Creating the Perfect Diet

What makes the perfect diet?

Is it the ideal calorie range, protein grams or macronutrient split?

What if you only focus on whole foods, go vegan, eat organic or take a ton of supplements?

There are a ton of variable to consider and the hardest part is figuring out where to start and what is going to work for you.  Inevitably a dietary approach that works like magic for one person could be totally unreasonable for another, even if you gave them the right amount of calories.  How can this be?  I mean what if your best friend's mom lost 50lbs cutting out all red meat?  Doesn't that mean that red meat is bad and obviously causes weight gain?  If it wasn't bad, how could cutting it out result in fat loss?

Context is King

Lets get one thing straight: in the world of diets, context is King (or Queen for that matter). When I say "diet" I simply mean whatever dietary approach you are using; it doesn't necesarily mean a crash diet 4 week cleanse.  It could be as simple as focusing more on whole foods.

Here's where people get lost in the forest focusing on the trees.  We are easily distracted by the outcome without ever being educated on why things worked.  And, you'll never hear WHY something worked in a checkout lane glamour magazine or internet keto diet ad.

Enter the Practical Example...

We need something to help give us an example of just how one variable is NOT always the culprit.

Typically, science associates higher intake of red meat with higher incidences of all-cause mortality.  Essentially, eating red meat is associated of dying earlier from pretty much all health perspectives.

It seems pretty cut and dry, right? But the details are usually lost on the general public or not shared with them at all, only confusing us further.  The confounding variables find that one of the reasons for red meat eaters to have higher all-cause mortality(Sinha et al 2009) is that they:

• Exercise less
• Drink more alcohol
• Smoke
• Eat fewer vegetables and fruit
• Lower education level (awareness is huge)
• Higher calorie intakes
• Greater overall body mass index

And vegan/vegeatrian diets tend to be associated with the best health, which from these two points would lead us to believe that the healthiest diet is one that is meat free!  After all, vegetarians and vegans diets are associated with reductions in type 2 diabetes (Tonstad et al., 2013; Vang et al., 2008), hypertension (Yokoyama et al., 2014; Appleby et al., 2002), and obesity (Vang et al., 2008; Rosell et al., 2006) when adjusted for covariates, such as age, gender, education, physical activity alcohol use and smoking. In addition, people following a vegetarian diet have been shown to have lower mortality risk compared to non-vegetarians, particularly from cardiovascular disease (CVD) (Huang et al., 2012; Kwok et al., 2014).

It should come as no surprise that eating fewer processed, calorie dense foods and focusing on more nutrient-dense, whole food source would improve your health. But when we look further we see that unlike red meat eaters, vegetarians and vegans tend to:

• Consume more fruits and vegetables (shocker!)
• Eat more whole foods
• Exercise more
• Smoke and drink less
• Have higher food education

The Devil is in the Details

When we step back and look at these findings, we can see that it isn't cut and dry.  It's not that red meat is bad or unhealthy but the OTHER lifestyle factors associated with red meat intake vs vegetarians/vegans is a huge driver of health.

And this make sense. If you're a lazy person who eats lots of processed food, never cooks and sits on the couch all day it is a far cry from the vegetarian who has to educate themselves on plant protein sources, try new recipes, shop differently and also care enough about animal welfare, the environment and their own well-being to invest that time.  Simply investing in a lifestyle that is less convenient shows that they are willing to put in more work towards their health and this is going to require a lot of education and effort - a dividing line for some people.

Science has debunked a lot of things for us: protein hurting your kidneys, saturated fats causing heart disease, salt causing high blood pressure, gaining muscle causing you to be slow and clumsy...the list goes on. In cultures from around the world you'll find people leading VERY healthy lives consuming things we've been told were downright bad:

• Salt/Sodium Intake (the PURE study showed that those at highest risk of having issues with sodium intake were the elderly and those wth existing high blood pressure, not really a shock. In fact, researchers concluded those at risk really only saw adverse affects with levels exceeding 5,000mg/day and North America on average is 4,200-4,800mg/day. They also concluded the recommendations for very low intakes were pretty much impossible to follow and were NOT helping the problem)
• High Carbohydrate Intake (Kitavans consume about 70% of their calories from carbohydrates AND their daily activity level is comparable with the U.S.  80% of them also smoke.  But they consume almost no Western foods, eat very little sugar and processed foods and consume no alcohol, caffeine or dairy. And they are really friggin' healthy and long-lived).
• High Fat/Saturated Fat Intake (In the 1940s, researchers compared Inuit populations who ate almost no carbohydrates but a huge intake of fat and saturated fat and found they were 4 times less likely to have heart disease than comparable European people. In fact, scientists have gone back to review why, over time, Inuit populations have seen a rise in heart disease and found it has been from the introduction of Western foods, especially sugar.

