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Sunday, 17 May 2015


The proverbial brick wall of bad dietary advice is a-crumblin’. This week brings truly world-changing news in the field of nutrition.

On May 8, the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) made its official comments on the 2015 Dietary Guidelines for Americans, and recommend dropping saturated fat from nutrients of concern due to the lack of evidence connecting it with cardiovascular disease.

However, because past advice from the Academy and others has caused issues with ALL of our body systems, I would also argue that this is actually earth-shattering news in the world of cardiology, nephrology, lipidology, endocrinology, pulmonology, orthopedics…. you get the point.

The Academy supported the scientific process used by the Dietary Guidelines Advisory Committee (DGAC) in drafting its recommendations for the 2015 Dietary Guidelines for Americans, but had somewhat different interpretations:

  1. They supported the DGAC in its decision to drop dietary cholesterol from the nutrients of concern list and recommended that it also drop saturated fat from nutrients of concern, citing a lack of evidence connecting saturated fat with cardiovascular disease;
  2. Expressed concern over blanket sodium (salt) restriction recommendations in light of recent evidence of potential harm to the larger population;
  3. Supported an increased focus on reduction of added sugars as a key public health concern; and
  4. Asserted that enhanced nutrition education is critical to any effective implementation.
Why is all of this so earth-shattering? Well, it brings an end to the era of jumping to conclusions and issuing recommendations before we had the science. It brings an end to a big experiment on the American people and, by extension, the rest of the world, which has failed miserably. It is an acknowledgment that the recommendations to restrict fat, most particularly saturated fat, which led to the recommendation to eat more than half of our energy intake EVERY day from carbohydrates was…WRONG! Yes, the food pyramid, eating sugared cardboard products and highly processed vegetable oil instead of real foods like meat and eggs were all just, I have to say it again, plain WRONG.

As an obesity physician who sees the fallout from the previous guidelines in the poor health of my patients every day, I am thrilled. I am thrilled because this means that more people will be helped. More people can realize that much of the reason that they are obese, have diabetes, high cholesterol, or metabolic syndrome is NOT all their fault. Yes, I really just said that. (What? Not blame a fat person for being fat? Uh, exactly. )

This is not news for the community of bariatrics physicians. We knew that fat was not the cause of the disease we treat nor for the related diseases, such as diabetes or metabolic syndrome. In fact, when the U.S. Department of Agriculture and later the American Dietetic Association (now the Academy of Nutrition and Dietetics) began recommending reducing fat and pushing an increased intake of carbs was exactly the years when our obesity and diabetes epidemic began. Just a correlation? We have much reason to think it is far more than correlation and is actually the cause.

That’s why in a recent TEDx Purdue talk I gave it the title “Reversing Type 2 diabetes starts with ignoring the guidelines.” The guidelines have been misguided for years, and work against patients with obesity, Type 2 diabetes, or metabolic syndrome.

In the last couple of years, there have been a number of articles in the medical literature removing the “villain” label from dietary fat. Now we need to take the next step, and take a harder look at what has likely been the real culprit at work with obesity and diabetes. Remember the bottom of the food pyramid? All those grains we were supposed to eat so we could avoid consuming fat? Well, we need to now turn our attention to those, too.

Meanwhile tomorrow dietitians from the BDA are going to be discussing Breakfast Cereals:

This chat is supported by the Association of Cereal Food Manufacturers to have an open debate around the ingredients and fortification of breakfast cereals.



Anonymous said...

Just turned my computer on and saw this mind blowing read. Just had to comment but now going back to take it all in.


Galina L. said...

I am still in doubts. Saturated fats are healthy when carbohydrates are limited, you can't have liberal amount of both, and I can't believe government is ready to tell everyone to cut on grains.

Gingi Freeman said...

Totally off topic, but what are your thoughts on raw milk...? -

Galina L. said...

In my lay person opinion, milk is not the necessary food, for many people it is the source of liquid calories.

Galina L. said...

About that website Gingi gave link to - if people desperately want to have goats on their property and drink goat milk - they have my support. Why not, if they are not unhealthy? I think a goat keeping is the better use of owned land than just manicuring lawn. When the blog author describes herself as a devoted christian who leads a Christ-centered life, it is a negative characteristic from my perspective. I can't relay to religious people.

Anonymous said...

12g of fat (6g saturated)
16g protein
31g of carbs
2.4g fibre
1.6g of salt

Bit high in carbs for me in a single sitting, but it's no longer unhealthy under the new advice!
May give one a try and see if the fat slows down the carb impact.

Lowcarb team member said...

"When the blog author describes herself as a devoted Christian who leads a Christ-centered life, it is a negative characteristic from my perspective. I can't relay to religious people."

Each to their own I reckon Galina, I am not religious in anyway but I have friends who are.


Galina L. said...

I do have religious friends as well, and we just avoid bringing up the subject of religion when we communicate and treat it as a private issue, also being a religious devotee is not the first thing which they would say about themselves. I also have yoga friends who give way too much credit to the Āyurvedic medicine than it deserves.I usually keep quiet unless I think my yoga friend is killing herself.

When I went to the blog which Gingi refereed to, the world GOSPEL(A Field Guide for Everyday Mission: 30 Days and 101 Ways to Demonstrate the Gospel) was the second thing which I noticed, the first one was a girl-the blogger dressed as a christian Taliban. All that was a little bit too much for me. Going to blogs is a personal decision , I can't go everywhere.