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In this day and age, you can¶t turn around without seeing promotion for weight-loss products,
diet books, or weight management programs. Whether it is a supplement, book, and club one
can join, they are talking to us on TV, in magazines, and while we peruse grocery store aisles,
and they all claim to work. In an effort to shuffle through the loads of different weight loss
methods, we examined classic genres of dietary based weight loss methods to cipher through the
media loved fiction to the evidenced-based techniques that have been proven scientifically.
These commonly recommended diets consist of higher or lower consumption of different
macronutrients, natural/ more organic diets and diets directed towards specific audiences
requiring specialized nutrition. The range of these diets go from publicized programs like The
South Beach Diet, Atkins, the Paleo Diet, as well as certain nutrition regimens for professional
athletes, diabetics, and heart disease patients. Fad diets often exclude certain foods, make
unrealistic promises in weight loss, label foods as either good or bad, promote buying foods from
specific stores or companies, promise little or no exercise, and are likely temporary. Although,
not all diets are fads, they can often be considered a crash diet where users will experience a
relapse in weight gain after coming off the assigned food restrictions.
Popular fad diets, Atkins or South Beach, for instance, work and were a media dream because
of the dramatic and quick results, but how scientifically sound were they? The initial weight loss
and raving testimonials is due largely to a diuretic effect as a result of depleted glycogen stores
(1). However, this is temporary, and weight loss rates slow around 6 months and resumes the
pace of reduced energy diets. On severe carbohydrate restriction, the body produces ketones to
provide fuel for the brain since the diet isn¶t adequately providing energy. In the state of ketosis,
the body uses carbon fragments produced from lipid breakdown instead of its normal energy
source, carbohydrates. This may explain why patients experience decreases in hunger and a
somewhat easy adherence to the diet (1). This sounds great, but can often cause problems if used
for a long duration. Problems include, kidney failure, high diet related cholesterol, osteoporosis,
and potentially cancer from lack of antioxidant containing foods (2). If low carbohydrate is a
method used, it must be tailored for the individual to avoid the potentially hazardous side-effects
that this type of diet imposes, however, for a more cautionary method, a low-fat, reduced energy
diet is the most studied dietary strategy. While this type of diet values lowering the consumption
of a particular macronutrient the following diet values a more primitive idea.

Humans evolved during the Paleolithic period, 2.6-10,000 years ago. DNA evidence
documents little change in the genome over the past 10,000 years (3). Though the genome has
remained unchanged, our diets and lifestyles are much more divergent from those of our hunter-
gatherer ancestors. These changes began with the agricultural revolution. The recent Paleo diet
fad is based upon the belief that the highly processed synthetic diets have led to the increase in
overweight and obesity in Americans. It is believed that the solution for reducing obesity and
weight gain is to return to the lifestyle and diet for which we have been genetically designed(3).
This has generated confusion and controversy among the American public as to what exactly is
the ideal diet. Proponents of Paleo, Atkins, and Ornish diets claim that there diet is the answer to
the overweight and obesity epidemic. Are the advices of these diets true? Are the discrepancies
between the diets we are designed to eat and what we eat today really the problem? Paleo
supporters claim that grains, dairy products, and sugars are the cause of the many medical
problems of modern man. Critics of the diet point to essential nutrients like vitamin D and
calcium that can sometimes be hard to obtain in modern versions of the Paleo diet. A research
study was performed to experimentally study the long-term effect of a Paleolithic diet in
comparison with a cereal based diet in swine feed. The study results showed the Paleolithic
group weighing 22% less and having 43% lower subcutaneous fat thickness at mid sternum (4).
Also, insulin sensitivity was significantly higher and the insulin response was significantly lower
in the swine consuming the Paleolithic diet. The mean of C-reactive protein was 82% lower and
diastolic blood pressure was 13% lower. In the evaluations of multivariate correlations, the
strongest explanatory variable for the variations of insulin sensitivity and response, C-reactive
protein and diastolic blood pressure when compared to other relevant variables such as weight
and subcutaneous fat was concluded to be diet (4). Weight was significantly different and the
subjects experienced significant positive changes in other health parameters. The Paleo diet
seems to have the healthiest approach of the higher protein diets. Paleo differs from Atkins in
that Atkins encourages foods that are high in fat such as butter and bacon. Paleo does not allow
high fat meats or processed foods such as butter and allows more high fiber carbohydrates,
unlike Atkins. Paleo also places increased importance on the glycemic index of foods and
requires moderation. Although the Paleo diet has been shown to reduce weight and offer other
health benefits, it will result in ketosis when carbohydrate intake is not sufficient (4). The
elimination or insufficient intake of a specific macronutrient is a concern over long period of
time in fad diets, but what about the new quick fix detoxification fad?
Detoxification remedies are a huge fad right now. Everyone is on the fast track to lose weight
and keep it off! Detox systems are advertised to help you get off those 5-10, hard to lose pounds,
but what are professionals saying about GI detox? Is it safe? One is in need of detox if they are
experiencing chronic pain, fatigue, weight gain, mild cognitive disturbances, immune disorder,
cancer patients, or psyconeurological patients (5). However, some professionals disagree.
Hepatic detoxification, restoration of liver cells, is a three phase process; detoxification, create
conjugates, and efflux proteins. Toxins accumulate in the liver and are influenced by ethnicity,
age, disease, environment, lifestyle, drugs, genetic variation, and dietary factors (6). Current
claims regarding detoxification diets are that they are vague and ill defined, misleading and
inaccurate. Following RDA guidelines will only result in natural cell rejuvenation and GI health
(7). Detox diets often requires the body to go into a fasting or even starvation state. Fasting for
long periods of time (> 2-3 days) can be very unhealthy, causing fatigue, dizziness, constipation,
dehydration, gallstones, and lowered immune functions because the body requires certain
vitamins and minerals to work properly. The body is naturally equipped to remove toxins
through the skin via sweat, colon, liver, and kidneys (8).

