Stress Less Pregnancy

Stress Less Pregnancy

Many pregnant women fret too much about the wrong things, and pay too little attention to issues that can genuinely harm their pregnancy and baby. See how your concerns compare to other women’s, then learn whether or not your fears are well-founded and—the bottom line—what you can do to have a healthy and happy pregnancy.

First comes the excitement, followed immediately by the worry. Once you’ve adjusted to the fact that you’re pregnant, you may find yourself stressing about whether your baby will be born healthy . . . or you might have a miscarriage . . . or you won’t be able to stand the pain of labor . . . or be able to breastfeed. The list goes on and on.

If you tend toward worrying in the first place, there’s plenty of fodder in the news to keep you on high alert (killer cat litter, toxic sushi, collapsing cribs), and even the more laid-back among you may have moments of anxiety when the nurse is searching for the baby’s heartbeat on the ultrasound, it’s time for prenatal tests or seemingly strange symptoms arise. Add the surge in pregnancy hormones, and you’ve got a surefire recipe for angst.

But pregnancy risks are generally low, especially for healthy women, and don’t warrant a high level of concern on the part of most moms-to-be. To counter excess anxiety, experts advise trying to change the negative chatter in your head and tone down any extreme thoughts. “To do that you need to focus on the evidence that contradicts your worrisome thoughts,” says Sari Shepphird, Ph.D., a psychologist in Los Angeles.

That’s why we asked experts to provide a reality check on 10 of the things pregnant women worry about most, based on a recent March of Dimes survey (the number beside each worry is the percentage of respondents who reported having that concern). “If you keep reminding yourself of the facts, it will reduce speculation, which in turn reduces worry and stress,” says Shepphird. Also, she says, instead of worrying about things you can’t control (that martini you had before you knew you were pregnant), focus on what you do have control over (how much weight you gain during pregnancy).

Here’s the bottom line on some of the fears you’re likely to face during pregnancy, along with issues you might want to pay more attention to (see “5 Things You Should Worry About,”). Plus, we tell you what really counts—the simple things you can do to move past worry and improve your chances of having a healthy pregnancy and baby.

1. Birth defects (78%)

REALITY CHECK:

About 97 of every 100 babies born in the U.S. arrive without a major birth defect, such as spina bifida or Down syndrome. That’s the optimist’s way of viewing the 3 percent risk of delivering a baby who does have one. Plus, many birth defects, such as club foot, webbed toes and even some heart defects, are minor or very treatable. “Surgical treatments are available nowadays, and many of them are very successful,” says Richard Olney, M.D., a clinical geneticist at the National Center on Birth Defects and Developmental Disabilities in Atlanta.
If you’re not in a higher-risk group, the chances that you’ll have a baby with a birth defect may be even lower: Risk factors include diabetes, epilepsy, smoking, drinking alcohol and obesity, although for 70 percent of all birth defects, the cause is unknown.

WHAT YOU CAN DO:

Act as if you’re pregnant as soon as you decide you want a child (or even before—half of all pregnancies in the U.S. are unplanned). “Most structural birth defects occur as early as a week or two after you miss your period,” explains Michael Lu, M.D., associate professor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles. Waiting until you know you’re pregnant may be too late to prevent these defects.

Take at least 400 micrograms of folic acid daily to reduce the risk for neural-tube defects, such as spina bifida; eat a healthy, balanced diet; avoid fish that contain mercury; stop drinking alcohol, smoking cigarettes or using recreational or over-the-counter drugs; don’t eat undercooked meat or change the cat’s litter box (both are possible sources of toxo- plasmosis, an infection that can cause birth defects); lose weight, if needed; and make sure your blood sugar levels are normal.

2. Miscarriage (75%)

REALITY CHECK:

The risk of miscarriage is probably lower than you think. For women younger than 35, it’s 10 to 12 percent; for 35- to 39-year-olds, it’s 18 percent. (It does rise to 34 percent for women 40 to 44 years old.) But a great many pregnancies are lost so early that a woman never even realizes that she conceived. What’s even more reassuring is that by the time you see a heartbeat on an ultrasound (usually by week six or seven), the chance of having a miscarriage drops to less than 5 percent, says Lu.

WHAT YOU CAN DO:

Remind yourself that most miscarriages occur because of chromosomal abnormalities that cannot be prevented; research does not show that exercise, sex or even heavy lifting can cause a miscarriage. One lifestyle caveat: Recent studies have shown that drinking two or more cups of coffee a day may increase your risk, as may contracting certain infections, including sexually transmitted diseases and gum disease.

3. Too much stress (74%) 

REALITY CHECK:
Everyday stressors like having to work late, getting stuck in traffic or arguing with your husband are not likely to pose a risk to your pregnancy or your child. But ongoing major stress accompanied by depression (the two often go hand-in-hand) may increase your risk of preterm delivery or having a low-birth-weight baby or a child with long-term behavioral issues.

“If you are impaired in some way by the stress—you aren’t able to get along with your co-workers or partner, say—that’s when it may have an impact,” says Tom O’Connor, Ph.D., a professor of psychiatry and psychology at the University of Rochester Medical Center in New York. “If your stress doesn’t reach that level, it may not be significant in terms of pregnancy complications,” he says.

WHAT YOU CAN DO:

For ongoing stress or depression, see a cognitive behavioral specialist who can teach you coping strategies, such as questioning the anxiety-causing chatter in your head. She can also teach you relaxation exercises and visualization to lower your stress hormone levels. You can even use the breathing exercises taught in childbirth classes. While practicing deep breathing, imagine what concerns you as you’re inhaling; then, while exhaling, picture yourself releasing the thought or concern that is on your mind. You can also use a phrase like “let it go” when you breathe out, says Shepphird.

4. Prematurity (71%)

REALITY CHECK: 

 Prematurity is a legitimate concern. However, worrisome as pre-term birth is, the great majority of babies in the U.S. are born after 37 weeks, which is considered full term (this may be changing; see “Rethinking ‘Full Term'"). An estimated 12 percent are born preterm, which increases their risk of health problems, but keep in mind that 70 percent of them are born between weeks 34 and 37. These so-called “late-term” babies still have increased risks, but they are less vulnerable than the tiniest ones. The biggest risk factors for preterm birth are having had a previous premature delivery, being pregnant with multiples, and having certain uterine or cervical abnormalities. Still, about half of women who deliver prematurely don’t fall into any high-risk category.

WHAT YOU CAN DO:

 Obesity, high blood pressure and diabetes are risk factors for prematurity, so try to maintain a healthy weight and make sure your blood sugar and blood pressure levels are normal. Avoid smoking, alcohol and recreational drugs (all are linked to prematurity), get good prenatal care and make sure you have all your necessary immunizations and have any infections (even minor ones) treated promptly, as infections are a leading cause of preterm birth. Ongoing major stress can also trigger preterm labor, so be sure to treat any severe anxiety or depression. Many mood-altering medications are considered safe during pregnancy; ask your doctor which ones might be best for you.

