5 Reasons the Whole30 is Not the Anti-Diet It Claims to Be

by Hannah Meier, RD, LDN

How does the Whole30 Diet hold up from a dietitian’s perspective? Hannah Meier breaks it down.

I’m calling it: 2017 is the year of the non-diet.

As a dietitian who ardently discourages short-term dieting, I was thrilled to read many articles posted around the new year with titles like “Things to Add, Not Take Away in 2017,” and “Why I’m Resolving Not to Change This Year.” Taking a step more powerful than simply abstaining from resolution season, influencers like these authors resolved to embrace the positive, stay present, and not encourage the cycle of self-loathing that the “losing weight” resolutions tend to result in year after year.

Right alongside these posts, though, was an overwhelming amount of press exonerating the Whole30—a 30-day food and beverage “clean eating” diet.

The founders of the Whole30, however, adamantly claim it is not a diet. Even though participants are advised to “cut out all the psychologically unhealthy, hormone-unbalancing, gut-disrupting, inflammatory food groups for a full 30 days” (including legumes, dairy, all grains, sugar, MSG, and additives like carrageenan), followers are encouraged to avoid the scale and focus on learning how food makes them feel rather than how much weight they gain or lose.

But our culture is still hungry for weight loss. The possibility of losing weight ahead of her sister’s wedding was “the deciding factor” for my friend Lucy (name changed for privacy), who read the entire Whole30 book cover to cover, and fought her “sugar dragon” for 30 days in adherence to the Whole30 protocol (only to eat M&M’s on day 31, she admits).

“Whole30 focuses on foods in their whole forms which is positive for people who are learning how to incorporate more unprocessed foods in their diet,” Allison Knott, registered dietitian and Friedman alum (N12) explains. “However, the elimination of certain groups of foods like beans/legumes and grains may have negative health implications if continued over the long-term.”

Diets like these trick consumers into thinking they are forming a healthier relationship with food. Though weight loss is de-emphasized, a trio of restriction, fear, and control are in the driver’s seat and could potentially steer dieters toward a downward, disordered-eating spiral.

I still think 2017 is the year of the non-diet, but before we get there we need to unmask the Whole30 and call it what it is: an unsustainable, unhealthy, fad diet.

1: It is focused on “can” and “cannot”

The Whole30 targets perfectly nutritious foods for most people (grains, beans and legumes, and dairy) as foods to avoid entirely, relegating them to the same level of value as boxed mac and cheese, frozen pizza, and Kool-Aid. And most bodies are perfectly capable of handling these foods. They provide a convenient, affordable, and satisfying means of getting calcium, vitamin D, potassium, phosphorus, and nutrient-dense protein. The Whole30 eliminates almost all the plant-based protein options for vegans and vegetarians. While the point of eliminating these foods, creators Hartwig and Hartwig explain, is to reduce inflammation and improve gut health, nowhere in the book or website do they provide scientific studies that show removing grains, beans and dairy does this for most people. But we’ll get to that later.

The Whole30 also instructs that participants not eat any added sugar or sweeteners (real or artificial), MSG (monosodium glutamate, a flavor enhancer that has been weakly linked to brain and nervous system disruption), or carrageenan (a thickener derived from seaweed and is plentiful in the world of nut milks and frozen desserts; conflicting evidence has both suggested and refuted the possibility that it is associated with cancer and inflammatory diseases), sulfites (like those in wine), or alcohol. Not even a lick, as they are very clear to explain, or you must start the entire 30-day journey from the beginning once more.

“I couldn’t go longer than 30 days without a hit of chocolate,” Lucy told me, explaining why she was dedicated to following the program exactly.

Why take issue with focusing on “good” and “bad,” “can” and “cannot” foods? As soon as a moral value is assigned, the potential for establishing a normal relationship to food and eating is disrupted. “The diet encourages following the restrictive pattern for a solid 30 days. That means if there is a single slip-up, as in you eat peanut butter (for example), then you must start over. I consider this to be a punishment which does not lend itself to developing a healthy relationship with food and may backfire, especially for individuals struggling with underlying disordered eating patterns,” Knott argues.

How will a person feel on day 31, adding brown rice alongside their salmon and spinach salad after having restricted it for a month? Likely not neutral. Restrictive dietary patterns tend to lead to overconsumption down the road, and it is not uncommon for people to fall back in to old habits, like my friend Lucy. “People often do several Whole30 repetitions to reinforce healthier eating habits,” she explained.

Knott relates the diet to other time-bound, trendy cleanses. “There’s little science to support the need for a “cleansing diet,” she says. “Unless there is a food intolerance, allergy, or other medical reason for eliminating food groups then it’s best to learn how to incorporate a balance of foods in the diet in a sustainable, individualized way.”

While no one is arguing that consuming less sugar, MSG and alcohol are unsound health goals, making the message one of hard-and-fast, black-and-white, “absolutely don’t go near or even think about touching that” is an unsustainable, unhealthy, and inflexible way to relate to food for a lifetime.

2: It requires a lot of brainpower

After eight years of existence, the Whole30 now comes with a pretty widespread social-media support system. There is plenty of research to back up social support in any major lifestyle change as a major key to success. Thanks to this, more people than ever before (like my friend Lucy, who participated alongside her engaged sister) can make it through the 30 days without “failing.”

But the Whole30 turns the concept of moderation and balance on its head. Perfection is necessary and preparation is key. Having an endless supply of chopped vegetables, stocks for soups, meat, and eggs by the pound and meals planned and prepared for the week, if not longer, is pretty much required if you don’t want to make a mistake and start over. The Whole30 discourages between-meal snacking, (why?) and cutting out sugar, grains, and dairy eliminates many grab-and-go emergency options that come in handy on busy days. So, dieters better be ready when hunger hits.

Should the average Joe looking to improve his nutrition need to scour the internet for “compliant” recipes and plan every meal of every day in advance? While the Whole30 may help those unfamiliar with cooking wholesome, unprocessed meals at home jumpstart a healthy habit, learning about cooking, especially for beginners, should be flexible. It doesn’t have to come with a rule book. In fact, I think that’s inviting entirely too much brain power that could be used in so many other unique and fulfilling ways to be spent thinking, worrying, and obsessing about food. Food is important, but it is only one facet of wellness. The Whole30 seems to brush aside the intractable and significant influence of stress in favor of a “perfect” diet, which may or may not be nutritionally adequate, anyway.

The language used by Whole30 creators to rationalize the rigidity of the diet could make anyone feel like a chastised puppy in the corner. “It’s not hard,” they say, and then proceed to compare its difficulty to losing a child or a parent. Okay, sure, compared to a major life stressor, altering one’s diet is a walk in the park. But changing habits is hard work that requires mental energy every single day. Eating, and choosing what to eat, is a constant battle for many people and it doesn’t have to be. Life is hard enough without diet rules. The last thing anyone needs is to transform a natural and fulfilling component of it (read: food) into a mental war zone with contrived rules and harsh consequences.

