NZ’s health leaders respond to our research publicity: Saturated fat…its bad, low carb radical and unsafe

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It was no surprise to see this one coming.  A perfect storm for the old powers that be in New Zealand obesity research and practice. The BMJ paper on why we got the saturated fat thing wrong, the ABC Catalyst series, and me out and about in the media talking about low carb high fat. I just noticed another one the NZ Herald just now by a NZ dietitian.
Looks like I (and those associated with me, sorry everyone) are now officially on the outer after this press release today (see this Experts decry fat diet – press release from the University of Otago (Professor Jim Mann)). It’s undersigned by key members of virtually every health organisation in the country.
I guess they are thinking that this document will shut everyone up, calm the uneducated masses, and we can continue our solution to the world’s problem with chronic disease?  How’s that going by the way?
I know you’d like me and my team to go away, but it’s not happening. Sorry for the inconvenience. Oh, and because of the Internet and open access science, the public is now able to do its own research.  And guess what? It has decided that the evidence isn’t convincing either. The world has changed.
The science of nutrition and chronic disease, and the public health approaches to nutrition are not solved. Let’s just get that straight – we (my team) don’t have all the answers, and neither do you.  I’ve been wrong before and could be wrong again, the reverse also applies guys.  Things will change.  Change is happening now.  It will happen again in the future.
Jim, do you recall being the younger scientist taking on the older ones in the BMJ 1979 in “Fats and atheroma: A retrial?”  Back then you were arguing about the complexity of nutrition and the need to go beyond fat and think about refined and processed carbohydrates. Everyone here has more in common than not.
For the record, I did correspond with Jim Mann yesterday.  Here’s part of what I sent him.  I think it puts down a reasonable position.
Jim…….My take is that I haven’t particularly been walking around promoting saturated fat (although to be fair I haven’t been talking about reducing it).  I have been walking around talking about diets higher in fat and lower in refined and processed carbohydrates.  I think I have some sound scientific reasons for this.  I will continue the line of research for the foreseeable future. I haven’t done much on athletes as they said in the paper.  Most of the recent work is secondary analysis of a few very large datasets we have from the US in hyperinsulinaemia. Also some basic work in low carb high fat eating.  So don’t believe everything you read in the newspaper. We do have a reasonable line of research going across this topic.
 What, in my view, we (all) have in common:
  1. That whole plants and animals are likely to be good for you and your chronic disease risk
  2. That foods which reduce inflammation are good for reducing chronic disease
  3. That sugar and processed carbs are not good, especially if you are insulin resistant (most of the vulnerable populations)
  4. That hyperinsulinaemia and chronic inflammation (both highly inter-related and can cause one another) are a problem and part of the mechanism for developing CVD and other chronic diseases.
  5. The Standard American industrial food diet and lifestyle is toxic, and much of the research showing different ways of eating show benefits simply because this diet is so bad.
  6. Trans fats and high omega 6 seed oils are inflammatory
  7. The interplay between hormonal physiology, built environment, food, and physical activity is complex.  This influences catabolic and anabolic states and therefore human energy homeostasis.  We don’t know exactly how the system works.  We have made the mistake (using Einstein’s words “make it as simple as possible but no simpler”) to describe the calories in and calories out dogma which we need to move on from.
What we seem to disagree on is:
  1. That SFA from whole healthy animals has any proven negative effect on human health in the context of the above (whole food eating).
  2. Attributing changes in populations to specific nutrients in a complex multifactorial disease using epidemiology which measures eating is fraught and is giving answers the opposite to those observed in decent robust RCTs.
  3. That low carb high fats diets are safe, efficacious, and useful for the public.

