[Good afternoon everyone and welcome to
update your plate, how to choose a healthy eating plan.
We’re not going to promise that we’re going to change your life today,
but I won’t be surprised if we do. Get ready for some fun and some really
valuable information. I’m going to be your moderator for the
next hour, but you are going to be a very important
part of what we do. We are going to ask you to share your
thoughts and polls to make sure that we’re providing you the information that
you want. Feel free to ask questions at any time
and there’s a couple of different ways that she can do that.
You can see the bottom of your screen if you’re talking,
if you’re joining us today using your smartphone,
there’s a question mark symbol at the top of your smartphone screen.
Just click on that type in the question and we will be happy to answer it in
real time. If you’re joining us on your laptop or
your pc, there’s a message box that says type
message here. Just ask what you want to know and we’ll
have our guest speaker answer it for you in real time and at the end.
Stick around because we’re going to have a webinar survey where we would love to
get information from you as well. Now,
as I mentioned, I’m your host,
but the star of the show is Jendy Newman.
She’s a registered Dietitian and a certified diabetes educator and she’s
been around the block once or twice on these topics,
25 years providing nutrition council and she’s done this not just in the Pacific
Northwest. She’s been in Ohio and Southeast Alaska
and she’s a proud (OSU) Beaver and she loves to cook and Garden and Kayak.
It’s so great to have you here today and we have a lot of people on the line.
More than 150 people attending. They all want to know what you know.
Welcome. Thank you,
Randy, and welcome everyone.
Whether you’re listening to the live webinar or later to the recorded
version, I hope you will find some nuggets to
improve your health today. So Americans are not alone in their
quest to make some healthier choices. The healthy eating index is done every
three to five years and the years that they most currently had data for 2013
and 2014 and out of a scale of up to 100,
the healthy eating index was 59. So that shows that Americans do not
align with even the dietary guidelines. This encourages us to shift towards
healthier eating. And while the dietary guidelines for
Americans may not be a fully whole foods diet,
that would be the highest bar that I would recommend.
It does significantly move us away from our ultra-processed eating styles. They often call it the standard American
diet or the acronym SAD, where we are generally eating 55 to 60
percent of our calories from ultra processed foods.
So this score 59 out of 100 actually shows improvement from previous years
because we’ve reduced trans fats and sweetened beverages a significant amount
and we’re actually consuming more whole fruits,
a little bit more whole grains, nuts,
legumes, and the good polyunsaturated fat.
So we need to give ourselves as a population,
some credit for improvements that we have made,
but we still have excesses, especially red and processed meats and
sodium and too low in vegetables. So what are some keys to healthy living?
So we would look at four main keys. Sticking to these four healthy lifestyle
factors doesn’t have to cost a lot or require more frequent medical visits,
but it can have a strong impact on personal and national health. And these four are:
1) not smoking, 2) not being obese,
3) getting 30 minutes of exercise daily as a minimum and 4) eating healthier,
getting more fruits and vegetables, whole grains and smaller amounts of
meat. So congratulate yourself for the areas
that you’re doing well and decide on what areas that you want to work on
next. Maybe you’ve done well this past year
fitting in more exercise but obviously since you’re here today,
maybe you want to work on the healthier eating part.
And especially because we know we can’t outrun a poor diet.
So in addition to exercise, we need to nourish ourselves and if we
work bit by bit on these four things, we can help wipe out 90 percent of our
diabetes risk, 80 percent of heart attack risk,
50 percent of stroke risk, and 33 percent of cancer risk. By not following these guidelines,
that actually accounts for about 78 percent of chronic disease in the United
States. So the quest for healthier eating can be
very overwhelming. We’ve got lots of different eating
styles and diets, you know,
Weight Watchers (R), the DASH,
vegetarian, all different kinds of things and,
you know, different people telling us that we
should follow this diet or that diet. the other interesting thing is that
science, the science of nutrition is still
evolving and some previous guidelines turned out to be misguided,
such as, you know,
fat was the enemy back in the seventies and that actually lead to excess
carbohydrate intake. So in this quest for perfect dieting,
sometimes we’ve gotten misguided in that counting calories or macros sometimes
can drive us crazy and we get overwhelmed before we start.
But what will healthier look like for you or will any of these eating styles
help you get there? So today we’re going to self reflect on
your current eating style and your health goal.
Be a critical consumer of health information,
explore to be cautious about and why. Review the top five rated healthy eating
styles according to US News and World Report,
and begin creating your long-term healthy eating style.
And we’ll also be sharing resources to assist you in your action plan.
I’ll let Randy launch our first poll Run to your computer screens right now.
Grab your mouse or your keyboard because we want to know who’s in our audience
today. What is your main motivation for being
here? Do you want to lose weight?
Do you want to prevent or manage a chronic disease?
And that can be a cardiac issue. Diabetes,
cancer. Do you want to deal with a
gastrointestinal intolerance or fuel a sport or a high energy need activity or
maybe it’s something else. What do you have to come to our
certified nutrition expert today? And in real time I can read your
responses and right now about one in 10 are saying other a three percent that
it’s a gastrointestinal intolerance issue,
about six percent fueling a sport or high energy need activity.
And maybe you’re thinking about starting your first five k,
the second largest is prevent or manage a chronic condition.
And there are a lot of those. And thank you for your responses.
I’m going to close the poll now and show you the results.
Number one, with the majority,
more than half of us are here because we want to lose weight today.
does that surprise you that most people are interested in losing weight or did
you, did you expect that that would be about
the, the spread that we have in our audience
members today? I’m not surprised because a lot in our
population weight has become a challenge and that’s contributing to a lot of our
other chronic medical conditions. So managing weight is a part of either
managing a condition or preventing a condition.
So it’s understandable that a lot of people are motivated or just because of
how they want to feel. Excellent.
Okay. So we’ve got a lot of people who are
going to try to lose weight. Help us figure out how to do it. All right.
