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Finally, a Diet That Really Works

Dec 13, 2004

Finally, a Diet That Really Works

Michael Mogadam, MD
George Washington University School of Medicine

Special from Bottom Line/Personal

You are not alone -- 90% of people who try to lose weight fail. Some of the diets they try cause health problems or aggravate existing ones. The majority of people who go on Atkins-style low-carbohydrate diets have cholesterol problems, cardiovascular disease and/or diabetes. These conditions can get worse on low-carb plans.

Very-low-fat diets (less than 10% fat) can increase stroke risk by 50%. Small brain arteries require an adequate amount of fat to maintain strength and prevent ruptures and bleeding.

To devise a diet that people can stick with and that will help them live longer, I reviewed more than 4,000 scientific works on nutrition, medicine and health. I created a contemporary version of the Mediterranean plan that is based on complex carbohydrates, produce, fish and the right kinds of fat.*

7 RULES FOR
HEALTHY WEIGHT LOSS

People who follow these rules can lose about one pound a week until they reach their target weights. They'll also reduce their risk of breast, colon, lung and prostate cancers by as much as 90% and risk of cardiovascular disease by up to 80%.

1Avoid solid margarines, shortenings and cooking fats. These account for 95% of the trans-fatty acids in the American diet, and they greatly increase risk of heart disease and diabetes. They're high in calories and elevate levels of harmful LDL cholesterol. They also increase risk of breast and colon cancers.

Important: Fats have a low food energy expenditure -- the amount of calories burned during digestion. If you eat 100 calories of protein, for example, 20 calories are burned during their trip from the mouth to the stomach, intestine and bloodstream. If you eat 100 calories of fat, only two calories are burned -- and many of the rest go into storage, especially if you're sedentary.

Monounsaturated fats -- found in some nuts (almonds, hazelnuts, pistachios and walnuts), seeds and olive and canola oils -- burn about 15% more efficiently than other forms of fat. If you are reasonably active, up to 40% of your daily calories can come from fat without causing weight gain -- as long as most of the fat is monounsaturated.

Bonus: Olive oil and other monounsaturated fats lower total cholesterol levels and reduce the oxidation of LDL, the process that can damage artery walls and increase risk of heart attack and stroke.

2Don't miss a meal. About 20% of adults skip breakfast. Many others skip lunch. People who skip meals invariably gain weight because they compensate by snacking frequently or overeating at the next meal. Their calorie intake over 24 hours often is higher than those who don't skip meals.

Skipping meals also raises LDL ("bad") cholesterol. The liver creates receptors, or "traps," that keep this harmful substance out of circulation. Skipping meals causes the liver to produce fewer receptors, which allows more LDL to remain in the blood.

3Don't eat high-glycemic carbohydrates. They cause a rapid surge of insulin that stimulates fat cells to enlarge and accumulate more fat. These foods include candies, cookies and cakes (which may contain sugar, honey or high-fructose corn sweeteners), as well as "white" foods, such as white bread, pasta, potatoes and white rice. High-glycemic carbohydrates also contribute to diabetes and the production of C-reactive protein, which increases risk of heart attack and stroke.

Try to avoid carbohydrates with glycemic indexes of 70 or more. Instead, focus on foods with lower glycemic numbers -- legumes, whole grains, most fruits and vegetables, etc. (see below).

4Eat lightly at night. You burn as much as 15% fewer calories at night than during the day. Slower evening and night metabolism means that calories are more likely to be stored as fat rather than burned for energy.

5Eat fish three to four times a week.** Ounce for ounce, fish has about half the calories of choice-grade red meat and less than one-third the calories of chicken or turkey -- but since it's high in protein, it helps you feel full. Fish also is rich in omega-3 fatty acids, which can reduce your risk of heart attack by 40%.

Important: Don't cook fish with corn, safflower, soybean or sunflower oil. These oils inhibit the absorption of beneficial omega-3 fatty acids. Use canola or olive oil instead.

6Eat dark-colored fruits and vegetables. The darker varieties have the highest concentrations of nutrients and antioxidants (plant chemicals that reduce the risk of cancer and heart disease).

Best vegetables: Broccoli, kale, spinach, sweet potatoes, tomatoes, watercress.

Best fruits: All berries, dark grapes, nectarines, peaches, plums.

Fruits and vegetables also are high in fiber, which takes up stomach space and helps to curb appetite.

7Exercise daily to increase your basic metabolic rate (BMR). About 70% of your daily calories are burned by the natural functions of muscles, cells, organs, etc. People with low BMRs tend to gain weight and find it more difficult to lose the excess pounds.

BMR is genetically determined -- but you can override nature with regular exercise. If you've been sedentary and start exercising, your BMR will increase by about 10% for several hours after exercise. This means more calories are burned even when you're sitting still.
GLYCEMIC INDEX
(for an average serving)

BREADS & GRAINS
Rice, white 125
Bagel 100
Croissant 100
Bread (hamburger bun) 95
Rice, brown or basmati 85
Bread (whole wheat) 80

CEREALS
Cornflakes 120
Cheerios 110
Special K 80
Shredded Wheat 80
All-Bran 65

DAIRY
Ice cream 95
Milk, skim 46
Milk, whole 45
Cheese 40
Yogurt (plain) 20

FRUITS
Watermelon 103
Banana 80
Orange 65
Peach 40
Grapefruit 36
Cherries 32

LEGUMES & VEGETABLES
Potato, white 120
Carrot 100
Potato, sweet 85
Kidney beans 45
Green beans 45

Editor's note: The glycemic index is not precise and can vary by 10 points or more for the same types of foods. For a more complete list, go to www.diet-i.com and click on "Glycemic Index."

*Always consult a doctor before starting a weight-loss program.

**Limit intake of fish that is high in mercury, such as swordfish, shark, king mackerel and tilefish, to four ounces (cooked) a week. Pregnant women and young children should avoid these fish entirely.
First Printed: June 1, 2004
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Bottom Line/Personal interviewed Michael Mogadam, MD, a specialist in cholesterol disorders, nutrition and digestive diseases. He is clinical associate professor of medicine at George Washington University School of Medicine, Washington, DC. Dr. Mogadam has a private practice in Alexandria, Virginia. He is author of Eating for Life (Signet) and Every Heart Attack Is Preventable (New American Library).