20/20 Diet

Holland Clinic's "20/20" Diet

Note About the '20/20 Diet' Name: 

I thought '20/20' was a pretty simple name for a diet based on 20 grams or fat and fiber and so I posted this in the early summer of 2013 (see below). The celebrity named 'Dr. Phil' recently (2015) published a book by the same name... They are NOT the same diets.
Mark Holland created the name '20/20 diet' in the summer of 2013

The 20/20 Diet

The "20/20 Diet" is the diet that I often (but not always) recommend for weight loss. I present the basics of it here to help people understand what kind of weight loss I offer. This is not an exhaustive treatment of the diet. That comes at the time of a patient's first visit to our office. But still, this little outline can help you understand where we are "coming from".

The "20-Twenty" Diet is my best effort at a diet that is simple enough to understand quickly, scientific enough to work and easy enough to live with. It's a tall order and I won't pretend that the diet is perfect. But I think that it's pretty good and that it does offer people something better than most: a fighting chance at long-term success. 

The 20/20 diet has two CORE rules:

Eat Less than 20 Grams of Fat Per Day
Eat More than 20 Grams of Fiber Per Day

And a Fair Number of Exceptions and Add-Ons:

"Good fats" (Anti-inflammatory fats like omega-3 fatty acids) are "free". You do NOT have to keep track of their fat grams
Sugars that contain fructose should be limited by common sense to small amounts
Probiotics (yogurt) and "prebiotics" (inulin) should be consumed at least once daily
Never skip breakfast
Eat at least 3 meals per day

And a Behavior Modification Rule:

Weight loss is never about NOT eating when hungry. The reverse is in fact true: weight loss is about eating when you are NOT hungry so that you never GET hungry. It's what I call "pre-emptive eating". 

THAT IS IT... (except of course that the devil is in the details. I'll have a lot more to say about them in-office)


To Learn More About the 20/20 Diet and About WHY is Works, Browse the Pages Below

What About Calories?

They’re covered. When you eat less fat and more fiber you eat fewer calories automatically. You never have to count calories on this diet and because you don’t, you won’t end up feeling deprived.

What About Starchy Carbohydrate?

Very high-glycemic index starches should generally be limited but for most people in a practical sense, starchy carbohydrate can be eating. This makes the diet far more liveable.

What About Sugar?

Sugar is different. Table sugar, high fructose corn syrup, fruit juice, agave syrup and honey all contain fructose and large amounts of fructose may cause weight gain.

Why Does Low Fat Work?

Because fat is calorie dense and easy to absorb. Even pure sugar has less than half the calories of fat. If you don’t eat fat, you can eat more food and get fewer calories at the same time.

Why Does High Fiber Work?

Same reason. Fiber has ZERO calories per gram and it fills you up.

What Food is Rich in Fat?

  •  Many animal products, especially
  • Fatty meats and lard
  • “Whole” dairy like butter, cream, whole milk, cheese and ice cream
  • Oils and shortening
  • Nuts and seeds (but the good news is that they contain so many "good fats" that they are free)
  • Avocados
  • Fried foods
  • Fast food
  • Snack foods like chips

What Foods Have Little or No Fat?

  • Fruits (except avocados)
  • Vegetables
  • Beans and peas (soybeans are medium-fatty)
  • Grains and most breads
  • White chicken and turkey
  • Most fish

What’s the Best Way to Tell How Much Fat is in a Food?

  • “Nutrition Facts” tables found on most food labels are the very best way to know how much fat is in a food.
  • If the food lacks a label, you can use several approaches:
  • Ask: if you’re in a restaurant, most servers know what’s low fat
  • Judge: If it’s fried, greasy, cheesy, creamy or otherwise ‘heavy’, it has a lot of fat. If it’s green or baked, if it’s mostly grains or vegetables, it’s probably OK.
  • Taste: As a last resort, use your sense of taste. If the food leaves a coating on your tongue, tastes ‘oily’ or if it is very creamy of ‘heavy’, you can bet that it has a lot of fat.

What is Dietary Fiber?

