Fat checking … sorry, fact checking

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As I was living vicariously on Facebook again this afternoon, I came across a forwarded page from nutritionist Christine Cronau. She was previewing tonight’s (Australian) ABC episode of Catalyst, on the topic of the low fat diet.

It’s not that she or the ABC are necessarily wrong about low fat diets. Some scientists have been sceptical of the evidence for low fat diets every since they were proposed in the late 1970’s [1]. Often, low fat foods have been manufactured with extra sugar to make them palatable again [2]. So while western consumers have been thinking they’ve been doing the right thing, they’ve probably been making the problem worse.

We’re also a society of carnivores, and the meat consumed in modern society is much higher in saturated fat. Plant and seafood based diets contain a high number of poly-unsaturated fatty acids (omega-3 and omega-6) which has also been a recommendation for our heart health, however a study in JAMA in 2012 suggested that high levels of omega-3 PUFAs did not protect from cardiovascular disease or reduce all cause mortality [3]. On the other hand, it appears that reviews of scientific research have suggested that saturated fat doesn’t pose a significant risk for cardiovascular disease or all-cause mortality either [4].

So it’s true that we may have to review exactly why plant based diets are good for us. What I raised an eyebrow at was her suggestion that, “What in the world did we do before cholesterol-lowering meds? Oh, that’s right, before we started mass producing sugar and back when we enjoyed plenty of saturated fat, heart disease was pretty much non-existent.”

This is a classic case of “two wrongs don’t make a right”. Sure, low fat diets are probably not the all-glorious panacea that they were touted to be, but suggesting that heart disease didn’t exist before the rise of sugar and low fat foods is grossly inaccurate. A quick glance at the data of the Australian Bureau of Statistics shows that heart disease peaked in the late 1960’s, which was coincidentally before we started mass producing sugar and back when we enjoyed plenty of saturated fat, and has since dropped significantly.

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Is that because of dietary guidelines recommending a low fat diet? There are many contributors to heart disease, so low fat diets can’t be singled out as the sole cause, especially in light of the reviews I discussed above. The reduction of smoking may be part of it, as smoking has dropped in the same amount of time, although a significant proportion of our population still smoke.

Whatever the reason, it isn’t a good reflection when you try and support your argument against a fallacy with a fallacy of your own. I haven’t read any of her other material, so her books maybe quite cogent. However, Ms Cronau’s Facebook post today provides a good example of how cognitive biases can sometimes blind us to facts that don’t agree with our chosen position, and why we all need to be careful when evaluating the evidence of “experts” on line.

References

  1. La Berge, A.F., How the ideology of low fat conquered america. J Hist Med Allied Sci, 2008. 63(2): 139-77 doi: 10.1093/jhmas/jrn001
  2. Malnick, E., et al. Low fat foods stuffed with ‘harmful’ levels of sugar. The Telegraph, 2014. http://www.telegraph.co.uk/health/healthnews/10668189/Low-fat-foods-stuffed-with-harmful-levels-of-sugar.html
  3. Rizos, E.C., et al., Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA, 2012. 308(10): 1024-33 doi: 10.1001/2012.jama.11374
  4. Hoenselaar, R., Saturated fat and cardiovascular disease: the discrepancy between the scientific literature and dietary advice. Nutrition, 2012. 28(2): 118-23 doi: 10.1016/j.nut.2011.08.017

The end of the sugar obsession?

I was flicking through Facebook this evening as I usually do, hoping to vicariously share someone else’s joy in life, when I came across this little tidbit, “You know what? Don’t quit sugar.”

The link was to a blog on mamamia.com.au (http://www.mamamia.com.au/health-wellbeing/you-know-what-dont-quit-sugar/) which asked if the tide of the quit sugar obsession was starting to recede.  It discussed the recent post of Sarah Wilson, a journalist for Fairfax and the author of several books on quitting sugar, which have become immensely popular by tagging on the coat-tails of David Gillespie’s “Sweet Poison” books.

In her blog, Wilson confessed to a barely forgivable sin of giving in to peer pressure and eating two chocolate croissants, then emotionally self-flagellating for the rest of the day.  That the symptoms that she described fitted nicely into the category of an anxiety neurosis didn’t seem to register with Wilson, who carried on like she had ingested a large goblet of hemlock.

