Top Ranked Diets Are So Not “Diets”

Photo courtesy of US News & World Report

Of course, any style of eating is actually considered a diet. But what I’m talking about here is a ‘diet’ in the traditional sense – a style of eating that includes an element of deprivation attached to it. Well, my friends…I’ve got good news for you! Not surprisingly, the best overall diets for health seem to focus on achieving a reasonable lifestyle that doesn’t require becoming a gym rat or only eating raw plants; gnawing mainly on roast beast that you had to wrestle into your grocery cart (in the most paleo-thetic way possible) or foregoing anything that tastes amazing AND hailed from a package or burger joint.

The U.S. News & World Report just announced the reigning champ of all diets. Drum roll please. After analyzing 32 popular diets, their panel of experts, including notables such as Robert Kushner, MD, David Katz, MD, Joanne Slavin, RD, PhD and Penny Kris-Etherton, RD, PhD, proclaimed the DASH Diet as No.1 in Best Overall Diets followed by the TLC diet and the Mediterranean diet in 3rd place.

The DASH, TLC (National Institutes of Health’s Therapeutic Lifestyle Changes diet endorsed by the American Heart Association) and Mediterranean diets are well-researched diets and all share the common benefit of reducing the risk of heart disease. This is good news as heart disease still plagues Americans as the No. 1 killer of both men and women. All three diets are similar as they all espouse monitoring calories, limiting (but not eliminating) sodium, sugar and animal protein and filling up the plate abundantly with vegetables, fruits and whole grains.

Also not surprisingly, Weight Watchers, which has always focused on monitoring calories and including all types of food, holds on to the top spot for Best Weight-Loss Diets. Notably absent from top rankings of “Best” categories for overall health, weight-loss, diabetes, heart health and any other category was:

• Paleo diet (last place)
• Dukan diet (tied for last place)
• Wheat Belly
• Low carb
• Any celebrity-written diet
• Juicing, acid-alkaline or detox program

Another thing the “Best” diets seem to have in common is that they were very much in side step with the 2010 Dietary Guidelines for Americans (MyPlate) albeit some slight tweaking. Though the “Best” overall diets didn’t make the top three ranking of “Best Weight-Loss Diets”, in my opinion, they certainly could easily be converted into a “Hannah Montana – best of both worlds” type diet by just adjusting the calorie level downward to suit your needs. The USDA has a Super Tracker that can help you figure out what that calorie level is and assign it to whatever type of diet you decide to follow. Might as well give heart disease a kick where it counts while dropping some poundage (if you need to) following the latest and bestest US News & World Report not-a-diet, diet! Good luck. Also, let me know if you’ve stumbled onto a dietary plan that you can stick to lifelong that was not mentioned here. Meanwhile, I wish you a healthy and delicious (non-diet) New Year!

Take Heart: This is One ER Doc You Don’t Want to See (except on television)

 

 

 

 

 

As featured today on WebMD Real Life Nutrition

By David Grotto, RD

Wow! That Giants – Patriots game last night sure was enough to make your heart skip a beat, eh?! Patriots fans may have felt a twinge in their chest at the end of the 4th quarter with that disappointing loss. And believe it or not, getting caught up in the excitement of an action-packed Super Bowl game might be enough to land you in the emergency room!

Doctors in the ER see their fair share of chest discomfort come through their doors. According to the Centers for Disease Control, every year about 785,000 Americans have a first heart attack. Many don’t even know they are having one, and depending on where in the heart the attack occurs, some won’t live to experience a second one. Heart disease is the number one killer of both men and women, accounting for nearly 600,000 deaths in the U.S. in 2009, according to the CDC, with an estimated declining figure for 2010 of 400,000 deaths, according to the World Health Organization. Slightly more than half of those deaths occur in men. And unfortunately, women are closing that gap.

Many women wouldn’t mind seeing the doc I interviewed for this post in the ER. You may know him from his appearance on The Bachelor or as “Dr. Travis” from the award-winning talk show, The Doctors. He doesn’t just play a doctor on TV – he actually is a highly trained emergency room doctor by profession. Dr. Travis Stork, MD graduated Magna Cum Laude from Duke University and earned his MD with honors from the University of Virginia. He works as an emergency room doctor and brings his real life experiences to the show he co-hosts and to his bestselling books: The Lean Belly Prescription and The Doctor Is In: A 7-Step Prescription for Optimal Wellness. But Dr. Stork would prefer never to see his fans in the ER. “You can’t reverse the effects of dead heart muscle once you’ve had a heart attack,” he says. “So don’t wait until you have one to start following a healthy lifestyle. You don’t want to come to the ER and hear me say ‘it’s too late.’” So with an eye on prevention, I asked Dr. Travis Stork to share his thoughts on our current battle against heart disease and his best advice on how to avoid ever seeing him in the ER.

