Does intermittent fasting have health benefits?

Sigh….I know! I know! It’s confusing. Every other week, a new diet approach. Keto. Vegan. Paleo. Here we go again. Bottom line is, there is no one diet fits all and part of what I do for you is give you the most up to date research available. Intermittent fasting is a new buzz phrase going around the internet health circles and to my surprise, there is no shortage of research surrounding this method of meal planning. It has definitely sparked curiosity amongst the science and health communities, particularly about its effects on obesity, insulin resistance, sleep cycles, and fat metabolism.

First, what exactly does intermittent fasting mean? Well, it’s what it sounds like….most commonly it involves a period of 2 days per week, every week, of no food whatsoever. However, some alternate days of fasting where every other day they eat and drink what they want and the opposite days they consume zero calories. And then there are some methods that specify time periods of each day where food is allowed and food is not. Usually you are allowed calorie-free fluids, but that’s it. The theory is that our body needs a “break” from food on a regular basis to produce health benefits. But what does the research actually say? These are the questions I’m going to attempt to answer.

1. Does it help with weight loss? This is really the million dollar question in my mind. I preach not to go more than 5-6 hours without eating because, after all, it actually slows your metabolism down and our bodies are designed to hoard calories when we don’t eat. Think of your body as if it were a car: food to the body is like gas is to a car. Without it, the body has no energy to move, which means the body is like a car that has run out of gas, parked on the side of the road….no fuel, nothing to burn. I’ve worked with so many clients who did not start losing weight until they started eating more often. Most drastic example I can think of is a woman who weighed more than 500 pounds and consumed only one meal per day that probably totaled to about 800 calories. She could not, for anything, lose weight. A month later, after eating double the calories, three meals a day with some snacks in between, she LOST weight. But that’s just my story, let’s look at some scientific studies.

In this small study of sixteen non-obese individuals, they lost an average of 2.5% of their starting weight after twenty-two days, so just three weeks, of alternate day fasting. However, they were HUNGRY. And that hunger never subsided. Do you think they kept at it after the study? A 5’5″ woman is technically overweight, but not obese, at 165 pounds….so if you lost four pounds in three weeks and you were starving, would you keep it at? Or find another diet, like the keto diet that is known to reduce hunger? It should be noted however that fat oxidation was increased during the study period, which means they were losing mostly fat mass and not muscle mass, this is a really good thing considering you want to keep your muscle mass when losing weight. These people did not maintain their losses, regrettably.

Here is a review highlighting several studies on alternate day fasting and comparing them to normal, calorie restricted diets (you know, the traditional method of weight loss you’ve probably tried a gazillion times.) They concluded that indeed, fasting is superior to producing weight loss and particularly, loss of fat mass. Pretty neat, huh? I’ve talked about the importance of this for preserving your metabolic rate in the past.

This last study compared individuals following an alternate day fast vs. combining it with exercise vs. exercise alone vs. a control group. These particular subjects were allowed a controlled, prepared meal that was provided for them around lunch time on the fast days. The meal was restricted to 450 calories and otherwise, calorie free beverages only. Feed days they could eat what they wanted, but they were given dietary counseling by a dietitian. Sounds pretty good, right? You may guess by now that the combo and alternate day fast group lost the most weight after twelve weeks at six and three kilograms (13.2 and 6.6 pounds), respectively. Again, most of the weight they lost was fat mass, not muscle. Awesome, right? It needs to be pointed out here though that they measured body fat using bio-impedance, which I’m not a fan of for accuracy….it’s the same kind you might use on your bathroom scale. Regardless, people are apparently losing the good kinda weight with intermittent fasting.

2. Does intermittent fasting improves insulin resistance and type 2 diabetes risk? I found lots about this one, too. The caution here if you have type 2 diabetes is that if you are taking medications that lower your blood sugar intentionally, many of the medications will not work without food OR they will work too well and cause hypoglycemia. So I’m going to begin this with an up front warning that what I’m about to say is not to be started without speaking to your doctor first if you are taking medications for diabetes. Okay?

In this pilot study (so just preliminary) on ten obese individuals, they experienced a reduction in their weight, body mass index, and fasting blood sugars after only two weeks. They fasted daily and only ate during a window of about six hours during mid-afternoon. Apparently they didn’t gorge themselves, because the article did say there was a spontaneous reduction in calorie intake measured from pictures they were required to take of all meals and food they consumed (talk about accountability!). At two weeks, this study really wasn’t long enough to say much, but six out of the ten said they would do it again.

In this study done on a small group twenty-four obese male war veterans, they did not see a significant change in fasting blood glucose or fasting lipids after six months of intermittent fasting (two nonconsecutive days a week.) Interestingly enough, their systolic blood pressures lowered and they did lose an average of twelve pounds…pretty good!

Lastly, in this review of several studies on the effects of intermittent fasting and insulin resistance, primarily reduction of type 2 diabetes risk, they concluded that the findings are showing promise for the use of alternate day fasting as an alternative to the traditional calorie restricted diets, but more research is required before solid conclusions can be reached.  I perused some of their reference articles and the theme seems to be that the results are more profound in mice than humans so far. There was another review I thought gave some really good insight and from what I gather, if you are going to try intermittent fasting for the purposes of improving your blood sugars and/or insulin resistance, focus on fasting during the evening times specifically. 

3. Does intermittent fasting help you sleep better? I bring this one up because we know that poor sleep habits lead to weight gain. So wouldn’t it be cool if there was a diet that could help you sleep better? I found two studies that looked at this. The first one was on eight volunteers who honored Ramadan, a religious period of fasting between dawn and sunset celebrated by the Islamic culture. They measured their melatonin levels via blood tests at baseline, during, and after. Unfortunately, they did not find any differences related to fasting. However, in this study, eight overweight individuals self reported better sleep when participating in time restricted fasting (food allowed <12 hours daily) for sixteen weeks. Subjective measurements are not usually as reliable, but these people obviously felt more refreshed waking up.

So what’s the verdict? Would you participate in fasting for a day or two per week or pick several hours each day to fast based on the evidence available? Seems like the information is promising, but the studies are small and preliminary. As for me, I’m not sure if I’m personally jumping on this bandwagon quite yet knowing there are other diets that are much easier to follow than this one.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free online support group here.

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Jillian McMullen, RDN, CSOWM, LDN

Is weight loss surgery the easy way out?

No, no it isn’t. If you opted for weight loss surgery, don’t ever let anyone tell you that you took the easy way out. If you know someone who opted for it, realize that the decision was most likely made after hours and hours of intense thought and discussion amongst family members and key medical providers. It involves drastic lifestyle changes with a serious commitment to habit alterations. But it’s lifesaving and as I said in my recent post, it is often the best decision that person has ever made for their health.

My goal for this post is to explain the options in the simplest way possible and drive home the fact that, although weight loss surgery may be the most successful end point for weight loss known to date, it certainly is not the easy way out. It’s only a tool, but a damn good one at that.

