Which Diets Are Best In 2022?

Which Diet Should You Choose?

Author: Dr. Stephen Chaney

Emoticon-BadMany of you started 2022 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only a month 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 2022”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited panel of 27 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 40 most popular diets.  The panel is not the same each year. Some experts are rotated off the panel, and others are added. The experts rate 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 2022?

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. The Mediterranean diet has been ranked #1 for 5 consecutive years.

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

#5: The TLC Diet (This diet was designed by the NIH to promote heart health.)

The Bottom 5: 

#36: Whole 30 Diet (A whole food, restrictive diet, designed for a 30-day jump start to weight loss. It was not designed for long-term use).

#37: Modified Keto Diet (A slightly less restrictive version of the Keto Diet).

#38: Keto Diet (A high protein, high fat, very low carb diet designed to achieve ketosis).

#39: Dukan Diet (High protein, low carb, low fat diet).

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

Best Weight-Loss Diets

The Top 5: Weight Loss

#1: Flexitarian Diet

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

#3: Vegan Diet (A diet that only allows plant foods).

#4: Mayo Clinic Diet (A diet designed to establish lifelong healthy eating habits).

#5: Ornish Diet (A whole food, semi-vegetarian diet designed to promote heart health).

The Bottom 5: 

#36: Fertility Diet (A diet designed to improve fertility, but the experts were skeptical that it would increase your chances of becoming pregnant)

#37: Whole 30 Diet

#38: Alkaline Diet (A diet designed to make your blood more alkaline, but the experts were skeptical about that claim)

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

#40: GAPS Diet

Best Diabetes Diets

The Top 5: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: Vegan Diet

#4: Mayo Clinic Diet

#5: DASH Diet

The Bottom 5: 

#36: Alkaline Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Sirtfood Diet (a very low calorie, fad diet that emphasizes plant foods rich in sirtuins)

#40: Whole 30 Diet

Best Heart-Healthy Diets 

strong heartThe Top 5: 

#1: Mediterranean Diet

#2: Ornish Diet

#3: DASH Diet

#4: Flexitarian Diet

#5: TLC Diet

#6: Vegan Diet

The Bottom 5: 

#36: Keto Diet

#37: AIP Diet

#38: Whole 30 Diet

#39: Modified Keto Diet

#40: Dukan Diet

Best Diets for Healthy Eating

The Top 5: 

#1: Mediterranean Diet

#2: DASH Diet

#3: Flexitarian Diet

#4: MIND Diet

#5: TLC Diet

The Bottom 5: 

#36: Raw Food Diet

#37: Atkins Diet

#38: Dukan Diet

#39: Modified Keto Diet

#40: Keto Diet 

Easiest Diets to Follow

The Top 5: Easy

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: Fertility Diet

#4: MIND Diet

#5: DASH Diet

The Bottom 5: 

#36: Modified Keto Diet

#37: Keto Diet

#38: Whole 30 Diet

#39: GAPS Diet

#40: 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: Vegan Diet

The Bottom 5 

#36: Dr. Weil’s Anti-Inflammatory Diet

#37: The Fertility Diet

#38: AIP Diet

#39: Alkaline Diet

#40: Gaps Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleThere are 3 take-home lessons from the rapid weight loss category:

1) If you are looking for rapid weight loss, any whole food restrictive diet will do. The top 5 diets are very different. For example, the keto and vegan diets are polar opposites, yet they both are in the top 5 for rapid weight loss.

  • 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 vegan diet 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) 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.

3) Don’t pay too much attention to the bottom 5 diets. None of them were designed with weight loss in mind.

Which Diet Should You Choose?

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

1) 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.

2) 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.

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

4) 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.

5) In case you were wondering, intermittent fasting ranked 26-30 and the Paleo diet ranked 26-33 on most of the list – not the worst diets, but a long way from the best. If you have a favorite diet I didn’t mention, check the US News website to find where it is ranked.

6) 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. These 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.

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. In the article above I summarize the US News & World Report’s “Best Diets In 2022”.

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.
  • 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.

Which Diet Is Best?

Tips For Loosing Weight And Keeping It Off

Author: Dr. Stephen Chaney

Diet season starts in just a few days! Like millions of Americans, you will probably be setting a goal to eat healthier, lose weight, or both. But which diet is best? Vegan, Paleo, Keto, 360, Intermittent Fasting, low-carb, low fat – the list is endless.

And then there are the commercial diets: Meal replacements, low calorie processed foods, prepared meals delivered to your door – just to name a few of the categories.

You can choose to count calories, focus on portion sizes, or keep a food journal.

And, if you really want to live dangerously, you can try the latest diet pills that claim to curb your appetite and rev up your metabolism.

The advertisements for all these diets sound so convincing. They give you scientific-sounding mumbo-jumbo to explain why they work. Then they talk about clinical studies they say prove their diet works.

If you are like most Americans, you have already tried several of these diets. They worked for a while, but the pounds came back – and brought their friends with them.

But, as the saying goes, “Hope springs eternal in the human breast. Surely some diet you haven’t tried yet will work for you.

There are such diets. But they will require effort. They will require a change of mindset. There is no magic wand that will chase the extra pounds away forever.

If you are searching for the perfect diet to start the new year, let me be your guide. Here are:

  • 4 tips on what to avoid and…
  • 6 tips on what to look for…

…when you are choosing the best diet for you.

What Should You Avoid When Choosing The Best Diet?

AvoidEndorsements.

Endorsements by your favorite athlete or public person are paid for. They don’t necessarily represent their opinion. Nor do they assure you that they follow that diet or use that diet supplement.

Endorsements by Dr. Strangelove and his buddies can be equally misleading. They usually tell you that the medical establishment has been lying to you, and they have discovered the “secret” to permanent weight loss and the “Fountain of Youth”.

Recommendations of the medical and scientific communities usually represent a consensus statement by the top experts in their field. I would choose their advice over Dr. Strangelove’s opinion any day.

2) Testimonials

Most of the testimonials you see online or in print are either paid for or are fake.

Testimonials by your friends can be equally misleading. We are all different. What works for your friend or your trainer may not work for you.

For example, some of us do better on low-carb diets, and others do better on low fat diets.

[Note: Some DNA testing companies claim they can sequence your DNA and tell you which diet is best. However, as I reported in a recent article in “Health Tips From The Professor”, independent studies show that DNA testing is of no use in predicting whether low-carb or low-fat diets are better for you.]

3) Diets Based on “Magic” Or “Forbidden” Foods or Food Groups.

I have often said we have 5 food groups for a reason. Each food group provides a unique blend of nutrients and phytonutrients. And each plant food group provides a unique blend of fibers that support the growth of different types of friendly gut bacteria.

The bottom line is that each of us does better with some foods than others, but there are no “magic” or “forbidden” foods that apply to everyone.

4) “Magic” Diets.

MagicI have written perhaps the first diet book, “Slaying The Food Myths”, that doesn’t feature a “magic” diet that is going to make the pounds melt away and allow you to live to 100. Instead, I recommend a variety of healthy diets and suggest you choose the one that fits you best.

