By Marika Sboros
Are you on a low-fat, high-carb diet because your doctor or dietitian says that it’s “healthy”?That’s “fake news”, says Scottish professor of metabolic medicine Iain Broom.
You are part of an “uncontrolled global experiment” over 40 years. It is one that has had “disastrous” results for people across the planet, Broom said.
Broom is an emeritus professor at Robert Gordon University, Aberdeen, and lectures at Aberdeen University. He was a speaker at the annual Public Health Collaboration (PHC) conference in London on May 19 and 20.
The PHC held its conference at the Royal College of GPs (RCPG). That made the RCPG into the medical profession’s strongest endorsement yet for LCHF and ketogenic diets.
In the final of a two-part review of the conference, Foodmed looks at why the conference also sounded the death knell for official low-fat dietary guidelines. And for the diet-heart hypothesis that saturated fat causes heart disease.
The guidelines are based on the diet-heart hypothesis. The conference called for radical change to conventional dietary guidelines globally because of the “disastrous” effects on public health.
Physician ‘by adoption’
Broom calls himself a biochemist by training and a physician by adoption. He was one of the first to adopt low-carb diets to treat obesity, diabetes and heart disease in Scotland. Critics accused him of killing patients with his dietary advice.
Ironically, he originally also advised low-fat eating. This aligned with Diabetes UK’s recommendations on fat intake. Since then, he has done more research and gone with the evidence.
He told the PHC conference that low-fat diets only became popular because food industry replaced dietary fat with sugar to make the food palatable. That made the diets high-carb as well as low-fat – and a disaster for public health.
Broom was one of many speakers who showed how official dietary guidelines have contributed to skyrocketing global rates of obesity, type 2 diabetes and heart disease. And why the guidelines need urgent revision.
Broom said that low-fat diets were not originally designed for weight loss or diabetes (both type 1 and 2) management. Researchers originally proposed them to reduce and prevent cardiovascular disease (CVD).
THE REAL PHC TARGET
The main target was cholesterol.
However, low-fat diets don’t work for CVD health. Broom cited the US Nurses’ Health Study that began in 1976. It has been called “the largest investigations into the risk factors for major chronic diseases in women”. The study showed no effect of dietary fat on CVD.
The long-term national US Women’s Health Initiative (WHI) that looked at 49000 post-menopausal women launched in 1993. It also showed no negative effect of saturated fat on CVD risk – and cancer and other risks.
Click here to read: TEICHOLZ: HOW LOW-FAT DIETS CAN KILL YOU
Likewise, a 2012 Cochrane review of 24 studies showed no effect on CVD risk or total mortality, he said.
Despite current conventional dietary “wisdom”, Broom said that low-fat, high-carb diets are also “inappropriate” for diabetics. Diabetes is a condition in which patients have difficulty metabolising carbohydrates. Therefore, it makes no sense to give them a high-carb diet, he said.
Experts also often say that once people become diabetic, it is harder for them to lose weight.
“That’s true,” Broom said, “but only if you keep giving them a high-carb diet.”
Diabetics currently die from complications of atherogenic CVD, he said. The benefits of low-carb diets for diabetic hearts are significant, he said. Among these is an increase in big, fat and “happy” cholesterol particles. These boost heart health. by reducing atherogenic CVD.
In his presentation, Scottish cardiologist Dr Scott Murray was critical of the medical profession and the medicalisation of normal human conditions.
He opened with an Aldous Huxley quote: “Medical science is making such remarkable progress that soon none of us will be well.” Murray followed it with an apt quote by South African Anglican Archbishop Desmond Tutu: “There comes a point when we need to stop just pulling people out of the river. We need to go upstream to find out why they are falling in.”
Big Pharma, and Medical Device company “trials” are driving the guidelines, Murray said. And those who make up guidelines for cardiovascular health are “barking up the wrong tree”.
They use clever “marketing” that ignores the role of hyperinsulinaemia as a key risk factor for heart disease, he said.
Big Food and Soft Drink companies, Coca Cola among them, also influence dietary advice.
‘Statins for all’ advice is wrong
“Physical activity is important but so is nutrition,” Murray said.
And just reaching for statins is not the answer. The “statins-for-all” advice is wrong, he said. More important is what’s going on metabolically inside the body. That’s the real cause of heart disease, he said.
The body’s cells are too efficient to make and burn fat simultaneously, Murray said. Thus, excess cellular glucose blocks fat from entering the mitochondria. And that’s bad news for tickers worldwide. He summed up the benefit of low-carb diets in five words: “Excess glucose destroys fat oxidation.”
Murray’s advice for heart and overall health is simple: “Hearts desire fat. Don’t compete with what you eat. And do train your heart and arteries to be resilient.”
He ended his talk with an amended quote by Edward Stanley, the 15th Earl of Derby: “Those who do not find time for nutrition and exercise will have to find time for illness.”
