April 2018 Blog – It Starts With Food
During the month of April, I read the book “It Starts With Food” by Dallas and Melissa Hartwig. The Hartwig’s are the husband/wife team behind the Whole 30 meal plan. As a RDN, I think it is important to be informed about alternative meal plans and right now the Whole 30 is very popular.
The first thing I looked at was the credentials of the authors. According to the website http://whole9life.com/about-us/ Dallas Hartwig, MS, PT is a functional medicine practitioner (under the mentoring of Dr. Daniel Kahlish), Certified Sports Nutritionist, and licensed physical therapist. According to the website https://whole30.com/about/ Melissa Hartwig, CISSN is a Certified Sports Nutritionist and Headmistress/Co-Founder of the Whole 30 team. It concerns me that they can be called Certified Sports Nutritionists without also being Registered Dietitian Nutritionists.
The next thing I look at is how do they come to their conclusion. “It Starts With Food” explains the science behind the Whole 30 plan. They have made a good effort to back up their claims with science-based research, but I don’t agree with all the conclusions they have made. And they admit in their book that not everyone agrees with their conclusions. While they have referenced several physicians in support of their plan, they do not mention anything about having the support of Registered Dietitian Nutritionists. After noting all of this, I decided to read the book with an open mind.
The meal plan is very restrictive. The first part of this book proceeds to eliminate (cold turkey) the following food groups: Sugars and Sugar Substitutes, Grains, Dairy, Legumes and Plant Based Oils. You are left with animal proteins, vegetables, a selection of fats (Olive, coconut and avocado oils and ghee) and maybe a little fruit – but only if the fruit does not trigger your sweet tooth. You are to eat this way for at least 30 days and it may take as long as 60 days to notice positive changes. And for the first 2 weeks you are likely to feel really crappy. After completing the 30 day program, you are encouraged to re-introduce grains, dairy and legumes, one at time, spacing them out 3 days a part and see how each makes you feel.
My thoughts and conclusions: This is a form of the paleo diet and I don’t think it is harmful, especially if you are only following it strictly for 30 days. If you have a patient who is motivated to follow this plan it will likely help improve control of her/his diabetes, but you may need to guide this patient on properly adjusting medications. If your patient is not motivated s/he will never follow such a restrictive meal plan. And as we all know, it is best to meet your patients where they are now (as opposed to where you would like them to be). I struggle with the fact that you only do this for 30 days. I find patients are most successful when you make small changes that they can incorporate into their lives long-term. Having said all that, I do think this is a good elimination diet. If you have a patient who is struggling with an out-of-control mysterious ailment this would be a good way to test how food impacts her/his health.
I would love to hear what you think of the Whole 30 meal plan and if it has had any impact on your practice. I will start a Forum on the SD State page of the AADE website. Feel free to join in the conversation.
Julie Jensen, MS, RD, LN, CDE
SD AADE Webmaster