My response to the technical points in the media release asking for evidence today

  1. The actual trials showing SFA reduction and health improvements are fraught because they are still mainly in the Standard American Diet (SAD) paradigm with small dietary modifications.  I agree that SFA intake in the context of the SAD might be problematic.  What I still have a problem with, in these trials, is that many (most) still use a control group eating the same old food.  Putting anyone on a diet different from the SAD will probably help.  Here’s the latest meta analysis.  In fact, the reality is that consuming SFA has positive effects on HDL cholesterol and reduces triglycerides.
  2. I’m not bothering with an in-depth rebuttal of the population studies.  There’s just too much (uncontrolled and unmeasured) going on there, with poor food measurement to say saturated fat causes anything.
  3. I particularly draw to your attention to the bit in the media release directed straight at me (just say my name guys I am comfortable with that). “However, the group suggests that those who advocate for radical new dietary approaches have a responsibility to provide convincing peer-reviewed evidence of long term benefit as well as absence of harm. Such evidence does not exist for diets high in saturated and total fat, and very low in carbohydrate”. I have tried to address these issues in depth below. But first, how a diet full of whole plants and animals, similar to what humans have eaten the whole time they have been on the planet (up until recently, when human life expectancy halved (agricultural revolution) and then got full of disability from chronic disease (last few decades)) is radical is beyond my reasoning.  Read the latest nutritional biochemistry and draw your own conclusions.
  4. Low carbohydrate diets being safe, efficacious and useful? RCT and mechanistic evidence shows that dietary saturated fat alone, in the context of a low carb diet doesn’t have the proposed cardio-metabolic risk effects of being harmful.  In fact, things all go the other way (improve) which is a very good sign.  I have put some references below, but also here’s a  recent meta analysis of the clinical trials of low carb high fat diets and their metabolic effects. People generally do better metabolically, adhere better, and control blood glucose and insulin better on low carb high fat diets than other diets.  Much of the reason for this (expanded below) is that when you become insulin resistant then a lower fat diet will provoke high insulin which only adds to the problem. Here is an excellent summary of the 23 RCTs on low carb high fat
  5. More on long term safety – Jim Mann’s main point on the stuff.co.nz article and media release about low carb high fat was around long term efficacy and safety. He does have a point – you can study this through RCTs, but the long term epidemiology isn’t there for eating actual whole plants and animals (short of the work on healthy indigenous populations, and that this is the sort of diet humans have eaten for 99.9% of the time they have been on the planet). There is certainly no evidence of harm – some people like to quote the Swedish women’s study to show there is harm of a high fat, high protein diet. I am not promoting this combination of eating. The epidemiology in this study is woeful because the lowest decile of population carb eaters was still getting 40 percent of their calories from carbs who also had to be in the highest decile of protein eaters – again not what I suggest – had poorer health outcomes.  Again if the cardio- metabolic risk factors are worth anything – then people do better.  Here’s a good dissection of this Swedish paper.

     I think this shows how epidemiology sometimes gives us what we want to see.  I agree that more work needs to be done.  My starting hypothesis is to look at human nutrition through an evolutionary biology lens – what food environments are humans adapted to? And what is the physiology around this?   I think we have to understand how and why insulin resistance happens and how that relates to chronic disease through inflammatory processes. I particularly recommend to you this paper which has a brilliant and comprehensive take on the evolutionary nutritional biochemistry and chronic disease development.  BTW – the 40% CHO diet and high protein combination in the Swedish study showing the highest CVD is very much the type of mix Professor Mann has advocated (to me at least) he would support.

  6. Some longer-term data on Type 1 diabetics and low carb high fat diets – good efficacy and safety.
  7. Mechanistically high SFA doesn’t translate to high plasma SFA in the context of low carb diets – see reference.
  8. I agree that people respond differently to different diets. Insulin resistance is important as to what diet we can tolerate.  Hyperinsulinaemia induces the direct and indirect effects for the major chronic diseases.  Impaired glucose tolerance doesn’t catch this until end stage.  Many many people get glucose into their cells at the right rate, but with hyperinsulinaemia.  Complex carbs may not help, and in fact be even worse because the carbs are digested slowly provoking longer hyperinsulinaemia – a reference. We will publish our analysis of this soon. But in the meantime see the work of Dr Joseph Kraft.
  9. The only way to diagnose this is a dynamic glucose tolerance test measuring insulin.  We have a database of 15,000 of these with insulin for up to five hours post OGTT. You will see the pattern of hyperinsulinaemia with normal glucose tolerance decades before impaired glucose tolerance.
  10. I contend that virtually every CVD risk factor either causes insulin resistance through inflammatory or other processes e.g. Sleep, stress, sugar, alcohol, smoking, pollution and so on.  Obviously some have other effects too (e.g. smoking). But also that age and ethnicity affect Insulin sensitivity – Maori and Pacific are likely to be more prone to the above.
  11. Here’s the kicker for me – in terms of health inequalities the current dietary guidelines probably perpetuate health inequities because the least at risk do the best and stay healthy. So even if the two types of dietary guidance are efficacious – which they are – albeit not equally distributed in their efficacy AND there seems to be no evidence of harm from a lower carb high fat – then we have no option but to go the high fat route because of the inequalities – although I acknowledge we need more work to understand this. That’s the reason I am pursuing this.

