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I have been privilaged enough to read a copy of the draft recommendations for clincal guidence on the managment of obestiy in Scotland.  This document ,the work of the NHS. is supposedly based on best evidence.  Naturally I read it with interest particularly in relation to dietary guidelines and exercise.  This draft document assures its readers that it is based on recent studies and each recommendation has been seperately rated for the strength of supporting evidence. 

All this seems very encouraging until you start to look closely at the section on diet and exercise.  As usual the low fat, low calorie message is repeated frequently in the main body of the report but when it actually looks closely at the comparitive diets it actually recognises that low carb is as effective as low fat. Indeed the most recent significant studies show that low carb is more effective both in the short and long term. Funny that such important reports which were published in leading journals across the world  fail to be properly reflected in not only the main part of the documetn but also in the specialist section.

The report makes it clear that there is robust evidence to show that exercise is very important to weightloss but actually the largest study on exercise did not indicate this at all.   The largest child obsity and exercise study in the UK showed quite the contrary and infact lost its government funding when it failed to show that exercise mattered.  Could it be that the results were not to the report writers liking?  

In fact the actual text of this apparent Scottish Report is actually a complete copy of an American report as they refer to diets we do not have in the UK. They refer to the Ornish Diet and the Zone Diet. 

What can one say other than Ho Hum. Yet another expert report which repeats the same mantra of the past 20 years – low fat low cal. Yet in the same period obesity has risen at alarming rates even while we eat less fat and less calories.

10 November 2008

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