Another year and some more new year’s resolutions to keep up with. Most of these will be left behind in a couple of months. But even so, not all resolutions are and more importantly should be too difficult to keep up with. Here my intention is to focus entirely on health concerns in our everyday lives and not about matters eschatological.

Besides the ones dealing with personal relationships or plans about professional activities, most frequently resolutions are about health matters. Some decisions like giving up smoking are pretty obvious and do not even require a discussion. Here one point. An acquaintance a few years ago said to me quite proudly that he had stopped drinking alcohol but when I asked about cigarettes he said that he was still smoking them. He is a pretty heavy smoker so I said to him only half in jest; from a health point of view you stopped the wrong thing.

Moderate alcohol consumption has some well established health benefits. However, even in a country where the use of alcohol is legal and morally acceptable, as physicians we rarely if ever recommend alcohol for health reasons. The problem is that few people, if any, can stick to what is described from a medical point of view as moderate consumption. And the abuse of alcohol on the other hand has many major health and social consequences that are quite unpleasant.

Many New Year’s resolutions are about losing weight and that revolve basically around two ideas, eating less and exercise. First about exercise. From a medical point of view, exercise has so many diverse benefits that all those fit enough to exercise regularly must do it. No, you do not have to run a few miles every day or do some strenuous gym stuff for exercise to be ‘useful’. Even a ten or fifteen minute brisk walk five days a week will provide most health benefits associated with exercise. And that is fine for most people. One important bit of advice particularly for older people that have been relatively inactive. Before starting any programme of significant exercise, getting a heart check might be a good idea.

As far as losing weight is concerned, exercise though a useful ‘adjunct’ is of little use as a primary method for weight loss. It takes a lot of pretty strenuous physical activity to burn off the calories consumed in just one hamburger eaten without any fries, regular soda or a milk shake. When I say that exercise is a useful adjunct, of course moderate exercise does burn off some calories and also helps other systems by improving circulation of blood to all parts of the body and perhaps increasing how many calories the body burns even during inactivity. Some investigations suggest that exercising or even a brisk walk is more beneficial if done on a relatively empty stomach.

Now comes the big question, which diet is the best to lose weight. Rule of thumb. If there are dozens of commercially available or published diets then clearly none of them is good enough to wipe off all the others from the market place. Dieting requires self discipline. There are some diets in which you can eat as much as you want except for this or that food group. But few of these diets can be adhered to for any period of time and it is well known that once a diet is stopped, most dieters will regain the weight they lost while on the diet. So, most physicians and other healthcare professionals will always recommend dietary changes that can be sustained.

The simple equation that comes to play in weight gain or loss is the number of calories consumed and the number of calories burned up. Average males or females require about fifteen hundred calories a day (does go up or down based upon body size) to sustain normal ‘metabolic’ processes in the body. What that means is that even at a state of perfect rest, our body is still functioning and burning calories. So, the only effective way to lose weight is to cut down on the number of calories consumed in a day. Starvation type diets are useless except for certain short term goals like being able to fit into a slim-cut wedding dress.

My purpose today is to talk of general principles. A ‘good’ diet is not only helpful in losing weight or in maintaining weight loss but is also important for general health and prevention of some medical problems. There is much confusion about what to eat or not to eat. First let me present two basic principles that I have mentioned before about a healthy diet. First, eat whatever you want but mostly plants. Second, avoid things that your grandmother would not recognise as food.

What the latter suggests is to avoid most ‘pre-cooked food’. Of course a generation ago there were foods that were cooked and stored but unlike those today they did not contain preservatives besides salt, vinegar or sugar, and there were no flavour enhancers or ‘trans-fats’ for taste improvement. In essence, all processed foods or precooked foods that come from a store freezer that only need to be heated before being eaten should be mostly avoided.

Also some fats are better than others. In general, fats derived from plants are healthier than those derived from animals. However, some butter on toast, or ‘ghee’ (clarified butter) are all perfectly healthy if used sparingly. The same is true of ‘red meat’ as long as it is lean and the fat has been trimmed by the butcher.

Past dietary recommendations to avoid fatty foods led to an unintentional side effect. People starting consuming more starch to feel full. This is probably in part responsible for the present epidemic of obesity and adult onset Diabetes (Type II) that we see in many countries including the United States. Fat and fatty foods including meat are better at making people feel full than starchy foods. So people tend to eat more starch if they eat less fat.

Latest dietary recommendations suggest that whole grains like whole wheat are better than white flour. That processed meats (sausages, bacon) should be avoided, that red meat is fine as long as the fat has been trimmed, though white meat is probably better. That home cooked meals or freshly cooked meals are superior to those bought from a store and are pre-cooked. And animal origin fats are not dangerous if used in moderation though vegetable origin oils are better when used for cooking.

The most important recommendation is that almost all traditional forms of food that are a part of most cultural traditions are just fine as long as they are used in a varied diet and eaten in moderation. And that home cooked food is the best, but an occasional visit to a local restaurant or fast food outlet is quite alright. And chose whatever diet you want to that will help you lose weight but then stick with a basic simple diet plan that helps you keep the weight off. No, there are no miracles diets.