“Diet” is one of those words where two people can say it and mean totally different things. And in a medical nutrition context, those differences are important. So what do we mean when we talk about diet vs. dieting? And how can we move from restricting how we eat to being more mindful of our habits? Because when it comes to food, what’s on our mind and what we put in our mouths matter.
On this episode of Mayo Clinic on Nutrition, we talk with Dr. Donald Hensrud about diet, dieting, and the topic that has launched a thousand Google searches: how should I eat?
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Read the transcript:
Diet vs. Dieting v1
Tara Schmidt: You are the only person who has ever told me you’ve gone on a salad journey with their spouse before.
Tara Schmidt: This is On Nutrition, a podcast from Mayo Clinic where we dig into the latest nutrition trends and research to help you understand what’s health, and what’s hype.
I’m Tara Schmidt, a registered dietician with Mayo Clinic in Rochester, Minnesota.
In this episode, we’re talking about diets. Or dieting. Or just plain diet. Because “diet” is one of those words where two people can say it and mean totally different things. And in a medical nutrition context, those differences are important. I love talking to people about their diet. But about dieting… well it can really depend.
So what do we mean when we talk about diet vs. dieting? And how can we move from restricting how we eat, to being more conscious and mindful of our habits? Because when it comes to food, what’s on our mind–and what we put in our mouths–matters.
To talk about diet, I’m joined by Dr. Donald Hensrud. He’s a general internal physician at Mayo Clinic in Rochester, Minnesota, and advises patients on nutrition, lifestyle medicine, and nutrition-based disease prevention.
Dr. Hensrud–welcome and thanks for joining me!
Tara Schmidt: Thanks for joining me today, Dr. Hensrud, I appreciate it.
Dr. Donald Hensrud: Happy to be here.
Tara Schmidt: Alright, we have a big topic, but it’s only four letters. Diet. So, what comes to mind for you when a patient brings up the word “diet”?
Dr. Donald Hensrud: Well, I think it’s important as we all do to go with the flow and some people may have a very different meaning of the word diet than other people. For some people, it just may mean what they’re eating, and they may want to know more about how to eat healthier. Other people may be on a very specific and sometimes overly restrictive program to lose weight.
That also fits under diet. And then diet can also be just healthy living habits, as part of a healthy living program, either for health or commonly for weight loss, which many people are pursuing.
Tara Schmidt: Yeah, let’s go into those three. I think that each patient or person that we see or member would use a different definition. Like you said, are you dieting or on a diet? That is what I would think of when we talk about oriented towards weight loss. I’m restricting likely calories or something that ends up in a calorie restriction. I’m going to say likely temporary, especially if it’s too strict.
But diet is also, sometimes I just say it’s what you stick in your mouth, right? All living things have a diet. All of our patients in the hospital are assigned a diet that may be a general diet or a diabetic diet or a bariatric diet.
And that just tells the kitchen essentially what kind of food is best for them or safest for them. I’ve had a few patients worry when I’ve written the word diet even in their chart that I was going to put them on some kind of regimen. And I was like, I was just writing down how you eat. I’m going to make some suggestions.
Have you ever had that before where people get nervous when you bring up diet?
Dr. Donald Hensrud: Absolutely. And again, we’re all a little bit different. We all eat and we all have our own ideas and views about what a diet consists of.
There are healthy diets and there are quite unhealthy diets. And it’s amazing how many different programs are out there related to that.
Tara Schmidt: It’s a billion-dollar industry, I believe. Multi. I’m sure.
So we’ve got diet as just generally the food you eat. What you stick in your mouth. No judgment attached.
Then we have diet as long-term eating habits–things we may want to change or make healthier.
And finally, the dreaded “diet” in scare quotes. Usually designed to be temporary and oriented towards weight loss. So…
How do you navigate when someone shares a likely fad diet with you or a very strict diet with you, and they say, well, this is what my cousin’s dog walker told me, that’s what works for them, or this is a commercial that I saw, or this is how our ancestors ate. How do you navigate that space?
Dr. Donald Hensrud: Nutrition is a personal issue, so I don’t get judgmental. I try and help people and explain what my understanding of the medical studies shows.
