Really, it shouldn’t be so difficult to figure out which eating regimen will set fire to fat while maintaining muscle. Fortunately, the International Society of Sports Nutrition just released its position paper, which combs through all existing scientific studies to report how every diet will affect your body composition. Here, we’ve pulled five of the most six-pack-friendly diets and streamlined how they’re great, as well as why they might be right (or wrong) for you—according to the hard science.
The food options available on the DASH diet closely mirror the eating plan recommended in the US Department of Agriculture’s MyPlate, with a focus on whole foods, such as fruit and veggies; fat-free or low-fat dairy; whole grains; and lean meats, like fish and poultry. (3) Meanwhile, the plan requires cutting back on, or preferably eliminating, processed foods, like sugary drinks and packaged snacks, and limiting red meat, which in excess has been linked to poorer heart health and heart failure, according to a study published in the journal Nutrition, Metabolism and Cardiovascular Diseases. (4)
When you're deciding to go on a diet, there are so many options to choose from. You can go keto and focus on healthy fats, try intermittent fasting, or just eat a certain amount of calories a day. One option you might not have tried yet, though, is the DASH diet, which has a simple goal: keeping your body (especially your heart!) as healthy as possible.
Dairy products contain varying amounts of lactose (milk sugar), which slows down weight loss. What’s more, part of the protein in milk generates a significant insulin response, which can have the same effect. Consequently, cutting back on dairy products may accelerate weight loss. This applies especially to dairy products typically lacking in fat, such as regular milk and various yogurts, but be careful with full-fat dairy such as cream and cheese all the same. And don’t forget whey protein powder, which is pure milk protein.
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? "They're everywhere, and people hear anecdotally that they work," McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. "But again, we don't know about the long term," she says. "And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return."
Due to the highly restrictive nature of the keto diet, it is not safe for certain populations, including pregnant or postpartum women, children or growing teenagers, or individuals with certain diseases. If you are considering this diet, it is important that you speak with your primary care physician first and work with a Registered Dietitian Nutritionist to make sure you are getting all of the essential nutrients your body needs to thrive.
Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed]
Salmon boasts significant anti-inflammatory properties thanks to its rich omega-3 fatty acid content, meaning it’s an excellent source of protein for those looking to jumpstart their weight loss. In fact, one study that examined the effects of weight loss and seafood consumption showed wild salmon to be the most effective at reducing inflammation—better than lean white fish and a fish-free diet. According to a study published in The Journal of Nutritional Biochemistry, fishy fatty acids may also signal thyroid cells in the liver to burn more fat.
DASH was first introduced at a meeting of the American Heart Association in 1996 and later published in the New England Journal of Medicine in 1997.  The DASH trial randomly assigned 456 people to different diets to test the effects of dietary patterns on lowering blood pressure. The authors surmised that eating a diet with many different foods with blood pressure-lowering nutrients would show a greater effect on blood pressure than eating single nutrients, such as found in supplements or in a limited diet. Three diets were tested: 1) a control diet, or a standard American diet, 2) a fruits and vegetables diet, similar to the control diet but providing more fruits and vegetables and less snacks and sweets, and 3) a combination diet rich in fruits, vegetables, nuts, and low-fat dairy foods with reduced amounts of saturated fat, total fat, and cholesterol. The last two diets were richer in nutrients associated with lower blood pressure, such as potassium, magnesium, calcium, fiber, and protein. All three diets provided about 3000 mg sodium, which is more than the recommended amount from the Dietary Guidelines for Americans but less than the average sodium intake for Americans. 
First, that study, which was reported upon widely, was on mice. Mice are not like humans in the way they fatten or contract metabolic diseases. Journalists/media should stop reporting on mice stories as if they were applicable to humans, especially when there is such a large body of clinical trial data on humans. Let’s be clear: rigorous clinical trial data on humans trumps any data on mice. Every time. And what does the rigorous data on humans say?
Pros: Technically a subtype of low-carb diet, the keto diet is unique: By depriving your body of carbohydrates, you not only force your body to become fat-adapted, but also, if you keep protein low as well, elevate your levels of ketone bodies, which is basically a sign your body is running on fat. The keto diet puts you in a unique metabolic state called ketosis wherein your brain burns ketones instead of glucose—and, in doing so, supposedly leads to clearer thinking. Physically, eating such a high amount of fat significantly increases your body’s ability to burn body fat, according to the study analysis. Research also shows keto athletes have a higher VO2 max, and are able to lose fat without losing strength or power.
