1 00:00:06,840 --> 00:00:12,520 JEREMY: Hello and welcome to another episode of Eat This Podcast with me, Jeremy Cherfas. 2 00:00:13,880 --> 00:00:21,320 One of the things I find deeply puzzling about the world of food is the sheer excess of advice on nutrition. 3 00:00:21,800 --> 00:00:29,960 For almost any given idea that some food or other is good, there's an excellent chance that you can find the exact opposite 4 00:00:29,960 --> 00:00:33,320 opinion in seconds. Butter will kill you. 5 00:00:33,520 --> 00:00:40,320 Seed oils will kill you. And it's as true for how you should eat as for what you should eat. 6 00:00:40,320 --> 00:00:44,880 Fast for 16 hours a day, or eat six small meals a day. 7 00:00:45,120 --> 00:00:51,920 You know the kind of thing. It seems that anybody can say almost anything they like when it comes to diet, 8 00:00:51,960 --> 00:00:57,760 nutrition and advice. And that's despite the fact that in many places around the world, 9 00:00:57,760 --> 00:01:03,630 it's actually illegal to give nutritional advice if you're not officially qualified. 10 00:01:04,470 --> 00:01:12,790 That's why I welcomed the chance to talk to Tara Schmidt, a registered dietitian at the Mayo Clinic in Rochester, 11 00:01:12,790 --> 00:01:18,670 Minnesota. She's the host of the Mayo Clinic's podcast On Nutrition. 12 00:01:19,190 --> 00:01:26,310 I took the opportunity to quiz Tara Schmidt about the long training she had to go through to become a registered dietitian -- 13 00:01:26,350 --> 00:01:30,430 bachelors, masters, internship, board exams. 14 00:01:30,910 --> 00:01:36,110 And I wondered how she felt about all that conflicting advice. 15 00:01:37,190 --> 00:01:44,070 TARA: Here's the analogy that I give. My husband is a financial advisor, so he has a degree in finance. 16 00:01:44,070 --> 00:01:49,070 He's passed all the exams. He can legally give people advice and he can trade their stocks, 17 00:01:49,070 --> 00:01:52,550 etc. I have money in a bank account too. 18 00:01:52,910 --> 00:01:56,670 I know a little bit about stocks and bonds. 19 00:01:56,670 --> 00:02:03,180 I have some, but I have no right to give people advice on the stock market. 20 00:02:03,420 --> 00:02:05,660 So I think that that's what happens with food. 21 00:02:05,700 --> 00:02:09,820 People have knowledge. Everyone eats, everyone has an opinion. 22 00:02:10,060 --> 00:02:15,580 But there are some people who probably don't have the qualifications to give advice. 23 00:02:15,940 --> 00:02:24,220 In the state of Minnesota, it's actually illegal to call yourself a nutritionist unless you are a registered dietitian. 24 00:02:24,780 --> 00:02:27,620 And that's again, different by country and different by state. 25 00:02:27,620 --> 00:02:34,660 But the Academy of Nutrition and Dietetics, who's kind of our governing body or credentialing body in the states, 26 00:02:34,900 --> 00:02:42,620 they have tried to kind of hammer down on: people who are registered dieticians, 27 00:02:42,620 --> 00:02:49,500 are the ones who have the qualification, the education and the background to give advice. 28 00:02:49,860 --> 00:02:52,540 JEREMY: But that doesn't stop people giving advice. 29 00:02:52,580 --> 00:02:56,140 TARA: Of course not. Of course not. Welcome to the world of the internet. 30 00:02:56,330 --> 00:03:04,970 JEREMY: Well, exactly. I mean, presumably you could you could live somewhere where there is no requirement for being registered or board certified 31 00:03:04,970 --> 00:03:10,010 or anything like that, and you can't stop people from somewhere else reading what you what you put out. 32 00:03:11,250 --> 00:03:11,730 TARA: Correct. 33 00:03:11,770 --> 00:03:13,370 JEREMY: Is that a problem for you? 34 00:03:15,050 --> 00:03:20,810 TARA: It's a frustration for me . Now, I would like it to be known that not everything that people put out there, 35 00:03:20,810 --> 00:03:23,810 whether they're a registered dietician or not, is incorrect. 