Not all diets created equally

I am often asked to prescribe a special diet or weight-loss pill for my patients. This seems to inevitably come up in conversation whenever I discuss healthy lifestyle choices and how best to modify risk factors to avoid heart disease.

What I think my patients actually want from me is a quick fix for weight loss.

Unfortunately, it’s not that simple. I do not have any magic cures.

The bottom line for weight loss is that you have to eat less and exercise more. It’s that simple. It takes about 3500 calories to lose or gain a pound.

Most people have no idea how many calories they consume in a given day. And they almost always believe they are eating much less and burning more.

One of my jobs as a physician is to provide opportunities for real lifestyle changes that are long-lasting and meaningful. It is also important to realize that a weight-loss diet is not necessarily a healthy diet. Conversely, a healthy diet may not cause someone to lose weight. Portion control, exercise and choosing foods wisely are all very important for successful lifestyle change.

Finding the fads

There is no shortage of direct-to-consumer marketing of potential weight-loss products, boutique diets and supplements. I am not a proponent of fad diets or fancy supplements promising weight loss. In my opinion, they don’t work long-term.

Some fad diets do indeed work. But many times, once you go off the diet, you are back to where you started. A perfect example is the Atkins diet. In a study published several years ago, people lost weight when they started this diet. But after two years most were back at or above their starting weight. Furthermore, many fad diets are not ideal for people with diabetes and those trying to control blood pressure and cholesterol.

A diet that might work

The Mediterranean diet has received a lot of media attention in recent weeks. The results of an important study were published in The New England Journal of Medicine suggesting that a “Mediterranean diet” supplemented by additional extra-virgin olive oil and nuts significantly lowered the risk of having a heart attack, stroke or dying from heart disease.

In fact, the Mediterranean diet was superior to a traditional low-fat diet. The results of this study confirmed earlier observations showing that a diet rich in olive oil, nuts, vegetables and cereals with moderate consumption of fish, chicken and wine coupled with low intake of dairy, red and processed meats, and sweets can be effective in reducing cardiovascular risk.