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Locally Grown

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In response to the piece I published a couple of weeks ago on Tom Brady’s diet, a reader posted the following comment:

“Great…except I’m not sure why farmer’s markets are included in the nutrition buzz fad list. I get most of my produce (veges, fruit, cheese, nuts, bread) from farmer’s markets because it’s better quality than the woeful stuff sold in Australian supermarkets, plus it supports local producers rather than the big supermarkets who make life difficult for our farmers.“

She is referring to the passage in which I wrote, “He [Tom Brady’s personal chef] hits on nearly every current nutrition buzz phrase except for farmers markets, raw, dairy free, gluten free, and no white foods, but don’t worry, he brings these up later.” The commenter inserted “fad” where I had used the word “phrase,” which may have been intentional or an oversight, but either way I think the substitution fits.

A fad, as defined by Merriam-Webster, is “a practice or interest followed for a time with exaggerated zeal.” Breaking down this definition into parts and focusing first on time, we see evidence that the boom of farmers markets might have a shelf life. Between 1994 and 2013, the number of American farmers markets more than doubled, but is beginning to plateau.

One of the main reasons produce is transported from a distance is because the land and conditions necessary for mass growth do not always exist within local communities. My friend took the following picture of me in front of a corn field in Iowa while we were on our cross-country bicycle trip. He could have panned the camera around in any direction and the picture would have looked pretty much the same. In fact, much of the country through which we rode is comprised of farmland all the way from the roadside to the horizon.

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The United States contains an estimated 954,000,000 acres of farmland and approximately 322,000,000 people, which equates to an average of 2.96 acres of farmland per person. In contrast, my state of Massachusetts is 6,754,560 acres in total and was home to a population of 6,745,408 residents in 2014, which equals a density of only 1.00 acre per person. Even if we were all ready and willing to transform our yards, roofs, and windowsills into our own personal farms, the math suggests we do not have enough land to meet our state’s food demands through local growth alone. The comparison is not perfect, as it neglects to account for exporting, but my point is that while farmers markets may satisfy the complete needs of some individuals and play a partial role for others, they will never be able to satisfy the masses without a radical shift in our population and/or how we construct our society.

The second part of the definition of a fad, “exaggerated zeal,” plays itself out in the belief that produce from farmers markets is inherently better for us and our environment than what one would find in the grocery store. The notion that locally-grown produce contains higher quantities of vitamins and minerals relative to fruits and vegetables shipped from far distances does have merit, as seen with vitamin C, for example, but how much does it matter?

Velandia et al. wrote, “Scurvy [which is caused by vitamin C deficiency] is a disease rarely seen in developed countries where fortified food products and multiple supplements fill the market. However, poor diets devoid of fresh fruits and vegetables and low food variety can still cause this often forgotten disease.” For people whose diets are restricted, upside exists for selecting foods that are dense in nutrients in order to make the most of what they are eating, but otherwise consumption of fruits and vegetables – regardless of whether they are purchased at a farmers market or the grocery store – is enough to prevent such deficiencies.

Buying locally-grown foods spares energy and emissions that would otherwise be expended to transport products from a distance. This makes sense, but the situation is not so black and white. The sample size is small, granted, but of the three farmers markets I have visited in my community, none of them sold organic produce, only conventional foods. How do we weigh which is more harmful/beneficial for the environment: transporting organic produce from a distance, or pouring chemicals into our local community to grow conventional fruits and vegetables? [Note: Additionally, as a reader pointed out after I originally published this piece, the very idea that organic farming practices are more friendly for the environment than conventional methods is up for debate.]

Because their popularity seems temporary in nature and based largely on an exaggerated good/bad food dichotomy, farmers markets make my list of nutrition buzz phrases/fads. Having said that, we make no judgments regarding where people shop or for their rationale for doing so. As long as people have access to the food they need to properly nourish themselves, it’s all good.

The GOAT(’s) Fad Diet

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If you are like me, you wonder what the baserunner and first baseman talk about between pitches. When an athlete meets a peer, the dynamic is presumably different from an interaction with a fan that likely centers around adulation and an autograph.

When dietitians get together, chances are high that at some point we will touch on whatever nutrition-related fads and ridiculousness are currently hindering our work. We laugh, not because we are making fun of anybody, but because misinformation is so pervasive and challenging to our profession that sometimes all we can do is approach our upstream paddle with humor.

The deeper reality, which often goes unspoken but is silently understood, is how terribly harmful nutrition myths, bad information, half truths, and fear mongering are to our patients. All it takes is one meme, 140-character post, headline, hyperlink, or soundbite and the population is led astray in an instant. Just one celebrity endorsement carries more weight in the eyes of many than the educated stances of professionals who have dedicated their careers to the field of nutrition.

Consider Allen Campbell, personal chef for Tom Brady and Gisele Bundchen, and the interview he recently gave to boston.com about his clients’ diets and their shared perspectives on nutrition. Initially I chuckled at the absurdity, but I quickly remembered that hundreds if not thousands of people are likely to risk their own health as they assume this, umm, information to be fact and internalize it.

Let’s look at some of the standout excerpts.

“My philosophy starts in my own life, and with my own lifestyle and eating habits. I make conscious decisions to buy local and organic, and to stay away from GMOs, and to think about the future of the planet and the future of humans.”

He hits on nearly every current nutrition buzz phrase except for farmers markets, raw, dairy free, gluten free, and no white foods, but don’t worry, he brings those up later.

“I took a plant-based nutrition course earlier this year. It was an online course through Cornell, and it’s taught by a doctor named T. Colin Campbell, who’s behind ‘The China Study.’ My philosophy is that a plant-based diet has the power to reverse and prevent disease.”

Four or five years ago, a patient came into my office touting “The China Study” – which has been largely debunked, by the way – and told me, “A plant-based diet is the only one that heals.” She also stated, “The government puts rat poison in the water, but they just don’t tell us.” Sometimes, apparently, hyperbole and paranoia go hand in hand.

“So, 80 percent of what they [Brady and Bundchen] eat is vegetables. [I buy] the freshest vegetables. If it’s not organic, I don’t use it. And whole grains: brown rice, quinoa, millet, beans. The other 20 percent is lean meats: grass-fed organic steak, duck every now and then, and chicken. As for fish, I mostly cook wild salmon. It’s very different than a traditional American diet. But if you just eat sugar and carbs – which a lot of people do – your body is so acidic, and that causes disease.”

Actually, most Americans get more than enough protein. Someone who ate just sugar and other carbohydrates would likely develop kwashiorkor, marasmus, or a similar problem related to protein malnutrition. We learned about these conditions in the first semester of actual nutrition school, but apparently they were never covered in Campbell’s online course.

If your body is acidic, your medical chart probably lists a diagnosis of metabolic acidosis, respiratory acidosis, or diabetic ketoacidosis – none of which are caused by overconsumption of sugar or other carbohydrates – and you are reading this blog from your hospital bed.

