Aug
01
2004

Citrus Fruit Peel Lowering Cholesterol

New research from London/Ontario in cooperation with the U.S. Department of Agriculature has shown that in hamsters cholesterol can be reduced by about 35% through a diet that contains compounds derived from orange peel.

A development company (KGH Syndergize, London/Ont.) under the lead researcher, Dr. Elzbieta Kurowska (PhD), has identified the active compounds in the peels of oranges or tangerines that are having cholesterol lowering properties. They are a group of substances known under the name of “polymethoxylated flavones” (PMFs) and have the advantage that they have no side-effects. They are naturally occuring and have been part of the food chain that our bodies are used to.

The research results were recently published in the Journal of Agricultural and Food Chemistry, which is a peer-reviewed journal of the American Chemical Society.

The animal and cell line experiments showed that the liver cell metabolism of cholesterol is changed so that bad cholesterol (LDL cholesterol) is lowered, but the good cholesterol (HDL cholesterol) is unaffected. When hamsters were fed a diet with 1% PMFs their LDL blood levels were lowered by 32% to 40%.

Citrus Fruit Peel Lowering Cholesterol

Citrus Fruit Peel Lowering Cholesterol

The experiments were so successful that there is now a human trial on the way where the longterm effects of PMFs on LDL levels is being followed. Dr. Kurowska cautioned that drinking orange or tangerine juice would be having many beneficial health effects. But in order to get the cholesterol lowering effect that you can achieve with the citrus peel PMF supplement you would have to consume about 20 cups of orange or tangerine juice every day.

Reference: The Medical Post, Vpl. 40 (June 22, 2004): page 18

Last edited December 8, 2012

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Jul
01
2004

Gene Therapy Can Repair Blood Vessels

When the first attempt of gene therapy were made, a concoction of LDL- receptor genes was infused into the portal vein of patients with a family trait of high cholesterol levels. This was back in 1989, and the results at that point were not encouraging.
In the meantime advances have been made in genetic research. Dr. Duncan Stewart of the cardiology department of St. Michael’s Hospital in Toronto who is considered by many as the guru of cardiac gene therapy, reports that we are now “at a crucial stage of the field”. He cautions, that having the gene on hand is only part of the answer. For good results it is also important to understand how the delivery system to the diseased organ works.

Gene therapy stands out from other treatment options, because instead of drugs, DNA is provided. DNA itself is not the therapeutic agent. It penetrates the cells where it sets up shop and produces proteins, which are needed for therapy. In the case of heart disease, where heart vessels are blocked or have been damaged, the idea is to send specific DNA sequences to the heart cells and stimulate the production of growth factors. These growth factors would trigger new heart vessels to grow and take over for damaged or blocked vessels. This is not just a dream of a research team: a gene therapy trial – the only one of its kind in Canada – is on its way under the leadership of Dr. Stewart. This ambitious project was launched in 2002. In seven sites across Canada 110 patients with heart disease are receiving the vascular endothelial growth factor gene (VEGF for short). The gene is being directly injected into the areas of the heart where blood vessels have become diseased or blocked. The placement is measured with a mapping system known as NOGA. At the end of the year the study enrolment will be finished. Patients will be followed up for results 6 months later. This therapy promises long lasting effects, but it  still has a long way to go.

Gene Therapy Can Repair Blood Vessels

Gene Therapy Can Repair Blood Vessels

Dr. Robert Hegele from the Blackburn Cardiovascular Genetic Laboratory at the University of Western Ontario is credited with uncovering eight genes for human disease (four of them are related to cardiovascular illness) and 80 mutations in other genes that are contributing to premature heart disease and diabetes. Dr. Hegel’s interest is to discover the villains that predispose people to illness, but at the same time he cautions that genes are not everything. Being genetically susceptible does not necessarily foretell one’s destiny when it comes to developing heart disease. Dr. Hegele emphasizes that the longer he works in the genetic field, the more he respects environment and lifestyle and finds that most people can even overturn genetic susceptibility and he leaves us with the final remark: “Tell your patients to stay away from tobacco, eat wisely and get that needed exercise.”

More info on arteriosclerosis (hardening of the arteries): http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Reference: The Medical Post June 29, 2004 (Vol. 40, No.26): page 35

Comment (July 9, 2012): Note that this trial failed to show effectiveness as indicated in the paper below. So, eat wisely, exercise and don’t smoke.

