Hypertension and nephrology

[Changing dietary guidelines in obesity. MOMOT recommendation]

PADOS Gyula1, SIMONYI Gábor1, AUDIKOVSZKY Mária1, BEDROS J. Róbert1

DECEMBER 20, 2014

Hypertension and nephrology - 2014;18(05-06)

[In the 70s and 80s due to the heart attack „epidemic” the low fat diet was encouraged based on the cholesterol theory, with moderate success. At the same time, the consumption of carbohydrates increased with the frequency of obesity rising from 1971 to 30% in the USA. Foods with high glicemic index and rich in carbohydrates result in a fast increase in glucose level, insuline actions also leading to glucose – fatty acid transformation and weight gain. Over the last decades several comparative trials have proven that with the low carb diet one can lose about 3- more than with the low fat diet in half a year. The excessive low carbohydrate Atkins diet over 1 year (), was superior even to ZONE (), LEARN (), ORNISH () diet, in another trial, over two years also the „low fat” diet. International Association for the Study of Obesity (IASO) recommends an increased protein intake (15 → 25%) along with carbohydrate with low glicemic index (GI). According to the summarized guidelines of the Hungarian Society of Obesitology and Excercise Therapy (MOMOT) low calorie (1200-1500 kcal / day), low-carb (<45%) – low-GI, high-protein (≥ 25%), low-fat (38→30%) diet is recommended, by witch a weight loss of 10 kg/half year can be expected. After half a year patient compliance deteriorates and they can hardly keep even the low-carb diet, whose significant advantage diminishes by this. We hope that patient compliance can be helped with two new appetite decreasing drugs, namely lorcaserin and a combination of phentermin and topiramat. Future dietary recommendations may be influenced by the new guideline issued in November 2013 by AHA/ACC, and the Obesity Society the final approval of which by NHLBI can be expected by June 2014.]

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  1. Szent Imre Egyetemi Oktatókórház, Budapest

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