Healthy Fast Food
Tips for Making Healthier Fast Food Choices
America has been called a "fast food nation" and for good reason. Everyday, one out of four Americans eats fast food. If you are eating out, fast food restaurants are often the cheapest option, but unfortunately, not usually the healthiest one. Eating just one fast food meal can pack enough calories, sodium and fat for an entire day, but the quick-and-cheap temptation can be hard to resist.
As an informed customer, you can make healthier choices and still enjoy the convenience of fast food restaurants.
Learning to make healthier choices at fast food restaurants
Making healthier choices at fast food restaurants is easier if you prepare ahead by checking guides that show you the nutritional content of meal choices at your favorite restaurants. Free downloadable guides help you evaluate your options. If you have a special dietary concern, such as diabetes, heart health or weight loss, the websites of national non-profits provide useful advice. You can also choose to patronize restaurants that focus on natural, high quality food.
If you don’t prepare ahead of time, common sense guidelines help to make your meal healthier. For example, a seemingly healthy salad can be a diet minefield when smothered in high-fat dressing and fried toppings, so choose a salad with fresh veggies, grilled toppings and a lighter dressing. Portion control is also important, as many fast food restaurants serve enough food for several meals in the guise of a single serving.
Top tips for healthy eating at fast food restaurants
Make careful menu selections – pay attention to the descriptions on the menu. Dishes labeled deep-fried, pan-fried, basted, batter-dipped, breaded, creamy, crispy, scalloped, Alfredo, au gratin or in cream sauce are usually high in calories, unhealthy fats or sodium. Order items with more vegetables and choose leaner meats.
Drink water with your meal. Soda is a huge source of hidden calories. One 32-oz Big Gulp with regular cola packs about 425 calories, so one Big Gulp can quickly gulp up a big portion of your daily calorie intake. Try adding a little lemon to your water or ordering unsweetened iced tea.
“Undress” your food. When choosing items, be aware of calorie- and fat-packed salad dressings, spreads, cheese, sour cream, etc. For example, ask for a grilled chicken sandwich without the mayonnaise. You can ask for a packet of ketchup or mustard and add it yourself, controlling how much you put on your sandwich.
Don't be afraid to special order. Many menu items would be healthy if it weren't for the way they were prepared. Ask for your vegetables and main dishes to be served without the sauces. Ask for olive oil and vinegar for your salads or order the dressing "on the side" and spoon only a small amount on at a time. If your food is fried or cooked in oil or butter, ask to have it broiled or steamed.
Watch portion size - an average fast food meal can run as high as 1000 calories or more, so choose a smaller portion size, order a side salad instead of fries, and don't supersize anything. At a typical restaurant, a single serving provides enough for two meals. Take half home or divide the portion with a dining partner. Sharing might make dessert (or something else indulgent) more of an option.
Watch your salt. Fast food restaurant food tends to be very high in sodium, a major contributor to high blood pressure. Don’t add insult to injury by adding more salt.
Avoid buffets – even seemingly healthy ones like salad bars. You'll likely overeat to get your money's worth. If you do choose buffet dining, opt for fresh fruits, salads with olive oil & vinegar or low-fat dressings, broiled entrees and steamed vegetables. Resist the temptation to go for seconds, or wait at least 20 minutes after eating to make sure you're really still hungry before going back for more.
Eat mindfully. Pay attention to what you eat and savor each bite. Chew your food more thoroughly and avoid eating on the run. Being mindful also means stopping before you are full. It takes time for our bodies to register that we have eaten. Mindful eating relaxes you, so you digest better, and makes you feel more satisfied.
Remember the big picture – Think of eating out in the context of your whole diet. If it is a special occasion, or you know you want to order your favorite meal at a nice restaurant, make sure your earlier meals that day are extra healthy. Moderation is always key, but planning ahead can help you relax and enjoy your dining out experience while maintaining good nutrition and diet control.
Guides can help you make healthier meal choices
Many fast food chains post nutritional information on their websites. Unfortunately, these lists are often confusing and hard to use. Instead you can go to other websites that provide health and nutrition information, but in easier to follow formats. Some even publish comparison downloadable guides or inexpensive pocket guides. Learn how to make a healthier meal selection at your favorite restaurant:
HealthyDiningFinder.com – allows you to search for restaurants offering a selection of healthier menu options and view the nutrition data for selected items. You can search for area restaurants or a specific restaurant.
Stop&Go Fast Food Nutrition Guide – this guide is particularly convenient and easy to use. Look up any of the major chain restaurants and find out how to make healthier choices. For more information, see below.
Guides for your individual needs
There are many websites geared toward how to make healthy choices at restaurants depending on your specific dietary needs, whether it is for diabetes, cancer, heart disease, or weight management. See below for specific listings.
Healthier fast food at burger chains
Healthy Fast Foods: Burger CHains Figuring out healthier options at your favorite fast food burger chain can be tricky. A typical meal at a burger joint consists of a "sandwich", some fries and a drink, which can quickly come in at over 1700 calories for something like Burger King's Triple Whopper with a large fries and a 16 oz. soda. A better option would be a regular single patty burger, small fries, and water, which is about 500 calories. Alternatively you may enjoy a veggie burger smothered in grilled onion and mushrooms. Or if you want a large beef burger, then skip the fries and soda and have a side salad and water instead.
