Make consistency a 'trend' when it comes to your diet

Posted: March 26, 2025

Simon Floss (host):
Hello and welcome to the “Health and Wellness” podcast series, brought to you by Sanford Health. I'm your host, Simon Floss with Sanford Health News. 
Various studies suggest that nearly half of Americans say that they want to lose weight. If you simply scroll any social media feed, there's countless people toting different diets as the best way to shed a few pounds or simply achieve your best health. 
And I'm sure you've heard of them – diets like keto, plant-based, carnivore, Mediterranean, intermittent fasting – and I'm sure you actually probably know someone who is on one of those diets right now. It can be hard to find a diet that fits you best and sets you up for success. 
So, to talk through all of the trendy diets you see online and weigh the pros and cons is the one and only Natasha Hansen. She's the senior sports dietitian at Sanford Sports. Natasha, how are you doing today?

Natasha Hansen, RD, LRD (guest):
I'm great. Thanks for having me.

Simon Floss:
Yeah. So last time we spoke, I think you said that you were like in the middle of training for a marathon or a half marathon. Is that right? 

Natasha Hansen, RD, LRD:
Yeah, I did. I ran the half marathon, the Sioux Falls half marathon in August. 

Simon Floss:
How did it go? 

Natasha Hansen, RD, LRD: 
Well, it was really hot. They actually canceled the full marathon. 

Simon Floss:
I remember that now. 

Natasha Hansen, RD, LRD: 
So, I was like, well, good thing I didn't sign up for the full, even though after I finished the half I was like, I can't even imagine this being half. Like it blows my mind.

Simon Floss:
For the people, I don't know where you're listening from, but we're recording from Sioux Falls, South Dakota, where like in the Midwest, that humidity in the summer is just ruthless, you know? 

Natasha Hansen, RD, LRD:
But I finished it, and it was my first half, so I didn't really have a time expectation, so that was kind of nice. I just finished it.

Simon Floss:
I'm sure, I'm sure you were flying, my friend. Well, let's get started here. So, we're going to talk about a handful of diets here. Wondering if you could first give a brief overview of each diet that we're going to talk about and a big one that's been around for the last five, six years-ish, is the ketogenic diet or keto diet. Quite a few folks listening to this have heard of it, but can you give us a brief overview of what keto is?

Natasha Hansen, RD, LRD:
Yeah, the keto diet is essentially a low-carb diet where you kind of put your body into what we call ketosis, and you start using ketones as energy instead of carbohydrates. And then essentially you're using more fats for energy instead of those carbs. The thought process behind it is that you're burning more fat.

Simon Floss:
I’ve seen people online and I've personally tried every single one of these diets myself, but I've seen a lot of people like have great success if they're looking for like weight loss specifically with the keto diet. But how might that diet impact overall health and wellness?

Natasha Hansen, RD, LRD:
What I've seen is that it will lead to a big initial significant drop in weight, but it's really hard to sustain that diet. Carbs are the energy source literally for your brain and for your muscles – the preferred energy source I should say, because then you start using fats. But since carbs are kind of that energy source to the brain and the muscles, fatigue is a huge symptom or side effect that I hear about a lot.

Simon Floss:
And especially if you're going to pair that with training, like athletic training and performance, you need energy. So if you're fatigued going into your workouts, imagine how hard that's going to be and how bad you might feel afterwards.

Natasha Hansen, RD, LRD:
Yeah. It's definitely not a diet that I'm recommending to athletes. And actually the ketogenic diet was originally designed for epilepsy, which is super interesting. And when I tell people that, they have no idea, but that's actually what the diet was originally designed for. I don't know the science behind it necessarily, but that is what it was originally designed for.

Simon Floss:
Fascinating. I am today years old learning that information. 
So, with keto, like you said, it's primarily fats. And what would be the percentage of people who are listening to this and macro tracking? What's like the percentage of fat out of the diet? I've heard some people say 70 to 80% and I'm like, are you only eating avocados? 

