Diet 101

How to Know Which Diets Are Actually Healthy

Losing weight doesn’t always mean eating healthy. A diet of carrots probably would lead to weight loss for a certain amount of time, but such a diet ultimately would result in nutrient deficiency and an unhealthy lifestyle.

According to the Centers for Disease Control and Prevention, a healthy lifestyle includes a balanced diet that emphasizes fruits, vegetables, whole grains and fat-free or low-fat milk products. A healthy eating plan often includes lean meats, fish and poultry as well as beans, eggs and nuts.

With so many diet options out there, how do you choose one that will result in both weight loss and healthy eating? Inside Columbia talked with two registered dietitians to get the skinny on which diets will give positive results and which just aren’t sustainable.


Keto

The ketogenic diet is similar to typical low-carb diets like the Atkins diet. It focuses on low-carb, high-fat intake and puts the body in a state of ketosis, which is when the body swaps out using carbs for energy and starts burning fat for energy. So far, so good.

Instagram influencers who stick to the keto diet often post pictures of meals consisting of lots of meat and cheese, making the diet something most people can get on board with. But eating bacon and cheddar cheese doesn’t sound all that healthy, and registered dietitians say it isn’t for most people.

“This is a loaded diet,” says Laura McDermott, a registered dietitian at Boone Hospital. “You feel so full on keto because you’re pumping your stomach full of fat.”

The diet was originally designed to help children with epilepsy, McDermott says. But there’s no long-term research to show the health risks for those following the diet.

Small and Steady
Little changes can make a big difference. If you aren’t ready to make a full-on lifestyle change or enter an extreme diet, there are a few suggestions that don’t take much effort but can still be a health change.

Those on the keto diet have to stick to about 20 to 50 grams of carbs per day. That’s about the equivalent of a single apple, McDermott says. But carbs aren’t a bad thing and can actually be beneficial in a diet.

Natural sugars, starches and fiber are all carbs that can have health benefits, according to the Mayo Clinic. The Dietary Guidelines for Americans recommends that carbohydrates make up 45 to 65 percent of total daily calories. Carbs are the body’s main source of energy and can protect against some diseases.

“Some evidence suggests that whole grains and dietary fiber from whole foods help reduce your risk of cardiovascular diseases,” according to the Mayo Clinic.

McDermott says many of her patients who follow the keto diet often have a difficult time with meal planning, and it’s not necessarily sustainable.

“You really have to choose wisely in the foods that you are eating,” she says. “I’m wary of any diets that take away whole food groups.”

The bottom line: The keto diet was originally designed for people with certain health issues, not for weight loss. It drastically reduces carb intake, which is not sustainable or healthy for most people. 

WW

Formerly known as Weight Watchers, WW isn’t like some of the other diets in this list. You can technically eat whatever you want while on the diet, but the catch is portion control and eating foods that are good for you.

Keep Track
Keep a food record for a couple of days so that you can see the portion sizes you’ve been eating or how frequently you’ve been snacking. 

WW uses a point system. After you sign up and put in your information, WW will give you an amount of points you can consume every day, and you can use those points however you want. There’s a list of dozens of foods, made up mostly of fruits and veggies, that are zero points. So, if you get really hungry, you can indulge in arugula to your heart’s content.

“It’s kind of like your bank account,” Jennifer Tveitnes, a registered dietitian at the Hy-Vee on West Broadway in Columbia, says “You have a certain amount (of points), and it’s up to you how you want to spend it. There are certain ways to spend the points better than others, but at the end of the day, you just don’t want to overdraw.”

Tveitnes says that out of all of the diet plans out there, she steers people toward WW the most because no food is off limits; they’re just eaten in moderation. The diet is also about making healthier choices and choosing foods that are higher in nutrients rather than fat.

“I’m going to feel more satisfied and less hungry if I spend my points on things like lean proteins, whole grains and fruits and vegetables (the healthier stuff) than if I blow all my points on a high-sugar, high-fat thing,” she says.

One difference between WW and other diets is that there is a cost associated if you want to be able to track points through their system. Prices vary, as WW often runs different promotions, but the average varies between $4.61 and $12.69 per week, depending on whether you get the digital-only subscription or the coaching subscription.

The bottom line: You can still lose weight and stay healthy while splurging on the things you love to eat. If you don’t like the idea of cutting out a certain type of food, WW might be for you. However, it does come at a cost.

Whole 30

Whole30 popped up on diet fads about a decade ago and has been particularly popular within the past five years. The premise is simple, but extreme for many people: Eat unprocessed foods for 30 days. While on Whole30, dieters cannot consume any added sugar (real or artificial), alcohol, grains, legumes, dairy, carrageenan (a thickening agent), MSG or sulfites. The diet promotes eating meats, fruits, vegetables, eggs and natural fats.

McDermott says Whole30 is extreme, but there are some positives. She says it promotes cutting out sugars and processed foods, which is generally nutritious. However, like other diets, completely cutting out certain food groups isn’t necessarily healthy.

Diets that cut out food groups are going to be really hard long term, and even though this is a 30-day diet, it will be really easy to jump back on what you cut out when you’re doing it so extreme,” McDermett says.