The Big Burger Chains
Less Healthy choices
1. Double-patty hamburger with cheese, mayo, special sauce, and bacon
2. Fried chicken sandwich
3. Fried fish sandwich
4. Salad with toppings such as bacon, cheese, and ranch dressing
5. Breakfast burrito with steak
6. French fries
7. Milkshake
8. Chicken “nuggets” or tenders
9. Adding cheese, extra mayo, and special sauces
Healthier choices
1. Regular, single-patty hamburger without mayo or cheese
2. Grilled chicken sandwich
3. Veggie burger
4. Garden salad with grilled chicken and low-fat dressing
5. Egg on a muffin
6. Baked potato or a side salad
7. Yogurt parfait
8. Grilled chicken strips
9. Limiting cheese, mayo, and special sauces
Healthier fast food at fried chicken chains
Healthy fast food: Fried chicken chainsAlthough certain chains have been advertising “no trans fats” in their food, the fact is that fried chicken can pack quite a fattening punch. According to the restaurant’s nutrition info, just a single Extra Crispy Chicken breast at KFC has a whopping 440 calories, 27 grams of fat, and 970 mg of sodium. A healthier choice is the drumstick, which has 160 calories, 10 grams of fat, and 370 mg of sodium. Alternatively, if you like the breast meat, take off the skin and it becomes a healthy choice at 140 calories, 2 grams of fat, and 520 mg of sodium.
Some tips for making smarter choices at fast food chicken restaurants:
The Big Fried Chicken Chains
Less healthy choices
1. Fried chicken, original or extra-crispy.
2. Teriyaki wings or popcorn chicken
3. Caesar salad
4. Chicken and biscuit “bowl”
5. Adding extra gravy and sauces
Healthier choices
1. Skinless chicken breast without breading
2. Honey BBQ chicken sandwich
3. Garden salad
4. Mashed potatoes
5. Limiting gravy and sauces
Healthy fast food: Mexican chains
Healthy fast food: Mexican chains Fast food chains that specialize in tacos or burritos can be caloric minefields or they can be a good option for finding healthy fast food. Rice, beans, salsa and a few slices of fresh avocado can make a very healthy meal. But adding cheese, sour cream and tortilla chips can turn even a good meal unhealthy. Be sure to also remember portion control since these types of restaurants can have enormous menu items (eat half and take the rest for another meal).
Several chains, like Taco Bell and Baja Fresh, have “healthy” menu options that feature less fat and fresher ingredients.
The Big Taco Chains
Less healthy choices
1. Crispy shell chicken taco
2. Refried beans
3. Steak Chalupa
4. Crunch wraps or gordita-type burritos
5. Nachos with refried beans
6. Adding sour cream or cheese
Healthier choices
1. Grilled chicken soft taco
2. Black beans
3. Shrimp ensalada
4. Grilled “fresco” style steak burrito
5. Veggie and bean burrito
6. Limiting sour cream or cheese
Healthy fast food: Sub sandwich chains
Healthy fast food: Sub sandwich chainsAmericans love all types of sandwiches: hot, cold, wrapped, foot long. Usually eaten with a salad instead of fries. The ads promote the health benefits of sandwich shops. Easier said than done... studies have found that many people tend to eat more calories per meal at a sub shop than at McDonalds. This may be because people feel so virtuous eating “healthy” like the ads promise, that they reward themselves with chips, sodas, or extra condiments.
You can make healthier choices at a deli or sub shop but you need to use some common sense.
Subs, Sandwich and Deli Choices
Less healthy choices
1. Foot-long sub
2. High-fat meat such as ham, tuna salad, bacon, meatballs, or steak
3. The “normal” amount of higher-fat (Cheddar, American) cheese
4. Adding mayo and special sauces
5. Keeping the sub “as is” with all toppings
6. Choosing white bread or “wraps” which are often higher in fat than normal bread
Healthier choices
1. Six-inch sub
2. Lean meat (roast beef, chicken breast, lean ham) or veggies
3. One or two slices of lower-fat cheese (Swiss or mozzarella)
4. Adding low-fat dressing or mustard instead of mayo
5. Adding extra veggie toppings
6. Choosing whole-grain bread or taking the top slice off your sub and eating it open-faced
Healthy Asian food
Healthy Asian FoodAsian cultures tend to eat very healthfully, with an emphasis on veggies, and with meat used as a “condiment” rather than being the focus of the meal. Unfortunately, Americanized versions of these ethnic foods tend to be much higher in fat and calories – so caution is needed. But here’s a great tip for all Asian restaurants – use the chopsticks! You’ll eat more slowly, since you can’t grasp as much food with them at one time as you can with your normal fork and knife.
Asian Food Choices
Less healthy choices
1. Fried egg rolls, spare ribs, tempura
2. Battered or deep-fried dishes (sweet and sour pork, General Tso’s chicken)
3. Deep-fried tofu
4. Coconut milk, sweet and sour sauce, regular soy sauce
5. Fried rice
6. Salads with fried or crispy noodles
Healthier choices
1. Egg drop, miso, wonton, or hot & sour soup
2. Stir-fried, steamed, roasted or broiled entrees (Shrimp chow mein, chop suey)
3. Steamed or baked tofu
4. Sauces such as ponzu, rice-wine vinegar, wasabi, ginger, and low-sodium soy sauce
5. Steamed brown rice
6. Edamame, cucumber salad, stir-fried veggies
Healthy Italian fast food
Healthy Italian fast food The anti-carbohydrate revolution has given Italian food a bad rap, but Italian is actually one of the easiest types of cuisine to make healthy. Stay away from fried, oily or overly buttery, as well as thick crust menu items, and you can keep your diet goals intact.
Watch out for the following terms, which are common culprits of high fat and calories: alfredo, carbonara, saltimbocca, parmigiana, lasagna, manicotti, stuffed (all have heavy amounts of cream and cheese). Generally Italian places have lots of veggies in their kitchen so it’s easy to ask to have extra veggies added to your meal.
