Nutrition in the Age of COVID-19 with Dr. Debbie Fetter

Q: What do you think of Keto and paleo dieting? Are these healthy lifestyle options?

Fetter: So, I feel like Paleo was really popular for a while and now, Keto has sort of replaced the popularity. But inherently, both of them are known to be low-carbohydrate diets. So Paleo is a high-protein, low-carb diet, whereas Keto is a high-fat, low-carb diet. So, with anything that I would recommend, I would encourage people to not cut entire food groups out of their eating patterns. So, with Paleo, as well as Keto, you can be missing out on some vital nutrients because of the elimination of certain food groups. So, poor carbohydrates are really taking the hit here. And we know that complex carbohydrates, so, whole grains and also your vegetables and your legumes and your beans, supply a lot of health benefits. And so, I would encourage people to still incorporate these into your own eating pattern. The focus on incorporating a lot of vegetables and lean protein is great, but I would advise against eliminating whole food groups and different foods that you enjoy in your eating pattern for long-term sustainability. And in terms of the research about these two eating patterns related to different health risks, there really hasn't been a full consensus to support one over the other or just for the typical healthful eating pattern, as recommended by the dietary guidelines of incorporating all those different food groups in. I think, what I would recommend is for people to focus on vegetables, whole grains, fruits, and lean protein sources as well as healthful oils, rather than trying to do Keto or Paleo and then, especially talking about Keto specifically, many people that have adopted the Keto diet don't actually do it correctly. It's an extremely high-fat, low-carb diet that many people don't even hit the low-carb involved in the amount of high-fat. And we know that dietary patterns that are high in fat and including saturated fat have been linked to an increased risk of different diet-related chronic diseases. So I would advise against incorporating that as a method for improving health.

Owlia: Plus, it's a bit counterintuitive to the balanced diet mindset, so….

Fetter: Exactly. And if you're someone like me that really enjoys a nice, freshly baked piece of bread or a good slice of pizza could be extremely hard to follow Paleo or Keto.

Q: Thoughts about mushrooms?

Fetter: they are a great addition to any eating pattern. They supply a lot of different nutrients in them, like different B vitamins. They're antioxidants. There's antioxidants in them. And especially if you're someone following more of a plant-based eating pattern, they can sort of stimulate a lot of the umami taste and feel that you would get associated with a meat product as well. So, for me personally, I love incorporating mushrooms into dishes. I do like a balsamic-roasted mushroom quite often. And then especially if you buy pre-sliced mushrooms, it's an easy pack to make something real fast. Some mushrooms have been known to be natural mutagens, which are essentially these compounds found naturally that have been linked to carcinogenic potential. But you would have to be eating these particular mushrooms every meal of the day. So like, mushroom soup for breakfast, lunch, dinner for years and years in order to see maybe any sort of significant effect on your health risk. So really, no need to worry about mushrooms being a natural mutagen.

Q: For people that find food prep overwhelming, how can it be broken down and made more manageable while still getting what you need to be healthy?

Fetter: Meal prep is definitely, I feel like, social media is showing a whole new light on it. I love seeing everyone's images of different meal prep. So Meal Prep Monday, Meal Prep Sunday. And I think it can certainly definitely be pretty overwhelming to make a whole batch of food for an entire week. So what I would recommend doing is taking the time to plan ahead for the week before going to the grocery store, looking at what you already have on hand and your fridge and your pantry and creating a couple different meals based around that. And once you go to the store, what I would recommend doing, maybe even before putting all the groceries away, is take out any of the produce items that you've purchased and chop them up right away and put them away that way. That will help cooking with them easier as well as if you want fresh produce to snack on. Like, I love having bell peppers on hand to snack on or cucumbers or my favorite, carrots, just in the fridge so that when I'm feeling like I, I love to eat, so, but sometimes I will go to eat when I know I'm not hungry and so it's just nice to have something that's nutrient-dense and fairly low in calories to go to in the fridge using a hand to snack on, and then to make meal prep an enjoyable experience. So, put on your favorite podcast like this one, put on some music, set up the mood, and to make simple meal prep meals. So, usually what I would recommend is choose one type of whole grain to make for the week. So something like maybe a big pot of quinoa, a big pot of brown rice, maybe you're feeling ambitious and going to bake some fresh bread to have on hand for the week, some sort of complex carbohydrate. And then, with, I'm a big fan of sheet pan meals, so you can chop veggies and roast them in the oven with a little bit of olive oil or avocado oil. And then, also at the same time, you can be cooking some sort of lean protein source like chicken or steak, pork, tofu in the oven or in a stir pan on the oven, kind of getting it all together at once to just kind of do it, do it that way, but not doing anything extreme in terms of recipes.

Q: Do you think suicide prevention and mental illness should be talked more about in schools to the young kids?

