Diet Plan

What is the Mayo Clinic Diet ?

the mayo clinic diet

The Mayo Clinic Diet

The Mayo Clinic Diet is a long-term weight management program created by a team of weight-loss experts at Mayo Clinic 1. The Mayo Clinic Diet is designed to help you reshape your lifestyle by adopting healthy new habits and breaking unhealthy old ones. The goal is to make simple, pleasurable changes that will result in a healthy weight that you can maintain for the rest of your life.

The purpose of the Mayo Clinic Diet is to help you lose excess weight and to find a way of eating that you can sustain for a lifetime. It focuses on changing your daily routine by adding and breaking habits that can make a difference in your weight, such as eating more fruits and vegetables, not eating while you watch TV and moving your body for 30 minutes a day.

The Mayo Clinic Diet also stresses key components of behavior change, such as finding your inner motivation to lose weight, setting achievable goals and handling setbacks.

Why you might follow the Mayo Clinic Diet

You might choose to follow the Mayo Clinic Diet because you:

  • Want to follow a diet that has been developed by medical professionals.
  • Enjoy the types and amounts of food featured in the diet, including unlimited vegetables and fruits.
  • Want to learn how to drop unhealthy lifestyle habits and gain healthy ones.
  • Want to improve your health and reduce your health risks by becoming more active and eating the recommended foods.
  • Don’t want to be precise about counting calories or grams of fat or eliminate entire groups of foods.
  • Want a diet you can stick with for life, not a fad or quick fix

Diet details

The Mayo Clinic Diet is the official diet developed by Mayo Clinic, based on research and clinical experience. It focuses on eating healthy foods that taste great and increasing physical activity. It emphasizes that the best way to keep weight off for good is to change your lifestyle and adopt new health habits. This diet can be tailored to your own individual needs and health history — it isn’t a one-size-fits-all approach.

The Mayo Clinic Diet has two main parts:

  1. Lose It ! This two-week phase is designed to jump-start your weight loss, so you may lose up to 6 to 10 pounds (2.7 to 4.5 kilograms) in a safe and healthy way. In this phase, you focus on lifestyle habits that are associated with weight. You learn how to ADD 5 healthy habits, BREAK 5 unhealthy habits and ADOPT another 5 bonus healthy habits. This phase can help you see some quick results — a psychological boost — and start practicing important habits that you’ll carry into the next phase of the diet.
  2. Live It ! This phase is a lifelong approach to diet and health. In this phase, you learn more about food choices, portion sizes, menu planning, physical activity, exercise and sticking to healthy habits. You may continue to see a steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week until you reach your goal weight. This phase can also help you maintain your goal weight permanently.

Follow the Mayo Clinic Healthy Weight Pyramid

The Mayo Clinic Healthy Weight Pyramid is a tool that helps guide you toward eating a balanced, nutritious diet while achieving a healthy weight.

The Mayo Clinic Diet doesn’t require you to be precise about counting calories or grams of fat. Instead, the Mayo Clinic Healthy Weight Pyramid serves as a guide to making smart eating choices. The main message is simple: Eat most of your food from the groups at the base of the pyramid and less from the top — and move more.

Vegetables and fruits, the foundation of the pyramid, should be your focus. These foods are low in energy density. That means you can eat a lot of them because they don’t contain a lot of calories. As you go up the pyramid, the food groups become higher in energy density — they have more calories for their volume. To lose weight, you should limit how many servings of these foods you eat.

The number of servings for each food group is determined by your daily target calorie level. If your target is 1,200 calories, your meal plan should include four or more servings of vegetables, three servings of protein/dairy and three fat servings.mayo clinic diet plan

Note: The Mayo Clinic Healthy Weight Pyramid

The Mayo Clinic Healthy Weight Pyramid is a tool to help you lose weight or maintain your weight. The triangular shape shows you where to focus when selecting healthy foods. Eat more foods from the base of the pyramid and fewer from the top.

Sample menu under the Mayo Clinic Healthy Weight Pyramid

This sample menu for a day follows the Mayo Clinic Healthy Weight Pyramid. The sample shows you how to fit in servings from each category in the pyramid without going over 1,200 calories. You can adjust the menu to suit your own tastes and calorie needs.

Sample menu (1,200 calories) 1
Breakfast
3/4 cup hot whole-grain cereal
1 small banana
Calorie-free beverage
Lunch
Tossed salad (2 cups romaine, 1/4 onion, 1/4 cup mushrooms, 1 medium tomato, 1 hard-boiled egg, 1/2 cup low-fat shredded cheddar cheese)
1 whole-wheat dinner roll
1 1/2 teaspoons butter
1/2 cup cubed pineapple
Calorie-free beverage
Dinner
3 ounces seared scallops in 1 teaspoon olive oil
Garlic mashed cauliflower potatoes
1/2 cup beets
Calorie-free beverage
Snack (any time)
2 plums
8 wheat crackers

 

Nutritional analysis for sample menu
Calories1,178
Total fat34 g
Saturated fat12 g
Monounsaturated fat11 g
Cholesterol256 mg
Sodium1,761 mg
Total carbohydrate157 g
Dietary fiber24 g
Trans fatTrace
Total sugar58 g
Added sugar0 g
Protein61 g

 

Mayo Clinic Healthy Weight Pyramid servings with the sample menu
Vegetables4
Fruits3
Carbohydrates3 1/2
Protein and dairy3
Fats3
Sweets0

Healthy snacking to help fill you up

If you feel hungry while following the Mayo Clinic Healthy Weight Pyramid, reach for more fruits and vegetables to snack on. Just make sure your fruit is either fresh or canned in water or juice — and that you pour off the liquid before eating.

Eat healthy foods and portions

The base of the Mayo Clinic Healthy Weight Pyramid focuses on generous amounts of healthy foods that contain a smaller number of calories in a large volume of food, particularly fruits and vegetables.

This principle involves eating low-energy-dense foods and can help you lose weight by feeling full on fewer calories. Healthy choices in each of the other food groups in moderate amounts make up the rest of the pyramid — including whole-grain carbohydrates, lean sources of protein such as legumes, fish and low-fat dairy, and heart-healthy unsaturated fats.

The Mayo Clinic Diet teaches you how to estimate portion sizes and plan meals. The diet doesn’t require you to eliminate any foods.

Increase your physical activity

The Mayo Clinic Diet provides practical and realistic ideas for including more physical activity and exercise throughout your day — as well as finding a plan that works for you. The diet recommends getting at least 30 minutes of exercise every day and even more exercise for further health benefits and weight loss. The diet also emphasizes moving more throughout the day, such as taking the stairs instead of an elevator.

Typical menu for the Mayo Clinic Diet Plan

The Mayo Clinic Diet provides several calorie levels. Here’s a look at a typical daily meal plan at the 1,200-calorie-a-day level:

  • Breakfast: 1/2 cup cooked oatmeal with 1 cup milk and 2 tablespoons raisins, 1/4 cup mango, calorie-free beverage.
  • Lunch: Quinoa and sweet potato cakes, tossed salad with fat-free dressing, calorie-free beverage.
  • Dinner: 1 pita pizza, 3/4 cup mixed fruit, calorie-free beverage.
  • Snack: 1 cup sliced bell peppers and 2 tablespoons hummus

You can have sweets — as long as you limit them to 75 calories a day. For practicality, consider thinking of your sweets calories over the course of a week. Have low-fat frozen yogurt or dark chocolate on Monday, and then hold off on any more sweets for a few days.

Before you begin The Mayo Clinic Diet, determine your starting point:

  • Record your initial weight. Weigh yourself at a time and in a manner you’ll be able to use consistently, such as right after getting up in the morning.
  • Determine your body mass index. BMI is a better indicator of body fat than is body weight. See the BMI table in the obesity article to determine your BMI. Write it down for future comparison.
  • Measure your waist. Use a flexible tape and measure around your body just above the highest points on your hipbones. Record your result.

You’ll also want to:

  • Consider your health. If you have health issues, such as diabetes, heart disease, shortness of breath or joint disease, are pregnant, or have any questions about your health, see your doctor before beginning this or any weight management program.
  • Assess your readiness. There’s a good time to start losing weight, and there’s a bad time. You don’t want to put off your start date any longer than necessary, but you don’t want to set yourself up for failure either by starting at a time when you’re facing a lot of obstacles.

Results

  • Weight loss

The Mayo Clinic Diet is designed to help you lose up to 6 to 10 pounds (2.7 to 4.5 kilograms) during the initial two-week phase. After that, you transition into the second phase, where you continue to lose 1 to 2 pounds (0.5 to 1 kilogram) a week until you reach your goal weight. By continuing the lifelong habits that you’ve learned, you can then maintain your goal weight for the rest of your life.

Most people can lose weight on almost any diet plan that restricts calories — at least in the short term. The goal of the Mayo Clinic Diet is to help you keep weight off permanently by making smarter food choices, learning how to manage setbacks and changing your lifestyle.

  • Other health benefits

In general, losing weight by following a healthy, nutritious diet — such as the Mayo Clinic Diet — can reduce your risk of weight-related health problems, such as diabetes, heart disease, high blood pressure and sleep apnea. If you already have any of these conditions, they may be improved dramatically if you lose weight, regardless of the diet plan you follow.

In addition, the healthy habits and kinds of foods recommended on the Mayo Clinic Diet — including lots of vegetables, fruits, whole grains, nuts, beans, fish and healthy fats — can further reduce your risk of certain health conditions. The Mayo Clinic Diet is meant to be positive, active, sustainable and enjoyable, so you can enjoy a happier, healthier life over the long term.

Risks

The Mayo Clinic Diet is generally safe for most adults. It does encourage unlimited amounts of vegetables and fruits. For most people, eating lots of fruits and vegetables is a good thing. However, if you aren’t used to this, you may experience minor, temporary changes in digestion as your body adjusts to this new way of eating.

Also, the natural sugar in fruit does affect your carbohydrate intake — especially if you eat a lot of fruit. This may temporarily raise your blood sugar or certain blood fats. However, this effect is lessened if you are losing weight. If you have diabetes or any other health conditions or concerns, adjust the Mayo Clinic Diet for your situation. For example, people with diabetes should aim for more vegetables than fruits, if possible. It’s a good idea to snack on vegetables, rather than snacking only on fruit.

  1. Mayo Foundation for Medical Education and Research. Mayo Clinic Healthy Weight Pyramid: A sample menu. http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/healthy-weight-pyramid/art-20045416[][]
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What is the Fast Diet or the 5-2 Fast Diet ?

the 5_2 diet

 

The 5:2 Fast Diet

Fasting has been practiced for millennia, but, only recently, studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism, and bolster cellular protection. In lower fungi, plants, and animals, chronic fasting extends longevity, in part, by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease, and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma, and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions 1.

In humans, fasting is achieved by ingesting no or minimal amounts of food and caloric beverages for periods that typically range from 12 hours to three weeks 1. In many clinics, patients are now monitored by physicians while undergoing water only or very low calorie (less than 200 kcal/day) fasting periods lasting from 1 week or longer for weight management, and for disease prevention and treatment 1. Fasting is distinct from caloric restriction in which the daily caloric intake is reduced chronically by 20–40%, but meal frequency is maintained.

Starvation is instead a chronic nutritional insufficiency that is commonly used as a substitute for the word fasting, particularly in lower eukaryotes (eukaryote is an organism with complex cells, or a single cell with a complex structure. In these cells the genetic material is organized into chromosomes in the cell nucleus. Animals, plants, algae and fungi are all eukaryotes), but that is also used to define extreme forms of fasting, which can result in degeneration and death.

Scientists now know that fasting results in ketogenesis, promotes potent changes in metabolic pathways and cellular processes such as stress resistance, lipolysis and autophagy, and can have medical applications that in some cases are as effective as those of approved drugs such as the dampening of seizures and seizure-associated brain damage and the amelioration of rheumatoid arthritis 2, 3, 4. Findings from well-controlled investigations in experimental animals, and emerging findings from human studies, indicate that different forms of fasting may provide effective strategies to reduce weight, delay aging, and optimize health.

The Fast Diet also known as the 5:2 Fast Diet is a diet created by the BBC journalist, doctor and author of the best-selling 5:2 diet, Dr. Michael Mosley. The 5:2 diet first reached the mainstream via a BBC Horizon documentary called Eat, Fast and Live Longer, broadcast in August 2012. The diet, which Mosley insists he was initially skeptical about, is not the only interesting discovery he has made through his research. Because of his family history of diabetes and his recent diagnosis for the metabolic syndrome, Dr. Mosley, instead of resorting to medication, decided to get drastic with his diet and see whether he could effect any change.

He ended up testing all sorts of different forms of fasting, including alternate-day fasting. Eventually, Dr. Mosley came up with something that he called the 5:2 Diet, where you eat normally five days a week and eat less calories on the other two days, which is really counting calories two days a week and eating normally the other five days. He stuck to that for about three months. During that period, he lost about 20 pounds of fat, his body fat went down from 28 percent to 20 percent, and his blood glucose went back to normal. However the body of evidence about 5:2 diet and intermittent fasting is limited when compared to other types of weight loss techniques.

The basic concept of intermittent fasting, where for two days of the week you restrict your calorie intake to about 2500 kilojoules (598 kcal) a day, giving your body a break from processing food and a period where your blood is not filled with glucose.

There’s exciting research indicating that intermittent fasting can have a very beneficial impact on your brain function, too. It may even hold the key to preventing Alzheimer’s disease. Dr. Mark Mattson, on his research with genetically engineered mice. They’ve been genetically engineered so they will develop Alzheimer’s or dementia around 1 year which equivalent of about 40 years or 50 years in humans. When he put them on a junk diet, a junk food diet, they developed it at about nine months. But when he put them on an intermittent fasting diet – alternate-day fasting diet in fact – they developed it at around two years, which is equivalent to being 90 years of age.

When he looked into their brains, he discovered that the ones who had been on intermittent fasting diet have grown 40 percent new brain cells particularly in the area associated with memory. He identified this thing called brain-derived neurotrophic factor (BNF), which seems to be driving those changes and also protecting the brains. He’s doing this big study in humans at the moment to see if the same thing happens with fasting humans.

Adaptive responses to fasting in humans

In most mammals, the liver serves as the main reservoir of glucose, which is stored in the form of glycogen. In humans, depending upon their level of physical activity, 12 to 24 hours of fasting typically results in a 20% or greater decrease in serum glucose and depletion of the hepatic glycogen, accompanied by a switch to a metabolic mode in which non-hepatic glucose, fat-derived ketone bodies and free fatty acids are used as energy sources (Figures C and ​A). Whereas most tissues can utilize fatty acids for energy, during prolonged periods of fasting, the brain relies on the ketone bodies β-hydroxybutyrate and acetoacetate in addition to glucose for energy consumption (Figure B). Ketone bodies are produced in hepatocytes from the acetyl-CoA generated from β oxidation of fatty acids released into the bloodstream by adipocytes, and also by the conversion of ketogenic amino acids. After hepatic glycogen depletion, ketone bodies, fat-derived glycerol, and amino acids account for the gluconeogenesis-dependent generation of approximately 80 grams/day of glucose, which is mostly utilized by the brain. Depending on body weight and composition, the ketone bodies, free fatty acids and gluconeogenesis allow the majority of human beings to survive 30 or more days in the absence of any food and allow certain species, such as king penguins, to survive for over 5 months without food 5.

In humans, during prolonged fasting, the plasma levels of 3-β-hydroxybutyrate (b-OHB) are about 5 times those of free fatty acids and acetoacetic acid (AcAc) (Figure A and B). The brain and other organs utilize ketone bodies in a process termed ketolysis, in which acetoacetic acid and 3-β-hydroxybutyrate are converted into acetoacetyl-CoA and then acetyl-CoA. These metabolic adaptations to fasting in mammals are reminiscent of those described earlier for E. coli and yeast, in which acetic acid accumulates in response to food deprivation 6, 7. It will be important to understand how the different carbon sources generated during fasting affect cellular protection and aging and to determine whether glycerol, specific ketone bodies or fatty acids can provide nourishment while reducing cellular aging in mammals, a possibility suggested by beneficial effects of a dietary ketone precursor in a mouse model of Alzheimer’s disease 8. It will also be important to study, in various model organisms and humans, how high intake of specific types of fats (medium- vs. long-chain fatty acids, etc.) in substitution of carbohydrates and proteins influences gluconeogenesis and glucose levels as well as aging and diseases.

Figure A: Concentrations of ketone bodies (acetone, β-hydroxybutyric acid, acetoacetic acid (AcAc)) and plasma free fatty acids (FFA) during 40 days of fasting in humans. Note the more than three orders of magnitude change in β-hydroxybutyrate (b-OHB) and the doubling of free fatty acids (FFA) 9.

ketone bodies during fasting in humans

Fasting and the brain

In mammals, severe caloric restriction/food deprivation results in a decrease in the size of most organs except the brain, and the testicles in male mice 10. From an evolutionary perspective this implies that maintenance of a high level of cognitive function under conditions of food scarcity is of preeminent importance. Indeed, a highly conserved behavioral trait of all mammals is to be active when hungry and sedentary when satiated. In rodents, alternating days of normal feeding and fasting (intermittent fasting) can enhance brain function as indicated by improvements in performance on behavioral tests of sensory and motor function 11 and learning and memory 12. The behavioral responses to intermittent fasting are associated with increased synaptic plasticity and increased production of new neurons from neural stem cells 13.

Particularly interesting with regards to adaptive responses of the brain to limited food availability during human evolution is brain-derived neurotrophic factor (BDNF). The genes encoding brain-derived neurotrophic factor (BDNF) and its receptor TrkB appeared in genomes relatively recently as they are present in vertebrates, but absent from worms, flies and lower species 14. The prominent roles of BDNF in the regulation of energy intake and expenditure in mammals is highlighted by the fact that the receptors for both BDNF and insulin are coupled to the highly conserved PI3 kinase – Akt, and MAP kinase signaling pathways. Studies of rats and mice have shown that running wheel exercise and intermittent fasting increase BDNF expression in several regions of the brain, and that brain-derived neurotrophic factor in part mediates exercise- and intermittent fasting-induced enhancement of synaptic plasticity, neurogenesis and neuronal resistance to injury and disease. Brain-derived neurotrophic factor signaling in the brain may also mediate behavioral and metabolic responses to fasting and exercise including regulation of appetite, activity levels, peripheral glucose metabolism and autonomic control of the cardiovascular and gastrointestinal systems 15, 16.

Hunger is an adaptive response to food deprivation that involves sensory, cognitive and neuroendocrine changes which motivate and enable food seeking behaviors. It has been proposed that hunger-related neuronal networks, neuropeptides and hormones play pivotal roles in the beneficial effects of energy restriction on aging and disease susceptibility. As evidence, when mice in which the hypothalamic ‘hunger peptide’ NPY is selectively ablated are maintained on a CR diet, the ability of CR to suppress tumor growth is abolished 17. The latter study further showed that the ability of caloric restriction to elevate circulating adiponectin levels was also compromised in NPY-deficient mice, suggesting a key role for the central hunger response in peripheral endocrine adaptations to energy restriction. Adiponectin levels increase dramatically in response to fasting; and data suggest roles for adiponectin in the beneficial effects of IF on the cardiovascular system 18. The hunger response may also improve immune function during aging as ghrelin-deficient mice exhibit accelerated thymic involution during aging, and treatment of middle age mice with ghrelin increases thymocyte numbers and improves the functional diversity of peripheral T cell subsets 19. In addition to its actions on the hypothalamus and peripheral endocrine cells, fasting may increase neuronal network activity in brain regions involved in cognition, resulting in the production of BDNF, enhanced synaptic plasticity and improved stress tolerance 20. Thus, hunger may be a critical factor involved in widespread central and peripheral adaptive responses to the challenge of food deprivation for extended time periods.

Our current understanding of the impact of intermittent fasting on the nervous system and cognitive functions is largely inferred from animal studies (see above). Interventional studies to determine the impact of fasting on brain function and neurodegenerative disease processes are lacking After 3–4 month, caloric restriction improved cognitive function (verbal memory) in overweight women 21 and in elderly subjects 22. Similarly, when subjects with mild cognitive impairment were maintained for 1 month on a low glycemic diet, they exhibited improved delayed visual memory, cerebrospinal fluid biomarkers of Aβ metabolism and brain bioenergetics 23. Studies in which cognitive function, regional brain volumes, neural network activity, and biochemical analyses of cerebrospinal fluid are measured in human subjects before and during an extended period of intermittent fasting should clarify the impact of intermittent fasting on human brain structure and function.

Figure B: Brain substrate utilization in three fasting obese volunteers after several weeks of food deprivation. Many studies suggest that human brain cells can survive with little to no glucose, but this has not been clearly demonstrated 24.

brain substrate utilization

Figure C: Intermittent Fasting modifies brain neurochemistry and neuronal network activity in ways that optimize brain function and peripheral energy metabolism. Four brain regions that are particularly important in adaptive responses to Intermittent Fasting include the hippocampus (cognitive processing), striatum (control of body movements), hypothalamus (Hyp, control of food intake and body temperature) and brainstem (control of cardiovascular and digestive systems). The brain communicates with all of the peripheral organs involved in energy metabolism. Intermittent Fasting enhances parasympathetic activity (mediated by the neurotransmitter acetylcholine) in the autonomic neurons that innervate the gut, heart and arteries, resulting in improved gut motility and reduced heart rate and blood pressure. By depleting glycogen from liver cells, fasting results in lipolysis and the generation of ketone bodies resulting in a reduction in body fat. Intermittent Fasting enhances insulin sensitivity of muscle and liver cells, and reduces IGF-1 production. Levels of oxidative stress and inflammation are reduced throughout the body and brain in response to Intermittent Fasting 9.

brain response to intermittent fasting

Fasting and Aging

Clinical and epidemiological data are consistent wit h an ability of fasting to retard the aging process and associated diseases 9. Among the major effects of fasting relevant to aging and diseases are changes in the levels of IGF-1, IGFBP1, glucose, and insulin. Fasting for 3 or more days causes a 30% or more decrease in circulating insulin and glucose, as well as rapid decline in the levels of insulin-like growth factor 1 (IGF-1), the major growth factor in mammals, which together with insulin is associated with accelerated aging and cancer 25. In humans, five days of fasting causes an over 60% decrease in IGF-1and a 5-fold or higher increase in one of the principal IGF-1-inhibiting proteins: IGFBP1 26. This effect of fasting on IGF-1 is mostly due to protein restriction and particularly to the restriction of essential amino acids, but is also supported by calorie restriction since the decrease in insulin levels during fasting promotes reduction in IGF-1 26. Notably, in humans, chronic calorie restriction does not lead to a decrease in IGF-1 unless combined with protein restriction 27. Although extreme dietary interventions during old age may continue to protect from age-related diseases, they could have detrimental effects on the immune system and the ability to respond to certain infectious diseases, wounds and other challenges 28, 29.

Fasting and Cancer

Fasting has the potential for applications in both cancer prevention and treatment. Although no human data are available on the effect of intermittent fasting or periodic fasting in cancer prevention, their effect on reducing IGF-1, insulin and glucose levels, and increasing IGFBP1 and ketone body levels could generate a protective environment that reduces DNA damage and carcinogenesis, while at the same time creating hostile conditions for tumor and pre-cancerous cells. In fact, elevated circulating IGF-1 is associated with increased risk of developing certain cancers 30, 31 and individuals with severe IGF-1deficiency caused by growth hormone receptor deficiency, rarely develop cancer 32, 33, 34.

In a preliminary study of 10 subjects with a variety of malignancies, the combination of chemotherapy with fasting resulted in a decrease in a range of self-reported common side effects caused by chemotherapy compared to the same subjects receiving chemotherapy while on a standard diet 35. The effect of fasting on chemotherapy toxicity and cancer progression is now being tested in clinical trials in both Europe and the US.

Fasting, inflammation and hypertension

In humans, one of the best demonstrations of the beneficial effects of long-term fasting lasting one to 3 weeks is in the treatment of rheumatoid arthritis. In agreement with the results in rodents, there is little doubt that during the period of fasting both inflammation and pain are reduced in rheumatoid arthritis patients 4. However, after the normal diet is resumed, inflammation returns unless the fasting period is followed by a vegetarian diet 36, a combination therapy that has beneficial effects lasting for two years or longer 37. The validity of this approach is supported by four differently controlled studies, including two randomized trials 4. Therefore, fasting combined with a vegetarian diet and possibly with other modified diets provides beneficial effects in the treatment of rheumatoid arthritis. Alternate day intermittent fasting also resulted in significant reductions in serum TNFα and ceramides in asthma patients during a 2 month period 38. The latter study further showed that markers of oxidative stress often associated with inflammation (protein and lipid oxidation) were significantly reduced in response to intermittent fasting. Thus, for many patients able and willing to endure long-term fasting and to permanently modify their diet, fasting cycles would have the potential to not only augment but also replace existing medical treatments.

Water only and other forms of long-term fasting have also been documented to have potent effects on hypertension. An average of 13 days of water only fasting resulted in the achievement of a systolic blood pressure (BP) below 120 in 82% of subjects with borderline hypertension with a mean 20 mm Hg reduction in BP 39. BP remained significantly lower compared to baseline even after subjects resumed the normal diet for an average of 6 days 39. A small pilot study of patients with hypertension (140 mm and above systolic BP) also showed that 10–11 days of fasting caused a 37–60 mm decrease in systolic BP 40. These preliminary studies are promising but underscore the need for larger controlled and randomized clinical studies that focus on periodic fasting strategies that are feasible for a larger portion of the population.

Fasting and the metabolic syndrome

Periodic fasting can reverse multiple features of the metabolic syndrome in humans: it enhances insulin sensitivity, stimulates lipolysis and reduces blood pressure. Body fat and blood pressure were reduced and glucose metabolism improved in obese subjects in response to an alternate day modified fast 41, 42. Overweight subjects maintained for 6 months on a twice weekly intermittent fasting diet in which they consumed only 500–600 calories on the fasting days, lost abdominal fat, displayed improved insulin sensitivity and reduced blood pressure 43. Three weeks of alternate day fasting resulted in reductions in body fat and insulin levels in normal weight men and women 44 and Ramadan fasting (2 meals/day separated by approximately 12 hours) in subjects with MS resulted in decreased daily energy intake, decreased plasma glucose levels and increased insulin sensitivity 45. Subjects undergoing coronary angiography who reported that they fasted regularly exhibited a lower prevalence of diabetes compared to non-fasters 46. Anti-metabolic syndrome effects of intermittent fasting were also observed in healthy young men (BMI of 25) after 15 days of alternate day fasting: their whole-body glucose uptake rates increased significantly, levels of plasma ketone bodies and adiponectin were elevated, all of which occurred without a significant decrease in body weight 47. The latter findings are similar to data from animal studies showing that IF can improve glucose metabolism even with little or no weight change 48. It will be important to determine if longer fasting periods which promote a robust switch to a fat breakdown and ketone body-based metabolism, can cause longer lasting and more potent effects.

How does the Fast Diet work ?

On the 5:2 plan, you cut your food down to one-fourth of your normal daily calories on fasting days (about 600 calories for men and about 500 for women), along with plenty of water and tea. On the other five days of the week, you can eat normally.

If we were to distill the Fast Diet into a single sound-bite, it would all come down to 5:2. That’s five days of normal eating, with little thought to calorie control and a slice of pie for pudding if that’s what you want. Then, on the other two days, you reduce your calorie intake to 500 calories for women and 600 calories for men.

  1. Day 1 Normal
  2. Day 2 Normal
  3. Day 3 FASTING (reduce your calorie intake to 500 calories for women and 600 calories for men)
  4. Day 4 Normal
  5. Day 5 FASTING (reduce your calorie intake to 500 calories for women and 600 calories for men)
  6. Day 6 Normal
  7. Day 7 Normal

Since you are only fasting for two days of your choice each week, and eating normally on the other five days, there is always something new and tasty on the near horizon. In short, it’s easy to comply with a regime that only asks you to restrict your calorie intake occasionally. It recalibrates the diet equation, and stacks the odds in your favour.

It is important to note that this is not a permanent eating program and once your insulin resistance improves and you are normal weight, you can start eating more food as you will have reestablished your body’s ability to burn fat for fuel.

One of the arguments for intermittent fasting is that it mimics the way our ancestors ate. They didn’t have access to food 24/7, and underwent alternating intervals of “feast and famine.” The human body is adapted to this, and research shows that abstaining from food now and then actually optimizes biological function all-around.

Perhaps best of all, intermittent fasting is not something you have to do non-stop for the rest of your life. Most who are insulin/leptin resistant would benefit from doing it continuously until the resistance resolves. However, once your weight is ideal and you have no high blood pressure, abnormal cholesterol ratios, or diabetes, then you can have more meals until or unless the insulin/leptin resistance returns.

the 5_2_diet_plan

How many calories on a non-Fast Day ?

You may have wondered how he came up with the recommendation that women have 500 calories and men have 600 calories on a Fast Day. Dr. Mosley used the rule of thumb that women need 2000 calories and men need 2400 calories per day and on a Fast Day you should eat a quarter of a normal day’s recommended calories. Some of you have also wondered exactly how many calories you should be eating on days when you’re not fasting.

Intermittent Fasting Actually curbs Your Hunger

Many are hesitant to try fasting as they fear they’ll be ravenously hungry all the time. But one of the most incredible side effects of intermittent fasting that we’ve found is the disappearance of hunger and sugar cravings.

Dr. Mosley had the same experience once he began fasting. Others have also contacted him saying they’re astonished to realize that hunger no longer dominates their lives; they’re back in control. Now, you get hungry because your body needs fuel. But the vast majority of people in the world, certainly in the developed world, are eating foods that severely inhibit their ability to produce lipase and use fat as an energy source. Lipase is inhibited because of high insulin levels, and your insulin rises in response to eating foods high in carbohydrates.

If you struggle with food cravings, especially sugar, know that once you make this shift to burning fat instead of sugar as your body’s primary fuel, your hunger for unhealthy foods will vanish, and you will not have to exert enormous amounts of self-discipline to resist unhealthy foods any longer. You will be back in control!

What can you eat on the 5:2 Fast Diet

  • High in healthy fats. Many will benefit from 50-85 percent of their daily calories in the form of healthy fat from avocados, organic grass-fed butter, pastured egg yolks, coconut oil, and raw nuts such as macadamia, pecans, and pine nuts.
  • Moderate amounts of high-quality protein from organically raised, grass-fed or pastured animals. Most will likely not need more than 40 to 70 grams of protein per day.
  • Unrestricted amounts of fresh vegetables.

Intermittent Exercise

Dr. Mosley is also a proponent of high intensity interval training (HIIT), and recently finished a new book called Fast Exercise.

  • Sedentary : Little or no exercise. This level is for someone who does not or cannot incorporate exercise into their daily life (eg drives rather than walks, takes the lift rather than the stairs, has a desk job or restricted mobility).
  • Lightly active : Light exercise or sports 1-3 days per week. This level would include people who incorporate walking and activity into their day to day activities but do not have an exercise regime at such or exercise or play sports fewer than three times a week.
  • Moderately active : Moderate exercise or sports 3-5 days per week. This level is for people who exercise or play very active sports at least 30 minutes non-stop at a time at least three times a week, every week. This is the level for people who keep up a good fitness regime that fits into their daily life.
  • Very active : Hard exercise or sports 6-7 days per week. This level would include serious non-professional athletes actively training for, eg, a triathlon that requires near daily hard exercise for at least an hour at a time.
  • Extremely active : Very hard exercise or sports more than once every day and a physical job. This level is for people doing exercise multiple times per day, at least an hour at a time and with the type of physical job that requires top fitness. This level is not common – most non-professional athletes in serious training will be in the “Very active” level at most.

Optimizing your brain function is yet another amazing benefit of applying these two powerful approaches – intermittent fasting and intermittent exercise. You’re actually able to think clearer, get more done, and be far more efficient. It’s a phenomenal side effect of following this type of program.

Health Effects of a Intermittent Fasting Diet

Dietary restriction has been shown in a variety of animal models to have many health benefits. Fasting, in which food isn’t consumed (but water is), represents the extreme form of restriction. Previous studies in animals and people suggested that periodic cycles of fasting may improve certain metabolic and immune functions. Fasting for 2 or more days, like the 5:2 Diet, however, is difficult for many people, and can have adverse health effects.

Here we review the fascinating and potent effects of different forms of fasting including intermittent fasting (including alternate day fasting, or twice weekly fasting, the 5:2 Diet) and periodic fasting lasting several days or longer every 2 or more weeks.

Fasting, the most extreme form of Dietary Restriction, which entails the abstinence from all food but not water, can be applied in a chronic manner as intermittent fasting or periodically as cycles of prolonged fasting lasting 2 or more days 1. In rodents, intermittent fasting promotes protection against diabetes, cancer, heart disease and neuro-degeneration (Longo and Mattson, 2014). In humans, IF and less severe regimens (e.g. consumption of approximately 500 kcal/day for 2 days a week), have beneficial effects on insulin, glucose, C-reactive protein, and blood pressure (Harvie et al., 2011).

A team led by Dr. Valter Longo at the University of Southern California 49 studied diets designed to mimic the beneficial effects of fasting while minimizing the risks and difficulty associated with complete food restriction. The research was funded in part by National Institutes of Health’s National Institute on Aging. Results were published in Cell Metabolism on July 7, 2015 49.

The team first tested cycles of prolonged fasting in yeast, a single-celled organism. Yeast that were switched back and forth from a nutrient-rich environment to water for several cycles had a longer lifespan and were better able to survive toxin exposure—a marker of increased stress resistance—than yeast not exposed to periodic starvation.

The team next tested a very low-calorie, low-protein diet in mice. The diet was designed to mimic some of the beneficial effects of fasting, including improving markers of longevity and metabolism. Middle-aged mice (16 months old) were fed the diet for 4 consecutive days, followed by 10 days of unlimited access to food. The mice overate during these phases so that their overall calorie intake was similar to mice continuously fed a regular diet.

Mice fed the diet twice a month for several months had various metabolic changes, including lower blood glucose and insulin levels, than mice fed a control diet. These metabolic markers all returned to normal levels during periods of re-feeding. Mice fed the diet had less fat around their organs (known as deep or visceral fat) at 28 months of age. They also had greater bone density at old age and increased nerve cell development in the brain. At the end of life, mice on the diet had fewer tumors and skin lesions than control mice.

The team next conducted a pilot study in a small group of people. Nineteen healthy adults consumed a proprietary plant-based diet that provided between 34% and 54% of the normal caloric intake with at least 9–10% protein, 34–47% carbohydrate, and 44–56% fat. Participants consumed the diet 5 days a month for 3 months (3 cycles), resuming their normal diet at the end of each diet period. A control group of 19 adults ate a normal diet.

People on the diet had improvements in blood glucose and decreased body weight compared to the control group. Those with initially elevated C-reactive protein levels (a marker of heart disease risk) had lower levels, while those with normal levels had no change. Reports of side effects were low and included fatigue, weakness, and headache.

“Strict fasting is hard for people to stick to, and it can also be dangerous, so we developed a complex diet that triggers the same effects in the body,” Longo says. “It’s not a typical diet because it isn’t something you need to stay on.”

More research will be needed to determine the long-term impact of the diet on human health and provide information on when and how such a diet might be applied.

Are there any side effects from intermittent fasting ?

Little is known about possible side effects as no systematic attempt has been made to study this issue. Anecdotal reports of effects include:

  • difficulties sleeping
  • bad breath (a known problem with low carbohydrate diets)
  • irritability
  • anxiety
  • dehydration
  • daytime sleepiness

However, more research would be needed to confirm these side effects and their severity.

If you are fasting, you may want to think about how fasting will impact on your life during your fasting days. You are likely to be very hungry and have less energy and this could affect your ability to function (such as at work), in particular it may affect your ability to exercise which is an important part of maintaining a healthy weight.

Also, intermittent fasting may not be suitable for pregnant women and people with specific health conditions, such as diabetes, or a history of eating disorders.

Because it is a fairly radical approach to weight loss, if you are considering trying IF for yourself, it is wise to speak to your GP first to see if it is safe to do so.

Summary

Based on the existing evidence from animal and human studies described, there is great potential for lifestyles that incorporate periodic fasting (Intermittent Fasting) during adult life to promote optimal health and reduce the risk of many chronic diseases, particularly for those who are overweight and sedentary. Fasting periods lasting longer than 24 hours and particularly those lasting 3 or more days should be done under the supervision of a physician and preferably in a clinic.

