Currently browsing posts about: Diets

I’ve saved this for Weekend Reading because it will take a weekend to get through it.  The report is a blockbuster: 37 authors, 47 pages, 357 references.

The Lancet commissioned this report from the EAT Forum, which brought together international experts on diet and health (most of whom I do not know) to define unifying dietary principles that best promote will promote the health of people and the planet.

Fortunately, the diet that is best for health is the same diet as is best for the planet.  The report defines it on page 5.

To summarize:

This report has many strengths:

• It is researched in depth and is now the reference source for information about needed dietary changes.
• It firmly links dietary health to environmental sustainability.
• Its findings are consistent with many previous reports on diet and health, including that of the 2015 Dietary Guidelines Advisory Committee DGAC).
• Its messages are unambiguous.
• The summary report is a big help
• The timing  is excellent; the 2020 Dietary Guidelines advisory committee, if it ever gets appointed, will have to pay close attention to the science reviewed in this report.
• It focuses on food, not nutrients (these meals meet the standards of recommended diets).

Does this report settle the questions?  Hardly.  Remember the fuss over sustainability (the “S-word?”) in the 2015 report of the DGAC?

• The meat industry does not like advice to eat less meat.
• The dairy industry doesn’t like it either.  Its trade associations emphasize its nutritional value and source of livelihood for a billion people.
• The food industry has lots of complaints.

There is lots to read and think about here.  Enjoy!

• The Lancet home page for the report (includes slides, links)
• The Lancet editorial accompanying the report
• The EAT Forum home page for the report (information about EAT, the launch, the commission members, etc)
• The EAT Forum summary report

Lisa R. Young.  Finally Full, Finally Slim: 30 Days to Permanent Weight Loss One Portion at a Time.  Center Street, 2019.

I don’t usually write about diet books, but Lisa Young did her doctorate with me and I have followed her subsequent career with great interest.  She has taught for years in my NYU department and has a lively private practice counseling clients about weight loss and other nutrition issues.

Her book explains what works best with her clients.  She must be fun to work with.  The writing is warm, friendly, and to the point.  Her advice is easy and sensible: eat what you like (especially of healthy foods), just not too much.   She is generous with tips about how to deal with parties, restaurants, and other challenging situations, what she categorizes as “slices of advice,” “bite-size goodies,” and “wedges of wisdom.”

Her main focus is on portion control:

Portion control is like a classic wardrobe: It never goes out of style.  It’s not a trendy fad but a proven method for healthful living.  When you enjoy balanced meals and nutritious foods in appropriate portion sizes, you can get off the weight-loss merry-go-found.  So go ahead and enjoy a glass of wine or an occasional ice cream cone (a single scoop!).  Eat brown rice, quinoa, and other healthy carbs.  It’s not only okay.  It’s the best way to achieve long-term weight loss and maintenance.

Good advice, and easy to take.

No wonder its getting such great press.

• She’s on the cover of the January 2 New York Post, with much more about the book on pages 25, 26, and 27.
• Here’s an interview Lisa did in September.
• And here’s one she just did with Diet Detective.

In a most unusual action, the New England Journal of Medicine has retracted a 2013 study of Mediterranean diets and published a new version of it at the same time.

The studies asked participants to consume one of three diets: (1) a Mediterranean diet supplemented with extra-virgin olive oil, (2) a Mediterranean diet supplemented with mixed nuts, and (3) a control diet with advice to reduce dietary fat.

The authors describe Mediterranean diets as containing a

high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation, consumed with meals.

The conclusion of the original, widely publicized, but now retracted study:

In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

The conclusion of the newly analyzed version:

In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

Looks the same, no?

The most thorough analysis of the study that I have seen comes from Hilda Bastian at PLoS Blogs.

Even for the full group, there was no statistically significant difference on myocardial infarction or CVD mortality – just for stroke. And in the supplementary information, there wasn’t a difference in the Kaplan Meier analysis for stroke either.

What are we to make of all this?

Diet trials are notoriously difficult to conduct and interpret and the Mediterranean diet—largely vegetarian with olive oil as the principal fat—was associated with great health and longevity based on studies of people who lived on the island of Crete immediately after the Second World War; they did not have much food to eat and were highly physically active.

And then there’s the matter of who paid for the study.  The retracted study and its revision were funded independently.  But a study published on June 13 concludes:

Adults who are overweight or moderately obese may improve multiple cardiometabolic disease risk factors by adopting a Mediterranean-style eating pattern with or without reductions in red meat intake when red meats are lean and unprocessed.

