I’ve devoted many columns to debunking nutrition myths, yet it can feel like a Sisyphean battle. The Internet and popular fad diet books spew forth an endless supply of misconceptions when it comes to nutrition – and no more so than in the domain of weight loss. Every day, I meet patients frustrated at their inability to lose weight despite obediently following diet advice they’ve read online or heard through the grapevine.

Albert Einstein famously defined insanity as “doing the same thing over and over again and expecting different results.” So if you continue to struggle with losing weight despite following the same dietary practices you’ve “heard” are right, you may have been given some bad advice. It can be difficult to unlearn many of the false dogmas you’ve come to internalize as dietary dictates, but the payoff may be worth your efforts.

Bad advice: Start your morning with a low-calorie, high-protein breakfast.

The reality: Your low-calorie, low-carb breakfast is undermining your weight-loss efforts.

You wake up motivated to start the day off right, so you are “really good” at breakfast and choose a super low-calorie option: an egg white omelet with spinach (no toast), an 80-calorie light yogurt or a lone banana. When hunger inevitably sets in by 10 a.m., you push through until lunch and make another “good” choice – like a giant salad. But then it all falls apart. At 3 p.m., you’re raiding the vending machine, foraging through your officemate’s candy jar or pounding coffee to stifle the hunger. By dinnertime, you’re so starving that you can’t control portions, and all you crave is carby rice or pasta dishes. Even though you just ate a big dinner, you still need “something sweet” after dinner, and wind up grazing right up until bedtime.

Why does it all fall apart for you at 3 p.m. and onward? Three words: low blood sugar.

Waking up after an overnight fast, your body has depleted most or all of its temporary carbohydrate stores, so blood sugar is at a low. Denying your body the calories and readily accessible energy (carbs!) it needs to confront its most active time of day produces a deficit. Your body will demand re-payment of this deficit later on in the day – in the form of extreme hunger and intense cravings for carbs that hit you at precisely the time of day your body is least efficient at burning it: at night, in front of the TV.

The advice to eat more at breakfast to help with weight loss sounds counterintuitive, but I’ve found that front-loading their calories and (high-quality) carbs into the first part of the day works wonders for patients in my practice. Interestingly, a recent study tested an extreme version of the “big breakfast” dietary pattern in two groups of overweight women on 1,400-calorie-a-day diets. The group given a hefty 700-calorie breakfast, 500-calorie lunch and 200-calorie dinner lost 2.5 times more weight compared to women whose meal pattern was reversed, with 700-calorie dinners matching the same exact foods as their peers ate for breakfast. The big breakfast eaters also had substantial improvements in their metabolic profile in terms of cholesterol and blood sugar control compared to the big dinner group. This interesting finding may shed some light into the body of evidence that’s found skipping breakfast to be associated with increased risk of obesity compared to regular breakfast eating.

The bottom line: A low-cal breakfast is not “being good.” It’s self-defeating. In my book, anything less than 300 high-quality calories for breakfast isn’t breakfast and probably won’t help you lose weight. Moreover, breakfast is not the time of day to skimp on carbs – dinner is. And it’s far easier to control your choices and portions at dinnertime when you’ve had a substantial and well-balanced breakfast and lunch. At breakfast time, I recommend pairing high-fiber carbs such as fruit, oats, beans, quinoa or whole wheat with high-quality protein from plain yogurt or kefir, eggs, lowfat milk or soymilk, cottage cheese or turkey, and a touch of satiating healthy fat from avocado, seeds or nuts. A good breakfast should hold your hunger at bay for at least a solid three hours.

Bad advice: If you’re overweight and struggling to lose, it may be because you’re not eating enough.



The reality: If you were truly eating “too few” calories, you’d be losing weight.

There is a misguided belief about how the metabolism works wherein many people believe that eating too little can stymie weight loss – or even cause weight gain. Once, a patient of mine shared a suspicion that her weight gain was the result of eating too few calories – and as a result, she had been adding additional snacks in between her typical meals to “keep the metabolism moving.” To this, I bang my head against the wall and say: No, no, no, no and no!

I suspect this pervasive misunderstanding stems from a well-publicized metabolic adjustment to actual starvation. That is, in cases of true and severe food shortage, the body’s metabolism will indeed slow down substantially in order to preserve as much energy as possible – some research suggests the body can reduce its rate of metabolism by as much as 30 to 40 percent. But this phenomenon has been observed in severe cases of prolonged starvation – such as in famines or hunger strikes. (And of course, these people still lose a tremendous amount of weight.) In the case of even a pretty ascetic 1,000- to 1,200-calorie weight loss diet among well-nourished people, there’s little chance you’ll encounter such a metabolic slowdown. The fact is that eating fewer calories than your body requires (called a “hypocaloric” diet) results in weight loss over time in all people, period. If eating fewer calories than the body required resulted in weight stagnation (or even gain!), then people with anorexia wouldn’t lose such dangerous amounts of weight, people on juice fasts wouldn’t shed pounds so quickly, and contestants on the Biggest Loser wouldn’t, well, lose.

Calorie deficits promote weight loss. So assuming you don’t have hormonal imbalances or take medications that promote weight gain, chances are if you’re not losing weight on your “diet,” then you’ve overestimated your calorie needs and are out-eating them. Unless, of course, you’re eating the right number of calories but are skipping breakfast, in which case go back to the beginning of this article and re-read it.

Bad advice: Certain “sugary” fruits and vegetables, such as bananas and carrots, should be avoided on a weight-loss diet.

The reality: All fresh fruits and vegetables have a place in your weight-loss diet, even if you have Type 2 diabetes!

I may not know you personally, but I can say with near certainty that if you are overweight or obese, you didn’t get that way by eating too many carrots or bananas. Or even watermelon or fresh grapes, for that matter. This ridiculous premise is based on a twisted application of the “glycemic index” first popularized by low-carb plans like the South Beach Diet.

The glycemic index measures the effect on blood sugar that a portion of that food with a set amount of carbohydrate has compared to a dose of pure sugar with equal carb content. But its limitation is that it does not take into account the blood sugar effect of typical portion sizes (called the glycemic load) of these foods – let alone the calorie content of these foods, or of the foods one might substitute for them. Is replacing a 90-calorie banana with a processed “low glycemic” energy bar or several handfuls of low-glycemic nuts a better bet for weight loss? All of these factors play into weight management in a dynamic way that the simplistic glycemic index doesn’t capture.

In reality, the vast majority of us consume far too few fruits and vegetables for good health, let alone to achieve a diet whose energy density facilitates a healthy body weight. To exclude two of the most convenient and well-liked fruit and vegetable options as you seek to lose weight amounts to self-sabotage. The nice thing about fresh fruits and vegetables is that they contain anywhere between 80 to 95 percent water, and they’re high in fiber – two things that make them self-limiting. Even if you go to town on some watermelon, a bag of baby carrots or bunch of grapes, you’ll wind up feeling stuffed well before you can do too much caloric damage – in a way that does not hold true for a bag of potato chips.

On a related note, recent research tested whether unlimited intake of fresh fruits had any effect on blood sugar control or weight among people with Type 2 diabetes compared to restricted fruit intake. The authors found that fruit restriction had no impact on blood sugar control, weight or waist circumference compared to high fruit consumption – even though the two groups differed by 2 pieces of fruit daily and no restrictions were placed on the type of fruit allowed. There’s a good reason that Weight Watchers made all fruits and vegetables “free”: People whose diets contain more of them tend to live longer and be leaner and healthier compared to people whose diets contain less of them. So don’t fear the banana or scorn the carrot!