Despite the new and exciting research being published everyday and the plethora of information we have access to in a few clicks of a button, nutrition is more confusing to most people than at any other time in history. The majority of my clients relay some kind of confusion, frustration or doubt about what diet is right for them. They ask me which one is best. Keto? Plant-based? Paleo? Mediterranean? GAPS? AIP? Whole 30? Low Carb? This is also complicated by the fact that you might have someone in your life right now experiencing positives or negatives from a diet change. You may have a co-worker that is doing keto (high fat, moderate protein, very low carb) and dropping mad weight and at the same time have a family member who went the opposite direction and did Whole Foods Plant-Based (low to moderate fat, low protein, high carb) and is now off meds. They swear it will work for you too. Maybe they're right. Maybe not. I hear a lot of overwhelm around eating which can lead to sticking with the status quo way too long or changing nothing at all. You maintain the same pattern, day in and day out but frustration builds because you just want to FEEL BETTER. I totally get that.
Hippocrates said it best:
My goal in this post is to help you overcome that overwhelm and indecisiveness so you can start to see and feel the results you so desperately want. Together let's forgoe our diet insanity, shall we?
My definition of diet insanity is: when you are eating the same foods in the same way over and over and over yet expecting different results.
Only You Know
My clients, families and friends ask: which diet or what foods will promote weight loss, increase their muscle mass, lower their blood sugar or blood pressure, give them more energy, improve their hormones, manage their autoimmune disorder and more.
An adaption from Smokey Bear's famous line - "only you can prevent forest fires," is my message. Only YOU can figure out the best diet for you. You see...there is NO one-size-fits-all diet. Pause the momentary freak out... I promise to guide you, nudge you and help you see more clearly why a certain eating pattern is ideal or not ideal for you. Nearly in every consult I conduct, I discuss with my clients the potential benefits, pitfalls, repercussions, deficiencies, struggles and wins if you do or don't plan your diet well, if you yo-yo, or overlook diet quality (no matter which diet you choose). Even if you are never able to meet with me one-on-one, there are 4 questions to ask yourself to navigate you towards the right way of eating... for you (not your neighbor, friend or family member).
1. What disease(s), symptom(s) or lab value(s) are you trying to improve?
2. What eating style makes you feel good, sleep good, have more energy and mental focus/clarity?
3. What do your genes say?
4. What eating style can you maintain for 6 months or longer?
But before you answer any questions, let's look at where different diets fall on the eating spectrum.
One experimental extreme is keto, the opposite is Whole Foods Plant-Based (WFPB). Smack dab in the middle is a balance of the two - a Mediterranean diet with a real-food, plant-heavy, balanced approach that doesn't exclude any food.
Health experts from U.S. News and World Report ranked 39 diets based on sustainability, effects on chronic diseases and weight loss, safety and nutrition. The results?
DASH (Dietary Approaches to Stop Hypertension), Mediterranean and Semi-Vegetarian/Flexitarian ranked in the top 3.
Now that you feel a little more comfortable with overall diets in general, let's break down those questions:
1. What disease, symptom or lab value are you trying to improve?
Research has shown that liver disease and kidney disease may both be worsened by a high fat diet (keto), so I'm wary of anyone attempting that who has pre-existing organ disease.
Autoimmune diseases usually benefit from avoidance of gluten and dairy, so Paleo or an AIP (Autoimmune protocol) diet may be ideal.
Keto, WFPB and Mediterranean have all been studied in regard to managing diseases like diabetes, heart disease and obesity.... and many, many show good results. Say what? How can that be? They are SO different!
I believe it is because a few common foods and eating patterns are shared by major diets. And that just might be your golden ticket to health. Let's take a look:
Visually this means you would be cutting out foods like the top row in both pics below and eating way more of the bottom rows.
Also consider the 10 leading causes of death (8 of which are lifestyle-related and/or preventable):
#1 Heart disease
#4 Lung Diseases
#8 Flu and Pnuemonia
#9 Kidney Diseases
Make sure the diet and lifestyle you choose reduces your risk of heart disease and cancer, in addition to what diseases run in your family or what you are predisposed to.
Heart disease risk is impacted by your level of exercise, inflammation, saturated fat intake, genes, and weight.
Cancer risk is reduced by abundant intake of antioxidants, fruits, vegetables, fiber, your genes and regular exercise among other factors.
2. What eating style makes you feel good, sleep good, have more energy and mental clarity/focus?
If you switched to vegan or whole-foods plant based and have experienced a dramatic surge in energy, lost weight, your body aches are gone and/or your blood sugar is improving, congrats! But if you aren't feeling great, investigate why. Vegans and WFPB-ers need to supplement with omega-3's, B12 and maybe more nutrients to ensure good health long-term.
If you started keto and hit the wall that is the keto-flu because you weren't managing your electrolytes well and/or tried to keep doing your high intensity workouts during the transition period from carb fuel to fat fuel (or due to a number of other reasons), that is really rough. But, that doesn't necessarily mean keto won't work for you. Maybe you need more electrolytes (like 2 cups bone broth + salty foods + avocados daily and epsom salt baths regularly). Or maybe you need to hold off most exercise for 2 weeks to transition. Or maybe keto is not ideal for you.