36 00:03:24,010 --> 00:03:31,170 And there are not many, but maybe even a few registered dieticians that don't have the same values or beliefs that I have. 37 00:03:31,170 --> 00:03:35,650 So everyone is entitled to their opinion, and food is a sensitive topic. 38 00:03:35,650 --> 00:03:43,370 I think that that's what's most challenging for me, is that people have really strong beliefs on these principles, 39 00:03:43,890 --> 00:03:49,450 and what I always go back to, and what I kind of tell myself at night when my blood pressure is high, 40 00:03:49,970 --> 00:03:55,920 is that I went to school for this. I did my internship at Mayo, so I've always been at Mayo Clinic. 41 00:03:56,680 --> 00:03:59,040 I learned from Mayo. I work at Mayo. 42 00:03:59,080 --> 00:04:06,240 We're very evidence based, and it's actually okay to recognize that that's a little bit of a bias that I have. 43 00:04:06,960 --> 00:04:13,600 Mayo, i think I can say, it has a little bit of what we would call biomedical bias. 44 00:04:13,840 --> 00:04:20,120 We don't do much unless there's about 10,000 studies saying the same thing. 45 00:04:20,320 --> 00:04:24,640 And that makes us a little slow sometimes, but that's also saved us many, 46 00:04:24,640 --> 00:04:28,240 many times. Right. So I'm proud to work where I work. 47 00:04:28,240 --> 00:04:30,200 I'm proud to be a registered dietician. 48 00:04:30,880 --> 00:04:35,880 But it can be difficult when there are people with a louder voice than I have, 49 00:04:35,880 --> 00:04:43,720 or there are people with more marketing dollars than I have spewing incorrect information. 50 00:04:43,720 --> 00:04:47,280 And I'm going to call it incorrect because either it's been disproven in research, 51 00:04:47,280 --> 00:04:51,960 or there is no research or evidence to say that it's correct. 52 00:04:52,320 --> 00:05:00,750 JEREMY: I did an episode a little while ago about fad diets, and one of the things that came up, 53 00:05:00,790 --> 00:05:09,270 they offer a simple kind of solution with a whole lot of beneficial results, 54 00:05:09,630 --> 00:05:14,310 and they may even work to begin with. 55 00:05:14,350 --> 00:05:14,870 TARA: They do! 56 00:05:15,110 --> 00:05:18,670 JEREMY: Yeah, but one of the things is that people fall off fad diets. 57 00:05:18,670 --> 00:05:22,110 If they did it for weight loss, then they put the weight back on. 58 00:05:22,830 --> 00:05:32,350 I just wonder, do you think it's possible to be addicted to the 59 00:05:32,350 --> 00:05:40,310 idea of a fad diet? The idea that some simple change is going to turn everything around. 60 00:05:41,110 --> 00:05:48,230 TARA: I think we are so used to things coming to us extremely quickly. 61 00:05:48,230 --> 00:05:50,430 I ordered something from Amazon yesterday. 62 00:05:50,670 --> 00:05:55,220 I would like it to be here in about five minutes and I expect it to. 63 00:05:55,500 --> 00:05:59,980 Right. And what fad diets do, and this is what I tell my patients and my members, 64 00:05:59,980 --> 00:06:03,540 if something seems too good to be true, it probably is. 65 00:06:03,820 --> 00:06:07,820 If you have a red flag kind of going off in the back of your mind, or ... 66 00:06:07,820 --> 00:06:13,500 I've seen a billboard that says, lose this many pounds, no exercise required, 67 00:06:14,060 --> 00:06:17,980 like beep beep. Let's back up here. 68 00:06:17,980 --> 00:06:23,100 This is not a good one. The problem is that fad diets work just like you said. 69 00:06:23,580 --> 00:06:27,260 They tend to be calorie controlled in some way or another. 70 00:06:27,260 --> 00:06:31,820 They would never say that, but they're somehow calorie controlling you, which mathematically works. 71 00:06:31,820 --> 00:06:34,300 Putting you in a calorie deficit, you lose weight. 72 00:06:34,780 --> 00:06:40,060 The problem with them is that they tend to be not sustainable. 73 00:06:40,060 --> 00:06:48,100 Whatever they're having you do is not likely going to fit into your lifestyle literally for the rest of your life. 74 00:06:48,220 --> 00:06:52,970 So we bounce back, we regain, and we start over looking for the next thing. 