Despite 5:2 diet increasing popularity, there is a great deal of uncertainty about the 5:2 diet with significant gaps in the evidence.

For example, it is unclear:

  • What pattern of intermittent fasting is the most effective in improving health outcomes – 5:2, alternative day fasting, or something else entirely different
  • What is the optimal calorie consumption during the fasting days – the 5:2 diet recommends 500 calories for women and 600 for men, but these recommendations seem arbitrary without clear evidence to support them.
  • How sustainable is intermittent fasting in the long-term – would most people be willing to stick with the plan for the rest of their lives ?
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  27. Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans. Fontana L, Weiss EP, Villareal DT, Klein S, Holloszy JO. Aging Cell. 2008 Oct; 7(5):681-7. https://www.ncbi.nlm.nih.gov/pubmed/18843793/[]
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  30. Insulin-like growth factor I (IGF-I), IGF-binding protein-3 and prostate cancer risk: epidemiological studies. Chan JM, Stampfer MJ, Giovannucci E, Ma J, Pollak M. Growth Horm IGF Res. 2000 Apr; 10 Suppl A:S32-3. https://www.ncbi.nlm.nih.gov/pubmed/10984284/[]
  31. Insulin-like growth factor I (IGF-I), IGF-binding protein-3 and the risk of colorectal adenoma and cancer in the Nurses’ Health Study. Giovannucci E, Pollak M, Platz EA, Willett WC, Stampfer MJ, Majeed N, Colditz GA, Speizer FE, Hankinson SE. Growth Horm IGF Res. 2000 Apr; 10 Suppl A():S30-1. https://www.ncbi.nlm.nih.gov/pubmed/10984283/[]
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What is the Grapefruit Diet and Does It Work For Weight Loss ?

grapefruit juice diet

Grapefruit

The Grapefruit Diet

Grapefruit is a citrus fruit. Grapefruit is a source of vitamin C, fiber, potassium, pectin, and other nutrients. Some components might have antioxidant effects that might help protect cells from damage or reduce cholesterol. It was found that red grapefruit has a higher content of bioactive compounds and a higher antioxidant potential than blond grapefruit.

People use the fruit, oil from the peel, and extracts from the seed as medicine. Grapefruit seed extract is processed from grapefruit seeds and pulp obtained as a byproduct from grapefruit juice production. Vegetable glycerin is added to the final product to reduce acidity and bitterness.

Grapefruit juice is used for high cholesterol, “hardening of the arteries” (atherosclerosis), cancer, a skin disease called psoriasis, and for weight loss and obesity. Diet supplemented with fresh red grapefruit positively influences serum lipid levels of all fractions, especially serum triglycerides and also serum antioxidant activity. The addition of fresh red grapefruit to generally accepted diets could be beneficial for hyperlipidemic, especially hypertriglyceridemic, patients suffering from coronary atherosclerosis.

In an study involving 72 hypercholesterolemic patients, ages 43-71 years who have had a coronary bypass surgery were divided into 3 groups. Groups 1 and 2, were given 100 ml and 200 ml fresh grapefruit juice, whilst group 3 was the control. After 30 consecutive days of fresh grapefruit juice supplemented diets, improvements in serum lipids levels were found in Group 1 and Group 2 versus control group (no changes in the CG were found). The researchers concluded that Diet supplemented with this juice positively influences serum lipid, albumin, and fibrinogen levels and their antioxidant capacities. Addition of fresh grapefruit juice to generally accepted diets may be beneficial for hypercholesterolemic patients 1. What is lacking from this study was the unknown substances in the grapefruit that affect the cholesterol and the antioxidants.

Grapefruit seed extract is taken by mouth for bacterial, viral, and fungal infections including yeast infections.

Grapefruit oil is applied to the skin for muscle fatigue, hair growth, toning the skin, and for acne and oily skin. It is also used for the common cold and flu (influenza). It is not clear how the oil might work for medicinal uses.

Table 1. Nutritional Value of Grapefruit

[Source: United States Department of Agriculture, Agriculture Research Service. USDA Food Composition Databases. 2]

Grapefruit and Weight Loss

The grapefruit diet has outlasted most fad diets. People were even trying it back in the 1930s. Its fans claim that grapefruit contains certain enzymes that, when eaten before other foods, help burn off fat. However, more evidence is needed to rate the effectiveness of eating fresh grapefruit daily increases weight loss in overweight people.

Grapefruit doesn’t burn fat and if you’re hoping that grapefruit will melt fat, you’re going to be disappointed. Remember the cabbage soup diet ? The detox diet ? How about the Hollywood 48 Hour Miracle diet, the Subway diet, the apple cider vinegar diet, the HCG diet and a host of forgettable celebrity diets ?

The truth is, almost any diet will work if it helps you take in fewer calories. Diets do this in four main ways:

  1. Getting you to eat certain “good” foods and/or avoid “bad” ones.
  2. Cutting calories. Swapping high-calorie foods for lower calorie alternatives and reducing portion sizes.
  3. Changing how you behave and the ways you think or feel about food.
  4. Getting to become physically active. Every weight-loss program should include physical activity. Exercise plus calorie restriction can help give your weight loss a boost. Exercise also offers numerous health benefits, including improving your mood, strengthening your cardiovascular system and reducing your risk of heart disease and type 2 diabetes. And exercise is an important factor in maintaining weight loss. People who get regular physical activity may be more likely to maintain their weight loss.

The best diet for losing weight is one that is good for all parts of your body, from your brain to your gut and not just for your waistline and wallet. It is also one you can live with for a long time. In other words, a diet that offers plenty of good tasting and healthy choices, banishes few foods, and doesn’t require an extensive and expensive list of groceries or supplements.

Successful weight loss requires permanent changes to your eating habits and physical activity. This means you need to find a weight-loss approach that you can embrace for life. Even then, you’ll likely always have to remain vigilant about your weight. But combining a healthier diet with more activity is the best way to lose weight and keep it off for the long term.

The classic version of the grapefruit diet meal plan involves:

  • Most versions of the grapefruit diet recommend eating it with every meal.
  • Cutting back on sugar and carbs (including rice, potatoes, and pasta)
  • Avoiding certain foods, such as celery and white onion
  • Eating more of foods that are high in protein, fat, and/or cholesterol (such as eggs, pork, and red meat)
  • Eating grapefruit or grapefruit juice before or with every meal
  • Most variations also cut calories, some to as low as 800 calories per day.
  • On the diet, you also drink 8 glasses of water and 1 cup of coffee daily.

Don’t bother with this diet. Such a limited variety of foods in small portions is the prescription for boredom. It’s exactly the formula to cause most dieters to give up trying to lose weight.

Grapefruit can be part of a healthy weight loss diet because it’s nutritious, not because of any mysterious fat-burning properties. If you’re a grapefruit lover, reap the benefits of this super-nutritious fruit by enjoying a serving before meals. A half grapefruit or a glass of grapefruit juice before meals may help fill you up, so you’ll eat fewer calories at meals and potentially lose weight.

Grapefruit juice and certain Medicines May Not Mix

Grapefruit and grapefruit juice are healthful, providing enough vitamin C, potassium, dietary fiber, and other nutrients to earn the American Heart Association’s “heart-check” mark. That’s the good news. The bad news is that grapefruit juice can interact with dozens of medications, sometimes dangerously.

Grapefruit juice and fresh grapefruit can interfere with the action of some prescription drugs, as well as a few non-prescription drugs. This interaction can be dangerous according to the Food and Drug Administration’s Office of Clinical Pharmacology 3. With most drugs that interact with grapefruit juice, the grapefruit juice increases the absorption of the drug into the bloodstream. When there is a higher concentration of a drug, you tend to have more adverse events.

Many drugs are broken down (metabolized) with the help of a vital enzyme called CYP3A4 in the small intestine 3. Certain substances in grapefruit juice block the action of CYP3A4, so instead of being metabolized, more of the drug enters the bloodstream and stays in the body longer. The result: potentially dangerous levels of the drug in your body 3.

The amount of the CYP3A4 enzyme in the intestine varies from one person to another. Some people have a lot, and others have just a little—so grapefruit juice may affect people differently when they take the same drug.

While scientists have known for several decades that grapefruit juice can cause a potentially toxic level of certain drugs in the body, more recent studies have found that the grapefruit juice has the opposite effect on a few other drugs.

Drinking grapefruit juice several hours before or several hours after you take your medicine may still be dangerous, so it’s best to avoid or limit consuming grapefruit juice or fresh grapefruit when taking certain drugs 3.

Examples of some types of drugs that grapefruit juice can interact with are:

  • some statin drugs to lower cholesterol, such as Zocor (simvastatin), Lipitor (atorvastatin) and Pravachol (pravastatin)
  • some blood pressure-lowering drugs, such as Nifediac and Afeditab (both nifedipine)
  • some organ transplant rejection drugs, such as Sandimmune and Neoral (both cyclosporine)
  • some anti-anxiety drugs, such as BuSpar (buspirone)
  • some anti-arrhythmia drugs, such as Cordarone and Nexterone (both amiodarone)
  • some antihistamines, such as Allegra (fexofenadine)

Grapefruit juice does not affect all the drugs in the categories above. Ask your pharmacist or other health care professional to find out if your specific drug is affected.

There is a well-characterized interaction between grapefruit juice and certain statins (drugs that can lower blood cholesterol). This interaction leads to the effective dose of a statin being increased, with resulting benefits in reducing LDL cholesterol and coronary heart disease. The risk of rhabdomyolysis (side effects of statin drugs causing the breakdown of muscle cells)  is much less in comparison, and overall, there is no need to advise people on statins to avoid drinking grapefruit juice 4.

Eating whole fruits linked to lower risk of type 2 diabetes

Eating more whole fruits, particularly blueberries, grapes, and apples, was significantly associated with a lower risk of type 2 diabetes, according to a new study led by Harvard School of Public Health researchers 5. Greater consumption of fruit juices was associated with a higher risk of type 2 diabetes. The study is the first to look at the effects of individual fruits on diabetes risk.

The researchers’ findings provided a novel evidence suggesting that certain fruits (blueberries, grapes, and apples) may be especially beneficial for lowering diabetes risk.

The researchers examined data gathered between 1984 and 2008 from 187,382 participants in three long-running studies (Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-up Study). Participants who reported a diagnosis of diabetes, cardiovascular disease, or cancer at enrollment were excluded. Results showed that 12,198 participants (6.5%) developed diabetes during the study period.

The researchers looked at overall fruit consumption, as well as consumption of individual fruits: grapes or raisins; peaches, plums, or apricots; prunes; bananas; cantaloupe; apples or pears; oranges; grapefruit; strawberries; and blueberries. They also looked at consumption of apple, orange, grapefruit, and “other” fruit juices.

People who ate at least two servings each week of certain whole fruits — particularly blueberries, grapes, and apples — reduced their risk for type 2 diabetes by as much as 23% in comparison to those who ate less than one serving per month. Conversely, those who consumed one or more servings of fruit juice each day increased their risk of developing type 2 diabetes by as much as 21%. The researchers found that swapping three servings of juice per week for whole fruits would result in a 7% reduction in diabetes risk.

The fruits’ glycemic index (a measure of how rapidly carbohydrates in a food boost blood sugar) did not prove to be a significant factor in determining a fruit’s association with type 2 diabetes risk. However, the high glycemic index of fruit juice — which passes through the digestive system more rapidly than fiber-rich fruit — may explain the positive link between juice consumption and increased diabetes risk.

The researchers theorize that the beneficial effects of certain individual fruits could be the result of a particular component. Previous studies have linked anthocyanins found in berries and grapes to lowered heart attack risk, for example. But more research is necessary to determine which components in the more beneficial fruits influence diabetes risk.

The researchers further endorsed current recommendations on increasing whole fruits consumption, but not fruit juice, as a measure for diabetes prevention 5.

Grapefruit and Vitamin C

Grapefruit juice can be part of a healthful diet—most of the time. It has vitamin C and potassium—substances your body needs to work properly. Vitamin C, also known as L-ascorbic acid or ascorbate, is a water-soluble vitamin that is naturally present in some foods, added to others, and available as a dietary supplement. Vitamin C is synthesized from D-glucose or D-galactose by many plants and animals. However, humans lack the enzyme L-gulonolactone oxidase required for ascorbic acid synthesis and must obtain vitamin C through food or supplements 6, 7. In the body, it acts as an antioxidant, helping to protect cells from the damage caused by free radicals. Free radicals are compounds formed when our bodies convert the food we eat into energy. People are also exposed to free radicals in the environment from cigarette smoke, air pollution, and ultraviolet light from the sun.

Vitamin C plays a role in collagen, carnitine, hormone, and amino acid formation. It is essential for wound healing and facilitates recovery from burns. Vitamin C is also an antioxidant, supports immune function, and facilitates the absorption of iron 8. High-Dose vitamin C, when taken by intravenous (IV) infusion, vitamin C can reach much higher levels in the blood than when it is taken by mouth. Studies suggest that these higher levels of vitamin C may cause the death of cancer cells in the laboratory. Surveys of healthcare practitioners at United States complementary and alternative medicine conferences in recent years have shown that high-dose IV vitamin C is frequently given to patients as a treatment for infections, fatigue, and cancers, including breast cancer 9.

Vitamin C is required for the biosynthesis of collagen, L-carnitine, and certain neurotransmitters; vitamin C is also involved in protein metabolism 7, 10. Collagen is an essential component of connective tissue, which plays a vital role in wound healing. Vitamin C is also an important physiological antioxidant 11 and has been shown to regenerate other antioxidants within the body, including alpha-tocopherol (vitamin E) 12. Ongoing research is examining whether vitamin C, by limiting the damaging effects of free radicals through its antioxidant activity, might help prevent or delay the development of certain cancers, cardiovascular disease, and other diseases in which oxidative stress plays a causal role. In addition to its biosynthetic and antioxidant functions, vitamin C plays an important role in immune function 12 and improves the absorption of nonheme iron 13, the form of iron present in plant-based foods. Insufficient vitamin C intake causes scurvy, which is characterized by fatigue or lassitude, widespread connective tissue weakness, and capillary fragility 7, 10, 12, 14, 15, 16, 17.

What are some of the Benefits of Vitamin C on Health

Due to its function as an antioxidant and its role in immune function, vitamin C has been promoted as a means to help prevent and/or treat numerous health conditions. Scientists are studying vitamin C to understand how it affects health. Here are several examples of what this research has shown.

Vitamin C and Cancer Prevention

Epidemiologic evidence suggests that people with high intakes of vitamin C from fruits and vegetables might have a lower risk of getting many types of cancer, such as lung, breast, and colon cancer, perhaps, in part, due to their high vitamin C content 7, 10. Vitamin C can limit the formation of carcinogens, such as nitrosamines 10, 18, in vivo; modulate immune response 10, 12; and through its antioxidant function, possibly attenuate oxidative damage that can lead to cancer 7.

Most case-control studies have found an inverse association between dietary vitamin C intake and cancers of the lung, breast, colon or rectum, stomach, oral cavity, larynx or pharynx, and esophagus 10, 12. Plasma concentrations of vitamin C are also lower in people with cancer than controls 10.

However, evidence from prospective cohort studies is inconsistent, possibly due to varying intakes of vitamin C among studies. In a cohort of 82,234 women aged 33–60 years from the Nurses’ Health Study, consumption of an average of 205 mg/day of vitamin C from food (highest quintile of intake) compared with an average of 70 mg/day (lowest quintile of intake) was associated with a 63% lower risk of breast cancer among premenopausal women with a family history of breast cancer 19. Conversely, Kushi and colleagues did not observe a significantly lower risk of breast cancer among postmenopausal women consuming at least 198 mg/day (highest quintile of intake) of vitamin C from food compared with those consuming less than 87 mg/day (lowest quintile of intake) 20. A review by Carr and Frei concluded that in the majority of prospective cohort studies not reporting a significantly lower cancer risk, most participants had relatively high vitamin C intakes, with intakes higher than 86 mg/day in the lowest quintiles 10. Studies reporting significantly lower cancer risk found these associations in individuals with vitamin C intakes of at least 80–110 mg/day, a range associated with close to vitamin C tissue saturation 10, 21, 22.

Evidence from most randomized clinical trials suggests that vitamin C supplementation, usually in combination with other micronutrients, does not affect cancer risk. In the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) study, a randomized, double-blind, placebo-controlled clinical trial,13,017 healthy French adults received antioxidant supplementation with 120 mg ascorbic acid, 30 mg vitamin E, 6 mg beta-carotene, 100 mcg selenium, and 20 mg zinc, or placebo 23. After a median follow-up time of 7.5 years, antioxidant supplementation lowered total cancer incidence in men, but not in women. In addition, baseline antioxidant status was related to cancer risk in men, but not in women 24. Supplements of 500 mg/day vitamin C plus 400 IU vitamin E every other day for a mean follow-up period of 8 years failed to reduce the risk of prostate or total cancer compared with placebo in middle-aged and older men participating in the Physicians’ Health Study II 25. Similar findings were reported in women participating in the Women’s Antioxidant Cardiovascular Study 26. Compared with placebo, supplementation with vitamin C (500 mg/day) for an average of 9.4 years had no significant effect on total cancer incidence or cancer mortality. In a large intervention trial conducted in Linxian, China, daily supplements of vitamin C (120 mg) plus molybdenum (30 mcg) for 5–6 years did not significantly affect the risk of developing esophageal or gastric cancer 27. Moreover, during 10 years of follow-up, this supplementation regimen failed to significantly affect total morbidity or mortality from esophageal, gastric, or other cancers 28. A 2008 review of vitamin C and other antioxidant supplements for the prevention of gastrointestinal cancers found no convincing evidence that vitamin C (or beta-carotene, vitamin A, or vitamin E) prevents gastrointestinal cancers 29. A similar review by Coulter and colleagues found that vitamin C supplementation, in combination with vitamin E, had no significant effect on death risk due to cancer in healthy individuals 30.

At this time, the evidence is inconsistent on whether dietary vitamin C intake affects cancer risk. Results from most clinical trials suggest that modest vitamin C supplementation alone or with other nutrients offers no benefit in the prevention of cancer.

A substantial limitation in interpreting many of these studies is that investigators did not measure vitamin C concentrations before or after supplementation. Plasma and tissue concentrations of vitamin C are tightly controlled in humans. At daily intakes of 100 mg or higher, cells appear to be saturated and at intakes of at least 200 mg, plasma concentrations increase only marginally 10, 31, 21, 20, 27. If subjects’ vitamin C levels were already close to saturation at study entry, supplementation would be expected to have made little or no difference on measured outcomes 21, 32, 33, 34.

Vitamin C and Cancer Treatment

More than fifty years ago, a study suggested that cancer was a disease of changes in connective tissue caused by a lack of vitamin C. In the 1970’s, it was proposed that high-dose ascorbic acid could help build resistance to disease or infection and possibly treat cancer 35.

During the 1970s, studies by Cameron, Campbell, and Pauling suggested that high-dose vitamin C has beneficial effects on quality of life and survival time in patients with terminal cancer 36, 37. However, some subsequent studies—including a randomized, double-blind, placebo-controlled clinical trial by Moertel and colleagues at the Mayo Clinic 38 did not support these findings. In the Moertel study, patients with advanced colorectal cancer who received 10 g/day vitamin C fared no better than those receiving a placebo. The authors of a 2003 review assessing the effects of vitamin C in patients with advanced cancer concluded that vitamin C confers no significant mortality benefit 30.

Emerging research suggests that the route of vitamin C administration (intravenous vs. oral) could explain the conflicting findings 7, 39, 40. Most intervention trials, including the one conducted by Moertel and colleagues, used only oral administration, whereas Cameron and colleagues used a combination of oral and intravenous (IV) administration. Oral administration of vitamin C, even of very large doses, can raise plasma vitamin C concentrations to a maximum of only 220 micromol/L, whereas IV administration can produce plasma concentrations as high as 26,000 micromol/L [46,47]. Concentrations of this magnitude are selectively cytotoxic to tumor cells in vitro 7, 41. Research in mice suggests that pharmacologic doses of IV vitamin C might show promise in treating otherwise difficult-to-treat tumors 42. A high concentration of vitamin C may act as a pro-oxidant and generate hydrogen peroxide that has selective toxicity toward cancer cells 42, 43, 44. Based on these findings and a few case reports of patients with advanced cancers who had remarkably long survival times following administration of high-dose IV vitamin C, some researchers support reassessment of the use of high-dose IV vitamin C as a drug to treat cancer 45, 46, 40, 47, 48. Surveys of healthcare practitioners at United States complementary and alternative medicine conferences in recent years have shown that high-dose IV vitamin C is frequently given to patients as a treatment for infections, fatigue, and cancers, including breast cancer 9.

It is uncertain whether supplemental vitamin C and other antioxidants might interact with chemotherapy and/or radiation 49. Therefore, individuals undergoing these procedures should consult with their oncologist prior to taking vitamin C or other antioxidant supplements, especially in high doses 50, 45.

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  23. Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med 2004;164:2335-42. https://www.ncbi.nlm.nih.gov/pubmed/15557412?dopt=Abstract[]
  24. Galan P, Briançon S, Favier A, Bertrais S, Preziosi P, Faure H, et al. Antioxidant status and risk of cancer in the SU.VI.MAX study: is the effect of supplementation dependent on baseline levels? Br J Nutr 2005;94:125-32. https://www.ncbi.nlm.nih.gov/pubmed/16115341?dopt=Abstract[]
  25. Gaziano JM, Glynn RJ, Christen WG, Kurth T, Belanger C, MacFadyen J, et al. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA 2009;301:52-62. https://www.ncbi.nlm.nih.gov/pubmed/19066368?dopt=Abstract[]
  26. Lin J, Cook NR, Albert C, Zaharris E, Gaziano JM, Van Denburgh M, et al. Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial. J Natl Cancer Inst 2009;101:14-23. https://www.ncbi.nlm.nih.gov/pubmed/19116389%20?dopt=Abstract[]
  27. Taylor PR, Li B, Dawsey SM, Li JY, Yang CS, Guo W, et al. Prevention of esophageal cancer: the nutrition intervention trials in Linxian, China. Linxian Nutrition Intervention Trials Study Group. Cancer Res 1994;54(7 Suppl):2029s-31s. https://www.ncbi.nlm.nih.gov/pubmed/8137333?dopt=Abstract[][]
  28. Qiao YL, Dawsey SM, Kamangar F, Fan JH, Abnet CC, Sun XD, et al. Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian General Population Nutrition Intervention Trial. J Natl Cancer Inst 2009;101:507-18. https://www.ncbi.nlm.nih.gov/pubmed/19318634?dopt=Abstract[]
  29. Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for preventing gastrointestinal cancers. Cochrane Database Syst Rev 2008;(3):CD004183. https://www.ncbi.nlm.nih.gov/pubmed/18677777?dopt=Abstract[]
  30. Coulter I, Hardy M, Shekelle P, Udani J, Spar M, Oda K, et al. Effect of the supplemental use of antioxidants vitamin C, vitamin E, and coenzyme Q10 for the prevention and treatment of cancer. Evidence Report/Technology Assessment Number 75. AHRQ Publication No. 04-E003. Rockville, MD: Agency for Healthcare Research and Quality, 2003. https://www.ncbi.nlm.nih.gov/pubmed/15523748?dopt=Abstract[][]
  31. Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, Wesley RA, Levine M. Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Intern Med 2004;140:533-7. https://www.ncbi.nlm.nih.gov/pubmed/15068981?dopt=Abstract[]
  32. Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. https://www.ncbi.nlm.nih.gov/pubmed/10217058?dopt=Abstract[]
  33. Padayatty SJ, Levine M. Vitamins C and E and the prevention of preeclampsia. N Engl J Med 2006;355:1065. https://www.ncbi.nlm.nih.gov/pubmed/16957157?dopt=Abstract[]
  34. Padayatty SJ, Levine M. Antioxidant supplements and cardiovascular disease in men. JAMA 2009;301:1336. https://www.ncbi.nlm.nih.gov/pubmed/19336705?dopt=Abstract[]
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  37. Cameron E, Pauling L. Supplemental ascorbate in the supportive treatment of cancer: prolongation of survival times in terminal human cancer. Proc Natl Acad Sci U S A 1976;73:3685-9. https://www.ncbi.nlm.nih.gov/pubmed/1068480?dopt=Abstract[]
  38. Moertel CG, Fleming TR, Creagan ET, Rubin J, O’Connell MJ, Ames MM. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have had no prior chemotherapy. A randomized double-blind comparison. N Engl J Med 1985;312:137-41. https://www.ncbi.nlm.nih.gov/pubmed/3880867?dopt=Abstract[]
  39. Bruno EJ Jr, Ziegenfuss TN, Landis J. Vitamin C: research update. Curr Sports Med Rep 2006;5:177-81. https://www.ncbi.nlm.nih.gov/pubmed/16830410?dopt=Abstract[]
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  41. Shekelle P, Morton S, Hardy M. Effect of supplemental antioxidants vitamin C, vitamin E, and coenzyme Q10 for the prevention and treatment of cardiovascular disease. Evidence Report/Technology Assessment No. 83 AHRQ Publication No. 03-E043. Rockville, MD: Agency for Healthcare Research and Quality, 2003. https://www.ncbi.nlm.nih.gov/pubmed/15040141?dopt=Abstract[]
  42. Chen Q, Espey MG, Sun AY, Pooput C, Kirk KL, Krishna MC, et al. Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. Proc Natl Acad Sci U S A 2008;105:11105-9. https://www.ncbi.nlm.nih.gov/pubmed/18678913?dopt=Abstract[][]
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What is the DASH Diet ?

DASH diet eating plan

The DASH Diet

DASH stands for Dietary Approaches to Stop Hypertension is similar to a Mediterranean-type diet 1. It is an eating plan that is based on research studies sponsored by the National Heart, Lung, and Blood Institute 2. The DASH diet eating plan includes vegetables, whole grains, poultry, fish, and nuts, and has low amounts of fats, red meats, sweets, and sugared beverages. It is also high in potassium, calcium and magnesium, as well as protein and fiber. This dietary approach has been shown to lower blood pressure, but little has been published regarding weight loss 1. In fact, a systematic review and meta-analysis on observational prospective studies on the effects of Dietary Approaches to Stop Hypertension (DASH)-style diet, showed that the DASH diet can significantly protect against cardiovascular diseases, coronary heart disease, stroke, and heart failure risk by 20%, 21%, 19% and 29%, respectively 3, 4.

The DASH diet is a lifelong approach to healthy eating that’s designed to help treat or prevent high blood pressure (hypertension). The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium and magnesium and eating foods that are low in saturated fat, total fat, and cholesterol, and high in fruits, vegetables, and low fat dairy foods 5.

DASH Diet plan

The DASH Diet

  • Emphasizes vegetables, fruits, and fat-free or low-fat dairy products.
  • Includes whole grains, fish, poultry, beans, seeds, nuts, and vegetable oils.
  • Limits sodium, sweets, sugary beverages, and red meats. The American Heart Association recommends 1,500 mg a day of sodium as an upper limit for all adults.

One teaspoon of table salt has 2,325 mg of sodium. When you read food labels, you may be surprised at just how much sodium some processed foods contain. Even low-fat soups, canned vegetables, ready-to-eat cereals and sliced turkey from the local deli — foods you may have considered healthy — often have lots of sodium

Along with DASH, other lifestyle changes can help lower your blood pressure. They include staying at a healthy weight, exercising, and not smoking.

Blood pressure is usually measured in millimeters of mercury (mmHg) and is recorded as two numbers—systolic pressure (as the heart beats) “over” diastolic pressure (as the heart relaxes between beats)—for example, 120/80 mmHg. Both numbers in a blood pressure test are important, but for people who are age 50
or older, systolic pressure gives the most accurate diagnosis of high blood pressure. Systolic pressure is the top number in a blood pressure reading. It is high if it is 140 mmHg or above 6.

High blood pressure is blood pressure higher than 140/90 mmHg and prehypertension is blood pressure between 120/80 and 139/89 mmHg. Prehypertension means that you don’t have high blood pressure now, but are likely to develop it in the future unless you adopt the healthy lifestyle. High blood pressure is dangerous because it makes your heart work too hard, hardens the walls of your arteries, and can cause the brain to hemorrhage or the kidneys to function poorly or not at all. If not controlled, high blood pressure can lead to heart and kidney disease, stroke and blindness.

Being overweight or obese increases your risk of developing high blood pressure. In fact, your blood pressure rises as your body weight increases. Losing even 10 pounds can lower your blood pressure and losing weight has the biggest effect on those who are overweight and already have hypertension. Overweight and obesity are also risk factors for heart disease. And being overweight or obese increases your chances of developing high blood cholesterol and diabetes—two
more risk factors for heart disease.

The original DASH trial 7 consisted of 459 subjects with systolic blood pressures <160 mm Hg and diastolic blood pressures between 80 and 95 mm Hg. For three weeks, all participants were fed a control diet low in fruits, vegetables, and dairy products, and with a fat content typical of an American diet (37% of daily caloric intake). During the following eight weeks, the participants were randomized to one of three diets: the control diet, a diet rich in fruits and vegetables, or the DASH Diet.

The DASH Diet was not low in sodium (salt), but still reduced blood pressure. A meta-analysis of 56 randomized, controlled trials that included over 3,500 participants did not support universal sodium restriction, but instead only recommended dietary sodium restriction in the elderly 8.

The DASH Diet reduced systolic blood pressure by 5.5 mm Hg and diastolic blood pressure by 3.3 mm Hg, as compared with controls. Subgroup analysis showed that African Americans and those with hypertension had the greatest reduction in blood pressure 7 . The DASH diet results might be applied to a larger group due to the heterogeneous population: half of the participants were women, 60% were African American, and 37% had household incomes of <$30,000 per year. One limitation of applying the DASH Diet to the general population is that the study was carried out in a very controlled setting, where all the meals were prepared for the subjects, and thus no comments may be made regarding attrition rates for the diet.

By following the DASH diet, you may be able to reduce your blood pressure by a few points in just two weeks. Over time, your systolic blood pressure could drop by eight to 14 points, which can make a significant difference in your health risks.

Table 1. Daily Nutrient Goals Used in the DASH Studies (for a 2,100 Calorie Eating Plan)

Total fat: 27% of caloriesSodium: 2,300 mg*
Saturated fat: 6% of caloriesPotassium: 4,700 mg
Protein: 18% of caloriesCalcium: 1,250 mg
Carbohydrate: 55% of caloriesMagnesium: 500 mg
Cholesterol: 150 mgFiber: 30 g

Footnote: 1,500 mg sodium* was a lower goal tested and found to be even better for  lowering blood pressure. It was particularly effective for middle-aged and older individuals, African Americans, and those who already had high blood pressure.

Abbreviations: g = grams; mg = milligrams

[Source 9 ]

Table 2. Tips for Lowering Salt (Sodium) When Shopping, Cooking, and Eating Out

ShoppingCookingEating Out
  • Read food labels, and choose items that are lower in sodium and salt, particularly for convenience foods and condiments.*
  • Choose fresh poultry, fish, and lean meats instead of cured food such as bacon and ham.
  • Choose fresh or frozen versus canned fruits and vegetables.
  • Avoid food with added salt, such as pickles, pickled vegetables, olives, and sauerkraut.
  • Avoid instant or flavored rice and pasta.
  • Don’t add salt when cooking rice, pasta, and hot cereals.
  • Flavor your foods with salt-free seasoning blends, fresh or dried herbs and spices, or fresh lemon or lime juice.
  • Rinse canned foods or foods soaked in brine before using to remove the sodium.
  • Use less table salt to flavor food.
  • Ask that foods be prepared without added salt or MSG, commonly used in Asian foods.
  • Avoid choosing menu items that have salty ingredients such as bacon, pickles, olives, and cheese.
  • Avoid choosing menu items that include foods that are pickled, cured, smoked, or made with soy sauce or broth.
  • Choose fruit or vegetables as a side dish, instead of chips or fries.

Footnote: *Examples of convenience foods are frozen dinners, prepackaged foods, and soups; examples of condiments are mustard, ketchup, soy sauce, barbecue sauce, and salad dressings.

Most Americans should consume no more than 2.4 grams (2,400 milligrams) of salt (sodium) a day. That equals 6 grams (about 1 teaspoon) of table salt a day. The 6 grams includes all salt and sodium consumed, including that used in cooking and at the table. African Americans and the elderly, are especially sensitive to salt and sodium and should be particularly careful about how much they consume.

Most of the salt (sodium) Americans eat comes from processed and prepared foods, such as breads, cold cuts, pizza, poultry, soups, sandwiches and burgers, cheese, pasta and meat dishes, and salty snacks. Therefore, healthier choices when shopping and eating out are particularly important.

Another DASH diet called DASH-Sodium — calls for cutting back sodium (salt) to 1,500 milligrams a day (about 2/3 teaspoon). Studies of people on the DASH-Sodium plan lowered their blood pressure as well.

To further investigate the effects of sodium restriction, the DASH-Sodium Trial 10 looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume. This second study involved 412 participants. Participants were randomly assigned to one of the two eating plans and then followed for a month at each of the three sodium levels. The three sodium levels were a higher intake of about 3,300 milligrams per day (the level consumed by many Americans), an intermediate intake of about 2,300 milligrams per day, and a lower intake of about 1,200 milligrams per day. Results showed that reducing dietary sodium lowered blood pressure for both eating plans. At each sodium level, blood pressure was lower on the DASH eating plan than on the other eating plan. Additionally, there was no significant difference between high (3,300 milligrams per day) and intermediate sodium (2,300 milligrams per day) intake on diastolic blood pressure for those on the DASH Diet. The greatest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,200 milligrams per day. Those with high blood pressure saw the greatest reductions, but those with prehypertension also had large decreases 10. The DASH Diet can reduce systolic blood pressure by 5.5 mm Hg and diastolic blood pressure by 3.3 mm Hg. However, the effect of sodium reduction on hypertension remains controversial. Lowering sodium to the levels of 1.2 g/day, as achieved in the lowest sodium intake group of the DASH-Sodium Trial, would be nearly impossible without changes in the food industry, as 75% of sodium intake comes from additions made in processing 11.

Detailed analysis showed that the DASH diet and reduced sodium intake reduced blood pressure for all the population subgroups studied. The following list shows the average blood pressure reduction for key subgroups:

  • For those with hypertension: 12/6 mm Hg (systolic/diastolic); for those without hypertension, 7/4 mm Hg.
  • For those over age 45, 12/6 mm Hg; for those 45 or younger, 6/3 mm Hg.
  • For women, 11/5 mm Hg; for men, 7/4 mm Hg.
  • For African Americans, 10/5 mm Hg; for non-African Americans, 8/4 mm Hg.

Other results include:

  • Compared with the typical American diet, the DASH diet alone (at the higher sodium level) reduced blood pressure by about 6/3 mm Hg for African Americans, and 6/2 mm Hg for other races.
  • For those with hypertension, reductions from the DASH diet alone were 7/3 mm Hg; and for those without hypertension, the reductions were 5/3 mm Hg. The effects of sodium reduction appeared in all subgroups and were greater for those who ate the typical American diet, compared with those on the DASH diet.
  • The effects from sodium reduction were particularly great for those with hypertension, African Americans, women, and those over age 45. Sodium reduction in those eating the control diet resulted in lower systolic and diastolic pressures by 8.3 mm Hg and 4.4 mm Hg, respectively, in hypertensives, and 5.4 and 2.8 mm Hg, respectively, in non-hypertensives.

“The blood pressure reductions achieved from this combination came in only 4 weeks and persisted through the duration of the study”, said Dr. Denise Simons-Morton, Leader of the NHLBI Prevention Scientific Research Group and a DASH coauthor 12.

Both versions of the DASH diet include lots of whole grains, fruits, vegetables and low-fat dairy products. The DASH diet also includes some fish, poultry and legumes, and encourages a small amount of nuts and seeds a few times a week.

The DASH diet generally includes about 2,000 calories a day. If you’re trying to lose weight, you may need to eat fewer calories. You may also need to adjust your serving goals based on your individual circumstances — something your health care team can help you decide.

Studies showed that DASH lowers high blood pressure and improves levels of cholesterol. This reduces your risk of getting heart disease.

Because the DASH diet is a healthy way of eating, it offers health benefits besides just lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke and diabetes.

