Elsevier

Progress in Cardiovascular Diseases

Volume 77, March–April 2023, Pages 78-85
Progress in Cardiovascular Diseases

Popular fad diets: An evidence-based perspective

https://doi.org/10.1016/j.pcad.2023.02.001Get rights and content

Abstract

Despite the emergence of stronger nutritional science over the past two decades, fad diets remain highly popular. However, growing medical evidence has led to the endorsement of healthy eating patterns by medical societies. This thus allows fad diets to be compared to the emerging scientific evidence as to which diets promote or damage health. In this narrative review, the most popular current fad diets are critically analyzed, including low-fat diets, vegan and vegetarian diets, low-carbohydrate diets, ketogenic diets, Paleolithic diets, and intermittent fasting. Each of these diets has some scientific merit, but each has potential deficiencies relative to the findings of nutritional science. This article also presents the common themes that emerge among the dietary guidance of leading health organizations, such as the American Heart Association and the American College of Lifestyle Medicine. While there are important distinctions between dietary recommendations emanating from various medical societies, each recommends eating more unrefined, plant-based foods, while eating fewer highly processed foods and added sugars, and avoiding excessive calorie consumption as an important nutritional strategy for the prevention and management of chronic conditions and promotion of overall health.

Section snippets

Dietary confusion

Controversy abounds in medicine. For example, within Cardiology, there is frequent debate as to which medications to use for which cardiac conditions, which imaging tests are best used to assess cardiac risk, and which patients deserve myocardial revascularization procedures. While important, none of these debates strongly capture the public's interest. By contrast, there has always been a strong public interest regarding the controversies which have roiled the world of nutritional science and

Low fat diets

One of the early fad diets to address health concerns over the last 50 years was the Pritikin diet, developed by Nathan Pritikin in the 1970s. Pritikin's focus was to promote a diet which would help reduce serum cholesterol levels. Pritikin called for a diet that emphasized the ingestion of complex carbohydrates, including whole grains and dietary fiber, foods low in cholesterol (e.g., limited egg consumption), and very low fat consumption. He advocated that fewer than 10% of calories come from

Vegan and vegetarian-based diets

A popular form of eating, often adopted by those trying to lose weight or transition to a healthier diet pattern, is the consumption of a vegan or vegetarian-diet. Generally, plant-based diets are an excellent choice for optimizing health, but pitfalls exist. Much confusion abounds due to the various terms that are frequently used to describe various forms of vegetarian diets. A list of the most used terms to describe vegetarian diets and their meaning are listed in Table 4. A “vegan diet”, a

Low-carbohydrate diets

Low-carbohydrate diets have been part of the mainstream for many years. Initial diet books advocating low carb diets, such as Eat Fat and Grow Slim and Calories Don't Count were appearing by the early 1960s. But it was the publication of Dr. Robert Atkin's book (Dr. Atkin's Diet Revolution) in 1972 that led to a strong popularization of low carb diets. The Atkins diet is best described as a low carb, high fat, high protein diet. Running counter to medical evidence or opinion, Atkins promulgated

Ketogenic diets

Ketogenic Diets are an extreme form of low-carbohydrate diets. The origins of the ketogenic diet were to reduce epileptic seizures which it does successfully, but with many long-term health risks.16 The potential value of a keto diet is based on an understanding of ketosis. Ketosis is defined as elevated ketones in the blood and urine, and, in the case of the keto diet, it is triggered by macronutrient composition that forces the body to shift from using its preferred fuel source (glucose) to

Paleolithic diets

The Paleolithic diet is another rendition of the low-carbohydrate diet, but like the keto diet, its popularity makes it worthy of its own discussion. The Paleolithic diet, also called the caveman diet, the primal diet, or the hunter-gatherer diet, is based on the theory that when our ancestors shifted away from a diet built on hunting and gathering and toward a diet built on agricultural practices, they set in motion the chronic diseases that plague humans today. Therefore, the Paleo diet is a

Intermittent fasting

Intermittent fasting is the practice of abstaining from or significantly reducing food intake for a set period of time. The most common forms of intermittent fasting are shown in Table 7.42 Intermittent fasting is promoted for everything from longevity, weight loss, diabetes reversal, and improved cardiovascular health. At a high level, intermittent fasting is based on the idea that fasting induces metabolic switching from liver-derived glucose to adipose cell–derived ketones. During fasting,

Fad diets in perspective

With an estimated one in five deaths globally associated with poor diet, the growing number of popular diets deserve increasing scrutiny as to their potential health effects.50 Each year, the US News and World Report enlists a panel of experts to rank popular diets based on various criteria including how easy it is to follow, nutritional completeness, safety, and their potential for preventing and managing diabetes and heart disease. In 2022, the top five highest ranking diets were all

Conflict of interest

None.

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