3-Hour Diet

Definition

The 3-Hour diet is based on the concept that weight loss is best achieved by eating small amounts frequently, in this case, every three hours.
Origins

The 3-Hour diet was originated by Jorge Cruise in the mid-2000s, Cruise was an overweight child who went on to lose weight, shape up, and become a self-proclaimed weight-loss expert. He has no formal nutrition training.

Cruise is the author of the New York Times bestseller 8 Minutes in the Morning, an exercise and diet program, and The 3-Hour Diet. He is a columnist for USA Weekend Magazine and is the diet and fitness editor for Good Housekeeping magazine. Cruise has discussed his diet and fitness philosophy on many television talk shows and is the weight-loss coach on AOL. He maintains a Web site at

Description

The 3-Hour diet is a diet regimen based on the philosophy that the timing of meals is more important than the type of food eaten in those meals. Cruise says the body’s basal (baseline) metabolic rate (BMR) can be increased by eating every three hours. Keeping the metabolic rate high is desirable because this makes the body burn more calories.



The three basic rules of the 3-Hour diet are:

* Eat breakfast within one hour of arising.
* Eat every three hours after that.
* Stop eating three hours before going to bed.

The 3-hour diet requires three meals alternating with two snacks at regular three-hour intervals. Certain foods are recommended, but the diet does not provide a day-by-day meal plan. Cruise also recommends drinking eight glasses of water daily. On the diet, caffeine is not limited, but dieters must drink two glasses of water for every cup of coffee. This offsets the dehydrating effect of caffeine, Cruise says. Alcohol is to be drunk only rarely. However, the diet does allow occasional fast food and some frozen or processed foods. One key to success on the 3-Hour diet is planning meals and snacks ahead of time. Knowing what they will eat for the next meal helps dieters stick to the diet.

The 3-Hour diet is not a low carbohydrate, high protein, or very low fat diet. Meals are required to consist of a reasonable balance of carbohydrates, protein, and fats. The emphasis is on choosing appropriate foods and on strict portion control. Although Cruise claims people can eat anything they want and still lose weight on his diet, in reality, by following the diet correctly, an individual is limited to about 1,450 calories a day. Many nutritionists consider this an appropriate calorie intake for slow, steady weight loss. Cruise claims that people following the 3-Hour Diet will lose 2 lb (0.9 kg) per week, and that they can target the spots on the body where they can lose fat. The diet is intended to last 28 days, with a repeat cycle for people who need to lose more weight.

The exercise aspect of the 3-Hour diet is somewhat confusing. Cruise initially claims that exercise is not a part of this weight-loss program and that the 3-Hour diet is good for individuals with arthritis or limited mobility. However, he also says that building muscle mass is important in weight loss because even at rest a pound of muscle burns twice as many calories as a pound of fat. This occurs because metabolic activity is higher in muscle cells. Ultimately Cruise does suggest exercises to go along with the 3-Hour diet, and they are generally not appropriate for people with sore joints or mobility limitations.

Function

Jorge Cruise claims that his 3-Hour diet will reprogram the body’s BMR and allow people to lose 2 lb a week. According to Cruise, if the body goes too long without food, what he calls the starvation protection mechanism kicks in. When this happens, the body begins to conserve energy, use fewer calories, and burn less fat. It is true that starvation causes the body to take action to conserve metabolic fuel. However, as a review of The 3-Hour Diet on the American Dietetic Association Web site points out, there is no scientific proof that going three hours between meals causes the body to think that it is starving or that eating every three hours will change the BMR.

Cruise also claims that dieters can target specific parts of the body from which to lose inches. There is no research to show that this is true, although specific exercises may build muscle and tone certain spots.
Benefits

The 3-Hour diet benefits dieters by providing a blueprint for relatively low calorie, balanced meals. People who are mindless or unconscious eaters often benefit from eating on a schedule. The 3-hour approach also helps to curb binge-eating behavior. Because they are required to eat at prescribe times, dieters do not get so hungry that they gorge themselves at the next meal. Nighttime eaters also benefit from the prohibition against eating three hours before going to bed. Another benefit of this diet is that it uses regular supermarket food, which keeps the cost reasonable. There are no required fees to participate.

One common complaint about the diet is that meal plans and menus are limited unless the dieter joins the optional fee-based Web site associated with the diet. Membership to the Web site is sold in 13-week blocks. Another complaint is that the dieter is strongly encouraged to buy Jorge Cruise dietary supplements to take while on the diet.

Precautions

As with any diet, people should discuss with their physician the pros and cons of the 3-Hour diet based on their individual circumstances.
Risks

There appear to be few risks to following this diet.

Research and general acceptance

The 3-Hour diet did not appear until the mid-2000s and as of 2007, no scholarly research has been done on it. There has been some research on the effects of eating many small meals instead of three large ones on dieting success. The results have been mildly favorable. Many weight-loss professionals support the idea of distributing calories across five or six meals during the day.

No research has been done on the ‘‘resetting’’ of BMR by eating small, frequent meals. The consensus among nutritionists is that people who lose weight on the 3-Hour diet do so more because calories are restrict to under 1,500 a day than because of any specific value in the 3-hour timing of meals. The timing may, however, help people to change their eating behaviors in constructive ways.

Resources top
BOOKS

Bijlefeld, Marjolijn and Sharon K. Zoumbaris. Encyclopedia of Diet Fads. Westport, CT: Greenwood Press, 2003.

Cruise, Jorge. The 3-hour Diet: How Low Carb Makes You Fat and Timing will Sculpt You Slim. New York: Har-perResource, 2005.

Cruise, Jorge. The 3-hour Diet Cookbook. New York: Collins, 2007.

Icon Health Publications. Fad Diets: A Bibliography, Medical Dictionary, and Annotated Research Guide to Internet References. San Diego, CA: Icon Health Publications, 2004.

Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.
ORGANIZATIONS

American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website:

JorgeCruise.com, Inc. PO Box 6220, San Diego, CA 92166. Office Telephone: 619) 523-3035 Customer Support Line: (877) 465-6743 Fax: (619) 374-2004. Website:
OTHER

Harvard School of Public Health. ‘‘Interpreting News on Diet.’’ Harvard University, 2007.

Health Diet Guide ‘‘3-hour diet.’’ Health.com. 2005.

United States Department of Health and Human Services and the United States Department of Agriculture. ‘‘Dietary Guidelines for Americans 2005.’’ January 12, 2005.

WebMD. ‘‘The Pritikin Principle.’’

Tish Davidson, A.M.
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3-Day Diet

Definition

There are a variety of three-day diets that circulate from person to person and on the Internet. They tend to promise weight loss of 10 lb (4.5 kg) or more in just three days.
Origins

The origins of the three-day diet are unclear. Some people believe that they go back to the 1980s when these kinds of diets were faxed from person to person. Three-day diets go by many different names, including the fax diet, Army diet, Navy diet, Cleveland Clinic diet, and many others. Often they are just referred to as three-day diets. Although many versions of this diet claim to have been created by one medical institution or another, no medical institutions have ever been known to come forward to claim responsibility for, or even to recommend, one of these diets. Many institutions that have these diets named after them, such as the British Heart Foundation or the Cleveland Clinic, go out of their way to inform dieters that the diet did not originate where its title claims.

The most common form of three-day diet on the Internet involves eating a large quantity of tuna and various vegetables during the day, with ice cream each evening. This diet seems to be similar to, or the same as, the three-day diet sold online by 3daydiets.net. It is unclear, however, if they are the developer of the diet, as they do not claim specifically to be.

Description

There are many versions of three-day diets circulating, all with the promise of bringing dieters significant weight loss in just three days. There are many variations in what dieters may and may not eat during these three days. One diet even calls for dieters to drink only water for the first day. On the second day dieters may eat fruit, and drink only fruit juice, and on the third day dieters may eat only vegetables, and drink only vegetable juice.


