I was attempting to give a friend and colleague some writing advice on Friday. Here it is in a nutshell: don’t be flowery and literary with your writing ” keep is short and simple. Because when communicating information of any sort (including health information), I believe the chances of someone acting on it (in the long term) are directly related to how comprehensible the advice is and how east the advice is to apply. In the world of health information, I do believe that less is often more.
I was therefore interested to read of a recent study which looked at adherence to two weight loss programmes [1]. One of these was a Weight Watcher’s diet based on a points system. Basically, from what I know of this diet, foods have different points values ascribed to them, and an individual is allowed a certain number of points per day. Individuals basically choose what they eat, but endeavour to stick to their point limit. The other diet tested was more prescriptive. Known as ‘Brigitte’, it provides users with specific instructions regarding what they should buy and eat. The Weightwatcher’s diet would be regarded as more complex, partly as a result of the fact that individuals need to know the points values for the foods they eat, and perhaps partly because users have to make more decisions for themselves about what they eat.
Anyway, the bottom line was that the complexity of the diet turned out to be the major reason why Weightwatcher dieters defaulted. Complexity was not a similar issue for those on the Brigitte programme. The authors of this study emphasise the importance of considering rule complexity to promote long-term weight management.
The relevance of this to low-carb and ‘primal’ or ‘paleolithic’ diets is that such diets are, in my view, relatively simple diets. Basically, in low-carb the rules are ‘don’t eat sweet and sugary foods as well as starchy carbs such as bread, potato, rice, pasta and breakfast cereals’. The Paleo ‘rule’ is to eat foods that we subsisted on for the vast majority of our time on this planet. Basically, that means the diet consists almost exclusively of meat, fish, eggs, nuts, fruit and vegetables (minus the potato).
You can see that ‘low-carb’ and ‘primal’ diets amount to pretty much the same thing. And both, as it happens, have a kind of simplicity. Eat like a caveman (or cavewoman). It doesn’t get much more uncomplex than that. And not only are the principles of them relatively easy to learn, these diets do not traditionally put limits on portion size or calorific intake. Which means, of course, no need to weigh or measure anything.
I have known, professionally and personally, countless individuals who have had lasting weight loss success and improved health by adopting lower-carb or primal eating strategies in their lives. I actually do believe that such diets are genuinely the most healthy for our species. But another huge boon of such diets is that they’re simple and easy-to-follow. As usual, less is more.
References:
1. Mata et al. When weight management lasts: Lower perceived rule complexity increases adherence. Appetite. 12th September 2009 Sep [Epub ahead of print publication]
I don’t doubt that simple is best. And at this point in time, I also like the science behind paleo/primal and low-carb diets. That said, it seems possible there’s another mechanism at work. Perhaps these diets work not because of what they include, but what they exclude?
Here in the states, there’s a talk show hosted by Rachael Ray, a woman who has made her name by cooking meals in 30 minutes. She recently had a woman on her show who had lost 100 lbs by following Rachael’s various cookbooks (which are NOT low-carb or paleo). And to Rachael’s credit, she suggested that the benefit was not in her recipes per se, but that by cooking meals (as opposed to take-out, restaurants or other store-bought processed foods), the successful dieter was benefiting by eating quality over quantity.
Perhaps keeping fructose and omega 6 to a minimum (or at least, avoiding high intakes of both together) gets you a good deal of the way there?
Good point, Beth, I concur, I mean ‘I agree’, with much of what you say.
Complexity has evolved in food and nutrition as it has in daily lives, and it is the complexity that is the real stumbling block. Pre-prepared food is perceived as being the simpler option by many, while the people that go down that route do not see the greater extension of trust, and of risk, that that route entails.
Howsoever people are persuaded to adopt healthier diets, be that by having their imagination fueled by promotion of the ‘paleo’, or by recognition of the distinguishing and disruptive features between the formative and modern diet doesn’t really matter. What matters is that people are liberated from being indentured to a life of poor health resultant from food generally marketed to them by large ‘food’ corporations. That then liberates them from being indentured to a life dependent upon drug therapies aggressively marketed to governments and physicians alike. The situation is becoming increasingly unsustainable.
Reports of Obama pressing for reform on health insurance reach us here, across the pond. The ‘how to pay and provide?’ is missing the point completely. The point is ‘why must we pay so much?’ – I think there is much by way of explanation in your last sentence. Consensus may be growing, as Johns’ preceding blog and comments shows, but big money rides on discrediting any emergent and alternative consensus, as the 43rd visitor comment to the preceding thread reveals.