Italian and Pizza Restaurant Choices
Less healthy choices
1. Thick-crust or butter-crust pizza with extra cheese and meat toppings
2. Garlic bread
3. Antipasto with meat
4. Pasta with cream or butter-based sauce
5. Entrée with side of pasta
6. Fried (“Frito”) dishes
Healthier choices
1. Thin-crust pizza with half the cheese and extra veggies
2. Plain rolls or breadsticks
3. Antipasto with vegetables
4. Pasta with tomato sauce and veggies
5. Entrée with side of veggies
6. Grilled (“Griglia”) dishes
Chains with natural, high quality fast food
Some fast food restaurants are working hard to make their food both healthier and tastier. One example is Chipotle, where their motto is “Food with Integrity”. The objective is to serve food that is better tasting, comes from better sources, is better for the environment, better for the animals, better for the farmers, and in turn this produces food that is better for us to eat. Unfortunately their portion sizes are still huge, so be sure to always pay attention to calories and fat content. The stated goals are:
Natural, high quality, healthier, fresher food
Naturally raised meat: All of the pork and chicken and more than half of the beef that is served at Chipotle is naturally raised. This means the animals were not given any antibiotics, growth hormones, their feed is all vegetarian with no animal by-products, and they have more space to move around. The animals receive care, rather than chemicals. Not only is meat raised this way healthier, it also tastes better! Most animals raised for meat spend their lives in Concentrated Animal Feed Operations (CAFOs) where they are crowded very closely together, requiring animals to be given antibiotics to keep infection from spreading.
Dairy products with no rBGH: The cheese and sour cream contains no recombinant bovine growth hormone (rBGH) a synthetic hormone that is injected into the cow to artificially increase milk production and which ends up in the milk products that we eat when used.
Using organic produce: Organic foods are grown without synthetic artificial fertilizers, herbicides or pesticides, which not only protects the soil and water quality but also provides us with foods that taste better, have more nutrients, and are free of potentially harmful chemicals.
Produce from local farms: Support organic and sustainable farming methods and purchase produce from local sources, which keeps the food as fresh as possible since it does not travel thousands of miles from the farm to the restaurant.
Zero trans-fats: No trans-fats (hydrogenated oils) in the frying oils. Trans-fats increase blood cholesterol which leads to a higher risk of heart disease (heart attacks, strokes). Recently several major U.S. cities (including New York City and Philadelphia), as well as in the state of California, have banned the use of trans-fats in restaurants.
Rabu, 24 Juni 2009
Selasa, 23 Juni 2009
How to lose weight safely and effectively
If you have decided to try and lose weight it is important to set a realistic, achievable target. Discuss this with your doctor, health adviser or dietician who can help you set short and long term goals.
Try and become more physically active and seek support
The best way to lose weight is a combination of eating less food and being more physically active. Choose activities that you enjoy, which are practical and easy for you to include as part of your lifestyle.
It is very helpful to get support from family or friends, or from joining a group. Having encouragement and support is essential to long term successful weight management. Remember to give yourself a pat on the back too - use positive affirmations to encourage yourself.
Reward yourself in a suitably healthy way for your achievements - for example you could buy yourself a new outfit to complement your new trim body, but don't use food as a reward!
* Only eat when you are hungry - it may be that your body really needs something else, such as exercise, or even water.
* Eat slowly, chewing every mouthful thoroughly and only eat to the point of feeling comfortably full. Don't feel guilty about leaving food on your plate once you feel full
* Try and avoid eating late in the evening and if you do, choose fruit or a low fat milky drink.
Setting goals for weight loss and dietary changes
Aim to lose no more than 0.5 to 1kg (1 to 2lbs) in weight every week. Remember, there is no quick fix answer to long term weight loss - it does take time. If you would like to record your weight, plot a graph so that you can monitor your progress - use a large scale so that a small but steady weight loss really shows. Rather than relying too much on what you weigh to give you a pat on the back, try and focus on how you feel and look and notice any positive changes as a result of changing what you eat.
During the initial few days of restricting energy intake, you will lose some water and glycogen (a type of energy stored in your liver and muscles) and not much fat. The rate of weight loss will then slow down and the proportion of fat lost should increase.
When you lose weight, you lose both lean tissue and body fat. What is important is the relative proportions of each. The ideal proportion is 75% fat loss and 25% from lean body tissue. This should occur when following a healthy eating plan which results in slow, gradual weight loss (0.5 to 1kg; 1 to 2lbs/week). Following a "crash diet" in which rapid weight loss is occurring, results in a greater loss of lean body tissue and less fat. There is evidence that crash dieting also results in your eventually putting on more weight than you lost.
Making changes to your diet in order to lose weight does not necessarily mean eating less food but it does mean choosing different types of food.
Decide on small, achievable changes that you feel able to make. Dietary changes should be practical and include foods that you enjoy.
Follow a healthy, well-balanced diet
Always try and follow the principles of a healthy, well-balanced diet, the details of which are outlined in this section. In summary, try to:
* eat regularly
* base your meals on bread, potatoes, rice or pasta
* eat plenty of fresh fruit and vegetables
* use only the minimum of spreading fats and vegetable oils
* choose low fat varieties of dairy products and meat, fish and alternatives
* eat only very occasionally snacks such as chocolate, cakes, biscuits, instant puddings, crisps etc as they are high in either fat, sugar or both
Try and become more physically active and seek support
The best way to lose weight is a combination of eating less food and being more physically active. Choose activities that you enjoy, which are practical and easy for you to include as part of your lifestyle.
