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David Katz, M.D.

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Dukan Diet: The Fad Diet of 2011?

Posted: 12/27/10 08:21 AM ET

A new year looms, so there is -- wait for it -- a new diet!

The new diet soon to be making the rounds is the "Dukan Diet," named for its French originator, Dr. Pierre Dukan. Propelling it to prominence at present is its adoption by the current mother of the future princess of the English realm, in preparation for the upcoming royal nuptials. In this world of ours where communal behavior seems far more responsive to what is published in People than in the New England Journal of Medicine, this will surely be enough to create a phenomenon.

And to that, I say: alas. Because, to me, this diet seems to be a load of carefully dosed nonsense.

As best I can tell, this is classic quick-fix weight-loss hooey. The diet seems to involve cutting out most foods -- carbohydrate foods in particular -- to lose weight fast. Then, foods are slowly added back to make the diet livable. But, to avoid weight regain, you have to keep circling back to the "just cut out everything" phase. Stunning, isn't it, that not being allowed to eat most foods leads to weight loss?

There is objection to this altogether objectionable diet from an unsuspected quarter: the Atkins camp. They contend that Dukan simply isn't doing it right, and that Atkins does it better. But frankly, this seems like the pot calling the kettle black to me. Basically, the Atkins camp doesn't want anyone else getting credit for, or making money from, silliness they came up with in the first place!

Quick-fix diets such as this do, indeed, cause rapid weight loss. So what?

Cockamamie cut-foods-out then add-them-back then cut-them-out diets are not about health. They are not about a healthy relationship with food. They are not about the long term. They are not about learning to love food that loves you back. And, they are not about family. While you are busy deciding what to cut out or add back to your dinner at 6 p.m., what the heck will your kids be eating? In an age of epidemic childhood obesity, shouldn't we be looking for family-based approaches to healthful eating, rather than "as long as I look good in my wedding dress, I don't care what anyone else is doing!" approaches?

The choice, of course, is yours. Will you Dukan? Speaking as a physician, it is best to stay away from the type of diet that calls for cutting foods out of your diet and then adding them back in.

Dr. David L. Katz
www.davidkatzmd.com
www.turnthetidefoundation.org

 

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A new year looms, so there is -- wait for it -- a new diet! The new diet soon to be making the rounds is the "Dukan Diet," named for its French originator, Dr. Pierre Dukan. Propelling it to promine...
A new year looms, so there is -- wait for it -- a new diet! The new diet soon to be making the rounds is the "Dukan Diet," named for its French originator, Dr. Pierre Dukan. Propelling it to promine...
 
 
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01:54 AM on 01/16/2011
Plenty ways to Shed Fat ....avoiding silly diets is a start, this diet sounds way too complicated. How about eat all natural, and reduce your intake of boxed and canned goods...how hard is that?
11:18 PM on 01/14/2011
Do what works for you and stick with it. Those are my two points for the week. I eat a balanced diet and exercise a least five days/week. My parents practiced balanced nutrition. They encouraged my sister and I to obtain plenty of outdoor play and physical activity. We only owned 4-5 games for our Colecovision; and we were limited to one hour of TV after school. I do the same with my children. Eliminating foods is not something that works for me; and I am not required to for medical or health reasons. Many our friends/neighbors have food allergies. Therefore, I am becoming more educated about common food ingredients being studied for their connection to physical and mental health afflictions.
02:19 AM on 01/02/2011
As a dietitian, I would love to see people not focusing so much on specific macronutrients. Low fat didn't work before, low carb works dramatically for awhile but evidence shows little to no difference after 1 year compared with other diets, and low protein is a bit rough on the body. Every person is an individual and different diets may work differently for them. Getting away from dieting is probably the best medicine by learning to listen to hunger/satiety clues and learning to seek the foods that your body needs. Much of eating is emotional and/or can be related to cravings caused by imbalance in the diet. A healthy relationship with food means never having to say "I'm on a diet". For some great info on getting away from the "diet" mentality and developing a lifelong, healthy, & trusting relationship with food, I would recommend books like "Intuitive Eating" by Evelyn Tribole, MS, RD & Elyse Resch., MS, RD.
(and no, for those wondering, I am not making any money off of recommending this book. I truly have an interest in healthy eating and realize the science is not perfect)
Let's get innovative and learn to love food, not fear it!
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eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
10:26 AM on 01/02/2011
As a dietitian, you have a responsibility to base your recommendations on accurate science.