However, I understand the allure of “magic” diets. Dr. Strangelove claims the diet will be effortless. He gives you some scientific-sounding mumbo-jumbo to convince you the diet is scientifically sound. Then he cites some clinical studies showing the diet will cause you to lose weight and will improve your health parameters (things like cholesterol, triglycerides, blood sugar, and blood pressure). It sounds so convincing.

Before you fall for Dr. Strangelove’s latest “magic” diet, let me share two things that may blow your mind:

    • The studies are all short-term (usually 3 months or less).
    • When you rely on short-term studies, the very low-fat Vegan diet and very low-carb Keto diet give you virtually identical weight loss and improvement in health parameters!

Those two diets are as different as any two diets could be. That means we can forget all the scientific-sounding mumbo-jumbo as to why each of those diets work. Instead, we should ask what these two diets have in common.

The answer is simple:

#1: The clinical studies are comparing “magic” diets to the typical American diet. Anything is better than the typical American diet! It is high in sugar, refined carbohydrates, saturated fat, and highly processed foods. No wonder the “magic” diets look so good.

#2: The diets are whole food diets. Anytime you eliminate sodas, fast foods, and highly processed foods, you will lose weight.

#3: The diets eliminate one or more food groups. Whenever you eliminate some of your favorite foods from your diet, you tend to lose weight without thinking about it. I call this the cream cheese and bagel phenomenon.

    • If you are following a low-fat diet, it sounds great to say you can eat all the bagels you want. But without cream cheese to go with the bagels, you tend to eat fewer bagels.
    • If you are following a low-carb diet, it sounds great to say you can eat as much cream cheese as you want, but without bagels to go with your cream cheese, you tend to eat less cream cheese.

#4: Because they eliminate many of your favorite foods, “magic” diets make you focus on what you eat. Whenever you focus on what you eat, you tend to lose weight. That is why food journals and calorie counters are effective.

#5: Finally, whenever you lose weight, your health parameters (cholesterol, triglycerides, blood sugar, and blood pressure) improve.

What Should You Look For In Choosing The Best Diet?

Skeptic1) Choose whole food diets. Avoid sodas, fast foods, and highly processed foods.

2) Choose primarily plant-based diets. These can range from Vegan through semi-vegetarian, Mediterranean, DASH, and Nordic. All are healthy diets. I have discussed the evidence for this recommendation in my book “Slaying The Food Myths”. Here is a brief summary.

When we look at long term (10-20 year) studies:

    • Vegetarians weigh less and are healthier than people consuming the typical American diet.
    • People consuming semi-vegetarian, Mediterranean, and DASH diets are healthier than people consuming the typical American diet.

If you look at low-carb diets:

    • People consuming plant-based low-carb diets weigh less and are healthier than people consuming the typical American diet.
    • People consuming meat-based low-carb diets are just as fat and unhealthy as people consuming the typical American diet.
    • The Atkins low-carb diet has been around for more than 50 years, and there is no evidence it is healthy long-term.

3) Choose diets that include a variety of foods from all 5 food groups. I have discussed the rationale for that recommendation above.

4) Choose diets that consider meat as a garnish, not a main course.

5) Choose diets that feature healthy carbs and healthy fats rather than low-carb or low-fat diets.

6) Think lifestyle, not diet. If you choose a restrictive diet so you can achieve quick weight loss, you will probably be just as fat and unhealthy next December 31st as you are this year. Instead, choose diets that teach healthy eating and lifestyle changes that you can make a permanent part of your life.

Tips For Losing Weight And Keeping It Off

You know the brutal truth. Around 95% of dieters regain everything they lost and then some within a few years. You have probably gone through one or more cycles of weight loss and regain yourself – something called “yo-yo dieting”. You may even be asking yourself if it is worth bothering to try to lose weight this year.

Rather focusing on the negative statistics of weight loss, let’s look at the good news. There are people who lose the weight and keep it off. What do they do?

There is an organization called the National Weight Control Registry that has enrolled more than 10,000 people who have lost weight and kept it off. The people in this group lost weight on almost every diet imaginable. However, here is the important statistic: On average people in this group have lost 66 pounds and kept it off for 5 years.

The National Weight Control Registry has kept track of what they have done to keep the weight off. Here is what they do that you may not be doing:

  1. They consume a reduced calorie, low fat diet.

2) They get lots of exercise (around 1 hour/day).

3) They have internalized their eating patterns. In short, this is no longer a diet. It has become a permanent part of their lifestyle. This is the way they eat without even thinking about it.

4) They monitor their weight regularly. When they gain a few pounds, they modify their diet until they are back at their target weight.

5) They eat breakfast on a regular basis.

6) They watch less than 10 hours of TV/week.

7) They are consistent (no planned cheat days).

Which Diet Is Best?

Now it is time to get back to the question you are asking right now, “Which diet is best?” I have covered a lot of ground in this article. Let me summarize it for you.

If you are thinking about popular diets:

  • Primarily plant-based diets ranging from Vegan to Mediterranean and Dash are associated with a healthier weight and better health long term.
    • If want to lose weight quickly, you may want to start with the more restrictive plant-based diets, like Vegan, Ornish, Pritikin or semi-vegetarian.
    • If you do better with a low-carb diet, my recommendation is the low-carb version of the Mediterranean diet.
    • If your primary goal is rapid weight loss, you could also start with one of the healthier of the restrictive low-carb diets, like the Paleo or the 360 diet. I do not recommend the Keto diet.
  • No matter what diet you start with, plan to transition to the primarily plant-based diet that best fits your lifestyle and food preferences. This is the diet you will want to stick with to maintain your weight loss and achieve better health long term.
  • Plan on permanent lifestyle change rather than a short-term diet. Otherwise, you are just wasting your time.
  • Eat whole foods. Big Food keeps up with America’s favorite diets and is only too happy to sell you highly processed foods that match your favorite diet. Avoid those like the plague.

If you are thinking about commercial diets featuring meal replacement products:

  • Look for meal replacement products that:
    • Do not contain artificial sweeteners, flavors, or preservatives.
    • Use non-GMO protein. A non-GMO certification for the other ingredients is not necessary. For a more detailed explanation of when non-GMO certification is important and when it is unnecessary, see my article) in “Health Tips From the Professor”.
    • Have stringent quality controls in place to assure purity. “Organic” and/or “non-GMO” on the label do not assure purity.
  • Look for programs that can provide clinical studies showing their diet plan is effective for weight loss and for keeping the weight off. Many programs have short-term clinical studies showing they are effective for weight loss, but very few have longer-term studies showing the weight stays off.
  • Finally, look for programs that teach permanent lifestyle change. This should include guidance on exercise and healthy eating.

I do not recommend most commercial diets that feature prepared low-calorie foods “shipped right to your door” as a major part of their program. The foods are highly processed. Plus, they include all your favorite unhealthy foods as part of the program. Even if they include lifestyle change as part of their program, they are undermining their message with the foods they are providing you.

