Slim Pickings

Imagine if you had to worry about each breath you took into your body-whether it contained enough oxygen, whether you were breathing deeply enough, exhaling sufficiently to expel carbon dioxide. It sounds ridiculous, but when you consider another basic human need-nourishment-that's exactly what has happened to many of us. People have become so removed from knowing how to nourish themselves properly that they seize blindly upon whatever new diet book rises to the tops of best-seller lists.

The Zone, Atkins, South Beach-not to mention the myriad others from Weight Watchers to Fit for Life to the Ornish Plan-each of these has at one time or another grabbed the collective attention of American dieters. In frequently touted statistics, we're the nation with the greatest number of dieters in the world, yet one of the most overweight.

Why, with so many varied resources available, and so much awareness, do so many of us still regularly battle our weight? At least part of the answer, it turns out, may lie in the solutions we have been offered.

The Personal Approach

Many popular diet books tend to tout one basic secret to weight gain and loss. Some decry carbohydrates and recommend large amounts of protein; others take an opposite tack, prescribing more carbs and less protein. Some worry about counting calories and fat grams; others claim food combining is the secret to melting away pounds.

The problem is, they may all be right-or wrong. Most doctors agree that differences in metabolic rates, genetics and other factors mean that what may work for one person may have disastrous results for another.

"There is no book ever published that has the right diet for everyone," says Dr. John Sullivan, a naturopathic and chiropractic physician with practices in Naples and Miami. The first thing he does with a new patient is run a series of tests to find out how that individual's body processes foods. Once he determines what foods are good for that person and what foods are, as he puts it, "poison," he's able to draw up a personalized weight-loss plan.

Dr. Caroline Cedarquist of the Cedarquist Medical Wellness Center in Naples has a similar theory. "It's really person-specific," she says. Using tests from blood work to a calorimeter to gauge a patient's metabolism, Cedarquist then recommends individualized diets to meet each patient's needs.

Body Chemistry

The reasons people gain and lose weight tend to vary, again depending on their body chemistry. One factor currently much in the public eye has to do with the glycemic index (GI), or how fast certain foods are metabolized and increase blood sugar. The GI is the basis of diets like Atkins, the Zone and the South Beach Diet, and it is, in fact, based in sound medical fact.

Certain foods-like white bread, potatoes, watermelon and bananas-are rapidly converted into sugar in the body, triggering an increase in insulin levels. "Normally, anytime your blood sugar and insulin are rapidly going up, it's signaling, 'Store fat,'" says Dr. Paul Finucan of the Alternative Health and Healing Center in Naples.

Insulin resistance can result when this process is repeated over time, and it can result in steady weight gain and increased difficulty in losing weight. In addition, says Cedarquist, left untreated it can lead to diabetes, heart disease and other illnesses.

The good news is that it can be treated with proper diet and other health practices, making it not only easier to finally lose weight, but to keep it off. With many fad diets, problems arise once the desired weight is lost: As soon as a person reverts to his earlier eating style, the lost pounds often come back with a vengeance.

Some of the more radical diet plans can actually change the structure of the body's fat cells. "You're starving the cells and your body adapts to your doing that," says Sullivan. "It's preservation. If you go off the diet, you'll gain weight 10 times faster."

Karli Sander, a registered dietician with NCH's Nutrition and Health Center, agrees: "Most of the time people end up gaining the weight back and then some."

"If you starve the body, it's going to slow the metabolism," adds Finucan, "and then as soon as [people] start eating again, they'll put on a lot of weight."

Dieting Misconceptions

The challenge, Sander says, lies in the nature of some of the regimented diet plans on the market. "Initially, fad diets will work because either way you end up cutting your calories down," Sander says. "The problem is that it's really hard to stick to them." And once people reach their desired weight and try to adapt to normal eating habits, "They don't know how to eat right," he adds.

"People interpret [high-protein diets] as 'I can eat whatever I want,'" says Finucan. "I don't agree with that-they go overboard." He and many other doctors don't have problems with the theory behind some of these diet plans so much as the execution. "Choose healthier-quality [proteins] and make that a priority," he says: Those proteins include lean fish, turkey, chicken and small amounts of lean beef.

"We try hard to educate [our patients] about what they should eat," he says. "If they're choosing good, healthy proteins and low-complex carbohydrates, I feel that's a healthy diet."

"Carbohydrate" has all but become a dirty word recently-it's often cited as the chief villain in weight gain by many diet plans. The importance is in understanding the nature of different carbohydrates, and how each affects the glycemic index.

Some carbs-called complex carbohydrates-are processed more slowly in the body, thus alleviating the insulin spike that can cause insulin resistance and consequent weight gain. These include whole grains like barley, brown rice and quinoa, and many fruits and vegetables: broccoli, chickpeas, cherries and so on. The fiber in these foods helps slow their conversion into blood sugar.

Problem carbs are the simple carbohydrates, including starchy offenders such as white bread, rice cakes and pretzels, as well as certain fruits and veggies: corn, baked potatoes, dried fruits and fruit juices.

Another reason people gain weight: "portion distortion," as Cedarquist calls it. Americans in particular are notorious for giant portion sizes, all-you-can-eat buffet-style meals, supersized fast-food items. The U.S. Food Guide Pyramid (which has engendered controversy of its own with its carb-heavy bottom layer, and is currently being revised to reflect current thought about nutrition) recommends certain numbers of servings of food, but many people don't realize how small a serving is: one piece of bread, for instance, or a cut of meat the size of a deck of cards.

Long-Term Balance

Of course, there's much more to proper nutrition than watching which carbs and proteins you take in. The body needs a variety of nutrients found in many different types of foods. And although fat has become an epithet in our society, many people don't realize we need a certain amount of it in our diet.

With fats, as with so many types of nutrients, it's which ones you choose: Healthy fats like fish oil, olive oil and flaxseed oil won't lead to the kinds of problems that less healthy choices-the saturated fats and trans fats found in many snack foods, for example-may bring about.

If you are thinking of beginning a weight-loss plan, the best idea is to talk to your doctor, a dietician or nutrition expert. Let them help you determine your personal needs and body chemistry and create a plan that is right for your body.

The best advice, it seems, is the unglamorous, common-sense approach we've been hearing for years: Choose a balance of healthy, lean proteins, complex carbohydrates and good fats. Watch portions, exercise and drink plenty of water.

"My way may not be as fast, but it's going to be healthy; it's going to be long-term," says NCH's Sander. "You'll feel good, you'll feel healthy-you'll be healthy."