including not providing adequate ironand calcium
needed for a healthy diet.
Other critics of the Cleveland Clinic diet note its
association with yo-yo dieting orweight cycling. Yo-
yo dieting is a phrase coined in the early 1980s by Kelly
Brownell, anobesityspecialist at Yale University, to
describe a repetitive pattern of weight loss and regain-
ing in which the dieter’s weight goes up and down like
a yo-yo. The weight cycle may be as small as 5–10 lb
(2–5 kg) or as large as 50 lb (22 kg). Weight cycling is
no longer thought to affectmetabolismbut it does
appear to increase a dieter’s risk ofgallstones, high
cholesterol levels, and high blood pressure. Therefore,
it is healthier to lose weight slowly through lifestyle
changes (including more exercise) and keep it off than
to use fad diets like the Cleveland Clinic diet as part of
a weight cycling pattern.Resources
BOOKS
Christopher, John R.Dr. Christopher’s Three-Day Cleansing
Program and Mucusless Diet, Rev. ed. Springville, UT:
Christopher Publications, 1978.
Perricone, Nicholas, MD.The Perricone Weight-Loss Diet:
A Simple 3-Part Plan to Lose the Fat, the Wrinkles, and
the Years. New York: Ballantine Books, 2005.
PERIODICALS
Brownell, Kelly B. ‘‘The Central Role of Lifestyle Change in
Long-term Weight Management.’’Clinical Cornerstone
2 (1999): 43–51.
Judge, B. S., and B. H. Eisenga. ‘‘Disorders of Fuel Metab-
olism: Medical Complications Associated with Starva-
tion, Eating Disorders, Dietary Fads, and
Supplements.’’Emergency Medicine Clinics of North
America23 (August 2005): 789–813.
Katz, D. L. ‘‘Pandemic Obesity and the Contagion of
Nutritional Nonsense.’’Public Health Review31 (2003):
33–44.
Roberts, D. C. ‘‘Quick Weight Loss: Sorting Fad from Fact.’’
Medical Journal of Australia175 (December 3–17, 2001):
637–640.
van den Berg P., D. Neumark-Sztainer, P. J. Hannan, and
J. Haines. ‘‘Is Dieting Advice from Magazines Helpful
or Harmful? Five-Year Associations with Weight-
Control Behaviors and Psychological Outcomes in
Adolescents.’’Pediatrics119 (January 2007): 30–37.
OTHER
Cleveland Clinic Diet. Cleveland Clinic. 2007. [cited May 2,
2007].<http://cms.clevelandclinic.org/
body.cfm?id=606>.
‘‘‘Heart Diet’ Not Affiliated with Hospital, Potentially
Harmful’’.Dear Doctor Column. University of Ala-
bama at Birmingham (UAB) Health System. December
8, 2003. [cited May 2, 2007].<http://www.health.uab
.edu/>.‘‘‘The OSHU Diet’—NOT from OSHU.’’ Ed. Cindy Fran-
cois.Lipid Clinic News. Oregon Health & Science Uni-
versity. 18, no. 1 (March 2003). [cited May 2, 2007].
<http://www.ohsuhealth.com/news/lipid/articles/lipid
_news1.cfm>.
Phony American Heart Association Diets: Seeking the AHA
3-Day, 7-Day, or Cabbage Soup Diet?American Heart
Association (AHA). [cited May 2, 2007].<http://www
.americanheart.org/presenter.jhtml?identifier=507>.
Zelman, Kathleen M., RD, MPH. ‘‘The 3 Day Diet.’’
WebMD. February 8, 2007. [cited May 2, 2007].<http://
http://www.webmd.com/diet/features/the-3-day-diet>.
ORGANIZATIONS
American Dietetic Association (ADA). 120 South Riverside
Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone:
(800): 877-1600. Website:<http://www.eatright.org>.
Cleveland Clinic. 9500 Euclid Avenue, Cleveland, OH- Telephone: (216) 444-2200. Website:http://
[http://www.clevelandclinic.org/.](http://www.clevelandclinic.org/>.)
Dietitians of Canada/Les die ́te ́tistes du Canada (DC). 480
University Avenue, Suite 604, Toronto, Ontario, Can-
ada M5G 1V2. Telephone: (416) 596-0857. Website:
http://www.dietitians.ca.
Partnership for Healthy Weight Management (PHWM),
c/o Federal Trade Commission (FTC), Bureau of Con-
sumer Protection. 601 Pennsylvania Avenue, NW,
Room 4302, Washington, DC. 20580. Website:http://
[http://www.consumer.gov/weightloss/.](http://www.consumer.gov/weightloss/>.)
Rudd Center for Food Policy and Obesity. 309 Edwards
Street, Yale University, New Haven, CT 06520-8369.
Telephone: (203) 432-6700. Website:http://www.
yaleruddcenter.org/home.aspx.
Rebecca J. Frey, PhDCobalaminseeVitamin B 12
Constipation
Definition
Constipation is a symptom characterized by either
having fewer than three bowel movements a week or
having difficulty passing stools that are often hard,
small, and dry.Description
Food in the process of being digested moves through
the intestines in as a slurry or watery mush. In the small
intestine, nutrients are absorbed from this material. After
most of the nutrients have been absorbed, the material
passes into the colon, or large intestine. Here much of
the water in the slurry is absorbed back into theConstipation