I would be remiss if I didn’t mention that Weight Watchers is highly recommended by most experts in the field. Weight Watchers emphasizes journaling and counting calories, which is a plus because it makes you focus on what you are eating. They also have a good lifestyle program and support that can help you transition to permanent lifestyle change if you are willing to put in the effort. However, I don’t recommend their prepared low-calorie foods. They are no better than foods provided by the other commercial diet programs.

The Bottom Line 

Weight loss season is upon us. If you plan to lose weight and/or adopt a healthier diet in the coming year, you are probably asking, “Which Diet Is Best?” In this issue of “Health Tips From The Professor” I give you:

  • 4 tips on what to avoid when selecting the diet that is best for you.
  • 6 tips on how to choose the best diet.
  • 5 tips on what to look for when selecting a diet featuring meal replacement products.
  • 7 tips on how to keep the weight off.

Then I put all this information together to help you choose the best diet, the best meal replacement product, and/or the best commercial diet program.

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.

 

 

Is The Paleo Diet Based On A Myth?

Are Starchy Foods Bad For Us? 

Author: Dr. Stephen Chaney

the paleo dietThe Paleo Diet is still very popular. And it does have its good points. It is a whole food diet. It eliminates sodas, junk foods, and highly processed foods. Any diet that does that can’t be all bad.

But is it unnecessarily restrictive? It eliminates starchy foods like grains, beans, peas, and corn. It is true that widespread consumption of these foods did not occur until after the agricultural revolution some 12,000 years ago. Our paleolithic ancestors probably did not consume significant quantities of these foods.

But did they consume other starchy foods? Our ideas about this have come primarily from comparing the diets of modern man with the diets of the few primitive hunter-gatherer populations that currently exist in our world. Based on that comparison, some Paleo advocates have concluded that the paleolithic diet contained few, if any, starchy foods.

More importantly, some Paleo advocates have gone a step further to assert that our bodies are not designed to eat starchy foods. They claim that foods like grains, legumes, corn, and potatoes are bad for us. They should be avoided.

How can we test whether these claims are true? After all, we don’t have any way of directly determining whether our paleolithic ancestors ate starchy foods or not. Or do we? That question is the topic of a new study (JA Fellows et al, PNAS, 118 No. 20 e2021655118 I will share with you today.

But first I need to acquaint you with what starch is and how we digest it. Once again, it is time for Biochemistry 101.

Biochemistry 101

professor owlStarch is simply a long polymer of glucose molecules. Digestion of starch starts in our mouth. Our saliva contains an enzyme called alpha-amylase that breaks the bond between adjacent glucose molecules. Alpha-amylase breaks starch down sequentially, first to maltodextrin (a shorter polymer of glucose molecules), then to maltose (two glucose molecules), and finally to glucose.

[Note: The nutrition gurus that tell you to read labels and avoid foods with maltodextrin are ignoring the fact that we produce maltodextrin naturally whenever we digest starch in the foods we eat.]

All humans contain the alpha-amylase gene. Simply put, that means that all humans have the potential to digest starchy foods.

However, not all humans have the same number of copies of the alpha-amylase gene. When we habitually consume a diet containing starchy foods, our bodies duplicate the alpha-amylase gene until our saliva contains enough alpha-amylase to easily digest the amount of starchy foods we are consuming. Simply put, that means our bodies are designed to easily adapt to the amount of starchy foods in our diet.

Most modern human populations have between six and 30 copies of the alpha-amylase gene. Our saliva contains a lot of alpha-amylase. However, the few primitive hunter-gatherer societies that still exist in our world have only two or three copies of the alpha-amylase gene. Their saliva contains very little alpha-amylase.

It is this difference that has led to the hypothesis that our paleolithic ancestors did not possess salivary alpha-amylase, which implies they didn’t eat starchy foods. This hypothesis also assumes that humans only began producing significant quantities of salivary alpha-amylase after the agricultural revolution when starchy foods like grains, rice, and beans became widely available.

This hypothesis is one of the central tenets of the Paleo diet. But we need to remember that it is just a hypothesis. It has not been directly tested because we thought there was no way to determine the starch content of the paleolithic diet – until now. However, before we get to the study that explodes this hypothesis, I want to revisit the Paleo Diet myths I described in an earlier issue of “Health Tips From The Professor”. I call this next section “Unicorns And The Paleo Diet”.

Unicorns And the Paleo Diet

the paleo diet and unicornsI titled this section “Unicorns and the Paleo Diet” because both are myths. In fact, the Paleo Diet is based on several myths.

Myth #1: Our ancestors all had the same diet. What we currently know as the Paleo diet is based on the diets of a few primitive hunter-gatherer societies that still exist in some regions of the world. However, when you look at the data more carefully, you discover that the diet of primitive societies varies with their local ecosystems.

The “Paleo diet” is typical of ecosystems in which game is plentiful and fruits and vegetables are less abundant or are seasonal. In ecosystems where fruits and vegetables are abundant, primitive societies tend to be more gatherers than hunters. They eat more fruits and vegetables and less meat.

The assumption that starchy foods were absent in the paleolithic diet is also a myth. For some primitive societies, starchy fruits or starchy roots are a big part of their diet. In short, our paleolithic ancestors ate whatever nature provided.

Myth #2: Our genetic makeup is hardwired around the “paleolithic diet”. In fact, humans are very adaptable. We are omnivores, which means we can eat whatever nature provides. We are designed to thrive in a wide variety of ecosystems. It is this adaptability that has allowed us to expand to every nook and cranny of the world.

For example, the enzymes needed to digest grains are all inducible, which means the body can turn them on when needed. Our paleolithic ancestors may not have eaten much grain, but we can very quickly adapt to the introduction of grains into our diet. As I described above, for alpha-amylase this adaptation occurs through gene duplication.

Myth #3: Our paleolithic ancestors were healthier than modern man: It some respects, the paleolithic diet is healthy, as I mentioned above. However, we need to remember that our paleolithic ancestors rarely lived past 30 or 40. They simply did not live long enough to experience degenerative diseases like heart disease and cancer. We have no idea whether a diet that served our paleolithic ancestors well will keep us healthy into our 70s, 80s and beyond.

How Was This Study Done?

Clinical StudyThis is a fascinating study, and one that would have been impossible just a few years ago. As I have described in previous issues of “Health Tips From the Professor”, studies on our microbiome, the bacteria that inhabit our bodies, is a rapidly evolving area of research.

When we talk about our microbiome, we generally think about our gut bacteria. However, the term “microbiome” includes all the bacteria that reside in our body, including those that reside in our oral mouth.

And, like our gut bacteria, the species of bacteria that reside in our mouth are heavily dependent on the foods we eat. Specifically, there are three species of oral bacteria that thrive on starch. They possess an “amylase binding protein” that allows them to capture salivary alpha-amylase and use it to break down dietary starch so they can use it as an energy source.

