I came across the following article today on the BBC website. It's very refreshing to come across a doctor in the UK who is actually in favour of a low carb diet.


There are lots of celebrities at the moment singing the praises of a diet which has a lot of protein and very little carbohydrate as a great way to lose weight. Do these really work and how can I find out more?
Maureen

Dr Trisha Macnair responds

Most doctors, every now and then, go through a complete change of opinion on some particular condition or treatment. In fact many medical journals, such as the British Medical Journal, carry regular columns called something like 'The day a patient changed my practice', in the hope of shaking up entrenched views and inspiring other doctors to look at things afresh.

And this is what has happened to me with low carbohydrate diets, such as the Atkins diet. A couple of years ago I answered Maureen's question with fairly standard reservations about the claims being made for high protein, low carbohydrate diets. The main focus of these diets is to reduce carbohydrate intake as low as possible - fat and protein can be freely eaten, which may mean that fat and protein intake is high (but not necessarily if you don't eat too much of them). The whole approach of the diet goes completely against much current thinking about the importance of carbohydrate as a staple of healthy eating, and the possible risks of too much fat. At that time there was little scientific evidence to show if or how low carb diets might work, and there were (and still are) some reasonable questions to be asked about safety - could they be harmful? But now, with research starting to back them, and the personal experience of trying this sort of diet, I am convinced that with a couple of adaptations they really can be an effective way to lose weight.

Claims based on effects on insulin
Low carbohydrate diets are supposed to work wonders because of the 'healthier' effect on insulin. Insulin is a hormone that controls sugar levels in the body. It is an essential hormone because it transfers glucose into the cells. Without it, the cells have no source of energy and cannot function.

The idea is that eating carbohydrates causes the release of insulin, which then tells the body to store the energy in the food as fat rather than burning it up. By avoiding carbohydrates you avoid insulin and its fat-depositing properties. Even though you may be eating fat you cannot deposit it in the body and may even be making a special chemical that breaks fat down.

Another key concept of these diets is that some people are 'insulin-resistant' - the body doesn't react well to insulin and very high levels must be produced to maintain normal blood sugar levels. Over secretion of insulin in this way, says the diet, further encourages fat to be stored.

Wonky science
There is no doubt that some of the scientific claims behind this sort of diet are a bit shaky - we simply don't yet fully understand many aspects of metabolism in the body. So it's worth maintaining a degree of scepticism because the science doesn't always match what we do know.

But for some people the diet does seem to work well. This may be because of the claimed effects on metabolism and fat deposition, or because eating protein lowers hunger so you eat less overall. But it could just be that eating carbohydrates (refined carbohydrates especially) makes you crave more carbohydrates and so generally eat more (some experts follow this theory of carbohydrate craving while others are very critical of it).

The diets may also work because they are usually reasonably low calorie as they involve lots of vegetables which fill you up at low calorie cost (unless you go crazy with the cheese!) and they emphasise the need to step up your metabolism with regular exercise and for example by eating early in the day to get your metabolic rate going. Celebrities often have the added advantage of being able to afford the help of a fashionable personal trainer, and time to spare in the gym.

Possible harmful effects
It's also important to recognise that there are some potential negatives with this way of eating. High protein diets have been linked to kidney damage, although low carb eating doesn't have to mean high protein intake, and the risk is probably limited to those who are vulnerable to kidney problems anyway, such as those people with diabetes.

A more general complaint is the lack of fibre in the diet, and many people find the constipation too much - I get round this by eating plenty of carrots and apples which are on the limits of what a true low carb-er is allowed to eat (as they contain sugars) but at least are not refined carbohydrates. Low fibre, high fat may also have implications for your risk of bowel cancer.

Despite concerns about fat intake and possible risks of atherosclerosis (heart and blood vessel disease), research at Duke University Medical Center in the USA has shown that this diet tends to have a very healthy effect on the levels of cholesterol and fats in the blood.

The researchers did have some worries about the levels of ketones (fat breakdown chemicals) that people produced on the diet but they were not sure whether this was a health risk or not.

The answer for some?
What the Duke University research does confirm is that that a low-carbohydrate diet can definitely lead to significant and sustained weight loss. I've found this out from personal experience - after a life of battling to lose weight I've shed 14kg in a trice, feel great and plan to eat this way for the rest of my life. Balancing against possible risks from the diet, losing weight has reduced my personal risk of developing diabetes by about 30-fold and the only downside so far has been that I've had to resign my breakfast marmalade and toast to 'rare treat' status.


http://www.bbc.co.uk/health/ask_doc...h_protein.shtml

What LC diet are they talking about?! Oh yeah, my diet is a VLCD! Only 3000 calories a day....that's almost starvation level!

Quinadal,

Yes, I can understand the dismissive nature of your post. However, what you should understand is that the medical establishment in the UK has always been extremely anti-low carb. This is one of the first articles I've ever seen in the UK, where a doctor is actually being positive about this woe, albeit with some glaring errors of what it's actually all about!

And I do feel that, even with these misconceptions, it is a step in the right direction for low carbing in the UK.

Similarly the BBC Diet Trials in the UK are not showing the Atkins diet in a way in which it should be shown, BUT it is having a very positive effect on the number of people who are now prepared to follow a low carb woe.

Demi.
Many thanks for posting the article. Certainly unusual for a doctor on the BBC to support low carb.....Think about all the awful miconceptions that the US TV stations have presented. Perhaps the fact that the BBC has no corporate sponsors helps.

I have been following the BBC bulletin board since you published the link. Lots of Atkins/low carb support and even one thread from Barry Groves the author of Eat Fat Get thin.

Of course the usual vitriolic anti Atkins attacks from time to time from ill informed people........

Personally, I take in about 35-45g of fiber a day! And I 've never had to resort to eating carrots or apples to do it

Before LC-ing I never met a veggie that I liked - let alone one I wanted to start a long term relationship with - now my grocery cart runneth over with whole grains and fresh veggies!

But, like you said Demi, the positives of this article should not outweigh the few misconceptions - they even exist on this side of the pond. Most people hear Low Carb and they automatically assume non stop cheese and bacon...

I do actually struggle with my calories due to the high veggie consumption... and I have read that the WOE by its very nature is calorically self regulating. (you can only eat so much fat before it makes you physically sick - its a hormonal response if I recall correctly - CCK?? - and lean protein and veggies are fairly low calorie food items)