So many diets to try; so little time. During my almost 70 years on this planet I have adopted three special diets on the advice of a physician and one on my own to lower my weight. I take dieting very seriously. I take my health very seriously. Here are some things I have observed and/or discovered as I modified my diet.
On the recommendation of my personal physician, I have changed my diet to combat food allergies, borderline (chemical) diabetes—now classified as prediabetes, and IBS (irritable bowel syndrome). To combat weight gain associated with a sedentary lifestyle as a college professor, I also went on the Sonoma Diet. Each of these diets meant major changes in the foods I consumed and affected what my wife prepared for me or what I prepared for her.
There are many types of diets but the two with which I am most familiar are restrictive diets and challenge diets. Restrictive diets limit the types of foods the dieter can consume. By restricting specific categories of food, these diets tend to result in weight loss, intentionally or unintentionally. The prediabetic diet and Sonoma Diet are examples of restrictive diets. Challenge diets identify foods that could be causing specific symptoms. These diets start out by eliminating all foods that could be responsible for the symptoms. Then representatives of foods in each class of foods are added back to the diet, one class at a time, to see if they elicit a response. The allergy and IBS diets are examples of elimination and challenge diets.
Strategy. Unfortunately, most physicians are ill prepared to guide a patient in dieting. I have much more faith in a registered dietitian (RD or RDN) than a MD. The physician who diagnosed me with chemical diabetes gave me a sheet of paper (preinternet days) and sent me to a dietitian. I read up on appropriate diets and studied the restrictions. My wife and I walked into the dietitian’s office with the piece of paper my physician had given me along with various study notes I had made. Before I could explain my thoughts and perspective, the dietitian ripped the papers from my hand and tore them to shreds in front of my eyes. It was then that I decided I would have to work out the details on my own. Faced with a similar situation today I would look for another dietitian—one specializing in prediabetes counseling.
The other options today include the internet or finding a useful book on the topic, written by a RD or RDN with a specialty in the specific area. In my experience I have found the internet to be about as useful as that piece of paper the physician gave me and the dietitian tore up. The internet can provide lists of foods to avoid and foods to consume. It can also provide some background on the rationale for a specific diet. If one scans more than a single site, however, contradictions begin to crop up leaving the surfer confused and dismayed. I have found that a good book by an expert in the area is generally the best way to go, but the book should also contain recipes.
Complications. Adapting to a new diet is difficult enough, but it becomes even more problematic if it needs to be merged with one or more other diets. Foods encouraged on the new diet may be forbidden on the previous ones and vice versa. Compromises are necessary, and knowledge of the underlying principles may be needed to make intelligent decisions. It is hard enough just developing a meal plan for the week without hunting down and studying the details on recommendations across these diets.
Then there is the problem with eating out. How can we know which menu items comply and which ones do not? We can communicate with the waiter, but how can we be sure that those concerns will ever make it to the head chef and eventually to our plate? Non-compliance may be easily detected for some meals such as excess gas production, elevated blood sugar if we check it or an allergic reaction. Less obvious signs such as weight gain may take longer. Yoni Freedhoff in The Diet Fix cautions us that it is difficult to lose or even maintain weight if we eat more than two meals out a week! Make that even more of a challenge for most other diets.
What can be even more distressing is the effect it has on family members. The meal preparer must learn new techniques as well as search out and prepare new recipes. Taking on a new diet generally means that everyone in the family is affected in some ways unless the food preparer takes on the persona of a short-order cook. The preparer must consider any dietary restrictions and food aversions of all family members to deliver a meal to the table that all members will appreciate. In response to a meal I, as the primary food preparer in the family, served one evening about ten days into my latest adventure, my wife commented “Oh, there are meals worth eating on this diet after all!”
Evaluation. My diets have had varying level of success. It took me two years of shots and diet modification to overcome my food allergies. I eliminated beer, wine, breads, anything with corn in it which included more processed foods than I ever imagined, and dairy products. I was losing three pounds a week, and I calculated the date that I would disappear assuming that rate of weight loss. Fortunately, I did not waste away to nothingness, and I was able eventually to add back all of my forbidden foods.
Dietary counseling has changed since I was first diagnosed with borderline diabetes. I designed a diet that limited my sugar consumption without greatly modifying my total carbohydrate consumption. I read about the glycosylated hemoglobin (now identified as A1c) and asked my doctor if he would test me for it. A1c readings are now considered the primary index for assessing diabetes and prediabetes. I have been on my low-sugar diet for over 30 years and have a record of my A1c values every 6 months. Only 4 of those tests showed me in the prediabetes range, none indicated diabetes. My eye doctors have not found any evidence of diabetic damage over those 30-plus years.
The Sonoma Diet and associated cookbooks have been my guide for losing weight and keeping it off for the past 15 years or so. My wife and I have found the recipes to be great, and it has helped to keep our weights within reason. Upon retirement I was able to lower my BMI from overweight land of 26.5 down to 24.9. A more concerted effort later lowered it 23.5. I was shooting for below 23 but was unable to get there at the time. Although a BMI is not the be-all, end-all for weight, particularly for Seniors, I felt good about my weight and health—at least until digestive issues came to the forefront. But, more about that and FODMAP next week.
Next week: Surviving a low-FODMAP diet