Losing weight: Lifestyle changes trump any diet
Fox News August 21, 2013
What's the best diet for maintaining a healthy weight and warding off
Is it a low-carb diet, a high-carb diet, an
all-vegetable diet, a no-vegetable diet?
Researchers say you'd be better off just forgetting the word diet,
according to an editorial published August 20 in the Journal
of the American Medical Association (JAMA).
Two researchers Sherry Pagoto of the University of Massachusetts Medical
School in Worcester, Mass., and Bradley Appelhans of the Rush University
Medical Center in Chicago call for an end to the so-called diet wars,
because they are all equally good, or bad, in helping people fight
In the end, patients only get confused thinking that one diet is superior
to another, they said, when in fact
changes in lifestyle, not diet types,
are the true ways to prevent weight gain and
the associated ills of diabetes and circulatory disease.
"The amount of resources that have gone into studying 'what' to eat is
incredible, and years of research indicate that it doesn't really matter,
as long as overall calories are reduced," Appelhans told LiveScience.
"What does matter is 'how' to eat, as well as other things in lifestyle
interventions, such as physical
supportive behaviors that help people stay on track long term."
The researchers cite numerous studies that demonstrated only moderate
success with various types of diet that focus on macronutrients: protein,
fat or carbohydrates; but regardless of diet, without a lifestyle change,
the weight comes back.
Conversely, several large and recent studies such as the Finnish Diabetes
Prevention Study and the China Da Qing Diabetes Prevention Study found
lower weight and lower incidence of diabetes among study participants many
years after the study's initial completion because the
taught how to
lose weight through
Lifestyle trumps diet
Pagoto described lifestyle interventions as three-prong:
to control portions,
reduce high-calorie foods and navigate restaurants), exercise counseling
(how to set goals, target heart rate and exercise safely), and behavioral
modification (how to self-monitor, problem solve, stay motivated and
"The 'diet' used within a lifestyle intervention can be low-fat, low-carb,
etc. It doesn't matter," Pagoto said. "In fact, at least one study
compared a low-fat lifestyle intervention with a low-carb lifestyle
intervention, and it made no difference.
The diet itself [is not]
instrumental to the lifestyle interventions success; it is the behavioral
piece that is key."
Pagoto agreed that a
vegetarian diet is associated with a lower risk of
weight gain and heart disease. A massive study involving more than 70,000
Seventh-Day Adventists, published in JAMA in June, found that
vegetarians and pesco-vegetarians (who eat fish) live longer than meat
eaters. But that doesn't mean a vegetarian diet is all it takes to help
you stay healthy.
"Adherence is key, and the way to destroy adherence is forcing foods on
someone they do not like, do not know how to prepare, or can't afford," Pagoto said.
Why diets go wrong
Indeed, the authors wrote that the only consistent fact in all the diet
studies is that adherence is the element most strongly associated with
weight loss and disease risk reduction.
five challenges to any diet that she sees with her
patients: having no time to cook or exercise; being too stressed out,
having family members bring junk food home; not having anyone to exercise
with, or feeling awkward exercising; and feel hungry all the time. The
ratio of fat to carb to protein doesn't come into play.
Most her of obese patients understand which foods are healthful and
unhealthful, she said. So she works with her patients to
find ways to make
healthy behaviors more routine, regardless of the patient's type of diet.
Pagoto and Appelhans call for more research on diet adherence. The authors
described the amount of adherence research as miniscule compared to that
on studying the large fad diets.
Similarly, the general population knows more about nuances of these diets Atkins, South Beach, the Zone and
such than they do about the basics of adherence; and that, the authors
said, is central to the obesity epidemic.
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