The Vertical Diet: A Dietitians Review

Outside of the niche community of serious strength athletes, The Vertical Diet is pretty unknown. But due to there being quite a few elite level athletes who follow the diet (including Hafthor “The Mountain” Bjornsson) who follow it, there is a large reputation behind it.

Another massive influence on this is that the founder Stan Efferding is very charismatic (and jacked) and creates compelling arguments as to why a lot of the aspects of this diet are beneficial for health and performance.

As a dietitian who specialises in working with strength athletes (with a focus on powerlifting specifically), I get quite a few questions about The Vertical Diet, so I thought I would go through some of the pros and cons.

What is The Vertical Diet?

The Vertical Diet is a diet that is based on whole foods that are high in nutrients. It is promoted through claims to optimise gut-health and improve performance.

A “horizontal” diet would be described as one that emphasises a wide-variety of foods. The Vertical Diet therefore focuses on a limited number of foods that Stan Efferding has chosen for specific reasons.

One of the pieces of reasoning behind this is that it is hypothesised that limiting the variety can help the body become more efficient at digesting the food. This would allow for better absorption of nutrients, while also making it easier to eat more total food volume across the day.

Unlike traditional “horizontal” diets that emphasize dietary variety across numerous food groups, The Vertical Diet focuses on a limited number of high-quality, nutrient-rich foods.

According to Efferding, limiting variety makes your body more efficient at digesting and absorbing nutrients, which should improve muscle growth, recovery, gut health, and metabolism.

The vertical component of the diet includes red meat and white rice. These are designed to make up the majority of the calories. Red meat is chosen because it is higher in iron, B vitamins and zinc. White rice is chosen as the main carbohydrate source because it is easy to consume a lot of carbohydrates through and it doesn’t take long to digest. This makes it easier for heavier strength athletes to consume more carbohydrates and calories.

On the horizontal component of the diet, there is more variety as these foods are chosen to meet micronutrient needs. They are specifically nutrient dense; however, the goal is to consume them in an appropriate amount and no more than that. They are designed to reach the optimal targets for micronutrient needs and no more. Adding more does not provide any additional benefit, so the preference is to focus the majority of the diet on the vertical component once these needs are met.

The foods chosen are generally low-FODMAP as well. They are designed to limit gas build-up and the bloating or other gastrointestinal issues related to that.

Foods Allowed on the Diet

Rice: white rice only
Red meat: beef, lamb, bison, and venison
Low-FODMAP vegetables: carrots, celery, zucchini, cucumber, capsicum, eggplant, spinach, butternut squash, etc.
Fruits: mostly oranges, 100% orange juice, cranberries, and 100% cranberry juice — but all fruits are allowed
Potatoes: white and sweet potatoes
Oils and fats: extra-virgin olive oil, avocado oil, coconut oil, butter, nuts
Fatty fish: salmon
Poultry: chicken, turkey
Eggs: whole eggs
Dairy: full-fat yogurt, full-cream milk, cheese
Sodium: bone broth, chicken stock, iodised table salt
Oats: only if soaked and fermented
Legumes: beans and other legumes, only if soaked and fermented

Pros:

There is no doubt that The Vertical Diet can be an option to help fuel elite performance. There are a lot of people taking their performance to the next level while utilising the diet, so it is worthwhile looking at the positives.

Less bloating

Due to the emphasis on low-FODMAP foods and avoiding any foods that are difficult to digest, The Vertical Diet can reduce bloating, constipation and diarrhoea in a lot of individuals. This alone can improve quality of life and make people feel better.

Easier way to eat more food

Due to the focus on easily digestible foods, it allows people to eat more total food volume. Generally, when strength athletes focus on high quality, nutrient-dense foods, they struggle to consume enough calories to maintain or gain weight. This can harm strength performance. Emphasising the foods in The Vertical Diet can overcome this barrier. The meal plans are also laid out in a way that makes it easier to consume large amounts of food. There is also a strategic way laid out to increase food intake.

Can be an easy way to adjust intake since it is so consistent

The diet can be great from the perspective of keeping it simple. When there is a lot of variety, it can be harder to consistently get an appropriate range of calories and macros for your specific goals, unless you are tracking your intake. With The Vertical Diet you will generally have pretty much the same 4-5 meals per day every day. If you wanted to gain size but weren’t in a calorie surplus, you have the option to either make the meals larger or add an additional meal. Vice-versa, if somebody wanted to be in a calorie deficit, they could do the opposite. This makes it really easy to adjust your calories based on your needs.

