Healthy eating guid F

As fitness and health professionals most of us are focussed on trying to play a part in encouraging our clients to adopt behavioural changes that will see them healthier in the long term future. Unfortunately, although we may be impacting on the clients we work with on a one-to-one basis, the epidemiological data on levels of obesity in the UK indicate that throughout the past decade things have continued to change for the worse in the general population.

Dr. Catherine Sanderson, looks back over the last 10 years at traditional nutrition and weight-loss advice and forward to the next decade.

rom a physiological/ biochemical perspective weight loss seems, and indeed is, relatively simple. It is a matter of energy balance. Weight loss will happen if the number of

calories consumed in a day is less than the number of calories expended. The key question is the extent to which the type of calories consumed (e.g. low or high fat, low or high carbohydrate, low or high protein in various combinations) impact on either the speed or the extent of weight loss. Over the past ten years the obesity epidemic has stimulated a lot of research that interestingly all reached the same conclusion – it really doesn’t matter!

It is the size of the calorie deficit alone that determines the amount of weight lost (1,2,3). Whilst weight loss is initially greater on very low intakes (<1,000kcals per day) physiological responses to these starvation situations such as decreases in metabolic rate, fat mobilisation and fat burning mean that over time weight loss slows. Deficits achieved by moderate decreases in intake together with enhanced activity are therefore more effective. As long as that deficit is maintained what is important is that food eaten suits an individual’s likes and dislikes and fits in with their lifestyle so that they can adhere to it for as long as it takes to reach their target weight (4). The problem is, as it has always been, subsequent maintenance of that weight loss for life and of course the quality of nutrient intake over lifetimes do impact enormously on health status (1). It is well established that eliminating whole food groups, unusual or potentially unhealthy combinations of foods, or very low calorie intakes are unsustainable in the long term and lead to most or all of the weight being regained (5).

Sadly though, throughout the past decade there has been an increasing concern that it is this – the advice we have been promoting on what constitutes a long term healthy diet that we may have got wrong!

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The REPs Journal 2012;23(January):18-21