Misapplied Information is a Bigger Problem than Misinformation

To be completely honest, there’s a ton of really good information available to us. Yes, there’s click bait and spammy junk. But, you can also access pubmed abstracts and sometimes even full articles. Many of the most well respected schools and institutions provide free training and information online (Stanford, Mayo Clinic, Cleveland Clinic and others).

And although there’s some training involved in navigating through the nuance of scientific studies, what I’m more concerned about is the misapplication of good information.

What I mean is this: We see others close to us (friends, family members, people we stalk on Instagram) make diet, exercise or other lifestyle changes. We think: well, I like them, trust them, admire them and I want their results. I SHOULD DO WHAT THEY’RE DOING!

What we don’t realize is that their metabolism, genetics, health, family and life histories, and myriad other things are different than ours. We’re AREN’T THEM! And--news flash--that’s a GOOD thing. So, I’d say if you try a new way of eating and it just doesn’t quite feel right, what your body tells you are hints to you that maybe something isn’t quite right.

So, although there’s unending good information available to us now, we should check in with ourselves and honor what your body and intuition tells us. Is this right for ME or someone else?  

What’s the Magic Health Pill?

My take on What the Health and The Magic Pill, two popular food and health documentaries

Over the past year, I’ve had people from all seasons of my life reach out to me and ask me what the H I think about the “What the Health” and “The Magic Pill” documentaries.

I have to be honest… I hadn’t even watched them. Although I’m obviously pretty interested in nutrition, health, and what we can do to reverse chronic disease, I sometimes need to just watch a binge-worthy documentary on Netflix (um… Wild Wild Country and Evil Genius anyone?!). I just need to shut off from all of that. Plus, I get to the point where I only need to watch 5 minutes of a documentary, see which “experts” they’ve interviewed, and I can already predict the bent to the show.

So, I finally bit the bullet. 

I picked these 2 out because they’re 2 of the most popular/high impact (people are making big health/diet decisions based on watching these), and they were both published in 2017. Other food and health-related documentaries I could have talked about include Fat Sick and Nearly Dead, Food Inc, Fed Up, Forks Over Knives, Cowspiracy, King Corn, That Sugar Film, and honestly more than I realized existed before watching each of these.

I had an intern working with me the past couple weeks, and we sat down to watch them (lucky her, right? Your assignment is to relax on my couch and watch movies with me). Together, we put this table (below) to compare and contrast the two documentaries. If you’re unlikely to read through the table, let me summarize it briefly here for you:

Ok, first before I go any further, I want to acknowledge that this is a very high level summary of what I see as the main themes, similarities and differences between the two documentaries. This is by no means comprehensive, and there is definite nuance to each.

So, now that we have that out of the way, here we go:

What the Health summary

What the Health (WTH) claims that a vegan, plant-based diet is the best health approach to eating. You should eat zero animal foods, and any chronic disease that comes from poor eating comes from foods derived from an animal. Sugar doesn’t matter. Eat all you want. You can see in the table that WTH is most concerned about processed animal products without concern for processed or refined carbohydrates. WTH would say that there is also no difference between organic or conventionally-raised foods.

The Magic Pill summary

The Magic Pill (TMP) claims that an ancestral “paleo” or ketogenic-type diet is the most healthful. Get back to the way we’ve historically eaten and let our genes lead the way. TMP would care more about highly processed/refined foods, overall. Quality of food is the higher priority over whether foods are animal or plant-derived.

Both documentaries hold big ag and big industry (pharmaceuticals and food) responsible for the cultural drive for this way of eating. They also both emphasize minimizing highly refined or processed foods (whether meat or carb). They both tell compelling stories of individuals who have dramatically changed their diet to follow the purported “best” way to eat, and you watch these people share how the diets have transformed their lives, leading to lower pain, less medication, and an overall better quality of life. Both documentaries tell compelling stories, and that’s what we all love. I can see why people choose to change their diets after watching either!

My take away: each of them emphasizes the importance of plant foods. Although they don’t address it in either movie we need to be mindful of the idea that you can eat a “healthy” version of either of these “diets,” and you can eat a less-healthy version (soda & chips are vegan and bacon & cheese are keto). So, using some common sense with their application is always important.

Is there a magic health pill?

So, What is the Magic Health Pill? I'm sure you can guess what I'll say, but there's no short cut to wellness. Eating more plants and less processed foods is always going to be a good way to approach your diet. The evidence is consistent in the literature that eating more plant foods is associated with better health outcomes. So, if you've never eaten your veggies, it's never too late to start.

I would say that if you’re unsure of what to do, just take a look at what you’re eating on a weekly basis (maybe keep a weekly log), and also pay close attention to how you're feeling. Do you have good energy, focus, good digestion? If not, your lifestyle may be playing a role in how you're feeling. As far as how you're eating, if half or more of what you eat is coming out of packages or windows (drive-thrus), then maybe a change would be worth it? If you’re eating mostly whole, minimally processed/refined foods, then you likely have a solid foundation. My only word of caution for the dietary approaches from each documentary is that they can both leave us vulnerable (similar to a Standard American Diet) to nutritional deficiencies if left unmonitored over a long period of time. There's no "one size fits all" approach to lifestyle changes, especially when it comes to diet. Integrative and functional healthcare practitioners are best equipped for monitoring and evaluating your nutritional status and would be a great sounding board for your efforts.

I know a really good nutritionist, if you’re looking for one.

So, what did you think about the documentaries? Have you made any changes since watching either or both of them?