3: It is elitist

When was the last time you overheard a stranger complain about healthy eating being expensive? Most likely, the protester was envisioning a diet akin to the Whole30. Grass-fed beef, free-range chicken, clarified butter, organic produce…no dry staples like beans, rice or peanut butter. Healthy eating does not exist on a pedestal. It does not have to be expensive, but it certainly can be depending on where you choose to (or can) shop. Let’s set a few things straight: You don’t need grass-fed gelatin powder in your smoothies to be healthy. You don’t need organic coconut oil to be healthy. You don’t need exotic fruits and free-range eggs to be healthy. Maybe these foods mean more than just nutrition, signifying important changes to be made within our food system. But it terms of nutrition, sometimes the best a person can do for himself and his family is buy conventional produce, whole grains in bulk, and Perdue chicken breast on sale because otherwise they would be running to the drive thru or microwaving a packet of ramen noodles for dinner. A diet like the Whole30, which emphasizes foods of the “highest quality,” does nothing more than shame and isolate those who can’t sustain the standard it imposes, further cementing their belief that healthy eating is unattainable.

4: It is socially isolating

Imagine with me: I am participating in the Whole30 and doing great for the first week eating fully compliant meals. Then comes the weekend, and “oh no” it’s a football weekend and all I want to do is relax with my friends like I love to do. For me, that typically involves a beer or two, shared appetizers (even some carrots and celery!) and lots of laughs. The Whole30 creators would likely laugh in my face and tell me to suck it up for my own good and just munch on the veggies and maybe some meatballs. (“But are those grass-fed and did you use jarred sauce to make them? I bet there’s a gram of sugar hiding in there somewhere.”)

But it is just a month—certainly anyone can abstain from these type of events for a mere 30 days (remember, “it’s not hard”)—but then what? Do you just return to your normal patterns? Or do you, more likely, go back to them feeling so cheated from a month of restraint that you drink and eat so much more than you might have if you’d maintained a sense of moderation?

Of course, there are people comfortable with declining the food-centric aspect of social life, for whom turning down a glass of wine with cheese in favor of seltzer and crudités is no big deal. And perhaps our social events have become a bit too food centric, anyway. Either way, using food rules to isolate one’s self from friends and family sounds an awful lot like the pathway to an eating disorder, and the sense of deprivation most people likely feel in these situations can snowball into chronic stress that overshadows any short-term, nutrition-related “win.”

Although, maybe we should get all our friends to drink seltzer water and eat crudités at football games.

5: It is not scientifically sound

Most of The Whole30’s success has come from word of mouth, stories, and endorsements from those who successfully made it through the program and felt “better” afterwards. The website, dismayingly, does not house a single citation or study referenced in creation of the diet.

It’s important to note that the Whole30 did not exist 20 years ago. The Whole30 is not a pattern of eating that is replicated in any society on earth, and it doesn’t seem to be based off any research suggesting that it is indeed a superior choice. At the end of the day, this is a business, created by Sports Nutritionists (a credential anyone can get by taking an online test, regardless of one’s background in nutrition—which neither of them has) part of the multi-billion-dollar diet industry. Pinpointing three major food groups as causing inflammation and hormonal imbalance is quite an extreme statement to make without any research to back it up.

What does the science actually show? Knott, who counsels clients in her Tennessee-based private practice reminds us that, “consuming a plant-based diet, including grains and beans/legumes, is known to contribute to a lower risk for chronic disease like heart disease, cancer, and diabetes. Grains and beans/legumes are a source of fiber, protein, and B vitamins such as folate. They’re also a source of phytochemicals which may play a role in cancer prevention.”

The Whole30 proposes eliminating grains because they contain phytates, plant chemicals that reduce the absorbability of nutrients like magnesium and zinc in our bodies. While it’s true that both grains and legumes contain phytates, so do certain nuts and some vegetables allowed on the diet, like almonds. It is possible to reduce the amount of phytates in an eaten food by soaking, sprouting, or fermenting grains and legumes, but research from within the last 20 years suggests that phytates may actually play a key role as antioxidants. In a diverse and balanced diet, phytates in foods like grains and legumes do not present a major micronutrient threat. Further, new findings from Tufts scientists provide more evidence that whole grains in particular improve immune and inflammatory markers related to the microbiome.

Legumes in the Whole30 are eliminated because some of their carbohydrates aren’t as well-digested and absorbed in the small intestine. Some people are highly sensitive to these types of carbohydrates, and may experience severe digestive irritation like excessive gas, bloating, constipation, etc. Strategies such as the FODMAP approach are used with these folks under professional supervision to ensure they continue to get high-quality, well-tolerated fiber in their diets, and only eliminate those foods which cause distress. For others, elimination of these types of carbohydrates is unsound. Undigested fibers like those in legumes are also known as prebiotics, and help to feed the healthy bacteria in our gut. Eliminating this beneficial food group to improve gut health goes directly against the growing base of scientific evidence surrounding the microbiota.

Dairy, for those without an allergy or intolerance, has been shown to provide many benefits when incorporated into a balanced and varied diet, including weight stabilization and blood sugar control. The diet also fails to recognize the important health benefits associated with fermented dairy products like yogurt.

In terms of the diet’s long-term sustainability, Knott adds, “There’s plenty of research to support that restrictive diets fail. Many who adopt this way of eating will likely lose weight only to see it return after the diet ends.”

Let’s not forget its few redeeming qualities

For everything wrong with the Whole30, there are a few aspects of the diet that should stick. The concept of getting more in touch with food beyond a label, reducing added sugars, and alcohol is a good one and something that everyone should be encouraged to do. Focusing on cooking more from scratch, relying less on processed foods, and learning about how food influences your mood and energy levels are habits everyone should work to incorporate into a healthy life.

Knott agrees, adding, “I do like that the diet emphasizes the importance of not weighing yourself. We know that weight is a minor piece to the puzzle and other metrics are more appropriate for measuring health such as fitness, lean muscle mass, and biometric screenings.”

Improving the nutritional quality of your diet should not eliminate whole food groups like dairy, grains, and legumes. It should not have a time stamp on its end date, and rather, should be a lifelong journey focusing on flexibility, moderation, and balance. Lower your intake of processed foods, sugars, and alcohol and increase the variety of whole foods. Et voilà! A healthy diet that won’t yell at you for screwing up.

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Thanks to Allison Knott MS, RDN, LDN for contributing expertise. Knott is a private practice dietitian and owner of ANEWtrition, LLC based in Tennessee. She graduated from the Nutrition Communications program at Friedman in 2012.

 

Hannah Meier is a second-year, part-time Nutrition Interventions, Communication & Behavior Change student and registered dietitian interested in learning more about non-diet approaches to wellness. She aspires to make proper nutrition a simple, accessible and fulfilling part of life for people in all walks of life. You can find her on Instagram documenting food, fitness and fun @abalancepaceRD, as well as on her (budding) blog of the same title: http://www.abalancedpace.wordpress.com

The Dr. Oz Effect

by Julia Sementelli

With the beginning of the new year inevitably comes an onslaught of promotions and advertisements for miracle diets, detoxes, and supplements that vow to help you shed pounds, live longer, etc. And when you think of diets and supplements, most likely two words come to mind: “Dr. Oz.”  He is a doctor, but he is also a registered dietitian’s worst nightmare. While dietitians are out there teaching patients and clients that weight loss cannot be healthfully achieved in a pill or in a 2 week “cleanse,” Dr. Oz is preaching the opposite. Read on for the inside scoop of how Dr. Oz further complicates the already messy, ever-changing world of nutrition and health, including an interview with the man himself.

