What's the Best Diet? Healthy Eating 101

Summary

Dr. Mike Evans discusses healthy eating, emphasizing that it's part of a broader healthy lifestyle. He clarifies there's no one-size-fits-all diet and suggests focusing on a pattern one can adhere to, like the Mediterranean diet, which includes moderation and quality food choices. The key is to make small, sustainable changes, such as eating breakfast, reducing TV time, and incorporating more physical activity. He also highlights the importance of social support and self-awareness in maintaining a healthy diet.

Takeaways

• 🍽 Healthy eating is a complex topic that involves more than just diet; it's part of a larger pattern of healthy behaviors including regular exercise, stress management, and sleep.
• 🏋️ Weight loss is conceptually simple—consume fewer calories and increase physical activity—but maintaining this balance is challenging due to the abundance of high-calorie food and a culture of inactivity.
• 🌐 The environment in industrialized countries, with its limitless supply of inexpensive, tasty, and super-sized food, makes it difficult to maintain a healthy energy balance.
• 🤷 There is no one-size-fits-all diet for weight loss; the key to success is adherence to a diet plan that suits the individual and can be sustained long-term.
• 🔍 The quality of food is more important than the quantity, with a focus on whole, unprocessed foods rather than obsessing over macronutrient ratios.
• 🍰 Sugar is ubiquitous and 'sneaky' in diets, often hidden in foods considered healthy, contributing to excess calorie intake.
• 🥑 Fats have a spectrum from unhealthy (trans fats) to healthful (MUFA and PUFA fats), and moderation in saturated fats can be part of a healthy diet.
• 🥩 High protein diets emphasize the importance of the source of protein, with healthier options being white meat, fish, nuts, and beans.
• 🌾 A diet rich in plant-based, unprocessed foods is associated with better health outcomes and is considered a smart dietary choice.
• 🥗 The Mediterranean diet, characterized by moderation, plenty of vegetables and fruits, and less meat, is backed by robust evidence for promoting health and longevity.
• 📈 Small, consistent changes or 'tweaks' to eating habits, such as eating breakfast daily or reducing portion sizes, can lead to significant long-term health benefits.

Q & A

What is the main focus of Dr. Mike Evans' discussion on healthy eating?

Dr. Mike Evans focuses on the complexities of healthy eating, emphasizing that it's not just about weight loss but also about making better life choices through a healthy cascade of behaviors like regular exercise, stress management, and sleep.

According to Dr. Evans, what is the key to successful weight loss?

Dr. Evans suggests that the key to successful weight loss is not about finding a magic formula but rather about consistency and choosing a diet that one can stick to, with more structure and in-person social support being significant factors for success.

Why does Dr. Evans believe that focusing on macronutrients is less important than focusing on food quality?

Dr. Evans believes that focusing on macronutrients can be misleading because it's more about the quality of the food you eat rather than the quantity. For instance, complex carbs from fruits, vegetables, legumes, and whole grains are healthier than simple carbs like free sugars and refined starches.

What does Dr. Evans say about sugar intake in industrialized societies?

Dr. Evans describes sugar intake in industrialized societies as 'sneaky' because sugar has found its way into many foods and drinks, often in high amounts, contributing to excess calories and potential health issues.

How does Dr. Evans view the role of fat in a healthy diet?

Dr. Evans explains that the role of fat has evolved from being seen as all bad to a more nuanced view where different types of fats have different impacts on health. He suggests that monounsaturated fats (MUFA) and polyunsaturated fats (PUFA) can be beneficial when replacing saturated fats.

What is the significance of the Mediterranean diet according to the video?

The Mediterranean diet is highlighted as a diet with robust evidence for promoting health and longevity. It emphasizes moderation, less meat, more vegetables and fruits, and is more about lifestyle and culture than strict food rules.

What does the National Weight Control Registry (NWCR) suggest about successful weight maintenance?

The NWCR suggests that successful weight maintenance involves a variety of behaviors rather than a single formula. These include modifying food intake, increasing activity levels, eating breakfast daily, watching less TV, and eating out less frequently.

How does Dr. Evans view the concept of weighing oneself as part of weight management?

