I am at present reviewing 3 new books that explain the principles of popular slimming diets. Today is the turn of the Cura Romana Weight loss Plan by Leslie Kenton, which was released in South Africa last month. According to the cover, this book is "The latest craze to obsess New Yorkers" and promises readers that they will "Lose up to 7 pounds a week", so I have no doubt that South Africans will also stand in line to purchase Ms Kenton’s book.
Wonderfully persuasive writing
Because Leslie Kenton is presented as “an award winning writer, television broadcaster and teacher”, who is “well known for no-nonsense, in-depth reporting”, I settled down to the 369 pages of this book with great anticipation, and I was blown away. I agree wholeheartedly that Ms Kenton is a consummate writer who makes a most persuasive case for using the Cura Romana Weight Loss Plan to lose weight.
obesity. My fervour lasted until mention was made that it is necessary to use human chorionic gonadotrophin (HCG) in the form of injections or as a homoeopathic spray when following this weight loss plan (Kenton, 2011).The author is so convincing and her prose is so beautiful that I passionately wanted to believe that at long last someone had come up with the answer to
Human Growth Hormone (HCG)
My disappointment was great, because years ago, when readers started writing to me about high-protein slimming diets and asked if one of the diets would stimulate the production of HCG and lead to weight loss, I contacted Prof Tessa van der Merwe, one of South Africa’s leading authorities in the field of obesity, for her option. After all, HCG is produced during pregnancy and promotes intra-uterine growth of the foetus. It is also used to treat cryptorchidism in prepubertal boys, hypogonadism secondary to pituitary deficiency in men and as a fertility treatment in women under careful medical supervision (Drugs.com, 2011). Prof Tessa replied: "Dietary measures cannot be used to manipulate growth hormone secretion or it's relationship with insulin." (Van der Merwe, 2008).
A while later one of my readers posted the package insert of the HCG weight loss injections she had been receiving to me, and it was frightening to read, because the injections were under no circumstances intended for weight loss, but were designed for treatment of male fertility problems. Package inserts of HCG specifically state that "HCG not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.”(Drugs.com, 2011).
The further I progressed with this book, the more worried I became. Instructions that individuals wanting to lose weight needed to use an Atkins-type diet providing only 500 kcal per day, and that they may have to continue the high-protein diet for an indefinite period, that users should take 3 gram of vitamin C per day during the initial 500 kcal/day phase (excessive intakes of vit C in tablet-form have been linked to kidney stones) and use 2 types of laxatives (psyllium husk and senna leaves) to prevent constipation, all started the alarm bells ringing.
What does Cura Romana entail?
The 9-week Cura Romana (Roman Cure) Weight loss Plan by Leslie Kenton, very briefly entails the following:
There are 2 stages, namely:
1) HCG + Food Plan (24 days)
2 feast days where patients are encouraged to eat as much as they like of all their favourite foods and commence treatment with HCG (4 homeopathic sprays/day).
The next 22 days combine HCG with a very-low energy, high-protein 500 kcal/day diet (which is intended to reset the body’s metabolism). The diet consists of only 2 meals a day of 100g lean meat or fish with one so-called ‘negative energy’ vegetable, one low-energy fruit and one bread stick per meal, plenty of water and various teas, a dose of psyllium husk (laxative), 3 g of vitamin C, and tea made of senna leaves (laxative). The HCG treatment is stopped on the last 2 days of stage 1.
2) The Consolidation (6 weeks)
In this phase patients no longer use the HCG spray and are encouraged to experiment with other foods to see which foods will cause weight gain and then omit them from their diet. Leslie Kenton says that “the culprits that made you gain weight were not fats or lack of exercise but the carbohydrates you ate - specifically the cereals, grains, starches and sugars.” Thus most individuals who use this book as their guideline to lose weight may end up trying to eat a high-protein diet for very long periods.
Will this diet work?
Anyone who reduces his or her energy intake down to 500 kcal (2100 kJ) per day, will definitely lose weight. And as mentioned last week, eating only very lean protein can suppress the appetite due to ketosis, improve satiety, prevent cravings and cause a diuretic effect (LaRosa et al, 1980).
In the short-term, this should not cause serious problems with deficiencies (such as calcium), although inducing ketosis for 3 weeks without medical supervision may be risky. At least the constipation that often plagues people who use a high-protein diet will be efficiently prevented by the psyllium husk and laxative tea. Patients would therefore, probably lose weight even without taking HCG.
As was the case with the Dukan Diet (Dukan, 2010), I suspect that most people who want to lose weight will not be able to sustain eating only proteins and a few low-energy vegetables and fruits for long periods of time (Foster et al, 2003; Stern et al, 2004).
The ADSA position
The Position Paper on the Atkins Diet published by the Association for Dietetics in SA (ADSA), prohibits me from recommending that anyone should eat only proteins and "negative energy: vegetables for months on end. Other things in this book, such as the use of the hormone HCG against the advice of experts in the treatment of obesity, the high intake of vitamin C (3 g/day) which could cause kidney stones, the use of laxatives which may lead to loss of normal bowel function, and skipping breakfast, are all in direct conflict with the goals of a balanced diet.
If the FDA of America and Canada’s Task Force on the Treatment of Obesity have issued warnings that the use of HCG for weight loss is potentially dangerous and close to malpractice (Kenton, 2011), then no health professional should prescribe this hormone for weight loss.
I am also not comfortable with some of the reasoning in this book. To cite but one example: people are urged not to use any cosmetics, body creams and even washing up liquids that contain animal or plant fat during the first phase of the Cura Romana, as this may stall their weight loss. The diet itself is made up of meat or fish which although lean, still contain animal fat, so I do not understand how some minute quantity of animal fat in 1 ml of hand cream is going to pass through the skin, enter the blood and have a dramatic effect on weight loss.
I can, therefore, also not recommend the use of the Cura Romana Weight loss Plan to my readers, but the quality of the writing in this book is superb.
- (Dr IV van Heerden, DietDoc, April 2011)
(Drugs.com (2011). Pregnyl Package Insert. www.drugs.com/prop/pregnyl/; Dukan, P (2010). The Dukan Diet. Hodder & Stoughton, UK; Foster GD et al (2003). A randomized trial of a low-carbohydrate diet for obesity. New Eng J Med, 348(21):2082-90; Kenton L (2011). The Cura Romana Weightloss Plan. Bantam, Press, London; LaRosa JC et al (1980). Effects of high-protein, low carbohydrate dieting on plasma lipoproteins and body weight. J Am Diet Assoc, 77:264-270; Stern L et al (2004). The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomised trial. Annals of Int Med, 140(10):778-85; Van der Merwe, T (2008).Personal Communication)
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