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Will the “Diet Debate” Ever End?
October 28, 2013
One of the joys (and burdens) of being a dietitian is the feedback that I get about the merits and pitfalls of various types of diets. Some people ask about certain types of diets because they’re curious or because they want to lose weight/manage their diabetes/live longer, etc. Other people take a firm stance or position (often zealous in nature) that the “X” diet (fill in the blank here) is really the ONLY diet to be following if one wants to lose weight or lower his blood glucose. They’ll argue and sometimes, I admit, become rather rude and dismissive if I or others won’t jump on their particular bandwagon.
Then, there are the health-care professionals, be they doctors, nurses, pharmacists, psychologists, or, yes, even other dietitians, who fully subscribe to a particular diet, eating plan, or way of life. Some are proponents of a vegan lifestyle (think Dr. Neal Barnard). Others eschew practically all carbohydrate (think Dr. Pierre Dukan) or maybe just particular carbohydrate foods, such as grains and dairy, for example (think Paleo diet).
Some health-care professionals (including dietitians) are more mainstream, meaning that they realize and recognize that there isn’t just one approach that will work for everyone — when it comes to weight and diabetes management, that is. Which brings me to the topic of this week’s posting: Will the diet debate ever really end?
A Google search revealed that Dr. Pagoto is an associate professor of medicine and also a licensed clinical psychologist, providing weight-loss counseling. She’s authored numerous papers and has published a book, as well. Dr. Appelhans is an assistant professor of medicine and is a practicing psychologist and obesity researcher.
Their opening sentence is,
The authors go on to state that despite the numerous types of “diets” out there, such as low-carb, low-fat, and Mediterranean, the differences in weight loss and metabolic risk factors are really very small, and that conducting more studies on these diets will likely not produce findings that would “significantly advance the science of obesity.”
Adherence is the key
And lest you be skeptical, know that lifestyle interventions (healthy eating, physical activity, and behavior modification) can be sustained. The Finnish Diabetes Prevention study, the Diabetes Prevention Program, and the China Da Qing Diabetes Prevention Study all showed that interventions can and do last a long time.
Cutting out carbohydrate or subsisting on green juice drinks will only get you so far; for any of the benefits to be long-lasting, you need to examine other areas, such as how much exercise you’re getting, along with your eating habits and patterns. Without also addressing these, your chances for long-term success dwindle. Therefore, should research dollars continue to be spent on analyzing the ideal macronutrient composition of the ideal diet? Or would they be better spent on finding ways to help people be more active, adopt healthier behaviors, and be able to stay with a plan for the long haul?
So, what IS the best diet?
As Pagoto and Appelhans write, behavioral adherence is much more important than dietary composition. There’s no single, effective approach to weight management or diabetes management. The ADA 2013 nutrition recommendations were just issued, and they clearly take the position that there is not a “one size fits all” eating pattern (new terminology) for people with diabetes. Hopefully we can recognize that there are many eating approaches that can work for people who need to lose weight and/or who have diabetes. Many factors play a role in what approach a person will take and what approach is truly the best for him.
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