The Great Diet Debate : page three (final) :

Fleming's study suggests the following:

1. The fewer calories consumed, the more weight is lost regardless of what sort of diet one consumes.

2. The type of High Fat diet followed by the subjects in this study led to negative changes in all cardiovascular risk factors measured. It is doubtful that a caring professional could, in good conscience, recommend a diet that would elevate total cholesterol, LDL's, triglycerides, homocysteine and fibrinogen. The High Carb/Low Fat protocol led to an improvement in all cardiovascular risk factors.

3. Sustained and significant reduction in weight requires persistent change in dietary and lifestyle habits. Reductions in weight were only statistically significant by the end of the year.

4. The modest 'middle of the road', Surgeon General/Heart Association type of diet does not lead to much weight loss and makes a negligible impact on cardiovascular risk factors.

I had some questions about the results and methodology which I was able to discuss with Dr. Fleming. I asked why the High Fat group were more than 50 lb. lighter on average than the Low Fat group when the subjects were randomly assigned. He assured me that this was not by design and that the random group selection just happened to result in many of the heavier subjects finishing up in the Low Fat group. I inquired about drop-outs, and there were none. The subjects were highly motivated and although overweight, were free of any major disease. All 100 subjects who began the study were still participating at the end of the year.

The High Fat group did not follow an Atkins protocol per se, but it was "very similar" to an Atkins' diet. Exercise was self-recorded which often results in hyperbole but, as Dr. Fleming pointed out, this was the same for all groups. The Low Fat group generally felt more energetic and "tended to exercise more frequently" although not significantly so. Insulin sensitivity was not measured.

Dr. Fleming's study is the most comprehensive dietary study I have read that attempts to look at the sustained effects of different dietary protocols. The fact that some questions remain unanswered points out how important it is to generate major Federally funded and foundation funded studies to provide some definitive answers which will enable professionals to give recommendations without having to use terms such as "maybe", "might", and "will possibly" which sound weak when matched with the excessive claims of some best selling diets. (There is a phrase, "Often wrong, but never in doubt", which comes to mind in reading the assertions of some diet salespeople).

Based on a previous study reported in Angiology, Dr. Fleming is completely convinced that an Atkins like high fat diet increases coronary risk factors, whereas he was able to show that a diet high in complex carbohydrates actually led to recovery of a viable myocardium. Dr. Fleming debated Dr. Atkins on the Today Show and came away singularly unimpressed with some of Dr. Atkins responses to specific medical questions. It will be interesting to see whether history is kinder to Dr. Atkins than two other high fat gurus, Dr. Tarnower and Dr. Stillman.

In her delightful book, "Losing It", Laura Fraser writes that there is a spotted history to the names associated to two huge selling low carbohydrate diets. The writer Samm Sinclair Baker co-wrote "The Doctor's Quick Weight Loss Diet" with Dr. Irwin Stillman and later worked with Dr. Herman Tarnower and the barely acknowledged Jean Harris, to produce "The Complete Scarsdale Diet". Dr. Stillman said that patients would lose between 7 and 15 lbs. in the first week and 5 lb. per week thereafter. Over 20 million people tried the Stillman diet which lost a lot credibility when he died of a heart attack. Dr. Tarnower's high protein diet had patients consuming only about 700 calories a day. He came to an untimely end when he was killed by his long time partner, Jean Harris. His somewhat ethically challenged life is detailed in the book, "The Jean Harris Case" by Denise Noe.

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EAT MORE, WEIGH LESS
DEAN ORNISH, M.D.

What separates Ornish's program from most other diets is that it's a health first, weight loss second program. In an earlier book "Reversing Heart Disease" he showed that risk factors associated with heart disease could be reversed by making dietary and other lifestyle changes. The book included experiments to show that even blood flow to the coronary arteries could be increased in response to diet, exercise and psycho/social changes. Ornish followed this with a book entitled "Love and Survival" in which he looked closely at the role of such factors as loneliness, companionship, meditation, family and love and their impact on the health, self esteem and longevity. In other words, Ornish is about more than weight loss, although he has published more peer-reviewed articles on weight loss than most of the other diet doctors combined. In "Eat More, Weight Less" Ornish looks at weight loss in the context of the whole person.

