IanD said:
Reduced carb diet is sustainable - the motivation is good health, active life, good BS control, reduced weight, improved cholesterol, etc.
Please, Fizz, don't take the negative approach that low carb is not sustainable. Encourage your patients, & set them a good example. You're obviously doing something wrong yourself at 21.5 stones! Why don't you join the forum as an enquirer & get advice.
p.s. I have answered your questionaire.
Thank you for helping with the questionnaire.
I can see myself getting drawn into the debate here
I think I should declare firstly that I have been a keen advocate of the low carb approach for many years, and am now on year 7 and starting to fail after initially good results. I have read numerous books and scientific papers on low carb, including Dr. Atkins's work. I still advocate low carb as the diet of choice.
As for doing something wrong, of course I am, I'm not sticking to it, and that is the whole problem.
Why don't I stick to it? This is a multi-factorial answer but mainly after 7 years I'm tired of constantly monitoring my diet, the expense of low carb eating, and the limitations it places on me.
Everyone has their own reasons for not sticking to it, redundancy, death in the family, finances, boredom, inconvenience, etc.
Despite all the theory and stories about how sustainable low carb diets are for every 1000 people who start them, only a few will still do the diet properly for the rest of their lives. I know all the theory about changing your eating habbits, but unfortunately the majority fail.
This I guess is the human element.
When we study treatments we look at the lifetime impact it has on a disease. Many treatments work very well theoretically and in controlled environments, but when introduced fail. examples are the contraceptive pill which is only 99% efficient, however if a person followed the instuctions to the letter the efficiancy should be 99.99%. Another example being the treatment of psoriasis with UV light, this works very well but is overall a poor treatment because patients can't comply with attending 3 times a week for 30 mins.
This is shown in the studies. The results of low carb are very good, especially in controlled environments. But studies prove that not enough people have the discipline to committ for longer than a few years, and certainly not for a lifetime. Again, this is the human element but it is of clinical significance in diet as a treatment for the nation's obesity. This isn't theoretical speculation, it's what is actually happening now.
As for the NHS promoting unhealthy diet, I agree totally. The fact that some cereals have the heart foundation logo on the box is alarming in my opinion.
I'm not a sceptic of the low carb approach. If a patient asked me for dietry advice I would recommend low carb very strongly, but the cold facts are this;
I'm 42 years old, 21.5 stones, hypertensive, with an enlarged heart. I've been trying to lose weight very seriously for over 10 years, including 7 years low carb. I, like many others, don't have another 10 years, If I don't do something that works now I will die. Studies show that I have already shortened my life by 15 years. Studies also show that surgery is the only treatment to have an impact on obesity.
Thanks again for all the comments and thoroughly enjoyable debate ... Fizz
