February 2015, Vol 3, No 2 - Inside Patient Care
Patricia Lininger, MSEd

There is an overabundance of information bombarding the masses and circulating via magazines, the Internet, and on social media regarding the latest diet trends and healthy eating plans.

The consequent discussions are rampant and often contradictory on what the best strategies for weight loss and weight management are, creating confusion for many patients.

Other patients may be initially confident that one of the new diet plans they have read about will result in the leaner and healthier outcomes they are hoping for, but soon after starting it, they feel too deprived. This results in their abandonment of the plan before achieving any measurable success.

Retail pharmacists and clinicians are in an ideal position to counsel these patients on healthier and more easily achievable nutrition plans and on the risks associated with certain diet trends, such as those requiring the elimination of entire food groups. They can provide patients with alternate options with validated health benefits, such as clean eating and consuming adequate fiber with fruits and vegetables and with intact whole grains.

Diet Trends

As previously mentioned, some popular trends in diet plans require the elimination or the minimization of entire food groups, such as eliminating or drastically limiting all carbohydrates, all meats, or all fat or dairy products, without providing alternative foods that can adequately supply the nutrients that will be missed. For example, diets requiring high protein consumption with no or very few carbohydrates limit some necessary nutrients for optimal health and adequate energy. Unfortunately, many of these diet plans that limit or eliminate beneficial food groups are often still touted as being the quick solution for weight loss.

Gluten-free diets, for example, are recommended for patients with gluten sensitivities, celiac disease, or Crohn’s disease—but eliminating all grain products without replacing them with other fibrous foods, can result in the elimination of micronutrients and therefore, is not recommended. Furthermore, it is not necessary for everyone to eliminate every type of grain. Whole intact grains have a valuable place in a healthy diet for most individuals.

Community pharmacists and clinicians should counsel patients who are considering eliminating food groups (eg, all grains or carbohydrates) from their diet to ensure the replacement of the macro- and micronutrients that will be eliminated. They can offer suggestions for healthier eating plans that provide all of the nutrients necessary for optimal health and functioning, which may include consuming whole and intact grains and/or other foods that provide adequate fiber and the micronutrients usually found in grains.

Healthy Trend: Clean Eating

As a nutrition, health, and wellness strategist, I naturally align with the clean eating agenda, believing that simple, whole, and natural plant-based foods that are nutrient and fiber rich and free from toxins, chemicals, and hormones are the healthiest choices.

Allowing for a gradual conformity to this clean eating plan can help to avoid the stress of a major change in the initial stage, because stress can become a harmful toxin in itself. Once tastes adapt and cravings have diminished, which can happen fairly quickly, whole and healthy foods often become personal favorites and then there are fewer struggles or feelings of deprivation. At that time, greater compliance naturally occurs.

The clean eating agenda is not a new diet fad; however, it has recently become a topic of greater interest for many people. Fortunately, after several years, high-protein diets that require consumption of low or no carbohydrates seem to finally be losing their popularity, and nutritional habits that are healthy overall seem to be taking hold.

Healthy Trend: Fiber-Rich Diet with Fruits and Vegetables

Another healthy trend that goes hand in hand with clean eating is the fiber-rich diet. There can be little debate that to achieve and maintain good health, fiber-rich and nutrient-dense fruits and vegetables (complex carbohydrates) are a must.

These valuable macronutrients contain many beneficial and health-promoting vitamins and micronutrients, along with a substantial amount of fiber that is essential for optimal functioning, energy utilization, and optimal health. The research data are promising that increasing fruit and vegetable consumption can lead to dramatic whole-body health improvements and disease prevention.1-3

In fact, studies over the years have linked an increase in the consumption of fruits and vegetables to a lower risk for several common diseases and degenerative disorders, including coronary heart disease, macular degeneration, diabetes, and certain cancers.1-3 Although a definitive association between increased fruit and vegetable consumption and cancer prevention has not been firmly established, the data suggest that further studies are warranted.3

If that promising evidence is not enough to encourage the masses to boost their fruit and vegetable intake, keep in mind that this healthy, albeit nondepriving eating habit, can also lead to weight loss. Of course, it is common knowledge that being at a healthy weight can further improve health and diminish risk factors for disease.

