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Saturated fat and cardiovascular disease controversy


Whether saturated fat is a risk factor for cardiovascular disease is a question with numerous controversial views. Although most in the mainstream heart-health, government, and medical communities hold that saturated fat is a risk factor for cardiovascular disease, some hold contrary beliefs.

Medical, scientific, heart-health, governmental and intergovernmental, and professional authorities, such as the World Health Organization, the American Dietetic Association, the Dietitians of Canada, the British Dietetic Association,American Heart Association, the British Heart Foundation, the World Heart Federation, the British National Health Service, the United States Food and Drug Administration, and the European Food Safety Authority advise that saturated fat is a risk factor for cardiovascular disease, and recommend dietary limits on saturated fats as one means of reducing that risk.

The initial connection between arteriosclerosis and cholesterol was made by the Russian pathologist Nikolay Anichkov, prior to World War I. Another significant contribution to the debate was made by the Dutch physician (internist) Cornelis de Langen, who noticed the correlation between nutritional cholesterol intake and incidence of gallstones (and soon after, arteriosclerosis and other "Western diseases") in the Javanese population in 1916. De Langen reported on his findings at the conference of the International Society of Geographic Pathology in 1935. These observations were made on patients admitted to the municipal hospital in Jakarta. Consequently, he studied this phenomenon in defined populations outside the hospital. He showed that the traditional Javanese diet, very poor in cholesterol and other lipids, was associated with a low level of blood cholesterol as well as a low incidence of cardiovascular disease (CVD), while the prevalence of CVD in Europeans in Java, living on the Western diet, was significantly higher. De Langen's colleague, Isidor Snapper, made a similar observation in North China in 1940. Since de Langen published his results only in Dutch, his work remained unknown to most of the international scientific community.



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Scarsdale diet


The Scarsdale diet is a fad diet designed for weight loss created in the 1970s by Herman Tarnower, named for the town in New York where he practiced cardiology, described in the book The Complete Scarsdale Medical Diet plus Dr. Tarnower's Lifetime Keep-Slim Program, which Tarnower wrote with an author of self-help books, Sam Sinclair Baker. The diet carries potential health risks and does not instill the kind of healthy eating habits required for sustainable weight loss.

The diet is similar to the Atkins Diet in calling for high protein and low fat and low carbohydrates, but also emphasizes fruits and vegetables. The diet's high fat ratio may increase the risk of heart disease. People following the diet can lose much weight at first, but this loss is generally not sustained any better than with normal calorie restriction.

The book was originally published in 1978 and received an unexpected boost in popular sales when its author, Herman Tarnower, was murdered in 1980 by his jilted lover.



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Sego (diet drink)


Sego was a US meal replacement diet drink formally marketed by Pet, Inc. (at the time Pet Milk) as Sego Liquid Diet Food. Introduced in 1961 and selling for approximately US25¢ each, Sego sales registered US$22 million to the company's Milk Products Division by 1965.

The name Sego derived from a Salt Lake City-based company, Sego Milk Products Company, that Pet Milk had purchased in 1925.

Sold in 10-ounce cans, before the advent of aluminum cans or cans with pull tabs, the beverages were available in flavors including Chocolate, Chocolate Coconut, Chocolate Malt, Vanilla, Strawberry, Banana and Orange—each providing 900 calories (initially, and subsequently 225 calories). Marketed under the taglines "See the calories go with Sego" and "Sego, it's great for your ego," Pet advertised the drinks being "thicker" and as having 10% more protein and 2 more ounces than other 900 calorie foods—e.g., Metrecal, its predecessor in the market and the market leader—asserting that protein "helps control hunger." In 1966, milk chocolate, caramel fudge and butter pecan flavors became available, and Pet Milk subsequently offered Sego branded pudding and soup—and, later still, diet bars.

By 1961, there were more than 100 meal replacement products on the U.S. market, and Sego competed with such products as Metrecal and Figurines by Pillsbury, and was ultimately superseded in the market place by such liquid diet drinks as Slimfast.

In the 2010 book The Hundred Year Diet, author Susan Yager called Sego "baby formula mixed water and a poor substitute for food."

Noted actress Tippi Hedren was discovered by Alfred Hitchcock while shooting a television commercial for Sego on the Today Show. Hedren later described the spot as "a story line; it wasn't just holding up a product and talking about it. It was a story and apparently he (Hitchcock) saw it."



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Semi-vegetarianism


A semi-vegetarian or flexitarian diet is one that is plant-based, with occasional meat products. In 2003, the American Dialect Society voted flexitarian as the year's most useful word.

Vegetarianism is the practice of abstaining from consuming meat. Along with the term flexitarian, which was listed in the mainstream Merriam-Webster's Collegiate Dictionary in 2012, other neologisms for semi-vegetarianism are reducetarianism and lessetarianism.

Common reasons for adopting a semi-vegetarian diet may be ethical issues relating to animal welfare (including health) or animal rights, the environment (see environmental vegetarianism) or reducing resource use (see economic vegetarianism), which are also arguments in favor of adopting a fully vegetarian diet. While semi-vegetarians may view the meat or animal products as occasional indulgences, staunch vegetarians may resent the term or view it as cheating or as a moral lapse. In contrast, many proponents of veganism embrace semi-vegetarianism as a way to get a broader section of the general public to act on arguments for veganism, with the consequence that more animal suffering and environmental devastation will be prevented than if the public views meat-reduction as all-or-nothing.