Good focus on micronutrients and performance

Sometimes concepts such as flexible dieting can be taken too far and completely underrate the importance of micronutrients. The Vertical Diet has an emphasis on ensuring all micronutrient needs are met, which can have carryover effects for performance. While going above these levels might not have additional benefits, avoiding deficiencies or inadequacies is important. Using iron as one example of this, if somebody was deficient in iron, they would feel fatigued and their training wouldn’t be as effective.
Performance is also optimised from a macronutrient standpoint too. The diet can be laid out in a way that meets appropriate ranges for protein, fats and carbs, while also distributing protein across the day.

Focus on non-dietary details

Not only is there a focus on the dietary aspects, there is a focus on lifestyle overall. In the book there is a lot of time dedicated to things such as sleep, short walks and regular blood tests. There is so much evidence that getting sufficient good quality sleep will help performance, but it is often overlooked. Short walks directly after a meal can help reduce blood glucose levels (mostly only relevant for people at risk of T2DM, but it can be particularly important for people at very high BMI’s in general). Getting regular comprehensive blood tests can help identify any issues early on that can be addressed, which can help improve health and performance.

Cons:

Red meat is expensive

Red meat is more expensive than other protein sources. While red meat isn’t the only protein source on the diet, it is the main form that is emphasised. The reason red meat is chosen over white meat such as chicken is because it is slightly higher in nutrients.
Switching some of the red meat for white meat really would have no negatives though. After reaching certain targets for micronutrients such as iron, zinc and B vitamins, there is no noticeable benefit for going higher. At the food volumes consumed, there is no doubt those targets would be met even if white meat was the preferential choice. This switch alone can make the diet a lot cheaper without sacrificing anything from a performance perspective.

Caution regarding red meat and health

While there have been certain recent guidelines suggesting that we do not need to reduce our current red meat intakes for health purposes, I’m of the opinion that it would be wise to be mildly cautious of going anywhere near as high what the vertical diet proposes. The vast majority of organisations have guidelines that recommend limiting red meat intake, with a particular emphasis on the linkage with bowel cancer.

There is a wealth of research out on this topic, but due to the variables involved it is hard to make a clear conclusion, which is part of why I’m choosing not to discuss the research here. Healthy user bias can mask what is really going on. For example, people who eat red meat are also more likely to partake in behaviours with negative effects on health, whereas those who follow plant-based diets tend to do the opposite. With that being said, I still stand in the camp of caution and wouldn’t take red meat intake to an extreme.

Staying on a low-FODMAP diet indefinitely isn’t ideal for gut-health

While The Vertical Diet isn’t specifically a low-FODMAP diet, it comes very close. It eliminates most gas-producing foods, which often overlap with high-FODMAP foods.

Since a lot of high-FODMAP foods are also great prebiotics, it appears as though staying low-FODMAP reduces microbial diversity in the gut. It also reduces the amount of Bifidobacterium and Lactobacillus which are associated with positive health outcomes.

Variety can be beneficial for gut health

While The Vertical Diet reduces IBS type symptoms off the bat, claiming it optimises gut-health is a stretch. There is research showing that consuming >30 plant based foods is linked with greater microbial diversity and associated with more health-promoting groups of bacteria when compared to <10 per week. Gut health is complex, and it is hard to make bold claims, but variety appears to be beneficial. Limiting to only a small number of foods like The Vertical Diet recommends could have negative effects due to this.

Needlessly restrictive

In addition to a lot of the pitfalls associated with the restriction, there really isn’t much evidence to support the idea that digestion is improved by limiting to the same foods over and over again. You can get the same results without restricting to this level.

Summary

Due to the cons I’ve mentioned, The Vertical Diet isn’t a diet I recommend. It has a lot of rules that aren’t necessary to achieve the desired outcomes.

From another perspective though, it doesn’t have any downsides from a physical performance perspective. It is very simple to follow once you get a rhythm with it. For people who like simplicity and find their diet is actually a lot better when they have less choices available, it could be a solid option in comparison to alternatives.

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