Natasha Hansen, RD, LRD:
Yeah, it's definitely super high in fats. Percentage, I think people are going as low as like 10% of their calories from carbs. General recommendations are usually about 50%. So going down to 10% and then you're increasing your fats and proteins. But I think it is more heavily focused on fats.

Simon Floss:
I've heard of people felt going into like when they get into ketosis, the keto flu. Have you heard of that? How can that be healthy? You know, if like your body gets sick doing a diet – 

Natasha Hansen, RD, LRD:
Yeah. And I think that's all that fatigue, you know? The fatigue kind of setting in almost making you feel like ill.

Simon Floss:
Ugh, yuck. So what are maybe some pros and cons to this diet?

Natasha Hansen, RD, LRD:
It may lead to some of that quick initial weight loss because you are using more fats as energy, but there are nutritional deficiencies that can go along with this diet as well because you're not getting much fiber, you're not getting many of those B vitamins that come in our whole grain carbohydrates. So again, that fatigue, the increase in fats, ideally, you're increasing your healthy fats, but if your fat percentage is 75% of your intake’s coming from fats, you're likely increasing your saturated fats in those unhealthy fats as well. So, those would be some of the cons.

Simon Floss:
What are examples of like saturated fats or unhealthy fats?

Natasha Hansen, RD, LRD:
Sure. Yeah. So anything, unfortunately it's a lot of foods. (Laugh) It's really unfortunate because there's a lot more saturated fats than there are unsaturated fats, which are going to be your healthy fats. 
But anything that's fried is going to be higher in saturated fats. There’re certain condiments like ranch and mayo, and alfredo, really tasty things, that are high in saturated fats, certain cuts of meat. You can actually see the fat on some cuts of meat. And those are going to be higher in saturated fats. 
And that's actually the difference between like your whole milk and skim milk is the amount of saturated fats.

Simon Floss:
Whole milk obviously would have more. 

Natasha Hansen, RD, LRD: 
Correct. 

Simon Floss: 
So, are there any, I mean other than initial weight loss, are there any positives? I've heard a lot of diabetics go on the keto diet and obviously they would have to have that guidance from someone like you or medical provider, you know. But are there any positives to this diet?

Natasha Hansen, RD, LRD:
It's also not a diet that I would recommend for diabetics, and I'm certainly not an expert in diabetes, but with diabetes, you want to have a consistent carbohydrate diet, not necessarily a very low carbohydrate diet because then you can go into hypoglycemia as well. And so, and that's a concern for diabetics as well. So, I don't think it would be a diet that I would recommend for those with diabetes either.

Simon Floss:
So, we sort of already alluded to it, but how does that diet affect fitness? Some folks say that when they quote, “know that they're in ketosis,” they actually feel better as far as being endurance athletes, but as we've talked about, carbs are super beneficial in overall athletic performance and training.

Natasha Hansen, RD, LRD:
Yeah, I think eventually, it depends if you're more of an endurance athlete, depending on the duration of your event or what you're training for, you're eventually going to hit a wall and you're eventually going to hit that fatigue that's going to set in without those carbohydrates. And so I don't think it's sustainable for especially endurance type training.

Simon Floss:
So, switching gears here, with both of these two diets sounding pretty fat forward, would you classify the BBBE diet or that stands for beef, butter, bacon and eggs diet, technically as a keto diet?

Natasha Hansen, RD, LRD:
Yeah, so the carnivore, the BBBE diet, the keto diet, they're all very low in carbs. And I think that's the overarching theme. And I will say too, like I think carbs get a bad rep. There’re so many different types of carbs, right? Sugar is technically a carb, so like the sugar in your soda is a carb, probably not the best carb, probably going to lead to weight gain. But then you have your whole grain type carbohydrates that are higher in fiber.

Simon Floss:
And sweet potato. Yeah, sweet potatoes: amazing. And healthy.

