Ch 21: Navigating Diets Flashcards
Dietary approaches can vary based on several factors, including but not limited to the following:
Energy (calorie) control, e.g., calorie counting, points-based commercial diets, or specific meal plans
Macronutrient composition, e.g., low-carb, low-fat, ketogenic, or protein-sparing modified fast
Food type/group choices and/or restriction, e.g., gluten-free, vegan, vegetarian, paleo, clean eating, or Mediterranean
Time-based restriction, e.g., fasting, time-restricted feeding, or cut-off times for meals/nutrients
Degree of flexibility or rigidity of the dietary restraint
It should be noted that in addition to a suitable diet, successful weight loss will also likely include:
Other behaviors, notably physical activity and behavior training such as self-monitoring
The primary weight loss principle
Overall energy balance
Other core principles of a successful diet include:
Macronutrient intake, micronutrient intake, overall food quality, and adherence to the diet.
To assess the potential usefulness of an individual diet method, one can ask the following questions:
- Does this approach lead to superior fat loss compared to other approaches?
- Does this approach lead to superior muscle mass gain (or retention) compared to other approaches?
- Is this approach likely to lead to any micronutrient deficiencies?
- Is the client likely to be able to adhere to this approach?
Does this approach align with the client’s food preference and tolerances? - Is there potential for this approach to cause negative health outcomes (e.g., worsening of blood lipids, insulin sensitivity, or other health markers)?
- Is this approach an evidence-based dietary approach?
Diet Approaches Based on Macronutrient Composition
Low Energy Diets (Calories)
Low Fat
Diets will be of about 800 to 1,200 kilocalories per day (kcal/d)
Low Energy Diets
Diets less than 800 kcal/d kilocalories per day (kcal/d)
Very Low Energy Diets
Advantage of Low Energy Diets
Such diets may be particularly useful in situations where rapid weight loss can have profound health benefits
Negative Effects of Low-Calorie Dieting and Rapid Weight Loss
Increased risk of lean body mass loss, particularly in those who are already relatively lean
Decreased athletic performance
Lowered ability to recover from exercise
Increased hunger versus more moderate calorie reduction (although not always the case)
Decreased food options
Difficulty in consuming sufficient amount of micronutrients
Very Low Energy Diets
Very-low-energy diets (VLED) should be followed only under the supervision of a medical professional. It is beyond the scope of practice for Nutrition Coaches to recommend or oversee the implementation of VLED for clients. A VLED is a doctor-supervised diet that typically uses commercially prepared formulas, such as liquid shakes or bars, to promote rapid weight loss in patients who are obese. VLED formulas are not the same as the meal replacements sold at grocery stores or pharmacies, which are meant to substitute for one or two meals a day.
Suggested Intake of Protein(g/kg)
01.2 to 1.6 g/kg body weight up to 2.3 to 3.1 g/kg fat-free mass
Suggested Intake of Protein(g/lb)
0.5 to 0.7 g/lb body weight up to 1.0 -to 1.4 g/lb fat-free mass
Low Fat Diet
Typically describes a diet where fat intake is 20 to 35% of total calories
Diets below that lower cut-off of 20% of total calories
Very low-fat diets (VLFD).
Potential Negative Impacts of Extremely Low-Fat Intakes
Can limit inclusion of foods with positive health impacts (e.g., nuts, seeds, olive oil, etc.)
Can make the diet more difficult to adhere to due to food restrictions
May lead to decreases in sex hormones such as testosterone (Hämäläinen et al., 1983)
Can lead to increases in triglyceride levels in the blood in the short-term (Lichtenstein & Van Horn, 1998)
Theoretically, can increase the risk of an essential fatty acid deficiency at consistent extremely low-fat intakes (<10% of total calories)
The following are some of the primary explanations for reduced calorie intake on a low-fat diet:
Reduction in calorie-dense foods
Reduction in hyperpalatable foods
Positive Impacts of Dietary Fat
Humans cannot make essential fatty acids, so they must be obtained via the diet.
Fat allows us to absorb fat-soluble vitamins: A, D, E, and K.
Cell walls contain fat.
Fats are involved in hormone production.
Helps avoid problems with low-fat diets
Advise basing most of dietary fat intake
Plant-based fats, particularly those high in monounsaturated fatty acids, as well omega-3 sources, such as fatty fish. In addition, animal foods such as eggs and dairy produce can confer health benefits and should not be avoided due to their fat content.