So here we go, let’s start with the laparoscopic banding procedure. Nothing is changed from your inside anatomy. So you still have your full stomach and intestines intact. The band is purely a restrictive procedure and is just what it sounds like, a band (think of it like a bracelet even) that is placed around the top portion of the stomach. At first, it’s just a fancy expensive bracelet. Shortly after surgery, it can be filled with a salt solution, called saline, to tighten its grip around the stomach, by injecting the fluid through a port that runs from the band to just under your skin. Think of it as blowing up a doughnut ring….that hole in the middle is gonna get tighter when it’s blown up. Problem is, this procedure doesn’t work. I know, that’s a bold statement for me to say, but in the ten years I’ve worked with bariatric surgery candidates, I only saw maybe three patients (out of hundreds) lose the expected 20-25% of their initial starting weight and maintain it off for more than one year. And guess what? All of them eventually had to have their bands removed due to complications and/or weight regain. Luckily, their bands were converted to the sleeve gastrectomy and they were able to continue their lives with a more permanent option.

People see the band as the “noninvasive, less risky” choice. However, that’s just not true. When you have a foreign object placed in your body, it doesn’t like it. The band can slip out of place, corrode, grow into the stomach, get infected, flip over and out of place, the port tubing can get a hole in it and leak, and the possibilities go on and on. Most often, one of two things would happen. I either saw people throw up over and over because food just wouldn’t go down where the band was and eventually their esophagus above the band placement would dilate, or get bigger, and they would end up with essentially two stomachs to fill. Think of it like an hour glass, one on top and one on the bottom….endless hunger. Or I saw them give up and live on liquid, soft foods that slid through the band into the stomach easier…..so milkshakes, pudding, ice cream, jello, mashed potatoes, and even fried foods. It’s not uncommon for someone to even gain weight after this procedure, as you could imagine. Some facilities have smartened up and don’t offer the band anymore. In my opinion, if a surgeon recommends the band to you, run the other way.

The sleeve gastrectomy has gotten lots of attention over the past five years or so for those who have a lot of weight to lose but may or may not have any major health problems. It is a purely restrictive procedure as the surgeon removes around 75-80% of the stomach in a vertical fashion, leaving a banana shape left. Don’t be mistaken, though, your stomach ends up smaller than a banana. Think “man’s index finger” size. It is very restrictive, but what I think helps people out the most is that the part of the stomach that gets removed is also the part that produces the hunger hormone, ghrelin.

So, yea, you may fill up on the same amount of food your two year old niece just ate, but you weren’t really hungry to begin with. And if you have read or listened to any of my content before, you may have heard me talk about how ghrelin increases in production in response to massive weight loss. It can’t with the sleeve gastrectomy. That’s a big plus. I do caution people against choosing this procedure if they have problems with stress or emotional eating or what I call “grazing.” If you don’t eat because of excessive hunger and you have a habit of nitpicking all day long out of boredom or stress, this procedure doesn’t do anything to stop that….you can still eat a small amount of food every couple of hours or so. You can’t, however, sit down to a large meal and finish it in your normal ten minutes. It’s going to take at least twenty minutes to finish off a 1/3 cup of ground turkey. Talk about eating to live! Expected weight loss is anywhere from 25 to 35% of your starting weight. This is life changing for the vast majority of those that are are successful at it.

The last procedure I’m going to talk about here is the roux en y gastric bypass. This one has gotten a bad rep for years which is why I believe there are so many new procedures constantly up and coming, like the stomach stapling at one time, then the lap band, now the sleeve, and the up and coming “balloon” (that’s for another post). But this one has stood the test of time for the last forty years now and remains the gold standard of weight loss surgery. Is it drastic? Yes. Does it involve a huge lifestyle change? Oh yes. Does it work? Yes. I’ve seen lives absolutely change for the better and people leave the hospital off their diabetes medications after having this surgery. There was no waiting period for weight loss, it was immediate. When we talk about this surgery, we are talking about a metabolic operation that changes the body’s hormones with some major rerouting of your digestive system. So, like the sleeve gastrectomy, hunger is no longer an issue. Nothing is actually removed, like in the sleeve, but the part of the stomach that produces the hunger hormone, ghrelin, no longer comes into contact with food. The major difference is that a large portion of the small intestines is rerouted to create a “Y” shape with the new, smaller, egg-shaped stomach and connected lower down the digestive tract which results in calorie malabsorption. Not only are you not hungry and restricted in how much you can eat in one sitting, but you also don’t absorb all the calories you eat at one time. Lastly, high sugar and high fat foods are a no go. You run a high risk of getting sick with the shakes, diarrhea, and breaking out in sweats if you eat even just one small bite of the wrong thing. Interestingly enough, lots of people who have had this surgery experience a change in their taste preferences anyway.

Since expected weight loss is closer to 35% starting weight, I recommend this procedure for the stress eater, person with a slow metabolism, chronic yo yo dieter, and most importantly, anyone with a serious health condition who requires massive weight loss to improve. This would include cardiovascular disease, obstructive sleep apnea, or diabetes.

This is your life, and if someone told you there was a cure for a known disease that you have, would you take it? In 2013, the American Medical Association recognized obesity as a chronic disease. At that point, health insurance companies began expanding their coverage for weight loss surgeries. A chronic disease is something that never really goes away. If you have been struggling with your weight, you know what I’m talking about. You succeed at a weight loss attempt temporarily, but the weight always finds its way back, somehow. I know that this is not for everybody and you may note even qualify.

If it is something you are considering or if you are in a place where you don’t quite qualify, but you’d like some help with your weight, feel free to reach out to me at the below links.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free online support group here.

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Jillian McMullen, RDN, CSOWM, LDN

The real reason to go vegan (hint: it’s not because meat causes cancer)

I want to start with a disclaimer, I don’t have Netflix. I know. But I rarely watch tv these days and when I do, it’s in the form of a Friday night animated movie with my kids. You’ll understand in a minute why this matters to the topic of vegan diets.

But first, let’s clarify what a vegan diet really is. It’s not the same thing as going vegetarian which is simply cutting out some or all animal products. Vegans are hard core. They don’t eat animal containing products of any kind including beef, poultry, seafood, dairy products, eggs, honey and any products containing such ingredients (i.e. whey, casein, lactose, egg white albumen, gelatin, cochineal or carmine, shellac, L-cysteine, animal-derived vitamin D3 and fish-derived omega-3 fatty acids.) Most vegans I have known rely on whole, plant based foods to compose their diets. The bulk of their diet comes from nuts, seeds, beans, fresh fruits and vegetables, rice, potatoes, and occasional dairy substitutes. They typically do not consume processed meat substitutes (that would be a flexitarian), processed junk food, added oils, and sugary drinks/sweets. These are health conscious people that often care about the environment too.

A certain movie on Netflix has been circulating recently about how healthy vegan diets are, suggesting if you follow them, you won’t get cancer, Type 2 diabetes, or heart disease. And highlights how unhealthy eating meat, poultry, processed meat, even fish, and all forms of dairy is. Cancer in a patty with melted diabetes on top, shall we?

As a reader of my stuff, you probably know by now, I have an opinion. But you should also know my opinions are based on quality evidence. I’ve read a thorough review of the movie but my post really isn’t to bash the movie. What I’d prefer to do is shed some light on the real reason you’d want to consider following a vegan diet instead of a bunch of bias and poorly backed reasons of why you shouldn’t eat meat. In the world of nutrition and scientific research, there are very little absolutes. When it comes down to it, nobody really has the answer. If they did, they would be extremely wealthy and these diseases that have become such epidemics would be eradicated by now. One little movie just doesn’t have the miracle answer. Sorry.