5. Labor pain (70%)

REALITY CHECK:

We’re not going to tell you labor doesn’t hurt—most women rate it as a 7 or 8 out of 10 on the pain scale—but you have options when it comes to easing both your pain and your fear of it. If you want to avoid medication, there’s much you can do to reduce the pain and the anxiety surrounding it, such as laboring in a tub of water, changing positions often during labor and practicing relaxation techniques like guided imagery.

Or, you may want to opt for pain meds. If you’re worried about the risks, rest assured that today’s epidurals are safe and mom-friendly. Though you may have heard that pain medications prolong labor, they don’t prolong the first—and longest—stage of labor, and may even shorten it, says Cynthia A. Wong, M.D., a professor of anesthesiology at Northwestern University Feinberg School of Medicine in Chicago. Epidurals do tend to lengthen the shorter “pushing” phase because they dull the otherwise intense urge to push, but there’s no convincing evidence that they increase the risk of Cesarean section or low Apgar scores for your newborn.

WHAT YOU CAN DO:

First, educate yourself about all your pain-relief options and their risks and benefits. If you are trying to avoid using medication, research suggests that a birthing coach or doula can help you “go natural” by reminding you to breathe, talking you through the stages of labor and reassuring you that nothing is wrong as the pain intensifies. Also learn what to expect, because the unknown can cause more anxiety. “If you know exactly what is causing the pain, it can reduce your anxiety,” says Erika Bleiberg, a doula in Glen Ridge, N.J. Anxiety can cause tension, which can make breathing more dif-ficult and the pain worse, she adds. Sign up early for a childbirth course, such as Lamaze, the Bradley Method or HypnoBirthing; classes fill up fast.

Also have a birth plan, but don’t make absolute decisions beforehand. “Women get disappointed and feel guilty when they have a plan and things change,” Wong says. If you’re on the fence and not sure how you’ll handle the pain, don’t try to be a hero and wait until you can’t stand it anymore. It takes at least 20 to 30 minutes between the time you say, “Give me the drugs!” until they’ve been administered and you feel relief.

6. Eating sushi (61%)

REALITY CHECK:

 Most experts recommend avoiding raw fish while pregnant because of the risk of being exposed to bacteria and parasites (these infections are often difficult to treat during pregnancy because some medications can be unsafe). But your actual risk may be quite low. “If sushi chefs are well trained and freeze fish adequately before serving it raw, the risk should be extremely low,” says Jeffrey Jones, M.D., of the U.S. Centers for Disease Control and Prevention. The other concern, though, is the mercury in some fish: Tuna can be high in this toxin.

WHAT YOU CAN DO:

Rest assured that if you desperately need to quell a sushi craving or you had some sushi before you knew you were pregnant, chances are you’re fine. To keep mercury consumption down but still benefit from the healthy omega-3 fatty acids in certain seafood, do not eat more than 6 ounces of fresh tuna a week, but do eat up on things to 12 ounces of canned light tuna or other low-mercury seafood, such as shrimp, wild salmon, catfish, sardines and anchovies.

7. Breastfeeding (60%)

REALITY CHECK:

You may have heard reality TV star Bethenny Frankel (or even one of your friends or family members) say that breastfeeding was “the hardest thing in the world.” The truth is, 90 percent or more of women can successfully breastfeed, given patience, realistic expectations and support. Most women think they will click with the baby right away and breastfeed effortlessly. If they don’t, many new moms worry that they have an unsolvable problem. “It takes two to three weeks before the mother and baby really know each other and the milk production matches the baby’s needs,” says Laura Viehmann, M.D., a pediatrician in Pawtucket, R.I.

WHAT YOU CAN DO:

Before you give birth, imagine yourself happily nursing your baby, and have a lactation counselor or doula lined up to provide expert advice if you need it. Also consider visiting a breastfeeding support group before your baby is born. “Women who have seen other women breastfeed are much more able to do so successfully,” Viehmann says.

Nipple pain is one of the most common reasons women give up on nursing, but this can be avoided with a good latch-on technique (watch our step-by-step video here). If you experience even a little pain when nursing, seek help immediately.

Another concern new moms have is that the baby is not getting enough milk, but your expectations may be too high. Newborns only drink about 1 1∕2 ounces of milk in the first 24 hours, and only a few ounces a day in the next few days, because you’ll produce colostrum— the calorie-dense, nutrient-rich “pre-milk”— before your milk comes in on day four or so.

Finally, try to surround yourself with people who will be positive and supportive of your efforts to breastfeed. “It’s a lot harder if you have people around you suggesting that you give the baby a bottle,” Viehmann says.

8. Losing the pregnancy weight (59%)

REALITY CHECK:

This is a valid concern, especially for the 41 percent of women who gain too much weight during pregnancy and for those who were very overweight before they got pregnant.

WHAT YOU CAN DO:

Stick to the Institutes of Medicine guidelines for weight gain during pregnancy and you’ll have an easier time taking it off later. If you’re normal weight (your body mass index, or BMI, is 18.5 to 24.9), gain 25 to 35 pounds; if you’re underweight (BMI less than 18.5), gain 28 to 40 pounds; if you’re overweight (BMI 25 to 29.9), gain 15 to 25 pounds; and if you’re obese (BMI 30 or higher) gain 11 to 20 pounds, though some experts believe obese women should stay at the low end of that range.

Try to stay active during your pregnancy and start exercising after giving birth as soon as you get the green light from your OB. Studies show that diet and exercise together to 12 ounces of canned light tuna or other low-mercury seafood, such as shrimp, wild salmon, catfish, sardines and anchovies. can help you lose weight postpartum faster than either tactic alone. And breastfeed: Recent research found that if you stay within the prenatal weight-gain guidelines and feed your baby nothing but breast milk for the first six months, you’ll likely lose all your pregnancy weight during that time.

9. Heavy lifting (57%)

REALITY CHECK:

There’s some evidence that being on your feet all day or having a job that requires heavy lifting may raise your risk of preterm labor, but the research is inconsistent.

WHAT YOU CAN DO:

If you’re at increased risk for preterm labor, you will be advised to avoid heavy lifting and prolonged standing. Worried about either? Talk to your boss about switching to a job that allows you to sit more or take more frequent seated breaks.

10. Getting to the hospital on time (55%)

REALITY CHECK:

Though it always makes the news when a woman delivers in a taxi or on the bathroom floor, in real life, it’s rare. In a study from England, 137 out of 31,140 babies were born before they arrived at a hospital over a five-year period—that’s less than a 1 percent chance. If it’s your first baby, you should have plenty of time: From the time your cervix is dilated 4 centimeters (when experts say you should head to the hospital) you still face an average of six hours for the first stage of labor (when your cervix dilates to 10 centimeters) plus another two hours of serious pushing, says Siobhan Dolan, M.D., M.P.H., an associate professor of clinical obstetrics and gynecology and women’s health at the Albert Einstein College of Medicine in the Bronx, N.Y. If it’s your second baby, the first stage of labor usually lasts two to 10 hours.

WHAT YOU CAN DO:

Most women don’t need to worry about this if they follow the guidelines above. If you had a very quick labor previously or you live far from a hospital, you should check in with your doctor or midwife sooner rather than later, Dolan says.

