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Fitness, Habits and Lifestyle, Health, Nutritionist Talk

Ditch the All or Nothing Mentality!

Our society has solely been focussing on ‘weight loss’ for a long time now. With the increasing number of individuals buying into the trend of fad diets, it is alarming to see the lengths to which people are willing to go, in order to lose weight. Avoiding carbohydrates, following extremely restrictive diets just before a special occasion, fasting for days together… The list is endless! All this makes me question What is our relationship with food like? Do we look at it as something to nourish us or something that we fear?
This article aims to throw light on our relationship with food. Beyond diets and weight loss, there are several factors that need to be looked at. Scaremongering is very common in the fitness industry and has lead to many of us having a skewed relationship with food.
For instance, When someone is on a ‘diet’ or is looking to change their habits for the better, they automatically assume that the only approach to do so is to be restrictive. This leads to an extremely rigid mentality, which we call ‘dichotomous thinking’. Dichotomous thinking is defined as thinking in terms of binary oppositions such as “good or bad”, “black or white”, or “all or nothing” (1). How does this apply to nutrition? A classic example of this would be ‘clean eating’. ‘Clean eating’ is a trend that has been growing rampantly and involves consumption of whole foods with no inclusion of processed foods. Now, this may look harmless, but invariably this trend has assigned moral values to food. Whole foods are ‘good’ and processed food is ‘bad’. With scant disregard to energy balance, we have assumed that eating ‘clean food’ has the ability to elicit weight loss and has a higher moral value. In contrast, ‘junk food’ is looked upon as inherently ‘bad’ and ‘unclean’. This tends to create fear or anxiety around ‘bad’ foods in the long run. Dichotomous thinking is not only restricted to food, but also weight (acceptable vs unacceptable) and diets (on a diet vs off a diet) (2).
To start with, I’m going to clear one myth that never seems to die in this field. No single food can cause weight loss or weight gain. No single food is inherently ‘good’ or ‘bad’. Assigning moral values to food and weight is problematic. In fact, rigid dietary control is often characterized by dichotomous thinking. Further, those engaging in rigid dietary methods are more likely to report symptoms of eating disorders, mood disturbances, higher anxiety and excessive concern with body size/shape compared to those with flexible dietary strategies (3). This is definitely a cause for concern. In contrast to rigid and restrictive eating patterns, a more flexible approach seems to have a positive effect on behaviours (4).
So how do you change your mindset? While this takes time, if you do have anxiety issues around certain food, the first step would be to stop ‘dieting’. Approach a professional specialising in eating disorders/disordered eating. Your relationship with food is a lot more important than you think. Restrictive eating and dieting only does more damage than good in the long run. Understand that any food in isolation is neither harmful nor beneficial. Some foods happen to be more nutrient dense than their counterparts. This article does not mean to imply that you now have a freeway to load up on cakes and pastries, nor does it say you need to only eat salads. The purpose of this article is to make you aware that extreme restriction is problematic. Learning a more flexible approach, instead of assigning labels to food improves your relationship with food and leads to a healthier lifestyle, both mentally and physically.

References:

(1) Oshio, A. Development and validation of the Dichotomous Thinking Inventory. Social Behaviour and Personality. 2009; 37(6):729-741.
(2) Dove, ER, Byrne, SM, Bruce, NW. Effect of dichotomous thinking on the association of depression with BMI and weight change among obese females. Behaviour and Research Therapy.2009;47(6):529-534.
(3) Stewart, TM, Willaimson, DA, White, MA. Rigid vs. flexible dieting: association with eating disorder symptoms in nonobese women. Appetite. 2002;38(1):39-44.
(4) Smith, CF, Williamson, DA, Bray, GA, Ryan, DH.Flexible vs. Rigid Dieting Strategies: Relationship with Adverse Behavioral Outcomes. Appetite.1999;32(3):295-305.
(5) Palascha A, van Kleef,E, van Trijp, HC. How does thinking in Black and White terms relate to eating behavior and weight regain?Journal of Health Psychology. 2015;20:638-648.

Diets, Fitness, Habits and Lifestyle, Health, Nutritionist Talk, Science

Fad Diets – Why they don’t work in the long run.

