Doc: Starvation diets are not what the doctor ordered

Dear Dr. Roach: I have a friend who lost weight on a diet designed to speed up metabolism. It seems very complicated and restrictive, and counters a lot of things I always thought to be true about weight loss, including the importance of “calories in/calories out.” Is there any research to support this diet, and do you think it is a realistic lifestyle to maintain?

L.B.

Dear L.B.: I looked through the information on these types of diets, and I found a mixture of advice. Some of it is very good, and some contradicts the best knowledge on weight loss.

Starvation diets are problematic. The body can adapt to starvation by increasing its efficiency, holding on to every calorie. People who have had a lot of weight loss have been found to have this kind of slower metabolism, and that makes regaining weight very easy. But, a few people do well losing weight with intermittent fasting. This underscores what works poorly for some people is absolutely helpful for others.

A recent study showed lower-fat diets and lower-carbohydrate diets are effective in helping people lose weight, when people avoid some of the most dangerous foods: simple sugars and refined grains. By choosing healthier foods and avoiding unhealthy ones, most lost weight without counting calories.

There is no good evidence that certain foods “speed up” the metabolism to make losing weight easier.

Dear Dr. Roach: I’m 61 and had chickenpox as a young child. I also had shingles around age 12, which consisted of a row of blisters following along one of my ribs, from the front to the back, all along my side. This was diagnosed by my family doctor at the time. Should I get the shingles vaccine? Am I more prone to getting it as an older adult? My current family doctor had no opinion.

A.M.

Dear A.M.: You are still at risk for shingles even if you had them in the past. I recommend the new two-dose shingles vaccine, Shingrix, for all people over 50.

Email questions to ToYourGoodHealth@med.cornell.edu.