I also take into consideration practicality and enjoyment. With eating, everybody has to have some fun at times. No one has perfect dietary habits. I haven’t met anyone with perfect dietary habits, nor do I want to. We all deviate just a little bit now and then. Some are better than others, but I try and work with people. Learn what their values are in regard to diet, nutrition, what their goals are and point out things that are objective that they may want to consider. Ultimately, we’re all going to eat what we want to eat. Anyway, so I try and educate people as best I can on objective information and ultimately they’ll determine what they want to do.
Tara Schmidt: What we commonly see is, when people quote, go on a diet, it means something very strict, usually temporary. And the thought process is if I can just endure this for a while and get down to my ideal body weight, then I’ll be able to maintain that. The studies do not support that. In fact, many people look at weight loss as two different phases, the weight loss phase, and then keeping that weight
Dr. Donald Hensrud: If people think about it, it should be just one phase. The same things that will help you to lose weight will also help you to keep it off. I wouldn’t use the dieter mentality, that you’re either on a diet or off a diet, but rather look at it as healthy lifestyle dietary changes.
Along with that, people shouldn’t expect perfection. If you expect perfection, that’s not going to work because people sometimes say, well, I’m never going to eat chocolate again. And two weeks later, the one-pound bag of M&M’s comes out and away they go.
Tara Schmidt: It sounds miserable also, right? Who wants to live a life like that?
Dr. Donald Hensrud: Exactly. There’s a lot of great foods out there. If people look at it as an opportunity, many people say when I was eating better, I felt better when I weighed less. People can use that and have some enjoyment regarding the way that they’re eating and the diet that they choose, so to speak.
Tara Schmidt: I like that you just referenced weight loss and weight loss maintenance as one phase because I know that in studies and anecdotally, of course, how many people have we seen go on said diet, they are successful with weight loss. We know that any diet can be successful in promoting weight loss if it’s calorie-restricted. But then whatever they are choosing to restrict, likely inappropriately in some cases, they’re going to stop it because they’re miserable or they’re hungry and they’re going to go back to typical habits. And now you end up often back at your initial weight, if not a few pounds higher.
Dr. Donald Hensrud: And we’ve seen this over and over and over. A usual mentality is people start out and they have a goal weight. But it’s been shown in the medical literature that people often have unrealistic goal weights.
They want to weigh something they haven’t weighed since high school, or they want to lose 50, 60, or 80 pounds. A goal weight is an outcome. It doesn’t tell you how to get there. So people have this goal weight. They go on an overly restrictive diet or an unrealistic long-term diet. And most people will, as you pointed out, they’ll lose weight for a while. Everybody plateaus. Nobody continues to lose weight. The problem is they usually plateau before they reach their goal weight and they get frustrated.
Another thing about human nature is I’ve seen, and you have too many different types of people. Some pounds to lose, some 80. But People in general look at the weight they still have to lose, no matter what amount it is, and they don’t celebrate their success.
Tara Schmidt: Non-scale victories. As we call them at the Mayo Clinic Diet, right?
Dr. Donald Hensrud: So people go on an overly restrictive diet. They may be successful. They don’t celebrate that. They get frustrated. And as you pointed out, they throw in the towel, they gain all the weight back again, and more in many cases.
Tara Schmidt: What if we have someone who has a large amount of weight to lose, medically speaking, that would benefit them, and they don’t lose over 15 percent of their total body weight. Yet, their eating habits are better, they’re exercising more, they’re easily able to walk up the stairs, their cholesterol is better, their blood sugar is better.
If we just, quote, judge that person based on their weight loss success, they wouldn’t necessarily look successful. However, in my book and in your book, they have done something incredibly amazing. Then we would say, keep on going, and maybe we’ll see where the scale goes. It’s not the only factor.
Dr. Donald Hensrud: This sounds funny too, but sometimes I’ll say to people if you are eating better, more healthfully, if you’re more active, your health is going to improve even if you don’t lose a pound.
In business or financial terms, having an unrealistic goal weight I want to make a million dollars, but not have a good financial plan on how to do it. It just isn’t going to happen.
Tara Schmidt: Sometimes I have no idea where people come up with their goal weights. Sometimes I’ll say, Where did you come up with that number? And they say, I don’t know. I saw it on the internet. Or, this is what I weighed in high school. And I would love to weigh what I weighed in high school, but things are different. I have two kids, and I’m not in three sports anymore. I have a full-time job and a family.
Also, why do I need to be at my high school weight? Is that going to change my health in any way? Am I going to be happier? I don’t know, I’ll probably be miserable because I can’t eat very much.
