New Zealand becomes first country to specifically warn against low carb, paleo and intermittent fasting
Yes true, New Zealand released its new nutrition guidelines late last year.
No real surprises in them. Little improvement over the old ones really, as well as a few interesting things like the “four food groups“. In case you are wondering, these are vegetables and fruit, grains (at least 6 servings a day), low fat dairy, and (some) lean sources of protein like nuts, fish, legumes etc.
They do now have an emphasis on whole, unprocessed foods, and do have a statement about limiting alcohol, which are both commendable. They also say that fat is important. But in every part of the detail it’s all about low fat and high carb. They also have a section on “Making Healthier Food Choices” which starts well by talking about unprocessed foods, but deteriorates into food labels and the Health Star rating system – which basically endorses processed foods.
Here’s a list of how to make healthier choices. It gives you an idea of where this is all going.
|Instead of this||Use this|
|Butter||Margarine or other plant-based unsaturated spreads|
|Lard and/or dripping||Water (for roasting meat), small amount of plant-based unsaturated oils (see below)|
|Coconut oil||Small amount of plant-based unsaturated oils, eg, canola, olive, sunflower or rice bran oils|
|Full-fat milk||Low- and reduced-fat milk|
|High-fat cheese, eg, mild, Colby||Reduced-fat cheese, eg, edam|
|Coconut cream||‘Lite’ coconut cream or milk, or use half water and half coconut cream|
|White bread||Higher fibre, dense whole grain bread|
|High-fat takeaways||Healthier option takeaways, eg, kebabs or wraps with plenty of salad, non-fried Asian rice or noodle dishes with plenty of vegetables|
|Sugar-coated breakfast cereal||Whole grain cereal, eg, porridge or whole wheat breakfast biscuits|
|Muesli bars||Fresh fruit or a small handful of unsalted nuts|
|Chippies and a cream-based dip||Raw vegetable sticks and hummus, or homemade popcorn (go easy on the salt)|
|Sugary drinks||Water. It is nice chilled, with fresh mint and/ or a slice of lemon|
|Fruit juice||Glass of chilled water and a piece of fruit|
|Dried fruit||Fresh fruit|
I’ve writen about this before, and we’ve sent in detailed scientfic and public health rationale for moving away from the current approach (MOH dietary guidelines feedback REVISED Appendix 9.5.14). We even suggested the real food guidelines – a set of public health nutrition guidelines which we think are much more sensible given the state of scientific evidence such that it is. The main idea being that there is an emphasis on eating real, whole food and forgetting about the emphasis on the mythical whole grain, the demonising of saturated fat, and low fat high carbohydrate in general.
But here’s the bit we found most objectionable
“This resource provides answers on some topical issues around eating (nutrition) and physical activity. The responses are based on the Ministry of Health’s monitoring of international research. Any new research is considered alongside the existing body of evidence and best international population health advice.”
Here are the first few topics…judge for yourself
Foods high in saturated fat include butter, cream, cheese and the fat from meat as well as coconut oil and palm oil. The link between saturated fat consumption, blood cholesterol levels and heart disease is well established, with evidence building over the past 60 years. Recent comments, highlighted in the media, have promoted high saturated-fat diets. These comments oppose widely held nutritional understanding of a healthy diet.
The current body of evidence supports replacing saturated fats with polyunsaturated fats, to reduce the risk of heart disease and stroke. In practice, this means using unsaturated fats such as plant-based oils and spreads instead of butter if needed for cooking and spreading. The few recent studies that endorse high saturated-fat diets are not sufficient to refute the existing body of evidence.
My verdict: This single issue is the one which makes it so hard for these people to move on to a more sensible set of public health nutrition guidelines. Decades poor research and poor interpretation of meta-analyses have lead the “old boys” into cognitive dissonance that means they will never change their minds. The public is now more savvy and is likely to realise that this is just silly. Recent sales of butter (up) and margarine (down and Unilever is thinking about abandoning its manufacture) are good evidence of this.
Low-carb, high-fat diets are sometimes promoted as a better way of losing weight than diets that contain more moderate and balanced amounts of carbohydrate and fat.
