Weighing the diet books
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And then there were three. For years, Dr. Atkins’ New Diet Revolution has dominated the bestseller lists.
But by last November, Atkins had company. Dr. Phil’s The Ultimate Weight Solution had cracked the top 10. And The South Beach Diet sat alone comfortably at number one. Where it should be.
But the South Beach Diet, isn’t perfect. Its rationale has some flaws. But for the first time in a long while, one of the most popular weight-loss books is recommending a healthy diet. Whether it helps those unwanted pounds to disappear any better than other diets is another question.

Weight Loss Formula
Most diet books follow a formula. Amid the dispelled myths, tips and personal success stories, nearly all promise that:
• It’s not a diet but a way of life,
• the food is delicious and you won’t be hungry,
• you’re overweight because you ate the wrong (not too much) food,
• you’ll lose weight because you’ll eat the right (not less) food, and
• the diet will prevent either the major – or virtually all – diseases.
If you believe all that, I have a potion to sell you that can cure all diseases and make you live forever.
With a few exceptions, the diet books selling today are those about “good carbs.” The Atkins and the South Beach diets argue that “bad carbs” are making us fat. The Atkins diet, which has urged dieters to limit all carbs since the 1970s, has adjusted its recent advice to accommodate the “good carbs.”

In a nutshell, here’s what they claim:
1. “Bad carbs” cause a quick rise in blood sugar.
2. High blood sugar raises blood insulin levels.
3. Insulin leads to weight gain (either by making the body store fat or by lowering blood sugar levels so much that it causes hunger).
The solution? Simple, say all the books. All the dieters have to do is eat “good carbs” (like whole grains, vegetables and beans) instead of “bad carbs” (like sugar, white bread and potatoes).
Yet most obesity experts, including those who believe in that advice, agree that the research cupboard is bare. “It’s amazing how few good studies have looked at how different carbohydrates affect weight loss,” says Walter Willett, chair of the nutrition department at the Harvard School of Public Health. “So far, the long-term evidence on weight loss is meager. We need bigger and longer randomized trials,” he adds.

And it’s not even clear that the rise in blood sugar that comes from eating “bad carbs” leads to high blood insulin levels, or that higher insulin leads people to overeat, says Xavier Pi-Sunyer, an obesity expert at Columbia University College of Physicians and Surgeons in New York. “And there is no evidence that the typical post-meal levels of insulin increase food intake or body weight,” he adds.

Diet vs. Diet
Here’s our take on the three most popular diet books today. Since no large long-term studies have pitted them head-to-head, we can’t evaluate the diet’s ability to make you skinnier. Instead, we’ve graded each book’s scientific credibility (Is the science solid?) and whether the diet it recommends is healthy. (In What You Eat, “yes” means frequently, “less” means rarely, if ever.)
This summary, of course, gives you only thumbnail sketches. You should read the books for more details.

The South Beach Diet by Arthur Agatston. Claim: Switching to “good carbs” stops insulin resistance, cures cravings, and causes weight loss. Good fats protect the heart and prevent hunger. What you eat: Yes – Seafood, chicken breast, lean meat, low-fat cheese, most veggies, nuts, oils; (later) whole grains, most fruits, low-fat milk or yogurt, beans. Less – Fatty meats, full-fat cheese, refined grains, sweets, juice, potatoes. Is the science solid? Healthy version of Atkins diet that’s backed by solid evidence on fats and heart disease. Is the diet healthy? Mostly healthy foods. Worst feature: Restricts carrots, bananas, pineapple and watermelon. Most preposterous claim: You won’t ever be hungry (despite menus that average just 1,200 calories a day).

The Ultimate Weight Solution by Phil McGraw. Claim: Foods that take time to prepare and chew lead to weight loss. Other “keys to weight loss freedom” include “no-fail environment,” “right thinking,” “healing feelings” and “circle of support.” What you eat: Yes – Seafood, poultry, meat, low-fat dairy, whole grains, most veggies, fruits, (limited) oils. Less – Fatty meats, sweets, refined grains, full-fat dairy, microwavable entrees, fried foods. Is the science solid? Tough-love manual that relies more on Dr. Phil’s opinion than on science. Is the diet healthy? Mostly healthy foods. Gives no menus, recipes, or advice on how much of what to eat. Worst feature: Readers may buy Dr. Phil’s expensive, questionable supplements, bars and shakes. Most preposterous claim: “Each of these nutrients (in his supplements) has solid clinical evidence (and a record of safety) behind it.”

Dr. Atkins’ New Diet Revolution by Robert C. Atkins. Claim: A low-carb diet is the key to weight loss (and good health) because carbs cause high insulin levels. What to eat: Yes – Seafood, poultry, meat, eggs, cheese, salad veggies, oils, butter, cream; (later) limited amounts of nuts, fruits, wine, beans, veggies, whole grains. Less – Sweets, refined grains, milk, yogurt. Is the science solid? Low-carb “bible” overstates the results of weak studies and the evidence on supplements. (However, in recent small studies, people lost more weight after six – but not 12 – months on Atkins than on a typical diet.) Is the diet healthy? Too much red meat may raise risk of colon or prostate cancer. Lack of fiber, vegetables and fruits may raise risk of heart disease, stroke, cancer, diverticulosis and constipation. Worst feature: Long-term safety not established. Most preposterous claim: “Only by doing Atkins can you lose weight eating the same number of calories on which you used to gain weight.”

Healthy Weight Loss
Diet books will continue to captivate and confuse the public. With people moving less and eating more, obesity rates – and interest in the latest diets – can’t go anywhere but up. Until better diet studies are done, our advice is to exercise and make sure your diet is healthy. It should be: • Low in saturated and trans fat to cut your risk of heart disease and possible colon and prostate cancers. That means eating low-fat versions of meats, cheese, ice cream, and milk, and cutting way back on fried foods (french fries, fried chicken, doughnuts) and fatty sweets (pies, frosted cakes, pastries, cookies, chocolate).
• Rich in vegetables and fruits to cut your risk of cancer, heart disease and stroke. Go for eight to 10 servings of vegetables and fruits a day.
• Low in (largely) empty-calorie foods. That means fewer sweets like regular soft drinks and desserts. If you still need to cut, limit (skinless white) potatoes and bread, pasta, rice, cereals and crackers made of refined flour.
If you’re able to resist unhealthy carbs and you want the fiber in bran and whole grains, lean more heavily towards healthy carbs (like whole wheat cereals, breads and beans), not sweets, white bread and refined pasta. If you have a sweet tooth and you find bread and pasta irresistible, lean towards more healthy protein (larger servings of seafood or low-fat dairy or poultry), not beef and cheese.

The Bottom Line
Dr. Robert Atkins died last year after falling on an icy pavement in New York City. The Wall Street Journal reported then, that based on the medical examiner’s findings, Atkins had a history of heart attack, congestive heart failure and hypertension. At the time of his death, he was quite heavy at 258 pounds. Dr. Phil, a practicing psychologist, although 6’4” tall is also clearly overweight at 240 pounds.
Fortunately, the good news, however, is this: Just because people buy self-help books, like those of Dr. Atkins and Dr. Phil, doesn’t mean that they follow all the advice. Otherwise, we would all be thin, happily married and wealthy people, with everyone living a purpose-driven life! [Tyrone M. Reyes, M.D., Philstar]

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