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Why Keto is Everywhere Right Now

By Leigh Wagner, PhD, MS, RDN

If you follow my Instagram, you know that I took a poll to decide whether I should blog about the ketogenic diet or the documentary “What the Health.” And, keto won, if only slightly. So, my hope is to give a really high level overview about keto with a few zoom-ins (without writing an entire referenced review article - but there are some references). I’m also hoping this will help you look good at dinner parties when someone’s diet endeavors inevitably come up.

So, here we go.

What are the potential benefits of keto?

As with most diets or “lifestyle changes” (as we love to call them in the biz 😜), diets often run in cycles, come and go. We have low fat, low carb, high protein, and every other nuanced permutation of different macronutrient (carb/fat/protein) amounts.

What’s different about the ketogenic diet, is that there’s some compelling evidence suggesting that it may be super helpful for some people with certain diseases (some, but not all, cancers, Alzheimer’s, and the OG therapeutic keto condition: epilepsy).

With that being said, one reason keto is becoming increasingly popular recently is because it can also help facilitate weight loss. And because of that simple reason, you can't escape it. Keto is everywhere right now. 

What is the ketogenic diet?

But before I get into that (and why), let me explain what the ketogenic diet, or “keto,” is.

The ketogenic diet is a diet that’s very high in fat (like 80% of your daily calories are fat), very low carb (like 5%) with moderate-to-low protein (like 15%). The idea (and reason it’s called “ketogenic”) is because the body, when restricted nearly completely of carbs, will shift into burning an alternative energy source called “ketones.” It’s like a flex fuel car.

What do ketones do?

So, ketones, which are sometimes called “ketone bodies,” are just tiny parts of fats that are broken down differently than normal (into 2 carbon molecules), and instead, they’re broken down into 3 carbon compounds called “ketones.”

INTERESTINGLY, (for a nutrition nerd), ketones can be burned by the body and the BRAIN - even though I was told in conventional nutrition school that our brains only run on glucose). The body is able to burn fats more easily that we have in reserve. Think stored fats… like in our bellies, butts, and thighs. I like to call this “fat burning mode.” So, our bodies can use this alternative metabolic process of ketone production and we don’t have to use sugar or carbohydrates to function.

Keto and the Atkins diet

So, the reason I brought up the idea of diets coming in and out of style is because, remember the Atkins diet? Atkins is basically a ketogenic diet.

To give you an analogy, Kleenex® is a brand of tissue, while Atkins® is essentially a brand of ketogenic diet. Does that make sense? And, apparently, (one of my clients told me), the original Atkins diet even instructed you to buy ketone strips (urine testing strips to measure if you’re making/burning ketones).

So, the “keto” diet in popular culture is really just the Atkins diet coming back as a new trend. Although, I would say that when I use the ketogenic diet therapeutically, I encourage clients to focus on high quality fats and oils (coconut oil, extra virgin olive oil, organic pasture butter, avocado oil, nuts and seeds) whereas I always remember people on the Atkins diet just eating cheese and bacon. Although, now as I'm looking around on social media at "keto" posts, it's confirming that there's a lot of bacon and cheese (palm to forehead).

Side note for the people who have diabetes or have family members who do: Don’t freak out on me too soon, you’re probably thinking about diabetic ketoacidosis.

Metabolic ketosis is NOT the same as diabetic ketoacidosis. Diabetic ketoacidosis is a very serious, dangerous problem and will lead to severe symptoms. Please work with your physician or integrative dietitian 😉 before you make any dietary changes.

The ketogenic diet and weight loss

So, here’s the deal with the weight loss stuff. With other “diets” (like low-fat or long-term low calorie diets), the body will adapt and lower its metabolic rate. On the other hand, with a very high fat, low-carb diet like keto, the body will maintain its metabolic rate (and lean body mass) and still allow weight loss.

From a 2018 article in the Journal of the American Medical Association (JAMA):

“… There are hints that the ketogenic diet may be different [than other diets]. A meta analysis of 13 randomized controlled trials suggested that people on ketogenic diets tend to lose more weight and keep more of it off than people on low-fat diets. People placed on these diets often report decreased hunger.”

But, before you go jumping on the keto bandwagon (really, I don’t encourage everyone to do this), remind yourself of how surprised you were that this diet is 5% carb and 85% fat. I’m not saying you should be scared of a high-fat diet (I eat a ton of it!), but I am saying that eating a really high fat, low carb diet in America in 2018 could be challenging to implement long term in your life, as a sustainable approach.

Instead, what’s most likely beneficial is that you not eat the same food all the time. Just like I told you that long-term calorie restriction can lower your metabolic rate (meaning our bodies burn fewer calories by adapting to protect itself from this contrived famine we’ve put ourselves on), if you eat more of a variety of calories, variety of macronutrients, variety of foods, at various times of day, and in various amounts… that’s probably even better for us.

If you’re a fitness junkie, you can think of this as “cross training” or always keeping your body guessing and not adapting to your 5-mile run you do every day. The body will adapt and may not benefit as much from the exercise – you always need to “switch it up.” 

As always, whole foods are best

As with any diet, you can follow a whole foods-based version of it (lots of plants, healthy fats and oils, and good quality protein) or you can follow a less healthy version. Vegans can eat potato chips and drink Coke and paleo dieters can eat bacon and cheese all day. That doesn’t make these diets healthy. I think you get the picture.

So, keto can absolutely be a helpful for certain people with guidance from someone skilled in using the diet therapeutically. I've seen it transform lives. There are tons of resources out there, but always keep in mind that often people are promoting what works for THEM and don’t get too tied up in that – you need to do what works for YOU.

So now that you have the basics of keto, have fun at your dinner party! And if you want more info on the keto diet, read my interview with a ketogenic diet expert.