5 things you SHOULD worry about

In the March of Dimes survey, fewer than half of the pregnant women said they were concerned about the following issues, all of which, experts say, pose serious potential risks.

1. GETTING AN INFECTION

Infections can be more serious during pregnancy and lead to complications such as preterm birth. In 2009, 5 percent of pregnant women who reported having the H1N1 virus (the “swine flu”) died, and 22 percent were admitted into the intensive care unit. Even a common urinary tract infection can lead to a dangerous kidney infection and preterm birth when you’re pregnant, so see your doctor immediately if you have symptoms of infection, such as fever, inflammation or pain. “Things that you might sit on when you’re not pregnant should be addressed more quickly when you are,” says OB-GYN Siobhan Dolan, M.D., M.P.H.

2. GAINING TOO MUCH WEIGHT

A three-state survey found that 41 percent of pregnant women are gaining more than the recommended amount of weight, the U.S. Centers for Disease Control and Prevention reports. Doing so can put you at risk of pregnancy complications, prematurity, birth defects, retaining the weight postpartum and having an overweight child. Try to eat twice as healthy when you’re pregnant, not twice as much.


3. NOT EXERCISING ENOUGH

Only 23 percent of pregnant women get the recommended 30 minutes or more of moderate exercise a day, according to a recent study. Lack of exercise can contribute to excessive weight gain, loss of strength and stamina just when you’re going to need them most, and pregnancy complica- tions. If you’re not exercising yet, start with leisurely short walks, then gradually increase your speed and walking time.

4. USING HOME CLEANING PRODUCTS

Try to avoid using bleach and other strong chemicals or use them only in well-ventilated areas, says Ted Schettler, M.D., science director of the Science and Environmental Health Network and co-author of In Harm’s Way: Toxic Threats to Child Development. The same is true for home improvement projects like painting or refinishing. Find nontoxic alternatives whenever possible, and forgo air fresheners, pesticides and lawn chemicals entirely. For more ways to protect yourself and your developing baby, go to fitpregnancy.com/goinggreen.

5. DEVELOPING GESTATIONAL DIABETES

About 6 to 8 percent of pregnant women develop gestational diabetes, which can raise the risk of serious pregnancy complications, and the numbers are growing. Plus, new research is showing that even expectant moms with borderline gestational diabetes—elevated blood sugar levels that are below the current cutoff point—have an increased risk of complications like preeclampsia, preterm delivery, having a too-large baby and needing a C-section. Exercise regularly, watch your sugar intake and cut back if you’ve been diagnosed or told your blood sugar is elevated.

It Safe For Pregnant Women To Eat Peanuts?

 It Safe For Pregnant Women To Eat Peanuts?

So long as they don't have nut allergies themselves, pregnant women shouldn't be afraid that eating nuts might trigger allergies in their child, according to a large new study.
In fact, when women ate nuts more than five times a month during pregnancy, their kids had markedly lower risk of nut allergies compared to kids whose mothers avoided nuts, researchers found.

"The take-home message is that the previous concerns or fears of the ingestion of nuts during pregnancy causing subsequent peanut or nut allergy is really unfounded," Dr. Michael Young said.
Young is the study's senior author and an attending physician in allergy and immunology at Boston Children's Hospital.

He cautioned that pregnant women shouldn't start eating peanuts and tree nuts to prevent their children from developing nut allergies, however.
"Even though our study showed a reduction of risk, I really have to emphasize that the way our study was done only shows an association," he told Reuters Health.
He and his colleagues write in JAMA Pediatrics that between 1997 and 2010 the prevalence of peanut allergies tripled to 1.4 percent of U.S. children.

For the new study, the researchers used data from a national study of female nurses between the ages of 24 and 44 years old. Starting in 1991, the women periodically reported what they ate.
The researchers then combined information on the women's diets from around the time of their pregnancies with data from another study of their children.

In 2009 the women completed a questionnaire that asked whether their children had any food allergies. Of 8,205 children in the study, 308 had food allergies, including 140 who were allergic to peanuts or tree nuts.

Tree nuts include walnuts, almonds, pistachios, cashews, pecans, hazelnuts, macadamias and Brazil nuts.

Overall, the researchers found that eating nuts while pregnant was not tied to an increased risk of nut allergies among children. On the contrary, the more nuts women reported eating during pregnancy, the less likely their children were to have nut allergies.

About 1.5 percent of children of women who ate less than one serving of nuts per month during pregnancy developed nut allergies. That compared to about 0.5 percent of children of women who ate five or more servings per week.

In other words, kids whose mothers ate nuts most often had about a third of the risk compared to kids whose mothers ate nuts least often.

The exception was children of women who themselves had a history of nut allergies. In those cases, when women ate nuts five or more times a week during pregnancy, their children had about two and a half times the risk of nut allergies compared to the kids of allergic mothers who avoided nuts during pregnancy.

"Certainly this is reassurance that eating nuts during pregnancy will not increase your child's risk of allergy," Dr. Loralei Thornburg said. "In fact, it may be tied to a decreased risk of nut allergies."
Thornburg was not involved in the new study but is a high-risk pregnancy expert at the University of Rochester Medical Center in New York.

However, "if there is a strong family history at all or if the mother herself has any food allergy, then she should go talk to her physician, because there is not clear data on that," Dr. Ruchi Gupta said.
Gupta is an associate professor of pediatrics at the Northwestern University Feinberg School of Medicine in Chicago and an expert on food allergies and asthma.

In an editorial accompanying the new study, Gupta wrote that it will take additional studies and research to understand why a growing number of children are developing food allergies and how to prevent it.

"What I do like about the study is it adds evidence that mothers-to-be should eat whatever they wish and not worry that the consumption of certain foods will result in allergies," she said.
SOURCE: http://bit.ly/Ms92Cy JAMA Pediatrics, online December 23, 2013

AIDS से भी ज्‍यादा खतरनाक 'सेक्‍स सुपरब

अमेरिका राज्‍य हवाई में 'सेक्‍स सुपरबग' के दो मामले सामने आने से हड़कंप मचा हुआ है. डॉक्‍टरों ने चिंता जताई है कि 'सेक्स सुपरबग' एड्स से भी ज्‍यादा जानलेवा है और उन्‍होंने अमेरिकी कांग्रेस से इसकी रोकथाम के लिए 54 मिलियन डॉलर की राशि की मांग की है, ताकि इसकी दवा की खोज की जा सके.

नैचुरोपैथिक मेडिसन के डॉक्‍टर एलन क्रिस्‍टीएंसन के मुताबिक, 'यह एड्स से भी ज्‍यादा खतरनाक हो सकता है क्‍योंकि इसका बैक्‍टीरिया अधिक प्रभावशाली और ज्‍यादा से ज्‍यादा लोगों को प्रभावित कर सकता है.'

इंटरनेशनल बिजनेस टाइम्‍स के मुताबिक सेक्स सुपरबग को गोनोरिया या H041 के नाम से भी जाना जाता है और इसकी खोज जापान में 2009 में की गई थी. तब एक सेक्‍स वर्कर इस सुपरबग का पहला शिकार बनी थी. हवाई में सेक्‍स सुपरबग का पहला मामला मई 2011 में मिला था और इसके बाद ये कैलीफोर्निया और नॉर्वे तक में फैल गया.

