At our “Diet and Diabetes” event held in Skipton in September 2016, Dr. Trudi Deakin was one of the keynote speakers. Trudi is a dietitian who has established X-PERT Health, a registered charity based in Hebden Bridge that provides a range of programmes which will enable educators and individuals to understand how the diet may be changed in order to control and prevent diabetes.  In her contribution she evaluated the reliability of the dietary advice being promoted to consumers. This has revealed some very serious deficiencies, which are described here. I am most grateful to Trudi for permission to re-produce her figures here.

In the UK, the Government relies on the Scientific Advisory Committee on Nutrition (SACN) to evaluate and interpret the scientific state of play. Then it is the responsibility of Public Health England (PHE) to translate the SACN recommendations into a format, which can be understood by the public. Although PHE is confined to England, there are similar bodies in Wales, Scotland and Northern Ireland that do the same job in those countries.

Previously I have been highly critical of conclusions reached by SACN with respect to the dietary recommendations, especially on carbohydrates (1). Leaving aside the validity of the SACN stance, Dr. Deakin has examined how accurately this is reflected in the PHE advice.

This is largely based on the recently released Eatwell Guide (2), which is:

a visual representation of how different foods and drinks can contribute towards a healthy balanced diet.”

Carbohydrates

The official advice on Dietary Reference Values (DRVs) the total carbohydrates intake should be 50% of energy, which works out at 260 gm per day. Dr. Deakin has calculated how the carbohydrate content of the various diets recommended by PHE and these are shown in Figure 1 below. This reveals that for all five menus analysed the carbohydrate content is invariably greater than the official reference value. On average there is 103 gm per day MORE than recommended, which is 40%!

 

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FIGURE 1

Sugar

Dr. Deakin did a similar exercise for sugar. The results are shown in Figure 2. The picture that emerges is almost exactly the same. This time the average excess is 42% higher than the official value.

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FIGURE 2

Total fat

Figure 3 shows that official advice is 70 gm/day but that this is only achieved with two out of the five menus and so the average is only 57 gm/day.

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FIGURE 3

Saturated fat (SFA)

It is evident that much less SFA that the official value of 20 gm/day. On average the intake advised by PHE is only 14 gm/day.

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FIGURE 4

Monounsaturated fat (MUFA)

Here again, the picture is essentially the same as for the SFA. Those complying with the PHE would only consume about 70% of the official recommendations (Figure 5).

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FIGURE 5

Polyunsaturates (PUFA)

This is the single exception where the PHE manages to comply with the official position.

Omega-6:omega-3 ratio

There are many different types of PUFAs but from a nutritional perspective the most important are the omega-3s and the omega-6s. Oily fish are a good source of omega-3s, while many “vegetable oils” are predominantly omega-6s. Ideally the ratio should be close to unity and the official advice is that it should not be higher than four. The PHE advice works out at 10 (Figure 6).

 

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FIGURE 6

Discussion

There is no doubt the introduction of the Dietary Guidelines, which happened in the UK in the 1980s coincided with the start of the explosion in type 2 diabetes (T2D) and obesity. We now have convincing evidence to show that the consequent changes in diet played a critical role in this deterioration in public health. So it is not in the least surprising that the way to reverse these changes is to adopt a diet which is low in carbohydrates and high in healthy fats (LCHF).

If PHE is to comply with it brief and responsibilities then it is imperative that the information that it disseminates to the public is a truly accurate reflection of the conclusions reached by SACN.

It is obvious from Dr. Deakin’s detailed analysis that this is not the case. Those who comply with the PHE advice will consume about 40% more carbohydrates and sugar than considered advisable by SACN. This absolutely appalling. The dangers of sugar are widely acknowledged. This has even been recognised by the Government, which has proposed the introduction of tax on sugar.

It follows pretty well automatically that if the diet has excess carbohydrates then there will be a deficit in the amount of fat consumed and that is exactly what has been discovered. Even then it is remarkable that the omega-6:omega-3 ratio is so far out. The PHE advice is for a ratio of 10 when the ideal is unity and certainly not more than 4. It is crucial that the balance between the omega-6s and the omega-3s is maintained. Omega-6s are inflammatory whereas omega-3s are anti-inflammatory (3, 4). There is plenty of evidence to show that the typical diet contains far too much omega-6s and not enough omega-3s.

There can be no excuse for this sheer incompetence on the part of PHE. This organisation has no remit to put its own “spin” on the official recommendations. It has a definite responsibility to provide a true and accurate representation of what has been produced by SACN. It has to be appreciated that the PHE publications play a crucial role in determining the information used by health professionals when devising training courses and advising members of the public. It is rather ironic that those likely to suffer most as a result are people who are trying to comply with the official advice.

It is somewhat salutary to have to conclude that despite my serious reservations about the SACN conclusions and recommendations, if PHE was to comply with them, there would undoubtedly be a significant improvement in public health.

References

  1. http://vernerwheelock.com/204-scientific-advisory-committee-on-nutrition-sacn-report-on-carbohydrates-and-health/
  2. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/551502/Eatwell_Guide_booklet.pdf
  3. A. P. Simopoulos (2002) Journal of the American College of Nutrition 21 (6) pp 495-505
  4. A. P. Simopoulos (2008) Experimental Biology and Medicine 233 (6) pp 674-688