Are you one of the approximately 50% of Americans trying to lose weight? If so, what score would you give the nutrient density of your diet? A small, new study shows that your score would most likely fall short of what public health agencies consider healthy.

The data was presented this week at the American Heart Association’s Scientific Sessions 2022 and found that only 1 in 4 dieters accurately assessed how healthy their diet was. 

The study followed 116 individuals between the ages of 35 and 58 who were attempting to lose weight. Everyone met with a registered dietitian to discuss their diet and tracked their daily food and drink intake via a fitness app for one year. In addition to tracking food and drink, they also were required to wear a device that followed their physical activity. At the beginning and end of the study, participants completed a two-day, 24-hour recall of their diet. The foods recorded in the recall were then calculated to provide a healthy eating index (HEI) score. The HEI assesses how close a participant’s diet is to the US dietary guidelines. The higher the score, the better quality of the diet. Participants were also asked to self-score their diet as well. At the completion of the study, 1 in 4 individuals had an HEI score that agreed with their perceived self-scores. Study authors noted that lower quality diets may often lead to frustration and weight gain.

The study’s lead author, Dr. Jess Cheng, is a postdoctoral fellow department of epidemiology at the Harvard T.H. Chan School of Public Health and the Department of General Internal Medicine at Massachusetts General Hospital. Cheng completed the research while she was a predoctoral fellow/Ph.D. candidate at the University of Pittsburgh School of Public Health. She told TODAY that “there is information from NHANES (National Health and Nutrition Examination Survey) that summarizes people’s strategies when attempting to lose weight. These data suggest that while people do attempt to change the quality of their diet, exercise and eating less are more commonly utilized strategies than changing the intake of certain foods (e.g., fruit and sugar).”

Cheng also noted that “it’s possible there is confusion regarding what a healthy diet is, which might be addressed by public health resources and healthcare professionals.”

If you’re trying to lose weight, how can you be sure you are doing it in a way that promotes both health and weight loss? Here are five ways to get started.

Focus on quality of calories over quantity of calories

When it comes to healthy eating, the quality of your calories will always trump the quantity. When you choose to eat something, ask yourself what benefit food will have on your health, weight loss goals and longevity. Then, focus on eating foods that meet this need at least 90% of the time. One way to do this is to reduce the intake of ultra-processed foods, which provide calories, yet no real nourishment. Replace the potato chip with roasted chickpeas and the hot dog with a wild salmon sandwich on a cauliflower bun, for example. If you still want to focus on tracking numbers, focus on the number of hours in your eating window. Multiple studies show that simply consuming your food in an 8-10 hour window (a type of fasting called time-restricted eating) may help to shed pounds.

Seek professional guidance

When it comes to healthy eating, you may need to dig deeper into free, public health resources. Cheng stated that “consumers may be familiar with MyPlate, which replaced the Food Pyramid and which gives a good visual depiction of a healthy plate. However, they may not be aware that there are healthy recipes and other resources to test your knowledge and build nutrition knowledge and skills available on the MyPlate website.” She also suggests that “consumers might also discuss their diet with their health care provider who may be able to refer them to additional resources or to a professional such as a dietitian.”

Shop for foods that fills you up

Getting most of your calories from plants is a great way to ensure that you get plenty of vitamins, minerals, and fiber. Fiber, healthy fats and protein increase satiety and fullness — meaning you’ll eat less over the course of the day. One way to do this is to simply focus on more color. Aim for seven colors each day between meals and snacks. For example, have some whole grain steel-cut oats with berries for breakfast, an apple with almond butter for a snack, and mixed greens salad with extra virgin olive oil and grilled salmon for lunch. For protein, colorful beans and lentils provide both protein and fiber. For individuals looking to mix in some animal sources of protein, high-quality sources such as salmon, skinless white meat poultry, and small amounts of lean cuts of meat, such as wild bison, may help to fill protein needs. 

Respect the power of sleep

Sleep is essential for effective weight loss. Aiming for a 7-hour window, for example, has been shown to help improve brain health and may also help to promote fat loss and inhibit excessive hunger and cravings.   

Look beyond the scale

In the current study, participants were asked to weigh themselves daily. This daily habit may lead to an over-reliance on finding success with the number on the scale. True success in health may start with a reduction in belly fat; however, improvements in metabolic numbers that assess lipid and blood sugar levels, as well as liver enzymes, will be the true key to longevity. If weighing yourself daily helps you stay on track, it’s worth trying, but it can’t replace a yearly visit to your primary care provider who can assess other important measurements that may be more critical to your overall health.

Losing weight — and keeping it off — is challenging. You’re human so you won’t be the picture of perfectionism every day. That’s not only normal but expected. Instead, focus on finding nutrient-dense foods and making health your primary goal. The weight will probably start falling off if you do.



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