Question 3
How do you
think further research could someday make a positive and/or negative impact on
the United State’s obesity issues? Do you think if research eventually found a way to utilize
intermittent fasting for safe, significant weight loss, the US population would
adhere to a fasting regimen to lose weight?
posted by Unknown @ 1:32 PM
14 comments
14 Comments:
I think research in all realms of the nutrition world is important in progressing forward. The thing that I think we always need to be careful with is reading too far in to single studies. Too often, we hear media take results from a single study and portray it as “the next miracle diet.” That is something that I would fear as being a potential for a diet regimen such as intermittent fasting. I think more meta analysis and review studies should be performed on the current research to make stronger conclusions. Such studies would also be helpful in finding gaps in the current research to help guide us towards new studies to be performed. In fewer words, YES, I do think that research would make a positive difference on the United State’s obesity issues! Clearly there are a number of other factors that influence obesity (genetics, environment, etc), but diet regimen studies are certainly a step forward.
As far as the second question, I do think that if studies found a safe way to use intermittent fasting with results of significant weight loss it would certainly peak the public’s interest. However, I still have my worries about people adhering when they are feeling deprived and restricted. It would take more convincing to get me to readily recommend all my clients go on such a diet.
Current scientific research is certainly guiding the public in their dietary decisions, and it is our job as health professionals to provide credible information and to provide science-based suggestions when individuals are turning to the media and other non-credible sources when searching for dietary advice. Research is certainly a POSITIVE step in the right direction, and something that is always changing - as we have seen with the transformation of dietary recommendations over time.
As stated in the first question, this diet is likely not for everyone. The thought of significantly restricting my intake for a few days every week certainly seems intimidating, but something that I would love to trial or monitor for results/success. Research is already suggesting that Intermittent Fasting is a safe and effective way to achieve significant weight loss, but I think that the biggest question relates to whether the diet and weight loss can be maintained over the long term. THIS is an area where current research on Intermittent Fasting is lacking.
I think that further research on this topic could be of great benefit for helping us to solve the puzzle that is the prevalence of obesity in our great country; however, research is one thing and getting people to actually stay compliant in the long term on an energy restricted diet of any type is entirely different war. In my mind, we need to find ways to convince the general public that eating better and moving more is just plain good for you. Many people seem to jump on the "flavor of the month" diet bandwagon, but really don't do much of anything to change their actual lifestyle in the long term. If we could find a way to make an ADF diet appealing to the general masses, sure I think many people would attempt it for awhile, but even in the case of a 25% feeding day as researched by Varaday and associates, would they maintain this in the long term?
I think research would need to be conducted for transitioning off of an ADF diet back onto a more "normal" generally healthy diet (think the MyPlate Model) once a goal weight is reached, as I highly doubt that anyone is interested in fasting every other day for the rest of their life (what if your birthday or special events keep popping up on your fasting day?!?!?). If we could master such a transition, RDs could recommend an ADF for x amount of time and then use that time to teach the participants about general healthy eating for once they reach their goal weight. Hopefully many would be able to keep the weight off after transitioning off of an ADF and onto a generally healthier diet that emphasizes portion control, plate balance and nutrient dense foods.
Amanda, I agree that it's always prudent to not get carried away with the results of a single study. Single studies are great for planting a seed, but many research studies with different analysis procedures, study participants etc. are needed to make stronger conclusions. Even when we have multiple studies showing one thing, there still may be another that has dissimilar or opposite results, which makes it even more difficult to give advice to patients. I like your point about systematic reviews and meta-analyses, as these are resources that I use quite frequently in practice. For instance, I gave a presentation on the mediterranean diet a few weeks back and I used meta-analysis data from Sofi and associates (for instance, http://ajcn.nutrition.org/content/92/5/1189.full). These studies are great for compiling the evidence for a more definitive answer. I like to use Cochrane Reviews on occasion too.
Research is the basis of pretty much everything that we do as dietitians so it's of the utmost importance for us to do our best to stay current with literature. This includes single studies and also meta-analyses, so we know what's out there to give our clients the most current information available. I think it's also important to point out that we can have all the research in the world, but having research available and getting people to actually make lifestyle changes are quite different things. It's not like we just learned that fruits and vegetables are great for health yesterday...but how many people actually consume the recommended amounts? I guess what I'm saying is that having a bazillion research studies is awesome, but it's then our job to translate that research into practical suggestions for our clients.