A recent client of mine, Mark (name changed for privacy), eats a fairly healthy diet: Greek yogurt and berries for breakfast, a salad with lean protein for lunch, and something from the Whole Foods salad bar for dinner (he doesn’t like to cook).  He says that his major downfalls are cookies and beer. Mark’s goal is to lose 30 pounds and improve his overall health given his family history of heart disease. “Give me a meal plan and I will follow it,” says Mark. I can work with that. He is actually a dietitian’s dream—someone who already doesn’t mind eating well and is motivated to lose weight. I thought his meal plan would be a breeze, until he said “Oh—I should tell you about my supplements.” I had expected a multivitamin and some daily vitamin D, but my hopes were dashed as Mark rattled off more than 15 supplements that he is currently taking, only one of them being a multivitamin. Among these supplements were resveratrol, an antioxidant found in red grape skins that he claims sheds years off of your life, and Conjugated Linoleic Acid (CLA), which apparently melts body fat. When I asked Mark where he learned about all of these supplements, he said “Dr. Oz.”

No two words can send angry chills up a dietitian’s spine quicker than Dr. Oz. While I am a fairly green registered dietitian, I have interacted with enough patients to see firsthand the power of Dr. Oz. Dr. Mehmet Oz started out as the resident expert on “The Oprah Winfrey Show” for five years before he was given his own spotlight, “The Dr. Oz Show.” He holds three degrees: a B.S. in biology from Harvard and an M.D. and M.B.A. from the University of Pennsylvania. He is vice-chairman of the department of surgery at the Columbia University College of Physicians and Surgeons in New York. He is also likeable. Consequently, he has become one of the most trusted doctors in the world and yet he uses words like “magical” and “miraculous” to promote supplements that promise to burn fat or prevent cancer. However, what the public may not understand is that a pill is not a miracle cure for anything. According to Stephanie Clarke, registered dietitian and co-owner of C&J Nutrition in New York City: “Most MDs get very little (or zero) nutrition education and background—so it’s a frustrating when they dole out nutrition advice or research without enough details or without thinking about how their messages will be interpreted by the public and related to real life eating.” But Americans continue to believe in the power of nutritional supplements recommended by a doctor that (most likely) has had minimal nutrition education and, more surprisingly, continue to buy them.  In fact, Americans spent more than $21 billion on vitamins and herbal supplements in 2015.  According to analyses, just the mention of a product on the Dr. Oz Show causes a surge in sales.

This phenomenon has been coined as “The Dr. Oz Effect.” Combine charismatic with a few letters after his name and you have someone who is more believable than the thousands of nutrition professionals that use science, not pseudoscience, to back up their recommendations. Even my own father, who has type 2 diabetes, an affinity for soy sauce (read: sodium), and meets my attempts to improve his diet with stubbornness, listens to Dr. Oz. Meanwhile, I have gone through four years of undergraduate education in nutrition, applying for competitive dietetic internships (50% acceptance rate), a one year unpaid dietetic internship, studying for and passing a comprehensive exam, and an additional two years of graduate work to get to where I am. And yet I still don’t have the influence that Dr. Oz does to change my father’s food behaviors.

As a dietitian, I strongly believe in balance. It is my goal to reduce the all-or-nothing thinking that surrounds eating and exercise. The media and people like Dr. Oz perpetuate this mindset, capitalizing on the public’s obsession with weight loss and diets by highlighting drastic regimens and alleged cure-all supplements. Diets do not work because they typically deprive a person of entire food groups, fats or carbohydrates, for example, and eventually the individual gives in and eats those food groups in excess since they have been denying themselves of them for so long.

The demonization of food, another spawn of the media, is the belief that particular foods are good or bad. It has resulted in mass confusion and further damage to peoples’ relationship with food. One of the most infuriating examples of this demonization is fruit. Yes, fruit. “I heard that the sugar in fruit is bad for you” or “I was told not to eat pineapple because it is high in sugar” are actual quotes that I have heard from clients. And not surprisingly, both clients attributed their beliefs to Dr. Oz. After some research, I discovered that, lo and behold, Dr. Oz did a segment titled “Can the Sugar in Fruit Make You Fat?” that most likely influenced these beliefs. Aside from vegetables, fruit is one of the most wholesome food groups, packed with fiber, antioxidants, vitamins, and minerals. Yet fruit cannot even avoid falling victim to the war on food. Conundrums like this exist for nearly every food: eggs, fish, coffee, potatoes…the list goes on. The only way to try to reverse the damage is to tell people that no food is off limits and remind them that there is no replacement for good eating and regular exercise. The only way that I have seen weight loss occur is with gradual and sustainable changes over time. And anyone that promises anything different is lying or worse, using pseudoscience to make outrageous claims.

Pseudoscience, the basis upon which Dr. Oz has constructed his lucrative empire, involves exaggerated and often contradictory claims that are not supported by reputable research. The media is also a culprit of using pseudoscience, composing articles and news stories from press releases of studies with small sample sizes or that use mice as their subjects. Just because it is effective or safe for mice, does not mean it will be safe for humans. Many writers for tabloids and mainstream magazines are stretched for time and are more concerned with quantity rather than quality given that their main goal is to make headlines that sell papers and magazines. Unfortunately, such writers and apparent health experts like Dr. Oz produce the majority of what the general public sees and uses to shape its food choices. However, according to a study published in the BMJ in 2014: “Consumers should be skeptical about any recommendations provided on television medical talk shows, as details are limited and only a third to one half of recommendations are based on believable or somewhat believable evidence.” That’s right—more than half of what Dr. Oz claims on his show regarding nutrition is not based on science. While the show has seen a dip in ratings, currently 1.8 million still tune into the Dr. Oz Show and are consequently exposed to information that is incorrect 50-67% of the time according to the 2014 study in the BMJ.

Dr. Oz has been criticized by a slew of medical professionals for his scam marketing, most notably in 2015 when ten physicians wrote a letter to the dean of health sciences at Columbia University requesting that Dr. Oz be removed as a faculty member due to his “egregious lack of integrity” on his TV show. Dr. Oz defends what he tells the public by claiming that “it’s not a medical show,” despite the fact that the show is titled The Dr. Oz show. Dr. Oz says that freedom of speech gives him the right to say what he wants to. But it is difficult to respect this freedom when he is a faculty member at a prestigious university that makes false claims on TV.