डॉक्‍टर एलन क्रिस्‍टीएंसन का कहना है कि हर साल एड्स और इससे संबंधित बीमारियों से दुनिया भर में 30 मिलियन लोगों की मौत हो जाती है, लेकिन सेक्‍स सुपरबग के इससे भी ज्‍यादा घातक होने की आशंका जताई गई है. उनके मुताबिक, 'गोनोरिया से संक्रमित होने से सेप्टिक शॉक हो सकता है और कुछ ही दिनों के अंदर इंसान की मौत भी हो सकती है. यब बहुत खतरनाक है.'

हालांकि अभी तक HO41 की वजह से किसी की मौत के मामले का पता नहीं चला है, लेकिन यूएस सेंटर फॉर डिसीज कंट्रोल एंड प्रिवेंशन (CDC) ने अमेरिकी सरकार से इसकी दवा की खोज के लिए 54 मिलियन डॉलर की मांग की है. स्‍वास्‍थ्‍य अधिकारियों का कहना है कि इससे बचने के लिए लोगों में जागरुकता फैलाने बहुत जरूरी है.

डॉक्‍टरों के मुताबिक अगर 'सेक्‍स सुपरबग' फैलता है तो इलाज के इजाद होने से पहले ही ये कई लोगों की जान ले लेगा. डॉक्‍टरों ने इससे बचने के लिए लोगों को हमेशा सेफ सेक्स करने की सलाह दी है. साथ ही उनसे कहा गया है कि किसी को भी नए संबंध बनाने से पहले अपने पार्टनर का टेस्ट करा लेना चाहिए.

THE ANTI-AGING DIET

THE ANTI-AGING DIET

Definition

The anti-aging diet, also called the calorie-restriction diet, is one that restricts calorie intake by 30%–50% of the normal or recommended intake with the goal of increasing human lifespan by at least 30%. When combined with a healthy lifestyle, people on the diet tend to have improved health, providing they consume adequate vitamins, minerals, and other essential nutrients.

Origins

The idea that a calorie-restrictive diet can significantly increase lifespan has been around since the 1930s. In 1935, Cornell University food researchers Clive McCay and Leonard Maynard published their first in a series of studies in which laboratory rats were fed a diet that had one-third fewer calories than a control group of rats. The lower-calorie diet still contained adequate amounts of vitamins, minerals, protein, and other essential nutrients. This calorie-restrictive diet provided much less energy than researchers had previously thought rats needed to maintain growth and normal activities. The rats on the lower-calorie diet lived 30%–40% longer than the rats on a normal calorie diet. Since then, more than 2,000 studies have been carried out, mostly on animals, investigating the connection between calorie restriction and increased longevity.

A reduced-calorie diet was taken a step further by University of California, Los Angeles, pathologist Roy Walford, who studied the biology of aging. In 1986, he published The 120-Year Diet and a follow-up book in 2000, Beyond the 120-Year Diet, in which he argued that human longevity can be significantly increased by adhering to a strict diet that contains all the nutrients needed by humans, but with about one-third the calories. In 1994, he co-authored The Anti-Aging Plan: Strategies and Recipes for Extending Your Healthy Years. His anti-aging plan was based on his own research and that of other scientists, including his study of diet and aging conducted as chief physician of the Biosphere 2 project in Arizona in the early 1990s. Walford was one of eight people sealed in Biosphere 2 from 1991 to 1993 in an attempt to prove that an artificial closed ecological system could sustain human life. He also co-founded Calorie Restriction Society International in 1994. Walford died in 2004 at the age of 79 from complications of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease (US) and motor neurone disease (UK).

Description

Anti-aging diets are regimes that reduce the number of calories consumed by 30%–50%, while allowing the necessary amounts of vitamins, minerals, and other nutrients the body needs to sustain itself and grow. Calorie restriction has been shown to increase the lifespan of various animals, including rats, fish, fruit flies, dogs, and monkeys, by 30%–50%. A few human studies have been done, but evidence of its impact on humans is very limited compared to results available from the animal studies. The completed studies suggest that calorie restriction may increase the maximum human lifespan by about 30%. The problem preventing scientists from offering substantive proof that humans can greatly increase their lifespan by restricting calories is that the current maximum human lifespan is 110–120 years and full compliance with the diet is difficult. A 30% increase would extend the human lifespan to 143–156 years. This is an exceptionally long time for a scientific study and requires involvement of several generations of scientists. Only several hundred people have ever been documented to live past age 110. The oldest person with confirmed documentation was Jeanne Louise Calmet (1875–1997) of France, who lived 122 years and 164 days.

Since 1980, dozens of books have been published offering specific calorie-reduction diets aimed at increasing lifespan. The most popular diets include the Okinawa Diet, Anti-Inflammatory Diet, Longevity Diet, Blood Type Diet, Anti-Aging Plan, and the 120-Year Diet. In the 2010s, other anti-aging diets emerged that were not entirely based on very low calorie intake. These include the Origin Diet (unprocessed food only, wild game), the RealAge diet (fruits, vegetables, whole grains, soy), the Eat Right, Live Longer diet (organic vegetarian), and the Age-Free Zone Diet (a high-protein, low-carbohydrate, calorie-restricted version of the Zone Diet).

Despite calorie restriction, maintaining a balanced intake of nutrients is essential for achieving any anti-aging effects. People who experience starvation or famine receive no longevity benefits since their low calorie intake contains inadequate nutrition. The calorie-restrictive diet is believed to most benefit people who start in their mid-20s, with the beneficial effects decreasing proportionately with the age one begins the diet.

Although there are variations among anti-aging diets, most reduced-calorie diets recommend a core set of foods. These include vegetables, fruits, fish, soy, low-fat or non-fat dairy products, nuts, avocados, and olive oil. The primary beverages recommended are water and green or black tea.

Guidelines on calorie reduction vary from diet to diet, ranging from a 10% reduction to a 50% reduction of normal intake. Roy L. Walford (1924–2004), author of several books on anti-aging diets, says a reasonable goal is to achieve a 10%–25% reduction in a person's normal weight based on age, height, and body frame. The Anti-Aging Plan diet recommends men of normal weight lose up to 18% of their weight in the first six months of the diet. For a six-foot male weighing 175 lb. (79.3 kg), that means a loss of about 31 lb. ( (14 kg). For a small-framed woman who is five-foot, six-inches tall and weighs 120 lb. (54.4 kg), the plan recommends losing 10% of her weight in the first six months, a loss of 12 lb. (5.4 kg).

Walford's Anti-Aging Plan is a diet based on decades of animal experimentation. It consists of computer-generated food combinations and meal menus containing the United States Department of Agriculture's dietary reference intakes (formerly called recommended daily allowances) of vitamins and other essential nutrients using foods low in calories. On the diet, the maximum number of calories allowed is 1,800 per day. There are two methods for starting the diet: rapid orientation and gradual orientation.

