3/11/2021 Eat This, Not That: The Promotion of What Is Diet Culture? Disordered Eating Through Diet Culture Shira Evans, MS, RD, CSSD, LD Coordinator of Nutrition Programs & DP2 Sport Nutritionist, Dartmouth College 1 2 Diet Culture Stats Fad Diets • Americans spend an estimated $66 billion annually on dieting resources Fad Diet Claims Evidence (plans, books, supplements, etc.) Keto Diet • Lose weight quickly • No long term studies • Ketosis is “natural” • Missing out on many vital nutrients • Multiple studies have found that dieting was associated with greater for well-being weight gain and increased rates of binge eating in both boys and girls. Low Carb (Atkins) • Weight loss • Research shows weight loss is not sustained • Almost half of American children between 1st– 3rd grade want to be Pegan (Paleo + Vegan) • Eat fruits, veggies, nuts/seeds, oil and • No research of long-term success nor thinner and half of 9 - 10-year-old girls are dieting. a little meat efficacy for health Whole 30 • Improve energy; weight loss • Rigid, many rules • Eat: Animal protein, fruits, veg • Some of the principles go against • Those who diet moderately are 5x more likely to develop an eating • disorder, and those who restrict food intake extremely are 18 times more No: dairy, soy, grains, legumes, years of nutrition research likely to develop an eating disorder. processed foods and sugar Alkaline Diet • Improve bone health, immunity & • Science, where are you?! weight loss by avoiding acidic foods 1. www.sciencedaily.com/releases/2008/04/080422202514.htm; 2. www.examiner.com/eating-disorder-in-philadelphia/pathological-dieting-precursor-to-eating-disorders; 3. Golden, N. H., Schneider, M., & Wood, C. (2016). Preventing Obesity and Eating Disorders in Adolescents. Pediatrics, 138(3). doi:10.1542/peds.2016-1649 ; 4. Golden, N. H., Schneider, M., & Wood, C. (meat, dairy, eggs, grains, gluten, (2016). Preventing Obesity and Eating Disorders in Adolescents. Pediatrics, 138(3). doi:10.1542/peds.2016-1649 ETOH, sugar) 3 4 Fad Diets Fad Diets Fad Diet Claims Evidence Fad Diet Claims Evidence Keto Diet • Lose weight quickly • No long term studies Keto Diet • Lose weight quickly • No long term studies • Ketosis is “natural” • Initial weight loss • Ketosis is “natural” • Initial weight loss • Missing vital nutrients for well-being • Missing vital nutrients for well-being Low Carb (Atkins) • Weight loss • Research shows weight loss is not Low Carb (Atkins) • Weight loss • Research shows weight loss is not sustained sustained Pegan (Paleo + Vegan) • Eat fruits, veggies, nuts/seeds, oil and • No research of long-term success nor Pegan (Paleo + Vegan) • Eat fruits, veggies, nuts/seeds, oil and • No research of long-term success nor a little meat efficacy for health a little meat efficacy for health Whole 30 • Improve energy; weight loss • Rigid, many rules Whole 30 • Improve energy; weight loss • Rigid, many rules • Eat: Animal protein, fruits, veg • Some of the principles go against • Eat: Animal protein, fruits, veg • Some of the principles go against • No: dairy, soy, grains, legumes, years of nutrition research • No: dairy, soy, grains, legumes, years of nutrition research processed foods and sugar processed foods and sugar Alkaline Diet • Improve bone health, immunity & • Science, where are you?! Alkaline Diet • Improve bone health, immunity & • Science, where are you?! weight loss by avoiding acidic foods weight loss by avoiding acidic foods (meat, dairy, eggs, grains, gluten, (meat, dairy, eggs, grains, gluten, ETOH, sugar) ETOH, sugar) 5 6 1 3/11/2021 Fad Diets Fad Diets Fad Diet Claims Evidence Fad Diet Claims Evidence Keto Diet • Lose weight quickly • No long term studies Keto Diet • Lose weight quickly • No long term studies • Ketosis is “natural” • Initial weight loss • Ketosis is “natural” • Initial weight loss • Missing vital nutrients for well-being • Missing vital nutrients for well-being Low Carb (Atkins) • Weight loss • Research shows weight loss is not Low Carb (Atkins) • Weight loss • Research shows weight loss is not sustained sustained Pegan (Paleo + Vegan) • Eat: 75% plants, 25% grass-fed meat • No research of long-term success nor Pegan (Paleo + Vegan) • Eat: 75% plants, 25% grass-fed meat or • No research of long-term success nor or fish; some GF grains OK; weight loss efficacy for health fish; some GF grains OK; weight loss efficacy for health Whole 30 • Improve energy; weight loss • Rigid, many rules Whole 30 • Improve energy; weight loss • Rigid, many rules • Eat: Animal protein, fruits, veg • Some of the principles go against • Eat: Animal protein, fruits, veg • Some of the principles go against years • No: dairy, soy, grains, legumes, years of nutrition research • No: dairy, soy, grains, legumes, of nutrition research processed