Extra references to 23 RCTs showing good outcomes for low carb diets compared to other diets. Actual data summarised here very nicely too

1. Foster GD, et al. A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine, 2003.

2. Samaha FF, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. New England Journal of Medicine, 2003.

3. Sondike SB, et al. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. The Journal of Pediatrics, 2003.

4. Brehm BJ, et al. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology & Metabolism, 2003.

5. Aude YW, et al. The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat. Archives of Internal Medicine, 2004.

6. Yancy WS Jr, et al. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Annals of Internal Medicine, 2004.

7. JS Volek, et al. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutrition & Metabolism (London), 2004.

8. Meckling KA, et al. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. The Journal of Clinical Endocrinology & Metabolism, 2004.

9. Nickols-Richardson SM, et al. Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet. Journal of the American Dietetic Association, 2005.

10. Daly ME, et al. Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes. Diabetic Medicine, 2006.

11. McClernon FJ, et al. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity (Silver Spring), 2007.

12. Gardner CD, et al. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study. The Journal of The American Medical Association, 2007.

13. Halyburton AK, et al. Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance. American Journal of Clinical Nutrition, 2007.

14. Dyson PA, et al. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Diabetic Medicine, 2007.

15. Westman EC, et al. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism (London), 2008.

16. Shai I, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. New England Journal of Medicine, 2008.

17. Keogh JB, et al. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. American Journal of Clinical Nutrition, 2008.

18. Tay J, et al. Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. Journal of The American College of Cardiology, 2008.

19. Volek JS, et al. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids, 2009.

20. Brinkworth GD, et al. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 months. American Journal of Clinical Nutrition, 2009.

21. Hernandez, et al. Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet. American Journal of Clinical Nutrition, 2010.

22. Krebs NF, et al. Efficacy and safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents. Journal of Pediatrics, 2010.

23. Guldbrand, et al. In type 2 diabetes, randomization to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Diabetologia, 2012.

42 comments

  1. I follow the UK press because I lived there for many years, and it’s interesting to see how readers respond differently to the same stories. When I read comments following stories on low carb diets in the Daily Mail (readers assumed to be uneducated and a bit simple) the response is often positive often based on their own experience, while in the Independent (readers assumed to be quite smart, probably with a degree) the response is critical of anything that departs from the received wisom of the experts (i.e. low fat). The smarter people purport to be, the more likely they seem to be to draw on the opinion of those they judge as equally smart and give them more credence than they deserve. I’ve noticed this in my own family. It can actually make intelligent people quite conformist in their beliefs. And of course, anyone who doesn’t agree with the princes of wisdom in our society is considered ‘fringe’. I guess that means you!

  2. This is so hilarious watching their house of cards in the wind.

    Tonight they air the statin episode, prepare for damage control overload…

    1. Hopefully there won’t be too many deaths from people stopping their medications!

  3. Reblogged this on Ash Simmonds and commented:
    This is so hilarious watching their house of cards in the wind.

    Tonight they air the statin episode, prepare for damage control overload…

  4. Lisa Te Morenga · · Reply

    Grant, these studies are not studies which we would consider provide long-term evidence of a cardioprotective role of HF diets. For instance the paper by Jennifer Keogh et al (number 17) reports data from 8 weeks of follow-up only. Subsequent papers reporting on outcomes at 12 months showed no benefits of the HF data and even showed impairment in flow mediated diliation. The Dimona study by Shai et al. did report follow-up after 2 years but the low carb diet was neither particularly low in carbs (40% TE) nor particualrly high in fat (39% TE). A key study you have omitted from your list is the Boston by Frank Sacks and colleagues from Harvard & Pennington Universities. This study showed that macronutrient compostition made no difference to weight at 2 years and the single most important factor explainng weight loss was adherence to any diet. This illustrates a major problem with regard to advocating radically different dietary patterns to those usual consumed by the general public; long-term dietary changes are required to see benefits but are very difficult to sustain. Falling off the high-fat diet bandwagon may lead individuals back to particularly unhealthy diets high in fats and sugars and providing far too much energy.