Dieting alone may result in significant weight loss, but the results can be increased and
maintained when regular physical exercise is added. When losing weight, it is often
recommended that patients reach 1 to 2 pound reduction per week (9). In order to do this, a 500
to 1000 kcal reduction per day is needed. Because it is difficult to remove up to 1000 kcals from
the diet and not suffer deficiencies or malnourishment, physical activity is needed to reach a
negative energy balance. The 2005 Dietary Guidelines for Americans issued by the U.S.
Department of Health and Human Services placed a strong emphasis on physical activity,
recommending levels ranging from 30 to 90 minutes per day for 5 days a week to reduce the risk
of chronic disease, manage weight and prevent weight gain, and to prevent regain of weight after
loss (10).
In addition to helping individuals reduce their weights, physical activity is imperative to
maintaining a healthy weight after weight loss. In one study by Jakicic, Marcus, Janney, and
Lang, 201 women were divided into 4 different groups varying in physical activity levels (11).
They were then followed as they lost weight via a reduced energy diet and increased physical
activity. At 6 months and 12 months the groups showed equal weight loss, but at 24 months the
most physically active group had maintained their weight loss better than the other groups, and
had maintained a 10% or more of initial body weight loss (11). This is most likely due to the
additional calories that were being burned by physical activity. Because physical exercise can
help individuals maintain an appropriate energy balance, it is extremely beneficial to weight
management and should be used in conjunction with an appropriate diet.
Registered dietitians (RDs) will not recommend a type of fad diet for most patients who are
seeking weight management. ³It is the position of the American Dietetic Association that
successful weight management to improve overall health for adults requires a lifelong
commitment to healthful lifestyle behaviors emphasizing sustainable and enjoyable eating
practices and daily physical activity´ (12). Although research has shown significant weight loss
in low carbohydrate diets, it has also discovered that the weight loss is only significant for the
first six months of the diet. By the 12th month of a low-carbohydrate diet the weight loss is
insignificant when compared to a low-fat, reduced-energy diet. RDs will recommend a low-fat,
reduced-energy diet as a dietary strategy for successful weight loss in an effort to help manage a
person¶s weight (12).


 
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1. Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-
protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad
libitum. Am J Clin Nutr. 2008;87:44-45
2. WebMD Medical Reference. ß

  . 2010. Available at:
http://women.webmd.com/guide/high-protein-low-carbohydrate-diets. Accessed
September 23, 2010.
3. O¶Keefe JH, Cordain L. Cardiovascular disease resulting from a diet and lifestyle at odds
with our Paleolithic genome: how to become a 21st-century hunter-gatherer. 2004;
Mayo Clin Proc;79:101-108.
4. Jonsson T, Ahren B, Pacini G, Sundler F, Wierup N, Steen S, Sjoberg T, Ugander M,
Frostegard J, Goransson L, Lindeberg S. A Paleolithic diet confers higher insulin
sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in
domestic pigs. 2006; Nutr Metab (Lond);3:39.
5. Bennet, P, Working up the toxic patient: practical interventions and treatment strategies
13th Internatl Symposium of The Institute of Functional Medicine
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Exper Toxicol 21:253-262.

7. Davis CD, Milner JA. Gastrointestinal microflora, food components and colon cancer
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12.Helen M. Seagle, MS, RD (consultant, Denver, CO); Gladys Witt Strain, PhD, RD (Weill
College of Medicine of Cornell University, New York, NY); Angela Makris, PhD, RD
(consultant, Huntingdon Valley, PA); Rebecca S. Reeves, DrPH, RD (Behavioral
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