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Swedish health advisory body says too much carbohydrate, not fat, leads to obesity

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6873 (Published 15 November 2013) Cite this as: BMJ 2013;347:f6873

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Re: Swedish health advisory body says too much carbohydrate, not fat, leads to obesity

The News item “Swedish health advisory body says too much carbohydrate, not fat, leads to obesity” (BMJ 2013;347:I6873) is not correctly reflecting the report by SBU, the Swedish Council on Health Technology Assessment.

First, we have compared diets aiming at reducing weight in obese not what is leading to obesity. Second, it is only in the short term that advice consisting of diets characterized as moderate and low carb are associated with a slightly larger reduction in weight than diets low in fat(6 months). No differences were seen after 12 and 24 months.

An English translation of the main conclusion is: “Weight reduction in adults. Several different advices on changes in dietary or drinking habits may reduce weight or waist circumference in persons with obesity. In the short term (6 months), advice on strict or moderate low carb diet is more effective as a means to reduce weight than advice on a low fat diet. In the long term, there are no differences in effects on weight between advice on strict or moderate low carb diet, low fat diet, diets high in protein, Mediterranean diet or diets aiming at low glycemic index”.

Another comment is that a Mediterranean diet was the only diet with effects on cardiovascular mortality or morbidity. All tables are in English and a summary in English will soon be available at http://www.sbu.se/sv/Publicerat/Gul/Mat-vid-fetma-/

The SBU report also discusses anticipated practical consequences. Individualization rather than a new fundamentalism towards low carb diets may be the bottom line there.

Nina Rehnqvist
Chair for the project on “Diets among obese individuals”
SBU, Swedish Council on Health Technology Assessment

Competing interests: No competing interests

22 November 2013
Nina Rehnqvist
Professor
SBU, Swedish council on Health Technology Assessment
Box 3657, SE-103 59 Stockholm, Sweden