Dr. Donald Hensrud: Another important point about this is BMI. It works good in populations, but does not necessarily work as well in individuals. There are some people who have a large frame size or a larger amount of lean tissue muscle mass compared to the average person. I’ve met many patients who, if they tried to weigh what a BMI chart would say they would weigh, they’d look like were starving.
Tara Schmidt: And the opposite of that. I don’t know if you ever use the diagnosis normal weight obesity. So someone who actually has a Normal on the BMI chart weight to height ratio. That’s all it is. But they’re metabolically not very healthy. Maybe their cholesterol is up. Maybe they have pre-diabetes Their waist circumference is larger than it should be. That person doesn’t necessarily get to celebrate their high school or their fabulous looking weight because inside they’re not necessarily any better off than maybe even someone who has excess weight on a chart internally is doing fabulous.
Dr. Donald Hensrud: And that can express itself in health effects. Somebody who doesn’t weigh a lot but has a higher percentage of body fat and a lower percentage of lean tissue may still have, if they have a genetic predisposition, diabetes or high cholesterol or something like that.
It can also affect people functionally. People who don’t weigh a lot but don’t have a lot of lean tissue and are normal weight obesity. As people age, we lose a little bit of muscle mass each year and that can affect us in terms of function risk of falling as we get older.
So, weight isn’t the be-all end-all. It’s one factor and we need to look at the big picture.
Dr. Donald Hensrud: We talked about all the things diet can mean, but let’s redefine diet. Your diet is what you eat. It can be healthy, or it can be unhealthy.
If you want to make a dietary change, think about your goals. Remember, it’s not all about weight loss. While weight and health are linked, you can still be healthy at a higher weight, or unhealthy at a lower weight. And sometimes over-focusing on weight can make us miss the big picture.
And one of those things you can miss is celebrating your victories! You can and should celebrate any amount of weight lost. You can also celebrate the benefits of eating healthier that aren’t related to weight, like being able to do more activities with less difficulty.
Okay, so now that we’ve recalibrated our mindset towards diet, let’s talk about the risks and rewards of making changes to our diets.
Tara Schmidt: Before you mentioned that there can be negatives to going on an overly restrictive or inappropriate diet. Where do the dangers lie in dieting?
Dr. Donald Hensrud: I think we can divide these up into physiologic or health effects, and then there are also psychological effects, especially tied in with weight management. From a physiologic basis, some of the diets out there are not going to improve health despite what people believe or what people promote. There is a risk in some diets of adverse health consequences.
The more extreme or more different a dietary pattern is from those healthy dietary recommendations in general, probably the more risks.
There’s a lot of interest now in intermittent fasting where people just eat for six or eight hours a day for part of the day. There are short-term studies and some basic science studies that are supportive of that. However, we don’t have real good long-term studies yet. So some people, instead of doing intermittent fasting six or eight hours a day, cut down to one meal a day. However, one of the risks of going down to one meal a day is the body goes into starvation mode, and the metabolic rate can decline, which actually makes it more difficult to lose weight because you’re burning less calories.
Even some healthy dietary patterns may have some risks associated. A vegan diet doesn’t include any animal products whatsoever. We do need some vitamin B12 in our diet, and that only comes from animal products. People who follow a vegan diet for years and years and years may develop vitamin B12 deficiency. And it literally takes years or even decades to develop. So there are some risks associated with that.
Psychologically, people don’t appreciate that as much as it really is out there. I often see this in women who are trying to lose weight. They beat themselves up. 73 percent of the population is either overweight or obese. And what that tells me is that there are powerful forces out there that are influencing our weight. It’s challenging. People look at this as a matter of willpower and things like that.
It’s not willpower. It’s that there are forces out there and we’ve got to do what we can to try and positively influence those things. But there should be no place for guilt, or again, if people are on an overly restrictive diet and they go off of it, then they feel guilty and the whole cycle starts all over again.
Tara Schmidt: Another risk that I do want to bring up is the risk of eating disorders or disordered eating. Because the number one risk for developing an eating disorder is technically dieting. It’s not a psychological diagnosis in your past, it’s not a family history, it’s dieting, even if that diet was well-intentioned and beneficial, and maybe even prescribed to you.
Being told or intentionally dieting is the number one risk factor for having an eating disorder. That scares me!
