When trying to lose weight, a number of factors can weaken your resolve and prevent you from making progress. But in many cases, the scale may refuse to budge, even if you stick to your plan. Study results show that part of the problem may lie in our food perceptions and misperceptions.
Researchers have found that people trying to lose weight often overestimate the health of their diet, a bias that could sabotage weight loss efforts. The preliminary research will be presented at the American Heart Association’s 2022 Scientific Sessions, which will be held in-person in Chicago and virtually, Nov. 5-7.
“We found that while people generally know that fruits and vegetables are healthy, there may be a disconnect between what researchers and health professionals consider a healthy, balanced diet versus what the public thinks be a healthy, balanced diet,” the study said. author Jessica Cheng, PhD, postdoctoral fellow in epidemiology at Harvard TH Chan School of Public Health and general internal medicine at Massachusetts General Hospital, both in Boston, in a press release.
About half of adults in the United States try to lose weight each year
Nearly half of American adults try to lose weight each year, according to the Centers for Disease Control and Prevention (CDC) (PDF), with the majority trying to eat more fruits, vegetables and salads.
This is an area most Americans need to improve. A CDC report (PDF) published in January 2022 found that only about 1 in 8 adults eat the recommended 1.5 to 2 cups of fruit each day, and only 1 in 10 eat the recommended 2 to 3 cups of vegetables per day. , including legumes.
Most people don’t realize how much their diet can be changed
To find out how people’s perceptions of their eating habits matched reality, the researchers recruited 116 adults between the ages of 35 and 58 in the Pittsburgh area who were trying to lose weight.
Study participants met with a dietitian one-on-one to discuss their nutrition, then tracked what they ate and drank each day for a year on the Fitbit app. They also weighed themselves daily and wore a Fitbit device to track their physical activity.
Researchers assessed participants’ diets at the start and end of the study and assigned each person a Healthy Eating Index (HEI) score based on the types of foods participants reported eating. .
The HEI is a measure of how well a diet aligns with the US government’s dietary guidelines for Americans. A score from 0 to 100 is assigned, based on the frequency of consumption of various food components such as fruits, vegetables, whole and refined grains, meat and seafood, sodium, fats and sugars. The higher the score, the healthier the diet.
Participants were also asked to perform a 24-hour food recall for two days at each time point.
At the end of the one-year trial, subjects used the HEI to rate themselves on the quality of their diet. The self-report of their baseline diet was a “rollback” because they recorded both their baseline and end diets at the end of the study; the difference between their baseline and end scores was their perceived diet change. A difference of 6 points or less between the researchers’ HEI score and the participant’s perceived score was considered “good agreement”.
Investigators found that 3 out of 4 participants’ scores were inconsistent, meaning that the overall health of their diets did not match expert ratings. In most cases, the subjects’ perceived score was higher than the HEI score assigned by the researchers – the mean perceived score was 67.6 and the mean HEI score was 56.4.
When judging the change in their diet over the 12-month study, only 1 in 10 participants correctly estimated how much they had improved in their eating habits. On average, participants only improved the quality of their diet by about 1 point based on the score assessed by the researcher. However, participants’ self-assessment was a perceived improvement of 18 points.
“People trying to lose weight or healthcare professionals assisting people with weight loss or nutrition-related goals should be aware that there is likely more room for improvement. diet than you would expect,” Dr Cheng said.
Some limitations to the results of the study
The authors acknowledged some limitations to the results. Participants were mostly female (79%) and the majority said they were Caucasian (84%), so the findings may not apply in the same way to other populations.
It should also be noted that the researchers only assessed perceptions of diet quality at the end of the study. Ratings throughout the study may have helped answer questions such as whether perception became more realistic over the course of the study or whether a person’s perception of their diet helps or hinders it. to make dietary changes, the authors said.
Lack of food safety awareness could lead to weight gain
“Overestimating the perceived healthiness of food intake could lead to weight gain, frustrations of not meeting personal weight loss goals, or a lower likelihood of adopting healthier eating habits,” says Deepika Laddu. , PhD, assistant professor in the College of Applied Health Sciences at the University of Illinois at Chicago, and chair of the AHA Council on Lifestyle Behavior Change for Improving Health Factors, in the press release.
Although it is not uncommon for dieters to overestimate the health of the foods they eat, these findings provide further support for behavioral counseling interventions that include more frequent contact with health professionals, such as dietitians or health coaches, to fill in the perception gaps and support long-term healthy and sustainable eating behaviors, Dr. Laddu said.
Food choices linked to 2 in 3 heart disease deaths
According to the AHA, a healthy diet is essential for heart and general health, as well as longevity. Heart disease is the leading cause of death for both men and women in the United States, causing approximately 659,000 deaths each year, according to the CDC.
More than two-thirds of heart disease-related deaths worldwide can be linked to food choices, according to a study published in October 2020 in the European Heart Journal Quality Care Clinical Outcomes. The authors of the study estimated that six million deaths could have been prevented by better diets.
Recommendations on where to find reliable information on the nutritional content of different foods
The AHA Dietary Guidance published in 2021 advises the following recommendations for adults:
- Eat a variety of fruits and vegetables
- Choose whole grains over refined grains
- Choose healthy protein sources
- Replace skimmed and low-fat dairy products with non-fat versions
- If you eat meat, choose lean cuts
- Use liquid vegetable oils instead of tropical oils and animal fats
- Choose minimally processed foods over ultra-processed foods
- Minimize foods and beverages with added sugar
- Choose foods with little or no added salt
- Limit or avoid alcohol
Learning about the nutritional content of different foods is a good idea, but beware of misinformation on the Internet, says Alice H. Lichtenstein, DSc, chair of the AHA’s Statement Writing Group and senior scientist and director of the Cardiovascular Nutrition Team at the USDA Aging Research Center in Human Nutrition at Tufts University in Boston.
Dr. Lichtenstein recommends getting information from reputable sources such as government websites such as the FDA or the National Institute of Health (NIH). “Advocacy organizations like the AHA or the American Diabetes Association will also have sound dietary advice,” she says.
She also recommends checking the internet for nutrition information on takeout or prepared meals. As a general rule, even for convenience foods or takeout, the less processed the better, according to Lichtenstein.
If you read about a certain food or diet that sounds “too good to be true,” it probably is, she says. If in doubt about embarking on any type of diet, talk to your healthcare provider, she added.
Eating healthier doesn’t have to be “all or nothing”
When it comes to developing a healthy eating pattern, it’s important to understand that you don’t have to be “all or nothing, to feel the benefits,” says Susan Strom, RD, at UNC Health in Chapel Hill, North Carolina, which was not involved in the research.
“Take a look at your usual intake and decide you want to change one thing and go from there,” she suggests. “Maybe it’s to stop drinking soda or to make sure you eat at least one fruit and vegetable every day or start cooking dinner at home rather than getting takeout.”
The important thing is to make changes that you can stick to in the long run so that they stick, she says. “Keep adding new goals for yourself around food and activity to improve not only the quantity of your life, but also the quality of your life.”
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