Hinshaw: So, I'm going to give an analogy back to cancer we were talking about before the commercial break. What if an oncologist told a mom and a dad or a dad and a dad or mom and mom, if your children ever learn of your cancer, it's such a shameful disease, your children will be permanently destroyed. You can never mention while you go to the hospital of the dog, your cancer is off limits, well, we probably sue that oncologist for malpractice. Kids need to know you've got cancer and kids can learn what cancer is at different ages, once they get older and older and understand more about it, and to know that the family is getting treated. But when I was growing up, it wasn't all that long ago, even though I'm an old guy, mental illness was deemed so toxic, you can never talk about it. Grade school, middle school, high school, talking about illness, there's health classes, talking about mental health concerns, we don't want to just teach kids the symptoms of depression or bipolar disorder or schizophrenia. Kids will learn and do well on the test at the end of the term. But when we do that with kids, kids actually get more stigmatizing because they learn the stereotypes and the bad symptoms. What we need to do is bring in people with lived experience. There's career day, you see a firefighter, you see a letter carrier, you see a doctor, you see people who have depression or eating disorders and talk about it as regular people who have been fighting an illness, the way people with cancer have been fighting an illness. That's the kind of education that'll take mental health issues off limits and bring them into the dialogue. As kids get older, they'll think it's fine to talk about it.

Q: Does dieting have a negative impact on your body than positive that we don't know about?

Fetter: I think it's important for all of us to reframe the whole concept of "diet" and really think about that in terms of the improvements that we want to make for our health, in relation to the foods that we eat and our movement, that this is a lifestyle change. So this is all not something that you do for a week and then it's done and you can go back to whatever you were doing before. So, making those small changes in order for them to be sustainable changes and not making everything all at once. So I think dieting can definitely have a negative connotation because the concept of dieting that we think of is asking an individual to make this drastic overhaul to their eating and activity all at once. And so it can, we're left with bad feelings, especially when a lot of times these diets are not sustainable and after the period of dieting, weight is regained, and then some that we've seen with contestants on "The Biggest Loser." And so, I think what would be more positive is just reframing like, "what are some improvements I can make for my eating pattern?" and "What goals can I set for myself? How can I track them?" So research has shown that tracking different changes and goals has led to greater success and tracking can be done a variety of ways. Anything as simple as a pen and paper to anything more complex, like some sort of smartphone application or website.

Q: Why do health companies make fad trends?

Owlia: Oh, I can even answer that one. We need a little cold, hard cash.

Fetter: Let's, let's hear your answer first.

Owlia: I mean, obviously, you're going to know more about this than me, at this point, it seems like a profitable industry, you know? Everyone's fat, they don't like how they look, and they're willing to pay X amount of money to do these fad trends that don't work just for the hope that they're going to lose weight.

Fetter: No, you are completely right. I got, I got nothing to add. You hit the nail on the head that it comes down to these companies want to make some money.

Owlia: They want to get some green and not the leafy ones.

Fetter: Yeah, so, it's, it's a way to tap into a consumer's desire with the promise, like, "Purchase this diet plan, buy this product, take our miracle ingredient and you will have the body that you've always that you're desiring." But society has created this picture of, which is, it is not meant, like we're all not meant to look the same. We all have different body sizes and shapes and we are all beautiful people. We all do not need to look a certain way. Yet society has ingrained in so many of us that we need to look a certain way. If we look this way, then we will be happy. And I think that's what it comes down to, is that if you change your body to look like this, then that will bring happiness. And that's not the case. The thing that will bring happiness is being true to yourself and being true to your own culture and tastes and social connections when it comes to eating. That will bring happiness. So, I always advise people, save your money, don't buy that diet plan. Don't buy that product out there. It comes down to figuring out the whole food choices that work well for yourself based on your culture, your taste preferences, and give yourself the freedom to have the cookie.

Q: What do you think is the best and most sustainable course of action for improvement?

Fetter: I mean, I think the first thing in relation to COVID is, is recognizing that we're all living in the midst of a global pandemic and we have to be kind to ourselves. Just getting through the day is a big challenge for many of us right now. Now is not the time to drastically overhaul your whole eating and activity levels. And I would advise people to focus on small goals. So, one thing that we can all do, myself included, is to write a list to ourselves about the goals that we want to accomplish in terms of our health and activity and eating. What changes can we make? And write them down, just write down a brainstorm a list, any goal, big or small, and then identify a small goal to work on. So, for instance, for myself, I too am not immune to the changes that the pandemic has had on our eating and activity, and I find myself sitting at a couple pounds heavier than I usually am. And so, I set the goal for myself to find a way to be active every day for at least one hour for myself. So, whether that is incorporating some exercise along with a walk or just moving around, some sort of goal, and I've been tracking that in my planner, and I feel really, much more accomplished with setting that that small goal for myself.

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