“Tom [Brady] recently outed Frosted Flakes and Coca-Cola on WEEI. I love that he did that. Sugar is the death of people.”

As it turns out, your brain runs on sugar, and without adequate glucose in your system, you risk a myriad of problems, including death. What Brady did was oversimplify a complex problem by scapegoating an ingredient, which plays into the fears that fuel disordered eating and eating disorders.

“No white sugar. No white flour. NO MSG. I’ll use raw olive oil, but I never cook with olive oil. I only cook with coconut oil. Fats like canola oil turn into trans fats.”

People continue to fear canola oil based on myths that run counter to actual science. Trans fats, which occur naturally in only trace amounts, are made in large quantities through a chemical process known as hydrogenation. This reaction, while not terribly complex, involves more than just sticking the substrate in the oven.

“[Tom] doesn’t eat nightshades, because they’re not anti-inflammatory. So no tomatoes, no peppers, mushrooms, or eggplants. Tomatoes trickle in every now and then, but just maybe once a month. I’m very cautious about tomatoes. They cause inflammation.”

The research supporting the notion that tomatoes cause inflammation is spotty at best, with some studies showing the exact opposite effect. The evidence is about as strong as that showing the positive impact that tomatoes might have on eyesight. Maybe if you ate more tomatoes, Tom, you would not have thrown that goal line interception against Philadelphia.

Do the kids eat the same things Tom and Gisele eat? “Yeah, I mean pretty much . . . . For snacks, I make fruit rolls from bananas, pineapple, and spirulina. Spirulina is an algae. It’s a super fruit. I dehydrate it. I dehydrate a lot of things. I have three dehydrators in their kitchen. I also make raw granola and raw chocolate chip cookies.”

I have no idea what a “super fruit” is, but I am assuming that being a fruit is a prerequisite for consideration, which excludes an algae like spirulina. Anyway, my colleagues and I consistently find that children raised in households where food is restricted tend to have significant overeating problems once they reach adulthood. Westgate SuperBooks declared Brady’s New England Patriots 9-2 co-favorites to win next month’s Super Bowl, while I will set the odds of Brady’s children bingeing on college dining hall pizza and soft serve much, much higher.

As the interview continues on, the topics turn away from general nutrition and instead touch upon examples of dishes the chef makes and his typical workday, neither of which are within the scope of this particular blog entry.

People look at Tom Brady, 38 years old and still at the top of his game, and figure his nutrition regimen must be at least partially responsible. That may be true, but as I have written before, both about Brady in particular and professional athletes in general, their upsides for rigidity are unlikely to exist for laymen, and the virtues they bestow upon their diets can be off base.

Consider Dave Scott, six-time winner of the Hawaii Ironman Triathlon, who famously washed off his cottage cheese before consumption in order to remove as much fat as possible because he believed a low-fat, high-carbohydrate diet gave him an edge over the competition. It strikes me as more than mere coincidence that Scott was doing this in the 1980s when fear of dietary fat was at its peak.

Similarly, while I have no doubt that Brady believes his diet enables him to perform his best, let us also recognize that his eating behaviors are reflections of nearly every single one of today’s nutrition fads.

He Said, She Said: Weight Watchers – Helping You Lose Since 1963

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He Said

We believe that people should have the freedom to choose whichever healthcare paths they wish to take, independent of whether or not we would recommend their selected treatment plans. Disclosure and transparency are corollaries necessary for building a foundation that supports patients as they make decisions regarding their own care. Today’s approaches are likely inferior to healthcare’s future toolbox, and part of what separates respectful collaboration from a sales pitch is candidly discussing both the pros and cons of available options so patients can make informed decisions. We are not afraid to admit “I don’t know” when that is indeed the most appropriate response. None of this makes us exceptional or great, but it does make us honest.

For a look at the flip side, consider Weight Watchers®. A magician once explained to me his secret: misdirection. He gets you to fixate on his right hand so you entirely lose track of what his left hand is doing. Weight Watchers uses ads emblazoned with their “Because It Works” slogan to capitalize – literally and figuratively – on your desire to lose weight while they hope you forget to ask for their definition of “works.” The large font in their television ads demands so much of your attention that you miss the fine print resulting from the Federal Trade Commission’s (FTC) action against Weight Watchers in 1997 that declared they must concede that “For many dieters, weight loss is temporary.” In reference to the commonplace weight regain that prompts clients to re-enroll in the program time and time again, Richard Samber, Weight Watchers’ former financial director, explained, “That’s where your business comes from.” Weight Watchers is profitable, in other words, because it can successfully create short-term weight loss and make you believe that their long-term failures are actually your own.

Weight Watchers distracts you with their glittery new SmartPointsTM system and hopes you will ignore the long list of previous systems, including the Weight Watchers Program Handbook for Ladies, the Quick SuccessTM Program, the original PointsTM program, and PointsPlusTM, that never worked nearly as well as they wanted you to believe at the time. Weight Watchers is not changing their program because “Now we’re enhancing our program based on the latest science,” as their Chief Scientific Officer, Gary Foster, wants you to believe; nor are they changing their program because they suddenly uncovered data showing its poor efficacy. This is not a case of “When we know better, we do better.” They knew for decades that their program was not working as well as their large print made you believe, but they continued to promote it anyway, and when forced by law to tell the truth, they wrote it so small that you probably missed it.

Despite their spin that Weight Watchers always worked and now they are just making it even better, Weight Watchers is changing for one reason: money. Over the last four years, the company has seen their stock plummet from $85.00 to $6.80 per share as customers and potential customers have turned instead to weight-loss apps or more holistic approaches. To combat the former, they are launching a new mobile app and an expanded coaching program that offers more extensive support outside of group meetings. Their response to the latter involves some sleight-of-hand trickery. “Beyond the Scale” appears to be the new slogan, replacing “Because It Works,” and their company logo has been tightened up to two letters, thus removing the word “weight.” Seeing as they are so poor at creating long-term weight loss, taking the focus off the scale would make sense, but it is just a surface-level marketing ploy. Taking a closer look reveals that weight is still the focal point of their approach.

A Weight Watchers spokeswoman recently told Good Morning America, “People would really spend a lot of time trying to figure out ‘How do I get my Doritos in? Oh, I can do it if I adjust this and adjust that.’ Now it’s not as important for them to make sure how they are getting their Doritos in. It’s much more important for them to say, ‘What am I putting in my body? How’s that going to make me feel?'” Sounds very similar to intuitive eating, or at least a perversion of it warped just enough so at first glance it appears to fit seamlessly with their weight-centered approach.

The problem is that intuitive eating and dieting mix as well as oil and water. In fact, the very first principle of intuitive eating, as stated by Evelyn Tribole and Elyse Resch, is “Reject the Diet Mentality.” Sure, some people pursue intuitive eating hoping to lose weight, but intuitive eating is not designed to be a weight-loss tool, and if someone is unable to at least put weight on the back burner, then he or she will never truly learn to eat intuitively. In other words, having one foot in intuitive eating and the other in weight-loss culture will likely get you nowhere.

