Understanding DietsHow to find the best one for you

Amanda B Figge, MS, RD, LDNDietetics & Nutrition

www.SpringfieldClinic.com/DoctorIsIn

Overview

• Different types of diets

– Pros and cons

– Nutritional concerns

• Example food plans of each diet

• Things to consider when choosing a diet plan

Overview

Diet

• Old French diete & Medieval latin dieta

– “daily food allowance”

• Latin diaeta & Greek diaita

– “a way of life, a regimen”

• Does NOT mean

– “what fabulous way am I going to starve myself this week”

Diet

Source: bostonmagazine.com, rubyjax.com

Weight Watchers

Weight Watchers

• Focus:

– Losing weight through diet, exercise and friends!

– Support network & regular monitoring

• POINTS!

– (Calories + (Fat x 4) - (Fiber x 10)) / 50

– High fiber, low-fat foods typically have the lowest points

– New Simple Start program

Weight Watchers

Pros

• Group therapy• Accountability• “No food is off-limits”

approach• Simple & easy method to

eating healthy • Can be low-cost • Online tools/apps

Cons

• Counting points becomes mundane

• “Saving up points” • Promotes foods with a lot of

added chemicals • For some people, it doesn’t

work!

Nutrients of Concern

• Typically there are no nutrients of concern with Weight Watchers as it allows for all foods to be a part of its program.

– Very low/zero fat intake could have negative consequences

Source: http://health.usnews.com/best-diet

Mediterranean Diet

Source: www.Oldwayspt.org

Mediterranean Diet

• Focus on:

– Fruits, vegetables, whole grains, fish, chicken, eggs, beans, nuts, olive oil and small amounts of dairy

– Plant food-based meal plan with minimal consumption of processed foods and red meats

– Increased use of herbs/spices, NOT condiments to flavor foods

Mediterranean Diet

• Focus on:

– Low in saturated fat• Olive oil as main source of fat

– Emphasis on family meals & physical activity

Mediterranean Diet

Pros

• Cited as one of the “healthiest diets in the world”

• Limits processed foods• Easy to follow

Cons

• Increased cooking time• Possible increased expenses• No minimum or maximum

intake levels established

Rossi, et al. (2013) Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). Diagbetologia, 56 (11), 2405-13.

DASH

• Dietary Approaches to Stop Hypertension

• Supported by:

– National Heart, Lung and Blood Institute

– American Heart Association

– USDA: 2010 Dietary Guidelines for Americans

– The Mayo Clinic

DASH• Focus on:

– Low Salt!

– Rich in fruits and vegetables, whole grains, low-fat/fat-free dairy, beans, nuts, seeds, fish, poultry, lean meats

– Limits sodium, sugar and red meats

– High in fiber, low in saturated & trans fat content

– Rich in potassium, calcium, magnesium

DASH

• Generally recommended for:

– Those with high blood pressure

– People who have diabetes or chronic kidney disease

– African Americans

– Individuals age 51 and older

Source: www.health.gov/dietaryguidelines/dga2005/ document/html/chapter4.htm

DASH

Pros

• Well-researched• Specific daily level of calories

and minerals meal plans• Can lower blood pressure• Easy to follow

Cons

• Possibly too high in carbs• Some find it difficult to meet fruit

and vegetable intake requirements = (10 servings/day)

Vegetarian Diets

• Focus on:

– Fruits, vegetables, grains, nuts/seeds, beans

– Typically, a diet that avoids animal products and hidden sources of animals (chicken stock, gelatin, lard)

– Vegetarian, flexitarian, vegan

– Pursued for different reasons

Vegetarian Diets

Source: kpao.org

Vegetarian Diets

Vegetarian Diets

• Widely supported

– Reduce risk of heart disease, some cancers, diabetes, obesity, hypertension, diverticular disease

– Typically low in fat and high in fiber

• Need to be smart!

