Four Popular Diets

Butter for breakfast?

Whether you’d prefer to live on bacon or bro cc oli, a diet has been in vented for you. What the long-term health consequences are , or if the diet will help you achieve

particular goals, is another question. A di et is any plan that sets forth a set of restrictions on eating, with a certain health target in mind. Four diets in particular have achieved popularity in the past few years: the intermittent fasting diet, which emphasizes eating within a certain time window; the ketogenic diet, which promotes fat over carbohydrates; the Paleo diet, which theorizes that eating like our Paleolithic ancestors will help you bypass diseases that plague developed societies; and the Plant Paradox, which postulates that a chemical compound found in certain plants is responsible for ill health.

Intermittent fasting: Fasting has been around as long as eating, but “intermittent fasting” as a voluntary, deliberate weight-loss approach has been popularized only recently by books such as The Complete Guide to

Fasting by Dr. Jason Fung and Jimmy Moore and The Fast Diet by Dr. Michael Moseley and Mimi Spencer.

“There are a few ways to do intermittent fasting,” said Dr. Madhavi Garimella, an endocrinologist with a practice in Los Alamos. “With the 5:2 method, you do two days of complete fasting and five days of eating whatever you want. Another popular IF method is 16:8 — you fast for 16 hours every day, leaving an eight-hour window to eat. So if you start eating at 7 a.m., you end at 3 p.m. You can move the window where you want, so long as you end up fasting for 16 hours. Yet another IF method involves complete restriction of calories to around 25 percent of normal calories — every other day.” Garimella said that several of her patients who have chosen to follow variations on the diet have done well. Unlike some other popular diets, IF is not about

Every diet is ultimately about reducing the insulin hormone. You do that in any diet by reducing carbs, but what are you replacing them with?

what you eat; it’s only about when you eat, “so there is not much controversy in terms of harm. You are not adding anything unnatural to your diet” or subtracting entire food groups, she said. “In my opinion, of all these diets, intermittent fasting makes the most sense. There’s a lot of data to support it, and it works with how your body works. You are giving your body the rest it needs.”

Mu Jing Lau of Santa Fe tried several versions of intermittent fasting before settling on 16:8. “After two months, I felt better. I wasn’t constantly snacking. Before, when I came home from work I’d just snack all evening until I went to sleep,” she said. When she adopted the 16:8 method, she initially skipped breakfast and ate only lunch and dinner. “But then I realized I like breakfast, so I eat at 9 or 10 a.m. Then I have a heavier lunch as my meal,” with no dinner or a very light one. “In the evening I do my regimen for my teeth, which stops me eating. That helps me stay empty for 16 hours.”

Mu said that while she was running a restaurant, Mu Du Noodles, her hectic schedule meant she ate without thinking. “When I had the restaurant, I was constantly eating. I never had time to sit down. Intermittent fasting was helpful for me because it made me more conscious of what I was eating,” she said. “I also lost all the fat around my midriff.” Mu said she has not changed the content of what she is eating, only the window during which she eats.

Her advice to others interested in the diet is to start slow. “If you have bad habits, those are hard to break. Give yourself some time. It doesn’t have to happen overnight. If you drank coffee forever and you suddenly stop, you will go into shock, so you do it gradually. When you start this diet, let yourself drink something during the fast, or eat a heavier meal before the fast. Adjust to your own preferences.”

The keto diet: The origins of this unusual diet go back to the 1920s, when it was developed not as a weight loss tool but as a treatment for children with severe epilepsy. Only decades later did it become popular for losing weight. By severely restricting carbohydrates, the keto diet forces the body to burn ketones from fat stores, rather than glucose, for fuel.

