Rules for Healthy Weight-Loss.

Get used to it. Diet books will continue to captivate and confuse the public. With Americans moving less and eating more, obesity rates--and interest in the latest diets--can't go anywhere but up. Until better diet studies are done, our advice is to exercise and make sure your diet is healthy. It should be:

* Low in saturated and trans fat to cut your risk of heart disease and possibly colon and prostate cancers. That means eating low-fat versions of meats, cheese, ice cream, and milk, and cutting way back on fried foods (french fries, fried chicken, doughnuts) and fatty sweets (pies, frosted cakes, pastries, cookies, chocolate). It also means substituting oil or tub margarine for butter or stick margarine.

Why? LDL ("bad") cholesterol may rise, or it may drop slightly, when you cut calories or lose weight, even if you're eating foods that are high in saturated fat.[1] But LDL will drop far more on a diet that's low in sat and trans fat.

And even if your LDL drops on a diet high in saturated fat, your risk of colon and possibly prostate cancer won't. Missing from much of the debate over diets is the evidence that either red meats or saturated fat--studies can't tell which--are linked to a higher risk of two out of the four cancers that claim the most American lives (lung and breast are the other two).

* Rich in vegetables and fruit to cut your risk of cancer, heart disease, and stroke. Go for eight to ten servings of vegetables and fruit a day. French fries, chips, and ketchup don't count. Sorry.

Why? In numerous studies, people who eat more fruits and vegetables have a lower risk of cancers of the lung, colon, stomach, esophagus, throat, and mouth. Other studies show that diets rich in fruits and vegetables lower blood pressure and are linked to a lower risk of stroke and heart disease.

* Low in (largely) empty-calorie foods. As most dieters know, if you're trying to lose weight, you start by cutting back on high-calorie foods that don't add many vitamins, minerals, fiber, or phytochemicals to your diet. That means fewer sweets like regular soft drinks and desserts. If you still need to cut, limit (skinless white) potatoes and bread, pasta, rice, cereals, and crackers made of refined flour.

Why? Short-term studies show that people eat fewer calories when they eat foods with lower calorie density.

TAKE YOUR PICK

The above rules apply to everyone. The rest of your diet should depend on which foods help you curb calories:

1. If you're able to resist unhealthy carbs and you want the fiber in bran and whole grains to stay regular, lean more heavily towards healthy carbs (like whole-wheat cereals and breads and beans), not sweets, white bread, and refined pasta.

2. If you have a sweet tooth and you find bread and pasta irresistible, lean towards more healthy protein (larger servings of seafood or low-fat dairy or poultry), not beef and cheese.

3. If you have high triglycerides and low HDL ("good") cholesterol--both signs of Syndrome X (see NAH, March 2000), lean towards more unsaturated fats (like olive or canola oil, salad dressings, nuts, and avocados). But don't go overboard. Their high calorie density means you can only eat small quantities.

[1] Amer. J. Clin. Nutr. 71: 706.2000.