A ranking by U.S. News & World Report, involving a panel of experts, evaluated 32 popular diets based on several variables including health, weight loss, and ease of following. In the 2014 list, the semi-vegetarian diet came in sixth place, ahead of both the vegan and vegetarian diets. Specific semi-vegetarian diets include:



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The Shangri-La Diet


imageThe Shangri-La Diet: The No Hunger Eat Anything Weight Loss Plan

The Shangri-La Diet is both the name of a book by the psychologist Seth Roberts, a professor at Tsinghua University and professor emeritus at UC Berkeley, and the name of the diet that the book advocates. The book discusses consuming 100–400 calories per day in a flavorless food such as extra light olive oil one hour outside of mealtimes as a method of appetite suppression leading to weight loss.

As a graduate student, Roberts studied animal cognition, specifically rat psychology. As a psychology professor, Roberts read a report by Israel Ramirez, a scientist at the Monell Chemical Senses Center, about the effect of saccharin on the growth and weight of rats. Based on this research, he developed a new theory of weight control. The theory led him to eat foods with a low glycemic index and to eat sushi many days in a row, which caused him to lose twenty pounds.

In 2000, Roberts visited Paris. He noticed an extreme loss of appetite and speculated that this was due to drinking flavors of soft drinks that were not available to him in the US.

The book features short anecdotes from followers of the diet who had heard of it through Roberts' blog or The New York Times. Roberts' diet is based on the fundamental principle of a set point – the weight which, according to Roberts, a person's brain strives to maintain. When actual weight is below the set point, appetite increases; when actual weight is above the set point, appetite decreases. Furthermore, eating certain foods can raise or lower the set point. Foods that have a strong flavor-calorie relationship (such as fast food or donuts) raise the set point, whereas bland foods which are slowly digested (like extra light olive oil or fructose mixed with water) lower the set point. Roberts states that the diet is based upon connecting two unconnected fields: weight control and associative learning. Because of this, the research behind the diet is from multiple fields, ranging from Pavlovian psychology to physiology to rat psychology.



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Slow-Carb Diet


imageThe 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman

The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman (2010) is the second book by American writer Tim Ferriss.

Ferriss's first book, and the one that made him well-known, was The 4-Hour Workweek. Two facts informed his choice for his new book's topic: Firstly, he felt he did not want to write another book on business, as "I've said what I have to say about business. [...] I don't want to be 'The 4-Hour Workweek' guy; I'd prefer to be known for the way I approach the craft of writing and storytelling." Secondly, of the top ten Google searches bringing visitors to his weblog, four searches were some variation on "lose weight". That, as he put it, left him with "no Option B. [...] my next book was going to be The 4-Hour Body, or I wasn’t going to write another book."

The author spent three years interviewing over 200 experts, from doctors to athletes to black-market drug salesmen. He claims to have recorded every workout he had done since the age of 18, and from 2004 (three years before his first book was published) he had tracked a variety of blood chemistry measurements, including insulin levels, hemoglobin A1c, and free testosterone.

The 4-Hour Body was published on December 14, 2010.

Ferriss describes The 4-Hour Body as "unlike any diet or fitness book...It's more like a Choose-Your-Own-Adventure book for the human body, full of ridiculous stories, practical philosophies, and larger-than-life characters." The book covers over 50 topics, including rapid fat loss, increasing strength, boosting endurance and polyphasic sleep.

There are five main food groups that are consumed on a slow carb diet: animal protein, vegetables, legumes, spices and fats/oils/nuts. A typical slow-carb meal will consist of one portion each of the first three groups and small amounts of the last two. Examples of foods in these groups are chicken, eggs, lamb, pork, fish and beef for protein, broccoli, cauliflower, eggplant, peas for vegetables, black beans, chickpeas, kidney beans and lentils for legumes, basil, garlic, ginger and salt for spices, coconut oil, macadamia nut oil, olive oil, almonds, brazil nuts, cashews for fats/oils/nuts.

One day per week is reserved as "cheat day" when all foods are allowed, similar to the carb-loading day in a cyclic ketogenic diet. As well as reducing the psychological stress of dieting, this serves to protect against the lowered metabolic rate that often accompanies dieting.



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Soft diet


A mechanical soft diet or edentulous diet is a diet that involves only foods that are physically soft, with the goal of reducing or eliminating the need to chew the food. It is recommended for people who have difficulty chewing food, including people with some types of dysphagia (difficulty swallowing), the loss of many or all teeth, surgery involving the jaw, mouth or gastrointestinal tract, and pain from recently adjusted dental braces.

A mechanical soft diet can include many or most foods if they are mashed, puréed, chopped very small, combined with sauce or gravy, or softened in liquid.