VEGF gene therapy fails to improve perfusion of ischemic myocardium in patients with advanced coronary disease: results of the NORTHERN trial. Stewart DJ, Kutryk MJ, Fitchett D, Freeman M, Camack N, Su Y, Della Siega A, Bilodeau L, Burton JR, Proulx G, Radhakrishnan S; NORTHERN Trial Investigators. Mol Ther. 2009 Jun;17(6):1109-15. Epub 2009 Apr 7.

Last edited Oct. 26, 2014

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May
01
2004

Chronic Inflammation Causes Cancer, Heart Attacks And More

When the Time Magazine devotes 7 full pages in the March 22, 2004 issue to the topic of inflammation as the source of most of the diseases of the Western World, you know that something important is happening in medicine. Christine Gorman and Alice Park have summarized some of the groundbreaking research of the past few years in this article. I will report about this article here, but also include direct links regarding some of the relevant research the authors have mentioned including some of the key links regarding the metabolic syndrome, which was not mentioned in the article.

Since the beginning of the obesity wave in North America it has become obvious that a cluster of diseases such as heart attacks, strokes, Alzheimer disease, cancer of the colon, multiple sclerosis, arthritis and others have also become more frequent. Dr. Paul Ridker, a cardiologist at Brigham and Women’s Hospital, was one of the pioneers of investigating inflammation as a possible cause and the common denominator of these diverse illnesses. He noticed that certain patients got heart attacks although their blood LDL cholesterol levels (the “bad” cholesterol) were normal. The theory at that time was that all patients who would develop heart attacks would come from a high-risk group of patients with elevated LDL cholesterol. The problem was that 50% of patients with heart attacks had normal LDL cholesterol levels. Dr. Ridker suspected that the C-reactive protein (CRP), which is found to be elevated in the blood of rheumatoid patients, would be somehow involved in the disease process of hardening of the arteries before a heart attack would occur. CRP is produced by the liver cells and by the lining cells of arteries in response to a general inflammatory reaction in the body. Examples of this would be rheumatoid arthritis patients and patients with autoimmune diseases, where CRP levels can be readily measured with a blood test. Dr. Ridker found that there was a very good correlation between the CRP level and the degree of inflammation as well as the risk for developing heart attacks and strokes. Further investigation by others confirmed that CRP levels were perhaps more important than LDL levels in predicting impending heart attacks. This is so, because CRP is the body’s substance in the blood stream that would be responsible for breaking up LDL containing deposits (plaques) in the walls of the arteries, which leads to heart attacks in the heart and to strokes in the brain.

Chronic Inflammation Causes Cancer, Heart Attacks And More

Chronic Inflammation Causes Cancer, Heart Attacks And More

Other investigators found that CRP was only one link in a complex chain of events that includes inflammatory substances (cytokines) from the fat cells as well as insulin and insulin-like growth factors from the metabolic syndrome. Leptins are also a factor as has been discussed under this link.
Dr. Steve Shoelsen from the Joslin Diabetes Center in Boston has developed a mouse model for the metabolic syndrome. These mice will produce huge amounts of inflammatory substances in their fatty tissue in response to any inflammatory process that is started in them. Anti-inflammatory drugs such as the statins or metformin, it is hoped, will be shown conclusively to dampen the inflammatory process and prevent heart attacks, strokes and diabetes as well as cancer, Alzheimers disease and arthritis. Heart disease has already been shown to be improved by anti-inflammatory drugs. Asthma is an inflammatory disease of the small bronchial tubes, which can be stabilized with the anti-inflammatory drug Avastin.

What can we do as consumers to prevent some of those life-threatening diseases? By reducing our weight through calorie restriction on a low-glycemic diet we can help to reduce the insulin-like hormone substances of the fatty tissue. Regular exercise of at least 30 minutes of a brisk walk daily or the equivalent of other sports activities will half our risk for colon cancer and many other cancers. A diet rich in fruits and vegetables as well as fish and fish oils will reduce the amount of free radicals in our system cutting down on the circulating inflammatory substances. This prolongs life, prevents all of the major diseases of modern civilization and leads to longevity as the study of the Okinawa diet has shown.

Based on an article in the Time Magazine, March 22, 2004 edition, page 54 to 60.

