United Press International surveyed 84 specialists for a 15-part series weighing in on the causes, consequences and costs of a global gain in girth and measures to curtail the corpulence. Part 2 serves up an overview of diet options.
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With weight-watching meal plans as plentiful as calories in a Double Whopper with extra cheese, no one should ever go hungry for a diet.
From Atkins to Zone, programs promising to peel off pounds span a range of theories and tactics. A sampling:
-- Atkins: permits protein-packed fare, including lean meat, fish and eggs, but curtails carbohydrate-rich foods, such as pasta, bread and some fruit.
-- Blood Type: forbids specific foods for each of the four blood types with the aim of improving digestion and causing weight to drop.
-- Fit for Life: provides guidelines for types of foods -- mostly fruits and vegetables, with a very small amount of dairy products and meat -- to eat in specific combinations at certain times of the day.
-- Low Fat: shuns butter, margarine, mayonnaise, sour cream and other added fats and replaces high-fat fare, including fried foods, snacks, cheese and meat, with low-fat versions.
-- Zone: establishes a meal plan -- by gender, activity level and percentage of body fat -- that includes 40 percent of calories from carbohydrates, 30 percent from protein and 30 percent from fat.
In tasting the smorgasbord of offerings, the slim of heart should give weighty consideration to whether a selection they savor can remain lastingly palatable, fitness and nutrition experts advise.
"Any sound diet that you adhere to forever can help you keep the weight off forever," said Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center and associate professor in the Bloomberg School of Public Health and the School of Medicine in Baltimore.
That most dieters find the longevity factor hard to swallow becomes apparent in numerous studies revealing 85 percent to 95 percent not only regain lost pounds within five years of shedding them but also pile on an average of eight more. U.S. surveys show 45 percent of women and 30 percent of men currently subscribe to a downsizing regimen.
"People go on a diet, lose some weight, then return to their previous eating pattern that initially caused their weight gain," explained biochemist Nancy Amy, associate professor of nutritional sciences and toxicology at the University of California, Berkeley, where she teaches a popular class on fad diets.
"Some people have developed bad dietary habits they need to break if they want to maintain a constant weight and not continually gain."
As one example, the Quarter Pounder with Cheese Extra Value Meal, which serves up in a single sitting 1,550 of the 2,000 calories most people need in a day, should not be on the menu of anyone attempting to go down a dress or pant size, she advised.
A tall order, considering 39 percent of Americans admit to craving fast food, and 57 percent report snacking between meals. A fat chance they have of losing weight, conceded 41 percent of the women and 28 percent of the men surveyed.
"We are absolutely consuming far too much food," said Samara Joy Nielsen of the University of North Carolina, Chapel Hill.
"At the same time, the composition of the food we consume has a lot to do with the total amount we eat," added Nielsen, whose study of more than 63,000 Americans showed "junk" food consumption has soared by 143 percent in the past 20 years. "If we ate more fruits and vegetables and other, higher-fiber, filling food, we would consume fewer calories."
The high-fat pizzas and salt-laden chips the masses savor ooze transfats, a compound formed during food processing that studies have linked to coronary heart disease.
"For most people, the problem is not cholesterol, but rather the total amount of fat in the diet," Amy said, noting product labels currently do not list transfats. To calculate its amount, consumers must add the grams of saturated, monounsaturated and polyunsaturated fat and subtract the sum from the total grams of fat listed.
Under newly revamped U.S. Department of Agriculture guidelines for healthy eating, fat should comprise between 15 percent and 30 percent of a diet, and saturated fat should be restricted to less than 10 percent of the total. The revised recommendations encourage women to eat 1,600 calories (6,700 kilojoules) a day, down from the previously suggested 2,200, and men, 2,000, 600 less than under past guidelines.
Counting calories and foiling fat compose the mainstream means of minimizing mass, but the carbohydrate-curtailing crowd seems to take exception to the message.
