All-liquid diet: too extreme?

Date: 26.07.2003
Post Via http://www.nutriaxis.com -- Bodybuilding, Health and Fitness News

Glenn Page hasn't chewed solid food -- not so much as a carrot -- in the five
months he has embraced a hospital-endorsed diet of chocolate and vanilla shakes
to lose weight. So far, his drastic steps toward better health have led to his
shedding 81 pounds and counting.

This Wayne County assistant prosecutor's wife and four children are adhering to
a partial liquid diet, eating fruits, vegetables and a few other low-calorie
foods as well as sipping shakes. In all, the family has lost 261 pounds -- more
weight than any of the 24 teams still participating in the yearlong Detroit News
Weight-Loss Challenge, which commenced in January.

While weight-loss experts agree liquid diets melt pounds away quickly, they
disagree whether the drinks are a good route to longterm better health. Most
dietitians insist slower is better when it comes to weight loss, because healthy
eating and exercise habits take time to adopt, and weight lost quickly is
generally quickly regained. The best diet, they say, is one that can be adhered
to for a lifetime.

"I personally feel (liquid diets are) not a great way for weight loss," says
Sujata Chaddha Jhaveri, a self-employed dietitian in Troy. "Weight loss has
always been about a change in lifestyle. As long as they're on very strict
supervision they do fine, but the moment they're left on their own, the moment
they come off of that and starting eating normal food, in no time they gain it
back. And it comes back with a vengeance."

Proponents of liquid diets -- especially the high-protein supplements used by
many hospitals -- say rapid weight loss is the best motivator for those who need
to shed serious pounds. And some new studies suggest those on low-calorie liquid
diets can keep weight off effectively with the right training.

"When you lose weight slowly, you're less likely to stay with the plan, because
it's too frustrating," says Pat Jurek, supervisor of the St. Joseph Mercy
Hospital's Center for Health Management and dietitian for the Page family. "This
works."



As a dietitian who used to stress all-food plans, Jurek says she watched too
many of her clients struggle without getting close to their weight-loss goals.
"How many people start a diet, never finish it and fail?" she points out.

Yet, it's tough to forget the famous television moment in 1989 when talk show
host Oprah Winfrey wheeled a wagon full of fat before her audience to represent
the 67-pounds she had dropped from her Optifast liquid diet. Months later, as a
nation watched, she gained the weight back and more. Rapid weight loss and
regain, experts say, can wreak havoc on one's metabolism, making further
attempts at weight loss even tougher.

"That was a setback for the very low calorie diet programs," Dr. James Anderson,
professor of medicine and clinical nutrition at the University of Kentucky in
Lexington, says of Oprah's liquid diet experience. "Many programs just went out
of business after that."

However, Anderson says very low-calorie or liquid diets have undergone a
significant makeover since the 1980s. Most today consist of protein-packed
800-1,000 calories, instead of the 500-600 calorie diets that left patients
feeling deprived.

A proponent of such diets, -- including the 800-calorie liquid diet of Health
Management Resources shakes that Glenn Page follows -- Anderson says his studies
show patients who lose weight quickly can keep it off more effectively than
those who follow an all-food diet and slowly adopt better eating habits.
Patients on liquid diets typically add low-calorie foods to the supplements
after 12-20 weeks, he says.

One research trial Anderson conducted, published in a 2001 American Journal of
Clinical Nutrition, followed patients in traditional food-based
weight-loss/nutrition classes versus patients using very low calorie liquid
supplements and taking such classes. After five years, those on the liquid diets
had lost more weight and had maintained four times as much weight loss as the
traditional dieters.

In addition, Anderson says of the 192 patients he's following at the University
of Kentucky's Weight Management Program who used liquid diets, 71 percent have
kept off an average of 61 pounds for 2.5 years.

Yet, many in the weight-loss field aren't convinced liquid diets are as
successful longterm.

"I have great respect for Dr. Anderson's work," says Fred Stransky, former
director of the Meadow Brook Health Enhancement Institute and professor emeritus
at Oakland University. "But if you look at the majority of research, long, slow
reductions in weight are the most successful. ... People who lose weight rapidly
tend not to keep it off."

Stransky, a doctor who lectures to primary care doctors about the importance of
dealing with obesity, advocates a low-fat, high-fiber diet (25 grams of each
daily) for weight-loss patients and stresses the importance of exercise (an hour
of daily aerobic activity is ideal, he says).

"I think (a liquid diet is) a last-chance approach for people who are in a
desperate situation," Stransky says. "For the vast majority of Americans, they
have to consider behavior change rather than the liquid diet approach."

John Foreyt, director of the Behavioral Medicine Research Center at the Baylor
College of Medicine in Houston, also downplay's Anderson's research.

"It's not randomized control trials, it's just case studies," he says, adding
the dangers of liquid diets are that people tend to think they can go back to
old habits once the weight is off. "The evidence isn't in that these (liquid
diets) work long-term, unless you make the lifestyle changes," he says.

However, Jurek says behavior modification classes are a key part of the Center
for Health Management's liquid diet program. The Page family and all the
center's clients take weekly classes, learning how they'll eat and continue to
exercise once they're back on a mostly food diet. Health educators talk to their
clients weekly and help them plan everything from how they'll fit more
vegetables into their diet to how they'll budget time to buy and cook them. The
center recommends taking 18 months of maintenance classes after dieters have hit
their goal weights.

Weight-loss experts agree patients eligible for an all-liquid diet must be at
least 30-40 pounds overweight and must be under a doctor's supervision. Jurek
says her clients can stay on an all-liquid diet for up to a year. They typically
add grocery store foods to the diet whenever they're ready or when they're
struggling to stick to supplements.

Once at an optimal weight, many of Jurek's clients continue to use supplemental
shakes, high-protein bars and special entrees in combination with a food diet to
help them maintain their weight indefinitely, she says.

Meanwhile, Glenn Page says his weight-loss has changed his life. Under a
doctor's supervision, he's stopped taking medication for high cholesterol and
high blood pressure, and has cut back on his diabetes medications.

"It doesn't bother me at all," he says of not eating regular foods. "The shakes
are very good, and they keep you full, so it's not a question of being hungry."

He plans to lose 20 more pounds before adding fruits, veggies and other foods to
his plate. And while he admits he's worried about going back to the choices a
food-based diet requires him to make, he's feeling confident and proud of his
and his family's success. They have already met more than 60 percent of their
yearlong weightloss goal of 390 pounds.

"I feel tremendously better," Glenn Page says. "When I had this big belly, just
turning over in bed was a chore."

Today, he rides a bike and plays soccer and basketball with his kids and walks
at least 40 minutes day. Pre-diet, just walking up the stairs had been
difficult.

"I think we wanted to change completely," says his wife, Barbara Page, who has
lost 59 pounds. "I really feel we will never go back to the way we were."

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