How to Make Fad Diets Healthier: A Guide to Maximizing Dietary Quality

In a nation where fast food reigns supreme and convenience often trumps nutrition, the American diet has long been a topic of concern. Research suggests that most Americans follow a Westernized diet high in saturated and trans fats, sodium, sugar, and calories. In addition, they tend to overconsume refined grains, animal proteins, and alcoholic beverages. Furthermore, around 80% of Americans habitually consume fewer fruits, vegetables, and fibers than recommended by the Dietary Guidelines for Americans (DGA). This disconnect between dietary recommendations and actual consumption is a cause for worry, as the quality of our diet directly impacts our long-term health.

The Alarming State of American Dietary Habits

Despite concerted policy-based and programmatic efforts to educate people about nutrition and healthy diets, most Americans do not follow public dietary guidelines. This fact is highlighted by the population's consistently low scores on the Healthy Eating Index (HEI) from 2005 to 2016, as revealed in the DGA survey for 2020–2025. To add to this concern, reports suggest that 17% of American adults followed a special diet during 2015–2018. Clearly, there is a growing awareness of the need for dietary improvement.

Understanding Fad Diets: A Comprehensive Study

But how do Americans navigate the maze of dietary choices, including popular fad diets? In a recent study, researchers delved into the world of fad diets in the USA, aiming to identify the most "popular" dietary patterns and assess their dietary quality compared to the DGAs. Here's an overview of their approach:

Identifying Fad Diet Themes

The study began by collecting data from peer-reviewed sources, websites, popular books, and blogs. They specifically searched for content using the keyword "fad diet" to identify common themes. The most frequently appearing themes were then used to establish a comprehensive working definition of a fad diet.

Selecting Popular Fad Diets

Researchers turned to Google Trends© to identify the 'popular' fad dietary patterns for inclusion in the study. The initial search using the keyword "diet" returned 25 dietary patterns. However, after elimination based on duplication, relevance, and inclusion/exclusion criteria, eight fad dietary patterns emerged for the final evaluation.

Analyzing Diet Parameters

Once the popular fad diets were identified, researchers meticulously studied the specifics of each pattern, including their mechanisms of action concerning weight loss and health outcomes. Parameters such as calorie limits, micronutrient compositions, restricted dietary components, required supplements, and special foods were thoroughly examined.

Creating DGA-Compliant Menus

To ensure that these diets aligned with the DGAs to the maximum possible extent, the research team used the operationalized parameters to create one-week menus, similar to how clinical dietitians devise meal plans for patients.

Assessing Dietary Quality

The team used the Automated Self-Administered 24-hour (ASA24®) dietary assessment tool to analyze dietary intake data and determine HEI-2015 scores, which range from 0 to 100. An HEI score of 100 indicated full adherence to the DGAs, while 0 indicated low adherence. The tool also collected information on specific foods, portion sizes, drinks, and condiments in each sample menu, helping the researchers calculate the means and standard deviations per nutrient.

Defining Fad Diets

Before delving into the specifics of dietary patterns, it's essential to establish a clear definition of what constitutes a "fad diet." In the context of this study, a fad diet is characterized by a pattern of eating aimed at rapid and often unsustainable weight loss. These diets may severely restrict calories and nutrients by omitting foods or entire food groups. Fad diets often recommend rigid eating patterns, diminish the importance of physical activity, and are commonly marketed through endorsements from celebrities or authority figures.

Identifying Popular Fad Diets

Utilizing Google Trends©, we scoured for popular diets that align with our definition of fad diets. The goal was to select diets that are widely searched and recognized as popular dietary patterns. After an exhaustive analysis, eight dietary patterns emerged as the focal points of our study:

1. Ketogenic Diet

2. Plant-based/Vegan Diet

3. Fasting Diet

4. Carnivore Diet

5. Liquid Diet

6. Military Diet

7. Low-FODMAP Diet

8. Paleo Diet

The Results: Assessing Fad Diets

The study categorized the popular fad dietary patterns as least, moderately, and most restrictive. The DGA-compliant, plant-based/vegan, and fasting diets were the least restrictive, while military, paleolithic, and low-FODMAP diets fell into the moderately restrictive category. The most restrictive diets included the ketogenic, carnivore, and liquid diets.

After maximizing adherence to the DGAs for each popular fad dietary pattern, the total HEI scores varied, ranging from 26.7 for the Carnivore Diet to 89.1 for the Low-FODMAP Diet. Total calorie provision also varied, with the Liquid Diet having the highest at 2,143 kcal/day and the Carnivore Diet the lowest at 1,302 kcal/day.

The majority of adequacy components for fruits, vegetables, and protein received high scores. However, the ketogenic, carnivore, and liquid diets did not meet the maximum vegetable, fruit, and protein intakes.

Micronutrient Analysis: Where Do Fad Diets Stand?

When it came to micronutrient analysis, several nutrients of concern emerged due to their underconsumption by Americans. Calcium, vitamin D, potassium, and fiber topped the list. Vitamin D was adequately supplemented only by the paleolithic diet, while calcium was sufficient in all diets except the paleolithic, carnivore, and ketogenic diets. Potassium was adequate in all diets except the ketogenic and carnivore diets, which also lacked fiber. Additionally, dietary patterns, except for carnivore and ketogenic diets, showed concerns about inadequate vitamin E and vitamin D intake.

Conclusion: Fad Diets and Dietary Quality

In conclusion, the study's analysis revealed that some popular fad dietary patterns have the potential to attain high dietary quality if carefully planned to follow the DGAs to the fullest extent. Notably, five fad diets reached the threshold for high dietary quality, represented by higher HEI scores. These diets included the low-FODMAP, vegan, military, fasting, and DGA-compliant diets. Even the ketogenic diet showed potential for achieving a high HEI score, despite its problematic nutritional adequacy.

This analysis emphasizes that even popular dietary patterns have the potential to promote health, provided individuals make small changes within the parameters of their chosen diet. It's clear that there is no one-size-fits-all approach to diet, and the key to a healthy lifestyle lies in understanding the specific nuances of each dietary pattern and making informed choices.

In a world filled with dietary misconceptions, remember that your chosen diet can play a significant role in your health. Be sure to consult with a healthcare professional before embarking on any diet, and consider the potential benefits and drawbacks based on your individual needs and preferences.

Journal reference:

Phelan JM, Joyce JM, Bode K, et al. (2023). Opportunities for Maximizing the Dietary Quality of Fad Diets. Nutrients, 15, 4526. doi: 10.3390/nu15214526. https://www.mdpi.com/2072-6643/15/21/4526

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