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June 24, 2019

Medicine Balls, Private Eye Issue 1486, 28 December 2018
Filed under: #health4all,Private Eye — Dr. Phil @ 7:59 pm

Food for Thought

Nutritional science is complex and conflicting, but the simplest strategy comes from activist and author of Food Rules, Michael Pollen; ‘Eat food, mainly plants, not too much.’ More recent research on the microbiome, the trillions of bugs that live in your gut and make it unique, is well summarised by Professor Tim Spector in the Diet Myth; ‘The most dangerous myth is the notion that we all respond to food in the same way, that when we eat food or follow certain diets our bodies behave like the bodies of identical lab rats. They don’t. We are all different. The obsession with the limited view of nutrition and weight as calories-in versus calories-out is unhelpful and distracting. The truth is that each of us responds to food differently even if the food and the environment are identical.’

Despite this variability, Spector draws some firm conclusions. ‘Diets that are high in sugar and processed foods are bad for our microbes, and by extension for our health, and diets that are high in vegetables and fruits are good for both.’ Spector is a fan of whole foods and variety – ‘your gut is like a garden’ – it needs diversity, but in moderation, and an overnight fast. Many people live long, healthy lives enjoying a variety of different fruit, veg, nuts, seeds, legumes, wholegrains, olive oil, fish, red wine, full fat yoghurt, cheese, red meat, coffee, dark chocolate etc. Others feel much better on a more restricted diet. Just about everyone agrees that refined sugar is bad for you, and makes you eat more. 

Beyond this, much anger and energy is wasted in ‘macronutrient wars’ – focusing on whether carbohydrates or fat do you more damage. This depends not just on an individual’s genes and microbiome, but where you live and how the nutrients are delivered. Parts of the world where up to ten times the global average of citizens live past 100 were coined ‘blue zones’ by the Belgian scientist Michel Poulain. They have much lower rates of chronic degenerative diseases such as dementia, heart attacks and strokes. But do they all eat the same magic diet? Er… no.  Some eat meat, some are vegetarians; some eat loads of fish, and some – like the Okinawans – have a very (shock, horror) high-carb diet based on sweet potatoes. All eat mainly seasonal whole foods, not processed. 

As for sugar, the current burning argument is whether having too much in your blood is a cause or merely the consequence of Type 2 diabetes. It’s extremely hard to prove cause and effect in nutritional medicine, because of all the variables stated above, and the Eye has received multiple letters on both sides of the argument. Readers such as Roger Fisken, a retired consultant diabetologist,  believe that calories are calories, whether they occur in fat or sugar, and we simple need to eat less and move more to lose weight, and that there is no evidence that sugar itself causes type 2 diabetes. (Letters last) He cites the “Evidence-based nutrition guidelines for the prevention and management of diabetes, March 2018” issued by Diabetes UK,  which says that one should “aim for weight loss of at least 5% … to reduce the risk of type 2 diabetes in high risk groups“.  People with established type 2 diabetes should “aim for at least 5% weight loss, achieved by reducing calorie (energy) intake and increasing energy expenditure.” The BDA does not specifically demonise sugar,but in November was ‘delighted to announce our new three-year partnership with (sugary soft-drink manufacture) Britvic Plc, to help achieve our vision of a world where diabetes can do no harm.’

Robert Lustig, Professor of Pediatrics at the University of California takes a wholly contrary view. He has published research on fructose – one of the components of sucrose (table sugar) – showing that restricting it reduces metabolic syndrome – a precursor of diabetes – in obese children,whether they lose weight or not. He believes this association is causal. Frinken believes obesity, not sugar,  is the main cause of type 2 diabetes. MD thinks it varies from person to person, but sugar has caused untold harm. And like the tobacco industry before it, the processed food industry has been keen to suppress the truth. As Lustig observes; ‘For years, soft drink companies’ public relations machinery has pushed the lack of physical activity as a cause of obesity, when there is evidence to reveal that although sedentary lifestyle contributes to chronic disease, physical activity’s impact is minimal at best and you cannot outrun a bad diet. Beverage companies have sponsored numerous public health efforts, provided they did not address soft drinks. The US Academy of Nutrition and Dietetics, British Dietetic Association (BDA) and the Dieticians’ Association of Australia all receive annual contributions from the food industry.It is extraordinary that the BDA promoted Nestle Health Science on its homepage. Nestle has not only been a prominent marketer of sugary products for children, but – according to Baby Milk Action – contributes ‘to the unnecessary death and suffering of infants around the world by aggressively marketing baby foods in breach of international marketing standards.’”