A round-up of all things nutrition (and food) this week

On the back of two seminars I was involved in I had a discussion with a friend about whether ‘low carbohydrate, high fat’ (LCHF) was a fringe concept. The seminars were run by Grant and delved into research on the adverse health effects of high insulin levels in the body. While most people understand the health risks of having high blood glucose levels, this might only tell half the story if insulin levels are chronically high to ensure blood glucose levels are kept in check. The seminars focused on an alternative approach to diet, lowering carbohydrate and increasing fat in those who didn’t have good metabolic function. The food Caryn advocated in the seminars focused on whole food: meat, fish, eggs, full fat dairy, an abundant vegetable intake (of lower carbohydrate variety) and natural sources of fat such as butter, coconut and olive oil instead of industrial seed oils and reduced fat spreads. The diet itself clearly isn’t ‘fringe’, however when you break it down and focus on nutrients (as LCHF does), it potentially removes something critical: the ability for people to understand what is being advocated. Focusing on nutrients leaves a large scope for interpretation – often erroneous – based on what people perceive to be LCHF. Often these diets conjure up images of fried eggs, fried bacon, no vegetables and certainly not nutrient-dense – quite different from what is really on the menu. I wonder if this reductionist approach to nutrition is in part is why people think LCHF is fringe. Obviously the portrayal of the message in the media plays an enormous role in people’s perceptions of nutrition – and this week, there was quite a flurry of activity in the nutrition field, with LCHF-related news hitting mainstream media – here and internationally – and garnering a lot of attention along with it. I thought I would compile the highlights below:

In the same week news articles reported that Sweden has adopted an LCHF diet as the national dietary guidelines, a UK cardiologist prints an opinion piece in the British Medical Journal (BMJ) regarding the villanisation of saturated fat to the detriment of our health. Strangely I couldn’t find any information on the Swedish guidelines in the news here – you would think that new dietary guidelines that shun traditional nutrition dogma would make at least page 6 of the North Shore Times. But no. Along the the opinion piece, Dr Aseem Malhorta appeared on a breakfast interview which can be found on the BBC Network. He did a good job of contextualising the inclusion of saturated fat in a whole food diet. It was a less about promoting liberal amounts saturated fat so much as it was a piece for shunning processed food. A few days later the UK Government announced that the food industry had committed to cutting the amount of saturated fat in their products, while the sugar content remains unchanged. A couple of example foods that were targeted included Belvita biscuits. A quick look on Nutritiondata.com backs up the nutrition information given in the article: 1 biscuit (12.5g) contains 0.5g saturated fat and 2.5g sugar. A serving size is four biscuits (and I challenge you to stop at four with these little numbers.) While a proposal like this is clearly months in the making, that there was a media release a couple of days after Dr Malhorta’s opinion piece in the BMJ seemed like a knee jerk reaction. It further perpetuates the idea that saturated fat is the bad guy, and deflects attention away from questioning processed food in general – the main premise of Dr Malhorta’s information that clearly serves to do the food industry no favours at all

A post on facebook by Christine Croncau brought to my attention that, in the US, 3.5 million people tuned in to hear Dr Oz do an about-turn on the role of cholesterol in heart disease (compared to the effect of processed carbohydrates).  It was startling. “Dr Oz, a well respected cardiologist, acknowledges the cholesterol myth…” Hang on, what was that?? Dr Oz is a well-respected medical doctor? That in itself was a revelation to me. The same doctor who showcased raspberry ketones as one of the five top fat-burners you could try?  Anyway, while I wouldn’t always hang my hat on what Dr Oz promotes, he definitely has some influence in the public space. And the clip is definitely worth a watch if you have 10 minutes as Dr Oz interviews Dr David Perlmutter, an experienced neurologist in the US and author of the Grain Brain – a book that explains his findings (through his clinic) and those of numerous studies of the effect that CHO can have on brain function and subsequent neurological disorders. The controversial part of that concept isn’t that sugar increases our risk of dementia – in fact alzheimers has been more recently termed ‘type 3 diabetes’ to reflect this relationship. What was more challenging was the idea that all carbohydrate has the potential to increase risk of dementia, and that Dr Perlmutter was advocating for an almost carbohydrate-free diet. Unsurprisingly when his book came out there was an immediate reaction from some of the influential people in the food industry space. This article from the Food Navigator is one example. To shamelessly cherry pick a quote from those opposed to his recommendations: “I mean, he is advocating people eat salmon and avocado for breakfast, is that realistic?”  Hmm… obviously the Whole Grain Council took exception to Dr Perlmutter’s recommendations, but strangely seemed more offended that he wasn’t advocating totally grain free – recommending the gluten-free grains of buckwheat, quinoa, sorgum, and rice (in moderation). They assert there is no scientific evidence to back up his claims that gluten affects the brain.  Irrespective of numerous articles such as this one I found just by doing a cursory search on Google Scholar, I wonder at what point his experience in the field serves as evidence.