Really think about the company name: Weight Watchers. Weight. Watchers. People who watch weight. How is someone possibly supposed to jump with both feet into intuitive eating in the context of weigh-ins and an emphasis on mass? It is fine and dandy for Foster to say, “[Weight] is an important metric, but not the only metric,” but when the scale continues to be the focal point and the most important measure of progress in the eyes of everybody involved, consider the bind clients will find themselves in if and when becoming more proficient with intuitive eating is at odds with the scale. With the attention still on weight, how long will it be before the newly developed intuitive-eating skills are abandoned in favor of old-fashioned restriction?

Weight Watchers launched a pilot study of their revamped program in New Jersey, and 38 of the 40 participants lost weight, including three women whose testimonies of having lost between 18 and 50 pounds were featured in the Good Morning America segment. “We still produce weight loss,” Foster said on the show. Pretty much any kind of restriction will lead to short-term weight loss, so it always blows my mind when companies act like their program is unique in this way. Remember, nobody knows how to produce long-term weight loss in more than a tiny fraction of people who attempt to achieve it. The right hand can attempt to distract you with all sorts of glowing testimonials and a small, short-term pilot study, but none of that suggests that this version of their program will work any better than its predecessors, and you know the left hand is still holding the FTC-mandated disclaimer due to the futility of the program.

Weight Watchers certainly has success stories, and they make sure you never forget it. Group meeting leaders are all former clients who have lost weight and kept it off (at least so far) through a combination of behavior change and a boatload of factors out of their control that happened to work in their favor. Their mere presence is a subtle sales pitch that conveys enticing testimonies of hope and success, making you believe that the next winner could be you if only you continue to partake. Weight Watchers emphasizes seduction over expertise and downplays that leaders do not necessarily have backgrounds in nutrition, exercise science, or anything remotely connected to health, but rather disciplines such as drama that lend themselves to charismatic performance. Why hire someone with solid and extensive qualifications in economics and finances to manage your money when you can instead attempt to follow in the footsteps of some dude who struck it rich on a convenience store scratch ticket?

The other issue with their use of leaders and celebrity spokespeople to pitch their product is that neither you nor I know for sure what they do or do not do behind closed doors in order to achieve and maintain weight loss. Both parties have incentive to keep their weight in check regardless of the costs. Leaders can lose their jobs if they regain weight, and my understanding is that celebrity endorsement contracts are contingent on continued weight maintenance. Behaviors kept private can range from the privileged (personal chefs, personal trainers, etc.), to the deceitful (employing other weight-loss techniques beyond the Weight Watchers program being credited), to the disordered (ever-increasing restriction and/or exercise, preoccupation with food and physical activity, social withdrawal), to the outright dangerous (very-low-calorie diets, unregulated supplements, eating disorders). Clinically, we have seen many patients whose eating disorders were triggered by competition in a weight-based sport such as crew or wrestling, participation in an appearance-based activity such as gymnastics or figure skating, or employment in a size-based field such as modeling or personal training. While I do not believe we have ever had a Weight Watchers leader or celebrity spokesperson as a patient, it stands to reason that they are similarly vulnerable to the emphasis placed on their weight and the pressure to maintain it.

For 52 years, Weight Watchers has deceived you by knowingly overstating the efficacy of their programs and blaming you for their own failures, all at the expense of your time, money, and health. Do you really want to bet your resources and well-being that the outcome will be any different this time around? You deserve more than smoke and mirrors, don’t you?

 

She Said

While this might be news to some of you, it’s been nearly two months since Oprah Winfrey announced that she has not only become a member of Weight Watchers (WW), but she has also bought 10% of the company and become a board member and adviser. According to O, she decided to join and later invest in Weight Watchers as she has “always struggled with weight” and was impressed by the company’s “holistic approach” to health and weight loss. On Ellen DeGeneres’s talk show (which aired on October 23rd), Oprah reported that she had already lost 15 pounds since August 12th and was truly enjoying the program.

Oy. Where do I start with how sad this whole situation is? I have always been a fan of Oprah, as I have seen her as a strong advocate for women, someone who has been through a lot in her life and who wants to help young girls and women become their true and best selves. While the media often focused (and still focuses) on her weight gains and losses, I was always impressed by her ability to bring people together, inspire, and educate. Oprah is so much more than her weight!

I remember in 2010, I was so excited to see that Oprah was having Geneen Roth on as a guest of her show to discuss Roth’s best-selling book “Women Food and God: An Unexpected Path to Almost Everything.” Roth’s philosophy is that the way one eats is directly related to one’s core beliefs about being alive. She is an anti-diet proponent who posits that by exploring one’s spirit and soul, one can break free from emotional eating, finding balance with one’s relationship with food and one’s body. On the show, Oprah was giving such high praise to Roth and her book, saying how she was inspired to “never diet again” and that this book was a life-changing read for her.

So that brings me to the present day. Really, Oprah? What happened? Because last time I checked, WW is a diet, a set of externally based rules that tells its members what and how much to eat in order to lose weight to become socially acceptable – pretty much the opposite of Roth’s message. As we have written about too many times to count, 95% of people who alter their diet in order to lose weight will regain the weight and usually end up heavier. Weight Watchers is no different – it is a diet! Whenever anyone tries to tell me that it is a “lifestyle,” not a diet, I really have to contain my eye-rolling reflexes. Want to figure out if you are on a diet? Here’s how: Are you purposefully manipulating your food intake based on a set of external (i.e., not internally based) eating rules? Is your main goal of said food manipulation to watch the number on the scale go down? Well, I hate to break it to you, but you are on a diet, my friend. And chances are, even if you do end up losing weight, you will regain that weight and then some.

In a purely monetary sense, Oprah’s investment in Weight Watchers is brilliant – contrary to its popular “It Works!” slogan, It Doesn’t! The company has admitted that the success rate of its members is embarrassingly low, and much of their research is based on data that was collected over the span of a year. Um, nice try! We all know that weight regain often occurs between 1 and 5 years post-diet. But of course Weight Watchers doesn’t have data that goes that far. What a surprise. The company’s business plan is so clever because it knows that the diet doesn’t work. 95% of their members will regain the weight (blaming themselves instead of the diet, of course) and will rejoin, creating an unending cycle of profit for Weight Watchers.

Listen, I don’t really blame Oprah for making this truly unfortunate decision – she is human, and she is not immune from the body-shaming, weight-loss messages women receive on a daily basis. But I am disappointed that she is choosing to participate in and endorse a company whose sole purpose is to tell women that they are not enough, that their worth should be measured by a piece of metal, and that weight loss is the only way to find one’s true and best self. Oprah, I really expected more from you.

