• Amy Sotis

Conflicting Nutritional Advice Leads to Discouragement


After my summary, I will be copying (with permission) a re-formatted article that is from CME course content by Gail Frank and Peggy Papathakis, geared toward nutritionists, dietitians, nurses, physicians and other health practitioners regarding the conflicting messages we have inadvertently given to patients by trying to simplify nutrition messages over the years. I believe any person seeking to better their health, lose weight, or gain nutrition knowledge can benefit from reading the course content summary. Here are a few main points and my own summarization in case you do not have time to read the whole thing:

1) Oversimplifying nutrition messages can lead to an unbalanced diet and one lacking in key macro and micro nutrients. For example, statements such as "eat a low-fat diet" have led many people to assume "fat is bad" and consequently miss out on a plethora of health benefits. Benefits from good fatty acids are reducing an inflammatory response in the body (which is what happens when you eat a high-sugar/simple carb diet), and promoting vitamin metabolism (i.e. you need some fat for the fat-soluble vitamins to be absorbed in the blood and metabolized). Additionally, as fat in food is replaced with simple carbohydrates, this causes blood sugar to spike and insulin resistance can set in over time leading to Type 2 Diabetes and obesity. There are of course "good fats" and "bad fats" and we need to be educated from a scientific perspective on which are which. Some good fats are nuts, avocado, coconut oil, olive oil, and some animal-product fats that are in the naturally occurring state in the meat.

2) Avoiding or limiting whole food groups (such as strictly following a "low-carb diet") can lead to a dieting habit where unhealthy cycles of restriction lead to feelings of depravation and longing to be "off the plan". Thus, this dieting cycle leads to the ever-common "addiction" to dieting resulting usually in discouragement to try to eat healthy at all. Low-carbohydrate diets, popular for their purported weight loss and glucose-regulatory effects, have been linked to suboptimal intakes of vegetables, fruit, vitamin C and fiber, and to a higher consumption of meat, cholesterol and total fat intakes. I don't believe that trying a diet plan is wrong but I know from experience that if you view your current view of eating as a form of weight punishment you will not stick with it in the long term. My overall goal of Luminaries is to get people to see healthy eating, cooking, and exercise patterns as a way of life, not a short-term fix.

3) Research is showing that Americans, by and large, really do care about their eating practices and habits, and a cognitive link between their health and their eating is there. The foods we eat, day in and day out, really do have the power to shape the course of our lives from a health standpoint. The question begs to be asked: "If people know this, though, why don't we eat better?" Part of this article is to show that although we think Americans are knowledgeable about healthy eating, there have been so many mixed, oversimplified messages throughout the years that the public is confused to a large extent about what really constitutes healthy eating. My goal of teaching on science-based nutrition, whether to businesses, churches, or on over-night retreats is to provide a sound basis for sustainable, inexpensive healthy eating that is also delicious and satisfying.

4) Vitamin and mineral requirements in the diet should come from food, not supplements. Yes its easy to pop a pill for a little extra nutrition “insurance,” but people may have the misperception that their diets do not matter as long as they take their supplements. You can't overdose on vitamins from food sources, but you can from pills. Over-supplementation of particular vitamins can result in competition for intestinal absorptive sites, over- or under-absorption of nutrients and, in extreme cases, physiological imbalances. Zinc, iron and calcium, for example, may compete for intestinal absorptive sites such that an inhibitory effect is seen if one nutrient is consumed in higher amounts than the others. Components such as phytonutrients, fiber, bioactive peptides and other non-nutritive factors in our foods are critical to optimal health and prevention of chronic disease, yet most of these components have not been packaged in supplement form

Healthy_Fajitas

"Healthy food" in the Luminaries Retreat definition, is largely unprocessed, freshly prepared vegetables, meats, fruits, beans, dairy products, and some complex grains. One recent retreat lunch was steak fajitas with careful substitutions from a typical Mexican restaurant style of preparation but this doesn't mean it isn't delicious and satisfying. Its still "real food" with an abundance of taste, vitamins, minerals, amino acids, fatty acids, and fiber.