The most common three-day diet, and the one that seems to be the most popular, is a three-day diet with a meal plan that instructs dieters what to eat for breakfast, lunch, and dinner. The specifics of the plan vary, as do what dieters are allowed to drink while on the plan. Some versions allow anything, others specify just water and diet soda in addition to the coffee and tea called for in the meal plan. Many require that dieters drink at least four glasses of water daily. Some allow diet soda to be substituted for the water. A common version of the three-day diet meal plan is:

Day 1

Breakfast: black tea or coffee, 1/2 a grapefruit, 1 piece of toast with 1 Tablespoon of peanut butter. Some version specify 1/3 of a grapefruit, some call for artificial sweetener to be added to the coffee, some allow grapefruit juice to be substituted for the grapefruit.

Lunch: 1/2 cup tuna, 1 piece dry toast, black coffee or tea. Some versions call for tuna in water, some call for artificial sweetener with the coffee or tea.

Dinner: 3 ounces lean meat, 1 cup green beans, 1 cup carrots, 1 apple, 1 cup vanilla ice cream. Some versions specify a low fat ice cream, other do not. Some versions call for 1 cup of beets instead of carrots.

Day 2

Breakfast: 1 egg, 1 slice dry toast, 1/2 banana, black coffee or tea. Some versions require artificial sweetened in the coffee or tea. It is not generally specified how the dieter should prepare the egg. Some versions call for a whole banana.

Lunch: 1 cup cottage cheese and six crackers. Some versions allow dieters to choose between 1 cup of cottage cheese and 1 cup of tuna. Some require six crackers, some allow eight. Most versions call for Saltine brand crackers.

Dinner: two hot dogs, 1 cup broccoli, 1/2 cup carrots, 1/2 banana, 1/2 cup vanilla ice cream. Some versions specify beef franks. Some call for 1 cup of cabbage instead of 1 cup of broccoli. Some versions require low fat ice cream.

Day 3

Breakfast: one apple, 1 ounce cheddar cheese, five Saltine brand crackers, black tea or coffee. Some versions allow or require artificial sweetener.

Lunch: one hard-boiled egg, one slice dry toast. Some versions allow black coffee or tea (with or without artificial sweetener) with this meal, others do not.

Dinner: 1 cup tuna, 1 cup carrots, 1 cup cauliflower, 1 cup melon, and 1/2 cup vanilla ice cream. Some versions call for 1/2 a cantaloupe instead of 1 cup of melon. Some versions require low fat ice cream.

There are other versions of the above three-day diet, with some specifying even more alternatives for the dieter, including an orange instead of grapefruit, cottage cheese instead of tuna, and various vegetable substitutions. Most versions tell dieters to use lemon, salt and pepper, mustard, vinegar, herbs, soy sauce, ketchup, Worcestershire sauce, and other seasonings to add flavoring to food during the diet, but nothing containing fat, such as butter. Most versions of the diet are very specific in saying that dieters have to follow the rules exactly to see the promised weight loss.

Function

The three-day diet usually promises that dieters will be able to lose 10 pounds in three days if the diet is followed exactly. Often the diet claims that this will result because the combination of foods called for by the diet causes some kind of increased metabolism that will burn pounds of fat. It is never made clear exactly what kind of reaction this is supposed to be, or how it is supposed to work. Often the diet says the dieter can repeat the diet after a few days of regular eating. Some version of three-day diets allow for as few as two days of normal eating, others require up to four or five. The three-day diets are intended to provide a dieter with extreme weight loss in a very short time and are not intended to change the dieters lifestyle or overall eating habits. Usually the diets go so far as to tell a dieter to eat whatever he or she was eating before the diet once the diet is over. The diets only caution is not to overeat. No exercise recommendations are made with three-day diets. Weight loss is supposed to come from increased metabolism and lowered calorie intake alone.

Benefits

There are many benefits to weight loss if it achieved at a moderate pace through healthy eating and exercise. Three-day diets, however, are not considered moderately paced and do not include exercise, or a well-balanced diet. Although the diets claim that a dieter can lose 10 pounds in three days, weight loss is likely to come mainly from lost water weight. There may be some psychological benefit to quick weight loss, but this is likely to be undone if the weight is gained back quickly after the diet is over.

Precautions

Anyone thinking of beginning a new diet should consult a physician or other medical professional. Daily requirements of calories, fat, and nutrients can differ significantly from person to person depending on age, weight, sex, and other factors. Talking to a doctor can help a dieter determine which diet is safe for that dieter’s individual needs, and a doctor can help a dieter choose a diet that fits in well with his or her long-term weight loss goals. Pregnant or breastfeeding women should be especially cautious when thinking of beginning a new diet because when a baby is receiving nutrients from its mother, what the mother eats can have a significant impact on the growth and development of the baby.

Risks

There are some risks associated with any diet, but diets that severely limit calories or the variety of foods that dieters may eat tend to be more risky than well balanced, moderately calorie-reduced diets. The most common three-day diet requires dieters to eat only about 1,000 calories a day, with some versions that have been analyzed consisting of at as few as 700 calories per day. This is too few for most people to maintain good health. A diet that contains fewer than 800 calories per day is considered a very low calorie diet. Very low calorie diets carry high risks of side effects, such as gallstones and cardiovascular problems. Very low calorie diets are only intended for the extremely obese who are experiencing significant medical problems due to obesity. These diets are carried out under the close supervision of physicians. They are not intended, or safe for, dieters to follow on their own.

QUESTIONS TO ASK THE DOCTOR

* Is this diet safe for me?
* Is this diet the best diet to meet my goals?
* Do I have any dietary requirements this diet might not meet?
* Would a multivitamin or other dietary supplement be appropriate for me if I were to begin this diet?
* Is it safe for me to follow this diet over an extended period of time?
* Are there any sign or symptoms that might indicate a problem while on this diet?

Dieters who follow a three-day diet may find that any weight lost is gained back as soon as the diet is over, and may even find that more weight is gained that was lost. Having a very low caloric intake makes the dieter’s metabolism slow down because the body thinks that it is starving. Then when a normal number of calories are reintroduced into the diet, the body wants to store extra fat in case there is a period of starvation again. This natural defense mechanism of the body against starvation can cause dieters who alternatively eat very few calories and then return to normal eating to gain large amounts of fat over time, even while they are trying to diet. Very low calorie diets pursued over only a few days also promote binge eating at the end of the diet.

Many of the versions of three-day diets, especially those intended for fasting, carry a high risk of vitamin and mineral deficiency. The body needs food from each of the food groups every day for good health. Drinking only fruit juices, or eating any very limited variety of foods, can make it nearly impossible for a dieter to get all of the nutrients required for good health. Any dieter considering this kind of diet should consult a physician about an appropriate multivitamin or supplement to help reduce this risk of deficiency. Multivitamins and dietary supplements carry their own risks, and can not replace a healthy, well-balanced diet.

Research and general acceptance

Three-day diets are not generally accepted as healthy, effective ways to lose weight for the long term. Although no scientific studies have been carried out to determine the effectiveness of common three-day diets, experts suggest that anything that promises dieters 10 lb (4.5 kg) of weight loss in three days is unlikely to be taking off fat. Instead, dieters are probably losing water weight, with possibly a little fat loss and some muscle mass loss through the reduced caloric intake.

The United States Department of Agriculture makes recommendations for a healthy diet in its MyPyr-amid food guidelines. MyPyramid gives recommendations about how many servings of each food group are required daily for good health. These recommendations can be found at Any diet that will produce sustainable, healthy weight loss should follow these guidelines and include foods from each food group every day. Sustainable diets should not be extremely restrictive of any food group, or be extremely calorie-reduced.

Many studies have shown that exercise and diet are more effective at producing weight loss when done together than either is done alone. Three-day diets do not usually have any exercise recommendations. Instead, they generally claim that a combination of foods will magically melt away fat without the dieter having to expend any effort. Healthy weight loss plans should include both a diet and an exercise component. As of 2007, the Centers for Disease Control recommended that adults get a minimum of 30 minutes of light to moderate exercise each day for good health.

