Tag Archives: diet

The Best Diet Part III

Welcome to the final installment of the best diet series. If you missed them, read part I and part II before moving onto this part. In this part, I will lay out the most important factors when considering which ‘diet’ to undergo. 

WHAT A SUCCESSFUL DIET REALLY MEANS

As you should know by now, there is no such thing as a ‘perfect’ diet. Not a single eating plan can possibly cover all of the possibilities and preferences of each person. On the other hand, there may be a ‘perfect’ diet for you at a certain time in your life/career. The key is to make sure it works for as long as you want it to. Of course, you will know if a diet works for you based on physiological and psychological assessments. Once you reach a goal, it will be time to either re-evaluate whether you should stick to the said diet or move on to bigger things.

To move towards finding the right eating plan for you there are a few general caveats to know if you want to to translate what the mountain of research has come up with. Each of the below points should be considered guiding principles when evaluating whether you would have success on a specific diet.

  1. It’s healthful. In other words, a good diet will make you look at what you’re eating. Remember the Twinkie Diet above? If your main goal is weight-loss, you can eat 800 calories of junk food per day and lose weight. In the respect, it works. However, it’s not enough to just control calories anymore. You can lose weight eating Twinkies all day, but how sustainable is that for your health? Diet quality matters, especially if you want to promote health and keep off any weight you lost.

 

  1. It’s individualized. A good diet should take into consideration your metabolic condition and lifestyle. In other words, a good diet should take into consideration your diabetes or high-level athletics. Diets should not be cookie-cutter. There is no such thing as a one-size fits all diet, although there may be slight variations between you and the next person. If you’re diabetic, it would make very little sense to eat the same way as a healthy, lean, and active person. Additionally, what type of activity are you doing? Are you an endurance runner, a weight-lifter, a sprinter, a dancer, or a coach potato? Certain sports necessitate more or less of nutrients for optimal performance.

 

  1. It’s fulfilling. A good diet should fulfill your body’s requirements for protein, fats, and carbohydrates without overfeeding you (unless your goal is to become a larger version). By keeping in mind that proteins and fats are more satiating than carbohydrates, you can then construct a weight-loss plan that can control hunger better while improving nutrient intake. In fact, carbohydrates are not technically necessary since the body can create it through an indigenous process, but it’s fulfilling because carbohydrates are required to optimize metabolic function and hedonism. And if you’re an athlete, carbohydrates are indispensable for optimal performance and body composition.

 

  1. It’s sustainable. Research shows that over 90% of people cannot stick to a diet for more than two years. I surmise this is probably because most people don’t know how to choose what diet is best for them and how to adjust a diet based on their preferences. Not knowing how to transition explains in large part why high-level athletes become fat and sick once they become working members of society. This is also a huge problem for high-school athletes going into college — ever heard of the Freshman-15? If Michael Phelps were to stop swimming but maintained his monstrous in-season training caloric intake, his ability to float would surpass his ability to swim in the blink of an Olympic second.

 

This last point is especially important in light of health-promoting diets. If you can’t stick to a diet, then it’s no good. If you go on a diet and lose 10% of your excess fat mass but gain it all back in two years, you’re no better at the finish than you were at the start. Think Biggest Loser. Somewhere there are reports of the contestants developing eating disorders and tipping the scales even more than when they started the show.

Having the “best” diet yet not sticking to it is like having a Bentley collecting dust in your garage. It’s nice to talk about and show people you have this “awesome” thing you can always turn to, but if you’re not going to use it to make yourself a better person, then it’s useless.

Please, don’t let this car collect dust. Source

Mediterranean, Paleo, vegan, Weight Watchers, low-carbohydrate, DASH, or any of the other slick Amazon best-sellers will help you become healthier and leaner. But underneath the veil of the fancy names and acronyms, most successful diets have the above things in common.

SO AGAIN, WHAT IS THE BEST DIET? USE THIS ANSWER.

