South Beach Diet

February 22, 2016


The South Beach Diet is a weight-loss diet first popularized in 2003 by cardiologist Arthur Agatston and outlined in his best-selling book, “The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss.”

It is important to understand from the outset that the South Beach Diet is a commercial weight-loss diet that makes money for those who sell its various products. There are many South Beach Diet products, including conveniently pre-packaged foods and cookbooks widely available both in stores and online. Commercial diets that provide accessible foods and are easy to follow also provide a steady profit stream to those selling its products. However, you don’t actually need to buy the products in order to follow the diet. 

The South Beach diet, which is named after a glamorous area of the city of Miami Beach, is a “modified” low-carbohydrate diet. It is lower in carbohydrates and higher in protein and fats than is found in most typical weight loss diets of its era. However, it is not an extremely low-carbohydrate diet. And in that respect, it is actually easier to follow for protracted periods of time.

The South Beach diet employs the glycemic index of foods and glycemic load (their relative amount) to explain which carbohydrates a person should avoid.  There is some evidence that increases in blood sugar resulting from high glycemic foods can boost appetite and therefore increase both food consumption and weight gain. Over the long term, weight gain and associated insulin sensitivity can contribute to many forms of cardiovascular disease.

The South Beach Diet distinguishes those dietary fats that are said to be “good” from those that are “bad”. It also limits fats that Dr. Agatston argues are unhealthy while emphasizing foods with “healthier” (monounsaturated) fats.

The South Beach Diet also emphasizes the consumption of whole grains and increased amounts of dietary fibre. Many fruits and vegetables are also part of the South Beach Diet.images-5

The main goal of the diet is to alter the ratio of the foods most people already consume in order to encourage weight loss and a healthier lifestyle. Dr. Agatston suggests that a ratio of higher protein and lower carbohydrates than is commonplace is a healthier way of eating whether you want to lose weight or not. For many people this actually may be true, but it is not true for everyone. It depends on where one starts, how active a lifestyle one already has, and many other individual factors.

One of the attractive aspects of the diet—and probably the reason it is still popular—is that people find they can adhere to it for a sustained time period, perhaps even over a lifetime.

The diet itself is a three-step program:

  1. the first phase eliminates many high glycemic items in order to reduce cravings and induce some relatively quick weight loss.
  2. the second phase slowly reintroduces some of these in smaller amounts and in an altered ratio with proteins in order to continue weight loss.
  3. the final phase is a maintenance diet designed to keep weight off. The diet emphasizes that in phase three, all kinds of foods can eventually be eaten in moderation, including some snacks and desserts which you can buy over the counter, as well as make for yourself.

Does the South Beach Diet actually work?

There are no specific long-term, randomized controlled clinical trials that we know of that are designed to measure the health outcomes of the South Beach Diet.

There have been no studies of the overall health or cardiovascular benefits of following a low-glycemic-index diet in healthy adults either. While eating foods like whole grains, unsaturated fats, vegetables and fruits could help to promote better health for many people, none of these very general items are inherently good for everyone. Some whole grains, for example, have high gluten content that can be very difficult for some people, while others do not. Some saturated fats are not a problem, and not all unsaturated ones are actually good for you. And vegetables and fruits vary greatly in their vitamin, fibre, sugar, and caloric content.

While altering the ratio of protein to carbohydrates is likely to lead to weight loss in the first phase of the diet, at least in part because that also reduces caloric intake, it is overly simplistic to suggest that this simply reduces cravings, though in some individuals it may do so.

Are there risks to the South Beach Diet?

The South Beach Diet probably has little risk because the first phase of the diet is short, and it only alters the ratio of foods already consumed.

Severely restricted carbohydrate diets do lead to ketosis, where the body uses stored fat for energy, and in some individuals this can lead to discomforts including nausea, headache, mental fatigue, and occasionally dehydration and dizzy spells. Bad breath is also often reported when the body is in ketosis. However, the South Beach Diet is not a severely restricted carbohydrate diet so most of these problems are not likely if one is actually following the recommended three sequences of the diet.

