The Dish on Diets
As cliche as it may sound, we are what we eat. What we put into our bodies has a huge impact on our physical and mental health. Changing up our diet can have big benefits, but the latest fad may not be the greatest, and every diet isn’t perfect for everyone. “Anyone considering making changes to their eating habits needs to ask what is realistic and what is sustainable,” notes Amy Knoblock-Hahn, Ph.D., of Whole Food Is Medicine. With that in mind, we asked local experts to break down three current dieting trends.
Ketogenic diets have been around for more than 100 years. While they originally were designed to treat drug-resistant epilepsy, these ultra low-carb meal plans are a weight loss fad endorsed by celebrities like Halle Berry and Kourtney Kardashian.
>> what to eat: The diet is high-fat and low-carb. Knoblock-Hahn says it typically derives more than 60 percent of its calories from fats and less than 10 percent from carbohydrates.
>> the upsides: The purpose of keto diets is to put your body in a state of ketosis, which is a good place to be, according to Hayley Sohn, dietician and founder of Basically It Meals. While in ketosis, your body burns fat instead of carbohydrates for energy. “When your body is using fat for fuel, the brain doesn’t become bogged down with the hormones necessary to process carbohydrates and sugar,” Sohn explains. Knoblock-Hahn adds that the diet can be very helpful for people who suffer from seizures.
>> the downsides: “A lot of people start the diet to lose weight very quickly, and you can accomplish that,” Knoblock-Hahn notes. “However, not all weight loss is fat loss. People also lose water weight and muscle, and typically, the weight loss isn’t sustainable.” She adds that there also are side effects to starting the diet, known popularly as the ‘keto flu.’ “When you deprive your body of its main source of energy, you’re not going to feel well,” she explains. “With carbohydrate withdrawal, you’ll typically experience headaches, fatigue and irritability.”
>> long-term viability: Both Knoblock-Hahn and Sohn say that a keto diet is difficult to maintain in the long run. “It’s not sustainable because you’re cutting out too many types of food,” Knoblock-Hahn says. Sohn adds that keto diets typically limit nutrient-rich fruits and vegetables while allowing high levels of unhealthy saturated fat. “There are healthier ways to get your body into ketosis,” she says. “Cutting down on sugars and simple carbs but not eating all high-fat foods is a better way to go.”
The paleo diet suggests you go prehistoric with what you put on your plate. The idea is to return to the diet humans were naturally meant to consume by recreating meals of the Paleolithic era, which dates 2.5 million to 10,000 years ago.
>> what to eat: The diet focuses on foods that could be obtained by hunting and gathering. According to Knoblock-Hahn, this means fruit, non-starchy vegetables, lean meats, fish and nuts. Paleo typically cuts out items that became popular after the advent of farming, including grains, sugar, salt and processed foods.
>> the upsides: While there are not currently any long-term clinical studies into its benefits, Sohn says the diet was developed to reduce heart disease, diabetes and obesity. “Paleo can introduce a very healthy eating pattern,” Knoblock-Hahn adds. “You get the benefits of fruit, vegetables and lean proteins. Plus, it’s great to limit your salt and sugar intake.”
>> the downsides: Sohn points out that the plants and game eaten by our ancestors were likely very different than what is available today, throwing into question the validity of the hypothesis on which the diet is built. Other considerations like climate, geography and changes in genetics raise questions of the diet’s efficacy. “Conditions aren’t the same as they were thousands of years ago, so there may be no reason to omit something from your diet just because our ancestors didn’t eat it,” Knoblock-Hahn notes, adding that healthy diets typically contain whole grains and some dairy, both of which paleo doesn’t allow. “I would question any diet that has you entirely omit any healthy food group.”
>> long-term viability: Sohn says the diet is probably too restrictive to continue for a sustained period. “It asks you to cut out a lot, and that can be hard to follow,” she says, adding that there is no reason for some of the foods like beans and other legumes to be restricted. She suggests a revised version of the diet that focuses on plant foods and unprocessed meat. “If you look at the diet as getting back to natural food and cutting out processed foods and sugar, then it can be really healthy,” she says.
