Do all foods really fit?

I can remember this vividly, a few years back someone uploaded a video to YouTube entitled “Sh*t girls say” which spawned off a whole bunch of stereotyped parody videos.  Why is this relevant? Because someone decided to do a parody video entitled “Sh*t Dietitians Say” and it was extremely accurate.  So accurate to the point that is highlighted the fact that all Dietitians at one point in their professional career have given the advice that “all foods fit.” “All foods fit” was a way of encompassing dietary diversity as well as recognizing and supporting better relationships with food for many people.  But there is one issue and that is as a Dietitian we are trained to use an evidenced based approach to nutrition. When there isn’t any evidence then we are to rely on our clinical skills and expertise.  For years “All foods fit” was given as advice when the evidence was lacking, now there is some evidence that’s definitely worth looking into.

Researchers in the University of Texas Health Science Center in Houston performed a study using 6,814 participants of varying races and genders and measured dietary diversity and it’s impact on health with different tools.  These tools include the total number of different foods eaten in a week, the distribution of calories across different foods, and the differences in individual food attributes that are relevant to metabolic health (eg sodium, fiber, trans-fat etc).  The researchers looked at the association of dietary diversity and changes in waist circumference in 5 years and the development of Type 2 Diabetes at 10 years. 
 
When the researchers finally gathered their data they looked at food count and evenness and found no associated changes in waist circumference or the development in diabetes.  Which basically means the dietary diversity was not linked to better health outcomes.  In fact, it was discovered that participants with the great diversity in their dietary intake had the greatest increase in waist circumference with 120% compared to those with the least food diversity.  
 
I know what your thinking, diversity means nothing if the food quality isn’t there right? Well the researchers took a look into this as well.  Using the Dietary Approaches to Stop Hypertension (DASH) score and the alternative Healthy Eating Index (AHEL) scores it was found that dietary quality was not associated with a change in waist circumference at 5 years.  However at the ten-year mark a higher diet quality was associated with a 25% lower risk of developing Type 2 Diabetes. 
 
The researchers, and I, were surprised to find that participants with greater diversity in their diets had a worse overall quality.  But they found those had a  higher dietary diversity were choosing more unhealthy foods than healthy foods, which could explain the relationship between less diversity in the diet and a reduced waist circumference.  In fact one of the researchers went on to say that Americans with the healthiest diets actually eat a relatively small range of healthy foods, which makes complete sense because you’re focusing on higher quality foods rather then getting diversity for diversity’s sake. 






Ben Sit, RD, Sports Dietitian, PTS
Owner, Founder and President of Evolved Sport and Nutrition
Complete Lifestyle Management

References 

University of Texas Health Science Center at Houston. (2015, October 30). 'Everything in moderation' diet advice may lead to poor metabolic health in US adults. ScienceDaily. Retrieved November 9, 2015 from www.sciencedaily.com/releases/2015/10/151030161347.htm

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