Are we making any progress in the war against heart disease?

Dr. Stork. The numbers are still alarming. It’s still the #1 killer of both men and women. Death rates are declining, which is good, so yes, we are making headway. But in some respects, we are doing worse. We’ve made advances in diagnosis. [Many] women most likely died of heart disease years ago but we might have thought it was from something else because we didn’t think of heart disease as a “woman’s disease”. In the last decade or so, there has been a new focus on women and heart disease and more progress is being made. But time is so limited with your doctor, so conversation is also limited and heart disease messages don’t always get out there. Media is doing a better job and I think our show is getting the word out. However, I’m concerned that if we don’t reverse our current obesity trend, it won’t matter how great our technology is — we won’t make the headway needed to continue to curb heart disease.

Let’s start with the doctor-patient relationship. What can be done to foster better communications there?

Dr. Stork. Feel empowered. Talk with your doctor about steps to improve your health. Ask him/her, “What are the steps I can take?” So much education has to take place outside of the doc’s office – there’s simply not enough time during a visit to cover everything. Knowledge is power. When you visit your doctor to discuss treatment strategies, bring information with you so he/she can tailor a program more to your needs. The doc will know where you’re coming from and can better gage your motivation to make lifestyle changes. What lab tests/technologies are the best indicators that we are at risk for heart disease? Dr. Stork. Cholesterol is a good baseline test. Just like what leads to glucose and blood pressure problems, heart disease starts early in life. Your cholesterol may be perfect at age 20 — at least you know where you are at, if you have it tested. If it is elevated, you need to take extra precautions. Having your blood pressure, glucose, and cholesterol tests done as recommended are the best ways to get a snapshot of your health and they are fairly cheap to have performed. Know your numbers! For example, 64 slice CT scans are often advertised to detect heart disease, but most insurance companies don’t pay for them. Why? Is it worth the out-of-pocket investment? Are they accurate? We have more and more tech that can detect heart disease earlier. But whether the CT scan shows or doesn’t show disease, you should live every day to maximize heart health regardless of the results. Why would you want to wait until you have a problem to act?

What dietary and lifestyle advice do you recommend for your patients and fans?

Dr. Stork. Be wary of some new food that gets positive press — the #1 food that is supposed to be the be all and end all when it comes to fighting heart or any other disease. Consumers tend to latch on to the next big headline. Our show checks out how valid the information is about a food or product before jumping on the bandwagon. People don’t need to get distracted by the headlines – keep it simple. Soluble fiber from oats can lower cholesterol. Ordering salads without the creamy dressings and instead using olive oil and vinegar is a simple thing to do. Don’t focus on can’t do, focus on can dos. I ride my bike to work every day, rain or shine. It’s important to do physical activity that you enjoy doing. I feel when we talk about physical activity in a clinical setting, it sounds so boring. Getting active can be as simple as just getting on your feet more and not about going to the gym more. Getting on your feet doesn’t have to be one of the things you hate. In fact, it can reduce C-reactive protein (a marker for inflammation). Try getting on your feet when you’re on the phone. Most say, “I can do that!” Those are the kinds of messages that people relate to – 30 more minutes of activity versus watching more TV. Try to view health as a hobby rather than something you dread. You will get more enjoyment out of life and have a more positive attitude.

Can you lower your cholesterol without drugs? Are their dietary supplements that you recommend for lowering cholesterol?

Dr. Stork. Be careful with dietary supplements. I believe that eating whole foods has the best benefit for your health. Beans, oats, nuts, olive oil in place of butter, and fatty fish are all heart-healthy foods. More docs are recommending Omega 3 supplements for helping to control triglycerides. My #1 advice: treat a supplement like you would a medicine and talk to your doc. Tell your doctor what you are taking so that it can be entered into the electronic medical record. That way he or she will know what supplements you are taking in addition to your meds and will have a better idea of what you are doing. There is a role for supplements but be cautious about how they are used.

We hear inflammation is tied to heart disease. What can we do to reduce inflammation?

Dr. Stork. Believe it or not, flossing your teeth everyday helps control inflammation and inflammation is connected to heart disease. Data on flossing and longevity is quite interesting – decreasing your bacterial load in your mouth is good for your gums and may be good for your heart. Eating fruits and veggies can also help reduce inflammation.

Are statins safe? Any concerns with them?

