Comparison of Diets There are many books, articles in magazines and web sites devoted to diet and offering advice in regards to what to eat. Most information available is promoting low carbohydrate diets. If a diet is low carbohydrate then it must be high in protein and fat. Below is a review of some diets that are encountered. Standard Western Diet In the United States, the average protein intake (as a percentage of calories) is 16% with a range of 10% to 22%.1 The average fat intake is 34% (as a percentage of calories) with 11% of the calories coming from saturated fats. Simple sugars comprise of 44% of the total carbohydrates with dietary fibre making up 6%. Meat consumption per person is at a record high with an increase 40% since the 1950s. The DASH Eating Plan (Dietary Approaches to Stop Hypertension) was one of three eating plans that were compared in research studies sponsored by the US National Heart, Lung, and Blood Institute (NHLBI).2 The goal of this research was to study the effects of diet on high blood pressure. The results showed that the DASH eating plan lowers blood pressure. According to the US National Heart, Lung, and Blood Institute, the diet: Is low in saturated fat, cholesterol, and total fat Focuses on fruits, vegetables, and fat-free or low-fat dairy products Is rich in whole grains, fish, poultry, beans, seeds, and nuts Contains fewer sweets, added sugars and sugary beverages, and red meats than the typical American diet However, it is still a high protein, high fat diet compared to the diets of other societies that have a much- reduced incidence of heart disease, cancers and other degenerative diseases. The American Heart Association3 has similar guidelines. Their recommendations include eating oily fish at least twice a week. As discussed earlier, there is ample evidence to suggest that fish oil or omerga-3 oils are not protective of heart disease. 8.-Diets.doc page 1 of 8 5 December 2015 16:22 Below is a table that shows the daily nutrient goals used in the DASH studies and a comparison with the average US Diet. There is an increase in the proportion of protein consumed in the DASH diet. Nutrient US Diet DASH Diet Total fat 34% of calories 27% of calories Saturated fat 11% of calories 6% of calories Protein 16% of calories 18% of calories Carbohydrate 50% of calories 55% of calories Fibre 6% by weight of 11% by weight of carbohydrate carbohydrate The Banting Diet William Banting was an English carpenter a very overweight carpenter and undertaker. He consulted “other high orthodox authorities (never any inferior adviser), but all in vain.” Eventually, in August of 1862 Banting consulted a noted Fellow of the Royal College of Surgeons - an ear, nose and throat specialist, Dr. William Harvey. As a result of his experience he wrote a successful “pamphlet” - Letter on Corpulence in which he describes his experience. I am now nearly 66 years of age, about 5 feet 5 inches (165 cm) in stature, and, in August last (1862), weighed 202 lbs. (97kg) Over a period of 12 months, he lost 46 pounds (21 kg) with his weight 167 pounds (76 kg). It was a big improvement but not exactly slim. His recipe for achieving this is: For breakfast, I take four or five ounces of beef, mutton, kidneys, broiled fish, bacon, or cold meat of any kind except pork; a large cup of tea (without milk or sugar), a little biscuit, or one ounce of dry toast. For dinner. Five or six ounces of any fish except salmon, any meat except pork, any vegetable except potato, one ounce of dry toast, fruit out of a pudding, any kind of poultry or game, and two or three glasses of good claret, sherry, or Madeira - Champagne, Port and Beer forbidden. For tea. Two or three ounces of fruit, a rusk or two, and a cup of tea without milk or sugar. For supper. Three or four ounces of meat or fish, similar to dinner, with a glass or two of claret. For nightcap, if required, A tumbler of grog - (gin, whisky, or brandy, without sugar) or a glass or two of claret or sherry. This plan leads to an excellent night's rest, with from six to eight hours' sound sleep. The dry toast or rusk may have a table spoonful of spirit to soften it, which will prove acceptable. Perhaps I did not wholly escape starchy or saccharine (sugar) matter, but scrupulously avoided those beans, such as milk, sugar, beer, butter, &c., which were known to contain them. 8.