Speaking with a knowledgeable professional before starting this (or another) diet is a good idea, especially if you have any health concerns or are taking any form of medication. And prior to beginning any diet plan it’s also a good idea to read about its limitations, then evaluate the diet and formulate your own views of its recommendations in a balanced way.

The most trenchant online critique of the South Beach Diet is probably one written by Joseph Mercola.
http://articles.mercola.com/sites/articles/archive/2004/06/09/south-beach-part-one.aspx
Mercola’s criticism is quite detailed and we recommend reviewing it on your own. However, it can be summarized as follows:

  • There are inaccuracies around carbohydrates especially with respect to normalizing insulin levels
  • toxin levels in fish are underestimated, and the costs of relying on them in a diet are exceptionally high
  • milk allergies associated with caselin are problematic
  • saturated fats from healthy sources are actually good (not bad) and we need more of them
  • artificial sweeteners (aspartame) are unhealthy
  • trans-fats are dangerous and ought to be avoided at all costs
  • carcinogenic oils such as those in peanuts containing traces, or more of afflatoxin are dangerous
  • the dangers of dependence on statins is unrecognized
  • weight loss will not occur in many individuals;
  • and finally, too little exercise is recommended.

Atkins Diet

March 14, 2016


What is the Atkins Diet?

In 1972, cardiologist Roger C. Atkins, MD, published Dr. Atkins Diet Revolution, which was followed in later years by a series of newer versions and cookbooks. The latest updated version, Dr. Atkins’ New Diet Revolution includes the diet that people interested in this approach should follow. The Atkins diet was among the earliest of a series of diets which dramatically reduce carbohydrate intake, control calories, and also recommend some daily exercise—even moderate forms like walking—as an effective element for weight loss and control. Exercise is not required, but strongly recommended in the Atkins plan. The Atkins diet is still widely used because it is accessible and generally helps people to lose weight, relatively quickly, and if they stick to the recommendations, to keep excess weight off.

Four Phases of the Atkins Diet

The Atkins diet includes four phases beginning with the elimination of nearly all carbohydrates and anything that includes added sugar for approximately two weeks. The subsequent three phases gradually broaden the diet to inclucutting-meat-19578277de some carbohydrates at a rate of about 10 grams of carbohydrates per week in the later phases until a weight goal is reached. At that point a maintenance diet is recommend. The diet does include up to two snacks a day, which helps control some cravings. Those following the diet are expected to measure their carbohydrate and overall calorie intake, and to drink adequate amounts of water.

This diet allows for consumption of high levels of animal protein and fats, though there is a vegetarian version that includes plant protein sources—so it is not just a ‘high meat’ diet, which is an often-voiced criticism. Rapid initial weight loss is common, and is due both to calorie reduction and through ketosis, a state where the body burns fat, rather than carbohydrates and sugars. The temporary side effects of ketosis may include nausea, mental fatigue, headaches and bad breath. It is also a diet that should not be used by pregnant or breastfeeding women. People with heart disease, diabetes, high blood pressure or high cholesterol levels, should talk with a healthcare professional before starting any diet, including this one.

Does the Atkins Diet work?leafy lettuce

Short answer: yes, if you stick with it. Diets excessively high in fat can be a worry for people who are already fat. And while care should be taken not to go overboard with the consumption of things like bacon, full-fat ice cream, etc., healthy fats are an integral part of nutrients that we all require, and so eliminating them is not wise either.

Research using carefully controlled comparisons conducted with people who are already experiencing serious health problems associated with obesity, such as diabetes and metabolic syndrome risks, have been conducted on many low carbohydrate diets including the Atkins diet. Many direct, controlled comparisons between low-carbohydrate diets and low fat diets have been completed and they reveal that low carbohydrate diets nearly always show weight loss well beyond that experienced by participants who are just on low fat diets.

