The Mayo Clinic Diet: A Review Of New Book From The Clinic Designed To Refute "Bogus Mayo Clinic diets"

The Mayo Clinic is one of the oldest and most respected medical institutions in the United States. The clinic itself is notable because it pays doctors on a fixed salary, which allows doctors to spend more time with patients. This is important because many doctors have to see patients quickly in order to stay in business. The practices of The Mayo Clinic are widely followed, and they have developed a powerful brand over the last century.

According to The Mayo Clinic, in the last couple decades people have sold or promoted diet plans that have no connection to the clinic. If you have read about a diet that promotes cabbage soup, grapefruit, bacon or meat it is likely that there is no relation to the actual Mayo Clinic.

In response to this, the Mayo Clinic has just published a new book (January 2010 is the publication date) whose goal is to refute these "bogus diets" and present a diet and weight loss plan that does represent the philosophy and work of the organization. The book sets out to provide guidance that "is not a fad" and promotes "good health" and a "healthy lifestyle." We were sent a copy of the book in advance of the publication, and were encouraged by what we read. This review also contains an excerpt from the book which is printed at the bottom of this page (with permission from the publisher.)

The Most Important Part Of The New Mayo Clinic Diet: The "Healthy Weight Pyramid"

Throughout the book and the journal there appears a "Mayo Clinic Healthy Weight Pyramid." Our first read of the pyramid was that it looked a lot like the one that Dr. Joel Fuhrman first advocated in his book "Eat To Live" in 2003. 

And this is important because his pyramid represented a radical departure from all conventional wisdom. Americans in particular eat a diet extremely high in grains, meat and dairy, and low in vegetables. The new Mayo Clinic Pyramid has at its base fruits and vegetables. Their advice is to "follow the general pattern of the pyramid and you'll be fine."

So we reached out to Dr. Fuhrman to get his take on the new Mayo Clinic pyramid. His main take was that it is "a big step in the right direction." But he implored us to outline some important distinctions before drawing too close a comparison. 

From our perspective, The Mayo Clinic in this book is advocating an approach to general health, while Dr. Fuhrman uses nutrition as a big component in helping to treat and reverse diseases. (His new deal with Whole Foods is an important validation of his work).  He continually asks us to be as precise as possible when we categorize his work. Which we do. 

In his view "interpretation of the worlds nutritional literature can be a life or death matter." Here is how he describes the differences between the two pyramids:

"1. They have nuts labeled (with a photo) as fats, not differentiating  oil and saturated fats (with their negative health effects) different from nuts/seeds with dramatically protective effects against serious disease.  And they have seeds/nuts placed above dairy and animal products, which they recommended 3 – 7 servings a day.  Diary or cheese supply the major load of saturated fats in the American diet and nuts and seeds are the foods that demonstrate the most dramatic protection against sudden cardiac death of any food on the dietary landscape in the largest and most respected studies.

2. They placed one giant label on carbohydrate, essentially equating the dramatic lifespan enhancing properties and weight loss benefits of beans, mixed in right along with white potato and bagels and pasta.

3. Wouldn’t you say consuming 2 – 4 servings of animal products a week (in my pyramid) is lots different from 21 to 49 servings a week (in the Mayo pyramid) ?   

4. Lumping all carbohydrates together, all proteins in another and then fats in another, at different levels is just wrong.   The macronutrient type is not a measurement of nutritional quality or weight loss potential.  Obviously those are not the measurements that determine health.  Overall, this confuses people even more, reinforcing the problem that created this epidemic of disease to begin with.  Most foods are a mixture of fat/carb/and protein, so their classification is inaccurate, but it is the nutritional quality of the food not whether one macronutrient predominates that is the main issue.  Their pyramid just restates the Standard American diet with the caveat of eating some more fruits and vegetables.   Not bad, and a step in the right direction, but certainly very far from ideal.

Overall, I think comparing their pyramid to the one in Eat To Live undervalues the careful science used in the construction of the Eat To Live pyramid and kind of credits their pyramid with more value than it deserves.   To equate or say there are only subtle differences between their “more conventional and socially acceptable” pyramid, with the Eat To Live (ideal nutrition) pyramid that maximizes results, lifespan and reverse disease is not quite fair and is distracts from the real value there.

My diet-style emphasizes 5 basic food classes that should be eaten even for those just taking baby steps into healthier eating just getting their feet wet.  These specific food classes should occupy a larger percent of the dietary pie chart.

1. At least one large salad of raw vegetables every day

2. At least 4 pieces of fresh fruit a day

3. At least 1 cup of beans a day, with a one cup goal

4. At least 1 ounce of seeds/nuts a day

5. A large double size portion of steamed green vegetables a day.

In other words, the beans and seeds/nuts and raw veggies and cooked veggies, are all important components of a healthy diet.   The basic volume of healthy food to shoot for gives some micronutrients quality for the appetite drive to even approximate normalcy."

