Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)

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Eat fewer calories and you will lose weight. The body, which is, after all, nothing more than a biochemical machine [my emphasis], knows no other arithmetic. Simple carbohydrates, much loved by Americans, were at fault, Atkins maintained: white flour, sugar, and potato products, those de-fatted processed products that had fattened America. By the end of the century, Brody was moderating her low-fat position to declare that fat can be a friend! Recounting the history of low-fat diet advice, Brody noted a major shift within the scientific community.

Following the findings of Willett and others, scientists were now claiming that it was not the total amount of fat but the kind of fat that mattered. Brody was converting to this point of view. The key to heart health now seemed to be reducing saturated and trans fats hydrogenated plant fat , but not all fats. Ignoring scientific studies that supported set-point theory, she argued that if low fat was not the answer to weight loss, we must count calories and exercise. The twenty-first century ushered in new enemies and new approaches.

Prevention readers were advised that if they wanted to be thin, they must cut out sugar and manage stress. Scientists showed that stress-induced cortisol promoted abdominal fat—declared the most dangerous kind of fat. The index offered a scientific way for readers to choose healthful carbohydrates that proponents maintained would not promote weight gain. In the new millennium, there was little agreement on which diet was the best either for heart disease prevention or weight reduction. It makes no difference if these calories are in fats or vegetables or cake or ice cream.

Change was at hand on the diet front. In a breakthrough article , Brody moved away from the one-size-fits-all low-fat diet that she had promoted with a religious fervor for more than twenty years to suggest that perhaps different diets worked for different people. Addressing the widespread confusion about fat and fats, she noted that no consensus existed among experts. She proposed that a one-size-fits-all approach no longer worked in a society as ethnically and culturally diverse as ours. It was becoming more and more apparent that the public health message promoting the low-fat diet had had unintended consequences: it had led some people to adopt an unhealthy diet—just as long as it was low fat.

Writing about the high-fat, low-fat controversy in , Brody emphasized the importance of a balanced diet. She pointed out that after three decades of popularity of the Atkins diet, scientists had still not tested it for long-term safety and effectiveness.

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She argued that the high-protein diet attracted those who failed on the low-fat diet. Brody maintained that it was not low fat that was fattening Americans, but more calories. Americans were eating on average calories more per day, and they had not reduced their fat consumption—if one used the higher total calorie count to figure percentages. Brody reiterated that it was just calories that mattered—no matter what kind. The Mediterranean diet found new followers as critics challenged the low-fat diet in the face of what many scientists and physicians were calling an obesity epidemic. Low-fat proponents had not foreseen that Americans would overindulge in refined low-fat carbohydrates.

One of the unanticipated consequences of industrial food technology was the ability of the food industry to flood the market with highly processed low-fat—but fattening—foods. They argued that substituting refined carbohydrates for fats was not the answer, explaining that refined carbohydrates—whether low fat or not—raise triglyceride levels and lower both good and bad cholesterol. They maintained that there was no evidence from clinical trials to show that reducing dietary fat would by itself lead to weight loss.

Rather, ignoring set-point theory, they maintained that it was too many calories and too little physical exercise that led to weight gain. So, by , the most recent research challenged the low-fat ideology that had held sway for so long, but at least some research affirmed Brody and Kolata's position that what counted was calories consumed and energy expended. Finally, in , the results of long-term studies on low-carbohydrate, high-protein, high-fat diets, such as Atkins, were published.

But it turned out that many people who succeeded on the diet were vindicated.

There’s no such thing as one perfect diet

People lost weight—and for many for whom low-fat or low-calorie diets had not worked, it was the first time they had lost weight. So what if the first 5—7 pounds were water? Many lost far more than this. The studies found that, contrary to expectations, the diet did not damage heart and blood vessels; in fact, in some patients readings improved.

As proponents had claimed, cholesterol levels did not rise, triglyceride levels fell, and HDLs improved. At the end of a year, however, both the low-fat and the low-carbohydrate diets produced about the same results in terms of weight loss. This was the same argument opponents of the low-fat diet had used when they argued that the fattening of America coincided with the decades in which the low-fat diet reigned as nutritional orthodoxy. After explaining why some people lost weight on the Atkins diet, Brody reiterated that it was only calories that mattered.