A study where participants are kept in a ward where they can be closely monitored at all times – this allows for precise measurements of metrics like energy expenditure or precise recording of food intake. These studies are extremely high-quality, well-controlled studies.
Metabolic Ward Study
Studies typically classify a diet as low-carbohydrate if the carbohydrate content is:
40% or less of total calories.
Truly low-carbohydrate, then the carbohydrate intake should be much lower:
50 to 150 g/d (Westman et al., 2007) or < 20% of total calories (Gulbrand et al., 2014).
low-carbohydrate diets
Overall, low-carbohydrate diets can be safely used as a dietary approach to decrease body fat. However, there is no fat-loss advantage over other dietary approaches of equivalent calorie and protein intake. A low-carbohydrate diet is most likely a suboptimal approach for many competitive athletes, particularly in sports with considerable energy contribution from the anaerobic system (Burke, 2015; Burke et al., 2017). A low-carbohydrate diet can be safely used as part of a healthy lifestyle; however, its health impact is dependent on the foods selected and not merely the macronutrient composition
Ketosis
A metabolic state where the liver is producing ketones (or ketone bodies) from fatty acids – there are three ketones produced in the human body: acetoacetate, beta-hydroxybutyrate, and acetone. These ketones are an alternative fuel (substrate) that the body can use during the time of low glucose availability brought on by starvation, very low-calorie intake, and/or carbohydrate restriction (or in clinical disorders).
It involves consuming a large percentage of calories from fat, moderate percentage of protein, and very little carbohydrate.
Ketogenic Diets
A natural metabolic state that occurs when the body starts producing ketones (ketone bodies) from fat. The body can use these ketones as a fuel (substrate) source to generate energy in place of glucose
Ketosis
A ketogenic diet typically requires carbohydrates to be restricted
Less than 50 grams per day (or 5% of total calories), protein intake to be moderate (20 to 30% of calories), and the remaining calories to be made up from dietary fat (usually 65 to 75% of calories).
It has also been found that ketosis can lead to the suppression of?
Ghrelin, a potent appetite hormone
Ketogenic Side Effects
Nausea, headaches, vomiting, and dizziness
Ketogenic Benefits
Ketogenic diets have shown to lead to improvements in cardiovascular disease risk in certain people, notably, decreases in blood triglycerides and increases in high-density lipoprotein cholesterol
The amount of energy (calories) expended to digest and metabolize food.
Thermic Effect of Feeding (TEF)
Defined as one containing more than 25% of total calories from protein or above 1.2 grams of protein per kilogram of body weight (g/kg) or 0.54 g/lb. The recommended daily allowance (RDA) for protein is currently set at 0.8 g/kg (0.36 g/lb). However, there is strong evidence showing multiple health and body composition benefits to consuming higher amounts, especially in the range of 1.2 to 1.6 g/kg (0.54 to 0.73 g/lb).
High-Protein Diet
High-Protein Diet Benefits
To preserve or increase fat-free mass (FFM), increase satiety, and increase the thermic effect of feeding (TEF). They show more body-fat reduction per unit of body weight loss when compared to low-protein diets.
Broad recommendation of protein intake for clients with a calorie reduced diet
Consume 20 to 40 grams of protein in three to four meals across the day.
The edible seeds of plants from the legume family that include dry beans, dry peas, cow peas, pigeon peas, lupins, lentils, fava beans, and chickpeas.
Pulses
Diet Approaches Based on Food Choices and/or Restrictions
Mediterranean Diet
Vegan
Vegetarian
Paleo Diet (Paleolithic Diet)
Gluten-Free
My Plate
DASH (Dietary Approaches to Stop Hypertension) Diet
Plant foods such as fresh vegetables, fruit, grains, and nuts make up the basis of the diet in addition to liberal use of olive oil. Fish, poultry, and dairy like cheese and yogurt are included in moderate amounts while red meat consumption is low
Mediterranean Diet
Mediterranean diet extends beyond food choices as it also accounts for social and cultural aspects
Communal mealtimes, resting after eating, and regular physical activity
A plant-based diet that excludes all animal products, including meat, fish, eggs, and dairy
Vegan
Lacto Vegetarian
No animal products except dairy
Lacto-Ovo-Vegetarian
No animal products except dairy and eggs
Pescetarian
No animal products except Fish, eggs and dairy
Flexitarian
Mostly Vegetarian with occasional meat or fish
Where there is net-positive protein balance (i.e., there is more protein synthesis than there is protein breakdown) – there is a net building of protein.