Calorie Restriction. Most of the research on type 2 diabetes supports the use of calorie restriction for improving many of the metabolic issues that contribute to the condition.   Both the keto diet and low-calorie diets have been shown to help reduce insulin resistance, and many researchers postulate that being in a calorie deficit is the key variable behind these positive effects.  For most of us, the keto diet is the better option to experience the benefits of calorie restriction because it allows you to cut your calories naturally without eliciting strong hunger pangs and cravings.
The Mediterranean Diet was identified in the 1960s as research continued to show populations from Mediterranean regions, particularly Southern Italy, the isle of Crete, and Greece, were considerably healthier, with less incidence of disease and longer lifespans than seen in other regions. Studies indicated that the way these populations ate seemed to be the common denominator and through research, the Mediterranean diet was formally born.
From an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16-week single-arm pilot diet intervention trial. We provided LCKD counseling, with an initial goal of <20 g carbohydrate/day, while reducing diabetes medication dosages at diet initiation. Participants returned every other week for measurements, counseling, and further medication adjustment. The primary outcome was hemoglobin A1c.
Your recipes sound wonderful. I have tried a few. I am a senior living alone and adjusting them can be a challenge. Let’s face it eating the same thing several days in a row can make even a good thing boring. Another thing you and most others posting recipes forget is some of us have very little to spend on food so reading your recipes is many times the only dream of good food.
What the expert says: ‘This is something that is used for athletes as part of their training. While it can lead to weight loss, carbohydrates are an energy source for the body, and restricting them can lead to headaches, fatigue and difficulty concentrating. You would be better to find the level of carbohydrates your body needs by eating normal portion sizes and a balance of all food groups.’
The following measurements were made every other week: anthropometric and vital sign measurements; urine testing for ketones; and assessment for hypoglycemic episodes and other symptomatic side effects. Weight was measured on a standardized digital scale while the participant was wearing light clothes and shoes were removed. Skinfold thickness was measured at 4 sites – the average of 2 measurements at each site was entered into an equation to calculate percent body fat . Waist circumference was measured at the midpoint between the inferior rib and the iliac crest using an inelastic tape; 2 measurements were averaged in the analysis. Blood pressure and heart rate were measured after the participant had been seated quietly without talking for 3 minutes. Certified laboratory technicians assessed urine ketones from a fresh specimen using the following semi-quantitative scale: none, trace (up to 0.9 mmol/L [5 mg/dL]), small (0.9–6.9 mmol/L [5–40 mg/dL]), moderate (6.9–13.8 mmol/L [40–80 mg/dL]), large80 (13.8–27.5 mmol/L [80–160 mg/dL]), large160 (>27.5 mmol/L [160 mg/dL]). Hypoglycemic episodes and symptomatic side effects were assessed by direct questioning of the participant and by self-administered questionnaires.
When it comes to managing diabetes, it is reasonable that reducing carbohydrate intake can help to lower and stabilize blood glucose levels. The positive effects of the ketogenic diet on diabetes control have been demonstrated in animal models, as well as in humans. We recently reported on several studies that demonstrated substantial metabolic benefits.
The subjects had a mean BMI of 42.2, mean age of 56 years, and were of either African-American or Caucasian descent. In their intervention, subjects consumed a LCKD diet with the goal of eating less than 20 grams of carbohydrates per day while reducing dosages of diabetes medication. Subjects also received nutritional counseling and medication adjustment every two weeks.
Cyclical keto diet: The Bulletproof Diet falls into this category. You eat high fat, low carb (less than 50 grams of net carbs a day) five to six days of the week. On day seven, you up your carb intake to roughly 150 grams, during what’s called a carb refeed day. Carb cycling this way helps you avoid the negative effects some people experience when they restrict carbs long term, like thyroid issues, fatigue and dry eyes. Learn more here about how carb cycling works.