So let’s outline some great reasons why a vegan diet would be a great option, sprinkled with a few reasons why it might not be a fit for you:

  1. Vegan diets are nutritious: this really is a no brainer. They are naturally higher in fiber, folic acid, vitamins C and E, potassium, magnesium, and many phytochemical than the typical western diet (aka standard American diet aka SAD). The fat content is also more unsaturated since there is no allowance for the primary sources it comes from like butter, beef, processed goods and poultry skin. However, there are going to be a few nutrients that will present a challenge and concerted effort to obtain adequate amounts is required. Vitamin B-12 to start with because the best source in the SAD comes from eggs and animal products. There is a product that you may have never heard of unless you circulate in the vegan communities called nutritional yeast, which can be fortified with B-12 (think parmesan cheese). Most solid vegans I know take daily sublingual supplements or bi-weekly injections. Really no way of getting around that one, a B12 deficiency can lead to all kinds of issues including permanent neurological damage, so don’t mess with it. Next ones are vitamin D, calcium, and long-chain omega-3 fatty acids. These three power house nutrients typically come from canned seafood and dairy products, both off the vegan menu. If flax seed, flax seed oil, and walnuts are a regular part of the diet, omega 3 fatty acids should not be a problem. And there are always vegan omega 3 supplements. It should be noted that the vegan supplements are not as bioavailable as the fish supplements, however. Some green leafy vegetables will provide plenty of calcium if eaten regularly especially kale, broccoli, and watercress. Almonds are also a great source of calcium all things considered. Plant-based dairy alternatives can be a good option too if fortified with vitamin D, B12, and calcium. I talk more about them in this recent post.
  2. There is possibility that vegans are at lower risk of heart disease, certain types of cancer, and type 2 diabetes. The research isn’t clear, folks. The movie which shall remain anonymous, gave studies, which to the average person unfamiliar with how research works, might sound compelling, if not downright terrifying. But much of what they cited was based off of dietary recalls and food frequency questionnaires. I did some of my own digging, that’s what I found too here, here, and here. As a dietitian, I’ve completed both myself and obtained thousands of dietary recalls. Can you give me an account of everything you’ve eaten for the past seven days including snacks, drinks, and meals? How about a month? I can’t either. That’s what they are basing their research on and then saying the amount of meat these people ate is linked to their cause of cancer. You can’t buy that. I will note, if these people are professing to be vegans and in two of the studies I linked to, the subjects are seventh day adventists as well, I’m guessing the researchers are taking their word that they don’t smoke, drink alcohol, or consume animal products. So over the 6 and 8 year follow up period these two studies took place, these people never messed up. Not once. Not ever. I’ll let you decide how likely that is. And how truthful people are about that. Especially when it comes to their religion.
  3. You could be thinner. True. Could be. I’m a weight loss expert. I’ve been working with people on weight loss for over ten years. I’ve never been able to adequately help someone lose weight without reducing their carbohydrate intake and increasing their protein intake. Quite opposite of a vegan diet. But certainly, the carbohydrate choices I recommend are fresh fruits, vegetables, whole grains, and beans/legumes. Really, I’m tired of of the 100-calorie snack packs and 1-point snack cakes filling up the grocery aisles advertised as weight loss foods. They aren’t. And they aren’t part of a vegan diet, that’s a win.

Obesity is the second leading cause of preventable death in the United States. Smoking is number one. My mission is to help you lose weight effectively and for good. I don’t buy for one second that eating a piece of bacon or any processed meat is like smoking five cigarettes. This study compared various types of cancer risks relative to habits like smoking history, processed meat, and red meat intake. However, they based their conclusions on food frequency questionnaires and did not take into account BMI or family history of cancer (although they gathered the information.) They did survey close to 500,000 individuals. So I will give it to them that they have numbers on their side. If you’ve ever talked to me about processed meat, you know I don’t like nitrites and nitrates because I do believe that there is strong evidence that they are linked to cancer and there are too many great nitrite-free options to risk it. But that doesn’t mean eliminate them altogether nor does that make a strong case to go vegan. In fact, this study found a reduction in all cause mortality when individuals replaced red meat with unprocessed white meat (chicken, fish, etc). But again, they obtained their evidence from questionnaires. So who really knows.

So far, maybe I haven’t given much compelling reason to go all out vegan. I’m really not anti-vegan at all. In fact, I’ve considered it myself but I live with two meat-lovers  and one-dairy lover so I prefer to keep the peace for now. At first glance, there is some compelling evidence that it’s the miracle diet we’ve been looking for. But then again, other diets are out there showing similar promises. Fact is, we don’t know enough about any of them and I’m not sure if we ever will. I don’t know anyone that has gained weight, could blame their cancer, heart disease, or diabetes on following a vegan diet. Quite opposite in all of the personal encounters I’ve experienced myself. If it’s something you are considering, have a plan, allow for a little flexibility, and incorporate supplements if necessary.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free support group here.

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Jillian McMullen, RDN, CSOWM, LDN

9 reasons why people are following a dairy-free diet

If you aren’t avoiding dairy like the plague, you probably know someone who does. If you don’t, you may have heard that it’s best to choose the full fat versions over the fat free or low fat. And what about those hormones? Should you choose organic? A dairy alternative?

What’s what? Why are they avoiding it? And should you? Let’s start with two of the biggest, most glaring reasons why someone would want to avoid dairy:

1. Lactose intolerance. In fact, according to the National Institutes of Health, as many as 65% of adults in the U.S. suffer from this – ya know, that bloated, uncomfortable gassy feeling that sends you to the bathroom after you’ve drinking a glass of milk or just eaten a bowl of ice cream?. It’s not an allergy, but just simply the body’s inability to digest lactose, the sugar found in milk, because it lacks the necessary enzyme, lactase, to break it down. It’s actually rare before the age of two. Milk is a big no no here, but often this includes cheese, cottage cheese, ice cream, and yogurt in large quantities. Those who have Irritable Bowel Syndrome, Celiac Disease, Crohn’s Disease, Ulcerative Colitis, or Diverticulosis will more than likely also have lactose intolerance. Many lactose-free options have been developed over the years such as Lactaid milk and my personal favorite, Fair Life ultra filtered high protein milk which now has available options to include DHA omega-3 fatty acids.

2. Milk allergy: this is more than just an intolerance to the lactose enzyme. Understand that an allergy is very different in that it is defined as a damaging immune response by the body to a substance. There is no tolerating even a yogurt or lactose free option if they want to avoid hives, anaphylaxis, or whatever it is that their body does in response to milk protein.

If you don’t fall into the above two categories, you may want to explore some of the other reasons with me to find out why people have sworn off dairy before you decide if you are joining the bandwagon or not:

1. Dairy is an acne-trigger: TRUE. Some research does, in fact show that high intakes of dairy are linked to moderate to severe acne in teenagers and young women due to the insulin-like growth factor-1 (IGF-1) found in milk. The IGF-1 is the primary mediator for the growth hormone and is present in pregnant milk-producing cows. I believe this hormone and others is to blame for why many people are so nervous about consuming cow’s milk and have made the switch to one of the many alternatives available on the market today. Read on.

