Wednesday, February 3, 2016

DIETS: The Good, the Bad & the UGLY!

This week I'm giving a quick snapshot of the information that I have collected on what diet books get right and wrong, as far as mental and physical health are concerned. It is based on the best scientific data collected on the healthiest, longest living people on earth. I compared what foods were being pushed, or excluded, in those diet books to what the healthiest populations on earth eat. The point that should become clear is that diet book authors aren’t stupid! They know what sells and what doesn’t. They’ve thought things through. For instance, let’s suppose there were two books on a shelf, sitting side-by-side. One book says people need to find ways to reduce stress while eating plant-centered meals and exercising daily. The other book says that people can eat steaks wrapped in bacon and by doing so will burn more calories watching television than others do while exercising (That is an actual assertion made by a diet book that I will cover). Do you think they know which one the average person is going to buy? We have to rise above the gimmicks if we want to make real changes.
I began my search for answers by looking at the populations that everyone discusses, the ones with the most centenarians. I’m speaking of those people living in parts of Sardinia, Greece, Japan, California and Costa Rica. Those were great places to start, but focusing only on those populations seemed too narrow for me, so I widened the search.

Thankfully, there is fascinating data on people in many other parts of the world.  There are groups of people thriving, despite their advanced age, in many areas of China, Africa, and India. One of the most important factors for me was that they are doing it without the advantages of an ultra-modern medical system. I took out the groups of people who had easy access to the best modern medicine available because, despite what conspiracy theorists claim, modern medicine can drastically increase life expectancy. I wanted to know who was living the longest based on diet and lifestyle, not on the quality of a community's medical system. I admit that cut out more populations than I would have liked. However, doing so still gave me many more groups to analyze than what I started with. I was pleasantly surprised to find how much they all had in common, despite being spread across the globe.
As culturally and genetically diverse as these populations are, they share three things in common. Overwhelmingly, they tend to have found ways to lower stress levels, get daily exercise and eat mostly unprocessed, or minimally processed, plant foods. Fruits, vegetables, grains, nuts, and seeds tend to make up the majority of their meals. Technically, they also seem to share one other characteristic. They don’t go on restrictive diets. In fact, I have yet to find a single study that documented any of these groups of people going on any type of diet. It seems to be a foreign concept to them. Thank goodness.
So, let’s compare what they predominantly eat with what the three main categories of diet books say we should eat. I’m categorizing all diets into three groups because the vast majority are just slight variations on the same three themes, which are Vegan/Vegetarian, Low Carb, and Paleo/Anti-Grainers. I realize that there are others, but these are, by far, the most popular. Also, I’m summing up 173 pages of notes I’ve collected on various diets into one post. Grouping them into three categories is the only way I can do it.
The Good: By nearly every metric used to measure health, vegans and vegetarians do well. As a group, they tend to get high marks. Regardless of ethnicity or cultural background, vegans and vegetarians often live significantly longer and experience less disease than people who consume large quantities of animal products. There is also strong evidence that strict vegans can halt, and in some cases even reverse, heart disease. These diets closely resemble the way the healthiest and longest living people on earth eat. However, the overwhelming majority of those populations do eat small amounts of various animal products.
The Bad and the UGLY: Notice before that I said “nearly every metric used to measure health.” Oddly enough, there is a good bit of evidence that suggests vegetarians and vegans experience MORE mental health problems than those who occasionally partake in animal products. There are many different theories as to why this is true. No one is suggesting that these diets cause mental illnesses, but there is evidence that a low intake of fats, EPA and DHA in particular, can exacerbate existing psychological conditions. Psychology today published an article a few years ago that highlights a few of the theories surrounding why there is a higher prevalence of mental health issues in the people who adopt these diets.1 I found it odd that no mention was made in the article that people often express concern over this type of diet being exceedingly hard to follow and that it often causes elevated stress levels. Feelings of social exclusion and stress are often reported to researchers who are studying those who have adopted these diets. Feelings of social isolation and increased stress levels, much less the strict nature of these diets, are enough to explain why the majority of people are unable to follow these diets, over the long term.