It is very helpful to get support from family or friends, or from joining a group. Having encouragement and support is essential to long term successful weight management. Remember to give yourself a pat on the back too - use positive affirmations to encourage yourself.
Reward yourself in a suitably healthy way for your achievements - for example you could buy yourself a new outfit to complement your new trim body, but don't use food as a reward!
* Only eat when you are hungry - it may be that your body really needs something else, such as exercise, or even water.
* Eat slowly, chewing every mouthful thoroughly and only eat to the point of feeling comfortably full. Don't feel guilty about leaving food on your plate once you feel full
* Try and avoid eating late in the evening and if you do, choose fruit or a low fat milky drink.
Setting goals for weight loss and dietary changes
Aim to lose no more than 0.5 to 1kg (1 to 2lbs) in weight every week. Remember, there is no quick fix answer to long term weight loss - it does take time. If you would like to record your weight, plot a graph so that you can monitor your progress - use a large scale so that a small but steady weight loss really shows. Rather than relying too much on what you weigh to give you a pat on the back, try and focus on how you feel and look and notice any positive changes as a result of changing what you eat.
During the initial few days of restricting energy intake, you will lose some water and glycogen (a type of energy stored in your liver and muscles) and not much fat. The rate of weight loss will then slow down and the proportion of fat lost should increase.
When you lose weight, you lose both lean tissue and body fat. What is important is the relative proportions of each. The ideal proportion is 75% fat loss and 25% from lean body tissue. This should occur when following a healthy eating plan which results in slow, gradual weight loss (0.5 to 1kg; 1 to 2lbs/week). Following a "crash diet" in which rapid weight loss is occurring, results in a greater loss of lean body tissue and less fat. There is evidence that crash dieting also results in your eventually putting on more weight than you lost.
Making changes to your diet in order to lose weight does not necessarily mean eating less food but it does mean choosing different types of food.
Decide on small, achievable changes that you feel able to make. Dietary changes should be practical and include foods that you enjoy.
Follow a healthy, well-balanced diet
Always try and follow the principles of a healthy, well-balanced diet, the details of which are outlined in this section. In summary, try to:
* eat regularly
* base your meals on bread, potatoes, rice or pasta
* eat plenty of fresh fruit and vegetables
* use only the minimum of spreading fats and vegetable oils
* choose low fat varieties of dairy products and meat, fish and alternatives
* eat only very occasionally snacks such as chocolate, cakes, biscuits, instant puddings, crisps etc as they are high in either fat, sugar or both
Rabu, 17 Juni 2009
Is the Atkins diet safe?
The Atkins diet, which is based on consuming high levels of protein and low levels of carbohydrate, has become a popular weight-loss approach among celebrities and the public. Two studies have been publicised as supporting the diet and confirming the weight-loss ability. But is this really the case? Are there still safety issues and is the diet a suitable approach for long-term weight loss?
What were the headlines?
Coverage of the two studies appeared in a range of publications. Headlines included "The fat and the thin of it", "Atkins diet is more effective and healthier than rival regimes", "High-fat diet confounds experts", "Controversial dietary plan proves healthier than expected", and "Atkins diet 'is beneficial and twice as effective as rivals'".
Most reports took the stance that together the studies prove the validity and safety of the high-protein diet, but although this may seem the case at first glance, a closer look at the research uncovers a different, and mostly unreported, story.
What is the bigger picture?
Both studies were published in the New England Journal of Medicine (NEJM). The first was conducted by the Philadelphia Veterans Affairs Medical Center, where 132 severely obese patients were randomly put on either a low-carbohydrate diet, or a low-fat diet, for six months. The Atkins dieters limited their carbohydrate intake to 30g a day and received counselling on healthy types of fat, such as omega-3 fatty acids. The low-fat dieters were put on a calorie-controlled diet, with no more than 30 per cent of total calorific intake from fat.
Only 79 people managed to complete the six-month trial. Low-carbohydrate dieters lost an average of 13 pounds, compared to four pounds for low-fat dieters. No significant changes in cholesterol or blood pressure levels were noted in either group, but the low-carbohydrate consumers did reduce their levels of triglycerides (blood fats) by an average of 20 per cent, compared to only 4 per cent in the other group.
"This study demonstrates that a low-carbohydrate diet can have beneficial effects in treating obesity," said senior investigator, Dr. Samuel Klein. "Additional research is needed to understand why subjects assigned to a low-carbohydrate diet lose more weight than those assigned to a conventional diet and to evaluate the long-term efficacy and safety of low-carbohydrate diet therapy."
The second study was carried out over one year, led by researchers at the University of Pennsylvania School of Medicine. Only 63 obese men and women took part, and were either assigned to a low-fat diet or the Atkins approach. All the participants met with a registered dietician at the start and then at three, six and 12 months into the programme.
They discovered that at three months Atkins dieters had lost an average of 14.7 pounds, compared with 5.8 pounds; at six months the losses were 15.2 pounds and 6.9 pounds respectively, and at one year they'd lost an average of 9.5 and 5.4 pounds. At one year, Atkins participants had greater increases in HDL cholesterol (18 per cent, compared with 3 per cent) and greater reduction in triglycerides. There was no change in either group in levels of bad (LDL) cholesterol.
"These preliminary data suggest that weight losses will be comparable to conventional approaches over a one-year period, but there may be more favourable effects of a low-carbohydrate approach in term of triglycerides and HDL (good) cholesterol," said Dr. Gary Foster, one of the researchers.
Although on the surface both studies appeared to show benefits from the Atkins diet, delving deeper into the details reveals a number of negative points. Most notably:
* Both studies were very small.
