Everyone is fascinated by the idea of the “perfect diet,” but does such a thing even exist?
While technological progress promises personalized dietary recommendations, social media is littered with the alluring headlines of pseudoscience.
When the line between truth and falsehood is blurred, evidence-based knowledge becomes critically important. So, against this backdrop, how should we plan our meals so that they are both healthy and a good fit for our daily lives?
Medscriptum spoke with nutritionist Rusudan Gvamichava on these very topics. In the interview, we discussed current issues in the constantly evolving science of nutrition, from personalized diets to gender-specific recommendations. These messages will help you filter information and understand how to make food a source of pleasure and health, not fear.
Salome Chkheidze: Many experts talk about the great potential of personalized nutrition based on the specifics of genetics and the microbiome, but what impact does this have on the average person?
Rusudan Gvamichava: Personalization is a very important topic because when talking about health issues, it’s essential to consider individual factors. While there are general recommendations that can be applied on a superficial level, we cannot go into depth without specific information and personal details about an individual. Therefore, I believe that a personalized nutritional plan is the only correct way when a person wants to achieve specific goals. This could be improving health indicators, managing weight, or any other reason. As for innovations on the market, such as nutrigenetics tests or other similar analyses, I think they are additional tools. At this stage, we do not yet have sufficient scientific evidence that these analyses provide more benefits than, for example, nutritional recommendations compiled based on an interview and a standard blood check-up. So I would say that these are more auxiliary, additional tools that are not very accessible. Nevertheless, it will be interesting to see how all this develops in the future. Over time, it will probably become more accessible and we may see even more benefits.
Salome Chkheidze: The microbiome is crucial for health, which is why the gastrointestinal tract is often called the “second brain.” The question is, is there an evidence-based diet that has a positive effect on mental disorders?
Rusudan Gvamichava: Absolutely. In recent years, this topic has become even more relevant, and the digestive system has been given a crucial role. I think the COVID pandemic accelerated this process even further. We should not forget that most of the absorption and assimilation of nutrients takes place in the intestines. Therefore, no matter how healthily we eat, if the body cannot absorb it, it affects everything – from mood to immunity. This issue is very important and familiar to many – the connection between mood and the digestive system, for example, when we are nervous, we may experience unpleasant sensations or diarrhea.
Recent studies have linked the Mediterranean diet to a reduction in the risk and symptoms of depression. This diet is rich in fiber, fermented products, healthy fats (omega-3), and antioxidants. Conversely, ultra-processed foods, which are often full of unhealthy fats and high amounts of salt and sugar, on the contrary, exacerbate anxiety and increase the risks of mental disorders. Therefore, a huge link between nutrition and mental well-being definitely exists, and by choosing food correctly, we can significantly support our health.
Salome Chkheidze: Since the time of Hippocrates, food has been considered medicine, yet a balanced diet is still not integrated with pharmacotherapy. (When talking about dietary restrictions for medical indications, most people only think of arterial hypertension). What is needed for nutrition to be integrated into the treatment plans for other pathologies?
Rusudan Gvamichava: In reality, science has supported all of this for a long time, but the problem is a change in the system, which has already begun in many countries, and hopefully, sooner or later, it will happen in Georgia too. Pharmacotherapy is given higher priority because it has a quick and measurable effect, whereas changing eating habits and diet requires a lot of time and effort. Unfortunately, it is difficult for people to believe how much power food has. They often think that solving a problem with a pill is an easier and permanent solution, but they quickly realize that there is no alternative to changing their dietary habits.
To change all of this, first of all, it is necessary to have professional nutritionists and dietitians with reliable education. In the world, and especially in Georgia, it is essential that their qualifications are not limited to just a few weeks of courses. For example, in the UK, other healthcare specialists, specifically family doctors, are also being actively retrained. Since the family doctor is the first point of contact for a patient, it is important that they can at least provide basic advice on this topic.
At the same time, it is important that nutrition is recognized as a separate profession and science. Also, the introduction of regulations would help a lot. Unfortunately, at this stage, anyone can say that they are a nutritionist or a dietitian, which often leads to disastrous consequences, even life-threatening situations.
When we talk about current topics, it is impossible not to discuss the evolution of weight management strategies. Today, when we live in the era of bariatrics and Ozempic, questions arise.
Salome Chkheidze: Against this backdrop, what unseen risks can be associated with relying solely on medication instead of developing healthy eating habits? Will we be able to maintain a healthy relationship with food in this new era?
Rusudan Gvamichava: Thank you for this question’s formulation, as the second part is often ignored. The emergence of such medications is, of course, a revolution in the system of weight loss and management. However, when medication becomes the only strategy, people can lose the ability to improve their eating habits. Data is still scarce, but it is known that weight often returns after stopping the medication. This happens because people do not change their diet and habits; they just take the medication, which causes a decrease in appetite. When the medication is withdrawn, the weight returns.
