Eating Well

Matthew Rensberry, MD, MBA

Created: 2020-04-27 Mon 15:34

Overview

  1. General Dietary Principles
  2. Common Diets
  3. Review further resources

Making Healthy Food Choices

Why eat well?

  • Weight management
  • Inflammatory response
  • Longevity

Consume less processed foods

  • Not all calories are equal
  • As food is processed, fiber and nutritional content is lost, while sugar remains
  • Results in more insulin exposure (fat)

Prepare food at home more often

  • Helps to lower your processed food intake
  • More economical option
  • Provide positive family experiences

Minimize added sugars

  • Americans average an added sugar intake of 88 g (22 tspn) daily! (350 kcal)
  • Mostly from processed foods and sugar-sweetened beverages

AHA recommendations:

  • Women consume less than 100 calories (24 grams) daily
  • Men consume less than 150 calories (36 grams) daily

What are added sugars?

  • Names that end in "ose" such as sucrose or fructose
  • Anhydrous dextrose
  • Molasses
  • Cane sugar
  • Syrup
  • Honey
  • Nectars
  • Fruit juice concentrate
  • More…

What about artificial sweeteners?

  • No calories
  • Sweet taste receptors are stimulated by both sugar and artificial sweeteners.
  • Change the bacterial composition of the gut

Artificial sweeteners:

  • aspartame
  • acesulfame-K
  • saccharin
  • sucralose
  • neotame
  • advantame

Don't overeat potatoes

In general, we eat too many potatoes:

  • The most consumed vegetable in the US
  • Often in calorie-dense, highly processed forms (french fries, potato chips, etc)
  • Choose sweet potatoes over regular potatoes (more fiber, are more nutritious)

Diets

  • People lose weight regardless of diet
  • What we eat direct affects our body's regulation of weight
  • Make dietary adjustments that you can maintian long term

Low Carbohydrate Diet

(Atkins, Keto, South Beach)

  • Decreased total carbohydrate intake
  • Goals are to burn fat for energy while avoiding feeling hungry
  • CCK released in response to fats/proteins

Who is this diet good for?

  • Those who have lost weight to prevent weight regain
  • Those who have diabetes or pre-diabetes
  • Can be helpful for:
    • Seizures
    • Alzheimer's
    • Parkinson's

Low-Fat Diet

  • Limit of total fat intake
  • Previously recommended by the US Government
  • AHA gave "Heart Healthy" label to low fat foods
    • Producers substituted fats with highly processed and refined carbohydrates
    • Increased inflammatory state
    • Refined carbohydrate consumption

Who is this diet good for?

  • Those with heart disease
  • Those who want to lose weight

Plant Based Diets

(Vegan/Vegetarian/Flexitarian)

People who consume a plant based diet:

  • Live longer
  • Lower rates of obesity

How these diets work

  • Lower caloric density
  • Reach satiety sooner
  • Less insulin exposure

Who is this diet good for?

  • Those who snack/mindlessly eat
  • Those with Pre-Diabetes/Diabetes

Low Glycemic Index Diet

Glycemic index (GI): a measure indicating the degree a food affects the rise in blood glucose levels

GI Value can be affected:

  • Length of cooking
  • Ripeness of food
  • Acid content of the food
  • How processed the food is
  • Surface area of food molecules

Who is this diet good for?

  • Those with Pre-Diabetes or Diabetes
  • Those with high cholesterol
  • For weight maintenance

Low FODMAP Diet

Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAPs)

  • Temporary restrictive elimination diet
  • After a period of time, some foods are reintroduced

Who is this diet good for?

  • Irritable bowel syndrome (IBS)
  • Functional gastrointestinal syndrome (FGS)
  • Small intestinal bacterial overgrowth (SIBO)
  • Some auto-immune disorders
  • Inflammatory bowel disease

Very Low-Calorie Diet

  • People consume less than 800 calories a day
  • Only follow a VLCD with the supervision of a physician
  • Only for a short time, such as a few weeks.
  • No exercise/High protein intake - not enough calories for activity

Adverse effects of being on a VLCD

  • Gallstones
  • Dry mouth
  • Fatigue
  • Constipation
  • Diarrhea
  • Headache
  • Dizziness
  • Muscle cramps
  • Hair loss

Who is this diet good for?

  • Severe morbid obesity who must lose weight quickly:
    • To qualify surgery
    • For potential fertility treatment
    • To help rapidly address a medical condition such as diabetes
  • These diets are not a first-line option

Mediterranean Diet

More a way to eat than a diet

  • Deemphasizes of:
    • Red meat
    • Sugar
    • Saturated fat
  • Encouragement of:
    • Fruits
    • Vegetables
    • Whole grains
    • Beans
    • Nuts
    • Legumes
    • Olive oil

Who is this diet good for?

Those with:

  • High blood pressure
  • Coronary artery disease
  • Diabetes

DASH Diet

Dietary Approaches to Stop Hypertension

Emphasizes:

  • fruits
  • veggies
  • whole grains
  • lean protein
  • low-fat dairy

Limit:

  • Sodium intake
  • Saturated fats
  • Added sugars

Who is this diet good for?

Those with:

  • High blood pressure
  • Coronary artery disease
  • Diabetes

Intermittent Fasting

  • Fed State
    • Lasts up to 3 hrs after eating
    • Energy comes from consumed food
  • Post-absorptive (fasting) state
    • Lasts 12 to 18 hrs after eating
    • Insulin levels drop / Glucagon levels rise
    • Energy comes from
      • Glycogen in liver and skeletal muscle cells
      • Keytone bodies made by the liver

Intermittent Fasting

  • 5:2
  • 16:8
  • Don't eat 3 hrs before bed

Summary of Diets

  • This is not all diets
  • Value of Caloric Restriction

Make every dietary choice purposely as one you expect to sustain for life.

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