Here is a chapter on arteriosclerosis from the Net Health Book, which explains inflammatory changes of the arterial wall:

http://nethealthbook.com/cardiovascular-disease/heart-disease/atherosclerosis-the-missing-link-between-strokes-and-heart-attacks/

Last edited October 26, 2014

May
01
2004

Sugar And Starchy Foods Cause Colorectal Cancer

A study from the Harvard University involving 38,000 women and having been started in 1993 has surprised the researchers. They wanted to find out whether there were certain foods that may cause colon and rectal cancer. So they administered a “food-frequency” questionnaire with 131 questions to women 45 years or older who entered into the study. Such factors as low-dose aspirin, vitamin E and beta-carotene were included in the questionnaire as was the exact food composition for the year prior to enrolment into the study.

A sugar load (glycemic load) was calculated. This way the impact of various sugar and starch containing foods could be assessed and compared among different subgroups regarding the later development of cancer in the colon and rectum.
When Dr. Susan Higginbotham and Dr. Simin Liu analyzed the diets of the 174 patients who did develop cancer (26 rectal cancers, 148 colon cancers) they found that the women with the highest sugar and starch load were 3 times more likely to develop cancer than the controls with a low glycemic load. High glycemic load foods are candy, cakes, cookies; any other refined flour products including white bread, pasta, French fries and baked potatoes. Together with other literature in this field the authors of this study concluded that the high glycemic food load leads to increased insulin levels in the blood as well as insulin-like growth factors. This in turn leads to cell division in normal and cancerous cells including the lining of the colon and rectum. In addition it is known that the C-reactive protein promotes an inflammatory response that will lead to heart attacks and to cancer.

Sugar And Starchy Foods Cause Colorectal Cancer

Sugar And Starchy Foods Cause Colorectal Cancer

Dr. Bob Bruce from the University of Toronto has shown in his research on colon cancer that insulin and related factors are important in the promotion of this cancer. He commented regarding the Harvard study reviewed here that more research is required before the exact cause of cancer of the colon and rectum would be understood. This knowledge is required before more effective preventative measures can be found other than a simple reduction of sugar and starch in the foods we eat.

Based on the Feb.4 edition of the Journal of the National Cancer Institute (U.S.) and the National Review of Medicine (Canada) March 15, 2004.

More info about Colorectal cancer can be found through this link.

Last edited October 26, 2014

May
01
2004

Age-Related Macular Degeneration Can Be Postponed

In a well-controlled study that was published earlier in 2004 Dr. Johanna M. Seddon

has shown that age-related blindness (AMD) is caused from an inflammation in the blood vessels, which is associated with an elevated blood marker, called C-reactive protein (CRP). The authors of this study also showed that the dry form of AMD would tend to deteriorate with age and/or from smoking cigarettes into the more serious wet form, a common cause of blindness.

The inflammatory component of cardiovascular disease is known to be controlled by the use of aspirin (ASA) or the statins, medication that is known to lower the bad LDL cholesterol. It is with this background that the author of the study that I am reviewing here, Dr. Jacque L. Duncan from the University of California at San Francisco, has examined the effects of ASA and of statins on AMD. 326 patients with AMD (204 with dry AMD, 104 with wet AMD from blood vessels forming underneath the retina and 18 with geographic atrophy) were followed between January 1990 and March 2003. Patients were at least 60 years old or older and followed at the San Francisco VA Hospital Eye Clinic.
Dr. Duncan found that patients with blindness due to wet AMD used ASA or statins significantly less than patients with stable AMD. Moreover, he found that patients who had AMD and took statins were 49% less likely to develop wet AMD and if they took ASA the were 37% less likely to develop wet AMD.

Age-Related Macular Degeneration Can Be Postponed

Age-Related Macular Degeneration Can Be Postponed

The study also suggests that there is a link between the inflammatory process that leads to heart attacks and strokes on the one hand and the further deterioration to blindness when dry AMD is not treated on the other hand. The notion that inflammation is the missing link in both of these processes is a relatively new finding.

More information about Macular Degeneration here.

Based on article by Dr. Jacque L. Duncan in the American Journal of Ophthalmology 2004;137: 615-624.