Consequently, the abundance of these three bacterial species in the oral microbiome is a precise marker for the amount of starch in a person’s diet. More importantly, high throughput DNA sequencing and supercomputers have made it simple to sequence all the bacteria in the oral microbiome and quantify the relative abundance of these three bacterial species.

You are probably thinking, “That’s fine, but how could you possibly determine the abundance of those bacteria in the mouth of a paleolithic human?” Here is where it gets really interesting!

The bacteria in our mouth form biofilms on our teeth, something we refer to as plaque. If the plaque remains on our teeth long enough, it calcifies, forming what is referred to as dental calculus (tooth tartar).

In the modern world we remove dental biofilms by brushing after every meal. We remove dental plaque and tartar by semi-annual visits to the dentist. But these are recent developments. They are not something our ancestors did.

Our ancestors simply accumulated dental calculus during their lifetime. More importantly, the dental calculus excluded air and water, so it preserved the DNA of the bacteria in their oral microbiome. That was the basis of the current study.

The study was a collaboration of 50 scientists over a 7-year period. The scientists sequenced 124 oral microbiomes from humanoid species in Africa, including Neanderthals (430,000 to 40,000 years ago), Late Pleistocene (129,000 to 11,700 years ago) humans, and modern-day humans.

Bacterial DNA from modern-day humans was obtained from dental calculus obtained during routine dental cleaning procedures by practicing dentists. The older DNA samples were obtained from dental calculus in the teeth of skeletal remains. The oldest DNA sample was obtained from a Neanderthal that lived around 100,000 years ago.

For comparison they also obtained bacterial DNA from the dental calculus of chimpanzees and gorillas, man’s closest primate relatives.

The species of bacteria in the oral microbiome from all these samples were determined by high throughput sequences and computerized analysis using high speed supercomputers.

Is The Paleo Diet Based On A Myth?

Question MarkThere were three important findings from this analysis:

  1. The species of bacteria in the oral microbiome of Neanderthals and Late Pleistocene humans was much more diverse than for modern humans. This suggests that their diets were more diverse (perhaps depending on what foods were available in their environment), while modern diets have become more standardized.

2) The species of bacteria that thrive on starchy foods were remarkably constant in the oral microbiome of all human species from Neanderthals to Late Pleistocene humans to modern-day humans.

3) The species of bacteria that thrive on starchy foods were virtually absent from the oral microbiomes of our most closely related primates – chimpanzees and gorillas.

The authors concluded, “This … supports an early importance of starch-rich foods in Homo evolution.”

In other words, our paleolithic ancestors likely did eat starchy foods. Their diet may not have contained grains, rice, or beans in significant quantities. However, they consumed whatever starchy roots, fruits, and vegetables they could find.

So, is the Paleo diet based on a myth? It depends on how you phrase the question.

  • If we ask whether our paleolithic ancestors consumed grains, rice, or beans, the answer is probably, “No”. The introduction of these foods in significant quantities probably depended on the agricultural revolution that occurred thousands of years later.
  • If we ask whether our paleolithic ancestors consumed starchy foods, the answer is probably, “Yes”. The foundation of the Paleo diet was based on a myth. Their oral microbiome contained bacterial species that thrived on starchy foods. In fact, starchy foods may have been an important staple in their diet because they are more calorie dense than other fruits and vegetables.
  • If we ask whether our paleolithic ancestors were capable of thriving on a diet that included grains, rice, and beans, the answer is also probably, “Yes”. The oral bacterial species that thrive on starchy foods do so by utilizing the alpha-amylase in human saliva. This means our paleolithic ancestors likely had enough alpha-amylase in their saliva to digest and to thrive on starchy foods like grains, rice, and beans.

Are Starchy Foods Bad For Us?

Starchy FoodsIt is not just the Paleo diet. Many popular diets have villainized starchy foods. Are starchy foods as bad for us as some “experts” would have you believe?

Let’s start by identifying starchy foods. If we think in terms of whole foods, they are:

  • Root vegetables (for example, potatoes, sweet potatoes, beets, carrots, and parsnips).
  • Legumes (for example, beans, peas, and lentils).
  • Grains (for example, wheat, rye, barley, oats, and rice).
  • Winter squash (for example, acorn squash, butternut squash, hubbard squash, and pumpkin).
  • Corn

These foods are good sources of nutrients and phytonutrients. Many of them are also excellent sources of fiber, including a special type of fiber called resistant starch. (I have described the benefits of resistant starch in a previous issue of “Health Tips From the Professor”.) These are foods that definitely deserve to be part of a healthy diet.

The only drawback of starchy vegetables is that they tend to be more calorie dense than other vegetables. While this was a “plus” for our paleolithic ancestors, it is not quite as advantageous in our modern world. If you are trying to watch your calories, my advice is to incorporate these foods into your diet sparingly.

However, there is another class of starchy foods you want to avoid. Of course, I am talking about highly processed foods made from grains, legumes, and corn. They retain all the calories but lose most of the nutrients, phytonutrients, and fiber of the foods they came from.

In short, starchy whole foods are a valuable part of a healthy diet. It is the starchy processed foods made from these whole foods you want to avoid. Of course, I am talking about bread, pasta, and pastries made from refined grains and sugar.

So, how do you know which starchy foods to avoid? My advice is not to become an expert label reader. Just eat foods without labels.

The Bottom Line

One of the founding principles on which the Paleo diet is based is that our paleolithic ancestors ate very few starchy foods, and the human body really isn’t designed to handle these foods. Accordingly, the Paleo diet recommends we should avoid starchy foods like grains and legumes. This has the unfortunate effect of creating an unbalanced diet that overemphasizes meat and animal fats.

But is this founding principle correct, or is it just a myth? When you look beneath the surface, you discover that it is a hypothesis based on the diets of the few primitive hunter-gatherer populations that still exist in our world.

It has been assumed that was as good an estimate of the paleolithic diet as we could get. After all there was no way to directly determine the starch content of the paleolithic diet – until now.

In this issue of “Health Tips From the Professor” I describe a novel approach that allowed scientists to determine the species of bacteria residing in the mouth of our humanoid ancestors based on the DNA extracted from the plaque coating their teeth. (For details on how this was done, read the article above.)

What the scientists found was that all human species, including a Neanderthal who died 100,000 years ago, harbored bacteria in their mouths that thrive on starchy foods.

The scientists concluded, “This … supports an early importance of starch-rich foods in Homo evolution.” In other words, our paleolithic ancestors likely did eat starchy foods. Restricting whole grains and legumes from the Paleo diet is based on a myth. They are an important part of a healthy diet.

For more details about the study and which starchy foods are bad 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.

Which Diets Are Best In 2021?

Which Diet Should You Choose?

Emoticon-BadMany 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?

Expert PanelUS 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 DietsWeight Loss

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

strong heartBest 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 FollowEasy

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?

Happy woman on scaleLet 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?

Which Diet Is BestWith 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.

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. In the article above I summarize the US News & World Report’s “Best Diets In 2021”.