You can turn your diet into a passport on the plate. This eating method is inspired by the traditional cooking styles of countries bordering the Mediterranean Sea.
>> what to eat: The diet is primarily plant-based, meaning fruits, vegetables, whole grains, legumes and nuts. Butter is replaced with healthy fats like oil, and herbs and spices are used to flavor food more than salt. Red meat is limited; the focus is on fish and chicken. Knoblock-Hahn says there are different variations of the diet, and a Greek version will include more dairy than a Middle Eastern one. “No food is off limits,” she notes. “The focus is on plant foods, and meat is more of a condiment than a main component.”
>> the upsides: “The Mediterranean diet has a lot of health benefits,” Knoblock-Hahn says. She explains that the focus on plants and heart-healthy fats means a lower risk of cardiovascular disease, and the whole grains, fruit, vegetables and nuts provide phytonutrients to help protect against cancer. Sohn adds that the diet is also thought to help with Alzheimer’s disease and dementia. “It is loaded with nutrients, fiber and oils that support brain health,” she says.
>> the downsides: Knoblock-Hahn says there aren’t really any negative side effects to the diet. Sohn cautions against misunderstanding its guidelines. “People hear ‘Mediterranean’ and think it’s all pasta, cheese and wine, but if you follow it correctly, there won’t be too many side effects,” she notes. “There may be some weight gain if you aren’t exercising. The diet is intended to be combined with about an hour of walking daily.”
>> long-term viability: Knoblock-Hahn and Sohn agree that the Mediterranean diet is very sustainable. “It’s not focused on cutting things out,” Sohn says. “You get to live your life without a bunch of restrictive guidelines. The diet also stresses the social aspect of mealtime with a focus on community and family, which makes it easier to stay committed.”
In t he U.S., more than 13.7 million individuals between the ages of 2 and 19 are well above a healthy weight, according to the Centers for Disease Control (CDC). That is a shocking 18.5 percent of the youth population. Obesity can put children at risk for heart disease, cancer and diabetes while also causing low self-esteem and psychological problems like anxiety and depression. While genetics can be a cause of the excess weight, behaviors like activity and diet play a big role.
Christy Gilcrease, a registered dietician at St. Louis Children’s Hospital, says food intake is a major problem when it comes to obesity in children and adults, but it’s important that kids get a balanced diet that doesn’t exclude carbohydrates, protein or healthy fats. “You can cut down on unhealthy fats and sugars, but we don’t recommend cutting out any food group,” she explains. “Just like with adults, portion size is important. Don’t just think about what types of food your kids are eating, but also consider how much.”
To help children build a healthy relationship with food, Gilcrease suggests:
>> Involving your kids in meal planning and prep
>> Eating together as a family and talking about the foods you consume.
>> Not eating in front of the TV
If your child has a problem with weight management, Gilcrease recommends the Healthy Start Clinic at St. Louis Children’s Hospital, which offers a multidisciplinary approach to support obese patients and their families.
Technological advances and other societal changes have made life easier but also less active. “It’s important that kids learn healthy habits when they’re younger because they’ll be more likely to be active when they’re older,” says Paul Jenkins, a physical therapist with the Young Athlete Center at St. Louis Children’s Hospital.
Jenkins suggests making physical activity a part of kids’ daily routines:
>> Make sure your child gets a minimum of one hour of physical activity a day.
>> Three times a week, make sure your child gets more focused exercise. Organized sports and dance are great options to achieve this.
>> Limit screen time to no more than two hours, and make sure this includes all screens (i.e., phone, computer and TV)
>> For younger kids, be active with them. Make physical activity something they associate with spending time together.
>> Don’t just focus on aerobic exercises. Strength training also has a lot of positive gains. >> Start kids with simple activities like push-ups, planks, squats and lunges
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