With bathing suit season right around the corner, you may be wondering which diet you should start ASAP to fit into your favorite bikini. Thankfully, researchers David Katz, M.D., and Stephanie Miller from Yale University School of Public Health’s Prevention Research Center recently published a review in Annual Reviews looking at the scientific literature on seven popular diet patterns for overall health benefits. Here’s what they found—and what I think.
There really is no clear definition of a low-carb diet, however if using the dietary recommended intakes from the Institute of Medicine (IOM), it would be consuming less than 45 percent of your total calories from carbs. A low-carb diet can lead to weight loss and maintenance because they tend to be restrictive in calories; however, replacing your carbs with too much fat and protein (i.e. calories) can instead cause weight gain. Any patient of mine who has tried a low-carb diet has typically failed because they were simply restricting foods that they loved to eat instead of learning how to eat carbs in a healthier way.
Lowfat Diet, Including Vegetarian
The problem with the lowfat craze (eating less than 20 percent of your daily calories from fat) is that in many instances there is an increase in caloric intake. Per the authors, “the intent of lowfat guidance was, presumably, to encourage consumption of naturally lowfat foods—namely, plant foods direct from nature, rather than highly processed, fat-reduced foods.” Bingo. A fat-free cookie is not calorie-free, nor is it a healthy replacement; it is still a cookie. And a vegetarian diet is not necessarily healthy either. However, a nutritious, lowfat, plant-based diet (including grains, just remember portion control) is associated with many health benefits.
Katz and Miller note that a low-glycemic diet has been found in to be useful with diabetic patients, and the majority of foods recommended are minimally processed—can’t aruge with that! But it also has led to restriction of certain fruits and veggies that should otherwise be enjoyed, such as carrots, which have a high glycemic index but low glycemic load. Personally I have always found this diet to be rather confusing, and since my patients generally don’t eat enough fruits and veggies to begin with, I typically don’t teach anything about the glycemic index.
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To date, there really hasn’t been anything negative written about the Mediterranean diet, which encourages consumption of olive oil, vegetables, fruits, nuts and seeds, beans and legumes, dairy, whole grains, and seafood, with a little intake of meat. Moderate wine intake is also recommended. I have found in my practice that this type of eating can be very successful in weight loss as long as portion sizes are adhered to. Too much of any fat, even the healthiest kinds, can equate to too many calories.
Mixed, Balanced Diet
The Dietary Approaches to Stop Hypertension (DASH) diet and the dietary pattern used in the Diabetes Prevention Program (DPP) are examples the authors used to describe this category of diets. Both are mostly plant-based inclusive of some animal products, with an emphasis on low-fat and nonfat dairy products. The DASH diet was originally tested for effects on blood pressure but has since been used for weight loss and general health promotion. There really is nothing negative to be said here in my opinion from a weight-loss perspective; however even though it was voted “Best Diet” by U.S. News and World Report, the authors feel that the decision was based more on consensus opinion than objectivity.
Most of us have heard about this diet by now. The emphasis of the diet is on avoiding all processed foods, which includes dairy and grains, and encourages intake of veggies, fruits, nuts, seeds, and lean meats. The authors note that "many of the plant foods and nearly all of the animal foods consumed during the remote Stone Age are now extinct.” Kind of makes this diet hard to follow exactly, no? It can’t be argued that eating more wholesome foods is the way to go, but eliminating dairy and grains when other “diets” have found them to be healthy, is where, for me, the line is drawn.
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The thing with a vegan diet is it can either be very healthy or quite the opposite. As stated in the review, “eating only plant foods does not guarantee a healthful, balanced diet. Sugar, among the more concerning dietary components consumed in excess, is of plant origin.” In other words, just because you see a chocolate bar labeled "vegan" doesn’t mean it is the healthiest choice. I tell my patients being a vegan is not a diet; it is a lifestyle. The same can be said of any diet.
Overall the consensus from Katz and Miller for health seems to a pattern of eating that is not rigid, overall has general dietary patterns, and is actually not a "diet." They encourage minimally processed foods and mostly plant-based foods. However, it does appear they leave room for dairy, grains, fats, and lean animal products. So in other words: Skip any diet labeled as such, especially if it is a fad.