pounds
powders, enemas,
colon cleansers e.g.
sea salt
 Liver, kidneys and
colon detoxify
 Extreme low calorie
General Motors* Diet, 7 Day Diet
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MODE OF ACTION
No alcohol, 10 glass water a must, only black
tea/coffee allowed
1. All fruits, no banana
2. Start with a potato, but rest all vegs day
3. Veg & fruits – no banana or potato
4. Upto 8 bananas and 3 glasses LF milk
5. Upto 20 oz beef and 6 tomatoes
6. All beef & veg
7. Brown rice, veg & fruit
General Motors* Diet, 7 Day Diet
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CLAIM
REALITY
 Unlimited wonder soup
 low cal veggies for filler
 Lose 10-17lbs/week
 Quick result– repeat
 Cleansing effects
 Emotional fulfillment
 Vegetarian version
 Optional exercise 10
mins
 Repeat at intervals to
maintain
 Sudden muscle
weakness, headache,
irritability, malaise,
hunger.
 Restricted choice,
nutritionally def.
What is wrong with semi starvation?
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 “When the body is suddenly deprived of adequate
energy, such as with involuntary or deliberate
starvation or semistarvation,the RMR adapts to
conserve energy against an unpredictable future by
dropping rapidly, by as much as 15% in 2 weeks.
When adequate food intake is restored, the RMR
returns to baseline levels”
Krause’s Food and Nutrition Therapy 2008
Page 535
CASE STUDY
Your client, Rizwan’s details are as follows:
•Age: 40 years
•Height: 5’ 10”
Weight: 200 lbs
•Body fat: 28% of total weight (56 lbs. of fat)
•Daily intake: 3,000 calories (2 big meals, lunch & dinner)
•Reduces his intake to 2,000/day through lots of meat, eggs & milk,
no carbs.
•Drops to 190 lbs. in 2 weeks and only feels slightly sluggish.
After three weeks:
•Weight loss stops
•Cuts calories to 1,500/day
•Weight drops to 180 lbs
•Needs more sleep, has occasional headaches and craves sugars
and bread.
•After 10 weeks:
•Achieved his goal weight of 170 lbs. & has a body fat of 27%.
Calculate his fat in lbs and fat free mass in lbs. What’s wrong with these
results?
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CASE STUDY
Post diet:
•Total weight: 170 lbs.
•Body fat: 27% (46 lbs. of fat)
•Weight lost: 30 lbs (20 lbs. of lean tissue and 10 lbs. fat)
• Primary loss = Lean mass, metabolism.
• Poorly balanced diet = immune suppressed.
• Difficult to follow same pattern for long
•What will happen when he goes back to usual eating pattern?
After 1 year (Now 41 years old):
•Weight: 203 pounds
•Body fat: 32% (70 lbs.of fat)
•Intake: Approx. 2,000 calories (2 big meals, lunch & dinner
•Remembers he lost weight on that diet and plans to do it
again.
•About to become a yo-yo dieter.
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The Dukan Diet
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MODE OF ACTION: Different phases
 Attack : 1-10 days unlimited lean protein/dairy
 Cruise : alternate pure protein – veg and protein.
Introduce unlimited (allowed) vegetables
 Consolidation: add 1 fruit, 2 slice bread, 1 piece
cheese. 2 free meals allowed in a weak
 Stabilization: eat what you like, but protein only
thursdays – forever.
“The Atkins Nutritional Approach”
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An evolving approach. Has been around since 1972.
 The New Atkins For a New You (2010)
Phases:
2 week Induction: high protein, high fat, low carb
Ongoing Weight loss: tiny increase in carbs
Pre maintenance: 10 gms increase/week (identify
optimum)
Life time maintenance: with option to drop back
The Atkins and Dukan Diets
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ANALYSIS
OVERVIEW
 Low carb diet
after about 48 hours,
ketones are burnt for
energy.
 Glucose is reserved
only for absolute need.
 Hunger is controlled
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by less changes in
blood sugar levels.