So typically when I work with individuals and groups,
I encourage you to think about where you are currently because I think that gives
you some good guidance on selecting a plan that’s going to be most appropriate
and doable for you. I’m going to give you a few questions to
think about. For self reflection and assessment.
There will be with the handouts available,
a worksheet for weight loss that I would encourage you to consider filling out,
even if it’s just for yourself, but you could take it to share with your
healthcare provider as well. So how did you get to your current
weight or health situation or what do I want to prevent?
What changes have I tried in the past? What did or didn’t work?
Was it balanced? Could I stick with it?
If in the long-term, what got in my way at that particular
time? When I tried it,
who can support me, how would I need to set myself up to be
successful and this is one of the challenges in our culture that often the
setting ourselves up well, and then how can I be kind to myself and
set realistic goals or plans if we are so black and white that we don’t give
ourselves a little wiggle room and be kind to ourself about the positive
things while we’re working on the other things.
sometimes we, we give up Usually when we talk about dieting,
we’re punishing ourselves. I’ve never heard the word kindness ever. Yeah.
So there’s a concept called acceptance-based therapy where we have
to accept where we are and deal with that situation and feelings in order to
work from there. And so we find that that’s typically
more successful. We recommend that you consult with your
health care provider or other health professional before starting any diet,
weight loss or exercise plan to determine if it’s right for you.
And this is general information, not intended to treat or diagnose a
medical condition or replace your healthcare team professional,
but they help you tease out where you might want to go from here and get
support. So let’s look at some big picture
we’ll get into more details as we go. So as we’re seeking a healthy eating
style, we want to think about,
does it follow a healthy eating pattern across your lifespan?
does it focus on a variety of nutrient dense foods? Amounts are portion limits,
calories from added sugars and saturated fats.
Number four, reduce sodium intake.
Number five, shifts to healthier food and beverage
choices. And does it support healthy eating
patterns for everyone in the household? so consider shifting energy.
You know, you’re personal energy from counting
calories and Macros, especially if you get frustrated by
that. If it’s a helpful thing and it’s,
it’s giving you some guidance, that may be okay for you,
but we’re finding some people are spending too much time in that and not
in just making some healthier shifts. So let’s take another poll to find out.
We’ve got over 200 people in attendance here.
That’s why we’re using this polling mechanism for you to weigh in.
We want to know…where do you get your nutrition news?
Do you get it from the major news outlets?
You watch CBS morning news, maybe you go to a government nutrition
site, maybe a diet program that you’re
enrolled in or thinking about enrolling in
from somebody in your family, your,
your, your husband,
your, your neighbor next door.
Maybe you get it on your online social chat.
Where do you go to get information that you feel is trustworthy?
And it’s interesting in our crew right now,
very few people trust the government. I think government nutrition sites have
about a five percent response rate just above that is the paid diet programs.
Next up, we love our family and friends to the
tune of about 19 percent. Most of us family/friends and online.
We are looking for our news from major news sources,
which would be television, magazines and online.
And are those reliable places where you should go or do you have suggestions for
maybe a better way to get our information? Sure.
Let’s take a look at that. I have some information on how to find
reliable health information and typically on Internet sites,
if we go to the slide, the best choices are .edu,
.gov’s can be, but we’ll talk about how that can be
problematic sometimes .orgs and with caution .coms and .net.
With the .Gov, I think some of the caution people have
is, they don’t feel that’s unbiased enough.
But I think if you look at multiple sources and do you look for the evidence
based, a lot of times that can be actually
quite good sources. Do you have a “go-to” internet site? Well,
one of my latest favorites that I have for you in a few slides is nutrition
facts.org. And so it’s an independent site.
There are also a Harvard Edu is one that I use frequently.
So those are two, two favorites right now that I refer
people to for credible information. So with books,
newspapers, and magazines it is recommended that you
checked the author’s credentials as well as they should also be from an
accredited organization or a university. In television,
you need to make sure it’s well researched.
Information of repeatable studies. We’ll talk in a moment a little bit more
about the hierarchy of scientific evidence and how some of what the news
media gets is the initial stuff. So in general,
you want to look for reliable health information that is current and
references are cited sources. Ideally,
you want to seek out multiple perspectives so you can get a
well-rounded view and be cautious if they’re advertising or selling a product
for profit if the site is about making money,
be thoughtful about whether that’s the best source of information. Correct.
So, hierarchy of scientific evidence.
This is a construct that when you look at research that’s done.
We start out with expert opinion, case reports at the bottom of the
pyramid and then over time as information is vetted,
you get to the gold standard of the top to the randomized control trials and
systematic reviews and meta analysis. So we really want to be looking as far
as evidence-based nutrition decisions in this upper part of this construct
because there’s increased strength in the data and decreasing bias.
And if you look at the news media, most of the reports in the media,
seven out of 10 nutrition-related reports come from these lower,
second-tier type studies. So often the research is kind of cutting
edge and interesting, but if you really look at the research,
even those researchers are saying that this needs additional studies to prove
what we’re discussing. so yes,
that often that hype is interesting and, and whatnot,
but and some of it may be safe to try, but we also have to look at the big
picture. So science marches onward.
So let’s look at some nutrition science updates.
I’ve been a dietitian for over 25 years. I’m having to learn with you guys as
well. But some of the things that we’ll unpack
here in the next few slides are quality of our food matters more than quantity.
and then the second on the nutrition updates slides is that healthy low
energy-density foods help with weight loss and diet quality.
And here’s a five minute video that you can look at later.
That’s from that nutrition facts.org that you might find interesting.
And then the third update is, “is a calorie still a calorie”
regardless of the source? and that ties in with a concept called
the carbohydrate insulin model. So let’s take a look at energy density.
So this slide just shows examples of what’s 100 calorie in carbohydrate,
protein, fat or alcohol.
