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Analysis Food for Thought

Making nutrition guidelines fit for purpose

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1579 (Published 16 April 2019) Cite this as: BMJ 2019;365:l1579

Rapid Response:

Making nutrition guidelines fit for purpose - Diet Wars

All diet changes require patient support and extensive dietary education in the longer term. There is no easy approach to changing lifestyle and requires the art of medicine to help patients to change. The use of food as medicine is a fallacy. The press, dietary studies with weak associations, medical literature and “so called expert opinion” contribute to the confusion1.

My approach to advising on diet is to divide patients into two groups: the newly diagnosed type 2 diabetes who are significantly overweight and those who require modest weight loss and healthy diet to reduce cardiovascular disease & mortality.
To reverse type 2 diabetes in the overweight, requires significant weight reduction. Recent studies have shown that a program using a very low carbohydrate, high fat, ketogenic diet can achieve this2,3.
The healthy diet option is a “Mediterranean diet” with sofrito and added nuts and extra virgin olive oil4.

Jeffrey Barron
Consultant Chemical Pathologist
Brighton & Sussex Medical School
Brighton.

References
1.Bero LA, Norris SL, Lawrence MA, Making nutrition guidelines fit for purpose BMJ 2019;365:l1579
2.https://www.diabetes.co.uk/news/2018/sep/low-carb-gp-dr-david-unwin-make... Source accessed April 21, 2019
3.Hallberg SJ, McKenzie AL, Williams PT et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study Diabetes Ther (2018) 9: 583. https://doi.org/10.1007/s13300-018-0373-9
4.Estruch R, Ros E, Salas-Salvadó J et al, Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts, N Engl J Med 2018; 378:e34 DOI: 10.1056/NEJMoa1800389

Competing interests: No competing interests

21 April 2019
Jeffrey L Barron
Consultant Chemical Pathologist
Brighton & Sussex Medical School, Brighton, UK
Brighton & Sussex Medical School, Brighton, UK