Recently, I had a request from a BBC journalist to contribute to a piece on low-carbohydrate diets. Here’s her request:
Essentially, I am really after the evidence as to whether the Atkins (and other low-carb diets) work (as a diet, and also are they good for our health?) – are you able to summarise the findings? I understand the thinking is just as controversial as ever.
There also seems to be a disconnect between the number of people on low-carb diets, and the NHS advice – which is that starchy carbs should make up a third of the foods people eat. Why is that?
In response, here’s what I wrote:
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Some people have a natural prejudice against low-carbohydrate diets, but actually there is an enormous amount of scientific research that supports them. To begin with, diets that are controlled in terms of carbohydrate but unrestricted in calories generally produce superior weight loss to those that are calorie-restricted and low in fat
One reason why low-carbohydrate diets are effective for weight loss are because they tend to be inherently more satisfying, leading many people to eat less quite automatically and, crucially, without hunger. However, there is some evidence that even when calories are the same, low-carbohydrate diets are better for weight loss than low-fat ones, and this might have something to do with their positive effect on chief fat storage hormones like insulin and leptin
There is an idea that while low-carb diets might indeed be effective for weight loss, they are bad for health, particularly the heart. This is because they have an image of being full of foods rich in saturated fat such as red meat, eggs and butter. Actually, people on low-carb diets tend not to eat more fat than they were before (they just eat less carbohydrate).
But perhaps more importantly, saturated fat is not strongly linked with heart disease at all. In fact, countries like France, Austria, Switzerland, Germany, the Netherlands, Sweden, Denmark, Norway and Finland consume a lot of saturated fat but have relatively low risk of heart disease. This evidence simply does not support the idea that saturated fat causes heart disease, and neither do other studies in which eating less saturated fat has not been shown to benefit health, including heart health.
Actually, there is plenty of evidence which shows that low-carbohydrate diets improves markers for heart disease across the board. For example, they tend to reduce levels of blood triglycerides (unhealthy blood fats), raise levels of ‘healthy’ HDL cholesterol and lower blood pressure. They also tend to shift the type of cholesterol in the bloodstream from the small, dense, damaging type, to the larger, less dense, more benign type.
Despite all this evidence, there are some who remain sceptical and will continue to argue for the clearly inferior low-fat approach. It’s a plain fact of life that thinking can be slow to change even in the face of overwhelming scientific evidence. Also, certain commercial concerns such as margarine manufacturers and bread makers have an interest in maintaining fat phobia and fund some of the bodies such as the British Dietetic Association and British Nutrition Foundation that assume to tell us what to eat.
However, the idea that the food industry has perverted nutritional messages is now widely known, and people are increasingly looking to the internet for their information. There you will find first hand accounts from countless individuals who have transformed their health for the better using low-carbohydrate eating, along with the science that supports this approach. Increasingly, this is what people are interested in, not the out-dated and unscientific views of their doctor, dietician, industry-linked nutrition organisation or Government.
When the piece was published on Wednesday, it struck me as laden with the usual negative rhetoric about low-carbohydrate eating. And my contribution was now condensed into the following words:
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John Briffa, a doctor specialising in nutrition and author of Escape the Diet Trap, is one of those who sets himself against the likes of the British Dietetic Association and British Nutrition Foundation.
The interest shows “first hand accounts from countless individuals who have transformed their health for the better using low-carbohydrate eating, along with the science that supports this approach”, he argues.
“Increasingly, this is what people are interested in, not the out-dated and unscientific views of their doctor, dietician, industry-linked nutrition organisation or government.”
It occurred to me that the journalist had asked me for the ‘evidence’, but none of that had that made it into the piece. So I wrote back to the journalist and ask her why that was and what her thought processes were regarding this. I pointed out that it made it look my case for low-carb eating was essentially based on anecdotal reports on the internet.
The journalist wrote back saying that she thought she’d stressed my scientific credentials (why this is important is not clear to me), but accepted my larger point and offered some adjustment. Here’s what she said regarding the science specifically:
In terms of expanding on the evidence, it was down to word count, and I felt I’d illustrated some of the evidence supporting and criticising low-carb diets in the headlines paragraphs, which link through to articles with more detail on the various studies.
However happy to add a little more to the section I attribute to you if can do so succinctly and my editor is OK with it.
I don’t know what ‘headlines paragraphs’ are, I don’t see any discussion of the actual science in the piece (where it should be, I would contend), and justifying the exclusion of the science on the grounds of ‘word count’ seem utterly specious to me (space on the internet is unlimited, unlike in print publications).
The journalist offered to link to a relevant blog post. I took up her offer and offered this summary of the evidence:
He says there is an enormous amount of scientific research that supports low-carb diets, and in particular the fact that studies, overall, find them superior to low-fat, calorie-restricted diets for weight loss. On top of this, he says, the internet provides “first hand accounts from countless individuals who have transformed their health for the better using low-carbohydrate eating”.
He argues that the evidence does not support the idea that low-carbohydrate diets are bad for the heart. “First of all, studies do not link saturated fat with heart disease, as is often claimed, and eating less saturated fat has not bee found to reduce heart disease risk either. Also, studies show that low-carbohydrate diets lead to an improvement in a range of heart disease markers including lower blood pressure, reduced levels of triglycerides and improvements in the types of cholesterol in the bloodstream.
In the end, though, this is the adjusted text regarding my appraisal of the science:
He says there is an enormous amount of scientific research that supports low-carb diets – particularly studies which find them superior to low-fat, calorie-restricted diets for weight loss…
You can read the whole piece here. But, unless someone actually links through to the piece I offered up here, the BBC piece is still essentially devoid of critical science.
So, in short, I was asked to summarise the research findings, but when I provided these the journalist appeared quite disinterested in conveying these to the public. I think this is poor journalism. And I think the public deserves better.[hr]
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