Author: John Morales

This story is part of a series. View the other stories here.

A call in 2011 changed the course of Lisa Pomerantz’s life.

She boarded a plane in Costa Rica to head back home as soon as she heard her father was diagnosed with pancreatic cancer. 

Her dad was a meat-and-potatoes kind of guy before beginning treatment, but he began juicing every day as he transitioned to becoming a raw vegan, a fully plant-based diet consisting of food that isn’t cooked, she said. 

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His transformation from a “standard American diet” to becoming the healthiest person in her life left an impression on her. 

“The doctors couldn’t believe that we started in November and by March we were celebrating his health on vacation,” Pomerantz said. “You know, it’s a diagnosis where people usually die within a year. My dad lived for seven years with it.”

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She was studying anthropology abroad before she got that call, but after coming home to spend time with her father, she got a job at a local juice bar. She met nutritionists and embedded herself in a health-passionate community as she watched her father undergo chemo and reach remission. Eventually, she discovered naturopathic medicine and decided to change her career path. 

Pomerantz received a doctorate in naturopathic medicine from Bastyr University and now treats patients at Mountain-River Naturopathic Clinic on Main Street in downtown Frisco. Naturopathic medicine focuses on natural remedies that often combine stress reduction, nutrition counseling, exercise and wellness. 

Like many Americans, patients come to Pomerantz after being bombarded with advertisements about the latest fad diets and trendy topics surrounding nutrition. 

“Keto, intermittent fasting — you know — there are even things that say you should be high carb, low fat to lose weight and then others say high fat, low carb,” Pomerantz said. “But really, you just have to listen to your body. The No. 1 thing is intuition, observing your body.”

Naturopathic doctors and registered dietitians help folks cut through all of the promotions and vast amounts of information out there to help identify deficiencies and sort out root causes of issues in their health. 

“At the end of the day, everybody’s health goals are different,” said Debbie Petitpain, a registered dietitian at the Academy of Nutrition and Dietetics. “The approach that you may want to take will be different than even a family member. A registered dietitian can help you come up with that individualized, tailored approach.”

With the latest diets, trendy techniques like intermittent fasting, exotic superfoods and endless supplements flooding the market, nutrition experts provided their best tips on how to navigate the muddy waters surrounding these topics. 

Fad diets

With 41{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} of Americans living with obesity, according to a Centers for Disease Control and Prevention study from 2020, nutrition is a common topic in the United States. 

Obesity is tied to numerous health conditions such as heart disease, diabetes and certain types of cancer. It comes with a financial burden, too. The medical cost of obesity was nearly $173 billion in 2019, according to the CDC. 

This puts a lot of pressure on people to seek ways to cut pounds, and people often gravitate toward trendy diets, Petitpain said. 

“A lot of people are really struggling to find a way to lose weight and often want to lose it quickly,” Petitpain said, “and that’s typically the big promise that these popular or fad diets make.”  

Atkins. Paleo. Keto. South Beach. Zone. Mediterranean. The list goes on. 

“There are so many diets,” said Nikki Withrow, a registered dietitian and associate professor at the University of Northern Colorado. “It’s a multibillion-dollar industry.”

Amid all of the choices, Petitpain said the most important thing is finding out long-term consequences of each and whether they are safe and effective. 

Whether its high-carb or low-carb diets — Petitpain said they all work in the short term, but they often are followed by weight gain a year later. 

“Primarily, if you’re going on a fad diet that you don’t feel like you can sustain as your forever diet, it’s probably not the best choice,” she said. 

Fad diets that are rigid and cut out entire food groups should be a red flag, Petitpain says.

Withrow agrees. Both said cutting out entire food groups is a concern because you lose out on vitamins, minerals, fiber, protein and other things that are proven to promote longevity and health. 

For example, Withrow said, “If you cut out gluten, instead of reducing quantity — what they don’t understand is that many grains in the United States are fortified with micronutrients — like magnesium, calcium, etc. … Often people do not understand how to maximize their nutrient intake.”

Having a medical evaluation before starting a diet is also important since it can detect underlying conditions that may be affected by restricting or adding certain food groups.

As far as what the studies say, Petitpain said the DASH diet has withstood the test of time after countless clinical trials, the gold standard of science. It stands for Dietary Approaches to Stop Hypertension, and it has a simple approach: cutting sodium and increasing fruits and vegetables. 

