bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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5 things low-carb gurus don’t want you to know

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I hate these lists: 5 foods you should never eat, 8 foods for a flat belly, and one I saw last week “10 Things Dietitians Say About Low-Carb Diets That Don’t Make Sense“. I should confess that as a dietitian, the headline alone immediately got my back up. Still, I took the bait and clicked the link.

Some of the stuff on there was quite reasonable, and some of it inaccurately portrayed dietitians and nutrition. It drives me nuts that we study nutrition for 4+ years in university, do internships, and must demonstrate continuous learning to maintain our professional status as registered dietitians, and yet those from other professions (and non-professions) are constantly proclaiming to the world that we’re nutritionally biased ignoramuses. Okay, so I didn’t exactly read this list with an open mind. No apologies.

Here are my top 5 retorts to this post and others in the same vein:

1. Low-Carb Diets Are Hard To Stick To

Have you ever tried a low-carb diet? There’s a reason why nearly everyone you meet who’s on a low-carb diet is singing its praises at a month or two in. How many people do you know who’ve consistently followed low-carb diets for years? Probably not many. There’s a reason for that. They are hard to stick to. Sure, you can feel physically satisfied on a low-carb diet but there are other aspects of it that can make it difficult to stick with. There’s the social aspect of food. It can be hard to follow a low-carb diet when others around you aren’t, forgoing birthday cakes and pizza. There’s also the restrictiveness that comes with a strict diet. You lose a lot of options when you cut-out or dramatically reduce carbohydrate intake. Finally, if you’re at all athletic, it can be extremely hard to train and perform at your best without carbohydrates.

2. The Opposite of Low-Carb Is NOT Low-Fat

Why is it that every time I hear someone poo-pooing on dietitians for our reluctance to support low-carb diets claiming that we push low-fat diets? The macronutrients are: carbohydrate, fat, and protein. While we all vary in our needs and desires for each of these, they all play a role in a healthy diet. I don’t know any dietitians who promote low-fat diets. Yes, in the past, because nutrition research is often flawed, we believed saturated fat was unhealthy. Most of us are over that. As I’ve said before, real dietitians eat butter.

3. Low-Carb Diets Are Not Proven To Be Safe In The Long-Term

As dietitians, it’s our job to provide people with the information that they need to make informed choices. When the average life span is over 80 years in Canada a two year study is but a drop in the bucket. Yes, you can probably be healthy on a low-carb diet. You can also be unhealthy on one as well. A diet of steak and bacon is low-carb, as is a diet of vegetables and fish. It’s a lot easier to get all of the nutrients that you need when you consume a greater variety of foods.

Yes, the Inuit ate high-fat low-carb diets. Will your low-carb diet consist predominantly of raw meat and seal blubber? I thought not.

4. Just Because You Can Be Healthy Following A Low-Carb Diet Doesn’t Mean That You Should

You can be healthy following all sorts of diets. You can also be unhealthy following them. A low-carb diet can be healthy, as can a vegan diet. You need to figure out what works best for you. Don’t let nutritional gurus convince you that their diet is the only way to go.

The main draw of a low-carb diet generally isn’t health anyway, it’s weight loss. These are not one and the same; no matter what the gurus may say. A healthy weight very much depends on the individual and health is not just physical. There is no shame in deriving pleasure from food.

5. We Don’t Like Diets

It’s nothing personal. We’re not eschewing your beloved low-carb diet because we have shares in the wheat industry. We tend to be wary of any diet because they are restrictive and have end dates and “cheat days”. The way you eat should be a way of life that you can maintain until the end of your life (which will hopefully be in the distant future because you’re following a healthy, enjoyable, varied, and balanced diet).


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Will an avocado a day keep the doctor away?

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Avocado photo by Paree on Flickr. Used under a Creative Commons Licence.

Last week everyone was all excited about new research touting the health benefits of avocados. The gist of it being that everyone should eat an avocado a day to lower improve their cholesterol profile. Now, I love avocados, but I still had to take a look at the study myself.