While the DASH diet is not a weight-loss program, you may indeed lose unwanted pounds because it can help guide you toward healthier food choices. A recent study showed that people can lose weight while following the DASH eating plan and lowering their sodium intake. In a randomized trial of 810 participants called the PREMIER Study 13, 14, who were placed into three groups to lower blood pressure, lose weight, and improve health. The groups included:

  1. Advice-only group received a 30-minute individual session with a nutritionist, which did not include counseling on how to make behavior changes.
  2. Established treatment plan, including counseling for 6 months to keep track of their diet, including calorie and sodium consumption, and their physical activity.
  3. Established treatment plan, plus counseling and use of the DASH diet.

After 6 months, blood pressure levels declined in all three groups. The two groups that received counseling and followed a treatment plan had more weight loss than the advice-only group. However, participants in the established treatment plan who followed the DASH diet had the greatest improvement in their blood pressure 13, 14.

By paying close attention to food labels when you shop, you can consume less sodium. Sodium is found naturally in many foods. But processed foods account for most of the salt and sodium that Americans consume. Processed foods that are high in salt include regular canned vegetables and soups, frozen dinners, lunch meats, instant and ready-to-eat cereals, and salty chips and other snacks.

Food labels sodium content
Food labels sodium content: The frozen peas. The canned peas have three times more sodium than the frozen peas.

You can eat red meat, sweets and fats in small amounts. The DASH diet is low in saturated fat, cholesterol and total fat.

Because the DASH diet is a healthy way of eating, it offers health benefits besides just lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke and diabetes.

Increasing Daily Potassium

The DASH diet eating plan is designed to be rich in potassium, with a target of 4,700 mg potassium daily, to enhance the effects of reducing sodium on blood pressure. The following are examples of potassium-rich foods.

Table 3. Sample Foods and Potassium Levels

Food GroupsPotassium (mg)
Vegetables
Potato, 1 medium926
Sweet Potato, 1 medium540
Spinach, cooked, 1/2 cup290
Zucchini, cooked, 1/2 cup280
Tomato, fresh, 1/2 cup210
Kale, cooked, 1/2 cup150
Romaine lettuce, 1 cup140
Mushrooms, 1/2 cup110
Cucumber, 1/2 cup80
Fruit
Banana, 1 medium420
Apricots, 1/4 cup380
Orange, 1 medium237
Cantaloupe chunks, 1/2 cup214
Apple, 1 medium150
Nuts, seeds, and legumes
Cooked soybeans, 1/2 cup440
Cooked lentils, 1/2 cup370
Cooked kidney beans, 1/2 cup360
Cooked split peas, 1/2 cup360
Almonds, roasted, 1/3 cup310
Walnuts, roasted, 1/3 cup190
Sunflower seeds, roasted, 2 Tbsp124
Peanuts, roasted, 1/3 cup120
Low-fat or fat-free milk and milk products
Milk, 1 cup380
Yogurt, 1 cup370
Lean meats, fish, and poultry
Fish (cod, halibut, rockfish, trout, tuna), 3 oz200-400
Pork tenderloin, 3 oz370
Beef tenderloin, chicken, turkey, 3 oz210

Footnotes: Before you increase the potassium in your diet or use salt substitutes (which often contain potassium), check with your doctor. People who have kidney problems or who take certain medicines must be careful about how much potassium they consume.

[Source 15 ]

Health Benefits of DASH Diet

  • Following the DASH diet will provide all the nutrients you need.
  • It is safe for both adults and children.
  • The diet is flexible enough to follow if you are vegetarian, vegan, or gluten-free.
  • It is low in fat and high in fiber, an eating style that is recommended for everyone.

The DASH diet sets the standard for a healthy diet. It has been widely studied and has many health benefits. Following this diet plan may help:

  • Lower high blood pressure 16
  • Reduce the risk for heart disease, heart failure, and stroke 3, 4
  • Help prevent or control type 2 diabetes 17
  • Improve cholesterol levels
  • Reduce the chance of kidney stones.

Dash Diet Guidelines

DASH Diet is a flexible and balanced eating plan that helps you create a heart-healthy eating style for life.

The DASH diet eating plan requires no special foods and has no hard-to-follow recipes. It simply calls for a certain number of daily servings from various food groups to provide your daily and weekly nutritional goals. This plan recommends:

  • Eating vegetables, fruits, and whole grains
  • Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
  • Increase potassium intake
  • Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel and palm oils
  • Limiting sugar-sweetened beverages and sweets.

The number of servings depends on the number of calories you’re allowed each day. Your calorie level depends on your age, sex, the amount of lean body mass (muscular, athletic, average or overweight), height and, especially, how active you are. Think of this as an energy balance system—if you want to maintain your current weight, you should take in only as many calories as you burn by being physically active. If you need to lose weight, eat fewer calories than you burn or increase your activity level to burn more calories than you eat.

What Foods To Eat

  • Fruits
  • Vegetables
  • Whole-grains
  • Low-fat dairy products
  • Skinless poultry and fish
  • Nuts and legumes
  • Non-tropical vegetable oils

What Foods to Reduce or Avoid

  • Saturated and trans fats
  • Sodium (salt)
  • Red meat (if you do eat red meat, compare labels and select the leanest cuts available)
  • Sweets and sugar-sweetened beverages
  • Alcohol and caffeine
  • Processed foods, which are often high in fat, salt, and sugar

Drinking too much alcohol can increase blood pressure. It also can harm the liver, brain, and heart. Alcoholic drinks also contain calories, which matters if you are trying to lose weight. The Dietary Guidelines for Americans recommends that men limit alcohol to no more than two drinks a day and women to one or less.

The DASH diet doesn’t address caffeine consumption. The influence of caffeine on blood pressure remains unclear. But caffeine can cause your blood pressure to rise at least temporarily. If you already have high blood pressure or if you think caffeine is affecting your blood pressure, talk to your doctor about your caffeine consumption.

Dash Diet Eating Plan

To benefit from the DASH diet eating plan, it is important to consume the appropriate amount of calories to maintain a healthy weight. The DASH diet eating plan can be used to help you lose weight. To lose weight, follow the DASH eating plan and try to reduce your total daily calories gradually. Find out your daily calorie needs or goals with the Body Weight Planner and calorie chart. Talk with your doctor before beginning any diet or eating plan.

General tips for reducing daily calories include:

  • Eat smaller portions more frequently throughout the day.
  • Reduce the amount of meat that you eat while increasing the amount of fruits, vegetables, whole grains, or dry beans.
  • Substitute low-calorie foods, such as when snacking (choose fruits or vegetables instead of sweets and desserts) or drinking (choose water instead of soda or juice), when possible.

Tips for Following DASH Diet

It’s easy to follow the DASH diet. But it might mean making some changes to how you currently eat. To get started:

  • DO NOT try to make changes all at once. It’s fine to change your eating habits gradually.
  • To add vegetables to your diet, try having a salad at lunch. Or, add cucumber, lettuce, shredded carrots, or tomatoes to your sandwiches.
  • There should always been something green on your plate. It’s fine to use frozen vegetables instead of fresh. Just make sure the package does not contain added salt or fat.
  • Add sliced fruit to your cereal or oatmeal for breakfast.
  • For dessert, choose fresh fruit or low-fat frozen yogurt instead of high-calorie sweets, such as cakes or pies.
  • Choose healthy snacks, such as unsalted rice cakes or popcorn, raw vegetables, or yogurt. Dried fruits, seeds, and nuts also make great snack choices. Just keep these portions small.
  • Choose whole grain foods for most grain servings to get added nutrients, such as minerals and fiber. For example, choose whole wheat bread or whole grain cereals.
  • Think of meat as part of your meal, instead of the main course. Limit your servings of lean meat to 6 ounces (170 grams) a day. You can have two 3-ounce (85 grams) servings during the day. If you now eat large portions of meats, cut them back gradually by a half or a third at each meal.
  • Try these snacks ideas: unsalted rice cakes; nuts mixed with raisins; graham crackers; fat-free and low-fat yogurt and frozen yogurt; popcorn with no salt or butter added; raw vegetables.
  • Try cooking without meat at least twice each week. Instead, eat beans, nuts, tofu, or eggs for your protein.
  • If you are allergic to nuts, use seeds or legumes (cooked dried beans or peas).

DASH diet guidelines

Here’s a look at the recommended servings from each food group for the 2,000-calorie-a-day DASH diet plan.

A) Grains 6 to 8 servings a day

Note: A standard grain (cereal) serve is about 500kJ

Grains include bread, cereal, rice and pasta. Examples of one serving of grains include 1 slice whole-wheat bread, 1 ounce dry cereal, or 1/2 cup cooked cereal, rice or pasta.

Grains are naturally low in fat. Keep them this way by avoiding butter, cream and cheese sauces.

rice and grains serving size

Focus on whole grains because they have more fiber and nutrients than do refined grains. For instance, use brown rice instead of white rice, whole-wheat pasta instead of regular pasta and whole-grain bread instead of white bread. Look for products labeled “100 percent whole grain” or “100 percent whole wheat.”

B) Vegetables 4 to 5 servings a day

Note: A standard vegetable serve is about 75g (100–350kJ)

Tomatoes, carrots, broccoli, sweet potatoes, greens and other vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.

Don’t think of vegetables only as side dishes — a hearty blend of vegetables served over brown rice or whole-wheat noodles can serve as the main dish for a meal.

vegetable serving size

Fresh and frozen vegetables are both good choices. When buying frozen and canned vegetables, choose those labeled as low sodium or without added salt.

To increase the number of servings you fit in daily, be creative. In a stir-fry, for instance, cut the amount of meat in half and double up on the vegetables.

C) Fruits 4 to 5 servings a day

Note: A standard fruit serve is about 150g (350kJ)

Many fruits need little preparation to become a healthy part of a meal or snack. Like vegetables, they’re packed with fiber, potassium and magnesium and are typically low in fat — coconuts are an exception. Examples of one serving include one medium fruit, 1/2 cup fresh, frozen or canned fruit, or 4 ounces of juice.

Have a piece of fruit with meals and one as a snack, then round out your day with a dessert of fresh fruits topped with a dollop of low-fat yogurt. Leave on edible peels whenever possible. The peels of apples, pears and most fruits with pits add interesting texture to recipes and contain healthy nutrients and fiber.

fruit serving size

Many fruits need little preparation to become a healthy part of a meal or snack. Like vegetables, they’re packed with fiber, potassium and magnesium and are typically low in fat — coconuts are an exception. Examples of one serving include one medium fruit, 1/2 cup fresh, frozen or canned fruit, or 4 ounces of juice.

If you choose canned fruit or juice, make sure no sugar is added.

Leave on edible peels whenever possible. The peels of apples, pears and most fruits with pits add interesting texture to recipes and contain healthy nutrients and fiber.

Remember that citrus fruits and juices, such as grapefruit, can interact with certain medications, so check with your doctor or pharmacist to see if they’re OK for you.

D) Dairy 2 to 3 servings a day

Note: A standard dairy serve is about 500-600kJ)

Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low fat or fat-free because otherwise they can be a major source of fat and most of it is saturated. Examples of one serving include 1 cup skim or 1 percent milk, 1 cup low fat yogurt, or 1 1/2 ounces part-skim cheese.

serving size of dairy, yogurt and cheese

Low-fat or fat-free frozen yogurt can help you boost the amount of dairy products you eat while offering a sweet treat. Add fruit for a healthy twist. If you have trouble digesting dairy products, choose lactose-free products or consider taking an over-the-counter product that contains the enzyme lactase, which can reduce or prevent the symptoms of lactose intolerance.

Go easy on regular and even fat-free cheeses because they are typically high in sodium.

E) Lean meat, poultry and fish 6 servings or fewer a day

Note: A standard lean meat, poultry and fish serve is about 500-600kJ.

Meat can be a rich source of protein, B vitamins, iron and zinc. Choose lean varieties and aim for no more than 6 ounces a day. Cutting back on your meat portion will allow room for more vegetables.

serving size of chicken

Trim away skin and fat from poultry and meat and then bake, broil, grill or roast instead of frying in fat.
Eat heart-healthy fish, such as salmon, herring and tuna. These types of fish are high in omega-3 fatty acids, which can help lower your total cholesterol.

F) Nuts, seeds and legumes 4 to 5 servings a week

Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein. They’re also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease.

Serving sizes are small and are intended to be consumed only a few times a week because these foods are high in calories. Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds, or 1/2 cup cooked beans or peas.

Nuts sometimes get a bad rap because of their fat content, but they contain healthy types of fat — monounsaturated fat and omega-3 fatty acids. They’re high in calories, however, so eat them in moderation. Try adding them to stir-fries, salads or cereals.
Soybean-based products, such as tofu and tempeh, can be a good alternative to meat because they contain all of the amino acids your body needs to make a complete protein, just like meat.

G) Fats and oils 2 to 3 servings a day

Fat helps your body absorb essential vitamins and helps your body’s immune system. But too much fat increases your risk of heart disease, diabetes and obesity. The DASH diet strives for a healthy balance by limiting total fat to less than 30 percent of daily calories from fat, with a focus on the healthier monounsaturated fats.

Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.

Saturated fat and trans fat are the main dietary culprits in increasing your risk of coronary artery disease. DASH helps keep your daily saturated fat to less than 6 percent of your total calories by limiting use of meat, butter, cheese, whole milk, cream and eggs in your diet, along with foods made from lard, solid shortenings, and palm and coconut oils.

Avoid trans fat, commonly found in such processed foods as crackers, baked goods and fried items.
Read food labels on margarine and salad dressing so that you can choose those that are lowest in saturated fat and free of trans fat.

H) Sweets 5 servings or fewer a week

You don’t have to banish sweets entirely while following the DASH diet — just go easy on them. Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.

When you eat sweets, choose those that are fat-free or low-fat, such as sorbets, fruit ices, jelly beans, hard candy, graham crackers or low-fat cookies.

Artificial sweeteners such as aspartame (NutraSweet, Equal) and sucralose (Splenda) may help satisfy your sweet tooth while sparing the sugar. But remember that you still must use them sensibly. It’s OK to swap a diet cola for a regular cola, but not in place of a more nutritious beverage such as low-fat milk or even plain water.
Cut back on added sugar, which has no nutritional value but can pack on calories.

I) Alcohol and caffeine

Drinking too much alcohol can increase blood pressure. The Dietary Guidelines for Americans recommends that men limit alcohol to no more than two drinks a day and women to one or less.

The DASH diet doesn’t address caffeine consumption. The influence of caffeine on blood pressure remains unclear. But caffeine can cause your blood pressure to rise at least temporarily. If you already have high blood pressure or if you think caffeine is affecting your blood pressure, talk to your doctor about your caffeine consumption.

7 Days DASH Eating Plan

Here is a week of menus from the DASH eating plan. The menus allow you to have a daily sodium level of either 2,300 mg or, by making the noted changes, 1,500 mg. You’ll also find that the menus sometimes call for you to use lower sodium, low-fat, fat-free, or reduced fat versions of products.

The menus are based on 2,000 calories a day—serving sizes should be increased or decreased for other calorie levels. To ease the calculations, some of the serving sizes have been rounded off. Also, some items may be in too small a quantity to have a listed food group serving. Recipes for starred items are given on the later pages. Some of these recipes give changes that can be used to lower their sodium level. Use the changes if you want to follow the DASH eating plan at 1,500 milligrams of sodium per day.

Abbreviations:
oz = ounce
tsp = teaspoon
Tbsp = tablespoon
g = gram
mg = milligram

Table 4. A Week with the DASH Eating Plan

Day One

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
3/4 cup bran flakes cereal:2203/4 cup shredded wheat cereal11
1 medium banana11
1 cup low-fat milk1071
1 slice whole wheat bread:1491
1 tsp soft (tub) margarine261 tsp unsalted soft (tub) margarine01
1 cup orange juice52
Lunch
3/4 cup chicken salad:179Remove salt from the recipe1203
2 slices whole wheat bread2992
1 Tbsp Dijon mustard3731 Tbsp regular mustard1751
salad:
1/2 cup fresh cucumber slices11
1/2 cup tomato wedges51
1 Tbsp sunflower seeds01/2
1 tsp Italian dressing, low calorie43
1/2 cup fruit cocktail, juice pack51
Dinner
3 oz beef, eye of the round:353
2 Tbsp beef gravy, fat-free165
1 cup green beans, sautéed with:122
1/2 tsp canola oil01/2
1 small baked potato:141
1 Tbsp sour cream, fat-free21
1 Tbsp grated natural cheddar cheese, reduced fat671 Tbsp natural cheddar cheese, reduced fat, low sodium1
1 Tbsp chopped scallions1
1 small whole wheat roll:1481
1 tsp soft (tub) margarine261 tsp unsalted soft (tub) margarine01
1 small apple11
1 cup low-fat milk1071
Snacks
1/3 cup almonds, unsalted01
1/4 cup raisins41
1/2 cup fruit yogurt, fat-free,
no sugar added
861/2
Totals
Totals2,1011,5075562 1/261 1/23 1/20
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories2,0622,037
Total fat63 g59 g
Calories from fat28%26 %
Saturated fat13 g12 g
Calories from saturated fat6 %5 %
Cholesterol155 mg155 mg
Sodium2,101 mg1,507 mg
Carbohydrate284 g284 g
Protein114 g115 g
Calcium1,220 mg1,218 mg
Magnesium594 mg580 mg
Potassium4,909 mg4,855 mg
Fiber37 g36 g

Day Two

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
1/2 cup instant oatmeal541/2 cup regular oatmeal with
1 tsp cinnamon
51
1 mini whole wheat bagel:841
1 Tbsp peanut butter811/2
1 medium banana11
1 cup low-fat milk1071
Lunch
chicken breast sandwich:
3 oz chicken breast, skinless653
2 slices whole wheat bread2002
1 slice (3/4 oz) natural cheddar cheese, reduced fat2021 slice (3/4 oz) natural Swiss cheese, low sodium31/2
1 large leaf romaine lettuce11/4
2 slices tomato21/2
1 Tbsp mayonnaise, low-fat1011
1 cup cantaloupe chunks262
1 cup apple juice212
Dinner
1 cup spaghetti:12
3/4 cup vegetarian spaghetti sauce479Substitute low-sodium tomato paste (6 oz)2531 1/2
3 Tbsp Parmesan cheese2871/2
spinach salad:
1 cup fresh spinach leaves241
1/4 cup fresh carrots, grated191/2
1/4 cup fresh mushrooms, sliced11/2
1 Tbsp vinaigrette dressing11/2
1/2 cup corn, cooked from frozen11
1/2 cup canned pears, juice pack51
Snacks
1/3 cup almonds, unsalted01
1/4 cup dried apricots31
1 cup fruit yogurt, fat-free,
no sugar added
1731
Totals
Totals2,0351,56065 1/47331 1/21 1/20
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories2,0272,078
Total fat64 g68 g
Calories from fat28%30 %
Saturated fat13 g16 g
Calories from saturated fat6 %7 %
Cholesterol114 mg129 mg
Sodium2,035 mg1,560 mg
Carbohydrate288 g290 g
Protein99 g100 g
Calcium1,370 mg1,334 mg
Magnesium535 mg542 mg
Potassium4,715 mg4,721 mg
Fiber34 g34 g

Day Three

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
3/4 cup bran flakes cereal:2202 cups puffed wheat cereal11
1 medium banana11
1 cup low-fat milk1071
1 slice whole wheat bread:1491
1 tsp soft (tub) margarine261 tsp unsalted soft (tub) margarine01
1 cup orange juice62
Lunch
beef barbeque sandwich:
2 oz beef, eye of round262
1 Tbsp barbeque sauce156
2 slices (11/2 oz) natural cheddar cheese, reduced fat40511/2 oz natural cheddar cheese,
reduced fat, low sodium
91
1 hamburger bun1832
1 large leaf romaine lettuce11/4
2 slices tomato21/2
1 cup new potato salad172
1 medium orange01
Dinner
3 oz cod:703
1 tsp lemon juice1
1/2 cup brown rice51
1 cup spinach, cooked from frozen, sautéed with:1842
1 tsp canola oil01
1 Tbsp almonds, slivered01/4
1 small cornbread muffin, made
with oil:
1191
1 tsp soft (tub) margarine261 tsp unsalted soft (tub) margarine01
Snacks
1 cup fruit yogurt, fat-free,
no added sugar:
1731
1 Tbsp sunflower seeds, unsalted01/2
2 large graham cracker rectangles:156
1 Tbsp peanut butter811/2
Totals
Totals2,1141,44774 3/44351 1/430
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories1,9971,995
Total fat56 g52 g
Calories from fat25 %24 %
Saturated fat12 g11 g
Calories from saturated fat6 %5 %
Cholesterol140 mg140 mg
Sodium2,114 mg1,447 mg
Carbohydrate289 g283 g
Protein103 g104 g
Calcium1,537 mg1,524 mg
Magnesium630 mg598 mg
Potassium4,676 mg4,580 mg
Fiber34 g31 g

Day Four

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
1 slice whole wheat bread:1491
1 tsp soft (tub) margarine261 tsp unsalted soft (tub) margarine01
1 cup fruit yogurt, fat-free, no added sugar1731
1 medium peach01
1/2 cup grape juice41
Lunch
ham and cheese sandwich:
2 oz ham, low-fat, low sodium5492 oz roast beef tenderloin232
1 slice (3/4 oz) natural cheddar cheese, reduced fat2021 slice (3/4 oz) natural cheddar cheese, reduced fat, low sodium41/2
2 slices whole wheat bread2992
1 large leaf romaine lettuce11/4
2 slices tomato21/2
1 Tbsp mayonnaise, low-fat1011
1 cup carrot sticks842
Dinner
chicken and Spanish rice341substitute low-sodium tomato sauce (4 oz)21513
1 cup green peas, sautéed with:1152
1 tsp canola oil01
1 cup cantaloupe chunks262
1 cup low-fat milk1071
Snacks
1/3 cup almonds, unsalted01
1 cup apple juice212
1/4 cup apricots31
1 cup low-fat milk1071
Totals
Totals2,3121,43644 3/473 1/25130
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories2,0242,045
Total fat59 g59 g
Calories from fat26%26 %
Saturated fat12 g12 g
Calories from saturated fat5%5 %
Cholesterol148 mg150 mg
Sodium2,312 mg1,436 mg
Carbohydrate279 g278 g
Protein110 g116 g
Calcium1,417 mg1,415 mg
Magnesium538 mg541 mg
Potassium4,575 mg4,559 mg
Fiber35 g35 g

Day Five

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
1 cup whole grain oat rings cereal:2731 cup frosted shredded wheat41
1 medium banana11
1 cup low-fat milk1071
1 medium raisin bagel:2722
1 Tbsp peanut butter811 Tbsp peanut butter, unsalted31/2
1 cup orange juice52
Lunch
tuna salad plate:
1/2 cup tuna salad1713
1 large leaf romaine lettuce11/4
1 slice whole wheat bread1496 whole wheat crackers, low sodium531
cucumber salad:
1 cup fresh cucumber slices22
1/2 cup tomato wedges51
1 Tbsp vinaigrette dressing1332 Tbsp yogurt dressing, fat-free661
1/2 cup cottage cheese, low-fat:4591/4
1/2 cup canned pineapple, juice pack11
1 Tbsp almonds, unsalted01/4
Dinner
3 oz turkey meatloaf205substitute low-sodium ketchup743
1 small baked potato:141
1 Tbsp sour cream, fat-free211
1 Tbsp natural cheddar cheese, reduced fat, grated671 Tbsp natural cheddar cheese, reduced fat, and low sodium1
1 scallion stalk, chopped1
1 cup collard greens, sautéed with:852
1 tsp canola oil0
1 small whole wheat roll1486 small melba toast crackers, unsalted11
1 medium peach01
Snacks
1 cup fruit yogurt, fat-free, no added sugar1731
2 Tbsp sunflower seeds, unsalted01
Totals
Totals2,3731,51956 1/452 1/461 3/420
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories1,9762,100
Total fat57 g52 g
Calories from fat26%22%
Saturated fat11 g11 g
Calories from saturated fat5%5%
Cholesterol158 mg158 mg
Sodium2,373 mg1,519 mg
Carbohydrate275 g314 g
Protein111 g114 g
Calcium1,470 mg1,412 mg
Magnesium495 mg491 mg
Potassium4,769 mg4,903 mg
Fiber30 g31 g

Day Six

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
1 low-fat granola bar811
1 medium banana11
1/2 cup fruit yogurt, fat-free,
no sugar added
861/2
1 cup orange juice52
1 cup low-fat milk1071
Lunch
turkey breast sandwich:
3 oz turkey breast483
2 slices whole wheat bread2992
1 large leaf romaine lettuce11/4
2 slices tomato21/2
2 tsp mayonnaise, low-fat672/3
1 Tbsp Dijon mustard3731 Tbsp regular mustard175
1 cup steamed broccoli, cooked from frozen112
1 medium orange01
Dinner
3 oz spicy baked fish503
1 cup scallion rice182
spinach sauté:
1/2 cup spinach, cooked from frozen,
sautéed with:
921
2 tsp canola oil02
1 Tbsp almonds, slivered, unsalted01/4
1 cup carrots, cooked from frozen842
1 small whole wheat roll:1481
1 tsp soft (tub) margarine261
1 small cookie601
Snacks
2 Tbsp peanuts, unsalted1/2
1 cup low-fat milk
1/4 cup dried apricots
Totals
Totals1,6711,47265 3/452 1/263/43 2/31
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories1,9391,935
Total fat58 g57 g
Calories from fat27%27 %
Saturated fat12 g12 g
Calories from saturated fat6%6%
Cholesterol171 mg171 mg
Sodium1,671 mg1,472 mg
Carbohydrate268 g268 g
Protein105 g105 g
Calcium1,210 mg1,214 mg
Magnesium548 mg545 mg
Potassium4,710 mg4,710 mg
Fiber36 g36 g

Day Seven

Breakfast
Number of Servings by DASH Food Group
2,300 mg Sodium MenuSodium (mg)Substitution To Reduce Sodium to 1,500 mgSodium (mg)GrainsVegetablesFruitsMilk ProductsMeats, fish, and poultryNuts, seeds, and legumesFats and oilsSweets and added sugars
1 cup whole grain oat rings:2731 cup regular oatmeal5
1 medium banana1
1 cup low-fat milk107
1 cup fruit yogurt, fat-free, no sugar added173
Lunch
tuna salad sandwich:
1/2 cup tuna, drained, rinsed39
1 Tbsp mayonnaise, low-fat101
1 large leaf romaine lettuce1
2 slices tomato2
2 slices whole wheat bread299
1 medium apple1
1 cup low-fat milk107
Dinner
1/6 recipe zucchini lasagna:368substitute cottage cheese, low-fat, no salt added165
salad:
1 cup fresh spinach leaves24
1 cup tomato wedges9
2 Tbsp croutons, seasoned62
1 Tbsp vinaigrette dressing, reduced calorie1331 Tbsp low-sodium vinaigrette dressing1
1 Tbsp sunflower seeds0
1 small whole wheat roll:148
1 tsp soft (tub) margarine451 tsp unsalted soft (tub) margarine0
1 cup grape juice8
Snacks
1/3 cup almonds, unsalted0
1/4 cup dry apricots3
6 whole wheat crackers166
Totals
Totals2,0691,421
Sodium Level
Nutrients Per Day2,300 mg1,500 mg
Calories1,9931,988
Total fat64 g60 g
Calories from fat29 %27 %
Saturated fat13 g13 g
Calories from saturated fat6%6%
Cholesterol71 mg72 mg
Sodium2,069 mg1,421 mg
Carbohydrate283 g285 g
Protein93 g97 g
Calcium1,616 mg1,447 mg
Magnesium537 mg553 mg
Potassium4,693 mg4,695 mg
Fiber32 g33 g

(Source 18).

Summary

The DASH diet eating plan is just one key part of a heart-healthy lifestyle, and combining it with other lifestyle changes such as physical activity can help you control your blood pressure and LDL-cholesterol for life.

To help prevent and control high blood pressure:

  • Be physically active.
  • Maintain a healthy weight.
  • Limit alcohol intake.
  • Manage and cope with stress.

Other lifestyle changes can improve your overall health, such as:

  • If you smoke, quit.
  • Get plenty of sleep (7-9 hours/day).

To help make lifelong lifestyle changes, try making one change at a time and add another when you feel that you have successfully adopted the earlier changes. When you practice several healthy lifestyle habits, you are more likely to achieve and maintain healthy blood pressure, healthy body weight and cholesterol levels.

Can the DASH diet promote Weight Loss?

The DASH eating plan was not designed to promote weight loss. But it is rich in low-calorie foods such as fruits and vegetables. Therefore, the DASH diet eating plan can be used to help you lose weight. To lose weight, follow the DASH diet eating plan and try to reduce your total daily calories gradually. To lose weight you’ll need to start with finding a way to eat fewer calories than you need. A calorie is a unit of energy, which is in the foods and drinks you consume. Scientifically, the calorie (a unit of energy) was originally defined as the amount of heat required at a pressure of 1 standard atmosphere to raise the temperature of 1 gram of water 1° Celsius. When you hear something contains 100 calories, it’s a way of describing how much energy your body could get from eating or drinking it. However, since calories are too small of a measurement to use when discussing nutrition and exercise, kilocalorie (kcal) measurements are used instead and the term is interchangeable with calories. Kilocalorie (kcal) is a unit of measurement for energy that is equivalent to 1,000 calories. Also,1 kcal or 1 kilocalorie is equivalent to 1 large Calorie (with an uppercase C) or 1,000 calories.

Some countries use kilojoules (kJ) to measure how much energy people get from consuming a food or drink.

  • 1 calorie = 4.184 joule
  • 1 kilocalorie (kcal) = 4.184 kilojoules (kJ)
  • 1 Calorie (1,000 calories) = 4.184 kilojoules (kJ)

Here’s how many calories are in your foods and drinks 19:

  • 1 gram of carbohydrate = 4 calories
  • 1 gram of protein = 4 calories
  • 1 gram of fat = 9 calories
  • 1 gram of water = 0 calorie

Most foods and drinks contain calories. You can find out how many calories are in a food by looking at the nutrition facts label. The label also will describe the components of the food such as how many grams of carbohydrate, protein, and fat it contains.

That means if you know how many grams of each one are in a food, you can calculate the total calories. You would multiply the number of grams by the number of calories in a gram of that food component. For example, if a serving of potato chips (about 20 chips) has 10 grams of fat, 90 calories are from fat. That’s 10 grams x 9 calories per gram. Some foods, such as lettuce, contain few calories (1 cup of shredded lettuce has less than 10 calories). Other foods, like peanuts, contain a lot of calories (½ cup of peanuts has 427 calories).

There are many unhealthy misconceptions about weight loss. There are no magical foods or ways to combine foods that melt away excess body fat. To reduce your weight, you’ll have to reduce your calorie intake.

Calories aren’t bad for you. Your body needs calories for energy. Your body uses energy (calorie) for everything you do from breathing and sleeping to exercising. Some people mistakenly believe they have to burn off all the calories they eat or they will gain weight. This isn’t true. Your body needs some calories just to operate — to keep your heart beating and your lungs breathing. When you eat, you’re replacing the energy (calorie) you’ve used, which helps you to maintain a healthy weight. But eating more calories than your body needs and not burning enough of them off through activity can lead to weight gain and other health problems such as type 2 diabetes, heart disease, high blood pressure, certain cancers (e.g., uterine, gallbladder, kidney, liver, and colon cancers) and death 20, 21, 22, 23.

Being overweight or obese is the result of an energy imbalance between your daily energy intake and your energy expenditure resulting in excessive weight gain 24. The amount of energy or calories you get from food and drinks (energy IN) is balanced with the energy your body uses for things like breathing, digesting, and being physically active (energy OUT):

  • The same amount of energy IN and energy OUT over time = weight stays the same (Energy Balance)
  • More energy IN than OUT over time = Weight Gain
  • More energy OUT than IN over time = Weight Loss

In order to lose weight, energy expenditures must exceed energy intake. To lose weight, most people need to reduce the number of calories they get from food and beverages (energy IN) and increase their physical activity (energy OUT). To achieve this imbalance, you can decrease energy intake, increase energy expenditures or combine a decrease in intake with an increase in expenditures. Being physically active and eating fewer calories will help you lose weight and keep the weight off over time. As a result, most weight loss recommendations advise combining a low caloric diet with an exercise program in order to achieve a significant energy deficit 25. A long-standing consistent observation is that regular exercise by itself is prescribed in small to moderate amounts resulting in modest weight loss or in some cases weight gain 26.

Weight loss of about 1 to 1 ½ pounds per week is considered reasonable and more likely to be maintained. For a weight loss of 1 to 1 ½ pounds per week, daily intake should be reduced by 500 to 750 calories. In general 27:

  • Eating plans that contain 1,200–1,500 calories each day will help most women lose weight safely.
  • Eating plans that contain 1,500–1,800 calories each day are suitable for men and for women who weigh more or who exercise regularly.

Very low calorie diets of fewer than 800 calories per day should not be used unless you are being monitored by your doctor. Because dieting can be harmful because your body responds to these periods of semi-starvation by lowering its metabolic rate. When you lose weight too quickly, you lose fat and muscle. Muscle burns kilojoules, but fat doesn’t. So, when you stop dieting and return to your usual habits, your body will burn even fewer calories than before because the relative amount of muscle in your body has decreased and your metabolic rate is slower. This kind of eating pattern can also affect your general health – just one cycle of weight loss and weight gain can contribute to an increased risk of coronary heart disease (regardless of your body fat levels). That’s why it’s more important to be able to maintain weight loss.

Energy balance is also important for maintaining a healthy weight. To maintain a healthy weight, your energy IN and OUT don’t have to balance exactly every day. It’s the balance over time that helps you maintain a healthy weight.

You can reach and maintain a healthy weight if you:

  • Follow a healthy diet, and if you are overweight or obese, reduce your daily intake by 500 calories for weight loss
  • Are physically active
  • Limit the time you spend being physically inactive

While people vary quite a bit in the amount of physical activity (exercise) they need for weight control, many can maintain their weight by doing 150 to 300 minutes (2 ½ to 5 hours) a week of moderate-intensity activity such as brisk walking. People who want to lose a large amount of weight (more than 5 percent of their body weight) and people who want to keep off the weight that they’ve lost may need to be physically active for more than 300 minutes of moderate-intensity activity each week.

You now know the basics about calories – the key to weight loss for most people is simply finding the right combination of exercise, healthy foods and cutting back on portions will help you lose those extra pounds. No fad diet required. In other words, eat healthily, watch your portions and get moving more. By losing just a few pounds with healthy eating and exercise, you’ll start to feel better. You’ll have more energy. To prevent the weight creeping back on, you need to keep going with the healthy habits you’ve formed.

Adults BMI calculator

Children and teens BMI calculator

Figure 1. Body Mass Index calculator

Body Mass Index calculator

Table 5. Body Mass Index range

BMI Range (kg/m²)
Weight class
Less than 16.5 kg/m²Severely Underweight
16.5 – 18.5 kg/m²Underweight
18.5 – 25 kg/m²
Normal
25 – 30 kg/m²Overweight
30 – 34.9 kg/m²Obese, Class 1
35 – 39.9 kg/m²Obese, Class 2
More than 40 kg/m²Obese, Class 3 (Morbidly Obese)

Figure 2. Body Mass Index chart

BMI chart

Footnote: A graph of body mass index (BMI) as a function of body mass and body height. The dashed lines represent subdivisions within a major class. The Body mass index scale show all people with high level of muscles also overweight or obese. This is because the BMI scale is designed in accordance to the body fat levels not body muscles mass levels. Therefore, BMI measure is not an accurate measure for muscular individual.

Figure 3. Waist to hip ratio

Waist to hip ratio measurement

How to lose belly fat

An active lifestyle and exercise routine, along with eating healthy foods, is the best way to lose weight and lose belly fat. Losing belly fat is not easy like taking a pill for a headache. Getting rid of your belly fat require you to change your beliefs, habits and lifestyle with a lot of sweat and self discipline. It’s a lifelong habit and lifestyle you need to maintain for the rest of your life! Managing your weight is a life-long commitment – not just following a diet for a few weeks to drop pounds. That’s because losing weight isn’t necessarily the problem, it’s keeping it off longer term that is difficult. Popular media is full of fad diets and magic weight loss potions endorsed by celebrities and supported by personal success stories. While many of these diets may help you to lose weight while you’re following them, as soon as you resume your usual lifestyle, the weight starts to creep back on. Remember, if the strategies you’re putting into place to lose weight are not strategies that you’ll be able to follow for the rest of your life, chances are you’ll regain any weight you lose.

