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Is one diet the best? A doctor weighs in

Editor’s note: This column will appear in Healthy Living on Sunday, April 15, 2012.


“Can you tell me about your diet?”  It seems like such an innocuous question, and it’s one I find myself asking my patients all the time. Yet it is a remarkably complex question, and cannot be answered   with a nuanced discussion worthy of its importance in a 15-minute office visit.

If you are health conscious and have been paying attention to the news about diets for the last couple of decades, you should be thoroughly confused.  Low-carb? No-carb?  High-protein? Mediterranean?

Why do the experts change their minds all the time, and why can’t you get a straight answer about what to eat to be healthy?

I am a simple primary care physician without a crystal ball, so I will not be able to provide you with an omniscient answer about the diet you must follow.  But I certainly can synthesize some pragmatic tips to help you get and stay healthy, since you are what you eat.

My first tip for you: Ignore the fads. The Atkins Diet, based on a low-carb/no-carb concept, has proved remarkably successful for losing weight quickly. But it wreaks havoc on the cholesterol levels of my patients and has not been studied in regard to its impact on heart disease. It can be very hard to follow, and once you step off the Atkins diet, rapid weight re-gain is very common. The same can be said about Sugar Busters.

The Paleo Diet seems to be the fad du jour, and I was initially intrigued because I find studying our evolutionary history often helps us understand modern-day questions.  However, the Paleo Diet relies much too heavily on animal protein as a source of calories, and I will explain later why this is problematic.

I won’t go into all of the fads out there, but if there is a cleanse involved, a single food item at the center of the diet (the grapefruit diet, the cabbage soup diet) or something that sounds pseudoscientific (the blood type diet, the Candida diet), then you should probably stay away.

Many of the people promoting fad diets are trying to make a buck off insisting that their simplified diet is the “best.” Hogwash!

What you find if you study fad diets is that anecdotal evidence of their success may abound, but scientific evidence is much harder to find.


Now that I have told you what not to do, I bet you are hoping I’ll tell you what to do. Well, I can’t.  Not with military precision.  Not with a step-by-step guide or meal plan or commandments.

When I ask my patients about their diets, I want to know what their daily schedule looks like, what foods they prefer, what is possible and sustainable, since we are all different. I prefer to give guiding principles rather than dictates. Here’s my advice.

First: Chose produce over processed foods. If it is not in a box, can or jar  but rather comes from the produce section, it is best. Nothing beats raw, real fruits, nuts, beans and vegetables in the nutrition they deliver.  They will not contain high-fructose corn syrup. You will get some calories but more water, fiber, vitamins and minerals than with that Twinkie you were thinking about.

Second: Avoid fast foods and eat out seldom.  Restaurants pump sugar, salt and fat into everything to increase the pleasurable taste of their foods.  Portion sizes are large to attract customers.  The result is a remarkably toxic mess of too many calories that expand your waistline and clog your arteries.

Third: If you must eat animal protein, try to keep it lean.  Fish seems to be the healthiest animal protein, while poultry, pork and beef are much more apt to cause health problems (I’ll discuss this more later in the column).

Fourth and perhaps most importantly: Avoid  liquid calories.  There is no redeeming quality to sugary soft drinks.  These empty-calorie sources not only are like gasoline on the fire for developing diabetes, but they cause bone mineral loss and tooth decay. Liquid calories—also found in iced tea and even fruit juices—pack on the pounds for most people.  Try your best to stick to water—it’s what nature intended!


Now you know what I preach. But what do I do in my own life?

Well, that all changed about eight weeks ago.  My brother, Jason Lillis, is an obesity researcher at Brown University in Providence, R.I.  He sent my family an email about eight weeks ago announcing that he and his wife could no longer ignore all the studies they have been exposed to and were becoming vegetarians.

He asked that my family read “The China Study” by  T. Colin Campbell and  Thomas Campbell Thomas M. Campbell II, and watch the documentary “Forks Over Knives.”   I must say, these works are well grounded in science, much more so that 99 percent of the fads out there.  They encourage a mostly plant-based, whole-foods diet—avoiding animal proteins and certainly avoiding processed foods.

These works highlight the dramatically increased rates of many different kinds of cancers found in societies that consume animal meat, compared with those that do not—a research finding that is gaining scientific steam.

As a result of my brother’s encouragement, my wife and I are eating much more vegetarian.  We still have an occasional piece of fish (not fried) and continue to eat some dairy.  But the beef, pork, chicken and turkey are no longer welcome.  The result has been more weight loss for us both, more energy throughout the day, better sleep and a greater general sense of well-being.

My best advice: Do your own research and watch the film my brother recommends. Try to figure out where you can make improvements in your diet.  Don’t beat yourself up over occasional indulgences, but try to do better on a day-by-day basis. You will feel better for it.


Dr. Christopher Lillis is an internist with Chancellor  Internal Medicine in Fredericksburg. He can be reached  at healthyliving@freelance