Fad diets and quick fixes aren't the answer to losing weight Facts on diet and health. LOSING weight would have to take the cake for the most popular new year's resolution - and those who started early might already be seeing some results. No carbs, no fat, no sugar, no alcohol - those on a strict regimen might have lost count of items on the "no" list. Yet a familiar part of this story is that the kilos lost are so often gained once New Year's Eve becomes a distant memory and the diet book is gathering dust. So how do people keep weight off in the long term? And is improving your diet better than going for a jog? Australians will fork out more than $827 million on dieting this year, according to IBISWorld research. While counselling services, and diet food and drink make up the bulk of the spending, $60.4 million alone will be spent on diet books. Yet it's not only the money spent on weight loss that's growing. ABS statistics show two-thirds of adult Australians are fat or obese and getting fatter. With that comes a high risk of developing type-2 diabetes and cardiovascular disease. Diet books make big promises to those desperate to lose weight. Celebrities spruik them. Diets are made to look easy. It's no surprise the books become best-sellers. The strict, four-phase Dukan diet - which relies heavily on meat protein and cuts out a whole range of other foods - became a worldwide hit when Carole Middleton mentioned she was using it in the lead-up to her daughter's wedding to Prince William. Then there is Six Weeks to OMG: Get skinnier than all your friends by British actor Venice Fulton. Coffee, cold baths and skipping breakfast are all advocated, as is eating whole-foods. A few years back, experts at the CSIRO released their own low-carbohydrate, low-fat diet. Women studied lost twice the amount of weight than the women consuming the same calories on a high-carbohydrate, low-fat plan. Unlike the more extreme low carb regimens, no food groups are excluded. The latest to make big claims about weight loss and even improved cognitive function (in mice) is the 5:2 diets or Fast Diet. This unconventional approach stipulates severe calorie restriction or fasting for two non-consecutive days a week and normal eating the other five days. One study of obese women showed they lost six kilos in eight weeks. There are countless others. To get some clarity, the Sunday Herald Sun gathered eight health experts to analyse eight different diets. Yet even among this group - which included a GP, a naturopath, nutritionists and dietitians - there was no clear consensus on the best and worst of the list. Nutritionist and author Lola Berry is a huge fan of the whole-food, no-grains approach of the Paleo or Caveman diet, but accredited dietitian Katherine Shone worries cutting out dairy could lead to poor bone health. Quite a few chose the CSIRO as one of the best, but Dr Leon Massage, Australian Medical Association Victoria's spokesman on weight loss and nutrition, believes it is too high in red meat and saturated fat. All diets have their advocates and detractors - even the ones that are scientifically tested. At the very basic level, losing weight is about "energy in versus energy out" says Ms Shone, who is Nutrition Australia spokeswoman. So despite their differences, you will lose weight on any diet if the calories you consume are less than you burn. Ms Shone says diets are attractive because "people want a magic fix" and these regimens don't address the underlying reasons why they are overweight. "They are spruced up to look easy and make a lot of promises but in most cases, these diets are not sustainable in the long term," she says. Strict diets can be a good way for people to kick-start their weight loss, says dietitian and Latrobe University's Associate Prof Catherine Itsiopoulos. "They achieve rapid results in the short-term and that is a big motivator for people, but then they need strategies to move into long-term patterns," she says. These strict diets are not normal ways of eating long term, and it becomes difficult to ostracise yourself from eating with family and friends. SHE is extremely wary of diets that ask people to exclude whole food groups and "unrealistic claims are made." (If this) is continued over more than a few weeks, it can lead to deficiencies in certain nutrients. This affects your mood and makes you feel grumpy," says Prof Itsiopoulos, who is Head of Department of Dietetics. If you restrict yourself too much, you are more likely to crave sweet things and can sabotage the efforts you've made. In addition to the obvious increase in calories, there are a couple of other reasons for post-diet weight gain or the yo-yo dieting effect. Some of the initial weight loss people experience on a strict high-protein diet can be fluid loss, because of the way carbohydrates are stored in the body, Ms Shone says. "The problem is when you reintroduce carbohydrates you regain that fluid," she says. Despite your best efforts, your body can also put up a fight of its own. When you deprive your body of calories, it thinks it's starving and, to protect itself, it slows down your metabolic