And we can see that when it comes to especially vegetables or fruit we get
large portions for that hundred calories,
proteins a little bit more concentrated. And then fat is even more concentrated,
so it’s only like a tablespoon or a thumb-sized amount of peanut butter for
100 calories. Alcohol is interesting in that it’s a
little bit less calories per gram than fat,
but it is still metabolized more like fat even though it comes from
carbohydrates, our body processes it.
more like that. And beverages are also tricky because
they provide calories that may not make you feel full.
So let’s take a look at dietary quality. So dietary quality is a concept that
when food comes in its natural package, it is a blend of the nutrients that’s
needed to go with that food. And this is an example of whole grain be
a whole week and the green bars show that whole wheat has this certain blend
of all the natural nutrients, whereas refined flour has a lot of that
stripped away and then enrich they’re adding back certain things.
but you know, even a child can tell you that they know
it’s healthy to eat a snack of an apple and a cheese stick or a handful of baby
carrots with hummus instead of the packet of Ramen or a bag of potato
chips. But it’s just not always what we want
because we have so many tasty processed food choices. So how did we get to where processed
foods like chips and Ramen is the standard instead of those healthier
snacks? We’ve allowed ourselves to be set up
poorly by the food industry and you know,
that affects the natural balance of the nutrients.
And then we have allowed ourselves to be marketed to our want versus reason.
So let’s take a closer look at it. Is a calorie still a calorie.
So there’s some different factors that affect metabolism.
We know if we have more lean body mass or muscle burns more calories than does
fat tissue. Natural hormones can affect our
metabolic rate. And we’re even learning that the
bacteria in our digestive tract or gut micro biome may have an impact on our
metabolic rate. And that’s a subject for a whole other
talk that maybe they could get an expert to explore if you’re interested. And then there’s the carbohydrate
insulin model. So this ties in that food quality and
the balance of macronutrients in a meal matter.
So for example, highly processed carbohydrates,
in a soda or Ramen noodles can cause excess insulin secretion to deal with
this bucket of carbohydrates compared to whole grain veggies or fruit that our
body was designed to have to unpack more slowly.
So those highly processed carbs actually increase fat storage and increase hunger
due to the fact that they cause an excessive release of insulin.
So let’s take a look at the conversion of food into blood sugar.
I think this helps a little bit and understanding how the balance aids
fullness and metabolism. So it shows the carbs,
the red are quicker release fuels than protein and fat,
which are slow release and have less of an impact on blood sugar. So a balanced meal with lean proteins
and vegetables and low glycemic carbohydrates and generous amounts of
low carb veggies and some unhealthy, some healthy unsaturated fats lead to a
lower glycemic meal that will prevent less excessive insulin lease that would
contribute to fat storage. Whereas if we just have,
you know, that soda by itself or we have that
packet of ramen noodles by itself, that’s going to be more problematic.
So we can look at an example of how reducing added sugar makes a difference
in your health. So reducing refined sugars reduces
insulin resistance that can promote diabetes,
it reduces inflammation that can promote heart disease and then it can improve
your metabolic rate. So our cartoon here shows the gentleman
that is more apple-shaped than pear shape and we know that shape isn’t as
healthy. You have more fat around your organs so
that visceral fat and a more fatty liver and fructose,
which is the kind of sugar in most added sugars as well as in concentrated fruit
juices, does boost liver,
muscle and fat. and that is more problematic for health Where the fat is stored is actually more
dangerous to your body than others. Correct.
So it depends on where the fat is. Interesting.
Well that means it’s time for another poll.
We want to find out about diets that you’ve used.
Have they worked for you? Have you tried them?
So it seems like every year there’s a new diet and we all race out to give it
a shot and it works and then it doesn’t work.
And have you tried the vegetarian or Vegan Diet?
Have you tried to Mediterranean Diet? What about a high protein or high fat
that would include Paleo, keto,
that would include Atkins. How about weight watchers?
They’ve gone through that program. What about pre-packaged foods where they
take out a lot of the decision making? The hmr diet is one that at PeaceHealth
is an advocate of. Have you tried that?
Or one of those other ones, or perhaps something different.
What kind of diet have you used that has worked for you?
Very possibly. You’ve tried a lot of diets and none of
them have worked for you. Click the other button and type your
answer in the chat window and we’ll be able to read some of those and in real
time I can tell you that it is a fairly even spread.
We don’t have a lot of vegetarians or vegans in our crowd right now.
About 15 percent, about 26 percent of us have tried the
Mediterranean diet. Next step,
that paid food program. I’m going to close the poll now and show
you the results. The most common one in our audience
today, 42 percent is the high protein or the
high fat diets Paleo. That’s keto.
That’s Atkins and I know that you have. I’m just going to say some concerns
about those diets, so anybody who clicked the high protein
or high fat, let’s listen really carefully to what
Jendy has to say about that. So there are a lot of options in here.
Mediterranean, high protein,
Weight Watchers(R), prepackaged foods.
Are you going to talk about each one of these? We have about 10 different eating
styles. We’re going to talk about today.
We’re going to talk about some to be wary of or cautious with and some of the
best ones, if you’re not familiar with it,
US News and World Report puts out an annual best diet review and while I
admit they are a .com, they get a pretty impressive group of
individuals. It’s a group of qualified experts
including physicians, registered Dietitians and specialists in
diabetes, heart health,
human behavior and weight loss. A number of them,
I recognize from continuing education programs that I have been to.
US News and World Report does this update every year and they’ve been doing
it for nine years, so it might be helpful in the future
because we know science is up dated with more good quality studies. One of our participants says,
we’ve lived with specific information for a long time,
but new studies keep coming out to contradict that information.
Like the food pyramid that we all learned about in grade school,
that’s upside down now. There’s so much new information,
so much contradicts that. How do you determine what is right?
It sounds like there are people out there trying to cut their way through
the confusion and that’s what we’re here for today. Right.
