by David Greenwalt
Diets that tell you to completely exclude certain foods or food groups rarely have any scientific basis. An exception to this could be elimination diets, which can help people with food allergies or intolerances figure out which foods they have reactions to. More likely, however, medically unsupervised exclusionary diets are an attempt by their authors to get you to purchase their latest diet book and/or “official” supplements “approved” by them.
Be sure and take the quiz when you’re through reading to test your knowledge and for fun.
In reality, unless you have a food allergy, intolerance or addiction, all real food can be part of a healthy diet.
This article examines the claims of one such exclusionary diet.
Claim 1: Scale weight says nothing about your health.
The reality: Scale weight does not tell you EVERYTHING about your health, but it certainly tells you SOMETHING.
Like a healthy fasting glucose and blood pressure, a healthy body composition is an indice of health-related fitness. Those who buy into the false narrative that body composition doesn’t matter as long as work capacity is strong have swallowed a misguided “functional-fitness” pill.
But what does scale weight have to do with body composition? Quite a bit.
Body mass index (BMI) is a measure of body composition based on height and weight. To calculate BMI you only need two things: height and weight. This is the reason it’s so universally used in wellness and medicine as a baseline indicator of fatness – it’s easy and completely non-invasive. BMI is your weight in kilograms divided by the square of height in meters.
BMI is demonized as a measure of body composition when the following reason is given; WHAT ABOUT ALL THAT MUSCLE MASS PEOPLE HAVE?! People (the 98%) don’t have too much muscle. If anything they have too little. Truth be told? Most who demonize BMI as worthless by using the muscle excuse are usually just carrying too many pounds of extra fluff. (39)
More times than not people who are assessed as being too fat based on BMI are exactly that – too fat. When 66 percent of the public is overweight and 35 percent are obese it’s not all that hard to be right when we presume a high BMI to correctly indicate that person is overfat.
Compared to people who are not overweight, people who are obese have a higher risk of many serious conditions, including:
- Premature death
- Heart disease
- High “bad” cholesterol and low “good” cholesterol levels
- High blood pressure
- Type 2 diabetes
- Gallbladder disease
- Some cancers (breast, colon, kidney, gallbladder, liver, endometrial)
- Osteoarthritis, and
- Sleep apnea (1).
The evidence that obesity is a risk for these conditions is not disputed. Being overweight or obese does not always mean that you will have one of these conditions, but it does increase your risk.
Bottom Line: Weight, along with other indicators of health – like fasting glucose, blood pressure, cholesterol levels or smoking status, for example – can help provide a picture of your overall health and risk of disease.
Claim 2: People should break up with their scales. The authors of this diet say that you shouldn’t weigh yourself, because the scale “maintains control of your self esteem.”
The reality: What someone feels when they step on a bath scale is quite individual. They may feel uplifted, neutral or negative. To say “the scale maintains control of your self-esteem” is defeatist at best and disinformation at worst. Daily self-weighing does not cause adverse psychological outcomes.
A recent review of 17 studies found that regular weighing was not associated with any adverse psychological outcomes, including depression or anxiety (2).
One randomized-controlled trial compared men and women who weighed themselves daily over a 6-month time frame, with others who did not. The group that weighed themselves daily actually had significantly lower rates of body dissatisfaction than those who did not use a scale. Those who weighed also reported more dietary restraint (3).
People who weigh themselves regularly also have more success when trying to lose weight and gain less weight back than people who do not weigh themselves (4, 5). People who weigh regularly are also more likely to avoid unwanted weight gain in the first place (4).
Bottom Line: Evidence supports regular, once-a-day weighing for no negative psychological effects and a behavior that may help you to achieve and maintain a healthy weight.
Claim 3:Your body knows how much you should be eating better than any calculator you’ll find on the internet.
The reality: Homeostatic control of food intake occurs, however, to say “Your body knows how much you should be eating better than any calculator you’ll find on the internet” as though it applies to everyone is, at best, misleading, and at worst completely irresponsible.
Physical, emotional, sensory, social, environmental, hormonal, hedonic and other factors all contribute to appetite regulation. While some can trust hunger cues, obese and weight-reduced people often have perturbations in the gut–brain axis compared with lean individuals.
This is evidenced by the drastic rise in the rate of Americans who are overweight or obese, and suffer from a variety of health issues as a result.
If our bodies actually knew how much we should eat, then why would so many more people be overweight and obese today than a few decades ago?
Studies have consistently shown that when people are presented with larger portions of food, they eat more (6, 7). This is true for both adults and children, and across a variety of foods and settings.
In one example, people who were unknowingly given a self-refilling bowl of soup (a bowl that refilled with soup from a hidden tube as they were eating), ate 73% more soup than those eating from normal soup bowls (8). Despite consuming so much more, participants with the self-refilling bowls said that they did not know they had consumed more, and did not feel any fuller than the other group.