“Real” Science

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Some of you may or may not know that one of my favorite activities is solving crossword puzzles. Not just any puzzles, mind you, but the Sunday New York Times crossword found in the very back of the magazine. Every Sunday, I eagerly sift through my newspaper and find the magazine, ready to start working on the puzzle and figure out all of those elusive answers. This week, as I was thumbing through the pages, I came across an article under the “Well” section of the magazine, which caught my eye: “Mind What You Eat: Can ‘intuitive’ eating be as effective as calorie counting?” written by Gretchen Reynolds. The picture accompanying this article was that of a corpulent, blind-folded man, whose stomach was feeding itself a piece of pizza.

Given the nature of the work that Jonah and I do, I was intrigued to see what Ms. Reynolds had to say about intuitive eating, especially since the idea of intuitive eating is still relatively unknown to most of the general public. As I read on, however, my curiosity turned to disappointment and frustration. The article was riddled with inaccuracies, and, above all, truly missed the point of what intuitive eating is all about.

Although the idea of intuitive eating (also called the “non-diet approach”) has been around for many years, Evelyn Tribole and Elyse Resch, two registered dietitians, brought the topic to the public’s attention in their 1995 book “Intuitive Eating.” In the book, the authors explain the 10 Principles of Intuitive Eating, including such ideas as “Reject the Diet Mentality,” “Honor Your Hunger,” and “Make Peace with Food.” The authors assert that by following these principles, an individual can create a healthy relationship with food, mind, and body. The basic “rules” of intuitive eating are quite simple: eat when you are hungry, eat what you are hungry for (not what someone else or some diet is telling you to eat), and stop eating when you are satiated.

While the book does discuss the likelihood that by eating this way one will reach their “healthy weight,” it is in no way meant to be a diet book or a how-to weight loss treatise. One’s “healthy weight” is not based on the BMI or what popular culture says is healthy – it’s the weight that one’s body arrives at when he or she is engaging in healthy behaviors such as eating intuitively, engaging in pleasurable physical activity, and managing stress.

Since weight loss is not the ultimate goal of intuitive eating, I was confused as to why Ms. Reynolds decided to compare the approach with calorie counting to see which resulted in more weight loss. In addition to this, the article was flawed in a number of ways.

Ms. Reynolds begins her article by saying that intuitive eating has not been studied extensively by researchers. This statement could not be further from the truth! Per the Intuitive Eating website, there have been over 40 studies which have looked at the health benefits of intuitive eating. According to Ms. Tribole who posted her reaction to Ms. Reynolds’ article on her own Facebook page, “last month a systematic review was published on Intuitive Eating with 24 studies, totaling over 9,000 people.”

Ms. Reynolds’ article goes on to discuss a study in which 16 overweight men and women were split up into two groups of eight: one group was assigned to a restricted-calorie diet between 1,200 and 1,800 calories per day, while the other group was to engage in intuitive eating. At the end of the study, which ran a total of six weeks, the researchers found that those in the calorie-controlled group lost more weight than those in the intuitive eating group. Given these results, posits Reynolds, limiting one’s calories is a more effective way to lose weight than engaging in intuitive eating.

Yikes. This article is problematic for a number of reasons. Firstly, the study itself is a poor one to use, as it has an extremely small sample size of 16 subjects and is conducted over a measly six-week time period. Secondly, to draw any conclusions about health outcomes from this study is wildly irresponsible. And thirdly, duh, of course the calorie-restricted group lost weight! This study literally gives us no useful information!

We all know that going on a diet results in weight loss for the vast majority of people. The question is: how likely is it that those individuals will actually keep the weight off for a significant period of time? Given that we know that approximately 95% of people regain the weight they lost through dieting, I’m willing to bet dollars to donuts that all of the individuals in this silly little study regained the weight they lost during the first six weeks of the study. In fact, I wouldn’t be surprised if they ended up heavier than when they started!

I guess the thing that bothers me most about this article is how it completely misses the point of what intuitive eating is all about. Intuitive eating is about eating in a way that promotes one’s health, not in a way that is meant to result in weight loss. Ms. Reynolds reinforces the diet mentality of the general public by her assertion that cutting calories is what is necessary to reach a healthy weight. Articles like this one just create more confusion for Jonah’s and my patients, as it backs up the ideas that weight loss should be one’s ultimate goal and that long-term maintenance of weight loss is achievable.

Stocking

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“I have to get rid of these leftovers or I will eat them all.” Sound familiar? The “them” in question could be leftovers from any holiday celebration that includes food, such as Halloween candy, Thanksgiving pie, Christmas cookies, New Year’s Eve hors d’oeuvres, Easter jelly beans, Memorial Day barbecue, or birthday cake and ice cream.

The aforementioned strategy for dealing with such leftovers sounds logical on the surface and might even seem to work for a little while. If the food is not there, you cannot eat it, right? As the never-ending cycle of holidays continues though, the strategy of avoidance reveals its downsides: stress, anxiety, deprivation, reinforcement of an oversimplified and misleading good/bad food dichotomy, and increased risk for episodes of overeating or outright bingeing.

An alternative does exist, one that takes less mental and emotional energy, allows people the freedom to enjoy holiday favorites without going overboard, and makes peace with food. This alternative is stocking, which is a well-known technique among practitioners who help people with emotional eating, compulsive eating, binge eating disorder, and supposed food addictions.

Stocking is the antithesis of quickly ridding the house of holiday leftovers, and it may initially seem counterintuitive. A full explanation of the technique requires more time and space than would be appropriate for this newsletter, but here are the highlights for your consideration.

Uncouple morality from food and eating behaviors

In order to feel more comfortable with stocking, people need to rid themselves of the good/bad food dichotomy and be able to temporarily put the hard science of nutrition on the back burner. Not all foods are the same nutritionally; it would be ridiculous to proclaim that an apple has the same nutritional value as a Twinkie, and I am not arguing otherwise. What I am suggesting, however, is to strip the moralization away from food. An apple is just an apple; you are not good or virtuous if you select it for your snack. A Twinkie is just a Twinkie; you are not bad, guilty, or weak-willed if you choose it instead. Sometimes your body’s cues will lead right to the apple, other times to the Twinkie, and either outcome is okay.

Establish an abundance of food at home

Identifying what food will feel best in your body means little if you do not have a reasonable shot of providing said food for yourself. Therefore, one of the tenets of stocking is to keep a wide variety at home, including foods that are seen as taboo and can trigger overeating or bingeing.

When our body is asking for a food we do not have on hand, we tend to overeat on the foods that are in the house. This can certainly occur with both adults and children, but we especially see this with teenagers who live in food-restricted households. Well-meaning parents might keep foods high in salt, sugar, or fat out of the house because they think that doing so creates a healthy food environment, but oftentimes it backfires. For example, the teenagers overeat on low-sodium potato chips that never really hit the spot while a small amount of regular chips would have done the trick, or they overeat on Newman’s Own fig cookies when really they just want a couple of Oreos.

Select foods based on intuitive-eating cues

One of the logistical differences between those who practice intuitive eating and those who do not is how food selection begins. Standing in front of the open refrigerator or scouring the pantry and cabinets and selecting whichever foods call to you is an external process that differs greatly from asking internal questions about what temperature, texture, flavor, color, etc., food will feel best in your body at that moment and seeing where it takes you.

