feature

Pick your ideal diet

Will it be our winner, Jenny Craig, or one of its rivals?

ur latest diet Ratings update has produced a new winner: Jenny Craig, a commercial program that combines personal phone or in-person counseling with a portion-controlled regimen of pre-made foods supplemented with home-made side dishes. What gave it the edge over the other big names we assessedstalwarts such as Atkins, Ornish, and Weight Watchers was a 332-person, two-year study of the program published in the Oct. 27, 2010, Journal of the American Medical Association. Ninety-two percent of participants stuck with the Jenny Craig program for two yearsa remarkable level of adherence and at the end of that time weighed an average of about 8 percent less than when they started. When we last rated diets four years ago, the winner was the Volumetrics diet, based on eating high-bulk, low-calorie food. In a sense, its still a winner: The Volumetrics brand is now part of Jenny Craig, which is why were not rating it separately this time. As for taste, Jenny Craigs prepared food was decent, though not great, as we noted in Diet Taste-off in our February 2011 issue. Continued on page 16

a plan for every taste: Whats for lunch

JENNY CRAIG
Jenny Craig at Home planned menu Overall score Nutrition Calories per day Percent of calories: Fat (23%) Saturated fat (6%) Carbs (58%) Protein (20%) Sodium (2,154 mg) Fiber (21 g/1,000 calories) Weight loss
Short-term

SLIM-FAST
85 &Z &Z &Z &Z &Z &X &Z &Z &X &Z &X &Z
Slim-Fast 3-2-1 Plan Overall score Nutrition Calories per day Percent of calories: Fat (27%) Saturated fat (8%) Carbs (53%) Protein (21%) Sodium (1,320 mg) Fiber (21 g/1,000 calories) Weight loss
Short-term

WEIGHT WATCHERS
63 &X
1,125 PointsPlus sample menu Overall score Nutrition Calories per day Percent of calories: Fat (18%) Saturated fat (5%) Carbs (58%) Protein (24%) Sodium (3,621 mg) Fiber (23 g/1,000 calories) Weight loss
Short-term

57 &X
1,865

1,315

&Z &Z &Z &Z &Z &Z &C &X &X &X &B

&X &Z &Z &Z &B &Z &C &C &C &C &C

Weight loss Dropout rate Weight loss Dropout rate

Weight loss Dropout rate Weight loss Dropout rate

Weight loss Dropout rate Weight loss Dropout rate

Long-term

Long-term

Long-term

Guide to the ratings

Ratings are presented in order of overall score, from left to right. Meals pictured are for a typical lunch from each diet. Overall score is based on adherence to nutritional guidelines and the results of published randomized clinical studies. (Nutrisystem did not receive an overall score because no information was available about its weight-loss results.) Nutrition is based on our analysis of a week of menus from each book or program, using The Food Processer software from ESHA research. (All menus were analyzed in 2011 except for the Ornish diet, which was analyzed in 2005 and has not changed.) Results were evaluated for adherence to the 2010 U.S. Dietary Guidelines for Americans: 20 to 35 percent of calories from fat (with less than 10 percent of calories from saturated fat), 45 to 65 percent from carbohydrates, and 10 to 35 percent from protein; fewer than 2,300 milligrams of sodium per day; and 14 grams of fiber per 1,000 calories per day. Calories did not figure into scores unless they totaled fewer than 1,200 a day. Weight-loss scores were derived from published studies. Short-term weight loss and dropout rates are for studies lasting six months or less, and long-term results are for studies lasting a year or more.

What you eat Branded, single-serving entres (many are frozen), snacks, and desserts, plus store-bought sides and beverages. Support There are weekly sessions with a counselor in person or by phone. Menu planner, physical-activity trackers, and personal journals are available on paper and at JennyCraig.com, which also has community discussion forums. Exercise All program materials and counseling emphasize exercise. The premium Metabolic Max program includes a digital armband that measures calorie expenditure around the clock so that you can fine-tune your diet. Price There are frequent specials, such as 20 pounds for $20. Annual membership is $399; Metabolic Max is $499 a year. We paid $264, plus $65 shipping, for two weeks worth of food.

What you eat A Slim-Fast bar or shake for breakfast and lunch, and a 500-calorie homemade dinner (recipes provided), plus three daily snacks of fruit, veggies, nuts, or a Slim-Fast snack bar. The standard menu provided fewer calories than recommended for a weight-loss plan. Branded products are available in grocery and drugstores and online. Support Theres a progress tracker, recipes, and online dietitian at SlimFast.com but no provision for intensive personal support. Exercise Apart from a brief FAQ on exercise, and the ability to chart minutes of daily exercise in your online tracker, youre pretty much on your own. Price Theres no charge for the website. A 24-pack of shakes sells for $23 on Amazon.com.

