Healthy Diet Archives - Page 4 of 4 - Health Tips From The Professor

Will Plant Proteins Help You Live Longer?

April 13, 2021 by Dr. Steve Chaney

Is A Vegan Diet Healthiest?

Author: Dr. Stephen Chaney

Unless you are Rip Van Winkle and have been asleep for the past 40 years, you have probably heard that whole food, primarily plant-based diets are good for you.

They help you control your weight.

They reduce inflammation.

They reduce your risk of diabetes and heart disease.

They even reduce your risk of some cancers.

But do they help you live longer? If we take that question literally, the answer appears to be no. There is no “Fountain Of Youth”. There are no diets that extend our lives significantly.

However, what if you could reduce your risk of premature death? It would be tragic to have your life cut short by a heart attack or some other major disease. What if you could prevent that?

And what if you could live healthier longer? It would be equally tragic to spend your golden years debilitated by chronic diseases like heart disease, diabetes, or dementia. What if you could delay these diseases and live healthier longer?

The study I discuss this week (Y Sun, Journal of the American Heart Association, 10:e015553, 2021) looks at the effect of different dietary protein sources on premature death.

This study, like many others, suggests that primarily plant-based diets are healthier than meat-based diets. But what does this mean for you? Should you go completely meatless? Is a vegan diet healthier than other plant-based diets? I discuss what we know and what we do not know about the vegan diet compared to other plant-based diets.

How Was This Study Done?

The data for this study were drawn from the Women’s Health Initiative (WHI). The Women’s Health Initiative was designed to help identify strategies for preventing heart disease and other diseases in postmenopausal women. It enrolled 161,000 postmenopausal women from 40 sites across the US between 1993 and 1998 and followed them through 2017.

This study excluded women who had heart disease or cancer when they entered the WHI study and women who had incomplete data on either their diet or their use of postmenopausal hormone therapy. They were left with 102,521 women, age 50-79 at time of entry, who were followed for 18 years.

Each woman filed out an extensive dietary survey at the beginning of the study. There were 25,976 deaths during the study. The cause of death was determined by reviewing death certificates, medical records, autopsy reports or by linkage to the National Death Index.

The investigators asked whether women who ate more plant proteins were healthier than those who ate primarily meat protein. To answer this question, they correlated protein sources in the diet with all-cause mortality and deaths from various diseases.

The greatest difficulty with this type of study is that people who eat more plant protein tend to have a healthier diet and a healthier lifestyle. That makes it hard to separate out the benefits of eating plant proteins from benefits associated with other aspects of their diet and lifestyle. So, the authors corrected their data for every factor known to influence the risk of heart disease, diabetes, dementia, and premature death.

Specifically, the data were statistically corrected for age, race/ethnicity, socioeconomic status, hormone use, lifestyle (smoking status, physical activity, and alcohol intake), baseline health status (diabetes and/or high blood cholesterol), family history of heart attack/stroke, dietary factors (calorie intake, dietary fiber intake, whole grain consumption, fruit and vegetable consumption, sugar-sweetened beverage consumption, glycemic load (effect of foods in the diet on blood sugar), and percentage of saturated fats, polyunsaturated fats, monounsaturated fats, and trans fats), and weight (BMI).

In short, the authors corrected for every other factor that could influence disease risk and/or premature death. By doing so, they were able to focus on the effect of protein sources on disease risk and/or premature death.

Will Plant Proteins Help You Live Longer?

The investigators divided the study participants into quintiles with respect the kind and amount of protein they consumed.

For animal protein, the intake ranged from 4 ounces/day in the lowest quintile to 9 ounces a day in the highest quintile (For comparison, 3 ounces is roughly equivalent to the size of a deck of cards).

For plant protein, the intake ranged from 2 ounces/day in the lowest quintile to 3.5 ounces/day in the highest quintile.

When you combine plant and animal protein in these women’s diet, plant protein ranged from 18% of total protein intake in the lowest quintile to 48% of total protein intake in the highest quintile.

When women who had the highest intake for plant protein were compared with women who had the lowest intake of plant protein, the women with the highest plant protein intake had:

12% lower risk of premature death from heart disease.

21% lower risk of premature death from dementia.

9% lower risk of premature death from all causes.

There was an inverse relationship between the amount of plant protein in the diet and premature death. Specifically, every 3 ounces of animal protein that was replaced with 3 ounces of plant protein resulted in:

22% lower risk of premature death from heart disease.

19% lower risk of premature death from dementia.

14% lower risk of premature death from all causes.

