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Jan092011

How does your weight loss program measure up?

 

There are hundreds, if not thousands of weight loss program options available. It seems like each promises results. How is that possible? It’s not, but it sounds good, doesn’t it? The reality is, each individual is different – different in his or her metabolism, personality, lifestyle and motivation. Achieving optimal health and long-term weight management requires programs that take each of these factors into account. Considering the points below may help you avoid going down the wrong path with a different program. Before you jump into the “latest and greatest” weight loss program, consider what the program entails. The following are points that describe weight management programs at Life Time. If you’re considering something different, compare it to the points below.

1. Nutrition is about food quality, not just calories

Many of the weight loss programs advertised say “you can eat whatever you want and still lose weight.” Don’t be misled. While counting calories may have some short-term effects on weight loss, it’s not a long-term solution. Most studies show that focusing only on calorie intake provides minor, short-term weight loss benefits.[i] This could be because people who don’t change the types of foods they eat end up eating more than they think, or it could be because the types of foods they eat actually keep the body from shedding body fat. Many people find that once they begin choosing the right foods, they can worry less about calorie-counting and portion sizes as they tend to take care of themselves. If the program you’re considering suggests regular microwavable meals, cereals and other meals out of a box, it’s probably not the best choice out there.

We know a diet based on quality foods is more important than calorie-counting. Quality nutrition comes from whole foods: fresh vegetables, fresh meats, fish and other proteins, nuts, seeds, fruit and some starchy carbohydrates. It might take a little more time a couple times per week to prepare these foods, but by cooking in bulk, you can have enough for a few days worth of meals. Don’t fall into the habit of basing your diet on convenience foods. They’re not that much more convenient than cooking the real thing.

2. Exercise is about more than calorie-burning

Some weight loss programs emphasize nutrition so much that exercise is an afterthought. These programs may look at any exercise as sufficient, as long as it’s done consistently and intensely enough. Walking, jogging, weight training and even gardening are considered as much the same – a way to increase total calories burned each day. Exercise does much more than that, especially when it’s the right type of exercise for the individual.

When exercise is seen as just a means for increasing the calories burned each day, people tend to overemphasize cardiovascular training and underemphasize resistance training. Although the total number of calorie burned during a 60-minute session of running may be more than 60 minutes of resistance training or interval training, the long-lasting effects of the intervals and resistance training tend to be greater. However, higher-intensity interval training and various resistance training workouts should be tailored to the individual. That’s why many weight loss programs lump all exercise together; it’s too complicated to account for individual needs. If you’re going to invest the time into working out each week, the workouts should revolve around your individual needs and goals.

3. Other lifestyle factors affect health and weight management

Sleep schedules. Stress. Occupation. Nutrition and exercise programs should be designed to improve lifestyles, not add extra stress to them. Without taking into account what an individual’s lifestyle is like, you can’t assume you know what’s best for him or her.

In the section above, I mentioned that many weight loss programs put most of the attention on nutrition, with exercise as an afterthought. There are some programs with exercise as the main focus. They may be based around high-intensity training – fast-paced resistance training or interval training. High-intensity means shortened rest periods and maximal efforts in most workouts. While this type of training works great for some people, it can be a disaster for others, who may be under a lot of stress already. Oftentimes, those who are overweight also have issues with stress, sleep and inflammation. If an exercise program is not modified for these issues, it can make things worse. Do you know someone who got hurt or sick several weeks after they started an exercise program? This is likely a result of the nutrition and exercise program not matching with the individual’s lifestyle needs.

Understanding the other factors that affect the ability to manage weight requires a combination of comprehensive questionnaires (like My Plan) and actual lab tests. Many people gain a better appreciation for how their diet, exercise and supplementation plans (or lack of them) affect their health when they can see what their lab test results show. You can’t fake it when your blood tests show issues with cortisol, hormonal imbalances, vitamin deficiencies and other measurements you had analyzed. Once you know the numbers, you can work with a Registered Dietitian to come up with an action plan.

4. Nutritional supplement protocols should be personalized, not generic

Weight loss will not happen because of a pill. Though there have been a few drugs in the past that supported weight loss, they also had severe side-effects. If a nutritional supplement is promising things that seem too good to be true, it probably is.

In considering nutritional supplements, be sure you’re covering the basics first. As Dr. Jim LaValle shows throughout his book Cracking the Metabolic Code® deficiencies in vitamins and minerals can have a significant effect on one’s metabolism.[ii] Covering basic nutrient needs includes a high-quality multivitamin, fish oil, and possibly additional vitamin D, calcium and magnesium.