Nothing Makes Sense and My Life is a Lie

When we recall all the dietary advice we've been given; no fat, no sugar, no meat, no dairy, not too much fruit, no eating past 6PM, no gluten, don't eat a lot of protein, lifting weights is bad for you and so on, we're left wondering if there is in fact, any food that is healthy.

We have to bring this back to context and look at what the results above show us.  One is that people who consume less refined and processed foods high in sugar and trans fats are probably healthier.  Staying active is good too. Eating fruits and vegetables is a great idea.  Choosing leaner cuts of meat but not being scared of saturated fat as long as it doesn't predominate your diet. Educationg yourself.  Taking time to shop and cook, probably socialize too!

Sometimes it feels like every nutrition tip or "fact" you've heard has been proved wrong.  The thing is, most nutrition tips or facts have some truth and falseness to them inherently because of how they are spun to get your interest.  Is saturated fat bad?  No.  But is a ton of saturated fat with very little omega-3s, no vegetable intake and lots of sitting around bad?  You betcha.  

In nutrition, nothing exists in isolation which is why qualifying any "X" food alone is not a good idea or fully thruthful.  We've all heard how brown rice is better than white because it's less processed, has more fiber and nutrients and has a lower glycemic index.  But glycemix index is a pretty poor way of judging a food because you never eat most foods in isolation: adding protein, fat and fiber to a meal drastically changes the glycemic index in a positive way.

In addition, the glycemix index of brown rice is 77, white rice is 79.....nothing worth writing home about.  Brown rice has some more nutrients but again we aren't trying to get all of our nutrients from carb sources anyway.  Standing alone, brown rice could be called better than white but the difference is marginal in the context that most people consume it as part of a mixed meal.

A little truth, a little falseness.  It's all how someone wants to spin it.

The Power of the Calorie

Lets take it as presumed that eating a diet higher in whole foods, veggies, fruit, fibrous carbs and lean protein is a good dietary approach.  Lets not worry about the macro split, high or low carb and so on.  Assuming a diet is focused on the above is pretty solid for anyone.

In this context, the main driver of weight lost or gained is the calorie.  The truth is, any calorie deficit can result in weight/fat lost.  It's true whether you want to believe it or not.  Eating 1000 calories a day of just bananas might not feel great or having you perform well but you would lose weight. You would lose some muscle because there is pretty much no protein and you'd end up with some hormonal problems because of the lack of fat but you WOULD lose weight.  That's the power of the calorie.  The calorie total really drives the direction of your weight loss or gain.

That's big picture stuff. 

Your body has a host of mechanisms in place to regulate your appetite and energy expenditure.  Lyle Mcdonald covers this a ton and I won't dare to go into any of the details here, that's for another post and some more research.  But just know that calorie status (whether it's whole food or not) is sensed by the hypothalamus and you have hormonal and nervous system changes related to that.  This makes sense that the calorie is the big picture item for the body too because in terms of survival, you can survive on shitty food if you have enough calories.  Maybe not THRIVE, but survive.  Sorry but it doesn't matter how free range that chicken is, if you only eat 300 calories a day from it you'll eventually whither away and die.

Two Paths Diverge

Covering the big picture is obviously crucial.  But most people go about it the wrong way.  Some focus only on calories leading them to choose lower quality foods (Crossfit is particularly guilty of this with whey protein and pop tarts being an example of "hey, it fits my calories and macros).  But it doesn't usually lead to good long-term outcomes. Plenty of people get lean with disordered eating practices and that's nothing worth bragging about.

Others focus only on food quality.  This is not a rebuke against that - it's a great starting place.  But again, you can eat the most Paleolithic diet you want but if your coconut oil intake exceeds your daily calorie needs, you'll gain weight.

So which is it?  Do we focus on calories or focus on food quality?

Both are important, I don't think you can have optimal health with just one and not the other.  But one thing that seems to confuse people is when they remove context from the situation and forget that by focusing on quality, many people control calories as a side effect.  And some people who focus on calories have solid eating habits and inherently make high quality choices anyway.

If I had to start somewhere though, I'd focus on food quality.  Often people fall right in line with their calories if they start adding more fruits and veggies, focus on quality proteins, have good eating habits, drink enough water and choosed high quality fats and carbohydrates.  Whole foods and lean proteins tend to be less calorie dense than processed, fatty or sugar-laden food sources.  Plus increased protein and fiber usually leads to higher satiety.  So calories tend to come down as food quality goes up.

