By Marika Sboros
This is big: nearly 200 doctors and allied health practitioners in Canada have signed an Open Letter to their government calling for urgent, radical reform of nutrition guidelines to include low-carb diets.
They say that authorities told Canadians to follow guidelines for nearly 40 years. During that time, nutrition-related diseases, such as obesity, diabetes and heart disease, increased sharply. The doctors are also concerned about sharp increases in childhood obesity and diabetes rates.
They say that the evidence does not support conventional low-fat dietary advice. In fact, they say it worsens heart-disease risk factors. They say that those responsible must be free to compile dietary guidelines without food and drug industry influence. They want the guidelines to promote low-carb diets as “at least one safe, effective intervention” for people with obesity, diabetes and heart disease.
At heart, the letter’s signatories call for mainstream medical advice to include low-carb, healthy-natural-fat. Here’s more of these doctors’ powerful challenge to orthodoxy.
It’s a daring initiative given that some signatories have already faced ridicule and attack from establishment quarters for their views on low-carb. There are also salutary examples in other countries of doctors who dared to challenge dogma and go up against powerful vested interests. In this case, there’s probably safety in numbers.
The letter’s drivers are anesthesiologist Dr Carol Loffelmann and anatomical pathologist Dr Barbra Allen Bradshaw. They have addressed the letter to Health Canada, the Federal Health Minister, and all Provincial Health Ministers. Click here to read the Open Letter.
In it, they knock the most enduring pillars on which official dietary advice rests. One pillar is the diet-heart hypothesis that saturated fat causes heart disease. Another is the CICO (calories-in, calories-out) theory of obesity. That’s the one that says obesity is the result of gluttony and sloth.
The letter includes a Points for Change “manifesto” that draws from the work of the US Nutrition Coalition (click here to read the Coalition’s work) and the UK Public Health Collaboration. Among these are that the guidelines should:
- Clearly communicate to the public and health-care professionals that the evidence no longer supports the low-fat diet and that it can worsen heart-disease risk factors;
- Eliminate caps on saturated fats and stop advising people to replace saturated fats with polyunsaturated vegetable oils to prevent cardiovascular disease.
- Favour “real” food, that is, whole, unprocessed foods that include full-fat dairy and regular red meat;
- Recognise controversy on salt and avoid a blanket “lower is better” recommendation;
- Not emphasise aerobic exercise as a weight-loss tool. In other words, language should not suggest that people can manage their weight sustainably just by creating a caloric deficit;
- Involve a complete, comprehensive review of the most rigorous data available;
- Promote low-carb diets as at least one safe and effective intervention for people struggling with obesity, diabetes, and heart disease, and
- Offer “a true range of diets” that responds to the population’s diverse needs;
Interestingly, the letter advances Brazil as a good example. Loffelmann says that’s because Brazil’s dietary guide is “as close to perfect as we can expect to get”.
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“Every corner of the world, every cuisine can adapt it,” she says. “It puts food and eating back into the centre of the guideline and requires no numbers, servings, or math.”
As well, eliminating modern processed foods is most important, she says, followed by eating “within your carb tolerance”.
Loffelmann and Bradshaw devised the letter after the Canadian Senate meeting and report into obesity in the country last year. Among those the Senate invited to give presentations were US investigative science journalist Nina Teicholz. Teicholz gave an hour-long presentation based on 10 years’ research for her groundbreaking book, The BIg Fat Surprise. Click here to listen to Teicholz’s testimony to the Senate that begins at1:03:40.
The Senate report made “some very sane recommendations about future food guidelines”, says Loffelmann.
“It excited us,” says Bradshaw, “because they were proposing the very things that will turn the health of Canada around.”
Among the report’s conclusions: “Canada’s dated food guide is no longer effective in providing nutritional guidance to Canadians.” By way of example, the report said that authorities often present fruit juice as healthy but it is “little more than a soft drink without the bubbles”.
That prompted Loffelmann and Bradshaw to organise a social community that started small – with just three members – but has grown quickly beyond their expectations.
The community now consists of approximately 1600 physicians and allied health professionals. These are people across Canada who are eating real food or low-carb or learning about it. As a result, many are now teaching whole-food, low-carb ways of eating to their families, friends and patients.
Success stories have been extraordinary: Family members and colleagues have overcome type 2 diabetes and obesity complications with simple dietary changes. Better still, they have done so without feeling hungry all the time.
The stories “touched us deeply”, says Bradshaw. “We realised that we have built a strong powerful community that wishes to impact change at a greater level.”
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The aim of the letter is simple, say Loffelmann and Bradshaw: the guidelines must change to change the health of Canadians.
Another signatory is diagnostic and non-vascular interventional radiologist Dr Vajid Khan, who works at Bluewater Health and is an adjunct professor at Western University.
He says that many physicians are aware of the need for change. “They know that prevention really is the best form of medicine,” Khan says. They also know that prevention of disease is the only way to avoid the impending collapse of Canada’s healthcare system and related economic deterioration.
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“Unless we do something about it collectively, our loved ones, our patients and ourselves will continue to suffer disease and diminishing health quality,” Khan says. “They will also die prematurely of countless afflictions brought about by harmful or inadequate nutrition.”
The letter’s recommendations are brief and easy to understand, he says. It also gives the scientific evidence to back up recommendations.
“If you are looking to make a positive change in your health, this is an excellent place to start,” Khan says. “Start today.”
In a best-case scenario, Loffelmann and Bradshaw hope that those responsible for Canada’s next dietary guidelines will read the letter carefully; that they will take to heart the real crisis facing the nation: escalating health care costs and population suffering; and that they will accept that these crises are in large part due to the guidelines as they are currently written.
“They hopefully will agree that this is the time for drastic action,” says Bradshaw.
Loffelmann says: “I hope everyone reads them and takes them to heart.”
Both hope that the letter will be “a stepping stone to changing the face of medical education in Canada”. They hope that the curriculum will focus on prevention, not just treatment, of chronic dietary diseases. Practicing physicians also need education in dietary treatment of diseases as it is poorly lacking in the current system.
Loffelmann hopes that everyone will read Canadian nephrologist Dr Jason Fung’s book The Obesity Code. In particular, she hopes that it will become required reading for medical students.
Along with their hopes, Bradshaw and Loffelmann have not-so-secret fears. In a worst-case scenario, they say it’s possible the letter could vanish into the medical establishment’s ether. Consequently, those in positions of power and influence could simply ignore it. Sufficient numbers in the medical community could block the point of change, perhaps enough to maintain the status quo.
There is always the possibility that low-fat, high-carb guidelines could remain the dominant paradigm. Bradshaw says that this will result in continued exposure to sugar, highly processed and refined food “and an even sicker population”. Loffelmann says that they have turned many skeptics around. However, they still face “a large bureaucracy that the old, failed paradigm still governs”.
Cognitive dissonance among doctors is another obstacle. That’s the psychological term for the extreme discomfort that happens when someone has to face compelling evidence that contradicts a deeply held belief. As a consequence, the belief usually wins over the evidence.
“We must get it right this time around,” say Bradshaw and Loffelmann,” because if we don’t, it will cause unnecessary suffering and death.”