Dr. Evans sees weighing oneself as a useful feedback mechanism that can help with daily food decisions and prevent weight regain. He mentions that 75% of NWCR subjects weighed themselves weekly, and 36% daily.

What is Dr. Evans' stance on the idea of making small changes or 'tweaks' to one's diet?

Dr. Evans advocates for making small, sustainable changes or 'tweaks' to one's diet rather than drastic overhauls. He believes that these small changes can lead to significant improvements over time and are more likely to be maintained.

What is the '80/20' rule that Dr. Evans mentions regarding healthy eating?

The '80/20' rule Dr. Evans refers to is about making healthier choices 80% of the time, allowing for some flexibility and enjoyment of less healthy foods the remaining 20% of the time. This approach promotes consistency and long-term sustainability.

Outlines

00:00

🍎 Healthy Eating and Weight Loss

Dr. Mike Evans discusses the complexity of healthy eating, emphasizing that it's part of a larger healthy lifestyle that includes regular exercise, stress management, and good sleep. He clarifies that weight loss is about energy balance, suggesting not eating as much and moving more. However, he points out the challenge of maintaining this balance due to the abundance of high-calorie food and a sedentary lifestyle. He dispels the myth of a 'best' diet for weight loss, stating that adherence and social support are more critical than the diet itself. The importance of food quality over macronutrient quantity is highlighted, with a focus on whole foods and less overeating.

05:01

🥦 Macronutrients and Diet Quality

This paragraph delves into the nuances of macronutrients, including carbohydrates, fats, and proteins, and their role in a healthy diet. Dr. Evans argues that the focus should be on the quality of these nutrients rather than their quantity. He explains that complex carbs from fruits, vegetables, legumes, and whole grains are healthier than simple carbs like free sugars and refined starches. The discussion on sugar consumption in industrialized societies is highlighted, emphasizing its sneaky presence in many foods. The role of fats is explored, with a distinction made between unhealthy trans fats and healthier monounsaturated and polyunsaturated fats. High-protein diets are also examined, with a preference for healthy protein sources like white meat, nuts, beans, and fish.

10:02

🌾 Mediterranean Diet and Healthy Behaviors

Dr. Evans introduces the Mediterranean diet as a lifestyle choice rather than a strict set of food rules. He outlines its emphasis on moderation, with more vegetables, fruits, and less meat, and the importance of shopping at markets for fresh produce. The paragraph also discusses the benefits of physical activity, social support, and self-awareness in maintaining a healthy diet and weight. The National Weight Control Registry's findings on successful long-term weight loss are shared, highlighting the importance of daily practices like eating breakfast, watching less TV, and engaging in regular physical activity. The concept of 'tweaks' or small changes to improve eating habits is promoted as a sustainable approach to healthy eating.

🚴‍♂️ Long-Term Health and Attitude Towards Eating

In the final paragraph, Dr. Evans discusses the importance of a long-term approach to health and the attitude towards eating. He suggests that awareness of personal eating triggers and habits can lead to healthier choices. The idea of 'redesign choice architecture' is introduced, which involves making small environmental changes to encourage healthier eating. The 80/20 rule is mentioned as a flexible and sustainable approach to maintaining a healthy diet, allowing for occasional indulgences while focusing on consistency in making healthier choices most of the time. The paragraph concludes with a note on 'Health at Every Size,' encouraging mindfulness and self-love in relation to eating and physical activity.

Keywords

💡Healthy Eating

Healthy eating refers to the practice of consuming a variety of foods in the right proportions to maintain good health. In the video, it is the central theme, emphasizing the complexity of making food choices and the importance of a balanced diet for overall well-being. Dr. Mike Evans discusses how healthy eating is interconnected with other healthy behaviors like exercise and stress management.

💡Weight Loss

Weight loss is the reduction of body mass, typically through a combination of diet and exercise. The script mentions weight loss as a common goal for individuals seeking to improve their health. Dr. Evans points out that while the concept is simple—eat less, move more—the execution is challenging due to the abundance of high-calorie food options and a sedentary lifestyle.

💡Energy Balance

Energy balance is the equilibrium between the calories consumed and the calories expended by the body. In the context of the video, Dr. Evans discusses how maintaining this balance is key to weight management. The challenge arises from the easy availability of high-calorie foods and the decrease in physical activity in modern lifestyles.