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.

Should I Avoid Whole Grains?

Will Whole Grains Kill Me?

Whole GrainsIt seems like just yesterday that health experts all agreed that whole grains were good for us. After all:

  • They are a good source of fiber, B vitamins, vitamin E, and the minerals magnesium, iron, zinc, manganese, and selenium.
  • Their fiber fills you up, so you are less likely to overeat. This helps with weight control.
  • Their fiber also supports the growth of friendly bacteria in your gut.

In fact, the USDA still recommends that half of the grains we eat should be whole grains. And, outside experts, not influenced by the food industry, feel this recommendation is too low. They feel most of the grains we eat should be whole grains. Foods made from refined grains should be considered as only occasional treats.

Then the low-carb craze came along. Diets like Paleo and Keto were telling you to avoid all grains, even whole grains. Even worse, Dr. Strangelove and his colleagues were telling you whole grains contained something called lectins that were bad for you. Suddenly, whole grains went from being heroes to being villains.

You are probably asking, “Should I avoid whole grains?” What is the truth? Perhaps the best way to resolve this debate is to ask, how healthy are people who consume whole grains for many years? This week I share a recent study (G Zong et al, Circulation, 133: 2370-2380, 2016) that answers that very question.

How Was The Study Done?

This study was a meta-analysis of 14 clinical trials that:

  • Enrolled a total of 786,076 participants.
  • Obtained a detailed diet history at baseline.
  • Followed the participants for an average of 15 years (range = 6-28 years).
  • Determined the effect of whole grain consumption on the risk of death from heart disease, cancer, and all causes.

Will Whole Grains Kill Me?

deadDr. Strangelove and his colleagues are claiming that whole grains cause inflammation, which increases your risk of heart disease and cancer. Heart disease and cancer are the leading causes of death in this country. In fact, according to the CDC, heart disease and cancer accounted for 44% of all deaths in the US in 2017.

Therefore, if Dr. Strangelove and his colleagues were correct, consumption of whole grains should increase the risk of deaths due to heart disease and cancer – and increase the risk of death due to all causes.

That is not what this study showed.

When the highest whole grain intake (5 servings/day) was compared with the lowest whole grain intake (0 servings/day), whole grain consumption reduced the risk of death from:

  • Heart disease by 18%.
  • Cancer by 12%.
  • All causes by 16%.

Furthermore, the effect of whole grains on mortality showed an inverse dose response. Simply put, the more thumbs upwhole grains people consumed, the lower the risk of deaths from heart disease, cancer, and all causes.

However, the dose response was not linear. Simply going from 0 servings of whole grains to one serving of whole grains reduced the risk of death from.

  • Heart disease by 9%.
  • Cancer by 5%.
  • All causes by 7%.

The authors concluded: “Whole grain consumption was inversely associated with mortality in a dose-response manner, and the association with cardiovascular mortality was particularly strong and robust. These observations endorse current dietary guidelines that recommend increasing whole grain intake to replace refined grains to facilitate long-term health and to help prevent premature death.”

The authors went on to say: “Low-carbohydrate diets that ignore the health benefits of whole grain foods should be adopted with caution because they have been linked to higher cardiovascular risk and mortality.”

Should I Avoid Whole Grains?

Question MarkAs for the original question, “Should I avoid whole grains?”, the answer appears to be a clear, “No”.

The strengths of this study include the large number of participants (786,076) and the demonstration of a clear dose-response relationship between whole grain intake and reduced mortality.

This study is also consistent with several other studies that show whole grain consumption is associated with a lower risk of heart disease, diabetes, cancer – and appears to lead to a longer, healthier life.

In short, it appears that Dr. Strangelove and the low-carb enthusiasts are wrong. Whole grains aren’t something to avoid. They reduce the risk of heart disease, diabetes, and cancer. And they reduce the risk of premature death. We should be eating more whole grains, not less.

However, the authors did point out that this study has some weaknesses:

  • It is an association study, which does not prove cause and effect.
  • Study participants who consumed more whole grains also tended to consume more fruits and vegetables – and less red meat, sodas, and highly processed foods.

However, I would argue the second point is a strength, not a weakness. We need to give up the idea that certain foods or food groups are “heroes” or “villains”. We know that primarily plant-based diets like the Mediterranean and DASH diets are incredibly healthy. Does it really matter how much of those health benefits come from whole grains and how much comes from fruits and vegetables?

The Bottom Line

Dr. Strangelove and low-carb enthusiasts have been telling us we should avoid all grains, including whole grains. Is that good advice?

If Dr. Strangelove and his colleagues were correct, consumption of whole grains should increase the risk of deaths due to the top two killer diseases, heart disease and cancer. Furthermore, because heart disease and cancer account for 44% of all deaths in this country, whole grain consumption should also increase the risk of death due to all causes.

A recent study showed the exact opposite. The study showed:

When the highest whole grain intake (5 servings/day) was compared with the lowest whole grain intake (0 servings/day), whole grain consumption reduced the risk of death from:

  • Heart disease by 18%.
  • Cancer by 12%.
  • All causes by 16%.

Furthermore, the effect of whole grains on mortality showed an inverse dose response. Simply put, the more whole grains people consumed, the lower the risk of deaths from heart disease, cancer, and all causes.

However, the dose response was not linear. Simply going from 0 servings of whole grains to one serving of whole grains reduced the risk of death from.

  • Heart disease by 9%.
  • Cancer by 5%.
  • All causes by 7%.

The authors concluded: “Whole grain consumption was inversely associated with mortality in a dose-response manner, and the association with cardiovascular mortality was particularly strong and robust. These observations endorse current dietary guidelines that recommend increasing whole grain intake to replace refined grains to facilitate long-term health and to help prevent premature death.”

The authors went on to say: “Low-carbohydrate diets that ignore the health benefits of whole grain foods should be adopted with caution because they have been linked to higher cardiovascular risk and mortality.”

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.

Is The Paleo Diet Bad For Your Heart?

Is The Paleo Diet Bad For Your Gut?

the paleo dietThere is a lot to like about the Paleo diet:

·       It is a whole food diet. Any diet that eliminates sodas, junk foods, and highly processed foods is an improvement over the American diet.

·       It includes lots of vegetables and some fruits.

·       It helps you lose weight, and any diet that results in weight loss improves your blood work – things like cholesterol, triglycerides, blood sugar control and more.

However, there are concerns the Paleo diet may not be healthy long term.

·       In part, that is because the diet is high in meat, red meat, and saturated fat.

·       Equally important, however, is what the diet eliminates – namely whole grains, legumes (beans), and dairy.

Those of you who have read my book, “Slaying The Food Myths”, know that I say: “We have 5 food groups for a reason”. This is particularly true for the plant food groups. That’s because each plant food group provides a unique blend of:

·       Vitamins and minerals. Those can be replaced with good multivitamin/multimineral supplement.

·       Phytonutrients. You can only get the full complement of health-promoting phytonutrients from a variety of foods from all 5 food groups.

