Following a diet that includes fruit, vegetables, nuts and olive oil is better than a low-fat diet for sustained weight loss, said a research team writing in Postgraduate Medical Journal (PMJ).
Led by Dr Aseem Malhotra, the team of senior UK academics and NHS (National Health Service) leaders suggest that a focus on food intake is important, but warn that crash dieting could be harmful to health. Official NHS advice is to monitor calorie intake to maintain a healthy weight.
A calorie is a unit of energy. In nutrition and layman's language, caloriesrefer to energy consumption through eating and drinking and energy usage through physical activity. But not all calories are created equal.
If calorie counting worked long term, America would be the thinnest country in the world. We are a nation of compulsive dieters and you wouldn't know it looking at us. Turns out the composition of what you're eating is crucial to how many calories you eat and how many calories you burn. In a study comparing 3 diets: low fat, low glycemic, and low carb, the people on the low carb diet burned 350 calories more than the low fat diet. And yet, our nutrition guidelines recommend a low calorie, low fat diet.
We often omit higher fat foods simply because they are higher in calories without taking into consideration what benefits we might get from them, such as staying fuller for longer
Malhotra said that there is 'very good scientific evidence' to now show that reducing refined carbohydrates, and particularly cutting out sugar from the diet, while increasing intakes of foods that are higher in 'good fats' such as oily fish, olive oil, and nuts is better for sustained weight loss and other health indicators. He says almost four decades of advice to cut back on saturated fats found in cream, butter and less lean meat has 'paradoxically increased our cardiovascular risks'.
"We have to look at the scientific evidence, and I think the important concept first of all, that we need to think about is that all calories are not the same, and they are not metabolised in the same way by the body," he said.
Earlier last summer, Dr. Malhorta stated in a BMJ publication, that a fundamental misunderstanding exists in the scientific community and among the lay public that has interfered with our collective ability to curb the obesity epidemic. The belief that we make our food choices deliberately and that they reflect our true desires sustains the status quo and obscures the reality that decisions about the food we buy and consume are often automatic and made without full awareness.
The current report also criticises the nutrition and weight-loss industry for focusing on calorie restriction rather than 'good nutrition.' Indeed, Malhotra warned that consumers should 'be very wary' of foods that are marketed as low fat or healthy, "because often the low fat foods are full of sugar."
"What's happened is the food industry have exploited this low fat message, which has been unhelpful unfortunately, and people are now consuming much more sugar."
"What's more responsible is that we tell people to concentrate on eating nutritious foods," said Malhotra - who advocated that people focus on buying whole foods and work to reduce their intake of fast foods and sugars.
Better than statins?
Writing in PMJ, the UK-based team also make the case that the Mediterranean diet may be more effective than cholesterol-lowering statin medication, citing research that suggests it quickly reduces the risk of heart attacks and strokes and is almost three times as effective at reducing deaths as taking statins.
Indeed, Malhotra, said the scientific evidence is overwhelming, and argued that the NHS is in a "key position" to set a national example by providing healthy food in hospitals and by ensuring doctors and nurses understand the evidence.
"We know the traditional Mediterranean diet, which is higher in fat, proven from randomised controlled trials, reduces the risk of heart attack and stroke even within months of implementation," he said.
Healthcare to lead the way?
"Our hospitals and surgeries are the frontline for delivering health, it's nothing more than common sense then that we should be leading by example," added study co-author Professor Terence Stephenson , chair of the Academy of Medical Royal Colleges.
He suggested that the UK health service can have a powerful influence over the health of the nation, both for good and bad.
"We wouldn't dream of letting people drink alcohol or smoke in any healthcare environment, so I find it incomprehensible that we facilitate and sometimes actively promote food and drink that in some ways cause as many problems. And although some positive steps have been taken on the food given to patients in hospital, their visitors and staff also deserve better," he said.
The main thing we need is common sense. Reduce or eliminate refined grains (anything 'white' like white bread, white rice, white pasta), cut out the sweets, replace potatoes for sweet potatoes, limit the consumption of red meat and processed meats, and eliminate other highly processed foods such as fast food.
Instead of sugar sweetened beverages (like soda, fruit drinks, sports drinks and energy drinks), drink water and other beverages that are naturally calorie and sugar free. It's not so much about how many calories we eat, but it will always be more about the quality of calories we eat.