Closer to home, ABC’s Catalyst show, a science journalism show on primetime TV show released the first in two part series that investigates the saturated fat, cholesterol and heart disease myth which is a good watch, and Grant was the focus of a Sunday Star Time’s piece on LCHF this week too.

While I love to see this information hit mainstream media, I often think it’s a double-edged sword. If ever our dietary guidelines did change to reflect an update of knowledge we would have to rely on avenues such as mainstream media to get the message across. And that message gets lost in translation, skewing people’s perceptions of what is being advocated for. Frequently. Take the first sentence on the BBC Network page: “the risk from saturated fat in foods such as butter, cakes and fatty meat is overstated.” Let’s be clear: the risk from saturated fat in processed, refined, sugary cakes is not overstated. If journalists reporting on the story aren’t able to get the facts straight, what hope is there for the general public reading it? Nutrition is confusing; food is not. Perhaps if we focused more on whole foods and less on nutrients the message might be clearer, and might seem less ‘fringe.’ Food for thought.

9 thoughts on “A round-up of all things nutrition (and food) this week

  1. Hi Mikki
    I first heard Grant speak about this a few weeks ago at a Comvita seminar, and attended his talk last week and it was certainly very thought provoking. I read further about it and came across this:http://synapses.co.za/lessons-bad-science-tim-noakes-samj/
    I wonder if you would care to comment, as essentially I think the author makes a good point, there seems to be no scientific evidence for LCHF – it may well be effective but like any other health intervention shouldn’t it have hard evidence?

    • Hi James, thanks for your email, and yes I saw this write up of a number of case studies too. I agree, it would be good to have hard evidence to back up any health intervention – and it is interesting that there isn’t any ‘hard evidence’ for a number of our recommendations to date – however as you well know, nutrition is a complex science and in order to run randomised controlled trials (RCTs) we need millions of dollars to control all of the variables! That said, there is good evidence to support the use of a low carbohydrate, high fat diet for obesity, type 2 diabetes and other metabolic disorders – these are small studies that are more effective in the short term, and as effective in the long term, as other means of weight loss. However, I think adherence is a big issue with any diet. One thing we can all agree on is that there is no ‘one’ diet for anyone. That’s why I like to get back to a whole food approach, where the focus isn’t on nutrients, it’s around reducing processed food. Doing that means you will naturally lower your carbohydrate intake, you won’t avoid natural sources of fat, and you’ll eat an abundance of vegetables with protein in moderation. The way we have eating for thousands of years. 🙂

  2. James – I very much second Mikki’s thoughts here. The vast majority of the ‘evidence’ for the current and conventionally accepted guidelines is anything but ‘hard evidence’. Some of it isn’t even soft evidence, e.g. consume 9-11 servings of cereal grains per day.

    There is little debate that the human diet has been some combination of meat, fish, fowl, vegetables, roots, fruits, nuts, and seeds for the longest part of our existence. These combinations are largely (though not always exclusively) lower in carbohydrate, higher in protein (especially animal protein) and higher specific types of fats (though not necessarily higher in total fat) than what we consume in a modern context. We have eaten ‘the human diet’ for something in the order of 84000 generations. We have eaten a modern processed food diet, with all sorts of weird and wonderful combinations for something in the order of two generations, if we are lucky. Yet the defenders of the modern foods and modern guidelines for consuming these foods feel that the onus is on those supporting ‘the human diet’ to prove that eggs for breakfast is better for us than a bowl of Cheerios.

    The silly thing is, we are asked to prove it with real evidence, yet when we do (the evidence is very high-level – Cochrane Group level), we are told the evidence is cherry-picked. Sigh.

    Mikki is on the money with her thoughts here. No matter what the label, most of us are advocating real food. When you actually see what our ‘evidence’ translates to on a plate – it is 100% food. An egg is food. A box of Cheerios is a list of ingredients. And that is hard evidence to argue with.

  3. Thanks for the responses Mikki and thatpaleoguy. For context’s sake, I’m not a nutritionist by any means, I’m a physiologist who enjoys sport thus has a passing interest in nutrition. I think you are absolutely on the money in saying adherence is key and no one diet will fit all people – and essentially that is why I asked the question. And I totally agree that real foods as opposed to processed are a preferable option. My inner scientist just likes controls and numbers :), but again you’re absolutely right that RCT’s are very time consuming and costly.

  4. Thanks so much, Mikki! This was extremely valuable and by synthesising a lot of additional media bits, you’ve made these issues much easier to understand! Cheers!

    • You’re welcome Rhoda, it can be really tricky to navigate all of the information out there, and this is just my take on it really 🙂

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