That's not always a truth as we're finding: I've had clients eating 1/2 jar of organic peanut butter a day and not leaning out -> remember how calories matter?

Strategies for Creating your Perfect Diet - Part 1

I am going to throw to things at you that you might not expect when talking about food:

1. Honesty - We cannot get anywhere and I mean ANYWHERE if you are not honest about what you're doing.  I am sorry but the truth is whether you report the 12 beers on the weekend or not, your physiology and body have the evidence to show.  I find this is often the biggest stumbling block for chronic and yo-yo dieters.

Social media has worked as a great (and sometimes terrible) way of revealing some things about people.  And lots of individuals who ask about nutrition, leaning out and how to make big changes post their alcohol, desserts, nachos, pizza and the like all over their FB wall.  Heck, they even check into the places they eat and drink compiling a roadmap of all their places they're consuming calories. Again, don't take this as me bringing down the hammer on your personal choices - I honestly won't criticize anyone for going out and having fun but if your choices constantly and directly contradict your goals AND you post them online for all to see, there's a personal honesty issue.

Here's why most people also can't just track calories and macros and see long-term success: they simply won't record their high calorie choices.  Again, honesty!!

2. Sustainability - I don't care in the LEAST if you've created the perfect diet with all checks and balances accounted.  Your diet could cure diabetes AND cure that weird rash on your leg but if it's too hard to follow, no one will. Yep, it's that simple.

This is why if I tell someone to eat 1/2 cup of carbs, I will recommend sweet potatoes, quinoa, oatmeal and fruit but if they can be successful long-term with some white rice or a slice of bread I don't push too much.  Why wrestle with someone over a minor detail - even if I get my way if they get sick of sweet potatoes and quit the program two weeks in we've both failed.  There has to be a middle ground where your choices aren't perfect but allow for it to become a lifestyle change - and overall good practices are adhered to.

Even the best and most responsible drivers don't always follow the speed limit but they follow the big picture rules that keep them and other drivers on the road safe.  This is how we need to let people eat.  Because inevitably it will be their birthday, they will want cake and we're both A-holes if we decide you can't have any.

Strategies for Creating your Perfect Diet - Part 2

Are we good on Part 1? Because if not then don't bother reading further - it won't help long term. If you're cool with the above then we can have the next piece in the conversation.

Since we're talking about improving food quality as taking the edge over counting calories and macros, let's start there.  I often DO have clients track their food as it helps them see how their choices play out in terms of protein, calories, fiber and more but if someone is not well-versed in those things then the learning curve is often too steep for most.

Here's some basic tenets I work on with most habit-based clients and as long as they're honest and consistent, it rarely fails to work.

-Focus on leaner cuts of meat.  93% lean and above for most animal proteins is a good starting place.  Fattier proteins like whole eggs and salmon,  are absolutely fine we just don't have them as often as others.

-Eat veggies and/or fruit at every single meal.  1-2 cups on average. You can pick your favorites here...it doesn't really matter that much as long as you pick sources you enjoy and will continue to eat.

-Include fibrous carbohydrates with each meal.  The amount varies based on the person, usually 1/2 cup to 1.5 cups depending but if it is fibrous and whole food in general then people are good.  If they occasionally sub a low carb wrap, ezekiel bread, white rice etc it's also fine as long as the amount is in line with the recommendations.

-Focus on quality fat sources. Avocado is awesome as is olive oil, grass fed butter, nuts and coconut oil.  If you need to cook with it then use the minimum rather then shallow frying everything. This generally is adjusted based on the person too since fat IS more calorie dense.  Again, a piece of cheese subbed in here and there wil also not ruin your plan.

-Eat slowly, don't eat in front of the computer or in the car.  Stop eating when you're satisfied but not stuffed.

We've got 5 major things to work on and honestly this covers it for most people.  

Protein and veggies stay relatively constant.  This helps adherence because once we agree on a set amount, you just have the same amount of protein and veggies ALL the time.  No matter what....put it on autopilot and then cruise along.

Carbohydrates get set too to a relatively constant amount.  Maybe just plug in a "hey get 1 cup fibrous carbs per meal".

Fats will get a set amount too and often people will get a lot of their necessary fat from animal protein and the fat they cook with, so we allow for the occasional nut butter, avocado, cheese etc and set an amount like "1 tablespoon per meal" or something like that.

What you might be thinking

I know how people think and I also hear this a lot.  I might reiterate the above to someone and they'll say "that's what I am doing now".  I know you THINK you are, but you aren't.  The reality is the 4oz of chicken you think you're eating is 2oz, the tablespoon of peanut butter is actually three tablespoons and the only veggies you eat are the lettuce on your sandwich.