The funder?  The Beef Checkoff and the National Pork Board.

Overall, the 2015-2020 Dietary Guidelines for Americans recommends Mediterranean dietary patterns for their health benefits, defines what goes into them in Table 1.2 (p. 35), and provides more details in Appendix 4 (starting on p. 83).

Mediterranean diets are delicious.  While the scientists are arguing about exactly how healthy they might be, enjoy!

A reader in South Africa, Effie Schultz, sends an item from NutraIngredients-USA about a new meal replacement product, Bear Squeeze, “packed with MCT [medium-chain triglyceride] oil, kale, pumpkin seed protein and probiotics.”  It is aimed at people on ketogenic (very low carbohydrate) diets.

The president of the company that makes this product, Max Baumann, says that he wants Bear Squeeze to be known as a “higher-end, cleaner Soylent.”

NutraIngredients says:

If there’s any indicator that a large group of consumers are stoked about a meal replacement powder formulated to meet the requirements of a ketogenic diet, let that be California-based Bear Squeeze’s performance on fundraising platform Indiegogo,​ ​where it raised 421% of its $25,000 goal, a good month before its fundraising deadline.

The brand also snagged the top prize​​ at the new beverage showdown competition at BevNET Live last month, showing that Baumann has gotten the industry excited about his brand as well.

Why this product?  There is money—lots of it—to be made, apparently.

The impetus to start Bear Squeeze,…was seeing the success of meal replacement brands like Soylent, which recently moved from exclusively digital to brick-and-mortar. Soylent CEO Bryan Crowley said last month that sales performance in the offline channel “blew away expectations.”​​​

I have to confess not getting this.  With plenty of healthy, delicious food around, and at a cost buyers of products like these can well afford, why would anyone want to substitute something that tastes pretty awful (I’ve tasted Soylent and doubt this can be much better) for fabulous food?  People who consume these products must not be foodies, alas.

Medium-chain triglycerides are easy-to-digest fats created and formulated for hospitalized patients with serious digestive difficulties.

I vote for food, glorious food, anytime.

Adrienne Rose Bitar.  Diet and the Disease of Civilization.  Rutgers University Press, 2017.

I did a blurb for this one:

Bitar’s fascinating thesis is that diet books are ways to understand contemporary social and political movements.  Whether or not you agree with her provocative arguments, they are well worth reading.

I also took some extra notes because the publisher wanted a particularly short blurb.  As you might suspect from my brief comment, I have some quibbles with some of Bitar’s arguments, but the book is interesting, well written, and worth a look.

Bitar deals with four categories of diet books: Paleolithic, faith-based, South Seas paradise, and detox (this last category strangely includes Michael Pollan’s and my work).

Here’s a sample from the chapter I thought strongest, the one on Paleolithic diets.  It refers to classic images of man arising from apes, and then degenerating into obesity.

These images suggest what is much more explicit in the text—that the diet is a story about humanity, about evolution, about civilization and dis-mankind.  The body of the individual dieter is situated in a long, deep history of mankind.  The dieter is biologically indebted to the Paleolithic Era and, in turn, the coming generations will be indebted to him.  Everyday body practices of the individual—eating, sleeping, walking—are elevated to symbols of mankind’s ascent or descent, failures or triumph, in the grand narrative of progress (p. 41).

I’m in Europe this week so especially interested in its public health efforts. This report is an example.

Healthy and Sustainable Diets for European Countries. Report of a Working Group. EUPHA (European Public Health Association), 2017.

The purpose of this report is to encourage public health professionals to promote policies that will enable individuals to make healthier food choices.  It’s a long report, but summarizes its goals in one quick table:

I cannot understand the revisionist attack on the work of Ancel Keys, who died at the age of 100 in 2004.  Most scientists are lucky to have made important contributions in one area.  Keys produced outstanding work in several:

• High altitude physiology
• The physiology of starvation (for this alone, he should be honored)
• Mediterranean diet benefits
• Heart disease epidemiology

The fuss, of course, is over this last one, particularly his role in the Seven Countries Study.  The arguments falls right into today’s absurd debate about sugar vs. fat as a cause of disease (absurd, because we don’t eat sugar or fat; we eat foods and diets that provide energy measured as calories).