It is also worth considering that rapid weight loss is often followed by a loss of muscle mass, which is the most undesirable outcome for health. When weight returns, it is almost always in the form of fat, because increasing muscle mass requires much more effort. The main risk is that society may develop a dependence not on food as an important tool for health, but on managing all of this with medication alone. Therefore, it would be good to often remind people that there is no alternative to a healthy diet and lifestyle, and that medication can only be an auxiliary tool, not the main instrument, and only when its use is absolutely necessary.
It is also unfortunate that these medications have become a mass-market product and are being taken by people who don’t actually need them. This will likely exacerbate the already growing problem of eating disorders.
Salome Chkheidze: Yes, the spread of misinformation probably exacerbates the situation… In the age of social media, it is difficult to filter information without inadvertently becoming a “victim” of pseudoscience. As a nutritionist, which of the most “dangerous” myths would you single out?
Rusudan Gvamichava: As for myths, I would say that the fasting trend is particularly relevant at this stage. It is dangerous to think that the longer you fast, the thinner and healthier you will be.
In addition, we often encounter unscientific articles on social media, where they write that a specific product, for example, pineapple, burns fat. Such information is, of course, false and has no scientific basis. In this case, eating pineapple is harmless to your health, which cannot be said for the propaganda of fasting.
Both abroad and in Georgia, we often see lifestyle bloggers who advertise 48-hour or 36-hour fasting. In reality, fasting is very dangerous for both mental and physical health. It can even be life-threatening.
Salome Chkheidze: What would you say about the growing business of nutritional supplements?
Rusudan Gvamichava: When people ask me about supplements, I always ask them why they had this idea in the first place or what they need them for. In most cases, the answer is: “I just heard it was good.” This is, of course, not a valid reason. Supplements always have a specific function. As the word itself tells us, it should supplement the main food and not be the main source of nutrients. I also hear the phrase: “I can’t manage to eat well anyway, so I’ll take a supplement in the form of a vitamin or mineral.” In such cases, I always remind them that supplements can never be a basic source of nutrition. It is important to understand what we need a supplement for and to find scientific research that confirms that a particular substance improves a specific indicator.
Often people take advice from unreliable professionals on social media, such as TikTok, which I would definitely not recommend. In recent years, the wellness field has become more of a business industry, where a lot of money is spent. Therefore, people should have the right expectations so they are not disappointed.
Salome Chkheidze: We often see products on the market that promise desirable results but actually contain no active compounds that could cause such an effect. In this case, how can we help people learn to “read ingredients correctly”?
Rusudan Gvamichava: First of all, it is necessary to have comprehensive information. New products often do not have a complete list of ingredients. Therefore, it is always important to contact the company and find information about each ingredient. ChatGPT can also be useful for simply understanding what each substance is. We should also pay attention to reliable international certifications. Sometimes many certificates are listed on products, but some of them may not even exist. This, as a rule, happens on a small market, and large companies avoid it.
Therefore, at this stage, verifying any information is the only way to protect ourselves from unnecessary expenses and health problems.
Salome Chkheidze: The concentration of nitrates in food has recently become a particular concern, and measuring devices have also become popular. What do you think about this issue, and do we have reason to be afraid?
Rusudan Gvamichava: This topic has become very active recently, which is good because public interest has also increased. It is difficult to talk about this because many things are still unknown. First of all, a great deal of responsibility rests with the agencies that control all of this. People often use home devices to check for nitrates, but, as is known, such devices are not always accurate, so relying solely on them may not be correct.
I wish that food safety specialists would talk about this topic more often and share information with us, for example, which devices are more reliable and how to use them correctly. A general tip might be that seasonal products have a lower nitrate content, but in several TV shows that I personally watched, nitrates were found in seasonal products (e.g., watermelon). Therefore, it is very important that we have qualified food safety specialists who will share information with the public.
Salome Chkheidze: Does the growing trend of “snackification“ change our biology or psychology? Are we sufficiently aware of the potential harm of ultra-processed foods, even in terms of developing food addiction?
Rusudan Gvamichava: Eating quite often becomes a mechanism for coping with emotions. This is often caused by foods with a crunchy texture, which are found in various snacks. We must understand that snacking has its purpose and can be an important part of a meal. However, it is necessary to plan it correctly. For example, if more than four hours pass between breakfast and lunch, a correctly chosen snack (e.g., fruit or nuts) can protect us from overeating at the next meal and help us refresh our energy. But if our meals consist only of snacks, this often disrupts our body’s natural cycle of hunger and satiety. In addition, ultra-processed snacks are addictive because their texture and taste (a combination of sugar, salt, and fat) are most attractive to our taste receptors. Therefore, it is important to choose a snack correctly if we need it to refresh our energy. Otherwise, it can become an active supplement of junk food in our diet, which we definitely do not need.
Salome Chkheidze: I also want to talk to you about infant feeding. Traditional advice sometimes contradicts new research and cultural practices. In some cultures, “baby-led weaning” is popular, where infants are allowed to feed themselves from an early age. How effective is this approach for a child’s development, including learning about food textures? Does it contain hidden risks?