There is no single diet that works for everyone. To lose weight you’ll need to start with finding a way to eat fewer calories than you need. This phase is referred to as the “energy deficit” or “hypo-caloric phase” of weight loss. The essential components of weight loss, regardless of type of diet, are decreased energy intake, increased energy output through physical activity, behavioral modification and alterations in the environment that foster all of these 3 components 22.

Most American adults are overweight or obese. What is your current weight? Are you overweight or morbidly obese? Because there’s a huge difference between someone who’s 500 pounds then someone who’s 200 pounds who’s trying to lose belly fat. For someone who’s extremely obese to lose 300 pounds is a lot harder that for someone who’s overweight trying to lose 50 pounds. For example, a 5’4’’ woman weighing 250 pounds with a body mass index (BMI) of 43 kg/m² losing 5% of her body weight, or 12.5 pounds, will have an ending BMI of 41 kg/m². This amount of weight loss could take up to 25 weeks, if she loses one-half a pound per week. Weight loss of one-half a pound to two pounds per week is reasonable and offers the best chance for long-term success, but for extremely heavy people, this may take many months or years. If further weight reduction is necessary after 10% of initial body weight is lost, it can be attempted with an increased calorie deficit after prior weight loss has been maintained for several months. In contrast, obese people often expect to lose 25% to 35% of their initial weight over the first year of obesity treatment. Dieters often maintain these expectations even when they are repeatedly informed that their goals are likely unrealistic even with weight-loss drug treatment 28. It is important to note that one-half to one pound per week of fat loss is a realistic, achievable goal that will improve your health. Additionally, it is difficult to continue to lose weight at such a rapid pace. Because in the beginning (the first several days) of weight-loss from low-calorie diet is due to water loss. This is especially true for those on severely low-caloric diets (with deficits of 1,000 calories per day), those on ketogenic diets, and those on very low carbohydrate diets 29, 30. Ketogenic diets or keto diets consist of 60-80% of calorie intake from fats and limiting carbohydrate consumption to less than 10% of daily intake. While keto diets have been shown to aid in weight loss/fat loss, studies have shown the primary mechanism behind weight loss is due to hunger suppression. A high-fat diet can suppress appetite since it is highly satiating, leading to decreased caloric consumption. Additionally, many studies have shown that calorically matched diets with identical protein levels aid in fat loss just as successfully as a keto diet.

Doctors and dietitians assess weight by measuring your Body Mass Index (BMI), a ratio of weight to height. The BMI is defined as the body mass in kilogram (Kg) that is divided by the square of the body height in meter (m2), and is expressed in units of kg/m², resulting from mass in kilograms and height in meters (see Figure 1). You can also use an online BMI calculator (https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm). A BMI between 25 and 29.9 kg/m² is considered overweight, and obesity is a BMI of 30 kg/m² or higher. Waist to hip ratio should also be measured, in men more than 1:1 and women more than 0:8 is considered significant (see Figure 3). Being overweight or obese puts you at risk for a myriad of health problems, such as ischemic heart disease, high blood pressure, cardiovascular disease, fatty liver disease, breathing problems (obstructive sleep apnea, ventilatory failure and asthma), type 2 diabetes, gastro-esophageal reflux disease (GERD), gallstones, some cancers, Alzheimer’s disease, renal failure and other health problems 31. Ninety per cent of people with type 2 diabetes have a body mass index (BMI) greater than 23 kg/m² and conversely it is estimated that the attributable risk of obesity for diabetes is between 30% and 70% 32.

Many factors can contribute to your weight. These factors include your environment (cultural and societal), family history and genetics, metabolism (the way your body changes food and oxygen into energy), and behavior or habits. Other causes of obesity include reduced physical activity, insomnia, food habits, endocrine disorders, medications, food advertisements, and energy metabolism 33. Most common syndromes associated with obesity include Prader Willi syndrome and MC4R syndromes, others like fragile X, Bardet-Beidl syndrome, Wilson Turner congenital leptin deficiency, and Alstrom syndrome are also associated with obesity 33.

Furthermore, your current health will also affect your ability to do physical activity and do weights to build lean muscle mass. For example, do you have any medical conditions that could hinder you lifting weights and doing aerobic cardio workouts? Because if you have existing medical conditions you may not be able to do the hard workouts in the gym in order to build the muscle mass you wanted.

Another thing to consider is your ‘WHY’. Why are you wanting to build muscle and have six pack abs? Is it for you and you have decided to change your life to live a healthier life? Or are you trying to impress other people? Do you want to ‘look healthy’ or do want to be healthy? Because if you’re doing it for yourself, your chances of reaching your goal is easier than if you’re trying to impress others with your beauty (aesthetic) and your appearance (cosmetic). Your primary reason (your WHY) is to lose enough weight to improve or maintain your health. The aesthetic and cosmetic effects of weight loss are “extra benefits” or ‘icing on the cake’.

Lastly, how serious and motivated are you in wanting your dream outcome like building muscle and losing your belly fat to have six pack abs? Most people are not serious and not motivated to do the work like dieting, eating healthy, exercising and lifting heavy weights. Most people just want a quick solutions like popping weight loss pills, taking supplements and following fad diets (popular celebrity endorsed short term diets that sound too good to be true that can cause nutrient deficiencies, fatigue, weight regain and disordered eating) hoping these quick fix ineffective, unhealthy and dangerous products will give them their dream results. Furthermore, most people want six pack abs to impress others and have the false impression that having big muscles and six pack abs will solve their self esteem and confidence issues. In reality, to become successful and achieve your dream outcome, you’ll need to first change your mindset, your beliefs and become self-aware that anything in life requires sacrifice, time, hard work, effort, being resilient, self-confidence, high self-esteem, healthy diet and dedication.

To achieve your dream outcome like building muscle and losing your belly fat to have six pack abs you’ll have to embrace challenges, views failures as opportunities for growth, and believe in your ability to achieve your dream. It involves setting clear goals (e..g, how much weight you have to lose, how many calories you have to remove from your diet), maintaining a positive outlook, and persisting through obstacles with resilience and determination.

How many calories do I need per day?

The total number of calories you need each day varies depends on a number of factors, namely your age, sex, height, weight, level of physical activity, and pregnancy or lactation status. According to the Dietary Guidelines for Americans, American female adult estimated calorie needs range from 1,600 to 2,400 calories per day and for males 2,000 to 3,000 calories per day 34. The average, healthy, adult, American male consumes approximately 2,800 calories per day, and the average female about 1,800 calories 22. But most people need different amounts of calories based on how their bodies work, how active they are and any weight management goals. And if you want to lose weight you’ll have to reduce your calorie intake.

Here is a general estimate of calories you need each day:

  • Sedentary lifestyle (little to no exercise)
    • Women: 1,800 to 2,400 calories
    • Men: 2,200 to 3,000 calories
  • Moderately active lifestyle (engages in moderate exercise/physical activity like walking or light yard work:
    • Women: 2,000 to 2,600 calories
    • Men: 2,400 to 2,800 calories
  • Very active lifestyle (engages in hard exercise/physical activity, or has a physically demanding job):
    • Women: 2,200 to 2,800 calories
    • Men: 2,800 to 3,200 calories

These are just general guidelines. It’s essential to consult with a nutritionist or a doctor who can give personalized advice based on your specific situation. Remember, it’s not just the quantity but also the quality of calories that matters for overall health.

Obesity results from the accumulation of excessive body fat, which is stored as adipose tissue. An energy deficit of approximately 3,500 calories is required to lose one pound of fat. However, there are several factors that can influence this particular number. These include compensatory changes in your resting metabolism (basal metabolic rate [BMR]), the energy cost of work, and discretionary physical activity, which can sometimes alter this figure by 100 to 200 calories. Your basal metabolic rate (BMR) also known as resting metabolic rate (RMR) is the number of calories your body burns while performing basic life-sustaining functions, such as breathing and keeping your heart beating. Your basal metabolic rate (BMR) is typically between 1,000 and 2,000 calories per day.

How to calculate calories you need for weight loss

You can calculate your basal metabolic rate (BMR) or resting metabolic rate (RMR) using the Mifflin-St Jeor equation 35, which is considered more accurate than the Harris-Benedict equation, especially for lean people. According to the Academy of Nutrition and Dietetics Evidence Analysis Library (EAL), the Mifflin-St. Jeor equation accurately predicted resting metabolic rate (RMR) using actual body weight within +/- 10% of measured RMR in 70% of obese individuals 36. Of the remaining 30%, 9% were overestimations and 21% were underestimations. The individual error range was a maximum overestimate of 15% to a maximum underestimate of 20%” 37. While the Harris-Benedict and WHO equations are often used in clinical practice with reasonable accuracy, results have been mixed regarding their applications to individuals who are overweight or obese 22.

The Mifflin-St Jeor formula for calculating your basal metabolic rate (BMR) or resting metabolic rate (RMR):

  • Males Basal metabolic rate [BMR] (kcal/day) = (10 X weight in kilograms) + (6.25 X height in centimeters) – (5 X age in years) + 5 (kcal/day)
  • Females Basal metabolic rate [BMR] (kcal/day) = (10 X weight in kilograms) + (6.25 X height in centimeters) – (5 X age in years) – 161 (kcal/day)

You can also use the free online Basal Metabolic Rate (BMR) calculator here: https://www.nasm.org/resources/calorie-calculator

Or the Body Weight Planner (https://www.niddk.nih.gov/health-information/weight-management/body-weight-planner).

The Body Weight Planner allows you to make personalized calorie and physical activity plans to reach a goal weight within a specific time period and to maintain it afterwards.

The Basal Metabolic Rate (BMR) calculator factor in your activity levels, overall goals, and calorie usage to help you craft a weight-loss plan.

Once you have found your basal metabolic rate (BMR), multiply your BMR by your Physical Activity Levels to provide a baseline daily caloric level for weight maintenance:

  • Sedentary (light physical activity associated with typical day-to-day life) = 1
  • Low Active (walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life), For males = 1.11 and females = 1.20
  • Active (walking more than 3 miles per day at 3 to 4 miles per hour, in addition to light physical activity associated with typical day-to-day life: 60 minutes of at least moderate intensity physical activity). For males = 1.25 and females = 1.27
  • Very Active (walking more than 7.5 miles per day at 3 to 4 miles per hour, in addition to light physical activity associated with typical day-to-day life: 60 minutes of at least moderate to vigorous intensity physical activity). For males = 1.48 and females = 1.45

Your Total Daily Energy Expenditure (TDEE) gives you the estimated number of calories you need to maintain your current weight based on your activity level.

To find your Total Daily Energy Expenditure (TDEE) multiply your Basal Metabolic Rate (BMR) by your Physical Activity Levels

For example:

  • Sedentary (little to no exercise): BMR x 1
  • Lightly active (walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life): BMR x For males = 1.11 and females = 1.20
  • Moderately active (moderate exercise/sports 3-5 days/week): BMR x 1.55
  • Very active (walking more than 7.5 miles per day at 3 to 4 miles per hour, in addition to light physical activity associated with typical day-to-day life: 60 minutes of at least moderate to vigorous intensity physical activity): BMR x For males = 1.48 and females = 1.45
  • Super active (very hard exercise & physical job or 2x training): BMR x 1.9

You can increase your basal metabolic rate (BMR) by:

  • Exercising more, especially interval training
  • Weight training to build muscle mass
  • Eating fat-burning foods
  • Getting enough sleep

After calculating your basal metabolic rate (BMR) or resting metabolic rate (RMR), your RMR should be multiplied by an appropriate physical activity factor to provide your baseline daily caloric level for weight maintenance. Once your baseline caloric level is known, your recommended calorie intake should be reduced to facilitate your weight loss.

If you want to lose weight, subtract 500 to 1000 calories from your Total Daily Energy Expenditure (TDEE) to get a daily intake goal. For weight gain, add extra calories. Reducing your calorie intake by 500 calories is a common strategy to yield a weight loss of approximately one pound per week, although reductions of up to 750 calories per day are sometimes used 38.
Another approach is to reduce your current caloric intake by 30% 38. Diets that reduce caloric intake relative to energy expenditure result in weight loss, regardless of macronutrient composition 38.

Here’s how to estimate how long it will take to reach your goal:

Jessie’s current weight is 150 lbs. She wants to lose 20 lbs.

  • 150lbs – 20lbs = 130lbs.
  • 20lbs loss at 2lbs/week = 10 weeks.
  • It will take Jessie about 10 week to lose the weight.

Remember, these are general guidelines only. It’s crucial to monitor your progress and adjust as necessary. Consulting with a nutritionist or health professional is always recommended for personalized advice.

How many calories should I eat to lose weight?

For a healthy and sustainable weight loss journey, it’s typically recommended you not to shed more than 2 pounds of fat weekly. This translates to a daily calorie deficit of 1,000 calories. It’s essential to note that when weight loss surpasses 2lbs within a week, it’s often water weight being lost, not just fat.

For those leading a more sedentary lifestyle, aiming to lose 1lb per week is a good starting point. This means creating a daily calorie deficit of 500 calories.

On the other hand, those who are more active naturally have higher daily calorie needs. So, when they’re trying to lose weight, they can afford to eat a bit more since their maintenance calories are already elevated.

For such individuals, aiming for a daily calorie deficit of 500-1,000 calories is realistic, potentially leading to a weight loss rate of up to 2lbs weekly.

What happens when your calories are too low?

Consuming calories below your body’s needs for an extended period can lead to various physiological and psychological consequences. Here’s what can happen when your caloric intake is too low:

  • Slower metabolism: Your body might slow down its metabolic rate as a defense mechanism to conserve energy. This can make weight loss harder over time and weight regain more likely once normal eating resumes.
  • Nutrient deficiencies: Low calorie intake can lead to inadequate intake of essential vitamins and minerals. Over time, this can result in conditions like anemia, osteoporosis, and impaired immune function.
  • Loss of muscle mass: Your body might start breaking down muscle tissue for energy, especially if protein intake is inadequate. This can further slow down metabolism and lead to weakness.
  • Hormonal changes: Reduced calorie intake can affect hormone levels, leading to disruptions in menstrual cycles for women, reduced bone density, and other hormonal imbalances.
  • Reduced energy and fatigue: You might feel constantly tired or find it difficult to concentrate.
  • Mood changes: Low caloric intake can influence mood. This can result in irritability, depression, or anxiety.
  • Impaired Immune Function: Your body might become more susceptible to infections due to a weakened immune system.
  • Hair and skin problems: You might experience hair loss, dry skin, or brittle nails due to inadequate nutrient intake.
  • Digestive problems: Constipation or other digestive issues can occur as a result of reduced fiber and fluid intake.
  • Fertility issues: Low calorie and nutrient intake can lead to fertility problems in both men and women.
  • Cardiovascular problems: Chronic low calorie intake can affect heart health, leading to low blood pressure, irregular heart rhythms, or other cardiovascular issues.
  • Increased risk of gallstones: Rapid weight loss from very low-calorie diets can lead to the development of gallstones.

Setting Realistic Goals

Realistic goals are achievable and manageable within your current circumstances. To set realistic goals, you can use the SMART method, which stands for Specific, Measurable, Attainable, Relevant, and Time-bound:

  • Specific: Define exactly what you want to accomplish
  • Measurable: Make your goal quantifiable so you can track your progress
  • Attainable: Ensure your goal is something you can do with your current resources
  • Relevant: Consider how your goal will improve your life or career
  • Time-bound: Set a deadline for when you want to achieve your goal

Here are some other tips for setting realistic goals:

  • Write it down: Make your goal feel more tangible by writing it down
  • Plan your steps: Think of one or two things you are ready, willing and able to change about the way you eat and exercise. Then set a goal for each. Consider three things:
    • What is the behavior that you will change? Be specific.
    • How often will you do this?
    • Don’t try to change too much at once. Be realistic.
  • Share your goal: Tell someone you trust about your goal to help you stay accountable and motivated
  • Focus on one or two goals at a time: Working on too many goals at once can make it difficult to complete any of them
  • Set a range: Set a range of what’s good, great, and excellent to help you stretch your goals

Here are some examples of goals that include the SMART method:

  • Eating goal: Four days each week (How Often) I will eat an apple instead of ice cream as my evening snack (Realistic and Specific).
  • Physical activity goal: Five days each week (How Often) I will take a 30 minute walk during my lunch hour since I don’t really need the whole hour to eat (Realistic and Specific).

Notice that the eating goal is not “I will eat more fruit” or “I will eat healthier.” The activity goal is not “I’ll walk more.” Goals like that are not specific enough.

There is no single target weight that will meet every one’s goals 22. Optimal weight reduction targets vary depending on your sex, height, weight, health, level of physical activity and medical conditions. Progress toward healthier weight goals should involve a gradual approach that minimizes health risks and is timed to your level of readiness. With time, greater weight loss may be possible if realistic goals are adopted, met, and sustained.

Most people may have unrealistic ideas of how much better they will look with even modest weight loss (i.e. a half-pound per week) 39. You need to have a realistic weight loss target set for yourself, which you have developed during consultation with your healthcare professionals (e.g., your doctor and dietitian). Most people’s weight loss targets are often unrealistically high and their time frames unrealistically short (e.g., targets of 25% or more of body weight in a few weeks rather than many months) 22. Numerous studies have shown that obese individuals hope to lose 25 to 35% of their initial weight within a year or less after beginning obesity treatment 22. Realistically, people only lose 5 to 15% of their initial weight over a year after beginning any kind of obesity treatment 22. Unfortunately, many dieters still maintain unrealistic standards even when they are repeatedly informed that their goals may be unrealistic 28, 40, 41.

A healthy weight-loss target is usually to achieve a weight loss of one-half to two pounds of body weight each week over six months (24 weeks), leading to a decrease of 5 to 10% in body weight from baseline 22. For example a 250 pound, 5’6’’ woman with a BMI of 40 that lost 12.5 pounds over six months, would have a 5% weight loss, and an ending BMI of 38.5. A 10% weight loss would result in a BMI of 36.3. The goal is to maintain this weight loss over time, and that is never easy. A weight loss of 5 to 10% is achievable and moderate enough to decrease some obesity-related risk factors, such as type 2 diabetes, high blood pressure, heart and blood vessel disease, and sleep apnea 42.

Once you set your goals, start setting up a plan to help you achieve them. After that it is vital to begin a weight maintenance program that includes the same three components used for initial weight loss such as dieting, physical activity, and behavior change to help prevent weight regain and maintain your new, healthier lifestyle 36.

Behaviors that will help you lose weight and keep it off

Set the Right Goals

Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and physical activity changes that will lead to long-term weight change. Successful weight managers are those who select two or three goals at a time that are manageable.

Useful goals should be:

  1. Specific;
  2. Attainable (doable); and
  3. Forgiving (less than perfect).

For example, “exercise more” is a great goal, but it’s not specific. “Walk 5 miles every day” is specific and measurable, but is it doable if you’re just starting out? “Walk 30 minutes every day” is more attainable, but what happens if you’re held up at work one day and there’s a thunderstorm during your walking time another day? “Walk 30 minutes, 5 days each week” is specific, doable, and forgiving. In short, a great goal!

Be prepared for setbacks

Setbacks are normal. After a setback, like overeating at a family or workplace gathering, try to regroup and focus on getting back to your healthy eating plan as soon as you can. Try to eat only when you’re sitting at your dining room or kitchen table. At work, avoid areas where treats may be available. Track your progress using online food or physical activity trackers, such as the Body Weight Planner (https://www.niddk.nih.gov/bwp), that can help you keep track of the foods you eat, your physical activity, and your weight. The Body Weight Planner allows users to make personalized calorie and physical activity plans to reach a goal weight within a specific time period and to maintain it afterwards. These tools may help you stick with it and stay motivated.

Overcome roadblocks

Remind yourself why you want to be healthier. Perhaps you want the energy to play with your nieces and nephews or to be able to carry your own grocery bags. Recall your reasons for making changes when slip-ups occur. Decide to take the first step to get back on track.

Problem-solve to “outsmart” roadblocks. For example, plan to walk indoors, such as at a mall, on days when bad weather keeps you from walking outside.

Ask a friend or family member for help when you need it, and always try to plan ahead. For example, if you know that you will not have time to be physically active after work, go walking with a coworker at lunch or start your day with an exercise video.

Nothing Succeeds Like Success

Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e.g., an initial reduction of fat intake from 40 percent of calories to 35 percent of calories, and later to 30 percent). It is based on the concept that “nothing succeeds like success.”

Shaping uses two important behavioral principles:

  1. Consecutive goals that move you ahead in small steps are the best way to reach a distant point; and
  2. Consecutive rewards keep the overall effort invigorated.

Reward Success (But Not With Food)

An effective reward is something that is desirable, timely, and dependent on meeting your goal. The rewards you choose may be material (e.g., a movie or music CD, or a payment toward buying a more costly item) or an act of self-kindness (e.g., an afternoon off from work or just an hour of quiet time away from family). Frequent small rewards, earned for meeting smaller goals, are more effective than bigger rewards that require a long, difficult effort.

Balance Your Food Checkbook

“Self-monitoring” refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, amount of physical activity, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you’re not sure how you’re doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually moves you closer to the desired direction and can produce “real-time” records for review by you and your health care provider. For example, keeping a record of your physical activity can let you and your provider know quickly how you’re doing. When the record shows that your activity is increasing, you’ll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.

While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day’s diet and exercise patterns won’t have a measurable effect on your weight the next day. Today’s weight is not a true measure of how well you followed your program yesterday, because your body’s water weight will change from day to day, and water changes are often the result of things that have nothing to do with your weight-management efforts.

Avoid a Chain Reaction

Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you’re more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to change the situation, such as by separating the association of eating from the cue (don’t eat while watching television), avoiding or eliminating the cue (leave the coffee room immediately after pouring coffee), or changing the circumstances surrounding the cue (plan to meet your friend in a nonfood setting). In general, visible and reachable food items are often cues for unplanned eating.

Get the Fullness Message

Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message that you’ve been fed. Eating slowly will help you feel satisfied. Eating lots of vegetables and fruits can make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear too small. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.

Seek support

Ask for help or encouragement from your family, friends, or health care professionals. You can get support in person, through email or texting, or by talking on the phone. You can also join a support group. Specially trained health professionals can help you change your lifestyle.

Eating behavior

Emotional eating can quickly sabotage weight loss efforts. For example, you have probably heard that some people eat to cope with stress. Others eat to preoccupy themselves when they feel bored. If you can pinpoint the emotions that cause you to reach for food, you can stay on track.

If you have recently eaten and find yourself craving food again, do a quick emotional check. Do you want food because you are hungry or to fill an emotional need?

Here are some tips to keep your eating in check:

  • Remember which emotions and situations trigger you to eat.
  • Write a list of other things to do to fulfill that emotional need, for example, call a friend, take a walk, drink some water or another zero-calorie beverage, send an email to a pal or do a few yoga stretches.
  • Track the food you eat, how hungry you are when you eat and how you feel at the time. You may get a better idea of which emotions trigger eating when you are not physically hungry.

If you are having a hard time, reach out for help. Involve family members and friends to help support your weight loss efforts. Support groups, therapy and members of your health care team can also help.

What is the best way to lose weight?

There is no one best way to lose weight, which is why doctors and dietitians work to understand your personal circumstances when making recommendations. There is no quick fix. Improving your diet and increasing activity can be key to losing weight, although are not the only factors that need to be considered. When aiming to lose weight it is important to have realistic goals that are achievable. Success boosts confidence in your ability to lose weight. A weight loss of between 0.5 to 2 pounds (0.5-1kg) a week is a safe and realistic target. Experts recommend losing 5 to 10 percent of your body weight within the first 6 months of treatment 43. If you weigh 200 pounds, this means losing as little as 10 pounds. Moreover, it’s not just about your weight on the scales, losing inches from your waist helps to lower your risk of conditions like type 2 diabetes and high blood pressure. To reach and stay at a healthy weight over the long term, you must focus on your overall health and lifestyle habits, not just on what you eat. Successful weight-loss programs should promote healthy behaviors that help you lose weight safely, that you can stick with every day, and that help you keep the weight off. People who successfully lose weight and keep it off develop techniques to make their new lifestyle and activity habits an enjoyable way of life and also make them life long.

You weight loss programs and weight loss maintenance programs should focus on changing your behavior to reduce energy intake by cutting unhealthy foods, decreasing sugar‐sweetened beverage consumption and fat intake, portion control, increasing fruit and vegetable intake, and adhering to a diet 44. Additionally, energy expenditure should be promoted through increasing physical activity.

American College of Sports Medicine recommendations for physical activity for Weight Loss and Prevention of Weight Regain for Adults 45:

  • Maintain and improving health: 150 minutes/week
  • Prevention of weight gain: 150 – 250 minutes/week
  • Promote clinically significant weight loss: 225 – 420 minutes/week
  • Prevention of weight gain after weight loss: 200 – 300 minutes/week

Strong evidence exists that exercise (physical activity) can reduce weight gain in those at risk for obesity, and many exercise training programs are capable of producing at least modest weight loss (~2 kg) 45. A question often encountered in the clinical setting from patients is how much exercise is needed to lose weight and what type of exercise training should be performed. Overall, the changes in weight in response to exercise training without caloric restriction are highly heterogeneous and individual differences can span weight gain to clinically significant weight loss 46. Patients should should consult their clinicians or dietitians on what are reasonable expectations based on their specific weight loss program. However, research data suggest that physical activity has an important role in the amount of weight regain following successful weight loss 47. Therefore, patients attempting to reduce recidivism after weight loss should engage in physical activity levels above 200 minutes/week 45.

Furthermore, high levels of physical activity and cardiorespiratory fitness (fitness) are inversely associated with cardiovascular disease, type 2 diabetes and all-cause mortality 48. Several epidemiological studies even suggest that high levels of physical activity or cardiorespiratory fitness reduces the health risk of obesity 49, 50. Moreover, cardiorespiratory fitness levels have been shown to alter the relationship of the obesity paradox, where high cardiorespiratory fitness level is associated with greater survival in all body mass index (BMI) categories 51. In summary, patients are encourage to adhere to exercise programs or engage in regular physical activity regardless of the weight loss achieved.

Another question that is often encountered in the clinical setting is if there is a difference between weight loss achieved through dietary means or through exercise training in terms of cardiovascular and type 2 diabetes mellitus risk factors. In an elegantly designed study, Ross et al. 52 randomized obese men (n= 52) to diet-induced weight loss, exercise induced weight loss, exercise without weight loss, or a control group for 3 months. The diet-induced and exercise-induced weight loss groups lost approximately 7 kg of weight (8% weight reduction), and had significant reductions in total fat mass, visceral fat and increased glucose disposal 52. However, the exercise-induced weight loss group had a greater reduction in total fat mass compared to the diet induced weight loss group 52. Importantly, the exercise-induced weight loss improved cardiorespiratory fitness (fitness) whereas the dietary group did not. In the group who performed exercise training without weight loss, the participants still experienced reductions in visceral fat and increased cardiorespiratory fitness.

The observations by Ross et al. 52 reaffirm that an exercise training program still confers health benefits to obese patients even in the absence of weight loss. Although dieting without exercise training has potential cardiovascular benefits, exercise training should be encouraged by to help patients improve cardiorespiratory fitness levels, which is an independent risk factor for cardiovascular diseases, type 2 diabetes mellitus and mortality 10, and may further augment the negative energy balance created by caloric restriction. Lastly, Ross’ observations suggest that there is a rationale for exercise training to be a part of weight loss programs as the authors observed greater changes in visceral fat, oral glucose tolerance, and glucose disposal in the exercise training group with clinically significant weight loss compared to the group with exercise without weight loss group 52.

Healthy Weight-Loss

Healthy weight loss is key for long-term weight maintenance. A variety of weight loss methods are available, from minimally structured self-guided methods to medically supervised very low calorie diet (VLCD; e.g., 400–800 kcal/day) regimens 53. Intensive, very low-calorie diets (VLCDs; e.g., ≤800 calories per day and especially <500 calories) produce significantly greater initial weight loss; however, these results are often not maintained over time 53. In a study done in 2008, participants were enrolled in a program designed to help maintain weight loss 53. Participants all initially lost weight using one of three methods, very low calorie diet (VLCD; e.g., 400–800 kcal/day), commercial programs or a self-guided approach 53. At the start of the study, those who had used a very low calorie diet (VLCD; e.g., 400–800 kcal/day) lost up to 24% of highest body weight in the last two year compared to those in the commercial programs and self-guided approaches who lost 17% 53. Results showed that those who used a very low calorie diet (VLCD; e.g., 400–800 kcal/day) regained significantly more weight than the other two groups by six months in the weight maintenance program 53. However, those who had lost weight using a self-guided method were able to maintain their initial weight loss with great success 53. It should be emphasized that the primary reason for losing weight is for better health outcomes; therefore, weight loss should occur by using healthy methods that can be maintained throughout your life 22. Concentrating on improving health outcomes and other risk factors rather than simply on weight loss is vital 22.

In most people, a 10% weight loss target can be achieved with a calorie deficit of 500 to 1,000 calories per day, leading to weight losses of one pound to two pounds per week (i.e. total calories deficit of 3,500 to 7,000 per week) 22. Cutting down on alcohol, dietary fats and sugary carbohydrates is a practical way to produce this calorie deficit 54. A comprehensive analysis of data that focuses on dieting and weight loss found that increased lean tissue (muscle tissue) is lost if the energy deficit of the diet is too large in combination with rapid weight loss 55. In contrast, inclusion of exercise (both cardio workout and weightlifting) and adequate dietary protein (60 grams per day, ranging from 0.8 g to 1.5 g per kg of body weight) helps to minimize muscle tissue loss 55. These dietary strategies should be incorporated into dietary treatment plans to minimize muscle mass reduction and maximize fat loss 22.

For women, a weight reduction plan of eating approximately 1,000 to 1,200 calories per day is suitable. According to the National Institutes of Health and the National Heart, Lung, and Blood Institute, a 1,200 – 1,600 calorie allowance for men or women who weigh 165 pounds, or more, and who exercise regularly is recommended 22. These calorie amounts along with increased physical activity and behavioral modification will likely produce a caloric deficit to achieve the targeted weight loss plan of one to two pounds per week 56. With a caloric deficit of 500 to 1000 calories per day, if followed with perfect adherence, after six months, weight loss of 26 to 52 pounds would be expected. However, in reality, losses are usually between 20 to 25 pounds, since adherence is never perfect 57.

It is recommended that you dieting should last for 6 months or less, because according to research after about six months, most people have great difficulty sticking to any diet, especially if it is very strict 22. Furthermore, your weight will plateau as your energy intake fluctuates and as your resting metabolic rate and energy output decrease. After six months of weight loss, you should focus on maintenance of the weight loss through a combination of diet therapy, physical activity, and behavior modification. If successful, after several months you can start a new weight loss cycle again 22. If further weight reduction is necessary after 10% of initial body weight is lost, it can be attempted with an increased calorie deficit after prior weight loss has been maintained for several months.

When you do not engage in a weight management program that includes all three components (i.e., diet therapy, physical activity, and behavior modification) you’re risking regaining all or extra weight increase 36, 57. Most people regain one-third of their lost weight in one year, and nearly half return to their original weight within five years 40. The more frequently you have has contact with your healthcare provider (doctor and dietitian), the weight loss and maintenance outcomes tend to be more successful 36.

Now you know the basics about calories and healthy weight loss, the key to weight loss for most people is simply finding the right combination of exercise, healthy foods and cutting back on portions will help you lose those extra pounds. No fad diet required. In other words, eat healthily, watch your portions and get moving more. By losing just a few pounds with healthy eating and exercise, you’ll start to feel better. You’ll have more energy. To prevent the weight creeping back on, you need to keep going with the healthy habits you’ve formed.

Low-Calorie Diets (LCDs)

Low-Calorie Diets (LCDs) are eating plans or meal plans that reduce your caloric intake to about 1,200 to 1,500 calories in women, and 1,500 to 1,800 calories in men 22. Low-Calorie Diets (LCDs) will result in weight loss if they are adhered to perfectly, regardless of their macronutrient composition 38, 58. This is because these low caloric levels will result in a caloric deficit for most overweight and obese adults. The National Institutes of Health have recommended low calorie diets (LCDs) of 1,000 to 1200 calories for women, and 1,200 to 1,600 calories per day for men, although adherence may be difficult with lower caloric intake 57. Either way, the rationale is that on such eating plans, a deficit of approximately 500 to 1,000 calories per day will be created, which should result in a slow progressive weight loss of one to two pounds per week 22. The MyPlate.gov website (https://www.myplate.gov/) that can be accessed by consumers provides a simple visual reminder to choose a variety of foods throughout the day and throughout the week. It represents what and how much to eat from each of the food groups over the course of the day, whether you eat on a plate, from a bowl, or another way.

It is important to recognize that when using fixed calorie diet plans, that even with perfect adherence, individuals will vary greatly in their weight loss. This is because their resting energy needs and physical activity, and thus energy outputs, often differ markedly, and may fluctuate even within an individual.

1200 Calories eating plan

Over the next 12 weeks you’re going to make healthier choices to help you lose weight and keep it off. From today, you’ll stick to a daily calorie intake of 1200 Calories.

Table 6. 1200 Calories Traditional American Cuisine

BreakfastEnergy (Kcal)Fat (gram)% FatExchange for:
Whole-wheat bread, 1 med. slice701.215(1 Bread/Starch)
Jelly, regular, 2 tsp 3000(½ Fruit)
Cereal, shredded wheat, ½ Cup10414(1 Bread/Starch)
Milk, 1%, 1 Cup102323(1 Milk)
Orange juice, ¾ Cup 7800(1½ Fruit)
Coffee, regular, 1 Cup 500(Free)
Breakfast Total 3895.210
LunchEnergy (Kcal)Fat (gram)% FatExchange for:
Roast beef sandwich
Whole-wheat bread, 2 medium slices1392.415(2 Bread/Starch)
Lean roast beef, unseasoned, 2oz601.523(2 Lean Protein)
Lettuce, 1 leaf100
Tomato, 3 med. slices 1000(1 Vegetable)
Mayonnaise, low-calorie, 1 tsp151.796(1⁄3 Fat)
Apple, 1 medium8000(1 Fruit)
Water000(Free)
Lunch Total 3055.616
DinnerEnergy (Kcal)Fat (gram)% FatExchange for:
Salmon, 2 oz edible 103540(2 Lean Protein)
Vegetable oil, 1½ tsp607100(1½ Fat)
Baked potato, ¾ medium 10000(1 Bread/Starch)
Margarine, 1 tsp344100(1 Fat)
Green beans ½ Cup, seasoned with margarine
5224(1 Vegetable)
(½ Fat)
Carrots, seasoned3520(1 Vegetable)
White dinner roll, 1 small70226(1 Bread/Starch)
Iced tea, unsweetened000(Free)
Water000(Free)
Dinner Total 4542039
SnackEnergy (Kcal)Fat (gram)% FatExchange for:
Popcorn, 2½ Cups 6900(1 Bread/Starch)
Margarine, ¾ tsp303100(¾ Fat)
Grand Total12473424

Footnotes:  Total Calories = 1,247; Total Carb = 58% kcals; Total Fat = 26% kcals; Saturated Fat = 7% kcals; Cholesterol = 96 mg; Protein = 19% kcals; Sodium (salt) = 1,043 mg (No salt added in recipe preparation or as seasoning). Consume at least 32 oz (950 ml) water. Recommended Dietary Allowance (RDA) is average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy people. 100% RDA met for all nutrients except: vitamin E 80%, vitamin B2 96%, vitamin B6 94%, Calcium 68%, Iron 63% and Zinc 73%.

