Diets: The Good, the Fad, and the Ugly

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Do you ever feel overwhelmed by today’s nutrition and weight loss landscape? We do. Some plans insist we avoid carbs at all costs. Others suggest getting in touch with our caveman roots. And still other diets – some that have been around for decades – promise a magic bullet (like cabbage soup) for dropping pounds. This episode of Total Health Radio takes a closer look at the pros and cons of these sometimes extreme eating plans and offers simple advice on what can be a surprisingly confusing topic: What is considered a healthy diet and how can we successfully follow it?

About the Guest
Ricia Taylor, RD, is a dietician with Kaiser Permanente in Georgia.

Episode Host
Joyce Gottesfeld, MD, is an OB/GYN with Kaiser Permanente Colorado, where she’s worked 17 years. She’s a wife, proud mother of three girls, runner and blogger. Read more about Dr. Gottesfeld.

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Learn More
If you’re looking for more information on healthy eating – and why fad diets are not the way to go – you may want to explore these websites and links:

DR. GOTTESFELD:  Welcome to Total Health Radio. I’m Dr. Joyce Gottesfeld. Every day we hear about some new diet, and whether it’s a five-day juice cleanse, or eating like a caveman, it can be hard to know what’s healthy and what’s dangerous. Today we’re joined by Ricia Taylor, a dietician with Kaiser Permanente in Georgia. She’s here to give us the good, the bad and the ugly about popular fad diets, and give us some tips for healthy eating. Thanks for joining us.

RICIA:  Thank you.  A pleasure to be on.

DR. GOTTESFELD:  So Ricia, let’s actually start with the ugly—the exciting stuff. What two diets have you seen that have become popular and are just not safe?

RICIA:  Wow, there are so many out there, but I guess the two that come to mind, one should steer clear away from any type of diet that tells you to avoid carbohydrates, but you can eat all the bacon, eggs, cheese that you want. Another that comes to mind is anything that says, hey, the cabbage soup diet; you eat cabbage soup for a week, and you can lose 10 pounds. Anything that promises a magic bullet, or that burns fat, or anything more than about, I would say, two pounds of weight loss a week. Those are things that we want to use caution. I mean, there are no foods or pills that magically burn fat, no super foods that are gonna melt the fat away while you sleep. Those diets that I just mentioned, they often claim that, “Hey, you’re gonna lose all of this weight without any exercise.” And there’s just no evidence that combining certain foods and no exercise is gonna promote weight loss.

DR. GOTTESFELD:  So there’s nothing magic out there?

RICIA:  Nothing magic out there. I mean—and in fact, these things can be harmful. I mean, if people were to do them long term.

DR. GOTTESFELD:  So basically, I’m guessing if you eat cabbage for a week, the reason you lose weight is because cabbage doesn’t really have any calories.

RICIA:  Absolutely. I mean, so you’re—it borders on the edge of a week-long starvation. And so with the cabbage soup diet it doesn’t promote balance, you’re not getting the calories you need; therefore you body has to compensate, and you actually may store food as fat. And so you’re right, because it’s so low in calories, you will lose weight, pretty much dehydrate yourself for that week, but when you resume to any type of normal eating, you’re gonna gain that weight back, and usually a few extra pounds to go with it.

DR. GOTTESFELD:  Yeah, that doesn’t sound good. And eating cabbage for a week? That’s gotta make you pretty gassy, right?

RICIA: It gets boring really quick!

DR. GOTTESFELD:  Boring and stinky! So let’s talk about fad diets. I have a lot of people ask me about gluten-free, and I know, as a doctors, that that diet is meant to treat a condition, but you start hearing about people treating it like some sort of fad diet, or that it’s somehow better than, you know, a normal diet.

RICIA: Than a normal diet.  Absolutely. I consider it a fad for most people. I mean, I kind of consider it the new kid on the block. People are using it for weight loss, and research supporting gluten free diet for weight loss just doesn’t exist. You were correct; gluten free diet is a diet that excludes the protein gluten, and it’s used to treat celiac disease. Gluten is typically found in wheat, barley and rye, and people who have celiac disease, when they do a gluten free diet, it can help them control their signs and symptoms and prevent complications. But people who are just using a gluten free diet because they heard it on TV on in an attempt to lose weight, there are a lot of gluten free—there are lot more gluten free products on the market than in the past. However, the gluten free products are usually higher in fat than the regular versions. So what people are using to lose weight       can be very restrictive, can be expensive to follow, and there’s no research or indication that it produces weight loss.

