BACKGROUND/OBJECTIVE: Diet books dominate the New York Times Advice Best Seller list and consumers cite such books as an important source of nutrition information. However, the scientific support for nutrition claims presented as fact (nutrition facts) in diet books is not known.
DESIGN/MEASUREMENTS: We assessed the quality of nutrition facts in the best-selling South Beach Diet using support in peer-reviewed literature as a measure of quality. We performed structured literature searches on nutrition facts located in the books’ text, and then assigned each fact to 1 of 4 categories (1) fact supported, (2) fact not supported, (3) fact both supported and not supported, and (4) no related papers. A panel of expert reviewers adjudicated the findings.
RESULTS: Forty-two nutrition facts were included. Fourteen (33%) facts were supported, 7 (17%) were not supported, 18 (43%) were both supported and not supported, and 3 (7%) had no related papers, including the fact that the diet had been “scientifically studied and proven effective.”
CONCLUSIONS: Consumers obtain nutrition information from diet books. We found that over 67% of nutrition facts in a best-seller diet book may not be supported in the peer-reviewed literature. These findings have important implications for educating consumers about nutrition information sources.
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Bravata DM, Sanders L, Huang J, et al. Efficacy and safety of low-carbohydrate diets: a systematic review. JAMA. 2003;289:1837–50.
Stern L, Iqbal N, Seshadrit P, et al. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004;140:778–85.
Yancy WS Jr, Olsen MK, Guyton JR, Basket RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med. 2004;140:769–77.
Astrup A, Meinart Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364:897–9.
Katz DL. Competing dietary claims for weight loss: finding the forest through the truculent trees. Annu Rev Public Health. 2005;26:61–88.
Katz DL. Pandemic obesity and the contagion of nutritional nonsense. Public Health Rev. 2003;31:33–44.
Cheuvront SN. The Zone Diet Phenomenon: a closer look at the science behind the claims. J Am Coll Nutr. 2003;22:9–17.
Berland GK, Elliot MN, Morales LS, et al. Health information on the Internet: accessibility, quality, and readability in English and Spanish. JAMA. 2001;285:2612–21.
Eysenbach G, Powell J, Kuss O, Sa ER. Empirical studies assessing the quality of health information for consumers on the World Wide Web: a systematic review. JAMA. 2002;287:2691–700.
New York Times Best Seller Web Page: http://www.nytimes.com/pages/books/bestseller/. Accessed May 2004.
Nutrition and You-Trends 2000 Final Report. American Dietetic Association: http://www.eatright.org/Public/SearchResults.cfm. October 1999.
McNamara SH. So you want to market a food and to make health-related claims—how far can you go? What rules of law will govern the claims you want to make? Food Drug Law J. 1998;53:421–36.
Ayoob KT, Duyff RL, Quagliani D. Position of the American Dietetic Association: food and nutrition misinformation. J Am Diet Assoc. 2002;102:260–6.
BMJ Clinical Evidence Literature Searching. Page: http://www.clincalevidence.com/ceweb/about/lit_search.jsp. Accessed September 2004.
American Heart Association. Website: http://www.americanheart.org. Accessed September 2004.
American Diabetes Association. Website: http://www.diabetes.org/home.jsp. Accessed September 2004.
Hu FB, Willet WC. Optimal diets for the prevention of coronary artery disease. JAMA. 2002;288:2569–78.
Kabagambe EK, Baylin A, Siles X, Campos H. Individual saturated fatty acids and nonfatal acute myocardial infarction in Costa Rica. Eur J Clin Nutr. 2003;57:1447–57.
He K, Rimm EB, Merchant A, et al. Fish consumption and risk of stroke in men. JAMA. 2002;288:3130–6.
de Roos NM, Siebelink E, Bots ML, van Tol A, Schouten EG, Katan MB. Trans monounsaturated fatty acids and saurated fatty acids have similar effects on postprandial flow-mediated vasodilation. Eur J Clin Nutr. 2002;56:674–9.
deRoos NM. Fat and arterial function. Metabolism. 2002;51:1534–7.
Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholestero; on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J Clin Nutr. 2003;77:1146–55.
de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779–85.