“In the short term, there is no doubt the ketogenic diet will work,” said Garimella. “The thing with both the keto diet and intermittent fasting is that they reduce insulin secretion. Insulin is a storage hormone and promotes fat formation if the energy you consume is not used. If there is a hormone to blame for obesity, it is insulin. Every diet is ultimately about reducing the insulin hormone. You do that in any diet by reducing carbs, but what are you replacing them with? With intermittent fasting, you replace them with nothing. With the keto diet, you replace them with fat. The diet proposes 80 percent of calories come from fat, about 15 percent from protein and 5 percent from carbs — which is less than 20 to 50 grams of carbs per day.”

Garimella said that her patients who have chosen this diet have had success. “Patients with diabetes have had decreased insulin requirements. One patient with diabetes lost quite a lot of weight on keto and improved his hemoglobin A1c — which is a marker that shows how bad diabetes is — to the prediabetes range. His numbers have improved and he feels great, but the question is, can he sustain it?” The diet does not have a good track record for sustainability, and there are little data to tell patients how their long-term health outcomes might be affected by the high levels of fat, she said.

Katharine Clark, a political consultant in Santa Fe, has lost 20 pounds on the keto diet since she started it after Thanksgiving. “I learned from doing the Paleo diet that I have to keep my carbs really low to lose weight: like under 35 grams per day.” The keto diet, with its very low carb count and with allowance for Paleoforbidden foods like dairy, made sense to her.

“On keto you don’t feel hungry. I used to be hungry when I got up, but now I can make it to 6 p.m. and realize I haven’t eaten.” The appetite-suppressant aspect of the keto diet makes it a good partner for intermittent fasting, if one chooses to do both — as Clark does. “I eat only in a six-hour window. I’m eating enough, just in a narrow window.”

She eats a late breakfast of eggs and bacon, and an early dinner such as keto posole — replacing the hominy with cauliflower. “My favorite burger place is RealBurger on Cerrillos. They will make me a bun-less burger and side salad without all the carby extras like croutons.” She said that keto can take some planning, but if people stock up on the staples, “like mozzarella, eggs and almond flour,” they will be more likely to stick to the plan.

One challenge for many people trying keto: it’s not meat-heavy. “You have to be careful about eating too much protein,” said Clark. It’s not just carbs but protein that can kick people out of ketosis. Only fat, or fasting, will reliably keep people in that fat-burning state. “I am always trying to add more fat to my diet. I don’t miss carbs that much, but I’m a protein addict,” Clark said.

Paleo: “The Paleo diet is one that could be more successfully followed on long-term basis; it is not so extreme,” said Laura McCann, a registered dietician and nutritionist with La Familia Medical Center in Santa Fe. “It’s a nutritious diet, with lean meats, nuts and seeds, some fruits and lots of veggies. It eliminates grains, beans and dairy.”

McCann said that her only concern with the diet is making sure the nutrition in the eliminated foods is found elsewhere. “I’d just want to make sure people are getting B vitamins, fiber — those nutrients you’d find in grains and beans.” This should not be difficult, she added, since Paleo-friendly foods like meat and vegetables have B vitamins and fiber.

The Paleo diet is based on the idea that modern processed foods are causing disease, and the solution is to eat like our ancestors did — our very distant ancestors, from the Paleolithic era. This means eliminating not just grains, beans and dairy but also soy, peanuts

and other legumes, refined sweeteners like sugar and corn syrup, and alcoholic beverages. The list of “no” foods can vary depending on the website or diet book you consult, but the idea is to eat as little processed food as possible.

Tatiana Shipkova, a bank employee in Los Alamos, started the Paleo diet after she developed digestive issues and was diagnosed with an autoimmune disease. The version she is on, Autoimmune Paleo (AIP), is a bit stricter than standard Paleo. “I start my day with a meal that usually people eat for lunch: some kind of protein — meatballs, fish, a piece of meat — with salad, avocado, sauerkraut and olive oil. This keeps me full until lunchtime. Then I have lunch made of baked or steamed vegetables, like sweet potatoes, zucchini, cauliflower, broccoli or onions, with a piece of meat or with liver. I’ll have soup in the evening, such as pumpkin or squash soup, a beet stew called borsht or mushroom stew. I am trying to eat a variety. Fruit and veggies are my snack.”