Both the writers for Prevention and the science writers for The New York Times carefully reported on scientific studies. They reflected a great faith in the validity of the studies and the value of reporting them to the wider public. They were not reluctant, however, to include their own point of view, comparing and interpreting these studies for readers. These writers reflect the larger American—journalistic—faith in science during these years before many questions were raised concerning the reliability of such clinical, epidemiological, and laboratory studies.

The popular media, in short, played a pivotal role in preaching the low-fat message, and, then, in more recent years, in questioning it. Several developments that came together in the s and s help explain how the ideology of low fat conquered America in those decades. The dietary context was an established tradition of low-calorie, low-fat dieting for weight reduction that predisposed Americans to accept what was promoted as a heart-healthy diet. A plethora of diet-heart studies carried out by scientists and physicians suggested that a low-fat diet might prevent heart disease. These studies drew on research that had been done from the s through the s.

By the late s, the federal government started promoting the low-fat diet, and shortly thereafter the food industry began to make low-fat products available and to advertise them widely. Low-fat foods proliferated in the s and s, demonstrated by the number of products available in grocery stores and the ads that appeared in magazines and on television. The rise of the ideology of low fat seemed to correspond with major reductions in risk factors for heart disease.

Was it coincidence, or could a causal effect be identified? These figures suggest that something in the American experience with heart disease did indeed change. These figures did not clarify the role of the low-fat diet, and so its influence in primary and secondary prevention remained in question. The most recent study of the low-fat diet suggests that it does not prevent heart disease.

The low-fat diet was not just intended to prevent heart disease, however. It was aimed at promoting weight loss. It was more difficult—if not impossible—to measure the efficacy of the diet for weight reduction. In the same decades that low fat conquered America, Americans in the aggregate were getting fatter.

Were Americans not practicing the low-fat recommendations? Or did they not work? Or did the outcomes vary according to race, class, ethnicity, gender, and age? Brody claimed that most Americans were not eating a low-fat diet. Others declared the low-fat approach ineffective for weight reduction and maintenance. Among this group was cardiologist Robert Atkins, whose ideas were vigorously attacked in both the scientific and popular press. There were countervailing cultural, social, and economic forces at work that undermined the low-fat approach and may help explain the fattening of America.

Students of obesity have cited factors such as the increased availability of processed foods, the introduction of labor-saving and entertainment technologies most prominently television , the rise of car culture, suburbs without sidewalks, the introduction and proliferation of fast foods, and junk machines in public schools.

One science writer has argued that high fructose corn syrup, which became a staple ingredient of the soft drink industry as well as numerous other foods, was a main contributor to the fattening of America from the s onward. Americans ate more processed foods. The changing social structure—for example, the two-worker family, or the single parent family—meant that families ate out more often.

Many Americans found that you can't eat processed food and lose weight.

June 5th, | Vol. , No. 21 | U.S. | TIME

Nor can you eat out and lose weight. In fact, many found that you just can't lose weight at all. Or, if you do lose it, you will gain it back. By , one obesity specialist, Kelly Brownell, argued that Americans were living in a toxic, that is, fat-promoting environment. Low fat conquered America, but while some Americans subscribed to and practiced it, many Americans either could not or did not live by the low-fat rules.

Some were confused by the low-fat advice, thinking they could substitute refined carbohydrates for high-fat foods. Many saw large portions of pasta as an allowed indulgence. Always hungry? Eat to appetite. Just be sure it is low fat.

The Runner's Food Pyramid

Many Americans did not practice the low-fat regime, resisting the low-fat message out of cultural choice, ethnic tradition, poverty, or sheer perversity. Proscribed were many ethnic and traditional American foods. Out were cream, chocolate, cheese, lard, butter, salad dressings, chicken skin, gravy, fried foods, and baked goods. What could be eaten? Fruit, but no cream. Low-fat advocates preferred processed substitutes, such as Cool-Whip. Bread, but no butter. Salad, but no dressing—unless it was low-fat. Fish, but no sauce.

