The Dukan Diet - Risk Worth the Reward?

Touted as a quick way to drop pounds (or stones as they say in Britain), the Dukan Diet is the latest weight loss craze to hit the U.S. In addition to Hollywood celebs, apparently Kate Middleton's mom has used it to slim down for Kate's big day - there are even rumors that Kate has used it herself. A new fad in the United States, the Dukan Diet is the # 1 diet in France and has been around in Europe for over a decade.

The reward of the Dukan Diet is rapid weight loss - but at what risk? Diets that cut out entire food groups - tend to be imbalanced and can lack important phytochemicals, vitamins, minerals, fiber and other nutrients. The Dukan Diet works like other highly restrictive no or low carb diets by putting the body into a metabolic state called Ketosis - which forces our bodies to burn fat stores. Low carb fans claim that it is the key to fast weight loss - as fat becomes the body's primary energy source. Critics say that ketosis causes bad breath, is dehydrating, and in some could potentially strain the kidneys, and cause other health issues like gout.

The Dukan Diet is sometimes referred to as the "French Atkins." Both diets have four phases and primary weight loss mechanism is low carb intake. The main difference is the Atkins diet encourages consumption of fat. Atkins also allows a small amount of vegetables from the outset, whereas the Dukan diet prescribes no fat consumption, no vegetables, and only a small amount of oat bran in the first phase.

The Dukan Diet is broken down into 4 phases:

Phase 1: The Attack

• Lasts one-to-ten days.
• Basically, you eat all the lean protein you want, 1.5 tablespoons of oat bran a day and lots of water.
• Daily 20 minute walk
• Reportedly people can lose an average of a pound a day in this phase.

Phase 2: Cruise

• Lasts as long as it takes to get to your goal weight.
• Same as the Attack Phase, but add in non-starchy vegetables every other day, and increase oat bran to 2 tablespoons.
• Daily 30 minute walk
• Weight loss is about two pounds a week in the Cruise Phase, so expect to do this phase for about 10 weeks if you have 20 pounds to lose.

Phase 3: Consolidation

• This phase is designed to prevent "rebound."
• Continue to eat protein, but you may also have non-starchy vegetables.
• You also add two slices of whole wheat bread, one serving of low-sugar fruit, one serving of cheese.
• One-to-two times a week, you can have a starchy food like rice or pasta
• One to two celebratory meals per week - where you can eat almost anything you want, including wine (1 glass) and dessert. "But no second-helpings"
• Daily 25 minute walk
• This phase lasts for 5 days for each pound of weight loss. So if you lost 15 pounds, you are on this phase for 75 days.

Phase 4: Stabilization

• You are able to eat whatever you want for 6 out of the 7 days (Dukan encourages you to continue to eat mostly consolidation foods).
• Three tablespoons of oat bran every day.
• And then, also, one day a week, you do the attack phase of just eating all protein - Dukan suggests Thursdays.
• Daily 20 minute walk - He says no elevators or escalators - always take the stairs!
  

Before diving into the Dukan Diet, people should consider the potential drawbacks:

• Restrictive - the attack phase removes major categories of foods - allowing for no fruits, vegetables, nuts, oils, and limited condiments, sauces, dressings. Later phases still strictly limit food categories.
  
• Ketosis can result in bad breath, lethargy, dehydration and moodines
• For people with type 1 diabetes, a dangerous condition called ketoacidosis has been linked to no carb diets.
  
• Lacks fiber which can lead to constipation
  
• Lacks essential fatty acids, vitamins and minerals. Over the long term, deficient diets can be linked to a possible increase in our risk of cancer, heart disease and osteoporosis.
• It is based on doctor's experience, not scientific studies - there is no bibliography or list of references in the book - lacking scientific research.
• People who are active and like to work out might want to look at whether or not this diet can appropriately support their energy needs for exercise and replenishment.
  
• Quality & type of protein is not addressed (free range vs. conventional). Too much of some kinds of protein (ie: beef) could actually cause an increase in cholesterol.
• Directions can be a little ambiguous, unspecific and confusing ("celebratory" meal is not well-defined, it says "have as much as you want, but no seconds," the final phase says eat whatever you want, but use the consolidation foods as your base?)

With all those risks, why does this restrictive diet have such a big following?

• Has helped millions of people lose weight - it is the #1 diet in France and has many testimonials and fans.
• No calorie-counting - in fact, it is strongly discouraged.
• High-protein foods slow the movement of food from the stomach to the intestine. Slower stomach emptying means you feel full longer and less hungry. But it also can mean sluggish digestion and constipation.
• Cuts out all sugar, processed grains, and almost all alcohol (except the occasional celebratory glass of wine). This improves blood sugar control and insulin sensitivity. But just cutting out the above foods will help most people drastically lose weight and reduce appetite - without all the other restrictions.
• Unlike other strict diets and cleanses where all you do is ingest a drink - the Dukan diet allows you to eat and chew "real" foods. Yet unlike cleanses - constipation can lead to a buildup of toxins as opposed to a cleansing of the digestive tract.
  
• It prescribes daily walking - exercise is important part of maintaining a healthy weight.
• It allows for "splurge" or celebratory foods in the final phases which can help people feel less deprived, however there are not good guidelines around these foods.
  

Conclusion
Whether or not a diet "works" - individuals need to decide for themselves if the risk is worth the rewards, and if they can sustain the diet. France’s National Agency for Food, Environmental and Work Health Safety named the Dukan Diet as one of 15 diets that are potentially risky. The British Dietetic Association doesn’t think much of it either, naming it as one five worst diets of 2011.

Diets that cut out food groups - tend to be imbalanced and can lack important phytochemicals, vitamins, minerals, fiber and other nutrients. Also - when you restrict calories to the extreme, it makes it hard to exercise - which is an important component of a weight loss program - as it helps to preserve muscle mass. If you have a couple of pounds to lose for an event, and only need to be on this diet a week or two - it probably won't do major damage - but for someone with a significant amount of weight to lose, I could not recommend this diet. A more balanced approach to weight loss that is sustainable and less drastic is a safer approach - it might take a little longer to get results - but will likely be more lasting and carry fewer risks. “Studies repeatedly show that the way these diets work is by reducing calories through elimination of certain foods,” and over time the rapid weight loss disappears, according to David Levitsky, professor of Nutritional Sciences and Psychology at Cornell University. If anyone decides to use this or any other restrictive diet plan - I highly recommend taking a good multi-vitamin supplement to help balance out any imbalances that will arise, and not doing it for any significant amount of time.

My philosophy about weight loss is to balance the digestive system, replace nutrient deficient foods with highly nutrient dense ones, increase the consumption of whole fruits/vegetables, exercise and manage stress. Putting the body into calorie or nutrient restrictive mode is not the most effective or healthy way to lose weight in my opinion.

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