rate, says Dr Massage, who is also founder of Melbourne's Body Metabolism Institute. He says slowing down your metabolic rate means your body reduces the amount of energy it uses to sustain itself. The worst is to come when you stop the strict diet. "You will lose weight when you really cut back in calories but you will pay the price later because (when you stop dieting) you will put on weight more quickly because your metabolic rate is slower than it was before you started dieting," he warns. "That's why fad diets and detox diets don't work long term," he says. It's enough to make even the most determined feel dispirited. A multitude of studies show all diets will work but at the two or five-year mark, people are at square one, says Prof Itsiopoulos. People need to seek advice about how to change their diet to a healthy one they can manage in the long term. She says people are easily swayed by marketing and don't pay enough attention to the food labels. There is a lot of confusion among the public on what is good for you and what isn't. Fad diets and quick-fix solutions aren't the answer. Prof Itsiopoulos says permanent weight loss happens when people adopt lifestyle changes and long-term healthy eating patterns, such as the Cretan Mediterranean diet, which has been a big focus of her work. This diet is rich in fruit and vegetables, legumes, oily fish and whole-grain breads, a glass or two of wine and fat from olive oil. Like the CSIRO diet, her research has proven people eating this way can not only lose weight but reduce risk factors relating to heart disease and type-2 diabetes. And this happens even before weight loss, which helps disprove the myth you can't be metabolically fit and fat. This also can be true of overweight people who exercise, says Dr Massage. He says while the goal should still be weight loss, those who are overweight can still improve things like cholesterol and blood pressure through exercise. As well as helping prevent lifestyle diseases, Dr Massage says exercise plays a vital role in losing weight and keeping it off for more reasons than you might imagine. Exercise burns fat and energy but unless you are a triathlete, it could never be used on its own to slim down. Those who do a half-hour jog to cancel out that chocolate bar are kidding themselves. "You would have to do 20 hours of aerobic walking or 12 hours of running to burn off 1kg of fat, so you can see on its own, it's not so good at weight loss," Dr Massage says. HE says exercise not only burns calories, it boosts your metabolic rate (it also helps prevent it slowing down), and it reduces hunger. Importantly, it also prevents muscle loss, which happens along with fat loss when you diet. The problem with people who are forever yo-yoing is that the percentage of their body fat increases because when they diet, they lose fat and muscle, and when they stop, they only regain fat. And they are slowing down their metabolic rate so they also regain fat more quickly, he says. So if you exercise and start eating a healthy diet, you will lose fat, build muscle and burn fat more quickly. If you raise your metabolic rate through exercise, it stays up burning more energy even throughout the day when you've stopped exercising. "When you consider how important exercise is for weight loss and health, you don't understand why everyone doesn't do it," Dr Massage says. He recommends a ratio of 80:20 diet to exercise to his patients and says any activity - whether it's walking to work or playing a game of tennis - is more important than what type of exercise. Dr Massage's weight-loss clinic has had proven success and he has even written a healthy lifestyle book of his own, I Can't Believe it's a Diet. There is one thing the experts can all agree on. Seek advice and pick a diet and exercise you can imagine yourself living with long term, rather than something you can only stick to for a few weeks. Jad Patrick, Associate Professor Catherine Itsiopoulos, Dr Antigone Kouris, Dr Sue Shepherd, Dr Leon Massage, Lola Berry, Tim Crowe, and Katherine Shone. Picture: Andy Drewitt Source: Sunday Herald Sun Eat normally five days and on two non-consecutive"fas" days, men eat 600 calories (250kJ) and women 500 calories (210kJ) Very simple to understand and easy to implement, though sticking to so few calories on the fast days would be hard. Small-to-moderate weight-loss may be expected. No forbidden foods. Animal research shows some benefi ts indisease prevention. Severe caloric restriction more stressful and difficult. Not suitable for children, teenagers, diabetics, people with a history (or potential) of eating disorders, the elderly. Calorie-restricted days are severe and may lead to bad breath, dizzy spells, irritability, dehydration and anxiety. No attention is paid to diet quality. The Cretan Mediterranean diet, Paleo diet. The Six Weeks to OMG diet, Dukan diet. Associate Professor Catherine Itsiopoulos head of Department of Dietetics and Human Nutrition, La Trobe University Diet includes low intake of red meat, lots of fish and a wide variety of plant foods: fresh fruits, leafy greens, onions, garlic and tomatoes, beans, legumes, nuts, wholegrain