The Effect Of Individual Animal Proteins On Mortality

The authors also looked at the effect of various animal proteins on premature death. For example:

Red Meat: Women with the highest consumption of red meat had:

14% higher risk of premature death from heart disease.

20% higher risk of premature death from dementia.

10% higher risk of premature death from all causes.

Eggs: Women with the highest consumption of eggs had:

24% higher risk of premature death from heart disease.

14% lower risk of premature death from dementia.

14% higher risk of premature death from all causes.

Dairy: Women with the highest consumption of dairy had:

11% higher risk of premature death from heart disease.

The authors concluded, “In this large prospective cohort study, we found that higher plant protein intake and substitution of animal protein with plant protein were associated with lower risk of all-cause mortality, cardiovascular mortality, and dementia mortality…Our findings support the need for consideration of protein sources, in addition to the amount of protein intake, in future dietary guidelines.”

Is A Vegan Diet Healthiest?

Years ago, as my brother-in-law was coming out of anesthesia at the end of quadruple bypass surgery, the first question he asked was, “Does this mean I need to eat tofu?” Obviously, nothing terrified him more than the thought of eating tofu the rest of his life. In the same vein, some of you are probably asking, “Does this mean I need to go vegan?”

The good news is that none of the women in this study were consuming a vegan diet. They were consuming a typical American diet with varying amounts of plant and animal protein. The group with the highest plant protein consumption were still getting 52% of their protein from animal sources.

This study shows that even people consuming a typical American diet can become healthier by simply swapping out some of the animal protein in their diet with plant protein.

However, you are probably thinking, “Plant protein is good for us, and a vegan diet is 100% plant protein. Does that mean a vegan diet is healthier than other plant-based diets?

The answer is………”Maybe”

If the linear relationship between plant protein consumption and risk of premature death could be extrapolated all the way to 100% plant protein, the answer would be obvious. Vegan diets would be healthier than other plant-based diets. But that extrapolation is an assumption. It might not be true.

For example, some recent studies suggest that completely eliminating meat, eggs, and dairy from your diet may slightly increase your risk of heart disease and stroke:

One recent study found that adding 1.4 ounces of fish/day to a primarily vegetarian diet decreases the risk of stroke by 20%.

Another study reported that adding one egg/day to a primarily vegetarian diet decreases the risk of heart disease by 12% and stroke by 10-26%.

These studies need to be confirmed, but they do suggest we need to be cautious about assuming that vegan diets are healthier than other primarily plant-based diets. This is why, when I recommend primarily plant-based diets, I include everything from vegan through semi-vegetarian, Mediterranean, and DASH.

They are all healthy diets. My advice is to choose the one that best fits your lifestyle and food preferences. And focus on whole foods, not processed foods.

The Bottom Line

A recent study asked whether women who ate more plant proteins were healthier than those who ate primarily meat protein. To answer this question, the investigators correlated protein sources in the diet with all-cause mortality and deaths from various diseases.

When women who had the highest intake for plant protein were compared with women who had the lowest intake of plant protein, the women with the highest plant protein intake had:

12% lower risk of premature death from heart disease.

21% lower risk of premature death from dementia.

9% lower risk of premature death from all causes.

22% lower risk of premature death from heart disease.

19% lower risk of premature death from dementia.

14% lower risk of premature death from all causes.

[Note: A 3-ounce serving is roughly equivalent to a deck of cards.]

I discuss the answer to that question in the article above.

For more details and a discussion about the vegan diet versus other primarily plant-based diets read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

What Is An Anti-Inflammatory Diet?

July 21, 2021April 6, 2021 by Dr. Steve Chaney

Can Diet Douse The Flames?

Author: Dr. Stephen Chaney

If you have arthritis, colitis, bursitis, or any of the other “itis” diseases, you already know that inﬂammation is the enemy. Chronic, low level inﬂammation is also a contributing factor to heart disease, cancer, and many other diseases. Clearly, inﬂammation is a bad actor. It is something we want to avoid.

Obesity and diabetes are two of the biggest contributors to inﬂammation, but does diet also play a role? With all the anti-inﬂammation diets circulating on the internet, you would certainly think so. How good is the evidence that certain foods inﬂuence inﬂammation, and what does an anti-inﬂammatory diet look like?

The Science Behind Anti-Inflammatory Diets

Let me start by saying that the science behind anti-inﬂammatory diets is nowhere near as strong as it is for the eﬀect of primarily plant-based diets on heart disease and diabetes. The studies on anti-inflammatory diets are mostly small, short duration studies. However, the biggest problem is that there is no standard way of measuring inﬂammation.