From http://www.garytaubes.com/2010/12/calories-fat-or-carbohydrates/

"Calories, fat or carbohydrates? Why diets work (when they do).

"Virtually any diet that significantly restricts the number of calories consumed, even a diet that is described as low-fat [...] will cut the total amount of carbohydrate calories consumed as well. This is just simple arithmetic. If we cut all the calories we consume by half, for instance, then we’re cutting the carbohydrates by half, too. And because these typically constitute the largest proportion of calories in our diet to begin with, these will see the greatest absolute reduction. If we preferentially try to cut fat calories, we’ll find it exceedingly difficult to cut more than 400 or 500 calories a day by reducing fat — depending on how much fat we were eating to begin with — and so we’ll have to eat fewer carbohydrates as well.

"Put simply, low-fat diets that also cut significant calories will cut carbohydrates significantly as well, and often by more than they cut fat."

Beckyrajcich: "low carb works dramatically for awhile but evidence shows little to no difference after 1 year compared with other diets,"

Not true.

Reducing carbs and increasing fat leads to lower blood triglycerides and higher HDL = lower cardiovascular risk. Every person, every time: lower risk.

http://qjmed.oxfordjournals.org/content/99/1/1.full
01:53 PM on 01/02/2011
Accurate science is very important and I stand by what I stated earlier and cardiovascular risk IS reduced with many diets when a person loses around 10% of their body weight. My quest to move beyond "dieting" is because it merely deals with the symptoms of a less than healthy lifestyle and does not address how the problem began. 95% of people who diet will regain the weight (this is based on accurate science). Why are they regaining the weight? Temporary weight loss is possible with a diet but it takes lifestyle change to maintain it and live as long as your genes and environment allow. It's important to get beneath the surface and discover what the barriers are to lifelong change and help people to find their permanent, healthful selves.
We live in a society where there is a desperate search for a way to fight obesity and this brings about many different diets including ones that focus on specific macronutrients. There is no doubt that evidence shows benefits of lower carb diets since many people are eating way too many to begin with. If we are in tune with our bodies, with the hunger/satiety signals and other cues, we will be able to identify what we need without measuring and counting grams or calories. Conscious eating is key, but we have to get there first.
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alteredstory
Hold on to the center
11:35 AM on 12/31/2010
I'm still a fan of the interval training + eating consciously thing. Food is fun, carbs are fuel.

Rather than denying yourself foods, eat delicious, entertaining food, just make the bulk of that fruits, veggies, and protein, with enough carbs mixed in to keep you going strong.

And then exercise so you use the protein you eat for building muscle and muscle tone.
03:25 PM on 12/30/2010
Yet another article in which the author starts off as if he's about to critique something in particular and then goes on to critique some vague idea.

There are a lot of qualifications in this article (presumably to cover for the fact that Dr. Katz doesn't really know what the Dukan diet is about). So it is 'as best as [Dr. Katz] can tell...' and the Dukan diet 'seems to be' and so on.

The basic gloss of what the Dukan diet is about isn't even correct in this article!

But the author doesn't need to know what the Dukan is actually about, all he does need to know is that 'the Dukan diet' will become a popular search phrase (given that the Dukan people have just splashed on increased internet marketing) and that writing an article optimized for 'the Dukan diet' will help drive traffic to his website and that of the turnthetidefoundation.
12:49 PM on 12/30/2010
It probably wouldn't do as well if it was called Rabbit Starvation Diet.
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Amanda Donovan
i am made of blue sky and hard rock and will live
12:43 PM on 12/30/2010
start here: dont eat anything with an ingredients list.
12:27 PM on 12/30/2010
"Diets" don't work, period. Going on a diet implies going off it at some point. Learn about nutrition (the information is out there if you look very hard for it), then buy healthy foods, cook them yourself, eat them in sensible portions and get some REAL exercise every day. It is the only thing that really works for the rest of your life. Check out some more nutritional and exercise advice on this site (it also includes many healthy, delicious recipes): http://doitthehardway.com/
04:34 PM on 12/29/2010
I went Vegan for 2010 and I dont see why it's not more popular! It's all about knowing what to eat http://www.fourgreensteps.com/infozone/lifestyle-health/what-vegans-eat-article
02:32 PM on 12/30/2010
Plenty of people know HOW to eat a vegan diet, but understand that it is not a good diet for a human being.
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eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
11:39 AM on 12/29/2010
Dr. Katz: "Cockamamie cut-foods-out then add-them-back then cut-them-out diets are not about health."

