Saturday, December 29, 2018

Diet


Zoë Harcombe interview: the author of The Diet Fix says we should forget everything we’ve been told about losing weight

Anyone who has ever been on a diet knows that counting calories and skipping meals is a quick hit but doesn’t work long term. Obesity expert Zoë Harcombe thinks she has the answer. By Louise France



HADLEY HUDSON/THELICENSINGPROJECT

The Times, December 29 2018, 12:01am

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Zoë Harcombe has been both an anorexic and an overeater. She knows what it’s like to have a love/hate relationship with the fridge. Now, 30 years on from the teenager who starved and binged, she flies across the world giving lectures to doctors about healthy, achievable weight loss. Since 2004, she’s helped numerous people to lose 4, 5, 6st – and to keep it off.

Her argument is that, “Somewhere along the way we seem to have forgotten why we eat.” Twice she has been invited to put herself forward to stand on America’s Dietary Guidelines Advisory Committee, which draws up official advice every five years – and is due to report again in 2020. Twice, she has declined. She’s more interested in getting Britons on track first.

“I’m on a mission to stop calorie counting,” she says. “I want to put an end to people eating less, doing more and, when they don’t lose weight, beating themselves up. Rip up every government document that has ever been written and eat real food.” Harcombe, you’ll be curious to know, is 5ft 2in and weighs 7st 8lb. She is a size 6. She is 53 and, on the day we meet for lunch, she is rocking a pair of faux leather jeans.

She orders sea trout and salad. She never snacks, and doesn’t drink alcohol. She hasn’t eaten a biscuit this century. But she does eat dark chocolate. Sometimes at breakfast.

Harcombe, it becomes clear, is not a fan of our foodie culture (she was trolled when she tweeted a negative comment about Bake Off and our national obsession with sponge).

She is a no-nonsense, middle-aged woman – which is refreshing. I’m weary of reality TV stars in bra tops telling me how to lose weight. With a mathematics and economics degree from Cambridge University and a PhD in dietary fat guidelines, she bases her weight-loss theories on science and common sense. Hers is a back-to-basics approach that makes you want to punch the air (and not the skinny person sitting opposite you eating a croissant).

“When you have a bad relationship with food, it takes over everything. I would like food to become what it should be, which is fuel. If MasterChef had an episode about real food that everyone could make, that would be helpful.”

She doesn’t believe in counting calories or weighing yourself every day. She has no truck with worrying about portion size, as long as you’re eating moderately healthy food (she isn’t a rabid clean eater). She doesn’t even think you should go to the gym (unless you love it and won’t go mad for muffins afterwards). There are no expensive, obscure ingredients in her meal plans. But like a lot of diet experts, she avoids the starchy carbohydrates you get from pasta or toast. She’s much keener on meat (red), fish (oily) and vegetables (apart from potatoes). This is the sort of sensible dietary advice your mum might give (as long as she doesn’t have a messed-up attitude to food, too – it often runs in families, something else Harcombe is good at dissecting).



Zoë HarcombeDAN KENNEDY

On a typical day, Harcombe – who is married with stepchildren and lives in the countryside near Chepstow, Monmouthshire – will eat fruit and full-fat Greek yoghurt for breakfast, along with a full-fat cappuccino (more filling than a skinny). She might even have a couple of squares of dark chocolate afterwards. The key is eating enough to keep her energy levels up until lunchtime without munching anything else. For lunch it’s often scrambled eggs in butter and smoked salmon – something quick that means she’s not thinking about food. For dinner she will have a piece of meat – often red meat, because it’s more filling than chicken or fish – and a pile of roasted vegetables or a big salad.

After dinner – which is eaten early to cram in overnight fasting time – she’ll brush her teeth. It stops Brexit-anxiety snacking during Newsnight, apparently. “Every time you put something in your mouth you stimulate insulin. Every time you stimulate insulin, you have switched off any chance of burning body fat,” says Harcombe. Better to eat three decent-sized meals a day. “To lose weight you need to spend as much as possible of your day not eating and not recently having eaten.”

She is careful not to have too many carbohydrate-heavy meals – and never to put proteins with carbs, because they’re moreish and we tend to overeat then. So, she’ll eat meat or brown rice with vegetables. She avoids alcohol, not because of the calories but because the liver is too busy getting rid of it and not breaking down body fat. (It takes one hour for the liver to process one unit of alcohol. During that time you won’t be burning fat.)