2. It contains harmful hormones: FALSE. As with with above, the word hormone gets people nervous and thus, there has been lots of public concern over the synthetic hormone, recombinant bovine somatotropin (rbST), that leaks (in miniscule amounts) into our dairy products from pregnant cows. What exactly is it and why is it used? Simply put, it helps the cows produce more milk, i.e. increases efficiency and productivity for their ahem, job. In fact, it’s been studied extensively in it’s twenty years in use and in this most recent review of those many studies, has been concluded totally safe. You have likely seen organic rbST-free milk and yogurt options available in your local grocery store and assumed they were better. From what I have researched, these are in response to market demand, not necessarily safety concerns. If I find out any differently, I will tell you. Promise. If you are still concerned, you have those available to choose from and certainly, if you are acne prone, go for them.

3. Dairy has been linked to certain types of cancer: FALSE except for possibly prostate, which remains inconclusive. In a 2015 analysis of 22 prospective cohort studies (1,566,940 participants), they concluded dairy was associated with a decrease in breast cancer incidence. And again, a study published last month (June 2017), they indicated after analyzing the results of 13 different studies (493,415 participants and 7453 cases) that increased calcium intake coming from diet and supplements was associated with a decreased risk of ovarian cancer. In another review, published at the end of last year, they concluded that cow’s milk is indeed associated with a reduced risk of colorectal, bladder, and gastric cancer as well but neutral for ovarian, pancreatic, and lung. With that many participants and cases, they make a strong argument. The jury remains out for prostate as there has been evidence that dairy raises the risk of prostate cancer, particularly because of the presence of the IGF-1 hormone. Stay clear if you’re a male and have a strong family history for now….in my opinion. It’ cancer, after all.

4. It raises diabetes risk: FALSE. In a 2016 analysis that included 22 cohort studies comprising of 579,832 individuals and 43,118 Type 2 diabetes cases, total dairy consumption, particularly from low-fat yogurt was associated with a reduced risk. Although another study found no difference using full fat yogurt, suggesting the benefits came from the fact that yogurt is rich in probiotics and the fat content is not as important. Lots of human subjects here, that’s what I like to see in results.

  • 5. It causes inflammation: TRUE, maybe. Looking at 78 studies, it really was a toss-up. This review concluded that dairy products, especially fermented ones, like yogurt, are anti-inflammatory. However, for people who have a known dairy allergy, it is definitely pro-inflammatory. Makes sense, that’s kinda what an allergic response is. As far as what it was that caused the dairy to be inflammatory, they did find more of an association with the dairy products highest in saturated fat.

6. It’s fattening and raises risk of heart disease: FALSE. In the same review, they discussed how in actuality, full fat dairy products raise HDL levels (a good thing). Although whole milk dairy products do tend to increase LDL cholesterol as well, understand that there are two types – small particle and large particle. The small, dense particle size are the ones that are more susceptible to oxidation and artery wall build-up, whereas the large are not. Dairy products have more of the large particles. That’s good. A recent meta-analysis of thirteen studies published in December of last year concluded plainly that :

Higher dairy fat exposure is not associated with an increased risk of cardiovascular disease.

7. It was never meant for humans, only baby calves. Personally, I find this to be a weak argument. One could argue that the only milk meant for humans is breast milk. However, many of us, myself included, enjoy soy milk, almond milk, and many of the other non-dairy novelties on a regular basis. The NHANES pubished in 2010 reported that indeed, children aged 2-4 and 5-10 did have higher BMIs when drinking higher quantities of milk (higher BMI was not necessarily equivalent to obesity). However, these results were used for the 2010 dietary guidelines for Americans to encourage milk consumption among children since a higher BMI (not necessarily obese) for a child is not necessarily a bad thing. After all, it is well known that calcium and vitamin D intake are linked to bone health and that milk is an excellent source of these vital nutrients. We also know that bone mass is developed during childhood and adolescence.

One might argue that calcium and vitamin D are also available from the many dairy alternatives such as almond, rice, soy, and coconut milk, and often in higher quantities. In this study, however, they found that our bodies absorb about 25% less of the calcium most brands of soy milk add to their product compared to cow’s milk. In other words, you need to drink about 12 ounces of soy milk to get the same amount of calcium you would get from an 8 ounce glass of cow’s milk. Another review pointed out that we simply don’t know the amount our bodies can absorb from all of the nutrient-fortified plant-based milk options to say whether or not it’s the same as drinking cow’s milk. Either way, no one can deny our children are consuming energy dense, but not necessarily nutrient dense diets and that’s a problem. Cow’s milk is the only product I know of that is consistently high in protein, potassium, calcium, and vitamin D while low in food additives including added sugars that is widely offered to children in their critical growth years.

Hear me out. If you read my blogs, I understand that some of you read holistic health sites as do I. And much of what I’ve said in this post goes against what you’ve probably read or heard. But I do not believe in living in fear, I believe in what it is evidence when it comes to this stuff. I dig as much as my time allows to avoid any potential bias and present the facts to you. If you have any personal experiences that differ and you need to remain committed to a dairy free diet, there are acceptable options to get your calcium from, including some you may haven’t even thought of yet like kale, broccoli, and canned salmon. If you need probiotics and extra supplementation, I have recommendations that I fully trust and use myself that I would feel confident in sharing with you. Feel free me to contact me if you’d like to discuss it more.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free support group here. We have an upcoming fitness challenge that’s going to be lots of fun!

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Jillian McMullen, RDN, CSOWM, LDN

Keto diet- is it everything and more?

Several weeks ago, I began a diet review series and I did a brief synopsis of the Keto Diet. I admit it wasn’t very thorough and because I keep seeing it pop up and another friend starting it, another friend losing weight with it, and another person swearing by it for their increased energy, I’m gonna do a more thorough review here. I especially see my friends in the holistic communities doing it- and it’s spreading faster than the Whole 30 diet once was.

Is this the newest fad that will be replaced by something better in a couple of years? Or is it here to stay and in several years we are going to see evidenced based research popping up at how it’s the best diet that we never knew existed and if we just figured out how healthy fat was for us earlier, maybe we wouldn’t be seeing the rise of heart disease, obesity, cancer, and other related diseases that we do today?

Well, let’s start with what it even is. Roughly 70-75% fats (you read right), 5-10% carbohydrate, and 20-25% protein. As you can see this is not your normal low carb diet that typically replaces the missing carbs with protein. It’s all about the fat. Why? Because the purpose of this diet is to put your body into ketosis, aka a fat burning machine. Just to give you a little science lesson here, our bodies preferred source of fuel is glucose (what carbs are converted to after we eat them). Now if you are eating a diet high in carbs, that is what you will burn first for energy. And everything requires energy in our bodies to function properly, including our brains. When the body runs out of glucose (will happen if you aren’t eating very many carbs), the liver is great at producing a back up, called ketones. Ketones come from broken down fat. Make sense?