Apologies to all, this is a health blog and my comments have drifted towards the political, sorry.
Yes Dr, I agree. But as Peter at the excellent Hyperlipid blog points out: you still need to get calories from somewhere! So low carb paleo is a (whisper it) high fat diet. Easy to achieve if you are using the technically non-paleo but paleo-analogous butter (or ghee) and cream. See the tremendous PaNu blog for a discussion of this point:
http://www.paleonu.com/panu-weblog/2009/6/13/using-dairy-to-substitute-fats-for-carbohydrates.html
Thank you Dr Briffa: you’re a beacon of sanity and integrity in the Unilever-sponsored world of UK media nutritionists!
Alzheimers is been referred to as a type 3 diabetic.
No refined sugars or processed foods goes a long way. You can eat bread etc. if it is wholegrain variety or contains loads of fat like Focaccia 😉
Having given up smoking in the late 1960’s I put on almost 28lb. I saw an advert. for a computer diet which restricted carbs. I was 30 years old. I lost the 28lb. in 10 weeks and felt brilliantly healthy. The diet was the precursor of Dr. Tarnower’s and The Atkins Diet. Since then I have tried other well known diets with failure each time. For me the low carb. diet works. Whenever I eat too many carbs. my vitality plummets. I am now 75. (and don’t look it) with clear skin, wrinkles just beginning around my eyes. On no medication whatsoever. Some of my friends are vegetarians. Dieting is not a contest between opinions. The proof of the pudding is in the eating thereof. I worked alongside Cardiothoracic Surgeons one of whom lectured on diet for a healthy heart (This in 1973) He theory was that heart problems arose when food manufacturers used fats, sugars and carbohydrates TOGETHER. He called it a leathal mixture. Good luck!
meat and fish, however, are not everyone’s cup of tea – nor are they cheap
my own mantra is simple too – no processed foods, everything raw or cooked from raw ingredients
though I would not, could not, eliminate milk and cheese, though strictly they too are processed
Simple is good. To relate this to former discussions about fats and oils. For oils eat only fresh nuts and seeds, oily fish but no other fats except those naturally in meat. THis means NO processed oils, no butter, no olive oil either. Just eat the olives. Simple.
I couldn’t agree more…but so many people I know shun low carb because “it’s too confusing”!!! I don’t get it. I tell people to eat meat/fish/fowl along with non-starchy vegetables (and berries) and a little full fat dairy. What is complicated about that?
I do agree that these diets work because they are so easy to follow….but also because of the effects on the body. High carb, for many of us, causes hunger and cravings. We don’t get that with low carb….and it’s MUCH easier to follow a diet if you’re not hungry and craving all the time!
Just a visit from the other side of the pond with a link to my take on the same subject. Hopefully we are both fighting the good fight doing no harm 🙂
http://calorielab.com/news/2010/01/19/dr-j-will-see-you-now-keep-it-simple/#more-6770
Something I’ve noted of late in my readings in this area & perhaps someone could make a comment on it. In many nutrition & biochemistry texts, glucose is said to be the preferred fuel for the body & as because of this, when you put fat & carbs into the body together, carbs (as glucose) is said to be burned first – preferentially. Well then if you apply that logic, alcohol should be the preferred fuel as this is metabolised preferentially over other available fuels.
Just another inconsistency in the whole high carb mantra that I thought I’d share.
hi Jamie,
from the point of view of the pathways by which fats, proteins, and carbohydrates are metabolised I find I am drawn to the elegance of the carbohydrate pathway, (and as a humorous aside I concede the alcohol pathway appeals!) but cannot discount the other pathways and marvel how energy is managed and stored.
Is it the needs of the cells that must be appreciated such that inference about dietary inputs can be drawn?
BUT the scientific explanation and the reductionism in thinking along the lines of metabolic pathways, interesting as it is, is arbitrary by degree.
Nature did not go to any great lengths to separate carbs, fats, and proteins. Instead it is a modern human phenomenon that does.
When the the physiological function of food is discussed SHOULD fibre be mentioned more often in the discussion?
Curiosity makes me wonder if fibre is natures’ first line defense against swamping the energy pathways. In turn can it help mediate the insulin/glucagon, and other axes?
Low Carb diet is really the best diet if you want to reduce weight and also to maintain a healthy body.*-`