Csiro Total Wellbeing Diet

The CSIRO total wellbeing diet (TWD) is a high-protein, low-fat, moderate-carbohydrate weight-loss and maintenance diet developed by Australia's national science agency, the Commonwealth Scientific and Industrial Research Organization (CSIRO). It is a very structured, calorie-controlled, and nutritionally balanced diet that includes exercise and large amounts of protein from meat, fish, and poultry.

The TWD was developed by CSIRO researchers at its Clinical Research Unit in Adelaide, South Australia. The CSIRO research was initiated in response to a large number of inquiries from dietitians concerning popular high-protein diets, whose use did not appear to be supported by scientific evidence. Previous CSIRO research had suggested that high-protein, low-fat diets were at least as effective for weight loss as high-carbohydrate, low-fat diets.

In research partially funded by Meat and Livestock Australia and Dairy Australia, the CSIRO team, led by Dr. Manny Noakes, developed the TWD for women who are overweight or obese. Dr. Grant Brinkworth was the exercise/nutrition physiologist on the team. The TWD was the culmination of eight years of research on diet composition, weight loss, and risks for developing diabetes and heart disease, conducted at CSIRO's Human Nutrition Clinic. In initial clinical studies the researchers claimed to have found clear health benefits and significant weight loss associated with their high-protein, low-fat diet. They further claimed that clinical studies showed the diet to be superior to a high-carbohydrate, low-fat diet with identical caloric intake, at least in a subset of women.

Meat and Livestock Australia distributed a booklet about the CSIRO diet in a women's magazine. The publisher Penguin then commissioned Noakes and Dr. Peter Clifton, director of the CSIRO Nutrition Clinic, to write the book The CSIRO Total Wellbeing Diet. It was a runaway bestseller in Australia upon its publication in 2005. A sequel was published in 2006.

The key components of the TWD are:

With the exception of its emphasis on meat, the TWD recommendations follow standard nutritional guidelines. The diet offers a variety of healthy food choices, including large amounts of fruits and vegetables, along with moderate exercise.

The basic daily TWD consists of:

The TWD has four different diet levels, which are designed to cover the varying energy requirements of the majority of people. Level 1 is approximately 1,337 calories (5,600 kilojoules) per day. Levels 3 and 4 have higher allowances of lean protein, low-fat dairy, and high-fiber cereal. Before choosing a level, CSIRO recommends that people calculate their basal metabolic rate (BMR), which is based on height, weight, age, and gender. The Harris-Benedict Equation then uses the BMR and a factor based on a person's activity level to determine daily energy expenditure in calories or kilojoules.

In general, the level 1 and 2 plans are suitable for women and the level 3 and 4 plans are suitable for men, who tend to be taller and heavier than women. A basic daily TWD for men consists of:

The TWD calls for a high amount of lean protein to prevent hunger. For dinner, the TWD recommends 28 oz. (800 g) raw weight of red meat per week or an average of 4 oz. (110 g) per day, as well as at least 14 oz. (400 g) of fish per week, or 2 oz. (56 g) per day, and 7 oz. (200 g) per week of skinless chicken with the fat removed. The diet calls for another 3.5 oz. (100 g) of protein for lunch, based on the cooked weight of processed meat, chicken, or tuna.

An extra serving of dairy can be substituted for 1.7 oz. (50 g) of protein at lunch. One dairy serving is:

The TWD contains moderate amounts of slow-releasing carbohydrates that are necessary for energy and maintaining blood glucose levels. These carbohydrates, primarily fruit and dairy, tend to have a low glycemic index (GI). They are digested slowly and help to keep blood glucose levels steady. Since total carbohydrate is limited to 40% of the total calories or kilojoules in the diet, the TWD has a low glycemic load (GL).

Fruits are limited to 11 oz. (300 g) per day, as two servings of unsweetened fresh or canned fruit (5.3 oz., 150 g) or unsweetened juice (5 oz., 150 mL). Equal amounts of dried or frozen fruit, vegetables, or unsweetened vegetable juice (5 oz., 150 mL) may be substituted for one serving of a fruit or vegetable.

Simple sugars and refined carbohydrates are not recommended. Sugar or honey as sweeteners can be used only in small amounts. Small amounts of sweeteners or thickeners can be used occasionally in cooking. One level teaspoon (4.9 mL) of sugar is equivalent to 10–14 calories (40–60 kilojoules).

The TWD recommends that the daily fat allowance be consumed as:

Two teaspoons (9.9 mL) of light margarine is equal to 1 tsp. (4.9 mL) of oil. Three teaspoons (14.8 g) of oil is equivalent to 2 oz. (56 g) of avocado or 0.7 oz. (20 g) of nuts.

