How to eat clean and lose weight

What does it mean to eat clean ?

“How to eat clean ?” Many clinicians find themselves at a loss to answer this common question from patients. The difficulty of offering a simple answer is understandable. The overwhelming volume of data generated by food and nutrition researchers coupled with sometimes contradictory findings, the seeming flip-flops in recommendations, and the flood of misinformation in diet books and the media can make it seem as though explaining the essentials of healthy eating is akin to describing the intricacies of particle physics. That is unfortunate, because there are now enough solid evidence from reliable sources to weave simple but compelling recommendations about clean eating.

The fundamentals of eating clean encourage you to consume more whole foods — such as fruits, vegetables, lean proteins, whole grains and healthy fats — and limit highly processed snack foods, sweets and other packaged foods. An example of a meal containing all of these foods would be a spinach salad with grilled chicken, quinoa, avocado, walnuts and apple slices.

Clean eating isn’t black and white. There’s room for flexibility and modifications, and it doesn’t require avoiding any certain food groups — unless medically necessary.

Clean eating also doesn’t mean that all foods must be consumed in the raw state. Cooking, pasteurizing and preserving are okay.

Replacing meals with store-bought protein shakes or sugary smoothies and juices is not an example of clean eating.

Although research on nutrients such as fats, carbohydrates, and specific vitamins and minerals has been revealing, it has also generated some dead ends, along with myths and confusion about what constitutes clean eating. A key reason is because people eat food, not nutrients. Furthermore, humans tend to follow relatively repeatable dietary patterns. Although it is harder to study dietary patterns than it is to study nutrients, new research has shown how some dietary patterns are good for long-term health.

One dietary pattern that may harm long-term health is the typical Western diet—rich in red meat, highly processed grains, and sugar, and lacking in fruits, vegetables, whole grains, and fiber. A host of studies have emphasized that this type of dietary pattern promotes atherosclerosis and a variety of cardiovascular conditions, including heart attack and stroke, peripheral vascular disease, and heart failure ¹, ².

A clean eating plan gives your body the nutrients it needs every day while staying within your daily calorie goal for weight loss. A clean eating plan also will lower your risk for heart disease and other health conditions ³.

All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease. Over time, if you eat and drink more calories than your body uses or “burns off,” your body may store the extra energy, leading to weight gain.

According to the Dietary Guidelines for Americans ⁴, a clean eating is eating a diet that is healthy. A clean eating plan involves:

• Emphasizes vegetables, fruits, whole grains, and fat-free or low-fat milk products.
• Includes lean meats, poultry, fish, beans, eggs, and nuts.
• Is low in saturated fats, trans fats, cholesterol, salt, and added sugars.
• Grains, at least half of which are whole grains.
• Controls portion sizes.
• Balances the calories you take in from food and beverages with the calories burned through physical activity to maintain a healthy weight.
• Consume less than 10 percent of calories per day from added sugars.
• Consume less than 5-7 percent of calories per day from saturated fats.
• Consume less than 2,300 milligrams (mg) per day of sodium (salt).
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age. It is not recommended that individuals begin drinking or drink more for any reason.

Here are some tips to help you meet the eat clean guidelines:

• Eating fruits and vegetables of different colors gives your body a wide range of valuable nutrients.
• A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other.
• Fruits, especially whole fruits.
• Include foods that contain fiber such as fruits, vegetables, beans, and whole-grains.
• Eat lean cuts of meat and poultry. Trim away excess fat and remove skin from poultry before cooking.
• Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.
• Limiting highly processed, packaged foods with a long list of ingredients, most of which are not natural. Ingredients listed on the food label should mostly be foods that you recognize, such as whole-grain steel cut oats, dried apple, flaxseed and cinnamon. Limit ingredients that you can’t identify or can’t easily pronounce, such as carnauba wax, soy lecithin and artificial flavor.
• Cutting back on foods with added salt, sugar or fat.
• Avoiding foods that are drastically altered compared with their natural form, such as apple juice versus a whole apple, chicken nuggets versus a fresh chicken breast, or vegetable chips versus fresh vegetables. Sometimes processing can be a good thing for foods, such as pasteurization that makes eggs and dairy products safe for consumption. Also, frozen fruits and vegetables are okay because they are minimally processed and can sometimes contain more nutrients than fresh varieties since they are frozen at their peak.
• Pay attention to portion sizes, especially at restaurants.
• Smaller portions equal fewer calories.
• Season your food with lemon juice, herbs, and spices, rather than using butter and salt.
• Choose foods that are baked, broiled, braised, grilled, steamed, sautéed, or boiled, rather than fried.
• Preparing and eating more foods at home. Start with simple meals to help you get into the habit, such as Greek yogurt and fresh berries for breakfast, or a whole-grain roasted turkey and avocado wrap with red pepper slices at lunch.
• When eating out, select a dish from the menu, rather than getting your money’s worth at the all-you-can-eat buffet.

