Intended for healthcare professionals

Rapid response to:

Feature Type 2 Diabetes

Low calorie and low carb diets for weight loss in primary care

BMJ 2018; 360 doi: (Published 13 March 2018) Cite this as: BMJ 2018;360:k1122

Rapid Response:

Re: Low calorie and low carb diets for weight loss in primary care

The low carb diet (inevitably high in fat and high in protein) and the ultra-low calorie (starvation) diets are not the only diets that are worthy of mention. Low fat starch based non-dairy vegetarian diets have been advocated for many years in the USA by Dr John McDougall and Dr Neal Barnard, who have a wealth of anecdotal evidence of diabetes and hypertension reversal. There are population studies which support this approach, including studies on Seventh Day Adventists. Worldwide meat consumption is associated with a Western diet, and adoption of meat into the diet is associated in migrants with increasing ischaemic heart disease, hypertension and diabetes. This phenomenon can be seen in Japanese and Latino migrants to the USA.

Side effects of low carb and low calorie diets such as headache and constipation are dismissed in these articles as minor, but anyone who has been on a bestselling low carb diet would probably think otherwise.

A low fat starch based non-dairy vegetarian diet has plenty of fibre, optimizes the gut flora and promotes regular bowel habits.

I must declare an interest in this. I have been interested in healthy diets for a long time and I understand that this area is controversial. While fortunately never having having either hypertension or diabetes, I have lost, on a low fat starch based non-dairy vegetarian diet, 13 kg in weight (BMI of 23.1) and achieved a total cholesterol of 3.7 without statins, without hunger or calorie counting, without headaches or constipation, and eating more bulky satisfying and tasty meals.

This way of eating is also good for the planet, which cannot be said for the approaches advocated in this edition of The BMJ.

Competing interests: No competing interests

19 March 2018
Joseph Murtinho-Braga
General Practitioner
Northdown Surgery
Margate, Kent