These cannot be treated as leading questions. In other words, if you have stocked up on, let’s say, Ben & Jerry’s Cherry Garcia, and you are trying to convince yourself that your body does or does not actually want the ice cream, then stocking will not work. Keep an open mind, ask these questions neutrally, and see where your body’s cues take you.

Maintain the inventory of foods at home, especially of triggering foods

Maintaining the abundance of food in the household is an important element of stocking. If the supply dwindles, you might feel like you need to hurry up and eat a particular food while it is still around. Should you ever run out and then buy it again, the food regains its luster. If you are stocking Doritos, for example, maintain a supply of, say, ten large bags at home. As soon as you finish two bags and are down to eight, go out and buy two more.

Be patient and use a neutral voice

Initially, you may find yourself eating certain foods when your body does not actually want them, but as you keep up the practice, eventually your trigger foods will blend in with all of the other foods in your pantry and no longer sparkle the way they do when they are brand new to the house. Until then, abstain from judging yourself harshly for eating episodes that do not go as you would have liked. Remind yourself that you are still in the early stages of the process and you are learning. With a neutral voice, examine what happened so you can respond differently when similar circumstances arise in the future.

Enjoy your new-found peace with food

Imagine how different your experience with leftover Thanksgiving pie would be if you routinely kept slices of pie in your freezer for whenever your body wanted them. Contrast the fretting you feel about the remaining Halloween candy to the relaxed liberation of always having a few bags of peanut butter cups in the pantry year-round.

For the stocking technique to be successfully implemented, foundational work to dispel nutrition myths, break up the good/bad food dichotomy, and uncouple moralization from food choices is necessary beforehand. Because this process takes time, it is probably too late for the stocking technique to be much help for you this Thanksgiving unless you have already been working on these prerequisites.

The cycle of holidays will continue though, so if you get started now, you might find you have a much more relaxing and enjoyable experience with this February’s Valentine’s Day chocolates than you would have if you continued down your current path.

Beginning to See the Light

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[Preamble: After the conference I am about to discuss came to an end, I sought and received permission from the organizers to use their slides in my blog. The only stipulation was that I had to credit the authors, most of whom I disagree with strongly, and this requirement gave me pause. While I may not see eye to eye with these doctors, I respect them enough as colleagues not to publicly embarrass them by name. The internet is an unnecessarily harsh place sometimes. Everything I am about to say is in the spirit of constructive criticism, not trolling, and I can make my points without calling anybody out. When it comes down to it, all of us are on the same team. Or at least we should be.]

Last year’s Cardiometabolic Health Congress spurred a wide range of reactions, the vast majority of which were various permutations of anger or disgust. Despite such unpleasantries, I returned for the Congress’s 2015 edition late last month. Self-flaggelation is not my thing, but if we do not venture out of our own circles and challenge our biases and beliefs by listening and talking with people who hold different points of view, then we risk deluding ourselves and repeating the same messages back and forth among people who already share our stance.

During an early break between presentations, I took a walk through the exhibit hall to see which vendors were in attendance and approached one weight-loss company that advertises, “The [company name omitted] was developed by doctors and is clinically proven to be safe and effective for weight loss.” Pretty much any kind of restriction will lead to short-term weight loss, so I always find it interesting when companies act like their program is unique in this way. According to the company representative working the table, he told me the people who go through their program consume between 800 and 1,300 calories per day.

Let’s put this calorie intake in perspective. According to the Food and Agriculture Organization of the United Nations, Somalians consumed an average of just under 1,700 calories per day per person between 1999 and 2001, which made the citizens of this east African nation some of the most undernourished in the world during that time. The situation in Somalia continues to be so dire that in fiscal year 2015, the United Nations World Food Program, with help from countries including the United States, delivered 40,680 metric tons of emergency food assistance to the people of Somalia.

Think about that. American dieters who follow this “safe” weight-loss program consume a level of nutrition so inadequate that if they were eating this little and living in a different region of the world, the United Nations would be sending cargo ships full of food to help them. When is Bob Geldof going to organize a star-studded benefit concert for dieters?

The diet program’s marketing material advertises, “And once you’ve reached your goals, [company name omitted] support continues with our Healthy Living Program, where you’ll learn how to transition and maintain your new, healthier weight for the long term.” Where is the evidence to support this claim? It only took the gentlest of pushes for the rep to concede he had none.

We do, however, have plenty of evidence to the contrary, including, but not limited to, the starvation study Ancel Keys conducted in 1944. After consuming approximately 1,570 calories per day (which, just to hammer home the point, is more than people on this diet program are afforded) for an extended period of time, the subjects, according to Judith Matz and Ellen Frankel, “. . . engaged in binge eating for weeks yet continued to feel ravenous. They overate frequently, sometimes to the point of becoming ill, yet they continued to feel intense hunger. The men quickly regained the lost weight as fat. Most of the subjects lost the muscle tone they enjoyed before the experiment began, and some of the men added more pounds than their pre-diet weight. Only after weight was restored did the men’s energy and emotional stability return.”

Data presented throughout the conference reinforced the long-term failure of diets as well. Among the slides are nine graphs showing data from various weight-loss attempts and they all depict the same pattern: sharp initial weight loss followed by slow and steady weight regain. A couple of the presenters discussed the hormonal and neurological survival mechanisms that kick in to promote weight regain after the body has experienced a period of restriction.

The discussion of these data and physiological reactions represented what I consider a noteworthy shift since last year’s conference. In 2014, very similar graphs were shown as well, but back then the weight-loss attempts were presented as successful because the end points were lower than baseline, even if the studies were short term and the trajectory of weight regain was still going up at the time of the study’s conclusion. This time, presenters were more forthcoming about the dismal results of weight-loss interventions.

Of course, that did not prevent them from hosting a vendor who sells weight-loss programs, nor did it keep some presenters from going into detail about lifestyle interventions that would supposedly lead to weight loss. The height of irony was at the end of a long day of discussing how diets do not work, the last presenter stepped to the podium and offered a how-to tutorial on dieting: measuring portions, daily weigh-ins, using apps that track calories, etc.

Not only did she recommend Weight Watchers, which in itself was as funny as it was horrifying, but she also cheerfully offered a list of “Plans that may be effective short-term (≤2 years) for weight loss,” including low-carbohydrate, low-fat calorie restricted, Mediterranean, vegan, vegetarian, and Dietary Approaches to Stop Hypertension (DASH), without any mention of what happens beyond two years. Did she think we would not notice such a glaring omission?

She also included a slide depicting a large polar bear trying to fit into a tiny igloo with the caption, “When it comes to management of obesity, one size does not fit all. Keep trying . . . and eventually you will find the perfect fit.” On what is she basing this claim? We saw no evidence presented whatsoever that any current methods of weight loss work in the long term except for a small fraction of individuals.

