In a previous blog I used the term “constructive ignorance” to describe the action of the Health Professionals Council in South Africa (HPCSA) in charging Professor Tim Noakes with professional misconduct for his views on a diet, which is low in carbohydrates and high in healthy fats (LCHF). This is certainly not an isolated example as there have been essentially similar issues in other countries.
Constructive Ignorance has been defined by my colleague Richard North as follows:
“There was a time – a long time ago – when I thought that information was the antidote to ignorance. All I had to do, I thought, was to get to the right people and tell them what they needed to know – the correct information – and all would be well with the world. Only latterly did I identify what I came to call “constructive ignorance”, after “constructive dismissal”, where people quite deliberately foster a state of ignorance. Largely, I surmised, they have adopted their narratives and need to protect them with a wall of ignorance. Otherwise, they crumble under the assault of facts, and their holders are faced with the inconvenience of having to rebuild them.” (1).
The latest is in Ireland, where Patricia Daly has been in trouble with the Advertising Standards Authority of Ireland (ASAI). One of her websites offers training courses for those looking to implement a ketogenic diet (KD). Her websites clearly explained that a KD is not suitable for everyone and that it needs to be done under supervision. Patricia has plenty of references, studies and quotes from leading scientists, cancer researchers and oncologists. It is clear to anyone who visits the website that she clearly acknowledges the limitations of the diet and is abundantly clear that a KD should never replace conventional therapy. But that although the evidence supporting the KD as an adjunct for cancer is pre-clinical, it is compelling.
Patricia and her co-author Domini Kemp have both recovered from cancer using a KD and a Low Carb High Fat (LCHF) diet, respectively, as part of the therapy, which was highly successful. Details of how this was achieved are described and explained in their excellent book entitled “The Ketogenic Kitchen”, which was the focus of a blog some months ago (3).
There are numerous examples of individuals who have had similar success and there are sound scientific reasons for concluding that diets, which have a high content of sugar and refined carbohydrates contribute to the development of various cancers (4). In addition there is a strong case for increasing the consumption of healthy fats that include many of the saturated fats (SFA), which have been condemned on the grounds that they raise cholesterol.
The blunt reality is that the conventional approach to the treatment of cancer leaves a lot to be desired. Despite the enormous resources devoted to research, we have actually made very little progress. As Professor Jane Plant discovered when she suffered breast cancer, there is very little attempt by the medical profession to focus on the cause. Like so many others, Professor Plant made radical changes to her diet that proved to be a crucial factor in her recovery.
In these circumstances, it seems eminently sensible to provide cancer sufferers and those who wish to take preventative measures with the current knowledge on the role of diet in the development of cancer.
The ASAI decision was made in response to a complaints by the Irish Nutrition and Dietetics Institute (INDI) with support from the Irish Cancer Society (ICS) (5). Interestingly, INDI has failed to answer several queries relating to possible sponsorship arrangements they have in place with food companies.
The main thrust of the objection was concerns about public safety with special reference to the use of a KD as a form of therapy for cancer. The information on the complaint provided by ASAI is rather garbled and includes the following:
- A KD is high in fat and low in carbohydrates, which can be restricted to 20 grams per day. Furthermore the fat comes from butters, oils and creams as well as protein foods such as meat, fish, eggs and cheese.
- A KD is challenging and restrictive so that it must be administered under appropriate supervision to ensure safety and efficacy.
- A KD is not currently recommended to people in Ireland by dietitians and oncologists.
Here are some of the key points made by Patricia’s material in response to the complaint:
In relation to the KD, Patricia stated that there was plenty of pre-clinical data (including humans as well as animals) showing that cancer growth was tightly linked to insulin signaling, IGF-1 and many of the other energetic pathways linked to insulin signalling.
There was other compelling evidence suggesting that carbohydrate restriction could offer significant benefits for cancer patients.
Patricia stated that she did not make claims, but rather report the findings of expert registered dietitians, medical doctors, oncologists and professors researching the ketogenic diet as an adjuvant therapy. She stated that the ketogenic diet was a very promising area of cancer research.
