Warning: This Post is Not Gluten-Free

You may have noticed a little trend these days: gluten-free foods. Lately, it seems like more and more food products are labelled "gluten-free". Do these labels look familiar?

Garbanzo beans don't naturally contain gluten.

This is a bag of coffee I recently purchased. Last time I checked, coffee beans don't contain gluten either. Granted, the gluten-free label may be on food products with additives that contain gluten or those that have been processed on equipment that may have been exposed to gluten. But I wonder if companies are placing these gluten-free labels on products in attempts to increase sales from consumers who believe gluten-free diets to be healthier? It sure seems like it.  

The truth is that while gluten-free diets have gained popularity in recent years, they are only medically necessary for those who have Celiac Disease or gluten sensitivity. But in other cases, simply restricting gluten in your diet is not likely to yield health benefits. 

A true "gluten-free" diet is very restrictive and omits things like wheat and other wheat products, barley, rye and triticale (a cross between wheat and rye). Wheat in particular is in so many food items that maintaining a strict gluten-free diet can be very challenging. Gluten is even found in some medications!

 I've read and heard claims that gluten-free diets can aid in weight loss but this just isn't true. Sure, someone who follows a gluten-free diet may lose weight, but it's likely because they're eating fewer calories from all the dietary restrictions than purely from avoiding gluten. 

So, that's the scoop on gluten-free diets. I'm not sure how much extra revenue food companies have earned from gluten-free adds, but it would be nice to see gluten-free labels geared towards supporting those who really need them rather than the latest fad diet.

Do You Have a Healthy Relationship with Food?

The relationship between the brain and the body is pretty interesting, especially when it comes to food. Have you ever found yourself wanting to eat something unhealthy and doing everything within your power to overcome temptation? I can certainly relate. For some reason, I thought it was a good idea to make cinnamon rolls last week. (Editors note: I'm 40 weeks pregnant and therefore cannot be held responsible for my decision making). So I made them, ate one, gave half of them away to friends and put the rest in the freezer. Thus far, it has taken every last shred of self-control not to break into my stash. Sound familiar?

So what's your solution to temptation? Pantry purge? Get rid of all "unhealthy" foods in the house? Give in and eat what you want or have a small bite, then walk away? Your reaction not only reveals what you would do, but also how you relate to food, which is just as important as what we ultimately put into our mouths.

Working in nutrition, I've seen a lot of disordered eating. These are not just clients with anorexia or bulimia, but oftentimes people I meet day to day. Between the media, unhealthy body images, the latest diet trend, social pressures and more, it can be very difficult to maintain a healthy perspective on what we eat. From what I've observed and studied, I've come to believe it's not just about telling people what to eat, but helping them think about food in a new, healthy way. In order to change how you think, it's important to know the difference between healthy and unhealthy thoughts and behaviors when it comes to food. 

Here's the Tiffany the Dietitian version of some of the "signs" of a healthy vs. unhealthy relationship with food. Ask yourself which way you feel most of the time.

This list could go on. What are some healthy vs. unhealthy perspectives you've observed?

  

"Bread is the Enemy" and Other Tall Tales

The more people I talk to about diet and nutrition, the more I'm convinced we have a serious case of bread-phobia in America. You've probably heard it too. How many people have you heard say they're "staying away from bread" in an effort to lose weight? Yeah.

At this point in the conversation, I usually explain the fact that weight is based on the principle of calories in, calories out, blah, blah, blah. This is never a popular answer. Why? Because it means that weight loss isn't easy; it means you have to eat less, move more, and develop new habits that form your lifestyle. It means you'll have to say no to seconds at dinner and eat sweets less often. It means you have to make a commitment to your health.....and stick with it.

It also means you'll have less risk of developing chronic disease, may live longer and have a higher quality of life, among many other things. I don't know about you, but that sounds worth it to me. Admittedly, changing lifelong habits is no easy task. And it seems that in an effort to avoid this, too many people simply resolve to avoid "bad" foods (common food-phobias include bread, bread products, meats, sugar, dairy, etc.) which can - and frequently do - result in nutrient deficiencies and other health problems.