You’ll notice that she is recommending proper, hearty meals. The problem dieters have, she says, is being hungry all the time. “We can’t sustain it,” she explains. “Which means we think we’ve failed. If we do lose weight, we end up needing fewer and fewer calories to avoid regaining it all again. Which means staying hungry long term – and no one can do that. It’s unnecessary and intolerable.”

Unlike most dieting experts with a book to sell, she makes no hyperbolic promises. She argues that, “The common diet goal of calorie counting to lose 2lb a week is worse than unrealistic. It is impossible. In my experience, 2lb a week is the minimum people expect to lose. Why am I the first person to tell a client that if they lose 2lb a week, week in, week out, until they reach their target weight, they will be the first person in the world to do so?” If she sounds frustrated, it’s because she is.

Millions of us still persist in counting calories. I include myself among them. I’ve met numerous weight-loss experts, from Jean Nidetch, an office clerk who started her Weight Watchers empire from a New York brownstone in the Sixties, to Professor Roy Taylor, who has made headlines this year for combating type 2 diabetes with diet, and they’ve all based their regimes on the notion that the calorie is king.

We need to get back to asking ourselves, ‘Why do we eat?’

The irony is that the c-word is a pretty outdated concept. It was 1918 when an American woman, Lulu Hunt Peters, wrote a book called Diet and Health, which first popularised calorie counting and went on to sell two million copies. At the time, the calorie was such a newfangled idea that she wrote it out phonetically to show her readers how to pronounce it. “Hereafter,” she wrote, “you are going to eat calories of food. Instead of saying one slice of bread or a piece of pie, you will say 100 calories of bread, 350 calories of pie.”

We’ve been doing pretty much this ever since, despite it being a lesson in futility. We probably don’t even know what a calorie is (it’s a measure of the energy released by food as it is digested by the human body; nope, I’m no clearer either), but ask us the exact number in numerous random foods and we can shout out the answer. A boiled egg? Seventy-eight! A small banana? Ninety! A two-finger KitKat? One hundred and six!

We often know these numbers – many of them guesstimates at best; at worst, made up by marketing departments – better than we know the mortgage rates on our own homes.

We might be desperate to be slimmer – in one US study, one in six women said that they’d rather be blind than fat – but we’re failing. According to the most recent statistics, 58 per cent of women and 68 per cent of men in Britain are overweight or obese. Around 4.6 million Britons have diabetes, the majority suffering from type 2, for which weight gain is a factor. Meanwhile, the global diet industry is worth £200 billion. If we do lose weight, 95 per cent of us put it back on. And then some.

Harcombe is the sane voice of the anti-diet movement, and she’s backed by increasing numbers of GPs. The diet industry, Harcombe says, is built on “cruel lies”. Her new book is called The Diet Fix. (She originally wanted to call it Don’t Diet.)

There are other books out next year that reflect this same disillusionment with diets – all of them by women who have also had issues around food, be it anorexia or binge eating. Whether it’s The F**k It Diet by Caroline Dooner or How To Feel the Fear and Eat It Anyway by Eve Simmons and Laura Dennison or Conquering Fat Logic by Nadja Hermann, calorie counting is increasingly seen as unhelpful.

Harcombe’s biggest bugbear is Public Health England, which, she says, has too many food industry figures on its panel. “Our public health advice has more likely caused the obesity epidemic than helped it,” she argues, citing the tenfold increase in weight problems in just 30 years in Britain. She dates our obesity crisis back to when we were told to eat carbs over fat, which was demonised. Faced with the bread basket, Harcombe says, only half joking, that she’d rather eat the pat of butter than the bread.

The Eat Well plate on the PHE website – she calls it the Eat Badly plate – still favours cereals, pasta and bread, despite a groundswell of experts arguing that this is the wrong way to go, including Dr David Unwin, the Merseyside GP who was recently placed ninth on Pulse’s annual power list for his anti-carb strategy with patients with type 2 diabetes.

“PHE advises cereal for breakfast, starchy food at lunchtime, starchy food for dinner,” says Harcombe. “When we are supposed to burn fat and lose weight, I have no idea.”

To understand her problem with carbs, she gives a biology lesson. To lose weight, you have to understand what the hormones insulin and glucagon do in the body. Whenever we eat any carbohydrate, glucose is released into the bloodstream. At this point, insulin is secreted by the pancreas to extract the glucose. Glucagon is the hormone that breaks down body fat, but it won’t do this if glucose is available for fuel. Furthermore, glucagon in only activated if in insulin isn’t present.