Allowable snacks include:

The level 1 TWD allows for two glasses (10 oz., 300 mL) of wine or about 205 calories (860 kilojoules) per week. Equivalent amounts of other alcohol or treats, such as 1.5 oz. (40 g) of chocolate, may be substituted. It is suggested that alcohol consumption be kept to a minimum during the first few weeks of the diet because alcohol can increase the appetite. Presuming that other medical conditions do not limit the acceptable alcohol intake, other TWD levels and the maintenance diet allow for increased amounts. However, alcohol intake should not exceed the recommended two standard drinks per day for women and four for men.

The TWD includes a “free” food list with minimal calories. Diet or low-calorie soups are an optional daily extra. Packet soups containing about 38 calories (160 kilojoules) per serving or vegetable soups made from the “free” list are appropriate daily. The TWD includes an average of 2-2.5 c. (.47-.59 L) of vegetables, or about 14 oz. (400 g), per day. Since vegetables tend to be very low in calories, eating more vegetables is acceptable and many vegetables are included in the “free” list.

Foods that can be consumed as desired include:

Allowable diet adjustments include swapping the mid-day and evening meals or distributing the diet components differently over the course of the day. However, the quantities and total intake should be the same each day. Other lean protein food can be substituted for meat. For example, a dinner might include 3.5 oz. (100 g) of meat, chicken, or fish and a vegetable protein such as 4.5 oz. (130 g) of cooked beans or 3.5 oz. (100 g) of tofu. Eggs are protein foods and one egg can be substituted for 1.7 oz. (50 g) of lean meat, chicken, turkey, ham, pork, fish, or low-fat cheese. Soymilk products or low-lactose milk products may be used for the dairy requirement.

Allowable substitutions within food groups include:

Whole-grain bread should be high in fiber, containing at least.07 oz. (3 g) per serving. Whole grain means that all of the components of the grain—the bran, germ, and endosperm—are present. One of the two daily slices of bread may be replaced with:

A low-fat coffee drink may be substituted for a similar drink such as tea with low-fat milk. Cocoa and herbal tea are on the “free” list.

Vegetarians can substitute cooked beans or lentils (9 oz., 260 g) or tofu (7 oz., 200 g) for meat, chicken, or fish (7 oz., 200 g). One egg can be substituted for 1.7 oz. (50 g) of meat, ham, pork, chicken, turkey, fish, or lowfat cheese. Legumes, including beans, split peas, lentils, and chickpeas, or tofu or other soy products can also be substituted for red meat. Vegetarians can substitute two eggs or 3.5 oz. (100 g) of low-fat cheese for 3.5 oz. (100 g) of the lunch protein requirement.

When choosing from a restaurant menu, the TWD recommends foods that are:

Foods to be avoided include:

The weekly menu plans are repeated until the desired weight loss is achieved and then a maintenance plan is implemented. The maintenance plan is the same as the weekly diet plan with the addition of about 120 calories (500 kilojoules) to the diet, as long as weight is not regained. Each week the following foods can be added back in any order:

Snack choices for the maintenance diet include:

On the maintenance diet the following foods may be exchanged:

The CSIRO Total Wellbeing Diet explains and details the diet and contains over 100 recipes. Book 2 includes some revisions and additions:

Because the TWD diet is high in protein, it tends to satisfy hunger and prevent overeating. Men, in particular, seem to appreciate the amount of meat in this diet. It provides nutrients such as iron, zinc, and calcium that may be minimal on a lower-protein diet. There are additional benefits from a high-protein meat diet:

The TWD can significantly reduce triglycerides and LDL (“bad”) cholesterol. Sustained weight loss, exercise, and moderate alcohol intake can increase HDL (“good”) cholesterol. Therefore, CSIRO researchers believe that the high protein in the TWD may help prevent heart disease and type 2 diabetes. Some experts also consider the TWD superior to other diets because it calls for a fiber intake in excess of.99 oz. (28 g) per day.

The TWD has other advantages:

Dr. Rosemary Stanton, a leading Australian nutritionist, has pointed out that the high amount of red meat in the TWD contradicts the Australian government's own recommendations. Whereas the Australian Guide to Healthy Eating recommends 2–4 oz. (56–112 g) of lean red meat three or four times per week, the TWD prescribes more than twice that amount. Consumers may be confused by these discrepancies. In addition, the trade organization Meat and Livestock Australia provided CSIRO with research funds and heavily promoted the book, suggesting possible conflicts of interest. People who are vegetarian may have a difficult time following the TWD.

