Fad or Fab? When is a dietary approach worth a go?

Fad Dietary Approaches.

Fad Dietary Approaches.

Dr. Sean Wheatley, PhD – Researcher and Trainer in Public Health/7 February 2017

Having worked for X-PERT Health for a whole over-four months now one thing that is more clear to me than ever is how controversial the field of diet and nutrition can be. The level of passion, sometimes even aggression, that can be seen in “debates” over the subject is incredible. In a previous blog I wrote about why one size doesn’t fit all, a statement I still believe. But there are a LOT of people who will preach regarding the superiority of one dietary approach over all others. There are people of this nature supporting most of the diets you’ll come across. And that is often because it “works for them”.

A standard response to try and discredit any other way of eating is to decry it as a fad. That is where this week’s blog comes in. How do people decide when something is just a fad, or when something might provide the sustainable success they’re looking for? How do you know when it might just be the one size that fits you?

Clean Eating (as seen on BBC Horizon…)

The first problem when trying to decide if a dietary approach has any substance is sometimes working out what it actually entails! There are many different varieties of certain diets that are grouped under the same name. I’m going to take “clean eating” as an example here, inspired by the recent BBC Horizon programme that looked at it (which is available here, until the end of February).

A large section of the BBC’s coverage of clean eating in this programme focused on the practices of a “doctor” in the United States (this guy) who promotes the power of alkaline eating. The logic is that our diet is too acidic, which makes our bodies too acidic, which causes disease. The solution therefore MUST be to eat alkaline foods to balance out all that nasty acid, restoring our body’s natural balance. HOORAY! Except that it’s nonsense. Our body is pretty good at managing its own acidity. The REAL problem in this example was the way the “doctor” in question preyed on desperate individuals. He convinced them that this method was capable of curing diseases; including cancer (you may have seen this sad example).

Somehow the BBC managed to use this, alongside some other relatively extreme examples, as part of a body of evidence to warn of the dangers of clean eating. But this probably isn’t fair on all the less dramatic, and more common, definitions of what “clean eating” actually is.

So what I am trying to say is that there are more and less extreme versions of lots of dietary approaches.

The extreme cases may or may not be dangerous, and may or may not be healthy (whatever that means). But that doesn’t mean we should judge a whole way of eating based on individual interpretations of it.

As far as clean eating goes, if we’re going to define it as a natural, whole-food diet then I have no issues with it. Clean eating for many people means eating real, non-processed food. Which is pretty sound advice.  Not dangerous, not a fad. If we’re going to promote it as a cancer-curing, miracle alkaline diet though than I’m not such a big fan.

The Plain Crazy

Not all dietary approaches have that broad a spectrum of varieties however. They don’t all include options that can be categorised as good and others that can be dismissed as fads. And there isn’t always a grey area. Some are just ridiculous. Generally speaking, if a diet sounds crazy it probably is. Particularly if it is backed by reality TV stars or Gwyneth Paltrow. When it comes to Gwynny the advice to ignore what she says, or at least most of it, doesn’t stop at diet; like this for example).

For the sake of completeness, and to give ourselves a little bit of a laugh, here are some examples of diets that I’m happy to throw under the “fad” bus (or to plain and simple write-off as absurd).

The cotton-wool diet. You just fill up on cotton-wool balls. If your stomach is full of cotton-wool, then there is no room for anything else and you won’t feel hungry. For a special treat why not soak them in orange juice to make them a little tastier?
The baby food diet. Low calories and small portions, it’s the perfect weight loss diet. Except it’s weird, and when has anyone managed to sustain weight loss simply by cutting calories?
Cabbage soup diet. High in fibre, low in fat. High in flatulence, low in taste.
Grapefruit diet. Enzymes in the grapefruit are suggested to help burn fat. So this diet says have it with every meal (normally in conjunction with cutting calories)! It’s been around since the 1930’s, so it has some staying power at least. Less weird than some of the others, but still going to brand this one as a fad.
Lemon juice diet/lemonade master cleanse. Promoted mostly as a detox aid. This approach adds some homemade lemonade (lemon juice with filtered water) to your diet, with relatively standard dietary restrictions also applied. The problem with this, as with all detox diets, is that our liver can handle its detoxing job just fine on its own. That is, unless you’re filling up on crap; in which case a bit of lemon juice is unlikely to turn the tide. To make it a master cleanse you need to throw in some maple syrup, a morning salt water flush, and a nightly herbal laxative tea too. Lovely.
Blood type diet. The story goes that people with different blood types need to eat different foods for optimal health. Broadly, if you’re blood Type “0” then you should eat lots of meat. If you’re an “A” then go vegetarian. “B” equals high dairy. And “AB” should be somewhere between those promoted for, you guessed it, “A” and “B”. There is no scientific evidence that this works, which is not surprising really.
“Drink your own urine” diet. Need I say any more?