His approach is simple and he is able to compress the whole of his "Life Choice" program into the first 80 pages of the book. The remaining 300 pages are mostly made up of recipes, which is another area in which Ornish separates himself from the pack. He gave his dietary guidelines to some of America's finest chefs and asked them to create a full low fat menu. I can attest to the quality of some of the chefs that are featured, having recently eaten at Chez Panisse in Berkeley (Paul Bertolli) and Greens in San Francisco (Deborah Madison). Ornish counsels people to "eat like a gourmet" with modest portions of great food instead of supersized, 'biggie' portions of junk. The Life Choice Diet that Ornish suggests is not revolutionary; you can find similar ideas from Pritikin and John Robbins. He preaches a relentless low fat mantra. Ideally this would be vegetarian, but he tolerates some lean meat and dairy so as not to exclude too many people whose palate is accustomed to animal fats.

Why eat a diet that is low in fat and high in complex carbohydrates?

1. Fat has 9 calories/gram, whereas protein and carbohydrates have 4 calories/gram. Therefore it is much easier to restrict your caloric intake by restricting your fat.

2. Your body easily converts dietary fat calories into body fat. One hundred fat calories can be stored as body fat by expending only 2.5 calories. Whereas your body must spend 23 calories - almost 10 times as much - to convert 100 calories of dietary protein or carbohydrates into body fat.

3. Complex carbohydrates are high in fiber, which slows down the absorption of foods, so that you feel comfortably full for extended periods on a modest caloric intake.

4. A typical 'Life Choice' diet will contain both insoluble and soluble fibers. Insoluble fibers increase stool bulk, which decreases the amount of time it takes food to pass through your intestines. This decreases the likelihood of problems such as constipation, hemorrhoids, diverticular disease, irritable bowel syndrome and colon cancer. Soluble fibers help increase the removal of cholesterol in the bile and also slow the absorption of carbohydrates so blood sugar levels remain more constant and the spiking of insulin is avoided.

5. A quality vegetarian, or near vegetarian, diet is a major protection against cardio-vascular disease and cancer.

6. There are some good reasons for people to decrease their meat consumption beyond those of personal health. The environmental impact of increasing meat production is profound. Without going into too much detail here are just a few insights into what massive meat production can mean. It takes less water to produce a year's supply of food for a vegetarian than a month's supply for a meat eater. Meat production is the biggest user of water in the Western United States. It has been estimated that the water that goes into breeding a 1000 lb. steer would float a destroyer. Over 80% of the corn and 95% of the oats grown in the U.S.A. are eaten by livestock. Livestock produce 20 times the excrement of the entire human population of the U.S. leading to pollution of ground water from run-off from feedlots.

   Given that a vegetarian Ornish type diet is healthy, leads to sustained weight loss and is good for the environment, why is it that people aren't bypassing the fast food outlets and embracing a vegetarian lifestyle?

7. By North American standards the 'Life Choice' diet is inconvenient, and convenience is one of the major drivers of our culture. Many of the 'Life Choice' meals involve planning, preparation and time, which people are reluctant to give in our gulp and run society.

8. People still question whether you can get adequate protein as a vegetarian, despite the fact that some of the greatest athletes in the world have been practicing vegetarians. Dave Scott (6 time Hawaiian Ironman Champion), Edwin Moses (unbeaten for 8 years in the 400m hurdles) and Martina Navratalova (who bulked up on fast food when she first came to America, and then recreated her body as a vegetarian). The claim is not that these athletes were great because they were vegetarians, but rather that they got all the protein they needed for world level performance from their diets. It is almost impossible not to get enough protein on any normal western diet.

9. Our taste buds seem to like the mouth-feel of fat because of its calorie density. Historically, fat has been the choice of our species for storing calories in preparation for times of famine. We now have refrigerators to store calories for us, but our taste -buds still respond favorably to the smooth texture of fat.

In summary, the 'Life Choice' diet suggested in 'Eat More, Weigh Less' is healthy, has a measured track record of sustained weight loss, is inexpensive and is good for the environment. However, it runs counter to our massively advertised convenience food culture. In schools, hospitals, airplanes, barbecues and cafes there is a certain hassle factor about eating vegetarian and most people succumb to the 'get along, go along' school of thought. Doctors have a hard time getting their patients to take prescribed medications and vegetarian living involves a lot more thought than taking a few pills. Typically people don't change when they see the light, but when they feel the heat, and maybe with the massive increase in obesity and diabetes and the continuing toll of heart disease and cancer, it just might be getting hot enough for people to choose Dean Ornish and health when making dietary choices.

