Tag Archives: book review

Book Review: The Dukan Diet

With a suspicion that the Dukan Diet may be the next diet fad in the U.S., I reviewed The Dukan Diet: 2 Steps to Lose the Weight, 2 Steps to Keep It Off Forever by Pierre Dukan (2011, first American edition). On Amazon.com’s rating system, I give it two stars.

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Think of Dukan as a Low-Fat Atkins Diet.

The Dukan Diet is apparently very popular in Europe. It’s comprised of four phases. The Attack Phase, also called “Pure Protein,” lasts usually two to seven days. Eat all you want from the protein-rich food list, mostly skinless chicken, low-fat meat, fish, and nonfat dairy. No carbs at all except for the dairy. The Cruise Phase is next: Alternate Pure Protein days with proteins and non-starchy vegetables until you’re at your goal weight. Eat all you want from the low-carb veggie list. Consolidation Phase lasts five days for every pound lost. Eat more variety but limited quantities: two slices of whole grain bread, one portion each of fruit and cheese daily, one or two servings of starchy carbs (e.g., legumes, flour, cereals), plus two “celebration meals” a week, carefully defined. Proteins and low-carb veggies are still unlimited. Finally, the Permanent Stabilization Phase is lifelong and similar to Consolidation Phase, but requires one Pure Protein day per week, such as Thursdays. Also, take no stairs or elevators. All phases include prescribed servings of oat bran.

During the active weight loss phases, this diet is low-fat, low-carb, and high-protein. You don’t have to count carb grams, fat grams, or calories. Presumably, Dr. Dukan has done all that for you, although he never shares the average calories consumed nor the macronutrient breakdown (i.e., what percentage of calories are derived from protein, fat, or carbs). The latter two phases are still very low-fat but allow a bit more carbs.

I liked this book more than I expected. It’s obvious the author has copious experience with dieters, especially women. The writing is clear. He’s a serious, earnest man, not a charlatan. Although some will criticize the book’s repetitiveness, it’s a proven educational technique. For weight management, Dr. Dukan and I agree that 1) weighing daily is good, 2) abstinence from sugar rarely eliminates the longing for sweets, 3) artificial no-calorie sweeteners are OK, 4) the 4-7 pound weight loss in Attack Phase is mostly water, not fat, 5) discipline and willpower are important, 6) after losing weight, you’ll regain it if you ever return to your old ways, and 7) a realistic weight goal is essential.

Dr. Dukan recommends at least 20-30 minutes a day of walking. He provides little information on resistance training, although increasing evidence supports it as a great weight control measure. I wish he’d mentioned high intensity interval training (HIIT).

The book contains numerous recipes, including a week of menus for the Attack Phase. Disappointingly, none of the recipes include nutritional analysis.

You’ll find an index. It doesn’t list glycogen. Insulin, a primary fat-storage hormone, is mentioned on only one page, one sentence.

This is one fat-phobic diet. In Dr. Dukan’s view, “fat in food is the overweight person’s most deadly enemy.” All fat consumption contributes to fatness, and animal fats “pose a potential threat to the heart.” It seems Dr. Dukan never got the memo that total and saturated fat content of foods have little, if anything, to do with heart or other cardiovascular disease. While criticizing Dr. Atkins’ diet for demonizing carbohydrates, Dr. Dukan demonizes fats. Yet Dr. Dukan does all he can to banish both carbohydrates and fats from his weight loss phases.

Dr. Dukan makes several erroneous statements, including 1) all food is made up of only three nutrients, 2) all alcoholic beverages are high in carbohydrates, 3) all shellfish are carbohydrate-free, 4) he implies that when dieting or fasting, we convert much of our fat into glucose, 5) there are no indispensable fats, 6) fat is bad for the cardiovascular system, 7) vinegar is the only food containing sour taste, 8) fruit is the only natural food containing rapid-assimilation sugars, 9) “Anyone who loses and regains weight several times becomes immune to dieting,” 10) weight loss releases into the bloodstream artery-toxic fat and cholesterol, 11) many overweight folks are unusually good at extracting calories from food, 12) some people can gain weight even while they sleep, 13) exercise is vitally important for losing weight, and 14) the Atkins diet raises triglycerides and cholesterol levels dangerously.