Dr. Donald Hensrud: Yeah, and I think the figure that I’ve seen is that 20 percent of people over time who go on overly restrictive diets can develop at least some form of an eating disorder. There’s some debate whether they’re predisposed to some extent to it or if its actually causal, but it certainly can bring that tendency out.
It’s not a good way to live to feel like you’re walking uphill the whole time and not enjoying things and following something that’s overly restrictive.
Tara Schmidt: Especially in our patients who have obesity, we also risk not identifying an eating disorder in them sometimes because they have excess weight. It’s not as clear cut as a 13-year-old teenage girl who looks like they have malnutrition. We also risk missing malnutrition in our patients with obesity, and that’s difficult to know that and recognize that and combat that, I think, in our field.
Dr. Donald Hensrud: Absolutely.
Tara Schmidt: I had a patient once tell me that they had lost 1,000 pounds and I said, can you clarify that for me please? I’m worried about you. But they really had had this incredible lifelong journey of their weight going up and down and they said one time I gained 75 and then I lost 50 and then I regained 100 and then I lost 110.
It was this cycle of gaining and losing and gaining and losing and that number, it honestly did add up to a thousand. And I said, that must have been really physically and mentally exhausting for you. And she was in my office, so clearly the journey hadn’t ended yet.
Dr. Donald Hensrud: Yeah. Yep.
Tara Schmidt: What I was referencing is essentially weight cycling. I go up, I go down, I go up, I go down. Does losing the weight count as the benefit if you regain it? Or does this hilly or mountainous pattern actually cause harm?
Dr. Donald Hensrud: The literature over the years hasn’t been entirely clear on that. There’s some studies that show that as you lose the weight, certain health parameters will improve, as you gain the weight, then you go back to baseline.
There’s a little bit of evidence that if you do lose it, you may have a little bit of a sustained depression and metabolic rate, although it’s not as much as what people think, in extreme circumstances. That may make it harder to lose the weight again.
Having said all that, having lost weight before and regained it is not a reason to not try again. In some ways, it’s like quitting smoking. People try many times before they’re successful. In a group of patients who’ve lost weight and maintained it for a long time, the National Weight Control Registry of what happened with people there, many people tried it many times, but all of a sudden there was a trigger, a triggering event that happened where a light bulb went on and they made sustained health habits and were able to keep their weight off long term.
Tara Schmidt: Let’s talk about the other side of dieting–the rewards. We know certain types of diets can have real health benefits, and sometimes doctors will prescribe dietary interventions for patients. What would be other health conditions or health diagnoses that you would ask a patient to go on a specific type of medically endorsed diet?
Dr. Donald Hensrud: There are a lot of them as you know. High blood pressure. In fact, losing weight and eating a healthy plant-based diet are the two most effective things to lower blood pressure.
Cholesterol and triglycerides. People can improve their lipids through dietary changes. Diabetes. Of the controllable risk factors, weight is the strongest risk factor for diabetes. The list goes on and on and even things such as celiac disease.
Another thing that often, I find this is underdiagnosed or food intolerances. And that’s more a dietary change but that can be in a healthy manner too. Many people have chronic GI symptoms. Lactose intolerance is probably the most common food intolerance. That would be another reason to make some dietary changes, is if someone suspects they have a food intolerance.
Tara Schmidt: You listed many diagnoses and I heard one time that there are a hundred different metabolic changes that can happen if someone has excess weight and loses weight intentionally. Is that the first thing you challenge your patients with when appropriate? When do you maybe prescribe a medication or challenge them with lifestyle? Do you do both at the same time?
Dr. Donald Hensrud: In general, I’ll start out with lifestyle recommendations and many guidelines to take into consideration. For blood pressure, before I prescribe a blood pressure medication, I want to see what bang they can get for their buck when they do lifestyle changes. I remember one specific patient who’s physician appropriately wanted to put them on a statin for their Lipids, a blood pressure medication and a medication for their elevated glucose, which was in the diabetic range. He came back 3 months later. He tried lifestyle. And his numbers were fantastic. Sometimes that can happen.
Also, to look at it a different way, everyone can benefit from healthy dietary changes, no matter who you are. And this is something that is interesting. Success in prevention is when something doesn’t happen.
Tara Schmidt: That’s not very exciting, though.
