EFFECTS OF FAD DIETS

The Effects of Fad Diets on College Students

Morgan Cole, Haley Farrow, Dannah Lewis, Cassidy Kimbrough

Centofanti School of Nursing, Youngstown State University

Nurs 3749, Nursing Research

Danielle Class

th
April 6 , 2022
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The Effects of Fad Diets on College Students

Among the rising rate of obesity and ever-changing beauty standards, consumers are

always looking for a way to lose weight fast. Fad diets seem like an easy way to do that, but are

they safe? Throughout this literature review the reader will be able to understand the harmful

effects and risks of fad diets such as Keto, Veganism, Juice Cleanse, and Weight Watchers . Fad

diets are considered diets that become popular for a short period of time that are not standard

dietary recommendations. These diets often become popular due to their claims for weight loss

or improvement of overall health. However, research shows these diets to be unsustainable for

long periods of time, cause vitamin deficiencies and can be damaging one’s overall mental

health.

PICOT

This literature review was conducted to identify the risk of malnutrition and other health

risks from following popular diet trends, specifically among the college population. The

following PICOT question was developed: Are college students who follow fad diets at an

increased risk for malnutrition, and other health risks, compared with college students who do

not follow fad diets.

Search Strategy

To collect research, EBSCOhost was the main search engine used. Terms to narrow the search

included fad diet* and keto or juice, vegan*, and weight watchers. There was a search limit from

the years 2017-2022. The databases included in the research were Cumulative Index to Nursing

and Allied Health Literature (CINAHL), ProQuest Nursing, and Medline. Academic or

E-journals, peer revision, and articles written in English were included into the criteria. Before

abstracts were reviewed, 1,015 results ensued. The abstracts were then evaluated for relevancy to
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the topic and inclusion of criteria and further evaluated to assess patient outcome and retention.

Since there were not many results that included the outcomes of patients following malnutrition;

the search strategy was changed to include the measurement of such. With new limitations the

results were further limited to 137 articles. All abstracts and titles were reviewed to be able to be

refined to the eight used in this literature review.

Literature Review

Connecting the different fad diets of Keto, Veganism, Juice Cleansing, and Weight

Watchers is their unsustainability for the human body. Harmful side effects can be seen

throughout each diet discussed. Participating in such restrictive diets for extended periods of

time results in malnutrition. The body depends on adequate nutrition to carry out basic daily

functions such as, metabolism, development, and responsiveness. Throughout this review the

reader will be able to identify the common harmful trends among the fad diets.

Keto

The Ketogenic diet, also known as Keto, is a diet that “consists of high fat (55-60%),

moderate proteins (30-35%) and very low carbohydrates (5-10%) (Jain, 2022). The eating plan

was designed to manage medical diagnosis such as diabetes, cancer, Alzheimer’s and epilepsy.

However, over the years the diet has been adapted by consumers who are looking to lose weight

fast. The diet deprives the body of carbohydrates, forcing the body to obtain energy from stored

fat, resulting in fat loss. “This reduction in carbohydrates puts [the] body into a metabolic state

called ketosis” when this happens the body's metabolism “shifts away from carbohydrates but

towards fat and ketones” (Jain, 2022). While this method delivers fast results, it is not

sustainable, just like many other fad diets. As soon as the consumer ends the keto diet, the body

resorts back to its natural metabolism and the weight that was lost ultimately comes back.
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Along with the psychological ups and downs of such a restrictive diet, Keto also comes

with some serious health risks. After the first couple of days on the diet the body needs to make

some drastic adjustments on how it metabolizes energy. This causes unpleasant short-term effects

such as “nausea, fatigue, headache, constipation, [and the] 'Keto flu’” which mimics symptoms

of the regular flu. (Jain, 2022). Besides short-term effects, Keto can put the consumer at risk for

developing serious long-term effects. The diet “induces metabolic acidosis, anemia, and

oxidative stress” compared to subjects who were not on the diet (Arsyad, 2020). These effects

open the door to many other health related problems. For example, with metabolic acidosis

comes electrolyte imbalances, muscle loss, and confusion. With anemia comes inadequate

oxygen in the body, irregular heart rate, and shortness of breath. The effects keto can induce

should not be taken lightly and consumers should be aware of the harm this diet can cause prior

to adapting it into their daily life.

