By Marika Sboros
It’s official and from Britain’s highest medical and dietetic levels: government-sanctioned dietary guidelines really are making you fat and sick.
The high-carb, low-fat, low-cholesterol message doctors and dietitians have given you for the past 40 years is proving to be the “biggest mistake in modern medical history”. It is one that has had “devastating consequences for public health” globally.
In a powerful public statement just released by UK National Obesity Forum (NOF) in association with the Public Health Collaboration (PHC), the country’s leading doctors, dietitians and scientists say: eating fat doesn’t make you fat; saturated fat doesn’t cause heart disease; to avoid type 2 diabetes, you need to … avoid “low-fat” foods, foods “proven to lower cholesterol”, high omega-6 polyunsaturated vegetable oils and starchy and refined carbohydrates. And you must stop counting calories.
They call for an urgent revision of the guidelines, saying that the role of poor dietary advice “has been ignored for too long”.
Now truly is the time to “bring back the fat”, say the statement’s authors.
The statement is endorsed internationally by leading academics, doctors, dieticians, nutritionists, sports scientists and health activists.
‘The real scandal: academics, institutions and journals whose primary responsibility is to patients and scientific integrity have at times colluded with industry for financial gain’
Not surprisingly, it didn’t take long for establishment knives to come out. In a BBC report, Dr Alison Tedstone, chief nutritionist for Public Health England (PHE), says the message to eat more fat is “irresponsible and potentially deadly”. (Click here to read PHE’s full response.)
The Guardian quotes Royal College of Physicians’ special adviser on obesity Prof John Wass saying there’s “good evidence that saturated fat increases cholesterol”, and to quote selective studies “risks misleading the public”.
The NOF and PHC authors finger the change in dietary guidelines in the US in 1977 and UK in 1983 as a root cause driving the twin epidemics of obesity and type 2 diabetes. They say science has been corrupted by commercial interests” with “undue influence” of the food industry on official guideline bodies posing a “significant threat to public health.”
The authors finger the change in dietary guidelines in the US in 1977 and UK in 1983 as being a root cause driving the twin epidemics of obesity and type 2 diabetes. They say science has been corrupted by commercial interests” with “undue influence” of the food industry on official guideline bodies posing a “significant threat to public health.”
But the “real scandal”, they say, is that academics, institutions and journals whose primary responsibility is to patients and scientific integrity have at times colluded with industry for financial gain.
NOF chair Prof David Haslam says that as a clinician, treating patients all day every day, he quickly realised that “guidelines from on high, suggesting that high-carbohydrate, low-fat diets were the universal panacea, were deeply flawed”.
Haslam, a physician in obesity medicine at the Centre for Obesity Research at Luton & Dunstable Hospital, and professor in obesity sciences at Robert Gordon University in Aberdeen, says his patients don’t lose weight or improve their health by cutting fats or calories.
“By working in the real world, rather than in a research lab or government department, it became clear that people will choose which food they eat, but may need guidance in how to enjoy their food but simultaneously avoid foods which will do them harm.
“I often contrast a Carravagio still-life masterpiece, giving ideal positive images of healthy food – pheasant, meat, fish, wine, cocoa, fruit and vegetable, with maybe a slice of bread – with the negative image of a traditional ‘diet’,and the strict instruction to cut out everything people enjoy, and wonder where the world went wrong,”
‘Public Health England’s current EatWell guide is more like a metabolic time bomb than a dietary pattern conducive for good health’
Current efforts have clearly failed, Haslam says. For proof: obesity levels are higher than they have ever been, and show no chance of reducing despite the best efforts of government and scientists.
A new approach is needed, he says, although “new” actually means “a return to 18th century values, drawn up before modern interference with basic principles occurred”.
Consultant cardiologist Dr Aseem Malhotra, a senior advisor to the National Obesity Forum, member of the Greater London Authority Food Board and founding member of the Public Health Collaboration says,
The change in dietary advice to promote “low-fat foods” in 1977 in the US and in 1983 in and the UK is perhaps “the biggest mistake in modern medical history resulting in devastating consequences for public health”.
Sadly, this unhelpful advice continues to be perpetuated, Malhotra says. Public Health England’s current EatWell guide is in his view “more like a metabolic time bomb than a dietary pattern conducive for good health”.
The message to the public to reverse obesity and type 2 diabetes must change: “Eat fat to get slim, don’t fear fat, fat is your friend. It’s now truly
time to bring back the fat,” Malhotra says.