Dr. Brian Mowll is the founder and medical director of SweetLife® Diabetes Health Centers and serves clients worldwide as The Diabetes Coach™. He is a master licensed diabetes educator (MLDE), CDE, and was one of the first doctors to be certified to practice functional medicine by the prestigious Institute for Functional Medicine. Since 1998, Dr. Mowll has been helping people across North America to optimize their health and metabolism, control blood sugar, and reverse type 2 diabetes using a natural, personalized lifestyle approach.
WY conceived, designed, and coordinated the study; participated in data collection; performed statistical analysis; and drafted the manuscript. MF assisted with study design, performed data collection, and helped to draft the manuscript. AC analyzed the food records. MV assisted with study/intervention design and safety monitoring. EW participated in the conception and design of the study, and assisted with the statistical analysis. All authors read and approved the final manuscript.
The keto diet is intriguing because it appears to run counter to the prevailing wisdom about the importance of lowering fat intake to prevent diabetes and heart disease, says a co-author of the new study, Gerald Grandl, PhD, a postdoctoral researcher at the Institute for Diabetes and Obesity at the Helmholtz Center in Munich. ETH Zurich conducted the study with University Children's Hospital Zurich.
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat . A similar diet was advocated by Dr. Frederick Allen of the same era .
There is a lack of scientific research when it comes to the long-term effects of the keto diet. When it comes to healthy eating and weight loss, creating sustainable, lifelong changes will result in the best outcomes. Most importantly, think about how this restrictive eating plan will fit into your lifestyle, and if you are willing to give up what may be some of your favorite foods. It’s important to make time for yourself to prepare meals at home and get regular exercise. Strive for progress, not perfection.
As a Certified Diabetes Educator, I was taught to educate my gestational diabetes and pregnant patients with diabetes to avoid fruits and dairy before noon. I know this is hard! That’s when you all are craving that glass of orange juice, but that’s the whole point here. We need you to give up that orange juice for the next six or so months for the sake of your baby. Instead, you can have a real orange with lunch; try it with a spinach salad with tuna salad and whole wheat pita. The nutritional value is pumped up by all those vitamins and the spike on your blood glucose will be reduced dramatically by the fiber in the real fruit combined with the protein you had in your lunch. You can even have a glass of milk; you’ve included all of your necessary food groups, and you are still only at 45 carbohydrates for the whole meal!
At the first visit, participants were instructed how to follow the LCKD as individuals or in small groups, with an initial goal of ≤20 g carbohydrate per day. Participants were taught the specific types and amounts of foods they could eat, as well as foods to avoid. Initially, participants were allowed unlimited amounts of meats, poultry, fish, shellfish, and eggs; 2 cups of salad vegetables per day; 1 cup of low-carbohydrate vegetables per day; 4 ounces of hard cheese; and limited amounts of cream, avocado, olives, and lemon juice. Fats and oils were not restricted except that intake of trans fats was to be minimized. Participants were provided a 3-page handout and a handbook  detailing these recommendations. Participants prepared or bought all of their own meals and snacks following these guidelines.
But DASH—which stands for Dietary Approaches to Stop Hypertension—is far from a fad diet. Created by the National Heart, Lung, and Blood Institute (NHLBI), the DASH Diet is designed to improve health in people with high blood pressure, a.k.a. hypertension. (In the U.S., one out of every three adults has high blood pressure, according to the Centers of Disease Control and Prevention.) U.S. News & World Report has named the DASH Diet the best overall diet for the past eight years.
What the diet advocate says: The food baby of the US reality couple Heather and Terry Dubrow (she stars in the Real Housewives of Orange County; he’s a plastic surgeon starring in a show called Botched). ‘As opposed to the keto diet that aims to get you to a ketogenic state of using fat as fuel, which isn’t healthy or sustainable in my opinion, interval eating helps you go into a fat-burning state that leads to increased energy and cell renewal - a process called autophagy, the toxin-eating phase,’ says Terry.
It usually takes three to four days for your body to go into ketosis because you have to use up your body's stores of glucose, i.e., sugar first, Keatley says. Any major diet change can give you some, uh, issues, and Keatley says he often sees patients who complain of IBS-like symptoms and feeling wiped out at the beginning of the diet. (The tiredness happens because you have less access to carbs, which give you quick energy, he explains.)
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose). Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.
