The 60 Minutes programme last Wednesday and again last night featured a story about former All Black Captain Taine Randell, who returned to his home town of Flaxmere in Hawkes Bay to promote a range of community based initiatives to help improve the health and wellbeing of the local population.
One initiative was to promote a change in eating habits, by teaming up with a nutritionist Ben Warren. He invited a local group of M?ori to embark on a 10-week controversial diet, high in fat and saturated fatty acids, to help promote weight loss and to help manage Type 2 diabetes. Results showed significant weight loss (an average of 8kg each) and an improvement in blood sugar control.
We contacted a number of New Zealand health and nutrition experts to ask for their views on this approach.
Elaine Rush, Professor of Nutrition at Auckland University of Technology, commented:
“Great news about the weight loss, improvement in glycated haemoglobin and blood sugar levels. This is a fantastic community action.
“The number of people with diabetes (including an estimate of those who have not been formally diagnosed) in New Zealand is in the order of 300,000 not three quarters of a million as the documentary said. Of those about 40 000 are Maori. It is a serious, decimating disease and more New Zealanders are on the path to the high blood sugar necessary to diagnose diabetes and it is being diagnosed at a younger age.
“Two cornerstones of health are regular physical activity and a balanced diet. The increase in physical activity in Flaxmere, particularly within a social community context, is having and will have health benefits for that community.
“Maori (and other ethnic groups) are genetically diverse and for an individual it is impossible to predict with certainty whether a disease will occur or a diet will produce the expected or the same outcomes. However, there is increasing evidence, in general, that a diet low in carbohydrate has beneficial effects on blood sugars and lipids, reduction of diabetes risk factors and the cardiovascular system. A low carbohydrate can also can help promote weight loss independent of the amount of fat, saturated or not. The quality of a diet is not just about calories or one particular food. The diet of a person with diabetes is the same as the diet recommended for everyone.
Traditional foods are considered part of a healthy lifestyle due to the hunting, cultivating and harvesting involved in obtaining these foods. Before colonisation and the introduction of farmed animals the main source of protein was kaimoana and birds. These foods are low in saturated fat. Vegetables are necessary to provide essential nutrients and fibre to the diet – although as with meat, not all vegetables have the same nutritional quality. A variety of starchy and non starchy vegetables and of colours helps ensure variety of nutrients. Great to see that white flour and sugar are off the menu – they are nutritionally poor.”
Registered Dietitian MaryRose Spence, from Nutrition Consultants in Auckland, comments:
“There are some interesting points in this programme. The Maori people typically have a good muscle mass even if they carry excess body fat. If they are going to lose weight, they will need to start their day with protein at breakfast. The usual breakfast of cereal/ fruit would just leave them hungry for the rest of the day. The breakfast the programme is promoting- with protein e.g. eggs will enable them to lose weight comfortably. I am aware of this as I have the technology in my practice that accurately measures body fat and muscle.
“When anyone loses body fat – their cholesterol and blood sugars have to improve. So all the health benefits seen in Flaxmere, are due to a reduction in body fat. This is not specifically a diet for type 2 diabetes – but it is the body fat loss that brings the result.
“In years gone by when Maoris were hunter/ gatherers they could eat a higher fat diet with regular protein. They were more active and didn’t have the problems with high body fat. However these days with less exercise and some meals often consisting only of carbohydrate their body fat has gone up, and I believe the modification they will need to make for continued successful weight loss is to reduce the fat level. Sure they can have some fat but they aren’t the active hunter/gatherer and weight loss will get to a certain level and then become difficult.”
Amy Liu, Registered Dietitian from Metro Consultancy Ltd, comments:
“We all know that long term weight loss is achieved by healthy eating (healthy food choices and controlled portion sizes) and increase in exercise. Carbohydrates, fat and protein are the three main macronutrients that provide us with energy. This very low carbohydrate diet, high saturated fat diet suggested is definitely not recommended for long term weight loss for the general population, especially in those with diabetes. Diabetes is a metabolic disorder whereby the body cannot regulate blood glucose levels properly. Weight reduction is usually necessary in type 2 diabetes, especially centrally, through long term healthy lifestyle changes.
“A healthy long term eating approach is to promote a healthy breakfast that is high in fibre (to promote regular bowels), low in fat and sugar (to prevent overweight, especially around the stomach). Lunch and dinner should consist of adequate portions of protein, carbohydrates and vegetables. Snacking on healthy snack (food and fluid) options in limited frequencies is also important as this could contribute to a majority of the total calorie intake.”