I reached out to the Dr. Oz team and received a response from Oz himself. When asked where he finds his nutrition information he said, “We obtain nutrition information from a wide variety of sources. We rely heavily on literature published in scientific journals as well as textbooks. In addition we consult a wide variety of experts including medical doctors and nutritionists. Our research staff is made up of myself a physician trained in preventive medicine as well as 3 medical students who take a year off to work with us. We evaluate all of the content on our show to ensure that viewers are getting accurate information. One of our researchers this year has a master’s degree in nutrition as well.” I am not sure which scientific journals Dr. Oz and his team are using, but when I researched “curcumin” and “oil of oregano,” two of the supplements that Dr. Oz has promoted on his show and that Mark, my client, is currently taking, the conclusion was that “the existing scientific evidence is insufficient to recommend their safe use.” In our interview, Dr. Oz said: “We also reach out to the Friedman school when we have difficult questions. I spent a day up at the school this summer meeting with a number of your faculty. Most recently I have spoken to an expert about fiber fortified foods and to your Dean about the current opinions on dietary fats.” He included a note that says that he and his team welcome interns to join them every month from September to June and students from Friedman are welcome to apply. *Insert eye roll*

When I asked about Dr. Oz and his team’s stance on nutritional supplements, he replied: “In general we believe that many have a place in people’s life to enhance nutrition. We always love to see more and better studies conducted on the utility of supplements in promoting health.” This is a nice response but when I begrudgingly watched a clip from the Dr. Oz show in which he says that Conjugated Linoleic Acid (CLA) can help to burn body fat, even without diet and exercise, I realized that what he says and what he does do not match. And aside from empty promises and putting people at risk with questionable pills, he is encouraging people to waste their money. This is what I told Mark in an effort curb his daily supplement cocktail. If the risk of taking his favorite “fat-melting” supplement won’t stop him, maybe the opportunity to save money will.

Dr. Oz is frustrating for many reasons, but for nutrition professionals it is the fact he uses his credentials as a physician to get away with promoting pseudoscience. Being a dietitian no longer involves simply telling people what to eat. It is trying to untangle the web of misinformation surrounding nutrition that clients have woven over the course of their lives and re-teach them what a healthy relationship with food should look like. While turning to supplements can seem like an easy fix, science shows that eating a diet based on whole foods like fruits, vegetables, whole grains, lean protein, and healthy fats, is the ideal diet. Science does not show that a pill is the secret to losing those last five pounds that keep hanging on. If scientists really found a cure for obesity, we would not be hearing about it at 4pm on a Tuesday afternoon. And unfortunately, the supplement industry is not going anywhere. The FDA and FTC regulate the supplement industry, but not very well. So it is up to trained and licensed nutritional professionals (i.e. registered dietitians) to educate the public about the dangers of supplements and listening to people who are simply “health experts.”

Julia Sementelli is a second-year Nutrition Communication & Behavior Change student and Boston-based registered dietitian who works in a local hospital and also counsels private clients.  You can find her on Instagram (@julia.the.rd.eats- Follow her!) where she strives to intercept confusing nutrition messages from self-proclaimed health experts with expert nutrition advice and tips (as well as some beautiful food photos if she does say so herself!).

 

 

What’s the Deal with Vitamin D?

by Katelyn Castro

There is always one nutrient that seems to linger in the media for a while. Lately, vitamin D has been the lucky winner! Considering that over 40% of Americans are vitamin D deficient, according to the National Health and Nutrition Examination Survey (NHANES), it’s worth taking a closer look at vitamin D.

Depression, cancer, heart disease, and type 1 diabetes are some of the many health conditions that have been linked to vitamin D deficiency. While it is too soon to point to vitamin D as a cure-all, this vitamin may be more important for our health than previously thought—especially during the winter months in New England!

Why is Vitamin D Important?

Vitamin D is most often known for its role in bone health, increasing calcium absorption and helping with bone mineralization alongside calcium and phosphorus. Historically, rickets in children and osteoporosis and bone fractures in adults have been the most common signs of vitamin D deficiency.

As a fat-soluble vitamin and a hormone, vitamin D is also involved in many other important metabolic processes. Did you know vitamin D activates over one thousand genes in the human genome? For example, vitamin D is needed for protein transcription within skeletal muscle, which may explain why vitamin D deficiency is associated with poor athletic performance. Vitamin D also regulates blood pressure by suppressing renin gene expression, supporting the possible relationship between vitamin D deficiency and risk of heart disease. Additionally, vitamin D status may alter immunity due to its role in cytokine production. Studies have found that vitamin D deficiency is associated with upper respiratory tract infections. While more research is needed to explore these connections, these findings continue to suggest that vitamin D plays an integral role in bone, muscle, cardiac, and immune health.

Where Do You Get Vitamin D?

Only a few foods are natural sources of vitamin D, including eggs and fatty fish like salmon, mackerel, tuna, and sardines. Instead, vitamin D-fortified foods like dairy products, juices, and breakfast cereals make up the majority of Americans’ vitamin D intake.

Sun exposure, on the other hand, can be the greatest source of vitamin D for some people–hence vitamin D’s nickname, the “sunshine vitamin.” Unlike any other vitamin, vitamin D can be synthesized in the body when the sun’s ultraviolet B rays reach the skin and convert cholesterol into a Vitamin D3, the precursor for vitamin D. Then, Vitamin D3 diffuses through the skin into the blood, where it is transported to the liver and kidneys and converted into vitamin D’s active form, 25(OH)D.

Research has found that exposing arms, legs, and face to the sun for 15 to 30 minutes twice a week provides about 1000 international units of vitamin D (equal to about 10 cups of milk!). Despite this robust source of vitamin D, deficiency is surprisingly common in the U.S.

Who is at Risk of Vitamin D Deficiency?

Many circumstances can alter vitamin D synthesis and absorption, increasing risk of vitamin D deficiency. Some of the factors that have been found to impact vitamin D status include the following:

  • Season: According to research, during the months of November to February, people living more than 37 degrees latitude north or south produce little or no vitamin D from the sun due of the angle of ultraviolet B sunrays. While vitamin D is stored in fat tissue and can be released into the blood when needed, our stores typically only last one to two months.
  • Limited Sun Exposure: Vitamin D synthesis can also be blocked when sunscreen is applied correctly or when long robes or head coverings are worn for religious reasons. For example, sunscreen with a sun protection factor (SPF) of 8 decreased vitamin D synthesis in skin by about 95% in one study.
  • Skin Color: People with darker skin pigmentation have also been found in research to have lower levels of vitamin D due to decreased synthesis. This is supported by the high prevalence of vitamin D deficiency among certain ethnicities, with 82% African Americans and 69% Hispanics found to be vitamin D deficient according to NHANES.
  • Weight: Studies also suggest that overweight and obese people may have higher Vitamin D requirements. Since they have more body fat and since vitamin D is a fat-soluble vitamin, vitamin D is more widely distributed in fat tissue, making it less bioavailable. As a result, more vitamin D may be needed for it to reach the blood stream for distribution in the body.
  • Age: Older adults have been found to have lower levels of the vitamin D, likely due to both decreased sun exposure and inefficient synthesis. One study found that 70 year-olds had about 25% of the vitamin D precursor compared to young adults, which decreased vitamin D synthesis in the skin by 75%.
  • Fat Malabsorption: When any gastrointestinal disorder or other health condition impairs fat absorption (i.e. liver disease, cystic fibrosis, celiac disease, or Crohn’s disease), vitamin D is also poorly absorbed and utilized since Vitamin D is a fat-soluble vitamin.

 Vitamin D deficiency can be especially concerning because symptoms like bone pain and muscle weakness may go undetected in the early stages of deficiency. Although physicians do not routinely check vitamin D levels, those at risk of deficiency may benefit from a serum 25(OH)D test. This is a simple test used to measure the level of vitamin D circulating in blood, with levels less 20 nanograms per milliliter commonly used to diagnose deficiency. However, some organizations like the Endocrine Society argue that levels greater than 30 nanograms per milliliter should be recommended for optimal bone and muscle metabolism.