Making an effort to add certain foods to your diet, like heart-healthy ones, is a great approach to navigating nutrition since it is easier to sustain than cutting out entire food groups, which often leads to psychological challenges like changes in mood. Making unrealistic changes in diet can also cause an unbalance in hormones that regulate feelings. 

“When we intentionally try to put our bodies out of balance, our body sees that as a threat to its overall well-being,” Petitpain explained. “As far as your body is concerned, you’ve just been stranded on a deserted island.”

Pomerantz said adding foods that target specific body parts is a good strategy, too. Since naturopathic doctors identify root causes of inflammation and issues with digestive health, people can work with dietitians to add foods to their diet that support vital organs, such as lymph nodes and kidneys. 

“We want to get people eating healthy diets,” Pomerantz said. “Standard American diet is abbreviated as SAD for a reason.”

Intermittent fasting

A polar opposite to diets, intermittent fasting is gaining publicity within the nutrition industry. 

This new approach focuses more on when people eat rather than what people eat. There are multiple ways in which it is employed, but generally it involves going set periods of time without eating followed by a regular eating pattern. 

While it’s gaining popularity, Petitpain said fasting is a technique with ancient roots of a spiritual and religious origin. The reason it is considered a trendy or new approach in nutrition is because scientists are now studying possible health benefits.

“I’ll say that the science is still emerging,” Petitpain said. “As far as the long-term outcomes … we don’t know yet what they are, but the amount of research that’s coming out in this field is just growing exponentially. It’s a very exciting time to watch it.”

The medical draw to intermittent fasting lies in how the body is designed to go long periods of time without eating, she said. The stomach is like a holding tank, but if it runs out of food, the body has a few mechanisms it uses as backups. 

The body’s cells need constant nourishment, so food is converted by the stomach and stored by our bodies in various ways. When faced with a lack of food, the body will empty sugar stored in the liver and release it into the bloodstream to fuel muscles and high-energy-consuming organs, such as the brain. Once those sugars are depleted, the body then starts to dip into fat storage, which is its long-term energy bank. 

“It’s sort of like your 401(k),” Petitpain said. “It starts to make (fat storage) more accessible. We obviously don’t want to touch our retirement plans, but we can if we have to.”

Being deprived of food also causes hormonal changes. When the body runs out of food, blood sugar levels go down along with insulin, which is a hormone that the body produces to help cells use glucose in the body. 

High blood sugar and high amounts of insulin in the blood have been associated with “all sorts of diseases, diabetes, obesity, inflammation, cardiac disease and vascular damage,” Petitpain said, which is why scientists are researching intermittent fasting’s safety and effectiveness. 

During a fast, “your body goes through a series of different repair processes, where it basically starts to break down old dysfunctional proteins in order to recycle those cells,” Petitpain said. 

That process can reduce inflammation, which may lower the prevalence of cancer according to some preliminary research.

Withrow agreed with Petitpain that there is some evidence to support benefits of intermittent fasting, but Withrow emphasized that “the rigor is not there, yet.”

Both urged caution and said a doctor or dietitian should be involved when approaching intermittent fasting since it can affect medications and also might have detrimental effects for people living with diabetes or hypoglycemia. 

“Intermittent fasting — where you’re going somewhere between eight to 12, maybe 16 hours without eating — there’s very little danger associated with that, as long as you are not on a certain type of medication, like blood sugar, blood pressure medication,” Petitpain explained.

People who are experiencing puberty or are pregnant should not employ this technique, either. 

However, anyone thinking about fasting should consider what it is that they are trying to get out of it, Petitpain said. 

Fasting is often sought out as a way to create self-awareness and mental clarity, she said, but those who seek it out for weight loss might not find it to be helpful, especially if they are trying to cut calories. 

“Being on a low-calorie diet is hard, and there’s plenty of evidence to substantiate that,” she said. 

Since you’re going from a period without eating and following it up with a period of normal eating, it can end up as a wash, which can be disheartening to folks seeking weight loss. 

“The data is not quite there yet, though, to show that fasting works as a long-term weight-loss strategy, and that’s still some evidence we’re looking for,” Petitpain said. “That’s why I think going into it with a more ‘I’m curious’ approach than really wanting a particular outcome is important.”

Withrow said more research is needed, but she did say that if people use intermittent fasting to eat for eight to 12 hours a day, they can consume all of the vital macronutrients and micronutrients that the body needs, which is promising. 