💡Macronutrients

Macronutrients are the three main types of nutrients that provide energy: carbohydrates, proteins, and fats. The video script discusses the focus on macronutrients in various diets and emphasizes that quality and the type of macronutrient consumed are more important than strict adherence to a specific macronutrient ratio.

💡Mediterranean Diet

The Mediterranean diet is a dietary pattern inspired by the traditional eating habits of countries bordering the Mediterranean Sea, known for its emphasis on fruits, vegetables, whole grains, and healthy fats. Dr. Evans highlights this diet as an example of a lifestyle that promotes health and longevity, rather than a strict weight loss regimen.

💡Dietary Guidelines

Dietary guidelines are recommendations for healthy eating that typically include advice on the types and amounts of foods to consume. In the script, Dr. Evans refers to Brazil's new dietary guidelines, which shift the focus from perfect macronutrient mix to a more holistic appreciation of food and its role in health.

💡National Weight Control Registry (NWCR)

The National Weight Control Registry is a research database that tracks the habits of individuals who have successfully lost weight and maintained that loss. In the video, Dr. Evans uses data from the NWCR to illustrate successful behaviors for long-term weight management, such as daily food intake modification and increased physical activity.

💡Food Diary

A food diary is a record of all the food and drink consumed over a certain period, often used for monitoring dietary habits. The script mentions that keeping a food diary can enhance awareness of eating patterns and potentially double weight loss by making individuals more mindful of their food choices.

💡Mindful Eating

Mindful eating is the practice of paying full attention to the experience of eating, which can lead to better food choices and an improved relationship with food. Dr. Evans suggests that being more mindful and aware of eating habits can help individuals make healthier choices and avoid mindless overeating.

💡Health at Every Size (HAES)

Health at Every Size is a movement that promotes body positivity and the pursuit of health rather than focusing on weight loss as the primary goal. In the video, Dr. Evans acknowledges the importance of this approach, advocating for a shift in focus from weight to overall health and well-being.

💡Small Tweaks

Small tweaks refer to minor adjustments or changes in behavior or habits that can lead to significant long-term benefits. Dr. Evans suggests that making small, sustainable changes to eating and lifestyle habits, rather than drastic overhauls, can contribute to a healthier life over time.

💡Redesign Choice Architecture

Redesign choice architecture involves altering the environment or context in which choices are made to nudge individuals towards healthier options. The script discusses this concept as a way to make healthier eating easier by changing the surroundings, such as using smaller plates or avoiding super-sized portions.

Highlights

Eating is a complex behavior that is part of a healthy cascade involving exercise, stress management, sleep, and better food decisions.

Weight loss is conceptually simple—eat less and move more—but maintaining this energy balance is challenging due to the abundance of high-calorie food and reduced activity levels.

No single commercial diet has been proven superior; success depends on adherence and the diet's ability to provide structure and social support.

Diets are essentially food rules that act as commitment devices to guide eating patterns and control impulsive behaviors.

Focusing on macronutrients is less important than the quality of food choices, emphasizing complex carbohydrates, healthy fats, and high-quality proteins.

Sugar is pervasive in diets and contributes to excess calories, with even 'healthy' foods containing high amounts of sugar.

Diabetes prevention is more about a healthy lifestyle cascade than strict sugar restriction.

The narrative on fats has evolved from demonizing all fats to recognizing a continuum with healthy unsaturated fats.

High-protein diets should prioritize quality sources like white meat, nuts, beans, and fish for better health outcomes.

Specific diets like DASH and low glycemic index diets have shown benefits for conditions such as high blood pressure and diabetes.

Plant-based diets rich in unprocessed foods are associated with better health and lower environmental impact.

The Mediterranean diet, emphasizing moderation and a balance of foods, has robust evidence supporting its health benefits.

The National Weight Control Registry shows that successful long-term weight loss is about behavior modification rather than a specific diet formula.

Daily self-weighing and food diaries provide feedback that can help prevent weight regain and improve weight loss efforts.

Small dietary changes or 'tweaks' can lead to significant long-term health benefits without drastic measures.

Increasing fiber intake and focusing on adding healthier foods rather than restricting can improve satiety and cardiovascular health.

