Conventional diets

For most people, the problem is not one of severe obesity, but a more modest excess body weight. Even for people who have a serious problem of obesity, it is likely that less drastic measures than those discussed above will be beneficial. The aim is to reduce energy intake to below expenditure, and so ensure the utilization of adipose tissue reserves. To anyone who has not tried to lose weight, the answer would appear to be simply to eat less. Obviously it is not so simple. As shown in Figure 6.3, there is a considerable, and increasing, problem of obesity in Western countries — and a vast array of diets, slimming regimes, special foods and appetite suppressants is available.

The ideal approach to the problem of obesity and weight reduction would be to provide people with the information they need to choose an appropriate diet for themselves. This is not easy. It is not simply a matter of reducing energy intake, but of ensuring at the same time that intakes of protein, vitamins and minerals are adequate. The preparation of balanced diets, especially when the total energy intake is to be reduced, is a highly skilled job, and is one of the main functions of the professional dietitian. Furthermore, there is the problem of long-term compliance with dietary restrictions — the diet must not only be low in energy and high in nutrients, it must also be attractive and pleasant to eat in appropriate amounts.

A simple way of helping people to select an appropriate diet for weight reduction is to offer three lists of foods:

  • Energy-rich foods, which should be avoided. These are generally foods rich in fat and sugar but providing little in the way of vitamins and minerals. Such foods include oils and fats, fried foods, fatty cuts of meat, cakes, biscuits, etc. and alcoholic beverages. They should be eaten extremely sparingly, if at all.
  • Foods which are relatively high in energy yield but also good sources of protein, vitamins and minerals. They should be eaten in moderate amounts.
  • Foods which are generally rich sources of vitamins and minerals, high in starch and non-starch polysaccharide and low in fat and sugars (i.e. nutrient dense). These can be eaten (within reason) as much as is wanted.

An alternative method is to provide people with a series of meal plans and menus, designed to be nutrient dense and energy low, and providing sufficient variety from day to day to ensure compliance.

To make this less rigid and prescriptive, it is easy to provide a list of foods with 'exchange points', permitting one food to be substituted for another. At its simplest, such a list would give portions of foods with approximately the same energy yield.

A more elaborate exchange list calculates 'points' for foods based on their energy yield, nutrient density and total or saturated fat content. The consumer is given a target number of 'points' to be consumed each day, depending on gender, physical activity and the amount of weight to be lost, and can make up a diet to meet this target. An advantage of this is that foods that might be considered forbidden in a simple energy-counting diet can be permitted — but a single portion may constitute a whole day's points.

An interesting variant of the exchange points system also allocates (negative) points to physical activity, so promoting physical activity as well as sound eating habits.

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