5. In-person, group support structure helps ensure success

Living a healthy way of life in today’s culture is tough, especially when spending most of your time with people who don’t see health and fitness as a priority. Surrounding yourself with others on the same healthy path plays a significant role in being able to make better decisions every day. The majority of studies on weight loss programs show that group support is one of the most significant factors in losing weight and keeping it off. Of course, some people find they don’t need the support of a group of people, but that is more the exception than the norm. Making a commitment to attend weekly in-person sessions and staying engaged online throughout the rest of the week is important for ensuring success long-term.

6. Guidance should come from educated and certified professionals

Some weight loss programs are led by sales reps or minimally educated individuals. They may be able to provide needed motivation and encouragement, but weight management requires more than that. Exercise programs should come from well-educated and certified personal trainers, and nutrition guidance from a combination of trainers and Registered Dietitians. Being able to work with these individuals one-on-one is a great way to ensure your program is as personalized as possible.

Summary

The Life Time Weight Loss programs and philosophy were designed around an understanding that each of the above components are important for a weight management program to be effective long-term. Other programs may get an individual to a weight goal temporarily, and not everyone requires each of the components above. However, before you invest time or money into a program, look for one that has each of these components. That way, your chance of long-term success will be much greater.

Share your thoughts or ask questions below.

Written by Tom Nikkola, Director of Nutrition & Weight Management

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.


[i] Taubes G. Why We Get Fat. And What to Do About It. New York. Alfred A. Knopf; 2011

[ii] LaValle J. Cracking the Metabolic Code®. Laguna Beach. Basic Health Publications; 2004

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Reader Comments (30)

General, but somewhat generic informaion and therefore, in context, self-serving. Help and educate, don't sell so obviously. Undermines credibility and therefore is in danger of being counter-productive.

January 12, 2011 | Unregistered CommenterDavid Walsh

I have had my 65 lb. weight-loss off of my 5'7" frame for around 10 years now (since 2001), and I can say that changing my lifestyle to being one that is healhty has transformed my self-confidence, as well as given me energy and a zest for life that I never dreamed possible. With a combination of daily exercise and eating healthy with mostly whole foods, as well as a good night's sleep and making sure I minimize the stress in my life, every day is a good day. I can honestly say that on the days that are less than desirable that we all experience, being in a healthy state of body and mind undoubtedly helps me cope with even the most stressful events that life throws my way. I started mostly with fast walking initially back in 2001 when I decied to go through with this healthy lifestyle transformation. I also started eating healthier with mostly whole foods (think veggies, fruits, whole grains, and lean protein), and manage my portions when I do indulge in the occassional treat. Eating this way became the new normal to me and is 'til this day. In 2005 I joined LIfeTime Fitness in Savage to step up my game by adding more intense cardio to my routine, and I have also added interval workouts. I do quite a bit of resistence work three times a week by lifting weights. Not only does having some lean muscle tone look good, but it keeps my metabolism humming at a much higher rate :) Please share your success stories, as I feel this keeps all of those of us who are "in-the-know" motivated. I know there are strength in numbers!

January 12, 2011 | Unregistered CommenterC-Bel

To David Walsh....you're a little too critcal...lighten up

January 12, 2011 | Unregistered CommenterGK

Why can't I print this article so I can read it at LifeTime?

January 12, 2011 | Unregistered CommenterBarb

Agree with gk, lighten up Dave, take a deep breath and feel better

January 12, 2011 | Unregistered CommenterRgh

Hey Barb
There is a "Print" link right at the end of the article.

January 12, 2011 | Unregistered CommenterTom Nikkola

C-Bel
Thanks for sharing your story! It's great hearing how your journey has been more than just about weight loss and has been about a healthier way of life all around. Keep it up!

January 12, 2011 | Unregistered CommenterTom Nikkola

Yeah David Walsh...you sound angry, lighten up!! I happen to believe there is a need for articles like this. You and I didn't learn anything, but I bet there are many people who did learn something new. Or maybe, just got motivated!

January 12, 2011 | Unregistered CommenterKG

Telling someone to "lighten up" due to a comment on a "weight loss" article... funny

January 12, 2011 | Unregistered CommenterTG

Thanks Tom! Got it!

