Scientific evidence obtained through rigorous methods is critical when advising the public on healthy eating patterns, especially since diet plays such a large role in long-term health.[1-5] But scientific studies are not without limitations. While they may prove that a certain diet works, they often don’t give guidance on putting that information into practice.
The “gold standard” in evidence quality is the randomized control trial (RCT) where participants are split into two groups: the control group gets a placebo (no treatment) while the treatment group receives the intervention. Ideally, the study is blinded, meaning that neither group knows which group they’re in, reducing the chance of the placebo effect. The RCT controls for all other factors between the groups (physical activity, age, etc.) so that differences in outcomes can only be attributed to the absence or presence of the treatment. When it comes to dietary lifestyle, however, such studies are incredibly difficult to conduct, for a number of logistical reasons. First, they are too strict to maintain for long periods of time, as is preferred when studying chronic diseases. Second, they don’t lend themselves to testing broad dietary patterns including whole foods; in order to maintain the level of control necessary for the RCT, researchers have to control how much and what participants eat in a very precise way. They have to control these factors to such an extent that they are no longer studying realistical dietary patterns and likewise cannot realistically provide support for translating treatment protocols to real world lifestyles; thus, weight loss, cholesterol, and blood glucose improvements quickly rebound in the months after a study concludes.
Jumpstart programs and social support groups present a very important supplement to the rigorous studies described above: they offer guidance for the practical application of evidence-based dietary advice for long-term lifestyle change.
In clinical trials, patients are prescribed strict diet plans that allow no room to personalize for individuals’ needs or preferences. And that’s the point: scientists want to see how effective a specific pattern of eating is on affecting health outcomes. To do so, they need to have precise measurements, down to the grams of protein consumed and decimal places of pounds lost. Any deviations from the plan result in decreased confidence in the diet’s effectiveness and in the validity of the study. And while this rigor is what allows for research to influence public policy and medical practice, it once again does little to help transform practice: it creates unrealistic expectations on individuals to follow diet plans without educating them on how to do so. After all, we live in complex, evolving communities, not sterile, controlled laboratories.
Jumpstart programs and social support groups present a very important supplement to the rigorous studies described above: they offer guidance for the practical application of evidence-based dietary advice for long-term lifestyle change. In research, these are akin to “self-management education” programs, where, instead of a doctor prescribing you a diet that interrupts your lifestyle, you are guided through skill- and community-building resources that shift your routines towards health-promoting practices.
Instead of passively receiving a diet plan in a clinical trial, participants in these more informal programs engage actively in lessons about nutrition, how to shop and cook affordably, and how to stay on track in social situations. The Center for Nutrition Studies (CNS) offers a 7-day Kickstart that incorporates recipes and plant-based education. Programs like these are often paired with community support groups such as Chef Del Sroufe’s Diet Daze Facebook Group, where people can share ideas, knowledge, struggles, and successes for sustainable weight loss and health. It is well known that many factors, including social context, convenience, and preference, influence food choices; and research has shown that interventions that incorporate nutrition education and social support are integral to long-term health behavioral change. [9,12,13]
Well-designed clinical studies provide important evidence for the power diet can play in the prevention, management, and reversal of some lifestyle diseases,[4,14-16] but there are other tools worth utilizing. By paying respects to non-clinical, community-led efforts to provide the missing support components needed for successful lifestyle changes, we elevate the evidence obtained in clinical studies. We bring those findings into the world of practice and create countless opportunities for sustainable change. While there is limited data on the quantitative effectiveness of these programs in the scientific literature, that’s almost the beauty of it: no strict randomization, weighing of foods, clinical lab visits, etc. Instead, you get to engage with healthy habits in your own environment, on your own terms. So, if you or a loved one is ever motivated to start a new health journey, don’t just settle on a meal plan or delivery service. None of us has to do it alone! Find a support group or community page where you can ask questions, learn cooking and physical activity skills, and make health a more sustainable, communal practice.
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