Perhaps when food was not as readily available as it is today, perhaps when there were fewer Frankenfoods, we were more likely to eat only in response to hunger cues. These days, with food and Frankenfood available almost constantly (at convenience stores, gas stations, fast food, vending machines, etc.), and typical portion sizes that have ballooned from 50 years ago, there seems to be a lot more than just internal cues influencing how much we eat.
Bottom Line: Many factors, well beyond physical hunger, influence how much we eat, including portion sizes and food availability.
Claim 4: You should eat NO added sugars of any kind.
The reality: It is a good idea to limit added sugars, since they can contribute to excess calorie consumption, obesity and resulting comorbidity.
Extra calories from any source can make us overweight or obese, which in turn increases our risk of diabetes, heart disease, some cancers, etc. Therefore, it is a good idea to avoid taking in more calories than our bodies need. However, there is no evidence backing up the claim that you need to absolutely avoid ALL added sugars.
Since almost half of added sugars consumed in the United States come from sweetened beverages (soda, sports drinks, sweetened teas, etc.), researchers have suggested that it might be better to focus on encouraging people to choose healthier beverages, rather than zeroing in on all added sugars (9).
Bottom Line: Limiting added sugars is a good idea. For a 30-day elimination diet and even beyond there’s no real harm in doing your best to eliminate added sugars (zero tolerance is not necessary), however, as you’ll see there’s no consistency in this diet’s recommendations. Stay tuned.
Claim 5: Added sugar is 100% off limits. Fruit juices are okay.
The reality: Sure, fruit juices are okay…in moderation.
Drinking fruit juice can help people to get more fruit into their diets. Unfortunately, however, it comes with more calories and none of the fiber that you would get by eating a piece of whole fruit instead.
For example, one medium orange has approximately 69 calories and just over 3 grams of fiber. One cup of orange juice has 112 calories – almost twice as much – and 0.5 grams of fiber. Since many people fail to take into account the calories that they drink, and since there is not much fiber to make you feel full, drinking juice can lead to excess calorie intake and increased risk of being overweight.
In addition, many people drink far more than the suggested serving size for fruit juice (just 4-6 ounces for children, 6-8 ounces for older kids and adults).
For kids, drinking more fruit juice than is recommended has been linked with increased calorie intake and obesity. It has also been associated with failure to grow normally and decreased height (likely because it is replacing other foods or drinks, such as milk)(37).
Finally, why would the authors of this diet say NO added sugar, but at the same time say that fruit juice is okay? Sugars from fruit juice may be more “natural” than processed sugars, but the levels of sugar can be comparable to the levels in a glass of soda. One type of 100 percent apple juice has 66 grams of fructose per liter – more than the 62.5 grams per liter in Coca-Cola or the 61 grams per liter in Dr. Pepper!
Our bodies do not differentiate between the fructose coming from fruit juice and the fructose coming from soda, so it seems inconsistent that a diet would say one is just fine while the other is absolutely not.
And since neither juice nor soda contains fiber, all of this sugar is absorbed very rapidly and our bodies pump out a lot of insulin to deal with it. Eating whole fruit, on the other hand, provides fiber in addition to sugars, so the sugars are absorbed more slowly.
Bottom Line: I don’t recommend, for those desiring weight loss, that any calories be in the form of liquids. Instead I recommend you chew your calories. Again, this elimination diet provides contradictory advice. If you have to 100% eliminate all added sugars then fruit juice should be off limits as well.
Claim 6:You should not eat grains. Eating grains causes hormonal and metabolic disruption, an imbalance of gut bacteria, and provokes inflammation. This includes wheat, rye, barley, oats, corn, rice, millet, bulgur, sorghum, sprouted grains, and all gluten-free pseudo-cereal like amaranth, buckwheat, or quinoa.
The reality: Grains (as well as dairy and fruit) provide us with complex carbohydrates, as well as numerous other vitamins, minerals, and phytochemicals.
Our bodies typically use carbohydrates as their preferred fuel. In addition to providing carbohydrates for energy, whole grains in particular can decrease our risk of getting many chronic diseases.
Studies show that eating more whole grains may reduce the risk of certain types of cancer, cardiovascular disease, diabetes, respiratory disease, and overall mortality (17, 18). Adults and children who eat whole grains also have better nutrient intake overall, and are more likely to be a healthy weight (19).
Eating whole grains (whole wheat, brown rice, oats, etc.) may reduce the risk of:
- Some types of cancer
- Cardiovascular disease
- Respiratory disease
- Being overweight
In addition, grains contain a lot of disease-fighting antioxidants. Components of grains (both refined and whole) have shown antioxidant and anti-inflammatory activities in both test-tube and animal studies. Therefore, scientists have suggested that grains may prevent oxidative damage and inflammation-related disease (20).