[Source 59 ]

1600 Calories eating plan

Table 7. 1600 Calories Traditional American Cuisine

BreakfastEnergy (Kcal)Fat (gram)% FatExchange for:
Whole-wheat bread, 1 medium slice701.215(1 Bread/Starch)
Jelly, regular, 2 tsp 3000(½ Fruit)
Cereal, shredded wheat, ½ Cup10414(1 Bread/Starch)
Milk, 1%, 1 Cup102323(1 Milk)
Orange juice, ¾ Cup 7800(1½ Fruit)
Coffee, regular, 1 Cup500(Free)
Milk, 1%, 1 oz130.0323(1⁄8 Milk)
Breakfast Total 4025.2312
LunchEnergy (Kcal)Fat (gram)% FatExchange for:
Roast beef sandwich
Whole-wheat bread, 2 medium slices1392.415(2 Bread/Starch)
Lean roast beef, unseasoned, 2 oz601.523(2 Lean Protein)
American cheese, low-fat and low-sodium, 1 slice
(¾ oz)
461.836(1 Lean Protein)
Lettuce, 1 leaf100
Tomato, 3 medium slices 1000(1 Vegetable)
Mayonnaise, low-calorie, 2 tsp303.399(2⁄3 Fat)
Apple, 1 medium8000(1 Fruit)
Water000(Free)
Lunch Total 366922
DinnerEnergy (Kcal)Fat (gram)% FatExchange for:
Salmon, 3 oz edible 155740(3 Lean Protein)
Vegetable oil, 1½ tsp607100(1½ Fat)
Baked potato, ¾ medium10000(1 Bread/Starch)
Margarine, 1 tsp344100(1 Fat)
Green beans ½ Cup, seasoned with margarine5224(1 Vegetable) (½ Fat)
Carrots ½ Cup, seasoned with margarine
5224(1 Vegetable) (½ Fat)
White dinner roll, 1 medium80333(1 Bread/Starch)
Ice milk, ½ Cup92328(½ Fat)
Iced tea, unsweetened, 1 Cup000(Free)
Water000(Free)
Dinner Total 6252840
SnackEnergy (Kcal)Fat (gram)%FatExchange for:
Popcorn, 2½ Cups 6900(1 Bread/Starch)
Margarine, 1½ tsp516100(1½ Fat)
Grand Total14904829

Footnotes:  Total Calories = 1,490; Total Carb = 52% kcals; Total Fat = 29% kcals; Saturated Fat = 8% kcals; Cholesterol = 142 mg; Protein = 19% kcals; Sodium (salt) = 1,341 mg (No salt added in recipe preparation or as seasoning). Consume at least 32 oz (950 ml) water. Recommended Dietary Allowance (RDA) is average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy people. 100% RDA met for all nutrients except: vitamin E 99%, Iron 73% and Zinc 91%.

[Source 60 ]

Very-Low-Calorie Diets (VLCDs)

Very-Low-Calorie Diets (VLCDs) are eating plans or meal plans that reduce your caloric intake to about 800 calories or less per day with a total of 50 to 80 grams of protein and 100% of the Reference Daily Intake (RDI) for vitamins and minerals per day, and are designed to produce very rapid weight loss while still preserving lean muscle mass 36. Very-Low-Calorie Diets (VLCDs) are reserved for special uses and for people at high obesity-related health risks where it is imperative to lose weight because of their potential for greater adverse metabolic effects and the consequent need for more extensive medical monitoring. Possible side effects of very-low-calorie diets (VLCDs) are fatigue, constipation, nausea, or diarrhea to more serious risks such as ketoacidosis and gallstones 22. Very-Low-Calorie Diets (VLCDs) contraindications include recent heart attack (myocardial infarction), heart conduction disorders, history of cardiovascular disease, kidney or liver disease, cancer, type 1 diabetes, and pregnancy 22. Behavioral contraindications to their use include bulimia nervosa, major depression, bipolar disorder, substance abuse, and acute psychiatric illness 22.

Very-Low-Calorie Diets (VLCDs) are often prescribed by your doctor as a form of intensive diet therapy, which require close medical supervision by a physician specializing in obesity care and should not be used long-term 22. Very-Low-Calorie Diets (VLCDs) are intended to induce quick and significant weight loss of about 3 to 5 pounds per week or 14 to 21 kilograms over 11 to 14 weeks 22. Very-Low-Calorie Diets (VLCDs) are sometimes used to provide a jump-start to further obesity treatment. This is typically done through meal-replacement liquid diets 61. Any diet, regardless of its caloric level, that provides less than half of an individual’s energy needs can be considered a Very-Low-Calorie Diet (VLCD) for that individual. However, virtually all adults have energy needs that exceed 1,000 calories per day, and therefore any diet below 500 calories, and for most individuals, diets below 800 calories, are Very-Low-Calorie Diets (VLCDs) 22. Depending on your caloric requirements, other dieting regimens that are higher in calories may also be VLCD for some people with very high energy needs using this same rule of thumb; for example, a 1,200 calorie diet prescribed to a man whose usual intake is 3,000 calories would also qualify as a VLCD 22.

According to the National Task Force on the Prevention and Treatment of Obesity, Very-Low-Calorie Diets (VLCDs) in patients with BMI >30 are usually effective in promoting significant short-term weight loss, in addition to improving coexisting obesity-related conditions (e.g., obstructive sleep apnea, poorly-controlled type 2 diabetes, hypertriglyceridemia) 62. However, Very-Low-Calorie Diets (VLCDs) require close metabolic monitoring with at least every 2 weeks doctor visits, and should only be prescribed and adjusted under the supervision of a physician specializing in obesity care 22.

The main advantages of the VLCD for patients include a rapid improvement in blood pressure, blood glucose, serum lipids and often-psychological status. For those who require surgery, the rapid loss of weight may reduce some of the surgical risks associated with obesity 22.

There are 2 major types of very-low-calorie diets (VLCDs) currently in use; commercial and “home-made” preparations. The commercial very-low-calorie diets (VLCDs) preparations include powdered products that are rich in egg- or milk-based proteins, are mixed with water, and consumed four to five times per day 22. The commercial products must provide at least 70 grams of protein by law, and often contain much higher amounts of high quality protein (70 to 100 grams), 50 to 100 grams carbohydrate, and up to 15 grams fat per day, plus vitamins and minerals in amounts to meet the Recommended Dietary Allowances (RDA) 22. These products are formulated under U.S. Food and Drug Administration (FDA) regulatory specifications. They are convenient and have a predictable and adequate composition when used as directed. Their major disadvantage compared to home preparations is their higher cost. The formulas or prepackaged meals are relatively choice-free and help dieters avoid contact with conventional foods, which in some cases may facilitate dietary adherence and remove temptation.

Several commercial weight loss programs are available that provide an entire program of commercially prepared very-low-calorie diets (VLCDs) plus the other essential aspects of a sound weight control program, including dietetic advice, exercise, behavioral modification, and supervision during the VLCD and post VLCD phases. The choices include the programs of HMRTM (Health Management Resources), OptifastTM (Novartis Nutrition), and MedifastTM. These programs employ health professionals who are trained in weight management, and a structured program that encourages adherence. The major disadvantage is that they are expensive ($3,000 to $34,000 for 26 to 28 weeks), and costs may not be covered by health insurance 63. Also, there is the uncertainty that the weight that is lost will remain so over the long run. Therefore a serious psychological as well as economic investment of effort in long-term weight management is also mandatory.

“Home made” VLCD regimens are sometimes referred to as “protein-sparing fasts” or “protein sparing modified fasts” (PSMF) 22. This is a misnomer since they do not “spare” protein except in contrast to a total fast. “Home made” very-low-calorie diets (VLCDs) are usually based on lean meat, fish or poultry and a few other foods plus supplements of two to three grams of potassium chloride and a multivitamin or multimineral supplement in amounts approximating the Recommended Dietary Allowances (RDA) 22. Without such supplementation, they may be nutritionally inadequate 22. When dieters are provided with appropriate dietetic counseling and health supervision by a physician who is experienced in the use of very-low-calorie diets (VLCDs) and other aspects of a complete weight reduction program, these formulations are also safe and generate rapid weight loss 22. The extremely low caloric versions of VLCDs (e.g., less than or equal to 800 calories per day), which are low in carbohydrate and sodium, promote a mild ketosis that gradually leads to diuresis and rapid weight loss in the first several days on the diet.

There seems to be little difference in outcomes between commercial and properly formulated homemade very-low-calorie diets (VLCDs). The National Institute of Health expert panel review of existing studies found that preservation of weight loss over the long-term (e.g., >1 year) was not different on Very-Low-Calorie Diets (VLCDs) from that of Low-Calorie Diets (LCDs) since most patients gained back 30 to 50% of the lost weight 22. Studies of VLCDs vary in their long-term results, but weight regain is common (3.1 to 3.7 kg during 21-38 weeks afterwards) 38. Combining a VLCD with behavior therapy, physical activity, and active physician follow-up may help to prevent this weight regain, and lend to greater weight loss 64. As such, the long-term advantages of VLCDs in weight control are unclear. Although weight gain is common after cessation of VLCDs, individual clinicians may decide that the expense and quick initial weight loss are worth it for their patient 36.

Patients on VLCDs should drink at least two liters of water per day to make up for decreased food intake and to prevent dehydration 22. Avoidance of caffeinated beverages is sometimes recommended, as they can further the risk of dehydration, although moderate use is not prohibited 22. Electrolyte imbalances may occur, and so may nutrient deficiencies if measures are not taken to prevent them on “home-made” VLCD, by use of appropriate supplements. Minor side effects that occur, even with appropriate physician monitoring of heart and general health status, include fatigue, dizziness due to orthostatic hypotension, muscle cramps, gastrointestinal distress (constipation and/or diarrhea), and cold intolerance 22. The risk of cholelithiasis (gallstones) is increased, and seems to be particularly high when weight loss is very rapid (e.g., >1.5 kilograms/week) 22. The risk of cholelithiasis (gallstones) can be decreased by administering ursodeoxycholic acid, including a moderate amount of fat in the diet, and limiting the amount of weight loss to 1.5 kilograms per week 63.

Alternate-day fasting

On typical alternate-day fasting diets, dieters consume 25% of their energy needs on the fast day, and food intake as necessary or desired (ad libitum) the next day 22. Many of the alternate-day fasting studies do not include control groups that undertake other dietary approaches to weight loss, plus the sample sizes have been small (15 to 64 subjects) and the durations short (8 to 12 weeks) 65, 66, 67, 68, 69. However, results to date show similar weight loss and improvements in metabolic factors as compared to studies using other dietary approaches to weight loss, as well as good adherence. For example, Varady et al 65 found that alternate-day fasting was a viable diet option, helping obese patients not only to lose weight, but to also decrease their risk of coronary artery disease (coronary heart disease). Emerging evidence suggests that the relative contribution of fat and carbohydrate in alternate-day fasting diets does not have an impact on weight and blood lipid profiles 70. An alternative fasting regimen that has become popular among some dieters is two days of fasting followed by five days of usual eating. Further research is needed with larger samples, dietary control groups, and longer durations before alternate-day fasting’s widespread use for weight loss purposes 22.

An alternative intermittent fasting regimen that has become popular among some dieters is two non-consecutive days of fasting and five unrestrictive days of usual eating each week 22. This “5:2 Diet”, developed by Dr. Michael Mosley in the United Kingdom, has spread widely throughout Europe, and now the United States. For the two fast days, men are to eat no more than 600 kcals, and women 500 kcals. Usually this consists of a very light breakfast and dinner with little or no lunch 22. Anecdotally, weight loss has been similar to other dietary approaches to weight loss (2 pounds/week) for short terms (6 weeks) 22. However, research is lacking on the “5:2 Diet”, so its long-term safety and efficacy has not been tested, and its appropriateness in varying populations is currently unknown 22.

Intermittent fasting

Intermittent fasting also known as “periodic fasting”, “time‐restricted feeding”, “alternate-day fasting” or “reduced meal frequency”, is when people restrict the time (e.g., 16–48 hours) during the day when they can eat 71, is another way of reducing food intake that is gaining attention as a strategy for weight loss and health benefits. Alternate-day fasting is one type of intermittent fasting that consists of a “fast day” (eating no calories to one-fourth of caloric needs) alternating with a “fed day,” or a day of unrestricted eating. Intermittent fasting focuses on the timing of when you can consume meals either within a day or a week. For example, someone may eat only during a 12-hour time period, such as 7 a.m. to 7 p.m. Skipping meals commonly consists of a daily fast for 16 hours, a 24-hour fast on alternate days, or a fast 2 days per week on non-consecutive days 72. Intermittent fasting is not a diet plan. While it may have some of the same health benefits as a diet, it’s really an eating pattern. It means you fast (don’t eat) during a certain period of time each day (usually an extended period of time). You then eat during another period of time each day (usually a smaller period of time). While you’re fasting, you can drink beverages that don’t contain calories, including water, black coffee, and unsweetened tea. There is still much for scientists and doctors to learn about intermittent fasting. Researchers have conducted only a few studies of intermittent fasting as a strategy for weight loss. They have no long-term data on the safety, how it affects the body and its systems and effectiveness of intermittent fasting for long-term weight maintenance.

Some popular approaches to intermittent fasting include:

  • Alternate-day fasting. Eat a normal diet one day and either completely fast or have one small meal (less than 500 calories) the next day.
  • 5:2 fasting. Eat a normal diet five days a week and fast two days a week.
  • Daily time-restricted fasting. Eat normally but only within an eight-hour window each day. For example, skip breakfast but eat lunch around noon and dinner by 8 p.m.

How fasting and eating is divided each day is called an eating schedule. One of the most common, easy-to-follow schedules is 16:8. This means you fast for a 16-hour period of time and eat your daily meals during an 8-hour period of time. For example, you may want to fast from 7 p.m. until 11 a.m. the next day. You would then eat a healthy lunch and dinner between 11 a.m. and 7 p.m. You wouldn’t eat anything after 7 p.m. until 11 a.m. the next day. This is just an example of times. You can select any 16-hour and 8-hour block of time that works best for your schedule. But it’s important to keep your eating window at the same every day.

Other intermittent fasting schedules include 18:6 (when you fast for 18 hours and eat for 6 hours) or alternating days. With alternating days, you fast for 24 hours, then eat a healthy diet for the next 24 hours, then fast again for the following 24 hours. This schedule continues using the every-other-day format. Another schedule option is 5:2. This is when you fast for two days a week, and eat a normal, healthy diet the other five days. This is a little different, though, as this schedule allows you eat one small meal of 500 to 600 calories on your fasting days.

The time you’re allowed to eat is called your eating window. During your eating window, focus on eating a healthy diet and maintaining portion control. Don’t eat too many calories and avoid junk food and fast food. While you don’t need to eat anything in particular, you do need to make sure you’re getting the nutrition you need. Some people choose to use the Mediterranean diet as a guideline for what to eat. This plan focuses on fruits, vegetables, beans, whole grains, and fish. You can also choose lean proteins and healthy fats.

During fasting, caloric consumption often ranges from zero to 25% of caloric needs 71. Alternative day fasting may consist of 24-hour fasts followed by a 24-hour eating period that can be done several times a week such as a 5:2 strategy when there are 2 fast days mixed into 5 nonrestrictive days 73. For time restricted fast programs, variations include 16-hour fasts with 8 hour feeding times, 20-hour fasts with 4-hour feed times or other similar versions 73. While both caloric restriction and intermittent fasting may result in overall decreased caloric intake, this is not integral to intermittent fasting. Intermittent fasting has been linked to better glucose control in both humans and animals 74. However, long-term adherence to caloric restriction is low while adherence to intermittent fasting may be more promising.

While researchers are still studying intermittent fasting, some research has shown it offers some health benefits. For starters, it’s common to lose weight when following intermittent fasting. That’s because your body is using fat—not glucose—as its energy source. Additionally, if you make wise food choices when you do eat, you’re likely eating fewer calories than before you started intermittent fasting. If you add exercise to the mix, it’s a great combination for not only weight loss, but also improved health benefits. Intermittent fasting may help people who have cardiovascular disease, neurological disorders, and some cancers. Intermittent fasting may also help lower your bad cholesterol and improve symptoms of arthritis.

The majority of studies of intermittent fasting in humans have considered whether intermittent fasting can be a potential strategy to reduce weight and correct adverse metabolic parameters amongst obese and overweight subjects 75. This is important since the problems of long term adherence to continuous calorie restriction for weight management are well known 76. Losing weight and being physically active help lower your risk of obesity-related diseases, such as diabetes, sleep apnea and some types of cancer. For these diseases, intermittent fasting seems to be about as beneficial as any other type of diet that reduces overall calories. Johnson et al. 77 undertook the first trial of intermittent fasting for weight loss amongst 10 obese subjects with asthma which tested alternate days of an 85% energy restricted low carbohydrate diet regimen. This study reported beneficial reductions in serum cholesterol and triglycerides, markers of oxidative stress (8-isoprostane, nitrotyrosine, protein carbonyls, and 4-hydroxynonenal adducts) and inflammation (serum tumor necrosis factor-α) 77. Circulating ketone levels were also elevated on the fasting days 77. In more recent 27 clinical trials, intermittent fasting resulted in weight loss, ranging from 0.8% to 13.0% of baseline body weight 71. Weight loss occurred regardless of changes in overall caloric intake. In the studies of 2 to 12 weeks’ duration, body mass index (BMI) decreased, on average, by 4.3% to a median of 33.2 kg/m². Therefore intermittent fasting shows promise as a primary care intervention for obesity, but little is known about long-term sustainability and health effects. Longer-duration studies are needed to understand how intermittent fasting might contribute to effective weight-loss strategies. Symptoms such as hunger remained stable or decreased, and no adverse events were reported. While intermittent fasting is a moderately successful strategy for weight loss, it shows promise for improving glycemic control, although it does pose a potential risk of hypoglycemia. However, to lose weight and keep it off, the best strategy is to adopt healthy eating and exercise habits that you enjoy so you can stick with them over time.

To get the benefits of intermittent fasting, you need to fast for at least 12 hours. That’s how long it takes your body to switch from using glucose for energy to using fat for energy. Additionally, it will take your body a while to get used to this new eating schedule. So don’t expect results right away. You may need to wait between 2 and 4 weeks to see or feel any results.

It may take 2 to 4 weeks for your body to get used to eating on an intermittent fasting schedule. During those first few weeks, you may have headaches and feel hungry, grouchy, or tired. Know you may feel this way before you start and make a plan to push through these feelings. After a few weeks, your body will get used to this eating pattern and those symptoms should go away. In the end, many people say that feel better following an intermittent fasting lifestyle.

High Protein Weight Loss Diets

High protein weight-loss diets are those that provide more than 1.6 grams per kilogram of desirable weight per day 22. Self-prescribed high protein weight-loss diets vary in their composition from about 28 to 65% of energy, providing 71 to 163 grams of protein per day. High protein weight-loss diets are currently popular as a new strategy for losing weight, and are usually quite low in their carbohydrate content. Some are clearly ketogenic, and severely limit carbohydrates to below 50 grams per day. Examples include the Doctor’s Quick Weight Loss Diet, The Dukan Diet, Dr. Atkins Diet Revolution, The 17 Day Diet and various iterations of the Paleo Diet 22. Diets that are extremely high in protein should not be undertaken for long periods of time, since their long-term safety has not been sufficiently studied.

Other diets are extremely high in protein, very low in carbohydrate and ketogenic, but also very high in fat, is Protein Power 78. Two other high protein diets with enough carbohydrate so that they are not likely to be ketogenic are The Zone and Sugar Busters 22.

Many high protein diets include elaborate instructions that prescribe strict, structured eating schedules, and involve limited food variety and dietary flexibility. The high protein diets that are ketogenic also induce quick initial weight loss because of their low caloric level, and their diuretic effect owing to glycogen depletion, and sodium and water loss 22. They may also be associated with decreased appetite due to the high protein intake, since protein may show to be particularly satiating 79, 80. Ketosis has long been said to reduce appetite, although little data supports this. Nonetheless, for some patients these constraints may help them to achieve and maintain low calorie intakes over the short run.

However, popular high protein weight-loss diets are not risk-free. Many of these high protein weight-loss diets advocate very high intakes of protein from meat and other foods that are also often high in saturated fat, cholesterol and sodium while they are low in dietary fiber, antioxidants, potassium, calcium, magnesium, and some vitamins 22. The purine content of meat, poultry, seafood, eggs, seeds, and nuts is high, and can increases uric acid levels and risk of gout in susceptible individuals 22. The high protein load may also increase urinary calcium loss if it is not buffered 81. In patients with diabetic kidney disease (diabetic nephropathy), very high protein diets may speed progression, although the data are not definitive 82. Because many high protein diets are often by default low in carbohydrate, they also can cause an increase in ketosis. Finally, high protein weight-loss diets do not necessarily promote greater long-term weight loss as compared to other healthier eating options 83, 84, 85.

Weight-loss programs to avoid

A fad weight loss diet is any diet that promises fast weight loss without a scientific basis. These diets often eliminate entire food groups and as a result do not provide a wide range of important nutrients. Fad diets may provide short-term results but they are difficult to sustain and can cause serious health problems. The best approach to weight loss is to follow a long-term, healthy and balanced eating plan and to exercise regularly.

Avoid weight-loss programs that make any of the following promises:

  • Lose weight without diet or exercise!
  • Lose weight while eating as much as you want of all your favorite foods!
  • Lose 30 pounds in 30 days!
  • Lose weight in specific problem areas of your body!

Other warning signs to look out for include:

  • very small print, asterisks, and footnotes, which may make it easy to miss important information
  • before-and-after photos that seem too good to be true
  • personal endorsements that may be made up

You can report false claims or scams by weight-loss programs to the Federal Trade Commission (https://www.ftc.gov).

Fad diets often lead to fast weight loss at first. But most of this weight loss is water and lean muscle, rather than fat. When you eat very little, your body begins to break down muscle to meet energy (kilojoule) needs. Unfortunately, this occurs much more easily than the breakdown of fat stores.

Breaking down muscle leads to:

  • Water loss, making it seem like you’re losing weight quickly
  • A reduced metabolic rate, so when the diet is stopped, it is much easier for your body to gain fat than it was prior to going on the diet.

As a result, over time, people can diet themselves fatter.

Fad diets often encourage a short-term change in eating behavior, rather than encouraging long-term, sustainable changes. It is essential that any diet meets nutritional needs, is practical and suitable for individual lifestyles.

Regular physical activity is important for those wanting to lose weight to help maintain muscle mass.

Healthy Eating Choices

Carbohydrates

Carbohydrates are your body’s fuel. Carbohydrates also play roles in gut health and immune function 86. For healthy children and adults, carbohydrates should make up approximately 45 to 65% of energy intake based on the minimum required glucose for brain function 86. However, some carbohydrates are more nutritious than others.

Foods that contain the most carbohydrates include:

  • Fruit.
  • Vegetables, especially potatoes and corn.
  • Legumes, including dried beans, peas and lentils.
  • Grains.
  • Bread.
  • Breakfast cereal.
  • Rice, pasta and noodles.
  • Low-fat milk and yoghurt.

These foods are rich in vitamins, minerals and antioxidants and are generally low in fat. This makes them well suited to a healthy eating plan. Some are excellent sources of dietary fibre, including wholegrain varieties, legumes, fruit and vegetables.

Foods with lots of added sugar like soft drinks, alcohol and sweets are another source of carbohydrates, but these contribute extra kilojoules with few vitamins and minerals.

Optimal carbohydrate intake should consist of high fiber, nutrient-dense whole grains, fruits, vegetables and legumes, without the added sugar 19.

The Dietary Guidelines for Americans recommends that carbohydrates should make up 45 to 65% of one’s daily calories 87. To calculate how many grams of carbohydrates you need, multiply your daily calorie requirements by 0.45 and 0.65 to obtain calories from carbohydrates.

  • (A) 0.45 x 2000 = 900 calories
  • (B) 0.65 x 2000 = 1300 calories

Divide answers in step 1 by 4 since there are 4 calories per 1 gram of carbohydrate

  • (A) 900/4 = 225g of carbohydrate
  • (B) 1300/4 = 325g of carbohydrate

Carbohydrates are eaten in the form of simple carbohydrates, like monosaccharides and disaccharides, or complex carbohydrates, like oligosaccharides and polysaccharides 86. Monosaccharides are the basic building blocks of all carbohydrates and include glucose, fructose, and galactose. Glucose is the simplest type of carbohydrates and is the major source of energy for your body’s cells 86. Glycogen is the storage form of glucose in animals and is present in the liver and muscle, but there is little to none in the diet.

Disaccharides contain two sugar units and include lactose, sucrose, and maltose. Lactose is a carbohydrate found in milk, and sucrose is basic table sugar.

Oligosaccharides consist of 3 to 10 sugar units and include raffinose and stachyose, which are in legumes.

Polysaccharides include greater than ten sugar units and consist of starches, glycogen, and fibers, like pectin and cellulose. Starches like amylose are in grains, starchy vegetables, and legumes and consist of glucose monomers.

Fibers are plant polysaccharides like pectin and cellulose found in whole grains, fruits, vegetables, and legumes but are not digestible by humans. However, fibers play a major role in gut health and function and can be digested by microbiota (microorganisms) in the large intestine 88. The recommended fiber intake is greater than 38 g for men and 25 g for women, which is the intake that research has observed to lower the risk of coronary artery disease (a heart disease that affects the main blood vessels that supply blood to the heart).

Does eating more carbohydrates cause body fat?

If carbohydrates control body fat, then you would expect that low-carb diets are less “fattening” than higher carbohydrate diets. This means that low carb diets should add less body fat to people than higher carbohydrate diets do. This is true in the most basic sense in that when you overconsume calories (Calorie IN more than Calorie OUT). You do store at least some of the excess calories as body fat. But studies don’t support that view that low-carb diets are less “fattening” than higher carbohydrate diets. It turns out that excess carbohydrates are relatively difficult to store as body fat, at least compared to fats.

In one study where people were overfed carbohydrates and fats, fats were stored ~20% more efficiently than carbs 89. In another study where people were overfed carbohydrates, there was a very minimal conversion of carbohydrates to stored body fat, indicating that it is very inefficient to turn carbohydrates into body fat 90.

Furthermore, low-carb diets are not necessary for weight loss, nor are they alone sufficient for weight loss. Carbs don’t necessarily control body fat after all. Over the last several decades there have been dozens of scientific studies comparing low-carb diets to other diets to examine their efficacy 91. There are plenty of studies whose results do not support the idea that carbohydrates per se control body fat. For example, in one study of 4,451 people, there was a lower risk of being obese or overweight if you consumed a moderate to high carbohydrate diet when compared to a lower carbohydrate diet 92. That study found consuming a low-carbohydrate (approximately <47% energy) diet is associated with greater likelihood of being overweight or obese among healthy, free-living adults 92.

Another study found that there was no real association between BMI and daily carbohydrate intake, suggesting that if carbohydrates did control body fat, it would be a relatively minor effect 93.

Ultimately, science tells us that carbohydrates are not more fattening than fats; in fact, it would make more sense to eat a few too many carbohydrates than a few too many fats. Indeed, this is what you see when you follow people who over-consume carbohydrates versus fats – they tend to gain a little less body fat 94.

Are low-carb diets are better for weight loss than other diets?

The majority of the clinical trials that have examined whether low-carb diets are better than other diets for fat loss show that low-carb diets result in the same amount of weight loss as other diets 95.

When you tightly control people’s diets and measure virtually every part of their metabolism, it is apparent that low-carb diets are not better for weight loss 96. They might be slightly worse for body fat loss than low-fat diets. This holds true even if you go to very low levels of carbohydrate intake 97.

Furthermore, when people adopt a low-carb diet in the real world and over more extended periods, they still see very similar results for weight-loss.

The primary findings from these studies have been:

  1. Low-carb diets are not necessary for weight loss. Virtually all types of diets can and do result in weight loss when there is a negative energy balance (i.e. an energy deficit).
  2. From a body fat mass perspective, low-carb diets may result in inferior fat mass reductions in shorter term diets.
  3. Adherence to low-carb diets is no better or worse compared to most other forms of dieting.
  4. Low-carb diets often result in more immediate water weight loss and glycogen depletion than moderate-carb diets.

In conclusion, although the idea that carbohydrates control body fat has been popular in the media, there is little scientific evidence to support it. Unless you have extreme levels of carbohydrate intake (Calorie IN more than Calorie OUT), there is no real link between carbohydrates and body fat. From scientific studies, it turns out that carbohydrates are less fattening than dietary fat. When followed in the real-world, low-carb diets can be useful for weight loss, but they are not any more effective than other low calorie diets.

Very low-carb diets can often result in a state called ketosis. This occurs when dietary carbohydrates are low enough, or fat is high enough, such that the body begins producing ketones at a level that allows them to accumulate.

It is often touted that being in a state of ketosis increases fat loss, but there is no good evidence to suggest that is true. In fact, one recent study showed that fat loss is similar, if not inferior, in a state of ketosis 98. If you choose to adopt a low-carb diet, ketosis may be a result of that process, but should not be the primary focus.

Furthermore, there is some evidence that if someone is an athlete engaging in higher intensity, higher volume exercise, ketogenic diets should be avoided as they can impair performance 99, 100.

Very low carbohydrate diets can come with unwanted and potentially dangerous side effects when followed for extended periods. For example, cardiac dysfunction, impairment of physical activity, hair loss, nausea, digestive issues, and lipid abnormalities are all common side effects.

How many carbs should you eat a day to lose weight?

For otherwise healthy individuals with no underlying medical conditions, there does not appear to be a truly minimal amount of carbohydrates that need to be consumed daily.

Your daily recommendations for carb intake are based on two primary criteria:

  1. Your total daily calorie requirements (your basal metabolic rate [BMR] or resting metabolic rate [RMR])
  2. Your intensity or volume of physical activity.

Higher total daily calorie needs come with higher recommendations for total daily carb intake, while lower total daily calorie needs come with lower recommendations. Furthermore, as your body relies heavily on carbohydrate intake for moderate to higher intensity physical activity, carb recommendations will increase as your total volume and intensity of activity increase.

Your total daily calorie intake can be estimated using the Mifflin-St Jeor formula above. However, there are also online tools that can be used that can help you determine how many calories you should consume daily. Such as the free online Basal Metabolic Rate (BMR) calculator here: https://www.nasm.org/resources/calorie-calculator

Or the Body Weight Planner (https://www.niddk.nih.gov/health-information/weight-management/body-weight-planner).

The Body Weight Planner allows you to make personalized calorie and physical activity plans to reach a goal weight within a specific time period and to maintain it afterwards.

After that, the number of carbs grams per unit of body weight can be estimated based on current guidelines from the American College of Sports Medicine and the Academy of Nutrition and Dietetics. These recommendations are generalized as follows 101:

  • Light Activity: 3-5 g carb/kg/day
  • Moderate Activity (1 hour of moderate exercise): 5-7 g carb/kg/day
  • High Activity (1-3 hours of intense, endurance exercise): 6-10 g carb/kg/day
  • Very High (4-5 hours of intense, endurance exercise): 8-12 g carb/kg/day

It is often recommended that more moderate carbohydrate intakes (1 to 3 g/kg/day) are consumed even in the context of weight loss.

Your muscles need carbs to fuel and recover from your workouts. At least 40% of your total daily calories should come from good carbs. Eat carbs 60 to 90 minutes prior to your workout, and then eat a combo of carbs and protein (2:1 ratio) within an hour after you finish.

Although many nutrition labels count all carbohydrates toward calorie intake, the truth is not all carbohydrates provide a meaningful number of calories as the human body does not digest and extract energy from all forms of carbohydrates.

In most situations, dietary fiber is considered a non-digestible carb and does not contribute to the total carbohydrate intake. As such, in many cases, fiber is subtracted from total carb intake. The grams of fiber is often subtracted from the total carbs grams to yield a total of usable carbs grams. For example, a food label may list 34 g total carbohydrate consisting of 4 g fiber and 6 g added sugar. By subtracting dietary fiber (4 grams of fiber) from total carbohydrates (34 grams) = 30 grams of usable carbs.

Protein

Protein is an essential nutrient that you need throughout life. Proteins are the building blocks of life. Protein is in every cell in your body. The basic structure of protein is a chain of amino acids 102. A protein is a chain of amino acids bound to one another via peptide bonds (chemical bond linking amino acids together to form a protein). When someone eats protein, it is broken down into its amino acids.

Your body needs protein to make, maintain, repair and renew bones, muscles, cartilage, hormones, enzymes, neurotransmitters, vitamins, blood and skin cells 86, 103, 104. Proteins provide energy (calories) if necessary, the others are fat and carbohydrates. Proteins do everything from fighting infections to helping cells divide. Protein is also important for growth and development in children, teens, and pregnant women.

Excess or deficiency of protein can lead to disease, resulting in nervous system defects, metabolic problems, organ failure, and even death 102. Clinical symptoms of inadequate intake of essential amino acids may include depression, anxiety, insomnia, fatigue, weakness, and growth stunting in the young. These symptoms are mostly caused by a lack of protein synthesis in the body because of the lack of essential amino acids 104. Kwashiorkor and marasmus are examples of more severe clinical disorders caused by malnutrition and inadequate intake of essential amino acids as a macronutrient 104.

High protein diets can promote weight loss via increased insulin sensitivity, fatty acid oxidation, appetite suppression, and feeling full. However, caution is necessary for people with diabetes who have gout because protein can elevate niacin levels, which may exacerbate gout-related symptoms.

The protein in your food is broken down into parts called amino acids during digestion. Your body needs a number of amino acids in large enough amounts to maintain good health. While there are hundreds of amino acids, humans use only 20 amino acids 102, 104.

Amino acids are classified into three groups 102:

  1. Essential amino acids. Essential amino acids cannot be made by your body, and must be supplied by food. Essential amino acids do not need to be eaten at every meal. The balance over the whole day is more important. There are 9 essential amino acids:
    • Histidine
    • Isoleucine
    • Leucine
    • Lysine
    • Methionine
    • Phenylalanine
    • Threonine
    • Tryptophan
    • Valine
  2. Nonessential amino acids. Nonessential amino acids are made by your body from essential amino acids or in the normal breakdown of proteins. There are 5 amino acids that are termed non-essential amino acids:
    • Alanine
    • Asparagine
    • Aspartic acid
    • Glutamic acid
    • Serine
  3. Conditionally Essential amino acids. Conditionally Essential amino acids are needed in times of illness, stress, starvation or inborn errors of metabolism. A healthy body can make conditionally essential amino acids under normal physiologic conditions. There are 6 amino acids that are called conditionally essential amino acids:
    • Arginine
    • Cysteine
    • Glutamine
    • Glycine
    • Proline
    • Tyrosine

You get protein (amino acids) in your diet from animal and plant-based foods such as meat, fish, eggs, dairy products, nuts, and certain grains, beans, peas, and lentils 105. Proteins from meat and other animal products are complete proteins. This means they supply all of the amino acids your body can’t make on its own. Most plant proteins are incomplete. So you should eat different types of plant proteins every day to get all nine essential amino acids your body needs. For example, pairing protein sources like rice and beans, hummus, pita bread, or oatmeal topped with almond butter. Regarding volume, it may be necessary to eat more plant-based foods to get a similar amount of protein and amino acid profile provided by animal-based proteins 106.

  • Animal protein – protein-containing foods from animals are meat, chicken, fish, eggs and dairy products. Meat and poultry foods should be lean or low-fat, like 93% lean ground beef, pork loin, and skinless chicken breasts. Choose seafood options that are higher in healthy fatty acids called omega-3s fatty acid and lower in methylmercury, such as salmon, anchovies, and trout. And stay away from processed meats or artificial (fake) meat.
  • Vegetable protein – protein-containing foods from plants include tofu, nuts, seeds, lentils, dried beans and peas, and soy milk.
    Good protein choices include:

    • Soy protein
    • Beans
    • Nuts
    • Fish
    • Lean chicken with no skin
    • Lean beef
    • Pork
    • Salmon
    • Anchovies
    • Trout
    • Low-fat dairy products

It is important to get enough dietary protein. You need to eat protein every day, because your body doesn’t store it the way it stores fats or carbohydrates. Furthermore, protein foods provide nutrients important for maintaining your health and body. How much protein you need depends on your age, sex, height, weight, health, and level of physical activity. The amount can also depend on whether or not you are pregnant or breastfeeding.

The recommended protein intake is 0.8 to 1 gram per kilogram of body weight per day 107. For strength training athletes adequate protein intake should range between 1.2 and 1.7 grams of protein per kilogram of body weight per day or 0.5 to 0.8 grams per pound of body weight 108, 109, 110, 111.

For healthy children ages 1 to 3 approximately 5 to 20% and children ages 4 to 18 approximately 10 to 30% of daily energy intake should come from protein. The daily recommended intake of protein for healthy adults is 10% to 35% of your daily energy intake based on the adequate amount needed for nitrogen equilibrium 19. One gram of protein supplies 4 calories. Therefore, if you consume 2,000 calories per day, this would work out to be between 200 to 700 calories of protein per day, you could eat 100 grams of protein, or 400 calories from protein, which would supply 20% of your total daily calories.

The recommended daily intakes (RDIs) can also be calculated by your body weight. The Academy of Nutrition and Dietetics recommends that the average individual should consume 0.8 grams of protein per kilogram or 0.35 grams per pound of body weight per day for general health. So a person that weighs 75 kg (165 pounds) should consume an average of 60 grams of protein per day. Since there are approximately four calories per gram of protein, 60 grams of protein would result in the intake of 240 calories.