What you eat Whatever you want, as long as you stay within your personalized points quota. The new PointsPlus program favors high-satiety, high-nutrient, low-fat foods. The sample menu had way too much sodium, thanks mainly to the bulk it up optional soups. Choose low-sodium varieties. Support In-person group meetings or online support your choiceare the programs mainstays. The vast WeightWatchers.com site includes a points tracker and countless other features. Exercise Its highly encouraged. You get extra points credits for exercise. Price Meetings are $39.95 a month, including website access. The online-only program is $47.90 for the first month and $17.95 per month thereafter.

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5 Excellent 4 Very good 3 Good 2 Fair 1 Poor

ZONE
ZoneFast Weight Loss Program Overall score Nutrition Calories per day Percent of calories: Fat (33%) Saturated fat (13%) Carbs (41%) Protein (26%) Sodium (2,171 mg) Fiber (10 g/1,000 calories) Weight loss
Short-term

ORNISH
54 &X &Z &V &C &Z &X &C &C &C &C &V &C
Sample menu from "Eat More, Weigh Less" by Dean Ornish, M.D. Overall score 48 Nutrition &C Calories per day 1,525 Percent of calories: Fat (6%) &B Saturated fat (1%) &Z Carbs (77%) &B Protein (16%) &Z Sodium (1,803 mg) &Z Fiber (31 g/1,000 calories) &Z Weight loss &C
Short-term

ATKINS
Ongoing Weight Loss from "The New Atkins for a New You," 30 g net carbs Overall score 48 Nutrition &V Calories per day 1,915 Percent of calories: Fat (64%) &B Saturated fat (18%) &B Carbs (13%) &B Protein (23%) &Z Sodium (2,498 mg) &C Fiber (14 g/1,000 calories) &Z Weight loss &C
Short-term

NUTRISYSTEM
Basic 28-Day Women's Plan Overall score Not rated Nutrition &Z Calories per day 1,270 Percent of calories: Fat (22%) &Z Saturated fat (7%) &Z Carbs (55%) &Z Protein (23%) &Z Sodium (2,371 mg) &C Fiber (24 g/1,000 calories) &Z Weight loss Not rated; no long-term studies available.
What you eat Branded single-serving breakfast, lunch, and dinner entres and a Nutrisystem dessert after dinnerall ordered onlineplus sides that you buy yourself. The Basic program that we analyzed features shelf-stable food, but the pricier Select program includes some frozen entres. Our taste tests of the Basic program food found it to be slightly inferior to Jenny Craigs products. No major nutrients are banned, and most meet recommended federal guidelines. Support Optional one-on-one support is available via online chat, e-mail, or telephone. The website includes community forums, tips and menus, a meal planner, and a progress tracker. Exercise It's encouraged but not the primary focus of the program. Price You order in four-week increments: $352 for the Basic plan of shelf-stable foods; $430 for the Select plan that includes some frozen entres.

1,260

Weight loss Dropout rate Weight loss Dropout rate

Long-term

Weight loss Dropout rate Weight loss Dropout rate

&C &C &C &V

Long-term

Weight loss Dropout rate Weight loss Dropout rate

&X &X &X &V

Long-term

What you eat Insulinsuppressing anti-inflammatory meals and snacks with a ratio of 30% lean protein, 30% fat (monounsaturated, from olive oil and nuts), and 40% low-glycemic carbs (mainly fruits and vegetables), plus nutritional supplements. Use your own foods (complicated); use Zone-branded pastas, snacks, and baked goods; or order Zone-compliant meals from an independent vendor. Support Register free at ZoneDiet.com for menus and recipes, or buy food for access to telephone support. Exercise Neither the diets books nor its website devotes much space to exercise. Price The full ZoneFast Weight Loss program, including food, supplements, and phone support, costs $179 every two weeks. Or you can buy Zone food by itself for $74.50 a week.

What you eat The menu we analyzed is near-vegan, with no added sugars, and so low-fat it actually falls below the recommended range. The newer Spectrum program, which doesnt include specific weight-loss menus, allows more low-fat dairy, some artificial sweeteners, and fish. The chef-created recipes are ingenious and flavorfullooking but daunting for people without significant cooking skills and the time to exercise them. Support Apart from his books, Ornish does not market his program to the general public. Exercise Ornishs latest book, The Spectrum, includes a chapter on physical exercise. Price For the general public, the price of the books.

What you eat Protein, cheese, eggs, nuts, mountains of nonstarchy vegetables (especially greens), oils, and the occasional serving of berries. No starchy vegetables, grains, fruits, or added sugars. Atkins-branded products (available online and in retail stores) arent mandatory. The aim: to force your body to burn fat, not carbs. The diets high fat and low carb count put it outside nutrition guidelines. Support Atkins.com has a community forum, a blog, scientific information, a personal progress tracker, and lots of recipes. Exercise Youre on your own. Price Nothing, unless you opt to buy the book or one of the many Atkins-friendly recipe books or carb-count references.