Resources top
BOOKS

Shannon, Joyce Brennfleck ed. Diet and Nutrition Source-book. Detroit, MI: Omnigraphics, 2006.

Willis, Alicia P. ed. Diet Therapy Research Trends. New York: Nova Science, 2007.
ORGANIZATIONS

American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website:
OTHER

The Diet Channel. ‘‘3 Day Diet.’’ 2007.

Tish Davidson, A.M.
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Jenny Craig Diet

Jenny Craig is a calorie-based three-stage lifestyle weight-loss program that incorporates pre-packaged food, transition to regular food, and long-term weight maintenance.

Origins

Jenny Craig and her husband Sig Craig founded Jenny Craig Weight Management Program in Australia in 1983. The program has since expanded to the United States, Canada, New Zealand, and Puerto Rico and offers both a center-based program and an at-home program. Craig, who has no training as a nutritionist, based her program on her own successful experience with personalized weight loss. The program has a medical advisory board consisting of at least one physician, nutritionist, and behaviorist. Prepackaged meals are planned by a registered dietitian.

Description

The Jenny Craig program is a three-stage program. In the first stage, dieters eat only Jenny Craig prepackaged foods that are supplemented with approved fruits, vegetables, and non-fat dairy products. These meals contain 50–60% carbohydrates, 20-25% protein, and 20–25% fats, and contain between 1,200 and 2,500 calories daily. This generally is in line with the federal Dietary Guidelines for Americans 2005. Vegetarian options are available. However, no other food is permitted during the first stage of the program, which can make eating away from home difficult. The prepackaged meals are intended to model healthy eating and portion control. In the United States in 2007, the cost of one month of pre-packaged meals was about $500. A personalized exercise program supplemented by optional workout videos and workout equipment encourage the dieter to become more active.

Once dieters have used the pre-packaged meals to become familiar with healthy foods and correct portion sizes, they move to the second stage of the program in which written material supported by consultants teach techniques for healthy meal planning, cooking, and eating out. This stage of the program is designed to develop lifelong habits of moderation and good food choices. The consultant also addresses behavioral issues such as handling stress and emotional triggers for eating.

The final stage of the Jenny Craig program is a maintenance stage. Dieters move into this stage when their weight-loss goal is met. This final stage is designed to keep weight off for life.

Dieters can join the Jenny Craig program in one of two ways. Jenny Craig Weight Loss Centers are physical locations that the dieter visits weekly for individual consultations with a Jenny Craig counselor. Unlike some other center-based weight-loss programs (e.g. Weight Watchers), Jenny Craig centers do not offer group meetings. The philosophy behind the Jenny Craig program is one-on-one weight loss help.

Dieters who live too far from a Jenny Craig center or who do not wish to attend one can join Jenny Direct. This is a complete at-home weight-loss program. In the Jenny Direct program, pre-packaged meals and weight-loss literature are delivered to the dieter’s home. The dieter is supported by online tools accessed through the Jenny Craig Web site and a required private 15-minute telephone consultation with a Jenny Craig consultant once a week. Consultants do not have formal training in nutrition.

The Jenny TuneUp is targeted at people who have fewer than 20 lb (10 kg) to lose. It is an entry-level program with a low enrollment fee. In 2007, the Jenny TuneUp was advertised in the United States as “Lose 20 lb for $20.” JennyOnTrack is a six-month program, and Jenny Rewards is a long-term program. Jenny Craig does not reveal the enrollment costs of the OnTrack and Rewards programs on its Web site, but they amount to several hundred dollars plus the cost of food. Lifetime memberships are available, as are programs for 13-17 year olds and breastfeeding women. All Jenny Craig advertising is geared toward getting the dieter to call a toll-free telephone number for additional information.

Function

The stated goals of the Jenny Craig program are to help the dieter:

* develop a healthy relationship with food
* live an active lifestyle
* achieve a balanced approach to living

The dieter is supported in reaching these goals by a 24-hour 7-day-a-week customer care telephone line, personalized meals and activity plans, one-on-one consultant support, online e-tools, and weight-loss manuals. By achieving these goals, the dieter learns to eat healthy foods in appropriate portions, incorporate exercise into the daily routine, and nurture her (90% of Jenny Craig clients are female) mental and physical well being.

Benefits

Jenny Craig promises dieters that if they follow her program, they will lose 1-2 pounds or 1% of their body weight weekly. Once the weight-loss goal is met, a maintenance program is designed to solidify lifestyle changes and keep the weight off. Jenny Craig does not make any claims about the percentage of people who successfully keep weight off for an extended period.

The Jenny Craig program appeals to dieters who want low-calorie meals without having to weigh and measure or dieters who are embarrassed to attend group weight-loss programs. They may be a good solution for single people who do not want to cook. However dieters with families may find that the prepackaged approach is less convenient if they still have to cook for family members.

QUESTIONS TO ASK THE DOCTOR

* Are their other diet programs that would better meet my goals?
* Do I have any special dietary needs that this diet might not meet?
* At what level of intensity is it appropriate for me to begin exercising?
* Do you have any experience with the long-term success of this diet?
* If one of your family members wanted to go on a diet, would you recommend this one

Precautions

Jenny Craig is a diet and exercise program that meets the basic nutritional needs of most people. As with all diet and exercise programs, individuals should check with their healthcare provider to make sure the program is suitable for them.

Risks

Meals on the Jenny Craig plan fall within the federal Dietary Guidelines for Americans 2005, and dietary supplements provided with the pre-packaged meals assure that the dieter of getting an adequate supply of vitamins and minerals. The greatest risk to this diet program is that people do not learn how to shop and prepare healthy meals on their own. They lose weight eating the pre-packaged meals, but when they transition to the next stage of the diet, they go back to their old eating habits and gain the weight back. This type of weight cycling or yo-yo dieting can cause potential health problems.

Research and general acceptance

The main client complaint about the Jenny Craig program is cost. Prepackaged food can cost around $500 per month in addition to steep enrollment fees and optional extras such as exercise videos and equipment. Some clients complain that the Jenny Craig personal consultants do not have any formal training in nutrition, and are more like sales people than counselors. Clients also criticize the taste and selection of meals. There is no way try Jenny Craig meals before committing to the program.

The Jenny Craig Web site offers many testimonials and inspiring success stories, but is thin on results from independently conducted research studies. One preliminary study that looked at weight loss, triglyceride levels (an indication of the amount of fats in the blood) and carotenoid levels (an indication of vegetable intake) was paid for by Jenny Craig and performed by a former Jenny Craig advisory board member.

Resources top
BOOKS

Craig, Jenny. The Jenny Craig Story: How One Woman Changes Millions of Lives. Hoboken, NJ: John Wiley & Sons, 2004.

Craig, Jenny. Jenny Craig’s Simple Pleasures: Recipes to Nourish Body and Soul. Birmingham, AL: Oxmoor House, 1998.

Craig, Jenny. Jenny Craig Diabetes Cookbook: Easy Homestyle Recipes for Healthy Living. Birmingham, AL: Oxmoor House, 1997.

ORGANIZATIONS

American Dietetic Association. 120 South Riverside Plaza, Suite 2000, Chicago, Illinois 60606-6995. Telephone: (800) 877-1600. Website: .

Jenny Craig Official Website: .

OTHER

Harvard School of Public Health. “Interpreting News on Diet.” Harvard University, 2007. .

Health Diet Guide “Jenny Craig.” Health.com. 2005. .

Hitt, Emma. “Jenny Craig Diet Promotes Weight Loss, Other Health Benefits.” Medscape Medical News, October 19, 2005. .

Northwesternutrition “Nutrition Fact Sheet: Jenny Craig.” Northwestern University, January 2007. .

United States Department of Health and Human Services and the United States Department of Agriculture. “Dietary Guidelines for Americans 2005.” January 12, 2005. .