It depends—whatever is working right now for whatever goals I have, and I should be able to stick to it”. It all boils down to context-dependent effectiveness and preference. Anything outside of that is just minor detail.

The answer probably is not as pretty as a dozen roses, but it’s the truth. You can force-feed yourself a diet you don’t like to lose the extra fat on your left eyelid, but what happens after you meet your goal? Are you going to stick to the diet? Do you know how to eat afterward? Do you know how to eat if you have a medical condition? Do these questions seem like a bunch of pester to you compared to what you should Tweet or tag on Facebook? Making dietary changes is a lifelong process, but it’s one that brings highly coveted awards. Stick with it.

As always I appreciate feedback, comments, and input. What is your perception of a good diet?

The Best Diet Part II

This is part two of a three part series on what the best diet is. In part I, I briefly went over the major dietary variants found in research and rattled off some of the research in support of them. Despite each diet having their own set of benefits–with many overlapping each other–they’re all running for ‘best diet candidacy’. In this part, I will go over a few general factors that determine whether one diet will work better than another. 

THE OMNIPOTENT CONNECTION—LIFESTYLE AND PREFERENCES

I hope all of this is connecting. If each diet has the potential to be the best, then it doesn’t matter which diet you’re on, right? That’s half true. In each study, you will have people who do not respond as well as others, because of… individual differences. Results of studies are averages and do not explain in full why some people saw better results than others. If that is the case, then it might be better for you to look at these studies, figure out which diet may suit your condition better, and experiment. That is probably the way to go. To boot, there are very smart doctors and researchers who also agree that the best diet for you is the one that fits your lifestyle and metabolic condition.

Yes, in the realm of nutrition, you are a special snowflake. Source

Indeed, large-scale experimental, observational, and free-living studies have been conducted comparing diets with differing macronutrients to each other. Although many of the studies above show that one diet may be superior to another, there also exists research showing that differing macronutrient composition may not matter depending on the situation. One such situation is weight-loss. In light of this statement, it is sound logic to re-consider the previous theory if there is a refuting scientific result.

Back in 2007, Gardner et al published a study that would send ripples through the wide ocean of diet research. They showed that the Atkins (low-carbohydrate) diet resulted in more weight loss and more favorable blood lipids than the Ornish (vegetarian, low-fat), ZONE (balanced, mixed), or LEARN (lifestyle-based, low-fat, mixed) diets. Even at 12 months, the Atkins diet held steady. Two elephants in the room here: 1) mean weight loss between Atkins and the second best diet was 4 pounds (not a whole lot in the grand scheme of things); and 2) at two years, participants in each of the four groups saw non-statistically significant differences. In other words, the Atkins diet was no longer more effective than the other three diets at two years (Gardner, 2007). What does this tell us?

Sustainability is the ultimate trump card. It’s the deciding factor between “(weight) losers” and losers. And it’s also the one thing that will keep the results coming like rain during monsoon season in Thailand. It can be what makes any diet the best.

One of the most cited studies comparing of the effects of different diets on weight loss was published in the New England Journal of Medicine in 2009. They concluded:

Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.” (Sacks, 2009)

Here is another study from the well-known and respected Journal of the American Medical Association. The authors summed up their findings as such:

Significant weight loss was observed with any low-carbohydrate or low-fat dietWeight loss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.” (Johnston, 2014)

And in another study published in PLoS One, Naude et al concluded that:

“Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets.” (Naude, 2014)

Finally, Foreyt et al put their conclusion rather nicely:

“Although “a calorie is a calorie” under the controlled conditions of a metabolic unit (i.e., only the level of calorie intake matters and not the source of calories), we conclude that these interrelationships are far more complex in the free-living situation. The different diet-related factors that condition energy balance, including total energy intake, satiety and hunger sensory triggers, and palatability, must be considered when assessing the efficacy of weight-reducing diets of different macronutrient composition.” (Foreyt, 2009)

In terms of weight-loss, the evidence is stacking in favor of a simple message: as long as you stick to a reduced-energy, weight-loss focused diet where you won’t feel like killing yourself, the dietary composition of carbohydrate, protein, or fat really don’t matter.