* Both used obese, or severely obese, participants, which isn't representative of the average UK dieter.
* There was a high drop-out rate, suggesting that people found the Atkins diet hard to stick to.
* They didn't address the harmful effect the diet could have on the kidneys.
* The difference between the weight losses at the end of the studies wasn't really that different.
Dr. Amy Joy Lanou, director of the Physicians Committee for Responsible Medicine in America, was quick to point out health dangers of the Atkins diet. "A Harvard study published earlier this year in the Annals of Internal Medicine showed that high-protein diets may cause permanent loss of kidney function in anyone with reduced kidney function. Other studies have shown that meat-heavy diets significantly increase one's risk of colon cancer and osteoporosis," she said.
Dr. Foster acknowledged the potential problems and said they're planning a longer five-year study. "This larger study of 360 participants will help us more fully assess the benefits and risks of low-carbohydrate diets on bone mass, kidney function, arterial function and exercise tolerance," he said.
What does this mean?
Brigid McKevith, a nutrition scientist at the British Nutrition Foundation (BNF), said, "We welcome the fact that the Atkins diet is being studied scientifically and that randomised controlled studies have been carried out, because it's very popular with the public."
However, she expressed concern at the small number of people studied and the high drop-out rate, as well as a number of key safety questions that are still left unanswered. "There are several potential problems with the Atkins diet. These include long term bone health, as with a very high protein intake the excretions of calcium increase, so there could be implications for the health of bones," she explained.
"There could be difficulties for people who have an underlying problem with their kidneys or liver, because it would be putting more strain on those organs, and problems in terms of heart disease too, as it's a diet very low in fruits and vegetables. Also, it's very low in fibre, so in terms of digestive health, it's not in keeping with our fibre and complex carbohydrate recommendations."
Belinda Linden, head of medical information at the British Heart Foundation, holds similar views. "The new studies do not indicate a dramatic weight loss for excessively obese people," she said. "Previous studies have shown that weight loss from the Atkins Diet may involve muscle loss rather than body fat. Another potential problem is that it is so far unclear from studies whether weight loss is sustained over a longer period than six months. One of the studies shows no significant difference at 12 months."
She added that, "With minimal fruit and vegetables included in the diet, it holds serious implications for coronary heart disease and cancer. Diets need to be varied to protect against these conditions - and this one isn't. This diet requires further long term and larger studies before its effectiveness can be confirmed."
What does this mean to me?
"My general feeling about the Atkins diet is that, like anything that severely restricts your calories, you'll lose weight. In the short term, if you want to do it for two weeks and lose weight, it probably won't do you any harm," said Dr. Paula Franklin, from Bupa Lighten Up.
However, she warned, "What you need to do in order to be healthy in the long term is to ensure your body has all the nutrients it needs. So, a long-term diet that doesn't include many fruit and vegetables (ie the Atkins) wouldn't be good."
"If you want to be a healthy weight in the long term, the best approach is really lifestyle change," said Dr. Paula Franklin. Fad diets lure people with a quick fix cure, but, says Dr Franklin, "there's no magic with weight loss, and unless you change both what you eat and what you do, you'll put weight back on again."
Summary
The Atkins diet is a very different approach to the recommended weight loss methods and the general consensus is that it's important more research is done into the long-term health effects, as at the moment they're currently unknown.
What were the headlines?
Coverage of the two studies appeared in a range of publications. Headlines included "The fat and the thin of it", "Atkins diet is more effective and healthier than rival regimes", "High-fat diet confounds experts", "Controversial dietary plan proves healthier than expected", and "Atkins diet 'is beneficial and twice as effective as rivals'".
Most reports took the stance that together the studies prove the validity and safety of the high-protein diet, but although this may seem the case at first glance, a closer look at the research uncovers a different, and mostly unreported, story.
What is the bigger picture?
Both studies were published in the New England Journal of Medicine (NEJM). The first was conducted by the Philadelphia Veterans Affairs Medical Center, where 132 severely obese patients were randomly put on either a low-carbohydrate diet, or a low-fat diet, for six months. The Atkins dieters limited their carbohydrate intake to 30g a day and received counselling on healthy types of fat, such as omega-3 fatty acids. The low-fat dieters were put on a calorie-controlled diet, with no more than 30 per cent of total calorific intake from fat.
Only 79 people managed to complete the six-month trial. Low-carbohydrate dieters lost an average of 13 pounds, compared to four pounds for low-fat dieters. No significant changes in cholesterol or blood pressure levels were noted in either group, but the low-carbohydrate consumers did reduce their levels of triglycerides (blood fats) by an average of 20 per cent, compared to only 4 per cent in the other group.
"This study demonstrates that a low-carbohydrate diet can have beneficial effects in treating obesity," said senior investigator, Dr. Samuel Klein. "Additional research is needed to understand why subjects assigned to a low-carbohydrate diet lose more weight than those assigned to a conventional diet and to evaluate the long-term efficacy and safety of low-carbohydrate diet therapy."
The second study was carried out over one year, led by researchers at the University of Pennsylvania School of Medicine. Only 63 obese men and women took part, and were either assigned to a low-fat diet or the Atkins approach. All the participants met with a registered dietician at the start and then at three, six and 12 months into the programme.
They discovered that at three months Atkins dieters had lost an average of 14.7 pounds, compared with 5.8 pounds; at six months the losses were 15.2 pounds and 6.9 pounds respectively, and at one year they'd lost an average of 9.5 and 5.4 pounds. At one year, Atkins participants had greater increases in HDL cholesterol (18 per cent, compared with 3 per cent) and greater reduction in triglycerides. There was no change in either group in levels of bad (LDL) cholesterol.
