"So what do you think about Banting?"
Do you ever dread bringing up what your profession is when you meet someone new? As soon as I am asked, I inwardly cringe and wonder if I should omit the truth or not. When I reluctantly tell the truth, I wait for that one inevitable question to immediately pop out of my new acquaintance's mouth... "so what do you think about Banting?"
There has been endless debate around this topic. Many reputable companies, such as the Heart and Stroke Foundation and the Association for Dietetics in South Africa have published articles, but people still seem dissatisfied.
What is it that draws people to the Banting diet so much? Why do they go from dietitian to dietitian, asking the same question, when every previous dietitian has given them the same answer?
What is Banting?
The Banting diet was first conceived by William Banting in 1869. He proposed that effective weight loss could be achieved by following an extremely low carbohydrate diet. He suggested reducing starches and sugars, but also suggested reducing saturated fat, for example, removing the fat off gravy.
Recently, Professor Tim Noakes from South Africa put forward a very similar diet, but with the inclusion of limitless saturated fat.
The idea is to reach a state where the body is starved of starch (less than 25g of carbohydrate per day), so has to switch to using fat for energy. This is known as ketosis.
Since Noakes' diet was similar to the Banting diet, it quickly took on the same name and became the rage in South Africa. I mean, who doesn't want to eat limitless amounts of bacon?
The only food group that needs to be restricted, according to Noakes, is starch / sugar. The 25g of carbohydrates allowed per day should come from vegetables and salad only.
Who was the diet intended for?
The Banting diet, as proposed by Tim Noakes, was intended for people with insulin resistance. He believes that most South Africans are insulin resistant, so will benefit from following this diet.
There is truth in this. Recent statistics show that, in South Africa, 70% of women and 40% of men are either overweight or obese. These percentages are alarmingly high. Anyone who is overweight or obese is at high risk of developing insulin resistance.
Ketogenic diets are useful for improving blood sugar levels, as well as blood cholesterol levels when a person is obese and/or has insulin resistance.
What is important to note here is that the diet was not suggested for someone who is a fairly normal weight, without insulin resistance, and who just wants to lose a few kilograms for aesthetic purposes.
Unfortunately, this key factor got lost along the way as the diet sky-rocketed to popularity.
Is this diet actually more successful than other diets?
Not quite. When compared to straight-forward reduced calorie diets (where starch, protein and fat were all maintained in "normal proportions") weight loss rates were the same, as long as the calorie intake was equal.
This shows that weight loss depends mainly on eating a reduced amount of calories and not really on cutting out starch. The Banting diet's success, however, largely relies on how easy it is to stick to it. It doesn't require as much willpower.
Eating lots of fat means that the person doesn't feel deprived.
Because of this, many people have found significant weight loss success when following the Banting diet.
Are there any risks?
The main concern with the Banting diet is the large amount of saturated fat it encourages people to eat. This is thought to be linked with heart disease, but there has been a lot of debate around this recently.
Studies that have found a link between saturated fat and heart disease were actual experiments performed on groups of people:
Their diets were controlled for certain periods of time and their blood lipid levels were observed. As saturated fat was increased, LDL cholesterol (the potentially harmful kind) increased too.
These same results have been found many times over many years. This is why dietitians and government organisations still believe that saturated fat is not healthy for our hearts.
2. Studies that have found no link between saturated fat and heart disease were mostly observational studies:
These studies looked at populations with high saturated fat intake and found that they had a low incidence of heart disease.
The problem is that numerous factors were ignored (BMI, blood pressure, physical activity level, genetics and other lifestyle factors, such as smoking and alcohol consumption).
This is important as there are also many native civilisations in the world with extremely high carbohydrate, low saturated fat diets who also have a low incidence of heart disease. For example:
The Okinawans ate 85% of their calories from carbohydrates and are the longest living culture in the world.
The Tahamara people ate 80% of their calories from carbohydrates and had extremely phenomenal physical abilities.
Observational studies alone are not enough to prove whether saturated fat is healthy for our hearts or not.
3. There are scientists who have been funded by the Dairy Industry to "neutralise the negative impact of milkfat by regulators and medical professionals."
This initiative began in 2008 at the global dairy industry meeting in Mexico City. Dairy companies felt that their sales were dropping due to the idea that saturated fat (milkfat) was unhealthy.
They specifically decided to fund scientists to prove that saturated fat wasn't as bad as it had been made out to be by government, doctors and nutrition professionals. This is an interesting point to keep this in mind.
4. From a dietitian's point of view:
I have heard numerous, experienced dietitians saying that they've had many patients come to them after following the Banting diet for a while with a worse problem than when they started out. Their blood lipid levels are often very high.
This is extremely case-specific and varies depending on how overweight the individual was to begin with and how rigidly they stuck to the diet. It is something to be concerned about though.
So is there any real conclusion?
At the moment, all we know is that there have been years of valid studies that have proven saturated fat to be linked with heart disease. All new studies proving otherwise may or may not be valid, but while this debate continues, let's try to keep things simple:
If you are obese or have insulin resistance, a ketogenic diet could lead to faster weight loss and improve your blood sugar and cholesterol levels:
If you want to try it out, then do so under the guidance of a registered dietitian and doctor.
This should be a temporary diet with the aim of reintroducing wholegrain carbohydrates at a later stage.
Try to get most of your fat from monounsaturated sources (eg: nuts, olive oil, oily fish, avocado, seeds etc.) rather than saturated sources until more solid evidence says otherwise.
If you are wanting to lose only a few kilograms or get into shape, a balanced diet including small amounts of wholegrain carbohydrates and plenty of fresh fruit and vegetables is still a safer and more sustainable route to go (see my nutrition basics page).
On a final note, plant-based diets containing starchy vegetables and natural grains have predominantly been linked to the lowest risk of heart disease for many years. Cavemen ate a diet rich in fruit and natural sugars, so the idea that "we weren't designed to eat carbohydrates" put forward by Noakes is seriously questionable. How is this fact completely overlooked in the whole Banting debate? Just a thought.
I hope you enjoyed this post. Please give me feedback and share it with your friends. Until next time, keep healthy, happy and free xx
References:
http://www.heartfoundation.co.za/topical-articles/highs-and-lows-low-carb-high-fat-lchf-diet
Feinman, R. D., Pogozelski, W. K., Astrup, A., Bernstein, R. K., Fine, E. J., Westman, E. C., ... & Nielsen, J. V. (2015). Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition, 31(1): 1-13.
Harcombe, Z., & Noakes, T. (2016). The universities of Stellenbosch/Cape Town low-carbohydrate diet review: mistake or mischief?: in practice-issues in public health. South African Medical Journal, 106(12): 1179-1182.
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Lukas Schwingshackl, Georg Hoffmann (2013). Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis. J Acad Nutr Diet. 2013 Dec; 113(12): 1640–1661. Published online 2013 Oct 17. doi: 10.1016/j.jand.2013.07.010
Malhotra, A. (2013). Saturated fat is not the major issue. BMJ, 347: f6340.
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Mozaffarian, D., Micha, R., & Wallace, S. (2010). Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med, 7(3): e1000252.
Opie LH (2014). Lifestyle and diet. Cardiovascular Journal of Africa. 25(6):298-301. doi:10.5830/CVJA-2014-063.
Talib A. Hussain, Thazhumpal C. Mathew, Ali A. Dashti, Sami Asfar, Naji Al-Zaid, Hussein M. Dashti (2012). Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. Oct 28(10): 1016–1021. Published online 2012 Jun 5. doi: 10.1016/j.nut.2012.01.016
