Another year, another chance to look back at the diet and wellness trends that captured our attention in 2018. It's not a surprise that the keto diet was the most-searched diet term on Google this year, according to their latest “Year in Search” report. Also near the top of the list: The carnivore diet and intermittent fasting. Keto recipes occupied five out of the top 10 food searches, and at least partially explains the popular craze of subbing veggies for starchy carbs. In 2018, cauliflower catapulted onto the scene—in menus, recipes and packaged foods. Case in point: The search for cauliflower gnocchi was up 2,300 percent. Veggie spirals also made a splash, and this year, it wasn’t necessary to own your own spiralizer. Now, these pasta replacements are widely available both fresh and frozen at your grocery store, as well as on many menus nationwide.

Plenty of other trends emerged this year among those on the hunt for good health. Below is a look at the some of the most popular diet crazes that fascinated us in 2018, as well as some pointers to determine if they’re worthy of a place in your wellness routine in 2019, or if you should bid them adieu before the new year.

Take These Trends into 2019

Digestive health

Granted, probiotics have been on the scene for several years, but the next wave of digestive health products have arrived, and the idea of being good to your gut is likely to last into next year (and well beyond). And science backs up this wellness strategy. There are trillions of bacteria in your gut, and they’re largely responsible for keeping your immune system in fighting shape. Though we’re still in the early phases of research, it’s widely believed that a disruption to this delicate ecosystem, known as the microbiome, can lead to problems outside the digestive tract, such as body-wide inflammation, autoimmune diseases, and metabolic conditions, including weight gain and diabetes.

“Everyone should strive to incorporate probiotics into their daily routine,” advises Roshini Raj MD associate professor of medicine at NYU Langone Health. Good gut wellness starts with your diet: Eat whole foods that offer a variety of fiber sources, such as fruits, veggies, and whole grains. These foods supply prebiotics—a type of fiber that feed the good bacteria, allowing them to thrive. A fiber-rich menu also nourishes the diversity of bacteria species in your gut, which helps protect you from diseases. Another dietary key to digestive health is fermented foods. These include yogurt and kombucha, which help keep your gut populated with beneficial bacteria.

Whether or not you need specialty bars and other packaged goods formulated with probiotics is another matter. “Science has not shown that probiotics improve general health,” says Dr. Shira Doron, infectious diseases physician and associate hospital epidemiologist at Tufts Medical Center. “Certain diseases and conditions have been studied, with varying results, some of which suggest that probiotics can mitigate symptoms. If you’re taking a probiotic for a specific condition, it is critically important that you use the same strain, formulation and dose that were shown to be effective in clinical trials; otherwise you cannot assume you will experience the same positive effect,” she explains.

And while rare, Doron notes that serious complications can occur. “The greatest risks are in those with severe immune compromise, disruption of the integrity of the bowel, and those with venous catheters in place,” she notes.

Probiotics may be linked to less serious side effects, too. One recent study among 30 people linked probiotics to potential brain fog and GI distress. “Rarely, some people experience side effects from taking a certain probiotic so I recommend they try a different one,” suggests Dr. Raj. As for those new products hitting shelves, Dr. Raj recommends sticking with reputable brands so you know that the probiotics being advertised on the label are actually going to end up in your body.

Mushrooms

The magical mushrooms of 2018 aren’t the psychedelic variety, but instead, are showing up in supplemental pills, teas and coffee, and even chocolate. The variety of mushrooms used in these products are said to be adaptogens, natural substances that help your body respond to various stressors. Some studies suggest that adaptogens can help boost your energy, immunity and ability to concentrate. But there’s a catch: Supplements may be inappropriate for certain people (such as those on medications for diabetes or high blood pressure) and we only have short-term info about their safety. As you know, even natural substances can be toxic, and one study found that a form of mushroom powder led to liver damage, so run any supplements by your doctor or dietitian before making them part of your wellness routine.

On the other hand, eating mushrooms on the regular is a good way to get some immune-boosting benefits as well as fiber and other protective compounds, including vitamin D.

One short study among people eating shitake mushrooms daily for four weeks found that they helped lower body-wide inflammation and boosted immune functioning. Other species are being studied for their potential to fight cancer, high cholesterol, diabetes and obesity. In addition to salads, omelets, and stir-fries, consider blending mushrooms with ground beef or turkey to cut back on meat and add more plant-based goodness. Or maybe you’d like to nosh on mushroom jerky, a cool new snack that hit the shelves this year.