What started off this most recent fuss is Ian Leslie’s The Sugar Conspiracy, which begins with the question “How did the world’s top nutrition scientists get it so wrong for so long?”  This alone is a red flag.  “Everything you thought you knew about nutrition is wrong” is a sure signal for caution; that’s not how science works.

The attack on Keys’ work induced the True Health Initiative to develop a ​White Paper in defense (here’s its press release).  Its authors: Katherine Pett (who had written a blog post in defense), Joel Kahn (who also wrote a blog post) Walter Willet (long a champion of Mediterranean diets), and David Katz (who wrote about it in his own blog post).

In response, Michael Joyner pointed out that R.A. Stallones (a professor of mine at the School of Public Health at Berkeley) had made the same arguments years ago.

Another defense of Keys’ work comes from Kevin Klatt, a nutrition biochemistry PhD student at Cornell.

Sarah Tracy, a science historian at the University of Oklahoma, has been working on a biography of Ancel Keys for years.  I can’t wait for it to come out.  We need to have Keys’ life and work put in reasonable perspective.

While waiting for the fat v. sugar debate to resolve (I’m predicting it won’t), eat a healthy diet, enjoy what you eat, and be skeptical when writers write about nutrients, not food.

Here’s another one of this site’s roundup of articles on specific topics, written from the perspective of food companies.  Paleo sells.

Special Edition: Paleo: Fad, Trend, or Movement?

Definitions vary, but most advocates of the Paleo diet think the dietary rot set in once humans stopped hunting and gathering and started to grow crops and raise animals for food. So grains, legumes, and dairy are typically off limits (although some Paleo fans say grass-fed dairy is OK). While critics say any diet that eliminates major food groups should be treated with caution, the number of products featuring Paleo claims and certifications is growing rapidly, and many retailers and manufacturers are now looking at how to tap into the trend, which some market researchers see as the next evolution of low carb, and gluten-free.

• Natural channel still accounts for bulk of Paleo product sales, but sales in conventional channels are growing faster, says SPINS: Where are Paleo-positioned products thriving? SPINS data break it down by channel and category… Read
• Low-carb, gluten-free and now Paleo… Another anti-grain fad or a true concern for bakers?: Bakers shouldn’t worry too much about Paleo, but the trend does call for increased grain education and better industry innovation, warn grain advocacy groups… Read
• Whole30 certification helps brands boost exposure, sales and shelf space: Certifying a product as approved by the popular Whole30 diet is a “pretty intensive” process, according to the diet’s co-creator, but for the few and proud that make the cut, the licensing deal can provide exposure to a fiercely loyal consumer base, boost sales significantly and help secure shelf space in competitive categories… Read
• PALEO IN FOCUS: Are we ‘supposed’ to drink cow’s milk? It’s the wrong question, says professor: ‘Paleo’ fans argue that the dietary rot set in when we stopped hunting and gathering and started producing foods (dairy, grains, legumes) our bodies are not adapted to digest. But does the theory behind this approach hold water?.. Read
• Passionate paleo followers can fuel brand awareness, sales for compliant packaged products: Between 1 to 3 million people in the United States follow the paleo diet, and yet relatively few packaged products comply with the regime – making it a market brimming with potential that once tapped could quickly drive brand awareness and sales, according to the co-founders of frozen dessert brand Snow Monkey… Watch now
• What’s the size of the Paleo foods prize? Mintel and IRI weigh in: Paleo themed product sales could soar to $4bn in the US in the next three years if enough manufacturers invest, according to IRI, although Mintel says we’re not looking at the next Greek yogurt… Read
• Paleo certification requests have doubled annually, scheme embraced by ‘household names,’ says Paleo Foundation: Demand for Paleo-certified products are on the rise. But is the diet – and the certification scheme – based on sound science? We chat with Paleo’s critics and proponents to get the inside scoop… Read
• Our Paleo ancestors were more active than us, but did they really have an optimal diet?: Supporters of the ‘Paleo’ diet (a hunter/gatherer-style approach to eating) urge us to eschew grains, dairy and legumes – among other things. But any diet that eliminates major food groups should be treated with caution, argue two high-profile dietitians we quizzed as part of our weight management special edition… Read
• Meteoric sales growth at Primal Kitchen: ‘Things just exploded as soon as we launched’: “We did everything you’re not supposed to do,” observes the COO of Primal Kitchen, which exploded out of the blocks with a sugar-free avocado oil-based mayo in February 2015, notched up revenues of $13.2m in 2016, and is expecting to almost double that in 2017. ..