How is the health care system going to manage advice on LCHF, now that SBU’s expert inquiry has shown that such advice provides more weight loss and better health markers?
I was asked to write an opinion piece about this to the Swedish Television’s opinion website, and below is the result:
LCHF Challenging Health Care’s Poor Dietary Guidelines
DIETARY GUIDELINES. The question of how we should eat to lose weight has been discussed for years, often quite passionately. Now an expert inquiry gives us the answer. Low-carbohydrate diets, such as LCHF, will produce faster weight loss and improved health markers. The report challenges the Swedish health care system, which still maintains that you should avoid fat and calories. It’s time for updated and more efficient dietary guidelines, writes Andreas Eenfeldt, physician and health blogger.
What should you eat to lose weight? Which dietary advice should health care give overweight patients?
This question has been debated for years, often in affect. But now the expert inquiry from SBU, the Swedish Council on Technology Assessment, has come with the answer in the report Dietary Treatment for Obesity. It’s the result of an inquiry over more than two years, in which several leading Swedish experts participated, reviewing 16,000 studies on the subject.
In conclusion, the inquiry finds that advice on a strict low-carbohydrate diet, such as LCHF, produces faster weight loss in obese individuals. Moreover, health markers will generally improve when obese people eat an LCHF-like diet. No signs of problems with unfavorable cholesterol profiles have been observed in the studies performed.
In the long term (one year or more) it’s difficult to really see any differences at all in weight studies, something that SBU suggests is due to lack of compliance. Most people in the studies will simply sooner or later fall back into their old habits, like a relapsing smoker.
To help patients more efficiently to make long-term changes in lifestyle will be a great challenge for the future. But first we need to know which lifestyle change works best for obese people. The conclusions from the new SBU report provide our best basis for updated guidelines today.
This report represents a major challenge for Swedish health care. Presently, the advice most often given is about avoiding fat and calories. But according to this new report it’s the still-controversial advice on low-carbohydrate diets that’s the most effective.
Should our health care system continue to provide advice, that’s been proven worst in tests, to individuals seeking help for their weight problems? No, of course this isn’t acceptable. Licensed health care professionals have to follow good clinical practice, and therefore this new report needs to be taken very seriously.
The project manager for the SBU report, Jonas Lindblom, for example tells media that the health care system should now offer low-carbohydrate diets as an option for obese patients. And in the Swedish morning paper Svenska Dagbladet science writer Henrik Ennart writes that this report “sweeps aside the last major concerns about [a low-carbohydrate diet], and opens the doors wide open to the country’s hospitals”.
Obesity is a growing problem throughout the industrialized world. In Sweden, the proportion of obese people since the late 80’s has more than doubled to 14 percent. Add the overweight and close to half the population has a weight problem. As the problem only has grown worse with each passing year, past efforts have clearly not been enough.
The new SBU report clearly shows that there are more efficient dietary recommendations. To transfer these to new guidelines and educating health care professionals in more efficient dietary counseling will now become a giant task for the health care system.
The hope is that the advice on low-carb diets, which are the most effective in studies, will also provide better outcomes for people with weight problems, even in real life.
Then only one difficulty remains: long-term changes in lifestyle.
Andreas Eenfeldt, physician, author and health blogger at DietDoctor.com
My title suggestion was “New Advice on LCHF a Challenge for Health Care”. But the change was quite good, many people do unfortunately receive bad dietary advice within today’s health care system. The potential for better results is enormous.
SVT Opinion: LCHF Challenges Our Health Care’s Poor Dietary Guidelines (original article in Swedish)