The Weight Loss and Nutrition Debates: Being Right vs. Actually Helping People

Weight loss and nutrition is right up there with religion and politics when it comes to passionate people defending their beliefs. There are several schools of thought and it seems they are always trying to one-up each other with their latest “solid peice of evidence”, case study or anecdotal story. It will not take very long for anyone who is looking for nutritional or weight loss answers, to either find a “new religion” and swear their faith to this particular way of life within weeks or even days of giving it a whirl, or, if they decide to dig a bit deeper… to become thoroughly confused and unsure which revered M.D. or Holistic guru to believe. Here’s a brief break down of the major religions… err, nutritional philosophies you will likely run into.

The “Balance in Everything” tribe

This is usually the space of mainstream medical, dietitians and large food corporations and government policy. It focuses on vegetables, fruits and grains, with moderate levels of animal protein intake, keeping fats to a minimum. This “traditional” approach is based on the original government food pyramid which is not just concerned with what is healthy, but what is most sustainable economically for business and government programs. The weight loss approaches of this tribe center around energy balance, meaning the goal is to take in less calories than you burn while still maintaining a balanced diet of carbs and proteins, but often restricting fats, and largely ignoring the underlying hormone imbalance (if they admitted to hormone balance being a significant factor, they would have to admit that the insulin therapies used for type 2’s actually cause obesity and make the disease worse). These are the same folks most likely to support bariatric sugery as an option. Their own efforts to help patients lose weight through diet usually fail and surgery is presented as an “easy button” for making change. Can you really ever feel like your provider believes in you when their brochure ends with surgery? Does the long-term data on surgery (3 year), turn out better than diet in their surveys because it’s truly a better option or because the providers fail at providing adequate support for a non-surgical intervention? And do they fail at providing non-surgical support because it’s simply not possible, or because surgery is 20 times more profitable and is covered by insurance? Just some questions we wonder about, and we’re not saying surgery should never be an option, but we are saying it shouldn’t be on the same menu with non-surgical lifestyle change services.

The “Plant-based” tribe

There are many levels of dedication to this particular way of life, but they all avoid eating meat. Some may compromise with fish, but red meat is like taking the lord’s name in vain. Vegan is probably the noisiest tribe in the world of nutrition, adopting the lifestyle as not just a health methodology, but as an ideology, aligning themselves with groups such as PETA. We’ve seen some vegetarian groups claim the number of vegans doubled from 2009-2011, however gallup polls put the overall vegetarian movement at a standstill from 1999 to 2012 at around 5-6% of the population. Vegetarians are an interesting group. While they brandish their personal experiences as the gospel for all, and are quick to point out so called “irrefutable” pieces of evidence against animal protein like the China Study, other more level headed veggie defectors bring some balance to the true health driving forces of plant-based diets. Of course you can get some counterbalance from the meat and dairy industry as well :), but we find perspectives like those of Denise Minger, with no agenda except to help people do their own critical thinking, to be of more value. Plant-only eaters will preach ad nauseam about weight loss benefits. Keep in mind when most people change to a vegetarian diet they eliminate a lot of junk by default. Calorie intake can go down dramatically at first from eating less fat. However this is not the case for everyone and in fact we help many vegetarian clients in our clinics (vegans are tougher to help unless they will compromise on dairy, since many of our products contain whey and whole milk proteins). Vegetarian lifestyle can be healthy for many but it’s not the panacea for avoiding disease that many of its evangelists would have you believe. There are risks you need to be aware of when you adopt this lifestyle so we encourage you to get a balanced perspective from a qualified nutritionist or doctor and educate yourself as much as possible through reading different opinions and testing, tracking and tweaking your own results.

The “Paleo” Tribe

Maybe you’ve heard this term by now, maybe not but essentially the Paleo folks follow a lifestyle akin to our ancestors before the invention of farming. Think hunter-gatherer menus of rooted veggies, nuts, berries and yes, plenty of animal meat. In fact, the hard core followers don’t just eat what most people think of when they hear the term animal protein, they eat “tail to nose”, believing that organ meats, bones and cartilage contain important pieces of the protein puzzle. The reality is that “Paleo” has been adopted very losely by most followers, who are just trying to avoid over-processed foods, most grains being part of that category. So you could call this a low-carb, high-fat lifestyle, but it’s also a whole food lifestyle so some might be getting what other “true low-carbers” would consider too much sugar in the diet. And most of the fats would fall into the healthier categories from sources such as fish, plant oils and nuts & seeds. Some add in dairy as well even though this wouldn’t have been possible in true Paleo times. Overall we see this as a strongly supported approach to a balanced lifestyle when trying to maintain an already healthy metabolism. Paleo will result in incremental weight loss for many, but not all. Just the elimination of grains will help most folks lose weight, at least for a while. That being said the weight loss can be slower and plateau rather quickly, especially for many women who might be more sensitive to the high fat intake of this diet.