75 00:06:53,290 --> 00:06:59,610 So that's weight cycling or yo-yo dieting, fad dieting, whatever word you want to say. 76 00:06:59,730 --> 00:07:02,130 The problem is that it works, but not long term. 77 00:07:03,250 --> 00:07:08,610 JEREMY: Yeah, but people go on to the next fad diet. 78 00:07:08,610 --> 00:07:12,170 They don't go back and do it again. 79 00:07:12,650 --> 00:07:17,650 So they maybe, maybe what they're doing is saying, okay, this time this is, 80 00:07:17,850 --> 00:07:19,250 this one is different. 81 00:07:19,810 --> 00:07:23,210 TARA: Yeah. And they are very good at marketing them. 82 00:07:23,690 --> 00:07:26,290 And they have a lot of money behind them sometimes. 83 00:07:26,770 --> 00:07:29,450 JEREMY: But the money behind them point is interesting. 84 00:07:29,490 --> 00:07:33,650 I mean, my feeling is that ... Well, I don't know. 85 00:07:33,690 --> 00:07:39,090 I don't know. I mean, the book, the book deal, buying the diet plan, all of that. 86 00:07:40,650 --> 00:07:43,370 L et me come back to a slightly different question. 87 00:07:43,410 --> 00:07:47,690 Do you think there's a sense in which people who do turn to fad diets, 88 00:07:47,690 --> 00:07:50,880 do you think they feel let down by the medical profession. 89 00:07:52,200 --> 00:07:59,760 TARA: I think that's possible. I also think part of the problem, it may be more so of the problem, 90 00:07:59,760 --> 00:08:05,520 is that we live, I believe, in an obesogenic environment. 91 00:08:05,520 --> 00:08:15,240 We live in an incredibly difficult environment to eat healthfully, to have regular exercise, 92 00:08:15,760 --> 00:08:20,840 to have non-exercise activity as part of our daily lives. 93 00:08:22,080 --> 00:08:31,200 I think calorically dense, low nutrient, highly palatable food is more accessible and often cheaper than your 94 00:08:31,240 --> 00:08:38,880 good old fruits and vegetables. So I think it's this horrific kind of tornado of the environment that we live in. 95 00:08:39,560 --> 00:08:48,390 The messages probably, that were given about body size and being a normal or lower weight equals health, 96 00:08:48,390 --> 00:08:53,750 which I disagree with, of course. Young girls, but also boys, you know, 97 00:08:53,790 --> 00:08:59,270 being exposed to "this is the right type of body to have" at a very, very young age. 98 00:09:00,030 --> 00:09:07,870 And then maybe not feeling that support from the medical field of this is what we can give you, 99 00:09:07,870 --> 00:09:15,230 because time is very limited in that sense, of course, and in what we often give people in the medical field -- 100 00:09:15,230 --> 00:09:20,990 which is, hey, let's put you in a reasonable caloric deficit for many, 101 00:09:20,990 --> 00:09:27,550 many weeks -- is not what they want because they want what's fast because that's how our brains work, 102 00:09:27,550 --> 00:09:28,150 I think. 103 00:09:28,710 --> 00:09:36,590 JEREMY: Yeah. O n the obesogenic environment, I mean, that's also something I've been very well aware of. 104 00:09:37,030 --> 00:09:44,230 Is there something specifically about ultra processed foods, do you think? 105 00:09:44,350 --> 00:09:49,900 Or is it just that they're engineered so that we eat more of them, do you think? 106 00:09:49,900 --> 00:09:57,820 W hat I'm getting at is, is it the ultra processing or is it that we eat so much of them? 107 00:09:58,620 --> 00:10:00,220 TARA: I think that's one and the same, right? 108 00:10:00,260 --> 00:10:08,980 So like you said, they are engineered by very, very smart people to be the exact crunch that you're looking for, 109 00:10:08,980 --> 00:10:17,420 to be the exact level of salty and sweet and mouthfeel and how quickly are they digested in the mouth, 110 00:10:17,420 --> 00:10:20,940 but also in the stomach. How are they packaged? 111 00:10:20,940 --> 00:10:27,700 How appealing are they to my children, who like colourful things or who want cartoons on their cereal box? 112 00:10:28,820 --> 00:10:35,820 And that mixture of ingredients, I think is problematic. 