WebMD. “Jenny Craig: What It Is.” .

Tish Davidson, A.M.
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Ketogenic Diets

Definition

Ketogenic diets are a group of high-fat, moderate-protein, and very low-carbohydrate diets given to treat some children and adolescents with epilepsy, and some adults with epilepsy and other diseases. The name ketogenic refers to the increased production of ketone bodies as a result of this special diet. Ketone bodies are three compounds that are formed during the metabolism of fats and are ordinarily excreted in the urine. An abnormally high level of ketone bodies is called keto-sis, and this condition is the goal of the ketogenic diet. It is thought that ketosis helps to control the frequency and severity of epileptic seizures, even though the reasons for this effect are not fully understood as of 2007.

Origins

It has been known since Biblical times that some people with epilepsy were helped by prolonged periods of fasting, with good results. In earlier periods of history, children were kept on clear liquids for as long as two or three weeks until their seizures improved. This type of fasting, however, was obviously not sustainable as a long-term treatment. In 1921, a doctor at the MayoClinic named R. M. Wilder devised a diet for patients with epilepsy that was intended to mimic the biochemical changes that take place during fasting—ketosis, acidosis, and dehydration. Dr. Wilder’s ketogenic diet provided 10–15 grams of carbohydrates per day, 1 gram of protein for each kilogram of the patient’s body weight, and the remaining calories from fat. The calorie level was 75% of the normal daily allowance for the patient’s weight, and fluids were restricted to 80 percent. Wilder’s diet was almost identical to the protocol used at Johns Hopkins in 2007.

Until the late 1930s, the Mayo Clinic ketogenic diet was used to treat adults as well as children with epilepsy. In 1938, however, the first anticonvulsant drug—phenytoin (Dilantin)—was introduced, and was quickly followed by others. As of the early 2000s, there are 20 different anticonvulsant medications given to patients with epilepsy. After these medications were introduced, people were less interested in the ketogenic diet; many doctors considered it unnecessary or too much trouble. The number of hospitals that used it as therapy fell off sharply, while many practitioners regarded it as a “holistic” or even “alternative” treatment for epilepsy.

Interest in the ketogenic diet was reawakened in the mid-1990s, when the father of a 2-year-old with seizures that had not responded to any medications or surgical procedures read about the diet in medical textbooks. He started his son on the ketogenic diet with very good results; the child stopped having seizures and was able to discontinue his medications. The father then established the Charlie Foundation, which continues to provide information and guidance about the ketogenic diet to parents, dietitians, and other health care professionals. Since 1994, the diet has been generally accepted by doctors; it is used in about 40 countries around the world for the treatment of childhood epilepsy. The costs of the diet are reimbursed by most insurance carriers in the United States.

Description
Classic ketogenic diet (Johns Hopkins protocol)

The ketogenic diet used at the Johns Hopkins Pediatric Epilepsy Center is commonly considered the standard or classic form of this diet. Its usual protocol for children between the ages of 3 and 12 years provides a ratio of 4 parts fats to 1 part protein and carbohydrates combined. Infants, toddlers, and adolescents are usually started on a 3:1 ratio. Individual patients may require ratios ranging from 2.5:1 to.

Potential side effects of the Classic Ketogenic Diet.

✔ Abnormally high levels of blood lipids after discontinuing the diet

✔ Decreased bone density

✔ Dehydration

✔ Growth retardation caused by protein deficiency

✔ Inflammation of the pancreas

✔ Kidney stones or gallstones

✔ More frequent infections due to a weakened immune system

✔ Nausea, vomiting, or constipation

✔ Protein deficiency, causing growth retardation

✔ Menstrual irregularities

✔ Vitamin and mineral deficiency

(Illustration by GGS Information Services/Thomson Gale.).

5:1; these ratios are worked out by fine-tuning the diet once the child has been started on it.

PREPARATION. The most important aspect of preparation for the ketogenic diet is deciding whether it will benefit the child. Most doctors prefer not to use it if the child is taking medications that are effective in controlling seizures without producing severe side effects. If, however, the child has tried two or more anticonvulsants without success, or is having serious side effects from the drugs, the ketogenic diet offers a chance to have a more normal life. It helps if the child is not a fussy eater and is willing to try foods that he or she might not ordinarily choose. The child also must be capable of self-control, as eating only a few cookie crumbs or anything else containing sugar (including toothpaste and other oral care products), will break the effect of the diet and possibly bring on a seizure.

Another important aspect of preparation is commitment on the part of the entire family. It takes considerable time and care to measure food portions, test the child’s urine at home, watch for possible side effects, and keep a balance between the needs of the epileptic child and the food preferences of other family members. Parties and holiday meals may require some advice from the dietitian so that the child can have a treat that won’t break the diet and will allow him or her to enjoy the meal or party with other friends or family members.

INITIAL FAST. The classic ketogenic diet begins with placing the child on a 24- to 48-hour fast followed by a stay of several days as a hospital inpatient, so that his or her body fluids can be measured and possible side effects monitored. The reason for the fast is to force the body to exhaust its glucose supply and begin burning stored fat for energy. The foods that are given after the fast are intended to keep the process of fat burning going by providing slightly fewer calories than the body needs and providing 80% of those calories in the form of fat.
KEY TERMS

Amyotrophic lateral sclerosis (ALS)—A rare progressive and eventually fatal disease affecting the nerve cells that control movement. It is also known as Lou Gehrig’s disease. As of the early 2000s, there is some evidence that the ketogenic diet can slow the progression of ALS.

Anticonvulsant—Adrug given toprevent or control seizures.

Double-blind study—A study in which neither the researchers nor the subjects know the identity of the persons in the experimental and control groups during the course of the research.

Ketone bodies—A group of three compounds (ace-toacetic acid, acetone, and beta-hydroxybutyric acid) that are formed in an intermediate stage of fat metabolism and excreted in the urine. Measuring the level of ketone bodies in the urine of a patient on the ketogenic diet is the primary way of assessing the diet’s effectiveness.

Ketosis—An abnormally high level of ketone bodies in the blood or urine, produced when the body begins to burn fat for energy instead of glucose (sugar).

Longitudinal study—A clinical study in which the researchers follow the same group of patients over a period of time. Most studies of the ketogenic diet have been longitudinal studies.

Prior to coming to the hospital, the child’s food records are kept over a three-day period so that the doctors will know the average daily calorie intake in order to tailor the special diet to the child’s need for growth. The goal is to maintain the child’s body mass index at the 50th percentile. The amount of protein in the diet is based on the child’s age, kidney function, and stress factors. While the child is in the hospital, the parents are given a four-day educational program to help them understand the diet and give them practice in preparing meals as well as monitoring the child.

The Johns Hopkins schedule for the child’s hospital stay is as follows:.

* Sunday (night before admission): Child begins fasting at home in the evening.
* Day 1 (Monday): Child is admitted to the hospital; fasting continues; fluid intake is restricted; and blood glucose is monitored every 6 hours
* Day 2 (Tuesday): Child is given “eggnog” for dinner (1/3 of the maintenance calorie allotment for dinner); blood glucose checks are discontinued. The parents are asked to start checking the child’s urine ketone levels. Ketone levels should be between 80 and 160 mg/dL when the diet is working properly.
* Day 3 (Wednesday): Breakfast and lunch are given as eggnog (1/3 of the maintenance calorie allotment for those meals); dinner (more eggnog) is increased to 2/3 maintenance level.
* Day 4 (Thursday): Breakfast and lunch are given at 2/3 maintenance level; dinner is the child’s first full ketogenic meal (not eggnog).
* Day 5 (Friday): After a full ketogenic breakfast, the child’s prescriptions are reviewed, follow-up is arranged, and the child is discharged from the hospital.