The following summarization by Luminaries Retreat, LLC is taken from the article “Unintended Consequences of Simplistic Dietary Recommendations: Good Advice Gone Awry?” by Gail Frank and Peggy Papathakis and references cited are from their original work published by Gannett Education. For brevity, some points in the article directed at health professionals is omitted.

Article content approved for reproduction by Gannett Education

“Unintended Consequences of Simplistic Dietary Recommendations: Good Advice Gone Awry?”

By Gail C. Frank, DrPH, RD, CHES, Professor of Nutrition

Director, Internship Program in Nutrition and Dietetics

California State University, Long Beach

and

Peggy Papathakis, PhD, RD

Associate Professor Food Science and Nutrition Department

Cal Poly State University, San Luis Obispo

How often do we hear nutrition advice oversimplified? Omit trans fats ... exercise more ... eat more fruits and vegetables ... avoid high-fructose corn syrup ... take your vitamins. Everywhere we turn, we hear simple dietary messages intended to improve health and well-being. Neighbors, friends, relatives and co-workers are adept

at becoming “experts” on a topic and readily share their perspectives and advice. Advertising and the media publish messages, often sensationalized and based on singular studies, advocating consumption (or avoidance) of certain dietary components to cure our ails. Physicians, in their haste, often prescribe overly simplistic dietary recommendations without looking at the bigger picture. Even public-health recommendations, for sake of simplicity, often focus on one “nutritional nugget” at a time. Often, consumers are confused, left with a convoluted view of what constitutes sound nutrition and a healthy diet. Trying to balance the plethora of singular nutrition messages offered through multiple communication venues, they lose focus on overall healthy eating. As nutrition professionals, we need to examine the outcomes of implementing simplified advice and assess the long-term, often unintended, effects these could have on health. Rather than simplistic messages, we need to provide individualized, comprehensive, yet feasible advice that promotes lifelong health and well-being.

Background

Unintended consequences can be defined as “any intervention in a complex system that may or may not have the intended result, but will inevitably create unanticipated and often undesirable outcomes.” While many people feel that simple nutrition recommendations can do no harm, often this type of advice can be shortsighted and lead to unintended and unhealthful consequences if the end result is an unbalanced diet. Anecdotal evidence of this phenomenon abounds; the most strongly substantiated examples include:

• The low-fat messages directed at consumers during the 1980s and ‘90s, intended to help them lose or manage weight and reduce their risk of heart disease, actually had the opposite effect as consumers misunderstood “low fat” to mean “low calorie,” which resulted in over-consumption. Between 1971 and 2000, the percent of calories from fat ingested by Americans decreased, but total fat intake increased and overall caloric consumption increased by 22 percent in women (corresponding to an extra 335 calories per day) and 7 percent in men (168 calories per day).1 In addition, the simple dietary recommendation to consume only low-fat or non-fat foods may influence an individual to restrict his or her intake of nuts, fish, avocado or oils that contain generous amounts of essential fatty acids, important to the inflammatory response2 and brain development.3 Focus-group research has found that consumers lack a definitive understanding of dietary fats, with many overwhelmed and confused about the various types of fats.4

• Avoiding or limiting whole food groups—in an attempt to reduce fat intake, lose weight, avoid animal products or out of concerns for intolerance symptoms—may similarly result in short-term nutrient deficiencies and long-term health consequences. Deficiencies in calcium, often the result of suboptimal dairy consumption, can result in fractures in children5 and osteoporosis and osteomalacia in adults.6 In fact, intakes of calcium, magnesium, potassium, zinc, sodium, folate, thiamin, riboflavin and vitamins B-6, B-12, A, D and E have been shown to be higher as more dairy is consumed.7 Low-carbohydrate diets, popular for their purported weight loss and glucose-regulatory effects, have been linked to suboptimal intakes of vegetables, fruit, vitamin C and fiber, and to a higher consumption of meat, cholesterol and total fat intakes.8 Research shows that eating a diet rich in whole grains is associated with reduced risk of heart disease, certain types of cancer and type 2 diabetes, and may also help in weight management.9