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Low-carbohydrate diets rising in popularity but experts warn balance is key

Sustainability of low-carbohydrate diet questioned in South Africa

Research has shown that weight loss alone improves markers of heart disease such as high blood pressure. Losing weight also helps in reducing the risk for a range of other diseases such as cancer and diabetes. With low-carbohydrate diets rising in popularity and many South Africans claiming astounding feats of weight loss, this can only bode well for the health and waistlines of South African people.

An online survey conducted by Resolution Health Medical Scheme (Resolution Health) and its wellbeing and rewards partner, Zurreal, showed that a resounding 66% of the more than 700 respondents who participated in the survey said that a low-carbohydrate diet had helped their weight loss goals in the long term. Almost 70% of the respondents also expressed confidence that a diet high in natural fats and low in carbohydrates would help them lose weight.

As many as 91% of the respondents who participated in the survey cited carbohydrates as being the number one enemy of those fighting the battle of the bulge, while 82% felt that sugar was a definite no-no for the weight conscious.

Mark Arnold, Principal Officer of Resolution Health, said that this survey was an extremely important exercise for the Scheme, firstly to fulfill the need of raising awareness about obesity and related healthcare risks and, secondly, to tap into the mindset of members and gauge their attitudes towards dieting.

“The results of the survey have revealed a definite shift in thinking among our relatively young, health-conscious membership base. In the past, the word ‘fat’ was a big taboo when it came to dieting. Even the fats found in nuts, butter and avocados for example, were avoided because of the perceived high-calorie content of these foods. In fact, almost 88% of the respondents stated that years ago they never would have thought that a diet high in natural fats and low in carbohydrates would have helped them lose weight,” says Arnold.

“With non-communicable diseases of lifestyle, such as heart disease, diabetes and certain types of cancers, on the increase in South Africa and obesity being a major risk factor for most of these diseases, it is certainly reassuring that South Africans are becoming more weight and diet conscious. As a medical scheme we are encouraged by the fact that more and more South Africans want to take ownership of their health and wellbeing,” Arnold states.

“However, while mindful eating is always highly beneficial, a great deal of concern has in recent times been raised by healthcare professionals about fad diets and their long-term impact on overall health and wellbeing, especially for people who suffer from chronic conditions,” he says.

Despite the success stories and growing popularity of low-carbohydrate diets, experts are quick to warn that balance is key and will always remain so. In fact, according to Dr Jacques Snyman, director of product development at Agility, owner of the Zurreal lifestyle programme and administrator to Resolution Health: “A thorough examination of the evidence has not yet shown the superiority and long-term sustainability of low-carbohydrate diets over a healthy balanced diet. Nor has any evidence been brought forward regarding the safety of this diet for patients with specific chronic conditions.”

“The diet seems to work as long as you follow it to the letter, however the real test for how sustainable this diet regime is over a long period of time will become evident when the person starts eating more carbohydrates again,” says Dr Snyman. Many doctors, dieticians and healthcare experts do not believe this approach is achievable for all South Africans.

In many households, a decent portion of protein such as meat or fish is only a dream. “It is simply not feasible to exclude carbohydrates in an already protein-depleted meal plan for many South Africans. It would be difficult to create a balance in diet if fats and only fats are left in the diet,” asserts Dr Snyman.

“Many plant-based protein sources such as legumes and beans are often rated as carbohydrates. If everyone went on a low-carbohydrate, high protein diet, it would become increasingly difficult to supply sufficient animal protein to a growing world population and this will place an even greater burden on the environment. The questions then are: ‘who will benefit most and is it suitable for all?’ To my mind this is simply not a sustainable way to eat for the majority for the rest of their lives,” remarks Dr Snyman.

Some practical guidelines to keep in mind for South Africans wanting to reduce their carbohydrate intake and live healthier lives:

  • Consult a professional first before embarking on a specific diet especially if you also already suffer a chronic condition such as diabetes mellitus, high cholesterol or heart disease.
  • Begin by restricting refined starches and carbohydrates such as white bread and white rice. Rather choose whole grains and whole-wheat options.
  • Choose foods that suit your budget with regards to red meat, poultry, fish, eggs, dairy products, legumes (beans), fruit and vegetables.
  • Avoid sugary products such as cool drinks, sweets and biscuits.
  • Stay away from processed foods.
  • Choose vegetables and fruit over high-starch meals
  • Control your portion sizes and increase physical activity to maintain sustainable weight loss.

“Diet alone cannot curb the rising epidemic of non-communicable diseases. Greater emphasis needs to be placed on promoting physical activity and making certain lifestyle changes,” asserts Dr Snyman.

High-fat diets need to be discussed with your doctor, especially if you already suffer from some metabolic disease or heart conditions. There are possible other dangers associated with eating a diet that is high in fats, such as a higher incidence of gallstones and gallbladder infection caused by increased bile being produced by the liver. Constipation is also another possibility due to the low-fibre content of the diet.

“If you are attempting a new diet, embark on it with caution and keep track of your blood pressure and blood sugar levels. Remember to share your biometric data (blood pressure readings, cholesterol values, etc.) with your scheme, if you are a member of a medical aid, so that your disease management programmes can track your progress and ensure you get the best possible assistance for chronic conditions timeously. Make sure you also exercise frequently. Just be honest with yourself and about how you feel and do not go to extremes.”