Once I have people log their food journal this becomes readily apparent and then we work our way down the list.  

Ill generally have someone work on the habits above and once they are pretty good on them we will fine tune.  From here we might start to restrict rice and focus on less calorie-dense carb sources, switch from bananas to berries, choose slightly leaner proteins and reduce added fats to meals.  Essentially the focus now becomes refining the broad choices by simply managing sources - without focusing on amounts too much.

Want a practical example?

Generic Meal Recommendation to new client

5oz cooked lean protein

1 cup fibrous carbohydrates

1 cup veggies

1 tablespoon added fat

Client approach to recommendation

5oz boneless skinless chicken thighs

1 cup cooked quinoa

1 cup spinach

1 tablespoon olive oil

Calories: 646

Protein: 47g

Carbohydrates: 40g

Fat: 33g

Refined suggestions once progress slows

5oz boneless skinless chicken breast

1 cup cooked sweet potato

1 cup cooked broccoli

1 tablespoon grass-fed butter

Calories: 469

Protein: 49g

Carbohydrates: 33g

Fat: 16g

The results show that simply following some basic recommendations, the client has a LOT of freedom is choosing foods they like.  They end up eating more protein, fiber and improve food quality and nutrient density.  Since they are more full and have better blood sugar control often clients will inherently eat less total calories for the entire day, even if a particular meal is larger than what they are used to.  I know this even if they don't and it doesn't matter at first.  All that matters is that they hit the big picture items and make it a lifestyle change.

Once progress slows I usually do not go with "eat less" from a food volume approach because not their meals will be smaller and they might be more hungry which doesn't bode well for adherence.  So instead you can see above how while keeping food volume the exact SAME, we chose slightly less calorie-dense foods and ended up with a 200 calorie reduction that the client probably won't ever notice.

Once progress slow again, I might just have them halve or remove the added fat from the meal.  Once again, food volume is pretty much the same which means we would've made an overall 300 calorie reduction (from just one meal!) without changing how full the person is.  Of course we could also keep the fat and lower the carbs depending on the clients feedback but you can see how methodical, logical and easily applicable this approach is.  

Enter calorie and macro counting

Once we've exhausted the above approach and the client might be feeling some sting from the reductions, we might have them start to track,  This is a great time to implement this because by now they are well versed in what each food source is, how portions work, which foods keep them the most full and satisfied and so on.

When they start tracking this now gives them the freedom to make choices that help them adhere to the plan without having to coach every single minutiae.  This is when clients start to see that strawberries are just as filling as a banana but less carbs.  Or avocado is a more filling fat souce than olive oil for the same calorie amount.  All these details get worked out through logging, applying and judging how the client feels and they tend to self educate. Maybe you can afford to sneak in some red wine but not a margarita.

Of course we never want food quality to take a dive but tracking allows for the next level of individualization.  And some people (most actually) NEVER need this, but if they want it or need it, it's there.

The problem with traditional approaches

Instead of the detailed approach I listed above, most people just make wild cuts to their nutrition:

No carbs

No meat

No fat

No fruit

Those cuts result in a disordered relationship with food, poor adherence, weight regain, confusion and frustration.   Approaches that people sell you like the ones directly above prey on your ignorance and fear.  You might not know any better to call B.S on them so you jump from diet to diet spinning your wheels.

The perfect diet for you requires you hitting some super-basic things and then refining and adjusting over time until you find an approach that works for your goals and your lifestyle.  Maybe you hate asparagus, I don't care....don't eat it.  But there's a veggie out there you DO like and WILL eat and that is the perfect veggie for you.

From Plane to Landing

If you jump out of plane with a parachute you can't pick your exact target from the plane and then just close your eyes and hope to hit it.  You need to make the broad and expansive first jump then continually adjust, assess and adjust again as you get closer and closer to your goal.  Most diets are a blind leap of faith that ends up with landing in some weird, wacky place like the top of a Chucky Cheese.  No one wants to be there.  A good dietary approach means being a more active participant and adjusting as you experience the ride so you can hit the right target. 

When in doubt, start broad. Be inclusive, not exclusive.  Don't argue about insulin and glycemic index if your daily fiber intake is 10g. Just hit the major things and see how you feel, check your results.  Then refine.  Hold out a bit longer and see how you feel, check your results. Repeat, repeat and repeat until you end up with something that works for YOU.  A good coach inherently knows this but still has to take you through the process, there's no shortcuts.

A faster landing from the plane might be no parachute.  It's a shortcut but it's a crappy shortcut.