How much protein do I need?

How much protein you need depends on your age, sex, height, weight, health, and level of physical activity. The amount can also depend on whether or not you are pregnant or breastfeeding. The recommended protein intake is 0.8 to 1 gram per kilogram of body weight per day 107. For strength training athletes adequate protein intake should range between 1.2 and 1.7 grams of protein per kilogram of body weight per day or 0.5 to 0.8 grams per pound of body weight 108, 109, 110, 111.

How to calculate your daily protein needs:

Convert body weight in pounds to kilograms (round to the nearest 10th).
 Multiply weight in kilograms by the range that best fits your activity levels.

Let’s look at an example:

  • Convert pounds into kilograms 150lbs / 2.2 = 68.2kg

The recommended protein intake is 0.8 to 1 gram per kilogram of body weight per day

  • 68.2kg (0.8g grams of protein per kilogram) = 54.6g
  • 68.2kg (1g grams of protein per kilogram) = 68.2g

For strength training athletes adequate protein intake should range between 1.2 and 1.7 grams of protein per kilogram of body weight per day.

  • 68.2kg (1.2g grams of protein per kilogram) = 81.8g
  • 68.2kg (1.7g grams of protein per kilogram) = 115.9g

Here are some practical protein equivalents in common foods. One ounce (30 grams) of most protein-rich foods contains 7 grams of protein. An ounce (30 grams) equals:

  • 1 oz (30 g) of meat fish or poultry
  • 1 large egg has six grams of protein
  • ¼ cup (60 milliliters) tofu
  • ½ cup (65 grams) cooked beans or lentils
  • 1 cup of dry beans has about 16 grams of protein
  • 1 cup of milk has eight grams of protein
  • 1 cup of soy milk has about seven grams of protein

Low fat dairy is also a good source of protein. An eight ounce container of yogurt has about 11 grams of protein

Most Americans eat enough protein in their diet but need to select leaner varieties of meat and poultry. Americans may also need to increase the variety of protein foods selected and choose meats less often. However, if you are vegetarian or vegan, the advice to eat meat, poultry, and seafood does not apply to you. Vegetarian protein options include beans, peas, lentils, nuts, seeds, and soy products.

What counts as an ounce-equivalent in the protein foods group?

The following examples count as 1 ounce-equivalent from the protein foods group 103:

  • 1 ounce of meat, poultry, or fish
  • ¼ cup cooked beans
  • 1 egg
  • 1 tablespoon of peanut butter
  • ½ ounce of nuts or seeds
  • ¼ cup (about 2 ounces) of tofu
  • 1 ounce tempeh, cooked

The table below lists amounts that count as 1 ounce-equivalent in the protein foods group towards your daily recommended amount.

Table 8. Daily protein foods general recommendations by age

Daily Protein Recommendation* in Ounce-Equivalents
Toddlers12 to 23 months2 ounce-equivalent
Children2-3  yrs
4-8 yrs
2 to 4  ounce-equivalent
3 to  5½ ounce-equivalent
Girls9-13 yrs
14-18 yrs
4 to 6  ounce-equivalent
5 to 6½ ounce-equivalent
Boys9-13 yrs
14-18 yrs
5 to 6½ ounce-equivalent
5½ to 7 ounce-equivalent
Women19-30 yrs
31-59  yrs
60+ yrs
5 to 6½ ounce-equivalent
5 to 6 ounce-equivalent
5 to 6 ounce-equivalent
Men19-30 yrs
31-59  yrs
60+ yrs
6½ to 7 ounce-equivalent
6 to 7 ounce-equivalent
5½ to 6½ ounce-equivalent

How much protein do you need for optimal muscle maintenance?

How much protein you need depends on your age, sex, height, weight, health, and level of physical activity. The amount can also depend on whether or not you are pregnant or breastfeeding. The recommended protein intake is 0.8 to 1 gram per kilogram of body weight per day 107. For strength training athletes adequate protein intake should range between 1.2 and 1.7 grams of protein per kilogram of body weight per day or 0.5 to 0.8 grams per pound of body weight 108, 109, 110, 111.

How to calculate your daily protein needs:

Convert body weight in pounds to kilograms (round to the nearest 10th).
 Multiply weight in kilograms by the range that best fits your activity levels.

Let’s look at an example:

  • Convert pounds into kilograms 150lbs / 2.2 = 68.2kg

The recommended protein intake is 0.8 to 1 gram per kilogram of body weight per day

  • 68.2kg (0.8g grams of protein per kilogram) = 54.6g
  • 68.2kg (1g grams of protein per kilogram) = 68.2g

For strength training athletes adequate protein intake should range between 1.2 and 1.7 grams of protein per kilogram of body weight per day.

  • 68.2kg (1.2g grams of protein per kilogram) = 81.8g
  • 68.2kg (1.7g grams of protein per kilogram) = 115.9g

Muscle mass is built when the net protein balance is positive: that is muscle protein synthesis exceeds muscle protein breakdown. Research shows muscle protein turnover is the greatest after working out. Additionally, it has been shown that muscle mass increases over time when resistance exercise (i.e. weight lifting, body weight exercises, etc) is combined with nutrient intake.

However, as you age, you need to increase your protein intake 108. Around 50 years of age, you need to increase the protein in your diets to 1 gram per kilogram of your body weight to maintain muscle mass 108. People that exercise regularly also need to eat more protein than the recommended daily intake 108.

Several studies performed by the group of Philip and others showed that protein supplementation did not further increase muscle strength among individuals who consumed adequate amounts of dietary protein 111, 112, 109, 113. However, with the aim of maximizing performance, individuals seeking to gain muscle mass are likely to consume more protein with the misconceived belief that large quantities of protein consumption might generate more muscle protein 114.

To increase muscle mass in combination with physical activity, it is recommended that a person that lifts weights regularly or is training for a running or cycling event eat a range of 1.2 to 1.7 grams of protein per kilogram of body weight per day, or 0.5 to 0.8 grams per pound of body weight 108. Consequently, the same 75
kilogram individual should increase their protein intake to 75 grams (300 calories) to 128 grams (512 calories) in order to gain muscle mass. This level of intake can generally be met through diet alone and without additional protein and amino acid supplementation 108.

When should I consume protein?

The process of protein turnover is increased with resistance training and can remain elevated for up to 48 hours in people beginning a new resistance training program 108. Therefore it is important to provide enough energy including protein so there is a sufficient pool of amino acids available to repair and build new muscle. You do not want to exercise on an empty stomach. In fact, exercising in an unfed state leads to an increase in protein loss making it more difficult for your body to both repair and build muscle 108. Your body can only use approximately 20–40 g of protein per meal. For best results, eat around this much protein every 3 to 4 hours.

Research suggests there are several benefits to pre-exercise protein supplementation 108. Pre-exercise protein supplementation helps to improve body composition by increasing resting energy expenditure up to 48 hours after exercise 108. This is important because it suggests that pre-exercise protein ingestion will not only help increase lean muscle mass and strength, but will also simultaneously reduce fat mass 108. However, the most scientifically supported and most significant benefits of consuming protein prior to exercise may be improved recovery and hypertrophy. This is thought to occur because of improved amino acid delivery 108.

Make sure you have a healthy diet that meets the current protein intake recommendations and then use supplements to add anything else you might need. A good diet will not make a mediocre athlete into a champion, but poor food choices can turn a champion into a mediocre athlete. The International Olympic Committee (IOC) position stand is that “the use of supplements does not compensate for poor food choices and an inadequate diet”. Reinforcing this importance of food, researchers have found that athletes eating a diet rich in nitrates from vegetables (not supplements) for just 10 days were able to enhance their exercise performance, compared to when they were eating their usual diet 115.

Protein supplement

Protein supplementation has been shown to improve muscle building with regular exercise training. Protein supplementation should contain a high amount of the amino acid leucine, which is responsible for muscle protein synthesis. Whey protein is a great option for leucine. Eating less protein may not be enough to rebuild muscles, and eating more doesn’t usually give you more benefits.

Whey protein is beneficial in supporting muscle adaptations due to its rapid absorption rate in addition to casein that has a slower and more sustained rate of amino acid absorption over a few hours 108. Branched chain amino acids are similarly beneficial and have been shown to aid in recovery from exercise with respect to not only protein synthesis but also aiding in replacing our muscle glycogen and delaying fatigue associated with exercise.

Protein supplementation after exercise may have a more profound impact on skeletal muscle hypertrophy. Several studies have demonstrated that protein ingestion following an acute bout of resistance training stimulates muscle protein synthesis for up to three hours 108. In contrast, failing to eat after exercise
may limit protein synthesis and therefore limit potential progress in lean muscle tissue development. Research actually suggests there may be an “anabolic window” such that protein intake within an hour of exercise has the greatest influence on resistance training adaptations 108.

Generally, naturally occurring animal proteins contain 2:1:1 ratio of leucine, isoleucine and valine. These proteins have been identified as providing optimal support of muscle adaptations with exercise training. In order to meet the recommended RDA a consumption of approximately 45 mg/kg/day of leucine and 22.5 mg/kg/day of isoleucine and valine is suggested 108.

What is the best protein powder supplement?

Creatine monohydrate is generally safe and can help you build more muscle mass 116, 117, 118, 119, 120, 121. Always check with your doctor before starting any supplement.

Creatine (N-[aminoiminomethyl]-N-methyl glycine) is an amino acid–like compound that is produced in your liver, kidney, pancreas, and possibly the brain from the biosynthesis of the essential amino acids methionine, glycine, and arginine, or obtained from dietary sources 122. The primary dietary sources are high-protein foods including meat, fish, and poultry. Once synthesized or ingested, creatine is transferred from the plasma through the intestinal wall into other tissues by specific creatine transporters located in skeletal muscles, the kidney, heart, liver, and brain.

Creatine as a dietary supplement is a tasteless, crystalline powder that readily dissolves in liquids and is marketed as creatine monohydrate or as a combination with phosphorous 123. The majority of creatine (95%) is stored in skeletal muscle (fast twitch, type 2): two-thirds in a phosphorylated form and one-third as free creatine 124. Creatine serves as an energy substrate for the contraction of skeletal muscle. The intention of creatine supplementation is to increase resting phosphocreatine levels in muscles, as well as free creatine, with the goal of postponing fatigue, even briefly, for sports-enhancing results 116.

Creatine is one of the most widely used dietary supplements. Athletes, body builders, and military personnel use creatine to enhance muscle mass and increase strength. Creatine is also used as an ergogenic aid to improve performance of high-intensity exercise of short duration 125, 126, 127. Creatine’s popularity as a dietary supplement was further increased by a 2006 study demonstrating its positive effect on cognitive and psychomotor performance 128.

Experiments among athletes and military personnel indicate that creatine taken at levels commonly available in supplements produces minimal, if any, side effects 127, 129. Using evidence from well-designed, randomized controlled human clinical trials of creatine, Shao and Hathcock 129 concluded that chronic intake of 5 g/ day of creatine was safe and posed no significant health risks.

Muscle creatine concentrations are increased by 20% with creatine monohydrate supplementation 124. Creatine monohydrate supplements increase lean body mass, as well as strength, power and effectiveness in short-duration, high-intensity exercises 130. The increase in body mass may be a result of the increase in intracellular water related to the osmotic properties of creatine 131. Studies on creatine monohydrate supplementation have shown short-duration improvements in sports performance and strength: specifically, in maximum-intensity exercises, muscle power, number of repetitions, muscle endurance, speed and total strength 132.

The use of creatine monohydrate can yield increases in power during short sprints of maximum intensity, which can be even more evident when repeated sprints are accompanied by short recovery periods 121. Furthermore, with creatine monohydrate supplementation, effects are also observed in muscle glycogen stores 131. This is important because the availability of muscle glycogen is the main determinant of sports performance in resistance exercises, and its depletion can lead to muscle fatigue 133. In addition, creatine monohydrate is one of the few sports foods supplements or ergogenic aids (substance used for the purpose of enhancing performance) with health claims authorised by the EFSA and the European Commission (EC), due to its evident effects on the health and sports performance of athletes 134, 135.

The approved health claims are ‘Creatine increases physical performance in repeated bursts of high-intensity exercise in the short term’ and ‘Daily creatine consumption can enhance the effect of resistance training on muscle strength in adults over the age of 55’. These health claims refer to the 3-g dose of creatine monohydrate 135. Resistance training should be performed at least three times per week for several weeks, at an intensity of at least 65–75% of one repetition maximum (1RM). The target population is adults over the age of 55, who are engaged in regular resistance training 135. Creatine in combination with resistance training and improvement in muscle strength 135.

Fat

You need to eat some fat even when you are trying to lose weight. The human body needs small amounts (3 to 6 grams) of essential fatty acids (Omega-6 and Omega-3 fatty acids). Fat is important for many body processes. Fat helps your body absorb nutrients and move nutrients around your body. Some fat is necessary as a carrier for the fat-soluble vitamins A, D, E, and K. Fat is the main source of energy storage in your body, fat contributes to cellular structure and function, fat keeps you warm, and protects your organs 136, 137, 138. Fat also helps with hormone production. Therefore your diet should not be devoid of fat. However, because fat is calorically dense (1 gram of fat has 9 calories of energy), it is often decreased on weight-loss diets to reduce energy intake.

Fat needs will vary by individual and will depend largely on your body composition goals and body types. For example, dietary fat recommendations are slightly higher in competitive athletes than non-athletes to promote health, maintain healthy hormone function, and maintain energy balance. Typical recommendations for athletes are 30 to 50% of total energy intake.

There are 4 main types of fats:

  1. Unsaturated fats are those that are liquid at room temperature. Examples include olive, peanut, and canola oils. We want to include as many unsaturated fats in our diet because they can decrease bad cholesterol, contain high amounts of antioxidants such as Vitamin E, and contain essential omega-3 and omega-6 fatty acids. Unsaturated fats are typically classified by how many hydrogen bonds they have in their structure: either 1 (mono) or two or more (poly).
  2. Monounsaturated fats. Monounsaturated fat is a type of unsaturated fat. Monounsaturated fats are liquid at room temperature but start to harden when chilled. Monounsaturated fats is one of the healthy fats, along with polyunsaturated fat. Monounsaturated fats are good for your health in several ways:
    • Monounsaturated fats can help lower your LDL (bad) cholesterol level. Cholesterol is a soft, waxy substance that can cause clogged, or blocked, arteries (blood vessels). Keeping your LDL level low reduces your risk for heart disease and stroke.
    • Eating plant foods high in monounsaturated fats, particularly extra virgin olive oil and tree nuts, may benefit heart health and blood sugar regulation. Monounsaturated fats from plants may lower bad cholesterol and raise good cholesterol. They also may improve the control of blood sugar levels. Replacing saturated fats with monounsaturated fats in your diet may lower the level of bad cholesterol and triglycerides in your blood. Triglycerides are fat cells that circulate in the bloodstream and are stored in the body’s fat cells. A high level of triglycerides in the blood increases the risk of diseases of the heart and blood vessels.
    • Monounsaturated fats help develop and maintain your cells.
    • Monounsaturated fats are found in plant foods, such as nuts, avocados, and vegetable oils. Monounsaturated fats are found in red meats and dairy products. About half the fats in these foods are saturated and half monounsaturated. Many plants and plant oils are high in monounsaturated fats but low in saturated fats. These include:
      • Oils from olives, peanuts, canola seeds, safflower seeds, and sunflower seeds.
      • Avocadoes.
      • Pumpkin seeds.
      • Sesame seeds.
      • Almonds.
      • Cashews.
      • Peanuts and peanut butter.
      • Pecans.
  3. Polyunsaturated fats. Polyunsaturated fat is a type of unsaturated fat. Polyunsaturated fats are liquid at room temperature but start to harden when chilled. Polyunsaturated fats include omega-3 and omega-6 fats. These are essential fatty acids that your body needs for brain function and cell growth. Your body does not make essential fatty acids, so you must get them from food. Polyunsaturated fats can help lower your LDL (bad) cholesterol. Cholesterol is a soft, waxy substance that can cause clogged or blocked arteries (blood vessels). Having low LDL cholesterol reduces your risk for heart disease. Polyunsaturated fats is one of the healthy fats, along with monunsaturated fat. Polyunsaturated fat is found in plant and animal foods, such as salmon, vegetable oils, and some nuts and seeds.
    1. Omega-3 fatty acids are good for your heart in several ways. They help:
      • Reduce triglycerides, a type of fat in your blood
      • Reduce the risk of developing an irregular heartbeat (arrhythmia)
      • Slow the buildup of plaque, a substance comprising fat, cholesterol, and calcium, which can harden and clog your arteries
      • Slightly lower your blood pressure
    2. Sources of omega-3 fatty acids include:
      • Fish such as salmon, anchovies, mackerel, herring, sardines and tuna.
      • Oils from canola seeds, soybeans, walnuts and flaxseed.
      • Soybeans.
      • Chia seeds.
      • Flaxseed.
      • Walnuts.
    3. Omega-6 fatty acids may help:
      • Control your blood sugar
      • Reduce your risk for diabetes
      • Lower your blood pressure
    4. Sources of omega-6 fatty acids include:
      • Corn oil.
      • Cottonseed oil.
      • Peanut oil.
      • Soybean oil.
      • Sunflower oil.
  4. Saturated fats. Saturated fats are those that are solid at room temperature. Examples include margarine, butter, whole fat dairy products, the fat marbling in meats, and coconut oil. Saturated fats don’t need to be avoided entirely, but diets high in saturated fats can increase bad cholesterol and triglycerides, increasing the risk for heart disease. The Dietary Guidelines for Americans suggest that less than 10% of calories a day should be from saturated fats. The American Heart Association recommends that saturated fats only make up 5 to 6% of your daily calories. For a 2,000 calorie diet, that is a total of 100 calories, or 11 grams a day. Foods high in saturated fats include:
    • Foods baked or fried using saturated fats.
    • Meats, including beef, lamb, pork as well as poultry, especially with skin.
    • Lard.
    • Dairy products like butter and cream.
    • Whole or 2% milk.
    • Whole-milk cheese or yogurt.
    • Oils from coconuts, palm fruits, or palm kernels.
  5. Trans fats. Trans fatty acids are unhealthy fats that form when vegetable oil goes through a process called hydrogenation. This leads the fat to harden and become solid at room temperature. Hydrogenated fats, partially hydrogenated oils (PHOs) or “trans fats,” are often used to keep some foods fresh for a long time. Trans fats are unsaturated fats that are artificially turned into saturated fats and increase heart disease and stroke risk by raising bad LDL cholesterol and decreasing good HDL cholesterol levels. High LDL (bad) cholesterol along with low HDL (good) cholesterol levels can cause cholesterol to build up in your arteries (blood vessels). This increases your risk for heart disease and stroke. Trans fats have also been known to increase the risk of developing type 2 diabetes. Trans fats are most commonly found in fried foods, frozen baked products such as pizza, non-dairy coffee creamers, vegetable shortenings, some margarines, crackers, cookies, snack foods, and other foods made with or fried in partially hydrogenated oils (PHOs). Because of the health risks from trans fats, the United States Food and Drug Administration (FDA) has banned food manufacturers from adding partially hydrogenated oils (PHOs) to foods. Although the food industry has greatly reduced the use of trans fat in recent years, trans fat may still be found in many fried, packaged, or processed foods. There are very small amounts of naturally occurring trans fat in meats and dairy from grazing animals, such as cows, sheep and goats. You should avoid foods made with hydrogenated and partially hydrogenated oils (such as hard butter and margarine). They may contain high levels of trans fatty acids. It is important to read nutrition labels on foods. This will help you know what kinds of fats, and how much, your food contains.

How much fat do I need?

To prevent any fatty acid deficiencies it is recommended that you consume at minimum 1g of fat per kg of body weight per day. According to the Dietary Guidelines for Americans 87, fats should make up 20 to 35% of your total daily calorie intake. For those attempting to lose body fat, 0.5 to 1 fat per kg of body weight per day should be consumed per day to avoid essential fatty acid deficiency. For healthy children ages 1 to 3, ages 4 to 18, and adults, approximately 30 to 40%, 25 to 15%, and 20 to 35% of daily energy intake should come from fat, respectively 86. Approximately 5 to 10% of your daily fat energy intake should consist of Omega−6 fatty acids (linoleic acid) and 0.6 to 1.2% of Omega−3 fatty acids (alpha-linolenic acid, eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) 19. Both omega−6 fatty acids (linoleic acid) and omega−3 fatty acids (alpha-linolenic acid, eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) are considered essential fatty acids, meaning that they must be obtained from your diet 139. Apha-linolenic acid can be converted into eicosapentaenoic acid (EPA) and then to docosahexaenoic acid (DHA), but the conversion (which occurs primarily in your liver) is very limited, with reported rates of less than 15% 140, 141. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential fatty acids, meaning the body can’t produce them and they must come from your diet 142. Therefore, consuming eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) directly from foods and/or dietary supplements is the only practical way to increase levels of these fatty acids in your body.

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are omega-3 fatty acids found in varying amounts in seafood such as cold-water fish like salmon, tuna, herring, and mackerel, as well as in fish oil supplements and seaweed. Eating 8 ounces per week of seafood may help reduce the risk for heart disease.

Some researchers propose that the relative intakes of omega-6s and omega-3s, the omega-6/omega-3 ratio, may have important implications for the cause of many chronic diseases, such as heart and blood vessels disease (cardiovascular disease) and cancer 143, but the optimal ratio, if any, has not been defined 144. Others have concluded that the omega-6/omega-3 ratios are too nonspecific and are insensitive to individual fatty acid levels 145, 146, 147.. Most agree that raising EPA and DHA blood levels is far more important than lowering linoleic acid or arachidonic acid levels 141.

For someone who weighs 150lbs (68kg), this would equate to 34-68g fat per day. Using both of these references you can calculate your daily fat needs:

To calculate your daily fat needs:

  • Convert body weight in pounds to kilograms (round to the nearest 10th).
 Multiply weight in kilograms by 1.

Let’s look at an example:

  • Convert pounds into kilograms 150lbs / 2.2 = 68.2kg

The recommended fat intake is 1 gram per kilogram of body weight per day

  • 68.2kg (1g grams of fat per kilogram) = 68.2g of fat per day

Weight loss diets that are moderate to low in fat (20 to 30% of calories) are called “balanced deficit” diets because they maintain a reasonable balance among macronutrients similar to that recommended in MyPlate, DASH, and the Dietary Guidelines for Americans 87, 64. They tend to achieve most of the caloric deficit by reducing fat from the typical level in North American Diets of about 34% or more of calories to 20 to 30% fat, 15% protein, and 55 to 65% of calories from carbohydrates. Some examples of low fat diets are the Weight Watchers Diet (25% fat, 20% protein, and 55% carbohydrate, with 26 grams of dietary fiber), Jenny Craig, the National Cholesterol Education Program Step 1 diet (25% fat), diets based on the MyPlate, the DASH diet, the Shape up and Drop 10 diet of Shape Up! America and the Nutrisystem diet 22. Popular diet books using this approach include The Biggest Loser Diet, The Mayo Clinic Diet and The Engine 2 Die 22. These dietary patterns have been extensively reviewed and appear to be effective for weight reduction on low calorie diets for most individuals 22.

Very low-fat diets such as the Pritikin Diet 148, the Ornish Diet 149 and The Spark Solution Diet 150 have been advocated not only for weight reduction, but also for improving cardiovascular risk profiles. The Ornish Diet 149, which is very low in fat (13% of calories) and saturated fat, very high in carbohydrate (81% of calories) and very high in fiber (38 grams), is part of a program that includes nonsmoking, exercise and behavior modification. The Ornish Diet 149 was shown to reduce some cardiovascular risk factors in a limited long term study. For those who can adhere to the Ornish regime it may be helpful. However, it may not be appropriate for all populations, such as diabetics.

What are Healthy fats?

Healthy fats include:

  • Monounsaturated fats
  • Polyunsaturated fats (omega-3 and omega-6).

The healthier fats are unsaturated fats. They can be found in sunflower oil, safflower oil, peanut and olive oils, poly- and mono-unsaturated margarine spreads, nuts, seeds and avocado. These are much better for you than the saturated fat found in butter, cream, fatty meats, sausages, biscuits, cakes and fried foods.

Foods that contain healthy monounsaturated fats include:

  • Avocados and their oils/spreads
  • Unsalted nuts such as almonds, cashews and peanuts and their butters/spreads
  • Olives and their oils/spreads
  • Cooking oils made from plants or seeds, including: olive, canola, peanut, sunflower, soybean, sesame and safflower.

Foods that contain healthy polyunsaturated fats (omega-3 and omega-6) include:

  • Oily fish like salmon, mackerel and sardines
  • Tahini (sesame seed spread)
  • Linseed (flaxseed) and chia seeds
  • Soybean, sunflower, safflower, canola oil and margarine spreads made from these oils
  • Pine nuts, walnuts and brazil nuts.

It is important to choose foods with the healthiest type of fat such as avocados, olives, nuts and seeds, and use healthy oils for cooking, for example, olive, canola, sunflower, peanut and soybean oil.

Reduce the amount of highly processed food you eat such as baked goods including cakes, biscuits and pastries, along with processed meat, and fried and takeaway foods. These foods are high in saturated and trans fats, added sugar and salt, and are not part of a heart-healthy eating pattern. Try to have these foods only sometimes and in small amounts.

Many Americans eat more fat than they need, which can lead to weight gain and heart disease.

What are Unhealthy fats?

Unhealthy fats include:

  • Saturated fat
  • Trans fat

Foods rich in unhealthy fats include:

  • Animal fats including butter, ghee and lard along with the visible fat/skin on meat
  • Hydrogenated plant oils like copha, vegetable shortening and some margarines
  • Coconut oil
  • Processed foods such as baked goods (cakes, biscuits and pastries), processed meat ( bacon, sausages, salami) and fried and takeaway foods.

Replace foods rich in saturated and trans fats with foods rich in healthy unsaturated fats as part of a healthy diet.

It is important to choose foods with the healthiest type of fat such as avocados, olives, nuts and seeds, and use healthy oils for cooking, for example, olive, canola, sunflower, peanut and soybean oil.

Reduce the amount of highly processed food you eat such as baked goods including cakes, biscuits and pastries, along with processed meat, and fried and takeaway foods. These foods are high in saturated and trans fats, added sugar and salt, and are not part of a heart-healthy eating pattern. Try to have these foods only sometimes and in small amounts.

Many Americans eat more fat than they need, which can lead to weight gain and heart disease.

The Role of Exercise

DASH diet recommends at least 30 minutes of exercise a day, most days of the week. Do exercises that get your heart pumping. To help prevent weight gain, exercise for 60 minutes a day. Exercise helps you lose weight and weight loss can help lower blood pressure 151. Regular physical activity is also one of the most important things you can do to improve your health. Being active may help you live longer and protect you from developing serious health problems, such as type 2 diabetes, heart disease, stroke, and certain types of cancer.

dash diet guidelines

Regular physical activity is linked to many health benefits, such as 152:

  • lower blood pressure and blood glucose, or blood sugar
  • healthy bones, muscles, and joints
  • a strong heart and lungs
  • better sleep at night and improved mood.

A 2013 report estimated that 18.2% of deaths annually in the United States (approximately 465,000 deaths) could be attributable to overweight and obesity 153. Another 2013 article asserted that there is no such thing as “healthy obesity” 154.

Moving more and sitting less have tremendous benefits for everyone, regardless of age, sex, race, ethnicity, or current fitness level 155. Individuals with a chronic disease or a disability benefit from regular physical activity, as do women who are pregnant 155. The scientific evidence showed physical activity is linked with even more positive health outcomes than previously thought with benefits even with small amounts physical activity. The Physical Activity Guidelines for Americans, 2nd edition 155, define regular physical activity as at least 150 minutes a week of moderate-intensity aerobic activity, such as brisk walking. Brisk walking is a pace of 3 miles per hour or faster. A moderate-intensity activity makes you breathe harder but does not overwork or overheat you. You should also do muscle-strengthening activities at least 2 days a week.You may reach this goal by starting with 5 minutes of physical activity several times a day, 5 to 6 days a week. You could then gradually work up to 10 minutes per session, 3 times a day. If you do even more activity, you may gain even more health benefits 156.

For most healthy adults, the Department of Health and Human Services recommends these exercise guidelines:

  • Aerobic activity. Get at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. The guidelines suggest that you spread out this exercise during the course of a week. Greater amounts of exercise will provide even greater health benefits. But even small amounts of physical activity are helpful. Being active for short periods of time throughout the day can add up to provide health benefits.
  • Strength training. Do strength training exercises for all major muscle groups at least two times a week. Aim to do a single set of each exercise, using a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.

When combined with healthy eating, regular physical activity may also help you control your weight. However, research shows that even if you can’t lose weight or maintain your weight loss, you still can enjoy important health benefits from regular physical activity 157, 152.

Physical activity also can be a lot of fun if you do activities you enjoy and are active with other people. Being active with others may give you a chance to meet new people or spend more time with family and friends. You also may inspire and motivate one another to get and stay active.

How much physical activity should I do to lose weight?

Physical activity is important in weight loss and all weight loss programs should include physical activity. If left on their own, most dieters become more sedentary during weight loss, especially if their diets are very low in calories 22. This is because a markedly negative energy balance reduces your exercise tolerance, your body’s maximal power output and increases your body’s sense of perceived exertion 158. Therefore, conscious efforts to increase physical activity while dieting should be attempted.

According to the 2008 Physical Activity Guidelines for Americans, recommendations for weight loss include engaging in 45 to 75 minutes of moderate-intensity activity per day 159. This can include activities such as walking at least three miles per hour, participating in water aerobics, ballroom dancing, or gardening. Alternatively, individuals could instead participate in 22 minutes of vigorous activity per day, such as swimming, jogging, jumping rope, or hiking. However, physical activity alone, without a reduction of calories, only induces modest reductions in body weight 22. Few studies to date have incorporated enough physical activity to achieve even a 5% weight loss using a physical activity intervention alone 22. When physical activity is paired with calorie restriction, it has a synergistic effect on weight loss 22. Despite physical activity modest effects on weight loss, physical activity is also essential for improving health-related outcomes relevant to many obesity related medical conditions (e.g., heart disease, type 2 diabetes, and possibly some cancers) 160. Physical activity is also vital in preventing weight regain and may enhance quality of life 160. There is a strong association between physical activity at follow-up and maintenance of weight loss. Data from the National Weight Control Registry, a registry of more than 3,000 individuals who have successfully maintained at least a 30-pound weight loss for a minimum of one year, shows that 90% of the individuals report that physical activity is crucial to their long-term weight maintenance. They report expending, on average, 2,700 calories per week in exercise, the energy equivalent of walking four miles seven days a week 54.

Once you lose weight, physical activity and exercise are still important for maintaining weight loss. For weight maintenance, 60 minutes of moderate activity per day or 30 minutes of vigorous activity per day is recommended 22. In addition, weight resistance activities, which involve all the major muscle groups, are recommended for two or more days per week 22. Resistance training increases muscle strength by making your muscles work against a weight or force. Different forms of resistance training include using free weights, weight machines, resistance bands, your own body weight or any other object that causes your muscles to contract.

Recent evidence supports the benefits of resistance training in increasing and/or maintaining lean body mass and bone mineral density 161, 162 and highlights their effects on muscular strength and muscle building 163, 164. Muscle building occurs when the size and/or number of myofibrils (actin and myosin) within a muscle fiber increases. It’s more common in fast-twitch muscles than slow-twitch muscles, and Type 2A fibers grow the most. Muscle building is a slow process. When you lift heavy weights, your muscles tear and your body experiences metabolic stress. In response, your body tells the proteins to increase, and your muscles slowly grow 165.

Exercise and weight maintenance

The American College of Sports Medicine position stand on physical activity intervention strategies to promote weight loss and weight regain emphasize the distinction between the minimum levels of physical activity to maintain health (150 minutes per week) and higher levels of physical activity to prevent weight regain (200 minutes per week) 45. Therefore, obese individuals who have successfully lost weight require a substantial amount of physical activity to maintain this weight loss 45. As indicated in the American College of Sports Medicine position, several major limitations to research of physical activity on weight regain exist including the observational and the retrospective nature of the existing literature from randomized trials 45. However, several studies in this area deserve mentioning. Using data from a physical activity weight loss study, Jakicic et al. 166 observed a dose response between the amount of self-reported physical activity per week and long-term success with weight loss at 18 months of intervention (composed of caloric restriction and exercise training). Adults who exercised greater than 200 minutes per week (−13.1 kg) lost more weight compared to those who exercised between 150-199 min per week (−8.5 kg), and those that exercised less than 150 minutes week (−3.5 kg) 166. A different study by Jakicic et al. 167 observed similar findings in post hoc analyses of a weight loss intervention composed of both caloric restriction and exercise training in women. After 12 months of intervention, women with greater than 200 min/week (13.6%) had maintained significantly greater percentage of weight loss compared to those who had exercised at 150-199 min/week (9.5%), and less than 150 min/week (4.7%). Lastly, Andersen et al. 168 evaluated the effect of low-fat diet (1200 kcals/day) in combination with either structured aerobic exercise training or lifestyle activity (patients were advised to increase their physical activity to recommended levels), and both groups lost approximately 8 kg of weight following 16 weeks of intervention. Weight maintenance was monitored for 1 year after the intervention, and those who were the most active lost additional weight (1.9 kg) whereas the group that was the least active regained a substantial amount of weight (4.9 kg). These data suggest that physical activity has an important role in the amount of weight regain following successful weight loss. Therefore patients attempting to reduce recidivism after weight loss are encouraged to engage in physical activity levels above 200 minutes/week 45.

What kinds of physical activities can I do?

You don’t need to be an athlete or have special skills or equipment to make physical activity part of your life. Many types of activities you do every day, such as walking your dog or going up and down steps at home or at work, may help improve your health. Try different activities you enjoy. If you like an activity, you’re more likely to stick with it. Anything that gets you moving around, even for a few minutes at a time, is a healthy start to getting fit.

The four main types of physical activity are aerobic, muscle-strengthening, bone-strengthening, and stretching. Aerobic activity is the type that benefits your heart and lungs the most. Table 4 summarizes the expected weight change from different exercise training programs in obese patients and describe the overall likelihood for clinically significant weight loss.

A well-known physiologic effect of exercise or physical activity is that it expends energy. A metabolic equivalent of task or MET, is a unit useful for describing the energy expenditure of a specific physical activity. A MET is the ratio of the rate of energy expended during an activity to the rate of energy expended at rest. For example, 1 MET is the rate of energy expenditure while at rest. A 4 MET activity expends 4 times the energy used by the body at rest. If a person does a 4 MET activity for 30 minutes, they have done 4 x 30 = 120 MET-minutes (or 2.0 MET-hours) of physical activity. A person could also achieve 120 MET-minutes by doing an 8 MET activity for 15 minutes.

Table 9. Expected weight loss from different modalities of exercise training

Exercise modalityWeight LossClinically significant weight loss
Pedometer-based step goal Range: 0 to 1 kg of weight lossUnlikely
Aerobic Exercise Training only Range: 0 to 2kg of weight lossPossible, but only with extremely high exercise volumes
Resistance Training only NoneUnlikely
Aerobic and Resistance training only Range: 0 to 2kg of weight lossPossible, but only with extremely high volumes of aerobic exercise training
Caloric restriction combined with aerobic exercise training Range: −9 kg to −13 kgPossible
[Source 47 ]

Walking

Walking is free and easy to do—and you can do it almost anywhere. Walking will help you:

  • burn calories
  • improve your fitness
  • lift your mood
  • strengthen your bones and muscles

You can download fitness apps that let you enter information to track your progress using a computer or smart phone or other mobile device.

Devices you can wear, such as pedometers and fitness trackers, may help you count steps, calories, and minutes of physical activity. Trackers can help you set goals and monitor progress. You wear most of these devices on your wrist like a watch, or clipped to your clothing.

Keeping an activity journal is another good way to help you stay motivated and on track to reach your fitness goals.

If you are concerned about safety, try walking in a shopping mall or park where it is well lit and other people are around. Many malls and parks have benches where you can take a quick break. Walking with a friend or family member is safer than walking alone and may provide the social support you need to meet your activity goals.

If you don’t have time for a long walk, take several short walks instead. For example, instead of a 30-minute walk, add three 10-minute walks to your day. Shorter spurts of activity are easier to fit into a busy schedule.