Social support is crucial for maintaining weight loss, with group support significantly improving long-term success rates.

Physical activity is associated with longer life, even in individuals with obesity, and aids in weight maintenance.

Redesigning the eating environment and personal habits can make healthier eating easier and more sustainable.

The 80/20 rule promotes a balanced approach to healthy eating, allowing for flexibility while aiming for consistency.

Health at Every Size encourages mindfulness and self-love, focusing on healthy eating rather than weight loss as the primary goal.

Transcripts

hi i'm dr mike evans and today i'm

talking about healthy eating

it's a huge topic eating seems simple

but it's actually pretty complex so

i thought it would just focus on what

i'd say if you and i sat down in the

clinic

i might start by wondering what we're

shooting for weight loss

less overeating healthy eating a longer

better life

then sticking with the big picture i'd

point out that eating is just one

behavior in a healthy cascade

exercising regularly leads to better

stress management and sleep which leads

to better food decisions

to more energy less chronic disease and

so on

if it's weight loss you're after that's

easy conceptually don't eat as much and

move more

the problem is it's not so easy keeping

up this energy balance in the real world

in industrialized countries we are

surrounded by a limitless supply of

inexpensive tasty super-sized

high-calorie food

the other side of the energy balance

equation ie activity has also changed as

our generation has a severe case of

sitting disease

nightly tv commutes spectacular video

games moving sidewalks

and most of us now are sitting knowledge

workers our culture pushes us towards

the easy button instead of making our

days harder

on the other other side of the equation

i think it's important to remember that

eating is grand

food brings together families builds

communities and gives us health

okay so let's start with the question i

most often get about eating

what's the best diet for losing weight

i'm not surprised people are confused

while you're watching this video there's

probably a pop-up window from the diet

industry telling you about a diet

a detox or a superfood not to mention

the hollywood star that just started

that diet

no research has shown convincingly that

one commercial diet trumps all the rest

the only thing that predicted success in

head-to-head trials was how well you

stuck to whichever diet you picked

so to reframe this our society lurches

from diet to diet looking for some magic

formula

but but it's not the formula as much as

the pattern

instead of obsessing about the exact

composition of a diet the science tells

us to choose the one you like the best

and can actually stick to

a cochrane meta-analysis in 2015 looking

at what bumped the success of commercial

weight loss diets showed it wasn't less

carbs or or fat

it was more structure and more in-person

social support

really diets are just food rules that

influence our pattern of eating

or what the economists call a commitment

device what self-aware people do to

improve their chances of controlling

future irrational

or impulsive behaviors so instead of

autopilot you follow a food world that

nudges you towards certain eating

decisions

mostly less overeating each commercial

diet has their own magic formula of what

we call macronutrients

so low carb high protein low fat sugar

and so on

and they typically have a story to go

with it so you can eat like a caveman or

use a scoring system or it's

pre-packaged or a famous doctor's take

or

or whatever and i suppose my two

messages with macronutrients are

one i i think we spent too much time and

energy focusing on them and two

it's really more about quality than

quantity

low carb well carbs can be healthy in

their complex form fruits veggies

legumes whole grains

and not so healthy in their simple form

like free sugars and and refined

starches

you know let's face it carbs taste

awesome and our society tends to overeat

them

so people who restrict their intake tend

to lose weight

however when we study relative weight

loss outcomes a 2014 systematic review

by dr celeste naud and colleagues looked

at weight and cardiovascular

markers of at-risk people on low-carb

diets that were followed for up to two

years

and they found no difference compared to

balanced weight loss diets

so how about lowering sugar well if i

had to pick one word to describe sugar

in industrialized societies it would be

sneaky

so so much sugar has worked its way into

our diets i mean

many drinks have eight or more teaspoons

of sugar the the average american intake

is approximately 20 teaspoons of sugar a

day

more in teenagers and less in canada

it's the obvious sweets but but it's

also foods we think of as healthy so

cereals and granola bars and fruit

juices

when high sugar contributes to excess

calories

that is when we seem to get into trouble

one interesting caveat is it is that

when i diagnose patients with

pre-diabetes the first thing they do is

drop sugar from their diet

however when we look at the diabetes

prevention trials it was less about

