Category Archives: Weight Loss

Remember the Ol’ Milk Diet?

hiking, Arizona, Steve Parker MD,

Tom’s Thumb trail in Scottsdale, AZ

I recall a milk diet to treat stomach ulcers in the mid-20th century. Tagamet changed that!

I’ve been reading scientific articles on low-energy liquid diets for weight loss and diabetes remission, and ran across a reference to a milk diet. I found impressive results in a 16-week study.

This was a small randomized trial that enrolled 45 very fat folks — BMI 41-47, average weight 122 kg (268 lb), mostly women — and assigned them to one of three diets:

  1. Control: conventional balanced diet of normal foods providing about 800 calories/day and at least 36 grams of protein.
  2. Milk: “variable combination of full cream or semi-skimmed milk and unsweetened yoghurt,” about 800 calories/day. BTW, a cup (240 ml) of whole milk has 150 calories.
  3. Milk Plus: same as the milk diet plus “unlimited amount of a single food selected by the patient on each day of the week. Of these seven extra foods, three were a fruit or vegetable, two were a high protein food, and two were a “favourite” food. The seven foods were repeated on the same day of successive weeks.” (If you understand this, you’re smarter than me, which wouldn’t be unusual.) Average calories were 1,350/day.

The researchers figured these adults were eating about 2,500 calories/day at baseline. Diabetics were excluded.


The Milk group lost the most weight. Eleven of the 14 participants completed the 16-week study, with an average weight loss of 11.2 kg (24.6 lb). Constipation was the only “serious” side effect reported. The authors admitted that deficiencies in some vitamins and iron might be a problem, but cited a similar but longer trial (24 weeks) that found no such deficiencies.

Eleven of the 17 in the Milk Plus group persevered for the whole 16 weeks. Average weight loss was 8.2 kg (18 lb).

Nine of the 14 in the Control Group were able to put up with it for the duration. Average weight loss was only 2.6 kg (5.7 lb). I suspect they had a bit of a compliance problem. When you weigh 268 lb, a 5.7 lb loss isn’t much.

“Analysis of compliance (not reported) showed that it was similar for the two milk diets but much lower for the conventional diet.”


The researchers opine that…

  • “Patients are more likely to respond to a simple diet which they have not tried before than to advice on conventional diets.”
  • Probably the best strategy is to rotate diets,…[to prevent compliance from falling].”

I wonder how well the Milk diet would work for someone who weighs 205 lb (93 kg) and just wants to lose 25 lb (11.4 kg).

I wonder how important are the exact proportions of “full cream or semi-skimmed milk and unsweetened yoghurt.”

As with all diets, weight regain will be a problem after the 16 weeks.

The Milk diet might be a good temporary option for someone who wants to lose more excess weight but has hit a weight-loss plateau in their current regimen.

I’m skeptical about the nutritional adequacy of the Milk diet.

My Advanced Mediterranean Diet is actually two diets, making diet rotation easy. And I tell you the secrets to prevention of weight regain!

Steve Parker, M.D.

Reference: Summerbell, C.D., et al. Randomised controlled trial of novel, simple, and well supervised weight reducing diets in outpatients. British Medical Journal, 317: 1487-1489. November 28, 1998.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one



Mediterranean versus Vegetarian diet for weight loss? Both work equally well, study says

Raw Brussels sprouts salad

It’s refreshing to see a vegetarian diet study that specifies which type of vegetarian diet was used.

Followers of two different healthy diet patterns showed similar reductions in weight, body mass index and fat mass after 3 months, found researchers from the University of Florence, Italy in conjunction with Careggi University Hospital, Florence.

The lacto-ovo vegetarian diet was however more effective in reducing ‘bad’ low-density lipoprotein cholesterol whereas Mediterranean diet followers saw a greater reduction in triglycerides.

“After 3 months of dietary intervention, both lacto-ovo vegetarian and Mediterranean diets were effective in reducing body weight, body mass index, and fat mass, with no significant differences between them,” ​commented study first author Professor Francesco Sofi.

Source: Vegetarian or Mediterranean diet for weight loss? Both work equally well, says study

Oldsters, Preserve Your Muscle Mass While You Lose Weight. Here’s How.

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“Honey, please come to the gym with me.”


Seniors who want to lose weight should hit the weight room while they cut calories, a new study suggests.

