Debunking Common Nutrition Beliefs

Crystal, my other RD half over at Real Life Women’s Health is back today with a post for you! If you don’t already, you can follow her on instagram for a bunch of other good stuff. Enjoy!

Happy Friday everyone! Bear with me here and settle in with a cup of coffee (or preferred beverage of choice) because this post is a bit long, but I wanted to be thorough! My hope is that this post will ease your mind on a variety of nutrition myths and misinformation and also provide some clarification.

Unfortunately, in the world we live in anyone can write anything about nutrition. This is problematic for a variety of reasons. There are also conflicting findings in the research itself and how that information is communicated to the public (you!) can further add to the confusion. It is common for my clients to cut out entire food groups from their diet in an effort to be “healthier” but when we dig deeper, we often find this isn’t the best for their overall health – which can be both scary and liberating. I don’t want to discount anyone’s lived experience with how a particular food makes them feel so this isn’t always the case, but it’s quite common.

Before we dive in, I want to say that no one food or meal has a direct impact on our health. It is our patterns over time that matter most and even then, only 30% of health behaviors (tobacco use, diet & exercise, alcohol use, safe sex) contribute to health risks and outcomes. Only 30% !! Socioeconomic factors like education, employment, income, family/social support, and community safety play a bigger role. That doesn’t mean we throw nutrition out the window, rather to say it’s not the whole picture. As a society, we have to stop demonizing foods and believing that our food and exercise choices alone are the end all be all to our health.

OK – so let’s get down to it.

Dairy

I might be biased because I love dairy, especially cheese! But besides that, this is a food group that contain all the macronutrients -carbs/fat/protein – gang’s all here! Dairy also provides calcium as well as some vitamin A, B12, riboflavin, zinc and phosphorus. For those of you interested in female hormonal health, full fat dairy is particularly beneficial. Recent studies have suggested that women who eat at least once serving of full fat dairy per day are less likely to have ovulatory disorders than those who consume low fat or nonfat dairy products. Yes! I’m not entirely sure why dairy has such a bad rap. The idea that it is “inflammatory” which is perpetuated by diets like Whole30 probably play a role. But the research simply isn’t there. A 2017 review of 52 clinical trials (aka a reliable source) investigated inflammatory markers in relation to the consumption of dairy products and found dairy is actually ANTI inflammatory.

Carbohydrates

Carbs just can’t catch a break! They are “evil”, “killing us”, “the cause of all our health problems”…has anyone else heard this nonsense?! Ohhh diet culture, back up off my beloved carbs.

A 2018 study looking at carbohydrate intake and mortality concluded that both high and low carb diets were associated with increased mortality. And there was minimal increased mortality when someone’s carb intake was in the middle – neither high nor low. If you’re eating well balanced meals you are likely to fall in this middle 50-55% range without even having to think about it. Our bodies know what we need.

Some facts on carbs:

• Your brain needs a minimum of 140 grams of carbohydrates a day – the equivalent of 3 ¼ cups of cooked pasta – JUST FOR YOUR BRAIN!
• Decreased glucose can lead to poor attention and impaired memory – ever have a hard time concentrating when hungry?
• Carbohydrates increase serotonin (our feel good neurotransmitter) – it makes sense we feel good when we eat carbs
• Our brains cannot store glucose so they need a constant supply from food
• If you are not supplying your body with adequate carbs, it will break down protein found in muscle, body tissues, and organs for energy
• For maximum functioning and metabolic potential, your body needs a carbohydrate intake of 50-60% of your total daily intake – even more reason to see carbs as a food group that does something FOR your body not TO your body

FATS

This may be the most underrated macronutrient. Did you know 60% of the brains dry weight is made up of fat? Essential Fatty Acids (EFAs) are required for maintenance of optimal health, but they cannot be made by the body and must be obtained from dietary sources. Inadequate fat intake is associated with increased risk of depression. On top of that, women need a certain level of body fat to maintain normal menstrual function. Fat has a multitude of benefits, plus it tastes good and is satiating! Personally, I feel better when eating plenty of fats (eggs, avocado, olive oil, cheese, nuts) and many of my clients report when they are eating adequate fats they feel so much better too. Omega 3’s are particularly important for brain health. Fatty fish is a good source, but if you don’t eat fatty fish like salmon 2-3x/wk you might want to consider a fish oil supplement.

PROTEIN

Protein seems, for the most part, to have escaped the wrath of diet culture. We need protein, yes, however as a population we eat almost double what we actually need – and in turn usually aren’t getting enough fats and carbs. We can only digest and use a certain amount of protein at once so those who eat a high protein, low carb diet aren’t absorbing all the protein they eat anyways. Trendy ways of eating like paleo and a keto usually have meals that are higher in protein and lower in carbs. The paleo diet excludes grains among other food groups despite the fact that paleobotanists have found starch granules trapped in the tartar on 40,000-year-old Neanderthal teeth with the distinctive shapes of barley and other grains. I thought that was so interesting! You can read more if you’re interested here.

Anti-inflammatory foods

For this one I will point you to this recent article by Tamara Duker Freuman, MS, RD, CDN. A really good read!