Part of the reason Whole30 is only for 30 days is that it promotes digestive health. The idea is to cut out foods associated with digestive, sensitivity or skin issues — such as dairy and grains — and slowly add them back to your diet after the 30 days are over.

Tveitnes says Whole30 can be beneficial for people who are having a lot of digestive issues or for people who are worried about food allergies or intolerances.

“In general, I’m not a huge fan of a diet that eliminates a food group,” she says. “But it is only 30 days, so I don’t necessarily discourage people from doing it because it is so short term.”

Pick One or Two Things to Focus On
Get that under your belt, then pick the next one. It can be as simple as only eating out once per week. Then after that, maybe you cut soda from your diet. “People want to do these huge lifestyle overhauls, which can be great, but it can end up being very overwhelming and difficult and frustrating,” Tveitnes says. “Then, if you end up failing or messing up even just once, a lot of times, that discourages and derails people.”

When reintroducing food, it should be one at a time and spaced out about one week apart so that the body is not overloaded.

The bottom line: Most Americans consume too much sugar in their diet, so Whole30 is a good way to get in the habit of reducing sugar. It can also be beneficial for digestive health. As a long-term diet, dietitians are wary because of the nutrients that Whole30 cuts out. 

Veganism

Veganism and vegetarianism are some of the hardest diets to maintain, especially if you like meat. Vegetarians exclude meat, fish and poultry from their diet, while vegans stay away from any animal products or byproducts. That means no eggs, dairy or other animal products such as honey.

The vegan and vegetarian diets have plenty of health benefits, including weight loss, lowering cholesterol and lowering blood sugar, Tveitnes says. However, such restrictions can complicate grocery shopping and eating out, making the diet hard to maintain.

Don’t Give Up Your Favorites
The CDC says it’s not healthy to completely give up foods you enjoy. However, it’s not good to eat them every day, and you should balance them out with healthier meals. 

“You might lose weight on them initially,” she says. “But then if you go off of them, usually the weight comes back.”

It is possible to get all of the necessary nutrients on vegan and vegetarian diets, but those who adhere to such diets need to be careful, especially when it comes to vitamin B. Some dietitians recommend that some vegans and vegetarians take a vitamin supplement. However, eating a wide range of beans, seeds and grains such as quinoa can help provide some of those necessary nutrients.

If you’re interested in a more plant-based diet but don’t feel comfortable making the full-on vegetarian leap, Tveitnes says the flexitarian diet is a good alternative. Essentially, it is the vegetarian diet with a little flexibility. Instead of eating no meat, you might incorporate fish or chicken into your diet once or twice per week.

The bottom line: If you aren’t crazy about meat and love meal prepping, vegetarianism or veganism might be for you. But if you don’t fit into that category, the weight will likely come back if you’re doing this as a temporary diet.

Paleo

The idea is simple: Eat like a caveman, lose weight. But what does it mean to eat like a caveman? Well, it’s more difficult than many people think.

The Paleo diet eliminates foods most people eat every day such as dairy, legumes, potatoes, refined sugar and grains. By the end, the only foods left are meat, fruits, vegetables and nuts. The Paleo diet is high in protein but cuts out foods that have important nutrients for our bodies.

Dr. Loren Cordain, a leader of the Paleo diet, had the idea that if people would eat like human ancestors did and eliminate modern foods, they could eliminate modern diseases such as cancer and diabetes.

Tveitnes says humans’ bodies have evolved, and many of the foods the Paleo diet cuts out have some serious health benefits.

“Our bodies have changed, our metabolism has changed and our lifestyles have changed,” Tveitnes says. “We don’t have the same lifestyles as our ancestors did, and so we don’t necessarily need to be feeding and fueling our bodies the same way.”

Many of the food groups eliminated from the Paleo diet — such as dairy, legumes and grains — have nutrients the body needs for heart and gut health, Tveitnes says.

Don’t Forget Fitness
Many of the above listed diets such as WW and the Mediterranean diet reward physical activity. The Office of Disease Prevention and Health Promotion suggests that adults should get 150-300 minutes of moderate-intensity exercise per week. 

“The fiber content in those foods has a lot of health benefits,” she says. “We could all probably use less sugar and more fruits and vegetables, but do we need to cut out some of these other food groups that have proven health benefits? Probably not.”

Food groups such as dairy can have healthy benefits like lowering blood pressure and can be a source of protein.

“Dairy is not evil,” Tveitnes says. “Calcium is important for bone strength.”

The bottom line: Breaking habits of eating processed food is a good thing. But why deprive the body of foods that have health benefits such as dairy, grains and legumes? If you want a healthy digestive tract, the Paleo diet might not be for you.

Other Diets

Mediterranean
Tveitnes and McDermott both suggest the Mediterranean diet as well. It’s a mostly plant-based diet that also focuses on grains, healthy fats such as olives and canola oil, cheese and chicken and fish every once in a while.

The Mediterranean diet rewards successes and forgives slip-ups, which is where many people fall off the wagon while dieting.

DASH
Tveitnes says she often suggests clients follow the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension and encourages a balanced diet that reduces sodium, according to the Mayo Clinic.

The diet includes a lot of whole grains, fruits, vegetables and low-fat dairy products. It also focuses some on fish, poultry, legumes, nuts and seeds.

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