Official advice in the English NHS on how to lose weight could radically change after a report has shown that counting calories is the wrong way.
A little personal anecdote here, over two years I lost about 25% of my former weight going from officially morbidly obese to just "overweight". I had support from an NHS dietician but the provider changed so I had to see a different woman. At our first meeting, she gave me the official manual which pushes the idea of counting calories. I was a bit polite as it was our first meeting but at the second had to tell her that I had lost (then about 20%) and "not a morsel of calorie counted food has passed my lips". Seems like I was right all along!
So what is the basis of this? From the British Medical Journal's Postgraduate Medical Journal
Rapid weight loss and regain is detrimental to health. Such ‘weight cycling’ contributes to hypertension, insulin resistance and dyslipidaemia resulting in increased mortality risk and worse cardiovascular outcomes. The weight loss industry, which promotes calorie restriction rather than good nutrition, generates US$58 billion in revenue annually in the USA even though long-term follow-up studies (up to 5 years) show that most people on rapid diets regain much of the lost weight; about two-thirds do not achieve health benefits and put on weight whether or not they maintain their diet or exercise programme.15 In contrast, with advice on a low-fat diet, the PREDIMED primary prevention randomised controlled trial, which included 7500 high-risk individuals initially free of cardiovascular disease, found that an energy-unrestricted Mediterranean diet (41% total fat) supplemented with extra-virgin olive oil or nuts achieved a 30% reduction in major cardiovascular events, with event reduction occurring even within 3 months.16 A key finding from analysis of PREDIMED subgroups showed that dietary intervention achieved consistently large reductions in cardiovascular disease risk irrespective of weight.
Concentrating on good nutrition rather than counting calories will not only improve metabolic health in the short term but may promote sustained weight loss. A recent randomised study published in the Annals of Internal Medicine showed that an energy-unrestricted higher-fat and low-refined-carbohydrate diet (restricting carbohydrates without fibre) resulted in more weight loss and a better lipid profile than a low-fat diet at 1 year.
In simple terms, eating a Mediterranean diet supplemented by olive oil and nuts is the most effective way of losing weight and sustaining the loss. The BBC has a
layman's explanation and I have put the important information about the authors in bold.
The PMJ editorial argues a focus on food intake is the best approach, but it warns crash dieting is harmful.
Signatories of the piece included the chair of the Academy of Medical Royal Colleges, Prof Terence Stephenson, and Dr Mahiben Maruthappu, who has a senior role at NHS England.
They criticise the weight-loss industry for focusing on calorie restriction rather than "good nutrition".
And they make the case for a Mediterranean diet, including fruit and vegetables, nuts and olive oil, citing research suggesting it quickly reduces the risk of heart attacks and strokes, and may be better than low-fat diets for sustained weight loss.
So this approach is supported by some of the most senior doctors in NHS England. One comment on the BBC article provides anecdotal support:
289.
food4thought
17th November 2014 - 11:43
My mother had a heart attack 7 years ago and was advised to have a quadruple bypass but she refused. They then said she would only have about 6 weeks to live. She just changed her diet, cut out sugar and has lots of fruit and veg with plenty of olive oil and oily fish ect. The doctor told her a year ago she no longer suffered from heart disease. Saved the NHS about £20,000 in the process!
(I hate to think what a quadruple bypass would cost the average US patient!)
Quite coincidentally I included my tips in a comment yesterday:
How many portions of fruit and vegetables (without dressings etc) do you have each day? At least double it to a minimum of 10 portions.
Have a protein breakfast (a couple of eggs on 2 slices of wholewheat toast for example) or a grain based one - home made muesli is simple to prepare overnight (put a cup of ordinary porridge oats and about a 1/3 of a cup of sultanas in a bowl, just cover with milk, ideally skimmed - leave overnight. In the morning grate in an apple and add more fruit to taste NO SUGAR) Add a very few roughly chopped nuts if you want to up the protein.
After 3pm do not have any high caffeine drinks - have either tea or decaff coffee if you want a hot drink, water if you want something cold - you can add lemon juice if you need to give it a boost.
Unless you are actually diabetic and need to monitor your blood sugar for insulin, get rid of the tester. Same for the weighing scales - weigh yourself no more frequently than once a week (women only every 28 days if you are still menstruating) Minor variations in both blood sugar and weight are normal and worrying about them constantly will put your blood pressure up.
An added complication of much US produced food is the amount of sugar and salt in surprising foods. Do not add salt to your food and try to cut it out completely. You may need it for some things like cooking pasta. Food will taste a bit bland at first but you will soon get used to it and taste the food not the salt.
I also pointed out that lo-salt condiments usually contain potassium rather than sodium chloride and additional potassium might be contra-indicated with some high blood pressure drugs. I should add - cut down on alcohol. Alcoholic drinks are "empty calories" and mixers used with spirits are almost always stuffed with sugar.
Most of all buy good quality foods. You pay less in money terms for cheap mass-produced stuff but eat more of it and it tastes worse. Get good tasty food and eat it slowly to enjoy it. Finally, get to know what your body tells you when you are hungry. Every so often have a fast day (or two if you can make it) so your stomach is empty. Believe me it feels different from that "oh it's 12.30 so I must need lunch" response.
Don't "diet", change your diet!