If you started eating WFPB and feel mentally foggy or cloudy, maybe you aren't providing your brain with what it needs while eating this way (i.e. omega-3 fats (Nutrients, 2016), creatine (British Journal of Nutrition, 2011) or B12 (NIH)). Or maybe that diet is not right for you. If you have certain genetic mutations that don't allow for proper conversion of plant-nutrients, like the genetic mutations (also known as SNPs) on the FADS gene, you may do better with animal sources (Clinical Nutrition, 2010). That could mean Mediterranean or semi-veg is more sustainable for you. Other reasons for brain fog include food intolerances, dependence on high glycemic and refined carbs and/or gluten, so Paleo or Keto may be beneficial.
3. What do your genes say?
This is an area I am fascinated with. Now that it has been decades since our genome was sequenced, genetic testing is much more affordable and easy to access with home test kits. I recently obtained my 23andme.com results and it has been SO interesting! I know more about myself than ever before. That's empowering (and I agree a bit daunting too)!
I'm especially interested in Alzheimer's because my paternal grandmother suffered terribly from Alzheimer's and eventually passed away after 10 years. Now thanks to companies like 23andme.com, you can know if you have one or two copies of the APOE4 that raises your Alzheimer's risk - like significantly raises it. Check out the Alzheimer's lifetime risk data from 23andme.com below:
Why would you want to know if you have this APOE4 genetic mutation or not? Because Alzheimer's is also known as Diabetes Type 3 which means it is majorly impacted by sugar and carb intake, blood sugar levels, exercise, smoking history and more. In addition, one or two copies of APOE4 significantly affects your ability to handle saturated fats. I recently listened to a fascinating (but very technical) podcast on the Found My Fitness podcast by Rhonda Patrick, PhD who interviewed Dr. Dale Bredensen, M.D., on preventing and treating Alzheimer's. Dr. Bredensen is a professor of neurology at the Easton Laboratories for Neurodegenerative Disease Research at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Watch it on youtube here, or listen to it here. He is an expert in the field and has been researching this disease for decades. His work (with collaboration of others) has resulted in at last 220 published research papers. He advocates a Mediterranean-style (lower in saturated fat, higher in mono and poly-unsaturated fats.... think nuts, seeds, avocado, olive oil vs. red meat and dairy) ketogenic diet for brain disease prevention and treatment.
Depending on what genetic mutations you have, you may or may not do so well with high saturated fat intake, also known as a hyper-responder to fat intake. You may gain more weight, have major increases in cholesterol or worsen your health in other ways from a diet rich in saturated fats.
If you have a mutation or SNP on the TREM2 gene, your risk for inflammation is higher. A Mediterranean diet has been shown in many studies to reduce inflammation. Or if you have SNPs on the CFH or the ARMS2 genes, your risk for macular degeneration is higher which may mean a semi-veg or plant-based diet is ideal for you so you get the most access to beta-carotene rich foods (like orange and green produce) to take care of your eyes.
4. What eating style can you maintain for 6 months or longer?
To avoid yo-yo dieting, and to sustain weight loss and avoid that dreaded weight regain + more weight gain, I advocate for a lifestyle change not a quick-fix.
Think about your family, friends, and those who you spend ample time with and how they eat and celebrate. We know eating is a social experience and if your diet isolates you, that likely means it is not sustainable or healthy for you emotionally and mentally. As many of my clients from India, Central America, Mexico or Puerto Rico have told me, a diet that excludes traditional staple foods in their culture like rice or beans makes it feel unsustainable. That isn't to say you can't spearhead changes for the whole family, or find agreeable substitutions for traditional staples, but it does mean more planning, motivation and consistency is required to "stick with it" in the setting of family meals and social events.
Do you exercise?
I view carbohydrates as fuel for physical activity and if you cannot/will not exercise regularly due to physical injuries, workload, schedule, etc., then a low-carb diet may be valuable and feel sustainable for you.
Also, consider, what foods do you love and what can't you live without? If fruit, or oatmeal, or potatoes are your favorite foods ever, then Mediterranean, vegan or whole-foods plant-based might suit you well. If you feel you can never live without cheese then consider Mediterranean or keto.
The Bottom Line
These questions and your answers will highlight the fact that you are the only you in the world, with a unique genetic make-up, upbringing, culture, food preferences and food memories. And all of that influences what eating style will be ideal for you and what is sustainable.
If all of this is too much and you still aren't sure, of course you can always book a consult with me here but if you'd rather not, focus on the basic principles shared by keto, Mediterranean, paleo and whole-foods plant-based diets:
- MORE plant fats, fiber, and non-starchy vegetables
- LESS fake foods, junk carbs, dairy and added sugars
How can you make this happen in daily life?
Eat veggie-heavy “S” foods daily: SOUPS, SCRAMBLES, SMOOTHIES, & SALADS
Snack on veggies/fruits and nuts/seeds
Aim for 50% veggies at all meals
Eat fiber-rich foods, consume resistant starches (read more about these starches in my post here), and consider a supplement like Benefiber, psyllium seed husks or a pre-biotic especially if on a low-carb diet (or if you need to manage cholesterol or blood sugar).
This is the foundation for how I eat everyday and my instagram feed (you'll see lots of salads, veggies and color). Sometimes we already know what to do, but seeing how to do it can help us make the change.
Real foods. Colorful foods. Whole foods.
Your health is waiting for you there.