Term Paper: Dieting Factors Americans Spend

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[. . .] As a result, the authors recommended that there needs to be a better match of the diet chosen with the individual patient's food preferences, lifestyles and cardiovascular risk profiles.

Dansinger and colleagues thus concluded that adherence may have been better if the participants were able to choose their own diet approach: No one diet is best for everyone, they reported. Thus, very low carbohydrate diets are not any better than standard ones for the total population.

One of the more extensive research studies that compared different dietary approaches is a meta analysis that was conducted by Nordmann et al. (2006). For their analysis, the authors identified those trials that compared the effects of low-carbohydrate diets without restriction of energy intake vs. low-fat diets in individuals with a body mass index of at least 25. The trials that were included had to report changes in body weight in intention-to-treat analysis and to have a follow-up of at least six months. As a result, the authors looked at the results of five trials, which included a total of 447 individuals. After six months, individuals assigned to low-carbohydrate diets had lost more weight than individuals participating with low-fat diets. However, more telling, this difference was no longer obvious after a year. In addition, the studies showed mixed results with healthcare changes. There were no differences in blood pressure; triglyceride and high-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-carbohydrate diets, but total cholesterol and low-density lipoprotein cholesterol values changed more favorably in individuals assigned to low-fat diets. Nordmann et al. (2006) thus concluded that low-carbohydrate, non-energy-restricted diets appear to be at least as effective as low-fat, energy-restricted diets in inducing weight loss for up to a year. However, it is necessary to weigh the potential favorable changes in triglyceride and high-density lipoprotein cholesterol values against potential unfavorable changes in low-density lipoprotein cholesterol values when considering low-carbohydrate diets to induce weight loss.

It is also apparent through these studies, as noted above, that adherence to diets is a complicating factor. A diet, such as a low-carbohydrate one, may be effective, but if the dieters only stay on the diet for a few months, little will be accomplished. In fact, such physiological swings from dieting to non-dieting are not healthy in the long-term. In the research that compared Atkins diet to the other three dietary approaches (Dansinger, 2005), it was seen that the low-carbohydrate is the more difficult diet for adherence. A study by Stern et al. (2004), which compared an a low-carbohydrate diet, such as that by Atkins, with a traditional diet found a significant weight loss difference between the two during the first six months. However, there was no difference in weight loss between these two groups after a year. Part of the reason for this is the diet composition. With a low-carbohydrate diet, much of the initial weight loss is the result of water and carbohydrate stores and not from body fat. There is thus a lowering in metabolism that leads to regain and feelings of lethargy due to low blood glucose levels. These lethargy feelings are noted previously in this paper as being related to low-carbohydrate eating. This state of ketosis does lower a person's appetite, but it also possesses severe adverse health consequences. As noted previously, there may be more of a weight loss in the first six months, because the dieters are more closely watching their intake of carbohydrates. After time, they become more lax because of the time it takes to adhere to this diet.

Discussion

Several common points can be recognized in this literature review. The first is that there does not seem to be a significant difference in following one diet over another in either weight loss or healthcare benefits. Granted, in some cases the low-carbohydrate diet does appear to lead to better results in the first several months, but these results do not last a long period of time for varying reasons. Secondly, adherence seems to play an important role in the diet's success. As was stated, adherence may be even more important than the diet itself. Third, people have varying physiological and lifestyle needs that impact their diets; these need to be taken into consideration when determining which diet will be best for them to follow. For example, Shai (2008) et al. found that Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets, but personal preferences and metabolic considerations may affect individualized tailoring of dietary interventions. It would be of interest to look at studies where the dieter and a healthcare provider together decided which diet would be best to follow based on certain criteria to see if there was greater adherence with greater acceptance and thus more productive results for the long-term. It would also be interesting to study those individuals who have remained on a diet for over three years to see if there are some diets that are better for the long-term, or if such long-term dieting is also based on the person's individual needs.

Conclusion

Numerous studies have been conducted by adherents of different forms of dieting. Supporters of the low-carbohydrate diet can point to the research that shows a greater weight loss in the first several months and some healthcare benefits. On the other hand, those who do not support the Atkins'-type diet point to studies where the benefits of the low carbohydrate diets decrease over time or specific health issues that may arise when remaining on a high-fat diet for too long of time. Everyone should agree that the amount of money spent on diets is prohibitive, especially when most do not work. The money could be better spent on a well-balance meal with the FDA approved food groups and an enjoyable exercise program a few times a week.

References

Dansinger, ML, Gleason, J., Griffith, J.L., Selker, H.P., & Schaefer, E.J. (2005) Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction. A Randomized Trial JAMA. 293:43-53.

Hellmich, N. Success of Atkins diet is in the calories. USA Today

Foster, G.D. et al. (2003) A multicenter, randomized, controlled trial of a low-carbohydrate diet for obesity. New England Journal of Medicine 348:2082-2090

Lecture material from course.

Miller, B.V. et al. (2000) Effects of a low carbohydrate, high protein diet on renal function. Obesity Research 8: 82S

Nordmann, A.J., et al. (2008) Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet N. Engl J. Med 2008; 359:229-241

Sawyer, L. & Gayle, E.A.M. (2008). Diet, delusion and diabetes. Diabetologia. 52.1, 1-7

Shai, I. et al. (2006) A Meta-analysis of Randomized Controlled Trials Arch Intern Med: 285-293.

Stern, L. et al. (2004)., 'The effects of low-carbohydrate vs. conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial', Ann Intern Med 140: 778-85

World Health Organization (2010) Obesity and Overweight. 18 October 2010 http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/

Iris Shai, R.D., Ph.D., Dan Schwarzfuchs, M.D., Yaakov Henkin, M.D., Danit R. Shahar, R.D., Ph.D., Shula Witkow, R.D., M.P.H., Ilana Greenberg, R.D., M.P.H., Rachel Golan, R.D., M.P.H., Drora Fraser, Ph.D., Arkady Bolotin, Ph.D., Hilel Vardi, M.Sc., Osnat Tangi-Rozental, B.A., Rachel Zuk-Ramot, R.N., Benjamin Sarusi, M.Sc., Dov Brickner, M.D., Ziva Schwartz, M.D., Einat Sheiner, M.D., Rachel Marko, M.Sc., Esther Katorza, M.Sc., Joachim Thiery, M.D., Georg Martin Fiedler, M.D., Matthias Bluher, M.D., Michael Stumvoll, M.D., and Meir J. Stampfer, M.D., Dr. P.H. For the Dietary Intervention Randomized Controlled Trial (DIRECT) Group

Effects of Low-Carbohydrate vs. Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors

Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets1_3

Julia A Ello-Martin, Liane S. Roe, Jenny H. Ledikwe, Amanda M. Beach, and Barbara J. Rolls

ABSTRACT

Background: Consuming foods low in energy density (kcal/g) decreases energy intake over several days, but the effectiveness of this

Comparison of the Atkins, Ornish, Weight

Watchers, and Zone Diets for Weight Loss

and Heart Disease Risk Reduction

A Randomized Trial

Michael L. Dansinger, MD

Joi Augustin Gleason, MS, RD

John L.… [END OF PREVIEW]

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