‘Flat Belly Diet’: a review of the hot new diet book–will it be your ticket to weight loss in 2009?
Well, well, well; it’s December 31st and people all across the fruited plain are engaging in a time-honored American tradition –making resolutions to lose weight.
Every year sees its own crop of hip new diet plans (remember Atkins? The South Beach Diet? The Zone?); this year’s frontrunner looks Liz Vaccariello’s
, delightfully subtitled
A Flat Belly is About Food & Attitude. Period. (Not a Single Crunch Required).
Now, if you’re like me, you’ve got food and plenty of attitude and wouldn’t know a crunch if came to your door selling Girl Scout cookies, so this one sounds like a fit. Let’s take a look at what this diet, that scintillatingly promises to get you to lose up to 15 lbs in 32 days, entails.
1. The whole shebang begins with a Four-Day Anti-Bloat Jumpstart that consists of 96 hours of mental preparation (a sort of dipping-your-toe-in-the-Flat-Belly-Diet if you will) designed to get you into the dieting mindset and to spark your enthusiasm with a loss of up to 5 3/4 inches before the end of the four days. 5 3/4 inches?! you snort. According to Vaccariello,
We tested the entire Flat Belly Diet — including the Jumpstart — on women just like you, holding weigh-ins on a biweekly basis. You’re reading their stories throughout this book, and you can find more by visiting flatbellydiet.com. More than half of your test panel lost at least 1 full inch from their bellies during the Jumpstart period.
2. Next, we get down to the nitty gritty — the Four-Week Plan, 28 days of meals and recipes that can be mixed and matched to your heart’s desire. You are allowed four meals of 400 calories per day; a MUFA is included at every meal.
What the hell is a MUFA? A MUFA is a monounsaturated fatty acid; foods containing these fatty acids have long been known to be beneficial to the body in a number of ways, including preventing heart disease, cancer, and decreasing the risk of dementia in old age. The Flat Belly Diet categorizes MUFAs into five categories: oils, olives, nuts and seeds, avocados, and dark chocolate. At least one of these is included in each recipe and meal plan in the diet.
3. The third, and optional, part of the diet is the Exercise Program, which includes instructions for fat-burning walks, and two sets of exercise instructions (complete with helpful pictures and diagrams) called the Metabolism Boost and the Belly Routine. There are weekly schedules for each of the exercise sets, a four-week walking plan, and a seven-day plan for people like me who want to do the whole thing but are too terminally lazy to keep track of what I’m supposed to be doing when.
Overall, the Flat Belly Diet has all the hallmarks of a diet fad getting ready to take off: it is simple to follow and provides enough detailed instructions to allow busy people to follow it without undue effort; it encourages eating healthy, low-fat foods; it includes inspirational true stories of real-looking people (not size 0 supermodels) who have succeeded on the plan; it emphasizes a positive attitude and includes journal sections for dieters to include their progress as well as their feelings about the whole thing.
In another lifetime, I took graduate courses at UC Davis in Nutrition, and, based on thatknowlege, frankly, I’d be surprised if anyone following this diet faithfully didNOTlose weight since it incorporates all three of the Holy Trinity of Weight loss: Eat less, eat better, exercise.
The only part of the Flat Belly Diet that gives me pause is its assertion that eating monounsaturated fatty acids specifically targets belly fat; unfortunately, many peoplemay purchase this book under the false impression that the exercises and meals in it are designed
for decreasing their tummy girth. A good deal of research has gone into stomach-shrinking methods, and they universally find that, while eating less and exercising decreases the fat in your body OVERALL, you can’t just target one area alone. You’ll lose weight and inches from your stomach, in other words, but you’ll lose it from everywhere else too, and possibly not quite in the proportions you had wished. And no amount of stomach crunches will burn fat only in your stomach. You’ll develop some kicking stomach muscles and burn fat all over your body, but not just in your stomach.
That said, however, the Flat Belly Diet is definitely one to give a fling if you are so inclined. If you do, best of luck!