113 00:10:36,140 --> 00:10:42,940 In addition to it tasting very, very good and having the ability for us to eat them in excessive quantities, 114 00:10:43,140 --> 00:10:49,450 I also think the ingredients themselves, of course, are inflammatory in many cases, 115 00:10:49,450 --> 00:10:51,090 not all, of course. 116 00:10:49,970 --> 00:10:56,010 I think we also have to be realistic when we talk about fad dieting. 117 00:10:56,010 --> 00:11:04,490 Like you said, one of the biggest factors of people who regain weight versus people who are able to maintain weight loss is actually not the 118 00:11:04,490 --> 00:11:10,570 diet that they started on. It was their percent adherence to that diet. 119 00:11:10,770 --> 00:11:15,730 So if someone adheres very, very well to a very, very restrictive diet, 120 00:11:15,730 --> 00:11:21,850 but they're able to adhere to it, they'll actually be just as successful as someone who only cut out, 121 00:11:21,890 --> 00:11:25,650 you know, 200, 300, 400 calories and did so. 122 00:11:25,730 --> 00:11:32,570 At the end of a year, regardless of the diet, people lose about the same amount of weight. 123 00:11:33,250 --> 00:11:38,650 The people who regained weight were those who were not able to adhere. 124 00:11:39,770 --> 00:11:44,000 So that's good and bad news, right? It's good news that any diet will work if you do it. 125 00:11:44,400 --> 00:11:48,040 It's bad news that any diet will work if you do it. 126 00:11:49,160 --> 00:11:58,440 JEREMY: That's that's really interesting, but the whole idea of the diet versus diet. 127 00:11:59,480 --> 00:12:08,040 How hard is it to get people to change what they eat, n ot for six weeks, 128 00:12:08,040 --> 00:12:12,320 not for six months, not for a year, but every single day. 129 00:12:12,720 --> 00:12:16,280 Is that something you can even try to do at the Mayo Clinic? 130 00:12:16,920 --> 00:12:19,440 TARA: We try to do it with the Mayo Clinic Diet. 131 00:12:19,440 --> 00:12:27,400 And this is, I always say, this is such a horrible sales pitch, but what we actually tell our members on our weight loss platform is: 132 00:12:27,400 --> 00:12:30,040 I hope you don't have to use this diet in the future. 133 00:12:30,440 --> 00:12:36,280 I hope this is an educational tool for you to learn how to eat healthfully, 134 00:12:36,760 --> 00:12:42,870 with an appropriate calorie amount with nutrient dense foods. 135 00:12:43,270 --> 00:12:45,230 And then I hope you can say goodbye to us. 136 00:12:45,230 --> 00:12:49,630 And that's probably not something that the finance department's real thrilled with. 137 00:12:49,630 --> 00:12:54,790 But again, our core belief is that we put our patients first, our members, 138 00:12:54,790 --> 00:12:56,870 in this case, it's a subscription programme. 139 00:12:57,230 --> 00:13:07,087 So we are more in the field of educating so people can learn how to do it and take that knowledge and go practice versus ... 140 00:13:07,087 --> 00:13:11,310 Many other, of course, dieting programmes out there could care less if you learn anything, 141 00:13:11,350 --> 00:13:14,750 as long as you're learning what the rules are for their programme. 142 00:13:14,750 --> 00:13:19,710 And again, people can be successful, but it's not that long term health that's the outcome. 143 00:13:21,110 --> 00:13:27,990 JEREMY: Is there any nutrition education in the public school system in the United States? 144 00:13:29,190 --> 00:13:38,950 TARA: Not very much. We'll say that it tends to fall to Health Class, which has a wide range of 145 00:13:38,950 --> 00:13:45,740 curriculum in terms of what people learn, it was Home Ec and Health Class back when I was young. 146 00:13:45,740 --> 00:13:50,340 It's now called Family and Consumer Science Education, I believe. 147 00:13:50,500 --> 00:13:58,900 But that's also something that's been cut very frequently from schools because they're more focused on math and science. 