"These preliminary data suggest that weight losses will be comparable to conventional approaches over a one-year period, but there may be more favourable effects of a low-carbohydrate approach in term of triglycerides and HDL (good) cholesterol," said Dr. Gary Foster, one of the researchers.
Although on the surface both studies appeared to show benefits from the Atkins diet, delving deeper into the details reveals a number of negative points. Most notably:
* Both studies were very small.
* Both used obese, or severely obese, participants, which isn't representative of the average UK dieter.
* There was a high drop-out rate, suggesting that people found the Atkins diet hard to stick to.
* They didn't address the harmful effect the diet could have on the kidneys.
* The difference between the weight losses at the end of the studies wasn't really that different.
Dr. Amy Joy Lanou, director of the Physicians Committee for Responsible Medicine in America, was quick to point out health dangers of the Atkins diet. "A Harvard study published earlier this year in the Annals of Internal Medicine showed that high-protein diets may cause permanent loss of kidney function in anyone with reduced kidney function. Other studies have shown that meat-heavy diets significantly increase one's risk of colon cancer and osteoporosis," she said.
Dr. Foster acknowledged the potential problems and said they're planning a longer five-year study. "This larger study of 360 participants will help us more fully assess the benefits and risks of low-carbohydrate diets on bone mass, kidney function, arterial function and exercise tolerance," he said.
What does this mean?
Brigid McKevith, a nutrition scientist at the British Nutrition Foundation (BNF), said, "We welcome the fact that the Atkins diet is being studied scientifically and that randomised controlled studies have been carried out, because it's very popular with the public."
However, she expressed concern at the small number of people studied and the high drop-out rate, as well as a number of key safety questions that are still left unanswered. "There are several potential problems with the Atkins diet. These include long term bone health, as with a very high protein intake the excretions of calcium increase, so there could be implications for the health of bones," she explained.
"There could be difficulties for people who have an underlying problem with their kidneys or liver, because it would be putting more strain on those organs, and problems in terms of heart disease too, as it's a diet very low in fruits and vegetables. Also, it's very low in fibre, so in terms of digestive health, it's not in keeping with our fibre and complex carbohydrate recommendations."
Belinda Linden, head of medical information at the British Heart Foundation, holds similar views. "The new studies do not indicate a dramatic weight loss for excessively obese people," she said. "Previous studies have shown that weight loss from the Atkins Diet may involve muscle loss rather than body fat. Another potential problem is that it is so far unclear from studies whether weight loss is sustained over a longer period than six months. One of the studies shows no significant difference at 12 months."
She added that, "With minimal fruit and vegetables included in the diet, it holds serious implications for coronary heart disease and cancer. Diets need to be varied to protect against these conditions - and this one isn't. This diet requires further long term and larger studies before its effectiveness can be confirmed."
What does this mean to me?
"My general feeling about the Atkins diet is that, like anything that severely restricts your calories, you'll lose weight. In the short term, if you want to do it for two weeks and lose weight, it probably won't do you any harm," said Dr. Paula Franklin, from Bupa Lighten Up.
However, she warned, "What you need to do in order to be healthy in the long term is to ensure your body has all the nutrients it needs. So, a long-term diet that doesn't include many fruit and vegetables (ie the Atkins) wouldn't be good."
"If you want to be a healthy weight in the long term, the best approach is really lifestyle change," said Dr. Paula Franklin. Fad diets lure people with a quick fix cure, but, says Dr Franklin, "there's no magic with weight loss, and unless you change both what you eat and what you do, you'll put weight back on again."
Summary
The Atkins diet is a very different approach to the recommended weight loss methods and the general consensus is that it's important more research is done into the long-term health effects, as at the moment they're currently unknown.
Jumat, 12 Juni 2009
How to lose weight the healthy way
Reviewed by John Pillinger, GP
The healthiest way to lose weight is neither crash diets nor bursts of exercise. The body likes slow changes in terms of food and exercise.
For example, someone who has not exercised for years should not rush into running miles a day or pounding the treadmill. Not only will the struggle to do so leave you feeling disheartened and demotivated, you're also far more likely to injure yourself and set your fitness levels back further.
The same goes for people who suddenly start starving themselves. Diets that severely restrict calories or the types of food 'allowed' can lead you to be deficient in the nutrients and vitamins that your body needs.
So if you need to lose weight, what should you do?
Energy needs and weight loss
Your body uses food for energy. It stores any excess energy as fat. This means if you eat more food than your body needs for daily activities and cell maintenance, you will gain weight.
To lose weight, you need to get your body to use up these stores of fat. The most effective way to do this is to:
* reduce the amount of calories you eat
* increase your levels of activity.
This is why experts talk about weight loss in terms of diet and exercise.
Introduce changes gradually
Small changes can make a big difference. One extra biscuit a week can lead you to gain 5lb a year – cut that biscuit out of your diet and you'll lose the same amount.
You are also more likely to stick to, say, swapping full-fat milk for semi-skimmed or making time for breakfast each morning than a diet that sets rules for all foods.
You should think of weight loss in terms of permanently changing your eating habits. While weight-loss goals are usually set in term of weeks, the end game is to sustain these changes over months and years.
Increase your activity levels
Someone who increases the amount they exercise, but maintains the same diet and calorie intake, will almost certainly lose weight.
No matter if you hate gyms - even light exercise such as a short 20 minute walk will be beneficial if done most days of the week.
Every single time you exercise more than usual, you burn calories and fat.
There are lots of ways to increase the amount of activity you do. Team sports, racket sports, aerobics classes, running, walking, swimming and cycling will all improve your fitness levels.