In the United States and other developed countries, the average adult can expect to live 80 years or more ⁵. With such longevity, it isn’t enough merely to consume the calories needed to sustain the body, build it, and repair it. The foods that supply these calories can influence the risk of developing chronic conditions, which range from heart disease and cancer to osteoporosis and age-related vision loss.

Although much remains to be learned about the role of specific nutrients in decreasing the risk of chronic disease, a large body of evidence supports the utility of healthy dietary patterns that emphasize whole-grain foods, legumes, vegetables, and fruits, and that limit refined starches, red meat, full-fat dairy products, and foods and beverages high in added sugars. Such diets have been associated with decreased risk of a variety of chronic diseases ⁶.

Diet, of course, is just one approach to preventing illness. Limiting caloric intake to maintain a healthy weight, exercising regularly, and not smoking are three other essential strategies. Compelling data from the Nurses’ Health Study show that women who followed a healthy lifestyle pattern that includes these four strategies were 80% less likely to develop cardiovascular disease over a 14-year period compared to all other women in the study ⁷. A companion study, the Health Professionals Follow-up Study, showed that similar healthy choices were beneficial in men, even among those who were taking medications to lower blood pressure or cholesterol ⁸.

Strong evidence shows that clean eating patterns are associated with a reduced risk of cardiovascular disease (coronary heart disease). Moderate evidence indicates that healthy eating patterns also are associated with a reduced risk of type 2 diabetes, certain types of cancers (such as colorectal and postmenopausal breast cancers), overweight, and obesity. Emerging evidence also suggests that relationships may exist between eating patterns and some neurocognitive disorders and congenital anomalies. Within this body of evidence, higher intakes of vegetables and fruits consistently have been identified as characteristics of healthy eating patterns; whole grains have been identified as well. Additionally, some evidence indicates that whole grain intake may reduce risk for coronary heart disease and is associated with lower body weight. Other characteristics of healthy eating patterns have been identified include fat-free or low-fat dairy, seafood, legumes, and nuts. Lower intakes of meats, including processed meats; processed poultry; sugar-sweetened foods, particularly beverages; and refined grains have often been identified as characteristics of healthy eating patterns.

Table 1. Elements of clean healthy eating

Table 2. Elements of 2 healthy dietary patterns

• Mediterranean Diet

Traditional diets developed in countries surrounding the Mediterranean Sea have been linked with lower rates of heart disease and other chronic conditions. Such diets also appear to transplant well to foreign soil. Among the 166,012 women participating in the National Institutes of Health Diet and Health Study, those whose diets most closely matched a traditional Mediterranean diet had reduced risks of all-cause mortality, cardiovascular mortality and cancer mortality compared with those following a Western diet ¹². A similar trend was observed for men. The impact was even greater among smokers. The Mediterranean diet has other health benefits as well, such as reduced risk of cancer, Parkinson’s disease, and Alzheimer’s disease ¹³. It has also been associated with control of asthma ¹⁴ and improvement in rheumatoid arthritis ¹⁵.