Processed foods and sugar

Everything I would say about sugar Robyn has written about here and she links to podcasts with Marci Evans talking about the science behind food addiction. To sum it up – while feeling like you are addicted to food or sugar is 100% a real thing and we’re not discounting that; the science doesn’t back it up and we know that restriction is what leads to these strong feelings of “addiction” and not a lack of willpower itself.

In terms of processed food, just because a food is “processed” doesn’t really mean much. Almost everything we consume that’s purchased from a grocery store has been processed in some way. This article by Laura Thomas, PhD speaks to this more. Also listen to her podcast and follow on instagram for more debunking.

Food sensitivity testing

First some clarification on terminology:

A food intolerance, or a food sensitivity, occurs when a person has difficulty digesting a particular food. This can lead to symptoms such as intestinal gas, abdominal pain or diarrhea.

A food intolerance is sometimes confused with or mislabeled as a food allergy. Food intolerances involve the digestive system. Food allergies involve the immune system. With a food allergy, even a microscopic amount of the food has the potential to lead to a serious or life-threatening reaction called anaphylaxis. This is not the case with a food intolerance.

IgE tests aim to measure allergies. However, IgE tests alone are not enough to diagnose an allergy, only a fraction of people with positive IgE tests are actually allergic to the food. IgE tests show you are sensitive to the allergen, but not that you necessarily have a clinical allergy. If you are allergic to a food, it’s usually determined at some point in childhood although some develop later in life. The top 8 are eggs, milk, fish, shellfish, tree nuts, peanuts, wheat, and soybean – these make up 90% of foods people are allergic to.

IgG tests claim to measure “sensitivities” but the are highly problematic. This article explains in more detail the myth of IgG food panel testing. This quote by Tamara Duker Freuman, an RD who specializes is digestive health sums it up well:

IgG or food sensitivity tests are NOT evidence based, IgG is a memory antibody that signals food TOLERANCE, not food intolerance…that’s why often people will have a “high response” to foods they eat most often, because it’s a memory antibody!

MRT (mediator release test) measures levels of cytokines, histamine, leukotrienes, prostaglandins and other mediators released from white blood cells after exposure to 150 foods and food chemical profiles. Some dietitians use this test followed by an elimination diet and anecdotally report improved symptoms in their patients. That being said, there are no peer-reviewed, published studies validating the test. A search for LEAP mediator release test on PubMed had zero results so more research is definitely needed.

Again, I don’t want to discount anyone’s lived experience with any of these tests and I am speaking more to the scientific evidence that does/doesn’t support them. In my experience often a person’s mental/emotional relationship with food results in GI distress because we know the brain and gut are linked. If you’ve heard the saying, “a stressed out brain leads to a stressed out gut” that is 100% true. I can’t count how many times I have heard someone say how a food used to bother them, but now that they eat it frequently and don’t assign moral value to it, they no longer have GI symptoms. Could avoidance of a particular food actually make you more sensitive to it? Perhaps. It makes sense. If you avoid particular foods for an extended period of time that can affect your gut microbiome so reintroducing that food might cause a little “discomfort” initially, but that should go away as you eat the food more frequently.

Regardless of the type of test, most dietitians will not do them for people with a history of disordered eating/ED. Many people with EDs do get this testing done and go on an elimination diet which can cause a relapse and worsen the disorder. If you are someone who falls into this category I would strongly caution against having these tests done.

The nocebo effect

This phenomenon occurs when you experience adverse events related to a drug, food or a treatment simply because you expect them to develop. A quote from Dr. Arthur J. Barsky – a professor of psychiatry at Harvard Medical School…

People who are prone to catastrophizing, neuroticism or anxiety may be more susceptible to the nocebo effect, experts say. And “if you tend to have lots of medically unexplained symptoms, you’re more likely to have a nocebo response.

In a study conducted to confirm a diagnosis of non-celiac gluten sensitivity (NCGS) in patients without celiac disease, 40% had a nocebo response meaning when they consumed a placebo product (aka gluten-free products) they indicated having symptoms in response to what they thought was gluten. Yes! The mind is strong. This response could be because people who assume they gluten intolerant are actually reacting to the fermentable carbohydrates in wheat products.

So, there are LOTS of factors to consider when we talk about food and our response to these foods – is it a true allergy, a nocebo effect, related to stress, distorted by disordered eating or an eating disorder? This takes a lot of curiosity and digging into and it’s far more complex that we often assume.

If you are having GI symptoms of any kind or feel like you need more support in figuring all of this out – speak to your non-diet dietitian as they are trained to support you in this process. You deserve to get the support you need!

Whew! Ok. Deep breaths. That was a lot of info. Save it and go back when you need. I hope you have a lovely weekend and remember – ALL foods fit!

References:

http://www.countyhealthrankings.org/explore-health-rankings/what-and-why-we-rank

https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/immunoglobulin-e-(ige)

https://www.ncbi.nlm.nih.gov/pubmed/26287637

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext

https://www.ncbi.nlm.nih.gov/pubmed/20227928

https://www.ncbi.nlm.nih.gov/pubmed/27523634