So it is challenging. And remember the food group model before
we even had the healthy pyramid. So we are shifting towards more of a
healthy plate and shifting towards more plant-based foods and choosing healthy
protein. We’re going to take a look at how these
41 popular diets across seven categories came out and they came up with they
constructed nine sets of rankings. So they came up out of these 41 diets.
They have a list of the five best overall diet,
best commercial diets, best weight loss,
best for diabetes, best for heart health,
easiest to follow, the best plant-based and the best fast
weight loss. You can go on line and view all this.
They have quite extensive information about each of these 41 eating styles.
The scoring categories may be helpful to understand and you have to drill in to
get those. So I’m sharing those with you here.
I’m not going to read this whole thing slide,
but just so that, you know,
they were scoring, how did it go in short term weight loss
so during the first 12 months and long-term weight loss.
So here they’re talking significant weight loss for two years or more.
and then how did it do for diabetes, heart,
ease of compliance, nutritional completeness and health
risks. Risk is an important one because I’m
losing weight rapidly if it comes with a long-term health risk,
best interest. Right.
That’s a challenge because sometimes we’re so singularly focused on just
losing weight or just getting those blood sugars down that we often lose
sight of the big picture. And that can be hard when you’re trying
something new. Sometimes you do have to be somewhat
singularly focused, but the challenges for how long and at
what time. So we’re gonna look at five of the
trendy diets or eating styles that you may want to approach with caution and
that includes a lot of the ones that some of you may have been trying.
So I really encourage you to stick with me for the rest of the talk because I
don’t want you to throw the baby out with the bathwater,
so to speak, because you’re probably learning lots of
good things about vegetables and some, perhaps some lean proteins that you can
certainly still utilize that information and it may be giving you a jumpstart. But
let me just say that another participant,
Bruce, writes in that keto has been great for
his long distance running needs, carbohydrates,
supplements, marathons and half marathons. Well,
he may want to talk to a sports nutritionist regarding that because he
might be missing out on nutrients for long-term health.
And I’ll have some slides here in a moment about long-term benefit for a
endurance athletes or with plans that do include some carbohydrates.
So we are going to look at Ketogenic, Atkins and Paleo,
and then two other that are not scored by US News and World Report,
intermittent fasting and the low FODMAP because people may have some questions
about those popular trends that are out there.
But I want people to think overall, we need to keep this bigger picture of a
healthy approach because I like this quote from Madelyn Fernstrom and she
said people are so desperate to lose weight that it’s really weight loss at
any cost because we’re, you know,
we’re feeling desperate and even rational people you know,
she says, you know,
normal thinking goes out the window. people might think “so who cares how
wacky or unhealthy the recommendation sounds to you.
Pounds are coming off, you’re happy,
but your body might be.” So that’s where the approach always guarantees weight
regain because we may not be getting the big picture.
And there are certain populations we have to be especially cautious with.
Extreme plans would typically not be okay for children or youth.
Women who are pregnant or breastfeeding. certain individuals.
If you have diabetes and are on medication,
we will talk in a moment about some exceptions for maybe newer type two
diabetics or under medical supervision people with eating disorders,
people with advanced kidney disease, and you may some people on certain
medications that need routine balanced diets.
So you definitely should discuss your situation with your healthcare provider
or a dietitian that’s knowledgeable with your condition before making major
dietary changes. So ketogenic was 38th overall out of 41. Yes,
that’s correct. So,
and this is not necessarily new for the ketogenic and the ratings.
So we’re going to talk a little bit about what the different diets are and
the claims and the ranking. So is very low carb so it’s like 10 to
five to 10 percent of calories or often 20 to 50 grams of net carbs per day.
It is very high in fat, 70 to 80 percent.
And it’s not a high protein diet. It’s actually quite modest.
10 to 20 percent. Some of the research studies that have
compared different ratios of macros. They kept the protein at about 80 grams
a day and doing that comparison. Initially this eating style was used as
a special diet starting in the 19 twenties to treat medication resistant
epilepsy and children where they didn’t really have any other options and it
currently is being used as a fast weight loss diet. it is claimed and there is some
scientific truth to this that shifting to using fats for ketones as a main
source of fuel versus glucose, lowers circulating insulin levels and
promotes weight loss so people feel full and they may eat fewer calories and
improve blood sugars. So as far as the rankings,
it was the lowest of all as far as healthy eating.
It was only 24th in diabetes. One area that it ranked well in was in
best fast weight loss, but at our next slide will show at what
cost. So it can be very hard to maintain this
truly high fat diet. So if someone is truly doing ketogenic,
it is quite high in fat. And the significant weight loss includes
a significant amount of water weight at least initially.
As you use up stored glucose in your muscle.
And typically you regain weight as you start eating some healthy carbs. Again,
initially there’s what they call the keto fog and then some unpleasant
symptoms that can be dangerous two weeks,
including hunger, fatigue,
low mood, irritability,
bad breath, some of the things like when we hear the
ads from them, medications on the TV,
make us think maybe I don’t want it, need to be on that medication.
So there can be some challenges there. There are increased risks for kidney
stone, osteoporosis gout and nutrient
deficiencies, primarily fiber a variety of b vitamins,
iron, magnesium and zinc.
And it’s never safe for kidney disease, pregnancy,
pregnant breastfeeding children and adolescents,
eating disorders type one diabetics. And it’s generally an adequate
carbohydrate for high energy sports. Little is known in the long-term safety
compared to low fat weight loss or even Mediterranean weight loss.
And the keto,
weight loss benefits seems to disappear over time.
So yes, people do lose weight on it.
but long-term weight loss is currently something that they would definitely
need more research for. As far as my expert opinion currently,
following this strictly should be best safe for patients with eps,
epilepsy and they would benefit from working with a Dietitian that
specializes in a ketogenic diet. I would say that lukewarm might be
overstating your feelings about the Keto Diet. At least in its more strictly followed
If people are using it as a guide to get more vegetables and eat maybe less junk
carbs, you know,
it could, it could shift the direction,
but there may be healthier ways to do that.