Rusudan Gvamichava: Baby-led weaning has become a very active feeding method in modern reality. I personally think that this approach is very interesting and effective for forming a child’s eating habits. It strengthens independence, which is especially important at this age (from about 5-6 months). At the same time, the child is given the opportunity to get to know food on their own. When a child is given food with a spoon that has a changed structure, they often don’t like it and form a negative association. Therefore, it is very important for the child to perceive food sensually—to pick it up with their hands, feel its structure, color, taste, and smell. A similar approach helps us prevent the child from becoming a “picky eater,” which is often rooted in childhood, for example, when children do not like greens in food or the consistency of cottage cheese and yogurt.
This approach requires a lot of patience from parents, especially mothers, because, as a rule, everything around gets messy during this time. However, the child needs maximum freedom to get to know everything on their own.
There is growing interest in introducing allergens and diverse dishes to children from an early age. What impact does this have on the development of allergies and the broadening oftheir palate during infancy?
Rusudan Gvamichava: According to the latest recommendations from the American Academy of Pediatrics (AAP),the introduction of allergens should be done in a timely manner but with great caution. Statistics show that the timely introduction of allergens can reduce the risk of developing allergies. In infancy, during the period of starting solid foods, a variety of foods creates a broad palate. This later helps a person develop healthy eating behaviors in adulthood. At a later stage, changing the habit of eating the same food is a big challenge.
Salome Chkheidze: How should we revise dietary recommendations to better meet gender-specific needs at different stages of life – for example, during pregnancy or menopause?
Rusudan Gvamichava: I would say that general recommendations often do not take into account the different stages of a woman’s life. I have high hopes that this will be taken into account more in the future, because it has only been in the last 20-25 years that women have been actively included in research. Before that, unfortunately, research was mostly based on men.
This is unfortunate, because the physiological, biological, and mental health systems of women and men are completely different. These differences are particularly evident in nutrition. A woman’s body has different needs in different phases because hormonal changes are constantly occurring.
It is crucial for women to consume foods rich in iron. This can be from animal sources (beef, liver) or plant-based ones (beans, chickpeas). To improve the absorption of plant-based iron, it must be consumed with Vitamin C. Iron-deficiency anemia is the most common deficiency in the world, and women and children are the primary risk groups.
The approach during pregnancy that “we should eat for two people” is already outdated. However, I would say that during this time, a double concentration on nutrition is definitely necessary. During pregnancy, the diet should contain more folic acid, iron, omega-3, and probiotics. We should also not forget the topic of lactation, when a mother’s energy needs increase by about 450-500 calories per day. We must remember that after childbirth, the mother needs just as much attention as the baby.
The menopause period is often a difficult stage for women because there is a sharp decrease in estrogen, which is associated with a decrease in bone mass, changes in metabolism, and other general changes in the body. At this time, the diet should be richer in calcium and Vitamin D. Also, if necessary, supplements can be included, as Vitamin D from food is often not enough.
In addition to physical changes, women should also be helped mentally during this time, as weight gain is common, which can increase the risk of mood changes or depression. Therefore, society and specialists in this field have a crucial role to play in helping women as much as possible during these periods.
Salome Chkheidze: What would you say about fasting in women?
Rusudan Gvamichava: I personally am against any form of fasting for women. If intermittent fasting is still comfortable for them, the most “friendly” approach would be the 16/8 regimen, where the fasting phase lasts for 16 hours. 24-hour or longer fasting, unlike in men, creates problems for women. In general, the female body is very delicate, and the functioning of its many systems depends on hormonal balance. Therefore, I do not support such strict approaches.
Salome Chkheidze: Given the growing use of artificial intelligence, what benefits and risks do you see in AI-driven personalized diets?
Rusudan Gvamichava: AI has entered our lives in a very big way, and it will probably stay that way. I would say that artificial intelligence can help us, for example, in analyzing food calories and general recommendations. However, I can’t say that personalization in this field is refined. During a consultation, the human factor plays a huge role: the interview, empathy, and understanding the context. Even a small detail is of great importance, which a specialist will only understand after asking specific questions. Therefore, we should perceive AI as an auxiliary tool and not as the main advisor. ChatGPT itself tells us that its advice is not medical, which is a very important reminder and we should not forget it.
Salome Chkheidze: And finally, given the large amount of conflicting information that exists today, what would be your main message as a nutrition expert to help our readers navigate it?
Rusudan Gvamichava: A person might think that there is no point in eating anything, because it seems that all food is problematic. Therefore, first of all, I would say that there is no need for an “ideal” diet or nutritional regimen. Nutrition should be based on knowledge and understanding, not fear. The topic of diversity is very important. Meals and recommendations should be tailored to our individual needs and not, for example, to the advice of a neighbor. We often think that if a certain diet worked for our neighbor, we can get similar benefits.
Food should not be seen as just a collection of calories. It is a great source of energy, pleasure, culture, and traditions. Understanding this is important because a robotic approach to food, calculating what is consumed and what is expended, is incorrect.
When discussing topics on social media, no matter how interesting the advice is, you should always check the competence of the person talking about it. Since there are no regulations in this field, it is important that we ourselves take care to evaluate the validity of the information. Remember, someone’s personal experience may not be useful for us and may have no scientific basis.