“Sorry, I can’t eat cake I’m on a diet”
By definition, a “diet” is the sum of energy and nutrients obtained from foods and beverages consumed regularly by individuals. To put it in simple terms, it is what you eat and drink on a day to day basis. Somewhere along the way, the meaning shifted to something more specific. Something that people dread. You guessed it right – Weight loss.
As a generation, we are used to quick results. Everything from groceries to electronics can be bought with a click. Unintentionally (or not) we have begun to channel that into how our bodies respond to an external stimulus, such as food and exercise. We expect results within a short span of time and will go to great lengths to ensure that it happens! Ever completely cut off a food group or had just juices for a week to shed some weight? That is exactly what I’m talking about.
This is what we call a ‘fad diet’. It’s nothing but a trend that claims to guarantee rapid weight loss and have an upper hand over our perfectly normal balanced diet. Most of the claims around fad diets might seem appealing.
“Guaranteed weight loss in a week!”
“Helps in removing harmful toxins from your body”
“Carbohydrates are stored as fat. Switch to fat as your primary source of energy.”
Sounds familiar? Although these claims might seem appealing, the diet by itself is extremely restrictive. Every single nutrient has a role to play in our body and nothing in isolation is inherently bad. Any ‘diet’ that you choose to follow is completely based on individual preference. But, is it sustainable? Is it personalised to help achieve your goals? It is imperative that everyone is informed of the pros and cons of these diets and make an informed choice. For that reason, here is a compilation of the most popular diets:
(1) Ketogenic diet: Both carbohydrates and fat can be used as a source of energy by the body. The body relies on glucose (broken down from carbohydrates) when one consumes their normal diet (1). In the complete absence or reduced amount (<20g) of carbohydrates in the body, the body enters a state of ketosis, wherein it relies entirely on stored fat for energy. Signs of ketosis can be identified by increased ketone bodies in the blood, headaches and fatigue due to extremely low carbohydrate intake and bad breath. Breakdown of fat results in the rise of ketone bodies in the blood, which are used as an alternate source of fuel. The ketogenic diet involves consuming minimal to no carbohydrates (~5% from diet) and using fat (~75% from diet) as a source of energy. It encourages consumption of copious amounts of fat from sources like bacon, ghee,butter,nuts,cheese etc. Starch, grains, beans and legumes, fruit and starchy vegetables are avoided. The sources of fat usually consumed in a keto diet are low chain triglycerides (LCT’s). Off late, consumption of fat sources that contain Medium Chain Triglycerides (MCT’s) like coconut oil are observed. Although they do not contain concentrated amounts of MCT’s, it is suggested that MCT’s generate more ketone bodies and may be more beneficial to incorporate in a keto diet (1).
Pros: A ketogenic diet was developed for children diagnosed with epilepsy. It was said to be therapeutic as fats do not spike insulin. It works by stabilising various mechanisms related to synaptic functions and thus has an anti-seizure effect. So you know who it actually benefits (2). Although, consumption of high amounts of fats can induce better satiety (3), thus reducing food consumption in subsequent meals. This can potentially help in losing weight. In order to adapt a ketogenic diet to the current lifestyles and improve adherence, a cyclical keto diet came into the picture. This involves following a keto diet for 4-5 days and increase carb intake for 1-3 days. There is currently no evidence to support the validity of a cyclical ketogenic diet.
Cons: A ketogenic diet can be extremely restrictive. Cutting all sources of carbohydrates can lead to irritability, ‘brain fog’, mood swings, headache and even constipation, due to lack of fibre in the diet. Although it might result in weight loss (provided you’re in a caloric deficit), it may not be sustainable in the long run. I mean, how long are you going to stay away from a good slice of pizza? On a more serious note, the exclusion of whole grains, fruits and vegetables could lead to deficiencies of B vitamins, iron, zinc etc. Further, the long term effects of such a high fat diet haven’t been studied.