A personal note: A few years ago I went vegetarian for nine months and then went vegan for three more. At the end of that year, I looked fantastic. I was slim, and my running times were excellent. Unfortunately, I was coming unhinged. For someone with my conditions, the struggle of always being the odd man out, always struggling to find foods I could eat, trying to consume enough protein, and feeling just a little bit deprived caused me untold grief. In other words, I can attest to the reports of higher levels of stress and social isolation that researchers have often received from people trying to be a vegan or a vegetarian. I admire individuals who can eat this way without negative emotional side-effects. However, despite my best efforts, I was unable to find a way to do it. Since making peace with the fact that, occasionally, I need to eat animal products, my mental health has improved, and my physical health has improved. I’m also running faster now than when I was as a vegan!
Low Carb (Atkins, The Zone, etc.)
The Good: They all reveal the unheard of, stunning, unbelievable fact that refined sugars are bad. I hope you detected my sarcasm there. The healthiest populations on earth don’t have high intakes of refined sugars. So, I suppose they did get that right.
The Bad and the UGLY: I could write four posts on how dangerous and ridiculous these diets can be. They aren’t new. William Banting wrote Letter on Corpulence in 1864. These type of diets popped up again in the 1920’s, 40’s, 60’s, 70’s and then in 1992 Atkins reissued his book as Dr. Atkins New Diet Revolution. It became the best-selling diet book in history, despite the fact that the “new diet revolution” wasn’t all that new. The National Academy of Sciences, the American Medical Association, the American Dietetic Association, the National Institutes of Health, the American College of Sports Medicine, the American Cancer Society, the Cleveland Clinic, Johns Hopkins and the American Heart Association have all made their opposition to this diet known. The Secretary of the AMA’s Council on Food and Nutrition said, “The whole diet is so replete with errors woven together that it makes the regimen sound mysterious and magical.” The Journal of the American College of Medicine published a report in 2003 that stated: “Carbophobia is a form of nutritional misinformation infused into the American psyche through...advertising...infomercials...and best-selling diet books.”

Wild claims are often made about ketosis, insulin sensitivity, and other medical terms. For instance, The Zone claimed on its back cover that: “You can burn more fat by watching TV than by exercising.” Jeffery Prince, a spokesperson for the American Institute for Cancer Research, was talking about low-carb diets and their ridiculous claims when he said, “When unproven science becomes a sales pitch some people get rich, and the rest of us get ripped off.”
Over fifteen million Atkins books have been sold, not to mention all the other books that simply tweak the same concept. Of the tens of millions of people who bought those books, how many can the National Weight Control Registry find who have lost weight, long term? After a decade of following people who have successfully lost weight, and kept it off, a chief investigator reported, “We can’t find more than a handful of people who follow the Atkins program in the registry and, believe me, we’ve tried.” What about the other low-carb diets? They report “Almost nobody’s on a low carbohydrate diet.” In fact, they found that most people who were successful in losing weight long-term were eating HIGH carbohydrate diets. This is an organization that is funded by the National Institutes of Health. We are talking about real researchers and scientists who are looking for real answers, and their message is clear. Of the estimated 26 million Americans who are currently trying to follow a low-carb diet, they have only found a “handful” who have had any long term success.
It’s not just American scientists and nutritionists who abhor this type of diet. In Europe hospitals are banning the Atkins diet. The British Nutrition Foundation and the British Dietetic Association has called the Atkins diet negligent, nonsense, pseudoscience and a massive health risk. The Australian Heart Foundation and the Australian Medical Association supported the Victorian Health Minister in issuing a warning to people of the dangers of high-fat fad diets. Some of the warnings of the short-term effects included things such as constipation, dehydration, low energy and poor concentration. Some of the long-term warnings included the increased likelihood of cancer, heart disease, depression, and osteoporosis. The minister has explained, “When we know something is bad for people, like smoking, then we let people know what the health risks are.”
