POPULAR DIETS 
                 Part Two: High Carbohydrate Diets 
         A lot of publicity has been given to a wide variety of diets lately. 
         Some of these advocate high protein intake, some stress 
         carbohydrate, others make no reference to carbohydrate or 
         protein. What are these diets supposed to achieve, and what, if 
         any, is the scientific evidence supporting them? 
         This answer is brought to you by many of the Australian nutrition professionals 
         who regularly contribute to a nutrition email discussion group. 
         "The diets reviewed here are 'Eat More Weigh Less' (Dr Dean Ornish), 'The 
         McDougall Program for Maximum Weight Loss' (Dr John McDougall), the 
         'Pritikin' Diet (Dr Robert Pritikin), 'Eight Weeks to Optimum Health' (Dr Andrew 
         Weil), and the 'GutBusters' program (Dr Garry Egger and Dr Rosemary 
         Stanton)."  
         In summary, all these diets are believed to be essentially health- promoting and 
         are likely to lead to loss of body fat in the medium to long term. Furthermore, 
         there is good evidence that the combinations of diets and lifestyles  advocated 
         by Dr Ornish and Robert Pritikin can be effective in preventing (and even 
         reversing) atherosclerosis (the 'hardening of the arteries' that can eventually 
         lead to a heart attack). 
         The major problem likely to be associated with attempting to adopt the diet of 
         Dr Ornish or Robert Pritikin is that these diets represent a huge change from 
         the typical Western diet. The massive reduction in fat intake recommended by 
         these authors (relative to usual fat intakes in Australia) probably means that 
         these diets will be maintained only by people with good reason to do so (such 
         as those who already have heart disease or diabetes) or who have extremely 
         strong will power. 
         Please note that anyone who does already have heart disease or diabetes (or 
         other medical condition that might be diet-related) should consult their doctor or 
         dietitian about appropriate alterations in diet and lifestyle, and always take their 
         advice rather than the advice offered here (or elsewhere). 
         Dr McDougall's diet is also basically sound, but he inappropriately recommends 
         eliminating bread during the early stages of weight reduction, and his 
         recommended rate of weight loss is excessive. He also believes (incorrectly) 
         that milk cannot be digested by most adults in Western countries. His 
         recommended very high level of carbohydrate intake (and low fat intake) also 
         mean that compliance with this diet may be difficult for many people. 
         Dr Weil's program is essentially orthodox, but he does advocate the almost 
         exclusive use of olive oil over edible oils. Although there is good evidence that 
         olive oil may be particularly health-promoting among the edible oils, it may 
         inappropriate (or at least premature) to advocate using only olive oil. Mono- and 
         polyunsaturated margarines and cooking oils and salad dressings (when used 
         sparingly) are also believed to be health-promoting.  
         The GutBusters program has been shown to be effective in achieving some 
         reduction in dietary fat intake and alcohol consumption, and a slight reduction in 
         waist size in Australian men. This program is worthy of consideration by men 
         (and women) who are serious about reducing their level of 'abdominal adiposity' 
         (more commonly known in Australia as a 'beer gut' when it occurs on men). 
         Finally, diet is only one lifestyle factor that needs to be considered in trying to 
         optimise health outcome. Physical activity is equally important. The 
         recommended lifestyle for optimal health and wellness includes a diet based on 
         a wide variety of nutritious foods (with the greatest emphasis on foods of plant 
         origin), and at least 30 minutes per day of moderately vigorous activity. 
         HIGH CARBOHYDRATE DIETS 
         Over the past several years many diets have been recommended to the public, 
         often with promises of improved health, greater life expectancy, and/or weight 
         loss resulting from adoption of each particular diet. Most of these diets can be 
         assigned to the 'high protein' or 'high carbohydrate' category, although some 
         don't fit neatly into either category. 
         The first point that needs to be made is that the term 'diet' doesn't have the 
         meaning it may have had a few years ago -- that is, a short-term change in 
         eating patterns to attain a specific goal (such as losing weight). Now, the 
         proponent of a diet is usually advocating an eating plan for a lifetime, not a 
         short-term means of overcoming a perceived problem (such as being 
         overweight). 
         In this answer (Popular Diets: Part 2), some popular high carbohydrate diets 
         are reviewed, with several high protein diets and 'in between' diets being 
         discussed in separate answers in this series of FAQs [see 'Popular Diets: Part 
         1' and 'Popular Diets: Part 3', respectively]. 