Some hospital programs do not require fasting to initiate the child’s diet. Follow-ups for most children take place at three-month intervals, although infants may be seen monthly. Children must take multivitamins and mineral supplements (particularly calcium) while on the ketogenic diet. Anticonvulsant medications are usually continued for the first few months of the diet, but may be given in lower dosages if the child responds well to the diet, or even discontinued altogether.

SAMPLE MENUS. A typical day’s menu for a child on the standard 4:1 ratio diet, allowing 1500 calories per day:

* Breakfast: egg with bacon, made with heavy whipping cream and butter, plus an apple
* Snack: peanut butter mixed with butter
* Lunch: tuna salad made with celery, mayonnaise, and heavy whipping cream, served with lettuce
* Snack: keto yogurt (made with heavy whipping cream, sour cream, strawberries, and artificial sweetener)
* Dinner: cheeseburger with lettuce and green beans
* Snack: keto custard (heavy whipping cream, egg, and pure unsweetened vanilla flavoring)

A computer program is available (listed in the resources below) to help parents and dietitians devise menus that will take the individual child’s food preferences into account as well as keep the meal selections within the correct nutritional ratio.

TAPERING AND TERMINATION. The ketogenic diet is a long-term diet but is not intended for indefinite use in children. Most children who respond favorably to it remain on it about two years. The diet must not be stopped abruptly, however; most doctors recommend that parents slowly start to add regular foods to the child’s menu to see whether the seizures are still controlled.

Sanggye Paik Hospital diet

The Sanggye Paik Hospital diet is a version of the ketogenic diet developed in Korea for the treatment of Asian children, whose diets typically contain much less fat than the diets of Western children. The Sanggye Paik protocol does not require an introductory fast and introduces high-fat foods to the patient’s diet gradually, although it uses the same 4:1 ratio of fats to protein and carbohydrates as the Johns Hopkins protocol. It is reported to have the same proportion of successes in patients as the Johns Hopkins ketogenic diet.

Modified Atkins diet

In 2003 the Johns Hopkins treatment center initiated a case series of six children and adults who used a modified version of the Atkins diet to control seizures rather than the classic 4:1 ketogenic diet. These patients were not admitted to the hospital; did not have to fast at the beginning of the diet; did not have calories, protein, or fluid intake restricted; were limited to 10-grams of carbohydrates per day; and were encouraged to eat foods rich in fats. Half the patients showed a marked reduction in seizures.

Based on this initial success, the Johns Hopkins doctors drew up a modified Atkins diet protocol for a group of 20 children, as follows:

* A carbohydrate counting guide is given to the patient’s family
* Carbohydrate intake is limited to 10g per day for the first month
* A generous intake of fats in the form of mayonnaise, butter, oils, heavy cream, etc. is encouraged, although precise amounts are not defined
* Clear carbohydrate-free fluids and calories are unrestricted
* The patient is given a low-carbohydrate multivitamin and a calcium supplement
* Ketones in the urine are checked twice a week and weight once a week
* Low-carbohydrate store-bought products (shakes, snack bars, etc.) are discouraged for at least the first month
* The patient is given a complete blood test and metabolic workup every three months

Of the 20 patients, two-thirds had a significant reduction in seizures, 9 were able to reduce medication dosages, and none developed kidney stones.

Function

The function of ketogenic diets is therapeutic— improved control of seizures in children, adolescents, and some adults with epilepsy; treatment of some other rare metabolic disorders; and slowing the progression of such other diseases as amyotrophic lateral sclerosis.

Benefits

The benefits of the ketogenic diet are improved seizure control without the need for large doses of anticonvulsant drugs with their associated side effects. Patients who respond well to the diet are able to lead more nearly normal lives. Patients with amyotrophic lateral sclerosis or other disorders being treated experimentally with a ketogenic diet may benefit by having their disease progress at a slower rate even when a cure is not possible.

Precautions

The most important precaution to note is that the ketogenic diet is not a do-it-yourself nutritional regimen. It is a serious form of therapy and requires careful medical supervision as well as parental monitoring. Patients on the diet must be followed by an experienced treatment team, usually based in a specialized epilepsy treatment center. Even though the diet may seem like a more “natural” way to control seizures than taking medications, it is based on a highly unnatural selection of foods and forces the body to obtain its necessary energy in an unusual way.

Another important precaution is preventing the child from accidentally ingesting sugar in over-the-counter medications, toothpastes, mouthwashes, or similar products. A list of sugar-free products can be found in PDF format on the Charlie Foundation website.

Risks
Success rate

Not all patients respond to the ketogenic diet. According to the Johns Hopkins treatment center, about half the children who begin the classic ketogenic diet will have at least a 50-percent reduction in seizures within 6 months. Half of that group will show greater than 90-percent improvement, with about 15% completely seizure-free. Many families are able to taper or completely eliminate the use of anticonvulsant medications.

As of the early 2000s, there is no way to predict ahead of time whether a child will respond to the diet. It is recommended that the child follow the diet for a period of 2-6 months before deciding that it isn’t working. Ineffectiveness is the single most common reason for children’s discontinuing the diet, although some discontinue it because they cannot tolerate the foods allowed even after fine-tuning, or because of side effects. The Johns Hopkins program reports that about half the children who begin the ketogenic diet in their treatment center are still using it a year later.

Side effects

Because the 4:1 ketogenic diet is an unnatural way to obtain nutrition, it has some potential side effects. Reported adverse effects in patients using the classic ketogenic diet include:

* Growth retardation caused by protein deficiency
* Vitamin and mineral deficiencies
* Nausea, vomiting, or constipation
* Abnormally high levels of blood lipids after discontinuation of the diet
* Kidney stones or gallstones. Parents are taught to monitor the child’s urine for blood as well as ketone levels, because blood in the urine is often an early sign of kidney stone formation
* More frequent infections due to a weakened immune system
* Inflammation of the pancreas
* Dehydration
* Decreased bone density
* Menstrual irregularities (in adolescent and adult females)

Research and general acceptance

Another area of recent research is the use of the ketogenic diet in the treatment of other disorders. It appears to be beneficial in the treatment of patients with glucose transporter defects (genetically transmitted disorders in which glucose in the blood cannot cross the blood-brain barrier) and a few other inborn metabolic disorders. In 2006 a group of researchers at Mount Sinai School of Medicine in New York reported that the diet shows promise in slowing the progression of amyotrophic lateral sclerosis, a progressive and fatal disease of the nerve cells that control movement.

Resources top
BOOKS

“Carbohydrate Metabolism Disorders.” Chapter 296, Section 19 in the Merck Manual of Diagnosis and Treatment, 18th ed. Edited by Mark H. Beers and Robert Berkow. Whitehouse Station, NJ: Merck, 2007.

Freeman, John M., et al. The Ketogenic Diet: A Treatment for Children and Others with Epilepsy, 4th ed. New York: Demos, 2007.

“Seizure Disorders.” Chapter 214, Section 16 in the Merck Manual of Diagnosis and Treatment, 18th ed. Edited by Mark H. Beers and Robert Berkow. Whitehouse Station, NJ: Merck, 2007.

PERIODICALS

Benbadis, Selim R., MD, and William O. Tatum IV, DO. “Advances in the Treatment of Epilepsy.” American Family Physician 64 (July 1, 2001): 91–106.

Coppola, G., P. Veggiotti, R. Cusmai, et al. “The Ketogenic Diet in Children, Adolescents and Young Adults with Refractory Epilepsy: An Italian Multicentric Experience.” Epilepsy Research 48 (February 2002): 221–227.

Freeman, J. M., E. H. Kossoff, and A. L. Hartman. “The Ketogenic Diet: One Decade Later.” Pediatrics 119 (March 2007): 535–543.

Hartman, A. L., and E. P. Vining. “Clinical Aspects of the Ketogenic Diet.” Epilepsia 48 (January 2007): 31–42.

Kang, H. C., and H. D. Kim. “Diet Therapy in Refractory Pediatric Epilepsy: Increased Efficacy and Tolerabil-ity.” Epileptic Disorders 8 (December 2006): 309–316. This article describes the development of the Sanggye Paik Hospital ketogenic diet.