I think this is an interesting and very important debate, and we will definitely publish any response from the Mayo Clinic right here.

The Importance Of Daily Journaling

The Mayo Clinic Diet includes a companion journal that is really well done. It is similar to the PEERtrainer online log format. When you open up their journal it leads with your goal and your notes. This is important because there is tremendous benefit to bringing daily focus to your goals and thoughts. If you write down that you are going to eat a certain thing or exercise a certain way, your odds of doing that go way up. Journaling works, period. It is what we built PEERtrainer around.

Their journal allows you to write down as much of what you want. Each log helpfully includes a daily motivation/weight loss tip, which is something that we have observed is very helpful to keep people on track. You will see thoughout The Mayo Clinic Diet a very strong focus on reinforcing new behaviors and eliminating old ones.

If you are one of those people who does not like to log into a website like PEERtrainer each day, you will find their journal format very helpful. It is probably the best portable journal out there.

"Finding Your Inner Motivation"

The Mayo Clinic Diet itself leads off on page 13 in the same way the PEERtrainer Tip Of The Day does: by telling you to ask yourself "Why do I want to lose weight?" This is important and sometimes harder than it seems. You have to have a really good reason to do anything. It is also an indicator that the entire book is on the right track, especially for people who are just starting out on the weight loss path or who are refugees from a failed weight loss plan.

The Importance Of Accountability and Readiness

The Mayo Clinic Diet highlights the importance of involving others in helping increase your odds of losing weight. They suggest enlisting friends, family and co-workers. If you truly have supportive friends and family then that is good advice. But you have to be careful. If you think about it, there is a reason people flock to in person Weight Watchers meetings, and join online support groups at places like PEERtrainer. Often times the best support is anonymous support. Nobody to judge you, sabotage you or guilt you into getting off track.

The Mayo Clinic Diet also highlights the importance of readiness and includes an eight question quiz to determine if you are ready to lose weight. We have observed these kinds of assessments (click here for the PEERtrainer online Weight Loss Readiness assessment)  are helpful, and are a useful tool to get you to ask yourself some tough questions. So often at PEERtrainer we see people leave a program and give us very honest feedback that they "just were not ready."

Good Focus On Breaking Habits

The Mayo Clinic Diet spends a lot of time focusing on breaking bad habits and creating new good ones. This is important because sometimes the smallest changes to negative patterns can help trigger the development of new ones. The hard part about bad habits is that they often require tremendous personal strength to change. It is one thing to hear that you should not watch TV while you eat, eat less sugar, only snack on fruits and vegetables, cut down on meat and dairy. It is another to put these into practice.

One of the best things about The Mayo Clinic Diet is that they don't just talk about these things and move on. Throughout the book they keep coming back to your behaviors, to identifying exactly how you can change them with specific suggestions.

Conclusion

The book is filled with solid advice. The only critique we have is that some of the issues they talk about can take a lot of work in practice, and the advice is often best viewed as a good starting point. The reality is that we often need all the help we can get. The most practical suggestion that we have is that if you get this book, make sure to use the journal they provide. Even if you only journal for two weeks, you are going to have an important conversation with yourself. Never doubt the power of writing down your thoughts.

If you are a book person and are starting out on your weight loss path you will find this book helpful. It is an excellent "Weight Loss 101" tool.

The Mayo Clinic Diet Journal (You Can Purchase Separately)

Book Excerpt:

Healthy Cooking

 

By the weight-loss experts at Mayo Clinic and Donald Hensrud, M.D., M.P.H. Authors of The Mayo Clinic Diet: Eat well. Enjoy life. Lose weight.

Healthy cooking doesn't mean you have to become a gourmet chef or invest in special cookware. Simply use standard cooking methods to prepare foods in healthy ways. You can also adapt familiar recipes by substituting other ingredients for fat, sugar and salt.

Use these methods

These methods best capture the flavor and retain the nutrients in your food without adding too much fat or salt.

• Baking. Besides breads and desserts, you can bake seafood, poultry, lean meat, and vegetable and fruit pieces of the same size. Place food in a pan or dish (covered or uncovered) and bake. You may need to baste the food with broth, low-fat marinade or juice to keep the food from drying out.

• Braising. Braising involves browning the meat or poultry first in a pan on top of the stove, and then slowly cooking it covered with a small amount of liquid, such as water or broth. In some recipes, the cooking liquid is used afterward to form a flavorful, nutrient-rich sauce.

• Grilling and broiling. Both grilling and broiling expose fairly thin pieces of food to direct heat and allow fat to drip away from the food. If you're grilling outdoors, place smaller items, such as chopped vegetables, in a long-handled grill basket or on foil to prevent pieces from slipping through the rack. To broil indoors place food on a broiler rack below a heat element.

• Poaching. To poach foods, in a covered pan gently simmer ingredients in water or a flavorful liquid, such as broth, vinegar or juice, until cooked through and tender. For stove-top poaching, choose an appropriate-sized covered pan and use a minimum amount of liquid.

