The SA Journal Diabetes & Vascular Disease Vol 12 No 1 (July 2015)

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VOLUME 12 NUMBER 1 • JULY 2015 7
SA JOURNAL OF DIABETES & VASCULAR DISEASE REVIEW
type of diet for weight loss, coupled with an exercise programme,
and then move onto the Mediterranean-type diet to achieve life-
long health benefits, thereby avoiding the cognitive and cardiac
changes of high-fat diets. Therefore starting a diet to lose weight,
such as the new Atkins or Noakes diet, is complementary with a
later switch to the long-term Mediterranean diet. As these diet
types come in sequence, they are not competitive.
The future
A safe prediction is that there will be more editions of existing major
books (Atkins in the USA, Dukan in Europe, Noakes in South Africa)
besides new diet books. New lipid-lowering pharmaceutical agents
are already being tested in large new outcomes-based studies on
their preliminary promise.
The best self-help policy may well be to start with a dedicated
programme for weight loss however achieved, whether by the new
Atkins or Noakes diet, but associated with sufficient exercise. The
next step would be to move on to the modified Mediterranean diet
(Fig. 2) aimed at living longer and living better.
Looking to the far future, having both fish and meat in the daily
diet of large populations would need substantial resources, which
will be increasingly limited as the human race expands. Maybe the
answer will lie in novel fresh nutritional sources such as algae-based
diets.
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Fig. 2. This dietary pyramid starts at the bottom, with low carbohydrate intake
of about 20 g per day, then as exercise increases, works up to 40 to 100 g of
carbohydrates per day while maintaining weight loss, with the lifelong aim of
maintaining the ideal weight. Note that poultry, fish and beef (free of visible fat)
are allowed in the initiating phase. From Opie,1 page 67.