Research
Perspectives in Practice
A Dietary Quality Comparison of Popular Weight-Loss Plans

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Abstract

Popular weight-loss plans often have conflicting recommendations, which makes it difficult to determine the most healthful approach to weight loss. Our study compares the dietary quality of popular weight-loss plans. Dietary quality, measured by the Alternate Healthy Eating Index (AHEI), was calculated via sample menus provided in published media for the New Glucose Revolution, Weight Watchers, Atkins, South Beach, Zone, Ornish, and 2005 US Department of Agriculture Food Guide Pyramid (2005 Food Guide Pyramid) plans. The criterion for determining which weight-loss plans were the most popular was their status on the New York Times Bestseller list. Weight Watchers and the 2005 Food Guide Pyramid plan were included because they are the largest commercial weight-loss plan, and the current government recommendation, respectively. Analysis of variance was used to compare nutrient information among the weight-loss plans. The AHEI scores adjusted for energy content were also compared. Of a maximum possible score of 70, the AHEI scores for each weight-loss plan from the highest to the lowest plan were: Ornish (score 64.6), Weight Watchers high-carbohydrate (score 57.4), New Glucose Revolution (score 57.2), South Beach/Phase 2 (score 50.7), Zone (score 49.8), 2005 Food Guide Pyramid (score 48.7), Weight Watchers high-protein (score 47.3), Atkins/100-g carbohydrate (score 46), South Beach/Phase 3 (score 45.6), and Atkins/45-g carbohydrate (score 42.3). Dietary quality varied across popular weight-loss plans. Ornish, Weight Watchers high-carbohydrate, and New Glucose Revolution weight-loss plans have an increased capacity for cardiovascular disease prevention when assessed by the AHEI.

Section snippets

Diet Selection

Eight weight-loss plans were selected for comparison, including New Glucose Revolution, two Weight Watchers plans, Atkins, South Beach, Zone, Ornish (8, 9, 10, 11, 12, 13), and the 2005 US Department of Agriculture Food Guide Pyramid (2005 Food Guide Pyramid) (14). Weight-loss plans were selected because of their status on the New York Times Bestseller list during the past 5 years. Weight Watchers and the 2005 Food Guide Pyramid plan were included because they are the largest commercial

Results

The AHEI scores (Table) ordered from the highest to the lowest plan were: Ornish (score 64.6), Weight Watchers high-carbohydrate (score 57.4), the New Glucose Revolution (score 57.2), South Beach/Phase 2 (score 50.7), Zone (score 49.8), 2005 Food Guide Pyramid (score 48.7), Weight Watchers high-protein (score 47.3), Atkins/100-g carbohydrate (score 46), the South Beach/Phase 3 (score 45.6), and Atkins/45-g carbohydrate (score 42.3). The omnibus test revealed a statistically significant

Discussion

The HEI was created by the US Department of Agriculture to identify dietary factors associated with reduced CVD risk and to evaluate a plan’s potential to improve physiological states such as blood lipid levels and obesity (7). The original HEI was inadequate to predict CVD mortality because it failed to distinguish between different types of carbohydrates and fats (26, 27). Using data from the Nurses’ Health Study and the Health Professional’s Follow-up Study, McCullough and colleagues (16, 17

Conclusions

The AHEI is a valuable tool in selecting a weight-loss plan that maximizes both weight loss and CVD prevention. None of the popular weight-loss plans studied achieved a perfect AHEI score, but the Ornish, Weight Watchers high-carbohydrate, and New Glucose Revolution plans were among the best performers using the AHEI and traditional dietary quality assessments. In light of limitations mentioned, further investigations are warranted to observe what patients actually consume when following a

Y. Ma, S. L. Pagoto, and P. A. Merriam are assistant professors of Medicine, J. A. Griffith is a research associate, A. R. Hafner is a research assistant, and B. C. Olendzki is an instructor of Medicine, all with the Division of Preventive and Behavioral Medicine, and I. S. Ockene is a professor of Medicine with the Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester.

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    Y. Ma, S. L. Pagoto, and P. A. Merriam are assistant professors of Medicine, J. A. Griffith is a research associate, A. R. Hafner is a research assistant, and B. C. Olendzki is an instructor of Medicine, all with the Division of Preventive and Behavioral Medicine, and I. S. Ockene is a professor of Medicine with the Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester.

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