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Like Diversity? So Does Your Gut: FOUR Eating Styles to Help Out

I can’t count the timers people have said to me, “this is the way everyone should be eating.” RIDICULOUS. The world is round. And there IS more than one eating style that’s good for your health.

This study looked at four eating styles known for their healthfulness: 

• The Healthy Eating Index 2010 (HEI 2010), is based on the 2010 US Dietary Guidelines for Americans. It focuses on fruits, veggies, legumes, whole grains, low-fat dairy foods and lean meats and other proteins.

This image has an empty alt attribute; its file name is MED-diet-ideal.jpg
“Alternative” Mediterranean diet:
Less credit for red & processed meat

• The Alternative Healthy Eating Index (aHEI), based on HEI-2010 but de-emphasizes meat and dairy foods.

• The Alternative Mediterranean Diet (aMED) focuses specifically on markers of inflammation and cardiovascular health. Its score does not consider dairy intake or potatoes and gives credit for less consumption of red and processed meats.

• Dietary Approaches to Stop Hypertension (DASH diet), developed to reduce hypertension with diet, it encourages plenty of fruits, vegetables and low-fat/fat-free dairy foods but nothing is excluded.

The researchers wanted to compare each eating style’s impact on the gut and the diversity of healthy gut bacteria.

Drum Roll…The Results Showed…

If you REALLY build it,
the good gut bugs will come

ALL four eating styles benefitted the gut – and in mostly similar ways The authors found the results showed “strikingly consistent patterns.”  People with higher scores on all four eating styles had less “bad” bacteria – the ones associated with inflammatory diseases like irritable bowel syndrome, diabetes, even colon cancer. 

Interestingly, the HEI-2010 – the more moderate of the eating styles studied and the one based on the 2010 Dietary Guidelines, was the only one of the four eating styles associated with lower amounts of harmful Escherichia-Shigella and Enterobacter, two species associated with diet-related conditions linked to systemic inflammation.

Higher scores on all the eating indices were also associated with a greater richness of beneficial fiber-fermenting bacteria in the gut.

For gut-geeks like myself, this study is incredibly interesting.  To consumers and “normal” people, here’s what it really means:

  • A healthy diet rules.  But not a single healthy diet.
  • There are at least four ways up the mountain to a healthy eating style.
  • It’s more about what you include than what you exclude!  Fruits, vegetables, beans and whole grains help grow the most beneficial bacteria, because they’re loaded with fermentable fiber. 

Why I like this study

  • It looks at diverse eating styles and their impact on gut diversity.  That is, how these eating styles positively or negatively impact our gut bacteria. 
  • The study used subjects with diverse ethnicities: Japanese American, Latino, Native Hawaiian, and African American, who were part of the Multiethnic Cohort Study
  • These were also senior citizens, average age: 69 years.

The study was long: subjects were enrolled between 1993-1996 and their gut bacteria were studied as of 2013-2015.

Study Weaknesses: 

All studies have limitations, but this one has fewer than most. Most observational studies like this look only at initial dietary intake and then analyze outcomes a decade or more later, not knowing if diets changed during the interim.  This study took dietary intake at the enrollment and also during a return visit in 2013-2015, at which time the subjecfts also provided a stool sample.

Cut-To-The-Chase Recommendations

The least “restrictive” of these four eating styles is a split between DASH and the regular HEI.  They don’t exclude anything, emphasize balance and are probably the easiest to follow. Best of all, they produce good gut health. 

Organic: The Answer To Cancer Prevention?

If anyone tells you they have the definitive answer, they’re misleading you.

Growing foods conventionally usually – but not always – involves the use of some pesticides when there’s a need to control harmful bugs, plant viruses, fungi, etc. that damage either the whole plant or the edible portion of it.  These compounds are expensive, so farmers tend not to use them unless absolutely necessary, and then in the least amount possible for the needed benefit. 

Organic crops are thought to be grown without pesticides, but there are hundreds of pesticides approved for use on organic crops.  Most are organic ones, but in certain circumstances, as with a particularly difficult to control pest, USDA has rules in place to allow limited use of a few dozen synthetic pesticides is allowed, and the food produced can still be labeled “organic”. 

But Is Organic Food Healthier?

Twice the price,
but twice the benefit?

“Healthier” has no formal definition, but let’s say it means you have a lower risk of developing cancer, since that’s a highly desirable outcome by everyone.  Would eating organic food make you less likely to develop cancer?

This recent study wanted to find out.  It was a prospective study – meaning that it went on for years before results were determined.  As part of a large study involving 68,946 French participants, all volunteers “self-reported” the frequency of consumption of organic foods.  Responses about consumption were multiple choice and ranged from 1 (“most of the time”) to 7 (“never”), with an option for “I don’t know”.  Demographic information was also gathered, including about household income.  This was interesting, because the top household income bracket was US $3,100, hardly “upper income” even in 2009, when the study launched.

The Good News: Organic Eaters Had Less Cancer

More frequently eating organic foods was “associated” with lower your cancer risk.   Key word, “associated”.  It’s the bane of my existence because it is often interpreted as “cause-and-effect,” a very wrong assumption. 

Why?  This study was “observational”.  These types of studies aren’t designed to evaluate cause-and-effect.  They can only generate a hypothesis that clinical studies could then evaluate for more direct conclusions.  This study is incapable of making such conclusions.