The above bolded statement literally means you can eat Twinkies all day and lose weight as long as you’re in a calorie deficit. But let’s get a couple of things straight, it doesn’t take a nutrition researcher to know that this won’t do any favors for your health. And if your health begins to decline, then losing weight is nothing but an afterthought in the wake of suboptimal performance in daily life, metabolism decline, and horrible quality of life.

Unless of course you’re like this. Source

What applies to weight-loss also applies to other goals. Subjects in these weight-loss studies volunteered and signed up because their goal was probably to lose weight. What about if you want to gain weight? Same story here—to gain weight, you must be in a caloric surplus regardless of macronutrient composition. For the purpose of this post, this is as simple as it gets.

What about performance? Simply put, it probably doesn’t matter, either… at least not until you become an elite athlete. At that point, you will probably have to fine tune things. No one has done a case study on him, but I highly doubt Michael Phelps eats like a normal human being. He probably eats like ten normal human beings.

After all, eating food does not just serve to keep you alive, but also to make you thrive. Don’t put low-octane gas into a high-octane car.

THE METABOLIC CONDITION CONNECTION

On the other hand, this may not apply if you have a certain medical condition that precludes the weight-loss. Like lifestyle preferences, metabolic, or medical, conditions are something that must be heavily considered when following a diet. Food can be an awfully powerful drug that if abused can lead to undesirable consequences. This is why Hippocrates, the founder of Western medicine, said,

Source

For instance, your risk of becoming diabetic is increased exponentially if you’re obese, and as much as losing weight greatly benefits diabetes management, the effectiveness of the diet can be determined by the macronutrient content. In the particular case of diabetes, losing weight is extremely helpful, but research on this front shows that low-carbohydrate diets outperform all others consistently in terms of glycemic control and lead to better weight loss than low-fat diets because of that glycemic control. Additionally, Feinman et al showed in their massive review that lower-carbohydrate diets are the most effective in terms of rates of diabetes remission and cessation of diabetes medications (Feinman, 2015).

There are other medical conditions that are affected by nutritional modulation. Non-alcoholic fatty liver disease, cardiovascular disease—high triglycerides, hypertension, suboptimal cholesterol levels—renal disease, and inflammatory bowel diseases represent just a small handful of disorders that is influenced by nutrition. Undertaking medical nutrition therapy on your own is ill-advised, so seeking out the help of someone who is licensed to proctor this type of stuff to tailor an eating plan based on lifestyle preferences, goals, and medical conditions is the best bet.

Stay tuned for the next and final installment of this series.

As always, I value your opinion. What kind of diet best suits you? How long have you been on your favorite diet?

The Best Diet Part I

This post will be part one of a three part post series going over the controversy of the ‘best’ diet. 

You make more than 200 decisions in a day—which phone to buy, where to go for vacation, who to date. Obviously these are questions that require tons of deliberation. The general quality of your life is often determined by questions that seemingly have little significance but carry a huge consequence. How about another question that we always ask ourselves, one that has the capability to have an enormous impact or none at all?

“What is the best diet?”

Again, right? Source

Of the hundreds of decisions you make per day, approximately 226 decisions will be about food (Wansink). Due to the propensity of food decisions in your daily lives, it goes to say that such a question is riddled with endless loopholes, criticism, lies, and truth. It’s talked about so commonly that you can just shrug it off, but the importance is scarily deceiving. Most importantly, the significance of this question lies within the context of the person asking it, because certainly, the idea that a perfect diet exists to fit everyone’s wants and needs may be nothing but a false truth.

And if you work in a field that is intricately involved with human health, disease, and nutrition—like a Registered Dietitian (RD)—it’s the worst possible question.  Dealing with a question that is entangled in a web of this and that is difficult enough to write in a blog post, imagine trying to explain it to a person who has no clue. RDs deal with not luxuries people think about once every few years like buying a house or car, but a commodity, and their responses directly affect those 226 daily food decisions people make. And because this question has been asked so many times and approached in so many different ways, the significance of it is slowly beginning to lose out to the myriad of options available in the mainstream.