    And on the topic of Paleo diets, it is worth remembering that our fabulously healthy paleo ancestors were lucky to make it to the ripe old age of 35, which is hardly a ringing endorsement of the paleo diet.

    1. HiLisa I will reply later, but where did I claim long term efficacy for those studies?

    2. Lisa… is this about diet? or is it about a complete lifestyle change which will bring a lowering of inflammatory markers (and associated illness and disease across the board) A loss of weight as in burning fat instead of carbs is a BONUS and brings about weight loss in due time.

      Surely medicine – health ought to be about saving lives not creating more patients, which adherence to the SAD diet and the advice currently given to diabetics and heart patients does.

      I myself, a diagnosed T2DM has brought my A1c’s back into the ‘normal’ non diabetic range without drugs in less than three months changing from high(er) carbohydrates and low fat, to NO carbohydrate other than what I obtain from fresh seasonal above ground vegetables and a few berries occasionally…. with fresh meat and fish all cooked with fat on…. very little other fats except for a little camembert cheese occasionally, nuts and avocado’s. I use butter and coconut oil to cook with….. I am getting better, my blood work is improving and I am staying with this life style….. I am never hungry between meals in fact my appetite has reduced. I have lost 10Kg so far.

    3. re paleo and the age old they only lived to 35 and then using that as vindication that their diet was bad. Is the age you quote life expectancy from birth. In modern times we can see that if we take life expectancy of those who make it through childhood to say 15, that life expectancy figures are dramatically different. Geoff Bond explains this in Deadly Harvest. Around 30% of babies would have died in their first year. I’m guessing this had little to do with diet and more to do with the vagaries of giving birth in the wild. And if 35 is an average expectancy and 30% are dying before the age of 1 – that means alot of people were living a lot longer than 35.

    4. Lisa, why would you cite speculation about prehistoric life expectancy, which no-one can know for sure or know the reasons for, yet ignore solid medical evidence like the long-term type 1 diabetes case studies, or the RCTs?
      With all due respect, it is pseudoscientific to base widely publicised, earnest, and commercially profitable recommendations on weak epidemiological associations while ignoring evidence from contrary epidemiology, RCTs and case studies.

    5. Lisa,

      Assuming you would prefer to keep any debate evidence-based, I would like you to provide a reference for your comment “And on the topic of Paleo diets, it is worth remembering that our fabulously healthy paleo ancestors were lucky to make it to the ripe old age of 35, which is hardly a ringing endorsement of the paleo diet.”

      You should perhaps read the following paper before assuming our HG ancestors were all dead by 35. Not that dying from trauma or infection is a ringing endorsement for continuing to feed the population on Fruit Loops and Cheerios instead of whole animal and plant foods as advocated by those who apply a paleo template.

    6. helsonwheels · · Reply

      Lisa, I just can’t help but ask… are you serious?

      1. Lisa Te Morenga · ·

        I wrote my Phd on the nutritional determinants of insulin resistance, so yes I am serious. I have also done actual research on the effect of high and low carbohydrate diets. In humans. Your qualification??

      2. helsonwheels · ·

        Congratulations on your PhD, Lisa, and well done on all the effort you have put into research and the work that you continue to do re the sugary drinks. I applaud that. I have a BSc sport and exercise science, and an advanced nutritional certification and wish to continue with tertiary education in nutritional science when I can again afford to study. I am also able to read, understand and take notice of what is going on in the world, including all of the research and anecdotal evidence that shows grain-free, low refined carbohydrate living (and high fat, though not always) is helping so many people.