Not sustainable long
term.
Protein should be lean
High fat a concern
Lower triglycerides
Low CHO & High Protein
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 Restricting all CHO is unhealthy 1
 Ketosis is a biochemical process in fat burning state 2
 Systematic Review of data 3:
 n= 229 hunter-gatherer societies
 Information on Anthropological and nutritional data
 Results: 76% of the societies derived >50% of their subsistence
from animal foods. The rest gathered plant foods
1. Karra,C ; Shape Up America’ Reveals The Truth About
Dieters, 2003
2. Volek, J.; Stephen D.(2011). Beyond Obesity. pp. 302, 2011
3. Cordain, L., J. B. Miller, S. B. Eaton, N. Mann, S. H. Holt, and
J.D. Speth. American Journal of Clinical Nutrition, 2000
The Good and the Bad Carbohydrate
 Is there such a thing as
a good CHO ?
 For weight loss, a good
CHO is one with lower
calorie density
 Fruits and vegetables
have lesser calories per
bite as opposed to other
CHO
 Healthy intake of CHO
between 45% to 65%
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The Paleo Diet
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OVERVIEW
ANALYSIS
 Includes only things
 sugar, refined CHO,
you can hunt, gather
and grow e.g. fish,
meat, veg, fruits and
nuts.
 No dairy
 Restricts most grains.
processed foods.
 risk of heart disease,
due to better fat
metabolism.
 Calcium deficiency.
The Macrobiotic Diet
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OVERVIEW
ANALYSIS
 Use of grains,
 Not a cure for cancer as
supplemented by vegs.
 Avoid processed foods
 Avoid red meat
 Fish, seafood, nuts,
fruits allowed 2-3
times/wk
advocated
 Severe forms very
restrictive
Why Conventional Weight Loss Diets Fail
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 They focus on weight loss not fat loss.

Starvation lowers energy expenditure
 Don't encourage lifestyle modification or exercise.
 Demand drastic changes in eating patterns
 Most often result in weight regain plus more
Nutritionally Sound Diets That Work
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 The DASH Diet
 The Mediterranean Eating Pattern
Which Weight Loss Diet Works Best?
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You can choose any diet for weight loss as long as you
take in fewer calories than you burn. 1
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n= 800 volunteers
Assigned to one of four diets : average protein, low fat; high
protein, low fat; average protein, high fat; high protein, high
fat.
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Results: At 2 years, weight loss across the four plans was
similar (7 to 9 lbs) There was no difference in feelings of
hunger, satiety, satisfaction or other markers of
cardiovascular risk.
1. Sacks, FM, Bray GA, Carey VJ, et al.
Comparison of Weight-Loss Diets with Different
Compositions of Fat, Protein, and
Carbohydrates. N Engl. J Med.2009
Which Weight loss Diet Should I Choose?
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1.
2.
3.
4.
4 Simple Questions
Will this diet teach you to eat right in the long
term?
Does it involve modification of behavior that
caused weight gain to begin with?
Can you follow this diet for an extended period of
time?
Does this diet offer sensible advice on exercise?
Successful Weight loss
Exercise
Diet
Behavior
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The Qur’an: Al Ma’idah ayah 87
“ O you who believe!
Make not unlawful the
good things which
Allah has made lawful
for you, but commit
no excess; for Allah
loves not those given
to excess”
َ‫َيا أَ ُّي َها ا َّل ِذينَ آ َم ُنو ْا ال‬
ِ ‫ُت َح ِّر ُمو ْا َط ِّي َبا‬
‫ت َما‬
‫أَ َحل َّ ه‬
َ‫ّللاُ َل ُك ْم َوال‬
‫َت ْع َتدُو ْا إِنَّ َه‬
َ‫ّللا ال‬
َ‫ِب ا ْل ُم ْع َت ِدين‬
ُّ ‫ُيح‬
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A
Balanced
Diet –
Still the
Best
Approach
clients'
history.do
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