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Prakash Chandran (Host): Fad diets. I can’t tell you how many I’ve tried with the hope of losing weight quickly, but some of them just aren’t that great for you. Let’s talk with Catherine Page an outpatient clinical dietician at Harrington Hospital. The is Healthy Takeout, the podcast from Harrington Hospital. I’m Prakash Chandran. So, Catherine thanks so much first of all for joining us. Secondly let’s talk about fad diets. I’ve heard so much about them. I actually just got off of a keto stint. I’d love to hear your thoughts on what a fad diet is and the different kind of misconceptions that people might have about them.

Catherine Page, MEd, RD, LDN, CDE (Guest): It’s interesting that you mentioned keto because that’s the big “new” one that’s out now. Even though it’s been around forever. So, basically, the definition of a fad diet is any diet that gives big promises. It may be quick weightloss. It may be you don’t have to exercise. You eat only certain particular foods and so for a lot of them; it’s big promises and not a lot of fulfillment or it’s very short-term fulfillment but it’s nothing that’s sustainable. And that’s the big thing when I talk to somebody about a fad diet is how realistic is this, like how long can you sustain this?

Host: Yeah, that makes sense, but I’m curious as to how you might separate a fad diet from one that actually works. Because for Keto for example, I did see that weightloss even though I hated the nutritional plan that I was on. I did see the weightloss that I was looking for. But I could definitely tell that it wasn’t something that I wanted to sustain. So, maybe talk a little bit about that.

Catherine: Okay. Keto works because what happens with the keto diet is it pushes you into what’s known as a hypermetabolic state. And basically what that means is it causes your metabolism to speed up because when we digest fats, when we use them as our energy source; out body goes into a heightened metabolism. So, yes, when you are on the keto diet, yes, you’re going to see weightloss. And most people see significant weightloss in that first four to eight weeks; the problem is, our body is not meant to run on a high fat diet. Our body is meant to have complex carbs coming in. So, those are things like fruits and vegetables and whole grains.

So, the big issue with the keto diet is yes, you are going to have success, but after about four weeks, it starts to affect your kidneys because it puts you in a state of ketoacidosis which means your blood acid level actually goes up and so your kidneys have to process out that extra waste and all that extra acid. So, after about four to six weeks, your kidneys start to have a negative impact such that you can actually see it in a blood test. So, I always tell people, if you are going to follow the keto, no more than four weeks. Use it as a jump start to get your weightloss started but then start bringing in reasonable portions of complex carbs because that’s what your body needs.

So, that’s what I always tell people when it comes to the keto, is yes, it’s a good starter, but it’s not sustainable because it’s too high in fat and the side effects are just too bad.

Host: Yeah, I think the biggest thing is that so many people adopt this as a lifestyle like something that they try to live their entire lives by, and it does have the side effects as you are talking about potential kidney problems when it comes to keto. So, one of the things that I would love to ask is how do you separate out what a change in lifestyle diet might be versus one of these fad diets like keto or Paleo or Whole 30 or one of these things that we’re going to hear about. How do you separate the two from one another?

Catherine: For me, when I’m talking to a patient or a client about it, the big thing is sustainability. How realistic is it? When I talk to a person, I don’t just ask them about what they are eating, I also ask them what do you do for a living, who do you live with. I ask them a lot of lifestyle questions because if it’s a mom with two kids who also works, keto may work temporarily, but then they still got to feed a household of people. So, I always ask realistically what’s the sustainability of this diet.

For a lot of people, most fad diets work because it’s the first time or the first time in a long time that they are actually paying attention to what they are eating. So, they are actually measuring their food. They are actually tracking what they are eating. They are thinking about what’s going into their mouths. So, my thought is, well why not think about it but think about it in a healthy manner so that most of what’s going in your mouth is your fruits and vegetables. You are still having some starch, but maybe it’s only a half a cup to a cup that’s coming in. You’re still having your protein, but maybe it’s only three ounces, four ounces. So, you still have to think about what you’re eating even when it’s a lifestyle meal, even when it’s a lifestyle diet. You still have to think about what you’re eating. It’s just most of what you should be thinking about is fruits and vegetables.