In order to accurately portray the harmful effects of the keto diet, two articles were

utilized; “Exploring the perception about Ketogenic Diet among young adults'' and, “Long Term

Ketogenic Diet Induces Metabolic Acidosis, Anemia, and Oxidative Stress in Healthy Wister

Rats”. The first article administered a questionnaire to 240 participants ranging from 18-25

years who were currently on keto. The questionnaire asked about “ketogenic diet knowledge,

purpose and usefulness of ketogenic diet, types, metabolic effect, [and] side effects” (Jain, 2022).

The article also touches on short term side effects the diet causes. The second article conducted a

study to determine the effects Keto had on Wister rats. The control group was put on the diet for

60 days and their “blood gas, cell counts, organ biomarkers, and plasma antioxidant superoxide

dismutase (SOD) levels' ' were analyzed (Arsyad, 2020). Both articles provided an abundance of

information used to write this literature review.

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Veganism

While evaluating the possible consequences of fad dieting, it would be imperative to

observe the widely growing population of those who practice veganism. Veganism is defined as

the practice of abstaining from the use or consumption of any animal products and viewed as a

generally healthy diet regimen. However, the inherent risk of malnourishment must be discussed

because there are micronutrients in meat and other animal products that cannot be obtained in

other foods. Strict vegans are at risk of vitamin B12 deficiency because this compound is only

found in animal products. Supplementation or intake of fortified food is therefore essential

(Amit, 2017). Although many vegetarians and in particular vegans consume high amounts of

fruits and vegetables, grains and nuts, intake of vitamin B 12 is usually inadequate. Subnormal

vitamin B 12 status is prevalent (50%–70%) in vegetarians or vegans in Austria, Germany, Italy,

Australia, India, and China (Woo, Kwok & Celermajer, 2019). Vitamin B12 can be supplemented

in a vegan diet to offset the consequences of low vitamin B12 levels.

A branch of the World health organization located in Europe conducted a systematic

review of 48 studies about the nutritional adequacy of the vegan diet. Protein intake was

examined in 26 studies of a total of 9,862 participants. Total protein intake in vegan groups was

the lowest compared to other diet groups. Total energy intake from protein was approximately

13–15%. The World Health Organization recommends protein intake 15% of total energy intake,

but this is dependent on factors such as sex, age, activity, health condition. The study reported

that in total 27.3% of the vegan population were below the acceptable range of protein intake. In

addition, 64.5% of vegans met the recommended daily protein intake and in 8.1% of vegans’

intake of protein was reported to be above the acceptable range (Bakaloudi, Halloran,
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Oikonomidou, Dardavesis, Williams, Wickramasinghe, Breda, & Chourdakis, 2021). Although

Vitamin B12 and protein can prove to be aspects of challenges to the vegan diet, many studies

conducted found that other macronutrient consumption is largely adequate in vegans.

The methods to analyze veganism as a potentially harmful diet were several research

articles. The first article that is referenced is “Vegetarian Diets in Children and Adolescents.”

Throughout this piece, the authors evaluated whether a vegetarian diet could provide the proper

nutrients that children and adolescents need. The study went through protein, iron, zinc, calcium,

and B12 levels in young vegans. Specifically, the information on B12 was implemented to

highlight potential points of malnourishment. Another article that is referenced to evaluate B12

was the article, “Vegan Diet, Subnormal Vitamin B12 Status and Cardiovascular Health.” A

sample across multiple countries was evaluated and the research specifically pinpointed Vitamin

B12 as it related to cardiovascular function. The study concluded that individuals that are B12

deficient, need B12 supplementation to improve any vascular changes and possibly prevent

atherosclerotic disease in the future. Additionally, the article, “Intake and Adequacy of the Vegan

Diet, A Systematic Review of the Evidence” was used for information about protein intake of

vegans. The sample found that 27.3% of the vegan population was below the recommended

protein requirements. This study found in general that vegan diets can be healthy when the low

intake of Vitamin B2, Niacin, B12, D, iron, calcium and iodine are properly supplemented.