Kang, H.C., H. S. Lee, S. J. You, et al. “Use of a Modified Atkins Diet in Intractable Childhood Epilepsy.”Epilepsia 48 (January 2007): 182–186.

Kossoff, E. H., J. R. McGrogan, R. M. Bluml, et al. “A Modified Atkins Diet is Effective for the Treatment of Intractable Childhood Epilepsy.” Epilepsia 47 (February 2006): 421–424.

Turner, Zahava, RD, and Eric H. Kossoff, MD. “The Ketogenic and Atkins Diets: Recipes for Seizure Control.”Practical Gastroenterology (June 2006): 53–64.

Zhao, Z., D. J. Lange, A. Voustianiouk, et al. “A Ketogenic Diet as a Potential Novel Therapeutic Intervention in Amyotrophic Lateral Sclerosis.” BMC Neuroscience 7 (April 3, 2006): 29.

VIDEOS AND COMPUTER PROGRAMS

Abrahams, Jim, and Meryl Streep (narrator). Introductory Video to the Ketogenic Diet. This is a video for parents of children with epilepsy using the ketogenic diet. It shows step-by-step meal preparation, food choices for the diet, and frank discussions of parents’ initial concerns as well as problems that families encounter in adhering to the diet. To order the video, parents should send a written letter and a check for $10 to cover shipping and handling costs to The Charlie Foundation at the address given below.

Ketogenic Diet Program, Epilepsy Association of Maryland. Ketogenic Diet Computer Program. This is a computer program for dietitians and parents to help plan meals for a child on a ketogenic diet. It is a Windows-based program requiring an IBM-compatible machine. The computer disk can be purchased ($150 for dietitians, $75 for parents, plus $5 fee for shipping and handling) at the following address: Ketogenic Diet Program, c/o Epilepsy Association of Maryland, 300 East Joppa Road, Suite 1103, Towson, MD 21286-3018. Telephone: (410) 828-7700.

OTHER

Epilepsy Foundation. General Information about the Ketogenic Diet. Landover, MD: Epilepsy Foundation, 2007. Available online at http://www.epilepsyfoundation.org/answerplace/Medical/treatment/diet/ (accessed March 28, 2007).

National Institute of Neurological Disorders and Stroke (NINDS). NINDS Summer Program—Erika Williams. “Stimulus Train Induced Bursting as an In Vitro Model of Epilepsy,” January 11, 2007. This is an updated report on research being conducted to determine which metabolic compounds produced in the bodies of patients on ketogenic diets may be responsible for controlling seizures. Available online at http://www.ninds.nih.gov/jobs_and_training/summer/2006_students/Abstract_Erika_Williams.htm (accessed March 28, 2007).

National Institute of Neurological Disorders and Stroke (NINDS). Seizures and Epilepsy: Hope through Research. Bethesda, MD: NINDS, 2004. Available online at http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm.
ORGANIZATIONS

The Charlie Foundation to Help Cure Pediatric Epilepsy. 1223 Wilshire Boulevard, Suite 815, Santa Monica, CA 90403. Telephone: (800) FOR-KETO or (310) 395-6751. Website: http://www.charliefoundation.org

Epilepsy Foundation. 8301 Professional Place, Landover, MD 20785. Telephone: (800) 332-1000. Website: http://www.epilepsyfoundation.org

Johns Hopkins Pediatric Epilepsy Center, Meyer 2-147, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287-7247. Telephone: (410) 955-9100. Website: http://www.neuro/jhml.edu/Epilepsy/keto.html.

National Institute of Neurological Disorders and Stroke (NINDS) Brain Resources and Information Network (BRAIN). P. O. Box 5801, Bethesda, MD 20824. Telephone: (800) 352-9424. Website: http://www.ninds.nih.gov.

U. S. Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857-0001. Telephone: (888) INFO-FDA. Website: http://www.fda.gov/

Rebecca J. Frey, PhD.
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Dr. Phil’s Diet

Definition

Dr. Phil’s diet is named for Dr. Phillip C. McGraw, Ph.D., the psychologist and life strategist seen on syndicated television. Popularly known as “Dr. Phil’ he developed a line of “Shape Up!’ weight loss products and simultaneously developed and published a book titled “The Ultimate Weight Loss Solution: The 7 Keys to Weight Loss Freedom.”

The Ultimate Weight Loss Solution was promoted as a combination of healthy diet, exercise, behavior modification, and thinking differently about food.
Origins

Dr. Phil was a private practice psychologist in Wichita Falls, Texas, before starting a trial consulting firm. It was in this business that he worked with television star Oprah Winfrey, consulting with her during a 1995 trial brought against Ms. Winfrey by members of the beef industry. Shortly after, Dr. Phil began appearing on Ms. Winfrey’s syndicated television show. By 2002, he was hosting his own syndicated daily television show and had become a well-known author and popular figure.

Dr. Phil has said that for 30 years, he counseled people battling weight problems and obesity He has said that he wanted to more widely address the problem of obesity with a behavioral and nutritional approach. In 2003, he introduced the book and a line of nutritional products. The diet products were marketed by CSA Nutraceuticals, along with involvement of companies that have produced similar health and nutrition products. At the same time that the products and book were being marketed, Dr. Phil focused on weight loss themes on his television show. However, he did not refer to the weight loss products on the show. He introduced his diet on a nationally broadcast television special featuring Katie Couric and 13 weight loss challengers.

Dr. Phil’s son Jay McGraw followed in his father’s footsteps and authored a book with a similar plan written specifically for teenagers. This book also was published in 2003.

Description

Dr. Phil’s diet involved a book outlining a diet plan and a line of diet food products and supplement pills. The food products included flavored shakes and snack bars. The shakes and snack bars were fortified.
KEY TERMS

Metabolize—To produce the chemical changes in the body’s living cells that provide energy for vital processes and activities.

with 24 vitamins and minerals The products’ supplements were geared toward helping people with apple or pear body shapes. The products were only on the market for about one year.

The introduction to Dr. Phil’s book follows his “down-to-earth’ delivery style. He tells readers that he is not going to tell them what they want to hear. He says that seven critical pieces, or keys, help achieve long-term weight loss. The book is filled with personal anecdotes, self-assessment quizzes, and chapters on each key. Dr. Phil writes that those who have kept their weight off use all seven keys. The seven keys are described below.

Right thinking

Dr. Phil refers to a person’s personal truth, or whatever it is about one’s self and the weight problem that a person has come to believe. He says that part of learning to lose weight is learning to get rid of thoughts that don’t work for weight loss and instead gain access to inner power and self-control. Dr. Phil says this helps people break the negative cycle of failed weight loss efforts and negative momentum. In the chapter, Dr. Phil lists 10 self-defeating messages that people often think about weight and weight control. For example, those who have problems with weight may label themselves or be labeled by others.

Healing feelings

This key refers to the way that some people eat to medicate themselves. Dr. Phil says that often people eat in response to negative emotions such as loneliness, stress, or boredom. Dr. Phil says that admitting to emotional triggers for overeating and learning to overcome the connection between emotions and food helps gain control over eating. The key helps to identify a process that is broken down into five manageable steps. Dr. Phil talks about forgiving one’s self and about learning to cope without food.
A no-fail environment

This key helps people manage the environment so that they can be more successful when trying to lose weight. The book provides advice on how to prevent needless snacking, overeating, and bingeing by removing tempting foods from the home, then from other environments such as work. He talks about shopping strategies, bringing healthy food choices into the environment, and even removing large-size clothes from the closet.
Mastery over food

Dr. Phil’s fourth key advises people to control habits by gaining mastery over food and through impulse control. The fourth key focuses on wiping bad, weight-gaining habits from their lives and replacing them with healthier behaviors. He lists weight-gaining behaviors and various pay-offs they offer to people. The chapter concludes with suggested behaviors to replace the weight-gaining behaviors, as well as the payoffs from the healthier behaviors.
High-response, high-yield foods

In this key, Dr. Phil discusses the nutritional value of various foods by describing a “high-response cost, high-yield food’ plan. Instead of offering meal plans or calorie-cutting, Dr. Phil’s diet talks about and lists foods that take longer to prepare and eat, and therefore are healthier. He contrasts these foods with those that take little time to prepare and eat, which normally offer higher calories and less nutritional value. He also mentions vitamin and mineral supplements in addition to high-yield foods.