So let’s take a look at the Atkins Diet. So this has been around since the
seventies now has some different versions.
it’s considered 37th in the overall best diet,
pretty low ranking. There are different carb levels.
There’s the 20 and the 40 gram of carb and then there’s a newer 100 gram net
carbs and it has been used for fast weigh loss.
It’s similar to keto, but it only does the strict usually for
two weeks versus longer term. and it does promote some similar weight
loss, improved insulin resistance,
and they say improved lipid levels. but it was also low ranking and healthy
eating was 39 to 41. It ranked quite poorly for heart health,
so 37 and it tied second for fast weight loss.
So some of the concerns are you have difficulty to stick with long-term with
high total and saturated fat. We have significant evidence for damage
to heart health. It’s difficult to follow for long-term
can be expensive and typically inadequate carbs for high energy sports,
not safe for pregnancy. Nor is it for people with diabetes who
are on medications. And again,
caution with kidney disease with an extremely low carb diet.
So let’s look at Paleo. Paleo has been around for awhile now.
and this is a eating style that was often talk,
it’s about as being like the caveman diet.
So based on meat, fish,
poultry, fruits and vegetables that were
available pre agriculturally. So it has some benefits and eliminating
modern era, processed foods,
whole grains, but maybe it goes too far and
eliminating all dairy and lagoons and it’s always okay to eliminate alcohol,
coffee and salt and refined oils. they say that it’s you know,
benefits type two diabetes, heart disease and weight loss,
and that you feel full and eat fewer calories.
So it ranged between the 20, sixth and 37th in all of the 41
calories, so wasn’t as low ranking as keto and
Atkins. Concerns are,
it can be harder to follow. It can be expensive because protein is
an expensive component of healthy eating style,
especially if we’re buying quality grass-fed type proteins,
it may be inadequate carbs for high energy sports and risk for certain
nutrient deficiencies. Calcium,
vitamins D and B. And if you really look at the research,
there are significant regional differences in what a Paleo Diet truly
was. And there is lackluster information on
long-term weight loss. So we’ve talked about three generally
lower carb plan so far. but there’s some interesting information
when we look at dietary quality and athletic performance.
And this is again, that nutrition facts,
that org, they have some Nice Ted talk style,
five minutes approximate videos that really dive deep into the research.
so you may want to be cautious if you’re trying to fuel a high energy sport and
again, we don’t want to miss out on nutrients
that are going to help us fight disease Based on what you just shared,
another participant wonders if it might be beneficial to start with our Atkins
to initially lose weight quickly and then when you hit that goal,
switch over to something that might be healthier,
is that a strategy that might be effective for some individuals that don’t have a
chronic medical condition and if they do that in moderation and specifically with
dietary quality in mine and not doing a particularly high saturated fat are
really high protein diet that that may be a situation that would be a safe way
to use that.
So let’s take a look at another area to look at with caution.
It’s not necessarily an eating style, but intermittent fasting is used for
weight loss and they pretty much say you kind of eat whatever you want.
but with the next slide of intermittent fasting,
it shows that alternate days there’s different versions of it.
So some advocates recommend alternate day fasting down to 25 percent of
calories that which might be maybe three to 500 calories for many individuals
with no food restrictions. And then there’s whole day fasting where
you might fast for one or two days per week,
where it’s either complete fasting or reducing calories to down to 25 percent
or the third version is a time restricted eating where you only eat
meals between 8:00 AM and 3:00 PM. So the claims are that it causes some
good types of stress that can cause your immune system to repair cells increasing
lifespan and promoting positive metabolic changes to lipid weight,
glucose and others. This was not ranked by US News and World
Report. And the concern here is most of the
research has been done in animal models. So it’s,
there’s not enough human research have significant higher quality studies to
say that this is where we need to go, but,
you know, we’ll know more as they have more
quality studies. one of my concerns as a Dietitian is how
does this work, especially in families because it’s
important for parents to be role models and so to see their parents fasting and
not eating, you know,
can send the wrong message to their children or even following an extreme
eating plan could be a challenge on intermittent fasting,
would not be safe for pregnancy. Children,
people with diabetes and on medications, those with kidney disease,
eating disorders, and certain medications.
Our next one is the low FODMAP, again,
not ranked by US News and World Report and it’s more of an elimination diet to
help tease out food intolerance and digestive problems rather than a fad
diet or an eating style. it does remove wheat,
rye or gluten ingredients, lactose,
certain fruits and vegetables, certain fibers,
high fructose corn syrup, sugar,
alcohol based sweeteners, and it’s a two to six week of
elimination. And you are encouraged to eat healthy
foods or the allowed foods. And then you reintroduce the eliminated
foods one at a time in increasing amounts to determine tolerance.
So it’s really used for people who have perhaps IBS or other gastrointestinal
problems that with single elimination diets only had marginal improvement.
So this is a more comprehensive temporary elimination diet that might be
helpful for some individuals but not just meant to be followed long term. and so it really may help people that
have IBS or other gas, bloating,
abdominal pain problems that they haven’t been able to tease out.
And then, you know,
it’s really recommended that if someone wants to do this they consider
discussing it with their healthcare provider.
Get a book, perhaps work with a Dietitian,
familiar with the FODMAP diet because you really need to set yourself up ahead
of time to be prepared and, do some record keeping on symptoms and
do the reintroductions correctly to get some good personal data on how you’re
doing with that. If you go to the next slide,
Ohio state put out a good overview of the FODMAP diet.
It’s available with this hand out, but FODMAP stands for fermentable,
monosaccharides and polyols. So they’re all things we didn’t know we were eating in
natural foods, but they’re just types of carbohydrates
that some people don’t digest. So there are some good resources there.
So now what you’ve all been waiting for is see what the five best ranked diets .