        My reply was in most part related to the last paragraph of your comment above. Grant, Jamie and others, have answered to that, but I was highly surprised that you would make such a statement. When I was growing up 40 years ago, an obese or extremely overweight person was a novelty. If the standard conventional diet we are all expected to follow is working so well, why the huge rise of diseases such as DM type 2, CVD/CHD, cancer, dementia, metabolic disregulation, not to mention the myriad of other ailments that are not life-threatening but can make life miserable?

        I myself had atopic eczema on both my hands and on other skin areas for over twenty years. It was extremely painful. The skin crusted, cracked, wept, bled and kept me awake at night. I often had to wear gloves to bed to stop myself tearing at it in my sleep. I spent a lot of time and money on skin specialists, doctor visits, creams, supplements and felt extremely self conscious about it. Steroid creams calmed it somewhat, temporarily, but they cannot be used continuously and it always returned. The ONE THING that has made a difference is removing gluten-containing grains and food products from my diet… at first I noticed it by coincidence when going through periods of abstaining from eating wheat etc and then going back to including wheat etc, again. The pattern of my skin gradually healing and then red scaley patches returning within a week or two of eating wheat products became quite marked. I made the then easy decision to cut the grains for good and followed an eating pattern without them. Then “Paleo” in various forms came onto my radar followed by LCHF and I have never looked back. I don’t need to eat as much as previously, I feel better physically and mentally. I no longer have the brain fog that was previously a constant part of life. My mood and affect have improved markedly, also. I can go for a three hour road bike ride on a cup of black coffee with butter and coconut oil blended in and that gets me through to the end of it and then some. No carbs required. I don’t intend to change the way I eat. My doctor is more than happy with my blood results. He actually told me he is envious of my HDL level! I eat full fat dairy (cream and butter) and my skin is still fine and in fact the awful acne I also had all over my back has since disappeared, too.

        I fully realise my experience is merely N=1 and not longitudinal (yet)… but I have no qualms about continuing with this lifestyle and recommending it to the many “walking-dead” I see who want to be healthy and can’t understand why good health and well-being escapes them, even though they are doing all of the “right” things. In my humble, not-so-well-educated opinion, we must start giving people an alternative to this high carb, low fat (a-la the food pyramid) diet that has been poorly recommended through historical political manoeuvring and manipulation of “research”. It is mystifying to me that there are people in the “establishment” who seem to have a vested interest in discouraging others from giving the LCHF lifestyle a try and robbing them of the potential to experience the life-changing and positive results that I and others report here and elsewhere.

  5. Jantaylor · · Reply

    It’s not rocket science, common sense jan

  6. Kevin O'Connell · · Reply

    From the press release:
    “those who advocate for radical new dietary approaches have a responsibility to provide convincing peer-reviewed evidence of long term benefit as well as absence of harm.”
    That is both bizarre and annoying.

    If only the predecessors (in the 1970s) of those who now ‘preach’ the Conventional Wisdom (CW) of low-fat/high carb (LFHC) had accepted their responsibility, instead of foisting on us the new-fangled LFHC wisdom (unsupported by any such evidence). That switch in CW, from the view that had prevailed since ar least the late 18th Century, began in the USA and was then adopted worldwide when I was a young adult in the 1970s.

    For myself, a couple of years of LCHF has now reversed many of the ill-effects of decades of following that ill-considered switch to LFHC. Unfortunately, back in the 70s and 80s I accepted and adopted the view of the ‘experts’. I now ignore the ‘experts’ (or ‘idiots’ as Dr Malcolm Kendrick prefers to call them) and do my own research.

    For anyone interested in nutrition, I recommend seeking out Clayton & Rowbotham (2008), “An unsuitable and degraded diet”. It’s a paper on the diet of the working class in Victorian England. There were certainly differences in infant mortality and infectious disease, but otherwise life expectancy was about the same as today ‘despite’ (according to modern CW, but more likely because of) their considerable intake of offal and fat, at least until the huge increase in sugar consumption from the 1880s on.

    Incidentally, the Malhotra BMJ article has been making ripples if not waves even here in anglophobe France.