Bottom Line: There is simply no evidence that eating single-ingredient grains causes the negative health effects that these authors cite. Unless you have an intolerance or allergy to grains, or celiac disease, eating whole grains may reduce your risk of many chronic diseases.
Claim 7: Green beans, snow peas, and snap peas are okay to eat, but other legumes are not. No dried beans (black, pinto, kidney, garbanzo, etc.), soybeans, peanuts, peas, or lentils are allowed. The author states that legumes are nutrient-poor, and contain anti-nutrients (phytates and lectins) that rob the body of minerals and could damage your intestines.
The reality: First off, legumes are anything but nutrient-poor. They are an excellent source of high-quality protein, and without the accompanying saturated fats that often come with animal protein. In addition, they are also an excellent source of fiber and folate, and are high in iron and zinc. Many beans are also a good source of calcium (23).
Legumes can help prevent and manage a variety of chronic diseases – including diabetes, hypertension, and high cholesterol.
Numerous studies have shown that people who eat more legumes have:
- lower blood glucose levels,
- lower blood pressure,
- lower cholesterol, and
- lower body weight (24).
Legumes and nuts do contain phytic acid, which at one time was considered an anti-nutrient because it can bind minerals and protein and make them less available. Recent research, however, has shown that phytic acid is a potent antioxidant with positive nutritional benefits.
Scientists have concluded that the antioxidant actions of phytic acid may even help prevent intestinal diseases and some types of cancer (25, 26). For example, one group of scientists found that phytic acid significantly decreased growth of ovarian, breast, and liver cancer cells (26).
Similarly, the lectins in legumes (proteins that can bind carbohydrates) have been suspected of causing intestinal disorders and causing allergic reactions (27). However, they are also being investigated for potential beneficial effects, including for anti-cancer properties, and for reducing obesity and type 2 diabetes (27).
It is important to keep in mind, too, that when we eat whole foods like legumes we are eating the whole food – not just a pile of lectins or phytates. The sum of the evidence has shown that legumes have positive health effects.
Like grains, legumes contain fibers that pass through the small intestine undigested, and are then fermented by the microbiota in the large intestine. Some have suggested that this inability to be digested may cause harm and an inflammatory response in the digestive tract.
The research, however, shows the opposite. A review of randomized, controlled trials found that people who ate the most legumes had the lowest levels of a specific protein that indicates inflammation (28).
Another study found that overweight adults who consumed more fermentable fibers from legumes for two weeks had significantly reduced appetite, food intake, and inflammation (29).
Bottom Line: Legumes have numerous health benefits, and, as long as the intake of these calorie-dense foods are monitored during weight loss, they can be included in a healthy nutrition regimen.
Claim 8: Fermentable carbs can promote an imbalance of gut bacteria and provoke inflammation. So avoid all whole grains but have any fruit you want.
The reality: To say one should avoid all whole grains but keep any fruit, if the idea is to reduce fermentable carbs, is conflicting at best and idiotic at worst.
FODMAP is an acronym for Fermentable Oligo-, Di-, and Mono-saccharides And Polyols. Reducing fermentable carbs is about reducing the foods that contain FODMAPs.
Most people don’t have any trouble with the amounts of FODMAPs encountered in a typical diet. But for those who do? When more than a small amount of higher-FODMAP foods are eaten they may experience severe bloating, distention, pain, and all kinds of other miseries. Even then? It’s usually not necessary to achieve a Zero-FODMAP diet in order to get relief.
Foods that are high in FODMAPs include most dairy products, certain fruits (including apples, pears, cherries, raspberries, watermelons, stone fruit, mango and papaya), certain vegetables (including artichokes, asparagus, cabbage, garlic, and mushrooms), certain grains (including wheat, rye, barley, and spelt), most legumes (including soybeans), certain sweeteners (including honey and agave nectar), and some food additives (such as chicory root, inulin, and xylitol).
Bottom Line: A low FODMAP diet may be necessary for a tiny fraction of the population, however, the real problem I have with the guidance of the elimination diet proposed is the inconsistency of banning all grains (that contain FODMAPs) but allowing any fruit (which also contains FODMAPs).
Claim 9: It is not healthy to eat any dairy products whatsoever, except for clarified butter or ghee.
The reality: Dairy is a top 8 allergen food, should be limited in my opinion, but dairy products can provide calcium, protein, B vitamins, friendly bacteria (yogurt) and numerous other vitamins and minerals.
Look, I’m not a fan of dairy. It’s on the top 8 food allergens list designated as “major food allergens” by FALCPA (Food Allergen Labeling and consumer Protection Act of 2004). Dairy is not necessary for a healthy diet – all of the nutrients in dairy can be gotten from other foods. In my 30 years of wellness coaching I’ll report, anecdotally, many students have more problems with dairy than about any other food. Even so? Going zero tolerance on dairy but allowing whatever for clarified butter and ghee is where I have a problem.