– Protein, calcium, vitamin D, iron, vitamin B12

http://www.vrg.org/nutshell/VRGPublicCommentsDGAC.pdf

Vegetarian Diets

Pros

• Much easier to follow in today’s world

• Affordable• Can help lower risk factors for

heart disease

Cons

• May be deficient in many nutrients

• Does not promise weight loss

Nutrients of concern• Calcium

– Milk substitute (almond, soy, coconut), cheese, yogurt, fortified orange juice, green leafy veggies, almonds/almond butter

• Iron– Dark leafy greens (spinach, swiss chard), oatmeal, rice, soy

products/legumes, almonds, pistachios, dried figs, raisins, enriched cereals (GrapeNuts, Total), molasses- Need increased Vitamin C

Nutrients of concern

• Vitamin B12

– Naturally (milk, cheese, yogurt, eggs), fortified in rice/soy/nut beverages, ready-to-eat cereals, nutritional yeast

• Protein– Lentils, beans, legumes, soy foods (tempeh, tofu, soymilk),

grains (kamut, wheat berries, quinoa), nuts and seeds, meat analogs

Nutrients of concern

• Vitamin D

– Fortified in milk, orange juice, ready-to-eat cereal, eggs, skin exposure to sunlight, some mushrooms

• Zinc

– Whole grain products, wheat germ, fortified cereals, nuts, beans

Paleo

• Aka “caveman” diet

Source: fitbomb.com, makethechanges.com

Paleo

Okay to eat Foods to avoid

Fruit Dairy

Vegetables Grains

Lean Meats Processed Foods & Sugars

Seafood Legumes

Nuts & Seeds Starches

Healthy Fats Alcohol

Modern Vegetable Oils

Paleo

• Focus on:

– Limiting processed foods

– Avoiding grains (even gluten-free ones) and dairy

– Not “low-carb” rather “smart-carb”

– A better balance of omega 6: omega 3 fats

– Grass-fed, organic meats preferred

– Many abide by 80/20 rule

PaleoPros

• Wide variety of paleo lifestyles

• Research is still in its infancy, but studies do support individuals may have a metabolic advantage when following paleo

• Improved omega 6: omega 3

Cons

• Wide variety of paleo lifestyles

• Can be more costly & time-consuming with meal-prep

• May be more difficult to follow when dining out

• Adjustment periods vary

http://somethingtochew.com/2014/01/16/how-carb-smart-are-you/

Paleo

• Not just for humans!

Nutrients of Concern (?)

• Calcium

– Almond milk, Greek yogurt (if permitted), dark leafy greens

• Vitamin D

– Milk substitutes, salmon/fatty fish, some mushrooms, egg yolks, sun exposure

Nutrients of Concern (?)• B vitamins (thiamin, riboflavin, niacin, folate)

– Thiamin: pork, nuts, fish– Riboflavin: nuts, dark leafy greens, mushrooms, eggs,

asparagus– Niacin: poultry, fish, pork, seeds – Folate: dark leafy greens, asparagus, avocado

• Fiber & Potassium:– Diet is typically meets recommendations

Wheat-Free/Gluten-Free

• Focus on:

– Gluten-free grains: oats, quinoa, rice, corn, potato

– Promotes intake of fruits, vegetables, dairy, meats and healthy fats

Nutrients of Concern

• B vitamins (thiamin, riboflavin, niacin, folate)

– Thiamin: pork, nuts, fish

– Riboflavin: nuts, dark leafy greens, mushrooms, eggs, asparagus

– Niacin: poultry, fish, pork, seeds

– Folate: dark leafy greens, asparagus, avocado

Wheat-Free/Gluten-Free

Pros

• (?) improved digestive system

• Can decrease processed food intake

• Simple to follow• Cost-effective

Cons

• May not guarantee weight loss

• Still allows processed foods

Anti-inflammatory Diet• Focus on:

– Eliminating foods that can potentially cause inflammation in the diet while increasing intake of foods with anti-inflammatory effects

– No single addition or subtraction of one food item will improve overall health; calls for a need for a total diet approach

– Avoid red meats (?), fried foods, milk and cheeses, white breads, flours, gluten, sugar, chemicals

Anti-inflammatory Diet

Source: www.drweil.com www.rawforbeauty.com

Anti-inflammatory Diet

Pros

• Most will feel some improvements in quality of life

• Increased fresh food intake

Cons

• Does not promise weight loss• May be more costly• No consensus on actual diet

Sample Meals

• Which menu looks like it would fit your lifestyle the best?