The rapid orientation method allows people to eat low-calorie meals rich in nutrients. This is a radical change for most people and requires a good deal of willpower. All foods low in nutrients are eliminated from the diet. The nutritional value and calories in foods and meals is determined by a software program available for purchase from Calorie Restriction Society International.

The gradual orientation method allows people to adopt the diet over time. The first week, people eat a high-nutrient meal on one day. This increases by one meal a week until participants are eating one meal high in nutrients every day at the end of seven weeks. Other meals during the day consist of low-calorie, healthy foods, but there is no limit on the amount a person can eat. After two months, participants switch to eating low-calorie, high-nutrition foods for all meals. Dieters are advised to view this diet as a lifestyle change rather than a quick weight-loss program.

A sample one-day, low-calorie, high-nutrition menu developed by Walford is:

• Breakfast: One cup of orange juice, one poached egg, one slice of mixed whole-grain bread, and one cup of brewed coffee or tea.
• Lunch: One-half cup of low-fat cottage cheese mixed with one-half cup of non-fat yogurt and one tablespoon of toasted wheat germ, an apple, and one whole wheat English muffin.
• Dinner: Three ounces of roasted chicken breast without the skin, a baked potato, and one cup of steamed spinach.
• Snack: Five dates, an oat bran muffin, and one cup of low-fat milk.

The three meals and snack contain 1,472 calories, 92 g protein, 24 g fat, 234 g carbohydrates, 27 g fiber, and 310 g cholesterol.

Function

The goal of the anti-aging diet is to slow the aging process, thereby extending the human lifespan. Even though it is not a weight loss diet, people taking in significantly fewer calories than what is considered normal by registered dietitians are likely to lose weight. Exercise is not part of calorie reduction diets. Researchers suggest people gradually transition to a reduced calorie diet over one or two years since a sudden calorie reduction can be unhealthy and even shorten the lifespan.

There is no clear answer as to why severely reducing calorie intake results in a longer and healthier life. Researchers have various explanations, and many suggest it may be due to a combination of factors. One theory is that calorie restriction protects DNA from damage, increases the enzyme repair of damaged DNA, and reduces the potential for genes to be altered to become cancerous. Other calorie reduction (CR) theories suggest that:

• CR helps reduce the production of free radicals (unstable molecules that attack healthy, stable molecules). Damage caused by free radicals increases as people age.
• CR delays the age-related decline of the human immune system and improved immune function may slow aging.
• CR slows metabolism (the body's use of energy). Some scientists propose that the higher a person's metabolism, the faster they age.
•  

Benefits

The primary benefits of the anti-aging diet are improved health and prevention or forestalling of diseases such as coronary artery disease, cancer, stroke, diabetes, osteoporosis, Alzheimer's, and Parkinson's disease. Studies show that most physiologic functions and mental abilities of animals on reduced calorie diets correspond to those of much younger animals. The diet also has demonstrated extension of the maximum lifespan for many of the life forms on which it has been tested.

Precautions

A reduced-calorie diet is not recommended for people under the age of 21 as it may impair physical growth. This impairment has been seen in research on young laboratory animals. In humans, mental development and physical changes to the brain occur in teenagers and people in their early 20s that may be negatively affected by a low-calorie diet.

Other individuals advised against starting a calorie-restricted diet include women who plan to become pregnant, women who are pregnant, and those who are breastfeeding. A low body mass index (BMI), which occurs with a low-calorie diet, is a risk factor in pregnancy and can result in dysfunctional ovaries and infertility. A low BMI increases the risk of premature birth and low birth weights in newborns. People with existing medical conditions or diseases should be especially cautious and consult with their physician before starting.

It is imperative that participants ensure that they continue to consume adequate levels of essential nutrients. Nutritional supplements and other forms of nutritional help are likely to be needed.

Risks

The anti-aging diet is very restrictive, and dieters need to adhere strictly to diet plans to ensure that they are receiving required amounts of key nutrients. A wide range of risks, related to physical, mental, social, and lifestyle issues, is associated with such a low-calorie diet. They include:

• hunger, food cravings, and obsession with food
• loss of strength or stamina and loss of muscle mass, which can affect physical activities, such as sports
• decreased levels of testosterone, which can be compensated with testosterone supplementation
• rapid weight loss (more than two pounds a week), which can negatively impact health
• slower wound healing
• reduced bone mass, which increases the risk of fracture
• increased sensitivity to cold
• reduced energy reserves and fatigue
• menstrual irregularity
• headaches
• drastic appearance changes from loss of fat and muscle, causing people to look thin or anorexic

Social issues can arise over family meals, since not all family members may be on a reduced-calorie diet. Conflict related to the types of food served, the amount of food served, the number of meals in a day, and fasting may develop. Other social issues involve eating in restaurants, workplace food, parties, and holidays. The long-term psychological effects of a reduced-calorie diet are unknown. However, since a low-calorie diet represents a major change in a person's life, psychological problems can be expected, including, in some cases, anorexia nervosa, binge eating, and obsessive thoughts about food and eating.

Research and general acceptance

Animal studies generally support the idea that a calorie-restrictive diet with adequate intake of essential nutrients increases lifespan. Few studies have been done in humans. In some small studies, people consuming a calorie-restrictive diet (under 1,400 calories daily) for five or more years had better heart function and lower blood pressure than those who consumed a diet of more than 2,000 calories daily. It is not clear whether the benefits come only from calorie restriction or from the increased fruits, vegetables, and whole grains consumed on most of these diets.

Resources

D'Adamo, Peter, and Catherine Whitney. Aging: Fighting It With the Blood Type Diet: The Individual Plan for Preventing and Treating Brain Decline, Cognitive Impairment, Hormonal Deficiency, and the Loss of Vitality Associated With Advancing Years. New York: Berkley Trade, 2006.

Delaney, Brian M., and Lisa Walford. The Longevity Diet. New York: Marlowe & Company, 2005.

Gates, Donna and Lyndi Schrecengost. The Baby Boomer Diet: Body Ecology's Guide to Growing Younger: Anti-Aging Wisdom for Every Generation. Carlsbad, CA: Hay House 2011.

Goode, Thomas. The Holistic Guide to Weight Loss, Anti-Aging, and Fat Prevention. Tucson, AZ: Inspired Living International, LLC, 2005.

Walford, Roy L., and Lisa Walford. The Anti-Aging Plan: The Nutrient-Rich, Low-Calorie Way of Eating for a Longer Life—The Only Diet Scientifically Proven to Extend Your Healthy Years. New York: Marlowe & Company, 2005.

Willcox, Bradley J., and D. Craig Willcox. The Okinawa Diet Plan: Get Leaner, Live Longer, and Never Feel Hungry. New York: Clarkson Potter, 2004.

EveryDiet.com. “The Longevity Diet.” http://www.everydiet.org/diet/longevity-diet (accessed June 24, 2012).

“50+: Live Better, Longer. Aging Well: Eating Right for Longevity.” WebMD. http://www.webmd.com/healthy-aging/features/aging-well-eating-right-for-longevity (accessed June 24, 2012).

Scientific Psychic. “Calorie Restriction Diet.” http://www.scientificpsychic.com/health/crondiet.html (accessed June 24, 2012).