-Diets.doc page 2 of 8 5 December 2015 16:22 Du Pont Diet Shortly after the First World War, the large American chemical firm E.I. DuPont, became concerned about the growing obesity problem among their staff. They hired Dr. Alfred Pennington to find out why traditional low-calorie diets were not working. Drawing upon the work of Pittsburgh doctor Frank Evans contained in the 1949 book, Diseases of Metabolism, Dr Pennington placed DuPont executives on a high-fat, high-protein, low-carbohydrate unrestricted-calorie diet4. His dieters reported they felt well, enjoyed their meals, and were never hungry between meals. The 20 obese individuals he treated lost an average of 10 kg each, in an average time of three-and-a-half months. This is based on the theory that people become fat because they can not fully break down carbohydrates and so they become converted to fat.5 Atkins Diet 6 Robert Atkins was born in 1930 in Dayton, Ohio. He received an undergraduate degree from the University of Michigan in 1951 and earned a medical degree from Cornell University. His cardiology residency was obtained at St. Luke's Hospital, New York. At the age of 33, he had his picture taken for an ID. He told Observer Food Monthly, "I looked at a picture of myself and realized I had a triple chin. ... I was eating junk food. Nobody had ever told me junk food was bad for me. Four years of medical school, and four years of internship and residency, and I never thought anything was wrong with eating sweet rolls and doughnuts, and potatoes, and bread, and sweets." An article exploring the study of Pennington's work, titled "A New Concept in the Treatment of Obesity", was published in the October 1963 issue of the Journal of the American Medical Association by Edgar S. Gordon, Marshall Goldberg, and Grace J. Chosy, and advocated for the complete elimination of sugar from the diet and a marked increase in both fat and protein Atkins had recently read the article in the journal. He says, 'It was so simple! I hadn't tried a diet before that. It was the only diet that looked like I'd enjoy being on it. I ate a lot of meat, and a lot of shrimp, and a lot of duck, and a lot of fish. And omelets in the morning, and salad and vegetables.' Atkins lost 12 kg in six weeks on a low-carbohydrate diet. 100% of his 65 patients who trialled the diet reached their target weights. In 1970, he wrote an article for Vogue on his low-carbohydrate, eat-all-you-want diet. In 1972 he published his book, Dr. Atkins' Diet Revolution, which sold 15 million copies. His program was condemned by the American Medical Association. Zone Diet – Dr Barry Sears Dr Barry Sears is the author and co-author of the approximately 20 Zone Diet books including Enter the Zone (1995), Mastering the Zone (1996), The Zone Diet (1999), The 7-day Zone Diet (2003) and A Week in the Zone (2004). He is a former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology. According to Sears, “for every one gram of fat you eat, you want two grams of protein and 3 grams of total carbohydrates”.7 This equates to approximately to obtaining 40% of energy from carbohydrates, 30% protein and 30% fat.8 Sears claims, “The underlying cause of chronic disease comes from the increased production of a natural fatty acid called arachidonic acid which is incredibly toxic at high enough concentrations.”9 He states “the most likely suspect gene-altering drama is increased consumption of omega-6 fatty acids, such as linoleic acid, which lower the percentage of omega-3 fats in the diet.” and “We have been become genetically altered by increasing linoleic acid to gain weight rapidly and make it difficult to lose.” 10 8.-Diets.doc page 3 of 8 5 December 2015 16:22 South Beach Diet - Dr. Arthur Agatston 11 Cardiologist Arthur Agatston and dietician Marie Almon as an alternative to low-fat approaches advocated by the American Heart Association created the South Beach Diet in the 1980s. This is a 3 phase dietary plan which is summarised below. Phase 1 – first 2 weeks eat healthy, lean protein (fish, shellfish, chicken, turkey and lean meats), loads of vegetables and salads, nuts, reduced-fat cheeses, low-fat dairy and good unsaturated olive and canola oil. Avoid starches (bread, rice, pasta) and sugars (fruit and fruit juices). Phase 2 – followed until you hit your target weight. Add back the foods you love, like the “good” carbohydrates – fruit, whole grain bread, whole grain rice, whole-wheat pasta, and sweet potatoes (no white potatoes). Avoid high glycemic foods. If phase 2 fails then return to phase 1. Phase Three – Avoid bad fats and bad carbohydrates. Good fats are unsaturated fats.