Conclusively, veganism is a more sustainable diet than others because it is often

motivated by moral beliefs rather than a short-term cleanse to lose weight quickly. Some

required nutrients for veganism may be of short supply in plant-based products and need

supplementation to avoid medical consequences. As long as these are addressed, veganism could

be classified as a healthy diet for college students to adhere to. Many campus dining halls are
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now offering vegan-friendly meals that are nourishing and rich in nutrients due to the growing

population of vegans of all ages.

Juice Cleanse

Juice Cleansing is also a popular fad diet that is used by many consumers. While

participating in this diet the consumer has only drinks made of fruits and vegetables for

breakfast, lunch, and dinner. Because of the “lack of solid food, and very low onset of caloric

intake and physical activity, bodily changes are attributed to the removal of toxins, resulting in

weight loss (Bona, Frogacs, & Tury 2018). The insufficiency of calories consumed, and the

temporary weight loss is mostly water weight. This is dangerous because with “excessive water

loss and mishandling of malnutrition syndrome, [it] can be fatal” (Bona, Frogacs, & Tury 2018).

The body requires lipids, proteins, vitamins, minerals, carbohydrates, and water to function and

maintain a feasible lifestyle. The consumer participating in a juice cleanse does not receive

enough fats or proteins to sustain a healthy lifestyle. With the removal of certain food groups

from one’s diet for prolonged periods of time, malnutrition will transpire.

With most fad diets, the results that follow are only temporary, this is true for juice

cleansing as well. To prove its instability, studies of the Juice Cleanse diet took place to find if

there were health benefits of a vegetable/fruit-based diet and what role it plays on the

microbiome. The microbiome is a set of microorganisms that live in the gut, specifically the

intestinal tract. Research shows that “weight loss remained significant and persisted over the

following 2 weeks, [however, this is] related to changes in the microbiome. These changes to the

microbiome are short lasting. In summary the 3-day vegetable/fruit juice-based diet induced

significant changes in the intestinal microbiota which were associated with weight loss”
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(Henning, Yang, Shao, Huan, Lee, Hsu, Lu, Thames, Heber, & Li, 2017). Nevertheless, with

such substantial results to the body it is important to use such diets in moderation.

The information gathered among juice cleanse dieting was summarized from the articles

“Health benefit of vegetable/fruit-based diet: Role of microbiome” and “Potential relationship

between juice cleanse diets and eating disorders. A qualitative pilot study.” Between both articles

a substantial amount of evidence was able to be gathered to form a good consensus. The first

article explains that a juice cleanse does in fact result in weight loss and was portrayed through a

study where “twenty healthy adults consumed only vegetable/fruit juices for 3 days followed by

14 days of customary diet. On day 4 [they] observed a significant decrease in body weight and

mass index which was maintained until day 14” (Henning, Yang, Shao, Huan, Lee, Hsu, Lu,

Thames, Heber, & Li, 2017). However, it is known that “this ‘detox’ is not only physiologically

harmful, but it is not proven to provide long-term help in mental health either” (Bona, Frogacs,

& Tury 2018). The evidence gathered from both articles allowed for a good balance of

perspectives on the juice cleanse diet.

Weight Watchers

Weight Watchers is a calorie counting fad diet that began in the 1960’s by Jean Nidetch.