So why do people do this? I dunno about you, but while a high fat diet sounds pretty fun to me, a diet made of mostly fat doesn’t. But there are lots of anecdotal reports of promising results when one follows this kind of diet. I’ll start with two that have evidenced-based research backing the claims up (because you know me, that’s what I’m about.)

Note: it was very difficult for me to find any studies published prior to 2017 (soooo….6 months ago) that called a ketogenic diet low carb high fat. Be aware of that because any other “ketogenic” diet before that in the research was defined as “low carb, high protein.” There is a huge difference and that’s not what we are talking about here. I worked with patients and personally participated in 2 published studies on very low calorie high protein, low carb diets for 7 years.

Weight loss: this article  published in 2013 reviewed 12 different studies and found in 1415 subjects, the average weight loss after 6 months on a high fat, low carb diet was 2 pounds vs. 1.6 pounds for those following a low fat diet. After a 6 month follow up it was difficult to assess because compliance was not so great and they consumed more carbs than allowed. Another study published in 2009 was done for a full year on 106 obese individuals and compared weight loss of those on a keto diet vs a low fat, high carb diet. They found that their average weight loss was the same between groups, both losing an average of 30 pounds. Pretty good, but neither diet was superior to the other. It just showed that following a reduced calorie diet yields weight loss.

I will add here that I’ve always said, I’ve failed at what I do if I helped you lose weight but you regained it all back. I don’t think we know enough about this diet for the purposes of weight loss to know if it’s not just another yo yo plan. Sorry.

Lipid levels: In the same 2013 review, they analyzed 1258 subjects and found their triglycerides decreased significantly, and their HDL levels increased significantly. Both good things. I like that and the amount of subjects is enough to say it’s valid.

Other indicators of Metabolic Syndrome: The 2013 review noted there was no significant difference between treatment groups in changes in systolic blood pressure (11 trials), fasting blood glucose (eight trials), insulin (six trials), HbA1c – average blood glucose over three months (four trials) and C-reactive protein (four trials).

Athletic performance: In this 2017 review, they concluded that long-term low carb, high fat diets appear to be safe and may even improve several metabolic risk factors for chronic diseases in the general population. They may even provide a promising way to help control body weight and fat mass while maintaining lean body mass in athletes who are participating in sports like tae kwan do, wrestling, lightweight rowing, cycling, and running. Additionally, there is some emerging evidence that a keto diet could improve the performance in ultra-endurance sports as well as those sports with repeated high intensity activities. If you aren’t an athlete, this could still be a good thing if you’re hitting up the gym and wanna try out that new cycling class.

Focus and Mood: this has been one result that many believers love the most. And why I believe they stick with it. Who wouldn’t when you feel great, you’re losing weight, and you’re better able to focus? Who doesn’t need that? Here’s what the available research says: in a 2009 study, they found that after 8 weeks, those following both low carb, high fat diet and a low fat diet had significant improvements in their mood and cognitive functions. However, after a year, the low carb, high fat diet returned to their baseline mood and cognitive functions while those on the low-fat diet continued with their marked improvements. You read that right. The low-fat diet group continued with the better mood, NOT the keto group. This study here in 1998 reported similar results on women eating a high carb diet. I’m just the messenger, don’t hate me! Now, I’m not recommending you go eat a bunch of carbs to feel better. Okay?

Here’s the thing, the concept of following a keto diet for weight loss is fairly new in the research world. So you’re not gonna find a whole lot out there to prove it does a whole lot for health yet. You will find a bunch out there to show the benefits of what it does for those with epilepsy unresponsive to medication. It works.

And don’t expect overnight results. It takes time for the body to adapt to ketogenesis. Some sources I’ve read say two weeks, others say up to a couple of months – assuming you don’t go off plan, not even once. So no cheat days allowed. This diet is for the type A strict meal planning types. Those who are willing to keep a food record and count their carbs, fats, and proteins will do best.

I’m a weight loss expert. And here’s what I know about long term, sustainable weight loss. It’s hard. Like, really hard. If you’re looking for a study that proves ANY diet to work and be the ending answer to our obesity epidemic, well good luck. You will surely find that one person who followed a high carb diet and lost 167 pounds and now has kept it off for 13 years. There’s gonna be that person following the Atkins diet since it’s introduction to the dieting world and it’s changed their life forever. And then there’s the rest of the dieting world still looking for what works for them. I did not find anything that said following the ketogenic diet was harmful, not even long term. In fact, quite opposite. So if you wanna try it because you know someone or more than a few someones who are following it and now they look and feel great and you think it’s something that could help you, well let me know! I’m always looking to be inspired by someone’s dieting success story.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free support group here.

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Jillian McMullen, RDN, CSOWM, LDN

Don’t believe everything you read

I don’t know about you, but it makes me a bit aggravated that we have to comb through piles of research articles to understand what’s in our food supply these days. I’m supposed to be a nutrition expert and even I get confused. I can tell you dietitians are confused too, because they buy in to a lot of the junk out there – and here’s the thing: most of it is opinion based. For instance, if you keep up with the latest nutrition trends, you likely heard about coconut oil recently and how the American Heart Association has deemed it “unhealthy.” They’ve gone as far to say that we should eliminate it from our diets in order to keep our LDL (aka “bad” cholesterol) at bay. In fact, many of the dietitians (not all) in the circles I run in support this stance. Why? Because “holistic” health is unpopular in a science-based community. I’ve experienced the ridicule directly. Sometimes it’s easier to just believe what the big governing bodies say than to go against the grain. The research is there for functional and homeopathic medicine, but it’s not popular in western medicine.

I’ve been there. I was employed by one of the most well known research-based teaching hospitals in the world for nearly ten years. Going against traditional medicine and what a doctor says isn’t very popular. But we need to think for ourselves sometimes, especially if we are going to call ourselves nutrition experts. Because they don’t have time to talk to people about their patients’ diets. It’s not their thing. Their thing is sick people. We are the ones who have a chance to talk to the well and we are blowing it.

Now let me be very clear. I am NOT one of those people that live in fear of the government’s conspiracy against the people. I am NOT one of those people that believe all big Pharma is out “to get us” nor do I believe doctors or researchers have the cure for cancer and they’re just all hiding it from us to stay rich. I’ve looked into the eyes of a doctor right before and right after he’s had to tell a patient they have cancer and their hope for a long future is shattered. Believe me when I say – being rich was not on that doctor’s mind. But I do believe when it comes to making money, the business of pharmaceuticals as well as food manufacturing is alive and well. But that’s for an entirely different conversation.

So let’s get to the subject of the American Heart Association’s so called “review” of the research. They picked four publications to focus on. By now you’ve probably read some rebuttals on the subject as have I. But as a dietitian, I feel it’s my responsibility to write my own evaluation on the subject and properly educate the public. So let’s start with the facts. The press and the AHA have spotlighted coconut oil as being the evil one yet has failed to mention that coconut oil was not the source of saturated fat in their core studies completed over 50 years ago (side note: I was taught to sick within this decade when reviewing research.) I’ve read it twice just to be sure. The saturated fat sources put to the chopping block come from dairy and animal fats in said studies. Those just aren’t the same thing. At the end, coconut oil gets it’s own section, and based off of seven studies they cherry picked, they concluded that coconut oil raises LDL cholesterol in the same way as animal and dairy fats and thus, conclude that it should be eliminated from our diets. They do admit these studies did not examine coconut oil’s direct effects on CVD. It was also noted to raise HDL cholesterol and lowered the LDL:HDL ratio, however (both good things.) I’ll just leave a recent study right here published at the end of 2015.

