The long view of lifestyle change: Part 2
This 2-part series discusses what is involved with “lifestyle change”, which many of us have been advised by our doctors or other health care providers to do. In Part 1, we first reviewed the overall contributors to health and disease: genes, environmental (including social and economic) factors, epigenetic factors (if or when certain genes are turned off or on) and, of course, lifestyle. We then focused specifically on two aspects of lifestyle: stress management and physical exercise. Part 2 focuses on another important aspect of lifestyle change necessary for attaining better health: nutrition.
What is the “best” nutrition?
Most of us understand and appreciate the old adage: “you are what you eat”. This has been confirmed by modern research, which tells us that “[o]ne of every five deaths across the globe is attributable to suboptimal diet, more than any other risk factor including tobacco”[i]. We are also seeing growing importance of a trend in health care called “food as medicine”[ii].
But what should we be eating?
Turns out this question is not so easily answered. Should we all be vegan? Vegetarian? Should our daily nutrition be paleo? Keto? Low-fat? Low-calorie? Plant-based? Mediterranean? Should we all avoid gluten? Dairy? Nightshades? Should we be fasting regularly? Should we focus on eating mainly “superfoods”? There are passionate advocates out there for each of these.
What on earth should we make of this? Why is it all so darn confusing?
There are some good reasons for the confusion[iii]:
1) Nutrition science is a relatively young field, having begun only in the middle of the nineteenth century. This means that as a scientific field it has been around less than 200 years (compare this to chemistry, which has been studied for about 2,000 years).
2) Most health research investigates disease and disease processes, not prevention (which is where nutrition becomes most important).
3) A lot of nutrition research is funded by entities that have a vested commercial interest in the outcome. For example, for many years the sugary-drink industry consistently funded research that investigated every cause of obesity except sugar consumption.
4) Studying the impact of nutrition on health is notoriously difficult since there are so many factors affecting health besides nutrition. Even participating in a nutrition study can affect eating habits. When you start writing down everything you eat, does this change what you eat? (Answer: yes!).
5) There are methodology problems. Most nutrition studies involve questionnaires that ask you about your eating habits. Do you remember everything you ate last week? (Probably not).
6) There are enormous differences between groups and also among individuals: men, women, young, old, physically fit (or not), etc..
7) There is heavy emphasis in the press placed on the results of single studies, this also makes for good “breaking news”. But it’s actually repeat studies showing similar results that reveal a lot more. Unfortunately, these don’t often make the news.
Are there any points of agreement?
Despite the difficulties and confusion associated with following or interpreting nutrition advice in the seemingly endless quest to find out what we should be eating, there are actually some basic points of agreement:
1) We can all learn more about nutrition, keeping an open mind about new research findings while understanding that nutrition research is an emerging science.
2) Many of us can benefit from eating more whole, minimally-processed foods (while eating less packaged, processed “junk” foods)
3) Many of us can learn more about managing portion control: how to eat primarily when we are hungry (rather than when we are anxious or simply because the food is there).
4) Many of us can benefit from eating proportionally more fresh produce (vegetables and fruits), and proportionally less meat and other animal products.
While there is clearly a lot more to good nutrition than these few simple guidelines, they are not so simple to implement. This is because for many of us, they involve changing our habits. And the longer a habit has been established, the harder it is to change.
There are other factors that make some of these changes difficult.
For example, processed and packaged foods contain certain basic ingredients that are quasi-addictive and therefore generate greater sales: sugar, salt and fat[iv]. Restaurants (even “higher-end” ones), incorporate these ingredients liberally into their dishes for the same reason. Packaged, processed and restaurant take-out foods are already prepared, so they have the additional appeal of convenience. Reducing or eliminating these types of foods can therefore be challenging.
Portion control can also be difficult. Some people engage in what’s called “emotional eating”: they eat to help relieve stress, anxiety or depression. Others are “grazers”, eating small (or not so small) amounts all day long. Both of these eating patterns typically contribute to weight gain and, eventually, obesity, and can be challenging to change for obvious reasons.
Finally, eating more fresh produce can be difficult for people who say they don’t like vegetables or don’t have the time or skills to prepare them. There is no question that preparing vegetables can require more creativity and time than slapping a piece of meat in the frying pan or on the grill.
The long view on nutrition
Much the same as managing stress and getting more physical exercise (discussed in Part 1), changing what we eat requires a long view: it takes time and patience.
For nutrition, the long view involves an additional shift: avoidance of the diet mentality. This one is challenging, since we are continually bombarded with information on “diet secrets”, “the best diet”, “quick diets”, “quick weight loss”, etc..
Diets are inherently temporary. Most people use diets to lose weight in order to be healthier, and then hope that after they return to what they were doing before, the weight will stay off. For those who are lucky, this might happen. But for many, it does not. This is why diets are not the key either to keeping the weight off or attaining long-term health. Some diets are also extreme and can even be dangerous.
The only reasonable perspective on nutrition as part of lifestyle change, therefore, is one that involves making sustainable changes in stages that eventually become permanent and part of a “new normal”.
Some people can do this on their own, others need the help of a prepared program along with a coach.
If you are interested in the individualized nutrition program I am certified to coach that aims for permanent change, call me for a free 15-minute consultation or book one through the online scheduler and learn more about Metabolic Balance®.
[i] “Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899507/
[ii] Downer, S, S Berkowitz, T Harlan, D Olstad, D Mozaffarian (2020) “Food is medicine: actions to integrate food and nutrition into healthcare” BMJ 2020;369:m2482 https://www.bmj.com/content/bmj/369/bmj.m2482.full.pdf
[iii] Berardi, J (retrieved June 6, 2022): https://www.precisionnutrition.com/nutrition-science-is-so-confusing
[iv] Rao, P, R Rodriguez, S Shoemaker (2018) “Addressing the sugar, salt, and fat issue the science of food way” Science of Food 2(12) https://www.nature.com/articles/s41538-018-0020-x.pdf