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Decatur Daily (AL)


Feb. 12--Whether it's Paleo, vegetarian, vegan or Mediterranean, choosing a diet can be a challenge.

Defining the term "diet," changing behaviors and choosing a diet that is sustainable for each person are the keys to healthy living, experts say.

Dr. Micah Howard, a family practice physician at Decatur Morgan Hospital, teaches a three-month program called Decatur Morgan Medical Arts Group Wellness. Geared toward sustainable weight loss, the program teaches diet, nutrition, appropriate exercise and behavior modification.

One of the key things Howard teaches in his program is the word "diet" itself.

"Everyone has a diet. You can change it to change your energy, metabolism, the way you look," Howard said. "Instead of becoming (the) diets, we change the person's diet."

The Standard American Diet consists of processed carbohydrates -- cereal, bread, pasta, cookies and cakes -- and not enough fruits and vegetables, said Lorrie Dogan, clinical nutrition manager at Decatur Morgan Hospital.

Like Dogan, Howard agreed that the SAD diet is flawed and overrates the importance of grains, noting that many people have an intolerance to gluten.

"It contains things that your body doesn't need, like hydrogenated oils and trans fats," Dogan said, adding that the foods are packed with chemicals, preservatives and too much salt.

Howard and Dogan offered insight into other healthier diet choices.

Howard's goal for his program is a sustainable weight loss, and he uses the Aggregate Nutrient Density Index Score as a nutritional guide. This diet encourages eating the highest amount of the most highly-nutritious foods.

For instance, foods such as spinach and kale are at the top of the scale and caloric dense foods such as soda are at the bottom.

"They can eat a high volume of food, but not intake the calories," Howard said.

Volumetrics refers to foods that can be eaten in infinite amounts without weight gain, Howard said, adding that eating your weight in kale and spinach could be done without having a caloric problem.

"You can eat a lot of food until you have that full feeling," Howard said.

According to Howard, his program increases the amount of fruits and vegetables, decreases caloric dense foods such as meats and dairy, and eliminates sugar.

Much like the ANDI Score, Howard said the Mediterranean diet is a healthy choice. The Mediterranean diet and ANDI Score are similar in that they're high in nutrition and low in calories.

Dogan said the Mediterranean diet is one of her top recommendations for not only cardiovascular recovery patients, but for anyone who wants to make a lifestyle change.

"The Mediterranean food guide pyramid emphasizes fruits, veggies, whole grains beans and flavorful herbs and spices. Eating fish at least twice a week, and poultry, eggs, cheese and yogurt in moderation," Dogan said.

The diet also recommends limiting red meat to no more than a few times a month.

Dogan said the Mediterranean diet has been proven to be a good diet for decreasing a host of chronic diseases such as cardiovascular disease, diabetes and cancer. She said it also can promote weight loss, but like other diets, people should avoid overeating.

"It's more of a lifestyle. It's not a structured diet," Dogan said.

Diets that cut out entire food groups -- the Paleo diet and vegetarianism -- can be beneficial, but Dogan and Howard said there are also some drawbacks.

The Paleo diet includes meats, seafood, vegetables fruits and nuts. It is a grain-free and dairy-free diet that mimics the caveman diet.

"I was told once to do the Paleo diet because of gastrointestinal problems and food allergies," Dogan said. "It might work short-term to help you figure out what grains you're allergic to, but to cut out a whole food group isn't recommended."

Dogan said the Paleo diet might help gluten-intolerant patients get rid of the inflammation in their GI tract and could gradually add back grains to see what you're allergic to.

Howard said the Paleo diet is a good way to make a lifestyle change, but is hard to sustain.

"You're going to get more nutrition because you're eating foods of a higher quality (unprocessed foods)," Howard said.

Vegetarianism can work out to be healthy, Dogan said, adding that it's mostly a lifestyle choice for people because of religious or moral beliefs. One problem it can cause is eating too much junk food, she said.

Vegetarians are missing out on vitamin B-12 and creatine, Dogan said.

"Deficiencies can cause poor memory, fatigue, depression, damage to the brain and can mimic the symptoms of multiple sclerosis," Dogan said. "Taking vitamins can help you. The bottom line is deficiencies can cause adverse effects on brain function."

Before selecting a diet, Howard said behavioral modification is the first step to manage weight loss.

"What we have to do is change the behaviors that cause us to be obese," Howard said. "We have to educate people on having the motivation to eating the right foods and motivation toward exercise. What we normally do are the things that cause us the most pleasure and least amount of pain."

For instance, Howard said people tend to eat food that gives them a feeling of happiness for a moment and the behavior is repeated. Although that feeling of happiness might be present, Howard said it would be better filled with nutritious foods rather than caloric dense foods.

"Some people say, 'I hate exercise.' Most of the people have a reason because they hurt themselves or because exercise is too difficult," Howard said. "A modification would be to do something that's easy for them to do."

Howard suggested doing one push-up a day or walking a quarter of a mile for seven days.

Although weight loss is a personal goal, Howard said it has to incorporate the family and community to be sustainable.

"Most people have about a 21-day tolerance for doing something out of their comfort zone. A diet or behavioral change you can do for a long time will give you the most sustainable results," Howard said. "If you do something you hate, you're eventually not going to do it anymore. It's human nature."

If someone can do something every day for 21 days, it creates a habit whether it is positive or negative, Howard said.

Dogan said the diet for each individual depends on food allergies and other dietary restrictions.

"You always want to go back to a dietitian that might figure out what the best path is for you," Dogan said. "Everybody is different and has different needs. Not one eating plan or lifestyle change will fit everybody."

Regardless of the diet of choice, Dogan suggested some universal rules. The food on the plate should be colorful like a rainbow.

"Eating whole foods -- fresh fruits and vegetables that are local, meats that have been fed the old-fashioned way and not full of hormones and antibiotics are good standards," Dogan said.

Leah Cayson can be reached at 256-340-2445 or Follow on Twitter @DD_Leah.


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