WEDNESDAY, Jan. 28 (HealthDay News) — If you’re among the millions of women who suffer from urinary incontinence, losing weight might just ease your symptoms, a new study suggests.
Published in the Jan. 29 issue of the
, the study found that when women lost about 8 percent of their body weight — an average of 17 pounds for this group — the frequency of incontinence episodes dropped by almost half.
“Weight is one of the biggest risk factors for developing incontinence and for worsening incontinence,” said study author Dr. Leslee Subak, an associate professor in the departments of obstetrics, gynecology, reproductive sciences, urology and epidemiology and biostatistics at the University of California, San Francisco.
More than 13 million American women have urinary incontinence problems, according to background information in the study. Observational studies have found an association between extra weight and incontinence, and other research has suggested that losing weight might be beneficial for relieving incontinence symptoms.
To confirm these findings, Subak and her colleagues recruited 338 women from Rhode Island and Alabama. The women had to be at least 30, with a body-mass index (BMI) between 25 and 50. A BMI over 25 is considered overweight and over 30 is obese, according to the National Institutes of Health. All of the women experienced at least 10 incontinence episodes in a seven-day period.
Two-thirds of the women were randomly assigned to the intervention group, which included diet, exercise and behavior modification, while the remaining one-third (the control group) received four educational sessions about weight loss, healthful eating and physical activity. All of the women received a self-help booklet with tips for improving their urinary incontinence.
The intervention group met for one hour every week for six months and were put on a structured protocol, including diet and exercise, designed to help them lose between 7 percent and 9 percent of their starting weight.
On average, the intervention group lost 8 percent of their body weight, or about 17 pounds each. The control group lost 1.6 percent of their body weight, or a little more than 3 pounds each.
After six months, the weekly number of incontinence episodes dropped by 47 percent for those in the intervention group compared to 28 percent in the control group. The intervention group also reported fewer episodes of stress incontinence — that’s incontinence that occurs due to extra pressure from laughing, coughing or sneezing. This group did not see improvement in urge incontinence — that’s the feeling of a sudden need to urinate.
“The reduced pressure from weight loss causes reduced pressure on the bladder,” Subak explained.
She said these findings confirm that weight loss can be considered a first-line treatment for women with incontinence.
“The weight we carry around affects our bodies in so many different ways,” said Dr. Janet Tomezsko, chief of the section of urogynecology at Northwestern Memorial Hospital in Chicago. “And, the more overweight you are, the more you have to lose to make an impact, but you can make an impact. It’s not an easy thing to do, but I think we’re going to see more and more programs that address weight loss, exercise and pelvic health.”
To learn more about incontinence in women, visit the
.

Tuesday, December 30, 2008
PALM BEACH GARDENS — It's New Year's Eve and you've just decided 2009 is the time to lose those extra pounds.
Where do you go?
Do you try the South Beach Diet, Jenny Craig, Weight Watchers or some new diet on the Internet?
Here's a thought: Why not try a doctor?
Dr. Stuart Wanuck, a urologist, has spent years treating enlarged prostates, kidney stones and erectile dysfunction.
But since last summer he's spent half his time giving vitamin injections, advising how to plan meals and monitoring patients' diets. Wanuck is a physician at AdvantaMD, one of a growing number of doctor-supervised weight-loss clinics established recently in Palm Beach County and nationally.
“As a urologist I often deal with older people with weight-associated health conditions such as diabetes and erectile dysfunction,” Wanuck said. “I wanted to try to get out front and do something to help prevent disease.”
AdvantaMD, the Center for Medical Weight Loss and Dr. Bernstein Diet and Health Clinics are among several doctor-directed diet clinics hoping to cash in on New Year's resolutions to get rid of unwanted fat.
“I feel more comfortable knowing a medical doctor is involved, providing support and doing medical testing,” said Dyan Barefoot, an AdvantaMD customer who is a Palm Beach County middle school teacher.