Unless you consider them 'elimination' or 'exclusion diets'. http://en.wikipedia.org/wiki/Elimination_diet

"An elimination diet is a method of identifying foods that an individual cannot consume without adverse effects. Adverse effects may be due to food allergy, food intolerance, other physiological mechanisms (such as metabolic or toxins), or a combination of these. Elimination diets typically involve entirely removing a suspected food from the diet for a period of time from two weeks to two months, and waiting to determine whether symptoms resolve during that time period."

Many people use elimination diets to determine problems with foods or food groups.

Major culprits include gluten, dairy, nuts, eggs, artificial colors or flavors, and yes... CARBOHYDRATES.
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DrP
09:54 PM on 01/01/2011
Thanks for saving me the time. I was thinking exactly what you have written here and all I need to do know is say "ditto" and thanks again.
06:18 PM on 12/28/2010
While it may seem like nonsense from a scientific point of view, this diet actually works very well! Some of my friends have successfully done it. They lost all the weight they wanted to and did not take it back (and that is the most important part, all other diets fail at this point). So why criticize it without any feedback? Especially in a country where most of people need to seriously take care of their overweight problem. Even if the best diet remains a combination of healthy food and activity.
12:59 PM on 12/30/2010
It has a basis in science. Look up 'rabbit starvation.'
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eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
10:46 AM on 01/01/2011
Interesting, I did not know it had a name.

aka Protein Poisoning, or mal de caribou

From Wikipedia http://en.wikipedia.org/wiki/Rabbit_starvation

"Vilhjalmur Stefansson wrote as follows:

"The groups that depend on the blubber animals are the most fortunate in the hunting way of life, for they never suffer from fat-hunger. This trouble is worst, so far as North America is concerned, among those forest Indians who depend at times on rabbits, the leanest animal in the North, and who develop the extreme fat-hunger known as rabbit-starvation. Rabbit eaters, if they have no fat from another source—beaver, moose, fish—will develop diarrhoea in about a week, with headache, lassitude and vague discomfort. If there are enough rabbits, the people eat till their stomachs are distended; but no matter how much they eat they feel unsatisfied."
04:27 PM on 12/28/2010
The truth is lots of packaged, commercialized carbs that fill our grocery stores
shouldn't really be for human consumption anyway.
Puffs of bleached sugar, flour and salt all in fancy packages pretending to be food.
And it's everywhere you go. In your face.
Mabey that's why cutting all this cr@p out makes people lose weight.
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maribelles
have opinion? win fans, lose fans
02:48 PM on 12/28/2010
I am wondering why anyone would take nutritional and dietary advice from an MD, when we know MD's
get about 3 hours of "party line" nutrition in school. Your essay has a lot of words which actually say nothing- what does "cutting out a lot of foods " mean? That sounds simple minded. There ARE a lot of "foods" in the Standard American Diet that we SHOULD cut out, and if authors go to the trouble to list them and why (which you did not in your article) , all the better a starting point.
Let's remember too that the vilification of Atkins came long ago, and Atkins himself and more currently the organization modified and developed the dietary approach further. There are many sensible foods one "can" eat on Atkins; one only need acquire a recent book for guidance.
So while I am not defending the Dukan diet, I am commenting on the fluff of this little article, which is essentially meaningless. This really sounds like something Sarah Palin would say... or write on her hand.
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HUFFPOST BLOGGER
David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
04:35 PM on 12/28/2010
The sole purpose of this post was to highlight the silliness of the Dukan Diet, which seems poised to enter the US riding a wave of hype.

If you would like to know what I believe we should eat, permit me to refer you to the 2nd edition of my nutrition textbook (http://www.amazon.com/Nutrition-Clinical-Practice-Comprehensive-Evidence-Based/dp/1582558213/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1207764677&sr=1-1) which provides detailed guidance both for general health promotion, as well as weight control and the prevention/management of chronic disease, as my most scholarly work on the topic. A book for the general public, called 'The Way to Eat,' is quite explicit as well, and perhaps more accessible to a general readership.

I am also the principal inventor of a nutrition guidance system now in roughly 1,000 US supermarkets (www.nuval.com), that has been shown to correlate with health outcomes in a Harvard study of over 100,000 people soon to be published. More of my thoughts on the topics you raise in the 'articles' section at www.davidkatzmd.com.