• Roasting. Roasting uses an oven's dry heat at high temperatures to cook the food on a baking sheet or in a roasting pan. For poultry, seafood and meat, place a rack inside the roasting pan so that the fat can drip away during cooking.

• Sautéing. Sautéing quickly cooks small or thin pieces of food. If you choose a good-quality nonstick pan, you can cook food without using fat. Depending on the recipe, use low-sodium broth, cooking spray, water or wine in place of oil or butter.

• Steaming. One of the simplest cooking techniques to master is steaming food in a perforated basket suspended above simmering liquid. If you use a flavorful liquid or add herbs to the water, you'll flavor the food as it cooks.

• Stir-frying. Stir-frying quickly cooks small, uniform-sized pieces of food while they're rapidly stirred in a wok or large nonstick frying pan. You need only a small amount of oil or cooking spray for this cooking method.

Find new ways to add flavor

Instead of salt or butter, you can enhance foods with a variety of herbs, spices and low-fat condiments. Be creative.

Poach fish in low-fat broth or wine and fresh herbs. Top a broiled chicken breast with fresh salsa. Make meats more flavorful with low-fat marinades or spices -- bay leaf, chili powder, dry mustard, garlic, ginger, green pepper, sage, marjoram, onion, oregano, pepper or thyme.

To bring out the sweetness in baked goods, use a bit more vanilla, cinnamon or nutmeg.

Adapting recipes

If the recipe calls for:  

Butter 

Margarine 

Shortening 

Oil 

For sandwiches, substitute tomato slices, catsup or mustard. For stove-top cooking, sauté food in broth or small amounts of healthy oil like olive, canola or peanut or use non-stick spray. In marinades, substitute diluted fruit juice, wine, or balsamic vinegar. In cakes or bars, replace half the fat or oil with the same amount of applesauce, prune puree or commercial fat substitute. To avoid dense, soggy or flat baked goods, don't substitute oil for butter or shortening, or substitute diet, whipped or tub-style margarine for regular margarine. 

Meat:

Keep it lean. In soup, chili or stir-fry, replace most of the meat with beans or vegetables. As an entrée, keep it to no more than the size of a deck of cards -- load up on vegetables. 

Whole milk(regular or evaporated):

 Fat free or 1% milk, or evaporated skim milk. 

Whole egg (yolk and white):

 1/4 cup egg substitute or 2 egg whites for breakfast or in baked goods. 

Sour cream 

Cream cheese:

 Fat-free, low-fat or light varieties in dips, spreads, salad dressings and toppings. Fat-free, low-fat and light varieties do not work well for baking. 

Sugar:

 In most baked goods, you can reduce the amount of sugar by one-half without affecting texture or taste, but use no less than 1/4 cup of sugar for every cup of flour to keep items moist. 

White flour: 

Replace half or more of white flour with whole grain pastry or regular flour. 

Salt: 

Use herbs (1 tbsp. fresh = 1 tsp. dried = 1/4 tsp. powder). Add towards the end of cooking and use sparingly -- you can always add more. Salt is required when baking yest-leavened items. Otherwise you may reduce salt by half in cookies and bars. Not needed when boiling pasta. 

The above is an excerpt from the book The Mayo Clinic Diet: Eat well. Enjoy life. Lose weight., by the weight-loss experts at Mayo Clinic and Donald Hensrud, M.D., M.P.H. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

Reprinted from The Mayo Clinic Diet, © 2010 Mayo Foundation for Medical Education and Research. Published by Good Books (www.GoodBooks.com). Used by permission. All rights reserved.

About Donald Hensrud, M.D.

Donald Hensrud, M.D., M.P.H., is chair of the Division of Preventive, Occupational, and Aerospace Medicine and a consultant in the Division of Endocrinology, Metabolism and Nutrition at Mayo Clinic, Rochester, Minn. He is also an associate professor of preventive medicine and nutrition at the College of Medicine, Mayo Clinic. A specialist in nutrition and weight management, Dr. Hensrud advises individuals on how to achieve and maintain a healthy weight. He conducts research in weight management, and he writes and lectures widely on nutrition-related topics. He helped publish two award-winning Mayo Clinic cookbooks.

About Mayo Clinic

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy that the needs of the patient come first. Over 3,600 physicians and scientists and 50,000 allied staff work at Mayo, which has sites in Rochester, Minn.; Jacksonville, Fla.; and Scottsdale/Phoenix, Ariz. Collectively, Mayo Clinic treats more than 500,000 patients a year.

For more than 100 years, millions of people from all walks of life have found answers at Mayo Clinic. Mayo Clinic works with many insurance companies, does not require a physician referral in most cases and is an in-network provider for millions of people.

Comments

[Weight Management]

I like the healthy cooking information. I love to eat, and the information made selecting the right foods to eat much easier.