One word of caution to Dean Ornish. He is 'consulting' with 3 of the top 12 global food giants as measured by 2001 gross income (Conagra, Pepsico and McDonalds). While it would be nice to think that some of the Ornish idealism would rub-off on corporate behemoths, it seems more likely that his input will be used to add a health related veneer to their product lines. (A visit to the Conagra web-site reveals that they have 4 major food categories to reflect the way "America eats" - Fun Foods, Comfort Foods, Favorite Foods and incongruously, Healthy Foods. Wouldn't it be better if all their foods were healthy?) Dean would do well to remember the old Chinese proverb, "He who lies down with dogs, wakes up with fleas." His long time accountant for the Preventative Medicine Research Institute is the Arthur Anderson organization.

Body for Life
Bill Phillips

'Body for Life' is another best selling diet and lifestyle package. The style of writing is friendly, folksy and very positive. The first thing that struck me on looking through the book was the gallery of 'before and after' photographs of clients of Bill Phillips. People are transformed from unsmiling, pasty, potbellied, scrawny individuals to grinning, tanned, flat-bellied, muscular body-beautifuls, with better haircuts. Many years ago Charles Atlas used the same sort of pictures to show how 'dynamic tension' (i.e. isometrics) could change 100 lb. weaklings into heavily muscled gods, who no longer tolerated sand being kicked on them by beach bullies.

'Body for Life' differs from other diet focussed programs in a number of significant ways:

1. A key part of the program involves strength training, using free weights and machines. The exercises are well illustrated, and are also featured on the well produced 'Body for Life' web site.

2. Both the strength training and aerobic training use the "high point" technique, which is a variation of Borg's 'perceived exertion' principle. The 'high point' is one of maximal effort for each activity.

3. Phillips is very specific about patterns of eating and provides lists of "Eating for Life Authorized foods". This includes some lean meats, low fats and what he refers to as 'quality carbohydrates'. Plenty of vegetables are featured and it's generally a good list of nutrient rich foods. The pattern of eating to be followed is 6 meals a day 6 days a week. Phillips recognizes that 6 meals a day could be time consuming and suggests that for 3 of the meals you consume his "high-tech nutrition shake, Myoplex" which has been 'scientifically designed to starve fat while feeding muscles'. A 1-800 number and web site are provided so you can order Myoplex. (Phillips notes" I'm not the type to take handfuls of vitamin pills and whatnot. I'm too busy for that, and my guess is that you are, too.) The thought does occur that if you are too busy to eat a handful of vitamins, you might also have trouble finding the time for 6 meals a day. A unique feature of the eating program is that once a week you have a "free day" when you can eat whatever you please. Psychologically this is astute, as people still feel able to 'indulge' themselves occasionally. Like Dr. Atkins, Bill Phillips lets you know you can still have the occasional burger. "If you want a Big Mac or two for lunch, go for it." However, reframing this, suggests that the six days are to be endured so that you can have one day of fun eating. Surely if you are going to 'eat for life' you should enjoy food every day.

4. 'Body for Life' is big on structure and recording. Forms are provided for recording eating, aerobic activity and strength work. In general this is a good idea because, until we start writing things down accurately, we have a huge capacity to deceive ourselves. The palest ink is better than the strongest memory.

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5. 'Body for Life' is a discreet 12 week program. It is specific, demanding and is basically a boot camp for the body.

6. 'Body for Life' began with a challenge in which a Lamborghini was offered as a prize for the best essay about how the 12 week 'Body for Life' program had transformed a person's life.

7. Bill Phillips practices his Universal Law of Reciprocation by donating money from the sale of his books to the 'Make a Wish Foundation'.

So there you have 'Body for Life', which is a structured 12 week exercise program during which you are encouraged to eat 6 meals a day from Bill Phillips 'authorized' list of foods, or have meal replacements in the form of Phillips' Myoplex shakes. Phillips seems like a nice guy with almost Anthony Robbins-like motivational skills

. I feel that 'Body for Life' is a decent exercise program upon which Bill Phillips has built a mountain of expectations. Anecdote is heaped on anecdote to describe the wonders of his 12 week program. The before and after pictures imply that in just 20 minutes a day you can have the physique of a competitive level body builder. Like Dr. Atkins he provides absolutely no statistical evidence for the success of his program and it would be such easy research to do.