Credit to the mammamia team who published some of the comments of real nutritionists like Cassie Platt, and eating-disorder counsellors like Paula Kotowitz, who said,

“Being harsh on ourselves, not only does not help, but makes us feel so much worse in the long run because it deconstructs our sense of self and causes us to beat up on ourselves. Isn’t it possible that there is a happy medium in there somewhere? It’s not crack. Just food.”

Platt, who is about to release a book titled, “Don’t Quit Sugar”, says,

“Your food choices should be based on biological and metabolic needs. What we eat should fuel our cells, facilitate growth, repair and reproduction and, most importantly, enable your body to function at its very best.”

Platt said that she has previously tried removing sugar from her diet and that she had to “claw” her way back to health.

The mamamia writing team summed up by saying,

“The benefits of reducing sugar intake are widely accepted in the scientific community but the idea of avoiding it altogether remains an issue of serious contention. And the possibility that these sorts of diet programs can mask dangerous eating disorders, is particularly worrying.”

They asked the question, “Has the sugar-quitting backlash begun?”  For the love of all things sacred, I seriously hope so.

About a month ago I wrote a piece about the quit sugar fad, and posted evidence that eating an extremely low carbohydrate diet is no better than eating a low fat diet, because it’s calories, not sugar, that makes all the difference to weight gain or loss.

A balanced, low calorie diet has been pushed by nutritionists and doctors ad nauseum for decades, but consistently neglecting to use words like “poison”, “toxin” or “death” has meant that the message is nowhere near as stimulating as the current whim.

Is it possible to have your cake and eat it too?  Absolutely.  My hero of nutritional science, Dr Rosemary Stanton, spoke at a Brisbane conference a couple of years ago and succinctly debunked Gillespie, Wilson and their ilk.  She also explained the concept of feasting, the long forgotten art form of having exceptionally good food once in a while, and enjoy it with friends, rather than eating substandard food every day by yourself, which is the modern trend.

Rather than gorging on sugar every day to compensate for your loneliness and despair, Dr Stanton advocated a diet high in vegetables and little or no processed food on a daily basis.  But then once a month or two, she advised to enjoy your favourite food, no matter what it might happen to be – cheesecake, ice cream, chocolate croissants – anything you like.  The only rules were to make sure that it is really good quality, the best that you can afford, so that it is worth savouring and looking forward to next time, and enjoy it with friends, since the social aspects of the food we eat are as important as the nutritional value.  Sage advice from someone who has been researching nutrition for longer than I’ve been alive.

I’m sure that by now, Sarah Wilson will have got over her sugar intoxication.  She may not have enjoyed it, but I hope that ends up being a pivotal moment in correcting the imbalance in our relationship to sugar, and living by the facts, not the latest fad.

Dieting. Is it really worth it?

In an opinion column on the Brisbane Times news site, Kasey Edwards wrote about the recent struggles that weight loss company Jenny Craig have had finding celebrities to endorse their product.

Edwards cited Australian actor Magda Szubanski, and Kirstie Alley before her, as typifying the difficulties that dieters have. She also stated that over the last 50 years of research, dieting has a typical success rate of only 5%.

Her source was unstated, but if it’s correct, then it’s somewhat disheartening. She said, “With such damning rates it is extraordinary that we still blame individuals for ”failing” at weight loss programs rather than accusing the diet companies of selling snake oil. Can you imagine buying any other product with a 95 per cent failure rate and then blaming yourself when it didn’t deliver on its promise?”

The question is then, “Do all diets suffer from the same failure rate, or are there one or two really successful diets who’s success is diluted by the failure of others?” The answer, not really. It depends on how long you measure for.

From the eMedicine article on obesity, “The results of most weight-loss programs are dismal. On average, participants in the best programs lose approximately 10% of their body weight, but people generally regain two thirds of the weight lost within a year. When defined as sustained weight loss over a 5-year follow-up period, the success of even the best medical weight-loss programs is next to nil. Most available data indicate that, irrespective of the method of medical intervention, 90-95% of the weight lost is regained in 5 years.” (Reference)

So, you can invest thousands of hours, and hundreds of dollars into a program, and the end result is most likely the same, nothing.

That sounds depressing. So what’s the point? Perhaps we should just quit while we’re ahead.

You could, but I think there is a solution. Dieting is not the answer, but I think making healthy lifestyle choices is.

That’s for another post.