A few weeks back, I advised a healthy dose of scepticism when faced with the fad diets of the new year. In fact, many of my blogs from last year carried a barely-hidden negativity towards ‘dieting’, so you could be forgiven for wondering whether dietitians have anything to do with ‘diets’ at all.

So, just to clarify a few points…

The ‘anti-dieting’ thing is really just my response to the standard media message that ‘diets’ are a short-term, quick-fix towards health goals, as implied by the phrase ‘going on a diet’. Of course the true meaning of the word ‘diet’, i.e. what people eat every day, is of huge interest to a dietitian.

In health (or at least relative good health), a sensible approach to diet and nutrition is usually all that is required. I’m not saying this is always straightforward to achieve, and there is always a degree of personalisation involved, but it does irk me when people try to overcomplicate and confuse things.

But beyond this, there is the truly complex world of clinical nutrition, where the provision of micro and macronutrients must be carefully manipulated in order treat specific diseases and conditions. Since this is usually of less relevance to the general public, I have chosen not to write too much about it, but occasionally, clinical dietetics finds its way into the public conscience.

One such example is the ketogenic diet, as typified by a recent Guardian article, which looked at the potential role of this diet in achieving weight loss.

Essentially, the ketogenic diet is a high fat and low carbohydrate approach, with fats converted to ketone bodies, which then replace glucose as a major energy substrate for the brain. It is by deliberately achieving a state of ‘ketosis’, whereby the level of ketone bodies in the blood increases, that the ketogenic diet has proven to be of huge clinical significance in treating epilepsy in children, and this is also the reason why this dietary approach continues to attract research with regard to the treatment of brain tumours.

While this Guardian article does touch on the origins, essentials and mechanisms of the ketogenic diet (as well as briefly mentioning, rightly, that it can be a challenging one to follow), I have one major bugbear here. Why pretend that the article is about weight loss, when almost all of the text refers to its role in epilepsy? I just think it’s a lazy method of trying to attract more readers.

Above all though, it’s interesting to see proper clinical nutrition mentioned at all in a major newspaper, and of course I particularly enjoyed the recognition at the end of the piece (albeit from Hollywood film director, Jim Abrahams), that the diet ‘requires a trained Dietitian.’ Too true, Jim.