GOOD FAD, BAD FAD

I recently listened to a food and health writer bemoaning food fads and predicting that anyone who makes dietary changes will fail. He suggested that science will eventually tell us how to eat, and in the meantime we should avoid “extreme” fads–like Whole30 or intermittent fasting. But how extreme are these dietary habits, and are they really fads at all?

What makes a fad, anyway?

If a fad is a deviation from the conventional wisdom , then I say that we should deviate away. Conventional wisdom does not always serve us well. Is it a fad to eat nutrient dense food rather than processed food? Is it a fad not to eat all the time? Is it a fad not to eat things that tear up your digestion and ruin your microbiome? Is it a fad to keep the fat from building up on your heart? 

Likewise, is it normal for the tens of millions of people suffering from autoimmune diseases, heart disease, metabolic syndrome, or Type 2 diabetes to think they’re largely powerless to heal their conditions through diet? 

The “fads” that have disrupted the conventional wisdom actually have thousands of years of experience behind them. The nutritional status quo has fewer than 50 years of slick marketing behind it and a track record of bringing on an overwhelming burden of chronic disease, disability, and medical expense.

The limits of conventional wisdom

Deviations from conventional wisdom by functional, evidence-based, and complementary practices have led to solutions to health problems that are still considered unsolvable by conventional practice. Many physicians still believe that people with Type 2 diabetes are doomed to inevitable progression, requiring increasingly higher doses of medication and, eventually, insulin therapy. Conventional dietary recommendations, such as low-fat, high-carbohydrate, and frequent small meals combined with calorie restriction almost guarantee this pessimistic outcome. 

On the other hand, unconventional “fad” diets, including low-carbohydrate, ketogenic diets, and fasting practices are shown to result in regression of diabetes with reduction or elimination of medications. These dietary approaches reduce visceral fat and improve associated conditions, including heart disease.

When a medication like an SGLT2 inhibitor, such as Jardiance, reduces visceral fat, conventional medicine embraces it as a miracle drug. These drugs work by eliminating glucose from the blood by excreting it in the urine–it’s almost like you never ate that pasta! For a mere $600 per month, you can reduce the burden of excess carbohydrate intake with an SGLT2 inhibitor. 

Or you can do the same thing with fasting.

We’ve learned–and continue to learn–lessons from exploring diet alternatives that challenge conventional wisdom. And many of them aren’t fads. Humans have evolved with the capacity to periodically fast, out of necessity or in spiritual practice. What we haven’t evolved to handle is a diet full of high-glycemic, ultra-processed foods. 

A calorie is not a calorie 

One argument we hear in conventional wisdom is “calories in, calories out.” This means that if you’re burning the calories you consume, through exercise, you’ll stay healthy. But not all calories impact our bodies in the same way. Foods that are processed, have less fiber, less protein, and more sugar, do not satisfy appetite and lead to higher calorie consumption. These processed foods, from pasta to cookies to pretty much anything our grandmothers wouldn’t have been able to cook at home, stimulate insulin and tell our bodies to store fat.

In macronutrient terms, fat, carbohydrates, and protein are metabolized differently. For example, fructose (the fruit found in sugar–a carbohydrate) goes straight to the liver, is turned into fat, and can cause insulin resistance in the long term. Meanwhile, our bodies burn more calories digesting protein.

Calorie restriction

Our bodies always try to hold onto our fat stores. When we restrict calories through conventional dieting, our bodies react by increasing our appetite and by lowering our resting metabolic rate (or Basal Metabolic Rate, BMR). Prolonged calorie restriction makes our bodies more efficient with the fuel it has–meaning our metabolism goes down and we burn less fat.

There are a number of things you can do instead of daily calorie restriction: intermittent calorie restriction through fasting; increase your muscle mass through strength training; follow a nutrient-dense, high-fiber diet, and practice mindfulness, especially when you’re about to eat. (The writer I mentioned at the start of this post got that right!)

It’s processed foods, not fads, that fail us

Ultra-processed food is the biggest cause of chronic disease. I’ll say it again: processed foods, even ones that claim to be healthy alternatives, cause heart disease, diabetes, and cancer. Highly palatable processed foods increase appetite, stimulate insulin and fat storage, are inflammatory, and reduce the nutrient density of our diet. The battle against processed foods includes reducing our exposure to its temptations and demanding accountability of the food industry and government to make nutrient dense foods more affordable and available.

One way you can remove the temptation of foods is through fasting (which is one reason we host monthly Community Fasts). Fasting is not a fad–it’s been practiced by people through all of recorded history. It’s also not dangerous or difficult if you’re prepared. And unlike calorie restricting diets, fasting for up to five days can actually increase your resting metabolic rate. 

Ketogenic, Whole30, and other “fad” diets

When we’re fasting or following a low-carbohydrate, high-fat diet (commonly called a ketogenic, or keto, diet) our livers produce ketones. Ketones are a good sign that your body is burning visceral fat for fuel. The brain, heart, and muscle all run great when fueled by ketones. 

Elimination diets, such as Whole30, aren’t just for weight loss. These diets are meant to be temporary and to help you find out what foods are good or bad for your microbiome and gut health. Many people do elimination diets to see if a certain food is making them feel ill or sluggish. Grains and dairy are commonly poorly tolerated. While elimination diets that eschew entire groups of foods aren’t sustainable in the long term, they’re powerful tools to help us discover underlying intolerances.

Every dietary approach has pitfalls and limitations. Some diets may limit some important nutrients (for instance, vegan diets are low in iron, vitamin B12, and protein). Being aware of these limitations isn’t meant to condemn the approach, but does provide an opportunity to be proactive. 

I agree that following fads and making thoughtless dietary changes is doomed to failure. But not all dietary changes deserve the bad rap of a “food fad.” To reclaim our health, we can and must thoughtfully challenge conventional wisdom and enact dietary changes based on each person’s needs and goals. And as we’re seeing with the growing popularity of fasting, low-carb, and elimination diets, many people are waking up to how conventional diet wisdom has failed us. 

The conventional advice to eat less, exercise more, and reduce fat has produced a country in much poorer health. The reductionist approach of nutrition science has too often supported processed foods over traditional natural foods. Exploration of “fad” diets, on the other hand, has led us to an understanding that health is individual, and comes from natural whole foods and lifestyles that support a diverse ecosystem in our bodies and our environment.

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