There are multiple markers of inﬂammation, and they do not change together. That means that in every study some markers of inﬂammation are altered, while others are not. There is no consistent pattern from one study to another.

In spite of these methodological diﬃculties, the studies generally point in the same direction. Let’s start with the strongest evidence and work our way down to the weakest evidence.

Omega-3 fats are anti-inﬂammatory (I. Reinders et al, European Journal of Clinical Nutrition, 66: 736-741, 2011). The evidence is strongest for the long chain omega-3s found in ﬁsh and ﬁsh oil, but the shorter chain omega-3s found in foods like walnuts, ﬂaxseeds, chia seeds and ﬂaxseed oil, soybean oil, and canola oil also appear to be anti-inﬂammatory.

Inﬂammation is directly correlated with glycemic index (L. Qi and F.B. Lu, Current Opinion in Lipidology, 18: 3-8, 2007). This has a couple of important implications.

The most straightforward is that reﬁned carbohydrates and sugars (sodas, pastries, and desserts), which have a high glycemic index, increase inﬂammation. In contrast, complex carbohydrates (whole grains, most fruits and vegetables) decrease inﬂammation. No surprise there. The second implication is that it is the glycemic index, not the sugar, that is driving the inﬂammatory response.

That means we need to look more closely at foods than at sugars. Sodas, pastries and desserts are likely to cause inﬂammation, but sugar-containing foods with a low glycemic index are unlikely to be inﬂammatory.

Fruits and vegetables are anti-inﬂammatory. This has been shown in multiple studies. At this point most of the research is centered on identifying the nutrients and phytonutrients from fruits and vegetables that are responsible for the reduction in inﬂammation. I suspect the investigators are hoping to design an anti-inﬂammatory supplement and make lots of money. I will stick with the fresh fruits and vegetables.

Saturated fats are inﬂammatory. At face value, the data on saturated fats appear to be contradictory. Some studies say that saturated fats increase inﬂammation, while others say they do not. However, similar to my earlier discussion on saturated fats and heart disease), the outcome of the study depends on what the saturated fats are replaced with.

When saturated fats are replaced with reﬁned carbohydrates, sugar and highly processed foods (the standard American low-fat diet), inﬂammation doesn’t change. This doesn’t mean that a diet high in saturated fat is healthy. It just means that both diets are bad for you. Both are inflammatory.

However, when saturated fat is replaced with omega-3 polyunsaturated fats (J.A. Paniagua et al, Atherosclerosis, 218: 443-450, 2011) or monounsaturated fats (B. Vessby et al, Diabetologia, 44: 312-319, 2001), markers of inﬂammation decrease. Clearly, saturated fats are not the best fat choice if you wish to keep inﬂammation in check.

I would be remiss if I did not address the claims by the low-carb diet proponents that saturated fats do not increase inﬂammation in the context of a low-carb diet. I want to remind you of two things we have discussed previously:

The comparisons in those studies are generally with people consuming a diet high in simple carbohydrates and sugars.

These studies have mostly been done in the short-term when the participants are losing weight on the low-carb diets. Weight loss decreases inﬂammation, so the reduction in inﬂammation on the low-carb diet could be coming from the weight loss.

The one study (M. Miller et al, Journal of the American Dietetic Association, 109: 713-717, 2009) I have found that compares a low-carb diet (the Atkins diet) with a good diet (the Ornish diet, which is a low-fat, lacto-ovo vegetarian diet) during weight maintenance found that the meat based, low-carb Atkins diet caused greater inﬂammation than the healthy low-fat Ornish diet.

Red meat is probably pro-inﬂammatory. Most, but not all, studies suggest that red meat consumption is associated with increased inﬂammation. If it is pro-inﬂammatory, the inﬂammation is most likely associated with its saturated fat, its heme iron content, or the advanced glycation end products formed during cooking.

What Is An Anti-Inflammatory Diet?

Anti-inﬂammatory diets have become so mainstream that they now appear on many reputable health organization websites such as Harvard Health, WebMD, the Mayo Clinic, and the Cleveland Clinic. Each have slightly diﬀerent features, but there is a tremendous amount of agreement.

Foods an anti-inﬂammatory diet includes: In a nutshell, an anti-inﬂammatory diet includes fruits and vegetables, whole grains, plant-based proteins (like beans and nuts), fatty ﬁsh, and fresh herbs and spices. Speciﬁcally, your diet should emphasize:

Colorful fruits and vegetables. Not only do they help ﬁght inﬂammation, but they are a great source of antioxidants and other nutrients important for your health.

Whole grains. They have a low glycemic index. They are also a good source of ﬁber, and ﬁber helps ﬂush inﬂammatory toxins out of the body.