If the AHA is going to advise against using coconut oil, why didn’t they recommend we eliminate dairy or meat from our diet? I mean, there was more evidence in their review on those two if you ask me. Now I’m not a vegan and I’ve discussed this diet in another post. But there are a lot of good things to be said about going vegan. But then again, the AHA are proponents of the DASH diet, so there’s that. And as you will see later, although they deny conflicts of interest, that remains questionable. They give honorable mention to the mediterranean diet as well, which I also highly recommend. This one is high in monounsaturated fat and those folks tend to have lower rates of heart disease.

Lastly, the underlying theme of this article was that polyunsaturated fats, more specifically omega-6 fats, will save the day. I’m not sure I buy that. It has been known from previous, more current research that eating a higher proportion of omega-6 (found in soybean oil) to omega-3 (found mostly in flax seed, walnuts, and fish) fat has a negative effect on heart health. I do, however, believe that lowering animal fat will decrease LDL cholesterol, which their studies in this review did show.

Scroll down to the very end of this review, not the post everyone’s reading about how unhealthy coconut oil is, but the actual published paper they are referring to. It was funded by eleven pharmaceutical companies including: Amarin, Amgen, AstraZeneca, Eli Lilly, Glaxo-Smith Kline, Merck, Pfizer, Regeneron/Sano, Takeda, Akcea/ Ionis, and Dr. Reddy. And it was also funded by several others including Esai (energy research and consulting firm), California Walnut Commission (Certified by the AHA, proponents of the DASH and Mediterranean diets), Ag Canada and Canola Oil Council, National Cattlemen’s Beef Association, Seafood Nutrition Partnership, TerraVia (algae oil high in monounsaturated fat, low in saturated fat), and Avocado Nutrition Science Advisors. Need I say more? I think I’m done here.

So what is coconut oil good for anyway?

  1. Oil pulling: the practice of swishing it around like mouthwash for about 10-20 minutes for oral hygiene purposes. In one study in particular, after just fourteen days there was a reduction in plaque forming bacteria, even as good as using chlorhexidine with distilled water. In a second study, oil pulling reduced plaque and gingivitis markers after just seven days and continued after thirty days.
  2. Weight loss aid: because it contains medium chain triglycerides, it has been found to decrease waist circumference after four weeks in subjects, particularly men. It has also shown a slight increase in metabolism, however this has only been a temporary effect which is why I don’t generally recommend it for that purpose.
  3. Antimicrobial and anti-fungal properties: this makes it great for fighting common skin infections and issues like acne, athlete’s foot, candida, even cellulitis.
  4. Moisturizer: again, great for healing dry, irritated skin and related conditions like eczema or diaper rash. It can even be used as a sunscreen, blocking 20% of UV rays.
  5. Anti-inflammatory: studies have shown it may help reduce this symptom of oxidative stress.
  6. Easily digestible energy source that won’t raise blood sugar levels: medium chain triglycerides are the easiest for our bodies to metabolize and thus, are used by the body quickly.
  7. Carrier oil: as an essential oil lover myself, some of them are considered “hot” and are better if mixed with a carrier and will actually be absorbed better because it holds them to the skin longer rather than the essential oil evaporating quickly. The possibilities are endless if using coconut oil since it already acts as a natural moisturizer and anti-fungal. Add essential oils and all of their various health benefits, you can have anything from bug repellents to sleep creams to extra strength anti-fungal creams and more.

These are just to name a few. Coconut oil has a high smoke point, which makes it easier to cook with than other oils like olive oil. It adds a variety of flavor to foods that need a twist. As with anything, no need to go overboard, if you are wanting the health benefits of consuming it, two tablespoons a day is plenty but anything less is probably not enough. And go for organic, extra virgin. The other stuff is highly processed and health benefits are stripped.

As you may have noticed, I’ve included a ton of links to evidenced-based research in this post. I believe in providing sound advice, I really do. Some of the stuff I’ve talk about has been referred to as “quackery,” but that’s just silly. I understand research and have participated in a few studies myself. It IS possible to have a respect for both sides. So now that we’ve cleared all that up, let me know in the comments what your favorite way to use coconut oil is!

P.S. Interested in some weight loss hacks? The event is over, but the replay is still up on Facebook!

P.P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free support group here.

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Jillian McMullen, RDN, CSOWM, LDN

Is a very low calorie diet right for me?

Have you ever considered going on a very low calorie diet, aka VLCD, to lose weight? Maybe you don’t even know what it is – rest assured, you probably have heard of them just not by this term. Some of you remember (or at least heard about) when Oprah melted before her audience’s eyes in the 80s after following the Optifast plan. More recently, you or someone you know is probably following the HCG diet plan. Both of these are VCLD plans. So let’s review them.

There are several types in existence on the market today – some with fancy names like the ones mentioned, but they all have one thing in common – they involve consuming 800 calories per day or less. Their means to achieve this intake vary from consuming meal replacements to following strict meal plans and some include taking supplements, injections, and/or appetite suppressants. Their calorie ranges typically go from 500 to 800 per day. The goal is to create rapid weight loss in a short period of time. As you can imagine, these types of diets can be very effective.

I am very familiar with the concept as I personally worked with clients in group and individual settings following a VLCDs for seven years. Our chosen modality was Optifast meal replacements because it is a product that can only be purchased at a clinical facility and a diet like this really needs to be followed under medical supervision. On this program, dieters get a choice of high protein shakes, bars, and soups totaling 800 calories per day. Some required appetite suppressants, but that was determined on an individual basis.

I will mention the HCG diet here too because it is the most common VLCD that I hear about in recent days. Simply put, it’s a 500 calorie strict meal plan paired with injections of human chorionic gonadotropin (HCG), a natural hormone that the body produces during pregnancy. Yea, sounds weird to be used for a weight loss diet, huh? Well, according to the website, “HCG releases stored fat to ensure the growing fetus during pregnancy receives the nutrients it needs to grow and develop normally. When HCG is taken in non-pregnant women and men, the body still releases the stored fat. Because there is no fetus present, however, the body uses the stores for energy or eliminates the rest. This enables the body to release stored toxins and fat. Abnormal fat is lost, leaving normal or structural fat and muscle tissue. This means you lose weight in those stubborn areas–hips, thighs, buttocks and upper arms!” 

Unfortunately, this just isn’t true and there is zero scientific backing that it actually works. In fact, if you look at the fine print directly on the website, you will find this little gem of an FDA statement: 

“HCG has no known effects on fat mobilization, appetite or sense of hunger, or body fat distribution. HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie restricted diets.”

I don’t like to be the bearer of bad news, but I will tell the truth, even when it hurts. So why do people lose weight on this diet? Because it’s only 500 calories.