DR. GOTTESFELD:  People look at the gluten free aisle in the chi-chi organic grocery store, and think that, you know, they should be eating that stuff, that it’s good for them in its own right. But really, it’s only good for you if you are sensitive to gluten or have celiac, or I’ve heard it called celiac sprue.

RICIA:  Sprue, exactly. Correct. And you would need to be diagnosed with that. Just eliminating gluten and then going to get tests can actually interfere with your test results, and so if you truly suspect that that may be the case, get tested and then consider a gluten free diet.

DR. GOTTESFELD:  OK, so let’s now talk about the whole carb issue—no carb diets, low carb diets. Tell us a little bit about that.

RICIA:  So, I mean, your low carb, no carb; they’ve been around for years. I don’t—personally, I don’t think they’re going anywhere anytime soon. I mean, these diets—the thing is, they’ve been proven effective for weight loss in short periods of time. But, they’re not sustainable. So if you think about a low carb diet, that—most of these diet plans out there, they’re recommending that you restrict carbohydrates to about 20 to 25 grams per day. Just to put hat into perspective, the Institute of Medicine recommends about a 150 grams of carbohydrate a day just for energy and proper brain function. So that’s…


RICIA:  …yeah, that’s quite a difference, 20 to 25, to 150. So the reason—we just can’t sustain that over long periods of time. Carbohydrates are how your body gets energy. Meaning, that’s your body’s preferred source of energy, so your body is more effective and efficient converting carbohydrates to energy than it is, say, like fat or protein. When I say carbohydrates, I’m speaking of any type of fruit, any type of starchy vegetables, so that’ll be like your corn, your peas, your sweet potatoes, any type of milk or yogurt. And so those type of dairy products, all of those are carbohydrates, and that’s what your body wants and needs. So when you deprive yourself or you restrict too much, I mean, it can lead to just some annoying things, like constipation, not having enough energy, I mean, and sometimes dizziness if we restrict it for too long, too much. But, I mean, those diets, they’re low in vitamins, they’re low in minerals, and they’re oftentimes low in fiber. And although, like I said, you may lose weight initially, it’s just not something you can live off of. Most people just report they feel pretty lousy after being on this type of diet for any length of time.

DR. GOTTESFELD:  Again, I’m sure if you decrease the number of calories you intake, you will lose weight.

RICIA:  On almost anything, absolutely.

DR. GOTTESFELD: On almost anything. OK, now here’s one that I find bizarre, and I will confess, I don’t know much about – what is this Paleo, or cave man diet?

RICIA: It is referred to as the cave man, or the hunter type of diet. My daughter just did a project on Paleolithic times, and so the thought is that if we eat like our Paleolithic ancestors did about 10,000 years ago, then we’ll weigh less, we’ll be healthier, and we’ll avoid disease. I’ve heard some nutritionists say, hey, if the cave man didn’t eat it, you shouldn’t either. And supporters of the diet believe that our bodies are genetically predisposed, or programmed, to eat that way. And so overall, the diet is low in carbohydrate, high protein and high fat. There’s no refined sugar, no dairy, no beans or peas. It’s high amounts of lean meat, poultry, fruit and vegetables. So the meat is not processed with antibiotics and hormones. It would be kind of like your fresh meat that you get from your local farmer’s market.

DR. GOTTESFELD:  So what do you think about the Paleo diet; is that the way to go, or…?

RICIA:  So–I mean, there are pros and cons with everything. I guess if I were to say, hey, what are the pros of this diet—it avoids processed foods. And so it there are no refined sugars, and you’re not eating a lot of processed foods, the processed foods is linked to obesity and heart disease. And so it can be helpful in that regard. Because it’s high in fruit and vegetables, and you’re focusing more on lean meats, it may be helpful for quicker—like quick weight loss. However, again, long term, it’d be very difficult to maintain that weight loss, and I don’t know if the weight loss that you achieve in a short period of time is worth some of the nutrient deficiencies that you may run into. Because there’s no dairy, the diet is very low in calcium and vitamin D, so you would definitely need to supplement. People need to make sure they are, in fact, choosing lean cuts of meat and not, you know, high fat cuts of meat that could actually lead to heart disease. And eliminating like all of the whole grain products eliminates a good source of fiber, which could also help reduce risk of disease. And so there are pros and cons; my personal opinion is that the cons kind of outweigh the good of the diet.