·       Fiber. There are many kinds of fiber and they each play different roles in our intestine. You can only get all the health-promoting varieties of fiber by consuming fruits, vegetables, whole grains and legumes.

·       Gut bacteria. What we call fiber, our gut bacteria call food. Each of the plant food groups supports different populations of friendly gut bacteria.

Based on this reasoning, one might suspect that the Paleo diet might alter our gut bacteria in ways that could be bad for our health. Until recently, this sort of reasoning was just a theoretical concern. That’s because:

1)    We knew far too little about the health effects of different populations of bacteria. This is rapidly changing. Several recent studies have systematically investigated the connection between gut bacteria and health outcomes.

2)    We knew our diet influenced the bacteria populations found in our gut, but we had no understanding of how these changes might influence our health. This too is changing. The study (A Genoni et al, European Journal of Nutrition, https://doi.org/10.1007/s00394-019-02036-y) I discuss this week is an excellent example of recent studies linking diet, gut bacteria, and risk factors for disease.

How Was The Study Done?

can you believe clinical studies doctorThis study recruited 91 participants from Australia and New Zealand. It was a very well designed study in that:

·       The Paleo diet group (44 participants) was recruited based on self-proclaimed adherence to the Paleo diet (< 1 serving/day of grains and dairy products) for one year or more. This is important because short term effects of switching to a new diet are confounded by weight loss and other factors.

o   After analyzing the diets of the Paleo group, the investigators found it necessary to subdivide the group into Strict Paleo (< 1 serving/day of grains and dairy products) and Pseudo-Paleo (> 1 serving/day of grains and dairy).

·       The control group (47 participants) was recruited based on self-proclaimed adherence to a “healthy diet” for 1 year or more with no change in body weight (A healthy diet was defined as a whole food diet containing a variety of foods from all 5 food groups). This is important because far too many studies compare the diet they are promoting to an unhealthy diet with a lot of sugar and highly processed junk foods. These studies provide little useful information because almost anything is better than an unhealthy diet.

·       The participants completed a diet survey based on the frequency of consumption of various foods during the previous year. However, because diet surveys based on the recollection of participants can be inaccurate, the investigators used two rigorous tests to validate the accuracy of those diet surveys.

o   The first was a 3-day weighed dietary record (WDR). Simply put, this means that participants weighed and recorded all foods and beverages before they were eaten for 3 days. Two of those days were weekdays, and one was a weekend day.

o   Secondly, the investigators used blood, urine, and metabolic measures to independently determine protein and energy intake of each participant. Participants who were identified by these means as under reporting both protein and energy were considered unreliable dietary reporters and were excluded from the analysis.

o   It is very rare to find a study that goes to this length to validate the accuracy of the dietary data used in their analysis.

The participants also provided blood, urine and stool samples and completed a physical activity assessment.

What Were The Differences Between The Paleo Diet And The Healthy Control Diet?

Paleo FoodsOnly the Strict Paleo Diet group was faithfully following the Paleo diet. In addition, most of the results with the Pseudo Paleo Diet Group were intermediate between the other two diets. Therefore, to simplify my discussion of this study I will only compare the Strict Paleo Diet group, which I refer to as the Paleo Diet group, with the Healthy Diet control group.

The Paleo diet emphasizes fresh vegetables, especially green leafy vegetables, and discourages grains. Thus, it is no surprise that:

·       The Paleo Diet group ate 74% more vegetables and 3 times more leafy green vegetables than the Healthy Diet group.

·       The Paleo Diet group ate only 3% of the grains and 3% of the whole grains compared to the Healthy Diet group.

The Paleo diet encourages consumption of meat and eggs and discourages consumption of dairy and plant proteins. Thus, it is not surprising that:

·       The Paleo Diet group ate 3 times more red meat and 5 times more eggs than the Healthy Diet group.

·       The Paleo Diet group ate 10% of dairy foods compared to the Healthy Diet group.

·       The Paleo Diet group consumed two times more saturated fat and cholesterol than the Healthy Diet group.

The most interesting comparison between the two diets was the following:

·       Intake of total fiber, insoluble fiber, and soluble fiber was comparable on the two diets.

·       However, intake of resistant starch was 50% lower in the Paleo Diet group. This is significant because:

o   Resistant starch is a type of fiber found primarily in whole grains, legumes, potatoes, and yams (Potatoes and yams are also dietary “no nos” on most low-carb diets).

o   Resistant starch is an especially good food for certain species of healthy gut bacteria.

Is The Paleo Diet Bad For Your Gut?

Bas BacteriaBecause resistant starch affects gut bacteria, the study next looked at the effect of the two diets on the populations of gut bacteria. This is where the story starts to get interesting. When they looked at different groups of gut bacteria, they discovered that:

·       Bifidobacteria were much more abundant in the Healthy Diet group than in the Paleo Diet group, and the amount of Bifidobacteria in the gut was directly proportional to the amount of whole grains in the diet.

o   This is important because previous studies have suggested Bifidobacteria help maintain intestinal barrier integrity and protect against irritable bowel syndrome and obesity.

·       Roseburia were also much more abundant in the Healthy Diet group and proportional to the amount of whole grains in the diet.

o   This is important because previous studies have suggested Roseburia protect against inflammatory bowel diseases like Crohn’s disease and ulcerative colitis.

·       Hungatella were much more abundant in the Paleo Diet group and were inversely proportional to the amount of whole grains in the diet.

o   This is important because Hungatella metabolize carnitine and choline, which are found in meats (especially red meats), egg yolks, and high fat dairy, into a compound called trimethylamine or TMA. TMA is then further metabolized in the liver to trimethylamine-N-oxide, or TMAO.

o   TMAO is a bad player. It is positively associated with heart disease, stroke, kidney disease, diabetes, and Alzheimer’s disease. However, the evidence is strongest for heart disease. TMAO has been called an independent risk factor for cardiovascular death.

Because of this, the study looked at TMAO levels in the blood of the two diet groups. These results were concerning:

·       TMAO levels were 2.5-fold higher in the Paleo Diet group than in the Healthy Diet group.

·       As might be expected, TMAO levels were positively correlated with red meat intake and inversely proportional to whole grain intake.

Is The Paleo Diet Bad For Your Heart?

heart diseaseWhen you put all the evidence together you have a compelling argument that the Paleo diet is likely to increase the risk of heart disease. Let me summarize the data briefly:

1)    The Paleo diet discourages the consumption of whole grains.

2)    Whole grains are a major source of a dietary fiber called resistant starch.

3)    Because the Paleo diet is low in resistant starch, it causes a decrease in two healthy types of gut bacteria and an increase in a type of gut bacteria called Hungatella.

4)    Hungatella metabolize compounds found in meat, eggs, and dairy to a precursor of a chemical called TMAO. This study showed that TMAO levels were 2.4-fold higher in people consuming a Paleo diet.

5)    TMAO is associated with coronary artery disease and is considered an independent risk factor for cardiovascular death.