The fact that few physicians are well trained in nutrition does not mean that having a MD degree precludes it! I respectfully note that my education in the subject went well beyond 3,000 hours, let alone 3.
03:14 PM on 12/29/2010
If you diss Atkins then it was not 3,000 hours well spent in my opinion. I haven't spent much time looking into the Dukan diet, but the only thing that bothers me about it is the fat restriction so far.
01:17 PM on 12/30/2010
It appears you have a serious misunderstand of the Dukan Diet as well as the Atkins Diet since this article is essentially a few paragraphs of "You are all stupid but I'm smart."

The Dukan Diet is a high protein macronutrient diet designed to eliminate for a time all other macronutrients. This induces a well known (but I'm sure not mentioned in the Diet) metabolic phenomenon called Rabbit Starvation. These people will lose weight quickly but in my opinion not safely because they are induce a wasting disease.

Atkins, on the other hand, is not a high protein diet as many people in your camp like to claim. Your protein intake may increase, but the key is to reduce carbohydrates while increase fat. In fact, in some cases they recommend reducing protein as well.

Atkins tend to keep their adherents longer because fat is extremely satiating. The Dukan Diet is unsustainable because you will literally die. That is why they only recommend a week or two of the diet and then returning to normal eating while reserving one day as an all meat day.

Honestly, Dr. Katz. I found this out is 3 seconds of research. 3,000 hours means nothing if you are just going to purposefully reinforce your own point of view. There are actual reasoned criticisms of the Dukan Diet without resorting to false comparisons and name calling.
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eLucida
Liberate Fitzwalkerstan, defeat A.L.E.C.
10:26 AM on 12/30/2010
Some MDs know too little, other MDs "know" too much.

For someone with the expertise, Taubes' GCBC would be a light evening's read.

But can you imagine the cognitive dissonance ?

If the foundation of a person's entire career (grant proposals, promotions, dept. chairmanships, conference invitations etc.) is based on following the USDA/AHA/ADA line you would have to be supremely confident (or a real renegade) to go against the party line.

To take it a step farther, imagine that you have patented a scoring system, based on excluding dietary saturated fats:

High scores are 'healthier':

Fat Free Milk 91
1% Milk 81
2% Organic Milk 55

How could you ever admit that you were wrong?

Once you figured out that promoting a calorie-controlled, low-fat, high-carb diet does not work, has not worked, and is in fact killing people (!) with diabesity then denial of the evidence would be the most appropriate response.

I'm afraid real change has to come from outside the system.
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Amanda Donovan
i am made of blue sky and hard rock and will live
12:36 PM on 12/30/2010
cosign, eLucida. fanned and faved.
09:11 PM on 12/30/2010
Yet another wonderful post from you eLucida. Sadly I cannot fan you again and again.
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Kitster
12:42 PM on 12/28/2010
I lost 110 pounds over the course of a year with the Eat Less Exercise More method, and I've kept it off for 2 years so far. I eat lots of fresh fruits and veggies and have mostly lost interest in sweets. I exercise vigorously about an hour a day on average. Fad diets like Atkins and this Dukan diet probably work well for the tiny percentage of people who are able to sustain them. I know people who achieved significant weight loss with Atkins, but I don't know anyone who could sustain that weight loss. A diet with lots of variety and smaller quantities seems to work well for me.
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GraniteSkyline
I wish you happiness!
10:47 AM on 12/29/2010
Congrats!
10:21 AM on 12/28/2010
If you give up all carbs and all sugar for 10 days, you'll see such results you won't believe it, and the cravings are wild at first. Once you "detox" you will no longer crave them, what a relief. At that point you can begin a "sensible" diet of complex carbs etc, and it will be easy to stick to and you'll eat differently forever. Environmental factors are huge. Whom you can't eat with, you can't have a relationship with. Oops. It will feel like hanging out with alcoholics when you're sober.
techjockey
Keeping My Gratitude Higher Than My Expectations..
12:59 PM on 12/28/2010
I don't think ditching friends because of what they eat is a healthy approach to weight management. It sounds a little fanatical & neurotic.
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GraniteSkyline
I wish you happiness!
10:50 AM on 12/29/2010
There are always diet snipers and saboteurs out there waiting to ambush a successful dieter. They need to be disarmed or avoided.
12:29 AM on 12/31/2010
I've tried to change my diet to something healthier and I've had people (supposedly good friends) give me shit about it.