Although there is no single diet that can be called “the” Mediterranean diet, those worthy of the name are high in extra virgin olive oil; high in whole grain foods and fiber; and rich in fruits, vegetables, legumes, and nuts. Small portions of cheese and yogurt are eaten daily; fish is consumed in varying amounts; red meat, poultry, eggs, and sweets are consumed sparingly. Modest amounts of red wine complement meals, and regular physical activity is a part of daily life. An example of a Mediterranean-type diet can be found here The Mediterranean Diet

• DASH Diet

In the 1990s, the National Heart, Lung, and Blood Institute sponsored a randomized, controlled trial called Dietary Approaches to Stop Hypertension (DASH) to see if certain changes in diet could lower blood pressure. The DASH diet emphasized fruits, vegetables, and low-fat dairy foods and limited red meat, saturated fats, and sweets. Compared with an average American diet, the DASH diet lowered participants’ systolic blood pressure by an average of 5.5 mm Hg and diastolic pressure by 3 mm Hg ¹⁰. A low-sodium DASH approach was even more effective; the results were comparable to those from trials of antihypertensive medications ¹¹. The impact of the DASH diet goes beyond lowering blood pressure. It has since been shown to reduce weight ¹⁶, the risk of coronary heart disease and stroke ¹⁷ and the development of kidney stones ¹⁸. Details of the DASH diet can be found here What is the DASH Diet ?

Dietary Fat

Dietary fat is a terribly misunderstood and mistakenly maligned nutrient. Myths and messages that have persisted since the 1960s warn that “fat is bad.” That dangerous oversimplification has helped launch dozens of largely ineffective diets and the development of thousands of fat-free but calorie-laden foods. It has also helped fuel the twin epidemics of obesity and type 2 diabetes. The message “fat is bad” is problematic because there are four main types of dietary fat with dramatically different effects on health.

Trans fats from partially hydrogenated oils are undeniably bad for the cardiovascular system and the rest of the body. These largely man-made fats elevate harmful low-density lipoprotein (LDL) cholesterol, reduce protective high-density lipoprotein (HDL) cholesterol, stimulate inflammation, and cause a variety of other changes that damage arteries and impair cardiovascular health ¹⁹. Higher intake of trans fat has been associated with an increased risk for developing cardiovascular disease, type 2 diabetes, gall stones, dementia, and weight gain ¹⁹.

Saturated fats from red meat and dairy products increase harmful LDL, but also increase HDL. A moderate intake of saturated fat (under 7% of daily calories) is compatible with a healthy diet, whereas consumption of greater amounts has been associated with cardiovascular disease.

Monounsaturated and polyunsaturated fats from vegetable oils, seeds, nuts, whole grains, and fish—especially the polyunsaturated omega-3 fatty acids—are important components of a healthy diet and are also essential for cardiac health. Eating polyunsaturated fats in place of saturated and trans fats lowers harmful LDL, elevates protective HDL, improves sensitivity to insulin, and stabilizes heart rhythms ²⁰.

Dietary fat per se is not associated with risk of chronic disease. In fact, diets that include up to 40% of calories from fat can be quite healthy if they are low in trans and saturated fat and emphasize polyunsaturated and monounsaturated fat ²¹. Although definitive data are not available on the optimal proportions of dietary fats, a low intake of trans and saturated fat and a higher intake of unsaturated fats reduce the risk of cardiovascular disease and diabetes.

Carbohydrates

In the United States, the reduction in the intake of dietary fat from 45% of calories in 1965 to approximately 34% today was accompanied by an increase in the intake of carbohydrates ²². These extra carbohydrates were largely in the form of highly processed grains. Processing removes fiber, healthful fats, and an array of vitamins, minerals, and phytonutrients, making processed grains such as white flour or white rice nutritionally impoverished compared with whole-grain versions. Consumption of a diet rich in highly processed grains is associated with an increase in triglycerides and a reduction in protective HDL cholesterol ²³. These adverse responses may be aggravated in the context of insulin resistance, which often develops during pregnancy or as part of metabolic syndrome. The prevalence of insulin resistance and type 2 diabetes are both increasing in the United States and around the world.

The Glycemic Index

The glycemic response refers to the measurable increase in blood sugar after consuming carbohydrates. The greater the postprandial spike in glucose a food generates, the greater that food’s glycemic index. Highly refined grains cause a more rapid and a greater overall increase in blood sugar than less-refined whole grains ²⁴. Greater glycemic responses are accompanied by increased plasma insulin levels, which are thought to be at the root of metabolic syndrome ²⁵ and have also been implicated in ovulatory infertility in women ²⁶. Diets with a high glycemic index or glycemic load (the product of dietary glycemic index and total carbohydrate intake) appear to increase the risks of type 2 diabetes and coronary artery disease, particularly among women who have some insulin resistance ²⁷. The dramatic loss of fiber and micronutrients during the milling process may also contribute to these adverse effects of highly processed grains.

