Sunday, December 20, 2015

Nutrition: Stop making it so complicated.

Paleo, keto, LCHF, vegan, vegetarian, carb back loading, if it fits your macros, fruitarian, banting, intermittent 5:2 fasting, vegan-paleo (surely not, these people must die of starvation pretty quick), low fat, dukan, gluten free, dairy free, taste free, just eat grapefruits. Confused, you will be.

Once upon a time nutrition was easy. There was a food pyramid and government advice of a balance diet, and it didn't work. People got fat, adult onset diabetes went through the roof and everyone was happy because we didn't know any different.

Failure on a plate: The food pyramid has now been replaced by the Eatwell plate in the UK. Notice how sugar and fat get the same segment. Good luck finding the research to support this. Source: NHS

Due to the media and the diet industry, and in no small part the fitness industry the general public are confused. It's easy to think that the average client knows all these different diets, knows what they mean and is going to follow your advice exactly. However, it is shocking how little the average person knows, or wants to or probably more accurately is willing to implement and change.

Your average client probably wants some weightloss, wants to get a bit more energy and feel better. They are probably not stepping on stage any time soon or trying to get contest ready. You may have your favourite nutrition approach, or the one that worked for you but it doesn't mean it is going to work for them.

And while as an industry we argue and squabble over minutiae in comment threads and who is right and wrong the public are generally getting fatter and sicker. Meanwhile some fella in France is eating a cake for breakfast and laughing in your paleo-face.

Almond croissant: French Paleo. Source: essential

Case in point: I have had people approach me for weight-loss advice who are eating 5 bowls of coco pops a day, drinking 30 glasses of juice and munching through 5 bags of crisps before lunch and want me to write them a nutrition plan. Now of course, most right minded people can probably figure out that eating 5 bowls of coco pops and drinking 30 glasses of juice a day is not that good for you. Except this person either hadn't or was in denial. (Of course, somewhere there is a carb back loader chomping through 1kg of Haribo and thinks 5 bowls of cereal sounds reasonable after a leg workout).

I can write the perfect plan for the above client right now, and it won't work. It would be too strict, too much of a change, they won't do it, even I wouldn't follow it so why would I expect someone else to. In reality this person needs to make gradual changes, behavioural changes. Whether they sub-consciously know that their diet is terrible or not is difficult to say. And even if they really knew nothing a quick google search or even some deep intuition would tell them that vegetables are quite good for you and replacing at least 10 glasses of fruit juice with some water or a couple of pieces of fruit would probably be a good idea.

Most people are not going to start tracking their macros on an app or start weighting their food. In fact, some recent research shows that people who use tracking apps like My Fitness Pal are more likely to cancel their gym membership than those who don't. Now the study didn't factor in age, as in younger people are more likely to use apps and younger people also happen to be more likely to cancel gym memberships than older people.

Extreme advice and preaching appeals to a minority. Your approach needs to be flexible, taking into account what that person realistically is going to change, do and achieve. Don't get too wedded to one approach, for example, deciding  everyone has to be paleo meat eater and then one of your clients is a vegetarian. You can tell them to not be a vegetarian but that is not going to work and is not necessary. Alcohol is a another big sticking point for a lot of people, if someone is drinking half a bottle of wine a night (which I see on a regular basis) telling them to not drink at all and sign up to the 12 steps is not going to work, they need a different strategy.

And as a trainer don't be afraid to admit that certain things are beyond what you can do in a 60 minute   training session. People lie, they tell you they have the perfect diet, they eat 800kcals a day, except they aren't losing weight, and they get defensive and they don't want to be judged. And much more so than when you talk about their exercise habits. You start get in depth and personal about what people eat, and drink and their relationship to food and happiness (and sorry to stereotype but especially with women) then you can hit a psychological hot spot and before you know it they are shutting down. I've lost count of the number of people who have told me their diet is fine, almost perfect, all they need to do is exercise, right?

Some things may be beyond your skill set, you may need to refer out. This person may need a nutritionist, and needs to start working on behavioural change. If it is not your area of expertise don't pretend it is, even if you personally managed to get beach ready and post some good photos on instagram.

The fact is there are populations all over the world living long healthy lives eating a variety of diets from Mediterranean, to vegetarian based, fish based, some eating more vegetables, some more fruit, some more meat or nuts. The commonalities are generally obvious - more fresh natural foods, less processed shit. Unless you're French, then you can keep living the paradox.

We need to stop confusing the public, the most powerful changes most people can make to affect their health are normally the simplest. The basics are generally obvious, and a flame war on the internet is not changing the lipid profile or BMI or diabetes risk of anyone sitting in a doctors surgery right now.

Focus on changing one thing at a time, keep it simple. Be honest, be flexible. What else can you do.

(Note: I wrote this while eating a pain au raisin and I'm fine with that).

Of course any carb that Nigella makes is perfectly fine.