(2) Paleo Diet: The Paleolithic diet or paleo diet resembles what hunters or cavemen ate several years ago. This diet primarily revolves around what our ancestors had access to – Whole foods. And by that, I literally mean, whole foods only. Sounds easy? Not really. You see, cavemen didn’t cultivate their food. So what they ate was what they could find. So on this diet, the idea is to avoid anything that could be made in a factory. What this diet would comprise of would be meat, free range eggs, fruits, vegetables, nuts and seeds. In order to adapt it to the current scenario, consuming spices/condiments and olive/coconut oil are acceptable. It has been speculated that they did have access to grains. However, evidence for a paleo diet to be superior than a balanced diet is still in question (4).
Pros: Any food that is ‘processed’ such as aerated beverages, most dairy products, legumes/beans, vegetable oils and even grains are not to be consumed on this diet. Since you will be consuming an abundance of fruits and vegetables, there lies an advantage. The focus on whole foods does steer us away from a conventional diet primarily filled with calorie dense foods of low nutrient content. In fact, studies have shown that a paleo diet improves insulin sensitivity, blood pressure and cholesterol (5).
Cons: To start with, the diet is pretty restrictive. More than it, it also creates a list of ‘good food’ and ‘bad food’. That by itself creates a sense of fear of food and is problematic. Further, we can follow a perfectly wise diet even with the inclusion of dairy, starch and legumes. The exclusion of dairy might lead to a deficiency in calcium(4).
(3) Detox diet: A detox diet is used to eliminate toxins from the body and assist with weight loss. These are also commonly known as juice cleanses. However, it can also involve consuming vitamins, minerals, laxatives and other ‘cleansing foods’ (6). While most commercial detox diets do not specify the ‘toxins’ they claim to remove, it should be noted here that the dose of the said toxin determines its harmfulness (7). For example, even an essential mineral like Iodine when present in excess can lead to thyroid disorder. Does that mean iodine in isolation is a toxin?
Various organs in our body, and in specific the liver are involved in eliminating potential toxins from the body. Commercial detox diets lure the masses promising rapid weight loss, but there is no scientific evidence to support this claim.
Pros: Well. This is a tough one. In a recent review on detox diets (7), it was highlighted that some plant based foods like coriander, citric acid (found in citrus fruits) and malic acid (found in grapes) can help in removing toxic metals from the body. However, most of these studies were performed on animals and can’t be generalised to the human population. While these detox diets may be successful in inducing weight loss in the short term, they may not be sustainable in the long run.
Cons: Detox diets involve severe energy restriction and might lead to nutrient deficiencies. For example, by just drinking juices for a week, one may not meet their recommended protein intake! Further, detox dieters could potentially be over consuming supplements/laxatives (7). A variety of nutrients need to be consumed on a daily basis, which a detox diet may not be able to provide.
(4) GM diet: A diet that was initially created for the employee of General Motors (GM), the GM diet allows you to eat a certain combination of foods each day. For example, on day one you eat only fruit (except bananas). On day two, only vegetables. This pattern of consuming specific foods continues for a period of 7 days. Since fruits, vegetables and other items allowed in the diet are low calorie, it has been shown to induce weight loss. However, as much as it is popular, there isn’t any research to support the claims of this diet.
Pros: Although a GM diet does include some whole foods, it follows a restrictive and specific pattern.
Cons: We need a variety of nutrients on a daily basis. By consuming just fruits throughout the day, other nutrients such as protein, fat and several other micronutrients available in whole grains, fruits and vegetables are neglected. Moreover, tendency to feel hungry might be prevalent. The weight lost on a GM diet may be temporary. Since it isn’t something you can follow lifelong (fight me!), there lies a possibility of regaining the weight lost.
Do you sense a pattern with all these diets? All of these diets involve restricting either all your food or a specific food/food group. Do you think that’s sustainable and that you can follow it life long? Not really right? In an ideal scenario, for a diet to be sustainable, it needs to be personalised to suit you and your goals. There isn’t one specific diet that is applicable to everyone. As mentioned before, all nutrients play a specific role in your body. Completely cutting yourself off from one for the sake of losing weight does more harm than good. Always make an informed decision when it comes to your fitness goals. The shortcuts might seem tempting, but remember health is wealth.

