Why This Registered Dietitian Tells (Some of) Her Patients to Avoid Kale Salads

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I’ve worked as a dietitian in a gastroenterology practice long enough to have seen many food trends come and go.

When I first started practicing, an austere, sugar-free regimen called the “candida diet” was popular among patients of mine who had gone the alternative health route before consulting with me, so I practically got whiplash when just a few years later, the juicing craze hit and suddenly everyone seemed to be consuming nothing but sugar.

After all, juicing just means creating a cocktail of concentrated sugars from the fruits and vegetables they derive from. Soon after, my patients ushered me through the paleo craze (what I call the neo-Paleolithic era of 2013-2014), and I’ve watched as increasing numbers of them have gone gluten-free since then as paleo and paleo-esque diets like Whole30 mandate cutting out gluten-containing foods.

Starting in 2015, I’ve been called upon by patients figuring out how to eat “normally” again after so-called clean diets scared them into thinking that dairy, sugar, grains, and legumes were basically poison. Soon after, I watched helplessly as the ketogenic diet claimed almost everything that was healthy and good from some of my patients’ diets in favor of bacon, beef, and cheese. Most recently, I’ve been helping patients make sense of the overwhelming dietary dictates emerging from personalized food sensitivity and gut microbiome tests.

The particulars of each new diet sensation vary, but the scenario I encounter with my patients on these programs has been remarkably consistent. People arrive at my office having recently adopted a new regimen for which they drastically change their usual eating habits—eliminating certain foods and wholeheartedly embracing others—all in a quest for better health, better energy, and better living. Sometimes, at least initially, weight seems to be coming off, much to their delight.

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