Weight WatchersBreakfast Lunch Dinner Snack

¼ cup egg substitute 2 oz sliced turkey 4 oz baked chicken 1 cup fat free milk

1 sl whole wheat bread 1 sc fat-free cheese

2/3 c. cooked whole wheat pasta

3 low-fat graham crackers

6 oz light yogurt 2 whole wheat bread

1 oz roll

1 orange 1 tsp fat free mayo Lettuce, Mushrooms, zucchini, peppers

1 tsp spray margarine 1 pkg baked chips 2 tbsp fat free dressing

1 pear 1 tsp spray margarine

Mediterranean Diet

Breakfast Lunch Dinner Snack

3 small whole wheat pancakes

Chickpea salad (garbanzo beans, peppers, olives, onions) + olive oil, spices

4 oz salmon Carrots, bell pepper slices

2 Tbsp light maple syrup

Large lettuce leaf 1 cup brown rice hummus

1 cup strawberries Whole wheat pita Spinach salad

1 cup fat free milk 1 cup cantaloupe

1 glass red wine

DASH

Breakfast Lunch Dinner Snack

Oatmeal Chicken waldorf salad

Roasted chicken breast

Kiwi

Applesauce Whole wheat roll Baked potato String cheese

Whole grain English muffin

Baby carrots Asparagus

Strawberry preserves

Cantaloupe Tomato & spinach salad

Light yogurt Fat free milk Balsamic vinaigrette dressing

Fat free milk

Vegan

Breakfast Lunch Dinner Snack

Oatmeal 1 cup veggie chili 2 cups vegetarian stir-fry (tofu, veggies)

1 cup dried figs

1 sl whole grain toast 1 whole grain roll 1 cup brown rice ¼ cup mixed nuts

2 Tbsp almond butter

1 tsp margarine 1 cup cantaloupe ½ cup orange juice

1 cup soy milk Carrot sticks

1 banana 1 apple

1 cup soy milk

Paleo

Breakfast Lunch Dinner Snack

2 egg veggie omelet (peppers, onions, mushrooms, tomato)

4 oz chicken 4 oz tilapia ½ cup pistachios

½ cup sweet potato 1 cup spinach salad w/ artichokes, red onion, red peppers, mushrooms

1 cup cooked butternut squash

1 small apple1 cup almond milk

½ avocado Olive oil + squeeze fresh lemon1 cup almond milk

Sautéed zucchini, yellow squash, onions, mushrooms

Wheat-Free/Gluten-Free

Breakfast Lunch Dinner Snack

Scrambled eggs + shredded cheese

Black bean taco (corn tortilla), peppers, onions, cheese, fruit salsa

4 oz chicken Yogurt + ½ cup strawberries

Rice cake Water 1 cup brown rice

1 Tbsp peanut butter Sautéed veggies

6 oz orange juice

Anti-inflammatory DietBreakfast Lunch Dinner Snack

Option 1 Oatmeal + walnuts

Turkey sandwich

4 oz salmon Dark chocolate pieces

Blueberries + raisins

Whole wheat bread

Spinach salad 1 cup skim milk

Green tea 1 cup fresh fruit 1 cup brown rice

1 glass red wine

Option 2

Spinach omelet 4 oz salmon 4 oz chicken Handful walnuts

½ Avocado Sliced pineapple Spinach salad Dried cherries

½ cup pico de gallo

1 cup steamed broccoli

1 cup cooked spaghetti squash + sautéed veggies

Considerations

• Obesity

– Limit calories and/or improve metabolism

• Hypertension

– Limit sodium intake

• Diabetes

– Limit carbohydrate intake

Considerations• CKD (stage III, IV)

– Limit potassium, sodium, phosphorus and (?) protein intake

• PCOS

– Limit carbohydrate intake

• Menopause

– Traditionally-low fat; Updated: lower carbohydrate

Considerations

• IBS

– Limit FODMAPs (wheat, dairy, beans, some fruits/veggies)

• High cholesterol

– Traditional: low-fat. Updated: low-carb + increased veggie and fruit intake

Considerations

• Food preferences

• Finances

• Current health status

• Special dietary considerations

• Beliefs/principles of different diet lifestyles

• What makes you feel the best?

Thank you!

• Questions?