In contrast, whole grains and foods made from whole grains, along with fruits, vegetables, and beans, provide slowly digested carbohydrates that are rich in fiber, vitamins, minerals, and phytonutrients. A substantial body of evidence indicates that eating whole grains or cereals high in fiber, rather than highly refined grains, reduces the risk of cardiovascular disease14 and type 2 diabetes ²⁸. Although reductions in the risk of colon cancer by diets rich in whole-grain fiber have been difficult to document, such a dietary pattern has been clearly associated with reductions in constipation and diverticular disease.

Protein

To the metabolic systems engaged in protein production and repair, it is immaterial whether amino acids come from animal or plant protein. However, protein is not consumed in isolation. Instead, it is packaged with a host of other nutrients. The quality and amount of fats, carbohydrates, sodium, and other nutrients in the “protein package” may influence long-term health. For example, results from the Nurses’ Health Study suggest that eating more protein from beans, nuts, seeds, and the like, while cutting back on easily digested carbohydrates reduces the risk of heart disease ²⁹. In that study, eating more animal protein while cutting back on carbohydrates did not reduce heart disease risk, possibly because of the fats and other nutrients that come along (or don’t come along) with protein from animals.

Vegetables and fruits

“Eat more fruits and vegetables” is timeless advice that has the backing of a large body of evidence ³⁰. Vegetables and fruits provide fiber, slowly digested carbohydrates, vitamins and minerals, and numerous phytonutrients that have been associated with protection against cardiovascular disease, aging-related vision loss due to cataract and macular degeneration, and maintenance of bowel function. The connection between vegetables and fruits and cancer is less well established. Although they do not have a blanket anticancer effect, fruits and vegetables may work against specific cancers, including esophageal, stomach, lung, and colorectal cancer ³¹.

Fruits and vegetables should be consumed in abundance, which means a minimum of five servings a day—and more is better. As few as 1 in 4 persons in the United States meet this guideline ³².

Beverages

The ideal beverage provides 100% of what the body needs water—H2O—without any calories or additives. Water has all of those qualifications. From the tap, it costs a fraction of a penny per glass. After water, the two most commonly consumed beverages are tea and coffee. Both are remarkably safe beverages, and have been associated with reduced risks of type 2 diabetes ³³, kidney stones and gallstones, and possibly heart disease and some types of cancer.

Two problematic beverages are sugar-sweetened drinks (sodas, fruit drinks, juices, sports drinks, etc.) and alcoholic drinks. One 12-ounce can of sugar-sweetened cola delivers 8–10 teaspoons of sugar, approximately 120–150 “empty” calories ³⁴. Not surprisingly, daily consumption of sugary beverages has been associated with weight gain and increased risk of type 2 diabetes ³⁵, heart disease ³⁶, and gout ³⁷. Alcohol in moderation (no more than one drink a day for women, 1–2 drinks a day for men) has been associated with reduced risks of cardiovascular disease and type 2 diabetes. On the other hand, even moderate drinking may increase the risk of breast cancer.

However, it is possible that a diet rich in folate may attenuate this risk. In the Nurses’ Health Study, the risk of breast cancer associated with alcohol intake was strongest among women with total folate intake less than 300 μg/d for alcohol intake ≥15 grams (g)/d vs <15 g/d which is the alcohol content of one “standard” drink. For women who consumed at least 300 μg/d of total folate, there was no increased risk of breast cancer associated with alcohol intake ³⁸. Drinking alcohol during pregnancy is not recommended due to possible health hazards to the developing child.

Vitamins and minerals

An optimal diet generally provides all the vitamins, minerals, and other micronutrients needed for good health. However, many women in the U.S., and a very large percentage of poor women, do not follow optimal diets ³⁹. Thus, for most women a daily multivitamin-multimineral supplement provides good insurance against nutritional deficiencies. Such supplements usually include extra iron, which is needed by the 9% to 11% of premenopausal women with iron deficiency ⁴⁰.