A review of 22 studies on dietary fiber demonstrated that consuming an additional 14 g of fiber daily resulted in significant weight loss.4

In another study by Fitzwater and colleagues, 69% of obese adults who were advised to eat a diet high in carbohydrates but low in fat, consisting of unlimited fruits and vegetables, lost a significant amount of weight in <4 months and continued to lose weight for the duration of the study.5

In another interesting study on families with ≥1 obese parent and non-obese child, one group was instructed to increase their consumption of fruits and vegetables, a second group was instructed to decrease their intake of foods high in fat and sugar.6 The outcome of the group consuming increased fruits and vegetables was a more significant weight reduction than that of the group following the decreased high-fat and high-sugar foods protocol. It is also worth noting that the group consuming more fruits and vegetables also decreased their consumption of foods high in fat and sugar.6

Healthy Trend: Eating Intact Whole Grains

In addition to the health benefits associated with fibrous fruits and vegetables, another highly beneficial source of fiber, which is often ignored, is whole grains. Grains have developed a bad reputation, first during the high-protein/low-carbohydrates craze, and now with the gluten-free/wheat elimination diets. However, whole grains are an excellent source of healthy, viscous fiber that have been associated with weight loss, health promotion, and disease prevention. A fully intact grain is a healthy fiber that slows the absorption and digestion of foods, eliminating sugar spikes, which can lead to an increase in insulin sensitivity.

According to a study by Jenkins and colleagues, viscous fiber was linked to a marked 20% reduction in glycemic response.7 The problem is, some whole grain products found on grocery store shelves are actually less than whole. In many cases, they have been crushed and/or partially processed, sometimes missing the viscous outer portion. Unfortunately, as long as they still have more than half of the grain included after the partial processing or disassembling of the grain, they can still be listed as whole grain product, even though their high-fiber, slow-digesting, and health-bestowing attributes may have been compromised.

However, when intact, whole grain fiber has been associated with lower risks of many of the same diseases as fruits and vegetables.8,9

It is also significant to mention that although there is no conclusive evidence available at this time, it is reasonable to assume that additional long-term studies may reveal a link between increased intakes of viscous fiber found in whole and intact grains with a reduced risk for colon cancer.

In addition to the health benefits listed above, the viscosity of whole grain fibers can increase satiety, resulting in decreased calorie consumption and greater ease when seeking weight loss. The slower digestion of this fiber provides extended energy and because of the more optimal glucose response, it can likely result in less fat storing. Adding whole grains, particularly intact grains and sprouted grains, can result in an efficient and clean digestive system that is better prepared for optimal energy utilization and fat loss.

Conclusion

As patients seek advice on the healthiest eating habits amid the current/popular trends, retail pharmacists and clinicians are in a position to inform patients of the benefits and efficacy of incorporating healthy habits, such as clean eating, which is the consumption of whole, simple, and unprocessed foods, and those grown and raised without toxins, chemicals, and hormones. Additionally, fiber-rich diets that include intact whole grains and plenty of fruits and vegetables can provide many health benefits, disease prevention, and weight loss.




References

  1. Hung HC, Joshipura KJ, Jiang R, et al. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst. 2004;96:1577-1584.
  2. Ma L, Dou HL, Wu YQ, et al. Lutein and zeaxanthin intake and the risk of age-related macular degeneration: a systematic review and meta-analysis. Br J Nutr. 2012;107:350-359.
  3. Story EN, Kopec RE, Schwartz SJ, et al. An update on the health effects of tomato lycopene. Annu Rev Food Sci Technol. 2010;1:189-210.
  4. Howarth NC, Saltzman E, Roberts SB. Dietary fiber and weight regulation. Nutr Rev. 2001;59:129-139.
  5. Fitzwater SL, Weinsier RL, Wooldridge NH, et al. Evaluation of long-term weight changes after a multidisciplinary weight control program. J Am Diet Assoc. 1991;91:421-426, 29.
  6. Epstein LH, Gordy CC, Raynor HA, et al. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obesity Res. 2001;9:171-178.
  7. Jenkins AL, Jenkins DJ, Wolever TM, et al. Comparable postprandial glucose reductions with viscous fiber blend enriched biscuits in healthy subjects and patients with diabetes mellitus: acute randomized controlled clinical trial. Croat Med J. 2008;49:772-782.
  8. Jacobs DR Jr, Andersen LF, Blomhoff R. Whole-grain consumption is associated with a reduced risk of noncardiovascular, noncancer death attributed to inflammatory diseases in the Iowa Women’s Health Study. Am J Clin Nutr. 2007;85:1606-1614.
  9. Mellen PB, Walsh TF, Herrington DM. Whole grain intake and cardiovascular disease: a meta-analysis. Nutr Metab Cardiovasc Dis. 2007;18:283-290.
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