Interestingly, amidst the bread and other food-related phobias, America has a record number of people with obesity, diabetes, high blood pressure and hyperlipidemia, all of which are lifestyle-related diseases. It seems as though avoiding bread just isn't working.

Articles on the internet like this one don't help much either. Here, a journalist postulates his theory that America is in an obesity epidemic due to grain products and sugar. His article, of course, completely ignores well-accepted and tested research that people are eating more than ever before. A lot more. According to the USDA, daily calorie consumption in America in 1970 totaled 2,170 calories whereas in the year 2000, daily calorie intake increased to 2,700. That's a 530 calorie/day increase, which leads to gradual weight gain overtime. Wait a minute, that's exactly what we've seen! In 1980, about 46% of US adults were overweight whereas 67% of adults were overweight in 2000. Now, about 1/3 of the US population is obese, according to the CDC. There is no doubt the trend toward overweight and obesity in the US continues to rise. The question is why. 

As I mentioned before, many people want to blame specific food groups: meat, sugar, bread, dairy, gluten, etc. I've heard them all. I admit, we do tend to eat a lot of breads and sweets. But labeling one or multiple foods as "bad" only perpetuates the problem of disordered eating and disordered thinking. Food is not the enemy; it's how we use it.

Some the major reasons we have weight-related problems in the US are related to the increased availability of food, more eating out, less cooking at home, sedentary lifestyles, and more disposable income. In summary, for various reasons, we eat more today than we did 50 years ago. 

The even more complicated question is how to resolve this problem. The answer involves understanding not only biochemistry, but psychology as well. Working with a healthcare provider - such as a registered dietitian - who provides not only education but continued support and accountability is what I've observed to be the most effective strategy for achieving and maintaining a healthy weight. I not only believe this, I've seen it work. Every. Time.

So next time someone tries to tell you that bread is the enemy, thank them for the advice and tell them that you're into eating a healthy, well-balanced diet. It'll rock their socks off.

Should You Go Paleo?

I'm a big fan of exercise. There's nothing quite like the feeling of a good workout. During a normal week, I try to do 4-5 days of cardio and 3 days of weight lifting. Recently, I wanted to give cross-fit a try since the program incorporates both cardio and resistance training. 

After a session, I decided I really liked the workout. I was a little surprised however when I saw the diet the cross-fit gym advocated: The Paleo Diet. Posted on the walls were things like "you're probably allergic to grain" and "avoid dairy". Also written in bold letters were foods that "you should eat". These included primarily meat, poultry, fish, fruits and vegetables.

Image from: http://www.marksdailyapple.com/how-to-succeed-with-the-primal-blueprint/#axzz1wz8D8wju

To me, the Paleo Diet sounds a lot like a revised version of the Atkin's diet (and we all know how that tune goes); emphasis on protein, fruits, vegetables and a view that carbs are the enemy. As I understand on the Paleo Diet, complex carbs like pasta and rice are allowed in moderation for athletes, especially during recovery. But in general, it is a high-protein, high-fat, low-carb diet that promises weight loss and the potential resolution of health problems like heart disease and diabetes.

Apart from the tendency to disordered eating I've witnessed many people experience when trying to eat "low-carb", here's the big problem with the Paleo Diet: it identifies the right problem (obesity in America) with the wrong solution (low-carb dieting). Carbohydrates are the primary source of fuel for our bodies, especially during periods of intense activity (like....say, a cross-fit workout). That said, there is no question America is in the midst of an obesity epidemic. The solution to the problem is simple in theory: eating healthy foods in smaller portions and moving more. The application of this solution is the challenge and involves much more than simple calories in, calories out dogma. Truly becoming healthy involves a commitment from both your mind and your body, and that is no easy task.

Still, it's important for those seeking weight loss or general health to remember that the latest fad diet is usually not the solution to lasting change. A few other problems with the Paleo Diet are the nutrient deficiencies that can occur overtime when restricting dairy and grain products (for example, Calcium, Vitamin D, B Vitamins, fiber and more). For those with health problems like diabetes, the Paleo Diet can increase risk of blood sugar abnormalities due to the lack of carbohydrates. 