References:

1) Walcyzk, T, Wick, JY. The ketogenic diet: making a comeback. The Consultant Pharmacist. 2017; 32(7), 388-396.
2) Rho, JM. How does the ketogenic diet induce anti-seizure effects? Neuroscience Letters. 2017; 637, 4-10
3) Paoli, A. Ketogenic diet for obesity: Friend or foe?. International Journal of Environmental Research and Public Health. 2014; 11(2),2092-1207.
4) Pitt, CE. Cutting through the Paleo hype: The evidence for the Paleolithic diet. Australian Family Physician. 2016; 45(1): 35-38.
5) Tarantino, G, Citro, V and Finelli, C. Hype or Reality: Should Patients with Metabolic Syndrome-related NAFLD be on the Hunter-Gatherer (Paleo) Diet to Decrease Morbidity?.Journal of Gastrointestinal and Liver disease. 2015; 24(3): 359-368.
6) Allen, J, Montalto, M, Lovejoy, J, Weber, W. Detoxification in naturopathic medicine: a survey. Journal of Alternative and Complementary Medicine. 2011;17(12):1175-1180.
7) Klein, AV, Hiat, H. Detox diets for toxin elimination and weight management: a critical review of the evidence. Journal of Human Nutrition and Dietetics. 2014; 28(6): 675-686.
8) Healthline. What is the Cyclical Ketogenic Diet? Everything you need to know.
9) Medical News Today. What are the signs of ketosis?
10) Harvard T.H. Chan School of Public Health. Diet Review: Ketogenic Diet for weight loss.
11) Masharani, U, Sherchan, P, Schloetter, M, Stratford, S, Xiao, A, Sebastian, A, Nolte Kennedy, M and Frassetto, L. Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in type 2 diabetes. European Journal of Clinical Nutrition.2015; 69(8), 944-948.
12) Harvard T.H. Chan School of Public Health. Diet Review: Paleo diet for weight loss.
13) Precision Nutrition. The Paleo problem.

Diets, Habits and Lifestyle, Health, Nutritionist Talk, Science

One Size Does Not Fit All.

If you meet a nutritionist/dietitian and they hand you a pre-made meal template without understanding your lifestyle, you need to do just one thing.

RUN.

It is not an unfamiliar practice for ‘nutrition coaches’ and for that matter even qualified nutritionists to hand out premade diet plans to any client that walks in. With the market flooded with ‘detox plans’ and ‘diet plans that require no exercise’, we are made to believe that there is one superior ‘diet’ that can help us achieve our fitness goals. Marketing does play a role, but it also reflects how gullible enough we are to actually be the target audience. It is imperative to understand that each of us are extremely different from one another. Everything from eating habits and food preferences to sleep schedules differ greatly from person to person. So how do we expect one universal ‘diet plan’ to work? You might agree to bite your teeth and eat what that template tells you to. But for how long? Is it teaching you how to build sustainable eating habits or is it just temporary? Are you looking at long term health or short term aesthetic outcomes?

With this in mind, several nutritionists and dietitians are now offering tailor made plans suited to each individual. These ‘personalised nutrition’ plans are slowly gaining momentum. Like the name suggests, these are interventions or advice that are developed from individual characteristics (1). Interventions like these may help in bringing out more effective behavioural changes (2). Personalised nutrition can be applied to individuals with specific conditions such as pregnancy or old age (1). The goal of such interventions are primarily to benefit health, but could also be applicable to meet specific goals such as performance in sport (3).

Here is an excerpt from nutritionist Varsha.

“I once had a client who consulted with a nutritionist before meeting me, this nutritionist did not take the said client’s lifestyle into account, did not interact much and asked her if she wanted to lose X number of kilos in Y number of months. She then based her charges on the number of kilos to be dropped. This has become a common practice. In addition, any information with respect to nutrition, is easily accessible on the internet. People need to know that these claims need to be backed by a body of research. For this reason, it’s always important to get guidance from a professional who is well qualified and up to date with current research.”

In 2016, a large study was conducted by Celis-Morales et al. (4) over 6 months, recruiting participants from seven European countries. They were either given conventional dietary advice or personalised advice based on the individual’s diet and phenotype and/or genotype. It was observed that a personalised diet was more effective in creating sustainable habits. Nevertheless, there are always two sides to a coin. While the theoretical evidence for personalised nutrition is still not clear, marketing can lure consumers into taking unreliable tests that have limited evidence.

In conclusion, it is imperative for you as consumers, to be aware of the various evidence based trust worthy nutritionists who care about your goals and more importantly, your health. While the evidence for personalised nutrition seems promising, it is also crucial for you, to be aware of unregulated tests in the market. Further, it is clear that there is no ‘one size fits all approach’, when it comes to nutrition. A diet and exercise plan suited to YOUR lifestyle, accounting for YOUR food preferences, goals and/or clinical condition(s) is what works always.