Diets and the Heart: No Best Diet
No, if there were all doctors would use it. What works for some people doesn't work as well for others. Imagine putting an Asian on a dairy diet and allowing no rice or noodle. Or putting an American on a diet that only allowed rice or noodle, or advising a Hindu to eat a diet that permits only meat. Try denying a Frenchman bread (Marie Antoinette didn't get this distinction). The results could be expected to be dismal. This is the reason that Terry Shintani designed the Hawaii Diet for people in Hawaii. Many other diets are popular because they seem acceptable to the people who are desperate for a way to lose weight. At one time we kept a list of them in the office, and gave sample copies to patients who asked. But there were so many that it became difficult to keep up with all the variations and answer all of the questions about whether there were actual studies, the problems and the usefulness of each type. Patients would be trying the "grapefruit diet" one week, the "miracle cabbage soup" diet the next and then asking about "Atkins", "the Zone" and "South Beach" as they gave up on each in succession.
Diets are very difficult to study because people will only eat what and when they want to. We can really only study diets in animals that we have under our absolute control. And animals are not people. A recent report of the American Dietetics Association suggested that some diets were more effectively heart healthy than others based on an analysis of menus. Unfortunately, this endeavor, while interesting, was not an appropriate test.
Among the diets studied Dean Ornish's diet scored highly. This is not a surprise as this is the only diet that has been scientifically demonstrated to reduce cholesterol deposits in the coronary arteries. This doesn't mean that it better than others, but it does mean that Dr. Ornish has put his theories to scientific testing. Many diets and programs are difficult to follow as is this one. But health is not about what is easy, it is about what works to keep you feeling well.
I can't be so admiring of the Atkins, Zone, or South Beach diets. There is a lot of money being made selling these diets. I don't blame the authors for trying to make a living, but if they want my approval of their diets they will have to put some money into proving that they work rather than just advertising their "success".
My mother claimed to have lost 2000 pounds on the Weight Watcher's diet (a bit of an overstatement, but she did live to be 92 and was on and off the diet for all of the years that I knew her). The advantage of the old Weight Watcher's diet was that the patient could learn it easily and always go back to it when the dresses started to get "skimpy" again. As a physician, I feel that putting things into patient's control in an easy fashion always helps. I'd love to be able to say that all of my patients follow Dean Ornish's recommendations for reducing their chances of a heart attack or stroke, but it wouldn't be true. Whatever works for the individual to get the weight closer to the healthy best for that individual will be better than the "highest rated diet". In other words, show me the results. One thing that doesn't work though is "bellying up to the buffet" on weekends and then expecting exercise to fix the problem. Whether you jog or swim you will not be able to burn more than 600 calories for one hour of (hard) work. So, if you expect to eat what you want and then burn it off, you are in for some disappointment.
An extra comment about diet: if you have a weight issue, it is a lifetime fight. Take off the weight, and keep it off. If you are doing it for a health issue such as diabetes or high blood pressure that health issue will still be there after you have lost the weight. So keep it off.