foods and sugar processed foods & sugar Alkaline Diet • Improve bone health, immunity & • Science, where are you?! Alkaline Diet • Improve bone health, immunity & • Science, where are you?! weight loss by avoiding acidic foods weight loss by avoiding acidic foods (meat, dairy, eggs, grains, gluten, (meat, dairy, eggs, grains, gluten, ETOH, sugar) ETOH, sugar) 7 8 Fad Diets The Smoking Gun… Fad Diet Claims Evidence Fad Diet Claims Evidence Keto Diet • Lose weight quickly • No long term studies Keto Diet • Lose weight quickly • No long term studies • Ketosis is “natural” • Initial weight loss • Ketosis is “natural” • Missing out on many vital • Missing vital nutrients for well-being nutrients for well-being Low Carb (Atkins) • Weight loss • Research shows weight loss is not Low Carb (Atkins) Smoking Gun:• Weight 95% loss of dieters fail &• regainResearch shows weight loss is sustained not sustained Pegan (Paleo + Vegan) • Eat: 75% plants, 25% grass-fed meat • No research of long-term success nor Pegan (Paleo + Vegan) the weight• withinEat fruits, veggies,1-5 years nuts/seeds, • No research of long-term or fish; some GF grains OK; weight loss efficacy for health oil and a little meat success nor efficacy for health “The diet industry is brilliant because it’s the one product Whole 30 • Improve energy; weight loss • Rigid, many rules Whole 30 that repeatedly• Improved fails and energy;makes you weight believe loss that it’s• Rigid,your many rules • Eat: Animal protein, fruits, veg • Initial weight loss, difficult to sustain fault”. -Dr. Mullenheim• Eat: Animal protein, fruits, veg • Some of the principles go • No: dairy, soy, grains, legumes, • Some of the principles go against • No: dairy, soy, grains, legumes, against years of nutrition processed foods & sugar years of nutrition research processed foods and sugar research Alkaline Diet • Improve bone health, immunity & • Science, where are you?! Alkaline Diet • Improve bone health, immunity • Science, where are you?! weight loss by avoiding acidic foods • Naturopath founder discredited on & weight loss by avoiding acidic • Naturopath founder discredited (meat, dairy, eggs, grains, gluten, principles of diet foods (meat, dairy, eggs, grains, on principles of diet ETOH, sugar) gluten, ETOH, sugar) 9 10 Intermittent Fasting Low Calorie Fasting Study Type Fast Feed Duration Alternate Day Fast 36-hour fast 12-hour feed Eat every other day Duration Food restrictions Daily Calories Diet Type One Day/Week Fast 24-hour fast Unrestricted on eating 1-2 Days/week days Control Period 3 months None ~3200 Variable, omnivorous Warrior Diet 20-hour fast 4-hour feed Daily Lean Gains 16-hour fast 8-hour feed Daily Diet Phase 6 months Reduced dairy & animal ~1600 Variation of fasting, 5:2 Diet Full day fast but 500- 5 Days/week 2 fast days/week protein mostly plant-based 600 cals allowed https://health.clevelandclinic.org/intermittent-fasting-different-types-explained https://apps.dtic.mil/dtic/tr/fulltext/u2/a473351.pdf 11 12 2 3/11/2021 Low Calorie Fasting Study Low Calorie Fasting Study Physical Findings Psychological Findings Physiological Findings Physical Findings Psychological Findings Physiological Findings • ~25% BW loss • ~25% BW loss • ↓ BMR • ↓ BMR • Muscle wasting • Irritability • Muscle wasting • Irritability • • • Edema • Apathy ↓ HR • Edema • Apathy ↓ HR • • • Hair loss • Depression ↓ Heart size • Hair loss • Depression ↓ Heart size • ↓ Body temperature • ↓ Body temperature • Lanugo • Anxiety • Lanugo • Anxiety • Dizziness • Social Aversion • Dizziness • Social Aversion • ↓ Coordination • Fatigue • ↓ Coordination • Fatigue • Distorted self image • Distorted self image • ↑ Obsessive thoughts • ↑ Obsessive thoughts • ↓ Sex drive • ↓ Sex drive • Self harming thoughts? • Self harming thoughts? https://apps.dtic.mil/dtic/tr/fulltext/u2/a473351.pdf https://apps.dtic.mil/dtic/tr/fulltext/u2/a473351.pdf 13 14 Low Calorie Fasting Study Low Calorie Fasting Study Physical Findings Psychological Findings Physiological Findings Physical Findings Psychological Findings Physiological Findings • ~25% BW loss • ~25% BW loss • ↓ BMR • ↓ BMR • Muscle wasting • Irritability • Muscle wasting • Irritability • • • Edema • Apathy ↓ HR • Edema • Apathy ↓ HR • • • Hair loss • Depression ↓ Heart size • Hair loss • Depression ↓ Heart size • ↓ Body temperature • ↓ Body temperature • Lanugo • Anxiety • Lanugo • Anxiety • Dizziness • Social Aversion • Dizziness • Social Aversion • ↓ Coordination • Fatigue • ↓ Coordination • Fatigue • Distorted self image • Distorted self image • ↑ Obsessive thoughts • ↑ Obsessive thoughts • ↓ Sex drive • ↓ Sex drive • Self harming thoughts? • Self harming thoughts? https://apps.dtic.mil/dtic/tr/fulltext/u2/a473351.pdf https://apps.dtic.mil/dtic/tr/fulltext/u2/a473351.pdf