Most people who want to lose weight have more than 12 pounds to lose. That’s why even the best weight loss drug in the world can only be an optional complement to other treatment. That’s why this piece of advice is number 18 out of 18. It may be a helpful addition for some people, but the advice higher on the list is what can make the biggest difference, by far.
I LOVE your recipes and entire program! You simplify eating healthfully and your recipes look delicious. I have arthritis and must eat a restricted diet that is anti-inflamatory. I can easily see ways to adapt some of your recipes. The diet forbids grains, beans, wheat, chick peas, potatoes, pasta, or any fruits or vegetables with seeds, etc. I was skeptical about this diet at first but if I stick to the diet, I really do experience less pain. I would so wish to have your recipes adapted for the home cook with substitutions of allowed foods for the forbidden. For instance, I am going to try to make your phyllo recipe using almond flour, and in other recipes using only pasture grazed dairy such as goat and sheeps milk cheeses, yogurts, eggs etc. Thank your for your inspiration and I would be so grateful if you would turn your gifted cooking attention to helping those of us in pain to adapt your delicious and healthful diet to include anti-inflamation recipes. There is a huge and eager market for this.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
Note: Because you'll be excluding some major food groups on the keto diet (grains, many fruits) you should definitely think about taking a multivitamin—especially one that contains folic acid, which helps your body make new cells and is often found in enriched breads, cereals, and other grain products, says Julie Upton, R.D., cofounder of nutrition website Appetite for Health.
Swanson, a professor of neurology who has researched the impacts of ketogenic diets on inflammation in the brain, got curious about the ketogenic diet when trying to treat the inflammation that persists for days after a person suffers a stroke. When he tried inducing a ketogenic state in mice with stroke injuries, he said, “I was overwhelmed by the effect.” Blocking glucose metabolism worked to suppress inflammatory genes, which in turn helped stroke healing.
The trick here is not only to avoid all obvious sources of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will be converted into glucose in your body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
“I think the caution with a low-carbohydrate diet is the idea that it’s very restrictive,” Zeratsky says. “When you start getting into the very low carbohydrates, when you’re talking about 20 grams, which for some people would be a cup of [starchy] vegetables. … If there is someone who is interested in it, it’s very important they understand what a low carbohydrate diet means in a practical sense.”
Also recognizing what worked 6 months to 1 year ago may not work today. Our bodies change over time and we have to adapt to those changes. So many factors affect your blood glucose levels; you will face hormonal changes, stress related changes, and your pancreas may not be working as well today as it did a year ago and we wouldn’t expect it to. Just as the heart of an 18 year old person is much stronger than it will be at the age of 50 years of age, your pancreas’ function will decline with age with the normal aging process. Many of my patients throughout the years have came to me feeling so defeated because now they have to go on medication or insulin. They are so relieved to hear this may not be due to anything they have caused by overeating or weight gain, it may be just the unfortunate natural progression of diabetes. Until we discover cures for the different types of diabetes, this is what we face.
The improvement in glycemic control occurred while medications for diabetes were discontinued or reduced in most participants (Table (Table5).5). During the study, hypertension and hyperlipidemia medication doses were not increased from baseline nor were new agents added, except in 3 individuals. No serious adverse effects related to the diet occurred. One participant had a hypoglycemic episode requiring assistance from emergency services after he skipped a meal but the episode was aborted without need for transportation to the emergency room or hospitalization.
The comments defending the keto diet suggest that the individuals are successfully using the keto diet to help them maintain a healthy weight and a healthier A1C level. The individuals also suggest that they view it as a way of life rather than a diet. This is good news for many of us who are facing the question of whether it will be helpful and necessary to reduce carbohydrate intake to keto producing levels in order to halt or reverse the onset of type II diabetes. I think like those individuals, Tami is speaking from her own personal experience where she had success losing weight, but had difficulty maintaining the keto diet long-term. I am sure that though you have been successful, you can understand that there are many who might find it difficult to maintain. I too have been given very bad guidance by Medical Doctors who lean on old Med School information to practice medicine rather than continuing to broaden their knowledge base and learn more about nutrition. I cannot get back the 20+ years of suffering with a debilitating disease that could have been cured because my doctors were not well informed or willing to listen to information that disagreed with their limited knowledge base. Those years are gone and the destruction to my body is not reversible. So I understand the anger you feel toward a system that isn’t working in the best interest of the patient. But I think that expressing anger toward those who disagree with our personal experience, is not solving the problem. Hopefully we can change the ADA guidelines by respectfully urging them to reconsider their position based on the sheer volume of the comments they receive from successful people like you, who are living the keto diet lifestyle and living better. I commend you for becoming your own best health advocates. Thanks for your encouragement and your passion. And thanks to Tami as well for sharing her personal experience and the information she had collected. We all have to be true to what we believe and we all have a right to come to our own conclusions. It is good to know that there are success stories out there. I wish you all good health and continued success. I also hope that one day medical training will do a much better job of preparing doctors to become their patient’s best advocates, actively learning and searching for cures rather than treating symptoms in ways that cause even more disease to develop. The system is failing so many of us.
