September 20, 2018
Central Massacusetts Health

With dieting, more are aware of importance, fewer take action

Maisie Ostyre, a registered dietician and owner of Eat to Live Nutrition in Natick, said she's often asked about different diets and what they mean. Meals such as cheeseburgers are OK in moderation, she said, as long as healthier meals are mixed in.
"It's not about one day or one meal. It's what you eat over time," says Lisa Gibbs, a dietitian at Saint Vincent Hospital Cancer and Wellness Center.

We've all heard of low-carb diets, juice cleanses, fasting, the Atkins Diet and the Cabbage Soup Diet, and have for many years.

There is so much information out there on what we should and should not be eating. And it seems like as soon as we hear about a certain type of diet and learn the basics, there is another one getting popular.

But according to a Georgia Southern University study published last year by the American Medical Association, when it comes to dieting, we may be over it.

From 1988 to 1994, the study says, 56 percent of overweight adults went on diets. From 2009 to 2014, that number went down to 49 percent, less than half.

Pass the doughnuts.

That's not to say, of course, that we all suddenly gorge on foods we know aren't good for us. It's just that the goal of eating healthy has seen a cultural shift, and that even includes the language we use, too: today we talk less about counting points and calories and getting skinny and more about eating clean and organic and getting strong.

Lisa Gibbs, a Tenet Healthcare oncology dietitian at the Saint Vincent Cancer and Wellness Center in Worcester, said that even a term like "vegan" can be intimidating to some.

"People can be scared of that word," she said. "I say 'plant-based.' It really depends on who you're talking to." In Gibbs' case, her patients are looking to ramp up their immunity while undergoing chemotherapy or radiation.

Professional dietitians like Gibbs are constantly educating clients who bring up questions on popular diet trends.

A Pew Research Center poll from 2016 showed just how conflicted people can feel. Just over half of American adults, 51 percent, said they heard or read news stories about diets that conflicted with earlier reaport "some of the time," and another 21 percent said they received mixed messages "all of the time."

Importance of eating healthy, no matter how

But the mere concept of a diet — which means examining one's eating habits — is a good thing in and of itself, pointed out Maisie Ostyre, a registered dietician and owner of Eat to Live Nutrition in Natick.

"I get asked a lot about Keto [low-carb] and Paleo [a nutritional plan based on the eating habits of our ancestors in the Paleolithic period], diets, and intermittent fasting. It sounds like a good idea. You're using fat for fuel. But not if you feel restricted," Ostyre said. "You risk rebound eating and are prone to eat whatever is available," including foods rich in sugar, sodium and bad fats. Which defeats the whole purpose, and then some.

She says that good nutrition consists not only of getting healthy habits established, but also figuring out how those habits will realistically fit into a client's life afterward.

But that being said, if Ostyre, a former Worcester bariatric-surgery nurse, has a client who is very interested in trying a specific diet, she won't always discourage them, she said. If it gets them to make changes and pay attention to what they are eating, at least, there are very fundamental benefits attached to that (even if they don't ultimately stick with that first initial plan).

There are signs that American adults don't necessarily eat healthier, even if they're more aware of the risks of ordering a side of fries instead of a salad or vegetables. Another Pew study found that Americans were more likely today than two decades ago to pay attention to what they eat. Yet eating habits today are less healthy than they used to be, the poll found. The effects of those habits are clear: 71 percent of American adults are overweight, and 38 percent of those are obese, according to the Centers for Disease Control and Prevention.

Needed: broader context

Both Gibbs and Ostyre recommend food sources from plants whenever possible, and moderation everywhere else. They say that it's better to focus on an overall diet or lifestyle rather than what a person is eating from meal to meal or snack to snack.

Gibbs — who works with patients looking to nutritionally boost their immunity during cancer treatments — adds that mainstream information on healthy eating often muddies the waters for those looking to make positive changes.

We often hear the word "superfood," for example — used to describe foods like avocados, spinach and salmon that are high in nutritional content — when it should really be a "superdiet," she said, with a variety of nutrients from different sources such as vegetables, fruits, nuts, beans and seeds, "in a variety of colors."

Asked about the notion that sugar feeds cancer, Gibbs said it's a question she gets asked a lot.

"It's not that simple," she said. "My explanation for it is that we know that in a person whose diet is just refined, without good foods, that over time, a diet that's high in refined, carbohydrate-rich, sugary foods — along with not exercising — puts the body in a state of inflammation, which can lead to conditions like cancer."

Flexible, realistic

Neither Gibbs nor Ostyre believe in combining any sense of dread or restriction with good nutrition. Gibbs adds that no one should ever eat a vegetable that they don't like.

"The last thing they need is this fear … about one particular food," said Gibbs, especially with many options out there on healthy choices and ways to create them, such as smoothies.

Ostyre agrees, and recommends clients eat a hamburger if they want a hamburger, as long as it's in moderation and offset with healthier choices as well.

"We used to recommend five [fruits and vegetables] per day. Now we recommend eight to 10 per day, and the more different colors, the better the cancer protection," and prevention of heart disease and diabetes, Gibbs said. The good news is that those numbers represent serving sizes: so one banana is usually two servings of fruit, for example.

"It's about eating plant-based foods and not just one in particular, and looking at the whole context of your diet."

Even reports of needing to drink 64 ounces of water a day are not the definite standard for everyone, Ostyre said. She said it is true that when we think we're hungry we are likely thirsty, but as long as urine is light or clear, one is not at risk of dehydration. Flavoring water is fine, she said.

Trendy diets are not always what they appear to be, and may be so limiting that those on the eating plans don't stick with them long.

"It's not about one day or one meal," said Gibbs. "It's what you eat over time."


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