She wishes British children were taught more of this stuff than they are now – and fears that the current carb-heavy diet of pizza and pasta they are served for school dinners is going to drive up obesity levels further (one third of Year 6 children in Britain are already obese or overweight).

The advice to “eat less, do more” doesn’t work, she says. “We can’t sustain a calorie deficit. We try to eat less, but our entire driver is to eat more – the opposite of what we want to happen.” We also end up having less energy. “Which means we want to do less. And if we then do more, what happens? We get hungry.” Her argument is that we can’t buck millions of years of evolution just because a diet book says that we should. It is, she says, impossible to outrun a bad diet. Far better to simply move around a lot during the day.

What is more, if we can sustain a calorie deficit, the body adjusts. It’s why the 5:2 diet – based on eating 500-600 calories a day for 2 days of the week – peters out. “It’s still a calorie deficit at the end of the day,” she says. “The body will adjust.”

Harcombe started counting calories when she was 16 after being teased at school. Now she knows that she was a healthy 8½st, but at the time she convinced herself she was fat. She recalls finding a booklet that said to lose 1lb a week, she simply needed to cut back by 3,500 calories (it’s Hunt Peters’ original theory from 100 years ago). “It wasn’t long before I was under 8st. Then under 7½.” It took a lot longer to get under 7st. Because she was needing to cut more and more calories to see the scales drop, she was subsisting on black coffee and apples (95 calories each). “I was constantly thinking: how can I eat less and do more?” She played hockey, badminton, tennis, went swimming. Her periods stopped. She was always cold. She started fainting. At her lowest she got down to 6st. Her mother, a PE teacher, took her to the doctor.

Now she realises that, like a lot of high-achieving, middle-class teenage girls, she was using food to prove herself. “My parents were not affectionate. If you don’t get affection, you work out that the next best way is to get attention. I thought I was building my self-esteem by losing weight.’

At Cambridge University, the opposite happened. She began to overeat. She’d sit in her room and eat a whole Wall’s Viennetta (789 calories). Followed by a box of Quality Street (44 calories per chocolate). Then crisps (184 calories a bag). She was lucky – when she got up to 10st, her brain overrode her emotional eating. When she read up about food, she started eating healthily for the first time in five years. It would mark the beginning of her fascination with nutrition.

Now she says, “The person who was addicted to food feels like an alien to me. But it helps when I’m sitting down with someone for them to know I’m being honest with them. Lots of us have a bad relationship with food.”

Harcombe doesn’t pretend that her advice is a miracle cure. She talks about “chipping away” at weight loss. “We need to get back to asking ourselves, ‘Why do we eat?’ ” she says. “Because we need essential fats, proteins, minerals and vitamins. And then eating food that will give us those things.”

No more. No less.



BOOK EXTRACT

Cut back carbs. Fill up on protein. Eat veg. A 7-day eating plan to stick on the fridge



Don’t calorie count

A significant calorie deficit will likely result in short-term weight loss, particularly the first time a person attempts to “starve”. But weight loss becomes increasingly less successful with further attempts to restrict calorie intake, as the body has no intention of letting the same devastation happen twice. After any initial weight loss, calorie intake will need to be continually reduced to try to achieve further weight loss. And the dieter is more likely to have to maintain a debilitating low-calorie intake to avoid this seemingly unavoidable regain. If they manage this, they will be fighting hunger on a daily basis.



Don’t go to the gym

We’re trying to eat less at the same time as doing more, but doing more makes us hungry. Our entire driver then is to eat more – the opposite of what we want to happen. Those who regularly go to the gym and participate in scheduled exercise classes often have little energy and inclination to be active at other times. Furthermore, most of us don’t like exercise (we were born to conserve energy) and so we reward ourselves when we have done exercise. You’re better off being functionally fit – doing normal activity as part of your daily life, such as walking to work, gardening, cleaning, carrying shopping – than doing 20 minutes at the gym and then “rewarding” yourself with junk for the punishment that you just endured.



Don’t worry about portion sizes

To lose weight we must nourish – not deprive. You may find that your meals need to be bigger and better (more nutritious) than they used to be because each meal needs to get you through to the next one. Your portions of meat, fish and eggs need to be more substantial if you are not filling up with (make that fattening up with) potatoes and pasta alongside. Eat real food – ie food in the form that nature provides it. This is the phrase I use to explain what real food is: “Oranges grow on trees; cartons of orange juice don’t. Cows graze in a field; Peperami sticks don’t. Fish swim in the sea; fish fingers don’t.” Choose whatever real food you eat for the nutrients it provides. This means you avoid junk food. Eat a maximum of three meals a day. Breakfast should contain eggs; bacon; smoked salmon or kippers; natural yoghurt; berries. Lunch and dinner should feature: meat; fish; eggs; cheese; yoghurt; vegetables and berries – real foods rich in fat and protein and naturally low in carbohydrate.