Photo: www.inkmedia.eu

The not-so-good news: the benefit of eating organic was minimal, at best.  The risk of getting cancer went down only 0.6% — that’s 6/10ths of one percent, and only for the most frequent eaters of organic food.  Even then, the benefit may be less than reported. Read on… 

Limitations of the Study, A.K.A. the “Fine Print”

The authors responsibly called out a fairly lengthy list of limitations of this study, and why the results need to be seen with caution:

  1. The participants were volunteers who were “likely particularly health conscious individuals”, therefore limiting the application of the results to the general public.
  2. The questionnaire used asked about frequency of consumption but not quantity.    Also, possible misclassification of organic foods, “cannot be excluded.”
  3. Follow-up time was short – an average of only about 4½ years.  Cancer can take many years to develop and it’s unclear what the diets of these participants were prior to participation.
  4. Possible “residual confounding resulting from unmeasured factors or inaccuracy in the assessment of some covariates cannot be totally excluded.”  This means there is a lot they didn’t measure or that they couldn’t measure accurately. 
  5. They could not exclude the non-detection of some cancers. 

Cut-To-The-Chase-Nutrition Takeaways

  • Will eating organic food help prevent cancer? Not based on this study.
  • Organic food is expensive, and thus out of reach of many, even if they can find it.
  • Organic doesn’t mean pesticide-free. 
  • Focus on this: A mountain of research showing the health benefits (including cancer risk reduction) of eating plenty of fruits, vegetables, beans and whole grains, was done using conventional foods! 

For 2019: Beets Go Big Keto’s “King” & “Ya Gotta Have A Gimmick!”

What kinds of diets do consumers want?  My previous post noted the top 3 diets – from a scientific standpoint – but nutritionists say consumers swap what’s safe and sound for what’s fast and flawed, preferring trendy diets like keto and intermittent fasting. 

Pollock Communications and Today’s Dietitian just released their annual survey of registered dietitian nutritionists (RDNs), this year totaling 1,342 respondents, who give their views of what’s tops to consumers. 

,Consumers’ fondness for flashy diets, like keto, is disappointing to RDNs like Dr. Joan Salge Blake, Associate Professor at Boston University and author of the textbook Nutrition and You.  She even says keto will have similar results in the marketplace with the drastic fat-free diets of the 90’s.  Back then, “We saw a plethora of non-fat cookies, (remember Snackwells??), ice cream, and candy products bulging in the supermarket aisles.”  Salge Blake predicts, “We are going to see Keto cookies, ice cream, and candy muscling out low-fat goodies down the supermarket aisles.” She reminds us that fat-free doesn’t mean calorie-free and too many calories of any type won’t help America’s waistline.  

Salge Blake concluded, “Haven’t we seen this movie before?   I think I know the ending.”

Consumers get it right – sometimes

You’ll see from the graphic above that consumers are liking some great foods!  Fermented foods are tops – again.  Good news for yogurt, kefir, kimchi (pictured), tempeh, and other foods that have the great anti-inflammatory properties fermentation often brings.

Other veterans to the list are:

Kimchi: a fermented food that’s tops for 2019
  • Avocados
  • Seeds
  • Nuts
  • Coconut products
  • Ancient grains (think farro and amaranth, among many others)
  • Exotic fruits (like lychees, horned melons, and dragon fruits)

The Newbies

Consumers are “beet”-ing a path to this delicious veggie and high time.  Beets are packed with both nutrients and flavor.  They’re also naturally high in nitrates, which can give a little boost  to exercise endurance. 

Blueberries, a newcomer?  Who’d have thought they’d ever been off the list?  Low in calories and among the best sources of antioxidants, I’d like to see people popping these somewhere into a meal or snack as often as possible.  Fresh or frozen, they’re fantastic. 

Disappointingly, kale got bumped from the #10 spot and replaced by plant-based “milks”.  The “halo” these beverages have is unfounded and kind of ironic, given that there is also consumer preference for “clean eating”, yet these beverages are pretty low in nutritional content, usually have little or no protein, none of the bevy of nutrients natural to real milk, and the only nutrients they do have are usually added. 

Ironically, there is very little of the identifying food in these drinks.  Only 3 or 4 almonds, for instance, are in a glass of almond milk.  Pretty expensive!  The foods these beverages are derived from are fantastic.  Eat almonds, rice, oats, and walnuts.  But milk is a far better beverage for nutrition.  One exception: soy beverages.  Soybeans are high in protein and for my patients who are allergic to milk or are vegan, it’s the closest equivalent.

Amy Myrdal Miller, RDN, president of Farmer’s Daughter Consulting and a member of the elite food organization Les Dames d’Escoffier, has mixed feelings about the survey’s results.  “I love seeing fermented foods at the top of the list. Fermentation creates so many powerful flavor molecules, which can lead to greater enjoyment of foods. But I hate seeing non-dairy milks. Cow’s milk provides so many essential nutrients in a natural, delicious form.”    

Keep in mind, this survey is what RDNs see as the top trends for 2019. Trends aren’t always positive! Facts aren’t always driving consumers’ decisions. Perceived truths are often the drivers, and there is no shortage of myths and misinformation about food and nutrition in the popular media.  

As for that other trendy diet consumers liked, intermittent fasting, isn’t that just a formal way of what we used to call, skipping a meal?

To sum up, here’s the complete list of

  1. Fermented foods, like yogurt
  2. Avocado
  3. Seeds
  4. Ancient Grains
  5. Exotic fruit, like acai, golden berries
  6. Blueberries
  7. Beets
  8. Nuts
  9. Coconut products

Now, make your 2019 about #factsnotfears!