Patricia provided a list of eight experts, six of whom were identified as based in the USA, and five medical professionals based in the UK who she stated were showing an active interest and/or were working with the KD as an adjuvant to conventional treatment for cancer. She also provided website links to current ongoing clinical trials on the KD for cancer and a link to how internationally interest into researching the KD for cancer was rapidly growing.
Patricia stated that there was lots of data (e.g. laboratory data, biochemical pathways, cohorts) demonstrating that a KD as a dietary strategy for cancer patients had significant potential.
She outlined that data showed that high glucose reduces p53, a tumour-suppressor gene that protects us from cancer. She stated that this was also an important tumour marker, referencing that comment by the complainant that the KD cannot affect tumour markers. Another tumour marker that had been shown to be modulated by the KD was TKTL1. Hyperglycaemia was a state of chronically elevated blood sugar levels. If this was the case in a cancer patient, a poorer prognosis could be expected, she stated. There was also research that shows that the higher the blood sugar levels were, the more tumour growth was experienced.
Regarding qualifications, the advertiser stipulated these as dipNT (Nutritional Therapy), mNTOI, Mbant. She stated that she was regulated in the UK (mBANT, rCNHC) as there was no suitable regulatory body for Nutritional Therapists in Ireland.
Despite providing numerous references to all the data, The ASAI requested that Patricia identify specific documentary content submitted which was relevant to grounding, supporting and evidencing her responses to the complaint. She was also asked to provide further and more detailed information and evidence regarding her qualifications. She clearly demonstrated her credentials.
She referenced that INDI and ICS have expressed views at odds with hers due to their differing approach to nutrition in the context of cancer support. She stated that there were two conflicting views on a very complicated debate going on worldwide.
The advertiser stated that she had provided full and comprehensive details of her qualifications and provided a link to www.bant.org.uk . She stated that nowhere in her resources was conventional treatment discouraged and references were repeatedly made for patients to seek medical supervision by health care professionals. She stated that she made it more than clear that she was a complementary and integrative rather than an alternative practitioner. She stated that wording that appeared clearly on her websites.
It was decided that Patricia could not make claims in relation to the efficacy of the KD in relation to cancer treatment until she could provide the appropriate evidence and was therefore in breach of the Advertising Code. The ASAI did not accept all the references and scientific papers provided by Patricia by leading researchers in US, Germany and UK.
This just one more example of how the establishment is fighting very hard to maintain the status quo on dietary advice. This advocates that the intake of fat, especially SFA, should be restricted and effectively replaced by complex carbohydrates. The most outstanding event has been the “trial” against Professor Tim Noakes in South Africa. Full details are available in the comprehensive blogs by Marika Sboros (6). The significance of this is that the LCHF diet has been subject to a very thorough evaluation in which much, if not all, of the relevant evidence has been scrutinised. The key points to emerge are that;
- The justification for the conventional dietary recommendations that are effectively based on the US Dietary Guidelines simply does not exist.
- There is a wealth of evidence, which demonstrates convincingly that an LCHF diet has considerable benefits.
- It has now become very clear that the crucial factor involved in a range of common chronic diseases/conditions is insulin resistance. These include type 2 diabetes, heart disease, obesity, Alzheimer’s Disease and many cancers. This is caused by excessive consumption of sugars AND foods, which are rich in starch that breaks down to glucose.
There is no indication that a diet, which is high in healthy fats such as butter, olive oil and coconut oil poses any danger to consumers. Similarly there is no evidence to show that carbohydrates are essential and many societies are perfectly healthy on LCHF diets. It is somewhat ironic that despite the growing evidence that a diet high in carbohydrates is actually quite dangerous for many people. Surely it is time that those who continue to support the conventional dietary recommendations recognised the consequences of the approach they advocate? The reality is that they continue to raise questions about the safety of LCHF, which are conjured out of thin air but fail to appreciate the genuine hazards linked to diets that have a high content of carbohydrates.
This is just one more battle in global war to achieve a radical change in official nutrition policies so that they are in line with the latest scientific knowledge. Patricia and Domini deserve credit for the tremendous work they are doing.
- A ketogenic diet is one which is LCHF so that the body is adapted to utilise fat as a source of energy through the production of ketones