As a nutritionist, it’s my job to find out the best way to keep my clients as healthy as they would like to be. Most of us know that food is medicine, perhaps the most powerful medication on the planet with the power to cause or cure most types of illness. Food is more than just calories, it contains information that controls every aspect of our biology and health, and being aware of it is what is required to advise people to prevent, treat and even reverse most chronic conditions.
The €1000000 question seems to be: What should I eat to feel good, lose weight and be sustainably healthy? And does it mean that you have to choose between being a vegetarian, vegan or Paleo diets? We all know people (or have heard of celebrities) that swear by one diet or another. And they look and perform in an envious way.
The problem with nutrition research
If you’re looking at the research on different diets it is easy to get confused. Vegan diet studies show they help with weight loss, reverse diabetes and lower cholesterol. Paleo diets seem to do the same thing. So, should you be shying away from animal foods and eating only beans, grains and vegetables or should you eat meat and fat without feeling guilty and give up all grains and beans?
Basically, each ‘tribe’ adheres to their diet with near religious dedication. And each can point to studies validating their point of view. I call this cherry-picking. After reading dozens of studies on vegan and paleo diets, even healthcare professionals can get confused. But I don’t because I read BETWEEN the lines and not just the headlines. I read the methods and analyse the actual data to learn what the studies actually demonstrate and not what those who carried out the studies are claiming to have proven.
The problem with nutrition research is that most of it relies on large studies of populations and their dietary patterns which is obtained mostly through dietary questionnaires or 24-hour dietary recall. The first study linking saturated fats to heart disease by Ancel Keys (which formed the basis of 50 years of dietary policy to eat low fat) looked at about 30 men from Crete and their previous day’s diet and linked that to the fact they had less heart attacks than people from countries whose diets was based on saturated fats. Not very convincing! In fact, most of the “evidence” that fat in general and more specifically, saturated fat is bad for us is currently being rigorously challenged by better and more explicit research.
These types of studies are further complicated due to the fact that it is very hard to isolate the factors that matter most. For example, when Japanese people move from Japan to the United Kingdom, they eat more meat and have more heart disease and cancer, but they also consume much more sugar than they did previously. So, it is the meat or is it the sugar? Hard to tell. These types of population studies also cannot prove cause and effect, they can only demonstrate correlation. Yet, the media and consumers take it as God’s Words. Another example: For a long time, we thought that dietary cholesterol was bad and were told to avoid egg yolks no matter what. It turned out that not only they are good for you buy they also have no impact on cholesterol levels.
Many experimental studies on vegan or paleo diets, which should give more direct evidence of cause and effect often have only small numbers of participants in the study, making it hard to draw accurate conclusions. What is even worse is that the diets they use for comparison (the control group) are not ideal alternative diets. Comparing a vegan diet of crisps and Red Bull, bagels and pasta to a paleo diet of healthy vegetables and grass fed meat won’t be very conducive, nor would comparing a paleo diet of factory-grown meat, pastrami and no fresh vegetables to a whole food, low glycaemic vegan diet. I hope you’re beginning to see where I’m going with this.
Similarly, eating a low fat compared to a high fat vegan diet has very different health benefits. The Eco-Atkins or high fat, high protein, low carb, low glycaemic vegan diet performs better for weight loss and cholesterol lowering than a low-fat vegan diet that avoids nuts, seeds and avocados.
Deciding which dietary route to take can be a tough job. I’ve chosen to become a flexitarian and recommend it to most of my clients. Keep in mind that most of us need to personalise the approach depending on our health conditions, preferences and needs. There is no such thing a magic bullet when it comes to diet and health.
What is a Flexitarian? Google says it’s a person who has a primarily vegetarian diet but occasionally eats meat or fish.
Let’s first focus on what is in common between paleo and vegan (healthy vegan that is), because there is more in common to smart eating than there are differences. They both focus on real, whole, fresh food that is raised in a sustainable way.
Here's what everyone seems to agree on:
Very low glycaemic load – low in sugar, flour and refined carbohydrates of all types.
High in vegetables and fruits of all varieties and colours is better. This provides a high phytonutrient content protective against most diseases. (Note that the paleo ‘tribe’ recommends lower glycaemic fruit such as berries.)
No chemicals, additives, preservatives, dyes, MSG, artificial sweeteners and anything else that you would never have in your pantry.
Low in pesticides, antibiotics and hormones and probably low or non-GMO foods.
Ideally organic, local and fresh foods should be the majority of your diet.
Containing higher amounts of good quality fats such as omega 3. And most camps advise good quality fats from olive oil, nuts, seeds and avocados. Although if you’re looking to reverse an existing cardiovascular disease you might want to consider a very low fat diet (but consult with your expert healthcare provider first).
Adequate protein for appetite control and muscle synthesis, especially in the very physically active and the elderly.
If animal products are consumed they should be sustainably raised or grass fed.