Older folks who performed resistance training while dieting were able to lose fat but still preserve most of their lean muscle mass, compared with those who walked for exercise, researchers report.

“The thought is if you lose too much lean mass, that this will exacerbate risk of disability in older adults,” said lead researcher Kristen Beavers, an assistant professor of health and exercise science at Wake Forest University in Winston-Salem, N.C. “Our findings show if your treatment goal is to maximize fat loss and minimize lean mass loss, then the resistance training is probably the way to go.”

We’ve know for a while that resistance training helps preserve muscle mass in younger folks during weight-loss programs. I’ve always figured the principle applied to older folks, too. It’s good to have proof. Average age of these study participants was 67.

Steve Parker, M.D.


Eat More Protein for Greater Weight Loss

Sous vide chicken and sautéed sugar snap peas. Chicken is a good source of high biologic value protein.

P.D. Mangan makes an argument for high-protein diets for those hoping to shed pounds of fat:

In humans, data collected from 38 different trials of food consumption that used widely varying intakes of protein, from 8 to 54% of energy, showed: “Percent dietary protein was negatively associated with total energy intake (F = 6.9, P < 0.0001) irrespective of whether carbohydrate (F = 0, P = 0.7) or fat (F = 0, P = 0.5) were the diluents of protein. The analysis strongly supports a role for protein leverage in lean, overweight and obese humans.”

In obese humans, substitution of carbohydrate with protein leads to far greater weight loss, nearly twice as much.

In a human trial, decreasing the percentage of protein in food from 15% to 10% led to increased calorie intake of 12%. However, increasing the protein percentage from 15 to 25% did not affect calorie intake, which shows that humans may target a certain amount of protein, and eat no more or less when they get it.

There’s more at the link.

Source: Higher Protein for Greater Weight Loss – Rogue Health and Fitness

DIETFITS: Why do dieters succeed or fail? 

Julia Belluz has interesting article at Vox regarding low-fat and low-carb diet success over the course of 12 months. Her focus is on a few individuals who participated and were outliers.

As I read this, I was reminded that successful long-term weight management starts and ends in the kitchen. It also took me back to 2009, when I determined that low-carb diets were just as legitimate as low-fat.

I don’t recall the author mentioning the typical pattern with 12-month weight loss studies: most folks lose significant weight in the first few month, then at six months they start gaining it back. Cuz they go back to their old eating habits. Sure, diets don’t work………..if you don’t follow them.

From Ms. Belluz:

As a longtime health reporter, I see new diet studies just about every week, and I’ve noticed a few patterns emerge from the data. In even the most rigorous scientific experiments, people tend to lose little weight on average. All diets, whether they’re low in fat or carbs, perform about equally miserably on average in the long term.

But there’s always quite a bit of variability among participants in these studies.Just check out this chart from a fascinating February study called DIETFITS, which was published in JAMA by researchers at Stanford.

The randomized controlled trial involved 609 participants who were assigned to follow either a low-carb or a low-fat diet, centered on fresh and high-quality foods, for one year. The study was rigorous; enrollees were educated about food and nutrition at 22 group sessions. They were also closely monitored by researchers, counselors, and dietitians, who checked their weight, waist circumference, blood pressure, cholesterol, and other metabolic measures throughout the year.

Overall, dieters in both groups lost a similar amount of weight on average — 11 pounds in the low-fat group, 13 pounds in the low-carb group — suggesting different diets perform comparably. But as you can see in the chart, hidden within the averages were strong variations in individual responses. Some people lost more than 60 pounds, and others gained more than 20 during the year.

Read the whole thing. It’s not long.

Source: Why do dieters succeed or fail? The answers have little to do with food. – Vox


Nuttin’ But Salads N=1 Experiment: Week 1 Summary


Let’s call this a chef salad (or is it chef’s salad?)

Click to learn what I’m doing.

My wife made nearly all of the salads. I have a few days off from my 12-hour shifts and will try to put at least one new super-salad together.

This is a taco salad. You can’t see much of the spicy hamburger meat under the quacamole. Somewhat time-consuming to make, but delicious.

My initial weight was 175.5 lb (79.8 kg). A week later I’m down to 171.6 lb (78 kg). Rounding off, that’s down 4 lb (1.8 kg). (See postscripts below!)