Diets

A love/hate relationship with weight loss emerged in 2018. The most recent Centers for Disease Control survey found that almost 50 percent of Americans tried to lose weight in the past year—a time when anti-diet sentiment was just as strong. As you can see from popular search terms, we’re clearly not ready to ditch dieting just yet, and that’s okay. Though the word “diet” puts some people off, reaching a healthier weight to feel better, manage your health with fewer medications, or to experience more energy, better sleep, and more confidence are worthwhile goals to pursue. Clearly, I discourage restrictive eating, but if you want to follow a plan that’s more inclusive than exclusive, includes generous servings of veggies, and helps you develop a framework for establishing sustainable, healthier eating habits that also encourages weight loss, I’m not going to knock it.

Tahini

2018 was the year of tahini! Tahini is one of the main ingredients in hummus, but this year, we discovered just how versatile it is. It can be whisked into salad dressings, stirred into sauces, baked into sweet treats, like quick breads and cookies, used to create a dip for veggies or just drizzled over fresh fruit.

Much like its nut butter cousins, tahini packs in some solid nutrition, including about 5 grams of protein and 3 grams of fiber (as well as vitamins and minerals) per 2 tablespoon serving. It’s made from ground, hulled sesame seeds, so it may be a nut butter option for people who are allergic to tree nuts and peanuts (though sesame seed allergies are also common).

Alternative Milks

This year, we learned that Americans don’t necessarily associate milk with dairy. That’s probably not surprising given the onslaught of non-dairy milks we’ve seen in recent years. But with more base ingredients than ever—almond, peanut, coconut, cashew, hemp, oat, pecan, flax, and pea protein, to name a few—it was a top healthy eating trend of 2018. Pinterest’s List of 100 Emerging Trends for 2019 noted searches for oat milk were up 186 percent. Even if you’re a dairy milk drinker, it’s worth considering expanding your milk repertoire. Each one has a unique flavor and texture, and therefore, you can customize your food and beverage experience by selecting different varieties. Coconut milk gives your smoothie a tropical flair, peanut milk is distinctly nutty, making it a nice match for overnight oats or chia pudding, and oat milk is full-bodied, so it works well in lattes. Just like I stock a variety of different nuts to keep meals and snacks interesting, I keep a few milks on hand to make my dishes that much more delicious. One final word on alternative milks: Some flavors have added sugars so be on the lookout to make sure you’re staying within the daily limits of 6 teaspoons for women, 9 for men.

TRENDS TO TOSS (OR MODERATE) IN 2019

Carnivore Diet

The award for the most bizarre trend in 2018 goes to this plan, which eliminates some of the healthiest foods, including fruits and veggies, nuts and seeds, beans, and grains (including whole grains). What’s left? Beef, chicken, fish, eggs, turkey, butter, milk, yogurt, and cheese. I’m typically open to any eating style that’s practiced in a healthy way, but since this plan is virtually devoid of beneficial nutrients, such as antioxidants, phytochemicals, and fiber, from plants, I can’t give it any props. And in fact, even if you’re losing weight eating nothing but animal foods, there’s still a good chance this plan will do some long-term damage. One study found that within two days of shifting to a mostly meat-and-cheese diet, your microbiome shifts in a way that promotes inflammation and intestinal disease. Plant foods are key to optimal health, as we know from studying people who live the longest, good quality lives, so let’s hope this diet trend gets dropped come the new year.

Activated charcoal

We can probably thank Instagram for making activated charcoal so popular since all the foods containing this ingredient are an eye-popping shade of black. From black ice cream to black smoothies to black granola to activated charcoal cocktails, this ingredient made the “it” list this year. Activated charcoal is believed to be a detoxifying agent and this has some merit: It’s often used to treat poisoning and certain drug overdoses. But at the same time, it also binds to certain vitamins and minerals, as well as some common prescription medications (like certain antidepressants). And it might cause constipation, which is probably not the detox advantage you’re looking for. It’s not a big deal to eat some Insta-worthy black food from time to time, but I wouldn’t make a wellness strategy out of activated charcoal.

Faux meats

Imitation meats have been around for a while, but new ingredients and manufacturing methods allow them to more closely resemble the taste and texture of actual meat, putting them on the mainstream map this year. The proof is in the Impossible Burger, which made its nationwide debut at White Castle this fall. There are environmental and health advantages to reducing meat consumption (especially red meat), however, these meat pretenders are highly processed and it’s always better to consume food in its whole and more natural form. There may be a time and place for imitation meats—say, you want to make your plant-based diet a bit more convenient from time to time—but make sure you’re keeping an eye on sodium, which can get high.

WHAT A NUTRITIONIST WANTS YOU TO KNOW

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