Let's start with that phrase everyone loves to throw around... 'This is not a diet. It's a lifestyle change' which somehow everyone believes to mean that their diet is not a diet when it's really...a diet. lol.
I think lifestyle change is like #duh but also it implicates to the general population that you make some change that you are finally okay with eating in restriction and only chicken and broccoli every night. It has such a bad connotation. Diet has the same rep. It's a gross nasty word to most people, including myself. But yet, I see patients every single day who tell me about the preverbal wagon they have jumped off and the next diet they are planning to do. Where do we meet in the middle? Intuitive eating has so much nuance and cognitive behavioral therapy involved (that I think is very important) but it would take me much more than 30 minute visits to deconstruct a mountain of diet culture to be able to help patients move into this in a healthful manner while also managing their chronic disease. Let me reiterate - it's WORTH IT but we have to work through a lot first (sometimes takes years).
So the point of that intro was to say: These are typically the two "diet protocols" that I get asked about the most frequently, and what my opinion is. So, I thought I'd shed some opinions here.
First things first, every thing that you read in some blog post (inclusive of my own) all the way up to the most highly educated and experienced in nutritional science is...opinion. Even the scientific process has many flaws, and as we all know, most of the time has bias. So, everything must be taken with caution. The second thing is that everything is made so reductionist in our world. The newest thing was the Harvard scientist who said coconut oil is poison. Like no, it's not. It's also not meant to be rubbed all over your body and eaten in gobs every day. Like, yall, for the love. It has saturated fat in it which is shown in clinical trials to not be good for you. But there's new evidence to show that saturated fat is NOT all bad for you. Wait, so now we are eating saturated fat again?
Nutritional studies are like basically impossible because they are so complex to show long term data? Where is this person from? What are their genetic markers? What kind of diets have they done in the past to determine their metabolism? Did they stick to the protocol 100% because we all know how hard that is? So, like, when you read an article or a study, keep all of this in mind. The more you get into it, the more you realize no one has the FOR SURE answers and most of the time, it's in the middle of the extremes.
The third thing to take into consideration is that none of these things REALLY matter for most of the population because 99.9% of the population is never going to stick with it long term. So, whatever you do, you must must must think about your relationship with food and the psychosocial aspects of changing the way that you do your food intake (I want to use the word diet but I don't mean diet - I mean the way we eat regardless of how many calories when I say 'diet'). But like, if you don't consider this, then you might as well not even waste your time. This information is information that is interesting and intriguing for what our bodies do and how they perform best, but it won't matter if you don't think about your relationship with food.
MOVING ON to the shortest part because this is NOT really what it's about...nom sayin? The point is that it's confusing. How can these super deeduper physicians tell me to eat plant based to cure all disease and then now all of these scientists are telling me to eat blocks of cheese and grass fed beef? What the actual heck? It's complete opposite.
There is evidence in both camps. There is evidence upon evidence in both camps. You can take whatever disease state you would like and go on pubmed.org and find all the literature for why plant based reduces the foci (cancer aggregating cells) and then how ketogenic diets starve the cells of sugar therefore causing them to not be able to multiply and grow. If you want to cure hypertension or cholesterol or diabetes or this or that or this or that, EAT PLANT BASED. NO WAIT, EAT KETOGENIC!
I find these two to be so polar opposite ways of nutrition that it's worth discussing. Ketogenic diets produce beta hydroxy buterate and acetate and ketones that have a multitude of different implications for health in a positive way. If you don't get into ketosis, then you are just starved of calories period and feel like trash. It's a very hard diet to follow that's not set up for success in society and is most of the time pretty costly. However, it causes quick weight loss which is why most will do it. That's also highly frustrating because people aren't doing it safely or appropriately. They are just restricting calories, eating high protein and calling it keto and it's dangerous.
Once adjusted to ACTUAL ketosis, you have great cognitive function and are able to fuel better in grueling endurance events (think ultras). Every person is different on when they will go into ketosis, which is essential for the benefits, and sometimes this becomes absolutely miserable to the point that a patient is not thriving at all in their life so what the heck is the point?
Plant based Pros and Cons
Obviously, I follow a plant based vegan diet 99% of the time. I do this from a social justice standpoint more than anything. I actually do think that cultures with minimal amounts of protein are very health enriched and it is hard to get all of your essential needs with a strict vegan diet. But then I know what they do to animals and I just refuse to put my dollar towards those establishments. But that's not what today is about ;) Plant based can also be great for some with relationships with food because they are able to eat in abundance and feel very healthy. Portion control isn't really needed because all of the foods are low in calories so you need tons and tons of volume. When you get this much volume, it can also help those with constipation issues (also why I love it).
Some cons are that it's difficult in social settings and it can be lacking in some various nutrients that you have to supplement (primarily b12) but the funny thing is that most of the time, the b12 that you get from meat is hilariously (not hilarious - I actually mean that like it pisses me off) injected into the cows. B12 is derived from the soil and the soil is not what it used to be which is why humans can't get adequate amounts from fruits and vegetables so they have to be injected with it. Personally, I'd rather take the supplement myself but the point is, I made that decision for myself. That might not be a decision that you make for yourself, and that's okay.
We all have different convictions in life and the world could not go around without that.
The truth is: Anything in an extreme fashion is dieting will always work...in the short term. But inevitably, it will not. Humans, as a species, are TERRIBLE at predicting the future and believe with all their little heart and soul that they will stick with some new extreme plan for the rest of their life, but then they fall off some wagon. So, that is why choosing the middle of the road is typically the more reasonable approach. Humans want a plan. They want to be told what's going to work, how many calories to eat, what the meals should look like and the time frame at which they are going to lose XYZ amount of weight, but that is just simply not what is going to happen. And until you ACTUALLY realize that and believe it, you will continue on the perpetual wheel of diet death for the rest of your life and it's a miserable life to live. We MUST figure out what works for us in mind, body, and soul. That's TRUE health.
Some questions you should ask yourself:
1. How is this serving me?
2. Why am I doing this?
3. Is this out of a spirit of love and compassion for my health or some "punishment"?
4. Is this something I see to be a quick fix? If so, do I feel that if I fix it quick that it will not just come right back and if so, then what is the point?
5. Have I done anything in the past that is related to this that has not worked? Why do I think that it would work this time?
I think that deconstructing the narratives of why we begin something are super important. That's not to say that this doesn't mean that you won't do it because as I've said, I am 99.9% vegan for the animals. But the flippant decision to bounce from diet to diet is just simply messing up your metabolism, and I think that's something we should safe guard.