  7. John Jardine · · Reply

    Keep up the great work Grant, I have been eating LCHF for the last two years or so, lost 20 kilos, diabetes, digestive problems and inflammatory arthritis under control and best of all I now feel fantastic with loads of energy.
    I attended your last seminar at the Millenium Institute and was overwhelmed that someone of your academic stature was finally prepared to put his head above the parapet and tell it as it really is.
    I was also heartened to hear one of your team debunk the nonsense that is
    being talked about regarding cholesterol and it’s effect on CVD. There are no studies that show that high cholesterol has any effect on heart disease,
    Again keep up the great work Grant, I will read your blog posts with great interest in the future.

  8. Its unfortunate that none of the Professors have seen fit to try to test the LCHF diet regime and prove scientifically that it is ineffective. They rely upon other studies which they then use to make their analysis. Each scientific study has flaws due to constraints placed upon it by the hypothesis they test. Would be nice to see testing the LCHF with full blood analysis to show the effect upon cholesterol and artheriosclerosis.

  9. I am a former morbidly obese, type 2 diabetic in remission because of people like you who put the information out there.

    It’s true though, Low Carb/High fat/Moderate protein from whole foods is very very bad, not for us, but for the processed food industry. Thank you for all you do.

  10. In this 1967 film about childhood obesity, overweight Jimmy is put on a low-carb paleo diet:

    Soon after, the advice changed, and the obesity epidemic began.
    People were not stupid in the past. They were not blinded by dogma; they were informed by experience.
    Insulin resistance, high fasting blood glucose, are nature’s ways of telling you you don’t need more carbohydrate.

  11. I would love you to oversee an experiment on me. But one person is not enough.

    I am 75, no longer taking BP meds. Dropped a bunch of weight in 1 few months after eliminating wheat. Now I am working at being in nutritional ketosis …. imperfectly. I have never been happy with trimming the fat off my beef steak nor with low fat dairy

    I’m so sorry the official stance is so closed to the science behind your findings. They should be out there working out an extensive study that today’s medical students can be involved in. Oh for a student who dares to risk a thesis in this area of nutritional health.

    I am so tired of medical doctors who cannot see past the party line and the drugs they are recommended to prescribe. That’s not to say drugs are unhelpful because that would be so wrong but that health comes from eating right too.

    Sadly I think of doctors as people to go to when I break my leg rather than when I feel bad. I have had to learn to be my own therapist to deal with obesity which largely stemmed from an intolerance of wheat, chronic fatigue or myalgic encaphalomyelitis, probably the same cause, Bells Palsy. Can the medical profession see how it has failed so many of us with their closed thinking?

    We need brave scientists like yourself so I am very thankful you are not stopping.

    Blessings

  12. Meant to say ….here in New Zealand we have the perfect situation to improve our health through diet if only we knew it. Good pasture fed animals and great vegetables. We need to promote these things and teach the supermarkets how to do their real food better.

    Blessings

  13. If epidemiology can inform recommendations, perhaps someone should do the following calculation. Compare the rates of obesity and diabetes at the end of the period when low-carb (cut out sweet and starchy foods) was the dominant advice given by official dieticians to the newly overweight, as in the 1967 video, with the rates today, after the later period when low-fat healthy-whole grains fewer-calories-more exercise became the drill.
    What would be the OR for that, epidemiologists? Might it be strong enough to suggest causation? Try it and see.

  14. Amy Curtis · · Reply

    Good work Grant. Obesity rates continue to rise despite current recommendations, we need to revise the guidelines and food pyramid. Many high carb foods are addictive so promote overeating…especially “fat free” and other “diet” foods. We don’t need clinically controlled trials to prove that, just look at the nutrition of our ancestors when there wasn’t the rates of obesity around. Eat natural, whole foods and the rest will follow (this will also not result in too much sat fat)!

    1. If your diet was 80% olive oil, 20% protein you would still be below the magic 10% saturated fat level you supposedly mustn’t ever cross. Just sayin’, you can eat your high-fat and have your low SFA too if that still matters to anyone. Not a lot of micronutrients in olive oil compared to animal fats, but I do find it pleasing and digestible.

