Bonnie Modugno, MS, RD - Top Rated Diets–What's Missing?
A recent report from US News Health captured my attention. Twenty two experts ranked 20 popular diets. The experts also identified the best diet for weight loss, diabetes, and heart health. This is supposed to be good news.
The report identifies the best diets byname and category. The reviewed diets include:
Glycemic Index Diet
Mayo Clinic Diet
Raw Food Diet
South Beach Diet
The hair on the back of my neck is standing out, so there must be more than a few things that bother me about this article. Let me try to address my biggest concerns.
1. Neither the study nor the experts talk about finding an approach to food that works for the person, as opposed to the goal or condition. The focus is on weight loss, diabetes, and heart health, not the individual. Why do health professionals keep doing that? Intellectually I know they know better.
2.The scientists place great emphasis on research, but research in weight management is horribly lacking.
Research is preoccupied with key questions: Did the patients lose weight? How much? How fast? Did they keep it off?
How much did cholesterol drop? What is their HgbA1C? Is it statistically significant? The focus is primarily on the goal. The process is mostly ignored.
3. The researchers seem preoccupied with their preconceived ideas of balanceand what our diets should look like. The words sensible and safe are used repeatedly in the top rated diets.
The higher carbohydrate bias championed by the health and medical community for the last 40 years is obvious in the critiques of each diet. Even moderate carbohydrate restrictions recommended in the South Beach Diet and The Zone Diet plans are criticized. The Paleo diet received the lowest rating of all.
4. The energy-balance equation is given far too much emphasis. Too few diets help people learn how to work with their bodies. Most diets limit calories one way or another. Certain diets manipulate energy from protein, carbohydrate, and fat, but still limit calories.
Too often a successful dieter enjoys the down regulation of energy hormones and other regulators while they are dieting but doesn’t understand why. No wonder after they slip, blow it, or successfully complete the diet, dieters can completely lose their footing.
5. Little attention is paid to the aftermath of a diet. The researchers talk about whether someone can be consistent or continue following the diet as a lifestyle. Why do we expect someone to follow a specific or rigid diet for their entire life?
In my experience, I find clients succeed best when they know how to eat well enough. They can eat “cleanly” for discreet periods of time, especially for specific goals. But it is also important for them to learn how to relax a bit and still get results.
In the process clients learn what is enough to keep them in a steady state–another word for maintenance. They learn what is more than they can handle–and how to get back on track.
I want my clients to learn how to manage the range of what works for them. I want them to cultivate skills to maneuver through the range. I hope they can learn an approach to food that is flexible and adaptable; an approach that truly works for them.
6. What happens when someone needs to lose weight and is also diagnosed with diabetes and heart disease? The diets were ranked for each condition. The ranking shifted significantly for each of the specific conditions.
The DASH diet ranks as the number one overall choice because of it’s “ability to prevent or control diabetes, and role in supporting heart health.” How does an average of scores by professionals who don’t have any information about a patient determine the best diet choice?
ENERGY METABOLISM IS A CORE COMPONENT OF EACH CONDITION
I am concerned that there is no discussion about the common metabolic pathways and factors that influence each of the conditions: obesity, diabetes and heart disease. Wouldn’t it help to explain how these conditions are linked to each other?
When my clients figure out an approach to food that works for them, blood sugar drops, lipids levels improve, and body fat takes care of itself.
A diet need to be an approach to food that works for someone and with someone, not the condition they are diagnosed with.