Natasha Hansen, RD, LRD:
Exactly. There's better carb choices and I think that's where maybe we get this idea that all carbs are bad, and I just don't agree with that. So, that's essentially the overarching theme I think of the carnivore and the BBBE diet as well.

Simon Floss:
I actually had never heard of that (BBBE) diet.

Natasha Hansen, RD, LRD:
I had to look it up too. I didn't know what it was, and I think my jaw dropped to the floor. This is all you're eating? Sounds like a heart attack to me. 

Simon Floss:
Seriously. Like, and how can that taste good? I imagine you get sick of that. Like I could maybe do that for like two days tops and then I would be miserable. How does BBBE diet, how would that affect your overall health and wellness? And would it have any positives or negatives to sports performance?

Natasha Hansen, RD, LRD:
Well, I think just to compare it to keto too, at least with the keto, you're getting some fruits and vegetables in there as well. With the carnivore and the BBBE diet, there's no fruit or vegetable intake because it's just animal proteins. 
So, that's even more risky for your saturated fats. I mean the bacon, beef, butter and egg, all of those have saturated fats in them. And so, to me, that's going to increase your risk for heart disease. And then you're not getting all those nutrients from fruits and vegetables, so you're missing out on all these nutrients.

Simon Floss:
I'm sure some people are listening and would say something like, oh, well I could just take a multivitamin or a handful of supplements. How would you respond to that?

Natasha Hansen, RD, LRD:
Supplements, there are certain cases where I recommend supplements, but supplements certainly don't replace food. The nutrients, vitamins, and minerals from your food are way better absorbed than from a supplement.

Simon Floss:
What are some of those instances where you would recommend a supplement?

Natasha Hansen, RD, LRD:
If somebody's deficient. If we've actually gotten some blood work, somebody's deficient in a certain nutrient, then we definitely need to think about adding some sort of supplement or adding that. 
Iron deficiencies are a common one that I see. Then we're adding a specific iron, not necessarily a multivitamin. If somebody, and this happens sometimes, they get clients that just refuse to eat, you know, vegetables and so this is a case where at least let's get that multivitamin in. 

Simon Floss:
Why wouldn't you eat vegetables? Veggies are great.

Natasha Hansen, RD, LRD:
It's all about how you cook them.

Simon Floss:
OK, so I'm curious. What's technically better for you? Cooked or raw vegetables?

Natasha Hansen, RD, LRD:
The cooking process does decrease some of the nutritional value, but you're still getting such a great value from a nutritional standpoint, even if you're cooking your vegetables. So, most people prefer cooked vegetables over raw vegetables. We're still getting a good value of nutrients from cooked vegetables.

Simon Floss:
And are cooked vegetables easier to digest?

Natasha Hansen, RD, LRD:
Yeah, you could say that part of the reason is because, so this could be a positive or a negative I guess, but part of the reason is because you're decreasing that fiber. Fiber takes a little bit longer to digest. And so, it could be easier to digest if you're cooking them.

Simon Floss:
Talking about vegetables. Well, I don't want to glance over the carnivore diet, so maybe really quickly we could go back to that, but I feel like we've already talked a lot about it. But what is the carnivore diet and how can it impact health and wellness?

Natasha Hansen, RD, LRD:
Yeah. The carnivore diet is really only eating foods that come from an animal. So, you've got any sort of animal meat, right? But dairy products as well, eggs, milk, and you're missing out on the nutrients from fruits and vegetables and plant foods as well. And ultimately compromising immunity when you're missing out on all those nutrients from fruits and vegetables.

Simon Floss:
So, talking about fruits and vegetables, let's talk about a plant-based diet. Walk me through that and weigh out some of the positives and negatives.

