Tuesday, January 08, 2013

Diet Book Review: The Dash Diet Weight Loss Solution

[Full disclosure: I was sent a free review copy by the publisher]
According to author Marla Heller, MS, RD, the Dash Diet Weight Loss Solution's approach is derived from the lesser known lower-carb version of the DASH diet and therefore it is not in fact the fairly well studied DASH diet. Of course you probably wouldn't guess that given the title and the jacket cover that includes this red dot that tells prospective buyers that the Dash Diet was ranked the #1 best diet overall by US News and World Report.

In a word I'd sum up this book's promises as hyperbole as the book repeatedly refers to the diet helping to, "reset metabolism", "turbocharge weight loss", and specifically target, "muffin top fat". That's a real shame as one of the main problems involved in modern day dieting are non evidence-based statements made by health authorities, as those statements misinform people from positions of trust. Take spot reduction. Spot reduction is sadly impossible yet a respected health authority repeatedly tells readers in this book that her diet will lead to preferential abdominal fat loss. Honestly, if you remember one thing from this post remember that the second you come across someone or something promising spot reduction your skeptical Spidey sense should start tingling.

Some of the book I found truly strange. For instance healthy weights were defined as the,
"weight at which you have no health problems"
as if weight somehow were blamable for everything that ails you and that loss would fix all. Exercise recommendations included literally walking in place in front of your television or walking around your office a few times before you sit down. Readers were also told that sugar-free jello is a wonderful replacement for fruit and that
"Eating burgers without the bun will become a habit"
The first two weeks involves a pretty standard low-carb induction phase and is billed as,
"2 weeks to Reset Your Metabolism, Turbocharge Weight Loss and Shrink Your Waistline"
No alcohol, starchy food (defined as bread, pasta, potatoes, rice, etc), fruit, sugar or milk. Heller warns that adherents will feel less energetic, get cranky, bored and may experience a "mini-meltdown". Sounds awesome. She notes that during the first two weeks your body will flush out "excess fluids", but really they're not in excess, they're just the fluids your body stores along with its carbohydrates, and yes indeed, when you're not consuming carbohydrates and you deplete your liver and muscle stores of glycogen you'll probably also liberate 10lbs of fluid (which will return just as quickly if you bring the carbs back into your life).

The book provides very specific meal plans and so I took the time to calculate the calories of the first day of the induction phase and the first day of the rest of your life to see what readers might be getting themselves into.

Day 1 of the first two weeks clocked in at 1,120 calories, while the first day of the rest of your life rang up at 1,250.

In my experience it's an exceedingly rare person who is happily satisfied on an average of 1,200 calories a day.

As well Heller notes that once you get to where you want to go weight wise you're to start bringing back dessert, potatoes and grains. But if you lose weight with a particular intervention (like for instance avoiding dessert, potatoes and grains) and then you stop that intervention, whatever weight you lost consequent to that intervention is likely to come back.

On the plus side for this book, the recommended foods are healthful and there's an emphasis on cooking from scratch. If you do choose to pick this one up, I'd encourage you to increase the portions provided until you feel satisfied as weight loss through white-knuckled 1,100-1,200 calorie hunger simply isn't going to stay off. Personally I'd much rather you ate more and lost less and stayed there than to crash your weight down with overly aggressive restriction only to gain it back again because like the rest of our species, you weren't up for a lifetime of unnecessary suffering.

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12 comments:

  1. I think what's most disappointing is the fact that authors are allowed to brand their diet concepts using well established and scientifically valid concepts such as "the DASH diet". As an RD, I have have recommended some version of the the DASH diet on numerous occasions but without many of the claims and promises that Dr. Freedhoff so nicely summarizes in his review.

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  2. Good review, except that I wouldn't necessarily characterize abdominal fat loss in terms of spot reduction because, in many an obese person, abdominal fat affects a rather large percentage of the body's surface area. In addition, restricting omega-6 industrial seed oils may help the body preferentially mobilize abdominal fat(1). Of course, we don't know this for sure because, to my knowledge, nobody has deliberately studied the relationship between omega-6 consumption and abdominal fat in humans(2).

    It's said that "Whether diets high in omega-6 fat promote weight gain and fat accumulation and contribute to Metabolic Syndrome is hotly debated." The matter will continue to be debated until it actually gets studied(3,4).

    References
    1. http://omega-6-omega-3-balance.omegaoptimize.com/2010/07/25/case-study-30days-of-high-omega6-dietstiffens-arteries-and-increases-belly-fat.aspx
    2. http://jonnybowdenblog.com/omega-6-fatty-acids-promote-fat-accumulation/
    3. http://www.asbmb.org/asbmbtoday/asbmbtoday_article.aspx?id=18365
    4. http://sciencenordic.com/vegetable-oils-promote-obesity

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  3. "Your body may experience a mini-melt down" lol... It is true that its best to not cut out every single thing from your diet in the long run though, many people do this and once they get that taste for their favorite sweet... the pounds come on fast. If you need help losing weight visit my blog! www.EatGoodStaySlim.com :)

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  4. I'm aware of two versions of the DASH diet that have been studied in the scientific literature. (DASH = Dietary Approach to Stop Hypertension.) But I'd never heard of a low-carb version. Thanks for the review.

    -Steve

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  5. This book sounds like a rehash of "The Metabolism Miracle" which also makes claims for "fixing" your "broken" metabolism with low carb. A recycled diet book? Imagine that.

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  6. This book is premised on a lower-starch/sugar version of DASH that included all of the key DASH diet foods. The key foods are the vegetables, fruits, and low-fat and nonfat dairy. There is no indication that refined starchy or sugary foods are critical to making the DASH diet work. So yes, after the 1st 2 weeks, you are on the complete DASH diet plan.

