Clinical Guide to Popular Diets

Caroline Apovian, Elizabeth Brouillard, Lorraine Young

• Editorial: CRC Press
• Año: 2018
• ISBN:
  9781351211444
• Edición: 1
• Categoría: Medicina
• Categoría: Nutrizione, dietetica e bariatria

It is no secret that the United States is facing an obesity epidemic with the obesity rates continuing to rise year after year. According to the Center for Disease Control, one third of Americans are now obese. It is no longer sufficient to simply point out the health risks of obesity to our patients as the reason to lose weight. Patients are seeking guidance in terms of what specific diet plan to follow and what foods should be eaten. There are thousands of diets on the market with new ones introduced daily. Not all diet plans have proven results, nor will they work for every patient. More importantly, not all diets marketed to the public are safe to follow for an extended timeframe. In fact, research shows us that diet composition is not the key to long term success, but compliance to a calorie deficient diet is the solution. So how does one choose which diet plan to recommend to patients?

Finally, a book for clinicians is here to help answer this question. This book provides information to help patients understand several different research proven diets on the market today including: the Atkins diet, the DASH (Dietary Approaches to Stop Hypertension) diet, the I diet, the Mediterranean diet, Paleo Diets, South Beach, Vegetarian diets, Weight Watchers, and the Zone diet. Each diet is carefully and thoroughly reviewed in this book by some of America's top obesity medicine and weight management specialists to provide health practitioners a knowledge of the diet composition, current research evaluating the diet, typical weight loss results, the pros and cons of the diet as well as which patients would most benefit from each diet plan.

This book provides the necessary tools for clinicians to feel comfortable discussing several of the more popular and scientifically researched diets with patients. This book offers solid information to advise patients, based on their specific health history, on which diet will afford the greatest chance for success.

1

The Atkins Diet

Laura E. Matarese and Glenn K. Harvin

Contents

Overview

How the Diet Works

The Atkins Plan

Current Research

Effects of Carbohydrate Restriction for Individuals with Type 2 Diabetes and Metabolic Syndrome

Effects of Carbohydrate Restriction on Cardiovascular Disease

Weight Loss, Compliance, and Recidivism

Typical Results

Pros and Cons

Is This Diet Right for You?

Conclusion

References

Overview

Despite the fact that there are well over 1000 published weight-loss diets in the lay literature, few have attracted as much attention as the Atkins Diet. The late Dr. Robert C. Atkins developed this low-carbohydrate, high-protein weight-loss plan which was publicized in his best-selling book, The Atkins Diet Revolution.1 Dr. Atkins promoted the plan as not only a quick weight-loss diet but as a change in eating for a lifetime. The diet was extremely popular allowing individuals to consume large quantities of meat and high-fat foods without considering caloric restrictions. Critics referred to the diet as a high-protein, high-fat, low-carbohydrate ketogenic diet which could be potentially harmful. Early claims on both sides were often fueled by perception and personal biases without scientific evidence. Eventually, the emergence of numerous clinical trials appeared in the scientific literature demonstrating the efficacy and safety of the Atkins Diet.

How the Diet Works

Historically, obesity has been considered to be a result of an imbalance in caloric intake versus expenditure. The idea was simple: when individuals take in more calories than they expend, the result will be weight gain. Given the growing incidence of obesity worldwide, however, it has become clear that this represents an over-simplification of a complex disease whose cure is more complicated than simply creating a caloric deficit. Physiologically, carbohydrate restriction, as opposed to a negative energy balance, is responsible for initiating the metabolic response to fasting.2 The Atkins hypothesis is that dietary carbohydrate, particularly from simple sugars, causes hyperinsulinemia, leading to insulin resistance, obesity, and the metabolic syndrome. Excess carbohydrate prevents effective lipolysis with resulting lipogenesis. Low carbohydrate diets reduce the dietary contribution to serum glucose thereby lowering insulin levels. Insulin is a potent stimulator of lipogenesis and inhibitor of lipolysis. Lowering insulin levels allows the utilization of stored body fat for energy. Severe carbohydrate restriction leads to a progressive depletion of glycogen stores eventually switching metabolism to lipolysis. With a reduction in dietary carbohydrate, there is a corresponding increase in dietary protein and fat. This leads to the production of ketones which act as an appetite suppressant and contribute to an overall voluntary caloric reduction.3,4 It has been proposed that inefficient protein and fat oxidation leads to additional energy loss since more adenosine triphosphate (ATP) is required to oxidize these macronutrients.5 Lipolysis is maintained despite excess calories because glycerol from fat is needed as a gluconeogenic precursor.2 The carbohydrate level required to produce the metabolic shift from lipogenesis to lipolysis has been debated, but it is thought to be between 20 and 50 g of carbohydrate per day in the initial phases of the diet. This contrasts sharply with the typical carbohydrate content of the Western diet which often exceeds 300 g per day comprising large quantities of simple, rapidly hydrolyzed carbohydrates.

The Atkins Plan

The foundation of the Atkins Plan is a reduction of carbohydrates. The diet has evolved over the years to currently offer two options (Table 1.1). With Atkins 20™, the starting point (Phase 1, I...