Aerobic exercise

Aerobic exercise is also called endurance activity, moves your large muscles, such as those in your arms and legs. Running, swimming, walking, bicycling, dancing, and doing jumping jacks are examples of aerobic activity. Aerobic exercise makes your heart beat faster than usual. You also breathe harder during this type of activity. Over time, regular aerobic activity makes your heart and lungs stronger and able to work better.

Below are examples of aerobic activities. Depending on your level of fitness, they can be light, moderate, or vigorous in intensity:

  • Pushing a grocery cart around a store
  • Gardening, such as digging or hoeing that causes your heart rate to go up
  • Walking, hiking, jogging, running
  • Water aerobics or swimming laps
  • Bicycling, skateboarding, rollerblading, and jumping rope
  • Ballroom dancing and aerobic dancing
  • Tennis, soccer, hockey, and basketball

You can do aerobic activity with light, moderate, or vigorous intensity. Moderate- and vigorous-intensity aerobic exercises are better for your heart than light-intensity activities. However, even light-intensity activities are better than no activity at all.

The level of intensity depends on how hard you have to work to do the activity. To do the same activity, people who are less fit usually have to work harder than people who are more fit. So, for example, what is light-intensity activity for one person may be moderate-intensity for another.

Absolute rates of energy expenditure during physical activity are commonly described as light, moderate, or vigorous intensity. Energy expenditure is expressed by multiples of the metabolic equivalent of task (MET), where 1 MET is the rate of energy expenditure while sitting at rest.

  • Light-intensity activity
    • Light-intensity activities are common daily activities that don’t require much effort.
    • Light-intensity activity is non-sedentary waking behavior that requires less than 3.0 METs; examples include walking at a slow or leisurely pace (2 miles per hour [mph] or less), cooking activities, or light household chores.
  • Moderate-Intensity activity
    • Moderate-intensity activities make your heart, lungs, and muscles work harder than light-intensity activities do.
    • On a scale of 0 to 10, moderate-intensity activity is a 5 or 6 and produces noticeable increases in breathing and heart rate. A person doing moderate-intensity activity can talk but not sing.
    • Moderate-intensity activity requires 3.0 to less than 6.0 METs; examples include walking briskly (2.5 to 4 mph), playing doubles tennis, or raking the yard.
  • Vigorous-Intensity activity
    • Vigorous-intensity activities make your heart, lungs, and muscles work hard. On a scale of 0 to 10, vigorous-intensity activity is a 7 or 8. A person doing vigorous-intensity activity can’t say more than a few words without stopping for a breath. Vigorous-intensity activity examples include jogging, running, carrying heavy groceries or other loads upstairs, shoveling snow, or participating in a strenuous fitness class. Many adults do no vigorous-intensity physical activity.
    • Vigorous-intensity activity requires 6.0 or more METs.

Bicycling

Riding a bicycle spreads your weight among your arms, back, and hips. For outdoor biking, you may want to try a mountain bike. Mountain bikes have wider tires and are sturdier than road bikes with thinner tires. You can buy a larger gel padded seat to make biking more comfortable.

For indoor biking, you may want to try a recumbent bike. On this type of bike, you sit lower to the ground with your legs reaching forward to the pedals. Your body is in more of a reclining position, which may feel better than sitting straight up. The seat on a recumbent bike is also wider than the seat on a regular bike.

Water workouts

Swimming and water workouts put less stress on your joints than walking, biking, or dancing. If your feet, back, or joints hurt when you stand, water activities may be best for you. If you feel self-conscious about wearing a bathing suit, you can wear shorts and a T-shirt while you swim.

You don’t need to know how to swim to work out in water. You can do shallow- or deep-water exercises at either end of the pool without swimming. For instance, you can do laps while holding onto a kickboard and kicking your feet. You also can walk or jog across the width of the pool while moving your arms.

For shallow-water workouts, the water level should be between your waist and chest. During deep-water workouts, most of your body is underwater. For safety and comfort, wear a foam belt or life jacket.

Exercising in water

lets you be more flexible. You can move your body in water in ways you may not be able to on land.
reduces your risk of hurting yourself. Water provides a natural cushion, which keeps you from pounding or jarring your joints.
helps prevent sore muscles.
keeps you cool, even when you are working hard.

Dancing

Dancing can be a lot of fun while it tones your muscles, strengthens your heart and lungs, and boosts your mood. You can dance at a health club, dance studio, or even at home. Just turn on some lively music and start moving. You also can dance to a video on your TV or phone.

If you have trouble standing on your feet for a long time, try dancing while sitting down. Chair dancing lets you move your arms and legs to music while taking the weight off your feet.

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What is Weight Watchers Weight Loss Program ?

weight wathers weight loss program
Weight Watchers weight loss program
Weight Watchers weight loss program

The Weight Watchers Weight Loss Program

Founded in 1963 by Jean Nidetch, Weight Watchers Weight-Loss Program:  the basis around this program helps promote the members to engage in regular meetings, and sessions promoting group support, alongside of a point system based off of the foods you eat.

Weight Watchers isn’t so much a diet, but it’s a lifestyle-change program. It can help you learn how to eat healthier and get more physical activity, so you can lose the weight for good. A backbone of the weight watchers weight loss program is multi-model access (via in-person meetings, online chat or phone) to support you from people who lost weight using Weight Watchers, kept it off and have been trained in behavioral weight management techniques.

In the review conducted by U.S. News & World Report with the help of a panel of 22 experts to make their choices to find the nation’s best overall diets for 2013 1. U.S. News evaluated and ranked the 38 diets, to be top-rated, a diet had to be relatively easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease. The US government-endorsed Dietary Approaches to Stop Hypertension (DASH) diet took the number 1 spot, while the Mediterranean diet came in second and Mediterranean-DASH Intervention for Neurodegenerative Delay (MND) Diet came in 3rd. The Weight Watchers Diet came in 4th tie with Therapeutic Lifestyle Changes (TLC), Mayo Clinic Diet and The Flexitarian Diet (casual vegetarian) 1.

In general, Weight Watchers Weight-Loss Program consists of tracking daily points (each point is about 50 kcal) based on your current weight and weight loss goals. Though a recommended macronutrient intake was not clearly specified, this program is generally consistent with the National Academy of Sciences acceptable macronutrient distribution ranges for adults, which are 45-65% carbohydrates, 10-35% protein and 20-35% fats 2. Thirty minutes of exercise on most days of the week was encouraged. You can earn FitPoints for walking, cleaning, gardening.

Participants were typically provided with access to weekly group meetings and support, behavioral counseling, individual contact with the dietitian
and educational resources such as recipes and meal ideas, as well as community discussion boards.

In December 2015, Weight Watchers introduced a new plan called SmartPoints 3. It tries to help people make smarter food choices and build a better relationship with food. Similar to their other points-based plans, every food and drink is assigned a points value. SmartPoints is calculated using calories, saturated fat, sugar and protein. No food is off-limits, but the plan assigns higher points values to foods higher in sugar or saturated fat, and lower points values to lean proteins. Most fruits and vegetables are zero points, similar to the old PointsPlus plan. Some condiments are no longer free, such as ketchup, due to the sugar content.

In short, the foods you choose to eat are converted into points. Each day, you’re allotted a certain number of points, with exercise giving you the option to earn more points. The number of points you’re allowed depends on your current weight, your weight loss goals, and so on. You get to eat a certain amount of points per day with a bank of extra points each week for days when you want to eat or drink more.

You also get activity points, which you can dip into if you’re out of weekly points and daily points. The idea is for this to happen very rarely. There are going to be days or weeks where you just consume more than allotted. The idea is to just keep track of it all.

As you lose weight, you are given fewer daily points, which aids your weight loss. Once you get to your goal weight, your daily points allotment goes up.

In addition, most Weight Watchers weight loss programs include a day or so a week in which you can eat whatever you want. This is rooted in an understanding of how the metabolism works – if you’re consistently making healthy choices, your body can easily recover from a splurge every now and then. It’s a good program because it’s not about denying yourself the foods you love. Rather, it’s about making sure that you’re eating well enough to indulge every now and then.

Additionally, Weight Watchers is well integrated with technology such as smart-phones. WeightWatchers.com is a great resource. While the in-person groups work for many, other people want a more private experience.The Online Plus plan allows this. If you opt for the Online Plus plan, you’ll get the chance to work to lose weight at your own pace. It features an 8-week crash course in making better choices, including a 24/7 chat line.

Both the online plan and the in-person group plan feature great integration with iPhone and Android, as well as your regular internet browser. Track your points, read about exercise routines or recipes, and more.

You can follow the plan online on your own. You’ll track your food choices and exercise, chart progress, and find recipes and workouts. There’s a coaching option if you prefer one-on-one consultations by phone, email, and text. Or you can go to in-person group meetings, where you’ll weigh in.

  • Although the Weight Watchers program is heavily supported with meetings, it can also be expensive. The start of the meetings is around $13.00 per meeting depending on the area that you live.
  • Group meetings are not for everyone. This is another reason why the online version works for many people, but you are not going to get the full experience.
  • Weekly weigh ins are required, and this may not be for everyone. Some people will be intimidated, and discouraged by weekly weigh ins.
  • Not as structured as most programs, which causes problems for some people.
  • If you don’t know your way around the kitchen, the premade meals and snacks make it easy. They’re a quick and easy way to control portion sizes and calories.
  • Unhealthy foods are allowed within this program, which do not promote health and long-term success.

Here are the key principles of Weight Watchers weight loss program

1) Talk and Plan

  • Establish goals
  • Start a basic document/spreadsheet
    > Record goals
    > Record BMI
  • Discuss weight loss methods : Start a discussion on what each of you would like to achieve and document this. You may want to drop down to a specific weight, target fat percentage or fit into certain size clothing. Throw around some ideal but realistic dates based on the idea that healthy weight loss is no more than 2 pounds (0.9kg) per week.
  • Document your starting weight and we strongly recommend you measure your body fat percentage. We think this is the best measure of performance as your overall weight is determined by muscle and fat weight amongst other things. We are concerned with fat lost above all things, losing muscle is not the ideal way to lose weight.
  • Motivate and get excited. It sounds silly to suggest you get motivated and excited. But just remember, you are going to be working as a team to achieve your goals to be healthier, better looking and happier people, it’s not hard to be motivated and excited by this prospect.

Food

  • Discuss dietary habits
  • Establish foods to avoid or eliminate
  • With your team you can have discussions about your diet. The types of foods you like to eat and eat regularly and consequently what foods you need to be more conscience about cutting down or avoiding altogether. Run past each other what meals you are eating throughout the day and during conversations you will naturally start to share ideas and tips.
  • Know Your Calories
  • Have a points system like SmartPoints used by Weight Watchers where every food gets a value as a way of evaluating food based on kilojoules, saturated fat, sugar and protein. Stick to your personalised budget and start seeing results. In order to keep this points system simple and easy to use, choose low carbohydrates and low ‘bad’ fat healthy foods. Calorie charts and understanding the calorie content of the foods you are ingesting became crucial to your diets also. This calorie calculator is an excellent tool that will help you understand how many calories you need to consume in order to keep losing weight for the duration of your goal.
  • Enjoy your food. If you do not enjoy your food then your efforts to eat better will fail. There are many foods to choose from and you will need to find the foods that you enjoy.
  • Don’t starve yourself. Not eating is one of the worst things you can do. You will feel physically and emotionally unbalanced. You will crave bad food, your metabolism will slow down and your body will go into starvation mode holding onto fat stores.
  • Drink plenty of water.
  • Listed the foods we would eliminate or enjoy only occasionally
    > Soft drink
    > Milk tea
    > Roast duck
    > Oily or fatty foods at restaurants
    > Buttered popcorn
    > Baked pastries
    > Dark chocolate instead of milk chocolate
    > Fried chips
    > Potato crisps
    > Sugar as an ingredient
    > White rice and bread
  • Listed the foods that we would eat more of and incorporate into our diets
    > Brown rice
    > Vegetables
    > Fruit
    > Yoghurt
    > Rice Cakes
    > Drink more water
    > Salmon and Sashimi
    > Whole grain bread with seeds
    > Oats for breakfast
    > Clear soups
    > Tuna – from a can, in a pasta dish (click here for recipe), in a salad, or with brown rice and vegetables just to name a few examples
    > Honey as a sweetener
    > Tea – even better without sugar, herbal such as green

2) Meeting (Support)

  • One Meeting
  • Same Time
  • Every Week

Decide on a day each week to put aside to meet, discuss your weight loss efforts and for the all important weigh in. The day of the week should be chosen carefully to ensure the meetings will occur every single week of the competition. Make the meeting a high priority, just as losing weight and being at your healthiest weight is a high priority itself. It’s also a fantastic excuse to get together.

Try to mimic the exact same conditions for the weigh in each week. Preferably the same time of the day and before you have a main meal to ensure that results from the weigh in are more accurate.

Fundamental to the Weight Watchers meeting experience is a weekly weigh-in to track progress. Many people find the accountability of being weighed by another person helpful to their weight-loss efforts.

Group System

One of the main appeals to the Weight Watchers system is that it involves regular group meetings. Now, maybe you’re thinking that the last thing you’d want to do is meet up and talk about losing weight. Weight loss is intensely personal and a lot of your self-esteem and sense of yourself is wound up in how attractive you think you are.

However, it’s for exactly this reason that the group meetings are so important. Meeting regularly with other people working hard to get – and stay – healthy is one of the reasons why the program boasts such success. Not only do you have a group of peers (even friends) to stay accountable to, you also can see what works and doesn’t work for others, and learn that you’re not in it alone.

3) Psychological (Behavior)

Despite knowing the logic behind weight loss and the nature of fluctuations, it is still all too easy to become discouraged. Having your friends there to support and reaffirm the nature of weight loss is extremely important.

  • Encouragement
  • Motivation
  • Reward
  • Penalty: Discouragement is one of the key setbacks for weight loss which is a main reason why having the support of friends who are sharing the weight loss experience is so beneficial. Having people to motivate and encourage you to do your best and to pick you up during moments when you feel discouraged will help keep you on track.
  • Reward and penalty. Friendly competition is a common motivator for many people (not so much for others) and for many participants the thought of beating each other was sweet while the thought of being left behind, not so much. A competition can be set up with rewards and even penalties if you wish. Of course there are other ways of rewarding yourself for healthy consistent weight loss. Indulging in fatty or sugary foods should not be one of them.
  • Tracking. Tracking your progress is very important. It will show your team if you are moving in the right direction and whether you need to change your approach.
  • Weekly Weigh In. The main event of your meeting will be your weigh-in which can be an intimidating experience, even amongst friends. Losing weight will make you feel ecstatic, but not losing weight or putting it on is a completely different story.

4) Exercise

Once you start to exercise it will raise your metabolism and losing weight will be easier. You will also feel much better. Burn more then you eat. In order to lose weight you must burn more calories than you are putting in, so the need to exercise to lose weight is very important. Not only that, it is of enormous benefit to your overall physical and mental health. Have Fun!

The more active you are, the more calories you can consume. Remember, you don’t want your body going into starvation mode. (you can specify your level of physical activity on this calorie counter). It is the same as using exercise to increase your Weight Watchers point allowance.

Some form of exercise every day.

Intense exercise a few times a week.

Being active with your team mates or on your own are both fantastic. Exercising by yourself is a nice way to relieve stress and to clear your thoughts while exercising with your team is a lot of fun and motivating.

Cardio and Strength training

Both Cardio and strength training contribute to weight loss with muscle helping you to burn more calories throughout the day and just doing wonders for your overall health.
The same rule applies to exercise as it does with diet. If you hate it, don’t bother. There are many ways of being active and exercising; you just have to find the one you enjoy. It might seem unlikely for some people that they will find a physical activity they will enjoy, but once you get started, give it ago and start to feel healthier and more capable, you will be very surprised.

Give cycling, jogging or cycling a try on routes that you find interesting or scenic, preferably close to your home. Many people find walking or jogging with music very enjoyable. Give group activities like mountain climbing, tennis, kayaking etc ago. It could become a very enjoyable weekly event.

Here are some exercises you can tryout:

  • Walked or cycled to and from work.
  • Intensive boxing lessons in the park with your own trainer.
  • Changed the intensity of our workouts often relating it to your diet.
  • Try different sports such as squash and mountain climbing.
  • Do both Cardio AND Strength training for females also !
  • Established a list of the exercises that you enjoyed, ensuring they covered the different parts of your bodies.
  • Changed the exercises you did regularly so that we would be pushed and tested in different ways. This maximizes the efficiency of exercise.
  • Made an effort to do 2 cardio and 2 strength training sessions per week.
  • If you do not like the gym, do all your cardio at the park and your strength training at home with free weights and other exercises that don’t require equipment.

Average Weight Loss on Weight Watchers Per Week

The average weight loss on the Weight Watchers Weight Loss Programs vary between individuals, some people are more successful and others are less successful and may even regain the weight they have lost and then some extra pounds.

Members who dutifully track their points can lose quite a few pounds the first week. Generally, people lose about 1-2 pounds a week.

Participants lose weight by creating a calorie deficit.[4] Weight Watchers is generally compatible with other diet approaches and/or food intake restrictions, provided participants use the Weight Watchers framework to measure and limit the quantity of food consumed while using the other diet plan to dictate the range of acceptable food choices.

If you plateau, the app gives you tips or changes your daily point count in order to help you keep losing. The company also has blog posts and message boards where you can seek out tips.

If you are wondering what is the best weight loss programs there are out there, you want to read the most comprehensive review (meta-analysis) conducted to date, a team of researchers 4, analyse all available articles and randomised trials on all popular branded diets including macronutrient composition diets (low carbohydrate, low fat, high protein, high fat).

Summary:

  • Weight loss differences between individual brand named diets were small with likely little importance to those seeking weight loss. For example, the Atkins diet resulted in a 1.71 kg greater weight loss than the Zone diet at 6-month follow-up.
  • The largest and most significant weight loss was associated with low-carbohydrate diets (8.73 kg at 6-month follow-up and 7.25 kg at 12-month follow-up) and low-fat diets (7.99 kg at 6-month follow-up and 7.27 kg at 12-month follow-up) than no dietary intervention over a 12-month period.
  • Behavioral support and exercise enhanced weight loss.

This study supports the practice of recommending any diet that a person will adhere to in order to lose weight 5.

Conclusion

Weight Watchers is good for anyone. Its focus on nutritious, low-calorie foods makes it great for people with high blood pressure or cholesterol, diabetes, and even heart disease.

In addition to Weight Watchers membership plans, other products (such as packaged foods, exercise equipment and DVDs, food preparation and storage tools, cookbooks, etc.) are available for purchase. Be prepared to spend some cash to get the full benefits of the robust program. It can be a bit costly, but it’s well worth it to reap the health perks of losing weight and keeping it off.

The key to successful weight loss is developing healthy diet and exercise habits. Diet just means eating healthy, lower calorie meals. Exercise means being more physically active.

Although people appropriately focus on diet when they’re trying to lose weight, being active also is an essential component of a weight-loss program. When you’re active, your body uses energy (calories) to move, helping to burn the calories you take in with food you eat.

  1. U.S. News & World Report L.P. Best Diets Overall. http://health.usnews.com/best-diet/best-diets-overall[][]
  2. http://www.weightwatchers.com/util/art/index_art.aspx?art_id=20921&tabnum=1&sc=805&subnav=Science+Library%3a+Health[]
  3. Weight Watchers. Our Approach. https://www.weightwatchers.com/us/our-approach[]
  4. Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, Ball GDC, Busse JW, Thorlund K, Guyatt G, Jansen JP, Mills EJ. Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults. A Meta-analysis. JAMA. 2014;312(9):923-933. doi:10.1001/jama.2014.10397. http://jamanetwork.com/journals/jama/fullarticle/1900510[]
  5. Johnston BC, Kanters S, Bandayrel K, Wu P, Naji F, Siemieniuk RA, Ball GDC, Busse JW, Thorlund K, Guyatt G, Jansen JP, Mills EJ. Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese AdultsA Meta-analysis. JAMA. 2014;312(9):923-933. doi:10.1001/jama.2014.10397. http://jamanetwork.com/journals/jama/fullarticle/1900510[]
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What is Ornish Diet ?

ornish diet

Ornish diet

The Ornish Diet

The Ornish Diet is also known as a Very-Low-Fat (VLF) diets that allow less than 15% of total calories from fat (with an equal distribution of saturated, monounsaturated, and polyunsaturated fats), 15% from protein, and 70% from carbohydrates. The Very-Low-Fat (VLF) diets are the main dietary factor in the Pritikin Diet as well. The Very-Low-Fat diet includes variations of vegetarian diets that may include eggs and dairy. Although an American Heart Association scientific statement concluded there were little long-term data to suggest that low-fat diets alone will sustain long-term weight loss, there is evidence that this diet can impact cardiovascular risk 1.

Dr. Ornish argues that protein and saturated fat increase the risk of mortality and chronic disease, therefore the fat content of your diet must be less than 10% fat with whole food and are plant-based. When comparing the Ornish diet with the highly processed, refined-carbohydrate-rich diet most Americans consume today it’s almost certainly healthier.

The problem with Ornish diet is it’s claimed that protein and fat are the cause of our health and weight problem today. Which is not true based on current  large observational studies that have found that diets high in fat and protein are not associated with disease and may even protect against it. Nutrition is complex but there is little evidence the world’s obesity epidemic and worsening metabolic disorders are the fault of protein or fat. If anything, our attempts to eat less fat in recent decades have made things worse !

When people vigilantly cut down on fat in the 1980s and 1990s, they replaced much of it with high-sugar and high-calorie processed foods.

During the time in which the prevalence of obesity in the U.S. nearly tripled (1970 – 2017), the percentage of calories Americans consumed from protein and fat actually dropped whereas the percentage of calories Americans ingested from carbohydrates—one of the nutrient groups Ornish says we should eat more of—increased.

Could it be that our attempts to reduce fat have in fact been part of the problem ? Some scientists think so and we believe the low-fat message promoted the obesity epidemic.

Furthermore, another aspect of the Ornish diet—avoiding all added oils and even high-fat plant foods like avocados and nuts—isn’t necessarily helpful. There’s now lots of evidence that unsaturated fat lowers blood lipids such as cholesterol and reduces heart disease 2. What’s more, a low-fat diet is, by definition, a high-carbohydrate diet. These diets tend to promote the release of insulin, the hormone that regulates blood sugar levels. In people who aren’t very physically active, high insulin levels send a signal that it’s time to store fat, which can lead to weight gain.

The Ornish Lifestyle Heart Trial 3 randomized 48 patients with moderate to severe coronary heart disease (CHD) to intensive life-style changes or usual care. The intensive life-style changes included a vegetarian diet with 7% of caloric intake coming from fat, moderate aerobic exercise, stress management training, smoking cessation, and group psychosocial support. A total of 195 coronary artery lesions were analyzed angiographically. Overall, 82% of experimental group patients had an average change toward lesion regression. At five years, there were 2.5 times fewer cardiac events in the intervention group, and the average percent diameter stenosis showed an 8% decrease in diameter, whereas the control group had 28% progression. However, the data are difficult to interpret due to the confounding effects of exercise, stress reduction, and 11-kg weight loss in the intervention group. Although the intervention seems beneficial, the small sample size and intense life-style changes raise concerns about the universal sustainability of such a program.

The Very-Low-Fat Ornish diet and intense life-style changes have significant results in terms of reducing risk factors and cardiac event rates. However, these studies are relatively small, and the programs involved may be influenced by selection bias. The programs require a motivated group of patients to undergo rigorous life-style adjustments. The VLF Ornish diet may be unnecessary if other life-style characteristics like exercise, smoking cessation, and stress management are optimized 4.

The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. (All groups consumed about the same amount of protein.) Protein, too, doesn’t look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not.

The other problem with Ornish’s antiprotein stance is that he lumps all animal proteins together. For instance, he wrote that animal proteins have been associated with higher disease and mortality risks. However that is only true if you combine processed meats like bacon, salami, pepperoni, hot dogs with unprocessed meats. A 2010 systematic review and meta-analysis of 20 studies found consumption of processed meat was associated with an increased risk of diabetes and heart disease but eating unprocessed red meat was not. A 2014 meta-analysis similarly reported much higher mortality risks associated with processed meat compared with red meat consumption and found no problems associated with white meat. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. Also the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does. So there’s little evidence to suggest that we need to avoid protein and fat.

The patients who followed the Ornish diet also quit smoking, started exercising and attended stress management training. The people in the control group were told to do none of these things. It’s hardly surprising that quitting smoking, exercising, reducing stress and dieting—when done together—improves heart health. But fact that the participants were making all of these lifestyle changes means that we cannot make any inferences about the effect of the Ornish diet alone.

Ornish Diet vs  Zone Diet vs Atkins Diet vs LEARN Diet for Weight Loss

In a 2007 study 5, where researchers randomly assigned 311 individuals to four groups: one group was assigned the high-fat, high-protein and low-carbohydrate (Atkins diet); the second was assigned Ornish’s very low-fat vegetarian diet, which requires consuming fewer than 10 percent of calories from fat; the third was assigned the Zone diet, which aims for a 40/30/30 percent distribution of carbohydrate, protein and fat (macronutrient balance); and the fourth was assigned the high-carbohydrate, low–saturated fat LEARN (for: lifestyle, exercise, attitudes, relationships, nutrition) diet. Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up. Weight loss at 12 months was the primary outcome. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non–high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Outcomes were assessed at months 0, 2, 6, and 12. The participants all had trouble adhering to their regimens, but all lost about the same statistically significant amounts of weight, and when compared head to head, the Atkins dieters saw greater improvements in blood pressure and HDL cholesterol than the Ornish dieters did.

Results 5: Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months, and mean 12-month weight loss was significantly different between the Atkins and Zone diets. Mean 12-month weight loss was as follows:

  • Atkins, −4.7 kg ( −6.3 to −3.1 kg),
  • Zone, −1.6 kg (−2.8 to −0.4 kg),
  • LEARN, −2.6 kg (−3.8 to −1.3 kg), and
  • Ornish, −2.2 kg (−3.6 to −0.8 kg).
  • Weight loss was not statistically different among the Zone, LEARN, and Ornish groups.
  • At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups.

Conclusions  5: In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. Average weight loss across all four groups ranged from 3.5 to 10.4 pounds. The authors note that “even modest reductions in excess weight have clinically significant effects on risk factors such as triglycerides and blood pressure.” While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.

In another study published in the Journal of American Medical Association, where a total of 160 participants were randomly assigned to either Atkins (carbohydrate restriction), Zone , Weight Watchers (calorie restriction), or Ornish (fat restriction) diet groups. After 12 months of maximum effort, participants on the Atkins Diet which had the lowest carbohydrate intake, lost more weight at 12 months than participants assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Weight Watchers or Ornish  diets. Each diet significantly reduced the low-density lipoprotein/high-density lipoprotein (HDL) cholesterol ratio by approximately 10%, with no significant effects on blood pressure or glucose at 1 year. Each popular diet modestly reduced body weight and several cardiac risk factors at 1 year. The participants all had trouble adhering to their regimens, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group. While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.

  1. A.H. Lichtenstein, L. Van Horn. AHA science advisory: very low fat diets. Circulation, 98 (1998), pp. 935-939[]
  2. American Heart Association. The Skinny on Fats. http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats_UCM_305628_Article.jsp[]
  3. D. Ornish, L.W. Scherwitz, J.H. Billings. Intensive lifestyle changes for reversal of coronary heart disease. JAMA, 280 (1998), pp. 2001-2007[]
  4. Journal of the American College of Cardiology. Volume 45, Issue 9, 3 May 2005, Pages 1379-1387. Diets and Cardiovascular Disease: An Evidence-Based Assessment. http://www.sciencedirect.com/science/article/pii/S0735109705003670[]
  5. JAMA. 2007 Mar 7;297(9):969-77. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. https://www.ncbi.nlm.nih.gov/pubmed/17341711[][][]
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What is the Zone Diet ?

Zone diet

Zone diet

The Zone Diet

The Zone Diet is created by Dr. Barry Sears based on his Zone book to control diet-induced inflammation for a lifetime. The Zone diet is designed so that a person’s daily calorie consumption is comprised of 40 percent carbohydrates, 30 percent protein, and 30 percent fat specifically advocates sparing use of grains and starches 1. More importantly, the precise 0.75 protein to carbohydrate ratio (3 gram protein for every 4 gram carbohydrate) is  required with each meal and is promoted to reduce the insulin to glucagon ratio, which purportedly affects eicosanoid metabolism and ultimately produces a cascade of biological events leading to a reduction in chronic disease risk, enhanced immunity, maximal physical and mental performance, increased longevity and permanent weight loss. According to the Zone Diet doctrine, every meal must conform to this 0.75 Protein : Carbohydrate in order to realize the purported health benefits 2. While fat makes up the remaining 30% of total energy. This program typically consisted of an active weight loss-phase in which the daily caloric intake was reduced to 1500 for males and 1200 calories for females, followed by a weight maintenance phase. The recommended macronutrient intake during both phases was 40% carbohydrates, 30% protein and 30% fats. Thirty minutes of exercise on most days of the week was encouraged. Participants were typically offered meal planning and nutritional counseling from a dietitian and group support. Other cointerventions include prepared foods to aid with adherence.

However, there is presently little scientific support for the connections made between the Zone diet, endocrinology and eicosanoid metabolism 3. In fact, a review of the literature suggests that there are scientific contradictions in the Zone Diet hypothesis that cast unquestionable doubt on its potential efficacy.

The underlying dietary principle based on the glycemic index (GI) of foods, specifically the Zone diet allows carbohydrate consumption as long as they have a low glycemic index (GI). The glycemic index (GI) is a measure of the blood glucose response to intake of a particular carbohydrate 4. The higher the peak in postprandial blood glucose levels, the higher the GI value. The glycemic load (GL) is the product of dietary GI and total dietary carbohydrate, providing a useful measure of the total glycemic effect 5. Table 1 shows a list of common foods and their associated GI and GL. A high-GI diet has been proposed to increase hunger and elevate free fatty acid levels, leading to an increased risk of obesity, diabetes, and CVD 6. Several in vitro experiments indicate that elevated postprandial blood glucose levels cause oxidative stress, leading to endothelial damage and activation of coagulation 7.

Table 1. Glycemic Index and Glycemic Loads of Various Foods 6

FoodGlycemic IndexGlycemic Load
Glucose100
Cornflakes9224
Baked potato8526
Instant rice7528
White bread7010
Coca-cola6316
Wheat bread5210
Carrot473
Spaghetti4120
Apple406
Lentil beans295
Peanuts131

On the Zone diet, you get 3 meals and 2 snacks a day. Each is a mix of low-fat protein, like skinless chicken, turkey, or fish; carbs (mostly fruits and veggies); and a small amount of “good” fat, like olive oil, almonds, and avocado.

Here is what a Zone Diet is all about:

  • Every meal on the Zone has the same proportions: 30% protein, 30% fat, and 40% carbohydrate. You need to stick to the 30% protein, 30% fat, and 40% carbs formula at every meal and snack. You can’t pile on the protein at lunch and then have all carbs for dinner.
  • And calories do count on the Zone diet. Women get about 1,200 calories a day. For men, it’s 1,500.
  • If you have high blood pressure or heart disease and were told to watch your salt, The Zone Diet’s emphasis on fresh ingredients and the shunning of prepared foods will likely fit well into your diet.
  • The Zone Diet also has fitness recommendations that closely follow those of the American Heart Association.

The precise 0.75 protein to carbohydrate ratio required by the Zone Diet with each meal is promoted to reduce the insulin to glucagon ratio, which purportedly affects eicosanoid metabolism and ultimately produces a cascade of biological events leading to a reduction in chronic disease risk, enhanced immunity, maximal physical and mental performance, increased longevity and permanent weight loss. No food is completely banned, but if you’re a carb-lover, you may find getting used to the Zone plan challenging. It encourages you to think of bread, pasta, grains, and other starches as condiments rather than as main or even side dishes.

Veggies and fruits that are relatively high in sugar — like corn, carrots, bananas, and raisins — are on the “unfavorable” list. Fatty red meat and egg yolks fall into the Zone’s “bad fats” column.

What that looks like on the plate is a palm-sized portion of protein, two-thirds of the plate filled with nonstarchy fruits and vegetables, and a dash of monounsaturated fat like olive oil or slivered almonds.

Zone Diet vs Atkins Diet vs LEARN Diet vs Ornish Diet for Weight Loss

In a 2007 study 8, where researchers randomly assigned 311 individuals to four groups: one group was assigned the high-fat, high-protein and low-carbohydrate (Atkins diet); the second was assigned Ornish’s very low-fat vegetarian diet, which requires consuming fewer than 10 percent of calories from fat; the third was assigned the Zone diet, which aims for a 40/30/30 percent distribution of carbohydrate, protein and fat (macronutrient balance); and the fourth was assigned the high-carbohydrate, low–saturated fat LEARN (for: lifestyle, exercise, attitudes, relationships, nutrition) diet. Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up. Weight loss at 12 months was the primary outcome. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non–high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Outcomes were assessed at months 0, 2, 6, and 12. The participants all had trouble adhering to their regimens, but all lost about the same statistically significant amounts of weight, and when compared head to head, the Atkins dieters saw greater improvements in blood pressure and HDL cholesterol than the Ornish dieters did.

Results 8: Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months, and mean 12-month weight loss was significantly different between the Atkins and Zone diets. Mean 12-month weight loss was as follows:

  • Atkins, −4.7 kg ( −6.3 to −3.1 kg),
  • Zone, −1.6 kg (−2.8 to −0.4 kg),
  • LEARN, −2.6 kg (−3.8 to −1.3 kg), and
  • Ornish, −2.2 kg (−3.6 to −0.8 kg).
  • Weight loss was not statistically different among the Zone, LEARN, and Ornish groups.
  • At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups.

Conclusions  8: In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. Average weight loss across all four groups ranged from 3.5 to 10.4 pounds. The authors note that “even modest reductions in excess weight have clinically significant effects on risk factors such as triglycerides and blood pressure.” While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.

In another study published in the Journal of American Medical Association 9, where a total of 160 participants were randomly assigned to either Atkins (carbohydrate restriction), Zone , Weight Watchers (calorie restriction), or Ornish (fat restriction) diet groups. After 12 months of maximum effort, the mean weight loss 9 for all 4 diets resulted in modest statistically significant weight loss, with no statistically significant differences between diets. In each diet group, approximately 25% of the initial participants sustained a 1-year weight loss of more than 5% of initial body weight and approximately 10% of participants lost more than 10% of body weight. Weight reductions were highly associated with waist size reductions for all diets, with no significant difference between diets. In women, mean body weight decreased by 5.1 kg (2.5% change from baseline) and waist size by 4.5 cm, whereas in men body weight decreased by 6.4 kg (3.1% change from baseline) and waist size by 3.1 (5.8) cm at 1 year. Participants on the Atkins Diet which had the lowest carbohydrate intake, lost more weight at 12 months than participants assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Weight Watchers or Ornish  diets.

Each diet 9 significantly reduced the low-density lipoprotein/high-density lipoprotein (HDL) cholesterol ratio by approximately 10%, with no significant effects on blood pressure or glucose at 1 year. Each popular diet modestly reduced body weight and several cardiac risk factors at 1 year. The participants all had trouble adhering to their regimens, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group. While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.

Conclusion

There is currently no specific research to prove that eating a certain ratio of protein, carbs, and fats (food proportioning) or certain food combination is going to rev up your metabolism and increase weight loss 10. But it is a proven fact that eating a calorie-restricted diet, like the one such as The Zone Diet, can help you lose weight.

You are likely to do best in The Zone if you love to pick out and prepare fresh vegetables and lean protein. But it will be a struggle if you love your white flour carbs and sweets. And it may be tough to stay in The Zone if you prefer to eat out a lot.

