When you think it's time to lose a few pounds, your head begins to spin with all the latest miracle-diet options – from teas and pills that claim to wipe out hunger to liquid lunches and candy-bar desserts that promise to peel away fat. The foremost in the bookshops and in the press these days are fad diets: egg, grapefruit, chemical, high-protein, water, juice and cabbage soup diets designed – according to the claims – to fill you up and slim you down fast. No wonder it's hard to know where to start.
Let's face it, if crash diets did work, we wouldn't need new ones that 'really works' every few months. All these diets promise weight loss and, in fact, most people do lose some weight after a few weeks on these diets. Surprised? Don't be. To lose weight, the equation is actually simple: reduce calories and increase exercise to create a calorie deficit, causing your body to use your body's energy stores.
Fad diets are repetitive and generally bland, and the complex and restrictive rules for eating make it difficult for anyone to overeat even the ones that insist you can eat all you want of selected items. Most people lose their appetite at the thought of eating the same thing time and time again that they actually eat even less than allowed.
This brings me to the questions raised by many of my patients. "Why can't I follow one of these diets, just for a few weeks? I just want to lose a few pounds." "My friend lost weight on the high-protein diet but my doctor is against it. Can you prescribe one for me?" Or, my all-time favourite with the advent of the protein diets: "But why did you put carbohydrates in my menu? Are you trying to keep me fat?"
For years, dietitians and doctors have been urging people to follow balanced diets – generally low on fat and high on carbohydrate. So why the lack of success and the onslaught of very low-calorie or high-protein diets?
Some people took the low-fat, high-carbohydrate diet idea too far. Cutting out fat but doubling the portions of rice and pasta, and eating low-fat but high-sugar cookies, chocolate and fruit yoghurts means you are going to be consuming a high amount of calories. No matter which way you look at it, calories count. They make the difference between weight loss, weight maintenance and weight-gain.
If you've tried the 'healthy diet' but have been unable to lose weight, blaming carbohydrates is a simple excuse. If you follow a low-calorie diet or a high-protein diet that eliminates carbohydrates, you are simply cutting calories. And for weight loss, calories count.
At the same time, there is an unsettling rationale to these fad protein diets. They tend to control, limit or exclude whole-grain carbohydrates – whole-wheat bread, rice, pasta – vegetables and fruit. To quote Dr Hensrud, M.D., director of the Mayo Clinic Executive Health Programme: "That's strange, given that an estimated one-third of all cancers are diet-related and the good guys in the cancer equations are the very foods that fad diets rule out. The American Cancer Society's number one dietary guideline is to 'eat more plant products, including whole-grain carbohydrates, fruits and vegetables'."
Simply put, following these types of diets don't allow for healthy eating. In fact, they are often the cause of nutritional deficiencies, particularly anaemia in teenaged girls and women. Deficiencies due to fad diets are easy to spot: extreme fatigue, hair loss, dry, scaly or acned skin. Not exactly attractive side effects to what people undergo to improve their looks! And this is the good side. The long-lasting side effects are an increased difficulty to lose weight with each repeated diet attempt. This is what we call the yo-yo effect.
The yo-yo effect is often seen in people who crash diet. Each time they diet, they lose weight, mainly calorie-burning lean body mass. They inevitably regain the weight since they lost the fat-burning effect of lean body mass, returning to a weight higher than they originally started at. Chronic dieting often permanently decreases your metabolism, or calorie-burning mechanism to favour weight-gain. So, chronic dieters' body fat increases, calorie-burning lean body mass decreases and their calorie needs decrease with their decreased metabolism, making it more difficult to lose weight with each diet. What happens is that they become very efficient at making and storing fat.
Study after study has shown that being overweight is a risk factor for many chronic illness such as heart disease and diabetes. So, wanting to lose weight is wise, not just vanity. And using medical common sense is better than buying into the claims of snazzy advertisements.
Calories fuel the body and unused calories are stored as fat. Dietetic associations around the world, the World Health Organisation, and the U.S. National Institutes of Health all say that the best way to shed pounds is twofold: cut back on calories and increase your physical activity.
Eat less, exercise more. It sounds straightforward and yet, a recent study published in the October 2, 1999 issue of the Journal of the American Medical Association found that most people trying to lose weight don't take this two-pronged approach. How you lower your calorie count is important. The safe way to cut calories is by eating fewer foods that are high in fats and sugars which are loaded in calories (i.e. refined sugar). Follow a balanced diet drawing from all the major food groups. Besides being healthy, diets rich in variety are easier to stick to and therefore more likely to succeed over time – which is what everyone is after.
I am a hypertensive and unstable angina patient. I have been advised by my doctor to take fruits, vegetables and low-salt, low-fat food. Can you tell me what kinds of foods, fruits and vegetables are advisable for me?
– Benilda Herrera, Abu Dhabi
For those with high blood pressure (hypertension) a low-fat diet which also helps reduce blood pressure is recommended. But it's also important to remember that sodium (salt) is essential for good health. But when we add salt during cooking or when eating processed foods or fast food, we tend to eat too much salt.
Preparation and meal planning tips to help cut back on salt:
Like fat, it is at the cooking stage that much of the salt gets added to the food, so be mindful of using the salt shaker.
Don't salt the cooking water of pasta or vegetables and use just a pinch, if any, when preparing rice.
Don't salt meat when cooking – add spices instead.
Remove the salt shaker from the table – use lemon pepper, Thai seasonings or an herb and spice-based seasoning.
The World Health Organisation recommends a diet with less than 1,500 mg per day (equal to 1/2 teaspoon of salt). Therefore, when buying commercial products, try to choose those with less than 200 mg salt per portion.
Foods that protect against high blood pressure:
Potassium helps the body keep normal blood pressure. Potassium is found mainly in fruits and vegetables, whole-grain cereals, lentils and chickpeas. 3 People with diets low in calcium generally have higher blood pressure. So, your diet should contain two servings of low-fat milk products a day.
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