148 00:13:58,900 --> 00:14:03,140 But I took a heck of a lot of science to become a registered dietician. 149 00:14:03,140 --> 00:14:06,260 So I think it should be in there in the science somewhere. 150 00:14:06,780 --> 00:14:14,500 JEREMY: Because it's kind of interesting what's happening, what I'm reading, what's happening with school diets that actually 151 00:14:14,500 --> 00:14:22,060 maybe school diets could possibly become better balanced nutritionally, 152 00:14:22,740 --> 00:14:28,380 because I'm sure children learn a lot of what is good to eat, unquote, 153 00:14:28,420 --> 00:14:30,980 from what they eat, what they eat every day at school. 154 00:14:31,980 --> 00:14:36,746 And certainly here in Europe, you know, countries like France, Italy, 155 00:14:36,746 --> 00:14:43,530 a lot of countries are very careful about what they feed children at state schools. 156 00:14:43,890 --> 00:14:46,450 TARA: Yeah. I don't think we're doing that in the United States. 157 00:14:46,850 --> 00:14:56,010 I would like to blame budget. It tends to come down to budget of why we can't 158 00:14:56,730 --> 00:15:05,290 do this better. So I would say in the United States, children are learning how to eat what is healthy and all of their 159 00:15:05,290 --> 00:15:12,930 habits more so at home, which is very difficult because when we talk about how do we change behaviours, 160 00:15:12,930 --> 00:15:18,970 or when you asked how difficult it is to change someone's diet, these things are very, 161 00:15:18,970 --> 00:15:22,730 very ingrained in us. They're very ritualistic. 162 00:15:22,730 --> 00:15:25,890 They're very habitual, very mindless. 163 00:15:26,090 --> 00:15:31,650 So when you have grown up in an eating environment with someone else, mostly, 164 00:15:32,210 --> 00:15:35,690 quote, controlling your food choices -- right? -- your parents for many years, 165 00:15:36,770 --> 00:15:43,880 I would imagine that's quite difficult to change when you come into adulthood and are in control of your own grocery bill and what ends up 166 00:15:43,880 --> 00:15:44,640 on the table. 167 00:15:45,600 --> 00:15:49,120 JEREMY: The other thing that's interesting, I find interesting, is that governments, 168 00:15:49,720 --> 00:15:55,640 governments everywhere issue guidelines for what people should eat. 169 00:15:56,160 --> 00:16:05,280 And one of the things that they all have in common is that people find it incredibly difficult to meet those guidelines, 170 00:16:05,280 --> 00:16:08,400 even something as simple as five fruit and veg a day. 171 00:16:10,360 --> 00:16:14,360 Why? Why is that? I mean, why can't ... 172 00:16:14,520 --> 00:16:21,840 You'd think government would be able to say, to give people an option that they could at least meet. 173 00:16:22,880 --> 00:16:25,840 TARA: I think it can be met. When you look at ... 174 00:16:25,880 --> 00:16:29,200 So I'm most familiar, of course, with the US dietary guidelines. 175 00:16:29,880 --> 00:16:32,760 When I look at them, I think they can be met. 176 00:16:32,760 --> 00:16:35,240 I don't think we're asking too much. 177 00:16:36,310 --> 00:16:46,270 What I think is difficult again is the time and the access and the familiarity and the trust that we're 178 00:16:46,270 --> 00:16:48,470 talking about when we talk about those guidelines. 179 00:16:49,630 --> 00:16:56,110 JEREMY: Are you saying that people trust the food manufacturers more than they trust the government? 180 00:16:57,350 --> 00:17:06,630 TARA: I think they mistrust where those guidelines come from, which I disagree with personally and professionally, 181 00:17:06,630 --> 00:17:11,310 because I know some people who sit on that board and they were professors of mine in college. 182 00:17:12,390 --> 00:17:22,030 I think there's an assumption of where did this come from, and who paid you to write 183 00:17:22,030 --> 00:17:28,910 this down? Which I again personally don't agree is true, but I think there is some mistrust, 184 00:17:29,110 --> 00:17:31,670 at least in our country, related to that topic. 