Fiber is plant material that we humans cannot digest and which therefore has zero dietary calories. Examples of pure fiber include bran and pectin.

What Food is Rich in Fiber?

  • Unrefined plant products including:
  • Whole grains
  • Fruits
  • Vegetables

What Foods are Fiber Deficient?

  • All animal products
  • “White” grain products like white flour
  • Sugar

Are Fiber Supplements as Good as “Natural” Fibers?

Yes, ounce per ounce, gram per gram they are, BUT most fiber pills and capsules contain less than one gram of fiber so it’s generally easier (and cheaper) to get fiber from foods.

Does Eating Low-Fiber Foods Harm Weight Loss?

No. Not as long as you get the 20 grams of fiber from something every day. 

What is “Soluble Fiber”, Insoluble Fiber, Resistant Starch and Should I care?

  • Soluble fiber dissolves in water. Fruit pectin is an example.
  • Insoluble or “bulk” fiber doesn’t dissolve and bran is a perfect example.
  • Some soluble fibers are “pre-biotic” meaning that they promote the growth of “good bacteria” in the gut. Bulk fibers lack this ability.
  • For purposes of weight loss, you can ignore the differences between soluble and bulk fiber.
  • “Dietary Fiber” listed on food labels reflects ALL the fiber found in a food. In other words, it is bulk fiber PLUS soluble fiber combined.

Frequently Asked Questions About the 20/20 Diet


Question: How fast can I lose on the 20/20 diet?

Answer: 1-2 pounds per week on AVERAGE.


Question: Will I see big water loss at first like people do on low-carb diets?

Answer: Probably not. The water weight from low-carb diets occurs because of something called ketosis. This doesn’t occur on low fat diets.


Question: What happens if I blow it and eat a lot of fat one day?

Answer: You will probably consume more calories and gain a few ounces of fat that you otherwise would have lost. That’s all. You won’t have massive overnight weight gain the way people do if they blow a low-carb diet like Atkins.


Question: What happens if I don’t eat enough fiber?

Answer: You won’t lose weight as fast and you may feel hungrier.


Question: How hard is it to get used to the 20/20 diet?

Answer: Most people find it easy, especially compared to low carb diets. On this diet you can eat like a normal human being.


Question: Are there any side effects to the 20/20 diet?

Answer: You may notice more intestinal gas at first. This is because of the fiber and it won’t last long (maybe 1-2 weeks). Fiber will also increase stool volume a bit and it should help keep you regular. Gallbladder stones are the big risk associated with fat reduction. Please consult the information I have provided about how to minimize gallstone risk.


Question: What are essential fats and will I get enough?

Answer: Essential fatty acids are fats that our bodies need and cannot make. We must get enough of these from our diets or we will become deficient. This CAN be a problem on low fat diets. The best way to prevent deficiency in essential fats is to take a fish oil supplement.


Question: Do I have to do the 20/20 diet to be on this program?

Answer: The 20/20 diet is PART of the Holland Clinic medical weight loss program. No, you are not required to follow the 20/20 diet, but for reasons outlined later, I believe that this is the best diet for most people. Still, you may certainly follow a different diet plan if you like but I do ask that you let me know.

Why This Diet:

The simple answer is because it actually works. Of course you've heard that line before. So here's where the real difference lies: the dietary advice we give patients is based upon the latest SOLID scientific research as published in world-class peer-reviewed bio-medical and nutrition journals.

Below are some of the key features of our diet:
Finally, we have listed some of the things that our diet is NOT
  • NOT a diet
  • No calorie counting
  • No starvation
  • Does NOT cause ketosis
  • Not some fad
  • Not based on theory but on solid evidence
  • Not a crash diet
  • Not temporary but rather is a life-long change
How we Teach Diet:
  1. At your first visit, Dr. Holland will hold a group "class" on our diet. This group will last about

    Visual Cues Play a Big Role Appetite

    Visual cues in medical weight loss

    ninety minutes.
  2. Printed materials
  3. Online. Dr. Holland blogs nearly daily and answers scores of patient emails. If you ever have any questions about our diet, you don't have to call and relay a message, you can speak to him here in real time.