I too used to teach the "low fat diet". This approach is what was engrained into me in university. This is what the government teaches and what it expects its employees to teach. And honestly, while we did do projects in university to find out what the literature was on various topics, the 'results' never strayed far from the tree...
My Educational Background:
I did my undergraduate degree in nutrition, did my Master of Science in Applied Human Nutrition, then went on to do my dietetic internship at Mount Sinai Hospital in Toronto, Ontario, Canada. From there, I was lucky to get work right out of my internship in a community hospital where I happened to do a number of my rotations. After a few different contracts, I landed a permanent job in outpatient Cardiology - in both Cardiac Rehab (helping patients who have had a heard attack get back their health) as well as a preventative metabolic clinic called the CHARM clinic (Cardiac Health and Risk Management Clinic). And while, I saw some success (honestly, a small amount!) by helping people get off of refined sugars, I didn't see huge sweeping success stories.
I think of out the 1000 patients I saw, I can count on 1-2 hands the number of patients who actually saw sustainable wt loss of 5 or more pounds... yes, sweeping success. And I FELT IRRELEVANT.
- Well, eventually my pre-diabetic patients' blood sugars would creep up to the diabetic ranges.
- I couldn't "normalize" their LDL (low density lipoprotein) cholesterol levels (which is of great debate now in the literature anyways - and a topic for a post all on its own).
- I could maybe bring down the triglycerides (fat in the blood that is elevated with high carbohydrate/grains/sugar/alcohol) with a lower carbohydrate/lower alcohol approach - but the diet then became more of a low fat + low carb diet for these patients... which means protein and vegetables/fruit with little dressing/fat.... not delicious and unsustainable!
- And HDL (high density lipoproteins)? no, my diet did not help increase that either (Because you need fat to increase HDL). I was actually taught that diet couldn't really increase HDL, and that exercise was needed to increase it... (sigh... I know better now).
I also struggled with the processed foods I was supposed to recommend:
- Margarine (highly processed, high in omega 6 fatty acids which in high amounts are not good for the body) instead of butter which has been around forever;
- Low fat dairy (processed, full of stabilizers which may or may not interfere with our gut microbiome, and full of sugar) instead of natural and delicious, full-fat unsweetened dairy;
- Focusing on the saturated fats in foods rather than questioning the processing in oils and packaged foods that 'according to the label' was a healthy food. What do you say to a patient who comes to you and says "Why is this bag of chips bad for me? There is no sugar, and no saturated fat, no trans fats, and low in fat"? I struggled to give an answer...
I started discussing health from a 'real food' perspective, and providing both sides of the story for my patients so they could make an educated decision for themselves...
The Two By Four To My Head:
The pivotal moment for me, was six years ago. My husband decided to cut out all the grains in his diet to lose weight... (clearly he wasn't seeing the results he wanted by the food I was cooking...). Well, I FREAKED! What do you mean, NO GRAINS!? I had been taught that you NEED 130g of carbs a day to live. (Of course, silly me, I never questioned how our ancestors did that... because a nice meal of carbs hasn't always been available. And while this concept is correct -we DO need the glucose to live- our liver can make it from fat without any issue).
Well, he cut those carbs for a week. And I watched like a hawk (and even tried to find ways to hide it in his food... no, I'm not joking) And guess what? He dropped 10 lbs from around his middle, that he has successfully kept off! MIND.BLOWN. This was a two-by-four to the head! What? How could this be? .... This began my journey into questioning everything I was taught.... but I was a lone ranger in a medical system that only welcomes the status quo. I didn't know where to start!
The Beacon of Light:
Until one fateful day, I saw a tweet... Yup. That's right. One of my RD friends re-tweeted a tweet by (former) Dietitian Cassie (long story, but she has finally given up her RD title after a long legal battles with the American Dietetic Association) talking about fat being good for us, and about eating real food... what? other dietitians and medical professionals have the same questions I do?
And this opened the rabbit hole that I fell into.... finding support from health professionals around the globe, and openly questioning a number of topics such as:
- Is fat is actually bad for us;
- Does dietary cholesterol really affect your cholesterol levels?
- What do our cholesterol blood tests actually tell us?
- Is breakfast really the most important meal of the day?
- Is skipping a meal really so bad?
- What should I actually be eating to be healthy? and
- WHAT SHOULD I TEACH MY PATIENTS?
Over the last 5 years, I have learned about the benefits of going 'low carb', balancing meals with protein, fat, and vegetables; and adding fruit and starchy vegetables to that, depending on the level of low carb a person wants or needs: liberal low carb (50-100g of carbs/day) or low carb ketogenic (20-50g total carbs/d).
May I just say.... in teaching the low carb approach in the last year, I have seen more people lose weight, waist circumference, and lower their blood sugars than I have in the previous 5 years combined. It is mind blowing how well this dietary approach can work. (I even had patients just stop coming to see me for follow up because they were doing so well and reaching their goals!).
Now, its one thing to teach this way of eating, but what about the evidence? Has it been established as safe and effective in the literature? Yes. The Virta Health Group did a lovely job of compiling the 76 research studies on the "low carb" approach; 6 of these studies lasted longer than 2 years - go look for yourself!
A long-winded way to say: this is how I stumbled on the low carb approach. And there is no turning back for me. Does this mean I never eat bread or sugar or goodies? No, but its either modified to be made with whole foods, or it's a rare treat. And when I eat it, I enjoy every bite. :)
As always, if you have any questions you can email me at firstname.lastname@example.org.
Wishing you the best of health,