As this is Blog 50, I thought it would be instructive to look back over some of the earlier blogs and attempt to highlight some of the key message that have emerged. It is now over 30 years since official guidelines on diet were first issued by health professionals and usually endorsed by governments. Prior to this there were policies which were designed to ensure adequate intakes of the essential nutrients such as vitamins and minerals. The “new nutrition” which appeared in the late 1970s/early 1980s focussed on the major constituents in the food, particularly the fats and carbohydrates. These recommendations were initially formulated in the USA, primarily because of concern about heart disease, where the death rates were among the highest in the world. The World Health Organisation (WHO) took the lead from the USA with the result that very many national nutrition policies all over the world were essentially the same as in the USA.
With respect to implementation, the emphasis has been on the advice to reduce the total fat and especially the saturated fat (SFA). Here in the UK between 1969 and 2000 the National Food Survey (NFS) shows that total fat consumption had fallen from 120 to 74 g/day. Over the same period the consumption of saturated fat (SFA) decreased from 56.7 to 29.2 g/day. (The NFS was discontinued in 2000). My own interest in exploring the scientific basis of these dietary guidelines has been stimulated by the fact the expected benefits in public health have certainly not materialised. While it is true that life expectancy has been extended, there is no convincing evidence that health generally has improved. We have the “obesity crisis” which has probably been over-hyped (See Blog 10) as far as most people are concerned. Of much greater concern is diabetes, which has doubled in the past 15 years and continues to increase at a rapid rate. Diabetes is just the tip of the iceberg. Those with diabetes are at an increased risk of heart disease, many cancers and Alzheimer’s Disease (AD). Unfortunately a high proportion of those diagnosed with diabetes are being advised to reduce their fat intake and to increase carbohydrates. There is plenty of evidence that this does not work. By contrast reducing intake of sugar and even the complex carbohydrates (bread, potatoes, pasta and rice) can successfully overcome diabetes to such an extent that many people no longer need to take drugs to control the disease (Blog 33).
The fundamental flaw in the establishment position is that the case for reducing SFA just does not stand up to critical examination (See Blog 16). Instead the focus of attention should be on reducing sugar (See Blog 35) although, as pointed out above, the so-called “healthy” complex carbohydrates do contribute to the development diabetes.
The reality is that the SFA are important nutrients in their own right….many of them are present in human breast milk! In addition the fat soluble vitamins are present in the fat so those who follow the official advice will be reducing their intake of these essential nutrients.
The rationale for the recommendation to reduce SFA is based on the so-called “cholesterol theory” which has now been totally discredited (although governments and the WHO still rely on it). It is based on the belief that a raised level of cholesterol in the blood (TC) is considered to be a risk factor for heart disease. Therefore if the TC can be lowered there will be a reduction in the risks of developing heart disease. It is claimed that the SFA increase TC and so reducing SFA will lower TC with a consequent reduction in deaths from heart disease. These arguments are extremely dubious but the hard reality is that we need information not on heart disease alone but on all diseases and conditions which will cause death. Evidence cited in Blog 8 shows convincingly that for people over age 60 when the vast majority deaths occur this is not true. In fact the death rate increases at the TC levels recommended by the authorities. For women it is clear that the higher the TC the greater the life expectancy. Hence the rationale used to underpin the recommendation to reduce SFA is completely false.
Unfortunately the “cholesterol theory” is fundamental to the case used by pharmaceutical industry to promote the sales of cholesterol-lowering drugs such as statins (See Blogs 26 and 27). In the light of the research showing the relationship between TC and all-cause death rates, it is difficult to understand why anyone would wish to lower their TC.
On a positive note, it is now becoming clear that one of the major causes of a wide range of chronic diseases is a lack of Vitamin D (See Blogs 48 and 49). We do not require Vitamin D just to prevent rickets. Vitamin D is produced in the skin when it is exposed to sunshine and many of the health problems can be traced to a lack of access to the sun. In order to raise the level of Vitamin D in the body to that achieved by access to sunshine it is necessary to consume much higher level than most of the official recommendations specify. Some scientists in the field advise a daily intake of up to 8000 International Units (IU) which compares with official recommendations of about 400 IU. If you do so make sure you have enough Vitamin K2 (See Blog 22).
However there are also other benefits from the exposure to sunlight which cannot be achieved by taking a Vitamin D supplement (See eg http://www.ted.com/talks/richard_weller_could_the_sun_be_good_for_your_heart.html)
Currently we are having plenty of sunshine so it is time for me to abandon my computer and get outside. I strongly suspect that if people were advised to spend time in the sunshine (and take some exercise) there would be much greater improvements in public health than can ever be achieved by the prescriptions of drugs.