The most firmly established benefit of vitamin supplements is that additional folic acid can reduce the risk of neural tube defects by approximately 70% ⁴¹. Current guidelines call for all women of childbearing age to take a daily supplement containing 400 to 800 micrograms (μg) of folic acid, or 4 milligrams (mg) for women with a child with a neural tube defect.

Calcium is important for the maintenance of bone strength. Precisely how much calcium is needed is a controversial question. World Health Organization guidelines recommend an intake of 400 mg/day. In the United Kingdom, 700 mg/day is considered adequate for women aged 19 years and older. In the United States, dietary guidelines recommend that adult women receive 1,500 mg of calcium daily ⁴², in large part by consuming 3 servings of low-fat or fat-free dairy products a day ⁴³. A lower-calorie, no-fat option is to get calcium from supplements.

For maintaining bone strength, other factors—including physical activity and vitamin D—are as important, or more important, than calcium. There is mounting evidence that current recommendations for vitamin D (200–600 IU/day, depending on age) are too low, and that 1,000 IU/day provides better protection against fractures and possibly heart disease and some cancers ⁴⁴ (see Vitamin D). Excess intake of preformed vitamin A (retinol) has been associated with an increased risk of hip fracture, possibly by competing with vitamin D ⁴⁵. However, elevated risk is seen at intakes slightly higher than the current Dietary Reference Intake of 700 μg per day. Given this concern, a multivitamin that delivers much of its vitamin A as beta-carotene is preferred.

How much should you eat ?

How much you should eat depends on the total number of calories you need each day varies, depending on a number of factors, including the your genes, age, sex, height, weight, your build (muscular or athletic or average or overweight) and level of physical activity. In addition, a need to lose, maintain, or gain weight and other factors affect how many calories should be consuming. In general, men need more calories than women do, and younger adults need more calories than adults in midlife and older. At all ages, adults who are more physically active need to eat more calories than those who are less active.

What is a healthy weight ?

Body mass index (BMI) is one way to tell whether you are at a healthy weight, overweight, or obese. It measures your weight in relation to your height. A BMI of 18.5 to 24.9 is in the healthy range. A person with a BMI of 25 to 29.9 is considered overweight, and someone with a BMI of 30 or greater is considered obese.

• To find out about your body mass index (BMI), you can use a FREE online BMI calculators from the Centers for Disease Control and Prevention (CDC) – for Adults ⁴⁶ and for Children ⁴⁷

Eat clean to lose weight

You Are What You Eat. Your Weight and Your Life is the Result of Your Habits.

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).

For a weight loss of 1–1 ½ pounds per week, daily intake should be reduced by 500 to 750 calories. In general:

• 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 (VLCD) of fewer than 800 calories per day should not be used unless you are being monitored by your doctor.

Table 3. Estimated Calorie Needs per Day, by Age, Sex, and Physical Activity Level

Notes: Within each age and sex category, the low end of the range is for sedentary individuals; the high end of the range is for active individuals. Due to reductions in basal metabolic rate (resting energy requirement) that occur with aging, calorie needs generally decrease for adults as they age.

These are only estimates, and approximations of individual calorie needs can be aided with online tools such as those available at www.supertracker.usda.gov ⁴⁸. To find out What and How Much To Eat, you can use a FREE, award-winning, state-of-the-art, online diet and activity tracking tool called SuperTracker ⁴⁹ from the United States Department of Agriculture Center for Nutrition Policy and Promotion ⁴⁹. This free application empowers you to build a healthier diet, manage weight, and reduce your risk of chronic diet-related diseases. You can use SuperTracker ⁴⁹ to determine what and how much to eat; track foods, physical activities, and weight; and personalize with goal setting, virtual coaching, and journaling.

[a] Sedentary means that you do only light physical activity as part of your typical daily routine.

[b] Moderately Active means that you do physical activity equal to walking about 1.5 to 3 miles a day at 3 to 4 miles per hour, plus your typical daily routine.

[c] Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the activities of your typical daily routine.

[d] Estimates for females do not include women who are pregnant or breastfeeding.

[e] If you need to lose weight, eat fewer calories than you burn or increase your activity level to burn more calories than you eat.

