January 29, 2023

Forget the outdated health advice, here’s how to lose weight

Prime Minister Boris Johnson

Prime Minister Boris Johnson

WITH his man boobs straining inside his shirt, Boris Johnson is evidence of a big problem on two legs, a high-vis reminder that Britain looks to have lost the battle of the bulge.

But does this mean that all attempts to reverse the UK’s obesity epidemic are doomed to failure?

The old broken record played by public health pontiffs – move more, eat less, count calories, avoid foods high in fat, sugar, and salt – patently doesn’t work. We inhabit a Groundhog Day world of yo-yo diets, where every short-lived and painfully achieved weight loss ‘victory’ is very likely followed by optimism-crushing weight gain.

Fortunately, some medics keep beavering away to free us from this loop of despair. Take GP David Unwin, the senior partner at Norwood Surgery in Southport, who in 2020, along with other academics, published in the British Medical Journal the results of a six-year study carried out amongst his own patients.

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By encouraging his chronically overweight patients who were either pre-diabetic, or already suffering from Type 2 diabetes (obesity and Type 2 diabetes often go hand-in-hand) to follow a carbohydrate-restricted eating plan, Unwin achieved heartening results. 46% of the participants went into remission from Type 2 diabetes, without the use of drugs.

Significant measurable improvements were also observed in weight loss, blood sugar, blood lipid (fat) profiles, liver function, and blood pressure. Good news for Unwin’s patients who, bear in mind, were otherwise looking either at a lifetime on drugs that commonly have side effects, or drastic bariatric surgery.

A bonus too for his practice, which made substantial budget savings on anti-diabetic and blood pressure medications.

Dr Unwin recently explained to fellow medic Dr Sebastian Rushworth why he had started his research. After more than 20 years as a GP using a conventional approach, he was disappointed with the results. “Gradually people got worst. I found it too depressing. Now my favourite patients are overweight with Type 2 diabetes.”

So how does Dr Unwin help these once dispirited patients turn the corner? His eating plan is low carb, higher protein, and medium fat, pretty much the antithesis of extant government advice.

While current UK guidelines tell you to “base your meals on starchy foods”, Unwin’s rule of thumb is to “cut out the white stuff [rice, potatoes, bread, pasta and so on] and turn it green”. In other words, if you were going to eat steak and chips, eat the steak but ditch the chips and eat green vegetables in their place.

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Now this isn’t a particularly original approach. The 1980s French diet expert Professor Michel Montignac was amongst the first to classify foods according to their glycaemic index, that’s how quickly they impact on your blood glucose levels.

Unwin himself was inspired by Dr John Briffa’s forward-thinking 2012 book, Escape the Diet Trap, which applied the same low carb/real food principles.

While nowadays more people understand that overtly sugary foods make you fat, Unwin’s big contribution, quite apart from his diet intervention study, has been helping people understand that starchy foods, like potatoes, rice, and cereals, digest down into astonishing amounts of sugar.

Have a side order of rice with your curry and you might as well be gobbling sweets because the effect of the rice on your blood sugar is similar.

Unwin devised a chart which shows the glycemic impact of foods visually as teaspoons of sugar. For instance, a 150g serving of boiled potatoes has a similar impact on your blood sugar to nine teaspoons of sugar.

If you follow Unwin’s approach, you’ll probably increase the amount of green vegetables you consume, eat plenty appetite-sating meat, fish, eggs, and full fat dairy, but cut back on sugary foods and carbs, both “brown” and “white”, because the former is only marginally better in terms of its blood sugar-raising effects.

Unwin’s view, which I share, is that we now consume higher carb diets than ever before in our evolutionary history, and that we humans weren’t designed to eat thus. He is among the growing number of GPs who see Type 2 diabetes as a disease of carbohydrate intolerance, and so recommend a low-carb to their patients. Unwin’s advice is that we should limit ourselves to less than 130g of carbohydrate a day.

Isn’t it sad though, that government ‘healthy eating’ tsars don’t keep up with this new persuasive research, or, at the every least, fund more extensive studies to test whether Unwin’s findings can be replicated on a larger scale?

Could it be that after decades of misinforming us, the public health establishment – in which I include not just government agencies but also health charities and NGOs that regurgitate its patently ineffectual message – would rather double down rather than do an embarrassing U-turn?

One glimmer of hope I spotted recently came from Second Nature, a company that claims to be the first digital programme used by the NHS for long-term behavioural change and sustainable weight loss.

It pitches its programme as an alternative to Joe Wicks, Weight Watchers, and Slimming World. Delivered by an app, it teams you up with a registered nutritionist and a ‘digital community’ of peers.

The NHS connection with Second Nature is all the more welcome because this company advocates lower carb; a departure from the standard paradigm.

The app discourages deadbeat methods, such as calorie counting, and recognises that low-fat diets leave you feeling deprived and hungry, which is unsustainable in the long-term.

If you follow Second Nature’s approach you may well find that you increase your intake of protein and healthy fats to feel fuller for longer.

The snag with the Second Nature app is that it costs £10 a week and upwards, whereas Dr Unwin has made all his diet advice and lots of explanatory material and infographics freely available online from the charity, Public Health Collaboration UK, and in the supplementary data appendix to his BMJ paper.

If you’re struggling with your weight, have a look. It won’t cost you anything and it could change your life.

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