Popularized in 1972 by the late Dr. Robert Atkins, founder and medical chair of The Atkins Center for Complementary Medicine in New York City, the once-ridiculed, low-carb approach got a big boost from research published in the respected New England Journal of Medicine last year. In one study, of 132 very overweight men and women, who tipped the scale at an average 288 pounds, those skimping on starch lost more weight and fared better on certain cardiovascular and diabetes measures than their peers on the more conventional, low-fat, calorie-restricted regimen espoused by most major medical groups.
The strategy defies traditional admonitions to limit fat intake to 30 percent of total calories and opt instead for starchy samplings, including pasta, breads, cereals and rice, which form the base of the USDA's "Food Guide Pyramid." Rather, it calls for reducing intake of carbohydrates, the building blocks of plant matter, and promoting protein-packed foods, such as lean red meat, poultry, fish and eggs.
Dating back to the 1860s, low-carb diets hit the front burner with Atkins''s books, which have sold some 15 million copies and attracted an estimated 25 million dieters to the plan.
"It has caught on because it works," said nutritional scientist Thomas Wolever of the University of Toronto in Canada.
"Cut out carbs from your diet for two days, and you will lose 3 pounds to 5 pounds in those two days -- virtually guaranteed," he added. "On the other hand, going on a low-fat, high-carb weight-reducing diet can take a week or two or more of going around feeling hungry before you see any effect on body weight."
The popularity of the program may reflect a backlash against the longtime fat restrictions that left dieters' stomachs growling for more filling fare.
"We have been so covered with low-fat advice for so many years, that this reversal seems like a ray of hope to people who want to lose weight," noted Sandy Procter, coordinator of the Expanded Food and Nutrition Education Program at Kansas State University in Manhattan.
How bright a ray remains to be seen. While studies have served up a good measure of evidence of the program's pound-peeling potential in the short term, only a meager helping of research has assessed its enduring effects on weight and health.
"We need more information about the long-term effectiveness and safety of the Atkins diet before it can be generally recommended," said Dr. Frederick Samaha, chief of the Cardiovascular Section at the Pennsylvania Veterans Administration Medical Center in Philadelphia, who headed the NEJM study.
Similarly, diet shoppers need to research a plan's physiology, biochemistry and pros and cons before determining whether it is the right fit for their personal goals, body type and health status, fitness experts advise.
Startup questions can include:
-- How hungry will it make me?
-- How well will it meet my nutritional needs?
-- How simple will it be to follow?
-- How much will it cost?
-- How long will I last?
A proper diet can promote health, helping to prevent such diseases as cardiovascular disorders, diabetes and cancer. Likewise, a mismanaged, miscalculated, misapplied or misdirected eating regimen can hamper health, possibly leading to vitamin deficiency or even malnutrition or potentially deadly eating disorders.
Joanne Ikeda, a nutritionist at UC Berkeley, found dieting actually promoted weight gain in morbidly obese women who had a Body Mass Index -- a height-weight ratio used to measure overweight -- of 72. A person with a BMI of 30 is considered obese.
"Women at higher weight levels were the ones who dieted most often, who lost weight repeatedly and who, in fact, ended up at the highest weight," said Ikeda, who specializes in research on minority cultures and serves as scientific adviser to the National Association to Advance Fat Acceptance. "Many started dieting before age 13; as a consequence, they ended up weighing 400, 500, 600 pounds."
To slice through some of the uncertainty, many experts advocate cutting a customized course to controlling corpulence, preferably with the assistance of a doctor, nutritionist and/or registered dietitian, especially for the severely overweight.
"Plans that are specifically tailored to an individual's needs and schedule would probably be the best method," suggested Linda Dong, a UC Berkeley graduate in epidemiology, now at the University of Washington in Seattle. "I don't believe there is one solution to guarantee weight loss -- otherwise everyone would probably be on it!"
To Gail Woodward-Lopez, a UC Berkeley expert on obesity and overweight prevention, the solution rests more on retaining than on reducing body size.
"I'm concerned so much attention is being given to weight loss that it detracts from the really important issue of opposing weight gain," she said. "Once you're at a certain weight, your body wants to go back there so it may be physiologically difficult to keep any further lost weight off. The research into this area is just beginning."
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Next: The carbohydrate conundrum
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Lidia Wasowicz is UPI's Senior Science Writer. E-mail [email protected]