During my seven year tenure with the Optfast program, I had the privilege of being a part of some fantastic success stories. People losing 50-100 pounds or more in just twelve short weeks. It was amazing and a true honor to see such transformation in the lives of people who would start the program feeling totally defeated from a lifelong history of yo yo dieting and failed attempts at exercise programs, demoralized by what they saw in the mirror, the number they saw on the scale, and horrified by the clothes they had to wear. Some of them would come because it was their one last big try before considering anything permanent like weight loss surgery. And I would watch them literally melt away before my eyes and go out and do things they never thought they could do again – tandem skydiving, mule rides in the grand canyon, mountain hiking, cross their legs, and tie their shoes.

But after seven years, the program needed to be ended because more than 75% of the success stories became another yo yo story. Almost every single person regained all of their weight back and then often more. It wasn’t for a lack of guidance to a gradual transition back to real food. That was provided along with weekly support. But they had to choose to participate and most didn’t.

Why is this? Because while you are in the weight loss phase, it’s fun, exciting, and you feel on top of the world. The maintenance part is where the real work begins. On a VLCD there is no planning or thinking involved – “eat this/drink this, move on with life and watch the pounds melt off.” In maintenance, you have to deal with real food choices and decisions between fried and grilled chicken, an extra bite of birthday cake, running through the drive through on a busy day, pre-packing lunch for work, and the normal weight fluctuations that come along with it. Exercise is more important than ever, something that is restricted while on the plan. The American College of Sports Medicine recommends those maintaining significant weight loss exercise 45-60 minutes most days.

So in summary, do I recommend VLCD as viable method of weight loss? Yes and no. They are extremely effective when safely monitored by a trained health care professional for getting the weight off and doing it quickly. If someone requires this for a lifesaving surgical operation, say they need to lose weight to repair a life-threatening hernia, remove a cancerous tumor, or it is a precursor to weight loss surgery itself – then it is a fantastic option. Nevertheless, I’ve seen some people have massive success and maintain it off in the long term. But those are the exception and are the rare, dedicated types that follow all of the rules. They calorie count, rarely go off their meal plan, exercise the recommend 60 minutes daily, live an active lifestyle overall, and eat breakfast daily, drink plenty of water, and keep themselves accountable with the scale on a daily basis. They also see their health care providers regularly for outside accountability.

Lifelong weight management is just that – it’s lifelong. No matter how you get it off, it is something that will always have to be at the forefront of your mind. Unfortunately, VLCD plans are too much of a “on the diet, off the diet” approach to create those necessary habits for sustained success.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle and lose weight, you may be interested in joining my free support group here.

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Jillian McMullen, CSOWM, RDN, LDN

Atkins vs. Weight Watchers

Continuing my series on popular diet reviews this week. As requested, I’m taking a look at the Atkins diet and Weight Watchers.

Atkins: in the  most updated versions, there are two plans, Atkins 20® and Atkins 40®, meaning you are allowed to consume 20 grams net or 40 grams net carbohydrates per day, preferably coming from vegetables only. What’s a net carbohydrate? Total carbohydrates minus the fiber content in a food since fiber is nondigestable (fun fact = if you go to Canada, these carbs are already subtracted for you on food labels.) Most of us have tried or known someone who has tried this one, and succeeded. Pretty basic to follow, consume no carbohydrates exceeding the daily limit including fruits, breads, pasta, rice, potatoes, sugary snacks, cereal, candy, etc. Basis is you will force your body to go into ketosis, which means it will begin to burn stored fat for energy rather than it’s preferred source, dietary carbohydrate. This equals rapid weight loss.

Pros: you get quick results. It’s also fairly easy to follow, which is pretty attractive – no real planning, counting, or real thought process like many other diets out there. And, in spite of what you may have heard, if you go to their website, they actually do have a maintenance plan which does involve adding carbohydrates back into your diet. Unfortunately, I’ve never met anyone that has done this in a planned way, however.

Cons: while not particularly harmful long term, ketosis can be rough. Many people have a real difficult time with the lethargy, headaches, dizzy spells, and possible stomach upset (nausea, diarrhea, and/or constipation) that occurs when they first take out fiber and other important nutrients that only carb-containing foods can provide. This is why I don’t recommend any diet that advises less than 100 grams total carbohydrate per day – and that is still LOW. The majority of Americans consume upwards of 300+ grams daily. If you drop down to 100, I promise you’ll see results. And here is the biggest con of all with the Atkins diet: I have worked with hundreds of patients and clients in weight loss for the past eleven years. The Atkins diet is almost always on their list of tried (and result-producing) past diets. I have NEVER, not ONCE, met someone who has not regained it all back (and often more) once they stopped the diet. Never. In my book, the end results of this diet is an additional ten or more pounds. Don’t do it.

For more information on their program, visit www.atkins.com. Who knows, if you give their maintenance plan a chance, maybe it might work?

Weight Watchers: this one is probably equally as popular in past diet attempts that I’ve heard from well-meaning dieters. They’ve changed it up over the years, which I believe is an improvement. Rather than counting calories, you use a system they call SmartPoints®, which are based on calories, saturated fat, sugar and protein. You get a “budget” to work with throughout your day and if you want to maximize that, you will need to earn “FitPoints ®” by increasing your daily physical activity.

Pro: I’ve always been a fan of this program if someone really needs accountability and guidance. Overall, they encourage consuming healthy foods but allow some flexibility. If you consume a high point food, well, you will quickly see the “cost.” And I really like the weekly meeting concept and view it as the biggest benefit they offer, although not everyone utilizes it. If you aren’t into the group thing, you can get a personal coach instead. With today’s growing technology and fast-paced lifestyle, they have grown with the times and offer online support systems now, too, all at very reasonable costs.

Cons: when you reach your goal weight, you earn a free lifetime membership – this means no registration fees ever again and free access to all of their digital tools and weekly meetings. Really great way to help people maintain their success. However, here’s the rub: as a lifetime member, you must weigh-in at a weekly meeting once a month, every month. Fair enough. BUT, if you gain as much as three pounds, you get charged a weekly fee for the next month until you can bring it back down within a two pound range. So, if you gained some water weight, got constipated, went out to eat and ate a salty meal the night before, well, your wallet is going to pay for it. While I agree with the concept, I don’t agree with the two pound window – it’s not based on normal weight fluctuations. But hey, they are a business and if everyone is considered a success, they don’t make their money. (If you want to read why I feel this way, head over to my previous post here.)

For more information on their options, visit. www.weightwatchers.com

So there ya have it. Two more diets for you. If you are totally in love with either of these diets, I’m only offering my insight and opinions with some facts mixed in. If you would like to learn more about a specific diet, let me know in the comments section.

P.S. If you’d like more information on the diet that I do recommend and how I’ve helped others lose 30-80lbs following simple steps, contact me here.

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Jillian McMullen, CSOWM, RDN, LDN

 

Ketogenic and the Whole 30 Diets – Yay or Nay?

I’ve recently started a series on some of the more popular diets right now to hopefully take the guess work out of whether or not you should consider them. For this week, I’m gonna focus on the Ketogenic diet and the Whole 30 diet.

