December 22, 2012

Two months ago I was 60 years old with a family history of Type 2 diabetes. I was 180cm tall, weighed 90.4kg, and my BMI was 28 which is in the overweight category (25-30) and not that far from obese (>30). My LDL cholesterol, triglycerides, blood glucose and serum insulin levels were all slightly elevated and my HDL borderline low all indicating a degree of carbohydrate intolerance/insulin resistance.

Today I am still 60 with a family history of type 2 diabetes. However I now weigh 82.5kg which brings my BMI down to 25 (borderline overweight). My bloods have not changed dramatically.

The first thing I have to admit is that I feel great. More energy, less sleepy in the afternoons, sleeping a bit better at night. Interestingly I did not notice any change in my exercise tolerance for the first few weeks then suddenly one day in week 6 I felt like I could have run all day and since then certainly my endurance has improved remarkably. Now whether this is due to the diet or the weight loss or improved fitness, one can’t be certain, but I have not really changed my exercise habits much (~20 mins moderate per day).

I have enjoyed the food. Once I got over the psychological barrier of the last 30 years of “fat is bad”, I have had no problems with the diet. Eggs and bacon for breakfast; cold meats, salads and cheese for lunch; fish or meat for dinner with lots of vegies, followed by berries and cream for dessert. Drank water, coffee, beef broth and most nights a couple of glasses of red wine. Snacks have mainly been almonds. I would say that I am not as hungry as previously and have no problems if I have to miss lunch. It has helped that I have had a bit more time recently for shopping and cooking.

We have been travelling a bit recently so that has given us some challenges. A week in Ireland without potatoes, and a long weekend in Paris without baguette, croissant, crepe au chocolat or crème brulee should have been impossible, but was not hard. Every restaurant we have been to in the past few weeks has had low carb options and most have been happy to replace potatoes/chips with extra veg.

Most people would regard me as being pretty conservative. I have never really been one for fads or radical ideas. In fact I have always dismissed things like fad diets quite scornfully. I have followed the dietary mantra of the past thirty years believing calories in versus calories out is what determines weight fluctuations, and believing eating a low fat high carb diet is the right thing to do. And yet that “perfect” diet just saw me put on weight slowly over that period.

The low fat theory won the battle over the low carb theory in the US about 30 years ago. Every government and dietary advice agency followed the US lead and advocated a low fat diet. Yet ever since that time the incidence of obesity and type 2 diabetes has steadily increased throughout the Western world. The story of how the low fat lobby won the political battle is well told by Gary Taubes in his books. It is quite depressing to me as a doctor that my profession appears to have got it wrong for so many years.

While there is no doubt that in many cases a strict low fat low calorie diet will result in some weight loss, the diet itself is not sustainable and nearly everyone puts the weight back on again. It seems to be that the low carb option is just as, if not more, effective in weight loss, and is much more sustainable.

There are many very intelligent people now challenging the whole idea of advocating a low fat diet. As a society and as a medical profession, we need to critically review the research evidence. Certainly the evidence in some cases is conflicting but an independent analysis is necessary.. We need to find clever, independent experts to review the current literature and to set us on a path where we can confidently answer this important question.

Meanwhile I am going to continue on my low carb high fat diet fairly convinced that for someone like me it is the best thing for my general health, my weight and the prevention of Type 2 diabetes.


  Weight kg Weight lbs
Pre-diet 90.4 199
Week 1 88.6 195
Week 2 87.2 192
Week 3 86.3 190
Week 4 85.5 188
Week 5 85.0 187
Week 6 84.7 187
Week 7 83.8 185
Week 8 83.2 183
Week 9 82.5 182