That 4 pounds can’t all be fat. Most of it must be water loss, lowered intestinal content, and perhaps lowered stores of glycogen in muscle and liver. I doubt any of it is muscle loss because I’m careful to eat adequate protein and am working out with weights twice weekly. From here on out the weight loss will slow dramatically if not stall completely.

Chicken salad with tomatoes and almond slivers

I like the simplicity of eating two large salads a day, and nothing else. In the event I get hungry between meals, I’m allowing another salad or a protein food (meat, eggs, fish, chicken, etc). But I haven’t done that yet. I eat before and after my shifts at the hospital. I’ve successfully fought off the temptations in the Doctor’s Lounge, my employer’s office, and invitations to the nurses’ potluck dinners.

That’s spiralized raw zucchini on top, canned beets on the sides

My wife has been in contact with 30+ folks online about the potential of this type of weight-loss program. Nearly all say “Yeah, I could see this happening, but only if I could have just one regular meal a day.” OK…but if it’s the wrong meal, you ain’t gonna lose weight. And does that meal start you down the slippery slope of noncompliance that ends in failure?

No name

I haven’t done any nutritional analysis yet. Maybe in the coming month.

Fajita salad?

I saw an ad on TV for Jenny Craig yesterday. They promised weight loss “up to 16 pounds in four weeks.” I have a powerful word to describe my opinion on that claim, but in the interest of decorum I’ll just say I’m skeptical. On the other hand, they could have said “up to 160 pound in four weeks” and both claims technically would be accurate. The key is “up to….” Up to includes both zero pounds lost and even weight gain. The average TV viewer is going to hear “up to 16 pounds in four weeks”and think, “Man, that sounds like a great program and I’m really going to lose a lot of weight quick!” But that’s not Jenny Craig’s fault.

Steve Parker, M.D.

PS: The day after I wrote this, my weight was 173.6 lb. So up from 171.6 That’s not an unusual fluctuation for someone my size. Assuming my scale is accurate, the change reflects hydration status, intestinal contents, and recent food intake.

PPS: Weight two days after original post was 173 lb (78.6 kg). The 171.6 above seems to have been a fluke. I’ll revise my first-week weight loss to 2.5 lb (1.1 kg).

This is one I made in a rush just before going to the hospital. I’d never tried canned makerel before – not bad. The red container holds commercial balsamic vinaigrette.

Nuttin’ But Salads: An N=1 Experiment

I could stand to lose about 10 pounds of excess fat. I’m sure my 20-year-old suits would fit better around the waist. Not that I’m overweight or fat. My BMI is 24.4 (weight 175.5 lb and height 5 feet and 11.25 inches. (Damn. I’m only 63 and already have some age-related shrinkage.)

So what I’m going to do for the next 30 days is eat only salads and see what happens. Not bland iceberg lettuce salads with a few tomato wedges drizzled with ranch dressing. No, these will be super-salads, meaning they provide an adequate amount of the myriad nutrients necessary for health. Right now I can tell you this will require variety and supplemental protein compared to the salads most folks visualize.

Salads have a long history of being “diet food.” Yet I can’t think of an extant popular diet based on them.

Any thoughts or predictions?

Steve Parker, M.D.

PS: How could a “nuttin’ but salads” diet lead to weight loss? I’m thinking there are certain foods that make people get fat, and avoiding them may lead to weight loss or prevent excessive weight gain. Certainly there are exceptions, but I’ve noticed the following items make people fat and keep them fat:

  • sugars, particularly if refined and concentrated
  • starches, particularly if refined and concentrated
  • soda pop, pastries, bread in all forms, pizza, candy, chips, cookies, cake, ice cream, pie, pasta, etc.
  • foods that taste too good, leading to over-consumption
  • excessive calories (from any source?)

I’m not sure about potatoes, beans, nuts, cheeses, and rice.

I also wonder if excessive variety may be a problem for many trying to lose weight, leading to too much temptation and experimentation. Maybe it’s good to get sick and tired of always eating the same thing. Maybe all you need is 3–4 different kinds of salads, plus protein food, and 1–2 fruits a day. Add more only when (if ever?) down to goal weight. Make a huge bowl of salad in the AM and eat it at mealtimes 2–3 times a day; make a different salad tomorrow?