Find something you enjoy that's easy for you to do in terms of location and cost. You are then more likely to build it into your routine and continue to exercise, despite inevitably missing the odd session through holidays, family commitments, etc.
* Get out and about at the weekend. Leave your car on the drive and walk to the shops. Try to incorporate longer walks into outings to the park, coast or countryside and take a picnic so you are in control of what you are going to eat that day.
* Every extra step you take helps. Always use the stairs instead of the lift, or get off the bus a stop before the usual one and walk the rest of the way.
* Use commercial breaks between TV-programmes to stand up and do exercise, or consider using an exercise bicycle in the living room while watching your favourite programme.
Reduce your calorie intake
If you are overweight, you can't continue with your current eating habits.
It's not possible to reduce body fat while eating lots of food, cakes and sweets. This doesn't mean you can never have any treats, but you need to learn how to limit these foods to small quantities - say, for special occasions.
In terms of weight-loss, you can get your body to use up existing stores of fat by eating less and making healthier choices.
This doesn't mean crash diet (anything less than 1500 calories), which usually ends up with you either getting weaker or giving up in desperation. Quick-fix diets can lead to a yo-yoing effect of drastic weight loss followed by weight gain, resulting in a vicious cycle.
There are no shortcuts to losing weight in a healthy and reasonable way.
Eating 300 to 500 calories less per day should lead to a loss of between one and two pounds per week. This is a realistic target. It may seem slow, but would add up to a weight loss of more than three stone in a year.
Fat contains the most amount of calories out of all the food types (protein, carbohydrates), so a good way to achieve this is to cut down on fatty foods and eat more wholegrain bread, fruit and vegetables.
Below are ways to reduce calorie intake without having to alter your diet significantly.
* Replace fizzy drinks and fruit cordials with water.
* Swap whole milk for semi-skimmed, or semi-skimmed for skimmed.
* Eat less lunch than usual. For example, make your own sandwich and limit the use of margarine/butter and full-fat mayonnaise (store-bought sandwiches often contain both).
* Stop taking sugar in tea and coffee.
* Have smaller portions of the food you enjoy.
* Avoid having a second helping at dinner.
* Cut out unhealthy treats such as confectionary, sugary biscuits and crisps between meals.
* Cut down on beer and alcohol.
All these things will influence your health in a positive way.
Finally, don't be tempted to skip breakfast – or any meal to lose weight. While skipping a meal will reduce your calorie intake for that hour, it will leave you much hungrier later on.
Not only are you likely to overeat to compensate, but you'll often make bad choices to fill the gap: a cereal bar is not as healthy as a bowl of cereal or as filling, leading you to 'need' something extra for lunch.
Irregular eating habits also disrupt your body's metabolism, which makes it harder to lose weight in the first place.
Write down your plan
Once you've decided on what changes you're going to make, write them down. For example:
Week 1
* Exercise: one 20 minute walk every lunch hour.
* Alcohol: none in the week, two small glasses of wine on Friday, Saturday, Sunday.
* Food: no chocolate or biscuits in the week, choose healthy snacks such as fruit, trim all fat from meat, eat no fried or fast food.
Once you start your plan, weigh yourself once a week before breakfast. Keep a record of this weight and see if a pattern develops.
It might take a week or two before you notice any changes, but they will steadily appear. After the first month you will be able to see the results and measure them in terms of looser fitting clothes.
Keeping your motivation up is one of the most difficult aspects of dieting. There will be days when healthy eating goes out the window and there will be weeks where you may not lose any weight – or put a little back on.
This is normal for everyone – dieters or not – so don't let it undo your plans for a slimmer you. You're not doing anything 'wrong', but you may need to look at your plan. Do you need to increase your activity levels? Make a few more changes to your diet? Put more effort into sticking to your current plan?
The other side of this is to make sure you celebrate your goals. While there is joy enough in stepping on the scales and seeing them dip lower, be sure to mark long-term progress with a reward such as new clothes or a night off from housework.
Celebrating is also a way to involve your nearest and dearest – it's up to you whether you want their encouragement in the form of gentle reminders not to eat certain foods, but support from other people can get you through the bumpy patches.
Health benefits of weight loss
Studies show that overweight women who lose between 10lb and 20lb halve their risk of developing diabetes. For men, the risk of heart problems reduces considerably.
Generally, we gain weight as we age. A few pounds over the years are not a problem, but people who gain more than 20lb compared to their weight as an 18-year-old will rapidly increase their risk of health problems due to that extra weight. In particular, women increase their risk of heart attack and double their risk of dying from cancer.
It may seem like these are problems to worry about in the future, but time flies by and tomorrow becomes today. By keeping your weight in the healthy range, you are less likely to be troubled by illnesses in your later years.
The healthiest way to lose weight is neither crash diets nor bursts of exercise. The body likes slow changes in terms of food and exercise.
For example, someone who has not exercised for years should not rush into running miles a day or pounding the treadmill. Not only will the struggle to do so leave you feeling disheartened and demotivated, you're also far more likely to injure yourself and set your fitness levels back further.
The same goes for people who suddenly start starving themselves. Diets that severely restrict calories or the types of food 'allowed' can lead you to be deficient in the nutrients and vitamins that your body needs.
So if you need to lose weight, what should you do?
Energy needs and weight loss
Your body uses food for energy. It stores any excess energy as fat. This means if you eat more food than your body needs for daily activities and cell maintenance, you will gain weight.
To lose weight, you need to get your body to use up these stores of fat. The most effective way to do this is to:
* reduce the amount of calories you eat
* increase your levels of activity.
This is why experts talk about weight loss in terms of diet and exercise.
