17 Aug 2021
Popular diets come and go, however the themes and basic ideas they suggest seem to remain. The Atkins’ Diet developed in the 1960s was similar to one proposed in the Victorian age, with its low carbohydrate principles being repeated in the Dukan Diet and, most recently, as ‘Keto’.
This is not to say that reducing intake of carbohydrate is not a good approach for some people as the research says it can be safe and effective over the short term (3-6 months) when compared to other types of diet including in the management of type 2 diabetes. This cycle of similar diets has been seen with different approaches with a range of low calorie and low fat diets having different branding over the years.
Why do diets, which in principle are similar, keep re-emerging with different names? It is thought it could be because changing diet can be quite challenging and difficult and there may be a tendency to drift back towards more ‘usual’ behaviour. So, is it the idea of going on a diet that could perhaps be part of the problem? Well some experts suggest it is and that it’s time to ditch the diet and find ways to rebuild a healthy relationship with food (and our bodies) and learn to eat in a conscious, intuitive and mindful way.
Problems with diet labels and tribes
When we look on the internet it seems there is a constant argument that one diet is better than another, or that the other diet (often one that is to government guidelines) is the reason we have an ‘obesity epidemic’. These nutritional skirmishes tend to cause lots of confusion and can make it more difficult to find out what is the best thing to eat and what eating pattern to follow. Perhaps the best piece of advice is to stop using labels to say how you are eating, as tags like ‘plant-based’, ‘keto’ or ‘clean’ rarely link to the nutritional content and overall dietary quality of the foods eaten. This, combined with the tendency of food manufacturers to produce foods to appeal to these labels, can mean the actual foods provided under this label can become less and less ideal.
However, identifying with a type of diet may be useful for some people and this can be seen with many of the online forums for diets which seem to be against government advice. An example of this are the many low carbohydrate forums, where people report they struggled when following government advice, but then they found ‘low carb’ things make them feel in a better place. In this situation, it is quite possible that many of these people have type 2 diabetes, and this diet may work better for them as most of the foods available tend to make claims linked to government recommendations. So, choosing a diet which is slightly different tends to mean more mindful food purchases as choices need to be made. In that case, there could be some effect of ‘the diet’, but it is highly possible that there is a more significant improvement in that person’s nutritional intake because of their more focused and deliberate dietary choices.
The idea that it may not be as simple as picking the ‘right diet’ became apparent when I supported Dr Giles Yeo, the Honorary President of the British Dietetic Association, to follow a vegan diet for a month. We concluded, that when choosing vegan options, whilst being careful to consume enough iodine, protein, vitamin D and iron, meant his food choices were perhaps thought through more than they might ordinarily have been. This is a common observation; it may not be the diet name that counts but more about how it encourages greater awareness of the foods eaten.
Perhaps the best piece of advice is to stop using labels to say how you are eating, as tags like ‘plant-based’, ‘keto’ or ‘clean’ rarely link to the nutritional content and overall dietary quality of the foods eaten
Mindfully living a healthy 'way of life'
Perhaps one of the issues with the philosophy of dieting is that it is often linked to restriction and, almost at times, punishment. All too often the act of ‘going on a diet’ is portrayed as a negative and even restoration for past mistakes. This mindset clearly does not work for the majority, otherwise we would not have a diet industry and the repeated cycle of rebranded diets and the unnecessary, and often unachievable, slim ideal. Beyond that, for a number of people, the way in which our society can see dieting is extremely harmful, with impacts ranging from discomfort eating and poor mental health through to eating disorders. What tends to have been forgotten is that the word ‘diet’ means ‘way of life’ from the Greek, ‘dieta’. It is just the ‘culture of slimming’ has over a long time, and in its wake, caused harm and perceptions of failure.
So, what can be done about this? For some people it can be an approach of self-acceptance about the fact that health and wellbeing is not determined by weight, after all that is just a number on a scale. Numerous approaches to counter this, including ‘Health at Every Size’, have been developed and do take that approach. Another effective approach is known as intuitive eating. This is an approach which is often shared by advocates of size acceptance where the solution is not to restrict what you eat but instead it is about relearning cues with respect to the hunger and the pleasure linked to eating. The aim of this is to re-educate yourself about when you need to eat and to recognise when you are satisfied and full. This approach is centred on self-care, where weight loss is not the goal, but can be a side-product. It is about looking after yourself, enjoying food and overall being kind to yourself to prevent the negative behaviours that can be seen with restrictive diets and yo-yo dieting.
So, what works? Well, that depends on what you feel you can do, what you can live with and, above all, enjoy. Eating should be about more than just controlling your weight, ideally it should be fun and even exciting! So next time you are tempted to try the next ‘new diet’ think again. Why not aim to try and enjoy a variety of healthy foods and try to worry less about which plan you are following (or not) or whether your ‘macros add up’? It might actually be better for both your mental and physical wellbeing!
Dr Duane Mellor RD
Lead for Nutrition and Evidence Based Medicine, Aston Medical School
Duane is a registered dietitian with a background in clinical dietetics supporting people living with diabetes he moved into medical education when joining Aston University. He is also the Associate Dean for Education (Quality Enhancement) in the College of Health and Life Sciences. where he works to support innovative teaching practice alongside engaging students as fellow professionals on the first steps of their careers.