How Much Vitamin D Do You Need?

Similar to vitamin D serum levels, no ideal vitamin D intake has been well established since many factors contribute to vitamin D status. The U.S. Institute of Medicine recommends 600 to 800 international units (IU) of vitamin D daily for adults, assuming minimal sun exposure. On the other hand, the National Osteoporosis Foundation recommends larger doses of 1000 to 1200 IU daily for adults to support adequate bone health. Although vitamin D toxicity is rare, an upper level of 4000 IU has been set by the Institute of Medicine since extremely high levels can lead to calcium buildup, and could cause poor appetite, nausea, vomiting, weakness, and kidney problems.

With limited amounts of vitamin D provided from food, even fortified foods, diet alone is usually inadequate to meet vitamin D needs. For example, you would need to drink about 8 cups of milk every day to reach 800 IU of vitamin D from diet alone! While sun exposure can supplement food intake to meet vitamin D needs, many Americans still fall short of their needs due the factors outlined above.

For the 40% of Americans who have been found to be vitamin D deficient, vitamin D supplementation can be an effective and safe way to meet needs. Whether you’re an avid sunscreen-user or living here in New England during these fall and winter months, a daily vitamin D supplement can ensure that vitamin D stores are adequate. Multivitamins typically provide 400 IU of vitamin D, but a separate vitamin D supplement (D2 or D3) with 800 or 1000 IU may be needed to meet daily intake recommendations.

Katelyn Castro is a second-year student in the Dietetic Internship/MS Nutrition Program at the Friedman School. During the summer, she enjoys soaking up the sun if only for an excuse to get her daily dose of Vitamin D. During the winter, you can find her trekking through the snow, bundled up like the boy in A Christmas Story, and contemplating whether she needs a D supplement.

 

 

Timing of your Meals–Does it Matter?

by Yifan Xia

How would you feel if you were told to not have dinner for the rest of your life? Skipping dinner every day might sound shocking to most of us, but it was once a very common practice in ancient China in the Han Dynasty. In fact, even today Buddhism and Traditional Chinese Medicine (TCM) promote this practice as a healthier choice than eating three meals per day. But does this practice have roots in science? Of course, controversy exists around this topic, but one thing that we can be certain of today is that the timing of our meals can have a much greater impact on our health than we originally thought.

Researchers investigating the circadian system (internal biological clock) have started looking at the effects of mealtime on our health. Surprisingly, preliminary evidence seems to support the claims of Buddhism and TCM, indicating that eating meals earlier in the day might help promote weight loss and reduce the risk of chronic disease.

What are circadian rhythms and the circadian system?

Circadian rhythms are changes in the body that follow a roughly 24-hour cycle in response to external cues such as light and darkness. Our circadian system, or internal biological clock, drives circadian rhythms and prepares us to function according to a 24-hour daily cycle, both physically and mentally.

Why do they matter to our health?

Our internal biological clock is involved in almost every aspect of our daily lives: it influences our sleep-and-wake cycle, determines when we feel most energetic or calm, and when we want to eat.

These days people don’t always rely on their biological clocks to tell them when to eat, and there are many distractions in the environment that can influence mealtime. We typically think how many calories we eat—and what we eat—are the major contributors to our weight and health, but researchers have found that eating at inappropriate times can disrupt the internal biological clock, harm metabolism, and increase the risk of obesity and chronic disease.

What does the research say?

Although currently the body of research evidence for this area is relatively small, there are several human studies worth highlighting. One randomized, open-label, parallel-arm study, conducted by Jakubowicz, D., et al and published in 2013, compared effects of two isocaloric weight loss diets on 93 obese/overweight women with metabolic syndrome. After 12 weeks, the group with higher caloric intake during breakfast showed greater weight loss and waist circumference reduction, as well as significantly greater decrease in fasting glucose and insulin level, than the group with higher caloric intake during dinner. Another study published in the same year with 420 participants noted that a 20-week weight-loss treatment was significantly more effective for early lunch eaters than late lunch eaters. In 2015, a randomized, cross-over trial, conducted in 32 women and published in International Journal of Obesity, showed that late eating pattern resulted in a significant decrease in pre-meal resting-energy expenditure, lower pre-meal utilization of carbohydrates, and decreased glucose tolerance, confirming the differential effects of meal timing on metabolic health. However, few studies were identified reporting negative findings, probably due to the fact that this is an emerging field and more research is needed to establish a solid relationship.

 So when should we eat? Is there a perfect mealtime schedule for everyone?

“There are so many factors that influence which meal schedules may be suitable for an individual (including biological and environmental) that I cannot give a universal recommendation,” says Gregory Potter, a PhD candidate in the Leeds Institute for Genetics, Health and Therapeutics (LIGHT) laboratory at the University of Leeds in the United Kingdom and lead author on the lab’s recent paper reviewing evidence of nutrition and the circadian systems, published in The British Journal of Nutrition in 2016. Potter also comments that regular mealtime seems to be more important than sticking to the same schedule as everyone else: “There is evidence that consistent meal patterns are likely to be superior to variable ones and, with everything else kept constant, it does appear that consuming a higher proportion of daily energy intake earlier in the waking day may lead to a lower energy balance and therefore body mass.”

Aleix Ribas-Latre, a PhD candidate at the Center for Metabolic and Degenerative Diseases at the University of Texas Health Science Center and lead author on another review paper investigating the interdependence of nutrient metabolism and the circadian systems, published in Molecular Metabolism in 2016, also agrees: “To find the appropriate meal time has to be something totally personalized, although [it] should not present [too] much difference.” Aleix especially noted that people who are born with a tendency to rise late, eat late, and go to bed late (“night owls” versus “early birds”) are more likely to be at risk for metabolic disease.

Do we have to eat three meals a day?

How many meals do you usually have? In fact, how much food makes a meal and how much is a snack? There is no universal definition, which makes these difficult questions to answer.

“To maintain a healthy attitude towards food, I think it is important to avoid being too rigid with eating habits … I do think consistency is important as more variable eating patterns may have adverse effects on metabolism,” says Potter. “Although there is evidence that time-of-day-restricted feeding (where food availability is restricted to but a few hours each day) has many beneficial effects on health in other animals such as mice, it is as yet unclear if this is true in humans. I’d also add that periodic fasting (going for one 24 hour period each week without energy containing foods and drinks) can confer health benefits for many individuals,” Potter comments.

[See Hannah Meier’s recent article on intermittent fasting for more.]

Based on their research, Ribais-Latre and his lab have a different opinion. “We should eat something every 3-4 hours (without counting 8 hours at night). Many people complain about that but then consume a huge percentage of calories during lunch or even worse at night, because they are very hungry. Eating a healthy snack prevents us [from] eating too [many] calories at once.” He suggests what he considers a healthier mealtime schedule:

–          6:00 am  Breakfast (30% total calories)

–          9:30 am  Healthy snack (10%)

–          1:00 pm  Lunch (35%)

–          4:30 pm  Healthy snack (10%)

–          8:00 pm  Dinner (15%)

What if you are a shift worker or your work requires you to travel across time zones a lot? Ribais-Latre’s advice is “not to impair more their lifestyle… at least it would be great if they are able to do exercise, eat healthy, sleep a good amount of hours.”