So, did I become a cross-fitter? No, but not because I was offended by the diet. I actually really enjoyed the workout, but the price tag just doesn't fit the budget right now. Instead, I do similar workouts at home and stick to a truly well-balanced, healthy diet. 

It looks a little something like this.

What are your thoughts on the Paleo Diet? Have you tried it?

Coconut Oil: Miracle Food or Food Fad?

One thing's for sure in the food world: coconut oil is in. Maybe coconut oil is the new kale? Or kale is the new coconut oil? I don't know. 

Seems like coconut oil has generated a lot of hype lately, but are the health claims based on science or is it just another food fad? 

Question:

Recently, a reader sent me the question: "Could you do a post about coconut oil? I've heard conflicting opinions about whether it is a healthier alternative or not... What have you seen about it?" -- Lauren

Answer:
 

This is a great question, in large part because it's so relevant right now. I can't even count the number of health claims I've seen and heard associated with coconut oil; from things like malnutrition and liver disease to baldness and stomach pain. Quite a spectrum, huh?

 These types of claims can be found from a simple google search as well as "health/nutrition" books, but are they true? Meaning, is there ample scientific evidence to support these claims? 

According to current reputable health sources, no. Many of the health claims are simply not well-substantiated by research. Here's what we know to be true about coconut oil: it has no cholesterol but is high in saturated fat, which should be limited in our diets. Instead of cooking with coconut oil (or eating it by the spoonful, which I no joke have witnessed), I recommend using heart-healthy oils low in saturated fat like canola oil, olive oil, safflower oil, sunflower oil, etc. 

Here are some helpful, credible references on coconut oil that summarize the consensus of current research:

American Heart Association: Know Your Fats

American Diabetes Association: Is Coconut Oil Good to use?

Academy of Nutrition and Dietetics: Healthier Options for Cooking Oils

Whenever you're wondering about the latest miracle food or supplement, I encourage you to look towards these types of reputable organizations for information in addition to your doctor or registered dietitian (RD). 

Thanks for your great question, Lauren!

Registered Dietitian Day

It's March 14th, or "Registered Dietitian Day" as initiated by the Academy of Nutrition and Dietetics just five years ago. The purpose is "to increase awareness of Registered Dietitians as indispensable providers of food and nutrition services and to recognize RDs for their commitment to helping people enjoy healthy lives". I couldn't have said it better myself, so I didn't.

I'm honored to be a Registered Dietitian and embrace the commitment to provide science-based nutritional care to individuals. Registered Dietitians are often mistaken for "nutritionists", but are actually quite different.

 Even my well-educated dentist wasn't too clear on the topic. Last month (as he's peering deep into my mouth), Dr.Dentist asks me what I do. Side note: don't you love when dentists strike up a conversation when they have their hands and three other utensils in your mouth? End side note. So I told him I was a dietitian.

He says "oh, so you're a nutritionist?". To which I answer "No, not exactly. Dietitians have degrees in nutrition, have completed an internship and an examination, abide by a code of ethics and can only promote science-based nutrition guidelines. If we don't do these things, our credentials can be revoked". He took a moment to take it all in. "So, it's kind of like being a doctor", he said. Then I said "like doctors and nurses, we can only promote guidelines that are science based and we have an accrediting organization that makes sure we do that. On the other hand, anyone can call themselves a "nutritionist". 

Dr. Dentist was totally amazed. Apparently this was the first time he had ever heard that a dietitian was different than a nutritionist.

Practically speaking, the danger of using a "nutritionist" is that many promote nutritional misinformation, which is not only confusing but frustrating. This unfortunately is far too common and that is why we have Registered Dietitian Day to get the word out that dietitians - not nutritionists - are the nutrition experts.

And this is me. Smiling at you wishing you a happy, healthy Registered Dietitian Day!

Q & A with the Dietitian

It's question & answer time!

Do you have a nutrition question you want answered? Wondering whether a certain food is actually healthy? Need tips on making affordable healthy meals? Hitting a weight loss plateau and need advice? Or maybe you want to know more about getting your kids to eat nutritious foods? You ask it, I'll answer it. Send me your questions at tiffanythedietitian@gmail.com.

