N.B. In this article, by diet, I mean not only weight loss “diets”, but also general nutritional fads and recommendations.
Not only for those who adhere to diets, but I also allow myself to include the various health professionals (I will not make friends here) who promote it with, the best of intentions. You know, they say that the road to hell is paved with good intentions.
Diets that had many names over the years
Ketogenic, intermittent fasting, Mediterranean, paleo, vegan: there are plenty of options. They are sometimes called diets, sometimes lifestyles, but they nevertheless all suggest the same thing: eat according to specific rules by favoring foods, avoiding certain others, to obtain positive results on health and, very often on weight loss. Eat less ultra-processed foods. Avoid added sugars. These are all tips that, indeed, can positively influence the health of a population. However, does the current nutrition discourse really help people in the long run, in real life? Here, I really want to focus your attention on this very important nuance: the long term and real life, and not a context of clinical studies. What is the real physical and mental health end product after months and years of dieting or nutritional recommendations?
The benefits of many of these diets on health and weight management are still well demonstrated through the scientific literature. Take, for example, the ketogenic diet, which has been a hot topic in recent years. You can find a lot of scientific data that shows noticeable improvements on several health parameters, including inflammation, blood sugar management, and weight loss. However, these are all data from short studies and in contexts that do not reflect real life at all.
The psychosocial dimension put aside
In nutrition, studies of a few weeks or a few months, not only are they too short, but it’s also very difficult, if not impossible, to believe that you can follow these recommendations for a lifetime. You know, feeding humans is very complex. It depends on our socio-economic background, our preferences, the relationship we have with food, our upbringing, and so on. Nourishing is part of a biopsychosocial model through which the physical, social, and psychological dimensions are constantly interrelated and inseparable. Unfortunately, research on nutrition and its impacts on health seems too often to focus only on the biological (physical) dimension, for example on metabolic parameters (glycemia, blood pressure, cholesterol, cancer, etc.), and that is a huge problem in itself.
There is a very fine line between food balance and perfectionism
The intention is noble to promote the positive effects on health of certain diets, but science tends to demonstrate with enough force that in the long-term, people turn back the clock with episodes of weight gain, periods of yo-yo, and probably a relationship to the disturbed eating, but studies never measure that. Among other things, did you know that the scientific literature seems to show that approximately 90% of people who invest in a weight loss process with diets return to their starting weight or gain even more after a few months or years? Did you also know that there is a lot of scientific data which suggests that it would be even more harmful to play yo-yo with your weight than to have a heavy weight which remains stable over the course of life?
Solutions in all humility
I myself have been part of the movement that strongly favors the biological approach to nutrition (I’m still very interested in it though) and its positive impacts on our metabolism and on our physical health. I don’t pretend to know the truth, nor do I try to downplay the importance of physical health. On the other hand, in order to bring about lasting changes in health, my clinical experience as well as the science of recent years confirm that a personalized approach that respects the biopsychosocial model will be much more likely to work in the long term. In that sense, asking people to follow dietary advice just because it improves biological parameters is doomed to fail; well, at least 90% of the time…
So, to concretely increase your chances of success, you must first choose a health professional who specializes both in nutrition, as well as in lifestyle changes and who advocates a comprehensive approach to overall health.
This will have to provide simple and concrete solutions on a daily basis that take into account the human being as a whole; among others are family, work, personality, past experiences, expectations, lifestyle, food preferences, their medical assessment and, above all, their deep reasons which explain this desire for change. Add to that patience, persistence and enjoyment, and you have the winning recipe for improving your eating habits for the rest of your life!
References:
- Yeo Jin Choi, Sang-Min Jeon et Sooyoung Shin. Impact of a Ketogenic Diet on Metabolic Parameters in Patients with Obesity or Overweight and with or without Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials. MDPI. 2020 Jul; 12(7): 2005.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400909/
- Nassib Bezerra Bueno, Ingrid Sofia Vieira de Melo et Terezinha da Rocha Ataide. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. British Journal of Nutrition. 2013. https://www.ncbi.nlm.nih.gov/books/NBK138038/
- Vanessa A. Diaz, Arch G. Mainous et Charles J. Everett. The Association Between Weight Fluctuation and Mortality: Results from a Population-Based-Cohort Strudy. Journal of Community Health. Volume 30, pages 153–165 (2005). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824662/
- Mee Kyoung Kim, Kyungdo Han,Yong-Moon Park, Hyuk-Sang Kwon, Gunseog Kang,Kun-Ho Yoon et Seung-Hwan Lee. Associations of Variability in Blood Pressure, Glucose and Cholesterol Concentrations, and Body Mass Index With Mortality and Cardiovascular Outcomes in the General Population. Circulation. 2018;138:2627–2637. https://pubmed.ncbi.nlm.nih.gov/30571256/
- Alison Fildes, Judith Charlton, Caroline Rudisill , Peter Littlejohns , A Toby Prevost et Martin C Gulliford
- Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. American Journal of Public Health. 2015 Sep;105(9):e54-9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539812/
- Michael L Dansinger1, Athina Tatsioni, John B Wong, Mei Chung et Ethan M Balk. Meta-analysis: the effect of dietary counseling for weight loss. Annals of Internal Medecine. . 2007 Jul 3;147(1):41-50. https://www.ncbi.nlm.nih.gov/books/NBK74633/