I’m trying not to bang my head on my desk as I’m writing this, so I’m going to stop now. It’s simple, I have yet to find anyone, who isn't selling gimmicks, that isn't horrified by what's in these books. Not only is long-term success on these diets as rare as sightings of the Loch Ness Monster, but the health risks are unbelievably high.
A Personal Note: Please, for the love of God, don’t do this to yourself!
The Good: These books cut out all highly processed foods, from refined sugars to refined grains. They also suggest eating wild game or pasture-raised animals. Cutting out processed junk food and meat that can be laden with growth hormones, antibiotics and pesticides is sound advice that can be backed up by solid science.
The Bad and the UGLY: Of all the diets U.S. News and World Report researched, they gave the Paleo diet the lowest marks. It’s because very little food that is available today was available to cavemen. That means the diet is inherently complicated, hard to follow consistently, and the most expensive, by far. Also, many on this diet use eliminating refined foods as an excuse to eat loads of meat that has little resemblance to that of prehistoric wild animals. This has led some to label the Paleo movement as Atkins Light. Not to mention there have been no randomized controlled trials, much less any meta-analyses, done on this type of diet. So, no one knows for sure if it’s healthy. Naturally, it’s assumed that those who lean heavily on eating fruits and vegetables and add in pasture raised animal products will do beautifully in future tests because those types of eating patterns fall in line nicely with what the healthiest people on the planet are eating. Those who turn the Paleo movement into Atkins Light may not be so lucky.
The lack of consensus on what the Paleo diet actually is does presents researchers with a problem. Some on the diet focus on fruits and vegetables while others eat plates full of bacon and eggs. Which one of those groups best represents the Paleo movement? Many in the movement will say that both groups are correct. Often, they will throw out a catchphrase to try and define their diet. It’s, “If a caveman wouldn’t eat it then you shouldn’t eat it.” What does that mean, exactly? That’s the problem. No one actually knows.
One of the more glaring problems that hangs over all the Paleo diet books is their stance on grains. To their dismay, grains are eaten by nearly every group of people on the planet that live the longest and are the healthiest. Often, the authors of these books use terminology to describe grains in a way that makes it seem that new revelations have been uncovered as to how unhealthy grains are. There haven’t been. 

Just because the authors throw around old terms, like they’re new, such as anti-nutrients, phytic acid, gluten and lectins doesn’t mean that grains are unhealthy. On the contrary, for the vast majority of people grains have been shown to lower the risk of heart disease, blood pressure, premature death and reduce the risk of many types of cancer. What isn’t mentioned in these books is the fact that lectins, phytic acid, amylase inhibitors, phenolic compounds and saponins have been shown to reduce blood glucose and insulin responses, as well as cholesterol and triglycerides. There is also a strong relationship between phytic acid, phenolics, saponins, protease inhibitors, phytoestrogens and lignans to reduced cancer risks. There have even been suggestions that antinutrients be renamed because of the false impression the name gives. Did you like how I used their technique of using scientific wording to make my point sound slightly magical and profound? As Einstein said, “If you can’t explain it simply, you don’t understand it well enough.” Here is the simple truth. For the vast majority of people, grains are associated with good health, not poor health.
What do I mean by grains are healthy for the vast majority of people? Well, the Columbia University Celiac Disease Center puts the percentage of individuals who have celiac disease at .55%. That's right, a half of one percent. The Center for Celiac Research at the University of Maryland estimates that around 5% of the population has some degree of sensitivity to gluten. These are two research institutions whose funding depends on studying people with gluten sensitivity, and they put the number of people who may be negatively affected between a half percent and five percent. That means the number of people allergic to dairy dwarfs the number of people who are allergic to gluten. When someone gets a rash or a tummy ache from dairy, they often make a wise decision; they don’t eat it anymore, and the rest of the world goes on about its business. However, due to the clever marketing of old terminology that sounds scary, people all over the world are terrified to eat grains. 