In some situations, there are additional restrictions. For example, patients who need to avoid acid reflux, such as those recovering from esophageal surgery for achalasia, are also instructed to stay away from foods that can aggravate reflux, which include ketchup and other tomato products, citrus fruits, chocolate, mint, spicy foods, alcohol, and caffeine. Foods such as tomatoes and blackberries may be restricted because they contain small seeds.

A puréed diet is commonly used for people who have difficulty swallowing, and provides a uniformly smooth consistency.

Most of the foods on this diet can be both puréed and thinned with liquids to be incorporated into a full-liquid diet.



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Sonoma diet


The Sonoma Diet is a dietary system that was developed by Connie Guttersen, and is a derivation of the Mediterranean diet.

The diet plan consists managing portion sizes and eating approved foods centered on 10 items known as the "power foods". According to the creator of the diet these foods were chosen for their nutritional value and intense flavors. The power foods are whole grains, almonds, bell peppers, tomatoes, broccoli, grapes, spinach, blueberries, strawberries and olive oil.

Dr. Connie Guttersen, R.D., Ph.D. is a registered dietitian and nutrition instructor at the Culinary Institute of America. She developed the Standards of Care for the Obesity Treatment Center in Bellevue, Washington and she served as an instructor on nutrition and food science at Texas Christian University.

As with the Atkins Diet, Zone diet and South Beach Diet, the Sonoma Diet has three distinct stages known as waves. The first phase which lasts 10 days is the most restrictive phase with the smallest number of foods allowed with the smallest portion sizes. During this stage, sugar intake is greatly reduced.

During the next phase a wider variety of foods are allowed and weight loss slows to a more gradual pace. Phase two continues until the target weight is reached. Phase three is known as the maintenance stage with a wider range of foods being allowed (including the occasional dessert).

This diet is not classified as a low-carbohydrate diet or low sugar diet. People following the diet are allowed to eat whole grains, breads and cereals during all three stages of the diet. The plan does recommend avoiding white flour, saturated fats and recipes with additional sugar.



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South Beach Diet


The South Beach Diet is a popular fad diet developed by Arthur Agatston and promoted in a best-selling 2003 book. It emphasizes eating high-fiber, low-glycemic carbohydrates, unsaturated fats, and lean protein, and categorizes carbohydrates and fats as "good" or "bad". Like other fad diets, it may have elements which are generally recognized as sensible, but it promises benefits not backed by supporting evidence or sound science.

The diet has three stages, and gradually increases the proportion of carbohydrate consumed as it progresses while simultaneously decreasing the proportions of fat and protein. It includes a number of recommended foods such as lean meats and vegetables, and has a concept of "good" (mostly monounsaturated) fats. It makes no restriction on calorie intake, includes an exercise program, and is based around taking three main meals and two snacks per day.

The first stage of the diet aims for rapid weight loss (13 lbs in 2 weeks). According to the UK's National Health Service, (NHS) the severity of the first stage of the diet may result in the loss of some vitamins, minerals and fiber. The NHS reports that dietary restrictions during stage one may cause side effects including "bad breath, a dry mouth, tiredness, dizziness, insomnia, nausea and constipation." Such symptoms would be rectified once the less extreme phases of the diet then began.

Like other fad diets, the South Beach Diet has been marketed with bold claims that are not supported by evidence and with an unrealistic promise of easy weight loss. The book which promotes it also contains some incorrect and misleading information. Nevertheless, some aspects of the diet correspond with dietary advice which is recognized as sensible: its last two stages are sufficiently nutritious to be considered healthy. Like other high-fat diets, its short-term safety has been established, but its long-term safety has not.

The diet is promoted as improving risk factors associated with cardiovascular disease, but the effectiveness for improving these risk factors is unclear because no evidence on its effects is available. A trial found no change in weight loss compared to usual care.



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Sustainable diet


A sustainable diet is defined as one that promotes food sustainability and ecological well-being.

Sustainable diets are eating patterns that look at the impact that food consumption has on planetary resources and health of humans and promote the needs of the environment, society, and the economy. This growing body of research is recognised by a variety of international bodies such as the United Nations Food and Agriculture Organization (FAO) and the World Health Organization (WHO).

A growing population and an increase in income is shifting global demands to what is known as the global diet. It demands a diet high in animal protein, oils, salts and processed foods.

Additional research and methods that will help address issues such as agriculture production methods, food waste, environmental problems like declination of biodiversity and global warming, are necessary for promoting sustainable diets. As well as to determine whether or not there should be concern on plant vs. animal diets and their impact on health.

In 2010, the FAO and Bioversity International defined a sustainable diet as:

those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources.

Some so-called "sustainable" diets mostly concentrate on issues to do with Low Carbon Diets which are structured to reduce the impact of global warming (e.g., Bon Appétit Management Company's, Eat Low Carbon Diet).

Others also focus on broader environmental factors, as well as social and economic challenges (e.g., WWF's LiveWell for LIFE, and the Barilla Group's "Centre for Food Nutrition" model).

Other regionalized diets include the Mediterranean diet which was used as a basis in research published in 2014 to outline an approach to develop metrics and guidelines to measure the sustainability of diets in a way that useful to inform stakeholders, measure change and aid decision-making processes at regional and national scales.



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