Dr. Guttersen attributes overweight to over-consumption of refined sugars and flours and other “fast-absorbing foods” that displace fruits and vegetables. Her remedy is to eat controlled portions of the fresh, minimally processed whole foods of the healthy Mediterranean diet. Portions are controlled by eating off 7 and 9-inch plates and from 2-cup bowls, covering percentages of the plate with protein foods, grains, fruits, and vegetables. Fatty food portions are also controlled. Allowable foods are numerous, including whole grain products, fruits, vegetables, chicken, lean beef, fish, poultry, pork, veal, low-fat dairy, legumes, eggs, nuts, and wine.

Her “Wave 1” lasts 10 days and is designed to teach portion control and to overcome habitual over-consumption of concentrated sugar, refined flours, and other highly processed foods. Wave 2 includes more variety, adds fruit and wine (optional), fat-free yogurt, and more calories. Both waves include unlimited particular vegetables characterized by high fiber and low calorie-density. In Wave 3—the rest of your life—you eat more fruits and vegetables and continue to avoid fatty meats, fruit juices, potatoes, full-fat dairy, trans fats, saturated fats, sugary sweets, and refined grains. She’s fanatical about avoiding saturated fats.

At first glance, it appears the author puts everyone on the same eating plan, whether a 325-pound ditch-digger or 150-pound desk jockey. However, she allows “bigger men” and very physically active women the option of more snack calories, about 400 daily. Dr. Guttersen never reveals how many calories are on the diet, nor how many should be. A review in Consumer Reports estimated that calories on Sonoma were 1,390 per day. That’s fine for most women, but inadequate for most men. The extra snacks for men, along with unlimited veggies, should get them up to a more reasonable intake.

“Consumer Reports” calls Sonoma an “updated lower-carb diet.” Sonoma may have more protein than the traditional Mediterranean diet, but it is by no means low in carbohydrates.

Dr. Guttersen recommends following her specific thrice-daily meal recipes for Waves 1 and 2, a total of 24 days. But you are free to come up with your own meals based on the approved-foods list and plate percentages. Her meals entail a significant amount of preparation, but the recipes look like they would be worth it.

Since this is a review, I feel obligated to criticize something. So . . . 1. Dr. Guttersen never discusses reasonable goal weights. 2. She doesn’t understand that jogging and biking are aerobic exercises, not strength training. 3. She doesn’t discuss exercise much, although does recommend it and gives good basic advice. 4. She recommends breakfast cereals with at least 8 grams of fiber per serving. These are unpalatable and, fortunately, rare. [Three grams per serving is fine.] 5. Sonoma is not as customizable as I would prefer. 6. Cold-water fatty fish should have made it onto her list of Top Ten Power Foods.

Dr. Guttersen provides an extensive scientific reference section, which is both admirable and helpful. Another feature I love is the pull-out section in the back of the book which summarizes the approved foods and depicts the plates and bowls with food percentages. Pin these to your refrigerator or take to the grocery store. An entire chapter is devoted to common problems of dieters, such as eating at restaurants.

The Sonoma Diet is a masterful application of the Mediterranean diet to weight loss. I congratulate Dr. Guttersen.

-Steve Parker, M.D.

References: ConsumerReports.org in May, 2007, rated seven popular book-based diet plans.