Beans and other legumes. They should be your primary source of protein. They are high in ﬁber and contain antioxidants and other anti-inﬂammatory nutrients.

Nuts, olive oil, and avocados. They are good sources of healthy monounsaturated fats, which ﬁght inﬂammation.
Fatty ﬁsh. Salmon, tuna, and sardines are all great sources of long chain omega-3 fatty acids, which are incorporated into our cell membranes. Those long chain omega-3s in cell membranes are, in turn, used to create compounds that are powerful inﬂammation ﬁghters.

Walnuts, ﬂaxseeds, and chia seeds are good sources of short chain omega-3s. The eﬃciency of their conversion to long chain omega-3s that can be incorporated into cell membranes is only around 2-5%. If they ﬁght inﬂammation, it is probably because they replace some of the saturated fats and omega-6 fats you might otherwise be eating.

Herbs and spices. They add antioxidants and other phytonutrients that ﬁght inﬂammation.

Foods an anti-inﬂammatory diet excludes: In a nutshell, an anti-inﬂammatory diet should exclude highly processed, overly greasy, or super sweet foods, especially sodas and other sweet drinks. Specifically, your diet should exclude:

Reﬁned carbohydrates, sodas and sugary foods. They have a high glycemic index, which is associated with inﬂammation. They can also lead to weight gain and high blood sugar, both of which cause inﬂammation.

Foods high in saturated fats. This includes fatty and processed meats, butter, and high fat dairy products.

Foods high in trans fats. This includes margarine, coﬀee creamers, and any processed food containing partly hydrogenated vegetable oils. Trans fats are very pro-inﬂammatory.

French fries, fried chicken, and other fried foods. They used to be fried in saturated fat and/or trans fat. Nowadays, they are generally fried in omega-6 vegetable oils. A little omega-6 in the diet is OK, but Americans get too much omega-6 fatty acids in their diet. Most studies show that a high ratio of omega-6 to omega-3 fatty acids is pro-inﬂammatory.

Foods you are allergic or sensitive to. Eating any food that you are sensitive to can cause inﬂammation. This comes up most often with respect to gluten and dairy because so many people are sensitive to one or both. However, if you are not sensitive to them, there is no reason to exclude whole grain gluten-containing foods or low-fat dairy foods from your diet.

Can Diet Douse The Flames?

In case you didn’t notice, the recommendations for an anti-inﬂammatory diet closely match the other healthy diets I have discussed previously. It should come as no surprise then that both the Mediterranean (L. Gallard, Nutrition in Clinical Practice, 25: 634-640, 2010; L. Schwingshackl and G. Hoﬀmann, Nutrition Metabolism and Cardiovascular Diseases, 24: 929-939, 2014) and DASH (D.E. King et al, Archives of Internal Medicine, 167: 502-506, 2007) diets are anti-inﬂammatory.

Vegan and vegetarian diets also appear to be anti-inﬂammatory as well. The anti-inﬂammatory nature of these diets undoubtedly contributes to their association with a lower risk of heart disease, diabetes, and cancer.

As for the low-carb diets, the jury is out. There are no long-term studies to support the claims of low-carb proponents that their diets reduce inﬂammation. The few long-term studies that are available suggest that low-carb diets are only likely to be anti-inﬂammatory if vegetable proteins and oils replace the animal proteins and fats that are currently recommended.

What does this mean for you if you have severe arthritis or other inﬂammatory diseases? An anti-inﬂammatory diet is unlikely to “cure” your symptoms by itself. However, it should deﬁnitely be a companion to everything else you are doing to reduce inﬂammation.

The Bottom Line

Obesity and diabetes are two of the biggest contributors to inﬂammation, but does diet also play a role? With all the anti-inﬂammation diets circulating on the internet, you would certainly think so. In this article I review the evidence that certain foods inﬂuence inﬂammation and describe what an anti-inﬂammatory diet looks like.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Which Diets Are Best In 2021?

March 16, 2021 by Dr. Steve Chaney

Which Diet Should You Choose?

Many of you started 2021 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only 2 months ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

Perhaps the diet isn’t working as well as advertised…

Perhaps the diet is too restrictive. You are finding it hard to stick with…

Perhaps you are always hungry or constantly fighting food cravings…

Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…

Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2021”. For the full report, click on this link.

How Was This Report Created?

US News & World Report recruited panel of 25 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 39 most popular diets. They rated each diet in seven categories:

How easy it is to follow.

Its ability to produce short-term weight loss.

Its ability to produce long-term weight loss.

its nutritional completeness.