What does Traditional Chinese Medicine say?

There are historical reasons behind the no-dinner practice in ancient China in the Han Dynasty. First, food was not always available. Second, electricity hadn’t been invented, so people usually rested after sunset and they didn’t need much energy at what we now consider “dinner time.”

However, there are also health reasons behind this practice. In TCM theory, our internal clock has an intimate relationship with our organs. Each organ has its “time” for optimal performance, and we can reap many health benefits by following this clock. For example, TCM considers 1:00 am – 3:00 am the time of “Liver”. The theory says that is when the body should be in deep sleep so that the liver can help to rid toxins from our body and make fresh blood. Disruption at this time, such as staying up until 2:00 am, might affect the liver’s ability to dispel toxins, leading to many health problems, according to the theory.

Many Western researchers do not seem to be familiar with the TCM theory. When asked about the practice of skipping dinner, Potter comments, “I think that skipping dinner can be a perfectly healthy practice in some circumstances; in others, however, it may be ill advised if, for example, the individual subsequently has difficulty achieving consolidated sleep.”

On the flip side, Ribais-Latre says that “skipping a meal is not good at all. We should not eat more calories than those we need to [live], and in addition, the quality of these calories should be high… If you can split those calories [to] 5 times a day instead of three, I think this is healthier.”

Even though there is no universal agreement on mealtime, the tradition of “skipping dinner” did come back into style several years ago in China as a healthier way of losing weight, and was quite popular among Chinese college women. Yan, a sophomore from Shanghai and a friend of mine, said that she tried the method for six months but is now back to the three-meal pattern. “The first couple of days were tough, but after that, it was much easier and I felt my body was cleaner and lighter… I did lose weight, but that’s not the main goal anymore… I got up early every day feeling energetic. Maybe it’s because I only ate some fruits in the afternoon, I usually felt sleepy early and went to bed early, which made it easier to get up early the next day with enough sleep… I’m eating three meals now, but only small portions at dinner, and I think I will continue this practice for my health.”

So what’s the take-away?

Mealtime does seem to matter. But exactly how, why, and what we can do to improve our health remains a mystery. Researchers are now looking into the concept of “chrono-nutritional therapy,” or using mealtime planning to help people with obesity or other chronic diseases. When we resolve this mystery, the question of “When do you eat?” will not just be small talk, but perhaps a key to better health.

Yifan Xia is a second-year student studying Nutrition Communication and Behavior Change. She loves reading, traveling, street dancing, trying out new restaurants with friends in Boston, and watching Japanese animations.

 

 

Debunking 6 Myths About Diabetes

by Katelyn Castro

Diabetes. Sugar. Insulin. Shots. You’ve probably heard of diabetes before, but unless you or someone close to you has diabetes, the media may have warped your perception of the disease. About one in ten Americans has diabetes, yet there are still many stereotypes surrounding the disease.

Even as a nutrition student, I didn’t really understand the serious and complex management of diabetes until two years ago. Working at a camp with kids and counselors with type 1 diabetes taught me more about the disease than I could have learned from any textbook. No one with diabetes wants be defined by their disease, but I’m confident that they do want others to understand what it’s like to be in their shoes.

Since November was National Diabetes Month, now is the perfect time to raise awareness and end the stigma surrounding diabetes. I reached out to friends who have diabetes or have siblings with diabetes, and reflected on my own experiences to get a better idea of the misconceptions out there. Below are some common myths about diabetes from a collection of personal experiences, stories, and conversations. Let’s get the facts straight:

1. Myth: If you take insulin, it means your diabetes is poorly controlled.

Fact: Insulin keeps people with type 1 diabetes alive. While most people have a working pancreas that makes the insulin you need to take up energy and keep blood glucose levels under control, those with type 1 diabetes do not. People with type 1 diabetes need insulin regularly through a pump or injections. About 5% of the population living with diabetes has type 1 diabetes.

People with type 2 diabetes, the more common type of diabetes, may not need insulin at first. Unlike type 1 diabetes, type 2 is progressive so the body gradually becomes resistant to insulin and can’t use it properly. A healthy diet, exercise, and medication can keep blood glucose levels in check in the early stages, but insulin may be needed eventually. In either type of diabetes, taking insulin to control blood glucose levels is critical for your health.

2. Myth: Eating too much sugar causes diabetes.

type-2-diabetesFact: Unfortunately, it’s not that simple. Type 1 diabetes is an autoimmune disease caused by a combination of genetic and environmental factors, including exposure to viruses or bacteria. Researchers are still trying to figure how these factors interact, but eating too much sugar is clearly not the cause.

Although eating too many sweets is not healthy for anyone, it’s not the direct cause of type 2 diabetes either. But, excess calories from any food can lead to obesity, which is a major risk factor for type 2 diabetes. When someone with prediabetes or another predisposition is overeating, the pancreas can’t keep up with the high demand of food and can’t use insulin effectively. In this way, eating too much (of any food) can increase risk of type 2 diabetes.

3. Myth: Only overweight and unhealthy people have diabetes.

Fact: Most people with type 1 diabetes are a healthy weight. When children and young adults are first diagnosed with type 1 diabetes, they may actually be underweight because they can’t take up the energy they need without enough insulin.

Although obesity is one risk factor for type 2 diabetes, genetics, ethnicity, age, and lifestyle factors also play a role. In fact, most people who are overweight never develop type 2 diabetes, and many people with type 2 diabetes are at a healthy weight or only moderately overweight. A family history of diabetes and personal history of gestational diabetes can increase risk of type 2 diabetes. Age (forty-five and older), ethnicity (African Americans, Hispanics, and Asian-Americans), and physical inactivity can also increase risk. Experts recommend people with one or more risk factors have their blood glucose levels checked every three years.

4. Myth: Diabetes is like an allergy to sugar. If you avoid it, you’re diabetes will be under control.

Fact: Everybody needs carbohydrates in their diet for energy, even people with diabetes. Simple carbohydrates, like sugar, may actually be crucial when people with diabetes have low blood sugar (hypoglycemia). Low blood glucose can cause weakness, irritability, and severe cases can cause seizures. High blood glucose can make people nauseous and drowsy, and untreated cases can lead to a coma. The key to managing diabetes is not to avoid sugar, but to keep blood sugar levels in a safe range.

Although lifestyle factors and medication can reverse type 2 diabetes in the early stages, there is currently no cure for type 1 diabetes. For people with type 1 diabetes, checking blood glucose levels, calculating carbohydrates, and adjusting insulin is a full-time job. Careful management can prevent complications related to diabetes later in life, such as kidney disease, heart disease, and neuropathy.

5. Myth: You have to follow a special diet if you have diabetes.

Fact: There’s no reason that people with diabetes need to follow a restricted diet. Like everyone else, people with diabetes can benefit from a healthy diet high in fruits, vegetables, whole grains, lean protein and healthy fats, and low in saturated and trans fats. Whether you have diabetes or not, sweets and desserts can be enjoyed in moderation.

Those with type 2 diabetes may have to pay closer attention to portion sizes of starchy foods to keep carbohydrates consistent throughout the day. Aiming for 45 to 60 grams of carbohydrates for each meal is usually a good start. Those with type 1 diabetes typically have more flexibility because they can adjust their insulin depending on the amount of carbohydrates they eat.

