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Diets come and go; some work and some don’t. Right now low carb high fat diets are trending and believers report incredible results, not only in weight loss but also in terms of reduction of cholesterol and improved health in general. But are they right?

There is something intensely personal about our choice of diet, but most people will agree that a diet that makes you feel healthy and well, and keeps your weight within the accepted body mass index (BMI) is a good one. A highly respected scientist, Tim Noakes is the first to say that LCHF diets are not for everyone. But one thing he is adamant about is that the benefits of a low-fat diet are myths, and that low-fat eating is unhealthy for anyone who suffers from insulin and carbohydrate resistance. He also maintains that not only will a LCHF diet enable obese individuals to lose weight and achieve an acceptable BMI, but they can also reverse all “known coronary risk factors.”

Some researchers agree with Noakes and the other advocates of a LCHF diet; others vehemently disagree.

The Tim Noakes Banting Diet

Unlike most other diets (including the original Banting) there are no set meal times, no portion sizes and no restrictions on kilojoules in the Tim Noakes Banting diet. Instead it involves eating minimal carbs (absolutely no sugar); loads of good, healthy fats; and moderate quantities of protein. Unlike Atkins, it is not a high protein diet.

Pointing out that it is carbs that make us fat and not fat, the authors of The Real Meal Revolution set out to show us that “fat is your friend,” and “insulin – the devil within.” The bottom line, they say, is that insulin (which is our bodies’ defence against carbs) transforms carbs and glucose into fat and then stores the fat so it cannot be used … and we get fat.

The diet recommends an intake of no more than 25 to 50 g (no more than 1,7 oz) of carbs in a day. It also uses fat as a tool to satisfy appetite and maintain energy levels. Pivotal to the diet are three lists that specify what can and can’t be eaten:
  1. The green “all-you-can-eat” list specifies dairy, fats, flavorings and condiments, nuts and seeds, sweeteners, and vegetables that have a carbohydrate content between zero and 5 g, as well as animal proteins up to 100 g (3,5 oz.) 
  2. The orange list that contains foods that can be eaten with circumspections, specifically fruits, nuts, vegetables and honey that contain between 6 g and 25 g carbs per 100 g.
  3. The red list that contains all the foods that should be avoided, either because they are high carb (like potatoes and other root vegetables) or toxic (like soya and seed oils.)

Most members of the two Banting FB groups I belong to report that they feel more energetic after a week of Banting. Not all lose weight immediately, but most start dropping inches. Again, the before-and-after photographs posted by those following the diet are incredible.

What Research Tells Us

If ever there was an area of research where studies continuously supply conflicting results, it is high fat versus low fat diets. The only area they sometimes agree on are that seed and vegetable oils (which are polyunsaturated fats) including sunflower, corn, safflower and canola oils, are potentially harmful to the body because they are highly oxidized. They also agree that partially hydrogenated oils and trans fats are also bad and should be avoided. But that’s where it ends.

So here's what some recent research tells us:

A study published by the University of Boston’s Department of Medicine in 2013 looked at the effects of a high fat low carb diet compared to a low fat high carb diet on weight loss, cardiovascular risk and inflammation in obese individuals aged 21 to 62. The study was carried out over a 12-week period, and they found that the LCHF group benefitted most. Even though it was a small-scale study, they concluded that LCHF diets may be more beneficial to inflammation and cardiovascular health of obese adults.

Just last year (March 2014) a research report published in the American Annals of Internal Medicine stated that the current available evidence “does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.” The purpose of the study was to summarize existing evidence relating to associations between coronary disease and fatty acids. This was based on guidelines that advocate changes in the consumption of fatty acid to promote heart health.

The team of researchers from the UK Universities of Cambridge, Oxford, Bristol, the Imperial College in London, as well as the US Erasmus University and Harvard School of Public Health looked at 72 studies that had considered links between coronary disease and fatty acids. They found no significant evidence that omega-3 and omega-6 polyunsaturated fats protect the heart or that saturated fats increase risks of heart disease.

The media was quick off the mark, and numerous articles appeared with headlines stating that there was “no link between saturated fat and heart disease.”

Walter Willett, chair of the Harvard School of Public Health’s Department of Nutrition immediately warned that the researchers conclusions were “seriously misleading.” One issue he highlighted was what would replace saturated fat if it was removed from the diet. If replaced with carbs or sugar risks of heart disease would stay the same, but if replaced with healthy fats (for instance olive oil, other plant oils or nuts) then risks would be reduced.

The National Health Services (NHS) UK said that since some people in the studies had cardiovascular disease or suffered cardio risk factors, the results might not apply to everyone. So they recommended people rather stick to current UK fat consumption guidelines that advise cutting down all fats and replacing saturated fat with some unsaturated fat. The guidelines do though confirm that fat is high in energy, and they state that by “frequently eating more energy than you need” (either in the form of fat, protein or carbs) will increase risks of becoming obese or overweight – which can increase cholesterol and increase risks of heart disease.

In September last year, the results of a US randomized trial were also published in the Annals of Internal Medicine. This compared the effects of low carb diets to low fat diets in terms of cardiovascular risk factors and body weight. A total of 148 men and women without diabetes or clinical heart diseases participated and the low carb diet proved to be more effective on both counts.

An even more recently published research report (January 2015) out of the University of Alabama found that a LCHF diet reduces abdominal and intermuscular fat and also increases insulin sensitivity in adults who are at risk of type 2 diabetes.

In opposition to these recent findings, a very small National Institutes of Health (NIH) study published in August this year found that restricting fat in the diet resulted in a much higher loss of body fat than achieved when carbs were reduced. The study involved only 19 men and women, all of whom were obese, and none of whom were diabetic. Their findings hinged on the fat that the reduced-carb diet effectively lowered insulin secretion that increased “fat burning.”

Closer to home (for Noakes and co), a recent study carried out at the University of Stellenbosch in South Africa looked at the effects on heart disease risk factors and weight loss of low carb diets. Using existing research on the effects of high-protein high-fat diets on heart health and weight loss, they found that neither had an advantage over the other. A bit of an anticlimax that really doesn’t tell us anything!

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