Wrapped up nicely with the “what is the best diet” are a couple of other multi-faceted questions that you probably want answers for sooner than your birthday.

What are the best foods to eat?”

What’s the best way to do [insert goal here]?”

So on and so forth. The best diet would be the best present ever. Although it makes sense that there is no one best diet and no one best food, these questions cannot be proven through science. If it could, then scientists would still not be spending hundreds of man hours and thousands of research grant dollars trying to figure out what the optimal diet is. Fortunately, science does shed light on the path you should take to achieve good health through diet.

For your next birthday. Source

THE MAZE OF DIETS

Follow any large media outlet and you’ll be sure to read, hear, or smell reports and journalists talking about whether you should “slash carbs to carve a sleek and sexy six-pack” or “drop pounds by dropping fat” or “eat like a caveman and look like one” (uh, do you actually want to look like this?). So much conflicting information, so little time—who to listen to?

Image result for caveman

It’s the grass-fed, organic, free-range, non-GMO, pastured limestone that helps him maintain perfect white teeth (source)

Outside of the lab, many camps have laid claim to a best diet, but no one seems to agree with each other fully. One study will come out today that refutes yesterday’s study on the same diet. On the vast intranet, you have various nutrition experts and armchair gurus going to war on their keyboards espousing their preferred diet without tickling the thought that their diet may not actually be the best. The devil is in the details, so asking a layperson to read a full article and understand the meaning of those details is like asking a dolphin to walk on land—it’s not going to happen. That’s why there’s the media to help, except they really don’t. Your best bet is to look for someone who actually reads and keeps up with the literature—say a doctor or an RD. Luckily, I do enjoy a good read and turning the knowledge of science into application is a passion of mine. Very basically, let me answer the almighty question, “which is the best diet”. And it is… <drum roll>

The Mediterranean diet.

A low-carbohydrate diet.

A vegetarian (or vegan) diet.

The Dietary Approaches to Stop Hypertension (DASH) program.

The Paleo diet.

Weight Watchers

… Hold the phone! Didn’t I just say that I would tell you what the best diet is? Why, yes, I did, and I did. I know that best is a term to denote a singular thing that is superior to all others in its respective category, but read on to find out why everything can be the best.

LET THE RESEARCH SPEAK

The topic of what diet is best is probably one of the hottest in nutrition research and a new study (and book) is published just as quickly as a baby is born. According to the research, it’s fine to contradict myself. Why? Because each diet is the best. Before we move onto why each diet can be the best, let’s look at very briefly what some of the recent research actually has to say in favor of the major dietary regimes and their spin-offs:

The Mediterranean Diet—one of the “children” from a combination of research and observation, the Mediterranean diet seeks to reflect the dietary habits of some of the healthiest people in the world. Unlike most dietary programs, the Mediterranean diet is one of the few scientifically studied that attempts to mimic what is actually consumed in observation. Specifically, the Mediterranean diet emphasizes fish, nuts, legumes, fruits, vegetables, and low glycemic carbohydrate sources. In the literature, a Mediterranean diet is similar to a moderate carbohydrate diet, about 40%. Some benefits:

  • Increased life span (Crous-Bou, 2014)
  • Decreased weight and obesity (Sayon-Orea, 2014; Huo 2014; Thomas 2007)
  • Improved non-alcoholic fatty liver disease (Zivkovic, 2007)
  • Improved hemoglobin A1c and other diabetes markers (Carter, 2014; Huo, 2014; Esposito, 2014)
  • Improved blood lipid panel (Huo, 2014; Richard 2014; Thomas, 2007)
  • Decreased risk of certain cancers (Whalen, 2014)

Low-carbohydrate diet—popularized mainstream by Robert Atkins, MD, this dietary protocol has really been in practice throughout mankind’s history. There are various societies that consume low daily carbohydrates, such as the Inuits. Because of carbohydrate’s ability to affect various health markers such as blood sugars, it is being more commonly manipulated, and with good results. Low carbohydrate diets can be characterized in the literature as anything under 40% and as low as 5% of total calories.