bread. Low in animal fat, rich in omega-3 fats and monounsaturated fats, beneficial for prevention of heart disease. Rich in antioxidants. Includes moderate portions of carbohydrates that are low GI and have high fibre. Can be used for weight loss if quantities of olive oil, nuts, dried fruit and wholegrain cereals are controlled. Some people may find it hard to cook vegetable-based dishes, especially legumes. Very high in fi bre so may cause gastrointestinal symptoms in some people Cretan Mediterranean diet. Dukan diet, 5:2 or Fast diet Adjunct Assoc Prof Antigone Kouris, Department of Dietetics and Human Nutrition, La Trobe University Diet is high-protein, low-fat, low carbohydrate - It includes 100 foods, of which 72 are animal-sourced and 28 come from plants. You can eat as much as you like, as long as you stick to those 100 foods. Four-phase diet, the fi rst invovles eating unlimited amounts of low-fat animal protein, for up to 10 days. Vegetables and fruit are subsequently re-introduced. Fast weight loss if adhered to. Low in saturated fat, added sugar. May appeal to people who don't like counting calories or watching their portion size. Filling. No clinical trials have evaluated the Dukan diet. Too high in animal protein and too low in vegetable protein, plant food and carbohydrates. Too low in potassium, too low in fi bre and good fats from plant foods. Unsuitable for children and families. Expensive. The Paleo diet and the Dukan diet. Dr Sue Shepherd, advanced accredited practising dietitian Start the day by drinking two cups of black coff ee then exercise for 30 minutes to one hour. Next, fast for three hours and then sit in a cold (15-20C) bath. Claims all carbs are the same, strictly limits sugar and fruit, while lean meat, fish, chicken and whole foods such as lentils, legumes, brown rice are allowed. Main meals, no grazing. Avoids refined sugars and processed foods. Caffeine and cold baths may boost metabolism. Encourages exercise. Promotes illogical beliefs, eg, that broccoli can be as bad for you as soft drinks. Skipping breakfast increases likelihood of dieter reaching for a high-energy snack mid-morning, and missing meals can be dangerous for people with diabetes. Does not allow eating after exercise, contrary to sports experts" recommendations. Emphases "skinny" rather than "health" and is at risk of promoting eating disorders. Cretan Mediterranean diet, CSIRO diet. Dukan diet. Dr Leon Massage, author and Australian Medical Association (Victoria) spokesman on weight loss and nutrition Diet is in three phases. Phase 1: To be followed for two weeks; strict; removes sugars and processed carbohydrates. Phase 2: Less strict; introduces fruits and grains into the diet; to be continued until target is reached. Phase 3: Maintenance phase; to be followed indefinitely. Believes in using "good carbs" (low-GI carbohydrates) instead of "bad carbs." Weight loss and health improvement. Decreases intake of trans fats and saturated fats, which is good for heart health. Decreases sugar and processed carbohydrate intake. Too generous with "healthy fats." South Beach diet. CSIRO Well-Being diet. Lola Berry, nutritionist and author of The 20/20 Diet Also called the primal diet. It removes processed foods and grains from the diet. You can eat fruits, vegies, meat, eggs, fi sh, poultry, nuts and seeds, honey and dates, coconut or any nut milk. No cereals, wheat, bread or any other grain, no dairy foods. Clean food, no additives, weight loss, great skin, more energy. Potentially, if not followed properly, lack of fibre, which can cause constipation. Hard to go out and have a dinner with mates. Paleo diet. None Assoc Prof Tim Crowe, dietitian and nutrition researcher at Deakin University Plant-based eating, including uncooked fruits, vegetables, nuts, seeds, grains and vegetable oils. To be followed indefinitely. Weight loss if strictly adhered to. Promotes foods linked with lower rates of heart disease and weight loss. Low in fat, added sugar and salt, and high in fibre. Diet is very restrictive, difficult to follow long term and to eat meals outside of the home. Associated with growth problems and malnutrition. Not appropriate for infants and children. Nutrient losses from cooking are overplayed. Katherine Shone, accredited practising dietitian , consultant dietitan at Nutrition Australia and sports dietitian at Olympic Park Sports Medicine Centre Well-balanced, calorie-controlled eating plan featuring a high protein and moderate carbohydrate intake. Promotes a high-fibre intake. Based on research by the CSIRO, a highly reputable organisation. The higher protein intake helps people feel full for longer. Does not restrict any core food groups. Provides adequate amounts of key nutrients such as iron, zinc and calcium. Acknowledges that a small intake of "sometimes/indulgent" foods every now and then is OK. Lifelong eating pattern. Some could struggle to consume the recommended three units of protein a day. Relies predominantly on animal-based protein sources, which tend to be higher in saturated (bad) fat. Cretan Mediterranean diet , CSIRO diet. Paleo diet, Dukan diet