Its safety.

Its potential for preventing and managing diabetes.

Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct nine sets of Best Diets rankings:

Best Diets Overall combines panelists’ ratings in all seven categories. However, all categories were not equally weighted. Short-term and long-term weight loss were combined, with long-term ratings getting twice the weight. Why? A diet’s true test is whether it can be sustained for years. And safety was double counted because no diet should be dangerous.

Best Commercial Diets uses the same approach to rank 15 structured diet programs that require a participation fee or promote the use of branded food or nutritional products.

Best Weight-Loss Diets was generated by combining short-term and long-term weight-loss ratings, weighting both equally. Some dieters want to drop pounds fast, while others, looking years ahead, are aiming for slow and steady. Equal weighting accepts both goals as worthy.

Best Diabetes Diets is based on averaged diabetes ratings.

Best Heart-Healthy Diets uses averaged heart-health ratings.

Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.

Easiest Diets to Follow represents panelists’ averaged judgments about each diet’s taste appeal, ease of initial adjustment, ability to keep dieters from feeling hungry and imposition of special requirements.

Best Plant-Based Diets uses the same approach as Best Diets Overall to rank 12 plans that emphasize minimally processed foods from plants.

Best Fast Weight-Loss Diets is based on short-term weight-loss ratings.

Which Diets Are Best In 2021?

The word WInner in white letters surrounded by a burst of colorful stars in 3d

Are you ready? If this were an awards program I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 5 and bottom 5 diets in each category (If you would like to see where your favorite diet ranked, click on this link). [Note: I excluded commercial diets from this review.]

Best Diets Overall

The Top 5:

#1: Mediterranean Diet

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: Mayo Clinic Diet

#5: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

The Bottom 5:

#35: Modified Keto Diet

#36: Whole 30 Diet

#37: GAPS Diet (A diet designed to improve gut health).

#38: Keto Diet

#39: Dukan Diet

Best Weight-Loss Diets

The Top 5:

#1: Flexitarian Diet

#2: Vegan Diet

#3: Volumetrics Diet (A diet based on the caloric density of foods).

#4: Mayo Clinic Diet

#5: Ornish Diet

The Bottom 5:

#35: Fertility Diet

#36: Whole 30 Diet

#37: Alkaline Diet

#38: AIP Diet (A diet designed for people with autoimmune diseases)

#39: GAPS Diet

Best Diabetes Diets

The Top 5:

#1: Flexitarian Diet

#2: Mediterranean Diet

#3: DASH Diet

#4: Mayo Clinic Diet

#5: Vegan Diet

The Bottom 5:

#35: The Fast Diet

#36: AIP Diet

#37: GAPS Diet

#38: Whole 30 Diet (A diet designed for people with autoimmune diseases)

#39: Dukan Diet

Best Heart-Healthy Diets

The Top 5:

#1: DASH Diet

#2: Mediterranean Diet

#3: Ornish Diet (A diet based on the caloric density of foods).

#4: Flexitarian Diet

#5: Vegan Diet

The Bottom 5:

#35: Keto Diet

#36: AIP Diet

#37: Whole 30 Diet

#38: Modified Keto Diet

#39: GAPS Diet

Best Diets for Healthy Eating

The Top 5:

#1: DASH Diet

#2: Mediterranean Diet

#3: Flexitarian Diet

#4: TLC Diet (A diet designed to promote heart health)

#5: MIND Diet

The Bottom 5:

#35: Atkins Diet

#36: Raw Food Diet

#37: Modified Keto Diet

#38: Dukan Diet

#39: Keto Diet

Easiest Diets to Follow

The Top 5:

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: MIND Diet

#4: DASH Diet

#5: Fertility Diet

The Bottom 5:

#35: Keto Diet and Modified Keto Diet (tie)

#36: Whole 30 Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Raw Foods Diet

Best Fast Weight-Loss Diets

The Top 5 (Excluding Commercial Diets):

#1: Atkins Diet

#2: Biggest Loser Diet

#3: Keto Diet

#4: Raw Food Diet

#5: Volumetrics Diet

Which Diets Are Best For Rapid Weight Loss?

Let me start with some general principles:

#1: If you are looking for rapid weight loss, any whole food restrictive diet will do.

The Atkins and keto diets are meat heavy, low carb diets. They restrict fruits, some vegetables, grains, and most legumes.

The Biggest Loser diet relies on restrictive meal plan and exercise programs.

The restrictions of the raw food diet are obvious.

The volumetrics diet restricts foods with high caloric density.

The vegan diet, which ranks #7 on this list, is a very low fat diet that eliminates meat, dairy, eggs, and animal fats.