  15. Hereni Marshall · · Reply

    Hi, I’m just wondering as a professor of public health what your thoughts are on population social determinants (poverty, education, housing etc) being the cause of disease and why you chose to focus on individual nutrition/diets? I guess what im trying to say is you’re obviously in a position to influence and an expert in public health; why not tackle the really big issues… Also have you any concerns about the link between animal products and breast cancer? Also I was wondering what your thoughts are on this type of diet being just another form of acculturation by diet? One last question if everyone starts eating this way how do we sustainably produce a diet such as this (especially when we hear the omega 3 levels in farmed salmon are not as they seem, and the impact of dairy farming on the environment)? Lots of questions but im really curious and would like to understand more about your approach.

    1. Catherine Crofts · · Reply

      Hi Hereni
      “Also have you any concerns about the link between animal products and breast cancer?”
      Which ones? There was the book “Your life in your hands” that (if I remember correctly) associated dairy consumption with breast cancer due to some studies in China. These studies showed that the women who consumed the most dairy had the highest incidence of breast cancer. What I am not sure if it discussed was that only the most affluent Chinese women could afford the dairy. Now we start having so many confounders, including increased calories, decreased manual labour, increased ability to have the diagnosis made, it makes it really hard to say that it was just the increased dairy that caused the increase in cancer rates……

    2. The question about social determinants is a good one. We have a society where the poor are basically encouraged (recommended) to eat grains, oils, and sugars because these are the “low saturated fat” foods they can afford. These are also the foods linked to breast cancer (if weak epidemiological associations are really “links”).
      The other non-dietary link to disease is one that Prof Grant touches on in this post – environmental toxins such as air pollution, workplace solvent and heavy metal exposure, pesticides, azo dyes in food etc.
      Any claim that dietary recommendations have lowered the rates of any disease has to be considered in the context of the times – the Clean Air Act, changing OSH regulations, the environmental movement in general, restrictions on the use of DDT and dioxins, reduced workplace exposures due to automation and unemployment, reduction of mercury exposure through changes in dental health and practice, Smokefree legislation, and so on.

      As for the environmental question: it is not a good use of land and water to throw away the fat from the animals we raise and eat extra grains etc. instead. Nor is it a good “sustainable” use to eat a diet that is so intrinsically unhealthy and non-nutritious that it needs to be supplemented with large quantities of energy-poor salad greens, fruits, and “superfoods” from all over the world. Veganism, for example, may look like an environmentally friendly option if you only compare calories per acre between say beef and wheat, but if the meat-eater eats the whole animal and the vegan has to get a wide range of extra low-calorie special foods and “superfoods” to be healthy, I’m sure any remaining difference doesn’t go far.

  16. Hereni I am sorry I am not the professor but I am old enough to have watched the disaster of the modern food plate.

    Sustainability is so simple. Good farming practice is always sustainable. Some of today’s practices are not ideal but given better education and information and learning from the anecdotal evidence of those farmers that have worked on sustainable farming we can do it here in New Zealand quite easily if you could only get past some dreary mind sets and the greed that has led to factory farming.

    As for poverty …. New Zealand should not have any poverty. It’s poor education, poor food choices and lack of knowledge that puts many people in this situation. I know what it’s like to live on a very limited income with very little money for food. I know how it feels to become dependent on cheap grains to feed my family. And I see the terrible damage it has done. A few changes to the way I spent my food dollars when my children were young would have made a huge difference to their general health and well being and their future success. How can children learn when they are in a carbohydrate induced brain fog much of the time?

    We have a responsibility to get out into the general public that they must make some serious lifestyle changes ASAP. The first one is to reduce carbohydrates and eat more healthy fats …. not seed oils, not transfats but things like coconut oil, full fat dairy and the fat on your meat…. except maybe chicken fat. Native diets of 40-50 years ago were healthy. Why not promote them?

    Have you had a sausage lately. All sawdust filling and no fat. What happens to the fat when meat is butchered?

    We live in a land of ‘milk and honey’ but the dietary guru’s have fiddled with our food until it’s mostly rubbish instead of the good healthy stuff God has provided us with.

    I don’t want to turn back the clock. I want to move forward with good science, healthy food and brainy, bright kids who do not suffer from sugar induced ADD

    We need more people promoting good food as once our brains are unclogged we can manage our lives 100% better. This sounds simplistic and sure it’s only part of the equation but it is one of the easiest things to change.

    There are plenty of voices talking about the obesity epidemic and it’s economic impact, still to come. Deal with diet first and many things will follow.