In regards to the second question, if we had 18 RCT studies that had extremely promising results for alternate day fasting, some people would probably be interested in it, but I still don't know if it would catch fire (unless it was advertised on Dr. Oz of course...). I have a tough enough time convincing some of the clients I work with to stop drinking four cans of soda per day, so I can only imagine the struggle I would have recommending that they skip meals every other day--even if the research was overwhelmingly positive. I really think that our first step with clients is just to focus on the basics of portion control and plate balance. If you can nail these strategies down with a client, then you could maybe go into the alternative diet strategies such as intermittent fasting at a later session if the client is interested.
Also, Jenn, I agree that whether or not this diet is sustainable in the long-term is a question that definitely warrants considerably more research. It'll be interesting to see where this research ends up. I've thought about trying an alternate day fasting diet for a year or so now, but I guess I just haven't committed to it. I already know it wouldn't be sustainable for me in the long term, but it'd be something that would be interesting to try. If any of you try it, let me know!
More research is definitely needed to determine the effectiveness of intermittent fasting for weight loss and how it can be managed safely. I would be hesitant to recommend an intermittent fasting diet to a client because of the lack of research, the feasibility of maintaining the diet, and the way the diet portrays food. I think the intermittent fasting diet portrays food negatively and I would be concerned that clients would take fasting to an unhealthy level. I also think the intermittent fasting diet is not realistic for certain populations i.e. athletes.
I would recommend more research in diets that are based off the MyPlate and a balanced diet because I believe those types of diets will benefit the general population more. I agree with Arthur that it would be tough to get most Americans to give up food for the fasting days. Food is very important to most Americans and is the center of most social gatherings i.e birthday dinners, family bbqs, etc. In a different culture the intermittent fasting diet might be more realistic, however I think Americans are too consumed with food. Therefore, a diet practicing moderation might be more realistic for the general population to focus on.
I also agree with Amanda that the average American sees one research article and runs with it. I think research articles provide us with great resources, however they can also be our worse enemy. What I mean by that is many clients read one research article surface level and decide to live by what that one research article says. Then, it becomes our job to explain the research article in more depth and to expose the "holes" in the research. In my experience with counseling we spend most of the time debunking myths about diet research rather than getting down to the facts. I believe it would be beneficial to educate clients on how to properly read a research article and how to decide when information is valuable or when the information presented is not backed enough by other research. A basic guide I would recommend for the general population to use in order to determine if research is valued is 1) Make sure the author is credible 2) Make sure the research is current 3) Make sure the study is done on humans (animal studies are a good first step, but for the general population I would recommend focusing on only human populations) 3) Find at least 3 studies that show positive results for the diet in order to avoid being swayed by one single article.
Obviously those are 3 very basic steps, but I think if the general population followed at least those steps less research results would be skewed in the media. I also think those 3 steps alone are a lot of work and therefore maybe people would decide to stop thinking they are all dietitians and listen to the people who actually study nutrition :)
Amanda, that is certainly true about how many people are desperate to jump on any fad diet that their friend said helped them lose two pounds! And I agree that people's compliance to the diet would be a major concern for weight loss success to be seen.
Arthur, I think the same way; that eating a well-balanced diet is the key to maintaining a healthy weight and healthy life. However, this is much easier said than done in most cases. As you all brought up, life can easily get in the way of healthy living ie birthdays, holidays, family/friend gatherings. So the intermittent fasting diet could be extremely hard to comply with long term.
Carly, that is a great point that I had not specifically thought of that it is not feasible for many people, such as athletes. Several other categories of people would also fit be unrealistic, such as diabetics, young/growing children, and sick/elderly adults.
It seems to be very much agreed on that more research is always beneficial in our field. I am curious to see what direction research will take next with intermittent fasting diets. Perhaps someday it will be a major fad diet trend that gets enough attention to excel progress on the research.
I think that future research outlining how to successfully implement an intermittent fasting diet plan could be beneficial. Ideally this research would determine realistic practice applications that would help practitioners enable their client’s to feel empowered, take responsibility for their health and food choices, and feel an inspired sense of control over their dietary decisions (rather than feeling restricted, deprived, and ravenous).
If safe and effective Intermittent Fasting techniques were established I definitely think the U.S. population would be open to trying it out. (Heck I think they would try it even if it wasn't deemed safe or effective. People are willing to try ANYTHING, ex: the cotton ball diet...). I think Americans are always seeking the next big trend, especially when it comes to “LOSING WEIGHT NOW!!!”and “LOSING WEIGHT FAST!!!!!”. (Or the flavor of the month diet, as Arthur put it). Of course as a science based field, we know that losing weight fast and now is typically unsafe and unsustainable. So I think it is our job to use the flavor of the month interest to reel them in to lifestyle changes that are more scientifically sound, like balance based on MyPlate, as Carly offered.