Anabolic Response
Refers to a dietary pattern consisting of high intakes of processed foods, prepackaged foods, fried foods, high-sugar drinks, and foods high in both refined carbohydrate and fat.
The Western Diet (sometimes called the Standard American diet)
Pitfalls with the Vegetarian Diet
- Protein Intake (Pea Protein Powder)
- Protein Quality (plant-based proteins are inferior to animal-based protein sources due to their poorer amino acid profile)
- Vitamin B12 (suboptimal vitamin B12 intake and/or outright deficiency)
- Omega 3 Fatty Acids (essential omega-3 fat is called alpha-linoleic acid (ALA) -EPA + DHA supplement. Vegan-friendly EPA/DHA supplements are available with the fats extracted from microalgae)
- Calcium (Vegans can obtain calcium from several sources with leafy green vegetables being a particularly good source)
- Iron (Non-heme iron has a much lower bioavailability than heme iron, meaning vegan clients may require even higher iron intakes to maintain adequate iron status, 1.8 X)
- Creatine (vegetarian clients may tend to have lower muscle creatine stores)
Creatine benefits
Mitigating age-related loss of muscle mass and strength and reducing risk of neurological disorders such as traumatic brain injury and Parkinson’s disease
Dietary approach that focuses on selecting foods that proponents of the diet claim humans were exposed to for most of our evolutionary history: meat, fish, vegetables, fruit, nuts, and seeds. In its strictest form
Paleo Diet (Paleolithic Diet)
Paleo Diet forbids:
Grains, legumes, dairy products, and most conventionally processed foods
The primary objection to recommending a paleo diet
It unnecessarily restricts foods and/or food groups that have strong evidence to support beneficial impacts on health
Most evidence very strongly supports the promotion of whole grains, legumes, and dairy consumption for human health
The term used to describe a collection of proteins found in grains.
Gluten
In wheat, gluten covers two related proteins:
Gliadin and glutenin
Gluten-containing grains include (but are not limited to)
Barley and rye
An autoimmune disorder where the protein gluten causes the body to mount an immune response, which leads to damage to the small intestine.
Celiac Disease
Celiac autoimmune response to wheat
Gastrointestinal distress, diarrhea, pain, rapid weight loss, and severe fatigue
A clinical condition induced by the ingestion of gluten leading to intestinal and/or extraintestinal symptoms that improve once the gluten-containing foodstuff is removed from the diet and celiac disease and wheat allergy have been excluded.
Non-Celiac Gluten Sensitivity (NCGS)
Currently, diagnosis is made based on exclusion
Most current attempt from the USDA to represent guidelines for healthy eating through a visual representation with supporting recommendations
MyPlate
The MyPlate recommendations are based on four primary goals
- Focus on variety, amount, and nutrition.
- Choose foods and beverages with less saturated fat, sodium, and added sugars.
- Start with small changes to build healthier eating styles.
- Support healthy eating for everyone.
DASH Diet Recommendations (courtesy of the National Heart, Lung and Blood Institute)
Eating vegetables, fruits, and whole grains
Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
Limiting foods that are high in saturated fat such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils
Limiting sugar-sweetened beverages and sweets
Translates to “as desired” and refers to eating or drinking as you are normally driven to (i.e., not purposely overeating or undereating).
Ad Libitum
There are various distinct iterations of a dietary approach based on intermittent fasting:
- Alternate Day Fasting
- 5:2 Diet
- Time-Restricted Feeding (TRF)
- Prolonged Fast (several days of fasting done every several months)
A protocol that is just as its name implies; the individual alternates between a day of fasting and a day of feeding (typically ad libitum dieting)
Alternate Day Fasting
It often allows a small amount of calories such as 25% of normal maintenance intake or 500 kcal
Derives its name from a description of the protocol: 2 fasting days and 5 feeding days per week.
The 5:2 diet
Calories can be consumed on the fasting days with a maximum of typically 500 kcal set for women and 600 kcal for men
Eating approach where there are specific eating and fasting windows across the day
Time-Restricted Feeding
Individual would fast for 16 hours in every 24-hour period, leaving a feeding window of eight hours
16:8 fasting:feeding approach
What is orthorexia?
A fixation on only eating healthy food.
A ketogenic diet typically requires carbohydrate intake to be restricted to less than how many grams per day?
50 g
In research, a low-energy diet (LED) most commonly describes a diet of approximately how many daily calories?
800 to 1,200 kcal/day