The authors of the study concluded: “Although the Paleo diet is promoted for improved gut health, results indicate long-term adherence is associated with different gut microbiota and increased TMAO. A variety of fiber components, including whole grain sources, may be required to maintain gut and cardiovascular health.”

Of course, studies like this are looking at associations. They are not definitive. What we need are long term studies looking at the effect of the Paleo diet on heart disease outcomes like heart attack and stroke. Until we have these studies my advice is:

·       Don’t accept claims that the Paleo diet is heart healthy. There are no long-term clinical studies to back up that claim.

·       Be aware that the Paleo diet affects your gut bacteria in ways that may be bad for your heart.

The more we learn about our gut bacteria, the more we appreciate the importance of including all 5 food groups in our diet, especially all the plant food groups.

Are Low Carb Diets Healthy?

low carb dietThe Paleo diet is not the only diet that is high in red meat and low in whole grains. The same is true for virtually all the popular low-carb diets. There are studies showing other low-carb diets also alter gut bacteria and raise TMAO levels, so there is a similar concern that they may also increase the risk of heart disease.

This is in addition to concerns about the high saturated fat consumption which increases the risk of heart disease and red meat consumption, which may increase the risk of certain cancers.

Finally, there are no studies showing that any low-carb diet is healthy long term, even the Atkins diet, which has been around for more than 50 years. Until we have long-term studies about the health consequences of low-carb diets, my advice is similar to that for the Paleo diet.

·       Don’t accept claims that low-carb diets are healthy. There are no long-term clinical studies to back up that claim.

·       Be aware that low-carb diets affect your gut bacteria in ways that may be bad for your health.

The Bottom Line

A recent study looked at the effect of the Paleo diet on an important risk factor for heart disease. Here is a brief summary of the data:

1)    The Paleo diet discourages the consumption of whole grains.

2)    Whole grains are a major source of a dietary fiber called resistant starch.

3)    Because the Paleo diet is low in resistant starch, it causes a decrease in two healthy types of gut bacteria and an increase in a type of gut bacteria called Hungatella.

4)    Hungatella metabolize compounds found in meat, eggs, and dairy to a precursor of a chemical called TMAO. This study showed that TMAO levels were 2.4-fold higher in people consuming a Paleo diet.

5)    TMAO is associated with coronary artery disease and is considered an independent risk factor for cardiovascular death.

Of course, studies like this are looking at associations. They are not definitive. What we need are long term studies looking at the effect of the Paleo diet on heart disease outcomes – like heart attack and stroke. Until we have these studies my advice is:

·       Don’t accept claims that the Paleo diet is heart healthy. There are no long-term clinical studies to back up that claim.

·       Be aware that the Paleo diet affects your gut bacteria in ways that may be bad for your heart.

·       Virtually all the popular low-carb diets discourage consumption of whole grains, so my advice for them is the same as for the Paleo diet.

The more we learn about our gut bacteria, the more we appreciate the importance of including all 5 food groups in our diet, especially all the plant food groups.

For more details on the study and what it means 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

Is The Paleo Diet Healthy?

Did Cave Men Have The Secret For A Longer, Healthier Life?

Author: Dr. Stephen Chaney

 

the paleo dietIt seems like everyone you talk to is following the Paleo diet or knows someone who is following the Paleo diet. It is the latest diet fad. But, is the Paleo diet healthy?

If you have been around for a few years, like me, you have seen lots of fad diets come and go. They are immensely popular for a few years. Then people discover their weight loss was temporary or they aren’t any healthier, and the diet slowly fades into obscurity.

Is the Paleo diet one of those fad diets that will fade into obscurity, or is it a healthy diet that will stand the test of time? A lot has been written about the Paleo diet, both pro and con. I have analyzed the science behind the claims and counter-claims so I can bring you the truth about the Paleo diet.

 

Unicorns And the Paleo Diet

 

the paleo diet and unicornsI titled this section “Unicorns and the Paleo Diet” because both are myths. In fact, the Paleo Diet is based on several myths.

Myth #1: Our ancestors all had the same diet. What we currently know as the Paleo diet is based on the diets of a few primitive hunter-gatherer societies that still exist in some regions of the world. However, when you look at the data more carefully, you discover that the diet of primitive societies varies with their local ecosystems.

The “Paleo diet” is typical of ecosystems in which game is plentiful and fruits and vegetables are less abundant or are seasonal. In ecosystems where fruits and vegetables are abundant, primitive societies tend to be more gatherers than hunters. They eat more fruits and vegetables and less meat.

The assumption that starchy foods were absent in the paleolithic diet is also a myth. For some primitive societies, starchy fruits or starchy roots are a big part of their diet. In short, our paleolithic ancestors ate whatever nature provided.

Myth #2: Our genetic makeup is hardwired around the “paleolithic diet.” In fact, humans are very adaptable. We are designed to thrive in a wide variety of ecosystems. It is this adaptability that has allowed us to expand to every nook and cranny of the world.

For example, the enzymes needed to digest grains are all inducible, which means the body can turn them on when needed. Our paleolithic ancestors may not have eaten much grain, but we can very quickly adapt to the introduction of grains into our diet.

Myth #3: Our paleolithic ancestors were healthier than modern man: It many respects, the paleolithic diet is healthy, as I will discuss below. However, we need to remember that our paleolithic ancestors rarely lived past 30 or 40. They simply did not live long enough to experience degenerative diseases like heart disease and cancer. We have no idea whether a diet that served our paleolithic ancestors well will keep us healthy into our 70s, 80s and beyond.

However, just because the Paleo diet is based on mythology does not mean that it isn’t healthy. Let’s look at the pros and cons of the Paleo diet.

 

The Pros Of The Paleo Diet

 

the paleo diet thumbs upThere are lots of things to like about the Paleo diet. For example:

  • It eliminates sodas, fast foods, processed foods, sugar and salt. Any diet that does that is a vast improvement over the typical American diet.
  • It emphasizes fresh fruits and vegetables, another big improvement over the typical American diet.
  • It has a healthier profile of fats than the other low carb diets. It favors grass-fed beef, wild-caught fish, and free-range chicken, so it has less saturated fat and more omega-3s. It also emphasizes healthy oils such as olive, walnut, avocado, and flaxseed. In this regard, it is clearly healthier than the other low carb diets. It does include coconut oil, which is a concern. As I have pointed out in a previous article, Is Coconut Oil Bad For You, there is no convincing evidence that coconut oil is healthy.
  • It emphasizes use of unrefined or extra virgin oils rather than refined oils. That is a plus for most oils because the unrefined oils are more likely to contain antioxidants and beneficial phytonutrients. It is, however, a concern for coconut oil because the unrefined oil is more likely to contain cancer-causing aflatoxins.
  • Like most other restrictive diets that eliminate processed foods, it can give short term weight loss, although long term weight loss is less certain.