While much of the focus at the PHC conference was on type 2 diabetes, speakers showed the benefits for LCHF and ketogenic diets for type 1 diabetics.
British GP Dr Ian Lake is a type 1 diabetic, manages his condition with an LCHF diet and minimal use of insulin. He called type 1 diabetes the “elephant” in the room.
“Diabetics are entitled to the same blood sugar as non-diabetics,” Lake said. He pointed to a lack of evidence-based advice for type 1 diabetics in the UK’s NICE (National Institute for Clinical Excellence) guidelines and Diabetes UK.
Type 1 diabetes treatment not working well
Diabetes UK now accepts low-carb diets as helpful for patients with type 2 diabetes, Lake said.
However, it claims “no convincing evidence” to support a recommended “ideal amount of carbohydrate for maintaining long-term glycaemic control” in type 1 diabetes.
Lake highlighted Diabetes UK latest (March 2018) advice to type 1 diabetics on what they can eat: “Anything”.
Best current guideline practice for treatment of type 1 diabetes was clearly “not achieving much”, Lake said.
Click here to read: TYPE 1 DIABETES: LOW-CARB DIETS DISH UP RADICAL NEW HOPE
Many in the UK have not even heard of US expert Dr Richard Bernstein, he said. Nor does anyone ever tell them that low-carb “is safe and OK”.
Lake also said that many type 1 diabetics are already using LCHF therapies and are achieving “very good results”.
Scottish GP Katherine Morrisson also uses low-carb diets for diabetic patients. She became interested in LCHF after her son was diagnosed with type 1 diabetes.
Usual treatment failure
She said that results from “usual” treatment for both type 1 and 2 diabetes are “poor”.
Morrison is co-author of the book, Diabetes Diet: For Weight Loss and Incredible Blood Sugar Control. She is also co-author of papers on low-carb diets for metabolic syndrome and diabetes.
Morrison said that doctors and dietitians who don’t use ketogenic diets for treatment of diabetes have an unreasonable fear of ketoacidosis. Ketoacidosis is a rare, potentially fatal condition seen mostly in type 1 diabetics.
“Ketogenic diets do not cause ketoacidosis,” Morrison said.
Dietary ketosis is a perfectly normal phenomenon, she said. It occurs when there is a relative lack of dietary carbohydrate. The body uses up body fat for fuel and a side effect is the “spilling of ketones” – a by-product of fat metabolism– into the bloodstream, breath and urine.
The amounts of ketones are “small and not dangerous”, she said.
She called it “crazy” to recommend a high-carb diet for diabetics, both type 1 and 2. (Doctors advised her to put her son on a high-carb diet when he was first diagnosed with type 1 diabetes.)
Morrison pointed out that even NICE (UK National Institute for Clinical Excellence) diet criteria now support low-carb diets.
Dietitian academic Dr Trudi Deakin was equally critical of her profession in her presentation to the PHC. Deakin said that there is nothing to suggest that orthodox-trained dietitians give advice that benefits diabetics.
Low-carb is ‘key’
“I’m not against dietitians. I am one. But they don’t give evidence-based advice.”
The major focus for diabetic treatment should not just be weight loss, Deakin said. That became another PHC conference theme. Deakin said that just as important is an emphasis on criteria for good metabolic management.
Diabetes UK is making “some right moves”, she said, but doesn’t go far enough. it is now well-established that type 2 diabetes can be put into remission, Deakin said. And low-carb dietary interventions are proving to be key.
Thus, the focus should be on helping patients to adhere to low-carb diets.
In her presentation, GP Dr Joanne McCormack made her support clear for LCHF therapies. She also called for doctors to be more proactive in offering low-carb options to patients.
Low-carb diets have clearly helped patients with a range of health issues, including diabetes and asthma, McCormack said. This raised the question why more doctors don’t recommend low-carb diets.
Make fat your friend
McCormack showed how dietary change helped her to lose weight and boost health. In her practice, McCormack aims to help patients make changes to boost their health. To that end, she runs the Fat is my friend and Healthy Living websites.
McCormack also took aim at vegetarian and vegan diets. There is “no scientific justification” for adopting these diets as “healthy”, she said. Ethical and environmental reasons were a different matter.
PHC speakers also looked at factors that militated against sustainability of a low-carb diet. One is sugar addiction. Yet despite the growing body of evidence, many doctors and dietitians still insist that there is no such thing as sugar addiction.
Clinical psychologist Dr Jen Unwin and Diabetes.co.uk chief operating officer Charlotte Summers showed that many opponents of sugar addiction have links to food and drug industries. They titled their presentation Bitter Sweet: Food Addiction and Diabetes. In it, Unwin and Summers looked at why food addiction in general and sugar addiction, in particular, are real and growing.
“We live in a sweetness saturated environment,” Unwin said.