Natasha Hansen, RD, LRD:
There are definitely a lot of positives of trying to eat more of a plant-based diet. You're getting your fruits and vegetables. Most plant-based diets also include like more of those whole grain, those better carbohydrates that I mentioned. And the only risk that I really see with the plant-based diet is not getting enough protein, if you think about it. 
There’s protein in plant sources. There's certainly a lot of like plant sources that have protein, but the best way to explain that to people sometimes is like, OK, if you take let's say a turkey burger or a veggie burger, you're probably going to have to have like three veggie burgers to get as much protein in a turkey burger. So, I'll talk that through with people who are considering the plant-based diet. You might have to eat more to be able to get the amount of protein that you need.

Simon Floss:
And if people are trying to, you know, lose weight – 

Natasha Hansen, RD, LRD:
Correct. I mean, you're technically having to eat more quantity to get all the protein that you need. And then we're risking loss of muscle mass and things like that too. 

Simon Floss:
I've heard people who say like, oh yeah, I switched to vegan, or I switched to plant-based, and I've just never felt better in my life. When it comes to vegetables and fruits, there are a lot of like quote unquote, and we should get to this later, “superfoods.” So, of course you're going to feel better because you're eating a wider variety of fruits and vegetables are quote unquote “superfoods.” But in the long run, much like the diets that we've discussed, it might not be the best for you. Is that right?

Natasha Hansen, RD, LRD:
Yeah, I mean, you're missing out on an entire food group. And that's what I always come back to is OK, are we missing out on any food groups here? And then which nutrients from that food group? So, what specific nutrients are we missing from there? Which, from animal proteins, would be like vitamin B12. So yeah, always kind of coming back to like, what are we missing from this, from this fad diet?

Simon Floss:
The buzzword “superfood.” Are there any actual superfoods? I've heard that like kiwi and blueberries are the greatest superfoods that you can possibly have. But we obviously need to talk to the pro. 

Natasha Hansen, RD, LRD:
I'm not a big fan of this word, and I do get asked this a lot. There's not one food that is going to give you everything that you need. And so, I'm just not a big fan of that word. There's certain, especially when it comes to a lot of fruits and vegetables that are super high in like antioxidants. And I think a lot of people use superfoods and antioxidants. Like typically when I hear of a food being a superfood, it's high in antioxidants, but it's always good to get a well-balanced of all foods.

Simon Floss:
(Laugh) And speaking of well-balanced, let's talk about the Mediterranean diet. A lot of places online say that this is the best overall diet one can follow. What comprises of this diet?

Natasha Hansen, RD, LRD:
Yeah, so this diet limits red meats and added sugar and it emphasizes on like healthy fats and whole grains. This out of the diets we've talked about so far, I like this diet the best because you're not eliminating any specific food group, you're increasing your healthy fats, you're limiting your red meat. It doesn't say you have to completely eliminate; you're just limiting your red meats and red meats are going to be higher in those saturated fats like I mentioned. And so I think this is a good, well-balanced diet.

Simon Floss:
And increasing your healthy fats. What are examples of healthy fats?

Natasha Hansen, RD, LRD:
So, healthy fats (include) avocados, olive oils, olives, nuts and seeds, any sort of nut butter. So, you know, you got peanuts, peanut butter, any sort of seed, sunflower seeds, pumpkin seeds, flax seeds, chia seeds, any sort of nut or seed is going to be a good healthy fat as well. And fish.

Simon Floss:
Ugh, I love fish. If I had it my way, I would eat salmon every single day of my life.

Natasha Hansen, RD, LRD:
Good for you. A lot of people are not like that.

Simon Floss:
I love it. It's really good. So, speaking of like nut butters, I'm curious, have you ever had, it's from this brand called 88 Acres. It's pumpkin seed butter and they like grind up pumpkin seeds until it has the consistency of like butter and it's green. It's so good. I'm not sure if you're a fan of nut butters?

Natasha Hansen, RD, LRD:
I am a fan of nut butters. I've heard of that brand, 88 Acres. Yeah. They have good granola bars that I'm often recommending to clients because they're really low in added sugar. They're higher in fiber, a little bit higher in protein. But I have not tried their nut butter. But I do think that sounds like something I would like.

