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Before you go BANTING…

It is no surprise that the low carb, high fat (LCHF) Banting diet, Tim Noakes advocates has caused some controversy to say the least.  The thought that a diet high in fat can result in weight loss is understandably an enticing one, but it is also causing many a healthcare professional fair concern.

As a dietitian, science is of great priority when it comes to the information I share with my clients. On this front, there is a great deficit to support the long term success and more importantly the safety of the Banting diet.  Greater than my concern with the lack of research, unanswered questions or the dismissal of high cholesterol as a cause for heart disease, is the interpretation of this diet by the greater public.  I strongly feel that if this diet is not just another fad, as Tim Noakes suggests it is not, then it has been prematurely and irresponsibly launched on the public.  My honest hope is that if this LCHF diet is truly the ‘revolution’ that Tim Noakes believes it to be, it would have firstly been tested for a duration far longer than 12 months and would not have been left to a handful of people to write a book advocating its benefits.

In my opinion, if the World Health Organisation (WHO) is not in on it, proceed with caution.  And this is what this article is really about – not to slate Tim Noakes – but rather to make sure that you do your homework to fully understand what the Banting diet is so that you do not mistake it for a high protein diet.  If you do your homework, you will also learn that Noakes is a marathon runner and his dietary success should therefore not be compared with a couch potato or a weekend warrior, exercising for a couple of hours during the week and maybe a longer stint on weekends. I think you may have gathered that I am not a fan of the diet but I know that many people are currently following a LCHF diet and many people are yet to flirt with the idea.

I have had the privilege to both hear Tim Noakes speak and to purchase his book, and am simply sharing some fundamental facts and some interesting gaps.  Noakes supports the Banting theory with the fact that the Food Pyramid was launched in 1977, just 3 years prior to the beginning of obesity in 1980.  The Food Pyramid suggests a diet based on grains (breads, cereal, pasta, rice) with plenty of fruit and veg, a moderate daily intake of lean meat, dairy and eggs with little room for fat and sugar.  Noakes also suggests that the Western diet is the opposite of what the human body is designed to eat and describes the Western diet as high in carbohydrates, processed foods and sugar.  I agree with this observation but then the current Western diet is not a reflection of the Food Pyramid.  It is instead a result of public interpretation, ignorance or noncompliance.  Processed foods are generally high in fat, high in sugar and low in fibre – the opposite of any foods recommended by dietitians, accused by Tim Noakes of prescribing high carbohydrate diets.

My concerns with Banting / LCHF dieting

One of myconcerns with the LCHF diet is the simplicity in the way it is presented.  Most notably, when reading through the recipes in the book “The Real Meal Revolution”, I found there to be a huge discrepancy in the fat type and quantity called for. Some recipes require a moderate tablespoon of olive oil while others are to be made with an entire block of butter. This lack of consistency in fat content is somewhat confusing.

I do not dispute that obesity is a crisis worldwide and I am gravely concerned about the increase in childhood obesity, specifically.  The WHO declares that “obesity has reached epidemic proportions globally, with at least 2.8 million people dying each year as a result of being overweight or obese.” According to the WHO, the worldwide prevalence of obesity almost doubled from 1980 to 2008.  So, while obesity may have started in the 1980s it was certainly not the severe problem it is today.  My (very simple) question is this: how can we blame our world obesity crisis on the Food Pyramid alone, without looking at the other hugely significant changes that have occurred in the past 3 decades? Changes that have certainly reached more people than the Food Pyramid.

The advances in technology and the corporate world alone have resulted in an increased number of desk jobs, less physical activity, increased stress, reduced time and an increased demand for convenience.  TV, DSTV, TV games, portable electronic games, computers, lap tops, cell phones, affordable cars, public transport, power steering, washing machines, SOCIAL MEDIA … the list is endless and yet untouched by Noakes during his presentation.  But even more shocking was his failure to mention the fast food industry and the contribution it has no doubt made to obesity and all its related health risks.  There is an odd relationship between people having all the convenience they could wish for and still not having time to prepare meals at home. This brings me to another Banting point. Do you have time to bake your own carb-free bread and other alternatives?  Many people eat meals outside of the home.  This includes take-aways, restaurant meals, supermarket deli foods, petrol garage snacks, pre-packaged meals and the office canteen.  Many of these meals are eaten without knowledge of their nutritional value (positive or negative) and without practicing portion caution.