Last edited October 26, 2014

May
01
2004

Physicians Use New Technology (GCFP) To Study Blood Flow

Researchers at the Duke University Medical Center have developed a new non-invasive method of visualizing blood flow through blood vessels of patients. It is a modification of the well-known MRI scan technology where a magnetic field realigns the center of hydrogen atoms (protons) during the time of the examination and the differences of the tissue and fluid qualities are reflected in the images created by this technology. This new application depicting moving blood in blood vessels is called “global coherent free procession” (GCFP).

The principle is that the investigator can focus on an area of a blood vessel upstream of the area to be examined and tag a portion of the blood flowing through with an energy pulse. As the blood continues to flow through the area of interest, the protons give off the energy again without any changes to the body fluids or the blood cells and the MRI scanner picks up the images of the blood flow through the blood vessel.
The advantage of this technique is that it is done without any catheters (it is non-invasive), there is no need for any contrast material to be injected and there are no X-rays needed. At the present time this is the only diagnostic technology available for examining a patient’s blood flow through the heart and its vessels in real time, which is very valuable for physicians (cardiologists).
Here is a link to the Duke University publication

Physicians Use New Technology (GCFP) To Study Blood Flow

Physicians Use New Technology (GCFP) To Study Blood Flow

Based on an article in the April 13, 2004 issue of The Medical Post , Vol.40, No. 15, p.5.

PS. When checked on Nov. 5, 2012 this procedure has not been widely accepted in medical circles. It seems to be still more of a research tool.

Last edited December 8, 2012

Mar
01
2004

Ankle Blood Pressure Reveals Diabetic Problems

One of the complications of diabetes is that ity leads to clogged arteries from peripheral artery disease and this can lead to heart attacks, strokes and circulation problems in the legs.

Recommendations were recently given to physicians in the December edition of the medical journal Diabetes Care that circulation problems in diabetics need to be monitored more stringently to avoid needless amputations.

Medically these circulation problems that affect mainly lower legs and feet are known as “peripheral vascular disease” (or PVD for short). PVD can be detected by the physician checking for ankle pulses. Another valuable and very simple test is to measure the blood pressure in the arm and at each ankle (using the stethoscope just under the inside (medial) ankle bone. If there is a major discrepancy between the arm and ankle blood pressure or if the ankle pulse is missing, this would be a sign of possible PVD. With a diabetic patient it would still be important to get the hemoglobin A1C under control through exercise, a low glycemic diet and possibly anti-diabetic medication. But the patient likely would have to be referred to a cardiovascular surgeon for further testing in order to find out whether there would be hardening of the arteries with circulation problems in the lower leg, the ankle or foot.

Ankle Blood Pressure Reveals Diabetic Problems

Ankle Blood Pressure Reveals Diabetic Problems

Dr. Peter Sheehan, the director of the Diabetes Foot & Ankle Center at the New York University school of medicine, stated that many patients and doctors overlook how frequent this condition is. About 33% of diabetic patients who are older than 50 years have PVD, but only a fraction know about it until it is too late. Once a patient has PVD in one of the legs there is a 4-fold risk of getting a heart attack or a stroke, because the hardening of the arteries is happening simultaneously in all of the body’s arteries. If the blood pressure is normal at the ankle, Dr. Sheehan recommends to check it again in 5 years.

Who should have the blood pressure check at the ankle? Here is a table that summarizes Dr. Sheehan’s recommendations.

Which diabetic needs the ankle blood pressure check?
High risk group: Remarks or more detail:
Anyone with leg PVD* symptoms legs tired or hurting when walking
Young diabetics
with other risks
smoking, high blood pressure, high cholesterol, diabetes present for more than 10 years are such risk factors
diabetics 50 years of age and over particularly when the hemoblobin A1C is high and other risk factors are present
*PVD peripheral vascular disease

Why is it so important to screen for circulation problems in the lower legs? Because this is the area where diabetics tend to get problems that often result in amputations of a foot or lower leg below the knee. With early detection of these problems and intervention by a cardiovascular surgeon often disastrous outcomes can be avoided.

More info is available at:

Diabetes: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

High blood pressure: http://nethealthbook.com/cardiovascular-disease/high-blood-pressure-hypertension/

Last edited October 26, 2014

Mar
01
2004

Inflammatory Marker Linked To Blindness

Up to now age-related blindness or “age-related macular degeneration” (AMD) as it is medically called, has been a mystery. The retina is the light-sensitive area of the eye similar to the film in a camera. The “macula” is that part of the retina that has the highest visual acuity. Several studies have been conducted lately regarding age-related blindness that shed more light on this important health hazard of old age, studies that one day might even lead to a cure or powerful preventative measures to avoid it from ever developing.