6. Myth: Playing sports and exercising can be dangerous if you have diabetes.

Fact: Gary Hall, an Olympic swimmer, and Jackie Robinson, a former baseball star, are two of many athletes who lived with type 1 diabetes. Need I say more? Exercise is just as important for people with diabetes as it is for anyone else. For people with type 2 diabetes, exercise may have extra benefits: improving blood sugar control, aiding in weight loss, and lowering blood pressure and blood cholesterol levels.

As long as those with diabetes pay attention to how they feel and keep an eye on their blood sugar levels during exercise, there is no need to feel limited. Staying hydrated, eating beforehand, and keeping snacks close-by can help people with diabetes stay safe during exercise. The sky is the limit! While diabetes is a serious and complicated disease that affects all aspects of life, it should never limit or discourage anyone from reaching his or her goals.

Katelyn Castro is a first-year student in the DI/MS Nutrition Program at the Friedman School. She is passionate about teaching nutrition to kids and has spent the past two summers working with kids with type 1 diabetes at the Barton Center.

Are Your Diet Choices Based in “Fact” or “Faith?” One Religion Professor Thinks It’s the Latter

by Katherine Pett

Looking for a nutritional antidote to food fears? Take a look at new release The Gluten Lie by Alan Levinovitz, PhD, and stop being scared of your sandwich.

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Despite what the sinister cover of The Gluten Lie by Alan Levinovitz, PhD, suggests, this book is not about gluten… entirely. When I first picked it up, I assumed the author meant to proclaim that gluten sensitivity, the diagnosis du jour, is nonexistent. But the book makes little attempt to determine what is and isn’t healthy. In fact, it’s the exact opposite of a diet book.

A religion professor at James Madison University, Levinovitz remains agnostic about the existence of gluten sensitivity: to him, it may exist or may not. In fact, he takes this neutral tone with every food fad he discusses, from banishing sugar to forbidding fat. There is evidence for and against each recommendation, but not as much as you’d think.

Levinovitz is primarily concerned with the belief systems that cause sweeping dietary crazes. As a professor of religion, no one is more capable of delivering the Good Word: Many of our beliefs about food are more religious than rational in nature. We unconsciously base food choices and food fears on faith, not facts.

The strict-sounding title is based on the book’s thesis: If you tell people something is true when the research is inconclusive, it’s a lie. Unlike religious leaders for whom myths are tools to give hope and guidance to a congregation, people who invoke science—rather than God—to inspire behavior change have an obligation to the truth, the whole truth, and nothing but the truth.

In the book, Levinovitz uncovers which nutrition “facts” are more rooted in legend than reality and reveals the (sometimes sordid) history behind them. For each of these hotly-debated food elements (ex., gluten, fat, salt, and sugar), there are authorities who swear that eliminating it will fix your life.

For example, gluten restriction, especially as a part of the CrossFit/Paleo paradigm, can seem a little, well, cultish. But it’s nothing compared to the originators of sodium-restriction who formed an actual cult. Known as “Ricers,” these people were a group of extremist dieters who followed low-sodium, rice-diet guru Dr. Walter Kemper of Duke University. The Rice Diet was not unlike today’s Paleo or Bulletproof diets in that it attracted a lot of attention and plenty of celebrity adherents, such as Buddy Hacket, Dom DeLuise, and multiple NFL players. It was different, however, in the sense that its founder kept a harem of devoted dieting women in houses he owned, connected their housing via walkways, and was named an heir in their wills.

But why, you might be wondering, would people believe that a no-sodium, all-rice diet will solve your problems? Especially now when people have access to Google, PubMed, and a world of scientific references and textbooks that tell us that balance is key to health? It turns out that it isn’t hard to make a convincing and seemingly science-based argument. All you need to do is pick a few studies, conveniently tweak the details so they match your framework, add a few scary statistics and unproven claims and, boom, you’ve written the next Wheat Belly.

To prove his point, Levinovitz shows how it’s done with a diet of his own invention: The UNpacked DietTM. In the book’s last chapter, Levinovitz creates a mock first chapter of a “science-based” diet book that explains how plastic packaging will make you sick and fat. The diet comes complete with numerous citations, references to seemingly authoritative researchers, and excellent graphics tracking bottled water use and the rise in obesity. Even though I knew the diet was meant to be facetious, I found myself seriously considering some of the arguments. “That sounds reasonable,” I heard my inner-voice saying.

Just after he nearly convinced me that plastic really is the source of all my problems, Levinovitz then repeats the entire chapter, but with cartoon thought bubbles pointing out each flaw in the reasoning. Every single point that seemed so meaningful is actually a careful misrepresentation of evidence that doesn’t prove nearly as much as the “author” would like. The similarities between the writing in The UNpacked DietTM and any other diet book gracing the bestseller list are uncanny. In fact, it made me wonder if Dr. Levinovitz missed an opportunity by deciding to pull back the curtain on the genre, rather than to partake in its riches.

Overall take? If you work in wellness or you’re just an avid follower of nutrition in the news, you need this book. If you have an annoying friend who bugs you about the newest “antinutrient,” you need this book so you can toss it to your annoying friend while you run away. This book is timely, given the wake of The Food Babe, expands understanding of the belief systems that underlie our country’s disordered eating culture, and acts as a reset button for our own food prejudices.

While he may not make the point directly, it is implied throughout the book: You can’t cheat death with “one simple trick” to get rid of belly fat. There is no toxic nutrient that causes all disease. So chill out. Eat your sandwich.

Interested? Check out a recent lecture by Levinovitz, where he explains the concept of his book:

Katherine Pett is a first-year Biochemical and Molecular Nutrition student at The Friedman School.  Follow her on twitter @smarfdoc or contact her at katherine.docimo@tufts.edu. 

Bulletproof Coffee: the Breakfast of Champions?

by Ally Gallop, BSc, RD, CDE

Imagine waking up in the morning to a breakfast of butter, oil, and coffee. Better known as Bulletproof Coffee, it’s the new rage in the diet world. With proponents noting marked improvements in alertness, hunger suppression, and weight loss, bulletproof coffee and its creator are altering the morning routine. But navigating through these claims, the science doesn’t align.

After a trip to Tibet in 2004, Silicon Valley businessman Dave Asprey tasted Tibetan Yak Butter Tea: a concoction of brewed tea, salt, and yak butter. Upon returning to the U.S., Asprey devised his own version. Now marketed as bulletproof coffee (or BPC), it pairs well with his newly released book The Bulletproof Diet. Advocates for BPC include U.S. Olympic marathoner Ryan Hall, Divergent actor Shailene Woodley, and singer/songwriter Ed Sheeran. BPC is said to be creamier than a latte, prevent hunger before lunch, increase alertness, and be loaded with vitamins A, E, and K2 alongside omega-3 fatty acids. Yet the most enticing reason in opting for this drink is because it seemingly causes weight loss without having to exercise.

The recipe for BPC is simple. In a blender combine many of Asprey’s own products:629px-Bulletproof_Coffee_Starter_Kit

  • At least 2 tablespoons of unsalted grass-fed butter,
  • 1-2 tablespoons of Brain Octane™ Oil, and
  • Bulletproof® Upgraded™ brewed coffee beans.

