Do Diets Work?

Written by Dr. Steve Chaney on . Posted in current health articles, Food and Health, Obesity

dietingObesity in America?

Author: Dr. Stephen Chaney

If you are like most Americans, you are either overweight yourself or have close friends and family who are overweight. That’s because 69% of Americans are currently overweight, and 36% of us are obese. Worldwide the latest estimates are that 1.5 billion adults are overweight or obese.

A new report, How The World Could Better Fight Obesity,  estimates that obesity is a $2 trillion drain on the world’s economy. That is equivalent to the global cost of war & terrorism and of smoking – and is double the global costs of alcoholism and global warming!

If you are like most Americans you have tried a number of diets over the years. All of them promised that they had the “secret” to permanent weight loss. You lost some weight initially, but here you are a few years later weighing as much as ever.

You are probably beginning to wonder whether any diets work long term. According to the latest study, the answer may just be “no”.

Really, Do Diets Work?

This study (Atallah et al, Circulation Cardiovascular Quality and Outcomes, 7: 815-827, 2014) was a systemmatic review of all of the randomized controlled studies of the four most popular diet plans – Weight Watchers, Akins, Zone and South Beach.

In case, you are unfamiliar with these diets, here is their philosophy:

  • Weight watchers is a food, physical activity and behavior modification plan that utilizes a point system to control calorie intake and features weekly group sessions.
  •  Atkins is based on very low carbohydrate intake, with unlimited fat and protein consumption.
  •  South Beach is relatively low carbohydrate, high protein diet that focuses on low-glycemic index carbohydrates, lean proteins, and mono- and polyunsaturated fats.
  • Zone is a low carbohydrate diet that focuses on low-glycemic load carbohydrates, low-fat proteins and small amounts of good fats.

The investigators restricted their analysis to studies that were greater than 4 weeks in duration and either compared the diets to “usual care” or to each other. (The term usual care was not defined, but most likely refers to a physician giving the advice to eat less and exercise more).

Twenty six studies met their inclusion criteria. Fourteen of those studies were short-term (< 12 months) and 12 were long-term (>12 months). Of the long-term studies, 10 compared individual diet plans to usual care and 2 were head-to-head comparisons between the diet plans (1 of Atkins vs Weight Watchers vs Zone and 1 of Weight Watchers vs Zone vs control). The majority of participants in these studies were young, white, obese women. Their average age was 45 years and their average weight at the beginning of the studies was 200 pounds.

What Did This Study Show?

If you have struggled with your weight in the past, you probably won’t be surprised by the result of the study.

  •  Short-term weight loss was similar for Atkins, Weight Watchers and Zone in the two head-to-head studies.
  •  At 12 months, the 10 studies comparing individual diets to usual care (physician’s advice to eat less and exercise more) showed that only Weight Watchers was slightly more effective than usual care (physician’s advice to lose weight). The average weight loss at 12 months was 10 pounds for Weight Watchers and 7 pounds for usual care. That is a 3 pound difference for all of the additional effort and expense of Weight Watchers!
  • When they looked at the two head-to-head studies at 12 months, there was no significant differences between the diets. Average weight loss in these studies was 7 pounds for Weight Watchers, 7 pounds for Atkins, 5 pounds for Zone and 5 pounds for usual care. There was only one study comparing the South Beach diets with usual care. It was a study comparing the results with severely obese patients following gastric bypass surgery, and it also found no difference between the diet program and usual care. Based on hype about these diets, you were probably expecting more than a 5 to 7 pound weight loss 12 months later!
  •  By 24 months 30-40% of the weight had been regained for the Atkins and Weight Watchers diets, which was comparable to the results for patients who were just told to eat less and exercise more. Not only was the weight loss modest, it also did not appear to be permanent.
  •  Finally, many of the studies included in this review also looked at improvement in other health parameters such as HDL cholesterol levels, LDL cholesterol levels, triglycerides, blood pressure and blood sugar control. The Atkins diet gave slightly better results with HDL levels, triglyceride levels and blood pressure in the short-term studies, but there was no significant differences for any of these parameters in the long-term head-to-head studies. None of the diets were any healthier than the others.

The investigators concluded: “Our results suggest that all 4 diets are modestly efficacious for short-term weight loss, but that these benefits are not sustained long-term.

A similar study in 2005 compared the Weight Watchers, Jenny Craig and LA Weight Loss diets (Tsai et al, Annals of Internal Medicine, 142: 56-66, 2005) and concluded “…the evidence to support the use of major commercial and self-help weight loss programs is suboptimal”.

weight loss and obesityA Weight Loss Diet That Actually Works?

My personal recommendation for the initial weight loss is a high protein diet – one that provides about 30% of calories from healthy protein and moderate amounts of healthy carbohydrates and healthy fats. The protein should be high enough quality so that it provides 10-12 gram of the essential amino acid leucine because leucine specifically stimulates muscle growth. The combination of high protein and leucine preserves muscle mass while you are losing weight. That is important because it keeps your metabolic rate high without dangerous herbs or stimulants.

However, the high protein, high leucine diet is still just a diet. It is an excellent choice for the initial weight loss, but what about long-term weight control?

The authors of this study said: “Comprehensive lifestyle interventions aimed at curbing both adult and childhood obesity are urgently needed. Interventions that include dietary, behavioral and exercise components…may be better suited to [solve] the obesity epidemic.” I agree.