January 12, 2011 | Unregistered CommenterBarb

For the most part- this is a good article. However, it says that nutrition advice should come from a combination of trainers and registered dietitians. There should be NO "and"! Registered dietitians are the only professionals with the expert qualifications to provide such advice and should not have to compete with trainers who tend to over-emphasize the need for protein and taking in very low amounts of carbohydrates, instead of distinguishing the different quality of carbs and fats. Another problem I have with this article is that while LTF is promoting Registered Dietitians, they do not hire them (or at least the club I am familiar with does not). While the job openings list the need for an RD, the person responsible for hiring decisions specifies that they do NOT want someone with clinical experience. By definition of the credential itself, RD's must have a large number of clinical practice hours to during the required graduate internship that is mandatory to test for the privilege of the credential. They do, however; seek someone with a background in sales for the nutrition position. It is illegal to use the title of offering the services of a registered dietitian, if in fact, the person is not (such as a personal trainer).

-Me, an RD

On the plus side, yes- a diet of whole foods combined with exercise is the way to go and quality of foods is highly important. However; counting calories is actually an excellent tool to track intake because it is known that a calorie deficit (either through reducing food intake, increasing energy expenditure, or a combination of the two) is ultimately what is responsible for weight loss.

January 12, 2011 | Unregistered CommenterMe, an RD

@Me, an RD:

Excellent points!

I do wonder if it's just the location that you are near that doesn't have an RD. The LifeTime that I go to (Rockville, MD) has an RD on staff. She teaches the nutrition components of the TEAM classes and has 1:1 clients as well. Hopefully the Rockville location is the norm, rather than the exception.

January 12, 2011 | Unregistered CommenterTara J.

Tara J, Me, an RD:
I just wanted to throw in a few points of clarification. Tara J, you're correct that Life Time does hire Registered Dietitians (Michelle Wong is great at your Rockville Club!). Ideally, we hope to have at least one at eat of our locations in the future, but we're pretty selective of who we'll bring on, which makes it challenging. However, we do have and RD that supports every club. Either an RD from a neighboring club supports another club, or Anika or Cindi provide support to members of those clubs from our corporate office. From an experience standpoint Me, an RD is correct in that we try to find those who have not only a clinical experience, but also a sports nutrition background as well. One of the taglines we often use is that weight management is "More than just calories in, calories out." The RDs we look for must understand how food choices influence other factors that affect weight management such as stress, sleep, inflammation, hormonal balance, etc. Because we offer other lab testing, our RDs must be able to understand the labs we offer and how food and supplements affect them. Today, we have about 70 Registered Dietitians nation-wide. While we expect our personal trainers to consistently educate members on nutrition and help guide them, we know nutrition prescription should only come through an RD. Sorry to add some much in here specifically about Life Time. Since the articles on this site are available to anyone, the main point of the article above was to make sure people are getting their education and information from credible sources. If you're looking for an RD at Life Time, you can talk with the fitness staff at your club or email clockhart@lifetimefitness.com.
Tom Nikkola
Director of Nutrition and Weight Management

January 13, 2011 | Unregistered CommenterTom Nikkola

I agree that nutrition is about food quality, not just calories....but with regard to weight loss, if you
don't understand calories and how much you put in your system, you will lose that game for sure!!!!

January 13, 2011 | Unregistered CommenterMark

It is not just pounds, its body composition,strength, feeling better both physically and mentally. It's about not having a second heart attack, battling cancer.

It's taken eighteen months, two trainers, two RDs, two surgeries, many hours on the treadmill, many massages, many "I quit moments", etc. I knew what I was doing to be healthy before LT, then I am kidding myself.

Put your hand over your mouth and just take some direction, even if you have to kick and scream some days. There is no finish line, just the end of the game.

January 13, 2011 | Unregistered Commenterdatagoddess

I'd just like to say that I agree with @Me, and RD...I have wanted to consult a RD @ my local club (Westminster, Colorado)...and the best option we currently have available is a RD "phone call consultation"...Emphasizing point 5 from this article - Id love and welcome an in-person option sooner than later!

January 13, 2011 | Unregistered CommenterErin

I have to say that I am very happy to see educated discussions around this topic. It is about time that we take a different approach to our nutrition and general well being, and critique narrow-minded diets that promise a lot, cost a lot, and most of them are not healthy, potentially creating psychological scars with their temporary weight-loss effects and later side effects.
I exercise regularly at LT, on average 2 yoga classes per week and some walking. This makes me feel good and as a result increases my appetite. Last year this time I started to think how could I shed 20 lb., and because I was not comfortable with any of the prescribed solutions out there, I decided to look for what works for me. Usually I eat home cooked meals, with fresh and organic ingredients from farm markets as much as possible. After some observation, I realized that I was eating way beyond my saturation point, which I noted was about 5 bites of any food. So, if I only could stop after 5 bites…. It was quite hard the first day, but I was able to control my eating habit and limit food intake to 5 bites of no more than three courses at one main meal. And it worked, in a couple of weeks I lost 10 lb. That was last year, and although I went back to my regular eating I never added them back. Now I have to have the strength to do it again for another two weeks to loose the remaining 10 lb and I’ll be good for life. Life is good!