Dr. Stork. Meds are patient specific. Statins can raise liver enzymes and possibly cause myopathies. But they can be very effective in lowering cholesterol. I take a two-pronged approach – just popping a pill is the wrong mindset. Meds are important. No matter what some people do to take care of themselves, they may be predisposed to heart disease, so meds might be appropriate for them. Yes, there are docs who are “meds first” and there are docs that are “lifestyle first”. We are getting better and better at offering lifestyle but some are still just giving meds – it’s easier. We probably do, as a profession, lean too much on meds because of the grim stats. It is difficult for many patients to make the necessary lifestyle changes.

How often should you see your doctor?

Dr. Stork. See your doc annually and have your cholesterol checked annually as well. Seeing your doctor should be tailored to your needs. The good news is if you take good care of yourself, then you don’t need to go to the doc as much. View health care as a check-up. The better choices you make, the longer time you can go between checkups. For example, if your blood pressure is elevated, you might have to see doc more frequently to make sure it is under control.

Final thoughts?

Dr. Stork. My personal belief is all of us should live our lives as if we have heart disease. Don’t wait until you have a diagnosis or a bad lab value to make the necessary lifestyle changes to lower your risk. Diagnostic tools are great, but why wait? Assume you will have heart disease unless you make the right choices. Control the risk factors: Smoking, high blood pressure, high cholesterol, high triglycerides, untreated diabetes, obesity, stress, and lack of regular exercise. What’s interesting is there are really three simple things you need to do – get active, eat better, and stop smoking. Concentrating on these three risk factors leads to all the others.

Thanks to Travis Stork, MD for sharing his wonderful advice. Next week I’ll offer some of my own advice on the best foods for fighting heart disease along with some yummy recipes! Stay tuned and have a great week!

Is It Too Late?