Exercise

Dr. Phil calls his sixth key to weight loss intentional exercise. He says that instead of becoming obsessed about exercise, people need to take a balanced approach of regular strength-building and heart-conditioning activities to burn calories. Dr. Phil says that intentional exercise can open the door to body control, a state where the body can better metabolize energy for losing weight and keeping weight off. He breaks exercise into categories of moderate activities and vigorous activities. In addition, the book lists the physical and psychological benefits of exercise.
Support

The book concludes with several appendices, such as food lists, a workout diary, and a sample exercise for stress relief and relaxation. Dr. Phil reminds readers that weight is managed, not cured. He explains danger zones that allow people to drift off course in managing their weight, then discusses avoiding these danger zones.
Function

Dr. Phil’s weight loss solution is for people who want to lose or manage weight. He presents the diet as an alternative to crash and fad diets As a psychologist, Dr. Phil approaches the diet from behavioral aspects as well as from the nutritional aspects.

Benefits

Dr. Phil says that in typical diets, the emotion fades soon after starting the diet. In interviews about his weight loss solution, Dr. Phil said that people have better chances of succeeding on weight loss efforts if they reprogram their lives and follow the seven keys to success. He said that fear keeps people from addressing the emotions involved in overeating. The diet also focuses on being healthy and having realistic expectations for a person’s age.

Precautions

Some nutritionists and scientists have questioned the evidence quoted by Dr. Phil for the success rate of his plan and nutritional products. Following any particular diet plan should be done only after consultation with a physician and/or licensed dietician. The advice of involving a nutritionist comes late in Dr. Phil’s book.

Risks

Among concerns was the nutritional balance of some of the Shape Up food products. Although Dr. Phil’s diet does not lean toward one food group and advises generally traditional diet advice of balanced diet mixed with exercise, it is best to involve a health care professional or registered dietary professional to ensure that the strategies are healthful and successful.

Research and general acceptance

In the book, Dr. Phil cites a bibliography, a consulting nutritionist, and an 80% success rate. But there are no specific scientific studies published or referred to that prove the success of the program or its individual.
QUESTIONS TO ASK YOUR DOCTOR

* What do you know about Dr. Phil’s diet and its success?
* How can I use the strategies in the diet but incorporate more current nutritional information?

strategies. After developing the Shape Up products, which consisted of herbal supplements, shakes, and snack bars, a lawsuit was filed stating that Dr. Phil had made false claims about their benefits. Reports showed that although the nutrition shakes were in good ranges for carbohydrates and fat, the nutrition bars were in relatively high carbohydrate and fat ranges. The lawsuit was filed in 2004 on behalf of three disappointed consumers. They said that that Dr. Phil had defrauded fans, making false statements about the supplement pills. CSA Nutraceuticals agreed to stop making the supplements in early 2004 when it faced an investigation from the Federal Trade Commission concerning false-advertising claims. The plaintiffs sought class action status for the lawsuit and reached a $10.5 million settlement in September 2006.

In an article in Food Processing magazine, a diet expert at the University of California at Berkeley was quoted as saying that Dr. Phil’s diet advice was not innovative. Yet she added that the advice was common sense. A review in the Tufts University Health & Nutrition Letter said there were several flaws with the book’s advice and that some of the advice contradicted other points in the book or did not make sense. The review listed some good points, including the fact that a dieter does not have to be strong 24 hours a day, seven days a week.

An American Dietetic Association fact sheet said that some of the book’s advice is good, such as behavior modification strategies that have been used in weight control programs for many years. But the review said that the book also contained nutrition and dietary recommendations that were mistaken or outdated. The review also stated that the advice for dealing with complicated emotional and other eating-related issues is made seemingly simple, but that managing these issues alone is not easy.
Resources top
BOOKS

McGraw, Phillip C. The Ultimate Weight Solution: The Seven Keys to Weight Loss Freedom The Free Press, 2003.

McGraw, Phillip C. The Ultimate Weight Solution Cook Book.The Free Press, 2004.

McGraw, Phillip C. The Ultimate Weight Solution Food GuidePocket Books, 2005.
ORGANIZATIONS

American Dietetic Association. 120 South Riverside Plaza, Suite 2000. Chicago, IL 60605. (800) 877-1600.

Teresa G. Odle
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How to Start a Diet - 2 Easy Steps

by Tom Harris

Sometimes when starting a journey the hardest part is the first step. Once it has begun you look back and wonder why it took so long to start. Often, wondering how to start a diet or where to begin stops a lot of people from taking that first step. This article will tell you how to start a diet in two easy steps.

The first step is to look at your life and decide if this is the best time to begin a diet. Pressures at home or on the job can make starting a diet and sticking to it more difficult. Also, starting a diet during the holidays can also be hard. It is better to wait to start a diet when you can focus on what you are doing and stay committed. Then it is to rush into starting a diet and not stick with it and experience the disappointment that comes with a failed diet.

After deciding this is the best time for you to start a diet, you need to find a good weight loss plan. One that is detailed and fits your weight loss goals and lifestyle. You should check the weight loss program and make sure that it is safe for your health. Also, that it gives you choices of what you can eat. There are several good weight loss programs that can be found on the internet.

This article will help you on how to start a diet. Follow these two easy steps and they will get you started on your journey towards reaching your weight loss goal. Make sure this is the right time for you to be starting a diet. Then find a good weight loss program that is safe and gives you choices of what you can eat.
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The Benefits Of Organic Food For Your Health

by Virgilio Vallecera

Organic food health service are debated more as opposed to ever. With people demanding to buy organic food more, researchers are tying to find the benefits and risks of eating organically.

Sometimes researchers have said that the organic food health assistance are truly nonexistent, while with other studies, multiple bonuses have carried on found. By researching organic foods, a person can find the real story nearly organic food health benefits.

Organic food health assistance may begin through the debate of the nutrition level of certified organic food versus regularly matured food. Depending on what information is read, different information is given.

According to the researching on organic food who the New York things did in 2003, their report was that "recent preliminary evidence suggests that the value of a few nutrients, especially vitamin C, chosen minerals and some polyphenols -- naturally occurring antioxidants that may windfall bolster the immune system -- are higher in organically grown crops."

This comment only supports such food health good things that a person can gain by eating fresh organic food.

Outside organic growing, many farmers, in order to have this plants grow perfect and more bountiful, add pesticides and toxins. Such food health good things stem from the lack of these types of toxins and pesticides.

Pesticides have been linked to making individuals ill, and can lead a person to avoid fresh vegetables that are needed for an overall healthy diet. Toxins in the body can cause questions such as headaches and tremors.

Because organic food vitality benefits permit reduce the risk of these undesirable benefits, natural and organic food should be definitely taken to consideration when choosing foods.

One particular such food vitality benefit occurs when the additives that are at last found in almost all foods are not used. Organic food generation prohibits the use of food additives such as preservatives, artificial sweeteners, and hydrogenated fat.

This in itself is excellent for all people but truly children. The a reduced number of artificial sweeteners that children can be exposed to the better according to several doctors.

Organic food health benefits are numerous. Debates rage as to how exact service organically grown food can offer the public. Some say that the nutrient concentrations are higher, others say properties are the same.

But one thing is for sure. Organically grown food bids small bit to no pesticides, and this can boost everyone be healthier. No question whether polls are right in linking certain ailments to pesticides or not, even children can gain for these food health benefits.

