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Zoned Out? Fad-Free Diet Works Best for Diabetes

New Nutritional Guidelines on the Horizon

By Paula Moyer
WebMD Medical News

June 12, 2000 (San Antonio) -- Despite never-ending warnings about how fad diets just don't work, few weight-conscious people can resist a simple solution. In general, though, people really should be skeptical of trendy claims, such as the latest that a high-protein, low-carbohydrate diet will melt away the pounds.

People with diabetes should be particularly wary, according to several nutrition experts here at the 60th annual meeting of the American Diabetes Association (ADA). They're hoping that people with diabetes can ignore the heavily marketed plans and learn to plan their meals, make manageable lifestyle changes, and increase their activity level.

The pitfalls of popular diets are well-known. Despite the appeal of a "quick-fix," it appears that "slow motion gets you there faster." Not only that, but weight lost rapidly is most often regained rapidly, too.

Scientific evidence behind fad diets is at best scant, says Marion Franz, MS, RD, who spoke at the meeting.

"Ironically, patients lose weight if we stress lifestyle changes and exercise and avoid mentioning weight loss," says Franz, a dietitian at the International Diabetes Center in Minneapolis.

Fad diets are often named, modestly enough, after those who develop them, such as the Dr. Atkins and Dean Ornish diets -- or else they have catchy names, such as the "Zone" and "Sugar-Busters!" And they often have a simplistic and self-serving explanation for obesity.

For example, several low-carbohydrate diets attribute weight gain to excessive insulin production that is caused by eating a high-carbohydrate diet, says Jackie Boucher, MS, RD, who also spoke at the meeting. She is a staff dietitian at HealthPartners, a Minnesota-based HMO.

People with diabetes should be particularly cautious about the recent wave of popular diets that are high in protein and low in fat, says Elizabeth J. Mayer-Davis, PhD, RD, who also spoke at the meeting.

"A high-protein diet is often in reality a high-fat diet. Consumers are encouraged to eat foods such as hamburgers and bacon," says Mayer-Davis, who is affiliated with the University of South Carolina in Columbia. "Since 75% of people with diabetes die of cardiovascular disease," such diets are particularly risky for them, she says.

Another concern about dieting is the risk of developing an eating disorder, Franz tells WebMD. Some studies have shown a link between restrictive dieting and the subsequent development binge eating, she says.

People with diabetes can soon expect some changes in the ADA's nutrition guidelines, to be released in 2001, Abhimanyu Garg, MD, who also spoke at the meeting, tells WebMD. The revisions will probably continue the trend toward individualization of diet plans. The new recommendations also will be supported by scientific evidence to back them up.

To ensure this, the ADA is in the process of reviewing 1,100 nutritional studies to make sure all recommendations are linked to the better management of diabetes, Garg says. An endocrinologist and professor of internal medicine at the University of Texas Southwest Medical Center in Dallas, he also is a member of the ADA Nutrition Task Force.

 

The periodically revised guidelines represent considerable progress since 1917, Franz says. At that time, the acutely ill patients were temporarily starved -- with only whiskey and coffee being given as comfort measures.

 

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