I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

#2: Restrictive diets ultimately fail.

The truth is 90-95% of people who lose weight quickly on a restrictive diet regain most of that weight in the next two years. The pounds come back and often bring their friends along as well. Many people regain more weight than they lost. This is the famous “Yo-Yo Effect”.

If dieters paid for one of the commercial diets, they may as well have burned their money.

When I talk with people about weight loss, many of them tell me the Atkins diet is the only one they can lose weight on. That would be impressive if they were at a healthy weight, but most are not. They are overweight. I am starting to see the same thing from overweight people who have used the keto diet to lose weight and have regained their weight.

#3: We should ask what happens when we get tired of restrictive diets and add back some of your favorite foods.

If you lose weight on a vegan diet and add back some of your favorite foods, you might end up with a semi-vegetarian diet. This is a healthy diet that can help you maintain your weight loss.

If you lose weight on the Atkins or keto diets and add back some of your favorite foods, you end up with the typical American diet – one that is high in both fat and carbs. This is not a recipe for long-term success.

Long term weight loss is possible if you transition to a healthy diet after you have lost the weight. In a recent article in “Health Tips From The Professor” I wrote about an organization called the National Weight Control Registry. These are people who have been successful at keeping the weight off. For purposes of this discussion, two points are important.

They lost weight on every possible diet.

They kept the weight off by following a healthy reduced calorie, low fat diet. (For what else they did, click here).

Which Diet Should You Choose?

With rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.

Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.

Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian.

Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.

Finally, focus on what you have to gain, rather than on foods you have to give up.

- On the minus side, none of the diets include sodas, junk foods, and highly processed foods. Teose foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.

- On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are some general principles:

If you are looking for rapid weight loss, any whole food restrictive diet will do.

Restrictive diets ultimately fail.

We should ask what happens when we get tired of restrictive diets and add back some of our favorite foods.

Long term weight loss is possible if you transition to a healthy diet after you have lost the weight.

#2: Which diet should you choose? Here the principles are:

Choose a diet that fits your needs.

Choose diets that are healthy and associated with long term weight loss.

Choose diets that are easy to follow.

Choose diets that fit your lifestyle and dietary preferences.

Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

What Do The US Dietary Guidelines Say About Supplementation?

February 23, 2021 by Dr. Steve Chaney

What Do The US Dietary Guidelines Say About Your Diet?

Author: Dr. Stephen Chaney

Science is always changing, and nutritional science is no different. As we learn more, our concept of the “ideal diet” is constantly evolving. Because of that, the USDA and the US Department of Health & Human Services produce a new set of Dietary Guidelines for Americans every 5 years.

The 2020-2025 Dietary Guidelines for Americans have just been released. As usual, the process started with a panel of 20 internationally recognized scientists who produced a comprehensive report on the current state of nutritional science and made recommendations for updated dietary guidelines. After a period of public comment, the dietary guidelines were published.

There were two new features of the 2020-2025 Guidelines:

They provided dietary guidelines for every life stage from 6 months of life to adults over 60.

The guidelines also addressed personal preferences, cultural traditions, and budgetary concerns in so that each of us can develop a healthy diet that fits our lifestyle.

What Do The US Dietary Guidelines Say About Your Diet?

Here are the 2020-2025 Guidelines in a nutshell:

Follow a healthy dietary pattern at every life stage.

Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.

Focus on meeting food group needs with nutrient-dense foods and beverages and stay within calorie limits. They went on to say, “A healthy dietary pattern consists of nutrient-dense forms of foods and beverages across all food groups [emphasis mine], in recommended amounts, and within calorie limits.”

They said, “the core elements that make up a healthy dietary pattern include:”

- Vegetables of all types – dark green, red, and orange vegetables; beans, peas, and lentils; starchy vegetables; and other vegetables.

- Fruits – especially whole fruits.

- Grains – at least half of which are whole.

- Dairy – including fat-free or low-fat milk, yogurt, and cheese; lactose-free versions; and fortified soy beverages and soy yogurt as alternatives. [Other plant-based milk and yogurt foods were not recommended because they do not provide as much protein as dairy. So, they were not considered equivalent foods.]

- Protein foods – including lean meats, poultry, and eggs; seafood; beans, peas, and lentils; and nuts, seeds, and soy products.

- Oils – including vegetable oils and oils in food, such as seafood and nuts.

Limit foods and beverages higher in added sugars, saturated fat, and sodium; and limit alcoholic beverages. Their specific recommendations are:

- Added sugars – less than 10% of calories/day starting at age 2. Avoid foods and beverages with added sugars for those younger than 2.