General guidance for achieving and maintaining a healthy body weight is provided below:

• Children and adolescents are encouraged to maintain calorie balance to support normal growth and development without promoting excess weight gain. Children and adolescents who are overweight or obese should change their eating and physical activity behaviors to maintain or reduce their rate of weight gain while linear growth occurs, so that they can reduce body mass index (BMI) percentile toward a healthy range.

• Before becoming pregnant, women are encouraged to achieve and maintain a healthy weight, and women who are pregnant are encouraged to gain weight within gestational weight gain guidelines ⁵¹.

• Adults who are obese should change their eating and physical activity behaviors to prevent additional weight gain and/or promote weight loss. Adults who are overweight should not gain additional weight, and those with one or more cardiovascular risk factors (e.g., hypertension and hyperlipidemia) should change their eating and physical activity behaviors to lose weight. To lose weight, most people need to reduce the number of calories they get from foods and beverages and increase their physical activity. For a weight loss of 1 to 1½ pounds per week, daily intake should be reduced by 500 to 750 calories. Eating patterns that contain 1,200 to 1,500 calories each day can help most women lose weight safely, and eating patterns that contain 1,500 to 1,800 calories each day are suitable for most men for weight loss. In adults who are overweight or obese, if reduction in total calorie intake is achieved, a variety of eating patterns can produce weight loss, particularly in the first 6 months to 2 years ⁵²; however, more research is needed on the health implications of consuming these eating patterns long-term.

• Older adults, ages 65 years and older, who are overweight or obese are encouraged to prevent additional weight gain. Among older adults who are obese, particularly those with cardiovascular risk factors, intentional weight loss can be beneficial and result in improved quality of life and reduced risk of chronic diseases and associated disabilities.

• Some foods — vegetables, nuts, fruits, and whole grains — were associated with less weight gain when consumption was actually increased. Obviously, such foods provide calories and cannot violate thermodynamic laws. Their associations with weight loss suggest that the increase in their consumption reduced the intake of other foods to a greater (caloric) extent, decreasing the overall amount of energy consumed. Higher fiber content and slower digestion of these foods would augment satiety, and their increased consumption would also displace other, more highly processed foods in the diet, providing plausible biologic mechanisms whereby persons who eat more fruits, nuts, vegetables, and whole grains would gain less weight over time ⁵³.

• You don’t have to give up all your favorite foods when you’re trying to lose weight. Small amounts of your favorite high-calorie foods may be part of your weight-loss plan. Just remember to keep track of the total calories you take in. To lose weight, you must burn more calories than you take in through food and beverages.

• To find out What and How Much To Eat, you can use a FREE, award-winning, state-of-the-art, online diet and activity tracking tool called SuperTracker ⁴⁹ from the United States Department of Agriculture Center for Nutrition Policy and Promotion ⁴⁹. This free application empowers you to build a healthier diet, manage weight, and reduce your risk of chronic diet-related diseases. You can use SuperTracker ⁴⁹ to determine what and how much to eat; track foods, physical activities, and weight; and personalize with goal setting, virtual coaching, and journaling.

SuperTracker website ⁴⁹

• To find out about how many calories you should eat to lose weight according to your weight, age, sex, height and physical activity, you can use a FREE online app Body Weight Planner ⁵⁴

• To find out about the 5 Food Groups you should have on your plate for a meal, you can use a FREE online app ChooseMyPlate ⁵⁵

Almost any diet will result in weight loss, at least for a short time, if it helps the dieter take in fewer calories than she burns.

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

1. getting you to eat certain “good” foods and/or avoid “bad” ones.
2. changing how you behave and the ways you think or feel about food.

Few dieters, however, are able to sustain weight-loss diets for long periods. Different palates, food preferences, family situations, and even genes mean that no single diet is right for everyone. What is needed is a dietary pattern that can be sustained for years, and that is as good for the heart, bones, brain, psyche, and taste buds as it is for the waistline. This diet should include plenty of choices and few restrictions or “special” foods. Data from randomized trials suggest that the nutrient makeup of a dietary pattern for weight loss matters far less than the number of calories it delivers.

