The Complete Scarsdale Medical Diet

Back in the 1970s, the late Herman Tarnower, a family doctor, cardiologist, and founder of the Scarsdale Medical Center, decided to have his weight-loss diet typed up and mimeographed for patients.


Back in the 1970s, the late Herman Tarnower, a family doctor, cardiologist, and founder of the Scarsdale Medical Center, decided to have his weight-loss diet typed up and mimeographed for patients. Turns out his patients passed those copies on to other dieters, and these people gave them to others, until the diet became an international hit. Then, of course, it was time to write a book. First published in 1978, it's still in print today. And not one iota of the diet regimen has changed: It still consists of a rigid two-week, low-calorie regimen that dieters must follow to the letter.

Tarnower contends that conventional diets are too slow and too complicated for most dieters to follow. That may be true, but the reality is that the best way to lose weight, or body fat, is slowly. Limiting food choices does make a diet simpler, but eventually you're going to have to handle the real food world. How long can anyone live only on grapefruit, toast, and black coffee for breakfast? Chances are this extremely low-calorie regimen will leave most people feeling deprived-if not the first day, at least by the end of the first week.





Basic principles:


Forget variety. Tarnower details a precise prescription of protein, fat, and carbohydrate (P-F-C) and translates it into 2 weeks of menus. No substitutions are allowed. The P-F-C mixture is geared to stimulate fat burning and, like the Atkins diet, put the body into a safe state of ketosis. Unlike Atkins, however, Tarnower calls for dieters to eat less fat so that as the body "demands more fat, it pulls it out of the fat storage areas." Once you've lost the weight, you transition to a "Keep Trim" plan.

How the diet works:


You eat what's on the 2-week menus. Period. Then you move to the maintenance regimen, which the book claims is not as restrictive. Huh? The "Keep Trim" diet has a long list of taboos: no sugar, no potatoes, no pasta, no dairy fat, no bread, no desserts. It's also big on don'ts: Don't eat peanut butter; don't cook with butter, margarine, or any kind of fat; don't eat sausage, bologna, salami, or other fatty meats; don't eat more than two slices of bread a day-preferably protein bread, toasted. This is a high-protein, low-carb, low-fat diet. As Tarnower himself states, the numbers balance out to 43 percent protein, 22.5 percent fat, and 34.5 percent carbs.

What you can eat:


Only what's on the menu. Breakfast every day includes half a grapefruit, one slice of toasted protein bread, and black coffee or tea. Lunch on Monday is limited to lean cold cuts, sliced tomatoes, and coffee or tea. Dinner is fish or shellfish, a salad, a slice of protein bread, a grapefruit half, and coffee or tea. You can snack on all the carrots and celery you want.

Does the diet take and keep weight off?


The book cover boasts that you can lose up to 20 pounds in 14 days. There's no clinical data to support this, but Tarnower provides anecdotal snippets from patients. There are also unsolicited testimonials from dieters who say things like, "I have completed 14 days of your diet and lost 14 pounds. This is the first diet that worked for me that isn't ridiculous starvation." Right.

Is the diet healthy?


No. Limited food choices make it unlikely that you'll meet requirements for many nutrients. For example, without milk, it's unlikely that dieters will get enough calcium. Vegetables will provide some fiber and nutrients, but it all depends on how much you choose to eat. A nutritional analysis of the Monday menu, with the addition of two carrots and two stalks of celery, adds up to 610 calories. With lean turkey at lunch and orange roughy at supper, the whole day's diet contains only 4.4 grams of fat-hardly enough to be adequate.

What do the experts say?


"Any strict, rigid plan that limits what a person can and cannot eat will help with weight loss," says Judith Stern, RD, ScD, vice president of the American Obesity Association and longtime nutrition professor at the University of California, Davis. "But these kinds of diets take away variety. The more prescriptive it is, the more boring it becomes. You'll lose weight, but it won't stay off." Registered dietitian Edee Hogan, a nutrition and culinary consultant in Washington D.C., is seeing a resurging interest in Scarsdale. She thinks some dieters thrive on discipline and strict regimens. "I've had a couple of clients follow it," she says. My problem with it is that people go off it. They can't stick to it."

Who should consider the diet?


No one.

Bottom line:


There's no secret fat-burning formula here. This is just an extremely low-calorie diet. Sure, weight will come off, but it will return.
Maureen Callahan, M.S., R.D
Last Updated: April 18, 2008

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