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January 23, 2020

Diet is an important factor contributing to health. Many eating strategies can lead to positive outcomes. There isn’t A Best Diet that applies to everyone in all situations. Some key points from the research on different diets (Freedman et al.,2001):

Obesity-related conditions are often improved with modest weight loss- 5%-10%.

Calorie balance over a prolonged period of time is a major determinant of weight loss.

Diets, of all sorts, that consistently reduce calorie intake (below maintenance) result in weight loss.

Generally, overweight individuals who consume high fat, low carb diets consume less than maintenance level of calories.

In the short-term, high fat, low carb ketogenic diets cause a greater loss of body water than body fat. In the long-term low carb reduced calorie diets result in significant fat loss.  There are numerous low carb diets consisting of a range of protein levels. Inadequate protein may lead to drastic reductions in bodily proteins.

A moderate fat, balanced, nutrient reduction diet is nutritionally adequate and appears to be relatively easy to follow for most people.

Many factors influence appetite and hunger. Factors:  macronutrient content, neurochemical factors, hormonal signals, gastric signals, food likes, genetic, environmental, and emotional factors.

When considering dietary compliance it is important to consider psychological issues (e.g. group support, frequency of dietary counseling, and coping with emotional eating). This area is often overlooked.

Low carb may be deficient in vitamin E, vitamin A, thiamin, vitamin B6, folate, calcium, magnesium, iron, potassium, and dietary fiber, thus a need for supplementation. 

Poorly planned vegetarian diets are often low in vitamin E, B12, zinc, calcium, essential fatty acids, essential amino acids, iron and phosphorus, thus a need for supplementation.

Generally, studies have found protein is more filling than carbohydrate or fat.

There is a plethora of research showing the importance of calories regarding various outcomes (weight gain, weight loss and health indicators).  So, why so much confusion?

Food heuristics are mental shortcuts used in relation to eating (Hale, 2010).  Examples of food heuristics: low carb diets, low fat diets, traditional bodybuilder diets and volumetric eating. These examples often lead to calorie deficits without having to count calories.  Just because you aren’t aware of how many calories you eat that doesn’t mean they aren’t important.  Diets/ eating plans that result in weight loss are diets that create calorie deficits and those that result in weight gain are those involving calorie surplus.

Dansinger and colleagues (2007) conducted a randomized trial comparing popular diets (Atkins, Ornish, Weight Watchers and Zone) to assess adherence rates and the effectiveness of weight loss and cardiac risk factor reduction.  The main outcome measures were changes in weight and  cardiac risk factors, and self reports measures of how well they stuck to the diet. The researchers concluded that each diet resulted in weight loss and a decrease in cardiac risk factors. The better a participant was able to follow the diet the  greater the weight loss and greater reduction in cardiac risk factors.

Many weight management programs are too generic and promote the one size fits all model. As an example, recommending the same calorie level and nutrient levels for an active athlete and an inactive individual is wrong in most cases.

Weight loss comes in various forms, including fat, body proteins, water, glucose, and vitamin storage. Body composition can be important for health, performance, and physique. In addition to weight loss, feeling of well being, body measurements, food expense, convenience, reliability and other factors are important. Don’t rely on the scale alone as a measure of success.

Supplements can play a positive role in weight management and health but they’re not magic. Supplements may compliment your program or make things more convenient.  Insisting that specific supplements or food replacements are essential for weight loss is wrong. What is it that makes these products better than other products, even when they consist of the same substances? I have asked question often to supplement reps….

There is no ultimate, best for everyone diet.  If you can’t stick to the diet, it won’t be successful. The psychological aspect of dieting is often overlooked, but is crucial in determining success. For many people, whether or not they stick to a diet is determined mainly by psychological issues — support systems, coping with emotions, quality & frequency of counseling. Pick a diet that you can stick with. If you hate all of the foods included in the diet and you’re excessively anxious about starting the diet maybe choose a different diet . A quality diet doesn’t have to consist of only bland foods.  Flavorful foods are important to long term adherence; it is an important predictor of what you consume over the long-term (Hale, 2018).  There are safe additives that can make your nutritious diet a flavorful diet. If you don’t like any of the food your eating it will probably be hard to stick to this long-term.

Implications for A Quality Diet:

Adequate calories. (This matters whether you’re consciously counting calories or not.)

Consume essential nutrients (nutrients that must come from diet; they can’t be made in adequate amounts in the body)

Include at least some foods you like. There isn’t a specific bland food mechanism that betters weight management efforts (the primary determinant of what people eat over a lifetime is food likes and dislikes- Eertmans et al., 2001)

Consider metabolic abnormalities (e.g. diabetes, insulin resistance, food insensitivity, food allergies, etc…)

Occasional breaks. (You don’t have to stick to the program 100 percent of the time to see the benefits- breaks provide physiological and psychological benefits)

Environmental factors (such as: Food likes / dislikes, Evaluative conditioning, Expectations, Variety and Sensory specific satiety, Eating w/ others, etc.). The underpinning factors here are often food consumption norms and food monitoring issues.

A quality diet in your current state may be different than it was in the past, or it may different now than it will be in the future.

Many roads lead to the same place. There isn’t a dietary road that everyone should follow. Individual circumstances are important when considering the best diet for you. A nutritious, flavorful diet you can follow for the long term probably exists.

Recommended Readings
What Makes The Best Diet?

A New Paradigm for the Study of Eating

Popular Diets: A Scientific Review

References

Dansinger, M., Gleason, J., & Griffith, J. 2005. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction.  JAMA, 29(1), 43-53.

Eertmans, A., Baeyens, F., & Van den Bergh, O. (2001).  Food likes and their relative importance in human eating behavior: review and preliminary suggestions for health promotion. Health Education Research: Theory and Practice, 16(4), 443-456.

Freedman, M., King, J., & Kennedy, E. 2001. Popular Diets A Scientific Review.  Obesity Research,9(1), 1-40.

Hale, J. 2018. What Influences Our Food Likes and Dislikes?. Psych Central. Retrieved on June 15, 2019, from https://psychcentral.com/blog/what-influences-our-food-likes-and-dislikes/.

Hale, J. 2010. Should I Eat The Yolk? Separating Facts From Myths To Get You Lean, Fit and Healthy.  Berkeley, CA: Ulysses Press.