sugar restriction

and more about the healthy cascade of

being active half hour a day

five to seven percent weight loss eating

less saturated fats and eating more

fiber

that reduce risk of progression to

diabetes by 58 percent

how about low fat well i think our story

has changed

on fat from all bad to again more of a

continuum

you have your trans fat so fried fast

food many packaged baked goods

uh not so good and we're reducing these

we have saturated fats

mostly in dairy and and red meat and

plant oils like coconut or palm

these seem not so good in excess but

okay in moderation then we have your

monounsaturated fats or mufa

the mediterranean diet which i'll

discuss in a second is pretty high in

mufasa so avocados nuts seeds olive oil

dark chocolate

and shows health benefits finally we

have pufas so these are the longer chain

fats found in oily fishes

early trials showed some reduction in

cardiac events

more recent trials not so enthusiastic

meta-analysis still showing some small

benefit

no harm so the suggestion is at least

two servings a week

people seem to do better when they

replace saturated fats with mufa and

pufa fats

what about high protein diets again it's

more quality than quantity

protein can come in different packages

with different health effects so

say comparing a high salt ham steak

versus a salmon steak or lentils or a

handful of almonds

most data points that if you eat healthy

protein white meat

nuts beans fish you do better especially

if it is spread throughout the day

perhaps most importantly at breakfast

there are also some diet showing good

results in people with disease so the

dash diet dropping high blood pressure

by

5 to 11 millimeters of mercury or or low

glycemic index diet dropping a1c

the measurement for blood sugar over

time and people with diabetes by 0.5

percentage points

many of our patients have high

cholesterol and dr david jenkins and his

colleagues here at the university of

toronto

have shown they can reduce cholesterol

by 35 with the portfolio diet

the data for vegetarianism has largely

come from cohort studies and now some

randomized trials showing that people do

better

it's hard not to conclude that a diet

rich in plant-based unprocessed foods is

a smart diet and of course

many people make the excellent point

that the burden on our planet is

is less with a vegetarian or vegan or

local diets

one way to think about all this is to

reflect on brazil's new dietary

guidelines

here they shifted from focusing on the

perfect macronutrient mix towards more

appreciation of food

stepping back a bit to see you know

we're buying more ultra processed

foods and packaged foods that can be

eaten anywhere and that maybe there's an

opportunity for healthier eating and

better relationships by encouraging

creating meals with your family and

friends

okay if there's no magic formula is

there a diet that actually does work

i think the answer is yes the diet is

more about culture and

small behaviors a diet not focused on

weight loss but unhealthy outcomes like

less cancer heart disease dementia a

longer life

the diet with the most robust evidence

is a mediterranean diet

instead of food rules or absolutes this

is more about moderation

less meat more veggies fruit for dessert

i think shopping at the market or at

least at the outer aisles of a grocery

store

not the processed foods for sale in the

inner aisles

it's called the mediterranean diet but

really it's more of a lifestyle

a region that traditionally includes

lots of physical activity

regular meals and good social support

so let's continue this shift from diets

to healthy behaviors that affect our

eating by looking at the national weight

control registry

the nwcr administers annual

questionnaires to more than 10

000 people more women than men who have

lost quite a bit of weight and kept it

off for more than a year

not surprisingly 98 said they modified

their food intake in some way and and 94

increase their activity levels but there

wasn't one formula

most restricted some foods some counted

calories

others ate all foods just limited their

quantities 78

ate breakfast every day the majority

watched less than 10 hours of tv

and ate out just three times a week and

these people generally exceeded the

prescribed half hour day of activity

averaging an hour a day mostly walking

nearly all registry members indicated

that weight loss led to improvements in

their level of energy physical mobility

general mood self-confidence and

physical health

feedback loops seem important losing

weight is one thing but it seems like

the trickier part

at least for about eighty percent of us

is keeping it off weighing yourself

and using this as a small nudge in your

daily food decisions is an example

75 percent of nwcr subjects weighed

themselves weekly

36 percent daily and they looked at this

more closely at the stop regained trial

where daily self wane was associated

with a decreased risk of regaining 2.3

kilograms or 5 pounds on average

another feedback nudge is a food diary

even just for a week

and easier now with apps patients find

this so simple they don't do it but but

