Banting? Don't stop your meds - docs


Cape Town - Tipping the scales at 153kg, a morbidly obese Brian Berkman was ready to undergo gastric bypass surgery as a last resort to solving his weight problems and uncontrollable diabetes and blood pressure.

Three years ago, Berkman decided to change his lifestyle, switching to a low carbohydrate, high fat (LCHF) diet – popularly known as the Banting diet – losing 70kg and arresting his diabetes.

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A breakfast fit for the most ardent Banting fan  soft scrambled eggs, feta, roast tomatoes, anchovies and crispy bacon. Picture: Frank ChemalyWhile Berkman remains on blood pressure medication, he had been advised by his doctor to cease treatment for his diabetes.

While Berkman remains on blood pressure medication, he had been advised by his doctor to cease treatment for his diabetes.

Despite the seemingly miraculous turnaround, health experts have warned against stopping medication, with at least one saying it would leave patients worse-off in the end.

The head of Nephrology and Hypertension at UCT and Groote Schuur Hospital, Professor Brian Reyner, said while the LCHF diet was perceived by some people as a simple diet, he cautioned that it was actually a highly complex issue and should be practised with caution.

He warned against stopping medication while on LCHF diet, saying medication should only be stopped under strict medical supervision.

“For instance, in people with hypertension, it may take two to three months before blood pressure becomes elevated after stopping their medication and, furthermore, stopping statin therapy after a heart attack or stroke could have disastrous consequences,” he said.

Berkman attributes his turnaround solely to the Banting diet, popularised by Professor Tim Noakes.

“I decided that the only way for me to shed weight and better manage my Type 2 diabetes and many other medical complaints, was to have the surgery. My physician and the surgeon agreed that I was a suitable candidate. For various reasons the surgery, scheduled for March 2012, was postponed three times,” he said.

Since his diet revolution three years ago, he has dropped nearly half his weight and is on a lowered dosage of his high blood pressure medication.

He said he no longer needs the nine diabetes tablets he took daily for several years after his doctor advised him to stop medication.

“I still do a range of blood tests every three months to check that I’m on track.

“I hope not to take meds for diabetes again,” he said.

Berkman isn’t the only person advocating going off medication while Banting.

Billy Tosh of Plattekloof lost 84kg over seven months.

He had weighed 163kg and was on 2 000mg of glucophage – diabetes medication – for seven years.

“The amazing thing was that as my weight fell off, my diabetes symptoms disappeared.

“After extensive blood tests and on the advice of my GP I stopped taking meds,” he said.

Margot McCumisky, branch manager of Diabetes SA, said while the organisation was not against the LCHF diet, “we don’t encourage people to stop taking their medication”.

“We often hear of people that stop taking their medication because they believe that they are cured by miracle diets.

“The fact is that there is no cure for diabetes. In most cases such patients end up developing serious complications such as kidney failure, amputation, strokes and heart attacks.

“It’s often difficult to tell when the diabetes symptoms are back, especially Type 2 diabetes. That is why it’s regarded as a silent killer,” she said.

Berkman was on four tablets of Gliclazide MR (30mg), four tablets of Meformin XR (500mg) and 30mg of Piolitazone on a daily basis. He said while there were no guarantees of him staying off medication forever, he credited his LCHF diet for allowing him to regain his health.

“I believe this is due, entirely, to the low-carb, high-fat Banting offering as I am never hungry or feel deprived as I did on previous diets. I also believe that I was addicted to sugar and to the sugar-producing carbohydrates in grains, so previous prescriptions of one slice of whole wheat, low-GI toast just kept me on the brink of my addiction with constant cravings,” he said.

On the LCHF diet, not only were food cravings suppressed and his energy regained, but he no longer lived in fear of death.

“Aside from the physical activities that I now look forward to, I feel healthier in my soul and, while this can’t really be tested, I feel smarter and better able to do my job as PR consultant and travel writer. I did have to give up a passion for gluttony and eating out and stop writing about restaurants which was an important part of my persona. That said, my tastes have changed so I no longer have the appetite for 15 courses of aubergine caviar and prawn foam.”

Tosh, who stopped his diabetes medication three years ago, said the diet not only corrected his diabetes, but his uncontrollable blood pressure had since normalised.

“My GP had informed me that I was in a very high risk category for suffering heart attack or a stroke. I had tried various diets over the years, but none worked over the long term. Then I met Tim Noakes, and over a period of 28 weeks I lost 84kg.”

Acknowledging the LCHF diet helps in reducing weight, Reiner said there was a lack of evidence around the long term safety of Banting.

He raised three areas of concern, citing that the high fat diet was associated with the development of atherosclerosis, the disease of the arteries that caused heart attacks and stroke in the long term.

Such a diet was also associated with developing colon cancer, and the increased consumption of animal products often led to increased protein in the body – spelling negative side-effects for the kidneys.

Maryke Gallagher, president of the Association for Dietetics South Africa, raised concern about the long-term health risks of a restrictive LCHF diet, saying such diets were not well understood.

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Cape Argus

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