The Bottom Line:

Your suspicions are correct. Diets don’t work!

A recent systematic review of 26 randomized controlled clinical trials of the Weight Watchers, Atkins, Zone & South Beach diets compared to the usual standard of care (recommendations to eat less and exercise more) concluded:

1) Contrary to what the advertisements promise, after 12 months all four diets gave comparable and very modest (5-7 pounds) total weight loss. The results with the diets were not significantly different than for patients who were simply told to eat less and exercise more.

2) By 24 months 30-40% of the weight had already been regained.

3) A previous systematic review of the Weight Watchers, Jenny Craig, and LA Weight Loss diet programs came to a similar conclusion.

4) My personal recommendation for the initial weight loss is a diet that is high in protein and the amino acid leucine because that type of diet preserves muscle mass.

5) For permanent weight control the authors of the recent systematic review recommended comprehensive lifestyle interventions that include permanent changes in diet, behavior and exercise. I agree. Diets never work long term – lifestyle change does!

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (1)

  • Merlena Cushing

    |

    Thanks for this excellent article. You are truly a help to me in explaining these differences. Glad you had hyperlinks to your two previous articles, too. I have requested Corporate make further critique of the HFLC diets so I can refute those with precise rebuttal – piece by piece. They have been working on my request according to field services. It has been a week now. Hope to hear soon. Nedra told me when I asked (Nutrition Matters seminar) that to answer it in depth, she would need more time – a whole seminar session – approximately 1 1/2 hours.. She had recently been to a huge seminar on the “keto” diets.

    I’m adding this article to the many by you which address most of what I have needed.

    By the way, the hyperlink to your comments is not live (gives an error message) in case you wonder why you haven’t had any until now. I had to take a circuitous route to get to an article that said “LEAVE A COMMENT” at the bottom.

    Thanks again for all of the good you do! Blessings, Merlena

    Reply

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Latest Article

Relieve Hip Pain After Sitting or Driving

Posted June 20, 2017 by Dr. Steve Chaney

Relief is Just a Few Movements Away!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

relieve hip pain after sittingI’m on a long business trip, speaking and teaching in Tennessee and New York, and the drive from Sarasota, FL meant many hours of driving over several days.  One of my stops was to visit with Suzanne and Dr. Steve Chaney at their home in North Carolina.  It was that long drive that became the inspiration for this blog.

After all those hours of driving, my hip was really sore. It was painful to stand up. While talking to Suzanne and Dr. Chaney I was using my elbow to work on the sore area, and when we were discussing the blog for this month it only made sense to share this technique with you.  So, Dr. Chaney took pictures and I sat at his computer to write.  I thought others may want to how to relieve hip pain after sitting or driving for long periods.

What Causes Anterior Hip Pain?

As I’ve mentioned in posts in the past, sitting is the #1 cause of low back pain, and it also causes anterior hip pain (pain localized towards the front of the hip) because the muscles (psoas and iliacus) pass through the hip and insert into the tendons that then insert into the top of the thigh bone.  When hip pain reliefyou try to stand up, the tight muscle tendons will pull on your thigh bone.  The other thing that happens is the point where the muscle merges into the tendon will be very tight and tender to touch. You aren’t having pain at your hip or thigh bone, but at the muscular point where the muscle and tendon merge.

It’s a bit confusing to describe, but you’ll find it if you sit down and put your fingers onto the tip of your pelvis, then just slide your fingers down toward your thigh and out about 2”. The point is right along the crease where your leg meets your trunk.

The muscle you are treating is the Rectus Femoris, where it merges from the tendon into the muscle fibers.  Follow this link, thigh muscle, to see the muscle and it will be a bit easier to visualize.

You need to be pressing deeply into the muscle, like you’re trying to press the bone and the muscle just happens to be in the way.  Move your fingers around a bit and you’ll find it.

Easy Treatment for Anterior Hip Pain After Sitting

relieve hip painHere is an easy treatment for hip pain after sitting you can administer yourself.  First, sit as I am, with your leg out and slightly turned.

Find the tender point with your fingers and then put your elbow into it as shown.

It’s important to have your arm opened so the point of your elbow is on top of the spasm.  It’s a bit tricky, but if you move about a bit you’ll come on to it, and it will hurt.  Keep the pressure so it’s tolerable, not excruciating.

After you have worked on this point for a few minutes you can move to the second part of the treatment.

hip pain treatmentPut the heel of your “same-side” hand onto your thigh as close to the spasm as you can get.  Lift up your fingers so the pressure is only on the heel of your hand.  You can use your opposite hand to help give more pressure.

Press down hard and deeply slide down the muscle, going toward your knee.  You can also kneed it like you would kneed bread dough, really forcing the muscle fibers to relax.

I’m putting in a picture from a previous blog to explain how you can also treat this point of your rectus femoris by using a ball on the floor.

As shown in this picture, lie on the floor with the ball on your hip muscle, and then slightly turn your body toward the floor so the ball rolls toward the front of your body. You may need to move the ball down an inch or so to get to your Rectus Femoris.

When you feel the pain, you’re on the muscle.  Just stay there for a minute or so, and if you want you can move so the ball goes along the muscle fibers all the way to your knee.

pain free living book coverIt may be a challenge to find this point, but it’s well-worth the effort!

In my book, Treat Yourself to Pain Free Living, I teach how to treat all the muscles that cause pain from your head to your feet.

Wishing you well,

Julie Donnelly

julie donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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