    Metabolism does not refer just to metabolic rate, but to all the biochemical processes needed to maintain life. A key metabolic process is the homeostatic regulation of blood sugar. When refined starchy and sugary foods are reduced in the diet, it does in fact help reduce the body’s need to over-produce insulin in order to keep blood sugar within desirable limits. And when people become insulin resistant it is the peripheral muscle tissue which becomes resistant to insulin. Unfortunately, abdominal fat still responds well to insulin, and the glucose which gets moved into fat tissue for storage, gets stored as fat. Cutting intake of starchy or sugary foods that cause glucose spikes or are in excess of what is burned by activity, will reduce visceral fat.

    The healthy weight definition, "weight at which you have no health problems" is one of several discussed in the book, including BMI and the MetLife tables, and reflects the complexity of resolving healthy weight recommendations for a populations, as opposed to individuals.

    Walking in place in front of a television is a great way to increase activity without having to worry about safety (obesity is prevalent at higher rates in unsafe areas of inner cities than in areas where it is safe to be physically active outdoors), cost of health clubs, or finding extra time. The point of this recommendation was to remove mental barriers to exercise and to make it easy for someone to get started.

    Sugar-free Jell-O helps replace the flavor of fruit, during the first 2 weeks where people are reestablishing a new base for their eating habits. Fruit is immediately reintroduced in the next phase. And you may be surprised to know that many endocrinologists are discouraging fruit for their patients. I’d rather have a plan that does include fruit.

    When people do choose to have burgers, I would like for them to develop the habit of avoiding the refined, starchy bun. And, as in the book, pair that burger with a salad and additional vegetables. Not a bad habit to develop for people who like to have burgers occasionally.

    Regarding loss of fluid in the early phase of the diet, please go to chapter 13, page 144, reference number 11. If you will read this study, you will learn that extra fluid loss is seen in the first few weeks both with a low carb and high carb diet. Even the authors were surprised at this finding, since it was previous thought (not proven) that low carb diets uniquely caused quick initial fluid loss.

    I have not provided specific portion sizes for most foods, so it is impossible to calculate specific calories. Readers are advised to eat more if they feel hungry in between meals. This allows people to discover how to control their hunger according to their needs. Regarding a 1200-calorie diet, short middle-aged women, trying to lose weight, need that calorie level. Taking advantage of much research on hunger and satiety, (after the first 2 weeks) the book encourages bulky and filling (and low-calorie for their volume) fruits and veggies, and sufficient protein and heart healthy fats for satiety. This is now common wisdom for healthy dieting advice.

    Grains are not excluded after the 1st 2 weeks. Please note the whole grain cereals and whole wheat bread. And there are desserts with every dinner with lots of variety after the initial phase. However, I am certainly encouraging the avoidance of most refined starchy and sugary foods, which are high-caloric density, low-nutritive value foods.

    And purely anecdotally, my readers and my patients report that they feel much better on this plan, they find their cravings reduced, and they are happy to continue with a lower-refined foods diet for the rest of their lives.

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    Replies
    1. Hi Marla,

      You do give very specific portion sizes (and recipes too). Easy to calculate. Breakfast Day 1 for instances calls for 1 ounce of Wheaties, 8 ounces of skim milk and 4-6 ounces of strawberries or raspberries. Lunch 1-2 light laughing cow cheese wedges and grape tomatoes. Lunch is 2-3 turkey and swiss roll ups which I took to be sliced light turkey slices and slices of swiss cheese, baby carrots and a small plum. Mid afternoon snack was 6 ounces of light blueberry yogurt and 10 cashews. Optional before dinner snack was 20 peanuts. Dinner was 4 ounces of tilapia with a salsa (for which you provided a recipe), fresh asparagus and strawberry jello. Really only places where you aren't specific are vegetables - tough to rack up the calories there though.

      Regarding not excluding grains after the 1st 2 weeks, it's true. The first two weeks seem like an induction followed by a pretty traditional low-carb level of carb grams after that.

      Glad your readers and patients are doing well and hope they continue to do so.

      As far as our other areas where we might disagree, I'll leave it to readers to consider where they land.

      Thanks for commenting,
      Yoni

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  7. I am particularly distrustful of any diet that purports to reset metabolism (anyway other than to slow it down). After loss, regardless of means, Ghrelin is chronically elevated, Leptin is suppressed and a number of other hormones and peptides are reset differently. Research is frustratingly deficient, but it is certain that no one can make claims that his or her diet can reset metabolism or turbocharge anything other than loss itself, which is not the issue long term. The issue is whether a program is sustainable and loss is maintainable. I am not persuaded that this diet passes muster.

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  8. Anonymous11:58 am

    I found this review very helpful. I'm not a dietician or scientist and I often find myself awash in misleading labels, promises, etc. Can anyone recommend the best no nonsense guidebook for following a DASH diet with heart health as a primary goal?

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  9. Anonymous9:39 am

    Thank God.I took a minute to read this review. I was reading the book and asking myself why a healthy sane person would substitute fruit with jello. Thank you for a great review.

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  10. Anonymous9:16 am

    I have high blood pressure and have been on this diet for 4 days now. I have not been hungry at all and I feel great. I have not had any sugar cravings at all. I'm really amazed and actually wondered if it was normal not to be hungry. I'm thinking about my health and not worried about the weight loss. If it lose that is great. My goal is to lower my blood pressure, which effects so many other things. I'm excited to see after two weeks if my bp has lowered.

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