Walford.com. “Getting Started On The Anti-Aging Diet.” http://www.walford.com/aastart.htm (accessed June 24, 2012).

American Aging Association, 25373 Tyndall Falls Dr., Olmsted Falls, OH 44138, (440) 793-6565, Fax: (440) 793-6598, americanaging@gmail.com, http://www.americanaging.org.

Calorie Restriction Society International, 187 Ocean Dr., Newport, NC 28570, (877) 481-4841, http://www.crsociety.org.

National Institute on Aging, Bldg. 31, Rm. 5C27, 31 Center Dr., MSC 2292, Bethesda, MD 20892, (800) 222-2225, TTY: (800) 222-4225, Fax: (301) 496-1072, www.nia.nih.gov.

GLYCEMIC INDEX DIETS

GLYCEMIC INDEX DIETS

Definition

Glycemic index diets rank carbohydrates based on their ability to affect blood glucose (sugar) levels. These diets generally consider foods high in carbohydrates, such as bread, sugar, and pasta, as “bad,” and low carbohydrate foods, such as meat, fish, and dairy products, as “good.”

Origins

Low-glycemic diet concepts were first developed in the 1960s and were originally designed for individuals with diabetes. At that time, the prevailing medical attitude was that a diet emphasizing well-balanced foods while paying special attention to carbohydrates (carbs) and avoiding carbohydrate-rich foods helped to control blood sugar and insulin levels. This came after a number of medical studies linked eating foods high in carbohydrates with elevated blood glucose levels in people with diabetes. In the 1980s, researchers developed the glycemic index (GI).

Before 1981, carbohydrates were classified as simple or complex. Simple carbohydrates include fructose (fruit sugar), sucrose (table sugar), and lactose (milk sugar). Complex carbohydrates are also composed of sugars but the sugar molecules are strung together to form longer and more complex chains. Foods high in complex carbohydrates include vegetables (e.g., potatoes), whole grains, and beans. In 1981, researchers David Jenkins and Thomas Wolever of the University of Toronto Department of Nutritional Sciences developed the glycemic index (GI). They published a study suggesting that using the glycemic index of foods was a more accurate way of classifying carbohydrates than the simple and complex system.

Since 1981, dozens of low-carb diets and diet books using the glycemic index have come out. Among the more popular glycemic index-inspired diets are the Sugar Busters Diet, Zone Diet, Protein Power Diet, Suzanne Somers diet, and South Beach Diet.

In 1997, epidemiologist and nutritionist Walter Willett of the Harvard School of Public Health developed the glycemic load as a more accurate way of rating carbohydrates compared to the glycemic index. This is because the glycemic load factors in the amount of a food eaten, whereas the glycemic index does not. The glycemic load of a particular food is determined by multiplying the amount of net carbohydrates in a serving by the glycemic index and dividing that number by 100. Net carbohydrates are determined by taking the amount of total carbohydrates and subtracting the amount of dietary fiber. For example, popcorn has a glycemic index of 72, which is considered high. However, a serving of two cups has 10 net carbs because of its high fiber content, for a glycemic load of seven, which is considered low.

Description

Glycemic index (GI) diets vary in the specifics but most have one simple rule: people can eat as much food as they want providing the foods have a low glycemic index ranking. Most foods that are rated high on the glycemic index contain high levels of carbohydrates. Some people with diabetes use the GI as a guide in selecting foods and planning meals. The GI ranks foods based on their effects on elevating blood sugar levels. Foods with a high GI tend to increase blood glucose levels higher and faster than foods with a low GI value. The GI is not a measure of a food's calorie content or nutritional value.

The GI is a ranking of carbohydrate foods that individuals with diabetes can use to manage their disease. The ranking is based on the rate at which carbohydrates affect blood glucose levels relative to pure glucose or white bread. Generally, the glycemic index is calculated by measuring blood glucose levels following the ingestion of a carbohydrate. This blood glucose value is compared to the blood glucose value acquired following an equal carbohydrate dose of glucose or white bread. Glucose is absorbed into the bloodstream faster than any other carbohydrate, and is thus given the value of 100. Other carbohydrates are given a number relative to glucose. The lower the GI of a food, the slower the rate with which it is absorbed into the bloodstream.

A number of factors influence the digestion and absorption rate of food, including ripeness, particle size, the nature of the starch, the degree of processing and preparation, the commercial brand, and the characteristics of the individual consuming the food. These factors naturally affect each food's glycemic index rank. In addition, differences exist in various glycemic indices of foods due to the choice of reference food, the timing of blood sampling, or the computational method used to calculate the glycemic index.

The glycemic index measures the quality rather than the quantity of carbohydrates found in food. Quality refers to how quickly blood sugar levels are raised following eating. The GI is a standard. It is determined by having ten or more healthy people eat a measured quantity of a digestible carb, usually white bread. The rise in their blood glucose level is measured for the next two hours. The rise is assigned an index value of 100. Other foods are compared to the standard in order to arrive at their ratings. The higher the GI number, the faster blood sugar increases when that particular food is eaten. A high GI is considered to be 70 and greater, a medium GI is 56–69, and a low GI value is 55 or less. A related value is glycemic load (GL). Glycemic load is calculated as follows: GL = GI x the amount of available carbohydrate in a 100 g serving/100. In general, low-carb diets recommend a glycemic load of 80 or less. A high glycemic load is considered to be 120 or more.

The following is the GI for a few common foods:

• cornflakes, 83
• grapefruit, 25
• watermelon, 72
• sugar, 64
• potato chips, 56
• white bread, 70
• sourdough bread, 54
• macaroni, 46
• baked red potato, 93
• french fries, 75

The GI is not a straightforward formula when it comes to reducing blood sugar levels. Various factors affect the GI value of a specific food, such as how the food is prepared (boiled, baked, sautéed, or fried, for example) and what other foods are consumed with it.

The following foods are acceptable on a low-glycemic index diet:

• cornflakes
• oats, barley, and bran cereals
• citrus fruits to slow emptying of the stomach
• a variety of vegetables, especially salad vegetables
• wild rice or brown rice instead of white rice
• whole grain breads
• al dente whole grain pastas
• reduced sugar desserts
•  

Function

Glycemic index diets have two separate functions. The first is to help individuals with diabetes or insulin resistance syndrome maintain normal and steady blood glucose levels. The second is to aid in weight loss.

The objectives of insulin management in diabetic patients are to reduce hyperglycemia, prevent hypoglycemic episodes, and reduce the risk of complications. For people with diabetes, the glycemic index is a useful tool in planning meals to achieve and maintain control of blood glucose. Foods with a low-glycemic index release sugar gradually into the bloodstream, producing minimal fluctuations in blood glucose. High GI foods, however, are absorbed quickly into the bloodstream, causing an escalation in blood glucose levels and increasing the possibility of hyperglycemia. The body compensates for the rise in blood sugar levels with an accompanying increase in insulin, which within a few hours can cause hypoglycemia. As a result, awareness of the glycemic indices of food assists in preventing large variances in blood glucose levels.

Athletes may also use GI diets to prepare for athletic competitions or to recover from training. Low GI is often favored before an event, while higher GI aids in the replenishment of glycogen stores.