If you are eating fish you should always choose low mercury and low toxin containing fish such as sardines, herring and anchovies or other small fish and avoid tuna and swordfish because of the higher mercury content
Here's where there's disagreement:
Dairy – Both the paleo and vegan tribes stay away from dairy and for good reason. While some can tolerate it, for most it contributes to obesity, diabetes, heart disease and cancer and may increase (not decrease) the risk of osteoporosis. I repeatedly come across dairy intolerance in the food intolerance tests I regularly carry out on my clients.
Grains– For many gluten creates inflammation, autoimmunity, digestive disorders and even obesity. But do all grains cause a problem? Not necessarily as long as consumed in limited quantities. All grains can increase blood sugar. And if you eat kind of flour made from grains, you might as well be eating cake. Stick with small portions (1/2 cup at a meal) of low glycaemic grains like black rice or quinoa. (However, for type 2 diabetics wanting to get off insulin and reverse their condition and for those with autoimmune disease, I recommend a grain-free and bean-free diet for a month or two to see how it works for them.
Beans – Beans are a great source of fibre, protein and minerals. But they are known to cause digestive problems for some. Furthermore, if you are diabetic, a mostly bean diet can trigger spikes in blood sugar. therefore, moderate amounts of beans (up to 1 cup a day) can be ok. Note that there are some who are concerned that beans contain lectins that may create inflammation or phytates that impair mineral absorption.
Meat – Now here’s the main bone of contention. All meat is NOT created equally. You must not compare feed-lot beef that raises cholesterol and increases inflammation, with grass-fed beef that has more cholesterol neutral stearic acid and contains protective omega 3 fats and vitamins A and D that raises glutathione and other antioxidants. Some studies show meat increases heart disease and death rates, whilst other studies show the opposite. It all depends on the quality of the study, but the evidence in my opinion is leaning toward meat not being linked to death or heart attacks for the reasons I explained above – there may have been other reasons excluded from the analysis in the meat eaters – such as they were higher carbs consumers, they were less active and they were more likely to smoke and drink alcohol. Eating moderate amounts of sustainably raised, clean meat, poultry and lamb and other ‘exotic’ meats such as ostrich, bison or venison as part a healthy diet is not likely harmful and is very helpful in reducing triglycerides, raising HDL (good cholesterol), lowering blood sugar, reducing ab-flab, supressing hunger, raising testosterone and increasing muscle mass. I recommend eating meat as a side dish or condiment, and only consume organic grass fed and sustainably-raised.
Eggs – For decades we were told that cholesterol is bad for us and because eggs contain cholesterol they must be bad. Now eggs are no longer consider culprits and don’t have any impact on cholesterol and are not associated with increased risk of heart disease. They are a great inexpensive source of important nutrients and protein.
Fish – To avoid mercury exposure choose small, omega 3 fat rich fish such as sardines or wild salmon. If you are a vegan and don’t want to eat anything who has a mother, then that’s perfectly fine. But it’s critical to get omega 3 fats, and not just ALA (or alpha linolenic acid) found in plants. You need pre-formed DHA which is what most of the brain is made from. You can get it from algae.
Everyone needs Vitamin D3, and omega 3 fats are hard to get for most. Supplements (or a regular sardine diet) are crucial. And for vegans, Vitamin B12 is also critical.
This leaves you with the best option: become a Flexitarian. No need to focus on how much you eat, instead focus on what you eat. Let your body’s natural appetite control-systems do its work.
Focus on the glycaemic load in your diet. This can be done on a vegan or paleo diet, but admittedly is harder on a vegan diet. Focus on more protein and fats such as nuts (not peanuts), seeds (flax, chia, hemp, sesame, pumpkin), coconut, avocados, sardines, olive oil.
Focus the right fats. Stay away from most vegetable oils such as canola, sunflower, corn, and especially soybean oil. Instead choose omega 3 fats, nuts, coconut, avocados (believe it or not) saturated fat from grass fed or sustainably raised animals.
Eat mostly plants – lots of low glycaemic vegetables and fruits. This should make 75% of your diet and your plate. I usually eat 2 to 3 vegetable dishes for each meal.
Focus on nuts and seeds. They are full of protein, minerals, and good fats and they lower the risk of cardiovascular disease and diabetes.
Stay away from dairy food – (unless you’re a calve wanting to grow into a cow). Instead, choose organic goat or sheep products (in moderation).
Avoid gluten – Better get tested and if you are not gluten sensitive, then consider it an occasional treat. Still, eat gluten-free whole grains frugally– they still raise blood sugar and can trigger autoimmunity.
Eat beans in moderation – for me lentils are the best. Stay away from big starchy beans.
Eat meat or animal products as a condiment, not a main course. Vegetables should take centre stage and meat should be a side dish.
Think of sugar as the enemy and only as an occasional treat – in all its shapes and forms.
I think that this way of eating is the most sensible for our health and that of our planet. It is sustainable and kinder to animals. We should all try to focus on what we know and customise it based on our preferences and beliefs. But we should leave religion out of nutrition while respecting individual choices and yes – vegans and paleo followers should not treat each other as the enemy. How do I eat? After researching nutrition for several years and analysing many scientific papers and treating scores of clients with food, I vote for being a flexitarian.