Diets – They’re Complicated.

You would never think that writing three blog posts about diet would be hard. Especially since this is more or less my profession, and I am rarely at a loss for words when it comes to talking about nutrition.

But when you get right down to it, diet – nearly everything about it is burdened by dislikes, disagreements, misinformation, magical belief and a host of other problems that end up making a causal conversation about it nearly as bad as politics or religion. Sometimes worse depending on the company.

So I am going to tell you a story.

I teach nutrition. Mostly to health professionals like dietitians, nurses, doctors and surgeons. Here in the U.S., and also around the world. It’s one of my favorite parts of what I do. I am often learning just as much from my audience as they are from me.

So recently, I am teaching a class to primary care physicians who had asked me to speak on dietary principles after bariatric surgery. They wanted to know about protein, fat and carbohydrate intake after the common surgical procedures like gastric bypass, gastric banding and sleeve gastrostomy. Seems easy enough…until you realize there is very little data to go on and most of the recommendations come from health professionals agreeing about what they do or making observations of what their patients do and how that might relate to health or weight-loss.

So I finish my talk and give some basic conclusions. I get a couple of good questions about protein. Then I get this:

Doctor – “So why do I want my patients to have any carbs? I mean, I just tell them to eat as few a possible – because they really don’t need them, right?”

A bunch of other people in the room sort of nod in agreement

Me: “Well, I can see why you might say that, but I am not sure it’s what you mean”

Doctor – raises eyebrows, gives curious look

Me: “I think that probably you do want your patients to have broccoli and kale and blueberries and other good colorful fruits and vegetables. And you might not mind if they have some lentils or black beans or maybe even an occasional sweet potato. I mean you likely do want them to consume foods with good antioxidants and fiber, right?”

Doctor: “Of course I do.”

Me: “Then you don’t actually mean to tell them not to have carbohydrates, because all those foods are carbohydrates. You just don’t want them to have refined sugars and grains and starches.”

Doctor: “Oh, right…I see what you mean.”

You see, here is the problem – we are all confused. Even your health professionals who are supposed to know the body are confused about the basics. And if they are confused about the basics, you can bet they are confused even more about the details. I try not be judgmental, because on some level they have a right to be.

The other day, someone posted a link to a study on Facebook supposedly showing that bacon will make you live longer (http://newrisingmedia.com/all/2013/9/30/study-shows-eating-bacon-will-make-you-live-longer). I am not going to dignify it further by discussing here.  But it’s a good illustration of the fact that the place we are at right now with nutritional research is this: I could make a decent argument for almost any diet from vegan to paleo being the best and find adequate research to be right.

What does this mean? Science aside, it likely means on some level that within reason there might be a wide range of eating types that are perfectly healthy for humans. It might also mean – and I think it does – that we need to ask a lot more questions before we can start running around saying with certainty that we know what the best diet is.

Best diet for what?

I will leave you with the words of two people I respect very much, Drs. Arya Sharma and Yoni Freedhoff who wrote the following in their book Best Weight: A Practical Guide to Office-Based Obesity Management (which you can find here: http://www.amazon.com/Best-Weight-practical-office-based-management/dp/0986588903/ref=sr_1_1?ie=UTF8&qid=1382390667&sr=8-1&keywords=best+weight).

The difference between dieting and a healthy lifestyle is easy to explain. A diet is the smallest number of calories and the greatest amount of exercise that a patient can tolerate. A healthy lifestyle is the smallest number of calories and the greatest amount of exercise that a patient can enjoy.

Think about that.

In Health,
Dr. Jacques

To view the other posts in this series, please click the below links:

Part 1
Part 2 

About the Author
Dr. Jacques, a frequent author in the OAC’s quarterly publication, Your Weight Matters Magazine, is a Naturopathic Doctor with more than a decade of expertise in medical nutrition. She is the Chief Science Officer for Bariatric Advantage (a Division of Metagenics, Inc)  a company dedicated to providing the best of nutritional care to weight-loss surgery patients. Her greatest love is empowering patients to better their own health. Dr. Jacques is a member of the OAC National Board of Directors.



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