         Among the most popular high carbohydrate diets are 'Eat More Weigh Less' (Dr 
         Dean Ornish), 'Eight Weeks to Optimum Health' (Dr Andrew Weil), 'The 
         McDougall Program for Maximum Weight Loss' (Dr John McDougall), the 
         'Pritikin' diet (Dr Robert Pritikin) and 'GutBusters' (Dr Garry Egger and Dr 
         Rosemary Stanton).  
         Although all these diets advocate increased carbohydrate intake compared to 
         the current typical Australian diet, they are not all identical in other significant 
         ways and so are addressed separately below (in no particular order). 
         EAT MORE WEIGH LESS (Dr Dean Ornish) 
         This diet is one of two that have the same name (confusing, isn't it!). Both Dr 
         Ornish and Dr Terry Shintani have chosen this name for their diet, but only the 
         Ornish diet is reviewed here. It is available as a book ('Eat More Weigh Less') 
         and some additional information is available at 
         http://www.fatfree.com/diets/ornish.html
                          . 
         The name of this diet is based on the concept that if you eat a very high 
         starch/high fibre diet, you can actually eat a greater total weight of food than 
         usual, and still lose body fat. As a result the diet advocates extremely high 
         carbohydrate intake. Following Dr Ornish's advice will lead to approximately the 
         same level of protein consumption as the typical current Western diet, but only 
         about one-third the usual quantity of fat. 
         The original point of the diet was to try to halt (and even reverse) the process of 
         atherosclerosis (the 'hardening of the arteries' that can eventually trigger heart 
         attacks). Dr Ornish recommends high consumption of 'complex carbohydrates' -
         - whole grain breads and cereals, fruits and vegetables -- rather than of simple 
         sugars. This makes the diet very high in volume and fibre (and therefore 'filling') 
         even though total kilojoule intake is relatively low. 
         Such a diet will very likely induce weight loss, because it has a 'low energy 
         density'; that is, you would have to eat a huge quantity of such foods before 
         your kilojoule requirement could be exceeded. Therefore, putting on weight, or 
         even maintaining a high body weight, would be very difficult on this diet. 
         Although this is not a totally vegetarian ('vegan') diet, Dr Ornish does not 
         include meat (red or white), eggs or fish in his list of recommended foods, and 
         suggests that only low-fat dairy food be consumed. His advice about dairy 
         foods is orthodox, but completely avoiding meat and fish ignores the 
         contribution that these foods can make to intakes of essential minerals such as 
         niacin, iron and magnesium (meat), and the important 'omega-3' fatty acids 
         (fish). 
         Dr Ornish recognises that there is more to good health and controlling our 
         weight than simply eating a particular diet. He also suggests networking with 
         others who have adopted his diet and providing mutual encouragement. 
         Relaxation and physical activity are also regarded as important. Finally, light 
         alcohol consumption is tolerated. All these are sensible recommendations and 
         are compatible with current, orthodox nutrition knowledge. 
         Dr Ornish has published peer-reviewed papers in prestigious medical journals 
         indicating that adherence to his diet, combined with stress reduction and 
         exercise, may be effective in halting the progress of atherosclerosis in heart 
         disease patients, and in treating diabetes. His results even suggest that some 
         of the damage to the heart's arteries can be undone (that is, reversal of 
         atherosclerosis has been observed). 
         However, much time is taken up in preparing the types of meals he 
         recommends. With today's busy lifestyles, and with most Western people used 
         to high fat intakes, this diet is probably suitable only for people who already 
         have atherosclerosis or diabetes (and then only when recommended by their 
         doctor or dietitian) or who have very strong will power and are extremely keen 
         to lose weight or to improve their nutritional status generally. 
         Summary 
         The Dr Ornish 'Eat More Weigh Less' diet is a nutritious and health-promoting 
         diet, although it places inappropriate limits on consumption of meat and dairy 
         products. This diet would very likely achieve the aims of reducing weight and 
         reducing the risk of heart disease in the vast majority of people, but its extreme 
         nature makes long-term compliance unlikely for all but the most strongly 
         motivated.  
         THE MCDOUGALL PROGRAM FOR MAXIMUM WEIGHT LOSS 
         This is the title of a book by Dr John McDougall. Other books he has written 
         include 'The McDougall Program for a Healthy Heart', 'The McDougall Program: 
         12 Days to Dynamic Health', and 'The New McDougall Cookbook'.  
         Founder of the 'McDougall Plan' for healthy living, this author has been 
         studying and writing about the effects of nutrition on disease for over 30 years' 
         according to information on his website. 
         In his books and through his website Dr McDougall advocates a diet that is 
         even higher in carbohydrate than the diet recommended by Dr Ornish. 
         According to Dr McDougall, 'A healthy diet...is more than 80% carbohydrate