I encourage you to go on the website and read more about them as well,
but the top five diets were number one, the Mediterranean,
number two, the DASH or Dietary Approach to Stop
Hypertension. Number three is flexitarian,
which is a vegetarian style diet that does allow some animal meats,
periodically And tied for fourth place is the MIND diet,
which is a combination of DASH and Mediterranean.
And we’ll explain that more in a moment when we talk about each one and the MIND
diet tied with Weight Watchers (R). Mediterranean was number one in six of
nine categories. Flexitarian was at least in the top
five, six of nine times,
same with Weight Watchers and DASH was in the top five,
five out of nine times and MIND four out of nine times.
So I think, you know,
if we’ve got this many people that have, that are experts you know,
looking at it, I would encourage you to dive in and
look at them a little bit yourself. There are a lot of things these eating
styles had in common. So if we look at some of what eating
patterns include and exclude. So a healthy eating pattern on the next
slide includes a variety of vegetables from all the subgroups and a dark red,
green and orange beans,
peas and starchy and other fruits especially whole fruits,
fruit juices it includes some grains but it doesn’t have to be big portions. It could even be three modest servings
of whole grains per day and they generally include some low fat dairy
products, cheese or yogurt,
or maybe a vegetarian-based fortified alternatives like soy milk or other
plant based milks. And then a variety of proteins.
It might be seafood, lean meat,
or some soy products. And then liquid oils,
preferably minimally refined. And then healthy eating patterns,
limit added sugars, saturated fats,
sodium and alcohol, if it’s consumed.
So the little picture of the spoons of sugar is the American Heart Association
guidelines. They are a little bit more strict on the
amount of added sugars. They go a little bit less than the 10
percent of calories so six teaspoons for women per day,
or 9 teaspoons for men . So it might be a good challenge to give
yourself if you have a significant sweet tooth. So next,
what are some of these five top-rated diets have in common?
So what’s in and what’s out? So what’s in in the top rated diets are
whole foods, so less processed and plant based foods.
So for a high ratio of your volume and that’s fruits and vegetables,
whole grains, legumes,
nuts, seeds and minimally processed oils,
lean proteins in modest amounts, mostly fish,
eggs, and with a limited number of yolks and
then balanced nutrition and high nutrition density.
developing a lifelong eating style versus patterns that you go on and off
and they also help you feel full so you’re not hungry right after the meal.
Initially, these plans may take some,
a little bit more time and planning and preparation,
but with practice and some smart shopping and planned leftovers and smart
dining out choices, they can be very doable,
but it’s not usually an instant change. What’s out with these top five diets are
processed and salty foods. Red Meat and processed meats especially
that are high in fat and animal fats that are high,
highly saturated, which is animal fats in general.
And then trans or hydrogenated fats which are primarily been eliminated from
our food system. There’s a few food items that are still
allowed to have it as they get reformulated and that excess sweets and
beverages are out, restrictive dieting that leave you
feeling hungry or focused on food is out,
and then extreme diets that have healthy food groups or harsh or hard to stick
with the long-term. So basically when it comes to diet or
healthy eating, everything old is new again because
we’re kind of going back to some less processed older eating styles.
So a number of you seem to be familiar with the Mediterranean diet,
but it was best overall. It’s the eating pattern that was based
on Crete, Greece,
and southern Italy and mid 20th century populations with long life expectancy
despite limited healthcare, emphasize mainly fruits and vegetables,
whole grains, a efficiency food,
olive oil, water as a primary beverage,
small amounts of dairy, especially cultured and may include
small amounts of red wine. Plus,
it also generally has a good social network and physically active lifestyle
built in. It tends to limit red meats and sweets.
benefits are, it’s balanced,
it can be followed long term significant amount of research that it does promote
weight loss, decreased diabetes risk,
heart risk, heart attack,
second heart attack risks. So for people who’ve already had their
first heart attack and improving blood pressure,
cholesterol, it’s also been shown to be healthy in
general and nurtures healthy babies and they slow memory loss. so it has a lot of pluses.
We’ve included in the materials that will be available after the program,
a number of resources, but I also wanted to give you some,
because I know people like menus, so eating well magazine has had put out
in the past their seven day Mediterranean menus at different calorie
levels. and even if you don’t follow it exactly,
it might give you some ideas for some healthy Mediterranean eating.
Let’s take a look at the DASH. So DASH stands for dietary approach to
stop hypertension. And it generally focused on foods you’ve
always been encouraged to eat and it lowers blood pressure significantly.
and it emphasizes fruits, vegetables,
whole grains, lean protein,
lagoons, fish and low fat dairy.
it’s high-blood pressure lowering potassicalcimagnesiprotein and fiber,
low in saturated fat by cutting fatty meats,
fatty dairy, and the tropical oils as well as cuts
sugar sweetened beverages and sweets. And it kept sodium at 2100 milligrams,
which is a teaspoon of salt and followers eventually if appropriate,
lower to about 1500 milligrams of sodium.
This eating style is balanced. It can be followed long-term,
it lowers blood pressure and bad ldl cholesterol and actually helps increase
the good HDL cholesterol. It can actually lower blood pressure
within two weeks and eventually lower systolic or the upper blood pressure
number as much as eight to 14 points. So here’s an example of really food as
medicine. There’s also two additional versions now
to address the need that some individuals need to lower carbohydrates
more so you can lower the carbs, for example,
even 10 percent and add a little bit extra lean protein or unsaturated fat.
and that’s still shown to even further lower blood pressure and decrease that
bad LDL cholesterol and triglycerides and reduce cardiovascular disease.
So let’s take a look at flexitarian and I know I’m covering these briefly
because you’re going to need to go dive into them a little bit more on your own. So flexitarian is a semi-vegetarian.
maybe some meals Vegan, but it allows you to choose meat
occasionally. It generally encourages to work into it
because not everybody can make a big change to vegetarian.
all at once. it encourages lean meat initially and
including more plant foods and allows for some flexibility and skill building.