Introduce changes gradually
Small changes can make a big difference. One extra biscuit a week can lead you to gain 5lb a year – cut that biscuit out of your diet and you'll lose the same amount.
You are also more likely to stick to, say, swapping full-fat milk for semi-skimmed or making time for breakfast each morning than a diet that sets rules for all foods.
You should think of weight loss in terms of permanently changing your eating habits. While weight-loss goals are usually set in term of weeks, the end game is to sustain these changes over months and years.
Increase your activity levels
Someone who increases the amount they exercise, but maintains the same diet and calorie intake, will almost certainly lose weight.
No matter if you hate gyms - even light exercise such as a short 20 minute walk will be beneficial if done most days of the week.
Every single time you exercise more than usual, you burn calories and fat.
There are lots of ways to increase the amount of activity you do. Team sports, racket sports, aerobics classes, running, walking, swimming and cycling will all improve your fitness levels.
Find something you enjoy that's easy for you to do in terms of location and cost. You are then more likely to build it into your routine and continue to exercise, despite inevitably missing the odd session through holidays, family commitments, etc.
* Get out and about at the weekend. Leave your car on the drive and walk to the shops. Try to incorporate longer walks into outings to the park, coast or countryside and take a picnic so you are in control of what you are going to eat that day.
* Every extra step you take helps. Always use the stairs instead of the lift, or get off the bus a stop before the usual one and walk the rest of the way.
* Use commercial breaks between TV-programmes to stand up and do exercise, or consider using an exercise bicycle in the living room while watching your favourite programme.
Reduce your calorie intake
If you are overweight, you can't continue with your current eating habits.
It's not possible to reduce body fat while eating lots of food, cakes and sweets. This doesn't mean you can never have any treats, but you need to learn how to limit these foods to small quantities - say, for special occasions.
In terms of weight-loss, you can get your body to use up existing stores of fat by eating less and making healthier choices.
This doesn't mean crash diet (anything less than 1500 calories), which usually ends up with you either getting weaker or giving up in desperation. Quick-fix diets can lead to a yo-yoing effect of drastic weight loss followed by weight gain, resulting in a vicious cycle.
There are no shortcuts to losing weight in a healthy and reasonable way.
Eating 300 to 500 calories less per day should lead to a loss of between one and two pounds per week. This is a realistic target. It may seem slow, but would add up to a weight loss of more than three stone in a year.
Fat contains the most amount of calories out of all the food types (protein, carbohydrates), so a good way to achieve this is to cut down on fatty foods and eat more wholegrain bread, fruit and vegetables.
Below are ways to reduce calorie intake without having to alter your diet significantly.
* Replace fizzy drinks and fruit cordials with water.
* Swap whole milk for semi-skimmed, or semi-skimmed for skimmed.
* Eat less lunch than usual. For example, make your own sandwich and limit the use of margarine/butter and full-fat mayonnaise (store-bought sandwiches often contain both).
* Stop taking sugar in tea and coffee.
* Have smaller portions of the food you enjoy.
* Avoid having a second helping at dinner.
* Cut out unhealthy treats such as confectionary, sugary biscuits and crisps between meals.
* Cut down on beer and alcohol.
All these things will influence your health in a positive way.
Finally, don't be tempted to skip breakfast – or any meal to lose weight. While skipping a meal will reduce your calorie intake for that hour, it will leave you much hungrier later on.
Not only are you likely to overeat to compensate, but you'll often make bad choices to fill the gap: a cereal bar is not as healthy as a bowl of cereal or as filling, leading you to 'need' something extra for lunch.
Irregular eating habits also disrupt your body's metabolism, which makes it harder to lose weight in the first place.
Write down your plan
Once you've decided on what changes you're going to make, write them down. For example:
Week 1
* Exercise: one 20 minute walk every lunch hour.
* Alcohol: none in the week, two small glasses of wine on Friday, Saturday, Sunday.
* Food: no chocolate or biscuits in the week, choose healthy snacks such as fruit, trim all fat from meat, eat no fried or fast food.
Once you start your plan, weigh yourself once a week before breakfast. Keep a record of this weight and see if a pattern develops.
It might take a week or two before you notice any changes, but they will steadily appear. After the first month you will be able to see the results and measure them in terms of looser fitting clothes.
Keeping your motivation up is one of the most difficult aspects of dieting. There will be days when healthy eating goes out the window and there will be weeks where you may not lose any weight – or put a little back on.
This is normal for everyone – dieters or not – so don't let it undo your plans for a slimmer you. You're not doing anything 'wrong', but you may need to look at your plan. Do you need to increase your activity levels? Make a few more changes to your diet? Put more effort into sticking to your current plan?
The other side of this is to make sure you celebrate your goals. While there is joy enough in stepping on the scales and seeing them dip lower, be sure to mark long-term progress with a reward such as new clothes or a night off from housework.
Celebrating is also a way to involve your nearest and dearest – it's up to you whether you want their encouragement in the form of gentle reminders not to eat certain foods, but support from other people can get you through the bumpy patches.
Health benefits of weight loss
Studies show that overweight women who lose between 10lb and 20lb halve their risk of developing diabetes. For men, the risk of heart problems reduces considerably.
Generally, we gain weight as we age. A few pounds over the years are not a problem, but people who gain more than 20lb compared to their weight as an 18-year-old will rapidly increase their risk of health problems due to that extra weight. In particular, women increase their risk of heart attack and double their risk of dying from cancer.
It may seem like these are problems to worry about in the future, but time flies by and tomorrow becomes today. By keeping your weight in the healthy range, you are less likely to be troubled by illnesses in your later years.
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