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feature PiCk your iDeal Diet

Continued from page 14 So if you need to lose weight, should you immediately sign up for Jenny Craig? Its obviously worth considering, but if you dont like the idea of eating prepackaged meals, it might not be for you. The diet that works is the one you can stay on, says Kathleen Melanson, Ph.D., associate professor of nutrition and food sciences at the University of Rhode Island and director of its Energy Balance Laboratory. If youre forcing yourself on a diet you hate, its going to be really hard to stick with long-term, she says. And these days, choices abound. You can follow the Ornish diet, a near-vegan plan with very little fat, or its diametric opposite, the Atkins diet, which allows almost two-thirds of your calories from fat. Or you can settle somewhere in between with the moderate regimens offered by Weight Watchers and Jenny Craig. As you make your decision, bear in mind some basic realities about weight-loss diets.

TATER ANd SIdES This Jenny Craig lunch is loaded with vegetables.

so we couldnt incorporate them into our Weight Watchers Rating calculations.)

Its OK to go low-carb

Calories, with an asterisk

To lose weight, you have to burn up more calories than you take in, no matter what kind of diet youre on. The first law of thermodynamics still applies, says Dean Ornish, M.D. But emerging evidence shows that some forms of calories are more filling than others. Protein is the most satiating nutrient, followed by highfiber grains, fruits, and vegetables. We used to believe that it was the same if you ate 200 calories of a cream puff or 200 calories of a chicken breast, says Karen Miller-Kovach, R.D., chief scientific officer for Weight Watchers. But people would ask, Why do I feel hungry sooner after eating the cream puff? Diet creators are taking advantage of this new insight to tilt their menus toward foods that will enable you to shed pounds with the fewest hunger pangs. For instance, most of the diets we rate feature liberal amounts of fiber and/or fruits and vegetables. In late 2010, Weight Watchers unveiled PointsPlus, a major revision of its venerable Points system of calorie-counting, to steer hungry dieters to the most filling foods. That chicken breast will use up only three points of your daily allowance, but the cream puff for dessert will cost you nine points. (The company has completed clinical trials of the new diet, Miller-Kovach says, but the results havent been published yet,

The 2010 edition of the U.S. Dietary Guidelines for Americans, which weve used as the basis for the diets nutrition Ratings, still frowns on eating 10 percent or more of calories from saturated fat from meat and dairy products and more than 35 percent from fats overall. So the Atkins diet, which is 64 percent fat calories overall and 18 percent saturated fat, ends up with only a Fair nutrition score. But theres more to the story. Evidence is accumulating that refined carbohydrates promote weight gain and type 2 diabetes

Refined carbs might be as harmful as fat.

through their effects on blood sugar and insulin. If you have insulin resistance, your insulin may go up to 10 or 20 times normal in order to control your blood sugar after you eat sugar or carbs, says Eric C. Westman, M.D., an associate professor of medicine at Duke University who co-wrote the newest version of the Atkins diet. But the insulin also tells your body to make and store fat. When you restrict carbs, your insulin goes down and you can burn your body fat, so you eat fewer calories and arent as hungry. Isnt it dangerous to eat so much fat? Thats still a subject of vigorous scientific debate, but its clear that fat is not the all-round villain weve been taught it is. Several epidemiology studies have found that saturated fat doesnt seem to increase peoples risk of cardiovascular disease or stroke. Other studies suggest that you might be even better off if you replace saturated fat with unsaturated fat instead of with certain carbs, the ones that turn to blood sugar quickly after you eat them,

such as white bread and potatoes. A nutrition researcher, Frank B. Hu, M.D., of the Harvard School of Public Health, recently wrote that he believes refined carbohydrates are likely to cause even greater metabolic damage than saturated fat in a predominantly sedentary and overweight population. Moreover, clinical studies have found that an Atkins or Atkins-like diet not only doesnt increase heart-disease risk factors but also actually reduces them as much as or more than low-fat, higher-carb diets that produce equivalent weight loss. On the other hand, the Ornish Program for Reversing Heart Disease, which includes a low-fat diet along with exercise, stress management, and group support, has proven so effective that Medicare now covers it for cardiac patients. While scientists sort this out, whats a low-carb dieter to do? Michael L. Dansinger, M.D., assistant professor of medicine at Tufts University and a longtime weightloss researcher, suggests this middle ground: a low-ish carbohydrate diet thats high in vegetables and lean protein, including dairy; moderate in fruit; with nonsaturated fat from sources such as olive oil, nuts, avocados, and fish.

Support matters

Our past reader surveys have found that the overwhelming majority of people who succeed at weight loss do it on their own. But dont discount the impact of a good emotional support system. The Jenny Craig diet, for instance, includes weekly counseling sessions, and group support meetings are the foundation of the Weight Watchers plan. Dean Ornishs program has run support groups for decades to help people follow his rigorous program. Most people think theyre going to have the hardest time with that support group, and yet its the secret sauce that makes the diet sustainable, he says. We have people still meeting 25 years after our first study ended.

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