However, it is not the proportions of macronutrients (carbohydrate, fat and proteins) that affect weight loss but the total energy in the diet. While people can lose weight with some low-carb, high-fat diets, this happens with other energy-controlled eating plans as well. Importantly, there is no evidence of the long-term benefits or safety of such diets. Based on all the current evidence, the Ministry of Health does not recommend low-carb, high-fat diets for weight loss.
My verdict: For goodness sake, have a look at the scientific evidence. We know that these diets work well for weight loss, especially for those people who are insulin resistant.
The ‘paleo’ or palaeolithic diet is an eating pattern claimed to be based on the diet of early ‘hunter-gatherer’ humans from the Palaeolithic period (around 2.5 million to 10,000 years BC). The diet consistsof vegetables, some fruit, nuts, naturally occurring fats and oils, meat and seafood. It excludes dairy products, grains, legumes, processed oils, sugar, salt, alcohol and coffee. The premise for the diet is that modern humans remain genetically adapted to the eating patterns of their ancestors, and so this continues to be the optimal way to eat for health.
Although the paleo diet includes many healthy foods, it is also linked to a number of issues. In particular, copying a ‘true’ Palaeolithic diet is difficult as very little is known about the diet of these early people and many of the specific plant and animal foods around during the Palaeolithic period no longer exist. Also, significantly, the diet excludes entire food groups that are important to healthy eating patterns. Examples are grains, legumes and dairy products.
Yes, New Zealand nutrition recommendations specifically go out of their way to tell people who have a template of eating that is based on whole unprocessed foods – those humans mostly ate for almost all of their evolutionary history – that this is not healthy and you shouldn’t do it!
My verdict: This is an embarrassment.
The little research available on intermittent fasting diets in humans has shown people can lose weight following this eating plan. Perhaps the best-known version of intermittent fasting is the 5-2 diet, where a person has five days of ‘normal’ eating and two days of a much lower energy intake (approximately 2100–2500 kilojoules per day, which is 25 percent of requirements). Over time, it reduces total energy (kilojoules) intake, which is the likely cause of the weight loss.
At present, no studies have shown how sustainable this eating pattern is or how it impacts on long-term weight or health outcomes. Possible immediate side effects from the ‘fasting days’ are extreme hunger, low energy levels, light-headedness and poor mental functioning. The quality of the diet on ‘normal’ days will also impact on health outcomes in the long term.
The 5-2 diet is not recommended for people with insulin dependent diabetes.
OK, because people with insulin couldn’t figure out how to adjust their insulin and this will drive hypoglycaemia? I assume everyone else can do intermittent fasting though by only selecting this group, cool.
My verdict: Yes more research needs to be done with fasting, but it could be really useful for people who are metabolically dysregulated and could even help some Type 2 diabetics who are dependent on insulin get off insulin. Why is this diet (one which doesn’t even restrict “food groups”) chosen as a target over the dozens and dozens of really silly ones out in the public space?
Recommendations to decrease sugar intake refer specifically to ‘free sugars’. Free sugars include all sugar added to foods as well as sugars that are naturally present in fruit juice, syrups and honey. This recommendation does not apply to the sugar that is found naturally in the structure of foods such as whole fruit and dairy products.
As well as sugar, whole fruit provide a range of nutrients including dietary fibre and phytonutrients (beneficial chemicals found in plants). Fruit along with a range of other foods is part of a healthy eating pattern.
Specifically what nutrients will people eating a whole food diet without fruit miss out on? So if your blood sugar is raised by eating fruit, especially high sugar fruits like grapes and bananas then thats OK – especially if you are insulin resistant and this provokes hyperinsulinemia?
My verdict: There is a widespread belief that unlimited fruit is OK no matter how poorly you can control your blood sugar and insulin. This belief is rubbish. Limiting fruit is a good option for people in this category.
There you go. New Zealand – the first country in the word to give women the vote, a country that prides itself as early adopters and innovators, is again first! We’ve warned people off low carb and paleo. That’s a shame really because these are two of the most promising ways to help fix the current metabolic diseases that affect our quality and quantity of life, and cost us billions of dollars.