His "scientific" information cries out for some form of documentation. For instance, on page 65 of 'Body for Life' we see that 'Scientific studies indicate that fat is burned much faster - up to 300% faster - when you exercise in the morning as opposed to doing the same exercise in the afternoon" and "Research indicates.....the majority of calories will be used up after our workouts, provided we don't eat for one hour after our exercise sessions." No first year college student could get away with phrases like 'scientific studies indicate' and 'research indicates', nor would they want to, if they wished to retain any credibility.

In many ways, 'Body for Life' is a misnomer as virtually the entire book is devoted to the 12 week program. There is lip service given to continued growth but little guidance. A program as regimented as this, with its 6 meals a day on authorized foods, tightly structured weight training and aerobic sessions and recording is probably not a program that people will do for life.

There is nothing about flexibility exercises in 'Body for Life' and I feel that in general Bill Phillips' approach is inflexible and not suited to being integrated as part of an ongoing lifestyle. As I read the book, I felt as though a TV infomercial had been transformed into the medium of print.

A Clinic Based Diet
Bernstein Health and Diet Clinics

The Bernstein Health and Diet Clinics began in Ontario, Canada and quickly spread throughout the Province with over 40 locations. They have now moved to British Columbia and have recently opened 3 clinics in the Vancouver area. The Bernstein program is a nursing supported, medically supervised program aimed at rapid weight loss (at least 10 lbs. a month) and is particularly suitable for people who have large amounts of weight to lose. They had some great publicity when Canada's leading late night talk show host, Mike Bullard, who was a Bernstein client, changed shape before the nation's eyes, getting slimmer and lighter week by week.

The diet is low carb., low fat, low calorie and uses controlled supplementation. The program is rigorous and disciplined and is designed to put people into ketosis. Clients who are careless and undisciplined in following the diet are not allowed to stay in the program.

I have no long-term data on the success of the Bernstein program, but it has an impressive record in getting people to lose weight rapidly. One of the realizations that occurs when working with people who've lost a considerable amount of weight, is that our medical system is prepared to spend untold millions of dollars treating the side effects of obesity, but does little to address obesity itself. Our society typically sees a major role of a physician as prescribing medication, but the physicians at the Bernstein clinics often have to make decisions involving reducing or eliminating medications for such conditions as hyperlipidemia, hyperglycemia, hypertension and type II diabetes. A number of chronic conditions also respond positively to weight loss, including chronic fatigue, fibromyalgia, osteoarthritis and depression.

Dr. Bernstein devotes a separate booklet to his Maintenance Program once clients have reached their target weight. For a nominal fee they can still get input from the support team who supervised their weight loss.

I wish data were available on the long-term success of Bernstein clients. It separates itself from other programs in the Low Carb/Low Fat debate in that it is low in both. In our permissive society it is interesting to see a program that has very clear expectations and reintroduces the concept of discipline to clients who have spent years of undisciplined consumption.

Diets on the Internet

eDiets.com

There are hundreds of diet programs on the net, which, like the diet books, feature the good, the bad and the flat out ridiculous. They all promise weight loss and they nearly all want to sell you products, especially vitamins. I am going to mention but one, namely, eDiets.com which is the Amazon of the internet diets. eDiets earned Forbes Magazine "Best of the Web" designation for nutrition/fitness websites.

In order to discuss eDiets with "Well" readers I had to pay $35.00 US to join and another $10.00 US for their fitness program. (There were many other ways to spend my money on the site, but I stopped at $45.00 US). I signed up in the afternoon and was the 2774th person to join that day. With almost a million members, one can see that diets are big business.

eDiets is an awesome piece of interactive technology which customizes your diet and exercise program as fast as you can type in your information. Once you have entered data about your age, weight, fitness and goals you can then access your totally customized fitness program. You are asked what equipment you have access to, and up comes your daily program picturing your activities on your equipment.

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eDiets has an excellent team of experts and I feel that their dietary suggestions are realistic and healthy. They make good use of the interactive capabilities of the net and you can get well-informed responses to all you questions. Modifying your diet or fitness program is easy. They offer support groups for your specific gender and age group, newsletters, coupons for obtaining groceries and health related products and a stream of reminders to keep your diet on track.

The ubiquitous Dr. Andrew Weil offers a line of vitamins and supplements but I was happy to see that all the after tax profits from his Polaris products go to fund his non-profit Polaris Foundation dedicated to integrated medicine.

eDiets has been built for the web and is way more than a book that you can access on your computer. It makes use of interactive technology to record, reinforce and inform. It is flexible and user friendly and can accommodate all age groups, fitness levels and dietary preferences.

