In the last 5 years there has been lot of noise about different types of diets, with different names and styles. Defining which one works best for the majority of the population with the goal of losing body fat, has become an odyssey for many.
Unfortunately now, losing weight and being healthy seem to be mutual exclusive. Majority of the conversation is based on opinions of people, magazines, books, and not reliant on scientific evidence. Yet changes in body composition have been studied widely to determine which diet is most effective and maintains health. Remember, when you are reading research there are a lot of limitations in studies, and the data need to be analyzed carefully.
We should realize, that there is no universally effective diet; no one-size fits all approach, that promotes sustainable weight reduction. It seems that there is evidence in short-term weight reduction using diets high in protein, low in carbohydrates, and intermittent fasting. However adverse effects are associated with one’s long term health if these diets are not adequately controlled. In the long term, the strongest evidence shows that different diets can only work when they create commitment in the person to follow it consistently.
It should not be forgotten that continual weight gain, if maintained over time, will lead to obesity becoming a multifactorial disease, beyond just seeing it as a fat accumulation. Obesity is a disease that occurs with low-grade inflammation affecting the rest of the systems in the body that can lead to metabolic diseases, such as type 2 diabetes, or coronary heart diseases.
We know that weight gain is undoubtedly the consequence of a positive calorie balance, that is, consuming more calories than we spend through daily activity, movement and exercise. However, what must be acknowledged is the genetic and environmental factors which play a very important role in context of each person.
For successful fat loss, the Academy of Nutrition proposes lifestyle changes, i.e. a diet with reduced processed food, focusing rather on the quality of the food and increasing the energy expenditure (physical activity). This must be in conjunction with focusing on the individual needs of each person. Therefore, it lacks scientific evidence to choose a universal diet for everyone, be it Paleo diet, keto, low carb, high-carb, vegan, vegetarian… because it seems that it does not matter as much what it is, but rather does it creates a negative energy balance in that individual. Therefore, what we believe in is to create a “negative energy balance” in the diet with good quality foods that maintain optimal health1.
As nutritionists, we propose different strategies according to the person’s requirements, since an elite athlete is not the same as a recreational athlete, just as the latter will not be the same as a sedentary person. Nor would an obese person be equal to another of better body composition, or even someone with some digestive pathology, such as an irritable bowel syndrome with another who does not have associated digestive pathology. All of these factors must be individualized for a success in the results. Thus, we divide our recommendations into the following categories, according to the objectives of each person:
1) Diet based on macronutrient manipulation. Changing the ratios of proteins, carbohydrates or fats; which can be low-carb, high carb, high protein etc.
2) Diet based on restriction of certain foods according to the person’s needs (gluten-free, paleo, dairy-free, vegan, vegetarian).
3) Diet based on time manipulation; like intermittent fasting.
If we have to make a generalized recommendation for weight management from a healthy point of view; we would recommend the Mediterranean diet. Schwingshackl et al. (2019) observed different epidemiological studies regarding diets and concluded that the Mediterranean diet could be the most effective from a health point of view because it was associated with lower cardiovascular risk, lower metabolic risk such as type 2 diabetes, and cancer2. In an analysis conducted by Nita G and colleagues, assessing the evidence and controversy regard diet guidelines for the treatment of Type 2 Diabetes, they also concluded that the Mediterranean diet was the most effective and optimal for these patients3.
What is known of the beneficial effects of the Mediterranean diet?
It relates to the least amount of lipids in the blood circulation, reduction of inflammatory parameters and oxidative stress at the cellular level, improved insulin sensitivity, improved endothelial function (improvement of blood pressure), slows gastric emptying and reduces appetite for longer periods. All this due to its high content of vegetables, fruits, legumes, nuts, fish and extra virgin olive oil which creates a high adherence to follow this type of diet, maintaining an optimal energy balance and enjoy good longevity.
There is no evidence that there is any special diet for fat loss that it works for everyone. The most important thing is to create a negative energy balance consuming nutritious good food and adhering to the program for the long-term. To do this, it is important to individualize, in order to accommodate their requirements.
This is only a general recommendation to guide the population, but any treatment or guideline must be individualized according to the needs of each. Our priority is individualization and it is the key to success in the final results. Please free to contact us to discuss what would work for you.
Sandra Serrano, Physiotherapist, Msc Clinical & Sport Nutrition, firstname.lastname@example.org Dubai Herbal and Treatment Center
Eat Well & Keep moving