Benefits

There is conflicting scientific research on the benefits of a low-glycemic index diet for both people with diabetes and people trying to lose weight. Glycemic index diets may help people with diabetes maintain constant levels of blood glucose. By consuming more fruits and vegetables and whole grains rather than processed foods, low-glycemic diets encourage higher fiber consumption.

Experts disagree regarding the use of the glycemic index in athletes' diets and in exercise performance. Research published in the January 2010 issue of Sports Medicine found that eating a low-glycemic meal prior to prolonged exercise may have some merit, though this effect may be minimized if carbohydrates are consumed during the activity. Regardless, a low-GI pre-event meal may be beneficial for athletes who respond negatively to carbohydrate-rich foods prior to exercise or who cannot consume carbohydrates during competition. Athletes are advised to consume carbohydrates of moderate-to-high GI during prolonged exercise to maximize performance, approximately one gram per minute of exercise. Following exercise, moderate-to-high GI foods enhance glycogen storage.

Precautions

If an individual has health concerns, a low-glycemic index diet should be undertaken only under the supervision of a doctor. Doctor supervision of the GI diet is not necessary when the individual is healthy and disease-free. People with diabetes should consult an endocrinologist, who may recommend discussing the diet with a diabetes dietitian.

Risks

Eating a diet based solely on the glycemic index of foods can lead to overeating and a weight gain rather than loss. No emphasis is placed on total calorie intake or on the amount of saturated fat content. By basing one's diet on glycemic index alone, it is still possible to eat excess calories and to gain weight.

Research and general acceptance

There is mixed acceptance of glycemic index diets by the medical community. Some studies have shown GI diets can be effective in controlling blood sugar levels in people with diabetes and in helping people lose weight. Other studies have contradicted these findings. No major studies or research has shown that GI diets are harmful to a person's health. The American Diabetes Association has adopted a position that there is not enough conclusive evidence to recommend the general use of a low-GI diet for people with diabetes. Not all physicians and endocrinologists (medical specialists who treat disorders of the glands, including diabetes) subscribe to the Association's position.

Resources

Beale, Lucy and Julie Alles. The Complete Idiot's Guide to Glycemic Index Snacks. New York: Alpha, 2011.

Raffetto. Meri B. The Glycemic Index Diet for Dummies. Indianapolis, IN: Wiley Pub., 2009.

Smith, LeeAnn. The Everything Glycemic Index Cookbook. 2nd ed. Avon, MA: Adams Media, 2010.

Foster-Powell, Kaye, Susanna H. A. Holt, and Janette C. Brand-Miller. “International Table of Glycemic Index and Glycemic Load Values: 2002.” American Society for Clinical Nutrition 76, no. 1 (2002): 5–56. http://www.ajcn.org/content/76/1/5.full (accessed August 9, 2012).

O'Reilly, John, Stephen Wong, and Yajun Chen. “Glycaemic Index, Glycaemic Load and Exercise Performance.” Sports Medicine 40, no. 1 (January 2010): 27–39. http://dx.doi.org/10.2165/11319660-000000000-00000 (accessed August 9, 2012).

Harvard Health Publications. “Glycemic Index and Glycemic Load for 100þ Foods.” Harvard Medical School. http://www.health.harvard.edu/newsweek/Glycemic_index_and_glycemic_load_for_100_foods.htm (accessed August 9, 2012).

Harvard School of Public Health. “Carbohydrates and the Glycemic Index,” Carbohydrates: Good Carbs Guide the Way. The Nutrition Source, Department of Nutrition, Harvard University. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/carbohydrates-full-story/index.html#glycemic-index (accessed August 9, 2012).

Higdon, Jane, and Victoria J. Drake. “Glycemic Index and Glycemic Load.” Linus Pauling Institute Micronutrient Information Center, Oregon State University. http://lpi.oregonstate.edu/infocenter/foods/grains/gigl.html (accessed August 9, 2012).

Mayo Clinic staff. Glycemic Index Diet: What's Behind The Claims. MayoClinic.com. August 24, 2011. http://www.mayoclinic.com/health/glycemic-index-diet/MY00770 (accessed August 9, 2012).

MedlinePlus. Carbohydrates. February 8, 2012 http://www.nlm.nih.gov/medlineplus/carbohydrates.html (accessed August 9, 2012).

University of Sydney. Glycemic Index. http://www.glycemicindex.com (accessed August 9, 2012).

Academy of Nutrition and Dietetics, 120 South Riverside Plz., Ste. 2000, Chicago, IL 60606-6995, (312) 899-0040, (800) 877-1600, amacmunn@eatright.org, http://www.eatright.org.

American Diabetes Association, 1701 North Beauregard St., Alexandria, VA 22311, (800) DIABETES (342-2383), askADA@diabetes.org, http://www.diabetes.org.

Center for Food Safety and Applied Nutrition (CFSAN), U.S. Food and Drug Administration, 5100 Paint Branch Pkwy., College Park, MD 20740, (888) SAFEFOOD (723-3366), consumer@fda.gov, http://www.fda.gov/Food/default.htm.

National Diabetes Education Program, One Diabetes Way, Bethesda, MD 20814-9692, (301) 496-3583, http://www.ndep.nih.gov

PRITIKIN DIET

PRITIKIN DIET

Definition

The Pritikin diet is a heart-healthy high-carbohydrate, low-fat, moderate-exercise lifestyle diet developed in the 1960s.

Origins

Nathan Pritikin, the originator of the Pritikin diet, was diagnosed with heart disease at the age of 42. In the late 1950s when Pritikin was diagnosed, about 40% of calories in the average American diet came from fats. Pritikin was given little medical guidance on how lifestyle changes might slow his heart disease. Although educated as an engineer, Pritikin devised his own heart-healthy diet, which he followed rigorously. Based on his experience, he opened the Pritikin Longevity Center in Florida in 1975. Here people could comeand immerse themselves for one or more weeks in the Pritikin eating plan.

Pritikin's diet came to national attention when Pritikin and Florida cardiologist David Lehr appeared in the CBS program 60 Minutes in 1977. The Pritikin Diet soon became the most popular diet of the 1970s. Since that time, many research studies have been done to evaluate the effectiveness of the Pritikin Plan, the results of which have been published in mainstream, refereed medical journals. More than 100,000 people have experienced the plan at the upscale Pritikin Longevity Center & Spa in Miami, Florida. Millions of others have bought Pritikin's books and tried the plan.

Nathan Pritikin developed cancer and committed suicide in 1985 at the age of 69. At his autopsy, doctors discovered no signs of heart disease, a fact they attributed to his rigorous life-long adherence to his diet. Robert Pritikin, Nathan's son, took over the Longevity Center enterprises after Nathan's death. While maintaining the core of the original diet, Robert updated some of the concepts in his book The Pritikin Principle: The Calorie Density Solution, which published in 2000.

Description

At the time Pritikin developed his diet, his concepts seemed quite radical. However, Pritikin was ahead of his time, and today, despite a few controversies, most of his principles have been incorporated into advice given on how to reduce the risk of developing cardiovascular disease by mainstream organizations such as the American Heart Association.