The first thing I noticed was that the research was “supported by a grant from the Hass Avocado Board” and that the lead author, Dr Kris‐Etherton, is a member of the Avocado Nutrition Science Advisory. According to one of the news items I heard, she insisted that she still would have published the research if it had not shown avocados to impart special benefits on cholesterol levels. Despite this, it’s still a significant red flag to me that the research was supported by the Avocado Board.

This was also a rather small study, looking at 45 individuals over five weeks. While the results were interesting, a larger study would be needed to draw any definitive conclusions. What were these interesting results? Bearing in mind that dietary adherence was self-reported, 90% allegedly stuck to their prescribed diets, and all participants maintained their starting weights. Participants were assigned to one of three treatment diets: low-fat, moderate-fat, or avocado. All three diets were found to lower LDL-C and total cholesterol. However, the avocado diet decreased both (LDL-C and TC) significantly more than the low- and moderate-fat diets. The avocado diet was also the only diet found to decrease the number of small, dense LDL particles (the really bad guys).

Okay, so avocados may impart health benefits. Does this mean we should all exponentially increase our grocery bills and start eating an avocado a day? Probably not. The participants in the study were predominantly white, overweight and obese, healthy Americans. If you’re not part of that group, the results may not apply to you. The study also only ran for five weeks and did not incorporate other life style changes such as exercise and weight loss. We can’t say if eating an avocado a day would impart the same health benefits to someone of a lower weight, different ethnicity, or disease state. We also don’t know if the benefits would continue beyond five weeks or if eating an avocado every day would be more beneficial than increasing exercise and/or losing weight. What about the effects of all three of these together?

Avocados are delicious and full of good nutrients. I don’t want to discourage anyone from eating them if they enjoy them. However, they are expensive, and their use in the treatment of conditions such as elevated cholesterol needs further investigation before we start prescribing an avocado a day.


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I guess some RDs are sexy

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Eat big meals… Fat goes quick! Photo by L’imaGiraphe (en travaux) on Flickr. Used under a Creative Commons LIcence.

Right on the heels of my post about we dietitians not being sexy, this article comes out in the Daily Mail, and I’m forced to eat my words (good thing there are no forbidden foods!). Dietitian Trudi Deakin is proclaiming a high-fat, low-carb diet to be the be all and end all, and she’s written the book to “prove” it. Sigh.

Now, as you (my regular readers) know, I’m certainly not one to shy away from fat. New readers, My original by line was “real dietitians eat butter”. However, I also subscribe to the school of thought that says too much of anything is bad for you. Be it fat, salt, sugar, or carrots. You can have too much of a good thing. According to Trudi, saturated fat is the key. While it’s become widely accepted that saturated fat is not the demon it was once believed to be, that doesn’t mean that it’s suddenly a dietary super hero.

Trudi claims that her diet is 82% fat, and she’s never felt healthier. She alleges that high-carb diets are fuelling the obesity epidemic. The gist is that low-fat was wrong so low-carb must be right. Why do we have to go from one extreme to another? I’ll say the same thing about this that I said about demonizing sugar: blaming one nutrient for obesity or chronic disease isn’t getting us anywhere. These are complex problems that aren’t going to be remedied with simple solutions.

This 82% fat has me curious though. What would a diet that’s 82% fat look like? According to Trudi:

BREAKFAST: Three eggs cooked in the microwave with butter and cheese, like a souffle, served with oily fish – smoked salmon or mackerel – or avocado.

LUNCH:A bowl of berries with double cream or a homemade walnut scone, made with ground almonds rather than flour, served with double cream

DINNER: Meat or fish with a serving of vegetables cooked in butter 

Just for fun, I entered this meal plan into my fitness pal to find out the breakdown. Obviously without quantities, it’s near impossible to say exactly what caloric and macronutrient totals would look like. Based on one serving of each of the items listed above, I would only be consuming 995 kcal, and fat would account for roughly 40% of these. If Trudi’s diet is being accurately reported, she’s obviously consuming greater quantities than I recorded, particularly of the high-fat foods. Regardless, it doesn’t sounds overly appealing to me. I’d rather be a few pounds heavier and die a couple of years earlier than never have cereal for breakfast, never snack, and put butter on everything (as much as I love butter).