The authors claim clarified butter or ghee have had the “offending” proteins that cause problems removed. Perhaps certain proteins have been removed. Maybe fewer people will exhibit sensitivity issues from clarified butter or ghee over milk or cheese or others. Then again, maybe not. The research is scant to non-existent on this issue.
Bottom Line: Strongly limiting dairy makes sense. As one of the top 8 allergens and anecdotal evidence I support plans to keep dairy intake to minimal levels. However, there is evidence that dairy products provide important nutrients and health benefits, and there is no reason to exclude them, especially, real-food, unsweetened Greek yogurt, for most.
Claim 10: All seafood is okay to eat.
The reality: Seafood is a rich source of nutrients, including protein and healthy omega-3 fats, and can definitely be part of a healthy diet. However, is it also the main source through which people are exposed to mercury.
Mercury is toxic to brain cells, and especially to the developing brains of babies in utero. Consumption of mercury-containing seafood by pregnant women is associated with later problems with fine motor skills, language, and memory among their children (31). Recent research indicates that harm may occur even when contaminated seafood is eaten infrequently (32).
Care must be taken, therefore, to choose seafood types from safe sources that are low in mercury.
In addition, shellfish are one of the leading causes of food allergy in adults. Like dairy, shellfish is designated as a “major food allergen” by FALCPA. Over six million Americans have allergies to seafood, and these can have very serious consequences, including potentially fatal anaphylaxis (33).
Bottom Line: While seafood from a safe source can be a very healthy food for those who are not allergic, not ALL seafood is okay for ANYONE to eat. Overall, mercury considerations noted, I like fish as a food and protein source. But if the elimination diet’s goal is to eliminating foods people are highly sensitive to then giving carte blanche to shellfish (a top 8 food allergen) is contradictory.
Claim 11: Bacon and sausage are okay to eat, but grains, legumes and dairy are not.
The reality: If a tiny amount of bacon and sausage are okay then so should be a tiny amount of the excluded foods.
That said, processed red meat such as bacon and sausage has been shown repeatedly to be linked to increased risk a number of chronic diseases – including stroke, breast cancer, colorectal cancer, prostate cancer, and death from cardiovascular disease (36). So go easy on consumption of them right? Right.
Whole grains, legumes, and dairy, on the other hand, have proven health benefits, as outlined above. Not everything about real-food, single-ingredient grains is great, however, the same guidance given for bacon or sausage could be applied to the excluded real-food grains. Go easy on them. Don’t over do it.
Bottom Line: There is no scientific basis for a diet that promises improved health to allow bacon and sausage, while completely excluding whole grains, legumes, and dairy foods.
Claim 12:Do not eat pancakes, in any form. The authors state that the “psychological impact of eating pancakes as part of your healthy eating, life-changing plan cannot be ignored.”
The reality: A real-food pancake, without being slathered in butter and syrups (or the like), is no more likely to create ill health or increase inflammation than any other real food.
At LLU we caution our students against trying to turn real foods into Frankenfood look-a-likes. This occurs when real food morphs into the taste, texture, and feel of Frankenfoods.
Might pancakes, even if made from real-food ingredients, be an example of this? Sure. But there’s no guarantee that having one pancake a month made from 100% real-food ingredients is going to trigger off-plan eating or stall weight loss. And there’s no science supporting any rationale that a real-food pancake is going to have any negative impact on health.
Claim 13: One bite of pizza or one splash of milk in your coffee in any 30-day period will ruin your efforts to improve health and reduce inflammation.
The reality: There is not a stitch of evidence to support any contention, for the 99% of human population, that, when taken literally as intended, ONE bite of pizza or ONE splash of milk in your coffee in a 30-day period will “break your health and healing reset.”
One extra splash of milk isn’t going to ruin anything. As for pizza and the like? We call Frankenfoods like pizza “splurgy” and we provide intelligent, well-thought-out guidelines as to when to have them and how much when you do.
Bottom Line: For all but the most incredibly sensitive/allergenic one bite of pizza or splash of milk, infrequently, will do nothing negative to your health and healing.
Elimination diets, usually starting with 2-4 weeks of some kind of hard core elimination abound. They’ve been around for decades. Starting five or so years ago it became trendy to do some kind of an elimination diet. We at LLU even had a version for a few years. We’ve since “grown up” and moved to recommendations for all, from start to finish, that they eat real food 90+% of the time while we provide guidance on limiting easy-to-overeat or foods most likely to cause people not only health problem but that are also likely to thwart weight-management goals. No more elimination dieting with a tricky re-introduction plan to follow.
Take the quiz to test your knowledge and for fun.