Dr. Donald Hensrud: No, you’re right. You’re right. We know from studies that making these changes in diet and other lifestyle habits can influence health, but you don’t see the heart attack that you prevent it, but we know that that doesn’t happen. There are many other examples of that. Making these changes can be extremely important to health and people with conditions or just prevention of general health conditions.
Tara Schmidt: So quote-unquote dieting can be a very personal journey–but also a very fraught one. Because short-term, highly restrictive eating practices just aren’t very effective for most people. If people do manage to lose weight on a short-term diet, they often gain it back, or even gain more weight.
And psychologically, diets can do real damage. They can create a cycle of guilt, but dieting is also the number one risk factor for developing an eating disorder.
That’s why we encourage people to adopt a more long-term idea of “diet”–where we make healthful changes for stable weight loss or weight maintenance–or not even focusing on weight at all.
Because a healthy diet isn’t just for people who want to lose weight. It can improve your overall well-being, and even help treat conditions like cardiovascular disease. And remember, sometimes success is all the stuff that didn’t happen–all the medical issues we prevent.
So let’s talk about how to start eating healthier and make it stick.
Tara Schmidt: We talked about people having an a-ha moment or some trigger that sparked a change in their eating. If you had someone who had done a lifetime of dieting. They wanted to go from overly restrictive, lots of rules, I’m a dieter to— I’m hoping to make a lifestyle change where I don’t have that mentality. How would you help someone kind of graduate towards that lifestyle change?
Dr. Donald Hensrud: The first thing I tell them is be kind to yourself. This is something where you don’t beat yourself up. Nobody’s perfect. So let’s go into this with an open mind.
I like to tell people if you’re going to make a change, it needs to be practical, realistic, and enjoyable enough to be sustainable over time. If it doesn’t fit those criteria, that’s going to make it more difficult to make these changes.
Focus on the positive. Especially when people first start out, attitude makes all the difference in the world. We both have seen people come in and they say, Oh, I gotta go on a diet. You know, life is over, but they’re approaching it in a negative way and it’s going to be a negative experience.
Then, I tell people, if you’re going to make changes in the way you eat, there’s certain things you should identify and address. Practicality is one. Taste is another. Getting enough to eat and feeling satisfied is another. Low in calories and healthy.
Like at our house, we keep foods around that fit those criteria so we can make something that’s healthy, fills us up, tastes good et cetera, et cetera very quickly on one of those nights where we don’t have a lot of time. A Greek salad, that’s one of our go-to’s. I’ve got a huge salad bowl. We may have some salmon or smoked salmon, a whole grain baguette. I can make it quickly. It tastes good. Fills me up. And it’s healthy. So it fits those criteria.
Approaching things in a positive, pragmatic way can really help people get off on the right foot and stay on the right foot when they’re doing this.
Tara Schmidt: And what you’ve been talking about a lot, Dr. Hensrud, is your environment. How can we adapt our environment? I can’t necessarily change how many fast food restaurants are in this town or that I have goldfish in the cupboard because I have toddlers who happen to enjoy goldfish, but I can change where the fruit is and how accessible the fruit is, right?
If I come home from work and there are chips and salsa in the cupboard, great. Let’s go to town. However, if there are not chips and salsa in the cupboard and there are healthier things like grabbing a handful of nuts, that’s great, too.
We don’t have to clear out our pantries, but what you have in your environment, and how accessible or inaccessible it is, I think can make a big difference.
So, A lot of dieting revolves around weight management. But a lot of people, even those who might not be looking to lose weight, just want to have a healthy diet. What does a healthy diet look like?
Dr. Donald Hensrud: There’s a lot of confusion regarding diet and nutrition, but I think if we look at the overall medical studies that have been done, there is a dietary pattern that is considered to be healthy.
Then, you know, there are some differences, but overall a dietary pattern that has less processed food. And now we have the term ultra-processed food. Ultra-processed food is something that is created and it usually has an ingredient list that has 200 words in it, and there isn’t much food left. Ultra-processed food has been tied into not only increased weight, but adverse health outcomes, different conditions, dyslipidemia, heart disease, etc. So I think that a good place to start is to eat minimally processed foods and eat foods in their natural state or prepared as close to their natural state as possible.
Then within that, I think that there’s evidence that a plant-based diet is very healthy. Generous amounts of fresh or frozen fruits and vegetables, whole grain carbohydrates.