The TWD was based on clinical studies of women who are overweight, some of whom had metabolic dysfunction. Therefore, the advantages of the TWD for men and women who are healthy are unclear.

CSIRO claims that the TWD is suitable for women who are pregnant or breastfeeding. However, women who are breastfeeding may need up to 700 extra calories (3,000 extra kilojoules) per day. CSIRO recommends that women who are breastfeeding should start with level 1 or 2 and include three servings of dairy for calcium. Additional bread and fruit can be added to satiate hunger and increase energy. Furthermore, because of the large amount of fish and seafood in the diet, women who are pregnant should check for the types of fish that are safe to eat during pregnancy.

The TWD is suitable for children who are overweight as long as it includes three units of dairy. However, a registered dietitian should adjust the number of calories for the age, size, and activity level of the child.

CSIRO claims that the TWD can be used effectively by people with diabetes, celiac disease (gluten intolerance), fructose intolerance, and irritable bowel syndrome. However, people with diabetes should consult their doctor or a registered dietitian before using the TWD. People with gluten intolerance should choose gluten- or wheat-free substitutes or substitute rice, beans, chickpeas, or lentils for bread. Those with irritable bowel syndrome may substitute a lower-fiber cereal and take psyllium supplements of 1.1 oz. (30 g) per day to obtain adequate fiber. CSIRO recommends that a registered dietitian be consulted if significant adjustments to the diet are required.

The TWD was designed for foods readily available to Australians and assumes the intake of significant amounts of processed foods. It is not suitable for societies and cultures with eating habits that are very different from those of Australians. A high-carbohydrate diet may be better suited to those who prefer to not eat large amounts of protein.

Although many people find it relatively easy to lose weight on high-protein, low-carbohydrate diets during the first few weeks, some people find it difficult to maintain a diet that is high in meat. In addition, some dieters find it difficult to maintain low-carbohydrate diets.

The TWD is based on research conducted by physicians at CSIRO, a highly respected organization. Earlier research had indicated that high-protein diets were at least as good, if not better, for women than high-carbohydrate diets, in terms of weight loss and muscle preservation. By 2007, CSIRO had completed five studies on the TWD, one funded by Meat and Livestock Australia and one by the dairy industry. The other studies were funded by CSIRO. According to CSIRO, their research proves that the TWD:

In the initial CSIRO study, 100 women who were overweight or obese were divided into two groups. One group was placed on a high-protein low-fat diet and the other group on a high-carbohydrate low-fat diet for 12 weeks. The high-protein diet consisted of 34% protein, 20% fat, and 46% carbohydrate. The high-carbohydrate diet consisted of 17% protein, 20% fat, and 63% carbohydrate. The caloric content of each diet was the same. The researchers monitored weight loss, changes in body composition, vitamin-B₁₂ status, bone-turnover markers, and disease-risk factors including LDL cholesterol and triglycerides.

Although on average, the women in each group lost the same amount of weight—18–20 lb. (8–9 kg)— women with high triglyceride levels lost significantly more weight on the high-protein diet. Only women with high triglycerides lost more abdominal fat than the women on the high-carbohydrate diet. The two groups of women did not differ in the other benchmarks that were examined. The researchers did find that more women dropped off the high-carbohydrate diet and that the women appeared to prefer the high-protein diet.

CSIRO was expanding its studies on the TWD to include male volunteers. However, the TWD has not been compared with other alternative diets. In particular, CSIRO has been criticized for not comparing the TWD to a high-protein vegetarian diet or comparing a high-protein vegetarian diet with a high-carbohydrate vegetarian diet. Furthermore, the long-term maintenance of weight loss with the TWD has not been determined.

The CSIRO Total Wellbeing Diet became the number-one bestselling book in Australia when it appeared in 2005. Over 600,000 copies were sold in the first year, making it the fastest-selling book ever in that country. Since the diet is based on research from Australia's leading scientific agency and the books were written by internationally known scientists, many consumers have taken its advice very seriously. The scientific team that performed the research was awarded the 2005 CSIRO Research Achievement Medal. However, the popularity of the diet has been primarily limited to Australia, in part because Australians tend to eat higher amounts of protein, particularly meat.

Many people object to the amount of meat in the TWD from a health standpoint, from a cost standpoint, and because of the environmental consequences of producing large quantities of meat.

See also Celiac disease ; Diabetes mellitus ; Fructose intolerance ; High-protein diet ; Irritable bowel syndrome ; Low-fat diet ; Metabolic syndrome ; Protein ; Triglycerides .