In a head-to-head trial ⁵⁶ of four diets loosely based on the Atkins, Ornish, and Mediterranean diets (low fat, average protein; low fat, high protein; high fat, average protein; and high fat, high protein respectively), participants lost an average of 13.2 pounds (6 kg) at 6 months, and had a 2-inch reduction in waist size, regardless of the diets they were following. At 12 months, most began to regain some weight ⁵⁶. Among those who completed the trial, the amount of weight loss after 2 years was similar in participants assigned to a diet with 25% protein and those assigned to a diet with 15% protein (average of 4.5 and 3.6 kg, respectively), and was also the same in those assigned to a diet with 40% fat and those assigned to a diet with 20% fat (average of 3.9 and 4.1 kg, respectively). There was no effect of carbohydrate level on weight loss within the target range of 35% to 65% of calories from carbohydrate. The change in waist circumference was also similar across the diet groups. Feelings of hunger, satiety, and satisfaction with the diet were the same across the board, as were cholesterol levels and other markers of cardiovascular risk. It is important to note that these averages hide huge variations in weight loss, with some participants losing 30 pounds or more while others actually gained weight during the trial ⁵⁶. This supports the idea that weight-loss strategies must be individualized. Group counseling was an aid to weight loss, suggesting that behavioral, psychological, and social factors are probably more important for weight loss than the mix of nutrients in a diet.

The best diet for losing weight is one that is good for all parts of your body, from your brain to your toes, and not just for your waistline. 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.

In the most comprehensive review (meta-analysis) conducted to date, a team of researchers ⁵⁷, analyse all available articles and randomised trials on all popular branded diets including macronutrient composition diets (low carbohydrate, low fat, high protein, high fat, etc.).

The branded diet programs being analysed were:

• Atkins Diet
• Biggest Loser Diet
• DASH (Dietary Approaches to Stop Hypertension) Diet
• Jenny Craig Diet
• LEARN (Lifestyle, Exercise, Attitudes, Relationships and Nutrition) Diet
• Mediterranean Diet
• Nutrisystem Diet
• Ornish Diet
• Pritikin Diet
• Rosemary Conley Diet
• Slimming World Diet
• South Beach Diet
• Volumetrics Diet
• Weight Watchers Diet
• Zone Diet
• Low Calorie Diet (LCD)
• Very Low Calorie Diet (VLCD)
• Low Carbohydrate
• High Carbohydrate
• Carb Counting
• Low-glycemic index (Low GI)
• Low-glycemic load (Low GL)
• Low Fat
• High Fat
• Ketogenic
• Scheduling (meals & meal pattern)
• Meal replacement
• Portfolio Diet
• High Protein
• Energy Density Diet
• Portion Control Diet
• TLC (Therapeutic Lifestyle Changes) Diet
• Vegetarian Diet

Conclusions:

• 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.
• There isn’t one “perfect” diet for everyone, owing to individual differences in genes and lifestyle.

This study supports the practice of recommending any diet that a person will adhere to in order to lose weight ⁵⁸.

Unfortunately, most weight-loss diets are hard to stick to long enough to reach your weight goal. And some may not be healthy.

The sheer number of weight-loss plans can be overwhelming. There’s overlap, but most plans can be grouped into a few major categories.

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 ⁵⁹. 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) ⁵⁹.

In addition to consuming a healthy eating pattern, individuals in the United States should meet the Physical Activity Guidelines for Americans ⁶⁰. Regular physical activity is one of the most important things you can
do to improve your health. The Physical Activity Guidelines, released by the U.S. Department of Health and Human Services, provides a comprehensive set of recommendations for Americans on the amounts and types of physical activity needed each day. Adults need at least 150 minutes of moderate intensity physical activity and should perform muscle-strengthening exercises on 2 or more days each week. Youth ages 6 to 17 years need at least 60 minutes of physical activity per day, including aerobic, muscle-strengthening, and bone-strengthening activities. Establishing and maintaining a regular physical activity pattern can provide many health benefits. Strong evidence shows that regular physical activity helps people maintain a healthy weight, prevent excessive weight gain, and lose weight when combined with a healthy eating pattern lower in calories. Strong evidence also demonstrates that regular physical activity lowers the risk of early death, coronary heart disease, stroke, high blood pressure, adverse blood lipid profile, type 2 diabetes, breast and colon cancer, and metabolic syndrome; it also reduces depression and prevents falls. People can engage in regular physical activity in a variety of ways throughout the day and by choosing activities they enjoy.

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