 

The Cons Of The Paleo Diet

the paleo diet thumbs down

There are, however, some concerns about the Paleo diet. Other experts have commented on the cost and difficulty in following the diet, especially if you eat out a lot, so I won’t comment on those aspects here. I will stick with nutritional concerns with the Paleo diet. For example:

  • It eliminates cereal grains, legumes, and dairy. I am always concerned with the nutritional adequacy of diets that eliminate whole food groups. For example:
    • Dairy is a major source of calcium and vitamin D in the American diet. Eliminating dairy has the potential to increase the risk of osteoporosis.
    • Whole grains, legumes and dairy are important sources of magnesium. Magnesium deficiency has the potential to increase the risk of heart disease, among other things.
    • Most Americans are already not getting enough of these nutrients in their diet. We can scarcely afford to eliminate foods that are good sources of these nutrients.
    • It is possible to carefully design a Paleo diet so these nutrients are provided by other foods, but most people don’t carefully design their daily diet.
  • It recommends increasing protein intake to 19 – 35% of calories. Because legumes have been eliminated, the increased protein intake is coming almost entirely from animal protein, primarily red meat and fish. I will discuss the health concerns with red meat below. However, there is a practical consideration as well. Grass-fed beef is not always available, especially if you eat out frequently. If you are not eating grass-fed beef, you will be taking in more saturated fats and the healthier fat profile of the Paleo diet will disappear.
  • It has been influenced by the recent hype about health benefits of coconut oil. Coconut oil is just one of several oils that are recommended. However, if you look on the internet today, coconut oil is featured in almost every Paleo diet recipe. Until we have definitive evidence whether or not coconut oil is healthy, I would emphasize the other oils recommended for the Paleo diet, and use coconut oil sparingly.
  • There are no studies showing the Paleo diet is healthy long term. In contrast, there are long term studies showing that Vegan, Mediterranean, and DASH diets decrease the risk of heart disease, diabetes, some cancers and Alzheimer’s.

 

Concerns About Red Meat

the paleo diet red meatThe International Agency For Research On Cancer (IARC), the agency created by the WHO to set international standards for cancer risk, has designated red meat as a class 2a carcinogen. That designation means that there is probable cause to believe that it increases cancer risk in humans. The evidence is best for increased risk of colon cancer and breast cancer, although there is some evidence that it may increase risk of pancreatic and prostate cancer.

The increased cancer risk of red meat does not seem to be due to its fat content, so grass fed beef is just as likely to increase cancer risk as conventionally produced beef. There are multiple proposed mechanisms for this effect:

  • When fat and juices from the meat drip onto an open flame, carcinogenic polyaromatic hydrocarbons are formed that stick to the surface of the meat. This can be reduced, but not eliminated, by lower fat meat choices.
  • When red meats are cooked at high temperatures, amino acids in the meat combine with a compound called creatine, which is found in all red meats, to form carcinogenic heterocyclic amines. This can be reduced by cooking the meat at lower temperatures.
  • Heme iron, which is found in all red meats, combines with other component of our diet to form carcinogenic N-nitroso compounds in our intestines.
  • People who eat high meat diets have an entirely different population of intestinal bacteria than people who eat no meat. Several recent studies suggest that the intestinal bacteria of meat eaters are more likely to convert the foods we eat into chemicals that increase the risk of cancer and heart disease.

To be clear, red meat is a probable carcinogen and we aren’t sure of the exact mechanism(s) that cause this carcinogenicity. We do not yet have definitive evidence that red meat causes cancer. However, there is good reason to be cautious about how much red meat we consume.

The good news is that the antioxidants, fiber and phytonutrients found in fruits and vegetables can block most of these cancer-causing pathways. That means that small amounts of red meat in a largely plant-based diet may not be as concerning. Specifically, an ounce of red meat in a large green salad or stir fry is much less likely to increase your cancer risk than a 6 ounce steak.

Is The Paleo Diet Healthy?

 

As mentioned above, there is a lot to like about the Paleo diet. It is healthier than the typical American diet, and it is healthier than most of the low carb diets. I have concerns about the nutrition adequacy of any diet that eliminates whole food groups and the heavy emphasis on red meat. There is also no proof that the Paleo diet is healthy long term.

Since the restrictions of the Paleo diet are based on mythology rather than science, my recommendation would be to loosen the restrictions on whole grains, legumes & low-fat dairy, and rely less on red meat as a protein source. If you did that, the diet would more closely resemble the Mediterranean and DASH diets, which we know are healthy long term.

 

The Bottom Line

 

  1. The Paleo diet is based on a myth.
    • Our paleolithic ancestors did not eat a single diet. They followed a variety of diets depending on the foods most available where they lived.
    • Our bodies are not genetically hardwired for a single diet, but are designed to adapt to a wide variety of foods. For example, all of us have the enzymes needed to digest grains, and those enzymes are inducible.
    • We don’t know whether the paleolithic diet is healthy. The average lifespan of our paleolithic ancestors was in the range of 30 to 40 years. We have no idea whether a diet that served our paleolithic ancestors well will keep us healthy into our 70s, 80s and beyond.
  2. However, the fact that the Paleo diet is based on a myth does not make it unhealthy. In fact, there is a lot to like about the Paleo diet.
    • It eliminates sodas, fast foods, processed foods, sugar and salt which makes it much healthier than the standard American diet.
    • It emphasizes fresh fruits and vegetables, which is also an improvement over the standard American diet.
    • If features a relatively healthy profile of fats, which makes it healthier than most other low carb diets.
    • It favors unrefined or extra virgin oils, which are generally healthier than highly processed oils. The exception is coconut oil because unrefined coconut oil may be contaminated with aflatoxins.
    • It can give short term weight loss, although long term weight loss is uncertain.
  3. However, there are concerns about the long-term safety of the Paleo diet. The minor concerns are:
    • The elimination of whole grains, legumes, and dairy from the diet creates the potential for nutritional deficiencies that can have long-term health consequences. It is possible to carefully design a Paleo diet so these nutrients are provided by other foods, but most people don’t carefully design their daily diet.
    • Most of the recipes you find on the internet for the Paleo diet use coconut oil. This is a concern because we don’t know whether coconut oil is healthy. My recommendation would be to substitute the healthier oils that are also part of the Paleo diet.
  4. More serious concerns are:
    • The heavy reliance on red meat. Red meat is classified as a probable carcinogen, potentially increasing the risk of colon cancer, breast cancer, pancreatic cancer and prostate cancer. The potential carcinogenicity of red meat is not reduced by substituting grass-fed beef for conventionally produced beef.
    • There are no clinical studies showing the Paleo diet is healthy long term. In contrast, there are long term studies showing that Vegan, Mediterranean, and DASH diets decrease the risk of heart disease, diabetes, some cancers and Alzheimer’s.
  5. Because the restrictions of the Paleo diet are based on myth rather than science, there are simple work arounds for the concerns. If one were to loosen the restrictions on whole grains, legumes and low-fat dairy & reduce the reliance on red meat, you would have a diet closer to the Mediterranean and DASH diets, which we know are healthy long term.
  6. For 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.

 

Health Tips From The Professor