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REVIEW SA JOURNAL OF DIABETES & VASCULAR DISEASE
52 VOLUME 12 NUMBER 2 • NOVEMBER 2015
and in the long term have the potential to increase the risk of
osteoporosis due to increased calcium excretion via the same
pathway.6
On a low-carbohydrate diet, once carbohydrate stores have
been used up, the only source of glucose available to the body is
from allowing the body to produce glucose using muscle and liver
stores.2 Some tissues in the body, such as the brain and red blood
cells, have an obligate requirement for glucose as their energy
source.2,6 Elimination or excessive reduction of carbohydrates in the
diet results in a reduction in fibre and whole-grain food intake,
which commonly leads to constipation. Persistent constipation over
the long term may lead to diverticular disease, which can increase
the risk for colon cancer.2
Restrictive diets have been found to result in vitamin, mineral
and protein deficiencies, cardiac, renal and metabolic disorders,
and even death. Very low-calorie diets will not sustain life for long.11
If only a very small amount of lean meat, fish and low-fat dairy is
allowed, there is the risk of inadequate intakes of calcium, iron, zinc
and high-quality protein.6 The cabbage soup or grapefruit diets,
which emphasise one food and exclude all others, is nutritionally
unbalanced and unscientific,6 and can also lead to nutritional
deficiencies. The claims made by proponents of some fad diets and
health foods, of superior health and freedom from disease, can
result in delays in people seeking necessary and competent medical
attention,12-15 which can exacerbate this problem.16
Food and mealtimes should not be a source of anxiety; it should
be part of the pleasure we derive from social interaction, and not
a reason to avoid it. Food faddism can promote inappropriate
behaviour around food. It is important to examine what behaviour
the eating plan elicits; you should not accept feeling intense
frustration when food-related practices are disrupted, guilt or self-
loathing when food transgressions are committed, chronic worry
about non-optimal health or food imperfection or intrusive thoughts
about food at inappropriate times.17 Balanced eating should negate
the need to behave obsessively around food.
Balanced diets
A balanced diet for overall health recommends an intake of 45
to 60% energy from carbohydrates, approximately 30% from
fat, depending on the medical history of the individual, and the
remaining energy from protein, however exceeding 15 to 20%
energy from protein is not always safe.2 A balanced diet should
include food from all food groups, in appropriate amounts.
A realistic, balanced diet should not require the purchase
of any commercial product and it can be sustained in the long
term. Balanced eating is safe for the whole family and results in
less isolation and less time spent on planning menus appropriate
for different family members. Best of all, it aids in the prevention
of diseases by helping to reduce risk factors and meet nutrient
requirements.
Questions to ponder when choosing a diet
• Is the information provided by a medical professional who is
accountable to a governing body? If so, is he/she willing to take
responsibility for the advice given, and is he/she available for
follow-up advice and questions?6
• Does the diet promote gradual, sustainable weight loss of 0.5
to 1 kg per week,6 and not more than five to 10% of body
weight in six months?
• Does the diet include food from all food groups in adequate
amounts, such as fruit and vegetables, cereal foods, low-fat
dairy and lean meats?6
• Is there overemphasis on any one food type? 6
• Does the diet recommend increased levels of physical activity?6
• Can you eat this way for the rest of your life?18 Is it easy to
maintain and does it promote long-term health?
• What are the financial implications of being on this diet? Is it
realistic and are foods readily available?
Conclusion
Any weight-loss plan undertaken should ultimately promote
health and well-being. It is important to remember that any clinical
condition requires the assistance of a medical professional to
diagnose and discuss treatment options with you, as an informed
patient. Your health is your responsibility and within your control.
Although a panacea for all weight woes would make weight
loss simpler, it is not advisable to aim for rapid weight loss on a
diet that negates the body’s need for balance. Food, delicious and
varied, is necessary to supply all the body’s nutrient requirements.
References
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