I have just been looking at a section of the NHS Choices website entitled “The Truth about Carbs” (1). I just cannot believe the utter rubbish that is presented here about carbohydrates.

Here are some extracts:

  • “Carbs” has become a dirty word in recent times, especially in the weight loss world, due in no small part to the popularity of low-carb diets such as the Atkins, Dukan and South Beach. The “carbs are bad” mantra from Dr Atkins and co has left many people confused about carbohydrates and their importance for your health, including maintaining a healthy weight.
  • Carbohydrates are a source of energy. When eaten, the body converts most carbohydrates into glucose (sugar), which is used to fuel cells such as those of the brain and muscles.
  • Carbs are important to your health for a number of reasons. In a healthy balanced diet they are the body’s main source of energy. High fibre, starchy carbs release sugar into the blood more slowly than sugary foods and drinks.
  • Carbs should be the body’s main source of energy in a healthy balanced diet, providing about 4kcal (17kJ) per gram. Carbs are broken down into glucose (sugar) before being absorbed into the bloodstream. From there, the glucose enters the body’s cells with the help of insulin. Glucose is used by your body for energy, fuelling all of your activities, whether going for a run or breathing. Unused glucose can be converted to glycogen found in the liver and muscles. If unused, glucose can be converted to fat, for long-term storage of energy.
  • Vegetables, pulses, wholegrain varieties of starchy foods, and potatoes eaten with their skins on are good sources of fibre. Fibre is an important part of a healthy balanced diet. It can promote good bowel health, reduce the risk of constipation, and some forms of fibre have been shown to reduce cholesterol levels. Many people don’t get enough fibre. On average, most people in the UK get about 14g of fibre a day. We are advised to eat an average of 18g a day.
  • Carbohydrate contains fewer calories gram for gram than fat, and starchy foods can be a good source of fibre, which means they can be a useful part of a weight loss plan. By replacing fatty, sugary foods and drinks with high-fibre starchy foods, it is more likely you will reduce the number of calories in your diet. Also high fibre foods add bulk to your meal helping you feel full. “You still need to watch your portion sizes to avoid overeating,” says Sian. “Also watch out for the added fats used when you cook and serve them: this is what increases the calorie content.”
  • While we can most certainly survive without sugar, it would be quite difficult to eliminate carbs entirely from your diet. Carbohydrates are the body’s main source of energy. In the absence of carbohydrate, your body will use protein and fat for energy.
  • However, cutting out starchy foods from your diet could put you at increased risk of a deficiency in certain nutrients, leading to health problems …, unless you’re able to make up for the nutritional shortfall with healthy substitutes.
  • It may also be hard to get enough fibre, which is important for a healthy digestive system and to prevent constipation. Healthy sources of carbs such as starchy foods, vegetables, fruits, legumes and dairy products are an important source of nutrients such as calcium, iron and B vitamins.
  • Cutting out carbohydrates and replacing those calories with fats and higher fat sources of protein could increase your intake of saturated fat, which can raise the amount of cholesterol in your blood – a risk factor for heart disease.
  • When you are low on glucose, the body breaks down stored fat to convert it into energy. This process causes a buildup of ketones in the blood, resulting in ketosis. Ketosis as a result of a low carbohydrate diet can be accompanied by headaches, weakness, nausea, dehydration, dizziness and irritability particularly in the short term.
  • Try to limit the amount of sugary foods you eat and instead include healthier sources of carbohydrate in your diet such as wholegrains, potatoes, vegetables, fruits, legumes and lower fat dairy products.

 

Many of the statements above cannot be substantiated. There simply is not the evidence to support them. I could spend a long time explaining why this is so but what I find particularly fascinating is the comments posted by people who have also been appalled by what is presented as official policy. Let them speak for themselves with some of their views:

  • since switching to a low carb (not no carb) diet my endurance training has improved dramatically. I never feel tired or lethargic, so carbs don’t have to be your main source of energy. By the way, I have also lost nearly 2 stones in weight and my blood pressure has fallen into the “ideal” zone. I eat loads of butter and cream, lots of green veg and eggs, and about the same amount of meat as before (but with the fat left on, which I used to trim off after years of ‘brain washing’!).
  •  The article still contains rubbish like :-“Can we survive without carbs?

    While we can most certainly survive without sugar, it would be quite difficult to eliminate carbs entirely from your diet. Carbs are the body’s main source of energy. In the absence of carbs, your body will use protein and fat for energy.”

    An unbiased article would point out that calories can be obtained from any of the three macronutrients and that your body has the largest energy store in the form of fats, not carbs.

    Bacon and egg is a carb free breakfast, steak with two green veg has a few grams. Nobody advocates zero carb diets but restricting to <100 grams per day gives many people benefits to health.

    If you want to lose weight reduce calories and make sure the ones you reduce are all carbohydrate – the optional macro nutrient.

