What's
the most efficient way to get rid of that girth? Should you do away
with carbohydrates entirely or eliminate fats from your diet? What is a
fad and what is fact?
One of the ongoing problems of
the human race is the battle of the bulge. No doctor's day is complete
without at least one patient who brings in a recommended diet to seek
advice. Through the years I have seen many such suggestions, often
confounding and many without grounding in firm scientific fact.
Besides this, one is often asked advice on various supplements or even
ayurvedic cures or homeopathic medicines or herbal remedies for weight
loss.
Some of the herbs contain thermogenic material that
fasten the heart rate and raises the blood pressure — the Chinese herb
Ma Huang, for instance. I have known a young individual who took
ayurvedic medication for weight loss and ended up with kidney failure.
This was presumably because of the metal content in the medication,
which induced the kidneys to fail resulting in premature death.
It
is for these various reasons that doctors are not keen to endorse
products of which they have little knowledge. Many of these have scant
scientific background as well. Dietetics today is a well developed
science and therefore many doctors, particularly diabetologists, will
have service as dieticians.
Also traditionally through time
doctors will give you broad dietetic principles and will leave you to
sort the rest out on your own. Many consider this important advice as
out of the realm of medical consultation because they feel advice is
restricted to medication.
I must admit I am often confused with the
dietetic advice that patients bring in. In essence one must understand
that there is no easy way to lose weight. If there were an easy way we
would never see an obese individual. The issue of reaching a goal is not
as difficult as maintaining it. Being obsessed with weight loss and
weighing yourself twice a day is certainly not the best thing to do. I
would consider girth as or even more important than weight. In today's
times obesity is measured as a basis of body mass index, which is the
weight in kg divided by the height in square metre.
When one looks
broadly at dietetics we have mainly carbohydrate food such as rice,
bread, protein food such as chicken, meat, tofu, and fats such as
butter.
Among the several popular fads, which I first heard about
from patients, was the South Beach diet created by cardiologist Arthur
Agatston. It basically is a diet that restricts carbohydrates and is
higher in protein and healthy fats. It restricts the carbohydrates with a
high glycemic index: those carbohydrates that tend to increase your
blood sugar faster. Twenty eight per cent of your daily calories is
derived from carbohydrates. This diet is modified into three phases.
Phase one lasting two weeks where you cut all carbohydrates and eat lean
protein, such as sea food and lean poultry. In phase two you add some
of the carbohydrates such as whole grain bread, brown rice, whole wheat
pasta. Phase three is one of maintenance: you follow a healthy mix of
the two. The South Beach diet also recommends exercise.
In fact, if
you consider the overall picture, restricting caloric intake will result
in weight loss. In the final analysis all food translates into
calories. This is not as simple as that, foods contain nutritional value
as well, not just calories; by that token, alcohol, which provides us 7
kcal/gm, would serve as a food. This is the reason most weight loss
diets restrict or deny you any alcohol. The Mayo Clinic diet lets you
enjoying the types and amounts of food featured in the diet, improves
you overall eating habits and makes you change your unhealthy life style
habits for healthy one.
Among the revolutionary diets that exist,
the Atkins diet comes to mind because of the controversies it created.
Though it was originally created in 1958, it did not come into
popularity till it was modified by Robert Atkins himself in 1972 and
2002. In fact the diet is based on the following simple logical
analysis. The body burns carbohydrates as its preferred fuel. If
carbohydrates are not available fats are burnt. If fats are not
available protein are consumed and you lose muscle mass. This is
basically what one sees in a starvation-affected population. There is
first loss of fat followed by muscle mass.
The Atkins diet
basically consists of cutting carbohydrates to an extent that fats burn
as fuel and the body expends more energy burning this fat. There was
significant controversy in the medical fraternity regarding this diet
and the American Heart Association warned that it increased the risk of
heart disease, but a 2006 study published in the New England Journal of
Medicine, countered this claim. In May 2009 the Annals of Internal
Medicine reported minor adverse affects such as diarrhoea, general
weakness, rashes and muscle cramps with such diets.
So the question
continues as to what to cut: fat or carbohydrate to lose weight. In a
recent article published in the Annals of Internal Medicine a low
carbohydrate diet seems better than a low fat diet. In a study done
involving 75 participants on a low-carbohydrate diet as compared to 73
on a low-fat diet, the former group showed significantly greater weight
loss.
In addition, the fears with a low-carbohydrate diet of a
change in cholesterol and heart disease could not be borne out. In fact,
the total and LDL cholesterol and sugar levels did not change in
either group, nor did the blood pressure. Those in the low-carbohydrate
group had lower levels of C Reactive Protein and inflammatory marker
risk for a heart attack.
It appears then that it is easier to lose
weight by cutting carbohydrates rather than fat, at least so it seems
from this recent study.
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