t is fascinating how calorie restriction is rephrased and repackaged over the years in diet trends. According to my social media feed, the latest thing trending is “Whole30®." I saw photos of my friends drinking black coffee, drinking water on a Friday night instead of cocktails, running, and eating salads. Intrigued, I had to look it up.
As a dietitian, I want to be familiar with all the diets out there so that if my patient casually drops a line that they are teaming up with a friend or family member to do a program, I am an informed educator and can give them the pros and cons. For my patients with diabetes, it can be even more challenging to work with their physician to adjust insulin, medication, and habits around this new lifestyle.
What is Whole30®?
- Vegetables (except below)
- Some fruit
- Good fats from oils, nuts and seeds
- Fruit juice as a sweetener
- Any form of sugar- real or artificial
- Alcohol or tobacco
- Grains of any kind (rice, wheat, oats, etc)
- Legumes (included peanuts, and any form of soy)
- Dairy (exception is clarified butter)
- Artificial anything- MSG, sulfites, or carrageenan
- Extremely strict 30 day policy. If you slip up—even a bite—you have to start over.
- You can not weigh yourself during the 30 days or do body measurements
- Vinegar is okay
- Clarified butter (where the milk solids are removed) or ghee is the only dairy source that is allowed
- Salt is allowed
As an educator, what would you be concerned about if your patient told you they were doing Whole30®? I would refer to food diaries (if they existed) prior to the Whole30® program to see where they were coming from. Some patients just don’t eat many breads and starchy foods, so this may be a similar plan for them—or if they were still hanging on to the Atkins diet from a decade ago, this would be an easy transition.
For most Americans, this would be a very big change to their eating habits. If last week they were consuming 350+ carbs a day, and this week they were consuming 75g of carbs per day, this would be a bit of a shock to their system. We all know that they would first lose some water weight, and then with our patients on a set insulin dose, they need to have a heads up for hypoglycemia. Add in a dose of extra exercise and they need to have their monitor by their side.
If your office is a safe place to come to with questions, you will be seen as an expert.
I don’t discourage patients away from trendy things and want to remain positive. I actually get a little energized when a patient who has been coasting through follow up visits, shares with me they are excited to try something new. I see this as an important step for them that they are actually taking the reins in their hands and playing with some new ideas for eating. I try not to be offended they they haven’t listened to me over the years, but encourage them and ask open ended questions like: How do you think that would change your carb intake? Do you feel full and do you have energy? What can I help you with? Have you increased the frequency of blood sugar testing to monitor things a little more closely?
At some point in the conversation, I may throw in the pros I see in this diet, like a shift to a lot more vegetables. The diet’s premise is to eliminate all things that could cause disturbances in mood, digestive, and weight gain challenges. After 30 days, you may slowly introduce certain things back into your diet and then monitor how you are feeling. I also ask questions about grains. If they have never noticed a problem with gluten or Celiac related symptoms, I will discuss the numerous benefits of whole grains. I also bring up the positives of low-fat dairy and high fiber, high protein legumes.
Overall, I think we should encourage our patients to read more about nutrition. They may have an interest in a certain way of eating, but it’s our job to ask open ended questions and work with them on a plan that provides them with a variety of nutrients. If your office is a safe place to come to with questions, you will be seen as an expert. If a patient comes up with a plan that works for them (within reason) we know they will be more likely to stick with it than if it comes from us on a worksheet.
About the Author
Amy Campbell is a dietitian and certified diabetes educator. She currently works in public health in Lexington, Kentucky and has been working in diabetes for over seven years.