Because of the lack of artificial ingredients, children can be healthier and happier. This happening alone is enough to fashion anyone start enjoying newly drafted organic food.
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Top 5 Weight Loss Strategies From A Top Level Personal Trainer

by Jon Atlas

You are ready to shed those energy draining, body crippling, unattractive extra pounds and you are ready to make it permanent this time. You are on the right track because you've taken the most important step toward your goal. That step is the decision to take action and stay committed. The following five proven strategies will serve as essential elements in your quest to achieve your weight loss goal.

1) You must put yourself into the right mindset. Don't think of your new efforts at weight loss as trying to do certain things every day. See your self living a new lifestyle, a new lifestyle that naturally includes behavior conducive to positive changes in your health and fitness levels. You transition into this new lifestyle by makng adjustments to your daily habits until these habits are in alignment with the goals you are aiming for.

2) Find an exercise partner. It can be a friend, a co-worker, or a family member. Why is this important? An exercise partner is a tremendous source of support. A partner is crucial on those days when you really don't feel up to exercising. Unless you are sick, a good partner won't let you slack and likewise your partner will need you to pull them up when they are not up for the workout. You being needed is an indirect but important type of support. With an exercise partner comes the element of accountability, which subconsciously reinforces your commitment to your quest.

3) Have a baby or get a puppy. These two strategies work in the same manner. I write about this one from first/second hand experience. My wife, Jeri-Jo, gave birth to our daughter, Darah, nine months ago. Today, she weighs less than she weighed before she got pregnant. What is the mechanism here? Jeri-Jo claims, "With Darah to care for, my mind is focused on her and her needs. Don't get me wrong, I'm not at risk for malnutrition, but I don't eat out of boredom any more simply because there is always something to do. The day flies by and I don't have time to snack on foods that cause weight gain."

The puppy strategy is very similar to the baby strategy. If you are not playing with it, training it, feeding it, walking it or cleaning up after it you are too tired to overeat. And, before you know it your new puppy is done napping and ready for more activities. Like caring for a baby, your puppy requires a lot of attention and mental energy. This prevents many people from unnecessary snacking that prevents weight loss.

4) If you are not ready for a baby or a puppy then take a up a new hobby. A new hobby will get you out of the house, stimulate your mind and prevent you from eating out of boredom. If your hobby is a fitness related activity, such as mountain biking or hiking, then you are really going to make some progress.

5) Drink more water. I know, you've heard this one before. But, can you truthfully say you are doing it? Not many people can. Ponder this. You consist of about 73% water. Your body gives off water all day and all night. You must continuously replenish your water levels in order for your body to function at its highest levels. Many fitness professionals talk about the metabolism slowing down as a result of too little food intake. However, just as important, yet rarely mentioned is water intake and its effect on metabolism. Not getting enough water can cause water retention and a slowing of the metabolism. Both of these can prevent weight loss and cause weight gain.

One little known strategy for boosting water intake is to drink 8 - 12 ounces as soon as you wake up. This helps wake up your metabolism. Another way to boost your water intake is to drink 10 - 12 ounces when you start to feel hungry. Instead of immediately reaching for food, drink the water and see if that calms your hunger until you are ready for your next meal.

Each one of these strategies can help you lose weight. But, by utilizing all of them, you are creating a formula for success. A formula that can be the foundation of your new lifestyle. Read more on this article...

Cabbage Soup Diet

Is It Difficult to Follow?
by Francisca Cahyaningsih

It's very easy to describe the cabbage soup diet - FAKE. There's no need to know anything more about this ridiculous diet. But in case you're curious here is some more information.

The origins of the cabbage soup diet are nebulous. It was one of the diets faxed from machine to machine in the early 1980's. The diet went under many names, often using a part of the name of a well respected institution such as the Russian peasant diet, or the St. Jude's diet. Needless to say, the diet has no relation to any of the institutions, nations, or people used in these names.

The cabbage soup diet calls for drinking nothing but water or unsweetened fruit juice on days when juice is allowed. A general outline of the diet is something like this.

Day one -- cabbage soup and fruit, but not bananas.

Day two -- cabbage soup as usual, and vegetables including a half baked potato without butter.

Day three -- add vegetables and fruit to the daily cabbage soup, but no bananas or potato.

Day four -- cabbage soup, eight bananas, skimmed milk.

Day five -- as much as 20 ounces of beef +6 tomatoes along with cabbage soup.

Day six -- cabbage soup plus as much beef and vegetables as can be eaten, but no potatoes.

Day seven -- cabbage soup, brown rice, vegetables, unsweetened fruit juice, but no potatoes.

The cabbage soup diet claims that people can lose 10 pounds in only one week. While it may be possible, most of that weight will be water weight. It's impossible to lose 10 pounds of fat in a week. It is however, possible to get sick from a lack of nutrition which is one danger with the cabbage soup diet.

The other problem with the cabbage soup diet is that it's a very difficult diet to follow. Not because it's too complicated, but rather because seven days of cabbage soup becomes monotonous. It was common for people to last only a couple of days before quitting. Even as more exciting cabbage soup recipes, including some with various spices, made the rounds people still quit early.

You don't have to turn to something goofy like the cabbage soup diet for weight loss. Exercise more and cut out calories in order to accomplish a goal. Read more on this article...

Fat Loss 4 Idiots

What Does it Take to Lose Weight?
by Paul Matthew Moore

Well, I would imagine that people are waiting with baited breath for the answer to that question. To begin, you must look at what does not work. When you have eliminated all the rubbish, you will arrive at the best possible answers for fat loss.

Food Diet

The internet and television are full of particular food diets. The green tea diet, grapefruit diet, acai berry and thousands more. You have celebrities and talk show hosts singing the praises of these wonderful new diets. However there seems to be a problem, they are impossible to stick with and they are dangerous to boot.

To get to where the rubber meets the road let us speak frankly. Who in their right mind wants to spend the rest of their life eating the same thing? My guess is no one! You may be thinking that is true but you do not have to remain on the diet for life. Okay but then what happens when you go back to eating the way you were before the diet? You gain all the fat back and it usually brings along a few friends.

The other end of this spectrum involves cutting out only one or two food groups. This may be a little easier to swallow, but it still has a problem. The human body requires certain types of foods to be healthy. When you take one of them completely away, you reduce the body's efficiency or worse.

Your body needs carbohydrates, protein, fat, vitamins, and minerals in order to function the way it was designed to. Therefore, all the above diets should be thrown in the garbage where they belong.

Diet Pills

Eat whatever you want and still lose fat, have you seen this commercial? Have you ever asked yourself what that kind of diet pill must be doing in your system to achieve that?

Diet pills work in one of several ways:

1) Decrease your appetite so you eat less 2) Increase your metabolism so you burn more calories 3) Relieve your body of fluids so you weigh less (at least temporarily) 4) Clean out your colon so you weigh less (again temporary)

Bottom line is this there is little a pill can do in your body to help you lose fat that is good for you or long lasting. Appetite suppressants are often little more than fiber that makes you feel full. Metabolism boosters can increase your heart rate in order to burn more calories and the last two's fat loss will only last until you rehydrate and eat again.

Good Fat Loss

Sorry folks but the best fat loss plan in the world is to eat healthier and exercise more. Fill your body with good foods from all the major food groups then get out and move your body. There is no magic diet pill that will accomplish that for you. A good start would be to keep a food journal for two weeks. This will allow you to see what is keeping you from your fat loss goals. It could be the three Cokes that you drink every day or the twice a week stop for fast food. You need to identify your trouble spots to develop a healthy eating plan. Then go for a walk, even a little walk will do your body good. Read more on this article...

Let's get started!!!

The reason why this blog has been created is simple: to help YOU lose weight; and if you have succeeded, to tell others how you did it. We are going to share some of our past experiences, but remember, you, the ones who read these lines, are the main characters. Good luck! Read more on this article...