    With respect. May we all have a healthier and brighter future living as nature intended.

    1. I am thinking about the “ordinary person’ who has a meter or two of dirt in the back yard… why can’t they, like me, use it to grown veggies in the season….. veggies which are NON GMO and not treated with other herbicides and poisons ….. yes we need agriculture – agriculture which treats the land with love and respect, but we can do some of our own as well without too much effort…..

      1. Exactly. I applaud those schools which are establishing veggie gardens and the children eat the produce they have grown.

        Blessings

  17. Great quesiotns worth a decent reply

    Hi, I’m just wondering as a professor of public health what your thoughts are on population social determinants (poverty, education, housing etc) being the cause of disease and why you chose to focus on individual nutrition/diets? I guess what im trying to say is you’re obviously in a position to influence and an expert in public health; why not tackle the really big issues…

    Fair enough. Probably I’d have to become a politician to sort the social gradient. Someone has to work in nutrition and well-being that’s my gig. I’d love to tilt the social gradient. My pint I think is that the current food guidelines certainly don’t help with inequalities because the people at the bottom of the social heap also are the worst affected by “healthy” food guidelines which provoke the problems in them.

    In terms of well being we are trying to be influence there and the social determinants of health anyway. Our work on the Sovereign well being Index is a good example of this work and advocacy see mywelbeing.co.nz
    —————————–
    Also have you any concerns about the link between animal products and breast cancer?

    I have concerns about the link between highly process foods including meat and all types of cancer

    —————————-
    Also I was wondering what your thoughts are on this type of diet being just another form of acculturation by diet?

    What promoting the eating of whole plants and animals as opposed to the Standard Industrial Food diet? I am suggesting that eating the way humnas have for the majority of the time they have been on the planet is a good idea.
    ————————————-
    One last question if everyone starts eating this way how do we sustainably produce a diet such as this (especially when we hear the omega 3 levels in farmed salmon are not as they seem, and the impact of dairy farming on the environment)? Lots of questions but im really curious and would like to understand more about your approach.

    Maybe sustainable farming and agriculture would help. We already have a sustainability problem. It’s getting worse. We also just plain have too many people on the planet which we don’t know what to do about…

    Look, I don’t have all the answers to lofe and everything. I’m just doing my best here.

    1. Jamie Scott · · Reply

      Create poorly thought out food standards, which then lead to the food industry being able to ‘create’ ‘healthy’ foods which meet the standards, but at a premium, or for those who cannot afford that premium, they can buy the ‘less healthy’ variants. Thus creating a perception amongst those who have less disposable income that healthy food costs too much.

      It has be shown, repeatedly, that eating real food requires LESS food to reach satiety. Less food = less money spent for individuals/families, and from the bigger picture, less food needing to be produced. A carton of locally produced eggs might be more expensive than a box of imported cereal, but those eggs are more nutritious, more filling, and don’t require milk (sustainability of dairy??), sugar (imported), yoghurts, and all sorts of other adornments, to make the meal palatable. And the eggs will last you several hours before you need to eat again. The cereal will not, meaning you need to find something else that is convenient for you to eat on the run. More money. More waste. Per item, whole food might appear more expensive. But per meal (given you can eat 2-3 meals per day and be thoroughly nourished), whole foods are considerably cheaper than the crap we are being dished up by the food companies (who are also the ones telling us it is value for money).

      On sustainability. Our meat farmers have VERY good international practices and can extract large amounts or protein per acre. I question the sustainability, however, of draining our rivers so that we can ship milk powder to an over-populated Asia.

      1. New Zealand feeding itself dairy or anything else has always been 100% sustainable. It’s us also feeding as many other countries as possible that’s the problem. If the argument is purely about what Kiwis should eat, sustainability of locally grown produce is not the issue. There are only a few million of us here.

  18. Catherine Crofts · · Reply

    If we reduce the amount of omega-6 polyunsaturated oils, it also decreases the need for omega-3 oils as we are trying to maintain a balance between them for good health.

    1. Very true, and fish oil is a by-product of fishing. A lot of fish is caught for people with vegetarian leanings, who need the protein etc. but are unwilling to eat mammals, so target “lower” animals like chicken and fish.

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