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Vegetables, but no butter. Chicken breasts, but no skin. Lean beef, but no gravy. No fried anything. No pies or cakes. Pasta, but no cream sauces. Complicating matters was the changing state of knowledge about fats. At first the advice was, give up butter: margarine is healthier. But just recently the advice is, give up margarine: olive oil is best. But, in general, butter and oils were disallowed, in the interest of the low-fat regimen, or the servings drastically reduced. Many staples of what Americans considered good eating were ruled out.

Following a low-fat diet was also expensive, inconvenient, and, in fact, elitist. One had to avoid most restaurants and most foods sold in grocery stores. Processed and fast foods were bargains and required little effort to prepare. The result was two cultures: fat and low fat.

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On the one hand, there was the dominant fat culture of donuts, pizza, ice-cream, burgers, fries, pastries, and ethnic foods adapted to American tastes, such as Chinese, Italian, and Mexican. These foods were readily available, cheap, and satisfying. Then there was the low-fat counterculture of fruit, vegetables, white meat chicken, fish, and salads—all to be eaten without cream, sauces, or butter. One irony of low fat was that sugar, being low fat, was still officially okay. But sugar combined with fat was condemned. Although scientists had found no correlation of sugar with coronary heart disease, sugar was a main ingredient in high-calorie treats when combined with fat or white flour, as it typically was.

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Favorite American desserts such as chocolate-layer cake, apple pie, cookies, and ice cream were off-limits. And, Americans were left with low-fat—but often just as fattening—substitutes. Low-fat sugar-laden cereals proliferated, and consumers were confronted with a dizzying array of choices.

In addition, by the s, even those assiduously subscribing to the low-fat regime for weight reduction and maintenance began to have trouble in restaurants, as both plates and portions got larger. High-fat ethnic food became more popular and more widely available, and it was tough for even for the most religious of low-fat disciples to eat out. Aside from these two cultures of fat and low fat, there was, dating from the s, a vibrant subculture that was embracing—yet again—French food. A little cream sauce? Roast chicken with skin? Why not? Imported creamy cheeses with crusty bread?

Yes, and add a good Bordeaux. Chocolate mousse? For a special occasion. And as more and more middle-class Americans traveled to Europe, they began to realize that there were broader culinary horizons—and they were not low-fat. And it didn't taste so good either! In short, while many Americans paid lip service to the ideology of low fat, they did not live it. They either could not or did not follow the prescribed dietary rules, or they thought that they could substitute refined carbohydrates for high-fat foods.

And then, rather abruptly, at the beginning of the twenty-first century, the end of the ideology of low fat—but not low-fat recommendations—seemed at hand. In , the latest incarnation of the low-carbohydrate craze began to sweep the nation. For Prevention , the date was May , when its cover featured the low-carbohydrate South Beach Diet.

Popular magazines started advertising low-carbohydrate foods, and Prevention published a survey rating the best-tasting low-carbohydrate processed foods. The magazine had done an equivalent special in for low-fat foods. Science writer Sally Squires pointed out that just when we think we have a health problem figured out, a new study is published, and uncertainty prevails.

This reality of science and medicine makes it difficult for citizens and policy makers, patients and consumers. High fat? Low Fat? Trans fat? Saturated fat? Polyunsaturated fat? Monounsaturated fat? No fat? Confusion and complexity provide a heyday for the media. Nevertheless, almost three years after the flurry of excitement over the low-carbohydrate South Beach Diet, the enthusiasm for low carbohydrate waned.

Low carbohydrate had its day, spawned many new processed foods, and many Americans found that it worked—at least for a while. With the low-carbohydrate diet, they could lose weight without feeling hungry, but many could not continue the regime forever. Some people did not feel good, lacking the energy to exercise or even climb stairs. Others felt deprived without bread, baked goods, and pizza. Yet some folks were not hungry, ate nutritious foods, and lost weight.