Will the diet work? I’m sure many have lost weight with it and kept it off. It does, after all, limit two of the major causes of excess weight: sugars and refined starches.

In considering rating this book two or three stars, I asked myself if I’d recommend it to one of my patients looking to lose weight. Initially I had concern that the diet may be deficient in essential fatty acids since it’s so fat-phobic. “Essential” means necessary for life and health. Then I figured that the body’s own fat stores would provide adequate essential fatty acids, at least in the first two phases. The later stages, I’m not so sure. Carefully choosing specific foods would eliminate the risk, but how many people know how to do that? Separate from that potential drawback, there are other diets that are better, such as The New Atkins Diet for a New You, Protein Power, The Advanced Mediterranean Diet, the Ketogenic Mediterranean Diet (free on the Internet), and The New Sonoma Diet. You’ll have no risk of fatty acid deficiency with those.

If you limit carbs, there’s just no need for fat-phobia.

Steve Parker, M.D.

Book Review: Low-Carbing Among Friends, Vol. 1

A few months ago I read “Low-Carbing Among Friends, Volume 1” by Jennifer Eloff, Maria Emmerich, Carolyn Ketchum, Lisa Marshall, and Kent Altena.

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If you’re serious about low-carb eating, you’ll want this book. Five well-known low-carb cooks and chefs present many of their best recipes in a straightforward format. All 300+ recipes are gluten-free, wheat-free, and sugar-free. I read through over half of the recipes and understood all the instructions; I’m confident I could make anything in this book.

Some of of the recipe ingredients will be a little hard to find. You may have to order a few of them online, and the authors tell you where to order. Unless you’re just dabbling in low-carb eating, you’ll want to stock up on some of these anyway.

I have an incurable sweet tooth. I like to share my cooking with my wife, but she has, um, (ahem)… “gastrointestinal problems” with my usual non-caloric sweetener, Splenda. That’s not very common, but is a well-known phenomenon. I was glad to learn herein that erythritol is a trouble-free alternative, GI-wise.

One thing I miss about standard high-carb eating is baked sugary items like cakes and muffins. Sure, I’ve read that if you stay away from those for four to six months, you’ll lose your desire. Not me. And I tried. In my next stretch of days off, I’m making a batch of Jennifer Eloff’s Splendid Gluten-Free Bake Mix and spending some time in the kitchen!

Not being previously familiar with him, I was particularly impressed with Kent Altena’s background. Starting at over 400 pounds (182+ kg), he lost over 200 pounds (91+ kg) and reenlisted in the U.S. National Guard and started running marathons (26.2 miles)! Thank you for your service to our country, Mr. Altena.

The book is laced with commentary from low-carb proponents, including Dana Carpender, Jimmy Moore, Dr. John Briffa, Dr. Andreas Eenfeldt, Dr. Robert Su, and me. I am honored to have been invited.

By the way, recipe measurements are given in both U.S. customary and metric units, which non-U.S. residents will appreciate. Serving size nutrient analysis includes digestible carb grams (aka net carbs). All recipe carb counts are under 10 g; most are under 5 g. All of these would jibe with my KMD: Ketogenic Mediterranean Diet.

If you’re tired of eating the same old things, I’m sure you’ll find many new dishes here that will become time-honored classics in your household.

Steve Parker, M.D.

Disclosure: As a supporter of low-carb eating, I contributed two pages to the book. I did not and will not recieve any remuneration, and I purchased my own copy of the book.