185 00:17:32,510 --> 00:17:35,860 JEREMY: Do food labels, do package labels help? 186 00:17:36,740 --> 00:17:38,100 TARA: If people read them. Yes. 187 00:17:38,540 --> 00:17:39,820 JEREMY: What's the if in there? 188 00:17:40,620 --> 00:17:44,220 TARA: We got to get people to ... That p eople don't look at them. 189 00:17:44,580 --> 00:17:52,380 Right? So if you turn a package over and you read the label, there's all the information that you need, 190 00:17:52,420 --> 00:17:57,820 right? B ut I do think there is confusion among that label. 191 00:17:59,100 --> 00:18:08,300 I think there is a lack of education related how to read that label and who has time, 192 00:18:08,900 --> 00:18:15,860 right? I'm a dietician, so I love flipping packages over and choosing the right one and explaining to my children why we're picking A versus 193 00:18:15,900 --> 00:18:25,620 B. B ut I also think that food marketing is quite fascinating and that a label can be extremely confusing to the average consumer. 194 00:18:26,220 --> 00:18:31,220 There's colours, there's words, there's marketing. 195 00:18:31,220 --> 00:18:32,850 Let's just leave it at that. 196 00:18:33,730 --> 00:18:41,810 JEREMY: Well, can marketing be regulated? S ome some governments around the world have managed to say, 197 00:18:42,250 --> 00:18:47,570 yeah, we insist that this is the way you label the food package. 198 00:18:48,210 --> 00:18:55,530 TARA: Yeah. And it can be. But then the food company knows a way around that, 199 00:18:55,530 --> 00:18:58,810 right. So if I give you a guideline of "you're not allowed to say this". 200 00:18:58,810 --> 00:19:02,010 Well, then they're going to say that. If you're not allowed to do this, 201 00:19:02,010 --> 00:19:05,810 then they're going to do that. So again, they're good at their jobs. 202 00:19:05,810 --> 00:19:09,930 And whether it's deceitful, I don't know . 203 00:19:09,930 --> 00:19:15,130 Whether it's just, you know, getting someone to buy their product, they're excellent at it. 204 00:19:15,130 --> 00:19:19,890 And again, they're also manufacturing foods that taste good. And I'm not going to deny that they don't taste good. 205 00:19:20,850 --> 00:19:30,410 I think the amount of information out there is getting muddy, right, is muddying what I want consumers to hear. 206 00:19:32,000 --> 00:19:34,520 Budget maybe making that difficult. 207 00:19:34,640 --> 00:19:38,880 Familiarity with these products, that have been around and get better and better, 208 00:19:38,880 --> 00:19:48,200 is difficult to change. And time is always going to be a barrier in terms of preparing healthy 209 00:19:48,880 --> 00:19:51,040 meals made from mostly whole foods. 210 00:19:51,480 --> 00:19:56,320 JEREMY: And and of course, nowadays you don't even need to diet because you can just get one of these drugs -- 211 00:19:56,320 --> 00:19:59,480 Ozempic and all the rest of them -- and that's fine. 212 00:19:59,640 --> 00:20:02,920 Y ou will stop eating. You will lose weight. 213 00:20:03,520 --> 00:20:06,200 Have those been oversold, do you think? 214 00:20:08,160 --> 00:20:15,080 TARA: I think there's an appropriate way to utilise these drugs and there's an inappropriate way. 215 00:20:15,560 --> 00:20:21,520 In a perfect world, these would be used in conjunction. 216 00:20:21,520 --> 00:20:23,840 And this is actually what the studies say. 217 00:20:23,840 --> 00:20:26,160 But no one ever remembers this part of it. 218 00:20:26,560 --> 00:20:32,550 These drugs are meant to be used in conjunction with a pretty regimented lifestyle programme, 219 00:20:32,590 --> 00:20:37,310 right. So when we look at the subjects, the study subjects who took these drugs, 220 00:20:38,430 --> 00:20:42,550 they were given counseling by registered dieticians. 221 00:20:42,550 --> 00:20:46,830 They were assisted in being in a caloric deficit. 