Lean sources of protein and dairy, beans, nuts, and heart-healthy fats such as olive oil. That is a good place to start and try and prepare foods with those as the main ingredients. But again, nobody’s perfect and everybody has a treat now and then. It’s just a matter of keeping that as a treat now and then and not having it become a regular part of the diet.
Tara Schmidt: And what I like to tell some people that are worried, okay, should I be on DASH? Should I be a Mediterranean? What about the MIND diet? I actually say, let’s take a step back and look at the key components of those. And they’re all kind of the same, right? So DASH might have a little bit more dairy because that was studying calcium and its effect on blood pressure.
Mediterranean is going to have a bit more fish. MIND is a combination of both of them, but they’re all plant-forward. High intake of fruits and vegetables, whole grains, beans, legumes, and unsaturated fats. And the fact that they’re all the same. And these are the ones that of course, we kind of celebrate in medical literature for their health benefits is good, right?
It’s not a bad thing. It actually proves our point that it doesn’t have to be overly specific. It’s what you prefer. If you don’t like fish, all right, we can find you other sources of those healthy fats. If you’re allergic to peanuts, don’t eat the peanuts, right? We can tailor those. But what are the overarching themes, right? I think that those repeat themselves in many, if not all of these, what we would consider healthful diets.
Dr. Donald Hensrud: Another way of looking at this is that if you look around the world at traditional diets, not necessarily what people are eating now, but the traditional Mediterranean diet. That’s a relatively healthy, higher-fat diet, but the fat comes mainly from olive oil, which has a lot of health benefits.
If you look at the other side of the world, there’s a traditional Asian diet. That’s a lower fat diet, more carbohydrates, things like rice, and depending on the type of carbohydrate eaten that can also be a healthy pattern of eating. Whole grain carbohydrates. So those are two examples of a higher carbohydrate low-fat diet or a lower carbohydrate higher fat diet.
But what’s important is to include healthy carbs. And healthy fats. You don’t have to go to real extremes, but just include the healthy and that makes it a little bit easier. Sometimes I see people who get even a little too carried away with details and lose sight of the big picture. People will say, well, I’ve heard blueberries are the best source of antioxidants.
So how many blueberries should I eat? Give me a break. Just eat berries.
Tara Schmidt: Throw an apple in there. That’s fine. Nothing’s wrong with that.
Dr. Donald Hensrud: That’s right. Yeah. There are nuances in regard to nutrition, but we still need to keep the big picture in mind and keep it practical and enjoyable. I can’t emphasize that enough.
Tara Schmidt: I would say an aspect of that is variety. Like the fruit, blueberries are great, of course they are, but you don’t have to just eat blueberries. Apples have their own benefits, even white vegetables and fruits have benefits. I know no one believes that, but the more variety you have in your diet, especially of things like produce, the more vitamins and minerals that are different from one another. If you only eat orange fruits and vegetables, you’re going to miss out on the things that blue fruits and vegetables give us.
Dr. Donald Hensrud: Excellent point. I get a question a lot. You probably do too. What’s the healthiest nut?
Tara Schmidt: Yes, I do.
Dr. Donald Hensrud: Each nut has a different nutrient profile, as you just mentioned. Almonds are high in calcium. Walnuts have a little bit of alpha-linolenic acid, which is converted into an omega-3 fatty acid.
If people eat a variety of nuts, they’ll get the widest variety of nutrients. It doesn’t have to be very specific and detailed. It can be a lot of fun to keep the big picture in mind when doing things like that.
Tara Schmidt: So, I’m intentionally eating more fruit, I’m going to add nuts to my diet, I’m going to cook with olive oil most often. How quickly do you think we can see some benefits? Maybe not physically, but internally. What expectations should we have around making that change?
Dr. Donald Hensrud: There are many different answers to that. One answer is the degree of change when somebody wants to lower their LDL or bad cholesterol. There’s genetics in the background, but often it’s how much they change their diet that will translate into how much their LDL cholesterol changes. In general, the greater the degree of change, the greater the benefits or changes in health that will occur.
Then, another question is how long does it take to develop a habit?
If you look in the literature on that, there’s a whole bunch of different answers. Three months is something that’s in the literature, that’s been around for a while. A colleague of mine thinks it takes a year or two for those things to become solidified in the way we do things.