Presenting these behaviors and diets as the key to long-term weight loss makes no sense, not when so many other people perform the same actions without achieving similar success, as evidenced by, among other indicators, the multitude of graphs and data they just showed us. The lottery crowns new millionaires every single day, but that does not mean your financial advisor is giving you sound, ethical, evidence-based advice if he suggests you take your life savings and invest in Powerball tickets.

“Big Soda”

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A friend recently sent me a New York Times article entitled “The Decline of ‘Big Soda'” and asked me my thoughts. The article begins with this opening line:

“Five years ago, Michael A. Nutter proposed a tax on soda in Philadelphia, and the industry rose up to beat it back.”

Okay, let’s stop right here. Once upon a time, I felt ambivalent about the idea of a soda tax. Now, however, my stance is clear: I am firmly against a soda tax.

Our country’s health woes are complex, only partially understood, and not entirely in our hands to fix, yet for reasons that baffle me, we continue to place too much confidence in our oversimplified supposed solutions. Perhaps people are scared, yearn for a sense of control, and find it more comfortable to point fingers at scapegoats than to face the truth. Human history is riddled with atrocities stemming from scapegoating, and in the world of nutrition, the blame game is harmful as well.

Taxing one food, nutrient, or ingredient separate from the others reinforces a “good food, bad food” dichotomy. Eating only “good foods” is largely unsustainable for most people, and although doing so might sound good in theory, the reality is that such rigid eating often comes at the expense of health’s other facets. When we ultimately consume foods we view as “bad,” feelings of guilt and shame quickly follow. A popular misconception is that feeling bad about ourselves will inspire change, but actually quite the opposite is more the norm. The worse we feel about ourselves, the less inclined we are to treat ourselves well. We eat a “bad” food, feel guilty about it, and proceed to take worse care of ourselves.

Better to recognize that the “good food, bad food” dichotomy is a harmful system, remove moralization from eating, and instead teach people the importance of individuality and moderation. After all, one person’s “bad food” is someone else’s “good food” and vice versa, so what do those labels really mean anyway? Cantaloupe is high in potassium, which makes it very helpful for my patients with hypertension but quite problematic for my patients with kidney disease who are on potassium restrictions. So, is cantaloupe a “good food” or a “bad food”?

If the basis of the soda tax is the beverage’s sugar content, then why are sodas singled out while sports drinks, iced teas, chocolate milks, smoothies, lemonades, fruit drinks, milk alternatives, yogurt drinks, and other sugary beverages skate by without a special tax? Orange juice has almost as much sugar (31 grams per 12 ounces) as Coca Cola Classic (39 grams per 12 ounces), so why are we not stigmatizing OJ?

One might argue that orange juice has upsides despite the sugar content, a point with which I completely agree, but the same is true for soda as well. Every single food you see in the grocery store, including soda, has its upsides; otherwise, nobody would buy it, the store would cease stocking it, and it would not reside on the shelves for you to see.

Sugar is dense in calories, and calories are a measure of energy, so for our neighbors whose financial hardships make getting enough food a daily battle, soda is a cheap source of energy. Increasing taxes on low-cost foods places additional pressure on the already financially strapped people who are most likely to make such foods a staple of their diets out of necessity. When people talk about racism, classism, and privilege in healthcare, the soda tax is an example of what they mean.

For those with medical conditions that make consuming enough energy a challenge, such as cancer, HIV, and anorexia nervosa, the caloric density of sugar-sweetened beverages makes these drinks, including soda, helpful options. Let’s not create additional issues for people who are already sick by specially taxing and stigmatizing the beverages that are part of their care.

For other people, soda is a play food, something that they simply enjoy even if it is not the best option for their health. Whether they partake only occasionally or frequently is irrelevant. All of us engage in a whole slew of activities that do not prioritize our health. We know how detrimental inadequate sleep can be, so why not institute a special tax on people who do not get enough? Why don’t we impose a tax penalty on people who live in cities with poor air quality? Let’s place an additional tax on people who are not physically active, or at least not as active as some other people think they should be. High heels can lead to orthopedic problems, so let’s tax stilettos more than other footwear while we’re at it.

Penalizing other people for their behaviors and how they choose to balance their health with life’s other elements suddenly loses its coolness factor once we realize that opening the door to this kind of judgment means we ourselves are subject to similar stigmatization and punishment, too. In other words, the finger that currently points at them might someday swing right around and point directly at you.

The “I’m an Expert” Trap

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SquareAs my freshman year of high school neared its conclusion, my math teacher, Mr. Evers, stood at the chalkboard and drew a large square, which he said represented the entire field of mathematics. He asked us how much of that square we thought we would learn by the time we graduated from high school. After fielding a few guesses, he gave us his answer by filling in a very small corner.

That blew my mind. At the time, I was a solid math student and I wondered how there could possibly be so much more to the discipline beyond what we already had under our belts. Once I got to Tufts and decided to major in the subject, I was introduced to sections of that square I had never even heard of before: complex analysis, abstract algebra, discrete mathematics, differential equations, linear algebra, number theory, numerical analysis, etc.

By the time I finished my degree, I had stretched my mathematical abilities to their fullest extent. Subsequently, more talented classmates of mine who continued on to graduate school in the field explored areas of the square that we never touched as undergrads.

Even the boundaries of that square are expanding as the field grows. A few years ago, a publishing company contacted me and asked if they could feature me in one of their textbooks, so I reached out to a couple of my favorite math professors to let them know. In one of their replies, he included mention that his current research is focusing on how the topography of a rotating sphere, such as a planet, can be mapped based on data collected from its poles. Well, we certainly never covered that in high school.

When Mr. Evers filled in the corner of his square, I learned an important life lesson that sticks with me today and reverberates through my work as a dietitian: A little bit of knowledge can be worse than no knowledge at all if we do not understand the context and erroneously believe ourselves to be experts.

Flipping through the study guide for one of my personal training certifications, I count 15 pages on nutrition. Unfortunately, some trainers learn the material in this one chapter and incorrectly believe themselves to be nutrition experts. When I hear trainers at the gym talking with their clients about food, way more often than not the information they are offering is grossly oversimplified at best and blatantly false and/or dangerous at worst.

Reading a handful of pages on nutrition does not make one a nutrition expert, just like reading the chapter in the same study guide about interpreting electrocardiogram results does not put me on the same level as a cardiologist. Too often, the greater context goes ignored or forgotten: Guys, that one nutrition chapter is nothing more than the tiny filled-in corner of my math teacher’s square.

This is not about picking on personal trainers; all practitioners, regardless of discipline, have bounds to our professions and we are all responsible for recognizing the limitations of our expertise. One of my patients, reluctant to work with a psychotherapist, asked me, “Can’t you just handle the therapy part?” Well, no, I cannot, although I was flattered that he felt comfortable enough with me that he would ask. Even Joanne, who has a degree in psychology, recognizes and respects the vast chasm between being able to identify the need for therapy and having the expertise to provide it.