  • There are essential Amino and Fatty acids but I have never heard of essential carbs. Carbs especially refined sort are the cause for obesity and excessive insulin which both combined are disastrous to the biological function and yet the NHS prescribe this diet (high insulin diet) which I find a real irony. NHS how much did you get paid by our sugar industry for this article
  • I hold the NHS very highly, therefore I am acutely embarrassed by the bad science in this article.
    Due to my recent diagnosis of diabetes I’ve been reading a lot of peer reviewed modern studies, and I’m becoming more and more mystified and frustrated by the nutritional advice by the NHS.
    Frankly, your recommended low-fat high-carbs regime is almost the last thing diabetic people should eat, which is bad news as correct nutrition is the first line of defence against diabetes.I’m going with Sweden and their sensible LCHF approach, instead. They’re at the forefront of research on obesity and diabetes, whereas you’re still using 40 years old fallacious and financially biased science from the United States.

VW note:

Apparently the article which I have cited was updated in the light of comments about the previous version. Here are extracts made in December 2013 and January 2014 in response to that:

  • Have the NHS been infiltrated by certain members of the food lobby or are they really this ignorant?
    No wonder this country has an obesity crisis!
  • Dreadful article. Old 70’s health myths dressed up as common sense advice.
    I do not understand how this is allowed to be put out as public information from the NHS.
  • Hello Sian, I am concerned that you are pushing the low fat dogma despite the relentless science and research that shows that the dogma is nonsense. The NHS has a public duty to admit low fat calorie obsession is a dead end. You do not deal with hormones, metabolism and gut health. Food quality and healthy metabolism are key to health, not carbs. Please stop defending the mistakes of the past. (Sian is the author of the article).
  • This is a very unbalanced article. It’s fine as a “pro carbohydrate” item but needs to be balanced by an article stating the opposing case based on the insulin hypothesis of obesity and the problems of carbohydrates in diabetes etc.There is a problem with the “science” above in that the article http://www.nejm.org/doi/full/10.1056/NEJMoa022207 does in fact demonstrate a statistically significant improvement in weight loss at both months 3 and 6 of around 4% of weight loss. Most of us would take an extra weight loss of 3 to 4 kg in 6 months and say “thank you very much, Dr Atkins”. That could be an extra half stone to some of us.

    At 12 months with a high dropout rate and the use of “baseline data carried forward” for the dropouts the weight loss difference is reduced to a mere 2% of body weight with P=0.26 so there is still an 80% probability of getting a better weight loss on the low carb arm of this one study.

    This article should be withdrawn and re-written.

  •  Perfectly sufficient fibre and associated food factors such as vitamins can be gained from a diet based on leafy greens and raw coloured vegetables.
  • This commentary is full of inaccuracy, fallacy, opinion, and error. Point wise:1. Fibre is a carb. strictly, but it is not digested or metabolised, so should not be described nutritionally as a carb.
    2. We do not need carbs at all – none.
    3. Starchy foods when cooked do not release energy slowly, they dump glucose into the blood quickly. This is contraindicated – utterly.
    4. There is no requirement, and no reason why grains need to be in the human diet at all.
    5. Carbs are the main source of energy when they make up the largest portion of intakes, sure – but there is no reason why this needs to be so. Fats and protein also contain energy.
    6. So what if fats contain 2.25 x the energy per g than carbs? If carbs cause you to eat 3 to 4 times as much total energy per day (which they do, due to insulin response).
    7. Glycogen shortage is not a problem during exercise in properly fat adapted individuals.
    8. This author has provided no supporting literature at all, it is an opinion piece, its full of ridiculous errors and fallacies, and its plain ignorant. NHS choices, really; come on.
  • I have been low carb for over a year. Result ; lower triglycerides, ldl static, hdl increased, fasting blood sugar lowered, energy levels increased. Oh and not to mention two and a half stone lighter. I eat lots of saturated fat and enjoy it. Am i constipated? No.You need to examine the huge and growing scientific evidence on low carb high fat diets.

CONCLUSIONS

I think there is no need for me to add anything further. The comments from the different contributors have addressed most of the issues which would be of concern to me. Although the article has been revised it looks to me that most of the earlier comments are still applicable, which means that there has been little improvement. It seems that the NHS has got into such a pickle that it is having to defend the indefensible. The tragedy is that while some individuals have been able to work things out for themselves, the vast majority are still at the mercy of people like the author of this article. The inevitable consequence is that many are suffering unnecessarily and dying prematurely. It is obvious that the current policies are not working and a complete re-think is required. The knowledge and information is readily available. It is an absolute scandal that it has not been incorporated into the NHS strategy.

If one wants inspiration then take a look at what is happening in South Africa, starting with a link to The Real Meal Revolution website (2).

REFERENCES

  1. http://www.nhs.uk/livewell/loseweight/pages/the-truth-about-carbs.aspx
  2. http://realmealrevolution.com/