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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What’s the *BEST* diet?

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There are so many diets out there; from low-carb (and its many iterations), vegetarian, vegan, low-fat, paleo, gluten-free and on and on. The one thing that many of their followers seem to have in common is the absolute certainty that their diet is the best diet. It amuses me when I see back-to-back tweets from people praising their chosen religion diet.

I’m sick of seeing people (especially my fellow dietitians) passing judgement on the diets of others, presuming that their chosen diet is superior. Power to you if you are healthy and enjoy following your diet of choice. That doesn’t mean that the diets followed by others are inferior. It doesn’t mean that only you (and others following the same diet) are eating “real food”. What the heck does that even mean?? I’m fairly certain that I didn’t imagine my last meal, that I didn’t consume “fake” food. Just because it works for you doesn’t mean that it’s going to work for everyone. This isn’t Mormonism, you’re not going to secure your place in foodie heaven by converting more people to your way of eating.

Each diet has its drawbacks and nutrients of concern. Each of these diets has its benefits. I could go through many of them and list out the pros and cons but that would be tedious for me to do and tedious for you to read. So which one is the best? The one that you are happiest and healthiest following. The one that you can easily follow for the rest of your life without feeling like you’re on a “diet”. Yeah, sorry, I sucked you in with that title. It’s the truth though. Me, I don’t follow a diet with labels. I enjoy a variety of foods. I eat meat, but I have been known to go weeks without it. I eat grains, but I try to vary them and may not have them at every meal. I’m an agnostic eater.


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Low-fat vs low-carb

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There’s a lot to unpack from this Daily Mail article a friend alerted me to. The premise: a couple of identical twin doctors decide they need to lose weight. In order to determine which fad diet is better, one goes low-carb, the other goes low-fat. The fact that they are genetically identical and maintained similar levels of physical activity means that they assumed any differences observed would be due to diet. While there is merit to using identical twins in research studies it’s important to note that this was not a scientific experiment. One subject in each group doesn’t lead to robust findings. Other issues: obviously both men knew which diet they were on and there was no control group. So, this wasn’t good science but it’s still possible that we could learn something interesting from their little “experiment”.

Before we look at what they “learned” from the experiment there are a few things in the article that I want to touch on. Firstly, the headline states that “one twin gave up sugar”. Well, yes, but this twin also restricted all forms of carbohydrate, not just sugar. The twin who went on the low-carb diet thought that it would be effective because of the insulin hypothesis of weight gain.

Because these carbohydrates are highly refined, they tend to raise blood sugars and blood insulin levels quickly.  This will tend to cause weight gain and obesity.  This is known as the Carbohydrate-Insulin Hypothesis (CIH), and is the basis of the Atkins diet and many other low carbohydrate (Dukan) and very-low-carbohydrate diets (ketogenic diet). (1)

While it sounds convincing, we know this hypothesis to be incorrect. For one thing, there are many people/populations who consume high-carbohydrate diets and never develop obesity. For another, insulin on its own does not cause obesity (2). Minor quibble, really, but as doctors discussing weight loss they should have their facts straight. Obesity is complicated and there’s no smoking gun out there.

An important point that they make is:

…despite being doctors – I also have a degree in public health – neither of us knew much about losing weight and eating healthily. 

These topics fall between the cracks at medical school. Yes, we understood biochemistry and food metabolism, and knew a lot about the consequences of being overweight. But which diets work, why we eat too much and why losing weight is so hard don’t sit within any medical speciality.

Pity that they didn’t take the opportunity at this stage to point out that this means that assuming your family doctor will tell you if your weight is a health concern or that they are a good resource for weight loss are dangerous assumptions. If you are concerned about your weight being a health issue you need to speak up and voice those concerns. Ask for a referral to a dietitian who specialises in weight management or to a reputable weight management clinic. I really wish they would have mentioned the great resource that we dietitians can be for all things diet and nutrition.

As you may have guessed, both doctors lost weight during the course of their experiment. I hope that they were the only ones who were surprised by this outcome. Naturally they lost weight; they were both on highly restrictive diets, they were both active males, and this was done over a very short period of time (one month). Imagine trying to sustain a diet with the barest minimum of fat or no carbohydrates for the rest of your life!

Fortunately, the doctors reached a conclusion that I actually agree with! That: “For any diet to work you have to be able to keep it up for the rest of your life.”  As I’ve said many times before: to see sustainable weight loss you need to make sustainable changes.


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Fat: Friend or foe?

Myth 25: If a food is low in fat or fat-free, it must be healthy.
What Dietitians of Canada says:
“Just because a food is low in fat or fat-free doesn’t mean it’s healthy. In fact, a lot of foods that are low in fat are definitely not healthy choices, such as candy, pop, low-fat cookies and fat-free frozen treats… There are, however, some foods that are higher in fat and a healthy choice, such as fish, avocados, nuts, seeds and nut butters. Choose foods wisely: Read food labels and consider a food’s overall nutrient content. Don’t judge a food by fat alone!”
What I say:
I think DC’s got this one right. Taking the fat our of foods and replacing it with something else does not make an unhealthy food any healthier. In our efforts to fight obesity we’ve become far too eager to vilify single nutrients. Fat has been unfairly targeted because it provides more calories than other macronutrients. In addition, certain types of fat have been implicated in chronic diseases such as dyslipidemia and heart disease. The truth is that anything in excess is bad for you. The healthiest thing you can do is to eat a predominantly plant-based diet (this means you won’t need to interpret many nutrition labels) and eat a variety of foods, not too much of any one thing. Fats are needed for absorption of fat-soluble vitamins (A, D, E, and K), they also provide many foods with flavour.