  • Improved satiety (Gibson, 2015; Erlanson-Albertsson, 2005)
  • Significant weight loss, even against FDA approved weight loss drugs (Yancy 2010; Yancy, 2004; Sharman, 2004; Bertoli, 2014; Tay 2008)
  • Improved blood lipid panels, especially in those with high triglycerides (Yancy, 2004; Thomson, 2010; Sharman 2004; Volek, 2008)
  • Improved diabetes markers, especially in those with compromised insulin sensitivity (Samaha, 2007; Feinman, 2015; Arora, 2005)
  • Decreased inflammation and tumor growth (especially in response to ketogenic diets)(Ho, 2014; Klement, 2011)

Low-fat diets—programs such as Dietary Approach to Stop Hypertension are those purported to improve blood lipids under the premise that saturated fat and cholesterol increase risk of heart disease and blood pressure. There is extensive evidence that free-living populations do follow a somewhat lower-fat diet and this can also include those who are vegetarian. Asian populations typically consume a diet lower in fat, for example. Fat content is usually below 30% and carbohydrates are higher, above 50%.

  • Decreased weight and obesity (Astrup, 2000; Astrup 2002; Hooper, 2012; Mueller-Cunningham, 2003; Tay, 2008)
  • Improved diabetes markers (Yokoyama, 2014)
  • Improved cardiovascular health, such as blood pressure and blood lipids (Yokoyama, 2014; Shridhar, 2014; Famodu, 1998; Nosova, 2015)
  • Improved inflammatory markers (Turner-McGrievy, 2014; Egert, 2014)
  • Improved non-alcoholic fatty liver disease (Ma, 2015)
  • Decreased risk of certain cancers (Fung, 2010)

Paleolithic diets—the attempt to emulate how our hunter-gatherer ancestors ate. “Paleo” diets have gained an immense surge of popularity since the late 1970’s when a seminal paper was produced citing anthropological data that our hunter-gatherer ancestors ate quite differently than how we are currently eating. Supporters of this program propose that by eating lean meats, vegetables, fruits, nuts, and seeds, and excluding dairy, legumes, wheat, and grains, we will see a boost in our health and performance because we will be eating concomitantly with our genetic makeup. Research does not give a clear macronutrient breakdown of a paleo diet, only that the program fits within the framework of the paleo principles mentioned above.

  • Improves weight loss and obesity (Boers, 2014; Mellberg, 2014)
  • Improves satiety (Jonsson, 2013; Jonsson, 2010)
  • Decreases risk of certain cancers (Whalen, 2014)
  • Improves cardiovascular risk factors (Jonsson, 2009; Klonoff, 2009)
  • Improves diabetes markers (Frassetto, 2009; Klonoff, 2009)
  • Improves metabolic syndrome characteristics (Boers, 2014; Lindeberg, 2012)

“THE RESEARCH HAS SPOKEN… AND I’M STILL CONFUSED”

The above is just a small handful of proposed health benefits of each diet. There are seriously hundreds of thousands of studies on each diet and their derivatives; it’s no wonder the average person has no clue where to start when it comes to which diet they should follow. I also refrained from going into the demerits of each diet because I do not want this post to be the length of half a book. Despite the small list, do you see a pattern? Here is the bottom line and the answer you have been waiting for:

Any diet will work. Any diet has the potential to be the “best diet”. And not surprisingly, each eating pattern overlaps with one another in some aspect of health, whether it’s improving diabetes, cardiovascular disease, or weight. The researchers in each study were looking at a particular end point, because frankly, it will be nearly impossible to study how each food affects each health biomarker, especially in context of individual differences. Nonetheless, each diet possessed the ability to improve health to a statistically significant degree.

Stay tuned to read how to connect the ‘best’ diet to your situation.

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