weight

From 1995 to 2005 the percentage of adults who are above normal weight increased from 45 to 54 percent.This morning I am reviewing women with diabetes in pregnancy.The median weight - the weight of the middle patient in the clinic - is 106.9 kg.When I was a medical student learning obstetrics only a little over thirty years ago a patient was considered high risk if she was over 90 kg.
I believe that this worldwide obesity epidemic is the result of a diet too high in refined carbohydrates,possibly influenced by the Pritikin diet which was very low in fat.It entered the global consciousness with the message that fat was bad despite the relative good health of the French and Mediterranean cultures who do not follow a low fat menu.In truth some fats are healthier than others and convenience food producers deliberately mislead the public about foods that contain them, successfully confusing them with lies which sound like truth.
High blood cholesterol levels can certainly contribute to arterial disease, increasing risk of heart attacks and strokes,but cholesterol in the diet does not of itself  cause high blood cholesterol - it is more related to saturated fat in the diet. However ,what is confusing to people is that saturated animal fats are also high in cholesterol so it seems that animal fats are bad because they contain cholesterol whereas the cholesterol is largely incidental.But now the food industry,which must be aware of what it is doing,has been able to claim or imply health benefits for non-animal fats.Palm oil is a vegetable fat which is relatively cheap and abundant, tastes good and produces a long shelf life. It is often marketed as containing "no animal fat" and "cholesterol free" although it is one of the unhealthiest high saturated fats you can consume.If the ingredients simply list "vegetable fats or oils" then it is likely to contain palm oil.Most packaged biscuits(cookies) and potato chips(crisps) contain palm oil unless specifically stated otherwise.The producers are deliberately trying to hide just how unhealthy these foods are.
Although not as directly injurious to body tissues as palm oil,the "fat free" deceit is a major source of the misguided notion that it is universally good to avoid fat in the diet.Unfortunately the absence of fat has two major consequences.Since the fat is usually compensated by an increase in carbohydrate most likely of the rapidly absorbed high GI(glycaemic index) variety : firstly these foods usually still have a high calorie content and excess carbohydrate is efficiently stored as fat; secondly, without fat the food no longer produces satiety.So you eat a rapidly absorbed low fat but high simple sugar food which is quickly emptied from the stomach and results in an insulin response which means that your sugar levels drop and you are no longer releasing good amounts of energy from the meal so you are tired and use less energy.Therefore,after your low fat/high GI meal you have stored fat ,are using less energy and feel tired and hungry.You can eat less than a thinner person and yet put on weight while feeling tired, hungry and miserable.The solution is to eat more protein,not to avoid fat(but healthy fats are preferred) and only eat complex carbohydrates,eg whole-grain(not even whole-meal) rather than white bread; bacon and eggs rather than cereal;fresh vegetables(fruit is less valuable) and smaller portions on smaller plates.
Whenever gestational diabetes is first diagnosed,the patients are educated about low GI diet and asked to have a half hour walk each day.They also check their glucose levels fasting and two hours after each meal.These are people who have usually struggled with their weight for many years and yet they all lose weight at least initially despite the growing baby.I used to ask them if they were getting enough to eat on the healthy diet and the answer was almost always yes.In fact most of these women who had previously been unable to lose weight despite intermittently starving themselves reported that they couldn't eat as much as was recommended because they were "too full".
The solution is available .There is only one healthy diet.It is the"weight loss" ,"heart health" ,"bowel cancer prevention" and "diabetic" diet containing good protein ,healthy fats and complex carbohydrates in smaller but more satisfying portions, with a little daily exercise.Sweet.