The authors say that the “most natural and nutritious foods available” – meat, fish, eggs, dairy products, nuts, seeds, olive, avocados – all contain saturated fat. The continued demonisation of ubiquitous natural fat “drives people away from nutritious, wholesome and health promoting foods”.
They cite recent high-quality research that suggests full-fat dairy is protective against type 2 diabetes and obesity. The authors refer to a survey from investment bank Credit Suisse that highlights a “substantial level of misinformation” amongst doctors and nutritionists in relation to dietary advice.
“Most shocking is that 83% of doctors thought butter was worse than margarine and 66% believed vegetable oils are beneficial for health.”
Popular read: NOAKES: THE IDIOT’S GUIDE TO LCHF AND BANTING
Given the immediate health threat posed by diet-related disease, the authors say it is “imperative that education curricula for undergraduate, postgraduate and continuing medical education incorporate up to date evidence-based nutrition”.
“Health professionals and the public must shift focus away from total and LDL cholesterol as a marker of cardiovascular health”, they write.
“Evidence clearly shows that a cholesterol profile characterised by high triglycerides and low HDL is more predictive of cardiac risk and a reliable surrogate marker of insulin resistance”, which is the most important risk factor for heart attack in young men.
The statement describes type 2 diabetes as a condition of “carbohydrate intolerance” , and refers to the recent work of award-winning British GP and clinical diabetes expert Dr David Unwin. Unwin has saved the country’s National Health Service (NHS) £45,000 per year for medications for diabetes by from putting his patients on a low-carb, high-fat (LCHF) diet, compared to the average for his clinical commissioning group.
“Replicating these results in the “9400 surgeries across the UK could potentially save the NHS £423 million/year on diabetes medications alone,” the authors say.
Referring to industrial vegetable oils, they say “omega-6 rich vegetable oil (such as sunflower and corn oil), linked to the increased risk of death, coronary heart disease, and cancer in humans as well as the growth of cancer in animal models cannot be considered safe”, and can “barely be considered a food”.
The authors say a call for a revision of the guidelines is not only about preventing disease. It is also about nutritional interventions that address and eliminate the root causes of chronic disease rather than a limited model of treating symptoms and risk factors with pharmacotherapy.
The fact that prescription medications are the third most common cause of death globally after heart disease and cancer should be “a wake-up call that the future of healthcare will require a strategy that incorporates evidence-based lifestyle changes to treat illness in addition or often as an alternative to medical treatments which come with side effects”, the authors conclude.
US paediatrics professor, Dr Robert Lustig, head of the Division of Endocrinology and Member, Institute for Health Policy Studies, University of California, San Francisco and President of the Institute of Responsible Nutrition, says the newly elaborated science of nutrition highlights the reasons for failure in dealing with the obesity and diabetes epidemics, yet national guidelines continue to the same practice.
Brazil, to its credit, has just issued its dietary guidelines that are about real food rather than about nutrients or calories, says Lustig.
Likewise, the new National Obesity Forum and Public Health Collaboration guideline focuses on real food over processed food, and makes the case that “the entire healthcare complex needs to relearn nutrition in order to be effective advocates for their patients”.
Dr Trudi Deakin, chief executive and research dietitian for X-Pert Health and founding member of the Public Health Collaboration, says dietitians’ professional code of conduct states that it is their responsibility to keep abreast of the latest research evidence.
“This allows freedom to work outside non-evidence based guidelines. Dietitians have the opportunity to set the record straight and provide the public with dietary advice that will really impact positively on their health and wellbeing by preventing and potentially reversing obesity and Type 2 diabetes,” Deakin says.
Deakin is author of Eat Fat: Step-by-Step Guide to Low Carb Living (X-Pert Health).
Samuel Feltham, director of the Public Health Collaboration and Master Personal Trainer says one of the biggest misconceptions is that people can eat what they like as long as they exercise.
“Nothing could be further from the truth. It’s time to promote a real food lifestyle which means nourishing the body with the best fuel and doing the right type and amount of exercise for the purposes of good health for all ages and all sizes, not for the purpose of weight loss,” Feltham says.
Prof Grant Schofield, Professor of Public Health, Auckland University of Technology, New Zealand, says evidence-based nutrition is needed to bring experts on a course where they can help those most in need.
“People suffering diabetes and associated metabolic diseases are paradoxically most affected by a set of public health nutrition guidelines we can best describe as outdated and never-proven science.”
- The full referenced report, including a more extensive document from the Public Health Collaboration on healthy eating guidelines and weight loss advice, is published on the National Obesity Forum and Public Health Collaboration websites on Monday 23rd May.
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