Friday, September 7, 2012

Are you trying a new diet or a new religion?

The other day one of my friends declared on Facebook that he was going to start living this "Paleo lifestyle" that he had heard so much about; he had already started eating the bugs and animals he found in the park and was running around his yard un-showered and unclothed.  I requested that he at least wear a loincloth at our next community outreach event, and then started thinking about the many different diet plans that are out there that start out with good principles and then the people that claim to follow the plan take it off the rails at some point.  I will review three plans in this post and briefly discuss the positive aspects of each plan, where people tend to stray from a healthy plan, and how to avoid going off the rails if you do choose to follow a similar plan.

The Atkin's Diet
The good:

  • Gives an excellent review in lay person terms about hormones such as insulin that play a role in appetite regulation, blood glucose regulation, heart disease, etc.
  •  One of many carb restricted plans that have been validated by evidence as a way to help people with metabolic syndrome/pre-diabetes/Type 2 diabetes lose weight and gain better control of their blood glucose levels and lipid levels (Link)
  •  People do experience an appetite suppression when they are producing ketones—basically when you don't eat carbohydrate and have glucose as a readily available fuel your body will start "breaking down" fat for fuel and ketones are the result.
  • Allows you to have certain kinds fat, which, let's face it, tastes good; fat also provides satiety to prevent overeating.
  •  Makes it easy for you to meet your daily protein requirements.
  •  Vegetable intake is encouraged and so are certain fruits after the first two weeks.
  • Helps people avoid foods empty of nutrition like white bread, pasta, white rice, etc.
  • Exercise is encouraged.

Where I've seen it go bad:

  •  Those who purchased the 1972 edition might not realize that certain fats really are better for us than others.  If they wind up using a lot of seed oils they might go too heavy on the omega-6 which is not so good for preventing inflammation, and there is evidence that eating a lot of deep fried food may influence the development of atherosclerosis (Link).  Those who purchase the latest version may not have the same pitfalls.
  • Some people start spending a lot of money on "low carb" substitutes and their shopping cart is full of "low carb" bagels, tortillas, pasta, brownies, meal replacement bars, chocolate sauce, etc.  These items are often high in cost but low in nutrition as far as vitamins and minerals go.  I personally haven't found a lot of the commercially produced items to be very tasty or filling either, but everybody's a little different.
  • Some people seem to think that calories no longer matter when following a plan like this, but that's not true.  You still have to take in fewer calories that what you were before to lose weight.  Granted, the ketosis can help you from consuming extra calories, and there is some evidence that you burn more calories on the low carb plan, but it is still possible to consume too much. (Link)
  • There's a tendency to forget that how much and what type of animal protein you consume has an impact on the environment around you.  Does your consumption support local farms that raise the animals humanely or are you feeding into the factory farm industry?

Avoiding the pitfalls

  • Figure out what substitutes you might actually want to spend money on and which you can do without (or you don't really care for the taste anyway).
  •  Check the calorie and carbohydrate count of any "low carb" foods you might buy against the original product.  Don’t be a victim to advertising and spend more money on something that’s not really that different.
  •  Cook from scratch more to avoid purchasing a lot of processed food.  You will enjoy the taste and the savings a lot more
  • Make sure your substitutes have some nutritional value to them.  Use lettuce leaves for tortillas, cut up zucchini for "spaghetti," use almond flour/chopped nuts to make quiche crusts, etc.
  •  Allow for "the real thing" as a treat every once in a while.
  •  Use pasture-raised butter, coconut oil, avocado oil/avocadoes, olive oil for your fats and avoid the deep fryer.

The Paleo Diet and the Paleo Diet Solution
The good:

  •  Gives a good overview of the role of diet in our evolutionary history.
  • Also gives a good review of various hormones and how they regulate appetite.
  •  Encourages people to intentionally create "scarcity," if you don't have it available then you can't eat it.
  • Encourages people to avoid processed food of all types.
  • Encourages the purchasing of animal protein from humane sources.
  •  Encourages people to cook more from scratch.
  •  Suitable for people with many food intolerances and gastro-intestinal problems.
  • Exercise is an integral part of the plan.

Where I've seen it go bad:

  • Tendency to fall for "ancient wisdom" fallacies (more details at Rationalwiki).  Paleolithic people did not evolve TO eat their diet; they evolved BECAUSE of their diet.  They ate what was around them (opportunistic omnivores) and what was around them was plant matter, insects, and animals.   They had no "special wisdom" about what to eat and not to eat (although plenty of myths later evolved around this later).  I've also seen some practitioners advocating other forms of woo such as acupuncture, use of "chew sticks" for cleaning teeth (which can cause unnecessary abrasions), and even people who claim to heal cavities using certain foods.
  • Yes, there is money to be made from making a new snack product and labeling it "paleo." I decided to try some "paleo snacks" just to see what they had, and one of the products they had was a brownie made of almond flour, coconut oil, etc that was at least 280 calories.  If you are a competitive athlete you might be able to handle that for a snack, but those of us just exercising to be healthy really couldn't spare that.  If you ate an ounce of nuts you would still get fewer calories.
  • The asking of the question "Is this paleo?" instead of "Is this going to help me meet my health goals?"  Guess what, even your certified humane pork is probably very different than the wild animal a paleolithic person would have eaten.  Your coconut pudding with honey would not have been consumed by a paleo person because there would have been no reason to combine the two, and she certainly wouldn't have eaten that honey on a regular basis either.
  • Some people have not figured out the difference between being skeptical of medicine and being plain old paranoid.  If your doctor wants to put you on a medicine for blood pressure, for example, without talking about lifestyle changes you should be skeptical.  But it also helps to have your tetanus shot up to date if you are going to be out in the woods hunting, and if you have a severe infection you might need to take antibiotics, and herd immunity for your kids is a good thing too!
  •  Even though the consumption of grains and legumes takes up a small part of our evolutionary history, some people have apparently adapted to be able to consume dairy and grains without suffering negative consequences.  As they say over at the evolutionary blog Nothing in Biology Makes Sense:  If we are going to use evolution to justify our dietary choices, why throw out the last 10,000 years of it? (Link)

