Friday, October 9, 2015

Frankenstein's Monster

So, a conversation with my wife got me thinking about diets, diet fads, and "lifestyle changes", which are basically new diets co-billed with a self-help psychology course.

So, I figured I'd let loose the hounds of snark and give my 10c on this issue.

Up front, I will state that, while I am a medical student, I by no means know everything - I am only a 1st year and a nutritional skeptic to boot. I have my biases, information, and lack of information. I am a staunch believer of the idea that "A little learning is a dangerous thing" and I encourage you, the reader to do your own research - including on journal databases like PubMed - as my own deficits colour my understandings and interpretations.

For ease of reading, I have broken this post into my four Ps of diets today: Psychology and Promises, Pronunciation and Science, Perception, and Personal thoughts.

Psychology and Promises
Well, for starters, if a diet never promised anything, no one would follow it. One of the big issues today, though, is that most, if not all, new diet prescriptions promise everything from weight loss to balanced hormones. Heck, I'm pretty sure that there might even be one promising to balance your chequebook.

The main thing is many of these diets promise changes beyond simple weight loss and, in our society of wholeness and jaded sarcasm, we've grown tired of recurrent fads, the ways diets make us feel, and high levels of prescription. Instead, we want something that will make us feel good and successful, that's easy to follow and understand, and that will impact our lives beyond our immediate weight/dietary health, because, frankly, we overwork ourselves to the point where we cannot afford ourselves the balance we need. (Case in point: I'm a medical student who has little time and no means to exercise)

What I find interesting is that many of these new lifestyle changes incorporate a psychological and social aspect to them, trying to go beyond the science of nutrition, which has improved over the years, and investigate the psychology of eating, habits, and addictions, often times adding in a social component through social media or support groups. The face of dieting has changed and it's a good thing, but I'm afraid that the science of nutrition is becoming more and more obscured by confounding factors.

Pronunciation and Science
A key grief I have with society today is its fear of science. I've written about it before and my views still stand. One of the big selling points of diets today is focusing on whole, raw, unprocessed foods and avoiding "Frankenfoods" at all costs. What is a frankenfood? anything pre-made that includes difficult-to-pronounce ingredients. I've seen many times the mantra, "If you can't pronounce it, don't eat it.

Frankenfood? Really?

How many of you are familiar with eicosapentaenoic acid? (Now, there's a party trick - try spelling that one)

Now, how many of you are familiar with omega-3 fatty acids?

What if I told you that eicosapentaenoic acid is an omega-3 fatty acid and that it's actually one of the omega-3 fatty acids we're recommended to eat? (Omega-3 is just a generic term for any fatty acid that has a C=C double bond on the third-last carbon)

You see, not every big word is bad - though they usually abbreviate the ones they want you to take. Take the subway bread/yoga mat debacle from the food babe. Yes, the component in question is an agent used in stabilising foams and is used in baking and manufacture of yoga mats. Well, firstly, bread is a foam by definition and, secondly, how many thought to check the FDA's safety standards? After all, the FDA is required to keep track of toxicity of ingredients and what is allowed to be an ingredient. If you really want to get up in arms about something, take acetaminophen - more than 4 mg in 24 hours will send you into acute liver failure and death. Heck, even water is toxic under the right circumstances; it just takes a whole crapton in a short amount of time.

Now, that being said, some modern additives are less beneficial for you like high fructose corn syrup. Virtually every other carbohydrate we eat is processed by the liver into glycogen storage during a fed state, but fructose actually cannot participate in glycogenesis in the liver. Instead, it is converted directly into fat.

You know what's even cooler, though? Carbohydrate stores actually help burn fat during sustained aerobic exercise. So, we can't just up and vilify carbohydrates - they form the majority of our energy intake, which we need for our body to actually function.

So, what makes a diet or "lifestyle change" stick?

Something I've noticed is that many of the more popular diets are the ones that grant you, as the dieter, more control. The modern trend of no processed foods and only whole, "real" foods has a huge element of control in it - you control what is in your food, not the food companies.

And, while we're mentioning food companies, let me also mention that there is an increased amount of skepticism towards big businesses. You see it in the rhetoric of any "anti-" crowd. You have your big business leeriness of the small business fundis. You have the big government conspiricists. You have your anti-Monsanto, anti-GMOers. In nutrition today, there seems to be an almost unhealthy distrust and disdain towards food business, with individuals talking about how food scientists are engineering our food to be more addictive and craveable so we buy more of it.

There's that science word again. No one ever blames X-businessmen. It's always the scientists that get the bad rep. (If only we scientists were more PR-savvy).

Why does there have to be some nefarious plot to enslave our tastebuds and wallets? Can we not take ownership of our own cravings?

It's also why many popular diets come from individual nutritionists who claim they have little interest in how many people buy their book - they'd all just rather you experience it and share it by word of mouth as they compete with hundreds of other nutritionists who have also published similar books with catchy covers and titles who also aren't in it for the money...

Oh wait.

See, we can play the business/money/conspiracy game all day. It's pointless and gets us nowhere. Let's just be honest. We like the foods we like and we want the foods we want. I have a pretty bad sugar/chocolate addiction. You don't see me blaming Lindt for making their chocolate so good.

So, let's exercise control, but don't blame it on the businesses just trying to make a quick buck.

Personal Thoughts
The thing with diets is that many of them have very good qualities and aspects, but they're filled with so much rhetoric and extraneous fluff that they you need to wade through a survey of books/publications/articles to get the real meat from it.

That being said, there are definitely good pointers to take in mind.
  1. A successful diet goes beyond simply what you eat. Mental state, stress, work load, emotional well-being, and activity are just a few factors that go into health, which is why there is such a push for lifestyle change instead of just a diet change.
  2. Research pays off. If you're unfamiliar with an ingredient, instead of simply avoiding it, take the time to research it. I can guarantee that you will find safety and toxicity information if you look hard enough and bypass the clickbait
  3. Take control of what you eat. You are responsible for what goes in your mouth. So, choose wisely, which leads to my next point.
  4. Quality of food matters. I'm not here to tell you what you can and can't eat. There are tons of articles telling you what to avoid and what to choose, but there are some general trends. Also, make a wise choice. You can buy a restaurant-made burrito or you can make one yourself. Depending on what ingredients you use, your home-made burrito is very likely to be healthier than the restaurant's.
  5. So does quantity. You've probably heard the mantra "Everything in moderation." I cannot stress how important that is. Balance is key. Balance your intake with your activity level. Balance your amount of carbohydrates with your necessary proteins and fats. If you elevate or eliminate one, the whole system will slowly fall out of whack.
I found a good article a little earlier. It's the Atlantic's article on a survey paper that was done sometime last year, which attempted to collate the various dietary papers that had been published and draw out the kernels of commonalities.