seeing what you've eaten can actually

double your weight loss

so i think awareness is undersold it

might be what you're eating or

weighing but it's also about knowing

that life is messy and to enjoy it we

need some flexibility

or that you simply feel better when you

eat better that's why i like the idea of

starting with small changes or as i call

them tweaks

maybe switch something you do a lot so

for example eating breakfast

snacking drinking you can switch your

average cereal for some oatmeal or

shredded wheat

a handful of almonds instead of a bag of

chips maybe switch three of your colored

drinks a day to water

i know this doesn't sound too sexy but

the dr mike switcheroo diet might

actually chip away at a pound a week or

or better yet might make you feel better

another angle

is adding instead of subtracting so dr

sherry pagoda and colleagues randomized

metabolically at risk individuals to

either a multifaceted american heart

association diet

versus the simpler advice of just

increasing fiber to 30 grams

throughout the day so getting on the

brand wagon a trip to beantown

berry picking both groups lost weight

dha group slightly more

and both improved cardiovascular markers

now i like this idea of pushing

healthier food rather than just

restricting or fencing off other food

other data showing satiety our feeling

of being

full is not just about calories calories

that come from proteins and

and fibers actually can make us feel

more full

another angle is social support which

can actually help our eating behaviors

another study where people were either

going it alone versus having three or

more friends or family members

supporting them

maintaining weight loss at 10 months

jumped from 24 to

66 on the subject of support having a

dietitian

even if just online helps they're like a

genius bar for your eating

activity is interesting the context of

eating research shows us that people who

are

active even when they have obesity live

longer than skinny sedentaries

so when my patients tell me they are

active but have been unsuccessful at

weight loss

i shrug my shoulders and say actually

you have been successful

you're active it's easier to draw

calories through diet but i

i think it's important to know that the

research shows that people who exercise

have more success at maintaining their

weight

my final two points about healthy eating

focus on this long-term play and

attitude

as restrictive diets have proven hard to

sustain many are now turning from the

individual

to what surrounds the individual

changing our eating environment to make

it easier to make the right choice day

after day

we call this redesign choice

architecture and involves two types of

what i call

quote nudge awareness first

is knowing that our world is full of

triggers towards unhealthier overeating

convenient shiny foods at the counter

super sizing marketing

as dr brian wansink points out most of

us don't overeat because we're hungry

secondly is an awareness of what nudges

you personally

we are creatures of habit we do the same

thing every week and each of us has cues

certain foods pastries at the coffee

counter a time

11 3 or 10 a predictable stressor

as wansing says the opportunity here is

to re-engineer small behaviors that move

you from mindless overeating

to mindless better eating maybe it's

redesigning your kitchen

when you leave cookies on the counter

they are much more likely to be eaten

but the same is true for fruits and

veggies smaller plates

glasses less super-sized containers and

not eating from the bag are simple

nudges to reduce mindless eating

redesign takes some self-knowledge are

you a nighttime nibbler or

an emotional eater i'm a grazer i'll eat

whatever is there so

my change is at the grocery store i know

it's pathetic i should cut fruits myself

but

mindless healthy eating happens for me

when i buy pre-cut fruit and just like i

might tell a smoker not to have

cigarettes in the house

i also don't buy super sour jude views

because i can't stop eating those things

my final behavior is more of an attitude

80 20.

so if you're making a healthier choice

80 of the time and your 20

is not too high cal i and you should be

thrilled

having a piece of dark chocolate a good

meal out some pie

we're into this for the long term so i'm

not looking for perfection

i'm looking for consistency so in the

end i hope i've got you to think a bit

differently about how you eat

instead of investing a single diet a

portfolio behaviors

small tweaks over big changes single

ingredient foods over multi-ingredient

and processed foods dinner at home

self-awareness depending less on

constant willpower and more in tweaking

your week to make mindless healthy

eating more likely

my final point is more about health at

every size you know i

i get that people want weight loss and

obesity is a risk factor for disease

but honestly if my patients can work

with their factory settings to be more

mindful of their eating

move more a bit more self-love and start

thinking more about what's healthy to

eat rather than what not to eat

i'd be happy so maybe now is the time to

start your very own better life

experiment

thanks for listening

you