What is the Best Diet for MY Health?
Lately, my patients have been asking me a lot of questions about popular diets that they have come across on the internet or on TV. I thought that this would be a good time to talk these diet fads and go over some real evidence-based information about food and health. I am a Naturopathic Doctor, but my I have a Master’s of Science in Nutrition, so I have been studying diets and nutrients for years. I like to prescribe certain diets to my patients for specific reasons, but I recognize that a diet that is restrictive should not, in most cases, be long term. The goal of maximizing health through nutrition should always come with a balanced diet. Here are some popular fads that I have come across and what the literature says about them:
- The Ketogenic Diet
There is good scientific literature to support the use of the Ketogenic Diet for Neurological disorders such as epilepsy, ALS, traumatic brain injury and cancer. Research also states that this way of eating helps with fast weight loss especially in the first two weeks to two years. However, beyond the initial weight loss effect it usually doesn’t continue and it is challenging for people to maintain this way of eating long term. In addition, if not done properly, there can be very serious complications associated with long-term Ketogenic diets. This includes dehydration, electrolyte imbalances, hypoglycemia and even kidney damage. There is also good research to show that drastic carbohydrate restriction can lead to hormone imbalances in women.
- Gluten Free
Though it is a topic of much debate, it is now recognised that Non-celiac gluten sensitivity (NCGS) is a condition characterized by intestinal and extra-intestinal symptoms. It is also recognized that it is challenging to distinguish NCGS from other functional gastrointestinal (GI) disease, especially irritable bowel syndrome (IBS). In these individuals, removing gluten will alleviate symptoms.
In addition to NCGS there is a strong relationship between gluten ingestion and aggravation of autoimmune conditions. This relationship has been especially strong in women with autoimmune thyroid conditions where gluten-free diets were associated with decreasing thyroid antibodies and increasing serum Vitamin D levels.
The argument against gluten free diets comes from the fact that most gluten free grains are low in fibre and a low fibre diet is related to poor health outcomes. However, this is only an issue if you are incorporating a lot of gluten free replacement foods (like breads, muffins, waffles, cookies, cereals).
When the juice is extracted from any fruit or vegetable all of the fibre is removed. Fibre is an important part of the health benefits of any fruit or vegetable. Once the fibre is removed, everything is concentrated leaving vitamin sugar water. Depending on the fruit or vegetable you are using, sometimes the sugar content can be very high taking away from some of the benefit you would be getting from the concentrated vitamins and antioxidants.
Any of the weight-loss benefits that you might get from doing a juice cleanse is often erased when you go back to your original diet. In addition, a juice diet is NOT sustainable long term. There are essential amino acids that you need from protein and fatty acids that you need from fat in order to survive. A human cannot live off of sugar vitamin water alone!
In my practice I don’t recommend incorporating juice into a balanced diet (for adults or children). If you want a lot of vitamins, minerals and antioxidants fast then have a smoothie, at least you will still have the fibre!
- Vegan “Plant Based”
There is sufficient evidence to support the fact that diets that are high in fruits and vegetables are associated with many health benefits, including reducing cardiovascular disease, decreasing obesity and preventing some types of cancer. However, this is not saying that you have to be vegan to achieve these benefits.
Though a vegan diet can be a healthy diet, and when done properly can give you most required nutrients, there is not sufficient evidence to say that a vegan diet is a healthier diet, especially if the meat is replaced by refined carbohydrates.
There is a plethora of evidence that supports decreasing red meat consumption, eliminating processed meats and decreasing high fat dairy products. However, there is also a lot of evidence to support the health benefits of including fish and eggs. And, no matter what books or documentaries say, you cannot get sufficient B12 or essential Omega 3 fatty acids from a vegan diet and therefore supplementation is necessary. Lastly, menstruating women often do poorly with a vegan diet since their requirement for B12 and Iron is so high that they often become anemic.
When it comes to diet, research does recognize that certain foods, or lack of foods, are related to increased mortality. Higher mortality has been linked to high sodium intake, low intake of nuts and seeds, high intake of processed meat, low intake of omega-3 fats, low intake of vegetables, low intake of fruits and, high intake of artificially sweetened beverages. A very small risk has also been seen with low polyunsaturated fats and high consumption of red meat . In addition, over consumption of dairy products has shown to decrease absorption of certain nutrients such as iron and zinc; and the majority of adults are in fact lactose intolerant which results in digestive inflammation and lack of nutrient absorption.
The research shows that an ideal diet contains a high amount of fruits and vegetables, nuts and seeds, and omega 3 fats from fish; a low amount of dairy products; and very limited processed foods, sodium and artificial sweeteners. When it comes to optimal diet, there is no one-size-fits-all solution. Genetics and other lifestyle factors play a significant role in the way that nutrients will ultimately affect you. However, any diet that encourages a shift from processed food high in sodium, sugar and saturated fat to a diet rich in whole unprocessed foods, no matter what the diet is, will always result in health benefits and enhance physical and mental performance.
The best way to know if your diet is right for you is to work with a professional!
Dr. Lisa Maddalena, ND
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