First question.....

QUESTION:

Hi Tiffany! Do you know what the final word is on a high dairy diet and weight loss? I know it's bounced around from dairy bad to dairy good. I was just curious because my weight loss has really slowed down even though I haven't changed my exercising and I've continued to slightly decrease my calories the smaller I get. (it's 1450 right now) so I'm looking a tweaking something, anything to help with my last 30 pounds. Thanks!!

--Andree

ANSWER: 

Hi Andree!

According to Registered Dietitians, as long as you don't have a dairy allergy, dairy products have always been considered healthy to include in your diet. Why? It offers calcium, vitamin D, protein, and carbohydrates to help keep you strong and energized. 

The dairy industry advertise that milk products can help you lose weight. This is only true as long as your total calorie intake is below your calorie needs. So, the weight loss comes from a calorie deficit rather than simply consuming dairy products. Aim to consume 3 servings of low fat dairy products per day as part of a healthy diet.

Now on to weight loss. Although it was not stated in her question, I'll give a little background : Andree is very active and exercises intensely at least 5 days per week, which in turn increases her calorie needs. After a few calculations based on height, weight and activity level, Andree should be eating at least 1600-1800 calories per day for weight loss. As odd as it may sound, it's important to eat enough calories when trying to lose weight to prevent your metabolism from slowing down. When we under-eat, a message is sent to our brains to slow our metabolisms to prevent starvation. To avoid this, it's important to eat adequately and only slightly less than your normal calorie intake.

The best way to determine your metabolic (i.e. calorie) needs is to consult a dietitian. A less precise, but still effective way is to figure out how many calories your body burns to maintain your current weight. Do this by recording what you eat for 2-3 days and adding your total calorie intake per day. Then, reduce that number by 250-500 calories per day and healthy, gradual weight loss will result.

The Scoop On Detoxing

During high school and college, I worked as a waitress at a restaurant called Cilantro. This wasn't just any restaurant. It was a vegan, organic, "raw food" restaurant, serving meals made from only raw ingredients such as fruits, vegetables, nuts and oils. The clientele were mainly "raw foodists" - people whose diets were either 100% or mostly raw foods. I'll be honest, I tried it. That lasted....oh....about an hour. Now, after many years of education and experience in nutrition, I know better.

Eat a plant-based diet to improve your health

Raw-foodists believe that consuming a diet of mostly raw foods - and the enzymes they contain - is the key to preventing poor heath. Let me say for the record that of course I am in favor of consuming a variety of raw fruits and vegetables. Totally healthy. But eating an entirely raw food diet can leave you deficient in certain essential nutrients. Like most fad diets, scientifically this one holds no ground.

Raw foodism goes hand in hand with naturopathic medicine. So, it's no surprise that many patrons at Cilantro also took part in various cleanses and detoxes, which are important components to naturopathic treatment. Certainly, detoxes and cleanses are nothing new to us. Even if you're not a raw foodist, you've probably heard of them or even tried one. I was always fascinated by the types of detoxes people were on -- there was the lemon juice, water, cayenne pepper and maple syrup cleanse. There was the juice cleanse....oh, and the coconut water cleanse. The list goes on. Detox diets can last up to several weeks, many claiming to rid the body of toxins and help drop unwanted pounds.

The reality is that detox diets and cleanses are more of a marketing scam than anything else. Most are not tested for safety or effectiveness and may pose serious health risks for people taking medications, who are pregnant, nursing, older adults or growing children. Thankfully, our well-designed bodies do a fabulous job of eliminating toxins from our system - no lemon juice or cayenne pepper required!

So, yeah. I don't recommend anyone do a cleanse. Instead, to promote a healthy body, focus on eating a mostly plant-based diet rich in fruits, vegetables, whole grains and healthy fats. Exercise regularly and achieve a healthy weight, if you are overweight. That's the best, and most well-tested, advice around. I know, it's not quite as exciting as a 5 day detox promising to make you drop 20lbs. But thankfully, healthy eating and exercise are safe and work every time!

You can read more about my take on holistic cleanses and detox diets here.