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Exploring Trends in Diet and How They Impact Patient Care Dr Hashtag Nutrition Exploring Trends in Diet and How They Impact Patient Care Dr. Jaime Schehr ND RD CDN Learning Objectives: • Discuss Current Trends in Nutrition and how they influence treatment / patient care • Identify specific trends, review and evaluate the traffic that drives trending diets • Discuss the basic principles of a healthy diet; evaluate whether the trending topics encompass healthy dietary practices or principals Presentation Outline • Identify top trends of 2015 • Exploration of market what causes diets to trend? • Research based vs. popular demand; where these two blend • Examples of trendy diets • Information pathways social media influence on diets • How to manage patient expectations vs. evidence; is there a difference? Topping the Charts in 2015 DIETS • Weight Watchers • DASH diet • Biggest Loser Diet • Mediterranean • Flexitarian Diet • TLC Diet • Paleo / Dukan • Fertility Diet • MIND diet • Mayo Clinic Topping the Charts in 2015 BOOKS • Whole 30 • Bon Appetite: The Food Lover’s Cleanse • The Blood Sugar Solution 10 day detox diet • How not to Die • It Starts with Food • Eat Fat Get Thin • Always Hungry • Strong Looks Better Naked • Pretty Happy A Look at the Numbers 60 BILLION The value of the U.S weight loss market. 108 MILLION The number of people on diets in the United States. 85% The percentage of customers consuming weight-loss products and services who are female. 1 HOUR Time spent on daily exercise by people who lost and kept off 30+ pounds for five years. $20108851220,000$11,500$500,000$33,000 Hour Percent BillionMillion to to $26,000 $3 Million 220,000 # of people in 2009 with a BMI >40 in the United States who had bariatric surgery. $11,500-$26,000 The average cost of bariatric surgery $500,000-$3 MILLION The average salaries paid to celebrity endorsers of major weight-loss programs. $33,000 The amount of money celebrity endorsers, on average, earn per pound lost. What the Numbers Tell Us • Exercise remains a critical aspect of sustained weight loss and health • The greatest driving force of a trend in the diet world is celebrity endorsement • One-third of the U.S population is on a diet Top Nutrition Trends of 2015 • Turmeric • Butter Coffee • Souping • Fermented foods • Bone Broth • Spiralizing • Sprouted Grains • Superfood Bowls • Sustainable Diets • Cauliflower is the new kale Cauliflower Craze Nutrition Trends & Headlines… Cholesterol POM juice In the Past 24 Hours: Artifical Sweetners and Weight Gain; The New York Times Why Carb Counters Are Running for the Cauliflower; The Wall Street Journal How Do We Navigate Through the Information to: 1) Know Your Foundations 2) Decipher what is healthy for patients 3) Stay current on trends and news Anti-Inflammatory Diets Purpose: Reduce Inflammatory markers, CV health, Metabolic Syndrome, TIIDM, Parkinson's, Depression, Alzheimer’s, Pain, Weight Management Exposure: Lean meats and fatty fish. Lots of fruits and vegetables. Healthy fats (avocados, nuts, seeds, EVOO or Canola) Anti-Inflammatory Diets The Attraction The Challenges • Realistic diet plan • Planning required • Rich in antioxidants • Ability to limit wine to • Plant based recommended amount • No portions and serving sizes noted #glutenfree 8 MILLION POSTS USING #GLUTENFREE 16K LIKES Anti-Inflammatory Diets The Research • Lyon Heart Study – AI diet Reduced death from repeat heart attacks by 50-70% • HALE Study – In those aged 70-90, diet changes alone reduced death from all causes by 23% – 65% lower mortality rate when regular activity, no smoking and moderate drinking were added • Study by Esposito et al. – AI diet decreased metabolic syndrome and cardiovascular disease #mediterraneandiet #antiinflammatory Low Carb Diets Purpose: Quick Weight Loss, Blood Sugar Control Exposure: Can be as low as 20g CHO/day, High PRO, High FAT, often limits/restricts ETOH The Attraction The Challenges • Initiates quick weight loss • Limiting • Can Improve • Can be high unhealthy fats – A1c • May need to learn to cook – Cholesterol & TG #’s foods differently and where to – BP eat out • Can Minimize – Inflammation – CHD, TIIDM, Obesity, Cancer #paleo Whats your opinion? #lowcarb #IIFYM Low Carb Diets The Research • Study by Foster et. al. – At 3m and 6m weight loss was significantly greater in low CHO diet group – At 12m both Low CHO diet group was the same as the conventional diet group • Study by Shai et. al. – Compared Low Carb to Mediterranean to Low-fat Diet over 2 years – Findings: • Low Carb diet showed decreased levels in C-reactive protein. • Low Carb dieters likelier to have urinary ketones • Mean weight loss over 2-years was 4.7kg for Low Carb, 4.4kg for Mediterranean diet, and 2.9kg for low-fat diet. • Study by Frassetto et. al. – 10 days on a Paleo diet resulted in decreased