Di Minno G, Tufano A, GaroDi Minno G, et al. Polyunsaturated fatty acids, thrombosis and vascular disease. Pathophysiol Haemost Thromb. 2002;32:361–4.
Leaf A, Kang JX, Xiao YF, Billman GE. Clinical prevention of cardiac death by n-polyunsaturated acids and mechanism of prevention of arythmias by n-3 fish oils. Circulation. 2003;107:2646.
He K, Merchant A, Rimm EB, et al. Dietary fat intake and stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ. 2003;327:777–82.
Kritchevsky S, Kritchevsky D. Egg consumption and CHD: an epidemiologic overview. J Am Coll Nutr. 2000;19:S549-S555.
McNamara DJ. The impact of egg limitations on CHD risk: do the numbers add up? J Am Coll Nutr. 2000;19:S540-S548.
Weggemans RM, Zock PL, Katan MB. Dietary cholesterol from eggs increases the ratio of total cholesterol to high density lipoprotein cholesterol humans; a meta-analysis. Am J Clin Nutr. 2002;75:33–5.
Albert CM, Gaziano JM, Willett WC, Manson JE. Nut consumption and decreased risk of sudden cardiac death in physicians health study. Arch Intern Med. 2002;162:1382.
Hu FB. Plant based foods and prevention of CVD: an overview. Am J Clin Nutr. 2003;78:S544-S551.
American Dietetic Association. Website. Available at: http://www.eatright.org. Accessed February 2005.
Kris-Etherton PM, Hecker KD, Bonanome A, et al. Bioactive compounds in foods: their role in the prevention of cardiovascular disease and cancer. Am J Med. 2002;113(Suppl 9B):71S-88S.
Di Castelnuovo A, Rotondo S, Iacoviello L, Donati MB, De Gaetano G. Meta-analysis of wine and beer consumption in relation to vascular risk. Circulation. 2002;105:2836–44.
Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002;288:2015–22.
Vermeulen EG, Stehouwer CD, Valk J, et al. Effect of homocysteinelowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial. Lancet. 2000;355:517–22.
Jenkins DJ, Kendall CW, Augustin LS, Vuksan V. High-complex carbohydrate or lente carbohydrate foods? Am J Med. 2002;113(Suppl 9B):30S-7S.
Fairfield KM, Fletcher RH. Vitamins for chronic disease prevention in adults: clinical applications. JAMA. 2002;287:3127–9.
Bouche C, Rizkalla SW, Luo J, et al. Five-week, low-glycemic index diet decreases total fat mass and improves plasma lipid profile in moderately overweight nondiabetic men. Diabetes Care. 2002;25:822–8.
Brand-Miller JC, Petocz P, Colagiuri S. Meta-analysis of low-glycemic index diets in the management of diabetes: response to Franz. Diabetes Care. 2003;26:3363–4.
Frost G, Keogh B, Smith D, Akinsanya K, Leeds A. The effect of lowglycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease. Metabolism. 1996;45:669–72.
Fung TT, Hu FB, Pereira MA, et al. Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. Am J Clin Nutr. 2002;76:535–40.
Anderson GH, Woodend D. Effect of glycemic carbohydrates on shortterm satiety and food intake. Nutr Rev. 2003;61(5 Part 2):S17-S26.
Anderson GH, Woodend D. Consumption of sugars and the regulation of short-term satiety and food intake. Am J Clin Nutr. 2003;78:843S-9S.
Raben A. Should obese patients be counseled to follow a low carbohydrate diet? No Obes Rev. 2002;3:245–56.
Roberts SB. High-glycemic index foods, hunger, and obesity: is there a connection? Nutr Rev. 2000;58:163–9.
Laboure H, Van Wymelbeke V, Fantino M, Nicolaidis S. Behavioral, plasma, and calorimetric changes related to food texture modification in men. Am J Physiol Regul Integr Comp Physiol. 2002;282:R1501-R1511.
USDA Nutrient. Database. Available at: http://www.nal.usda.gov/fnic/foodcomp/search/. Accessed September 2005.