It's quite simple. The science does not support the view that grains are unhealthy. In fact, many of the healthiest populations on the planet not only eat grains, but many of them also eat refined grains, such as white rice and various types of bread. Unfortunately for the authors of the anti-grain books, the large-scale studies don’t match up with their small scale, or what often appears to be cherry-picked, research.
In case anyone out there has missed out on this whole phenomenon, let me give a sampling of some of the lines directly out of Grain Brain: “I’m referring to all the grains that so many of us have embraced as being healthful - whole wheat, whole grain, multigrain, seven-grain, live grain, stone-ground and so on. Basically, I am calling what is arguably our most beloved dietary staple a terrorist group that bullies our most precious organ, the brain.” “I will demonstrate how fruit and other carbohydrates could be health hazards with far-reaching consequences.” “This is a game changer.”  In a radio interview, he stated, “We’ve never in 99.9 percent of our time on this planet eaten carbohydrates. They weren’t available.” The only problem with that assertion is it doesn't seem to fit the facts at all. The small amount of data we have points to the fact that, as hunter-gatherers, we predominately ate carbohydrates in the form of fruits and vegetables. Hunting was much more dangerous and labor intensive than picking up fruits and vegetables off the ground. Good grief. This isn’t rocket science!
After striking terror into the hearts of many readers, the author of Grain Brain (I can’t bring myself to write his name) brags on the Mediterranean Diet. He then has to concede, “Although it does allow room for grains, it’s very similar to my dietary protocol. In fact, if you modify the traditional Mediterranean diet by removing all gluten-containing foods and limiting sugary foods and non-gluten carbs, you have yourself the perfect grain-brain-free diet.” Wait. What? Apparently, they have a fantastic diet that has been getting wonderful results for millennia. All we have to do is overhaul the majority of it, and then we can have a diet that meets his standards. Does anyone else feel like a slick salesperson is trying to sell them a bill of goods? I want the truth, not a sales pitch.
Is anyone wondering what other scientists and researchers have to say about the anti-grainers? Here is a small sample. In 2014, the American Journal of Cardiology published a commentary on Grain Brain that stated: “The declaration that a single, simple ‘cure’ can successfully treat numerous diverse diseases and symptoms is reminiscent of the oratory of the ‘snake oil’ merchants of generations ago.” David Katz, a Yale physician and nutrition researcher, had similar sentiments. He dismissed Grain Brain outright when he said, “I also find it sad that because his book is filled with a whole bunch of nonsense, that’s why it’s a bestseller; that’s why we’re talking. Because that’s how you get on the bestseller list. You promise the moon and stars, you say everything you heard before was wrong, and you blame everything on one thing. You get a scapegoat; it’s classic. Atkins made a fortune with that formula.” And finally, Jonathan Eisen, who is a microbiome expert at the University of California, stated: “To think we can magically heal diseases by changing to a gluten-free diet and taking some probiotics is idiotic, quite frankly. It resembles more the presentation of a snake-oil salesman than that of a person interested in actually figuring out how to help people.”
A Personal Note: I am friends with several level-headed paleo eaters. We have a blast and often eat the same things. They focus mainly on eating fruits and vegetables and pasture raised animal products. What’s not to love about that? I will say that they are affluent and have a great deal of free time to devote to eating this way. That certainly helps. As with anything, the trouble begins when things are taken to extremes and wild, ridiculous claims are made.
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      As always, I wish you wonderful mental health and great successes eating healthy meals. If you, or someone you love, is severely depressed or anxious, please click the link to the right and you will be directed to the International Association for Suicide Prevention. It is a fantastic resource and is staffed by wonderful people.
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