DR. GOTTESFELD:  Right, nothing—nothing extreme. Well, and I can’t help thinking that people in Paleolithic times—well, I mean, they didn’t live as long as we live now. Their live expectancy was a lot lower, so. I’m not saying that because of their diet; it’s probably because when they were hunting they got eaten. But, you know. OK, last thing. What about juicing?

RICIA:  Oh, very popular. I’m hesitant when speaking to my patients to refer to it as a meal plan, because it’s not sustainable alone. I mean, juicing is not meant to replace a meal. If a person is not big on fruit and vegetables, it can be a creative way to get fruit and vegetables in for kids, or adults. But if you are using it to replace a meal, you to plan carefully in that you would need to add perhaps Greek yogurt to get some protein in. You would need to be juicing a variety of colors of fruits and vegetables, because different colors provide different nutrients. I guess a point of caution—when you juice, you’re extracting the juice from the whole fruits and vegetables, which is gonna result in fewer vitamins and minerals. You also, when you’re juicing, you’re gonna miss out on the fiber because it’s eating the skin of the apple that is going to give you the fiber. Again, I mean, it can be a creative way to get in, but it should supplement your diet. When juicing, you gotta make sure and watch how many pieces of fruit—if you’re doing a lot of juicing with all fruit, I mean, fruit—you gotta still watch calories and sugar content because you can have three or four pieces of fruit, and the calories add up to more than if you were to sit down and eat a four course meal. I mean, not to mention a spike in blood sugar that goes along with it. But when I hear about people juicing, I kind of ask them, “What are your plans?” If you’re trying to cleanse–I mean, we can do the same thing with just eating fruit and vegetables. The recommendation is five to nine pieces of whole fruit and vegetables a day. So I tell people, hey, if you’re just really wanting to juice, do half of it in juicing, but make sure you’re still getting in some whole fruit and vegetables. I mean, juicers can range from $50 to $500…

DR. GOTTESFELD:  My goodness.

RICIA:  So when I–you know, think about how much money people are spending on juices, you can buy a whole lot of fruit and vegetables, you know, to eat, for the amount that you’re spending. But again, like anything else, it can be used as a supplement to your diet. We just don’t want to replace a meal with juicing, or let that be your sole source of vitamins—or fruit and vegetables.

DR. GOTTESFELD:  So we heard about some of the ugly; we heard about some of the fads, and I think we heard a lot of good stuff, too, which is, you know, having some balance in your diet. Can you summarize briefly for us before we sign off—what is a healthy diet?

RICIA:  So, healthy diet—it’s not complicated; that’s what I want people to understand first. It’s not complicated. If we make healthy and wise choices 80% of the time, then we’re on the right track. It I had to just sum it up, I would say, hey, if a person can eat breakfast daily–I mean, within two hours of waking up as often as possible, this is gonna get your metabolism going and give you the brainpower to start your day. During the day, don’t go too long without eating, not longer than four to five hours. This is gonna help prevent you over eating at your next meal and give you the sustained energy to make it through the day. And balance is so important. We want to make sure we include some of those carbohydrates we mentioned earlier—starchy vegetables, fruit, whole grains. Include them at each meal. That’s going to give your body what it needs, that’s fueling your body when we add lean amounts of protein with the carbohydrate, that’s just gonna help you feel full for a longer period of time. But eating right is just eating the things you enjoy, your way, in the right amounts.

DR. GOTTESFELD:  Well, thank you, Ricia, so much, for being with us today. I feel like I could talk to you about this forever. I appreciate your coming on the show today; have a great rest of your day.

RICIA:  Thank you.  You as well.

DR. GOTTESFELD: Well thanks for joining me for another great show. I’m Dr. Joyce Gottesfeld, and don’t forget: more information and resources are available on our website at


This show is for educational purposes only. If you have specific health concerns, you are encouraged to address those with your personal doctor. And as always, if you’re having a health emergency, please call 9-1-1 or go to the nearest emergency department.