So in that version of kindness to yourself when you’re trying to make a
change, I think it’s good that way.
It has similar benefits to a vegetarian diet and reducing weight,
lower heart disease risk, diabetes risk and cancer risk and can be
easier to follow. As you get to a more vegetarian version,
it is recommended that you take a balanced multivitamin for your age if
you’re staying on it long-term. Also,
the concept of, you know,
Oh, I’m going to have some meat,
but maybe not bingeing when you have that,
just have some. And enjoy it,
but you know, don’t get into a binge over that.
I had trouble finding a graphic for this and I think they were missing fish in
here, so somebody didn’t edit their graphic
very well, but I would definitely a flexitarian
diet would include seafood there. So let’s take a look at the ties for
fourth place. the MIND diet is one of them.
And it was one of the fourth best overall.
And MIND stands for Mediterranean DASH intervention for Neurodegenerative
Delay. So it’s basically a combination of the
Mediterranean and DASH Diet with a focus on certain foods that can lower risk for
mental decline. It emphasizes in more detail that you
should have at least one dark leafy green a day,
berries a minimum of two times per week or at least five times per week. Legumes,
at least five times per week. Whole grains at least three times per
day. And Seafood,
at least a total of four to six ounces a week.
poultry, two servings a week.
That could be about a three to four ounce serving and then all of oil,
a tablespoon worth at least daily, and if you drink up to five ounces of
wine per day. So this eating style limits red meat,
sweets, solid fats,
full fat cheeses, fried foods,
and fast foods. It is also balanced and can be followed
long term and the, and in the benefits they showed that it
lowered Alzheimer’s risk by 35 percent in those who followed it moderately well
and up to 53 percent in those who adhere to it more rigorously.
Research is ongoing because this is one of the newer eating styles out there.
And a five year National Institute of Health Study is underway to understand
long-term impact of the diet. Currently the research team notes and
some other papers are showing that they’re finding it to be superior to
DASH and Mediterranean for preventing cognitive decline.
So let’s take a look at the other tie for number four Weight Watchers (R).
So not only was Weight Watchers (R) number four tie best overall,
but it was number one for best weight loss and best commercial diet,
and they’ve changed their name a little bit.
Now they’re actually calling themselves WW with the phrase Wellness That Works.
Most people may be familiar with this national commercial plan.
They have a variety of ways you can participate,
whether you want a digital only experience online personal meetings or
personal coaching subscriptions, it does still use the point system that
allows you to choose points for higher calorie foods whenever you like.
So it has that flexibility, but it definitely emphasizes healthy
lower calorie foods with fruits and vegetables. being,
a huge part of it. And then it now includes 200 other foods
that are zero points, which includes some proteins and other
items like eggs, corn,
skinless poultry, nonfat plain yogurt,
beans and peas, lentils and Tofu.
It steers people away from foods higher in sugar and saturated fat.
it does also include behavioral management techniques that help with
permanent weight loss. And some of the benefits are they
generally are good for most anyone. great for people with high blood
pressure, high cholesterol or diabetes,
and even for heart disease. And it helps prevent and manage diabetes
in six to 12 months studies and does reduce LDL,
the bad cholesterol and triglycerides and helps reduce the ratio of the bad
cholesterol to the good cholesterol. We’re running out of time.
I want to get to questions from audience members because we have several
good ones here. I would hate to miss out on that,
but please race to your laptop or your desk right now.
You’ve heard the good and the bad,
the benefits, the drawbacks to these different polls,
both the good ones and the bad ones. Which one sounds like it might be right
for you in the DASH, the flexitarian that’s a Vegan who wants
to still eat a little bit of meat, MIND or Weight Watchers or another one.
And if other sounds right for you, go ahead and type it into chat window
right now. About seven percent of people say other,
the DASH Diet, even though it was ranked number two,
not a lot of people here going for that. Only about five percent right now.
Flexitarian is 10 percent the MIND and the Weight Watchers at 30 percent.
But, I’m gonna close this poll now and show
you the results of our audience. Almost half the people here are
interested in this Mediterranean diet. They liked a lot of what they had to
hear. A couple of questions I want to ask you
right now. I could take a moment and,
Julian wants to know if this MIND diet might be recommended for Parkinson’s.
What do you think about something like that? It would be recommended as healthy
eating style for someone with Parkinson’s disease.
But again, you should double check with your
healthcare provider that is managing your Parkinson’s disease as well as your
medications. Joan wonders “How safe do you think palm
oil is for the heart?” Tropical saturated oils are certainly
better than the Trans hydrogenated that they used to have in them,
but they are not as healthy as liquid oils,
like extra virgin olive oil or avocado oil.
So usually they’re in processed foods. So this is that challenge.
How much processed food do we want to eat?
So so now and then having, you know,
a treat food that has that in it, probably not a big deal,
but if it’s part of your daily diet probably something to watch out for and
get more minimally processed liquid oils. A couple of people have written in about
soy and GMO, and is it healthy for women?
What are your thoughts on, might play a role in healthy? Sure.
As far as my expert opinion and I’d have to go back in and look at the details,
but when I’ve looked at it in the past, generally unless you have a health
condition or a certain type of cancer where your oncologist is recommending
you avoid all soy, then you know that you would want to
follow that. But as far as natural from edamame
beans, Tofu and soy milk,
and it’s not just like a lot of soy protein powders,
that should be okay. And you can always go organic.
So if I have people that are using on a regular basis in a vegetarian or if they
have a lactose intolerance and are choosing soy milk routinely,
go with organic because that’s going mean it cannot be GMO (genetically
modified). One more question in here real quick.
How about if somebody can’t give up the red meat but 97 percent grass-fed
organic? Is that a step in the right direction? So that would be a step in the right
direction. And then I would add the other caveat is
think about smaller servings. So if you’re used to six or eight ounce
cooked servings, you’ll see if you can shrink that in
half and use meat more as a condiment and you’ll try a few vegetarian meals a
week to get some other variety and get some beans in there.
so moderation and a better quality would be a good strategy. Excellent.