- Saturated fat – Less than 10% of calories starting at age 2.

- Sodium – Less than 2,300 mg per day – even less for children younger than 14.

- Alcoholic beverages – Adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more. There are some adults who should not drink alcohol, such as women who are pregnant.

For more details, read the 2020-2025 Dietary Guidelines for Americans.

The Dark Side Of The US Dietary Guidelines

The US Dietary Guidelines point Americans in the right direction, but they are never as strong as most nutrition experts would like. The 2025 Dietary Guidelines are no exception. They have two major limitations:

#1: The food industry has watered down the guidelines. This happens every time a new set of guidelines are released. The food and beverage lobbies provide their input during the public comment period. And because they fund a significant portion of USDA research, their input carries a lot of weight. Here are the 3 places where they altered the recommendations of the scientific panel:

The scientific panel recommended that Americans decrease the intake of added sugar from 13% of daily calories to 6%. The final dietary guidelines recommended reducing sugar to 10% of daily calories.

The scientific panel recommended that both men and women limit alcoholic drinks to one a day. The final dietary guidelines recommended men limit alcoholic drinks to two a day.

The scientific panel included these statements in their report:

- “Dietary patterns characterized by higher intake of red and processed meats, sugar-sweetened foods and beverages, and refined grains are…associated with detrimental health outcomes.”

- “Replacing processed or high fat-meats…with seafood could help lower intake of saturated fat and sodium, nutrients that are often consumed in excess of recommended limits.”

- “Replacing processed or high-fat meats with beans, peas, and lentils would have similar benefits.”

These statements are included in the final report, but they are buried in portions of the report that most people are unlikely to read. The summary that most people will read recommends shifts in protein consumption to “add variety” to the diet.

#2: The guidelines do not address sustainability and do not explicitly promote a shift to more plant-based diets. Again, this was based on input from food lobby groups who argued that sustainability has nothing to do with nutrition.

If you are concerned about climate change and the degradation of our environment caused by our current farming practices, this is a significant omission.

I have covered this topic in a recent issue of “Health Tips From the Professor”. Here is a brief summary:

In 2019 a panel of international scientists was asked to conduct a comprehensive study on our diet and its effect on both our health and our environment.

The scientific panel carefully evaluated diet and food production methods and asked three questions:

- Are they good for us?
- Are they good for the planet?
- Are they sustainable? Will they be able to meet the needs of the projected population of 10 billion people in 2050 without degrading our environment.

They developed dietary recommendations popularly known as the “Planetary Diet”. Here are the characteristics of the planetary diet.

- It starts with a vegetarian diet. Vegetables, fruits, beans, nuts, soy foods, and whole grains are the foundation of the diet.

- It allows the option of adding one serving of dairy a day.

- It allows the option of adding one 3 oz serving of fish or poultry or one egg per day.

- It allows the option of swapping seafood, poultry, or egg for a 3 oz serving of red meat no more than once a week. If you want a 12 oz steak, that would be no more than once a month.

Unless you are a vegan, this diet is much more restrictive than you are used to. However, if you, like so many Americans believe that climate change is an existential threat, I would draw your attention to one of the concluding statements from the panel’s report.

“Reaching the Paris Agreement of limiting global warming…is not possible by only decarbonizing the global energy systems. Transformation to healthy diets from sustainable food systems is essential to achieving the Paris Agreement.”

In other words, we can do everything else right, but if we fail to change our diet, we cannot avoid catastrophic global warming.

What Do The US Dietary Guidelines Say About Supplementation?

The authors of the 2020-2025 US Dietary Guidelines have relatively little to say about supplementation. However:

They list nutrients that are of “public health concern” for each age group. Nutrients of public health concern are nutrients that:

- Are underconsumed in the American diet.

- Are associated with health concerns when their intake is low.

They state that “dietary supplements may be useful in providing one or more nutrients that otherwise might be consumed in less than recommended amounts.”

They recommend specific supplements for several age groups.

Here are their nutrients of public health concern and recommended supplements for each age group:

#1: General population.

Nutrients of public health concern are calcium, dietary fiber, and vitamin D. They state that supplementation may be useful for meeting these needs.

#2: Breast Fed Infants.

Supplementation with 400 IU/day of vitamin D is recommended shortly after birth.

#3: Vegetarian Toddlers.

Iron and vitamin B12 are nutrients of concern.

#4: Children & Adolescents.

Calcium and vitamin D are nutrients of concern. Dairy and/or fortified soy alternatives are recommended to help meet these needs.