If you follow through on their dietary and exercise suggestions, I feel that you will get your money's worth.

So You Want to Lose Weight?
Some Thoughts by Martin

«You know it don't come easy.» ~ Ringo Starr

Over millions of years we have evolved as a vigorous active animal species who hunted and searched for food in the wild and, when it was available, ate to excess as a hedge against future shortages. In the 21st century our species with its design for physical activity and ability to survive famines has been dropped into an environment where minimal movement is the norm and massive amounts of prepared food is available at every turn. It is a formula for disaster and the disaster is happening before our eyes with men, women and children eating themselves into health threatening oblivion. This lifestyle is proving to be exportable beyond North America and I was recently speaking to a lawyer from the Arab Emirate, Qatar, where a remarkable 57% of the 200,000 plus Qataris are not just fat, but obese. Diabetes is rampant and perhaps the only good thing they have going for them is that they dress in flowing robes which hide their bodies from the world.

Dr. Walter Willett of the Harvard School of Public Health says, "sedentary lifestyles and a cornucopia of food have transformed people into the equivalent of corn-fed cattle confined into pens. We have created the great American feedlot."

So he gave up his diet and sat in a tree And ate himself to eternity. From 'The Phenomenal Cat' ~ Ray Davies, The Kinks

7 Steps To Lose Weight and Keep it Off For People who Really, Really want to be Slimmer

I don't have space for a diet book and I'll focus this section on people who need to lose at least 25 lbs. and probably a whole lot more.

1. FOR THE HEALTH OF IT The poet Spencer said, "We are part animal, part child, part scholar and part saint, but first be a good animal."

   There are many reasons to lose weight, but a primary one is to be a good animal so that you can function at a high level. People lose weight to look better when they fall in love; they lose weight for high school reunions and for vanity. The best reason to lose weight is for your health; being overweight is associated with many major chronic diseases. Therefore, however you decide to lose weight make sure it's healthy. I recommend staying away from pills and surgery if possible. If the weight gain was associated with your lifestyle, it is best addressed by a lifestyle solution. Medical solutions such as pills and liposuction might temporarily deal with the symptoms, but don't address the underlying causes. There is little point in sacrificing your health to an unhealthy diet regimen. As Dr. Lee et al show in the following graph, in terms of longevity, you are better off being fat and fit, than slim and unfit.

   

2. YOU HAVE TO CONSUME A LOT FEWER CALORIES THAN YOU BURN. FOR THE INITIAL 8 WEEKS OF THE DIET, EAT APPROXIMATELY 1000/1200 HEALTHY CALORIES A DAY. [Note: Successful participants in the National Weight Control Registry average1400 calories a day and expend 400 calories in physical exercise.]

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   Over the years I have changed my thinking about the initial phase of a diet. I believe it is psychologically important to experience weight loss in response to your changes in eating and exercise. When I wrote the Official Weight Loss Manual for the Canadian Federal Government in 1984, it was a lifestyle modification book called "The Phacts of Life" that shaped eating and exercise behaviors by making a 250 calorie difference each day. But in the Brave New World of the 2000's a 250-calorie difference each day would mean losing just over 2 lbs. (about 1 k.) in a month.

   IF YOU ARE VERY FAT, NO ONE WILL NOTICE 2 LBS. NO ONE WILL SAY, "OH, YOU'VE LOST SOME WEIGHT, GOOD FOR YOU." YOU'LL LOOK IN THE MIRROR AND THINK, "MIRROR, MIRROR, ON THE WALL, WHO IS THE FATTEST OF THEM ALL?" AND THE ANSWER WILL COME BACK, "YOU".

   It is psychologically devastating to make a commitment, give up your cookies, ice cream, wine and cake, drive past your favorite fast food outlet, throw away your chocolate and even start a walking program and nobody notices that you've lost weight.

   I want you to lose weight quickly so you are soon reinforced by your friends and colleagues. I want you to lose weight fast so that you can experience the difference with you own senses.