Englyst KN, Vinoy S, Englyst HN, Lang V. Glycaemic index of cereal products explained by their content of rapidly and slowly available glucose. Br J Nutr. 2003;89:329–40.
Behall KM, Scholfield DJ, Hallfrisch J. The effect of particle size of whole-grain flour on plasma glucose, insulin, glucagon and thyroidstimulating hormone in humans. J Am Coll Nutr. 1999;6:591–7.
Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, Roberts SB. High glycemic index foods, overeating and obesity. Pediatrics. 1999;103:p656.
Saris WHM. Sugars, energy, metabolism and weight control. Am J Clin Nutr. 2003;78:850S-7S.
Blundell JE, MacDiarmid JI. Fat as a risk factor for overconsumption: satiation, satiety and patterns of eating. J Am Diet Assoc. 1997;97(7 Suppl):S63-S69.
Bobak M, Skodova Z, Marmot M. Beer and obesity: a cross-sectional study. Eur J Clin Nutr. 2003;57:1250–3.
Dallongeville J, Marecaux N, Ducimetiere P, et al. Influence of alcohol consumption and various beverages on waist girth and waist-to-hip ratio in a sample of French men and women. Int J Obes Relat Metab Disord. 1998;22:1178–83.
Janssens JP, Shapira N, Debeuf P, et al. Effects of soft drink and table beer consumption on insulin response in normal teenagers and carbohydrate drink in youngsters. Eur J Cancer Prev. 1999;8:289–95.
Graham TE, Sathasivam P, Rowland M, Marko N, Greer F, Battram D. Caffeine ingestion elevates plasma insulin response in humans during an oral glucose tolerance test. Can J Physiol Pharmacol. 2001;79:559–65.
Liu S, Willett WC, Manson JE, Hu FB, Rosner B, Colditz G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am J Clin Nutr. 2003;78:920–7.
Bell EA, Roe LS, Rolls BJ. Sensory-specific satiety is affected more by volume than by energy content of a liquid food. Physiol Behav. 2003;78:593–600.
Rolls BJ. The role of energy density in the overconsumption of fat. J Nutr. 2000;130(2S Suppl):268S-71S.
Ludwig DS. Dietary glycemic index and obesity. J Nutr. 2000;130(2S Suppl):280S-3S.
National Institute of Diabetes and Digestive and Kidney Diseases. Website. Available at: http://www.niddk.nih.gov/. Accessed September 2005.
Leser MS, Yanovski SZ, Yanovski JA. A low-fat intake and greater activity level are associated with lower weight regain 3 years after completing a very-low-calorie diet. J Am Diet Assoc. 2002;102:1252.
Willett WC, Leibel RL. Dietary fat is not a major determinant of body fat. Am J Med. 2002;113(Suppl 9B):47S-59S.
Ornish D. Avoiding revascularization with lifestyle changes: the Multicenter Lifestyle Demonstration Project. Am J Cardiol. 1998;82:72T-6T.
National Restaurant Association. Available at: http://www.restaurant.org/. Accessed September 2005.
Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA. 2004;291:2847–50.
Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics. 1998;101(3 Part 2):497–504.
Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA. 1999;282:1523–9.
Story MT, Neumark-Stzainer DR, Sherwood NE, et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002;110(1 Part 2):210–4.
Perrin EM, Flower KB, Garrett J, Ammerman AS. Preventing and treating obesity: pediatricians’ self-efficacy, barriers, resources, and advocacy. Ambul Pediatr. 2005;5:150–6.
Huang J, Yu H, Marin E, Brock S, Carden D, Davis T. Physicians’ weight loss counseling in two public hospital primary care clinics. Acad Med. 2004;79:156–61.
None of the authors have any conflicts of interest to declare.
Dr. Goff was supported by a training grant from the Robert Wood Johnson (RWJ) Foundation while this study was conducted. The RWJ Foundation holds no responsibility for the content of this manuscript.
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Goff, S.L., Foody, J.M., Inzucchi, S. et al. Brief report: Nutrition and weight loss information in a popular diet book: Is it fact, fiction, or something in between?. J Gen Intern Med 21, 769–774 (2006). https://doi.org/10.1111/j.1525-1497.2006.00501.x
- health information
- weight loss