03.What the experts say
Are the diets nutritionally OK?
Most programs rely on limiting carbohydrates and restricting kilojoules to put the dieter into a state of ketosis. However, our experts have several issues with the nutrition profiles of the diets.
- Most are around 4000kJ per day in the main weight-loss stage. Only AlphaSlim, Betty Baxter and Kate Morgan come close to 5000kJ per day, which is regarded as the minimum to get all your necessary micronutrients. At less than 5000kJ – even with added supplements – levels of other nutrients and beneficial food chemicals such as phytochemicals can be compromised. Decreases in metabolic rate are also a risk, as the body tries to protect itself against starvation. Since we assessed the diets, Tony Ferguson has changed its program to include an option which increases the energy to 5000kJ per day and contains more carbohydrates.
- Some of the programs contain about 100 grams of carbohydrates per day; several contain much less. Too little will result in ketosis and can also risk the loss of muscle rather than fat. Although in some cases eating sufficient protein can help protect muscle, it’s a fine balancing act as too much protein can also cause problems.
- All the diets fall short on fibre in the weight-loss phase (except Betty Baxter which adds it to the meal replacements). Some are low even when a fibre supplement is included – too little fibre can cause constipation.
- To keep the carbohydrates low, some programs either ban or severely limit cereal foods, including wholegrains, which are proven to have long-term health benefits, such as reducing the risk of some cancers and heart disease.
- MediTrim and Xndo replace meals with drinks that don’t meet the Australian standard for meal replacements, but both are careful not to call their drinks meal replacements.
- The only program to get the nutritional thumbs-up from our experts is Betty Baxter, which has a reasonable amount of kilojoules, enough carbohydrates to keep ketosis in check and allows low-GI wholegrain carbs even in the early stages.
The big upsell
Apart from the cost of the program and meal replacements where they’re used, most programs also include supplements which add to the pharmacy’s bottom line.
- Multivitamin and mineral supplement. Most programs recommend these, which the pharmacy conveniently sells (program-branded or otherwise). Only Dr Tim’s Success doesn’t require you to buy any additional supplements to meet vitamin and mineral needs and even makes a point of this in its marketing. However, one of our shadow shoppers was sold three pharmacy-packaged vitamin and herbal supplements as part of their Dr Tim’s Success starter kit.
- The fact so much of the nutritional intake is from supplements or vitamins added to the meal replacements concerned our panel. Real food is the best way to get vitamins and minerals – there is still much not known about the other important components of real food, and taking more of some nutrients than you might need in the form of multiple supplements is not ideal.
- Diet pills. The most popular diet pill-type supplement with most programs is chromium, which is supposed to reduce sugar cravings. But our experts say the evidence for this is far from convincing.
- Fibre supplements are another popular upsell – either program-branded or not – and they’re available from the pharmacy. According to the experts and our analysis of the diets, you’re likely to need them.
- The fibre levels of all programs, except Betty Baxter, are too low and constipation is a real possibility.
- Flaxseed oil. Our experts questioned why several programs suggest daily flaxseed oil as a way of getting sufficient omega-3 fats.
- Flaxseed oil goes rancid very quickly and can have a most unfavourable fat profile. Other more stable oils, such as olive oil, would be better, along with advice to eat fish at some evening meals.
- Other extras. Xndo had the most extras on offer – instant coffee, soft drink and cordial at $1.60 per serve, which is an expensive way to buy “diet” soft drink and cordial.
What is ketosis?
When your body doesn’t get enough carbohydrates, it produces ketones from body fat, which it burns instead of carbohydrates to produce energy. Some people experience ketosis when they eat fewer than 100g of carbohydrates a day; once carbohydrates are at 50g most people will experience it.
Some organs of your body, such as the brain and red blood cells, need glucose for energy, and if you don’t eat enough carbohydrates to supply them, your body will break down protein – from your muscles if you’re not eating enough protein – as an energy source for these organs.
What are the benefits?
Quick initial weight loss (mainly due to fluid loss) may increase your motivation. Some people claim the fluid loss also reduces feelings of bloating. Ketosis can also help make you feel less hungry.
And the downsides?
Some undesirable side-effects are mild dehydration, poor athletic performance, nausea, bad breath, risk of blood pressure problems, an increased risk of osteoporosis and muscle and blood vessel damage. It may also make concentrating on mental tasks more difficult.
These programs are of obvious financial benefit to the pharmacies, and a constant stream of short-term clients will shift a lot of product off the shelves. Will you lose weight? If you follow them closely, yes. Will the pharmacy setting provide you with your own highly skilled weight-loss advisor? Our experts think not.
Considering the inadequate training of consultants, little ability to tailor programs and deal with individual circumstances and habits, as well as the lack of close, qualified supervision, CHOICE does not recommend these programs. The current regulations and voluntary codes of practice covering weight-loss programs are insufficient. CHOICE wants to see a national accreditation system, including minimum standards for training, covering all programs, consultants and leaders who counsel people on losing weight.