Avoiding the pitfalls:

  •  Learn more about evolutionary biology and how it relates to our food intake beyond what it is explored in the diet books.  Catching Fire: How Cooking Made us Human ( link) is one good place to start, and Richard Dawkins’ The Greatest Show on Earth ( link) is a general book on evolution that is quite readable.
  •  Keep in mind that natural is not always better, and that just because something was done one way several thousand years ago doesn't mean its ok to do now.
  • Be appreciative of the aspects of modern medicine that have enriched our lives.
  •  Ask "Does this help me meet my health goals?" as opposed to "Is this paleo?"
  • Portion sizes/calories still count.  Sure nuts are included, but it won’t help you if you eat the whole bag at one sitting. Use nut flours sparingly as well.
  • Be very careful of people using "Paleo/Primal" to sell their snacks.  You might wind up with a much higher calorie item than what you thought.
  • Some people do fine with dairy, others don't.  Some people avoid grains most of the time to limit calories but do allow for a treat sometimes, figure out what you personally can handle.

Vegetarian/Vegan Diets
The good:

  •  Encourage the eating of nutrient dense plant foods.
  • Encourages eating a variety of vegetables and usually promotes creative ways to improve them.
  • Encourages humane treatment of animals.
  • Encourages good stewardship of environmental resources.
  • Encourages good stewardship of financial resources.
  • Sometimes encourages the use of unprocessed foods.

Where I've seen it go bad:

  •  Some people eliminate animal foods only, but do not make a point of eating nutrient dense plant foods
  • Some people merely ask "is it vegan?" not "Does this help me meet my health goals?"  See my post about Oreos, which are vegan.
  •  People avoid factory farms, but they buy items "Big Agriculture" has produced and therefore are not good stewards of arable land.
  • Some people purchase a lot of processed meat substitutes made from isolated soy protein or snack foods that are labeled organic.  This is not good stewardship of finances, in my opinion, and you are likely taking in foods that are empty of nutrition.
  • Some people aren't careful with how much carbohydrate they are consuming and this can be problematic if you have diabetes or another insulin resistant problem.
  •  Some people play a weird numbers game which makes some foods look like they contain more of a nutrient than they really do.  One I’ve seen frequently is “broccoli contains more protein per 100 calories than beef,” which is technically true, but you also have to consume about 4 cups of raw broccoli to get the 20-30 grams of protein needed at a meal.

How to avoid the pitfalls:

  • As stated in a previous post, eat your vegetables, avoid processed snack foods and processed meat substitutes as much as possible.
  • Be careful with your portion sizes when it comes to grains and limit added sugars and carbs that are empty of nutrition.
  • By from local farms as much as possible, particularly if they are mixed farms.
  • Ask "Does this help me meet my health goals" as well as "Is it vegan?"
  • Make sure that the food you are eating contains a decent amount of protein for the portion size that you are consuming, in other words, that portion should be the equivalent of 1 ounce of meat.

Other considerations for EVERYBODY!

  • Make sure you are not being, well, annoying.  Do you give advice on what people should eat when they haven't even asked?  Do you walk into someone's home and tell them they are eating the wrong kind of bread or that they shouldn't even eat bread at all without them asking?  Do you complain loudly in the restaurant that there's "nothing" for you to eat?  Do you wonder why you are not invited to parties?  There is nothing wrong with speaking up for yourself (e.g. telling a host ahead of time that you have food allergies), but you can do it in a nice way, and even offer to bring a particular dish that’s “safe” for you.  And if you are reading this blog, you probably have access to the internet, so look up restaurant menus ahead of time and call ahead to ask about ingredients whenever possible.  Maybe people will see you eating a certain way and ask you about it, but if they don’t, as an adult they probably don't want to hear advice they didn't ask for.
  • Listen yourself when you talk about your diet.  Do you back up your claims with evidence?  Or do you sound like an overenthusiastic cult member?  If you sound like the latter, you better do some more research.
  • Keep in mind what's right for you might not exactly fit the bill for someone else.  The person with the hereditary blood disorder is probably eating meat for a reason.   The person who doesn't always buy grass fed beef may not have found a way to budget for the other.  Try not to make any snap judgments before you've walked in that person's shoes.
  • Your new diet probably won't make you live any longer than what your genetics want you to live.  Live healthier, yes, live longer, not necessarily.

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