Iron, folate, vitamin B6, vitamin B12, and magnesium are also nutrients of concern for adolescent females.

#5: Adults (Ages 19-59).

30% of men and 60% of women do not consume enough calcium and 90% of both men and women do not get enough vitamin D.

#6: Pregnant & Lactating Women:

Calcium, vitamin D, and fiber are nutrients of concern for all women in this age group.

In addition, women who are pregnant have special needs for folate/folic acid, iron, iodine, and vitamin D.

Women who are pregnant or thinking of becoming pregnant should take a daily prenatal vitamin and mineral supplement to meet folate/folic acid, iron, iodine, and vitamin D needs during pregnancy. They go on to say that many prenatal supplements do not contain iodine, so it is important to read the label.

All women who are planning or capable of pregnancy should take a daily supplement containing 400 to 800 mcg of folic acid.

#7: Older Adults (≥ 60).

Nutrients of concern for this age group include calcium, vitamin D, fiber, protein, and vitamin B12.

About 50% of women and 30% of men in this age group do not get enough protein in their diet.

My Perspective:

The US Dietary Guidelines use foods of public health concern as the only basis for recommending supplementation. I prefer a more holistic approach that includes increased needs, genetic predisposition, and preexisting diseases as part of the equation (see the diagram on the right). I have discussed this concept in depth in a previous issue of “Health Tips From The Professor”.

I have also taken this concept and made supplement recommendations for various health goals in a free eBook called “Your Design For Healthy Living”.

Some people may feel I should have included more supplements in my recommendations. Others may feel I should have included fewer supplements in my recommendations. No list pf recommend supplements is perfect, but I have tried to include those supplements supported by good scientific evidence in my recommendations.

The Bottom Line

The USDA and Department of Health & Human Services have just released the 2020-2025 US Dietary Guideline. In the article above I have summarized:

Their recommendations for a healthy diet.

Their recommendations for supplementation.

The dark side of the US Dietary Guidelines.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Have A Healthy Thanksgiving

November 24, 2020 by Dr. Steve Chaney

The Holidays Don’t Have To Be Unhealthy

I realize that in this strangest of years many of us won’t be heading “through the woods and over the hills to grandmother’s house” this year. However, we will probably be gathering with a few friends and family. So, it is time for my annual reminder that we can have a healthy Thanksgiving this year.

While “Healthy Thanksgiving” doesn’t quite have the appeal of the more familiar “Happy Thanksgiving” greeting, I used it here to make the point that Thanksgiving dinner (and many other holiday meals) doesn’t have to be an unhealthy affair.
After all, there is a lot to like about the ingredients in Thanksgiving dinner. Turkey can be a healthy, low- fat meat, if prepared correctly. Sweet potatoes, yams, winter squash and pumpkin are all loaded with vitamin A and other important nutrients. And cranberries are a nutrition powerhouse.

Have A Healthy Thanksgiving

Here are some tips to make your Thanksgiving meal one that contributes to your health:

1) Skip the basting. Choose a plain bird and cook in a bag to seal in the moisture. Remove the skin before serving.

2) Refrigerate the turkey juices and skim off the hardened fat before making gravy and use a gravy cup that pours from the bottom to minimize fat.

3) Use ingredients like whole wheat bread, vegetables, fruits (cranberries, raisins, dates or apples), nuts and your favorite spices for the stuffing and bake it in the oven rather than in the turkey.

4) Serve your sweet potatoes or yams baked rather than candied and let your guests add butter and nutmeg to taste.

5) Use skim milk or buttermilk rather than whole milk and skip the butter for your mashed potatoes.

6) Give your meal gourmet appeal by cooking your green vegetables with garlic, nuts and herbs rather than creamy or fat-laden sauces.

7) Don’t serve the meal on your largest plates. By using smaller plates, you ensure smaller portion size and even that second helping isn’t quite so damaging.

8) Consider something like a cranberry, walnut, Greek yogurt parfait for dessert. However, if everyone is expecting grandma’s chocolate pound cake recipe, use small dessert dishes. Of course, you can also experiment with using less fat or sugar when you make the cake.

9) Use a low calorie, plant-based protein shake for one or more meals the day before and/or after Thanksgiving so that your total fat, cholesterol, and caloric intake over the three-day period is not excessive.

By now you have the idea. There are lots of little things that you can do to make your Thanksgiving dinner one that your waist and your heart will thank you for. Bon Appetit and have a Happy, Healthy Thanksgiving!

The Bottom Line

If you make healthy food choices and choose your portion sizes wisely, you can make this a Healthy Thanksgiving as well as a Happy Thanksgiving.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.