I do know a little bit about nutrition (what heavy person doesn't?). I wanted a plan that followed sound nutritional guidelines and had some research to back it up. This one does. Marla does a great job of explaining why the things I learned about nutrition in my 20s aren't working for me in my 40s, and then lays out, clearly, concisely, and with menus and recipes, what *will* work...and it did. I was nervous about cutting down on grains--I attempted the Atkins plan a few times and it just made me sick--but I felt fine. The menu plans are satisfying and tasty, and Marla has really helped me to re-frame the way I think about food.
The Mediterranean diet has long been recognized as one of the healthiest and most delicious ways to eat. The core concept behind this healthy diet is to eat like the people who live in the Mediterranean region—fill your plate with fresh fruits and vegetables, healthy fats, whole grains, legumes and fish and enjoy moderate amounts of red wine. This 7-day Mediterranean meal plan features these good-for-you foods and delicious flavors for a week of healthy of eating. Plus, at 1,500 calories you're on track to lose a healthy 1 to 2 pounds per week.
My husband and I have been doing this diet for a while now. And let me tell you it works. He has lost weight and his blood pressure has gone down!! It isn't a hard diet at all, the first 2 weeks you learn to live without carbs , but that isn't to bad. The 2nd phase you start adding some carbs back along with other foods. It's all about making the right choices.
On the flip side, hypos can be an issue, especially early on…and if you treat them too aggressively, they could knock you out of ketosis. I remember my first 3 weeks on keto, my CGM trend line hugged a blood sugar of around 80. It was glorious, but I had to reduce insulin substantially through trial and error and felt like I was low every five seconds.
Pros: Compared to eating a traditional diet, switching to a low-carb diet can significantly reduce body fat, studies show. Cap your carb intake at 20% of daily calories and the weight-loss results are even stronger—plus, you can reduce your risk for heart disease and stroke. Some research suggests low-carb diets are even better than low-fat diets: One study in Annals of Internal Medicine found that people who limited their carbs lost eight more pounds than those who cut back on fat. If you cut back on carbs enough, your body learns to burn fat as fuel instead. Studies are mixed on how low-carb diets affect performance, but some evidence suggests that endurance performance can actually improve among people whose bodies adapt to fat-burning fairly easily.
That’s because the DASH Diet has been proven to work, says Reshmi Srinath, M.D., an assistant professor at the Icahn School of Medicine at Mount Sinai. One study found that people who followed the DASH Diet had lower blood pressure and LDL (bad) cholesterol levels than those who consumed a typical American diet or an American diet infused with extra fruits and veggies.
This diet plan focuses on foods that are sources of protein and fat, which will help to keep you feeling full which may help you eat less overall. However, the keto diet is not a license to eat as much bacon and cheese as you want. It is even more critical to make good choices while on this diet because following a strict keto diet could result in vitamin and mineral deficiencies. And while the diet does eliminate many processed and ‘junk’ foods, it also limits many fruits, vegetables, and other important fiber-rich carbohydrate foods, which provide many health benefits.
But beyond that, experts aren't convinced that the keto diet has any other scientifically-proven health benefits. In fact, it may have some distinct downsides. If you follow the keto diet incorrectly, for example (like by eating lots of saturated fats, versus healthy unsaturated fats), you're at risk of raising your cholesterol levels. “The best strategy to keep your heart healthy is to get as much fat as possible from unsaturated sources such as olive, avocado and canola oils, nuts, seeds, avocados, and olives," says Ansel.