Diets that are low in carbohydrates and higher in protein and fat usually lead to feeling satiated, so people don’t eat as much or feel hungry quite so quickly between meals. Both of these kinds of diets lead to reduced caloric intake—and weight loss. But it happens faster, and may last longer for people who reduce carbohydrate intake than for those who strictly reduce fat intake yet take in roughly the same amount of calories.

A concise review [1] of the findings published in 23 peer review journals (which included studies of the Atkin’s diet among them) concluded that when low-carbohydrate and low fat diets are compared, people not only lose significantly more weight much faster on low carbohydrate diets, but that no adverse effects were reported for either form of diet. Blood pressure tends to drop in both types of diets. In research where people actually follow the low carbohydrate diet very closely to the end of the study, blood sugars can drop well below the level that require diabetics to use medication. Slightly more people were also found to adhere to low carbohydrate diets, probably because they reduce hunger due to adequate fat and protein intake. Where diets are unsatisfying, people often abandon the study because they lose motivation to continue. On that basis, low carbohydrate diets are superior, but faster weight loss can also be highly motivational on its own.

Overall, since low carbohydrate diets (including the Atkins diet) are effective and include no serious adverse effects, they have much to recommend them for most people, most of the time.

[1] Gunnars, Kris, https://authoritynutrition.com/23-studies-on-low-carb-and-low-fat-diets/ (July 2015)


Paleolithic or Paleo Diet

March 7, 2016


What is the Paleolithic (“Paleo”) diet?

The Paleolithic diet (Paleo or Primal diet) refers to a high protein, low carbohydrate diet associated with hunting animals and gathering plants in the manner of our Paleolithic or Stone Age ancestors.

images-4The Paleo diet recommends consuming:

  • animals, including nearly all of the parts
  • animal products such as honey, eggs
  • specific vegetables like roots, tubers, leaves, flower-tops & stems
  • fruits, raw nuts & seeds
  • sometimes cultured dairy products from pastured animals, & small amounts of pre-soaked legumes, introduced at later stages of the diet

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Why Paleolithic?

Those advocating for the Paleo diet say that humans became superbly adapted to such a diet by 50,000 years ago, and that we should continue to follow this diet to be healthy. They believe humans are poorly adapted to consuming grains associated with agriculture which only developed about 12,000 years ago. They argue that cultured grains and legumes are inherently unhealthy and the cause of many chronic diseases of civilization.

How accurate is this depiction of Paleolithic eating?

Anthropologists have determined that humans have consumed a vast variety of foods for millions of years. People who hunt and gather food eat whatever is available in the environments in which they live. Studies reveal that compared with contemporary humans in North America, our ancestors consumed about three times as much vegetable matter, and they ate meat when and where it was available.

Our ancestors ate:

  • Far more coarse fibre
  • More protein
  • More omega-3 fatty acids
  • More fats (mostly unsaturated)
  • Many more vitamins (including C) and minerals
  • Far less salt & sugarrunning deer
  • Far fewer carbohydrates, especially very few grains

Problems with the Paleolithic Diet

  • Most of the foods that Paleolithic peoples would have consumed are no longer available, and we can only approximate foods recommended in this diet. For lean meat, we would have to eat turkey or farmed game animals; and most of our berries are much larger, contain much more sugar and far less vitamin C, A and essential minerals than wild berries.
  • Many Paleo diets also assume that ancient peoples ate mainly meat to acquire protein, which is not true. Our ancient human ancestors ate what they could get their hands on, and that varied a great deal depending on where they lived. It also changed a great deal through the seasons, and due to many environmental factors beyond their control.  Some ancestral groups relied heavily on plants, others on animals (including many kinds of eggs and insects), and still others on a mix which changed with the seasons. If we can say one thing about their diets, it was diverse! And that’s an important message. Getting plenty of minerals and vitamins is much easier when eating a diversified diet.
  • The paleo diet also assumes that humans have not evolved to digest legumes and grains,  and that eating them can cause what advocates call “diseases of civilization”, such as coronary heart disease, obesity, hypertension, type 2 (adult onset) diabetes, epithelial cell cancers, autoimmune diseases, and osteoporosis. These diseases are rarely seen or simply not found amongst hunter–gatherers and other non-westernized populations. Many people who consume grains and legumes have problems due to the defensive properties that can make them difficult to digest—however, sprouting and soaking them helps to avoid many of these digestive issues.  Recent studies have also shown that in some places eating cereals and grasses is also quite ancient, predating agriculture. How we digest food has also certainly changed and is also related to how we prepare it.  Just under half the human population, for example, has developed the ability to digest dairy foods. And the microbial communities that thrive in our digestive tracts have certainly had plenty of time to evolve into new kinds of colonies. They can do so within our own lifetimes, let alone over thousands of years.