And I want to remind everyone all the questions that you submit,
if we can’t get to them during this live broadcast,
we will respond to you afterwards. So keep the questions coming.
Alright. Best fast weight loss,
what do you got for us? Right?
So we have a few slides to go, if you have time to stick with us,
hang on, or you can listen later.
So the best fat weight loss was HMR (the health management resources) a
nationwide weight loss program that’s medically supervised.
They have either in clinic or at home options and it does have prepackaged
foods and shakes and PeaceHealth offers this medically supervised program and it
does perform very well among the other HMR programs in the nation.
Typically three times as much weight is lost using a program like this that has
the behavioral management techniques and the meal replacements compared to
traditional diets. So,
you want to make sure you’re really taking the education and the behavioral
management techniques and they do have versions of it for those who don’t need
to lose quite as much weight, where you’re definitely adding fruits
and vegetables along with the package meals or shakes. And so number two was a four-way tie for
fast weight loss with Atkins and keto that we’ve already talked about in the
past. Octavia is medifast,
which is somewhat similar to HMR. a packaged food and does include some
real food along with it. And then the Weight Watchers (R),
which we had already talked about, but remember that Atkins and keto got
low scores on being healthy, so if you want to use some of some
concepts from those, but make sure you’re getting some of the
healthier things in it that might be suitable if you don’t have a chronic
medical condition. So we
have some information from our previous webinar.
Food is Medicine that was talked about the Mediterranean Diet.
So the Harvard healthy plate is probably a healthier version of a more
Mediterranean plate compared to the myplate.gov. and then I’ve added our recommendations
for how to use your hand as a portion control guide to make it practical.
So feel free to look at that in more detail.
And then as you’re working on constructing your healthy eating style,
keep in mind some concepts, try not to be too rigid with yourself.
you know, some people like to think the add slash
20 rule, I’m going to try to eat healthy,
less processed 80 percent of the time. and when you’re getting started,
if you haven’t been successful with other,
you know, plans that are a little bit more of a
big change. see how you can fit.
healthy into your lifestyle and your taste initially so you can kind of stick
with it. And remember that quality matters so
less refined, processed foods and that also
proportions are balancing the ratio of foods on your plate and portion sizes
matter. We also are encouraging to go for a
variety of colorful foods because we get lots of good nutrients in the different
colors of fruits and vegetables. Even some grains or colorful ones like
forbidden rice is a purple color. Avoid hidden sources of fat,
sugar, and highly processed foods.
And ask your doctor if you need certain supplements.
If you’re on a vegetarian diet or have certain food groups you don’t tolerate
and be mindful about all food choices so you know,
if you eat mostly at home, start there and then you,
if you eat out a lot, start there.
and think about how you shop, asked for help to adopt and stick with
healthy eating habits. Our social network makes a big
difference in how healthy we choose to be in our physical activity,
in our food choices. So surround yourself or encourage your
network to be healthier and practice cooking your own food more often and if
you’re a social person and try to find a way to do that with your social group.
So think about what will healthier look like for you.
Might just be starting out with a higher ratio of nutrient rich foods.
maybe it’s really planning simple meals so you eat out less.
reducing unhealthy, maybe sugary or processed foods.
Maybe you’re a meal skipper and you need to think about meal frequency or timing,
or maybe portion control is one of your big challenge.
With beverages, maybe you’re a Starbucks (R) fan and you
need to make some better beverage choices but also keep in mind some other
lifestyle things like getting your activity and maybe even better sleep
because that can make you help, have more energy to be active and make
healthy choices. So think about taking action to shift to
long-term healthy eating styles. So you can certainly do the self
assessment on the extra handout that we have,
the worksheet for weight loss for you and then decide what’s what you think’s
going to work best for you. Are you a person whose previous,
more extreme attempts have not worked? Maybe you need to go slower get certain
things down first or maybe you’ve had a scare and you’ve had your first heart
attack and you really need to go big and make some healthy changes in a bigger,
quicker way. and you may need to ask for help to stay
on track think about how can I make, even though I want to make a big change,
how can I make it simple and set myself up? I think how you want to track your
progress. If you get frustrated with detail macro
counting on my fitness pal or something, then maybe something where you’re just
taking food photos or you know, doing simplified recordkeeping to help
you stay aware versus something that’s going to make you go crazy and think
about regularly reassessing whether it’s before a grocery trip and you know,
if you had an unrealistic plan, tweak it or if things are going really
well, then challenge yourself to go the next
step. So we have,
as mentioned earlier, we have the resources and handouts.
Then there’ll be available soon. The recording should be available at
least by next week, maybe sooner.
And you’ll have access to the presentation.
Slide the overview handout with the resource list.
a one page summary. Each of the top three types of diets,
Mediterranean, DASH and vegetarian.
It’s not exactly the flexitarian because I couldn’t find a one-page sheet on
that, but I have a vegetarian one for you and
then we have that weight loss worksheet, so
I think that pretty much wraps it up. Thank you for joining us today,
we’re very grateful. A recording of today will be available
for you to review, so if you didn’t take notes or if you
missed it the first time, you’ll be able to come back the handouts
in summary so that you can do this. Keep in mind that we have a lot of
possessions in life that we value a lot like cars,
houses, cell phones.
The most important possession that you have is your body.
That’s the one thing that you’re going to have for your whole life.
So invest some time, do some research,
and make sure you’re treating your most important possession with the attention
that it deserves. You can sign up for a monthly newsletter
which will give you alerts about future webinars,
also health news, special offers and local events.
And to do that, just go to peacehealth Dot org forward
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you’ll have the chance to do it there. Thanks so much.
Let us know what you think. Did we give you the information that you
wanted and we sure hope so and if not, engage with us.
We’re here to help. Have a great rest of the day everybody.
Thanks for joining us.