  1. ZonePerfect Nutrition Program (2004) http://www.zoneperfect.com/site/content/guide_02_ZoneDiet.asp[]
  2. Sears B. “The Zone.” New York Harper Collins, 1995[]
  3. J Am Coll Nutr. 2003 Feb;22(1):9-17. The Zone Diet phenomenon: a closer look at the science behind the claims. https://www.ncbi.nlm.nih.gov/pubmed/12569110[]
  4. D.J.A. Jenkins, D.M. Thomas, S. Wolever, et al. Glycemic index of food: a physiological basis for carbohydrate exchange. Am J Clin Nutr, 34 (1981), pp. 362-366[]
  5. D.J.A. Jenkins, C.W.C. Kendall, L.S.A. Augustin, et al. Glycemic index: overview of implications in health and disease. Am J Clin Nutr, 76 (2002), pp. 266S-273S[]
  6. K. Foster-Powell, S.H.A. Holt, J.C. Brand-Miller. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr, 76 (2002), pp. 5-56[][]
  7. P.J. Lefebvre, A.J. Scheen. The postprandial state and risk of cardiovascular disease. Diabet Med, 15 (1998), pp. S63-S68[]
  8. JAMA. 2007 Mar 7;297(9):969-77. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. https://www.ncbi.nlm.nih.gov/pubmed/17341711[][][]
  9. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43-53. http://jamanetwork.com/journals/jama/fullarticle/200094[][][]
  10. Annual Review of Public Health Vol. 26:61-88 (Volume publication date 21 April 2005). COMPETING DIETARY CLAIMS FOR WEIGHT LOSS: Finding the Forest Through Truculent Trees. https://doi.org/10.1146/annurev.publhealth.26.021304.144415[]
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Is Alkaline Diet The Secret To Weight Loss ?

alkaline diet

What is Alkaline Diet

Much has been written in the lay literature as well as many online sites expounding on the benefits of the alkaline diet. This post is an attempt to balance the evidence that is found in the scientific literature.

Life on earth depends on appropriate pH levels in and around living organisms and cells. Human life requires a tightly controlled pH level in the serum of about 7.4 (a slightly alkaline range of 7.35 to 7.45) to survive 1. The ‘acidity’ of human blood is highly stable (pH = 7.35–7.45) in healthy individuals and cancer patients 2. The pH is a number that shows how acidic or alkaline a substance is. A pH of less than 7 is acidic, and greater than 7 is alkaline. The pH of blood is about 7.4. Acidosis also called acidemia is a condition in which there is a shift in the acid-base balance of your body to have more acid than normal, often causing the pH of your blood and body tissues to fall below pH 7.35 (the healthy normal range of pH is between 7.35-7.45, with the average at 7.40). Acidosis occurs when acid builds up or when bicarbonate [HCO3] (a base) is lost.

Acidosis can be due to increased acid or decreased base:

  • Increased acid production within the body
  • Consumption of substances that are metabolized to acids
  • Decreased acid excretion
  • Increased excretion of base

Acidosis may also be caused by decreased carbon dioxide (CO2) elimination in respiratory disorders such as emphysema, by metabolic problems such as kidney disease and diabetes, or as the result of ingesting poisons (ethlylene glycol, methanol) or overdosing on certain medication (salicylates); it can also be caused by losing bicarbonate (HCO3), as in diarrhea.

Alkaline diet refers to the idea that as foods are digested and metabolized, they create a more alkaline environment in the body 3, 4. For example, animal protein is a major source of sulphur-containing amino acids that create a higher acid load in the body. The amount of acids released is related to the type of amino acids they contain. In fact, amino acids can be divided into neutral (alanine, phenylalanine, glycine, isoleucine, leucine, methionine, proline, tryptophan, valine, asparagine, glutamine, serine, threonine, cysteine, and tyrosine), acidic (aspartate and glutamate), and alkaline (arginine, histidine, and lysine). Specifically, lysine, arginine, and histidine form hydrochloric acid, while cysteine and methionine are converted to sulfuric acid 5. Moreover, foods containing phosphorus, both of natural origin or from food additives, further increase the acid load introduced with the diet 6. On the other hand, vegetables and fruits are major sources of certain minerals, especially potassium, after being metabolized, produce alkali species that are able to neutralize acids 7.

The proponents of alkaline diet believe that an acidic environment promotes ill health whereas an alkaline environment is beneficial and promotes good health, based on the “acid–ash” hypothesis developed over 100 years ago 8, 9. The acid–ash hypothesis suggests that to achieve a more alkaline load, you must consume more fruit and vegetables with only a moderate intake of protein. The diet also calls for avoiding added sugars. They claimed that the food you eat can affect your body’s pH and that as your blood that is naturally alkaline (pH 7.4) is being upset by eating acid foods. By trying to change your blood pH to be more alkaline through eating mostly alkaline foods, followers of alkaline diet believe that they can cure disease, including cancer. Proponents of the Alkaline Diet say that when you load up on excess amounts of protein, sugar, caffeine and other highly processed foods, your pH levels are thrown off track, your bodies become more acidic, and that can lead to weight gain and disease. The remedy, they say? Eat fresh vegetables, fresh fruit and other “alkaline-promoting foods” such as soy products, legumes, and certain nuts and grains. “Acid-promoting foods”, which include meat, fish, poultry, dairy products, processed foods, white sugar, white flour, and caffeine, are discouraged. Because alkaline promoting foods has a higher pH level than does acid promoting foods, proponents of the alkaline diet say that it can neutralize acid in your bloodstream, boost your metabolism and help your body absorb nutrients more effectively. Some even say that alkaline promoting foods can help prevent disease and slow the aging process. Researchers haven’t verified these claims. Despite this, many of those following an alkaline diet insist on testing the pH of their urine multiple times per day to make sure that their bodies aren’t too acidic. Moreover, marketers of alkaline diet imply that the diet changes will raise your blood pH, but a well-conducted randomized trial of alkaline diet changes altered only your blood pH by 0.014 units, while the urine pH increased by 1.02 units 10. Another study reported that high fruit and vegetable consumption and low meat intake could significantly alkalinize the urine pH in healthy men and women of ages up to 79 years 11. While diet and other metabolic processes can affect the pH level of your urine, what you eat does not determine your blood’s pH level. And the pH of your urine has no effect on weight loss and no correlation with the risk of cancer or inflammation-related medical conditions.

The alkaline diet proponent suggests that eating an alkaline diet can create a hostile alkaline environment and therefore kill cancer. Interest in an alkaline diet mostly stems from laboratory studies suggesting that cancerous tumor cells have an acidic environment  (pH ~6.5) surrounding them, which promotes the invasiveness of the cancer cells (e.g., by activating proteolytic enzymes and digesting their surroundings) whilst inhibiting the growth of the normal host cells 12, 13, 14. However, neither cancer cells nor healthy cells can survive in an alkaline environment. Scientists are investigating whether this acidic environment promotes cancer development or enhances metastasis 15.

Your blood pH (7.4) is tightly regulated by your kidneys and respiratory system. Any excess acid is excreted in the urine. Your blood pH is not altered by your dietary intake. The only situation in which blood pH is altered is during metabolic acidosis, when an individual is critically ill. Furthermore, there is no scientific literature establishing the benefit of an alkaline diet for the prevention of cancer at this time 16. A 2016 systematic review of studies on alkaline diet and cancer found that an alkaline diet could change the pH of urine to be more alkaline, but not that of the whole body 16. The body regulates the pH of blood through several internal processes. Food does not affect it. This systematic review of the literature revealed a lack of evidence for or against diet acid load and/or alkaline water for the initiation or treatment of cancer 16. Promotion of alkaline diet and alkaline water to the public for cancer prevention or treatment is not justified 16. Additionally, a review of the body of evidence regarding the acid–ash or alkaline hypothesis for bone health found that the hypothesis is not supported and there is no evidence that altering the diet acid load improves bone health 17.

Since the 2016 review 16, a 2019 observational study 18 found that diets categorized as more acid-producing were associated with increased risk, and alkaline diets were associated with decreased risk, of estrogen receptor-negative (ER-) and triple-negative breast cancers. Another observational study 19 found that scores suggesting a more acidic diet were linked with increased markers of inflammation and poorer outcomes among some early-stage breast cancer survivors. Diet scores associated with blood and urine pH are derived from calculations based on total animal protein consumption and levels of one or a few minerals.

Current scientific evidence points to the benefits of alkaline diet for people with chronic kidney disease 20, 21, 22, 5. Many studies have shown that a diet high in acid load is associated with an increased incidence of chronic kidney disease (CKD), CKD progression 23, 24, 25 and diabetes 26. Chronic kidney disease (CKD) means that your kidneys are damaged and can’t filter blood as they should. This damage can cause toxin and wastes to build up in your body 27. Chronic kidney disease (CKD) can also cause other problems that can harm your health 5. Chronic kidney disease (CKD) common complications include hyperkalemia, metabolic acidosis, calcium-phosphorus metabolism impairment, water and sodium metabolism alterations, changes in the composition of the gut microbiota, oxidative stress, hyperhomocysteinemia, chronic low-grade inflammation, and normocytic normochromic anemia 28, 29, 30, 31, 32. Diabetes and high blood pressure are the most common causes of chronic kidney disease (CKD). If left unchecked, chronic kidney disease (CKD) can evolve into end-stage renal disease (ESRD). At this stage, the kidneys are no longer able to remove enough wastes and excess fluids from the body. At this point, you would need dialysis or a kidney transplant.

In summary, eating a diet with plenty of fruits and vegetables – which is what some people mean when referring to an alkaline diet –  gives many health benefits and can help maintain a healthy weight. A study from more than 100,000 people starting in the mid-1980s until 2014 found that eating an average of five servings of fruits and vegetables a day is linked to a reduced risk of death from heart and respiratory diseases. Eating more fruit is also associated with a lower risk of cancer. Most types of fruits and vegetables led to these results, except fruit juices and starchy vegetables such as peas, corn, and potatoes. Try to eat about 3 to 5 servings every day. Fruit is also a good source of fiber, vitamins, and minerals. You should try to eat about 2 to 3 servings of fruit each day. However, the average American adult only eats about one serving of fruit and 1.5 servings of vegetables a day.

The Role of pH in Various Cells, Organs, and Membranes

The pH in our body may vary considerably from one area to another with the highest acidity in the stomach (pH of 1.35 to 3.5) to aid in digestion and protect against opportunistic microbial organisms. But even in the stomach, the layer just outside the epithelium is quite basic to prevent mucosal injury.

The skin is quite acidic (pH 4–6.5) to provide an acid mantle as a protective barrier to the environment against microbial overgrowth. There is a gradient from the outer horny layer (pH 4) to the basal layer (pH 6.9). This is also seen in the vagina where a pH of less than 4.7 protects against microbial overgrowth.

The urine may have a variable pH from acid to alkaline depending on the need for balancing the internal environment. Foods can be categorized by the potential renal acid loads.

  • Fruits, vegetables, fruit juices, potatoes, and alkali-rich and low phosphorus beverages (red and white wine, mineral soda waters) having a negative acid load.
  • Whereas, grain products, meats, dairy products, fish, and alkali poor and low phosphorus beverages (e.g., pale beers, cocoa) have relatively high acid loads.

alkaline diet foods

How your body maintains a healthy and stable blood pH

The pH of blood is about 7.4 (a slightly alkaline range of 7.35 to 7.45). Your blood pH is highly stable within a normal range of pH 7.35 to 7.45 and it’s tightly regulated by your kidneys and respiratory system. The primary pH buffering system in the human body is the bicarbonate (HCO3) and carbon dioxide (CO2). Bicarbonate (HCO3) functions as an alkalotic substance. Carbon dioxide (CO2) functions as an acidic substance. Therefore, an increase in serum bicarbonate (HCO3) or a decrease in CO2 (carbon dioxide) will make blood more alkaline. The opposite is also true where decreases in bicarbonate (HCO3) or an increase in carbon dioxide (CO2) will make blood more acidic. Acidosis also called acidemia is a condition in which there is a shift in the acid-base balance of your body to have more acid than normal, often causing the pH of your blood and body tissues to fall below pH 7.35 (the healthy normal range of pH is between 7.35-7.45, with the average at 7.40). Acidosis occurs when acid builds up or when bicarbonate [HCO3] (a base) is lost. The carbon dioxide (CO2) levels are physiologically regulated by the pulmonary system through respiration, whereas the serum bicarbonate (HCO3) levels are regulated through your kidneys by two mechanisms: bicarbonate [HCO3] (a base) reclamation mainly in the proximal tubule and bicarbonate [HCO3] (a base) generation predominantly in the distal nephron. Elevated pH above 7.45 and elevated plasma bicarbonate (HCO3) level above 30 meq/L characterize metabolic alkalosis. When bicarbonate (HCO3) is elevated the arterial partial pressure of carbon dioxide (PaCO2) must also be elevated to maintain pH to its normal range. Therefore with metabolic alkalosis, the compensation is to decrease alveolar ventilation (hypoventilation) in order to increase the arterial partial pressure of carbon dioxide (PaCO2).

To understand acid-base buffering system, it is important to recall that pH is governed by the ratio bicarbonate [HCO3] (a base)/arterial partial pressure of carbon dioxide (PaCO2) (an acid). So long as the ratio is normal, pH will be normal.

Normal body functions and metabolism generate large quantities of acids that must be neutralized and/or eliminated to maintain blood pH balance. Most of the acid is carbonic acid (H2CO3), which is created from carbon dioxide (CO2) and water (H2O). Carbon dioxide (CO2) is produced as the body uses glucose (sugar) or fat for energy. In its normal state, the body maintains carbon dioxide (arterial partial pressure of carbon dioxide [PaCO2]) in a well-controlled range from 35 to 45 mm Hg by balancing its production and elimination. Lesser quantities of lactic acid, ketoacids, and other organic acids are also produced.

  • Carbon dioxide (CO2) + water (H2O) -> H2CO3 (carbonic acid) -> HCO3 + H+

According to the Henderson-Hasselbalch equation (Figure 1), maintaining physiological pH depends on arterial partial pressure of carbon dioxide (PaCO2), which in turn depends on alveolar ventilation (hypoventilation causes acidosis and hyperventilation causes alkalosis). The kidneys participate in maintaining the stable pH by reabsorption of bicarbonate (3,600 mmol of bicarbonate is filtrated in glomeruli during 24 hour) and excretion of hydrogen ions from nonvolatile acids (including sulfur and phosphate) as titratable acidity (0.3 mmol hydrogen ions/kg/day) and in the form of ammonium ion (0.7 mmol hydrogen ions/kg/day) 33, 34.

Serum bicarbonate (HCO3) concentration can be calculated from a blood gas sample using the Henderson-Hasselbalch equation, as follows (see Figure 1 below):

  • pH = 6.10 + log (HCO3 ÷ 0.03 × PaCO2)
  • Alternatively, bicarbonate (HCO3) = 24 × PaCO2 ÷ [H+]

Because pH and arterial partial pressure of carbon dioxide (PaCO2) are directly measured, bicarbonate (HCO3) can be calculated.

Another means of assessing serum bicarbonate (HCO3) concentration is with the total carbon dioxide content in serum, which is routinely measured with serum electrolytes obtained from venous blood. In this method, a strong acid is added to serum, which interacts with bicarbonate in the serum sample, forming carbonic acid. Carbonic acid dissociates to carbon dioxide and water; then, carbon dioxide is measured.

Note that the carbon dioxide measured includes bicarbonate and dissolved carbon dioxide. The contribution of dissolved carbon dioxide is quite small (0.03 × PaCO2) and is usually ignored, although it accounts for a difference of 1-3 mEq/L between the measured total carbon dioxide content in venous blood and the calculated bicarbonate in arterial blood. Thus, at an arterial partial pressure of carbon dioxide (PaCO2) of 40, a total carbon dioxide (CO2) content of 25 means a true bicarbonate concentration of 23.8 (ie, 25 – 0.03 × 40).

Your lungs and kidneys are the major organs involved in regulating blood pH. And to compensate for the metabolic acidosis, you increase your breathing rate (hyperventilation) to increase carbon dioxide (CO2) elimination 35, 36.

  1. The lungs flush acid out of your body by exhaling carbon dioxide (CO2). Raising and lowering the respiratory rate alters the amount of carbon dioxide (CO2) that is breathed out, and this can affect blood pH within minutes 37.
  2. The kidneys excrete acids in the urine, and they regulate the concentration of bicarbonate (HCO3, a base) in blood. Acid-base changes due to increases or decreases in bicarbonate [HCO3] concentration occur more slowly than changes in carbon dioxide (CO2), taking hours or days. Bicarbonate (HCO3) reabsorption occurs in the kidneys in every part of the tubules. About 85–90% of the filtered bicarbonate is reabsorbed in the proximal tubules, 10% in the ascending arms of the Henle loop, 6% in the distal tubules, and 4% in the collecting tubules 33, 34.

Both of these processes are always at work, and they keep the blood pH in healthy people tightly controlled. The absolute quantities of acids or bases are less important than the balance between the two and its effect on blood pH.

Buffering systems that resist changes in pH also contribute to the regulation of acid and base concentrations. The main buffers in blood are hemoglobin (in red blood cells), plasma proteins, carbon dioxide (CO2), bicarbonate (HCO3) and phosphates.

Carbon dioxide (CO2) plays a remarkable role in the human body mainly through pH regulation of the blood. The pH is the primary stimulus to initiate ventilation. In its normal state, the body maintains carbon dioxide (CO2) in a well-controlled range from 38 to 42 mm Hg by balancing its production and elimination. In a state of hypoventilation (breathing that is too shallow or too slow to meet the needs of the body), the body produces more carbon dioxide (CO2) than it can eliminate, causing a net retention of carbon dioxide (CO2). The increased carbon dioxide (CO2) is what leads to an increase in hydrogen ions (H+) and a slight increase in bicarbonate (HCO3), as seen by a right shift in the following equilibrium reaction of carbon dioxide:

  • Carbon dioxide (CO2) + water (H2O) -> H2CO3 (carbonic acid) -> HCO3 + H+

The buffer system created by carbon dioxide consists of the following three molecules in equilibrium: carbon dioxide (CO2), H2CO3 (carbonic acid), and bicarbonate (HCO3). When hydrogen ions (H+) is high, bicarbonate (HCO3) buffers the low pH. When hydroxide (OH) is high, H2CO3 (carbonic acid) buffers the high pH. In respiratory acidosis, the slight increase in bicarbonate  (HCO3) serves as a buffer for the increase in hydrogen ions (H+), which helps minimize the drop in pH. The increase in hydrogen ions inevitably causes the decrease in pH, which is the mechanism behind metabolic acidosis.

Figure 1. Henderson-Hasselbalch equation

Henderson-Hasselbalch equation

[Source 38 ]

Figure 2. Acid-base buffering system

acid-base compensation

Figure 3. Kidneys control of plasma bicarbonate (HCO3)

Kidneys control of plasma bicarbonate

Abbreviations: CCD = cortical collecting duct; IMCD = inner medullary collecting duct

[Source 34 ]

Respiration

The pulmonary system adjusts pH using carbon dioxide (CO2); upon expiration, carbon dioxide (CO2) is projected into the environment. Due to carbon dioxide (CO2) forming carbon dioxide (CO2) in the body when combining with water (H2O), the amount of carbon dioxide (CO2) expired can cause pH to increase or decrease. When the respiratory system is utilized to compensate for metabolic pH disturbances, the effect occurs in minutes to hours 39.

Renal adaptation

The renal system affects pH by reabsorbing bicarbonate (HCO3) and excreting fixed acids 39, 40. Whether due to pathology or necessary compensation, the kidney excretes or reabsorbs these substances which affect pH. The nephron is the functional unit of the kidney. Blood vessels called glomeruli transport substances found in the blood to the renal tubules so that some can be filtered out while others are reabsorbed into the blood and recycled. This is true for hydrogen ions and bicarbonate. If bicarbonate (HCO3) is reabsorbed and/or acid is secreted into the urine, the pH becomes more alkaline (pH increases). When bicarbonate (HCO3) is not reabsorbed or acid is not excreted into the urine, pH becomes more acidic (pH decreases). The metabolic compensation from the renal system takes longer to occur, days rather than minutes or hours.

The renal adaptations are extensive 41:

  • Increased urinary excretion of sulfate, phosphate, urate, and chloride;
  • Increased urinary excretion of calcium;
  • Decreased urinary excretion of citrate;
  • Increased urinary excretion of ammonium ions; and
  • Kidney vasodilatation and increased glomerular filtration rate.

The kidneys mitigate but do not eliminate all the excess acidity. As the kidneys lose function with aging (when GFR is lower than 30 mL/min/1.73 m²), their ability to excrete acid becomes impaired, which may be another explanation for the loss of bone with aging 42. In fact, counteracting metabolic acidosis helps to preserve muscle mass and to improve bone metabolism 43, 44, 45.

Bone for acid buffering

The major reservoir of base is the skeleton (in the form of alkaline salts of calcium), which provides the buffer needed to maintain blood pH and plasma bicarbonate concentrations when renal and respiratory adaptations are inadequate. Acid-promoting diets are associated with increased urinary excretion of both calcium and bone matrix protein and decreased bone density 46. Neutralizing acid intake with diet or alkalinizing supplements decreases urine Calcium and bone matrix protein excretion. Also, to a much smaller degree, skeletal muscle can act as a buffer.

Other buffer systems

Other buffer systems in the human body include the phosphate buffer system, proteins, and hemoglobin. All of these contain bases which accept hydrogen ions which keep the pH from plummeting. The phosphate buffer system, while present globally, is important for the regulation of urine pH. Proteins assist with intracellular pH regulation. Red blood cells use the reaction above to help hemoglobin buffer; carbon dioxide can diffuse across red blood cells and combine with water. This alone would cause an increase in hydrogen ions; however, hemoglobin can bind hydrogen ions. Hemoglobin also can bind carbon dioxide without this reaction. This depends on the amount of oxygen that is bound to hemoglobin. This is called the Haldane effect and the Bohr effect. When hemoglobin is saturated with oxygen, it has a lower affinity for carbon dioxide (CO2) and hydrogen ions and is able to release i

The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health?

There is some good news for fans of alkaline eating. The Alkaline Diet is a plant-based and discourages added sugar, so it may help your weight and health, although not because of the pH. People who eat balanced, plant-based diets tend to have lower risks of chronic diseases like high blood pressure and diabetes. There is also research indicating that vegetarian diets may lead to lower risk for some types of cancer. However it is not clear yet if these lower cancer rates are due to diet alone, or other lifestyle factors that often go in tandem with plant-based diets (like not smoking).

As for weight, a diet rich in whole grains and fruits and veggies, and low in processed foods may be a good way to get or stay slim, however you’ll still need to pay attention to portion sizes, total calorie intake and exercise regularly.

  • Chronic Acidosis and Bone Disease

There is online information promoting an alkaline diet for bone health as well as a number of books. However, a recent systematic review of the literature looking for evidence supporting the alkaline diet for bone health found no protective role of dietary acid load in osteoporosis  47.

There is evidence that in healthy humans the increased sodium in the diet can predict the degree of hyperchloremic metabolic acidosis when consuming a net acid producing diet 48. As well, there is evidence that there are adverse effects of sodium chloride in the aging population. A high sodium diet will exacerbate disuse-induced bone and muscle loss during immobilization by increasing bone resorption and protein wasting 49. Excess dietary sodium has been shown to result in hypertension and osteoporosis in women 50, 51. As well, dietary potassium which is lacking in the modern diet would modulate pressor and hypercalciuric effects of excess of sodium chloride 52.

Excess dietary protein with high acid renal load may decrease bone density if not buffered by ingestion of supplements or foods that are alkali rich 53. However, adequate protein is necessary for prevention of osteoporosis and sarcopenia; therefore, increasing the amount of fruit and vegetables may be necessary rather than reducing protein 54.

  • Alkaline Diets and Muscle

As we age, there is a loss of muscle mass, which may predispose to falls and fractures. A three-year study looking at a diet rich in potassium, such as fruits and vegetables, as well as a reduced acid load, resulted in preservation of muscle mass in older men and women 55. Conditions such as chronic renal failure that result in chronic metabolic acidosis result in accelerated breakdown in skeletal muscle 56. Correction of acidosis may preserve muscle mass in conditions where muscle wasting is common such as diabetic ketosis, trauma, sepsis, chronic obstructive lung disease, and renal failure 57. In situations that result in acute acidosis, supplementing younger patients with sodium bicarbonate prior to exhaustive exercise resulted in significantly less acidosis in the blood than those that were not supplemented with sodium bicarbonate 58.

  • Alkaline Supplementation and Growth Hormone

It has long been known that severe forms of metabolic acidosis in children, such as renal tubular acidosis, are associated with low levels of growth hormone with resultant short stature. Correction of the acidosis with bicarbonate 59 or potassium citrate 60 increases growth hormone significantly and improved growth. The use of enough potassium bicarbonate in the diet to neutralize the daily net acid load in postmenopausal women resulted in a significant increase in growth hormone and resultant osteocalcin 61. Improving growth hormone levels may improve quality of life, reduce cardiovascular risk factors, improve body composition, and even improve memory and cognition  62. As well this results in a reduction of urinary calcium loss equivalent to 5% of bone calcium content over a period of 3 years 63.

  • Alkaline Diet and Back Pain

There is some evidence that chronic low back pain improves with the supplementation of alkaline minerals 64. With supplementation there was a slight but significant increase in blood pH and intracellular magnesium. Ensuring that there is enough intracellular magnesium allows for the proper function of enzyme systems and also allows for activation of vitamin D 65. This in turn has been shown to improve back pain 66.

  • Alkalinity and Chemotherapy

The effectiveness of chemotherapeutic agents is markedly influenced by pH. Numerous agents such as epirubicin and adriamycin require an alkaline media to be more effective. Others, such as cisplatin, mitomycin C, and thiotepa, are more cytotoxic in an acid media 67. Cell death correlates with acidosis and intracellular pH shifts higher (more alkaline) after chemotherapy may reflect response to chemotherapy 68. It has been suggested that inducing metabolic alkalosis may be useful in enhancing some treatment regimes by using sodium bicarbonate, carbicab, and furosemide 69. Extracellular alkalinization by using bicarbonate may result in improvements in therapeutic effectiveness 70. There is no scientific literature establishing the benefit of an alkaline diet for the prevention of cancer at this time.

Conclusion

Alkaline diets result in a more alkaline urine pH and may result in reduced calcium in the urine, however, as seen in some recent reports, this may not reflect total calcium balance because of other buffers such as phosphate. There is no substantial evidence that this improves bone health or protects from osteoporosis.

Alkaline diets may result in a number of health benefits as outlined below 71:

  • Increased fruits and vegetables in an alkaline diet would improve the K/Na ratio and may benefit bone health, reduce muscle wasting, as well as mitigate other chronic diseases such as hypertension and strokes. There is some evidence that the K/Na ratio does matter and that the significant amount of salt in our diet is detrimental.
  • The resultant increase in growth hormone with an alkaline diet may improve many outcomes from cardiovascular health to memory and cognition.
  • An increase in intracellular magnesium, which is required for the function of many enzyme systems, is another added benefit of the alkaline diet. Available magnesium, which is required to activate vitamin D, would result in numerous added benefits in the vitamin D apocrine/exocrine systems.
  • Alkalinity may result in added benefit for some chemotherapeutic agents that require a higher pH.

From the evidence outlined above, it would be prudent to consider an alkaline diet to reduce morbidity and mortality of chronic disease that are plaguing our aging population. One of the first considerations in an alkaline diet, which includes more fruits and vegetables, is to know what type of soil they were grown in since this may significantly influence the mineral content. At this time, there are limited scientific studies in this area, and many more studies are indicated in regards to muscle effects, growth hormone, and interaction with vitamin D.

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  71. J Environ Public Health. 2012; 2012: 727630. Published online 2011 Oct 12. doi: 10.1155/2012/727630. The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health ? – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/[]
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Can Cabbage Soup Diet Help Me Lose Weight ?

cabbage soup diet

Cabbage

The Cabbage Soup Diet

The cabbage soup diet is generally considered a fad or crash diet. As the name suggests, the diet requires that you eat large amounts of cabbage soup for seven days. During that time, you can also eat certain fruits and vegetables, beef, chicken, and brown rice, according to a set schedule. There’s not a lot of room to tweak the diet, since it’s so rigid. Because the cabbage soup diet is low in complex carbohydrates, protein, vitamins and minerals, you shouldn’t stay on it for more than a week at a time.

It is low in fat, because you eat mostly vegetables. But it’s not vegetarian or vegan, since some meat is allowed.

Proponents of the cabbage soup diet say it’s a good way to quickly lose a few pounds. You may lose weight on the diet because it drastically limits calories. But it is not only fat that you’ll lose. Your weight lost is likely to be a combination of water and fat, and may even include muscle.

The cabbage soup diet has other disadvantages. Depending on the recipe for cabbage soup, the diet can be high in sodium. So cut back on the sodium, hold back on using the salt shaker when making the soup or cooking your food. The large amounts of cabbage also can make you more prone to flatulence.

Because you’re not getting proper nutrition, you may feel weak or tired while on the diet. And once you stop the diet, it’s easy to regain any weight that you lost.

Fad diets like this one may be tempting, but keep in mind that long-term weight loss depends on making lasting healthy changes in your eating and exercise habits.

cabbage soup diet

 

What You Can Eat

Just like the name says, the bulk of this diet is fat-free cabbage soup, eaten two to three times a day with other allowed foods assigned each day. Here’s what you can add:

  • Day 1: Fruit, except bananas
  • Day 2: Vegetables like leafy greens (not starchy), but no fruit
  • Day 3: Fruits and vegetables
  • Day 4: Bananas and skim milk
  • Day 5: Beef (or baked chicken without the skin) and tomatoes
  • Day 6: Beef and vegetables
  • Day 7: Brown rice, unsweetened fruit juices, and vegetables

There are different recipes for the soup, which is recommended every day of the diet. They all have similar ingredients, such as tomatoes, green peppers, mushrooms, onions, and bouillon.

Does It Work ?

Yes. You’ll lose weight, but only in the short run. This is strictly a lose-weight quick scheme. And once you stop the diet, it’s easy to regain any weight that you lost.

You’ll likely get less than 1,000 calories a day on the limited menu. That’s far fewer than the 2,000 daily calories recommended for most adults. Because you’re not getting proper nutrition, you may feel weak or tired while on the diet.

Since you’re getting so few calories, the pounds come off quickly, but mostly you’ll lose water weight. And chances are, you’ll gain it all back as soon as you start eating a normal diet again.

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Does Lemonade Diet Help With Weight Loss ?

Lemonade Diet
Lemonade
Lemonade

The Lemonade Diet

The Lemonade Diet, also called the Master Cleanse, is a liquid-only diet consisting of three things: a lemonade-like beverage, salt-water drink, and herbal laxative tea.

Celebrities including Beyoncé have used this diet. But it’s far from the principles of healthy eating, and the results aren’t likely to last.

The claim is simple: Give it 10 days (or more) and you’ll drop pounds, “detox” your digestive system, and feel energetic, vital, happy, and healthy. You’ll also curb cravings for unhealthy food.

Does It Work ?

Because you’re getting so few calories, you’ll probably lose weight. You’ll also be losing muscle, bone, and water. And you’re likely to gain the weight right back.

It’s an unhealthy way to temporarily lose weight.

There’s no proof that detoxifying leads to long-term weight loss. Plus, you don’t need to detox your body — your liver takes care of that.

For lasting change, you’re better off eating a healthy diet of fruits, vegetables, whole grains, low-fat dairy, and lean proteins like fish, skinless chicken or turkey, and healthy fats like olive oil.

What You Can Eat and What You Can’t

You’re only allowed a salt-water drink, a “lemonade,” and an herbal laxative tea for the first 10 days. You can’t have any solid food, and you can’t drink alcohol.

After 10 days, you can gradually add back foods, but only a few at first, starting with juice and soup, and leading to raw fruits and vegetables. After this, the plan calls for eating very little meat and no dairy.

Conclusion: This is not a diet we recommend. If weight loss is the goal, it is better to lose weight gradually with a balanced diet that makes sure you get the nutrients you need. Cross this one off your list.

What is Detox ?

Before it was co-opted in the recent craze, the word “detox” referred chiefly to a medical procedure that rids the body of dangerous, often life-threatening, levels of alcohol, drugs, or poisons. Patients undergoing medical detoxification are usually treated in hospitals or clinics. The treatment generally involves the use of drugs and other therapies in a combination that depends on the type and severity of the toxicity. 1

The detox programs now being promoted to the health-conscious public are a different matter. These are largely do-it-yourself procedures aimed at eliminating alleged toxins that are held responsible for a variety of symptoms, including headache, bloating, joint pain, fatigue, and depression. Detox products are not available by prescription; they are sold in retail stores, at spas, over the Internet, and by direct mail. Many are advertised as useful for detoxifying specific organs or systems; others are portrayed as “whole body” cleansers. Here is a review of some of the most widely promoted procedures and products.

Detox Diets

A seemingly infinite array of products and diets is available for detoxifying the entire body. One of the most popular is the Master Cleanse diet, favored by a number of Hollywood celebrities. Dieters take a quart of warm salt water in the morning; consume a 60-ounce concoction of water, lemon juice, maple syrup, and cayenne pepper throughout the day; and finish with a cup of laxative tea in the evening. Proponents of the Master Cleanse diet recommend adhering to it for at least 10 days.

Purpose : To restore energy, lose weight, and relieve symptoms of chronic conditions like arthritis and fibromyalgia.

Evidence of effectiveness : There are no data on this particular diet in the medical literature. But many studies have shown that fasts and extremely low-calorie diets invariably lower the body’s basal metabolic rate as it struggles to conserve energy. Once the dieter resumes normal eating, rapid weight gain follows. Much of the weight loss achieved through this diet results from fluid loss related to extremely low carbohydrate intake and frequent bowel movements or diarrhea produced by salt water and laxative tea. When the dieter resumes normal fluid intake, this weight is quickly regained.

Risks : The diet is lacking in protein, fatty acids, and other essential nutrients. Carbohydrates supply all the calories — an extremely low 600. The daily laxative regimen can cause dehydration, deplete electrolytes, and impair normal bowel function. It can also disrupt the native intestinal flora, microorganisms that perform useful digestive functions. A person who goes on this diet repeatedly may run the risk of developing metabolic acidosis, a disruption of the body’s acid-base balance, which results in excessive acidity in the blood. Severe metabolic acidosis can lead to coma and death.

Cost : The price of the book and a handful of food items.

Intestinal Cleansing

Numerous kits are marketed for this purpose, most of which include a high-fiber supplement, a “support” supplement containing herbs or enzymes, and a laxative tea, each to be used daily. Manufacturers of the herbal detox kits recommend continuing the regimen for several weeks. Such regimens may be accompanied by frequent enemas.

Purpose : The aim is to eradicate parasites and expel fecal matter that allegedly accumulates and adheres to the intestinal walls.

Evidence of effectiveness : Several studies suggest that milk thistle, which is often included as a supportive supplement, may improve liver function with few side effects. But there’s no medical evidence for the cleansing procedure as a whole. Promotional materials often include photographs of snake-like gelatinous substances expelled during cleansing. When these pictures are not faked, they are probably showing stool generated by large doses of the regimen’s fiber supplement. More important, the rationale for intestinal cleansing — to dislodge material adhering to the colon walls — is fundamentally mistaken. When fecal matter accumulates, it compacts into firm masses in the open interior of the colon; it does not adhere to the intestinal walls as the “sludge” depicted in the advertisements.

Risks : Like fasting, colonic cleansing carries a risk of dehydration, electrolyte imbalance, impaired bowel function, and disruption of intestinal flora.

Cost : A month’s supply of the supplements and laxatives sold on most Web sites is $20 to $70. The manufacturers recommend continuing the procedure for two to three months.

Foot detox

One method employs a special type of adhesive pad worn on the bottoms of the feet during sleep. Another approach is to immerse the feet for 30 minutes in a basin, sometimes referred to as an “ionic foot bath,” containing salt water and two electrodes that supply a low-voltage electric charge.

Purpose : Toxins are allegedly drawn out of the body through the soles of the feet.

Evidence of effectiveness. Both methods claim to emit ions that stimulate the outflow of toxins through the feet. The pads contain tourmaline crystals, which are purported to emit ion-generating infrared rays. The foot baths allegedly generate ions by running an electric current through salt water. However, there is no scientific evidence that ionic changes in the environment can stimulate a discharge of toxins through pores in the feet — or any other part of the body, for that matter. Promoters assert that the success of the process can be monitored by a color change in the pad or in the water of the foot bath as impurities are leached from the body. But the pads, which are impregnated with wood vinegar, have been shown to turn the same dark color whether they absorb foot perspiration or are sprayed with tap water; and the color of the foot bath changes because the metal electrodes corrode.

Risks : No ill effects on health have been reported for either method.

Cost : Single-use pads average $1. Ionic foot bath sessions are available at spas for $40 to $50. Ionic foot bath devices are sold online at prices ranging from $85 to $2,000.

 

  1. Harvard University – Harvard Health Publication May, 2008 : The dubious practice of detox – http://www.health.harvard.edu/staying-healthy/the-dubious-practice-of-detox[]
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