The low-carbohydrate diet appeared to improve the health profiles of some individuals with a variety of medical problems. Blood pressures and cholesterol levels dropped. Low-carbohydrate and low-fat approaches were not necessarily at odds. Low carbohydrate can mean low fat, but it often doesn't. That said, we have moved well beyond the early high-fat Atkins diet of the s to a more moderate approach. The new low-carbohydrate diet, exemplified by Arthur Agatston of South Beach Diet fame and others, encourages the consumption of complex—not refined—carbohydrates.

Low carbohydrate is in retreat as a national dietary phenomenon. While some people will continue to live and benefit from a low-carbohydrate life, many have tried and rejected it. The low-carbohydrate movement peaked in February , with 9. These data suggest the swift rise and fall of low carbohydrate, from spring to fall Bread sales had been in decline even before the low-carbohydrate craze, but the downward spiral continued with the promotion of low-carbohydrate diets.

But think about it: how could bread, the foundation food of so many cultures, stay out of favor for long? Who could imagine that Americans would renounce bread, pizza, pasta, and sandwiches? The push since early has been for whole grains, with a stress on the importance of complex carbohydrates.

Robert C. Atkins in New York, shipped fourteen truckloads of food to the Christian Appalachian Project to be used to feed the hungry in Appalachia. A local example of the end of the low-carbohydrate craze. The store had opened in and was featured in an article appearing in the local paper. Meanwhile, even though the major focus of popular health writers and the scientific community was on the low-fat and low-carbohydrate diets, since the early s the Mediterranean diet had been steadily gaining adherents. Some scientists, low-carbohydrate promoters, and debunking science writers began to challenge the efficacy of the low-fat diet as a preventive measure for heart health and weight reduction.

Prominent among these were Walter Willett and his colleagues at the Harvard School of Public Health, who promoted the Mediterranean diet, which had been advocated since the s by Ancel Keys and others. Willett and his colleagues maintained that trans fats should not be eaten at all and saturated fats kept low. They declared polyunsaturated and monounsaturated fats heart-healthy, to be consumed in moderation. Although vegetable oils were calorie-laden, they were important for weight reduction because they promoted satiety.

A diet with moderate fat intake was more likely to result in long-term adherence, weight loss, and maintenance. These researchers promoted avocados, nuts, and olive oil not only as heart-healthy, but also as an important part of a successful weight-loss, weight-maintenance program.

Neither low-fat nor low-carbohydrate, the Mediterranean diet, with its moderate consumption of health-promoting fats, emerged as a middle way. Brody and Kolata had been writing about the work of Willett and colleagues throughout the s, and by both were promoting the Mediterranean diet.

Willett had been arguing since the early s that Americans should forget low fat and embrace good fats. By the end of the decade, Brody acknowledged that the right kind of fat could be a friend: namely, avocados, walnuts, vegetable oils, and fatty fish. She noted a major shift in dietary recommendations. Scientists were modifying the monolithic low-fat diet, the principal recommendation for heart health and weight loss for thirty years.

With criticisms of low-fat mounting, Brody urged a return to the traditional idea of counting calories and exercise for weight reduction, heart health, and selective fat reduction—away from trans and saturated fats in favor of vegetable fat and fatty fish. By , Brody was suggesting customized diets. Both scientists and popular writers were moving away from the one-size-fits-all low-fat approach. The low-fat diet still had its place in heart-health and weight-loss programs, but it was not the only diet recommendation, and scientists and popular health writers conceded that it might not be the best diet for all.

Marketing research data point to as the year when the turn away from low fat became noticeable. Marketing data show that sales of low-, no, and reduced fat products that totaled These figures suggest that the ideology of low fat was beginning to give way to a more moderate dietary approach after It is not clear what effect, if any, the new guidelines—and new pyramids, now customized into twelve different models to satisfy the needs of diverse populations, according to age, sex, activity level—will have on American eating habits.

Recent challenges from the results of the Women's Health Initiatives WHI study, released in early February , suggesting that the low-fat diet was not preventive of cardiovascular disease in post-menopausal women, came too late to have much of an impact on the turn away from the low-fat diet.