January 16, 2011 | Unregistered CommenterCris5

@Tom: For clarification-I was actually told by the person responsible for hiring at the LTF where I now work in a different position, when I called to check on my application status, that they were looking for RD's that do NOT have clinical experience but rather SALES (not sports nutrition) experience. The position remained open for over a year and believe me, with the shortage of jobs during this time period, it was not due to a lack of qualified applicants. So while you are saying you agree with my former statements, you misquoted or misunderstood what I had written. It was not about selecting a quality candidate for the job and LTF was not looking for experts in the nutrition field, but rather were looking for someone who was going to make the company money, which I feel is a severe shame and what is currently wrong with this country regarding obesity rates that continue to rise. You may hope to have an RD at all locations, but currently--you do not!

January 16, 2011 | Unregistered CommenterMe, an RD

I have consulted with a LFT dietician and felt that all she was doing was pushing products and tests availbel at life time. It was very hard to take her seriously although the diet advise was good. She kept pushying me to buy fast fuel, expensive vitamins and supplements, and then have all kinds of labwork.. and metabolic tests. I felt like I had to fight a pushy car salesperson. I would love to see a RD that is not selling me products and that is affordable. At $75 per session, it is not sustainable for me. I wish LT was more focused on the well being of all rather than making big money in products and services.

January 24, 2011 | Unregistered CommenterMAR

@MAR. They wanted me to take on the role of pushing supplements too but while yes, there are situations that require supplementation, the general public can meet their needs with food that is far healthier & more economical that supplements. Not to mention- supplements are not subject to any legal regulations to tell you what is in those capsules, powders & pills. So frustrating!!!

January 24, 2011 | Unregistered CommenterMe, an RD

No RD really wants to work for LTF once he/she finds out that the company forces them to push supplements on all clients, which is something that goes against the principals of sound nutrition advice. As a former sous chef for this company, it was quite frustrating to hear them tout their "healthy way of life cafe" products as healthy. Everything is loaded with mayo and vegetable oil-not only high in unhealthy fats and calories, but lacking nutrition. By looking at the menu you can see that the main emphasis was the avoidance of carbohydrate-a diet trend that has proven many times to be a temporary weight loss boost that leads to more weight regain once the grains are added back into the diet. Gluten-free also became a trend there, when really gluten-free is a medical therapeutic diet for individuals with diagnosed Celiac disease and is of no benefit to the general consumer. The promotion of low-carb and gluten-free fad diets is very harmful for those who do not have medical needs for these diet therapies. This company is great at marketing, but is doing a serious and potentially dangerous disservice to it's members by all the misinformation they spread.

August 22, 2011 | Unregistered CommenterMe, an RD

Randomized controlled trials showing significantly more weight loss with low carb diets.....

Brehm BJ, et al. A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. J Clin Endocrinol Metab 2003;88:1617–1623.

Samaha FF, et al. A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity. N Engl J Med 2003;348:2074–81.

Sondike SB, et al. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. J Pediatr. 2003 Mar;142(3):253–8.

Aude YW, et al. The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat. A Randomized Trial. Arch Intern Med. 2004;164:2141–2146.

Volek JS, et al. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutrition & Metabolism 2004, 1:13.

Yancy WS Jr, et al. A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia. A Randomized, Controlled Trial. Ann Intern Med. 2004;140:769–777.

Nichols-Richardsson SM, et al. Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High- Protein vs High-Carbohydrate/Low-Fat Diet. J Am Diet Assoc. 2005;105:1433–1437.

Gardner CD, et al. 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. JAMA. 2007;297:969–977.

Shai I, et al. Weight loss with a low-carbohydrate, mediterranean, or low-fat diet. N Engl J Med 2008;359(3);229–41.

Krebs NF, et al. Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adolescents. J Pediatr 2010;157:252-8.

Summer SS, et al. Adiponectin Changes in Relation to the Macronutrient Composition of a Weight-Loss Diet. Obesity (Silver Spring). 2011 Mar 31. [Epub ahead of print]

Daly ME, et al. Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes–a randomized controlled trial. Diabet Med. 2006 Jan;23(1):15–20.

Westman EC, et al. The effect of a low-carbohydrate, ketogenic diet versus a low- glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr. Metab (Lond.)2008 Dec 19;5:36.