Simon Floss:
Well, I will also caveat it by say by saying you know be careful because it's so good (that you can end up eating the whole jar). 

Natasha Hansen, RD, LRD:
Probably not very cheap either.

Simon Floss:
No, no it's not. But you know, no good things are. Lastly here as we're rounding third, the intermittent fasting, what is that?

Natasha Hansen, RD, LRD:
Intermittent fasting. There's so many different variations to this diet, but basically, you're limiting what I call fueling window. You're limiting that to like a certain timeframe. Sometimes people even go like, I'm going to fast every other day, so I'm only going to eat every other day. Or sometimes it's like, I'm only going to eat between like 10:00 AM and 6:00 PM so you're kind of limiting your fueling hours.

Simon Floss:
I was huge into intermittent fasting. And I feel like there might be some pros and cons that we could talk about, but maybe one of the cons, if you're only giving your body a specific window to eat, then in theory your body's hanging on to what you just gave it for as long as possible, because it’s like, oh, I don't know when we're going to eat next. So, in theory, could your metabolism actually slow down because of intermittent fasting?

Natasha Hansen, RD, LRD:
Definitely. Yep. So, if you get to the point where your body kind of starts to switch into starvation mode, no matter what you're eating, your body's going to store that as fat because it's in starvation mode. And it's like, and when you store things as fat, your body can hang on to that energy a little bit longer. And so that's why our body does that when we're in starvation mode. 
But yeah, you’re kind of tanking your metabolism, or there's certainly better ways to do the intermittent fasting. But I think essentially the overall thought process behind it is like, if you're decreasing your window of eating, you are decreasing your calorie intake, which isn't always the case. I've ran into situations with clients where it's like, you're eating a lot (laugh) in a short, short period of time. Yeah. Like that cannot feel good on your stomach. 
So, I think since there are so many different variations of this diet. It really just depends how somebody's doing it.

Simon Floss:
You said there's good ways to do it, or a smart way to do it. What's a smart way to do it? I've heard that you shouldn’t eat three hours before bed or something like that. Is there any truth to that or merit to that?

Natasha Hansen, RD, LRD:
Yeah, I do get asked what time should I stop eating? I get asked that a lot. And it really depends what time you're going to bed, because I don't give people a specific time – you should stop at 7:00 p.m. – because it depends on your work schedule. Like what if you're not going to bed until 2:00 a.m.? Well, that's a really long time to go without having some sort of snack. 
I generally don't recommend the intermittent fasting diet. There's really no scientific proof that it's any more effective than your traditional low-calorie diet because again, I think that's the overarching idea is that OK, you're consuming less calories, but there's no difference between that or the intermittent fasting or just going on a lower calorie diet.

Simon Floss:
Everybody talks about whole foods. And not just the, you know, the grocery store. Although I love Whole Foods grocery stores. 

Natasha Hansen, RD, LRD: 
I do too. It's incredible. 

Simon Floss: 
Those macaroons. Oh my gosh.

Natasha Hansen, RD, LRD:
I also love Trader Joe’s, and I wish we had one here in Sioux Falls.

Simon Floss:
Man, I know. I think there's been like some sort of like write to the mayor movement to get a Trader Joe's into Sioux Falls and, you know – 

Natasha Hansen, RD, LRD:
Well, I will join (laugh). I'll be right out there if anyone else wants to join me (laugh).

Simon Floss:
And all of their stuff's actually like really cheap too. 

Natasha Hansen, RD, LRD: 
Exactly. It's amazing. 

Simon Floss:
So, “whole foods,” very high search volume online. What are whole foods and how are they incorporated or not incorporated into these diet trends that we've discussed?

