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Low Calorie Diets |
Every effective diet is ultimately a reduced calorie diet. Some achieve this through macronutrient restriction without conscious caloric reduction and others by direct calorie counting. It is the latter sort of diet, one that focuses directly on calorie intake that I will focus upon here. Portion reduction predates the concept of calories. It is plainly obvious that starvation leads to weight loss and so it is not surprising that people would conclude that deliberate weight loss should also involve starvation be it total or partial. Indeed deliberate portion reduction is effective and total starvation very much so. Unfortunately, total starvation leads to death and therefore hardly constitutes a lifestyle change. Even used in the short term, total starvation is extremely dangerous and causes serious loss of lean body mass including muscle and vital organs. Total starvation plays no legitimate role in weight control today. Protein sparing fasts are designed to provide dieters with only the bare minimum of daily protein in order to reduce lean tissue loss. Along with protein, these diets generally provide electrolytes though not necessarily enough for all patients. Protein sparing fasts are covered in more detail here. Protein sparing fasts are the most radical of the modern approaches to weight control and they do produice rapid weight loss, but there is no evidence that this manner of weight reduction is any easier (and may be harder) to maintain than slower approaches. Classical "low calorie" diets generally provide somewhere between 800 and 1800 daily calories. Above about 1800 calories the distinction between a deliberately "low" calorie diet and macronutrient-restricted diets begins to blur. Perhaps the most commonly encountered calorie limit for diets is 1200 per day. Many people have tried such diets. People following moderately low calorie diets generally feel hungry and this sensation grows more intense the longer people adhere to this calorie limit. Interestingly, this sort of hunger may not accompany very low calorie diets like protein sparing modified fasts because those radical diets induce a metabolic condition called ketosis which reduces appetite. Unfortunately, diets above roughly 1200 daily calories induce little ketosis and therefore leave people increasingly ravenous and this is the principle problem with such diets. In the end, moderately low calorie diets are effective as long as people follow them butfollowing them becomes increasingly difficult as appetite grows. Thus it is the essential criterion of liveability that low calorie diets fail to satisfy and this failure has caused them to fall into deserved disfavor. The only circumstances under which I will prescribe a low calorie diet for a patient is when the patient has an urgent need for rapid weight loss in order say, to undergoe bariatric surgery or because of extremely brittle type-2 diabetes and then, in those rare circumstances, I generally prescribe a protein sparing modified fast. Otherwise, low calorie diets are rather barbaric and totally fail to recognize that patients are human beings who get hungry and not robots that can simply "dial-in" a daily calorie limit. |
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