Wow, that’s a loaded question. It can mean so many different things to so many different people. What’s the best diet for a person living with diabetes? How many of you have been asked this at least once in the past week? If we teach our patients to carb count, that’s good enough, right? Which is healthier; low-carb, low-fat or vegan? Probably depends on whose research you are looking at and the sponsors of the study. Sometimes I get overwhelmed with these discussions. It makes me think back to all the changes and hot topics I have seen with what once was considered a “diabetic diet.” Back in the early 90s, when I first worked in a hospital as a dietitian, most patients were on either a 1200 cal ADA, 1500 cal ADA, 1800 cal ADA or 2000 cal ADA diet. Each meal allotted for so many exchanges at each meal. Those exchanges were meat, starch, fruit, vegetable, milk and fat. There was also a free foods list that I would personally consider most things full of sodium or chemicals. Each exchange was based on a specific portion size. These meal plans were rigid but provided a variety of food groups and a variety of nutrients. Because all calories were accounted for, the ADA diets were effective for weight loss. Some patients felt like they were forced to eat foods that they really did not want. I do think one benefit was that patients had a better idea of the total volume of food they should be consuming in a day. I feel with today’s extra-large portion sizes that portion control has become very distorted.
Back in the 90s, some of the hot topics were “oat bran”, “cholesterol free’, “low-fat” and “fat-free.” I am sure you can think of others. I remember Dunkin’ Donuts selling these huge oat bran muffins, probably 75-90 grams of carbs, at patients thinking they were eating something healthy. Olestra was popular then, even in potato chips. However, patients soon found out this had a laxative effect on them.
We didn’t hear the term “Keto Diet” back then but instead, heard the term, the “Atkins diet.”
I think we can all agree that a healthy diet is one that helps you maintain a healthy weight and that provides a variety of “whole foods”, ones with less processing and possibly less ingredients on the label.
In today’s fast-paced world with fewer people eating at home, I think its very challenging to help patients make good choices and even harder for those who rely on food banks where many processed foods are donated. I know there are food banks that are trying to provide more fresh produce but again, that consumer would need to know what to do with it of have the proper tools/appliances at home to prepare it.
Back to our patients, the typical ADA diets have gone away and it’s our job to work with patients to make better choices in whatever their lifestyle permits and which diet they prefer to consume. Some of the hot topics of today are avoiding inflammatory agents such as gluten, soy and dairy. The Keto Diet is very popular today as well. Consumers are more vigilant with label reading as far as preservatives and chemicals added to foods. Those who try to avoid these things, sometimes refer to it as “Clean Eating.”
Wow, what was that first question, “What is a healthy diet?” I would love to hear your thoughts on this. What have you seen change through the years and what challenges are you facing today? I hope this little walk down memory lane on diet trends and fads was enjoyable. I know it was for me.
Joyce Kulick RD, LDN, CDE