August 22, 2011 | Unregistered CommenterVanessa

Actually what the research indicates is that initial weight loss may be greater but the end of 6 months there is no difference between a low-carb diet or a moderately reduced fat diet. Then if you look at sustainability you will see the because the low-carb diet restricts food groups, it is more difficult and less desirable for people to stay on it for a long time. I have not looked into your article references specifically posted but either the research has been misinterpreted, or is not high-quality, evidence based, research studies with a high number of subjects, limited variables, etc. I spend years in school going over this research and disagree greatly with you. Most of the research you have posted refers to older studies that surfaced during the most recent low-carb diet fad wave. I see that several are more modern; however, they are quantifying the subjects that these diets may help and they are saying severely obese adolescents. These diets may be okay for a very short duration to kick-start weight loss, but should not completely limit any food group and should definitely emphasize carbohydrates from vegetables and fruits. I personally, would not ever tell a child not to follow a low-carb studies as research shows that the brain runs off of glucose-the most basic building block of sugars. You are not helping anyone learn how to eat healthy by trying to give them a quick, temporary fix. They need to work with a professional and learn the different types of carbohydrate and where to get the nutrients essential for health.
Remember the first principle of most health care professions, especially dietetics & nutrition is 1st: DO NO HARM!

August 22, 2011 | Unregistered CommenterMe, an RD

To Me, an RD:
I find it unfortunate that you are so close-minded to what nutrition is all about - not about weight and calories in/calories out. It is about fueling our bodies & metabolism so that we can live a productive, optimal functioning life! Not just take what comes our way & decline in function (energy, mood, sleep) until some day, after years & multiple medical practitioners, we are diagnosed with a medical condition. We do NOT have to live that way. Are you familiar with ADA's DIFM practice group? This is exactly what Life Time is all about - integrative & functional nutrition to help our members live the best life day in and day out. This, of course, is all acquired via customized member recommendations & if we are to succeed in reaching our personal goals we need to make sure we are ready in the inside first (thus lab testing). If we have insulin resistance, thyroid dysfunction, nutrient deficiencies, are under stress, etc. we can follow our calories in/out until we are blue in the face and all we will do is hit the wall and get frustrated. Our body is NOT ready to succeed! We need to support our biochemistry and metabolism with proper nutrition, exercise, lifestyle habits, and nutrition supplementation (by the way, all of our products are pharmaceutical-grade, evidence-based & we do not push them, we recommend only those that will help support their current biochemical status). If it were all about calories in/calories out, would we have the obesity epidemic of 70% Americans being overweight/obese? NO! I hope this sheds some light on what sets us and our RD's apart from the typical clinical setting. We absolutely need the clinical experience as RD's, however need to have deeper understanding of biochemistry and metabolism to succeed in truly helping our members. Hopefully you have read the multiple "success stories" on our website as well. Our main goal at Life Time is to help transform our member's lives. It is being done! In regards to gluten - it is most certainly not a fad. Not only is Celiac disease coming back with a vengeance, but there are multiple gluten sensitivities impacting our immunity, inflammatory processes, and therefore quality of function as well as weight. You should read up more about food sensitivities/intolerances, which make up 90-95% of all food reactions & are very difficult to detect without testing or experimentation with diet. Actual food allergies are only 5-10% of the equation. We are not a "low carb" institution - we are a "lower carb" than typical US diets and we are certainly focusing on the whole, natural versions vs. processed grains as bread, cereal, pasta. Hope that clarifies a few of your misguided interpretations.

August 23, 2011 | Unregistered CommenterCindi Lockhart, RD

I'm pretty sure personal insults are not called for this, especially considering we are both in the same profession? YOu are correct that weight loss is not simple and that calories in vs out is not the whole picture; however, it's a great starting point. I also would not disagree that the goal is to fuel our bodies for optimal functioning. I never ever promoted the idea of filling up on junk food or whatever "taking whatever comes your way" was intended to mean. I am a huge advocate of preventive health measures, including proper nutrition that consists of small lifestyle changes over a period of time. I also agree that healthy eating should be personalized to the individual and take into consideration personal health issues, deficiencies, etc. that the person has. I never claimed it was all about calories in vs out, but research does indicate that weight loss can be achieved on any diet when there is a negative energy balance-meaning it doesn't matter if you cut carbs, fat, or anything else. So promoting a low-carb diet is not beneficial, plus it commonly leads to nutrient deficiencies while failing to teach people how to eat a healthy, balanced diet. Yes, some people have thyroid and other metabolic problems that need to be addressed, but we should not assume that all or even most do. We should be attempting to teach them the foundation of healthy eating because while it seems common sense to people with a background in nutrition, most people do not have the correct information on how to do so, misinterpret it, or simply don't know how to make the lifestyle changes to help them fit this in their lives.