Shipkova said that she does get cravings, and she misses bread and baked goods, but the diet has left her feeling so much better that it’s worth it. “My immune system is more calm. I can see it, for example, in significant reduction in eczema and joint pain.” When she has carb cravings, she makes “tortillas out of cassava flour, or patties with cassava flour and carrots, or fried plantains — those make me full. If I crave sweet, I usually mix berries with coconut oil and have those.”

From a medical point of view, “Paleo is noncontroversial,” said Garimella. “It sounds great to go back to beginnings and avoid processed foods.” Not all the details make scientific sense, she said, but the diet seems harmless and potentially beneficial.

“Once again, there are no long-term studies to evaluate benefits or harms. All these diets say to avoid processed carbs. We eat too many carbs all around,” and any medically sound diet starts with reducing that intake, she said. While the keto diet replaces the missing carbs with fat, the Paleo diet “doesn’t replace them with anything in particular.” The foods promoted on the diet — lean protein, fresh produce, healthy fats — easily fill in the gap left by removing pasta, rice and soda.

The Plant Paradox: Based on a book by cardiologist Steven Gundry and popularized by singer Kelly Clarkson, this diet is founded on the claim that “plants don’t want to be eaten.” Plants make one protein in particular, lectin, to stop animals like us from eating them, Gundry said. “Once ingested, [lectins] incite a kind of chemical warfare in our bodies, causing inflammatory reactions that

can lead to weight gain and serious health conditions,” book marketing materials explain.

“The Plant Paradox is a diet that eliminates certain lectins, limits sugar in any form, curbs high intake of polyunsaturated omega-6 fats and focuses on eating leafy greens, cruciferous vegetables, clean protein and good fats,” said Lorin Parrish, owner of BODY of Santa Fe, who said she has been avoiding lectins since before this diet had a name.

Parrish said that she has done “extensive blood work and medical tests” for decades to monitor her overall health and rate of aging, and has seen only benefits from eliminating lectins and “all foods that have founded controversy around them. This means I don’t have to wait [for study results] to find out if something is good for you or not, such as wine, alcohol, saturated fat, processed foods and sugars of all kinds. The thing about diet, health and stress is that we can always do better, be healthier, which is what I’m interested in.”

“The Plant Paradox is just gaining traction,” said Garimella. “It is very restrictive, and in addition to avoiding processed food, which makes sense, it also has you avoid grains, legumes, nuts, nightshade vegetables, dairy and certain fruits. While the diet is too new to have much data to support it, I have one patient with autoimmune conditions who put herself on the Plant Paradox diet and feels better.” Garimella speculated that this may be due to her patient avoiding processed foods overall, not just lectins. “I personally am not convinced about the diet,” she said.

“Lectins are considered antinutrients,” said dietician McCann. “That means they interfere with the bioavailability of beneficial nutrients.” The problem with avoiding antinutrient-containing foods is that “those foods are still highly nutritious, and their nutrient content outweighs their antinutrient content. For example, the absorption of zinc. Zinc is an important mineral for growth and development, and we find zinc in grains, nuts, seeds, but those foods have higher levels of phytates, which are another antinutrient.” Avoiding that antinutrient could cause people to miss out on an important source of zinc, she said.

Still, many anecdotal reports support the efficacy of the Plant Paradox. “This approach to diet can only make us healthier whether you agree with the lectins controversy or not,” said Parrish. She added that the diet’s associated recommendations to eat more greens, eliminate sugar and avoid processed food “have no controversy around them.”

Those considering going on any restrictive diet should do the research and understand why it’s worth committing to that way of eating, said Shipkova. “I think before starting a diet, you have to be sure that you absolutely need it. Then it is easier to stick to the diet. Read a good book about it — I read Sarah Ballantyne about Paleo AIP. Understand the science behind it, because certain things may not work for you, and you’ll have to improvise. Once you start seeing results, you will want to stick to the diet.”