   SEE THE DIFFERENCE; FEEL THE DIFFERENCE IN THE FIT OF YOUR CLOTHES, AND EVEN TASTE THE DIFFERENCE AS YOUR TASTE BUDS COME BACK TO LIFE

   Psychologically it is easier to make a big change than a minor change. When you are eating a healthy 1000/1200 calorie diet it actually frees you from having to make a lot of difficult decisions. In a supermarket you don't even need to look at the bakery section; candy and ice cream are irrelevant and only the no-fat items in the dairy cases need be considered. Celebrations can be honored with something other than food or drink and if people ask why you are not eating more, politely explain it's at your doctor's suggestion.

3. YOU NEED TO BECOME AWARE OF CALORIES.

   Many diet gurus tell you that you needn't count calories on their diet. 'The Zone' has nutrient 'blocks', 'Body for Life' has portions, Dr. Atkins cuts out most of your carbs and lets you eat fat and Dr. Ornish slashes the fat and lets you fill yourself on fruit and vegetables.

   The simple truth is that if you consume more calories than you burn you will put on weight. If you burn more calories than you consume you will lose weight.

   CALORIES COUNT SO YOU NEED TO COUNT CALORIES. YOU NEED TO BE AWARE OF CALORIES, YOU NEED TO KNOW HOW MUCH EXERCISE IT TAKES TO BURN OFF YOUR FAVORITE FOODS, OR EVEN YOUR DIET FOODS.

   Using my pedometer I've started thinking of food in terms of the number of steps it takes to burn it off. (see articles in 'Well' Spring and Summer 2002 issues) It takes about 20 steps to burn off one calorie and I was amazed to discover that one Triscuit (21 calories) with nothing on it would take 400 steps to walk off. A supersized McDonalds meal with Coke and fries is the equivalent of 35,000 steps (about a 6 hour walk). Once you understand this it becomes obvious that :

   IN ORDER TO LOSE WEIGHT YOU MUST CUT DOWN THE CALORIES YOU PUT IN YOUR MOUTH.

   Telling someone who is trying to control their weight that they needn't be aware of calories is like telling someone who is trying to manage their bank account that they needn't be aware of money. One of the early diet doctors, Dr. Herman Taller, actually wrote a book called, "Calories Don't Count" which was a high fat, low carb program. He was subsequently convicted on 6 counts of mail fraud for promoting a brand of safflower capsules, which the court called a "worthless scheme foisted on a gullible public."

4. EXERCISE

   I have spent my life as an exercise physiologist with a broad interest in athletics and physical activity. It sounds like heresy, but the chances are you will not lose weight with an exercise program. I remember talking with Dr Kenneth Cooper in the early 70's when he was doing his pioneer work on "Aerobics" (he actually created the word) and he talked of his experience in the U.S. Air Force. A percentage of airmen in basic training were so fat that they were not fit to serve their county. They were put in a special training group designed to take the weight off, affectionately known as the 'Baby Whales'. Initially Cooper tried to exercise them nearly 8 hours a day, but this did not have a big impact on their weight. He then put them on a 1000 calorie a day diet and added exercise and the weight came falling off, leaving these young men in the best shape of their lives. For the first 2 months while you are on a highly restricted diet you must exercise a minimum of half an hour a day. This is about 1/50th of your day and if you can't find time for that, you are really not committed to the program. I love the concept of 10,000 steps, and a pedometer is a great investment to motivate you to do a minimum health sustaining walk. Although you won't lose a lot of weight on a walking program, it will firm up muscles, help the circulation and open up your mind. (Great thoughts begin in the muscles). Day by day you might be burning an extra 250 calories a day, which isn't much in a week, but does add up to 25 lbs. of weight burned off in one year. Caloric restriction is the key to weight loss, but movement is the key to weight maintenance. In addition to your walking or other cardiovascular activity, include regular strength and stretching exercises. Of all the pieces of home fitness equipment I've found, nothing is better than the Swiss ball (exercise ball) for developing general strength and flexibility. (See article in Spring 2001 issue of our Well newsletter entitled 'Size Matters' by Guy LeMasurier)

   

5. FOOD SELECTION

   If you want to lose weight cut out all the junk. This means ice cream, pop, cake, cookies, french fries, chips, burgers, doughnuts, cream sauces etc. Also watch out for the sugar which is hidden in hundreds of commercial products; read the labels. My recommendation is for an Ornish plus sort of diet. With plenty of fruits, vegetables and grains, and your choices of healthy, lean protein such as fish, lean beef and poultry. You will be saving money on junk food, so spend a little extra to get organic vegetables, free range meat and non-farmed fish. By learning to use herbs and spices you can always be eating great tasting, low fat food.