Natasha Hansen, RD, LRD:
I would say when you're, when referring to whole foods, it's a really broad terminology. It really means like unprocessed or minimally processed foods that are close to their natural state. So basically, you're choosing less processed, less packaged, less fast foods. 
And also another thing that I think of when I think of whole foods is like one ingredient foods. Sometimes I'll talk to my clients about this, like, OK, chicken, egg, fruit, a piece of fruit, a vegetable, you know, one ingredient foods. And try to incorporate those more into your diet.

Simon Floss:
We've already talked about it a little bit, but which of these diets that we discussed are good and which ones should maybe consumers ditch? Or is it maybe more about just finding out what works for you based on your individual needs?

Natasha Hansen, RD, LRD:
Nutrition is very individualized, and that's, I honestly take pride when I work with my clients of taking a very individualized approach. 
But really the best diet is the one that you can sustain for the longest period of time and one that's going to fit within your life.
Based on the diets that we've talked about, I like the Mediterranean diet. Again, you're not excluding any specific foods. And I like the idea of like eating more of a plant-based diet, but maybe not only limiting yourself to just plant-based foods, but maybe your diet is higher in plant-based items.

Simon Floss:
And you talk about taking an individual approach for each of your clients. How do people contact you or other dietitians at Sanford and why should someone choose Sanford for their nutritional needs?

Natasha Hansen, RD, LRD:
Yeah, so people can just call the Sanford Fieldhouse front desk. The Sanford Fieldhouse is just located right across from the Pentagon. I've also had people just stop in, ask about me at the front desk, and if I'm available, I'll just come out and talk. We also have a webpage, the Sanford Sports webpage, where you can find, if you go under nutrition, there's a way where you can contact me directly right through there as well. And then I'll get that email and then I'll reach out. 
But you know, I've been a registered dietitian for nine years now. I have lots of experience with a wide variety of population. I've had a 9-year-old and I've had a 70-year-old. So, I have worked everywhere in between too. 

Simon Floss:
Didn't this summer, didn't you say you were the lead sports nutritionist for Kansas University or something? 

Natasha Hansen, RD, LRD:
Yeah. So, before starting at Sanford Sports in November of (20)23, I was the director of performance and nutrition at KU from 2018 to 2023. So, a lot of experience within the collegiate athletic setting as well.

Simon Floss:
Did you did you meet, oh, what's his name? He plays for the Raptors now. Grady Dick? 

Natasha Hansen, RD, LRD: 
Yeah. 

Simon Floss:
Cool. Nice. Wow, small world.

Natasha Hansen, RD, LRD:
He was only on the KU team for one year, so I got to know him as much as I could in that one year, but yes, I did work with him. Yeah.

Simon Floss:
I watched the Raptors game last night and I was like, oh, yeah. I went to a KU game once and I got to see him play, so it was kind of cool. But I'm so sorry I interrupted. But that's just a very cool thing that I think a lot of people would want to know. You really know your stuff.

Natasha Hansen, RD, LRD:
Yeah. And I think another reason to work with me is just because I take that individualized approach. And what I mean by that is like, I want to work with my clients, whatever's going to work best with them. 
And I'm very flexible. I'm not someone who's going to be like, super strict. I really do think that all foods fit within your diet. It really is about moderation and being able to not overindulge. And so, I'm never going to say like, you can't eat this. And I think people really appreciate that.

Simon Floss:
I was listening to something online and the someone said, “I don't view like, cheat meals as like a cheat meal. I call it a treat meal,” so that way there's like a little bit of positivity associated. 

Natasha Hansen, RD, LRD:
I do like that better. 

Simon Floss:
Well, we actually ran out of time. I could talk about this for hours and hours and hours but thank you so much for letting us come out and talk to you today. 

Natasha Hansen, RD, LRD:
Thanks so much for having me.

Simon Floss:
A reminder that you can find this podcast and many others on your favorite podcast apps like Apple, Spotify, YouTube, or by heading on over to our website, news.sanfordhealth.org. Thanks again for listening. I'm Simon Floss with Sanford Health News.