Fad Foods: Hint: There really aren't any new diets

By David Steinkraus

Wednesday, August 9, 2006 2:12 AM CDT

If you search the books section on Amazon.com for the word diet, you'll come up with 173,950 returns, or you would have a couple of weeks ago. The number of diet books may well have expanded by now, keeping pace with Americans' expanding girth.

If you had looked at some of the results, you would have found that people who bought "The Sonoma Diet" also bought "The Mediterranean Diet," and "The Cheater's Diet." On the other hand, people who bought "The Fat Smash Diet" also purchased "Ultrametabolism," the buyers of which also bought "The 7 Myths about Weight Gain," and "The Fat Resistance Diet."

The reasonable question is: If all this worked, why aren't people thinner? And it doesn't work, most likely because it's all boring. (See sidebar.) The citizen dieter Barb Gustin did them all. Well, certainly not all 173,950 of them, but she did a whole bunch. Gustin, who lives in Caledonia and is a single mom, said she tried a couple of weight-loss programs through her church.

One required her to dish up a portion of food, then divide it, putting one half in the refrigerator and eating the other.

"It became really cumbersome, and I got really lazy."

She saw books on the supermaket shelves. "Any of those, I think I tried every single one of them."

She had tapes that she listened to in her car and which were supposed to subliminally affect her weight control.

"I did a grapefruit diet. I got tired of eating grapefruit, and I think part of that was there's so much acid in the grapefruit."

And she did the majors, Weight Watchers, for example. "Atkins, I got severely sick. I had to get my gall bladder out." It was all the fat in that high-protein, low-carbohydrate plan.

The scientist dieter Gregory Petsko picked the Atkins diet. He was looking for a diet to write about for his column in the British scientific journal Genome Biology, and as a biochemist (professor of biochemistry at Brandeis University) Atkins makes sense from a biochemical standpoint, he said.

"There is a direct connection between insulin levels and fat metabolism," he said, and a well established biochemical pathway that connects fat with sugar intake. "I think that's one of the reasons why it was appealing to many scientists."

Several dozen people wrote e-mails in the wake of his column in December 2003, quite a number for a diet column, he said.

And Atkins worked. He lost seven or eight pounds fairly quickly. His breath smelled bad, but he knew that would happen as his body became "ketotic," producing chemicals called ketone bodies (such as acetone, which is what you smell in nail-polish remover) while it adjusted to metabolize large amounts of fat. But like the native people of the Arctic, who live on diets comprised mainly of whale and seal meat and blubber, he knew his body would eventually adjust.

"Carbohydrates probably didn't come into the human diet until the baking of bread and the eating of vegetables and so forth." So it's not that this diet is dangerous for most people, but you do tire of it, he said. All diets on the market work initially because at first you cut your caloric intake, and that means you must lose weight if you're expending more energy than you take in, he said.

He quit Atkins after a few months, but some of its lessons still linger. "I eat almost no candy, or anything like that." He watches his carbohydrates generally, and he runs, 5 miles a day for three days each week, which is what his 58-year-old body will tolerate.

What else makes sense biochemically? Well, Petsko said, the South Beach diet looks reasonable. "It's basically just a balanced diet." There is less carbohydrate than people in the United States eat. "It's not what Americans want to hear, but it's the one thing that pretty much works all the time."

Extreme tools Gustin tired of all her attempts. All were too boring, or they didn't produce a weight loss that was large and immediate. She found her answer in an operating room. Earlier this year she had gastric bypass surgery to rearrange her digestive system.

It was no small goal that she had. After beating alcoholism, she substituted food for drink and gained 100 pounds. She's lost 69 pounds so far.

"I keep reminding people, gastric bypass surgery is not the solution. It is a tool to help you get to the place you want to be." She still has to maintain a particular diet in order to continue to lose weight.� The difference is that if she eats what she shouldn't, such as too much sugar, she'll get sick.

There was a time not too long ago when she stopped losing. She re-examined her habits and found that she had resumed eating out regularly. "I started bringing my lunch again, and my weight's dropping again."

The dietician "Almost exclusively, when you look at fad diets out there, they're eliminating or almost eliminating one of the food groups," said Becky Koeppen, 49, a dietician at the Aurora Health Care clinic in Mount Pleasant.

Most such diets are associated with a book, and while the books differ there is similarity, she said, either very low carbohydrates or very low fat or vegetarian, "and they just kind of do remakes of those diets by different names."

For very short-term use, any diet is not dangerous, Koeppen said.

"If someone starts doing it for month, that's where you can get deficiencies." One woman she saw had been on a restrictive diet of only 1,000 calories per month. The woman came in with an irregular heartbeat, had vitamin and mineral deficiencies, and her electrolytes - the ions such as sodium and potassium which are crucial for cell and muscle function - were out of balance. Koeppen particularly cautions people with diabetes against low-carbohydrate diets because they can lead to low blood sugar.

Many of the people she counsels have already tried a few diets, Koeppen said, and she has found that her clients' experiences parallel those of Gustin and Petsko.

"Because so many of the diets eliminate favorite foods, people can't stay on them." Some require too much detailed preparation, and some require adherents to by special foods which eventually become a burdensome expense.

For most people Koeppen advises adding more color to their plates. Many meals, especially restaurant meals, are mostly brown and white. "So I try to get people add more color, which means adding more fruit and vegetables." Many people seem to do well on the middle phase of the South Beach diet which emphasizes fresh fruits and vegetables, lean protein, and limited carbohydrates, she said.

What she talks about with her patients is their habits, their eating trends. If you ask them, Koeppen said, most people already know what the problem is. They know they're eating too much pasta or eating out too often. So she talks about making better food choices when they eat out, or being more careful about reading food labels for calorie information, or considering how large their food portions should be. (The number of calories in a restaurant portion have almost doubled since the 1970s, she said. "When I show them what is considered a serving size, they're always surprised by that.") Plans are individualized because no one idea will fit any person. "That's why all the books don't work."

"Everybody wishes there was a quick little pill," she said. "It's lifelong changes you're looking at. How am I eating? How am I living? What am I looking at long-term?"

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