Cultural factors also create the conditions for sugar addiction to develop. Among these are celebrations and holiday periods, as well as the tradition of “office cake” and, of course, marketing of sugar-laden products.
Unwin and Summers showed the mechanisms by which Big Food and Big Sugar increase the addictive properties of their food products. One is “hyper-palatability”.
Unwin referred to research by US scientist Dr James DiNicolantonio showing that sweet sensations are “one of the most intense sensory pleasures”. As well, refinement of sugar significantly adds to its addictive properties. It helps to make sugar is addictive as hard drugs, such as cocaine and opiates.
Routine screening for food addiction seems “a sensible step” for patients with newly diagnosed type 1 and 2 diabetes, Unwin said. And current advice for “moderate” sugar intake is simply “poor advice” for diabetics.
One of the highlights of the conference was testimony from a “low-carb family”. Nutrition therapist Claire McDonnell Liu and husband, Jason, run Leafie Health, a Leicestershire based non-profit organisation supporting families that want to use food as medicine to improve health
In her presentation, Liu dispelled many myths about safety, efficacy and compliance in LCHF and ketogenic diets for very young children.
She told how she and her husband turned to a gut-healthy LCHF diet to cure their son Rudy (now seven) of chronic, red, raw eczema that required frequent hospital admissions as an infant. Dietary change cleared his skin within three months, Liu said. It has remained clear since.
And when daughter, Leafy (5), developed a life-threatening seizure condition at the age of six months, the family turned once again to food as medicine.
Food as medicine
Liu told how a modified ketogenic quickly reduced Leafy’s seizures from 60 a day to two or three a year. Compared to a classic ketogenic diet, a modified version has less fat, no liquid restrictions and a wider variety of nutrient-dense foods.
Food as medicine can sound daunting to lay parents’ ears but the PHC gathering showed that it’s not rocket nutrition science. Liu said that the formula for her children’s success is simple: good fats, low carbs and lots of nutrient-dense, real foods.
Another leitmotif running through the conference was physical activity.
McCormack and GP Dr Zoe Williams were among those who emphasised the importance of physical activity in overall health and wellbeing.
Williams is director of the British Society for Lifestyle Medicine, Public Health England (PHE) Clinical Champion, Physical Activity, a member of BBC’s Trust me, I’m a Doctor and founder of the Fit4Life community sports trust. Many may also know her as a star in the TV reality show, Gladiators.
She titled her talk: Physical Activity: Are We Practising or Preaching? She presented research on the efficacy of health professional advice.
Pushing physical activity
For example, to get one smoking patient to give up cigarettes, doctors have to advise 50 to 120 patients. To get one inactive patient to meet recommended levels of physical activity, doctors would have to advise 12.
“Both have comparable health benefits,” Williams said.
She, therefore, called on doctors to “make every contact count for physical activity”.
Williams also looked at the UK Chief Medical Officer’s basic guideline for physical activity for adults. These include 150 minutes of moderate intensity activity in durations of at least 10 minutes a week or 75 minutes of vigorous intensity activity or a combination of both.
For older adults (65+), the recommendation includes balance and coordination activities at least two days a week
Her advice: “Something is better than nothing. Start small and build up gradually. Even 10 minutes has benefit and start today. It’s never too late to start.”
More perspective on physical activity came from a presentation by Southport GP Dr Simon Tobin and global Parkrun chief operating officer Tom Williams. Parkrun is a programme of free, weekly, safe and easy 5km-timed runs around the world, open to all.
From small beginnings, it has grown to 1,400 events across 20 countries and 250,000 participants every week. Parkrun globally will soon have more than 3-million active runners.
Tobin is a Parkrun trainer, diabetic lead and ambassador for health and wellbeing. He presented a slide with a quote: “It’s not that obesity, diabetes and heart disease runs in your family. It’s that nobody runs in your family.”
Tobin described Parkrun as “transformative, beyond the physical”. It isn’t just about individual health. Tobin said that Parkrun contributes to a “happier, healthier planet”.
He gave moving case histories of people who had improved their health in body and mind after starting Parkrun.
One woman who suffered from severe depression said that she had lifted her mood and weight significantly after starting Parkrun. Another said that her diabetic nurse had “applauded” her results.
“Without my local parkrun to inspire and motivate me, my numbers would not be as good as they are and I don’t believe that I would be running,” the patient said.
Another case showed the redemptive nature of physical activity. Barrow Police tweeted that their “best Parkrun runner” had been released and competed in his first run. He came second and told police that Parkrun “changed his life”.
That’s the “power of sport”, Barrow Police tweeted.
Tobin and Williams had simple messages for health professionals. Chief among them was that they should encourage general practices and hospitals to promote the local Park Run. And before doctors start patients on lifelong medication, they should offer the chance to change their lifestyle”.
Doctors should also try Parkrun for themselves, Tobin said.