holsteins in field

Studies

Several clinical trials have compared versions of the Paleo diet with other well studied and useful diets to see what the differences might be. Only a few of the studies employed control groups, and all but one used relatively small numbers of people.

In the largest study to date, during a two year long randomized and controlled study of seventy obese, postmenopausal women, researchers looked at the impact of the Paleo Diet in comparison to the Nordic Nutrition Recommendations[2]. Fat was significantly reduced in both groups after six months. But the reduction was much greater in the Paleo diet group. After two years the two groups were not really different, but both had continued to experience some other important changes. The researchers concluded that the Paleo Diet had beneficial effects versus the Nordic Nutrition Recommendations in terms of overall body fat, waist size and triglyceride levels. They noted, however, that after two years, sticking to high protein intake became difficult for some Paleo Diet subjects. So changes in their body size did not always continue, although other healthy changes remained.

In a smaller study[3], researchers did a controlled test with so-called type 2 diabetic and pre-diabetic volunteers with heart disease, comparing one group that consumed a Paleo Diet (in this study, lean meat, fish, fruit, both leafy and starchy root vegetables, eggs and nuts) and another on the popular “Mediterranean Diet” (fish, oils, margarine, low fat dairy products, whole grains and fruit). Both groups improved, but those on the Paleolithic diet improved more and faster.

Many people find that Paleo dietary regime is quite satiating, meaning that people feel full and are likely to stick to it for longer periods of time than some other diets. In the one long term study, after several years, significant numbers re-gained weight, although they did not gain even more weight. This means that one of the worst attributes of many diets—rebound and increased weight gain after dieting—may be avoided when people follow the Paleo diet recommendations. More long term studies are required before this finding can be confirmed.

Conclusion

Although the rationale for the paleolithic diet is overly simplistic, it still is certainly better for us than the high simple carbohydrate and sugary diet that is now so common. It seems to reduce the severity of some serious problems associated with many cardiovascular diseases, particularly through positive changes to insulin resistance. These problems include: diabetes (type 2), abdominal obesity, high blood pressure, elevated cholesterol, fatty liver (a precursor of cirrhosis and perhaps liver cancer), atherosclerosis associated with coronary artery disease, strokes and peripheral vascular disease. There is also an association with a number of abnormal growths related to high levels of circulating insulin because insulin is actually anabolic hormone which promotes growth. These problems include various skin lesions and polycystic ovary syndrome, male pattern hair growth on women, and overall increased growth and “coarser” features.

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Bibliography
[1] Carrera-Bastos, Pedro , Maelan Fontes-villalba, James H O’Keefe, Staffan Lindeberg and Loren Cordain. The western diet and lifestyle and diseases of civilization. Research Reports in Clinical Cardiology 2, 15-35 (2011).

[2] C Mellberg, S Sandberg, M Ryberg, M Eriksson, S Brage, C Larsson, T Olsson and B Lindahl. Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial, European Journal of Clinical Nutrition 68, 350-357 (March 2014) | doi:10.1038/ejcn.2013.290

[3] Lindeberg S, et al. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 50, 1795-1807 (2007).