This is a frequently asked question. Many are often uncertain regarding optimal, and individualized, diet choices. It is a consistent misperception that if you eat more ‘fat calories’ that you would increase your body weight. It certainly has been the general understanding of most people. It has also been extensively promoted by official governmental agencies over the last 40 years. Unfortunately this ‘nutritional experiment’ has been clearly demonstrated to be major failure. In the late 1970s a Senate committee, led by Senator George McGovern, published the Dietary Goals of the United States, which suggested a decrease of consumption in red meat, eggs, and dairy. Replacing these foods with fruits, vegetables, and grain based carbohydrate sources. The average American diet then took a dramatic shift. The resulting paradigm has now become so entrenched that changing and modifying these belief systems has been extraordinarily difficult. The Senate committee publication was followed by a United States Department of Agriculture publication in 1980. This report also supported mostly avoiding fat of all kinds despite substantial data which cast significant doubt on the science of these assumptions. Unfortunately, this belief system became entrenched in the general consciousness of the American public, policy and decision makers, the United States Department of Agriculture food pyramid, the American Dietetic Association, and the American Heart Association. The result of the inclusion of refined carbohydrates such as pastas, breads and cereal products, as defined by the Food Pyramid, has contributed to an increase of Type-2 Diabetes by 166% from 1982 through 2012. The resultant added cost to the healthcare system translates to approximately 245 billion dollars. Additionally almost 33% of the country now qualify diagnostically as Obese. Though heart disease has diminished somewhat, it is largely thought to be attributed more to individual life style choices, and early diagnosis and intervention. Some would opine that the inclusion of cholesterol modifying medications have also played a role, but substantial debate continues surrounding this topic. Currently, the American Heart Association recommends a limit of about 7% of calories from fat for anyone greater than 2-years-old. However the data is very consistent regarding the health attributes of higher fat consumption. For instance, the Mediterranean diet, which, on average, includes about 40% of its calories from polyunsaturated and monounsaturated fats has been repeatedly demonstrated to improve health and reduce overall mortality. Clinical studies have shown a 35% decrease risk of metabolic syndrome, 43% decreased risk of weight gain, improvements in cholesterol status. In addition, two recent meta-analysis studies have supported there is no evidence that saturated fat is a substantial problem. The inclusion of healthy fats in the diet can be substantially beneficial. Below are some simple bullet points notating basic considerations:
Try to shift the diet more to a Mediterranean type diet emphasizing protein, fruits, vegetables, essential fats, nuts, and ‘real food’. (As it occurs in nature. Not as it appears in various ‘highly processed’ incarnations on the grocery shelves.). it is important to comparatively note that relevant epidemiological analysis of cardiovascular outcomes in medical trials demonstrate that statin therapy provides a relative risk reduction of 30%. In contrast, the Mediterranean diet studies show the primary prevention of cardiovascular disease with a Mediterranean Diet also reduces the relative risk about 30%. Interesting that the diet is just as effective as the medication!
- Carbohydrates. In my experience, assuming individuals do not have specific allergies to any given foods, fruits and vegetables are generally very well tolerated. Refined carbohydrates, however, tend to raise insulin levels and lead to weight gain and subsequent complications therein.
- Fat consumption. Obviously, the data on the Mediterranean diet where often 40% of the calories coming from fat is very supportive. Still, most people still feel guilty eating a steak. Be reassured that this is certainly acceptable, but be sure to include sources of polyunsaturated and monounsaturated fats, and fish and sources of Omega-3 oils.
- Eliminate trans fats. Sources of trans-fats, such as margarine, largely replaced butter in the early 1970s. However, the trans fats have been shown to have a high risk of inflammatory changes in the body leading to heart disease and other complications. Be sure to include healthy oils such as olive, coconut, and avocado. Consider the possibility of food sensitivities and allergies. I have seen several instances where people have unknown allergies to dairy, grains, and other foods. Diagnosing the problem, and then then eliminating the offending food from the diet can lead to a substantial improvement in overall health and subsequent weight loss.
- Diet sodas. It would seem reasonable that drinking a non-caloric beverage would help with weight loss. It has been suggested that mythology leads to a ‘cognitive distortion’. If the individual feels like they have consumed a beverage without calories they are then ‘entitled’ to have French fries or some other unhealthy calorie dense inclusion with their meal. In fact, a Purdue study showed that diet sodas often lead to weight gain, a tendency for overeating, and double the risk of metabolic syndrome, which is a well-known risk factor for eventual heart disease. I have seen many individuals who have improved dramatically just by eliminating the consumption of diet sodas in their diet with symptoms improving to better metabolism, overall energy, cognitive clarity, inflammation, etc.
So, in other words, the main feature is to, as I say, “Eat, Drink, and be Merry”, and not worry so much about the guilt of increased fat in the diet as it probably will show substantial benefit in the long run. Besides, the view in the Mediterranean is much better!