Although many Americans still subscribe to the ideology of low fat, and some try to follow a low-fat diet, the general move in is toward a more moderate approach, best exemplified by the so-called Mediterranean diet. I presented an earlier version of this article at the annual meeting of the American Association for the History of Medicine in Madison, Wisconsin in May Many people provided help and encouragement: Sincere thanks to Micaela Sullivan-Fowler at the Ebling Health Sciences Library at the University of Wisconsin, Madison for her gracious research assistance and to my daughter, Louisa La Berge, who helped with data collection in Madison.

Thanks to the librarians of Emory and Henry College for allowing me access to their collection of Prevention magazines. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation.

Volume Article Contents. La Berge. Oxford Academic. Google Scholar. PDF Views. Cite Citation.

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Permissions Icon Permissions. Abstract This article examines how faith in science led physicians and patients to embrace the low-fat diet for heart disease prevention and weight loss. Open in new tab Download slide. Allied Sci. For the reducing diet habits of college women, see Margaret A. Theodore M. Paris: Bachelier, Katherine Flegal et al. On the idea that one's lifelong weight should remain the same as it was at age of eighteen or twenty-five—if that was a normal weight, see Walter C. Curiously, the location of women's waists has not remained constant.

While, for most of the twentieth century, the waist was located a couple of inches above the navel, in some recent catalogs, such as Eddie Bauer, the waist is now measured around the navel. Lack of agreement on where the waist is located has consequences for health and disease because one of the ominous signs of cardiovascular disease, part of the so-called metabolic syndrome, is a waist measurement greater than 35 inches for a woman.

InfoTrac OneFile, accessed 7 February The tape measure should lay snug not pulled tight against your skin. She or he then places the lower edge of the tape measure just above the mark and extends the tape around the abdomen, keeping it parallel to the floor. The editors then explain the conundrum: the waist is in a different location in terms of clothing and health.

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This discrepancy is rarely explained in either the scientific of popular health literature. In fact, this is the first full explanation I have seen anywhere. Infotrac OneFile, accessed 7 February Knopf, , On Americans' penchant for quantity over quality, see Alexis de Tocqueville, Democracy in America , ed. Heffner New York: Mentor, , ch. See the classic article, W. Kannel et al. See also, William G. Daniel Levy and Thomas J.

Public Health , April , 95 , — Irvine H. Page et al. Circulation, , 23 , —36, , Helen B. Hubert et al. Ahrens, Jr. Times Mag. See, for example, George Bray and B. But the low-fat diet was being challenged by a minority of scientists. Jeremy Greene tells this story in some detail. See Jeremy A. Both Nestle and Taubes recount this part of the story. The actual product name is SnackWell's. Nestle, Food Politics , 65— See Nestle's ch. Such diets may increase appetite and discourage any weight loss. Times , 5 February , A1, B16; for a related article on the federal dietary guidelines, see Seth S.

Times , 5 February , C1, C8. For Brody's personal health column, see Jane E. Times , 18 June , C1. Jane E. Norton and Co. Times , 13 October , Section 6, 32, column 1. Times , 7 June , Section A, 8, column 5. The study was published in the 7 July issue of J. Wilson et al. Times , 11 October , Section 4, 8, column 1. Times , 15 November , Section C, 1, column 1. The long copy helps you make the case for those who are less easy to persuade, and will include a couple more CTAs. In the end, the decision will come down to testing. The first step is to create the headline. This is the most important part of your sales page, because if you get it wrong, your visitors will be quick to leave.

These tend to be a little bit longer. Check out our guide to creating high converting headlines for help with this tip. The more descriptive and unique you can get the better. Anyone wondering how to write a sales page that converts has to understand the principle of features vs. Your visitors care more about what your product or service will do for them, than they do about all its fancy attributes.

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Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)
Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)
Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)
Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)
Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)
Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)
Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points) Dieting by Design: Inspiration, Encouragement, and Proven Strategies (Turning Points)

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