222 00:20:46,830 --> 00:20:53,390 They had an exercise programme. These drugs are going to be absolutely life changing for a lot of people, 223 00:20:54,350 --> 00:20:58,830 and they're going to improve and likely save lives of many people, which is fabulous. 224 00:20:58,830 --> 00:21:01,270 We've been waiting a long time for something like this. 225 00:21:02,190 --> 00:21:12,190 However, I am very concerned with the large numbers of patients who go off of these 226 00:21:12,190 --> 00:21:18,070 drugs, which is quite high, whether that's financial barrier or side effects, 227 00:21:18,070 --> 00:21:23,950 etc. if they have not changed the foundation of their lifestyle. 228 00:21:24,270 --> 00:21:26,350 Have we just gone back to fad dieting? 229 00:21:26,350 --> 00:21:28,420 Have we just gone back to yo-yo dieting? 230 00:21:28,780 --> 00:21:35,380 A nd that's concerning for me, especially because these drugs are going to have a larger impact on things like lean mass, 231 00:21:35,420 --> 00:21:37,900 bone mass, etc. 232 00:21:39,780 --> 00:21:48,380 JEREMY: I t's hard to avoid the impression that, at least when you look at the marketing, 233 00:21:48,820 --> 00:21:57,100 that sometimes these drugs are used by people who can afford them to lose a silly amount of weight, 234 00:21:57,540 --> 00:22:06,900 and that they're not used by people who ought to be able to afford them and really need to not just lose their weight, 235 00:22:06,900 --> 00:22:09,180 but get their health under control. 236 00:22:11,020 --> 00:22:14,060 I have no idea how that's going to play out. 237 00:22:14,100 --> 00:22:16,660 Do you have any do you have any thoughts on that? 238 00:22:18,180 --> 00:22:23,180 TARA: I do know, and I think one of the studies was just stopped from a safety standpoint, 239 00:22:23,180 --> 00:22:30,690 I do know that those companies are working tirelessly on creating an oral agent of these drugs, 240 00:22:30,930 --> 00:22:34,610 which should, in theory, decrease the cost significantly. 241 00:22:35,290 --> 00:22:38,810 So that would be the hope that in the next, let's call it five years, 242 00:22:39,090 --> 00:22:46,050 accessibility in terms of cost and maybe therefore in terms of coverage will improve. 243 00:22:47,010 --> 00:22:56,730 JEREMY: What's the one ... I mean, we keep coming back to sort of changing, not changing the diet you follow, 244 00:22:56,730 --> 00:23:06,610 but changing your diet. What's the one thing you would like everybody to know and maybe to act 245 00:23:06,610 --> 00:23:07,050 on? 246 00:23:09,010 --> 00:23:16,250 TARA: I find myself saying the phrase eating pattern quite often in my education and in my counseling. 247 00:23:16,570 --> 00:23:23,130 I think we fall to articles about singular foods, right? 248 00:23:23,170 --> 00:23:25,440 This singular food is great for you. 249 00:23:25,880 --> 00:23:30,320 Eat it. Unlimited amounts. This singular food is horrific for you. 250 00:23:30,600 --> 00:23:37,680 Are processed foods good or bad? So I get asked a lot about singular nutrients and singular foods. 251 00:23:38,360 --> 00:23:44,280 And I always come back to -- before we talk about that food, can we talk about your eating pattern? 252 00:23:44,720 --> 00:23:51,960 And the word diet would be a wonderful substitute if people recognize that diet is just simply what you put in your mouth to nourish 253 00:23:51,960 --> 00:23:59,680 yourself. So I talk a lot about eating pattern, because if you want to enjoy an ultra processed snack food that we 254 00:23:59,680 --> 00:24:08,120 know has no nutritional value, that's okay in my book, because how often do you have it and how much? 255 00:24:08,160 --> 00:24:10,720 JEREMY: Four times a day. As much as I can get. 256 00:24:11,480 --> 00:24:13,800 TARA: Well, then I'll counsel you on that, right? 257 00:24:14,280 --> 00:24:21,040 But we tend to have all of these questions or all of this vilification of these. 258 00:24:21,080 --> 00:24:26,030 This food is bad and this oil is bad and you should be substituting it for this one. 259 00:24:26,190 --> 00:24:33,190 Where we have so many wonderful foods in this world, some that are more nutritious than others. 