Obesity, not LCHF, touted as the great evil

Tanya Wyatt and Gary Koekemoer write in response to a recent Weekend Post report  where a dietetics lecturer warned against low-carb, high-fat diets

Obesity is at an epidemic level in South Africa. The latest WHO estimates put the level at 26% in this country and a recent Lancet study estimates 69,3% of SA woman are overweight or obese. If ever there was a public health priority, surely this would be it?

Yet in your “Diets could put the bite on your body” (Weekend Post 28 May 2016) article, it would seem that both your reporter and NMMU dietetics lecturer Ms van Tonder see LCHF (not obesity) as the great evil.

“Sounding the warning”, “dangers of”, “the latest fad”, “lost favour”, “dire short- and long-term effects” and “debunking the notion that an LCHF diet was a healthy choice” are the terms used. Not much room for doubt there. Is the article promoting the view that LCHF is dangerous?

The article refers to a “report” by the CEBM at Oxford as its one source. Problem is that it isn’t actually a report! It’s a response to a report put out by the UK’s National Obesity Forum called “Eat fat, cut the carbs and avoid snacking to reverse obesity and Type 2 diabetes”.  If you read the response you’ll note that it’s a critique of the NOF’s methodology, rather than an assessment of LCHF itself.

The second source is a joint statement by NSSA & ADSA that is supposedly in response to the CEBM response. The NSSA/ADSA statement, however, makes no reference to the CEBM response but does acknowledge that “at present, there is a lack of conclusive evidence regarding the health effects of low carbohydrate diets over the long term”. Its critical view of LCHF is entirely based on preliminary cohort studies focused on low carbohydrate intake.

Your article fails to mention ADSA’s vested interest in the matter; that ADSA is the complainant in an on-going HPCSA case against Professor Tim Noakes (who has an A1 scientist ranking in nutrition and exercise science) for allegedly dispensing unconventional advice about LCHF on Twitter.

Prof Noakes, along with three other authors (including a nutritional therapist), has popularised the centuries-old Banting lifestyle in SA through the recent publishing of The Real Meal Revolution (which has sold over 250,000 copies in SA) and claims to have 6,000 pages of proof to back his claims about LCHF.

‘Dietitians, especially, may feel a little threatened’

The stated goal in TRMR is “to change your life by teaching you to take charge of your weight and your health through the way you eat”. Sounds dangerous, doesn’t it? Dietitians, especially, may feel a little threatened.

As an aside, Prof Jacques Rossouw (Noakes’s most vociferous academic critic) withdrew from presenting evidence against Prof Noakes without giving reasons for doing so. Just saying.

The article does, however, off the basis of the unsubstantiated hatchet job, go on to make the claim that weight loss is about “a balance between energy intake and energy used… Therefore reducing the energy density of meals and increasing physical activity would achieve this goal”.

In short: count your calories and exercise more. No discussion about whether all calories are equal (e.g. sugar vs. broccoli); that exercise builds muscle (thus potential weight gain); that our brains are our biggest energy consumers (and that they can successfully use ketones as a source of fuel); that much of modern eating consists of processed carbs (coated in trans fats) and the role that individual’s metabolisms and lifestyles play in weight loss success.

Of course it’s necessary to be exposed to the research and expert opinion out there, but surely the emphasis should be on understanding what is working and why no country is succeeding in reducing obesity?

Instead, the article chooses to vilify those calling for people to take responsibility for what they eat and how they live. LCHF diets may not be your cup of tea, but if your aim is educating the public so that they, in turn, make informed choices, it should require that – at the very least – reporters read their source documents and provide multiple perspectives, and that specialists acknowledge their own self-interest in promoting their profession.

‘I’m no Banting, Paleo or Atkins groupie’

I’m no Banting, Paleo or Atkins groupie but what I do know about obesity and weight loss is that it’s complex. The science is far from settled and teaching the public to take responsibility for their diets and health seems to be the only sane way to go.

Since everyone agrees that biochemical uniqueness in every individual is a given, it makes sense to have people explore what does and doesn’t work for them, individually.

This means that, instead of promoting/criticising one type of diet, we should be encouraging people to experiment with many. At the end of the day, finding out what works for you is where good health, energy and weight will be found.

 

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