Keep in mind, BPC is meant as a breakfast replacement. So let’s compare the BPC nutritional content to that of a typical breakfast: two scrambled eggs, an apple, black coffee, and a slice of whole grain toast with a tablespoon of peanut butter.

Typical Breakfast BPC *Unable to find specific nutrient data for grass-fed butter and omega-3 content.**The USDA Foods List only lists information for vitamin K1.
Calories (calories) 491 461
Total Fat (g) 23 51
Saturated Fat (g) 4 43
Omega-3 Fatty Acids (mg) < 1 n/a*
Total Carbohydrates (g) 48 0
Total Fiber (g) 10.4 0
Protein (g) 24 0
Vitamin A (IU) 803 400
Vitamin E (mg) 1.88 0.4
Vitamin K1 (μg) 9.5 0.8
Vitamin K2 (μg) n/a** n/a**
Caffeine (mg) 142 142

Starting the day off with a high-fat brew that shuns hunger and enhances alertness sounds like a great idea. Losing weight is easier when your stomach isn’t grumbling. High-fat BPC in the gut slows the rate of stomach emptying, suppresses ghrelin (the “eat more” hormone), and reduces the amount of calories consumed at subsequent snacks and meals. Since fat takes the longest to leave the stomach and be digested, even in its liquid form, Asprey’s claim makes some sense.

But Asprey’s claims regarding omega-3s and vitamins A, E, and K2 are cloudier. The amount of these nutrients in grass-fed versus conventionally grain-fed beef is higher. Yet only 60% of studies found a statistically significant difference. Further, no research exists on the amount of omega-3 fatty acids in butter- all the research comparing omega-3 contents is in types of beef, not dairy.

Recently, I contacted Kerrygold, a popular brand of grass-fed butter, and asked them to elaborate on the omega-3 content their product. They responded by saying that they have no research on omega-3’s present in butter. While grass-fed dairy may be a wiser nutritional source, there is currently no research that supports Asprey’s supposition that it has more omega-3s.

The caffeine content of BPC is likely the source of increased alertness drinkers report. It’s also possible that if the coffee truly does have a higher omega-3 content, those omega-3s could give the brain extra power.

Asprey’s line of Bulletproof® Upgraded™ coffee beans are touted as being free of mycotoxins (i.e., mold), which he claims are pervasive components of every other coffee on the market. However, coffee producers like Starbucks and Dunkin Donuts have long known about these mycotoxins. That’s why coffee beans are wet-processed, which means that the beans are washed to eliminate the mold. So the upgraded brew is no better than the rest.

But what really stands out about BPC? How about its fat content: the brew fulfills 23% of both your daily total caloric and fat intake. The Institute of Medicine (IOM) recommends 25-35% of daily total calories should come from fat. BPC fulfills that quota on its own. The Canadian Society of Intestinal Research also reminds us how fat is a stimulant for the intestines. Higher intakes may result in abdominal cramping, diarrhea, and floating stools. But that’s never advertised.

Being so high in calories, how can BPC help weight loss? If, like with any diet, fewer calories are consumed, then weight loss may occur. Asprey’s book recommends following a low-carbohydrate diet as to induce ketosis. And food restriction generally leads to weight loss.

In an interview with Runner’s World, University of California Davis’ director of sports nutrition Liz Applegate debunks Asprey’s idea behind Brain Octane™ oil, which is made of medium-chain triglycerides (MCTs). Asprey believes that the oil increases the body’s ability to burn calories because it is processed differently than other fats. Unlike long-chain triglycerides, MCTs pass directly from the gut into the bloodstream and are immediately available to be burned for energy. However, Applegate notes that there is no scientific evidence to support MCTs’ ability to increase metabolism and promote weight loss. If consumed in amounts that surpass the body’s immediate needs, MCTs will still be converted to and stored as fat.

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Breakfast of Champions?

Ultimately, this article wouldn’t be complete without attempting BPC myself. I found it odd watching butter dissolve into my morning cup. The oil slick on top was definitely unsettling. Using coconut oil and regular coffee in place of Asprey’s oil and beans, the concoction was creamy with a subtle hint of coconut. My hunger was suppressed the rest of the day, cravings for carbs were reduced, and I was able to forgo my mid-morning snack. In comparison to my normal routine of breakfast and a snack, I likely saved 120 calories. But due to an injury, I was unable to exercise. Would this daily pattern of high-fat BPC power me through morning exercise sessions?

Should YOU add BPC to your diet?

The typical breakfast provides protein and fiber, long having been touted as essentials for their hunger-suppressing properties. But choose BPC, and neither exist. The idea is you can’t have both food and BPC.

For those who already eat breakfast, replacing it with BPC on a short-term basis or intermittently could be all right. The BPC’s calories are appropriate for a morning meal. Caloric intake may even be less, depending on what one would normally eat. However, the habit of drinking coffee alongside breakfast may return, thereby increasing total calories consumed. In a recent article, Chris Gayomali, a journalist for Fast Company, tried BPC for two weeks. By the end, he was adding toast in addition to his BPC. After two weeks he ditched BPC completely because he missed eating solids.

Diet trends tend to fail due to deprivation. Given that all other meals and snacks consumed throughout the day remain constant, having BPC and food in the morning could lead to weight gain since it is so high in calories.

If you’re adamant about BPC, doing so every-other-day and ensuring intake of higher fiber and protein foods is advised. That way you can indulge while still limiting saturated fat intakes, promoting gut health with fiber, and sparing protein. Following the IOM guidelines, you wouldn’t require any additional fat on a BPC day. On those days opt for vegetable-dishes, lean protein, and unsaturated fats, like those from nuts, plant oils, and avocados.

For those who don’t typically eat breakfast, adding almost 500 calories of BPC in addition to your usual food consumption could lead to significant weight gain.

So what’s the final consensus?

When it comes to Bulletproof Coffee, the science is lacking. Egregious claims that the oil supplies “fast energy for the brain,” “reduces brain fog,” and is responsible for “rebalancing…yeast in the gut” are stated on Asprey’s website. Yet they lack any footnotes for supporting literature.

We also can’t look at foods in isolation. Rather, the whole diet matters. Asprey’s BPC argument focuses on the nutrients in two items: butter and oil. Humans are encouraged to seek variety in the foods we eat. The typical breakfast I detailed above already contains all of the nutrients advertised as part of BPC and more. If for an entire month one were to replace their breakfast with solely BPC they would be missing out on vital nutrients that variety would fulfill.

Like any other diet, BPC is supposedly “universal.” It’s meant to meet the needs of all of its followers. For me, I felt full. Others may be starving after just a couple hours.

And ultimately, Dave Asprey is a businessman. His empire includes a line of pricey oil and coffee beans in addition to travel mugs, T-shirts, and anti-aging skin creams. With a booming business plan, book, and BPC shops in the works, Asprey is raking it in when you drink his breakfast of champions.

Ally Gallop, BSc, RD is a Certified Diabetes Educator and is studying towards an MS/MPH focusing in health communication and epidemiology. She continues to drink black coffee alongside her high-fiber and scrambled egg breakfast.