The “All Carbs are the Devil” Tribe

Ok so that label might be generalizing a bit, but it does capture the sentiments of this group in our experience, who offer beat downs to those who question it, second only to the fundamentalist vegan “gangstas”. We will say folks following this lifestyle for any extended period of time would not likely (as in never) be a patient at one of our clinics. If you don’t eat carbs as a general rule your likelihood of being overweight is zero. So does that mean carb-elimination is the ultimate answer to weight control? Well first, let’s see what they mean by “no carbs”. The reality is that these folks do eat carbs. In fact, one of the newest leaders to gain fame in this movement, Dr. David Perlmutter, has daily carbohydrate targets between 50-80g as part of his prescribed lifestyle, which he uses in clinical practice to treat patients who have or are developing neurological disorders such as Alzheimer’s and Fibromyalgia. Those carbohydrates come from vegetables, nuts and berries. And that is all the body needs in terms of minimum carbohydrate intake. So you may be asking what’s the difference between these folks and Paleo? Not a lot, accept that most Paleo followers don’t concern themselves with a strict limit and tracking of carbohydrate intake. Some paleo eaters could be getting considerably more carbs if they eat more starchy veggies and sweeter fruits. Some of the “no carb” crowd are proponents of Ketogenesis as a lifestyle. That’s a fancy term for living off fat (instead of glucose) for energy on a daily basis. Most people need to be under 50g of carbs to stay in “Ketosis” and some need to be as low as 30-40g based on our clinical experience and studies available on the subject. A John Hopkins study followed children who were on a ketogenic diet for 7 years, with no observed adverse effects, so those questioning it as a sustainable lifestyle, it is if you are motivated enough to stick with it. The beauty is they can generally go to town on fats, as long as they keep carbs and sugar to minimum, and in fact Dr. Perlmutter says that is one of the main objectives, to increase healthy fat intake which is vital to brain health, and the elimination of grain which is detri”mental” to brain health. Alzheimer’s is increasingly linked to metabolic dysfunction caused by an excess of carbohydrate intake.

Is Low Carb Approved? It depends on your situation and your definition of low carb.

Is Low Carb Approved? It depends on your situation and your definition of low carb.

Even though low-carb is shown to be a very healthy lifestyle for many, we don’t haul out an automatic stamp of approval for everyone. There are many factors to consider such as having healthy kidney and liver function and medical supervision for cardiovascular conditions. Also it’s not just about the elimination of carbs, but adequate and quality protein and fat intake. Athletes may do better with higher carb intake although this isn’t true for all athletes, some of which are discovering the power of a low carb lifestyle. In fact, one of the most famous promoters of the carb-loading strategy, Professor Tim Noakes, shocked his massive runners following by changing his opinion supporting carb-loading to the exact opposite… eliminating wheat and sugar. We find that most people can enjoy higher carb foods as part of a healthy lifestyle if they lean strongly toward whole-food and develop sensible meal planning for only occasional processed high carb-high fat dishes (creamy pastas, pizza, pastries etc.) which describes the Standard American Diet that has led to epidemic chronic disease. For weight loss, low carb is a well-studied and effective approach. The key is maintaining compliance and safety to reach your outcome. We don’t use high fat meal plans for ketogenesis, because high fat intake can compromise the rate of burning your own fat, and the safety of the diet in some people. After weight loss and insulin sensitivity is re-established, for most people the benefit of super low-carb may be diminished.

So what tribe should you pick?

What’s clear is that it’s time to rethink processed grain & sugar, including bread and pasta, as being a staple in our diets. But don’t expect the conventional health care community to accept this science any time soon, there’s too much politics riding on the processed-grain solution for feeding the world’s growing population. Outside of preventing starvation, we can’t see a compelling reason to make grains a required diet item, other than pure enjoyment on occasion, and grains are not a long-term solution for feeding the world (unless we want to deal with a world of diabetics). We’re not fanatic like some folks. Although we get where they are coming from, it isn’t realistic to expect our culture to just say good-bye to grains, which are a deep-rooted cultural element in addition to an economically convenient source of calories for public assistance programs and schools. You can still enjoy a piece of freshly baked bread or a bowl of pasta as part of a healthy lifestyle. Although for some people, complete elimination is warranted. We don’t suggest joining any tribes. We suggest finding what works best for you, with the help of an experienced professional who doesn’t bend too hard one way and bases the recommendation on the individual person, not on their own personal ideology.

Well done is better than well said.

Benjamin Franklin

We’ll Leave the Tribes To Debate Each Other, and Just Keep Helping Thousands of People Get Healthier

The interesting part to us, about the tribal experts with all their righteous intellect, is that they are often astute at supporting why their position is right and others are wrong (even if the argument only works in their own head), but ask them how many people’s lives they have personally transformed. Or better, ask them how they help people who aren’t ready to accept their ideology but still need help. Are only certain people worthy of help? (just as many religious zealouts are only interested in helping those who are ready to accept their faith) While tribal experts will convince you they have the best answers to a healthy diet for the few who are willing to adapt them, other leaders are focused on helping populations to achieve health outcomes. They do it with non-invasive methodologies that help bridge the gap from a very unhealthy lifestyle, to a much improved one, even if it doesn’t match their favorite philosophy.

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