Diets Don’t Work?

See, I told you I was right! Exercise is important! A WebMD article by Carolyn Wilbert recently reported on a Danish study of 154 overweight people. First, they lost weight on a strictly controlled diet. Then they were followed for six months on diets containing varying amounts and types of fat and carbs.

Nearly everyone regained weight, although at least 60% kept off at least 10% of the weight they had lost. The type of diet didn’t matter much when it came to weight regain. The “healthy pyramid” diet, featuring monounsaturated fatty acids such as olive oil, seemed to improve certain diabetic risk factors such as fasting insulin levels and LDL/HDL cholesterol ratio.

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The authors concluded that “the frequency of exercise was considered the strongest predictor of weight loss maintenance.” The study was published in The American Journal of Clinical Nutrition. According to Wilbert’s article, “In an accompanying editorial, authors suggest that weight loss strategies should be individualized and geared toward improving healthy parameters [such as cholesterol ratio and insulin sensitivity – DS] and the prevention of weight gain, with less emphasis on initial weight loss. Diets low in refined carbs, avoiding trans fats from hydrogenated oils, and moderate intake of unsaturated fats are recommended because of the health benefits — despite only moderate weight loss.”

How much exercise? While most research has found that 30 minutes a day, five times a week is enough for basic health needs, long-term weight loss requires more. Current guidelines recommend 60 minutes daily of moderate physical activity. That’s a lot — it’s more than I do — but that’s what keeping weight off requires. Once heavy, a body always wants to be heavy, so you have to find activities you like well enough to do them for 60 minutes a day. Diabetes Self-Management magazine’s most recent article on making exercise fun might be a good place to start.

Great newsletter
I found out about this story and the one I shared in my last blog entry (“Food Politics”) from an e-mail newsletter called Stone Hearth Fitness.

I don’t know how I got on the mailing list, but I like it. They have a diabetes newsletter as well. They make a good free holiday/new year gift to yourself; you can write [email protected] to request to be added to the list.

  • CalgaryDiabetic

    Dear David.

    First let me wish you all a happy new year.

    This is good news and bad news. I was under the impression that my inability to loose weight was due to my LACK OF MORAL FIBRE(Yes correct English spelling, a British concept). This was also applied ungenerously to the Canadian Aircrew that could not fly any more because their nerves were mush. Well they at least had a good excuse only a 33% change of survival per 30 flights over Germany, my obesity is not as glorious. So if it be LMF then it appears that I am not alone.

    The bad news is how are we going to do 1 hour or more likely some of us need 3 hours per day of strenous exercise when we suffer from LMF.

    Or is it better to forget about weight loss before it drives us to suicide and try and stabilise our weight at some low level of obesity and try and improve our health by exercise and diet?

  • CalgaryDiabetic

    Dear David.

    The facts support your answer 100%.

    Shaming the participants was and still is immoral.

    Yours and our aircrews were shot to pieces because of a lack of escort fighters. Our High Command said they were not technically feasible and yours said they were not needed in spite of actual combat reports from China. The Mustang and Thunderbolds solved the problem.

    Time to cut this out before the boys in white come with the straight jacket.

  • David Spero RN

    Dear CD,
    Thanks for the New Year wishes.

    You wrote: “Or is it better to forget about weight loss before it drives us to suicide and try and stabilise our weight at some low level of obesity and try and improve our health by exercise and diet?”
    YES!! YES!! That is absolutely right and is pretty much what the Danish study recommended. If you do that, weight loss may or may not eventually follow, but you’ll be healthier.

    The “Lack of Moral Fibre” label, as it seems you understand, is an attempt to get people to do what you want them to by shaming them. Unfortunately, this strategy is used against heavy people all the time. It doesn’t work. Never. Because it’s a bunch of BS. “Moral fibre,” or “willpower” have nothing to do with behavior change.

    Re: how much exercise is needed – let’s not be ridiculous. 3 hours of strenuous activity a day would probably kill you. But 1 hour / day of moderate activity is doable and helpful. You might have to work up to it, but you can get there, if you like it and if you see it as helping you. You can combine different kinds of activity. Keep a log and notice small benefits.

    Good luck,
    David

  • beautybelle

    OK, so I increase my length of time exercising. How do I keep my blood sugar from dropping, without ‘feeding’ the insulin… and lose weight.

  • Steve Parker, M.D.

    The journal Clinical Diabetes in 2008 published science-based advice on how to prevent weight regain. Here’s a link to the full article

    -Steve

  • David Spero RN

    The Clinical Diabetes article Steve mentions is worth reading. It’s a review of over 100 studies on preventing weight regain.

    High points – weight regain is probable but not inevitable. Weighing yourself every day helps. Exercise is crucial, but you don’t have to the 60 – 90 minutes a day all at once.

    This might answer your question, BeautyBelle. Prevent lows by spreading your exercise through your day. Total steps per day and general activity level are often more feasible than structured bouts of very vigorous activity. Also, eat before your workout, so you don’t start out low. Carry glucose drops just in case.

    The CD article does include dietary advice, but the only specific recommendation was more fruits and vegetables. The evidence seems to show that “rigid diet restriction of certain food groups” was not as useful as “flexible control.” In other words, don’t make yourself crazy.
    David

  • CalgaryDiabetic

    Dear David.

    Quite a brain full trying to read the whole study, so thanks for your summary and I will try to read the whole thing piece-wise.

    Not totally surprised that they take no position re make-up of the diet but I bet if I started a cult where it would be blasphemous to eat anything but sauerkraut my members WOULD lose weight.

    I have just started a carb avoidance diet maybe not as serious as Dr. Bernstein or Dr. Atkins and I do not feel as hungry as with an ADA eat tonnes of carbs, good for you diet. The BG readings are way better with less injected insulin. So they all say to eat a healthy diet. What is healthy for a diabetic on exogenous insulin? Peanuts are healthy but not for all people.