Host: Yeah, I’m so glad that you said that. Because I think so often, we think about oh there’s a template out there called keto or the Paleo diet that I can just map on top of my life, but what I’m hearing from you is that it’s very individualized. It depends on how you are living day to day. It depends on your bio-individuality and one of the things that we talked about at the top of this episode is the difference in advice that you might get from a nutritionist where there’s no credentialing involved versus what you are Catherine as an outpatient clinical dietician. Can you maybe separate out what the difference between the two of those are for our audience?

Catherine: Oh, thank you so much for asking. What a nutritionist is, is anybody. You can get a certificate in nutrition that might have been weekend course. It might have been a six week course. It might have been a six month course. And it could cover anything from a specialized diet type to just general healthy eating. So, it’s very general. It’s usually a certificate.

To be a dietician, you have to have a degree in food and nutrition and dietetics. And then beyond that, is what’s known as a registered dietician. So, you need the degree and then you complete currently the interns that I have under me are doing 1500 hours of internship rotation. So, they are actually working with patients and working in the industry and then they sit for a three hour course to become credentialled. So, then you become a registered dietician. So, there’s a lot of education and experience and mentoring that goes into becoming not just a dietician but a registered dietician.

So, people need to be aware of that when they meet with someone, they say oh, I have a certificate in nutrition. It’s a limited education versus actually meeting with a dietician or a registered dietician.

Host: Yeah, it’s really important that you made that distinction and I’m so glad I asked because one of the things I want our audience to know is that normally when you think about these things, you are like well I’m just going to see a nutritionist but seeing someone that is that registered clinical dietician is going to know the effects that it has on the body because you are trained, there are a certain amount of hours that you have to meet. It is a difference in terms of the care and the advice that you are getting. Wouldn’t you say that’s true?

Catherine: Oh absolutely. Absolutely. Because yes, in terms of schooling, we have to go through anatomy, and physiology and all the chemistry classes as well as how do the foods affect the body. How do they change within the metabolism of the body. When I talk to someone, I talk to them about lifestyle, but I also talk to them about any disease states. If they’ve got thyroid issues, we discuss that. If they’ve dealt with cancer, we discuss that. Because it all impacts what you eat, how you eat. So, it’s definitely – I definitely take it from a lifestyle approach so it’s okay let’s see how we can get you eating healthy within the life that you’re leading with all these other possible issues that you might have going on.

Host: Right. The same diet will not work the same for every single person. And I think that is a theme that we keep touching on. That everyone is different, and you have to take your lifestyle into consideration and really take that comprehensive look into your health. So, it’s very obvious that another diet is going to come on board, just soon enough. So, when your patients come to you and say look, I was reading a magazine and there’s this new diet that’s supposed to be better than keto, Whole 30 and Paleo all combined, what do you think about it. What is the advice that you give them before trying one of these things out?

Catherine: Again, like I said, sustainability, how long can you follow it, what’s it eliminating. Because once you eliminate a food group; you eliminate key nutrients. And once you start eliminating key nutrients; that’s when people start craving those types of things. So, I always ask people how real is it, how sustainable is it, and if it’s with the 21 diet where you’ve got this many blues and this many yellows; I always tell people you know you can measure that out the same way and eat like that without the little plastic cups. So, that’s the big thing I always ask is how realistic is it and how sustainable is it. Do you need to buy special foods, do you need to eat in a certain way and how feasible is that within your lifestyle.

So, that’s the big thing is sustainability. Because it’s – what I always tell people and I know it sounds really grim because plenty of people say well how long do I need to eat like this and I’ll say well how long do you want to live. And some people are like no, no, I’m serious. And I’ll tell them, so am I. if you want to live 30 more years, you need to eat like you are going to live 30 more years. if you only want to live another five, go ahead and eat like you are going to live five years. And so, when they think about it that way, then it becomes sort of this light bulb moment of oh, heh, I really need to think about healthy eating and reasonable portions and where my ounce of my food is coming from and how it’s coming in.

Host: Absolutely. So, sustainability and that comprehensive look and making sure that when you decide to try one of these diets, it’s always best to go to a registered clinical dietician so they can give you that look from a studied and measured way. So, thank you so much Catherine. I really appreciate it. that’s Catherine Page, an outpatient Clinical Dietician at Harrington Hospital. Thank you so much for checking out this episode of Healthy Take Out. Head to www.harringtonhospital.org to get connected with Catherine Page or another provider. If you found this podcast helpful, please share it on your social channels, that really helps us out. And be sure to check the entire podcast library for topics of interest to you. Thanks and see you next time.