   As a safety net, by all means add a good multi-vitamin, fish oil capsules and any other supplements of your choice. Once your weight is approaching your goal my modified food pyramid is a useful guide to food choices and lifestyle.

6. MINDSET

   This is tremendously important. The mindset must be that, "I'm going to comply with my eating program. I am not going to look for loopholes, short cuts, free passes or Papal dispensations. If I do deviate, I will get right back on the program."

   Many diet authors will tell you that it is not a question of willpower, but IT IS!! It does take willpower to teach your body/mind not to eat food just because it's available. It takes willpower to say "no". It takes willpower and a conscious effort to ignore the come-ons of the fast food franchises. It takes willpower not to succumb to "friends" who, on discovering you're trying to lose weight, feel they're being 'friendly' by helping sabotage your program. It takes discipline, which has not been a popular concept in our permissive society.

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   James Hill Ph.D. for whom I have enormous respect notes, "In fact, I'm beginning to think that weight loss is a different process than weight maintenance, and it's the latter that is more important. Keeping it off has to do with how willing you are to change your life." Hill is the co-director of the National Weight Control Registry, which is following more than 3000 people who have lost an average of 60 lbs. and kept it off for 5 years. There is a striking similarity about how these people maintain their weight loss.

   1. Regular physical activity, averaging over 400 calories a day.

   2. Eat a low fat, high complex carbohydrate diet.

   3. Eat breakfast.

   4. Weigh themselves frequently!!

   They do not lose touch with their bodies or the realities of weight gain. In order to stay lean, you will need a lifetime of vigilance. Dr. Susan Roberts of Tufts says, "Most people who are thin can't eat everything they want, when they want it." It's not as tough as it sounds because healthy habits, like bad habits, become part of you. "Habits are too light to be noticed until they are too strong to be broken." As our new fridge magnet says, "Nothing tastes as good as slim feels."

7. RECORDING (WRITE IT DOWN)

   The palest ink is better than the strongest memory. (The Chinese have a proverb for everything) Write down your goals for weight and physical activity. Write down a plan for your meals and a shopping list and stick to it. Without a written plan you are vulnerable to impulse purchases. Remember to try and shop after you've eaten and not when you're hungry.

   Record your weight once a week. One of the characteristics of people who successfully maintain weight loss in the National Weight Control Registry is that they weigh themselves frequently. Record your weight change, record your activity and make note of changes in aerobic fitness, strength and flexibility.

   Remember most people lie to themselves and others. They underestimate the number of calories they consume and they overestimate the amount of exercise they do. Recording will help you get real.

   MAINTENANCE

   After your 2 months on a 1000/1200 calorie per day diet, gradually increase your caloric intake until you are living a healthy, active lifestyle where energy, in equals energy out and you are at a weight which feels right for you.

   Maybe this doesn't sound easy, but it's safe, sensible and it works and you're really going to like the new you.

«I just left myself today
I got up and walked away.»
~ Terry Allen

Weight Loss Warning

One of the reasons that people fail to maintain their weight loss is that they have unreasonable expectations of what will happen once they've lost weight. "When I lose these 40 lbs., I'll be happy, my spouse will like me more, work will be easier and the world will be a better place." But when your spouse is critical, (or, if you're single, no one asks you out), the promotion you expected does not happen and depression creeps back, it's easy to say, "why do I bother, I might as well eat whatever I like." You tell yourself, "things couldn't be worse" but, of course, they can.

«One thing they don't tell you 'bout
The blues when you got 'em
You keep fallin' 'cause there
Ain't no bottom
There ain't no end.»
~ Emmy Lou Harris

It's a lot tougher to beat the blues when you're overweight and sick than when you are slim and healthy. Whatever else happens, or doesn't happen, eating well and exercising gives you a sense of being in charge and of doing your best to honor the gift of life that you've been given. You don't need a guru; you don't need to buy special foods or sign up for an Internet diet. More than half the successful people on the Weight Control Registry follow their own program. In my song, "Guru du jour" the last verse says it all.

«You are the trainer
The dietitian is you
You're the psychologist
You're the guru.»

REBUILDING THE PYRAMID

The original USDA pyramid was modified by Dr. Walter Willett. Martin has added his own spin to the schematic. Fruits and vegetables form the foundation of the pyramid as they are the major source of health giving, cancer fighting antioxidants and nutrients and can assist in weight maintenance.