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By Adam Brimelow Health Correspondent, BBC News
A Mediterranean diet may be a better way of tackling obesity than calorie
counting, leading doctors have said.
Writing in the Postgraduate Medical Journal (PMJ), the doctors said a
Mediterranean diet quickly reduced the risk of heart attacks and strokes.
And they said it may be better than low-fat diets for sustained weight loss.
Official NHS advice is to monitor calorie intake to maintain a healthy weight.
Last month NHS leaders stressed the need for urgent action to tackle obesity
and the health problems that often go with it.
The PMJ editorial argues a focus on food intake is the best approach, but it
warns crash dieting is harmful.
Signatories of the piece included the chair of the Academy of Medical Royal
Colleges, Prof Terence Stephenson, and Dr Mahiben Maruthappu, who has a senior
role at NHS England.
They criticise the weight-loss industry for focusing on calorie restriction
rather than "good nutrition".
Better than statins
And they make the case for a Mediterranean diet, including fruit and
vegetables, nuts and olive oil, citing research suggesting it quickly reduces
the risk of heart attacks and strokes, and may be better than low-fat diets for
sustained weight loss.
The lead author, cardiologist Dr Aseem Malhotra, says the scientific evidence
is overwhelming.
"What's more responsible is that we tell people to concentrate on eating
nutritious foods.
"It's going to have an impact on their health very quickly. We know the
traditional Mediterranean diet, which is higher in fat, proven from randomised
controlled trials, reduces the risk of heart attack and stroke even within
months of implementation."
The article also says adopting a Mediterranean diet after a heart attack is
almost three times as effective at reducing deaths as taking
cholesterol-lowering statin medication.
The authors argue the NHS is in a "key position" to set a national example by
providing healthy food in hospitals and by ensuring doctors and nurses
understand the evidence.
'Common sense'
Prof Stephenson says the service can exert a powerful influence, for good or
ill.
"Our hospitals and surgeries are the frontline for delivering health, it's
nothing more than common sense then that we should be leading by example.
"We wouldn't dream of letting people drink alcohol or smoke in any healthcare
environment, so I find it incomprehensible that we facilitate and sometimes
actively promote food and drink that in some ways cause as many problems. And
although some positive steps have been taken on the food given to patients in
hospital, their visitors and staff also deserve better."
Public Health England is reviewing the dietary advice conveyed in the "eatwell
plate" - which is used across the UK for guidance on what food to eat. Its
recommendations include calorie-counted recipes to help achieve a healthy
weight.
Dr Alison Tedstone, the chief nutritionist at Public Health England, said there
was no single silver-bullet solution.
"Government advice is to eat plenty of bread, rice, potatoes, pasta and other
starchy foods, plenty of fruit and vegetables; and some milk and dairy
products, meat, fish, eggs, beans and other sources of non-dairy protein.
"Foods high in salt, fat and sugar should be eaten less often and in small
amounts. If you are currently overweight you will need to eat less to achieve a
healthy weight and be active as part of a healthy lifestyle."
The chairman of the National Obesity Forum, professor David Haslam, welcomed
the article.
"A calorie is not just a calorie and it is naive for anyone to think the
complex hormonal and neurological appetite systems of the body respond to
different substances in the diet in identical fashion."
He said banning fast food outlets in hospitals would be a "legal minefield"
given the extended contracts in existence. But he said healthy nutrition
programmes could be put in place - as has happened in other big organisations -
to counter what he called their "sinister effect".