One such study is the one by Dr. Johanna M. Seddon and co-workers published in the Feb. 11, 2004 issue of the Journal of the American Medical Association. Almost 1000 patients with various degrees of age-related degrees of blindness from the Age-Related Eye Disease Study (AREDS) were classified by the degree of their macular degeneration. I have produced the bar graphs below based on these studies.

Four groups were defined, namely those with no AMD who served as controls, those with mild AMD, those with moderate AMD and those with severe AMD who were legally blind. They suspected that an inflammatory marker in the blood stream of these patients, called C-reactive protein (CRP), might be present in the more severe cases of blindness when compared to the control group who did not have any inflammatory changes in the macula. As can be seen by the bar graph above this is exactly what the test results indicated. They also found that smokers (blue bars) tended to have slightly worse blood tests in terms of CRP (more inflammatory substances circulating in the system) within the same severity category of the age-related eye changes.

CRP (mg/L) Levels in Various Degrees of Severity of Age-related Macular Degeneration (AMD)

Inflammatory Marker Linked To Blindness

Inflammatory Marker Linked To Blindness

When the investigators studied the risk for the highest percentile of the CRP tests within various subgroups to show AMD they found several differences as is shown in the next table. First there was a low probability to develop AMD in a person with a normal looking macula and that risk was set at 1.0 as comparison. In contrast a person with a normal looking macula who smokes has a 1.5-fold risk of developing AMD later. Patients with a moderate degree of AMD have about a 2-fold risk of getting a severe degree of AMD later (smoking or not). It seems that once the inflammatory cycle has started, the process of causing a moderate degree of AMD is so strong that the effect of smoking will not add that much in comparison.

This is the first study of this kind that has established that CRP can be used as a screening for the risk to develop AMD. CRP has already been established as a test for monitoring progress in rheumatoid arthritis or to monitor for the risk of developing a heart attack or stroke.

Another study by Dr. Johanna M. Seddon and co-workers was published recently in the Archives of Ophthalmology. 261 people aged 60 years and older with established AMD were followed for 4.6 years and checked for deterioration. 101 patients had deterioration of their AMD.

Risk of Developing Age-Related Macular Degeneration (AMD) in Highest CRP Percentile
 Inflammatory Marker Linked To Blindness1

The authors analyzed the patients’ diet habits and found that increased fat intake was a high risk factor for deteriorating AMD. Both vegetable and animal fat had a 2-to 3-fold increased risk for deterioration of the AMD to a more severe stage (legal blindness). Fish, omega-3 fatty acid and nuts had a protective effect, but only when omega-6 fatty acid (linoleic acid) intake was low in the same group. The studies showed that the risk of age-related blindness was reduced by 40% when patients ate nuts at least once per week. The authors concluded that a “fat conscious diet” would be good for “maintaining good eye health” and at the same time be beneficial for prevention of heart attacks and strokes.

The authors will do further studies to investigate potential ways of helping patients with AMD and to understand the mechanisms of the disease process better.

References: 1. JAMA 2004;291:704-710  2. Arch Ophthalmol – 01-DEC-2003; 121(12): 1728-37

Last edited December 8, 2012

Feb
01
2004

Cinnamon A Natural Insulin Booster For Diabetics

In a recent edition of the medical journal Diabetes Care an interesting article appeared regarding the healing effects of the spice cinnamon. A medical research team in Pakistan (Dr. Khan et al.) in collaberation with a U.S. research team divided a group of 60 comparable diabetics (males and females) in the age range of 45 to 55 and fed one half different concentrations of cinnamon while the other half served as a placebo control. There were three different concentrations of capsules of cinnamon given: 1g, 3 g and 6 g. The placebo control group got capsules with inert material. Here are the results:

The placebo control group showed no change in blood values. The effect documented in this table was achieved after 40 days of cinnamon exposure and was “washed out” after 20 days. Other experiments had found that the substance MHCP (methylhydroxychalcone polymer) is the active ingredient in cinnamon that stimulates insulin and also acts on insulin receptors similar to insulin.