Points are collected based on the foods consumed by the user, how much water they drink and

how active the user is. While in recent years, Weight Watchers has attempted to change the

format of their program to stray away from the encouragement of dieting and calorie restricting,

the popularity of this program still adds it to the list of well-known fad diets that are used by

college students. In a study done by Apovian et al., it was discovered that the leaders of Weight

Watchers are not medical professionals but rather “Weight Watchers Graduates” (2018). This

means that the people who run this program have no schooling on nutrition and are not qualified
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to provide users with diet plans or recommendations. Despite the fact that there are no

professional medical experts involved in this program, Weight Watchers has shown success in

short term and long term weight loss, however, other long term effects have also been found. All

diets come with a list of rather mild side effects, most often though, these side effects soon

subside. Following the Weight Watchers program can lead to long term consequences including

constipation, headaches, inadequate nutrition levels along with numerous other health risks from

the lack of medical expertise involved with the program. These long term effects provide a cause

for concern with this fad diet, and fad diets alike. Due to these negative effects, fad diets lack the

support of health professionals and organizations.

According to Sam Emerson et al. there is little to no research proving that fad diets are

safe in the long run (2020). This is due to the fact that most, if not all, fad diets encourage a

decreased daily caloric intake and the elimination of specific foods that deprive the consumer of

important nutrients leading to malnutrition. Another flaw seen in trending fad diets is that they

do not promote long term healthy eating. This can be attributed to a number of reasons including

the fact that they can be hard to follow for long periods of time due to the challenge of following

the restrictions that are encouraged. This can lead the participant to give up on the so-called diet

and return to old eating habits or they begin a new trending fad diet. This cycle of dieting is

called yo-yo dieting and is described in the article, The Health Risks of Fad Diets as a restricting

food intaking, losing weight, over eating and regaining the weight lost, experiencing feelings of

disappointment and guilt along with negative emotions and a poor body image and then

repeating this cycle (Emerson et al., 2020). Such frustration can cause these vulnerable

consumers to develop eating disorders such as bulimia and anorexia due to their poorly

developed relationship with food. One may read about these detrimental long term effects of
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Weight Watchers and simply choose to explore another fad diet, however, all fad diets carry the

risk of causing poor health and malnutrition from different restrictions.

The information used to show the negative effects of the Weight Watchers diet and fad

diets in general was found in two separate articles. The first article, “Clinical Guide to Healthy

Diets” broke down the Weight Watchers program beginning with an overview and a brief

background of the program and ending with the pros and cons seen in the diet. The second article

utilized was “The Health Risks of Fad Diets”. This article summarized fad diets and the cycle

that is often created by following these types of diets. It also listed all the negative characteristics

seen throughout most popular fad diets. Both articles supported the idea that fad diets, including

Weight Watchers are not recommended and come with significant negative effects. They also

suggest consulting a medical or dietary expert for suggestions on losing weight rather than

following the new “trending” diet.

Recommendations for practice

When starting a new diet it’s always important to consult a registered dietitian. This is

because they will have a foundation of knowledge regarding the adequate amounts of calories,

macronutrients, and micronutrients the body needs to function adequately. Certain diets can lack

these macronutrients, micronutrients and overall calories that the body needs for sufficient

energy and nutrient absorption, resulting in many health risks that have major consequences.

Dietitians recommend lifestyle changes rather than fad diets to bring sustainable results

compared to quick fixes. It’s important to make healthy changes that will last, not just for the

short term.
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Conclusion

In summary, fad dieting can prove to have some potential downfalls in college age

students. Through the evaluation of keto, veganism, juice cleanses and Weight Watchers, it can

be determined that it is imperative to understand the potential consequences of these diets. Some

consequences could include an altered metabolism, fluctuating energy levels, disordered eating,

and malnourishment. These diets must never be looked at as a solution to lose an unhealthy

amount of weight very quickly. If done correctly and in the right circumstances, a diet such as

these could provide some benefits. Regardless, the culture of fad dieting stems from societal

pressure to be thin and should be taken on with caution.

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