The Pritikin Plan is a diet that is high in whole grains and dietary fiber, low in cholesterol, and very low in fats. Fewer than 10% of calories come from fats. This is much lower than the average twenty-first century American diet, in which about 35% of calories come from fats. It is about half the amount of fats recommended in the U.S. Department of Agriculture's Dietary Guidelines for Americans. The diet is also lower in protein than is suggested in the federal guidelines. However, in general, the Pritikin Plan reflects many recommendations in the Dietary Guidelines for Americans. It results in low-calorie, nutritionally balanced meals. In addition, the Pritikin Plan calls for 45 minutes daily of moderate exercise such as walking, another recommendation in line with mainstream medical advice.

The newest version of the Pritikin Plan calls for avoiding foods that are calorie dense. These are foods that pack a lot of calories into a small volume of food (e.g., oils, cookies, cream cheese). Instead, plan followers are encouraged to choose low-calorie foods that provide a lot of bulk (e.g., broccoli, carrots, dried beans). This way, dieters can eat a lot of food and feel full without taking in a lot of calories. The plan does not limit the amount of healthy fruits and vegetables a dieter can eat, and it suggests that dieters divide their food among five or six smaller meals during the day.

The Pritikin Plan is based on eating a particular number of servings of each group of foods as follows:

• At least five 1/2-cup servings of unrefined carbohydrates such as wheat, oats, brown rice, starchy vegetables such as potatoes, or dried beans and peas. Refined-grain products (white flour, regular pasta, white rice) are limited to two servings daily, with complete elimination considered optimal.
• At least four 1-cup servings of raw vegetables or 1/2-cup servings of cooked vegetables. Dark green, leafy, and orange or yellow vegetables are preferred.
• At least three servings of fruit, one of which can be fruit juice.
• Two servings of calcium-rich foods such as nonfat milk, nonfat yogurt, or fortified and enriched soymilk.
• No more than one 3.5-ounce cooked serving of animal protein. Fish and shellfish are preferred. Lean poultry should optimally be limited to once a week and lean beef to once a month. This diet is easily adapted to vegetarians by replacing animal protein with protein from soy products, beans, or lentils.
• No more than one caffeinated drink daily. Instead drink water, low-sodium vegetable juices, grain-based coffee substitutes (e.g., Postum), or caffeine-free teas.
• No more than four alcoholic drinks per week for women and no more than seven for men, with red wine preferred over beer or distilled spirits.
• No more than seven egg whites per week.
• No more than 2 ounces (about 1/4 cup of nuts) daily.

Other foods such as unsaturated oils, refined sweeteners (e.g., concentrated fruit juice, corn syrup), high-sodium condiments (e.g., soy sauce), and artificial sweeteners (e.g., Splenda) are “caution” foods. They are not recommended, but if they are used, the plan gives guidance on how to limit them to reasonable amounts. Animal fats, processed meat, dairy products not made with non-fat milk, egg yolks, salty snacks, cakes, cookies, fried foods, and similar high-calorie choices are forbidden.

The plan also calls for at least 45 minutes of moderate exercise daily such as walking. People who check into the Longevity Center receive a personalized exercise program after a physician gives them an examination. This doctor follows their progress while at the center and makes a written report at the end of their stay that they can take home to their personal physician. People who do not visit the Longevity Center can receive support and inspiration through the plan's extensive website. Pritikin has also developed a family plan aimed at families with obese children.

Function

Unlike many diets, the Pritikin Plan never claims that a person will lose a certain amount of weight within a certain length of time. People who follow the plan, which is a low-calorie diet, do lose weight and keep it off so long as they stay on the plan. However, the plan is primarily intended to cause changes in lifestyle that will promote heart health for a lifetime.

Benefits

The Pritikin diet claims the following health benefits:

• lowered total cholesterol and LDL or “bad” cholesterol
• lowered blood pressure
• better control of insulin levels
• decrease in the circulating levels of compounds that increase the risk of heart disease and blood vessel damage
• a substantially reduced risk of heart disease, hypertension, type 2 diabetes, and breast, colon, and prostate cancers.
• lifetime freedom from obesity and all of its associated health risks and lifestyle-limiting conditions
•  

Precautions

As with any diet, people should discuss with their physician the pros and cons of the Pritikin Plan based on their individual circumstances. This diet may not be right for actively growing children.

Risks

The greatest risk to this diet is that it is too rigorous for many people, and that they will lose weight on the diet and then gain it back when going off the diet, causing weight cycling (yo-yo dieting) and the potential health problems that repeated weight gain and loss cause.

Research and general acceptance

Unlike many diets, the Pritikin Plan has the respect of much of the medical community and has a thirtyyear history of delivering on most of its health promises. Supporters of the diet point to many studies done by both Longevity Center doctors and outside investigators and published in highly respected journals such as the Journal of the American Medical Association and the New England Journal of Medicine. People do lose weight and keep it off, along with decreasing the risk of heart disease when following the plan.

Dietitians also like the fact that the diet teaches people how to eat well using ordinary foods rather than special pre-packaged foods. This keeps the cost of following the plan low, especially since the plan calls for dieters to eat only small quantities of meat. In addition, theplanis designed to provide a balance of vitamins and minerals from food and does not rely on dietary supplements.

The biggest criticism of the Pritikin Plan is that it requires rigorous self-discipline to stay on for a lifetime. People who do well on the Pritikin Plan tend to be highly motivated and zealous about following the diet. Many healthcare professionals feel long-term success for most people is more likely to occur if the dieter follows a well-balanced but less rigorous diet.

Some dietitians also take issue with whether the low-fat component of the diet allows people to get enough beneficial fats such as omega-3 fatty acids and whether absorption of the fat-soluble vitamins A, D, E, and K is impaired. These criticisms have not been supported by research findings; however, critics were handed more ammunition by a long-term study of 49,000 American women ages 50–79 that found that a low-fat diet had no effect on the risk of developing heart disease or cancer. The study was published in February 2006 in the Journal of the American Medical Association. The findings are controversial and go against much current medical thinking.

Resources

Bijlefeld, Marjolijn, and Sharon K. Zoumbaris. Encyclopedia of Diet Fads. Westport, CT: Greenwood Press, 2003.

Icon Health Publications. Fad Diets: A Bibliography, Medical Dictionary, and Annotated Research Guide to Internet References. San Diego, CA: Icon Health Publications, 2004.

Pritikin, Robert. The Pritikin Principle: The Calorie Density Solution. Alexandria, VA: Time-Life Books, 2000.

Scales, Mary Josephine. Diets in a Nutshell: A Definitive Guide on Diets from A to Z. Clifton, VA: Apex Publishers, 2005.

Pritikin Longevity Center. “About Pritikin.” http://www.pritikin.com/home-the-basics/about-pritikin.html (accessed October 3, 2012).

“The Pritikin Principle.” WebMD. http://www.webmd.com/diet/pritikin-principle-what-it-is (accessed October 3, 2012).

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: U.S. Government Printing Office, December 2010. http://health.gov/dietaryguidelines (accessed September 27, 2012).