Contributor: Kathy Warwick, RD, LD, CDCES
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If you want to start a spirited discussion, ask a group of people about the best “diet” out there. Chances are, there will be as many strong opinions as there are folks in the room! After working with clients for nearly 40 years, my answer to this question is “diets don’t work” or “DIET is a four-letter word.” Here's why:

• Diets tend to be restrictive and temporary, with most dieters sticking it out only a few weeks to a few months.
• Diets can also be expensive when special foods are required, or the entire household can’t eat along with the dieter.
• Dieting is characterized by deprivation and can foster an unhealthy relationship with food and feelings of guilt or failure.

Intermittent Fasting is a hot topic these days. The approach doesn’t focus as much on what foods are eaten or eliminated, but on the time frame allowed for eating or fasting patterns. Fasting has long been a part of spiritual practices in many religions, but it has become popular as a weight-loss method. There are many different approaches, including:

• alternate-day fasting
• five days eating and two consecutive days fasting each week
• every other week energy restriction
• time-restricted-eating

Because there are so many different interpretations of intermittent fasting, it is difficult to find conclusive evidence for the safest, most effective method. Only 11 short-term trials have compared Intermittent Fasting to a daily routine of reduced calories, and no randomized trials have compared time-restricted-eating to daily calorie restriction. A meta-analysis published in 2019 suggested that weight loss using intermittent fasting was comparable to continuous daily calorie restriction. Some evidence suggests a slightly higher percentage of fat loss with intermittent fasting, and time-restricted-eating has shown decreased insulin resistance in a small study in men with prediabetes.

There are many safety considerations for those living with diabetes when it comes to fasting; primarily, the need to adjust medications to avoid significant hypoglycemia. Fasting is not recommended for:

• children
• pregnant or lactating women
• older frail adults
• immunocompromised patients
• those with a recent stroke or heart attack
• those undergoing cancer treatment

It may be easier to adhere to time-restricted-eating and to incorporate it into a healthy lifestyle plan. People following this plan will eat during an 8-10 hour window and then fast for 16-14 hours. Studies have shown that nighttime eating and eating most calories later in the evening are tied to greater insulin resistance and heart disease. By eating earlier in the day to align with circadian rhythms and limiting nighttime snacking, people with diabetes may reduce calorie intake and improve insulin sensitivity. If you are interested in periodic fasting or time-restricted-eating, you should have a detailed discussion with your diabetes healthcare provider.

Other nutrition hot topics are eating locally and decreasing food waste. Finding a farmer’s market or nearby produce stand may take a little research if you prefer fresh in-season offerings, but local supermarkets have begun to offer more locally grown items as well. By eating in-season fruits and vegetables, you can up your nutrition and cut the food budget. Remember that all canned, frozen, and fresh fruits and vegetables are equally nutritious.

Food waste in the US totals about 1 pound per person daily or 103 tons annually. This represents 30-40% of the food produced, and most of it ends up in the landfill. Have you ever passed up a bag of carrots or apples because their appearance wasn’t perfect? Well, we are pretty spoiled here, and we tend to expect flawless produce. Several start-up companies have begun to market “ugly” fruits and vegetables, which provide just as much nutrition and may be used in most cooking applications. With 54 million Americans who are food insecure, doing our part in each of our households to reduce food waste can mean more food available to be shared with those in need.

Our last hot items are the air-fryer and the instant pot (or a combo of the two!) I had resisted the urge to purchase another kitchen gadget, but these two appliances can save you time and expand your menu horizons, especially if you are juggling work and home life while trying to manage a complicated disease. Check out these great lower-carb meals and recipes that no doubt will be crowd-pleasers:

• 39 Air-fryer Recipes from delish
• 50 Best Keto Air Fryer Recipes from Everyday Family Cooking

What’s the bottom line? Healthy lifestyle eating or long-term eating pattern changes are the answer. No quick fixes, no miracle cures, no sensational headlines, but lifelong gradual changes in habits are more likely to pay off in better health outcomes.

Kathy Warwick is a Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist with 39 years of experience in several areas of dietetics practice. She is owner of Professional Nutrition Consultants, LLC in Madison, Mississippi, providing diabetes education and support, long-term care consultation, hospice consultation, wellness program services, media communications, and medical-legal consultation.

Kathy speaks regularly to community and professional groups and has presented multiple national webinars. She has authored several articles and serves as a medical reviewer for Healthline.com and Medical News Today. Kathy currently serves as the Associate Editor of On the Cutting Edge, for the Diabetes Dietetic Practice Group of the Academy of Nutrition and Dietetics. She is a Past-President of the Mississippi Academy of Nutrition and Dietetics. In her spare time, Kathy enjoys her grandbabies, gardening, caring for her chickens, yoga, and a weekly art class.