The more we continue our education, the more we realize just how much learning still remains, not just on an individual level, but on that of our field and society as a whole, too. When it comes to nutrition, realize that graduate students, professors, and other researchers are all working diligently at universities, hospitals, and research centers across the globe in search of answers to outstanding and complex questions regarding food.

Part of actually being an expert means recognizing the grays and nuances, the dearth of crisp absolutes, and that sometimes the best answer to a patient’s question is, “I don’t know, but let’s see what we can do to find out.”

He Said, She Said: Weight Loss for Athletics

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He Said

“You’re an RD, right?” That’s what one of my patients asked me last year shortly before he got up from the table and walked out of my office, never to return. It was more of a rhetorical question, really, his polite way of telling me I don’t know how to do my job.

He and I were only in each other’s lives briefly, as that was not only his last visit, it was also his first. His new patient paperwork stated that he wanted to lose weight in order to complete a marathon. Upon reading that, I contacted him in advance of his visit and offered a heads-up that I would help him to run his best, and as a consequence of doing so, he might also lose weight; but I would not be helping him to lose weight in hopes that it would improve his running because – contrary to popular belief – that is not how things actually work.

Although I suspected he would respond by cancelling the appointment, to his credit he had an open enough mind to meet with me and discuss our different points of view. Elite marathon runners are all very skinny, he told me, so it only seemed logical to him that if he could alter his body to look more like theirs, then he would in turn become a better runner.

Way back in my sophomore year of high school, I held the same belief. When I looked at those teammates on my track team who were faster than me, I noticed that for the most part they were leaner than me. Consequently, I attempted to change my body by restricting my fat intake (Back in those days, people were scared of fats the same way people nowadays fear “carbs.”) in hopes that I would also run better.

In fact, I ran worse. My mom took me to a dietitian who educated me, dispelled some of the nutrition myths that I held, and convinced me to increase my fat intake. My times in all events dropped, and I was the fastest I had ever been in my young running career without my physique ever changing all that much.

Having a leaner, smaller, or lighter body can certainly have athletic upsides sometimes, just as having a heavier or larger body can sometimes be advantageous, and I am not arguing otherwise. However, a significant difference exists between an athlete who naturally has a given size or shape versus someone who tries to force his or her body into that mold. That is where so many people, like my 15-year-old self and the patient I mentioned earlier, get tripped up.

Anecdotally, we see many examples of athletes who perform worse after intentionally losing weight. Last month, I wrote about how CC Sabathia has struggled since cutting his carbohydrates in an effort to lose weight. He and his slender frame are in the midst of experiencing the two worst seasons of his career, both of which have come since he lost weight.

Sabathia gave an interview earlier this year in which he talked about the fatigue he now experiences. Carbohydrates are our main source of energy. Now that he follows a low-carbohydrate diet, no wonder he currently tires early in games now. Only twice in my life have I failed to complete bicycle routes that I set out to ride. The first was when I fell off my bike in Montana and fractured my back. The other was when I was briefly experimenting with a low-carbohydrate diet and did not have the fuel necessary to make it home.

This summer, I had a couple of rowers come to me hoping to lose weight so they could compete in lightweight crew. Each of them believed that if he could shed enough weight to just make the 160-pound cutoff, he would dominate. However, they were not taking into account that the processes necessary to alter their bodies (over-exercise and/or dietary restriction) were likely to leave them unable to put forth optimal performances. A well-nourished and properly-trained 159-pound athlete is probably going to row much better than his or her 159-pound teammate who maintains that weight by existing in a state of depletion.

At the same time, let us acknowledge that not every athlete is already at the weight at which they can perform his or her best. Some athletes, just like the rest of the population, are subject to behaviors, such as emotional overeating, that might be impacting weight. However, putting the horse before the cart means directly addressing issues that might be hindering performance while allowing weight change to naturally occur or not occur as a consequence. To try losing weight in hopes of becoming a better athlete though is to have the process backwards.

 

She Said

Some of the individuals who come to see me for nutrition counseling are student athletes who are struggling with an eating disorder (ED). These cases are particularly challenging, as one of the cruxes of being an athlete (at least at a competitive high school or college level) is making sure one is in top physical condition to succeed in one’s sport. While this desire to be in the best athletic condition might be approached in a healthy and manageable way by some individuals, for those who are predisposed to EDs, it can sometimes start, trigger, and/or worsen the individual’s ED.

In the sports where weight control is believed to be paramount to success (e.g., gymnastics, ballet, track and field, etc.), this focus and, in some cases, obsession with being “lean,” “fit,” or “cut,” can result in the athlete eating in a restrictive manner (e.g., cutting out carbohydrates, only eating vegetables and protein) and exercising excessively. Initially, these individuals seem to be doing the right thing, taking care of themselves and making the sacrifices needed to become the best at their sport. The problem arises when the obsession with weight, food, and exercise takes over the athlete’s life. Examples of this include avoiding social situations that involve eating in order to train harder at the gym, exercising even while injured or sick, and panicking when being faced with foods that are not on the “clean eating” food list.

While these scenarios are red flags in and of themselves, the physical ramifications of these behaviors are serious as well. One of the most common outcomes that results from overtraining and undereating in female athletes is the Female Athlete Triad. This syndrome is characterized by three conditions: energy deficiency with or without a diagnosed ED, menstrual disturbances or absence of period completely (amenorrhea), and loss of bone density resulting in osteopenia or osteoporosis. In a nutshell, when an athlete is not eating enough to fuel her training, this can lead to dangerous health problems.

Some health professionals believe that individuals who are dealing with the above problems can continue to participate in their sports as long as they are getting nutrition education from a registered dietitian and having regular check-ups with their primary care physician to make sure they are medically stable enough to compete. While I agree that for some individuals it is just a matter of education and monitoring, for those with EDs, allowing them to continue with their sport could greatly hinder the recovery process. An ED is a multifaceted problem that needs a full treatment team including a therapist, dietitian, and doctor who is knowledgeable about EDs. The focus should be on helping the athlete become physically healthy while dealing with the underlying psychological issues that are part of the ED.

When I am working with a student athlete who is exhibiting disordered eating and/or excessive exercise, I always defer to the physician on the treatment team to make the call about whether the patient is medically safe enough to participate in his or her sport. The work I do with the patient centers on helping them understand what their body’s needs are fuel-wise. This might include educating the patient about carbohydrates and why they are a necessary macronutrient (for athletes and non-athletes) and how to eat to improve one’s athletic performance.

If you or someone you know seems to be struggling with an ED related to being an athlete, it’s important to take action. Talk to your doctor as soon as possible to prevent the situation from becoming worse. Find a therapist and a dietitian who are adept at working with athletes who struggle with EDs. It is also important to alert the sports team’s trainer and coach to the problem, as they will be an integral part of the treatment team. When all of these pieces of the treatment team are in place, the likelihood of recovery is much higher.