Ketogenic diet: a special high-fat, low-carbohydrate diet – usually three to four grams of fat per gram of carbohydrate and protein combined coming from heavy whipping cream, butter, mayonnaise, and oils. Why it is used: it helps to control seizures in some people with epilepsy and should be prescribed by a physician and carefully monitored by a dietitian. This is not just a low carb diet like the Atkins.  It is supposed to produce ketones in the body (hence the name), which are formed when the body uses fat for its source of energy. Normally our body uses carbohydrate as its primary energy source. In normal circumstances, the bare minimum I ever recommend is 100 to 130 grams of carbohydrate. This diet includes minimum carbs, often under ten grams per day, to force the body to use fat for energy.

Pros: in those with intractable seizures meaning, non responsive to medications, it can greatly reduce their frequency and severity of seizures. It can cause rapid weight loss, but a ketogenic diet in the true sense is going to do anything but. Also, prolonged ketosis is not a natural state that the human body functions well in (which I will explain below in the “cons” section.) Having said that, it can be life saving and changing for those merely surviving one seizure to the next.

Cons: since the body is designed to use carbohydrates for energy, expect to feel pretty sluggish. Our primary food sources of carbohydrate include fruits, vegetables, whole grains, and dairy. So you can expect constipation as well. If you aren’t constipated, you may have diarrhea due to the high fat content or, if you’re really lucky, alternating. Other issues related to a high fat diet include reflux, nausea, vomitting, and kidney stones. In addition, it’s not very nutritionally balanced and even mineral absorption issues can occur causing hair loss, weakened bones, muscle cramps, acute pancreatitis, impaired focus and memory (the brain needs sugar), high cholesterol, increased inflammation, depressed mood, and even menstrual irregularities. Sounds fun, right?

Whole 30 diet: this diet claims that food, primarily grains, sugar, alcohol, and legumes, are the root of all your health ailments. I see this one daily in the health circles I run in. Most people that follow this are doing so because they want to feel better. Nothing wrong with that. It’s temporary and the closest thing I can compare it to is an elimination diet I put people on who are allergic to multiple foods and they aren’t sure which one(s) are the culprit. The theory is after thirty-one days, you will know right away which food is the cause of your health problems because you feel terrible once you reintroduce it back into your diet. While I agree we could all go without sugar and alcohol and be better off for it, I have never met a person who has allergies, irritable bowel syndrome, or chronic knee pain because they eat mini wheats for breakfast and legumes at dinner time. Sorry, but I’ve been a dietitian for a while now and I’ve never seen nor read any validated research backing this up. Having said that, I’m all for a diet that advocates eating more fruits, vegetables, nuts, seeds, and advocates cooking more and eating less processed food.

Pros: it’s an overall very healthy diet that eliminates sugar and refined, processed food – all of which we eat too much of. It’s also high in fiber and protein, two things I’m a big fan of in any diet.

Cons: while I love the idea of getting people to cook more and eat more whole foods, zero eating out and zero convenience food options is going to make this difficult for many in our fast paced society. This diet is only for the motivated individual who can really dedicate themselves to focusing on their food for the month. I’m not really excited about the idea that it’s a temporary diet – going on a diet just means you plan to go off a diet. But hey, if you truly feel better, it could be the beginning of something great, right?

So there ya have it. Two more diets for you. If you are totally in love with either of these diets, I’m only offering my insight and opinions. None of this is meant to hurt feelings of any die hard fans. If you would like to learn more about a specific diet, let me know in the comments section.

Also, if you’d like more information on the diet that I do recommend and how I’ve helped others lose 30-80lbs following simple steps, contact me here.

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Jillian McMullen, CSOWM, RDN, LDN

Paleo? Vegan? Mediterr-wha? Which diet should I be following?

This has been a popular theme recently in my life so I thought I would give my take on the various diets all over the internet in the coming weeks. My hopes is the clarify some of the confusion and help you decide what is best for your situation. For this post, I’m going to start with the two that I feel are fairly popular and recommended frequently by health professionals.

  • Paleolithic – most commonly known as just, “Paleo” and also known as the “Caveman Diet.” Wildly popular and recommended by doctors, chiropractors, personal trainers, and others for those looking to get lean, gain energy, and lose weight. In summary, it eliminates grains, refined sugar, dairy, potatoes, salt, refined oils like canola oil, and wheat. It consists of nuts, seeds, eggs, olive oil, coconut oil, lean meats, fish, fresh fruits and vegetables. No processed food whatsoever if you are truly following the concept although there are lots of “paleo-friendly” packaged foods on the market that go against this idea. Everyone’s gotta maximize the marketing potential, right?

Pros: it can yield weight loss because it cuts out the calorically dense junk food and it promotes satiety because it tends to be high in fiber and good protein. It doesn’t require you to count calories if weight loss is the goal, which is a big pro for most.

Cons: you’re likely going to have to fill in nutrient gaps, specifically folate, the B vitamins, calcium, and vitamin D which are all found in dairy products and fortified grains. It’s very difficult for the average person to follow long term due to it’s elimination of convenience food and therefore, restaurant meals.

  • Plant based whole foods also known as Vegan. Numerous research has shown the health benefits of following this diet such as lower blood pressure, reduced blood lipids, reduced blood sugar levels, and weight loss to name a few. To truly follow this diet – as in “Forks Over Knives” style, you will need to eliminate all processed and highly refined foods such as added oils and sugars, meat, dairy, eggs, and seafood. It includes fruits and vegetables, whole grains such as wild rice, oats, barley, quinoa, whole grain pasta, millet, and sprouted grain breads, beans, nuts, legumes, seeds, avocados, dried fruits, potatoes, hummus, tempeh, and tofu.

Pros: Could possibly lead to weight loss due to the elimination of calorically dense, highly processed junk food. This diet is also rich in fiber, antioxidants and vitamins/minerals from their natural sources – fruits, vegetables, whole grains, and legumes. All which may lead to reduced risks of various types of cancers.

Cons: At first, some may find they are hungry because of the drop in protein intake from animal sources. Supplementation from vitamin B12 is required on this type of diet. There is a risk of iron deficiency because it is best absorbed by the body from animal sources rather than from plant sources. So a person on this diet should be mindful to consume a good source of vitamin C along with a high iron containing food to maximize absorption. Eating in restaurants can be a challenge.

As you can see, both have excellent qualities and downfalls, too. They both take massive amounts of commitment, but have big health payoffs. I recommend starting small, regardless of which one you choose. Overhauling your entire life overnight will never work, so start with removing refined, processed sugars and carbohydrates out of your life first. That’s good for everyone and clearly, it is important enough to be included in both diets I’ve discussed here. In fact, I will be surprised if they are allowed in any of the diets worth anything that I discuss in the coming weeks.

So, what does it mean to eliminate processed, refined carbohydrates? This means you are getting rid of what I call the “six C’s.” In other words – cereal, cake, candy, cookies, chips, and crackers. That about covers it. But for completes sake, foods that come in a box with an ingredient list and sugar content are also processed – granola bars, pretzels, baked goods (especially white versions), fruit snacks (including this for moms), chocolate(s), and of course, added sugar of any kind. If you are going to use it, try agave or honey. They are both going to be processed in the body just like white table sugar but they at least contain some added antioxidants – so still use sparingly.

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Jillian McMullen, CSOWM, RDN, LDN