260 00:24:33,750 --> 00:24:38,710 And I do think that they can all fit, but people don't really like that answer. 261 00:24:38,710 --> 00:24:43,230 They want to be told exactly what to eat, exactly what not to eat, what to never have, 262 00:24:43,470 --> 00:24:46,790 what they should yell at their sibling forever eating. 263 00:24:47,390 --> 00:24:52,150 But we don't eat in a vacuum. And this is also part of why nutrition is so hard to study, 264 00:24:52,190 --> 00:24:56,230 right? Because it tends to be retrospective or it tends to be population based. 265 00:24:56,230 --> 00:24:59,910 We don't lock people in rooms and feed them often. 266 00:25:01,510 --> 00:25:05,910 JEREMY: You know, it's sort of gone away, but five or six, maybe ten years ago --- 267 00:25:05,950 --> 00:25:10,710 I don't know, time flies -- the people who kind of locked themselves in a room voluntarily, 268 00:25:10,710 --> 00:25:15,110 the tech bros and what have you, they were going for this sort of, you know, 269 00:25:15,150 --> 00:25:18,470 the complete nutrition in a drink. You don't need to eat. This is refueling. 270 00:25:18,510 --> 00:25:22,620 Soylent. That's kind of gone away. Is that a good thing? 271 00:25:26,500 --> 00:25:36,780 TARA: I think so because what was that? Providing you with health is so complex. 272 00:25:36,900 --> 00:25:39,780 I think we really look for it to be easy. 273 00:25:39,820 --> 00:25:41,980 We look for a pill. We look for a food. 274 00:25:41,980 --> 00:25:48,900 We look for a supplement because we are so used to having these very simple answers. 275 00:25:49,220 --> 00:25:59,020 And I beg people to take a step back and focus on singular changes, as small as they may 276 00:25:59,060 --> 00:26:09,060 be, as opposed to dramatic rules: five pounds in five days; drink or take this pill and you'll get everything that you 277 00:26:09,060 --> 00:26:13,140 need. Because I think food is more than just nutrients. 278 00:26:13,540 --> 00:26:17,060 It's social. It's comfort, good or bad. 279 00:26:17,060 --> 00:26:21,450 It's a way that we celebrate. It can be a way that we grieve. 280 00:26:22,050 --> 00:26:31,970 It's meant to be pleasurable. Maybe we've gotten too good at that, but it's more complex than just eating for 281 00:26:32,290 --> 00:26:35,290 calories and vitamins and minerals. 282 00:26:37,370 --> 00:26:44,330 JEREMY: Amen to that. I was talking to Tara Schmidt, lead dietician for the Mayo Clinic Diet, 283 00:26:44,850 --> 00:26:51,770 and I really liked her point that "diet is just simply what you put in your mouth to nourish yourself". 284 00:26:52,170 --> 00:26:58,330 You look after that and you won't need anything that's actually labeled as a diet. 285 00:26:58,850 --> 00:27:03,010 But of course, I'm not actually giving advice here. I'm just expressing my opinion, 286 00:27:03,170 --> 00:27:05,610 which you should definitely agree with. 287 00:27:06,210 --> 00:27:11,770 I'll put a link to the podcast Tara Schmidt hosts in the show notes at EatThisPodcast.com. 288 00:27:15,970 --> 00:27:18,970 It's also time to do the marketing thing again. 289 00:27:19,040 --> 00:27:28,200 So let me first thank all the people who donate to support the show, which keeps it available for everyone and which makes the transcript 290 00:27:28,200 --> 00:27:33,640 possible. You can join them from the website at eatthispodcast.com/supporters. 291 00:27:36,880 --> 00:27:45,920 And then there's my occasional request that if you like the show, please leave a rating or review wherever you get your podcasts. 292 00:27:46,280 --> 00:27:49,000 Better yet, tell a friend directly. 293 00:27:49,280 --> 00:27:53,560 It all helps to introduce new people to Eat This Podcast. 294 00:27:54,080 --> 00:27:57,040 And if you do do that, thanks so much. 295 00:27:57,080 --> 00:28:06,640 I really appreciate it. From me, Jeremy Cherfas and Eat This 296 00:28:06,640 --> 00:28:09,880 Podcast, goodbye and thanks for listening.