I am pretty confident in my understanding of biochemistry and metabolism since that is the foundation of a degree in dietetics and the fact that I graduated at the very top of my class from a very difficult undergraduate program as I was truly invested in learning the underlying mechanisms of nutrition in the body. At the same time I am wise enough and concerned enough for the health of my clients/patients that I will quickly admit I am not an endocrinologist. I'd venture to guess that neither are you. I certainly hope that you and LTF are referring your clients out to a credentialed endocrinologist and recognizing that you do not have the expertise (if you are only an RD,) despite how knowledgeable you are on the subject of hormones, thyroid and metabolic disorders. I'd say one of the reasons (which there are many) that we have so many Americans remaining obese is that non experts are attempting to educate these individuals in areas outside of their scope. So in hiring nutritionists, personal trainers, or anyone other than a credentialed RD to provide nutrition guidance is a major problem with this company! The club I worked at used a personal trainer to sell and deliver nutrition packages and even the corporate nutrition newsletter emails were created by a personal trainer who claimed to have been educated in nutrition--but had no formal dietetics degree. This is absolutely not okay!

Congrats on your success stories- I hope they are sustainable successes. The problem is often that low-carb diets and restricting foods, making diets very specific, etc is that they are not able to be maintained and the weight is regained. Why not go back to teaching true nutrition and helping people understand how all foods can fit in a healthy lifestyle by educating them on nutrition topics? I realize this is not conducive to the goal of corporate health clubs who want to retain members and possibly have clients fail to keep them buying pt sessions and nutrition consults, but this completely goes against my values and ethics as a health professional.

I am also very aware of Celiac disease and the increase in number of diagnosis, not because it has become more common, but rather because methods to test for it and understanding of the disease has developed. I was responsible for creating a 30 page public document on Celiac disease in 2007 that is still being used at that hospital for both in-patients and out-patients with Celiac disease. The problem is that gluten-free diets are for people with Celiac disease and serious gluten-sensitivities-not for weight loss or for general consumers, which unfortunately people are adopting this as such diets. It is a therapeutic diet that is being misunderstood and incorrectly publicized and is catching the attention of people who should not follow it. If you are aware of all the foods, beverages & products that contain gluten-you would understand that a gluten-free diet is severely limiting and essentially ensures significant nutrient deficiencies. It's not just wheat, barely, rye, oats... that contains gluten. It's practically in everything-even gum wrappers! The major part of our diet should come from carbohydrates, so tell me how you can limit so many things from a diet and expect people to meet their nutrient needs? If you are so worried about the inflammation hype-which granted has some real relevance, why doesn't LTF focus on reducing the saturated fat on their "healthy way of life" menu? I was the sous chef there- are you aware of what goes into those recipes? I have a copy of all of them and it's absolutely absurd! Full fat mayo and vegetable oil is in all the dressings and chicken salad, tuna salad, asian tuna salad, egg salad, etc. There is no emphasis on complex carbohydrates there at all! Pretty sure very few of the grains served at LTF are whole grains. Yes, I know you can choose whole grain wheat bread, but come on-pizza dough, white bread, bagels, etc--these are not "natural", even though "natural" means nothing. It is whole foods we are looking for!

I in return hope this clarifies your poor interpretations and attempt to back a company that is concerned with sales and not health!

