BOOK REVIEW
April 17th, 2011

Dukan Diet: 2 Steps to Lose the Weight,
2 Steps to Keep it Off Forever
by Dr. Pierre Dukan

The Dukan Diet--another twist on high-protein/low-carb--is one of the latest best sellers among fad-diet books. Fad diets are always sold as some magical breakthrough, or magical combination of eating the "right things, in the right way." The reality is that high-protein diets date back over 150 years (to 1860!), and if they actually worked--in the long term--we wouldn't have two-thirds of our population overweight or obese.

Here's five things to think about before choosing to take the plunge:

1) ANY diet that reduces calorie intake works… in the short-term.

2) However, long term outcomes (at 6-months, 1-year, or 2-years) for high-protein/low-carbohydrate diets are no different than any other reduced-calorie diet.[i],[ii],[iii]

3) Early weight loss on high-protein/low-carbohydrate diets is often marginally better than other diets. Here's why that's often the case:

a) Higher protein intake keeps hunger away better, so it's easier to eat less.
b) Low carbohydrate intake accentuates early water losses (for more detail see weight loss plateaus).
c) Satiety-specific satiation (you become bored with allowed foods, so you eat less!).

This seeming early advantage is temporary, as already noted.

4) How long do you really want to avoid foods with proven health benefits, such as fresh fruits and vegetables, and whole grains, which are rich in vitamins, minerals, antioxidants and phytochemicals?

5) How do you plan to keep the weight off? Weight loss maintenance requires permanent lifestyle changes, that are best "practiced" while you are losing weight.

In reality there is no special combination of carbohydrate, protein and fat that helps people burn fat or lose weight. Over the years many studies have looked at this issue, and always find that for weight loss, variations in protein, carbohydrates or fats, make no difference—it always comes down to calories.

The bottom line is that focusing on protein, fat or carbohydrates serves only to distract you from dealing with the real causes of overweight—too many calories and too little activity. The fad-diet gurus know you don’t want to hear that, and are all too eager to sell you their latest book. Your body weight however is a simple calorie-equation, and there’s just no fooling it.

If you want to lose weight, my best advise is to start where you are at, and look for "easy changes" to improve the quality of your diet. Forget "going-on-a-diet," instead approach it as a lifestyle change. It occurs to me that this is the classic Tortoise and the Hare scenario. Slow and steady gets you there and can surely keep you there!

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[i] Foster GD, et al. Weight and Metabolic Outcomes after 2 years on a Low-CHO versus Low-fat diet. Ann Intern Med 2010;153(3):147-157

[ii] Foster GD, et al. A Randomized Trial of a Low-Carbohydrate Diet for Obesity. NEJM 2003;348:2082-90.

[iii] Skov AR, et al. Randomized trial on protein vs. carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obesity 1999;23:528-36.