Photo courtesy of www.fatbellyexercises.com As featured in the Real Nutrition section on WebMD By David Grotto, RD, LDN As promised, I offer you  part deux of  Houston, I Don’t Think I Have a Problem…yet… Some of you were kind  enough to share a bit of your own weight management struggles with me last  week, and I really appreciate that. But I couldn’t help but sense that there   are those of you who are still quietly waiting in the wings, hovering between   pre-contemplation and contemplation, trying to figure out if you even have a  problem or not. And if you do realize that you have health problems, many of   you might be figuring out what your problems might be and then pondering what  you can realistically do about them. All of this can be quite a pain and   perhaps you are feeling one of those big “why bother?” moments coming on.   You’ve been down this path before and the odds seem like they are always   stacked against you. You lose a pound only to gain back two. I get it…totally   frustrating. Is it even worth trying anymore? Do we have a hope of ever  getting back to the glory days state of health we once enjoyed? If you read The Fat Trap by Tara Parker-Pope in the New York Times, you may have come away with the feeling that when it comes to losing weight   for many of us, the only real “losing” that will be happening in your future  will be that of hope…a total downer for sure. But thankfully, in come the  cavalry of science, common sense and hopefulness. I read a very eloquent   retort to Jessica Parker-Rope’s article from David Katz, MD, MPH featured in  the Huffington Post in which he pointed out that when we ask: “Our bodies: with us or against us?” we are asking the wrong question. I asked the   optimistic yet pragmatic Dr. Katz to weigh in on our ‘health state of the  nation’ and to also expound upon some of the challenges and solutions that he  discussed in his article. Have we thrown in the proverbial towel? Are we in the right mindset to make serious changes at this  time? What will it take before we act? Dr. Katz: The one word answer is passion.  When enough of us are passionate about this cause, we will turn the tide. I’m  not sure we’re there yet – but I think we’re getting there. You spoke of an  “optimal environment that works with our natural traits and tendencies” in  your rebuttal to the Fat Trap featured in the Huffington Post. Describe what  you mean by an “optimal environment.” Dr. Katz: Up to a point, we might contend that a Stone Age environment is optimal for our native traits. But that point   would be a life span of about 40 years, MAX! One of the problems with invoking our native Paleolithic environment is that Stone Age humans died at 20 on average, and rarely made it past 40. Still, that is the environment to which we are adapted – so it’s a starting point. The true optimal is a   modified Stone Age environment: one in which food is direct from nature,  there’s routine physical exertion, clean air and water – enhanced by  protection from the elements and predators and pathogens. In essence, we need wholesome food close to nature, the conditioning daily exercise native to our animal vitality, adequate sleep, avoidance of toxins, control of stress and loving relationships in our lives. These are our native tonics. How do we go about achieving this environment? Dr. Katz: Incrementally – one paving stone,  sandbag, program practice, and policy at a time. We don’t need a Stone Age  environment to get exercise every day – but we need incremental modifications  of the built environment and daily routine to move us in that direction. We don’t need mammoth meat or Stone Age plants to chew on – but we do need to eat more plants and foods closer to nature in general. We have the means at our disposal to do that—we just need to apply them. Do you feel our present dietary guidelines are appropriate? What would happen if we actually followed them re: rates of obesity, heart disease, diabetes, longevity, etc.? Dr. Katz: They are appropriate – although not optimal. Let’s acknowledge that they are devised by government agencies with a need to keep large corporate interests placated. The Dietary Guidelines are openly a blend of science and politics, not pure public health science. But despite their limitations, they are much better than the typical American Diet. So yes, were we to better approximate them, rates of heart disease, cancer, stroke, diabetes, sleep apnea, arthritis and so on would come down substantially. If we got to truly optimal diets, exercised routinely, and avoided tobacco – we could eliminate fully 80% of the entire chronic disease burden.  ‘Tis a consummation devoutly to be wished! Do you feel that the food industry is doing enough to change the environmental landscape? If not, what needs to change here? They are not doing nearly enough. What needs to change is that they must take responsibility for creating the prevailing preferences for copious additions of sugar and salt and fat. As is, they tend to throw up their hands and argue they are just trying to keep the customer satisfied. But they had a hand in creating the palate that prevails in the USA—in essence, they cultivated the addictions and now provide the fixes! They should work a whole lot harder to help cure the addictions. They should stop using marketing to distort accepted truths about nutrition (what on earth is “enhanced” water?). And they should embrace measures of nutritional quality developed by objective 3rd parties, not their own hired guns. What changes would you like to see to promote more physical activity? Dr. Katz: Programming adapted to every setting and ability level. Programs that fit into every school and work day.  Ways to be active all at once; in small doses; in planes, trains and automobiles. We are not going back to the Stone Age, so we have to engineer solutions that fit into the modern world as it is. Our ‘abe’ for fitness   program is an example of what I mean. So is our school program, ABC for   Fitness. Is there enough consumer awareness to drive change? Is it out of our hands at this point? Have we reached the point where we can no longer decide for ourselves what’s best for us? Dr. Katz: Consumer awareness is not enough – but consumer passion is [enough to drive change]. It is not out of our hands. Demand trumps supply and if every loving parent and grandparent in the country came together around causes devoted to protecting the health of children, no special interest group could withstand our collective might. We have the power – but we need common cause. It begins with common understanding – so we professionals have our work cut out for us. We must   cultivate the common will so we come together to pave the way. I think what Dr. Katz  proposes will take nothing short of a massive collective effort requiring many intricate wheels to turn simultaneously to work. I agree that we do have many of the tools, the power, and the knowhow at our disposal to make real change for the better happen. But I do wonder, as Dr. Katz mentioned, if we have enough passion to pull it off. Your thoughts? Do we have what it takes to turn the boat around?

Happy New You! What? Don’t Give Up Yet!

I’m not much of a resolution type of guy but I do think the process of making them is fun – as long as you don’t take them too seriously. Apparently, the rest of America has caught on to this too and its predicted that in another week or so, many “resolutions” made will no longer be taken seriously by their makers either. Unfortunately, broken resolutions are often followed by feelings of remorse, failure and dismay.

I wanted to share a few informative and motivational videos with you that may help either get back on track with your new efforts or keep you on track if you haven’t thrown in the towel yet!

The first video was made with my friends from the International Food Information Council. It’s all about helpful tips for weight management – from goal setting to choosing the best optimal foods for middle management.

The second video is actually a Livestream event that was recorded on January 5th which featured Lisa Lillien (aka Hungry Girl), Andrea Metcalf national fitness celebrity and author of the new book Naked Fitness, Douglas “Duffy” McKay, N.D. Vice President, Scientific & Regulatory Affairs for the Life Supplemented campaign, and yours truly. It was entitled the Power Hour of Wellness where we discussed the benefits of a healthy lifestyle that includes diet, exercise and appropriate use of dietary supplements. There were lots of great “resolution” tips given that may be of help to you on your new path to greater wellness. Good luck and don’t forget, you can always seek guidance here if you are struggling. And if you are being successful, I’d love to hear your story, too!!

Powerhour of Wellness

Here’s some coolio photos from the Powerhour of Wellness shoot.

This slideshow requires JavaScript.

Happy and Healthy New Year to everyone!

The Guyatitian