Cinnamon A Natural Insulin Booster For Diabetics

Cinnamon A Natural Insulin Booster For Diabetics

Dr. Richard A. Anderson and his colleagues at the Human Nutrition Research Center of the U.S. Department of Agriculture had already published a number of medical papers on the effects of cinnamon. He was the co-author of this study from the Department of Human Nutrition, NWFP Agricultural University of Peshawar, Pakistan.

Effect of cinnamon on blood values of diabetics
Blood component
investigated:
% Reduction
of blood test:
Blood sugar
level

18-29%
Triglycerides (blood
fat value)
23-30%
LDL cholesterol
(damaging cholesterol)
7-27%
Total cholesterol 12-26%
HDL cholesterol
(protective cholesterol)
unchanged

The interesting observation here is that several cardiovascular risk factors (blood sugar, triglycerides and LDL cholesterol) are simultaneously being reduced with something as simple as cinnamon powder. The authors stated that the cinnamon oil is not effective, only the cinnamon powder or a cinnamon stick dipped into tea (the water soluble component of cinnamon or MHCP). Dr. Anderson also warned not to make the mistake to eat more cinnamon buns or apple pie as there would be unhealthy amounts of sugar, starch and fat added. He suggested that the best to do instead would be to simply sprinkle cinnamon powder over whatever you are presently eating, as this will reduce the risk of getting diabetes or will reduce the risk of a heart attack in diabetics.

This article based on: “Cinnamon improves glucose and lipids of people with type 2 diabetes.” Diabetes Care – 01-DEC-2003; 26(12): 3215-8.

Here is a link to diabetes mellitus (type 2 diabetes).

Last edited December 8, 2012

 

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Jan
03
2004

Any Diet A Winner Research Says

 

Dr. Michael Dansinger reported at a recent annual meeting of the American Heart Association about a study where he compared the effect of 4 major diet plans on the lowering of risk factors for heart disease.

Dr. Dansinger is the director of obesity research at the Tufts New England Medical Centre’s Atherosclerosis Research Lab in Boston. Originally, the objective was to see whether any of the following four diets investigated would be superior: the Atkins diet, the Ornish diet, the Zone diet and the Weight Watchers diet. In the table below there are links for each of these diet plans. Briefly, the Atkins diet is a high protein/low carbohydrate diet; the Ornish diet is a vegetarian/low-fat diet; the zone diet is a low-glycemic load/balanced protein/low fat diet; weight watchers is a calorie restricted diet.

160 obese patients were divided into 4 groups and assigend to one of these four diet plans. They were instructed in the type of diet plan they were to follow in 4 couselling sessions in the beginning of the weight loss program. The participants ranged in age from 22 to 72 years of age (average age 50) and had on average starting weight of 220 lbs.

Any Diet A Winner Research Says

Any Diet A Winner Research Says

They were to follow the diet plan for 2 months strictly and were allowed to follow less supervised for another 10 months. To the surprise of the research team under Dr. Dansinger they all lost about the same amount of weight (average of weight loss 10 lbs or 5% of body weight), in other words they were all successful with any of these programs and none was superior. Below are the results in modified tabular form.

Dr. Dansinger indicated that the focus would now have to shift from “which is the best diet plan” to “which is the best diet plan for a particular patient”. The doctor should attempt to fit the weight loss programs that fit patients’ food preferences best and that patients can easiest fit into their lifestyle. This will hopefully lead to the lowest dropout rate. This trial showed that the Zone diet and the Weight Watchers diet had the least dropout rates. But those who stayed on the Atkins or Ornish diet were successful with their weight loss program also, as these may have been fitting these patients best.

Comparison of various diets with regard to weight loss effectiveness
Diets that
were compared:
Reduction of
heart risk (Framingham score):
Dropout rates
over 1 year:
Atkins diet
12.3% 48%
Ornish diet 6.6% 50%
Zone diet 10.5% 35%
Weight Watchers
diet
14.7% 35%

In other words, if the one diet plan does not work satisfactorily, try another one. The common denominator with all food plans was some form of calorie restriction despite all of the differences.

Based on The Medical Post, Dec. 16, 2003 (p. 15).

Here is a link to the Net Health Book’s weight loss and diet chapter.

Last edited December 8, 2012