He Said, She Said: Celebrity Diets

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He Said

In an interview with ESPN at last month’s Major League Baseball All-Star Game, Mark Teixeira, first baseman for the New York Yankees, fielded questions about the gluten-free, dairy-free, sugar-free diet he has reportedly been following since the off-season. Although he nicknamed his set of food rules the “no fun diet,” Teixeira praised his diet for bringing about his return to health and all-star-worthy performance based on his belief that the foods he had eliminated are inflammatory to the body.

Each time an athlete speaks up about his or her fad diet and its associated pseudoscience, life gets a little bit harder for the rest of us. Already, so much of my time with patients focuses on reeducation involving the food myths and misinformation that are so prevalent in our society. The Teixeira interview and others like it add fuel to the fire.

The problem is not that Teixeira has excluded gluten, dairy, and sugar from his diet. This is his body, his career, and his life, and I am in no position to judge him for the choices he makes regarding these entities or for whatever he believes, accurate or otherwise, about food. We all get to decide for ourselves how we want to lead our lives and what we want to believe, and he is subject to the same freedom.

Rather, the problem is how the dietary choices of athletes are framed and conveyed to the rest of us, the incorrect information and insinuations that often come along for the ride, and the bizarre phenomenon existing in our society whereby we put more stock in health advice doled out by celebrities than actual licensed healthcare professionals.

As a general theme, people tend to be more vocal about their dietary successes than their disappointments, which gives us a warped view of reality. Teixeira is not at fault for discussing his diet at the All-Star Game, not when the interviewers made a point to ask him about it. But would his diet be the subject of such conversation if his year was not going so well?

Consider his teammate, CC Sabathia, who lost a bunch of weight (temporarily, at least) after adopting a low-carbohydrate diet a couple of years ago. His diet and its associated weight loss got plenty of media attention back then, but hardly anybody seems to be talking about it now. Perhaps ESPN would have asked Sabathia about his diet at the All-Star Game if he was invited to be there, but as it turns out, he is in the midst of the second worst statistical season of his 15-year career, both of which have come after he went low-carb.

Did cutting carbs and losing weight cause Sabathia’s career to suffer? Possibly, but neither you nor I know for sure. While a correlation certainly exists, causation remains a question mark. Nutrition definitely impacts sports performance, but so does a host of other factors. Regarding Sabathia, elements like age, injury history, and general wear and tear are at play as well, not just his eating and weight.

Just as we cannot scapegoat Sabathia’s diet and lost weight for his poor play, we cannot automatically credit Teixeira’s newfound food rules for his bounce-back season. Perhaps he is simply healthy again for the first time in a long while after undergoing wrist surgery a couple of years ago. After all, except for 2013 and 2014 when he was injured, Teixeira has been one of baseball’s best players for over a decade, and it sure sounds like he was eating gluten, dairy, and sugar during all those years of dominance earlier in his career.

We see these same themes in other sports as well. A televised Novak Djokovic tennis match cannot go by without the commentators throwing in at least one mention of his gluten-free diet, which he credits for catapulting him to the status of number one player in the world. Yet, never once have I heard anybody in the media talk about the eating habits of Roger Federer, arguably the best player in the history of the sport and someone who has continued to compete at an elite level at an age well past when most tennis professionals retire. His diet consists largely of foods like cereal, pancakes, and pasta – in other words, plenty of gluten.

Could it be that Djokovic’s career took off not so much because he cut out gluten, but rather because his years of training, practice, and experience have come together during the window of prime age for a tennis player to produce great results? Similarly, perhaps Federer’s longevity, ability to stay healthy, and years of domination have less to do with pancakes and syrup and are more due to talent, hard work, smart coaching, and efficient mechanics.

If you find yourself tempted to adopt a fad diet because a successful athlete is preaching it, look at the big picture and remember that most of his or her peers are probably not following his or her diet and are also doing quite well for themselves, but their eating patterns are not as sensational and therefore not garnering the same attention.

On a more macroscopic level, challenge yourself to consider how much sense it really makes to be taking nutrition cues from an athlete or any other celebrity. My computer and telephone are essential for my work as a dietitian, and I use them daily, but I only know how to use what I believe works best for me. It would be a mistake to fancy me an IT expert, assume that I really know what I am doing in that regard, and emulate my choices. Similarly, looking to professional athletes and other celebrities as you shape your own eating makes little sense either.

 

She Said

About two months ago, there was a big buzz on the Internet (and news media) that superstar songstress/actress/business mogul Beyoncé had an “amazing” announcement to share with everyone. The plan was for her to make this announcement to all of her fans on the Good Morning America TV show, and it was going to blow everyone away. Of course, the Internet was shivering with excitement. Could it be that Beyoncé and Jay-Z are having another baby? Does Bey have a new album coming out, and is she going out on tour? Has she discovered the cure for cancer? The suspense was killing everyone!

Well, it appears that all she had to tell us was that she has found the secret to losing weight (and keeping it off) and living a fabulously healthy life. How did she achieve this, you ask? Well, by following a diet, of course! Per its website, the “22-Day Revolution” diet is a “plant-based diet designed to create lifelong habits that will empower you to live a healthier lifestyle, to lose weight, or to reverse serious health concerns.” The diet’s author, “world-renowned exercise physiologist” Marco Borges, is on a mission to help his clients find “optimum wellness” by eating a completely vegan diet. According to Borges, by eating “nutrition-packed” vegan foods, people will be able to “transform their lives, bodies and habits.”

Ugh. Can we please just stop the insanity? Every time a new celebrity announces their latest and greatest diet discovery, it makes me cringe. Given that the majority of my patients are those that struggle with eating disorders (ED), I am fully aware that these diets can be the gateway to a life full of pain and suffering, as most EDs start when one decides to diet. Young girls are especially vulnerable to these celebrity diets because they often put these actresses, musicians, and models on an impossible pedestal. Even though most magazine images are photoshopped nowadays, most young girls are not aware of this and aspire to be as lean and slender as Gwyneth Paltrow or as fit and toned as Kate Hudson.

The fact of the matter is that celebrities are not like the rest of us – they are the minority, not the majority. Even if they did not diet like they do, I doubt that their physiques would be much different than they are now. It’s genetics, pure and simple, and they have “won” in the genetics lottery of life. So, even if you go low-carb like Gwen Stefani or Paleo like Megan Fox, it’s highly unlikely that you will end up looking like these celebrities.

These diets or “lifestyle changes” touted by celebs do much more damage than good. Not only do these diets tell us that we cannot trust our bodies’ hunger and fullness signals (and therefore need to follow food rules to be “healthy”), but they also give us a nearly impossible goal of looking like these celebrities if we eat like them. And if someone is predisposed to EDs, each new celebrity diet is like lighting a match and tossing it into a powder keg – nothing good will come from it.

My advice? Whenever you hear about a new celebrity diet that promises to help you lose weight and keep it off, turn back the clock, or magically cure your health condition, please change the channel, toss out the magazine, or click on another website. Celebrities don’t know what’s healthiest for you to eat – only your body knows that!