Unfortunately, I don’t foresee any significant improvements in the nation’s battle with obesity until there is a societal shift in the current food environment and a significant reconciliation of our collective approach to dietary behaviors and health. BUT, I think that if packaging improved dietary behaviors as the trendy new thing: Intermittent Fasting is going to help individuals make that shift towards caloric balance, implement dietary moderation, and have more confidence while navigating the food environment, then I would be willing to partially hop on to the Intermittent Fasting bandwagon. At the end of the day, I think promoting healthful dietary behaviors is most important, and if appealing to the general public’s interest in the “hottest dietary craze” is a way to get scientific based recommendations out there, then I am all for it.
Further research can have positive effects in educating health care professionals such as RDs to make recommendations for weight loss if a fasting regimen can help promote weight loss. Finding an effective way to promote weight loss would be beneficial for the obesity issue that plagues America. However, i can imagine the difficulty in adhering to a fasting regimen for prolonged periods of time, especially when our environment constantly stimulates us with food. It may be a method to promote weight loss although it may not be a long term solution. Steps to finding more conclusive evidence for this diet is helpful for the obesity epidemic, nonetheless. It may become the next fad diet, but it can also be useful to some individuals needing to lose weight for their health. I do worry that the idea of fasting may get out of hand and people will fast completely rather than intermittent fasting, which then becomes risky starvation.
Losing weight is not as challenging as keeping the weight off. The key is teaching people how to eat after they lose the weight. Looking long term, I agree with what many people said in the previous two questions; fasting eating patterns could be a challenge to maintain. Teaching generally healthy eating patterns seems like a more realistic approach. I would like to see more research on the psychological aspects of weight management. It is almost like we need to reprogram the way we approach food to foster healthier habits. Fasting can be a tool to lose weight, but I don’t see it being the solution to our obesity problem.
I very much agree with Desiray's mention of the food environment. The food environment is definitely a big player in American food choices. I really like the idea of taking advantage of behavioral economics and the cue-habit-reward loop. It is far to easy to just grab something unhealthy that is convenient than to make the effort to find a healthier option to eat. If the environment is altered to make the healthy choice the easy choice (behavioral economics). It is hard to eat healthy for a lot of people. Most people don't want or don't care to put that much thought into perfectly planning and then hunting down their food in a tempting, junk laden environment. Let's be honest people have a lot of other things going on in their life. By using behavioral economics and making the healthy choice an automatic habit, requiring no conscious thought, versus a time and effort consuming thought process, the obesity issue may not be solved in entireity, but at least we would be a little better set up for success.
I would agree with Amanda and say that more research in obesity treatment should be welcomed. It is crucial to have research conducted regularly in the nutrition field in order for advancement in processes. I believe it is important to have different organizations researching similar weight loss procedures to have confidence in a certain method.
I'm not sure that intermittent fasting would be successful in the US. Many diets become very popular in the media so possibly it could become a "trendy" new diet. I agree with Carly that this diet is not appropriate for all individuals, especially children, and in order for it to be effective people need to be educated on the proper technique. I do not believe individuals would be able to adhere as well without the education piece.
As many others have expressed, I also feel that further research within the area of weight loss will absolutely have a more positive impact upon the issues of obesity in this country. Obtaining a more clear understanding of weight loss and the surrounding mechanisms will certainly help for us as health care professionals to make more confident decisions.
I think that Arthur brings up an excellent point in regards to the second question. We can have numerous positive results from research pointing towards intermittent fasting as the way to go but it still does not improve the overall efficacy of the diet. The diet is still very challenging to follow and I do not foresee it trending in the future. It is simply not an easy enough "quick-fix" for people to jump on the bandwagon in my eyes.
I do see benefits of this diet and I agree with John that there needs to be further research. Like Sophie mentioned, this diet is not for everyone, so it is important to keep that in mind. I think that an intermittent fasting diet may be appealing to people and seem less overwhelming than some other diets like the DASH diet, but I also think it would be a difficult diet to follow for a long period of time. It could be more of a quick fix than a lifestyle change. I think people who are highly motivated to make changes could really succeed at this type of diet, as long as they don't over eat on their ad libitum days. It will be interesting to see the research on intermittent fasting diets in the years to come.
Amanda mentions an important point: we have to be careful with research and how the media may exaggerate the results of one study to portray a miracle diet. It can easily lead to a possibly helpful weight loss method to unhealthy eating patterns. I agree with Gina that people need to learn healthy eating habits in order to help the obesity epidemic. Simply following an intermittent fasting diet to lose weight does not equate to keeping the weight off, especially when an intermittent diet may not be easy to adhere to for many people. However, further research is always beneficial and can help improve our understanding of the body and how it reacts to the food we eat and how frequently we eat, even if it isn't a miracle diet.
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