August 23, 2011 | Unregistered CommenterMe, an RD

I am an RD, and would like to add that it is completely wrong to assume that someone doing a low carb does not eat fruits and vegetables. I have used lower carb diets for years with great success, but I make it a point to get clients eating 8 to 10 servings of non starchy vegetables per day at a minimum. I encourage 2 fruit servings each day as well, for those whose blood sugar and insulin resistance can tolerate it. (Most can by the way, when they cut down on starches.) As for weight loss not being any different at 6 months, if you look at most study results, the low carb groups are almost always down at least a few pounds from the low fat calorie controlled diet groups. Most studies show weight being regained on all types of diets, due to non compliance, not because the diets themselves wouldn't work if people stuck with them. If the weight loss differences aren't much at 6 months, other parameters usually are, such as HbA1c. In the Gardner study cited above, after a year all groups regained weight, but it was the low carb group that still had the greatest weight loss at the end of a year, and that was even with so-so compliance. I have seen studies conducted on very low carb diet studies that got astounding results for those that could stick with it. (One such study was conducted at Duke and the dropout rate was pretty high). This low carb level does not allow for very many non starchy vegetables, which over time would not be advisable. But certainly a diabetic with very high triglycerides could do such a diet initially to get better control and then transition to a 25-30% carb diet, which allows for lots of non-starchy vegetables and a little starch and fruit (which can help satiation tremendously I have found,) while still allowing weight loss and correction of blood sugar and lipids. Anyway, my main point is I find many dietitians and other health professionals wrongly assuming that people on low carb diets don't eat fruits and vegetables. Even on very low carb diets, they eat some non starchy vegetables. My personal opinion is that over time a diet that includes lots of non starchy veg's and a little fruit is healthiest and this can be done on 20-30% carb levels, which are still well below the typical 50-60%. Finally, shame on me an RD for not checking out the studies cited for this article - they most certainly are well done and are eligible to add to our database of evidence. In fact, the Gardner study had very high publicity around the time it was published, and was considered a breakthrough study, as was the Brehm study (even though it is older) which did not get nearly the attention. The Brehm study was phenomenal because it actually bothered to assess whether weight lost on low carb diets was from water (it was not - it was body fat.) In addition they assessed bone density and found no changes in bone density on a low carb diet. The problem was and is our major health institutions like the American Heart Association, do not want to recommend low carb diets until more research is done. They have had concerns about water loss, bone loss and more, but those things are slowly but surely being investigated, and so far are not being found to be a problem. The one outlier is the small percentage of people who get some elevation in LDL, that is almost always accompanied by drastic increases in HDL. This too is being investigated, though not quickly enough. I point here to Eades discussions, which point out what everyone else is ignoring that low fat, low calorie diets often reduce LDL but they tend to cause increases in small dense LDL particles which are far more atherogenic than large particle LDL. In addition, he cites studies which found that large fluffy LDL increases on low carb diet, but it is thought to be far less atherogenic and some think may actually be protective against heart disease, In the meantime, both the ADA's (Am Dietetics Assc and Amer Diabetes Association) have at least acknowledged that low carb diets are effective for weight loss and diabetes management, and state that they can be used for up to a year, but not more since most studies have not followed groups past a year. In Sweden, Nielsen, et al have been following a group of diabetic pt's for well past a year and they show continued weight loss, lowering of blood sugar, lowering of medications and on and on, even a patient who came out of renal failure. There are questions still surrounding low carb diets, and continued research will sort out the answers. In the meantime, I do not hesitate to recommend them for weight loss and especially for people experiencing the milieu of problems related to insulin resistance (elevated blood sugar, blood pressure, high cholesterol/triglycerides, low HDL, increased waist to hip ratio). I was hard won-over to this position, trust me. In the old days I used to be able to help people lose weight with 1800 cal (or whatever calorie level) ADA low fat diets. Not any more. I find using a low calorie, low fat diet, I typically have to go down to 1000 or 1200 calories. People are starving on that level, and can't maintain it. It seems to me people are much more insulin resistant today and many can't lose weight without reducing carbs. It is this type of predicament that has many people saying maybe dieting isn't good, but as long as we have a tool to help people lose weight, improve risk factors, and most of all feel better, that is what I want to do. By dropping carbs and increasing protein and fat, I get the desired result and people are much more satisfied on the diet. Because the weight of the evidence is accumulating on low carb diets, many researchers are now encouraging their peers to reconsider their position on them. I already have.

August 23, 2011 | Unregistered CommenterLL, another RD

Wow! First, I think that maybe people jumping in this late in the conversation should reread and follow the posts from earlier as things are being taken out of context and the original messages have been severely altered over the course of this discussion. My posts have been referring to overweight individuals who are generally healthy-ex: No diabetes. And I don't feel you should shame on me or have the right to say that. I have not had time to read the research-which doesn't mean that I won't when I get other things finished. Do the studies specifically compare the outcomes of low-fat vs low-carb diets, because that was the topic of interest at hand. It wasn't weather low-carb diets work. Yes, we know all diets work! And as I mentioned before, and you repeated, they are not sustainable diets because people don't comply long-term. I am aware what foods consist of carbohydrates and that those extend beyond grains and cover fruits, vegetables, and even dairy products. So are you saying that it is okay to go against what the ADA and general agreement is to make the 45-65% of our diet carbohydrates? I feel that it is a little ballsy to jump on the front wave of what may or may not prove to be true after much much more research. I'm all for keeping an open mind and considering alternative perspectives, but would not just assume because a handful of studies have come out that this is the new truth. I realize this is population specific, but what about endurance athletes? I know that my body runs quite efficiently on a good foundation of complex carbohydrates. Again, I think it highly important to differentiate between simple sugars and complex sources. And for those needing to prevent plateaus and weight gain, it is quite difficult to meet calorie needs without starchy vegetables and really a variety of foods from all food groups. There are many times I see even female athletes needing 2,500 plus calories/day based on their lean body mass and RMR. This conversation is essentially pointless if people keep taking everything out of context, missing the point, and supporting a company that is okay with hiring sales people over an RD for the position of administering nutrition advice and that was the original point of this discussion.