BP, decreased total and LDL cholesterol, and improved insulin response Socially Conscious Diets Purpose: Eat healthfully to minimize carbon footprint Exposure: No, or very limited, animal products in the diet. Eat no more meat than is recommended in the dietary guidelines. Socially Conscious Diets The Attraction The Challenges • Good for environment • Potential Vit Deficiency • Rich in antioxidants (iron, B12) • Animal friendly • Patient must be aware of PRO sources • Cost • Availability EWG FOOD SCORES #flexitarian #vegan #monomeal#macrobiotic Socially Conscious Diets The Research • Study by Raphaely et. al. – Individuals in the most developed countries over consume meat – Flexitarianism can significantly decrease the cost of stopping climate change if diets were implemented • Study by Barnard et. al. – Low-fat vegetarian and vegan diets were associated with sustained weight loss and decreased plasma lipid concentrations Intermittent Fasting Purpose: Allow the body to use FAT instead of CHO for energy . Improve insulin mediated glucose uptake. cognitive improvement & focus Exposure: • 3-1-2-1 Diet • Intermittent Fasting (5:2) • Warrior Diet: under-eat/fast during the day and eat at night • The fast diet • The 8 hour diet #intermittentfasting Intermittent Fasting The Attraction The Challenges • Only restriction is on • Different than timing, not food expected meal norms • Simple “rules” • Not eating • Balancing exercise and fasting • Medication Interaction Intermittent Fasting The Research • Study by Mattson, et.al. • IF enhances cardiovascular and brain function • IF reduces BP and increases insulin sensitivity • Study by Longo et. al. • In rodents: IF protects against diabetes, cancers, heart disease, and neurodegeneration • In humans: IF helps reduce obesity, hypertension, asthma, and rheumatoid arthritis • Study by Harvie et. al. • IF was as effective as continuous energy restriction on weight loss, insulin sensitivity, and other health biomarkers—leptin, total cholesterol, LDL, high- sensitivity C-reactive protein, TG’s, and BP • Study by Varady et. Al. • ADF may effectively modulate metabolic and functional nutrition risk factors. • ADF may be effective in preventing or delaying the future occurrence of common chronic diseases, at least in animal models. Other Popular Diets • Nordic Diet • Atkins • Mediterranean Diet • Paleo • Vegan • Dr. Weil Diet • Pegan • Whole 30 • Fat Black Diet—bulletproof coffee • Biggest Loser • Keto Diet • Weight Watchers • Viking Diet • • Zone Diet Meal Replacement Plans • Gluten Free/Wheat Belly • Raw /Macrobiotic • Sugar Detox • Alkaline (acid/base balance) • Low Fat Diets • Flexible/If it Fits Your Macros • Mono Meal Diet • Clean Eating • Detox Diets • Blood Type Diet • Skinny Gut • Baby Food Diet • Flexitarian • Intermittent Fasting • Dukan Diet Food Trends • Ancient Grains: Quinoa, Spelt, • Grass-Fed Dairy Freekah, Millet, Buckwheat, • Spiralizing and Amaranth • Coconut Oil • Seaweed • “Souping” is the new juicing • Sprouted beans, flours, • Kalettes (mix of kale and legumes, nuts, and seeds Brussels sprouts) • Tumeric • Seeds and nuts for superfoods • Butter and Coconut Butter • Bowls • Cauliflower in everything • Juicing • Tigernuts • Smoothies • Animal welfare • Matcha Tea • Environment • Bone Broth • Epigenetics • Fermented Food Popular Blogs Influencing Diet • Well+Good • Goop • Food Politics • Stupid Easy Paleo • No Meat Athlete • Buzzfeed Food • Summer Tomato • Hangry Pants • I ATE a PIE • Authority Nutrition • The Picky Eater • Oh She Glows • Deliciously Ella • Refinery29 • Choosing Raw • Healthy, Happy, Life • The Paleo Diet • Huffington Post What Does This All Mean? • Trends are largely a spin on the already existing • Staying abreast of trends can benefit the relationship between practitioner and patient by improving communication • Use clinical judgment and understand the foundation of the trend Communication "It has long been recognized that difficulties in the effective delivery of health care can arise from problems in communication between patient and provider rather than from any failing in the technical aspects of medical care. Improvements in provider-patient communication can have beneficial effects on health outcomes". Appropriate reassurance or pragmatic suggestions to help with problem solving and setting up a structured plan of action may be an important part of the patient care that is required. Med Clin North Am. 2003 Sep;87(5):1115-45. Patient-doctor communication. Teutsch C. Choosing the “Right Diet” Lean Protein Real CARBS Vegetables/Fruits Food Healthy Fats The role of the practitioner is to guide the patient to the most appropriate diet; regardless of its popularity. Trends should not be associated with negativity but rather a tool for the practitioner to use in greater access and exposure to diet change. .
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