Obesity does not happen overnight and I doubt that 3 years of implementing the Food Pyramid could have caused the beginning of such a pandemic.  In my experience, people are not so compliant. If people gained weight because of the Food Pyramid guidelines, it was likely due to misinterpretation and in my personal opinion the Food Pyramid was too late because the Big Mac was born in 1968!  In 1969 McDonalds had already sold its five billionth burger and by 1971 had infiltrated into all the 50 states of America.  At the notable start of the climb in obesity in 1980, McDonald’s was celebrating their 25th anniversary of a rapidly expanding business. The year 2011 saw McDonalds operating in 119 countries worldwide and we know there is not just one per store per country.  I am picking on McDonald’s but the fast food industry is enormous and simply cannot be blameless.

All that aside, if you are still tempted to go Banting, be sure not to misinterpret the guidelines. LCHF Banting does not mean high protein. And this is where my major concern lies. Just to make it clear again, I do not believe that a diet high in saturated fats is good but my bigger worry lies with people attempting to achieve a LCHF diet and unintentionally consuming a high protein diet instead.  I have had patients tell me that they could not continue the LCHF diet because of all the meat they were having to eat.  If you do the LCHF diet, you must do it as Tim Noakes describes it.  Noakes also says it is a forever diet – you cannot stop it without expecting to regain the weight you lose.  The idea is not that you can eat as much fatty meat as you like. You will not be replacing your eliminated carbs with extra meat and its fat but rather with just fat … by itself.  Noakes himself will tell you that a high protein diet will kill you.  He is not saying that you should eat bacon for breakfast, lunch and supper but rather that you should leave the skin on your chicken and cook it with a block of butter and some cream.  Before you embark on a LCHF diet, at your own risk, you should make sure that you can both stomach it and afford to sustain it.

On the plus side of Banting

There are however a couple of Banting recommendations I do agree with. One, the daily consumption of vegetables. Two, the effort we should make to reduce highly refined carbohydrate containing foods and beverages containing carbohydrates in the form of fructose, sucrose or glucose. Beyond that, it is sufficient to limit high fibre, low fat carbohydrate containing foods to meals and snacks only, ensuring a 2 to 3 hour window for blood glucose clearance before consuming more carbohydrates. This means avoiding the consumption of sugar and sugar containing beverages separate from your meals and you will find that this has been a South African Food Based Dietary Guideline for many years.

It amuses me that people feel the complete elimination of carbohydrates from meals rather than a reduction in portion size is the only way to successfully lose weight.  In my experience, people who struggle to lose weight are eating more carbohydrate than what is recommended by the standard prudent guidelines, most often without realizing it.   The key is not to “cut out carbs” for however long you can survive it, but rather in knowing your carbs and practicing portion control.  Carbohydrate is not a food group but a nutrient found in many foods.  Your daily carbohydrate allowance includes carbohydrates found in starchy foods, fruit, dairy products, legumes and starchy veg. Carbohydrates found in foods outside of this list will most likely be carbohydrates eaten in excess of what you need. In addition, poor carbohydrate choices are often accompanied by fat and added sugar – cakes, pastry, biscuits, rusks, salty crackers, chocolate, donuts, samoosas, fried chips, potato crisps etc.  These foods are not to be consumed as regular snacks but rather as occasional treats, in small quantities.

There is no need to be radical but simply being mindful of what you eat, seeking professional help if necessary, and engaging in regular physical activity is the most successful way to maintain a healthy weight.

Other related articles:

The thing about FIBRE

Putting Carbohydrates in Their Place


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