While Trudi may be content with this restrictive diet for now, it will be interesting to see what will happen with time. Most people following low-carb diets find them to be extremely difficult to follow over the long-term and usually relinquish them. Aside from the difficulty adhering to these low-carb, high-fat diets, there are other risk factors to consider.

Children with epililepsy following ketogenic diets provide us with some insight into the long term effects of a ketogenic diet. A study of children following a ketogenic diet found that poor growth was common. Other side effects were kidney stones and bone fractures.

There’s some other misinformation in the article. Trudi states that she consumes 30 grams of protein at breakfast because “your body doesn’t store it.” Um… I don’t know where this is coming from. While 30 calories at breakfast is certainly reasonable, excess calories, regardless of macronutrient, will be stored as fat.

The unfortunate thing about most weight management research is that “long term” equals several months to a year. While someone might experience weight loss, and find a high-fat diet relatively easy to adhere to for a few months, years, or a lifetime, are a far different story. Trudi’s been following this diet for less than year. Let’s see the tune she’s singing in a decade. Until then, you might want to take her high-fat diet with a grain of salt, or better yet, a baked potato.


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Are we all really getting too much protein?

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This story is one of the oldest ones. When I was study nutrition in university I remember learning that most of us eat more protein than we need. While it’s undoubtedly true in most cases. It’s a little bit more complicated than: we eat more protein than we need to, end of story.

It’s important to note that there are a number of times that protein requirements are increased, such as for athletes, those recovering from injuries, and those endeavouring to lose weight. However, the recommendation for adults is roughly 45-50 grams of protein per day; more precisely, 0.9 grams per pound of body weight. We can easily eat this in one meal. And the problem is that many of us do eat this in one meal, neglecting the rest of our meals.

New research is indicating that we can’t utilize anymore than 20 grams of protein at one sitting. This means that, while we may be consuming plenty of protein at supper time, we may still not be getting enough protein. Many of us neglect breakfast. Even if we consume breakfast it’s often toast or cereal and many of us don’t get any more than 7 grams of protein in the morning. Distribution is important. To optimize protein utilization we should aim to consume 15-20 grams of protein at each meal. This may mean rethinking breakfast, and supper for that matter. Try to incorporate protein-rich foods at breakfast (e.g. eggs, beans, nuts, seeds, Greek yoghurt) and try to eat more meatless meals for supper. When having meat for supper don’t make it the biggest item on your plate. Treat meat like an accoutrement and make vegetables the stars of your suppers.


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Sorry, dietitians just aren’t sexy

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Something that’s been weighing on my mind a bit lately is the disappointment that many people seem to have with dietitians and the reasons for this. Basically, it boils down to the fact that we’re not sexy. Nope, we can’t tell you the next great superfood you must buy daily (spoiler: there is no such thing as a “superfood”). We won’t recommend any breakthrough weight loss supplement; sorry, whatever Dr. Oz is selling we’re not buying. We won’t tell you “never eat these five foods“. And we won’t tell you that paleo, Atkins, low-carb, low-fat, gluten-free, vegan, <insert any trendy diet here>, is the best diet.

There are no shortcuts to health. There are no foods that you should never ever eat (I mean, obviously, there are some foods that should be consumed on an occasional basis, such as candy, and others on a regular one, such as vegetables). But we’re never going to tell you not to eat something. We’re also never going to tell you what diet to follow. Our job is to help you figure out the diet that works best for you and how to optimize it to make it as enjoyable and healthy as possible.

Yes, I know that there are loads of other people out there who are more than happy to tell you that their diet is the best, the only, the diet to end all diets. I know that, that level of certainty can be alluring. It’s much more appealing to have someone tell you exactly what you may and may not eat when you’re struggling on your own. It’s not easy to hear that no foods are off the table and that no superfood is going to swoop in to the rescue. However, let’s not confuse confidence with competence. Dietitians are here to help you make the best choices for you, not to impose our own dietary regimes on you. Maybe we’re not sexy or fun or exciting but we’ll be here for you when all of those other diets let you down.