Don’t weigh yourself

If your inclination is to give up when the scales don’t give you the “reward” that you’re looking for, then don’t get on the scales. If weighing is more likely to demotivate you than to motivate you, then don’t do it. Develop instead non-weight measures of success. Are you sleeping better? Is your skin clearer? Do you have more energy throughout the day and fewer sugar highs and lows? Make sure that you have a number of measurable things to motivate you – not just the number on the scales (which can vary for all sorts of reasons anyway, from water retention to recent food intake). I advise people to view weight loss as a “chipping away” exercise. Lose a pound or two, maintain, lose another couple of pounds, maintain. The successful dieter is the one who can maintain commitment even when they don’t feel that they are losing weight right now.



DAY 1





ROMAS FOORD

Breakfast Bacon and eggs.

Lunch Salade niçoise. Place a tin of tuna or a tuna steak on a bed of salad. Add a hard-boiled egg, olives and anchovies (optional).

Dinner Stir-fried vegetables and brown rice. Cook 50-75g (dry weight) of brown rice (takes 30 minutes). Chop lots of vegetables (carrots, courgettes, onions, peppers, green beans, baby sweetcorn, etc). Stir-fry in olive oil on a high heat for 5-10 minutes. Add tofu for extra protein.



DAY 2





ROMAS FOORD

Breakfast Porridge with water or low-fat milk.

Lunch Brown rice salad. Precook 65g dry weight brown rice – cook extra rice on Day 1 for an easy Day 2 lunch – and leave to chill. Add finely chopped salad ingredients (cucumber, spring onions, pepper, celery, crushed garlic clove). Use olive oil and black pepper as a dressing.

Dinner Roast chicken with vegetables or salad.



DAY 3





ROMAS FOORD

Breakfast Greek (full-fat) yoghurt with berries.

Lunch Roast chicken salad.

Dinner Chilli and rice (4 portions). Cook 65g (dry weight per person) brown rice. Heat 2 tbsp olive oil and gently fry 2 finely chopped onions. Add 1 chopped red pepper, 1 crushed garlic clove. Fry for 4 minutes. Add 1.5kg mixed veg cut into cubes; tin of chopped tomatoes; tin of kidney beans; 2 sliced chillies; chilli powder to taste. Stir for 20 minutes.



DAY 4





ROMAS FOORD

Breakfast Brown-rice cereal. Available in the gluten-free section in supermarkets and/or in health food shops. I like it dry, but add low-fat milk if you prefer.

Lunch Baked potato and leftover veggie chilli. Precook a baked potato when you have the oven on for the roast chicken. Reheat lunch in the microwave at work.

Dinner Salmon, mackerel or any large piece of fish – ideally oily – with vegetables or salad.



DAY 5





ROMAS FOORD

Breakfast Plain or ham omelette.

Lunch Chef’s salad. A bed of salad with hard-boiled eggs, tinned fish, cheese and/or cold cuts of meat.

Dinner Rice pasta in tomato sauce. Cook the pasta according to packet instructions. For the sauce, heat 2 tbsp olive oil until sizzling. Fry 1 chopped onion and 1 crushed garlic clove until soft (2-3 minutes). Stir in 400g chopped tomatoes. Heat for 2 minutes. Add 2 tsp basil, season and mix with the cooked pasta.



DAY 6





ROMAS FOORD

Breakfast My protein shake. Put 2 eggs, 200ml thick natural yoghurt and 1 rounded tsp decaf ground (instant) espresso powder in a blender and mix thoroughly.

Lunch Fruit platter, plain oat biscuits, low-fat cottage cheese.

Dinner Steak with vegetables or salad.



DAY 7





ROMAS FOORD

Breakfast Scrambled eggs.

Lunch Roast lamb, pork, beef or chicken. Selection of vegetables.

Dinner Stuffed peppers. Boil 50-75g (dry weight) of brown rice. Stir-fry chopped, mixed vegetables in olive oil and then mix the rice and vegetables. Use to fill a deseeded pepper shell. Bake in a medium oven for 20-30 minutes, until the pepper is soft when touched with a fork.


The Diet Fix, by Zoë Harcombe, is publish

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