Supplements 

Most people know vitamins and minerals are essential in any diet, but with millions of options on the market and new products every day — often backed by claims for just about any ailment — it can be overwhelming. 

“It is a ginormous, booming, money-rich industry,” Petitpain said. “We’re used to these weird-smelling bottles on the shelves of the health food store, and now you can’t even pick up a water bottle without wondering what they’ve put in it to — air quote — enhance your well-being. It’s everywhere.”

A CDC survey found that the consumption of over-the-counter vitamin, mineral and herbal supplements is widespread. 

Petitpain said supplements do have benefits and are commonly used in medical practice since it helps fill gaps in people’s diets. 

“There is some evidence to show that the American diet is lacking in some of the nutrients that we know can enhance our health,” Petitpain said. 

This is especially true for certain people, like picky eaters who don’t eat a wide array of foods. 

Even if you aren’t picky with what you eat, there are some vitamins that are hard to get enough of in a normal diet.

“Vitamin D is actually something that is found in very few foods,” Petitpain said, explaining how most milks are fortified with it to help people achieve the daily recommended values. For people who live in northern parts of the world, they might not get enough sunlight to provide the vitamin D their bodies need, so supplements can be helpful. 

Doctors and registered dietitians often use supplements to help fix deficiencies they identify through their medical practice, but with so many persuasive claims out there, many people use them without consulting a doctor or nutritionist first. 

The main concerns with supplements are rooted in how they can interact with medications in bad ways, how some people use them in replacement of medication or seeking medical care, and how some have a potential to cause harm if used incorrectly, according to a study published in the American Medical Association Journal of Ethics. 

Unlike prescription or over-the-counter drugs, dietary supplements are not approved by the U.S. Food and Drug Administration for safety or effectiveness before they hit the market. 

To help navigate this, Petitpain said people should look out for third-party testing that often comes with seals of approval for meeting certain requirements. 

A position paper published by the Academy of Nutrition and Dietetics lists organizations such as ConsumerLab.com, NSF International and U.S. Pharmacopeial Convention as examples. 

Petitpain said multivitamins are common, and when folks ask her about taking them, she recommends finding one that doesn’t have levels of vitamins and minerals that exceed the daily suggested values. 

“If you’re taking more than you need, you’re basically just urinating out your paycheck,” she said. 

Superfoods

People will ship food from across the country in order to receive the benefits promised by certain plants coined as superfoods. They often pay a hefty price tag, too. 

But Pomerantz, who studies natural remedies and healing properties of plants, said people don’t need to go through all of that effort. She said you can find plants with detoxifying powers that are packed with vitamins and minerals at your local grocery store rather than looking for goji berries imported from China. 

“I think you can get totally by with blueberries,” she said. “Blueberries are one of the most potent superfoods loaded in antioxidants.”

Antioxidants are substances that combat harmful byproducts that are produced by cells as they work to stay alive and reproduce. They neutralize the byproducts and prevent destruction to our cells, especially proteins and DNA. 

Plants produce these substances as a way to protect themselves out in the wild and to grow stronger to withstand the stresses of nature. 

We then harness these defensive chemicals by eating the plants, Pomerantz said.

“We get the vitamins and minerals from the plants that are absolutely essential because they get input into our own metabolic processes,” she explained. “They help us produce energy. They help us do our detoxification. They help produce our DNA in our body.”

To obtain these benefits, Pomerantz said people should add plants to their carts by looking at their colors. Each color brings different benefits at a cellular level for our bodies. 

Dark, leafy greens of all kinds are a great superfood, Pomerantz said, and the same goes for dark berries. The skin of eggplants pack a punch, and colorful peppers contain essential components that support immunity and overall health. 

Nuts, seeds, salmon — there are a lot of superfoods in grocery stores, and those who want to go to the next level can look for locally produced fruits, vegetables and meats. 

“As soon as we harvest food, it’s starting to lose some of its nutrients, and then who knows how long it takes to get from the farm to our supermarkets,” she said. 

Pomerantz’s father used juicing as a way to help harness more detoxifying powers from plants, and his raw vegan diet helped ensure he was eating a variety of fruits and vegetables. 

While Pomerantz feels his approach was monumental in his health journey, she said people can reap similar benefits by adding more fruits and vegetables into their diets, whether that’s by drinking tea, making smoothies, juicing or picking recipes that incorporate more vegetables than they would normally use in their meals.