August 23, 2011 | Unregistered CommenterMe, an RD

What's wrong with saturated fat? Mmmmmmm!! Here's a few more studies you can put on your "to read list":

Meta analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. American Journal of Clinical Nutrition 2010

Dietary cholesterol: from physiology to cardiovascular risk. British Journal of Nutrition 2011

August 23, 2011 | Unregistered CommenterVanessa

Yes the studies do specifically compare them head to head. There are many studies now comparing them head to head. If you look at the actual study results instead of the final conclusions where they consistently say there is "no statistically significant difference" in weight loss, the low carb diets are almost always a few pounds lower even at the end of the year. That's what is frustrating. I went through ADA's weight management certification course. In it they taught that even if a diet and exercise program manages to prevent age-related weight gain, it will lower risks. Yet when studies show that low carb diets (even with poorer compliance over time) do this and even help people maintain a couple of pounds of weight loss - they still are not acknowledged as having any value. In addition the low carb diet always yield better results when it comes to risk factors like triglycerides, and low HDL, but this is always overlooked because in some studies a small percentage of people have small to moderate increases in LDL on low carb diets, even though further investigation has found that the LDL is the "large particle" type which is not harmful. In addition, some studies have found that low fat diets increase the amount of "small particle" LDL which is very atherogenic. Sometimes I think people still look no further than the Web MD info on low carb diets - which is old and outdated. No studies have validated the kidney damage concern, the osteoporosis concern and certainly not the cholesterol issue they state could be a problem on low carb diets. In fact, study after study is finding lipid profiles improve more on low carb diets than low fat ones, even if the subjects don't lose weight. Whereas on low fat diets, lipid profiles don't improve unless people lose weight, and sometimes not even then. I also don't understand why we keep saying people need more carbohydrates for energy to exercise. That is in fact a problem. Eating more carbs makes it take longer to start burning fat during exercise. If a person is not overweight and wants to keep up an intense exercise program yes, they can eat more carbs, but for 67% of our population (our overweight population) the goal is to get into fat stores as quickly as possible. Low carb diets are sustainable if they are not done in the severe 10% versions, but this is not what most people are advocating because it doesn't allow for enough fruits and vegetables. Willet and Liu found low carb diets did not raise risks and actually lowered risks, especially when they included plenty of plant foods and plant sources of proteins, like beans and nuts. Am Dietetics Assoc and Am Diabetes Association acknowledge low carb diets as a valid option if used for a year. They are not saying they are dangerous after a year, they are just saying they can't vouch for them past a year, because the studies looking at them for longer than a year are limited. Though, if you look into those studies, the results continue to be positive with no harmful effects showing up. The American Dietetics Association refers to the Cochrane Database evidence analysis which comes up with "fair" amount of evidence for weight loss rating on low carb diets - that's why they are no longer completely poo-poohed. I find this staggering because when I look at studies of low fat calorie controlled diets, the weight loss is also very modest. Many times in the studies that bother to measure if the weight loss is from body fat, only a very small percentage of the weight loss on low fat diets is actually from body fat when compared to higher protein low carb diets. If they lost weight, and they didn't lose fat, what did they lose? Muscle. That certainly is not sustainable. I am sorry - I feel over time the evidence is going to be strongly in favor of low carb diets for today needs, where we seem to have an epidemic of insulin resistance. In fact it probably should already be given higher ratings from the evidence analysis if they looked at more parameters than simply the number of pounds of weight loss. If you can maintain a healthy weight, blood pressure, blood sugar and lipds on higher carb intake, there is no problem. We are referring to the people who can't. Go to nmsociety.org. This is a website run by researchers in this field who present all the evidence on low carb diets.

August 25, 2011 | Unregistered CommenterLL, another RD

Thank you for sharing the information. Weight loss is a great problem of modern Americans and if not treated it can lead to various side effects like problems with heart, hypertension, psychological complexes including depression. So, each case of extra weight should be analyzed separately to my mind in order to determine the reasons and to prescribe a correct course of treatment. All these techniques may be useful but not each of them can suit to a concrete separate case.

September 27, 2011 | Unregistered CommenterMilenaS
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