What tends to categorise these diets is an over-consumption of one particular thing, or a general lack of nutritionally dense foods (i.e. foods that actually provide some nutrients, vitamins, or minerals that your body can benefit from).  There are certain things that are essential in a diet, because our body needs them but can’t make them itself. This includes certain fatty acids (that funnily enough we get from fats), certain amino acids (that we get from proteins), and a host of vitamins and minerals. If the main component of your new diet is cotton wool you probably aren’t going to be meeting your body’s basic needs.

I look forward to the day one of the diets I have derided is proven to be the saviour of human health.

Low fat versus low carb (a sidebar)

It would be remiss of me not to add a note about the eternal struggle between low carbers and fat-phobics. The association with this blog is that there are people on both sides who like to refer to the “other” diet as a fad!

Staunch supporters of a low fat diet like to decry the low carb dietary approach by warning of the body’s need for carbohydrate for energy and questioning how any diet that cuts out a food group can possibly be healthy. Carbs were conspicuous by their absence from the list of “essential” foods above though. We don’t NEED carbs, we can get energy from other sources, and our body can make its own carbs if required. Low carb also doesn’t mean NO carb, so nothing is necessarily being cut out anyway! Many people who eat low fat actually eat less fat than the amount of carbs their low carb counterparts consume, which is ironic. There is plenty more for fans of irony to like about these diet wars. Other examples include:

Criticism over conflicts of interest.

With person A mocking person B’s funding from Coca-Cola whilst person A is filling their pockets with income from the book they’re selling.

Criticism over the lack of evidence of long-term safety of a diet.

From a supporter of a different diet that also has no evidence of long term safety. Most diets don’t really, as good nutrition research is difficult to do; particularly over an extended period.

The suggestion that low carb is the new kid on the block.

And using that as an opportunity to beat it with the fad stick, is also common. But doesn’t stand up to scrutiny when you look at the traditional diets of humans. I won’t pretend to be an expert on the subject, but agriculture was a relatively late addition to the spectrum of human skills so the consumption of carbs would not have been top of the menu in days gone by. Many indigenous populations, for example tribes in Africa and the Inuit in North America, still survive on mostly fatty foods; with very low rates of modern chronic conditions such as diabetes and cardiovascular disease. Low carb diets are not new.

On the other side of the coin there are low carbers (plenty of them) who snort with derision at the mere mention of following a low fat lifestyle. Who consider the thought of following the dietary guidelines of the UK laughable. Now where the carb content of a low fat diet comes from wholegrains and non-processed varieties this approach may well work for many people, and indeed it does. It is no fairer to dismiss a low fat diet based on people filling their plates with refined grains in the form of breads, cereals, and cakes and biscuits than it is to dismiss clean eating because of the promotion of alkaline foods as a cure for cancer.

My conclusion would be that it is moderately absurd to refer to either of these conflicting schools of thoughts as fads. Either side of this particular debate can consist of a diet made up of real foods that are not processed and with sufficient variety to meet all of the “essential” components we need to eat.

So what’s the bottom line?

We’ve gotten there via a different route, but I’m going to end in pretty much the same place as I did in the “one size doesn’t fit all” blog; and not just because I lack the creativity to come up with an original conclusion. There are a host of different dietary approaches, but if you avoid the ridiculous and the extreme options then whatever you’re left with may well be what works for you.

If you are eating a diet that is based mainly on real, non-processed food that allows you to meet your own health goals and that you enjoy then there is no need for you to experiment with something else*; no matter what your friends and family, the BBC or Gwyneth Paltrow are telling you.

* There are a couple of caveats. Firstly, you need to ensure you’re not creating any new health problems by having a diet lacking in any essential nutrients.  Secondly, some people may well need to adapt their diet away from what they might want to be eating. For example, if someone has insulin resistance (as most people with Type 2 diabetes, and a lot of people who are overweight or obese, do) then they may need to limit the amount of carbohydrate they are eating as their body may well struggle to deal with it.

As with all our blogs and other work we’d love to hear your thoughts and feedback, so feel free to comment below, drop me an e-mail at sean.wheatley@xperthealth.org.uk or tweet us/me at @XPERTHealth or @SWheatley88.

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