Barefoot, 40, said she lost 20 pounds after nine weeks on the program, which includes meal replacements and weekly visits with doctors, a nutritionist and other support staff.
Although weight-loss experts say they are pleased more doctors are taking on the nation's obesity epidemic, critics question whether physicians have the appropriate training and whether their pricier programs are worth the extra cost.
Some doctors are moving into the weight-loss business for the same reason many physicians started offering Botox: It's a new revenue source in which patients pay directly for services instead of through their insurance companies.
“Doctors see this as an opportunity to supplement their income through medical services paid out of pocket,” said Karen Miller Kovach, chief scientific officer of Weight Watchers International. Although it is important to consult a doctor before a major diet, there's no proof dieters in doctor-directed diet clinics are more successful than those led by non-doctors, she said.
Wanuck, who spent three decades as a urologist before coming to AdvantaMD, acknowledges most doctors spend little time counseling their patients about weight loss. They don't have the time, he said.
An estimated 80 million Americans go on diets every year, spending more than $30 billion annually on programs and products.
Unlike traditional programs such as Weight Watchers, which costs about $10 a week, doctor-supervised programs can cost $100 a week or more.
But customers such as Tina Hill, 41, of Jupiter, say it's worth it.
Hill started going to Dr. Bernstein's Diet and Health Clinic in Palm Beach Gardens in March. She had blood and urine tests and a physical exam when she started and routine lab tests during the program. A strict meal plan limited her to fewer than 900 calories a day, one-third of the average adult intake.
In fewer than five months, she went from 220 pounds and a size 18 dress to 145 pounds and a size 5. “I feel great,” she said on a visit to the center to get her weight checked and receive a vitamin B12 shot.
Hill said the program has taught her to see food as fuel rather than an entertainment source. “It's been a lifestyle and behavior change,” she said. In addition to 60 sites in Canada, Dr. Bernstein has eight clinics in Florida, including Delray Beach and West Palm Beach. “Medical supervision is important because if you go on a diet, patients can run into trouble if they have chronic diseases or are taking medication,” said Dr. Stanley Bernstein, a family physician who founded the company in Toronto in 1974.
Bernstein notes that doctors get little training in diet and nutrition. He said doctors need to upgrade their knowledge before working with patients. In his program, patients see the doctor every other week and nurses three times a week.
Dr. Frank Onofrio had retired from his internal medicine practice in Lake Worth when he joined Bernstein's Palm Beach Gardens clinic late in 2006. He went to Canada for training on Bernstein's program, which claims a 70 percent success rate. Though diet and exercise has been the conventional mantra to lose weight, Onofrio tells patients to limit any strenuous exercise during the diet.
But some diet experts disagree.
“Diet and exercise are the key and people who try to diet alone are not successful in the long term because they are not able to sustain weight loss and improve their health,” said Tara Gidus, a registered dietitian in Orlando and spokeswoman for the American Dietetic Association.
Gidus said the best diet programs incorporate a team of professionals such as dietitians, doctors and behavioral health counselors. “I don't think the doctor's presence for three minutes is the key thing to change eating behavior,” she said.
Dr. Atul Madan, chief of the division of laparoendoscopic and bariatric surgery at the University of Miami Health System, said any weight loss program should be done in conjunction with a health care professional, though not necessarily a doctor. “Just because you have an M.D. doesn't mean you know weight loss,” he said. The key is the health professional – whether a dietitian, psychologist, nurse practitioner or doctor- should have expertise in weight loss.”
“For a moderately healthy person there's often no need for a doctor to be directly involved,” said Michael Perri, a researcher at the University of Florida College of Public Health.
But some patients like the convenience.
Penny Shifrin, 48, of Lake Worth, has tried all types of diets but she was attracted to the one-on-one counseling she gets each week from the Center for Medical Weight Loss in Atlantis. “It's very clear when I leave what I have to focus on and it makes it easier to get to your goal.”