I think what’s important is that people don’t underestimate their ability to change and keep their options open as they make changes. Many people can think of foods that they didn’t like years ago and now they like, and vice versa. Sometimes we don’t appreciate as much that we can continue to make changes in the way we eat. My wife and I have been on a salad journey throughout our relationship, not intentionally, but as we’ve been going on, we’ve tried new things.
We were in Greece. Once we got hooked on Greek salads. For a while, we were eating a spinach salad with a little bit of sunflower seeds and hot olive oil on it. Caesar salad. Throughout our relationship, we’ve gone through periods and now we’ve got the best of all worlds because we can pick and choose and try all these different salads that we like.
Tara Schmidt: And it doesn’t have to be forever. If you find one that you don’t like or get sick of it, you change it and that’s okay. You are the only person though that has ever told me you’ve gone on a salad journey with their spouse before.
Dr. Donald Hensrud: I’m a little weird. I work like this.
Tara Schmidt: It doesn’t surprise me though.
You recognize that when you ask patients about their diet, there are some people who have a really hard time doing a dietary recall. I’ll say, well, why don’t you just give me yesterday?
And they’re like, I have absolutely no idea what I ate for breakfast yesterday. How can we make people more aware of their diet, if they’re one of those people who wouldn’t know what to change because they don’t recognize some of the habits that they have?
Dr. Donald Hensrud: Even in my general examinations, I ask all my patients what they eat for breakfast, lunch, dinner, and snacks. People can do a self-assessment also. They can keep a food journal or diary or record and write down what they eat for a few days or so. Usually, we say maybe two days during the week and one day on the weekend. You get a cross-section of what people eat.
Tara Schmidt: And food tracking or food monitoring does not have to do with calories if you don’t want it to. Let’s say I had this many servings of vegetables or this many servings of fish this week. Because Sometimes we can get overly focused, I think, on something like calories, but you can have a pretty poor diet, let’s say, on a calorie-restricted diet. And you can also have a wonderful one.
Dr. Donald Hensrud: There’s a lot of information online. You can look and get some good information on what’s a healthy dietary pattern and compare that with what you’re eating, with what the recommendations are.
And again, there’s a lot of leeway there. Some people will have either case preferences or they grew up eating or different ethnic foods. But I think look for patterns over time and then you can compare what you’re eating with what is recommended and come up with some changes.
Tara Schmidt: Well, I’ve been in enough lunchtime meetings with you to know that you do have a pretty excellent diet. I worry about eating in front of you sometimes. You’re a good example to all of us. You say that no one’s perfect, but Dr. Hansard’s pretty good, everyone.
Dr. Donald Hensrud: I do try and practice what I preach, but every once in a while, I’ll get a hankering and I have a quality quantity that I talked to patients about. Some foods you eat for quantity and fruits and vegetables are quantity foods. Other foods if you’re going to have them. Try not to eat a lot of them, but go for quality. So if you’re going to have red meat, ice cream, chocolate, wine or alcohol, things like that, geez, there you go. So every once in a while, my sweet tooth will flare up. I will get the best piece of baklava I can find, and I will enjoy it tremendously.
If we allow ourselves to, it makes it easier to stay on the program long term.
Tara Schmidt: I completely agree with you. Sometimes I will say, ask yourself, is it worth it? That really yucky ice cream that gives everyone diarrhea, like, was that worth saving the calories?
Why don’t we just have the really, really good ice cream and we don’t have it every day and we have the best, Half cup, cup and we enjoy every second of it.
Well, thank you again for being here I appreciate your time Dr. Hensrud.
Dr. Donald Hensrud: My pleasure. This is an enjoyable journey and hopefully will be for a lot more people.
Tara Schmidt: When making changes to your diet, focus on long-term changes that are practical, realistic, sustainable, and enjoyable. You can do things to set yourself up for success, like making sure you have healthy foods on hand for snacks and quick go-to meals.
And while there are many ways to have a healthy diet, some guidelines to keep in mind are healthy carbs, healthy fats, fruits and veggies, whole grains, and minimal processed foods.
Last but not least, you don’t have to be perfect! Food should be enjoyable, whether it’s a salad, or the occasional cupcake.
TÏhat’s all for this episode. But if you’ve got a question or topic suggestion, send us an email at mcpodcasts@mayo.edu, or leave us a voicemail at 507-538-6272.
Thanks for listening! And until next time, eat well, and be well.
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