PS: Recipes I want to try: Cinnamon Swirl Cookies, Green Bean and Bacon Salasd, Gingerbread Biscotti, Tuan Burgers, Blueberry Muffins, Pecan Sun-Dried Tomato and Bacon Cauli-Rice, Spicy Shrimp with Avocado Dressing, 24-Hour Chili, Harvest Pancakes, Breakfast Casserole, Bacon Wrapped Jalapeno Poppers, Stuffed Mushrooms, Broccoli Bacon Salad, Seven Layer Salad, Sausage Quiche, Low-Carb Pancakes, Stuffed Hamburgers, Eggplant Parmeson, Flax Bread, Splendid Gluten-Free Bake Mix, and Mock Danish.

Book Review: The Blood Sugar Solution

I just finished reading the No.1 book at Amazon.com, The Blood Sugar Solution: The UltraHealthy Progam for Losing Weight, Preventing Disease, and Feeling Great Now!  Published in 2012, the author is Dr. Mark Hyman. I give it three stars per Amazon’s rating system (“It’s OK”).  Actually, I came close to giving it two stars, but was afraid the review would have been censored at the Amazon site.

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The book’s promotional blurbs by the likes of Dr. Oz, Dr. Dean Ornish, and Deepak Chopra predisposed me to dislike this book.  But it’s not as bad as I thought it’d be.

The good parts first.  Dr. Hyman favors the Mediterranean diet, strength training, and high-intensity interval training.  His recommended way of eating is an improvement over the standard American diet, improving prospects for health and longevity.  His dietary approach to insulin-resistant overweight/obesity and type 2 diabetes includes 1) avoidance of sugar, flour, processed foods, 2) preparation of your own meals from natural, whole food, and 3) keeping glycemic loads low.  All well and good for weight loss and blood sugar control.  It’s not a vegetarian diet.

The author proposes a new trade-marked medical condition: diabesity. It refers to insulin resistance in association with (usually) overweight, obesity, and/or type 2 diabetes mellitus.  Dr. Hyman says half of Americans have this brand-new disorder, and he has the cure.  If you don’t have overt diabetes or prediabetes, you’ll have to get your insulin levels measured to see if you have diabesity.

He reiterates many current politically correct fads, such as grass-fed/pastured beef, organic food, detoxification, and strict avoidance of all man-made chemicals, notwithstanding the relative lack of scientific evidence supporting many of these positions.

Dr. Hyman bills himself as a scientist, but his biography in the book doesn’t support that label.  Shoot, I’ve got a degree in zoology, but I’m a practicing physician, not a scientist.

The author thinks there are only six causes of all disease: single-gene genetic disorders, poor diet, chonic stress, microbes, toxins, and allergens.  Hmmm… None of those explain hypothyroidism, rheumatoid arthritis, systemic lupus erythematosis, tinnitus, migraines, irritable bowel syndrome, Parkinsons disease, chronic fatigue syndrome, or multiple sclerosis, to name a few that don’t fit his paradigm.

Dr. Hyman makes a number of claims that are just plain wrong.  Here are some:
  – Over 80% of Americans are deficient in vitamin D
  – Lack of fiber contributes to cancer
  – High C-reactive protein (in blood) is linked to a 1,700% increased probability of developing diabetes
  – Processed, factory-made foods have no nutrients
  – We must take nutritional supplements

Furthermore, he recommends a minimum of 11 and perhaps as many as 16 different supplements even though the supportive science is weak or nonexistent.  Is he selling supplements?

After easily finding these bloopers, I started questioning many other of the author’s statements.   

I was very troubled by the apparent lack of warning about hypoglycemia (low blood sugar).  Many folks with diabetes will be reading this book.  They could experience hypoglycemia on this diet if they’re taking certain diabetes drugs: insulin, sulfonylureas, meglitinides, pramlintide plus insulin, exenatide plus sulfonylurea, and possibly thiazolidinediones, to name a few instances.

If you don’t have diabetes but do need to lose weight, this book may help.  If you have diabetes, strongly consider an alternative such as Dr. Bernstein’s Diabetes Solution or my Conquer Diabetes and Prediabetes.

In the interest of brevity, I’ll not comment on Dr. Hyman’s substitution of time-tested science-based medicine with his own “Functional Medicine.”

Steve Parker, M.D.