Low carb, high fat diet: Doctors get training
'We want you to be curious about science'
The low carb high fat diet has finally made its way into medical curricula.
Last week the country’s first accredited LCHF online course for doctors and allied health professionals was launched by the Nutrition Network at a special breakfast.
Some of the lecture titles in the 25-hour course include diabetes and obesity, low carb for women, the legalities of prescribing a LCHF diet, LCHF and mental health, and statins and cardiovascular disease.Dr Hassina Kajee, a specialist physician and obesity expert, is a board member for the Noakes Foundation – which is part of the Nutrition Network – and had originally worked in the public sector for many years.
She said her message to medical professionals was this: “We don’t expect you to start Banting. We first want you to be curious enough about the science.”
She said she and her colleagues at the Noakes Foundation needed doctors “on board” as they could not field all the interest and questions from the public.
The launch comes hot on the heels of a clinical trial in America which bolsters the Nutrition Network’s belief that an online course for medical professionals is now crucial.
Earlier this month, Virta Health in San Francisco released its one-year peer-reviewed trials of diabetic patients who had been put on preventative diets.
Sixty percent of them reversed their type-2 diabetes in one year, and 94% of insulin users reduced or stopped usage.
The preventative approach – rather than treating the condition with statins – “substantially improved obesity, blood pressure, cardiovascular disease risk and inflammation”, the researchers said in a statement.Professor Tim Noakes, who has been leading the LCHF charge for some years now in South Africa, said that training doctors would create a large return on investment for the health sector.
“The doctors are most important because they’re the ones seeing the patients,” he said, adding that he believed for every doctor who underwent the training or advised on the LCHF diet when appropriate, around 10,000 to 15,000 patients would benefit.
“The pharmaceutical industry drives us not to believe in this diet,” he said, citing the generous profits they make from statins being prescribed for diabetes sufferers.
“We do not need to re-prove the value of the diet. Human beings have been eating it for millions of years and, without that high fat and protein, we would not have developed our brains the way we did,” he said, adding that advice given was often based on the 10% of carb-tolerant outliers rather than the 90% for whom carbs are a problem.
Noakes and his colleagues blame the changes on what happened in around 1977 in America, when the food guidelines changed to say a high carb diet (70% of total diet) was optimal, when there was no evidence at all.
He said that 20 years after that, you see the diabetes epidemic happening in all the countries that adopted those guidelines, while in America in the 1960s, when carbs made up only 40% of a diet, the population was leaner.
At last count, in 2016, a record 19 million obese or overweight adults were recorded in South Africa.
But, said Dr Clint Cupido, head of health at state-owned Victoria Hospital in Wynberg, Cape Town, implementation would not be an easy ride.He said that the our health system had “no nutritional service” built into it.
Cupido explained that he remained inside the public health system to change it from within, but that “no amount of evidence would help” if research is not implemented.
He added: “We want to challenge the status quo. But those of you in the private sector get 45 minutes with your patients. You can speak to them and explain the benefits. In public health we get only five minutes with our patients. How do we then change what is happening on the ground?”
Kajee then indicated that the Noakes Foundation had actually earmarked Victoria Hospital as a site for collaboration.
Dr Neville Wellington, a diabetes management expert and one of the lecturers on the newly-minted course, shared the journey it had taken to get to this point.
“The prevailing theory before all this was that fat was the problem. Patients were being advised to increase their medication until they got things under control. To me this seemed counterintuitive.”
In 2012, he got a letter from Noakes about the research on, and value of, a low carb diet.
“If glucose is very damaging to the cells, why are we pushing it up instead of reducing it to treat diabetes?” he said he had asked himself.
“I then plucked up the courage and met with Prof Noakes,” he said, adding that years later, the profits from The Real Meal Revolution were finally used to set up the Noakes Foundation.
From there they realised the science needed to be more “inclusive” and that medical professionals – who are at the coalface of advising patients from all socio-economic groups – should be included in the processes of sharing information.
He said of the high levels of carb and sugar being consumed by society: “Economically, this is going to cripple us.”