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“I don’t think the fear of disease or the fear of adverse consequences is what gets anybody to make a long term change. I think it’s connecting with the positive aspect of whatever it is you’re choosing.”
In this episode of the Mindspace podcast, Dr. Joe speaks with Dr. Kara Nance. Kara is a physician, double-board certified in Internal Medicine and Obesity Medicine. She is the founder of WellessenceMD, a medical practice in Chicago with an innovative, integrative approach to primary care and weight management. Kara is a certified Mindfulness-Based Stress Reduction teacher and uses mindfulness with her patients to address the cognitive, emotional, and behavioural components of diet.
Kara takes Dr. Joe on a fascinating tour of nutrition science, clinical best-practices, and the wisdom she has gained from many years of practice. Their conversation covered:
- An analysis of several popular diets including the Ornish, paleo, ketogenic, and plant-based approaches
- The scary truth about sugar
- The challenges of managing our kids sugar intake
- The role of the microbiome
- How mindfulness can promote healthy eating
- And a variety of practical tips and tricks to maintain healthy eating habits
If you’d like to learn how to practice mindfulness to help with your diet, eating habits or any other unhelpful habits, please reach out to Mindspace: mindspacewellbeing.com.
Here are some highlights from their conversation:
What other approaches besides the ketogenic diet are you recommending to your patients?
The number one thing that I say is to all extents possible avoid processed foods. I think that anything that is not a whole food is a potential culprit.
There was actually a recent study done where people were fed a processed food diet versus a whole food diet. And they had the exact same number of calories and the exact same macronutrient distribution. But one was processed, and one was not.
And what we discovered was that the people who were eating the processed foods actually consumed more calories than the people who weren’t eating the processed foods. So I do think that’s pretty interesting. They consumed those calories over a similar period of time. It seems like they ate a little bit more quickly. So that’s the first thing that I say, try to get to a whole foods diet as best you can.
I also tell people to become mindful of how many carbohydrates they are eating. And then if people want to go through a detox and just get off sugar completely, there’s a variety of ways that we can support people in doing that. But even just saying, ‘I’m going to have 50 grams per day less than I do right now on average.’ And maybe the next month or week taking it down another 50. That’s another reasonable approach.
Although if people are addicted to these sugars and these carbs, it can sometimes be more difficult to do that than it is to go cold turkey because we have to remember that craving can be like a bonfire. Where the more you feed it, the stronger it becomes. So if you just stay away from the sugars, stay away from the carbs, the cravings will lessen over time for sure.
There’s no one food that I think all people are potentially addicted to. I think it’s a wide variety.
So back to the question about other diets. The paleo diet is another one that I think many people do well with. This is a diet that says, ‘Let’s try to mimic what our ancestors were eating a hundred thousand years ago.’ It’s a variety of animal based proteins, as well as naturally occurring animal and plant based fats as well as a wide variety of any fruit or vegetable that you can find.
Now some people will have trouble with fruit. We have to remember that our fruits have been genetically selected to be very sweet and have high levels of sugar. So I actually have some patients that identify as fruit addicts. And had taken everything else out of their diet and were still metabolically stuck until they took fruit out as well.
Can you speak to what the science says is the most healthy way to eat?
The interesting thing is that–there was a recent study done that looked at a wide variety of different diets. It looked at them in terms of weight loss. And it actually found that with all of these different dietary approaches similar amounts of weight loss were achieved.
They also saw that with all of these different dietary approaches after a year similar amounts of weight regain also occurred. So if you trust that data, there’s really not necessarily one diet that’s best for everyone.
Now with that being said, if you have certain metabolic diseases like diabetes, I think that a ketogenic diet may be a better strategy. But I think this whole idea around saturated fat and cholesterol and these kinds of foods leading to heart disease is only true if you’re also eating those foods with carbohydrates. In the absence of carbohydrates, the oxidizing effects of the cholesterol and the other inflammatory things that we know lead to disease processes really don’t seem to be happening with protein and fat, even from animal sources.
Well, that sounds kind of important. I’m not sure how many people are aware of that.
Yeah. Yeah. On the one hand, I want people to hear that a ketogenic diet is a healthy alternative, but if you decide to just increase the amount of protein and fat you’re eating, and you still have your toast, and your rice, and your cookies, you’re actually probably creating more harm than if you were following a more traditional mediterranean diet. That was one of the ones you mentioned that has more like 30% fat, instead of the 65% fat of the ketogenic diet.
So I think that it’s important to look at the overall diet and your overall compliance rate. And just figure out where it is that you think you can land.
And if you do want to try to follow something that is a lot stricter like a ketogenic approach and you do fall off the wagon, recognizing that the sooner that you can get back into your ketogenic habits, the easier it will probably be.
The yo-yo diet effect actually can be somewhat detrimental. There are some studies that suggest each time people regain their weight, they regain a little bit more than what they had lost. And that’s not the result of fad dieting or the ketogenic or any specific dietary approach. It’s just when the set of habits is abandoned that enabled the person to lose the weight, the body goes back to this fat-mass set point. And it seems like each time the set point rises a little bit higher. So it’s a little bit harder to get back down there the next time.
So if something is too restrictive and is resulting in a lot of yo-yoing in regards to weight, then I recommend that people get rid of the processed foods to the best of their ability and just really to pick whatever approach that they sustain with more ease, with less suffering. Because at the end of the day, we want eating to bring joy. Eating is a wonderful thing. And we really don’t want to overcomplicate it or make ourselves too stressed. But I think it’s important to have these intentions around what do I think is going to be best for me.