Editor’s Note: Dr. Frank M. Sacks was the lead author of one of the largest and longest studies ever to compare the effectiveness of different kinds of diets on weight loss. His study was published in the Feb. 26, 2009 issue of The New England Journal of Medicine.
Arthritis Today: Can you tell us a little bit about the significance of this weight loss study?
Dr. Sacks: The question of what type of diet that can facilitate weight loss is really old and hotly debated, and there are loads of divergent findings in the scientific literature. In other words, there are some findings that favor a low-fat, high carbohydrate diet, some findings that favor the total opposite kind of diet, and there are often problems with many of those kinds of studies.
What we wanted to do was to really test a big range of dietary fat, carbohydrate and protein intakes in a large number of people, 811, and extend it through two years with continual support, with behavior and nutritional sessions in groups and individually.
And we also wanted to make clear that all the diets we’re testing are healthy to prevent heart disease or to prevent diabetes, and some experts would feature one versus another.
We created a really neutral atmosphere. We didn’t want people to go in with a bias that one diet would work better than another.
The results, in a way, surprised us. We thought that the higher protein diet would be more satiating and lead to better weight loss long run, but we didn’t find that at all. We found that protein content really didn’t matter.
What really counted was people’s engagement in the program. Maintaining their commitment and what diet they were assigned to really didn’t have any influence at all.
Arthritis Today: In your paper, you admit that people had a hard time sticking to the diets that were most different from the way they ate before they started the study.
Dr. Sacks: Yes. That’s one of the problems with one of the more extreme popular diets.
For example, take this very low carbohydrate Atkins Diet. What the Atkins studies show is that after the first couple of months, people don’t get down to those very low carbohydrate levels. If they did initially, they can’t maintain that. We didn’t want to test a very low carbohydrate intake. We wanted to study a very large range of carbs, but the lowest carbs, 35 percent, we thought would be possible to go for. What we found was that over time people kind of gravitated back to what their usual carbohydrate, fat and protein intake was. And all in all, their weight loss didn’t suffer from that. What really counted was their engagement in the program.
About 3 weeks before a major flare of RA, which I did not know I had, I had revamped how I ate. I did not go on a diet. I just changed how I ate. I started eating 2 pieces of fresh fruit in the morning with a glass of milk. I would then eat about a hundred galories every 1 to 2 hours depending on how I felt. I would go no longer than 2 hours between eating. My husband would set out my food for the day when he would be gone and I would eat and drink from this arrangement of food. I was totally bed ridden and could not get up without his assistance. In the 7 months that I was bedridden and did not kow I had RA I lost 100 pounds. typically people will gain weight while bedridden and not moving. In jan of 2010 I went to a rheumatologist for the first time, in a wheel chair. After the first month and loads of test I was informed I had RA. Now this was added onto my fibro, a major injury to my neck,shoulder and back, Alkolosing Spondalysis, osteo conditis desicance(another form of arthritis) diabetes, high blood pressure and a myraid of diseases. I was started on plaqunil which managed to get me up and walkig by July really well, In august I went into a flare again and have been put on Imuran with little results so far. The good news is that I can walk some, losing the hudred pounds resulted in not havng to use insulin anymore and I was using three different kinds and testing 5 or 7 times a day, onlu having to take 2mg lo lisinapril every third day, and this is all because I lost the hundred pounds. I still ned to lose another hundred pounds and this hundred will be slower but I will get there. I have noticed that many foods do cause a reactio in me that I just never paid attention to before, I am trying now to find out which foods do effect my arthritis and which ones are helpful. Sending good thoughts to everyone i their struggles and prayers and blessing to all Take care Marti
Grains (ALL OF THEM unless pure or raw)
Cereals
Dairy (ALL Dairy content unless)
Vegetables:
Tomato's
eggplant
bell peppers
onions
scallions
carrots
potatos
radish's
parsnip
turnups
Rice
corn
millet
amaranth
Shell fish
Good foods:
Raw Honey
Fresh fruit;
pineapple
Berries
oranges
Ginger (if taking NO blood thinners)
Greens (above ground)
Nuts
Lean meat/ game (omega's)
fish (Watch your servings if your race doesnt tolerate the high mercury intake)
poultry- white meat no dark meat
Olive oil
Cayanne
Red/ green chilli powder/ pepper (ironicly its helped me on piercing days)
habanjero
fish oil w/o addatives except the capsule.
Soy Francisco, esposo de Soledad. Estoy alarmado por el poco peso de mi esposa, perdió masa muscular y bajó
14 kilos, pesaba 74kilos y mide 1.67 mts
aveces está con fatiga, come lo normal, 4 comidas diarias: frutas, verduras, lacteos, carnes, ahora le mandaron comer más carne roja pues tiene un poco de anemia; en eso estamos.
Quiere aumentar de peso,¿que dieta deberia seguir? alguien conoce algun tratamiento alternativo para mejorar su calidad de vida? Porque una vez por año, más o menos, su enfermedad, segun lo que le dice su Dra., manifiesta una reacción, muy agresiva para ela, es como un empuje, lo que le impide caminar, y moverse, sufre mucho de dolor, y es muy angustiante para mi, para la familia y tal vez más para ella, porque siempre fué una persona hiperactiva, y de repente sentirse así, la deprime y con razón.
Bueno, agradezco este espacio de expresión, espero poder tener noticias en breve.
Les deseo unas muy Felices Fiestas.
Estamos en contacto.
Gracias.
Francisco.
I've been told by several physicians that I have mild osteoarthritis in my hand and knees. I would like to get a list of foods and supplements that are known to stay away from. One more thing, why do I have, what appears to be, fluid below my knee caps. Some days it's more noticeable.
Thank you.
Other than putting more weight on the joints, how does the food we eat effect non weight barring joints ei. in the hands and in the neck?
How much does eating the foods that reduce swelling really help? Could a diet so devised be used in place of medication?
sensible healthy eating will overcome
obesity. This is what people need to
focus on. keeping off fast food, cakes,
fried food, pies, etc. And eat more fruit,
veg,and pasta. Not the Atkins or any other diet. Educate people to do this and problem solved.
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