If this text was being written a decade ago, the information contained within would center largely around food quality. Sugar would be demonized, fats might be vilified, and diabetic exchanges would likely be emphasized to assist with portion control.
Clean Eating/Food Quality Emphasis
Food “quality” is typically used as a term referencing the micronutrient content of a food – i.e. favoring foods like fruits and vegetables over processed, refined foods like cereals and chips.
From a physiology perspective, we need certain quantities of micronutrients to avoid sickness, developing disease, and even regulating our endocrine system.
With this in mind, proponents of a “food quality” based approach will tell you that every meal consumed should be the highest quality, most micronutrient dense, sources available. This would exclude the allowance of processed or refined foods – even if consumed within an individual’s daily caloric (or macro) requirement.
The paleo diet is the best example of this in recent history.
Pros of a quality based approach
There are a lot of positives to a quality based approach that can even include overcoming autoimmune diseases.
When consuming a diet composed of nutrient rich foods, you are at a far lower risk for any vitamin and mineral deficiencies, resulting in less inflammation, increased immunity, and usually increased overall health as would be defined by clinical lab work.
Empirically, we have also seen a lot of weight loss achieved on “clean eating” diets.
Cons of a quality based approach
While it is undeniably “healthy” to only consume unrefined foods, minimally processed foods, and foods that would be considered acceptable within an ancestral approach, it is not always the easiest thing to do from a practical approach.
In most societies, food is part of social gatherings. By reducing the types of foods you are willing to eat, you are also reducing the likelihood of being able to actively participate in the eating portion of social gatherings. For you, the nutritionist, this may not seem difficult – but as we have seen in work with our clients, this is not something they like to give up very easily.
There is no quantity control in quality based approaches. Paleo advocates will tell you to “eat when you are hungry, as long as it’s paleo.” Unfortunately, regardless of micronutrient content, calories still matter. Chronic caloric underconsumption will yield long term metabolic adaptation, and chronic caloric overconsumption will yield body fat accumulation. This is an undeniable truth.
Finally, by limiting your food selections, you are also limiting the activity of specific enzymes within your body. Failing to consume a specific food or food group for long periods of time can reduce the enzymatic activity so much that you never fully regain the use of it. Lactase is a great example of this as long term dairy exclusion can create an inability to digest dairy later in life.
Quantity Specific Approach (Flexible Dieting)
Controlling energy intake/output to create a caloric deficit or surplus, as has been previously discussed in this text, is the fundamental quantity specific approach. With that said, we recognize that there have been several quantity specific approaches over the years. For the purposes of this text we would like to focus on flexible dieting, or a macronutrient based approach.
Flexible Dieting has its origin in the early 2000’s, and is predicated on the fact that it is not “what you eat” but rather “how much you eat.” It has been postulated (and proven), that food quality is inferior to quantity when actively pursuing aesthetics and/or athletic performance.
A gross misconception of this approach is the advocacy of low quality foods. While proponents of flexible dieting methods absolutely believe that no food is “off limits,” this is not an active promotion of eating refined and processed foods.
Prescriptions for a flexible diet approach will usually come in the form of a protein, carbohydrate, fat, and fiber prescription. These numbers are typically adjusted over the duration of the “dietary phase” in an effort to meet the end goal. There are no restrictions on what specific foods are consumed assuming that all macronutrient targets are met at the end of the day.
Pros of a Flexible Diet
As discussed earlier, a “quality focussed” approach can make social settings very difficult to remain compliant from a dietary perspective. This is certainly not the case in a flexible diet approach. With zero restriction in terms of which specific foods are consumed, the only area of focus will be to ensure that the quantity remains within the macro allotment for the given day. This is very favorable for those individuals that enjoy the social aspect of feeding.
It sounds redundant to say that there are no restrictions, but there are no restrictions. We recognize that all of our clients have favorite foods, and this approach allows them the freedom to eat them.
Finally, we have also found a flexible approach to truly create an understanding of what a client is consuming. Instead of simply labeling a food as “good” or “bad,” clients are able to understand what they are consuming, and this fundamental learning process will ultimately lead to longer term, more sustained results.
Cons of a Flexible Diet
While the allowance of virtually any food within this protocol allows for “freedom,” we have sometimes seen the focus improperly shifted to an EMPHASIS on lower quality (more refined foods).
Tracking food intake can be viewed as laborious, and therefore will shift some potential clients away from even considering this approach (this can be solved with a simple conversation, but it is worth noting).
Long term sustainability is often questioned with this approach. “Do I have to track forever?” This will be covered in the application portion of the text, but it is a potential downfall of the flexible diet approach.
As a whole, the instructors in this course support the use of all methods, when applicable. We have found that the majority of clients will thrive in a flexible diet approach, but this comes with a heavy emphasis on food quality within the overall context of quantity. This is to say that we recommend eating the RIGHT AMOUNT of the BEST AVAILABLE foods.
Later in this text, you will learn how to assess which approach is best for your client.