By Bob LaMendola
October 14, 2003
Trying to lose weight? You may not have to follow the same diet forever. And don't expect miracles. None of the innumerable plans preaching no carbohydrates or no fat or no sugar or no whatever will work for everyone, researchers said at an international conference on obesity in Fort Lauderdale on Monday. It's possible that people may have to use one diet to lose the weight, another diet to keep it off in the long run.
"This idea of one-size-fits-all, trying to find 'the' diet, it's never going to work that way," said Barbara Rolls, a nutrition professor at Penn State University. "None of us have any magic answers. None of the diets have any magic answers."
The only overriding truth for losing weight is boringly basic: Consume fewer calories than you burn, and get some exercise to keep the metabolism burning.
Researchers said they realize that the lack of clear guidance about how best to become slimmer is confusing to an American public that is growing heavier by the day.
Almost two-thirds of adults in this country now are considered overweight. All those extra pounds translate to increased diabetes, heart disease and many other problems.
What to do? At the Fort Lauderdale convention of about 1,000 nutrition specialists, a panel of four nationally known researchers reviewed the major weight-loss approaches and found all had their pros and cons.
The panel of four said the classic food pyramid taught in school -- calling for the heaviest intake of grains and starches, followed by fruits and vegetables, dairy products, fish, chicken and the smallest in red meat and sugar -- probably should be rewritten. But not much.
All agreed that carbohydrates such as white bread, foods made of processed flour and potatoes should no longer be considered the most healthful. The main staples should be fresh produce, whole grains and legumes such as beans.
"I don't think we're ready to reinvent nutrition," Rolls said.
None of the four were ready to endorse the Atkins-style diet of all protein and almost no carbs. Still, at least three small studies showed that Atkins shed more weight than the standard low-fat diets prevalent in the past few decades, without the expected side effects of raising cholesterol and fat levels.
"There were no ill effects, which was surprising given what we know about low-carb diets," said Gary Foster, clinical director of weight and eating disorders at the University of Pennsylvania.
Obese people following the meat-heavy diets lost twice as much weight -- 9 percent vs. 4 percent in one study -- with better levels of triglycerides than the low-fat group. The theory is that proteins satisfy better, while carbs burn fast, raise blood sugar levels and disrupt the metabolism.
Some experts theorized that the Atkins folks were just eating less. One small study on Monday challenged that notion. It found that those on the high-protein diets lost more weight than those on low-fat diets, even when eating an extra 300 calories a day.
But there are still many unanswered questions about protein diets, namely how long the weight loss will last. One study showed that over a year, the Atkins group began to gain back some weight they had lost and grew closer to the low-fat group. There's also no idea of whether loading with protein will have long-term effects on the body.
Carbs may not be as bad as the Atkins crowd believes, said Dr. David Ludwig, director of obesity programs at Children's Hospital in Boston.
Studies show that only highly processed grains and sugar may be the problem, while people on diets featuring slower burning whole grains and other starches lost twice as much weight as those on low-fat diets, he said.
"Low-fat diets have proved disappointing in the long run," Ludwig said. They work for some, but many people cannot stick to them in the long run.
It's possible, however, that the best approach for some people may wind up being using a high-protein diet to drop the pounds and then switching to a moderate reduced-fat diet to maintain their weight, the researchers said.
More research is needed to try to figure out which patients will do better on which diet.
For some practical, immediate help, Penn State's Rolls unveiled a study showing that eating a big but light salad before dinner resulted in people eating less calories overall at the meal. The idea is they filled up on the salad and displaced heavier food coming later, she said.
But be careful. A light salad means veggies topped with low- or no-fat dressing and cheese. Rolls said that if the salad was heavier, laden with high-fat dressing and cheese, people wound up eating more calories than if they had skipped the salad altogether.
"I don't think telling people to eat less is the right answer," Rolls said. "Sometimes it's eat more, more of the right things."
Bob LaMendola can be reached at firstname.lastname@example.org or 954-356-4526.
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