I have been in the profession of nutrition and dietetics long enough – more than 30 years – to know there is no point in having a verbal or written stoush with the likes of David Gillespie, lawyer turned anti-fructose, anti-seed oil evangelist. He and others are challenging the scientific thinking of the day and that is not necessarily a bad thing. In fact, if you are interested in discovery and science that is what we are trained to do.
What does concern me very much is the backward and somewhat naive stance of classifying foods as "good" and "bad". When I started working in teaching hospitals I disagreed with use of the terms "forbidden" and "allowed" on diet sheets given to patients as part of their nutrition education. I thought it punitive and threatening.
The terms "poison" and "toxic" are equally inappropriate when we are talking about foods. For some people with intolerances and allergies or certain medical conditions these terms may have relevance but I still don't like them.
I recommend a more positive approach, focusing on what to eat rather than what not to eat. What you put on your plate is often more important than what you remove.
Don't demonise individual foods
In my opinion, there is no single food or nutrient that will kill you and there is no single nutrient or food that will cure you. I know some of you are thinking 'what about polar bear liver and vitamin A toxicity? Granted, there are some exceptions but they are rare.
Demonising individual foods or components of food is dangerous and overly simplistic.
We cannot solely blame fructose for the obesity crisis when there are so many other factors that come into play. Some argue that our consumption of sugar has decreased by 23 per cent in the past 30 years while obesity rates have risen.
I am not a brain expert but I find it hard to accept David Gillespie's view that fructose is the root cause of dementia. Surely brain ageing has something to do with it?
I feel the same way about saturated fats and cardiovascular disease or seed oils and cancer. No single nutrient or food is to blame. A combination of factors contributes to chronic disease.
Put simply, there are no bad foods per se. There are some that lack nutritional integrity but consumed occasionally, in small quantities as a celebratory food or treat, they would have no long-lasting negative effects on our health.
Being able to enjoy the occasional treat without feeling guilty reflects the wisdom of a well balanced diet, both physiologically and just as importantly, psychologically.
But there are poorly balanced diets. There are diets that have excessively large portions of foods and drinks that contribute too many kilojoules – whether the source is sugar, fat, protein or alcohol.
When we think of poor nutrition we think of overconsumption of fats, sugars and salt, but poor nutrition also relates to deficiencies of nutrients such as iodine, folate, iron and vitamin D, not to mention fibre, which are real concerns for some Australians.
All this food negativity, conflicting nutrition advice and the scare tactics relating to the causes of disease are likely to result in confusion, anxiety, obsessive eating behaviours, food phobias, disordered eating such as orthorexia or, at the other extreme, complete disdain and cynicism, with eating becoming devoid of pleasure. How healthy is that?
We need to remember that the study of nutrition is a science and, with advances in research techniques and methodologies, our understanding of wholefoods and the impact on our health can only improve.
Nutrition studies are not straightforward. It is extremely challenging to identify which nutrient or phytochemical component in food is having a positive or negative effect on our health outcomes. Once you deconstruct a food into individual nutrients and administer them in large enough quantities to measure an effect in a study, the components can act differently compared with when you eat the wholefood in the context of a diet and eating pattern.
Nutrition advice – such as the Australian Dietary Guidelines developed by the National Health and Medical Research Council – has to be evidence based.
For more than 75 years the Australian government, primarily through the NHMRC and government departments, has provided nutrition advice to the public through various guides and policies.
What should Australians eat?
Every five years the Dietary Guidelines are reviewed. An expert committee is appointed to rigorously review the latest scientific literature and analyse the body of scientific evidence in relation to quantity, quality, as well as clinical impact and relevance to Australians.
The working committee this time included eight Professors holding chairs in medicine, nutrition, epidemiology, public health and exercise physiology plus four PhDs. They reviewed 1128 scientific studies and spent many months debating and discussing recommendations before releasing the guidelines.
While the direct link between saturated fat and cardiovascular disease is weakening, just about every authoritative nutrition organisation in the world agrees that replacing saturated fat (such as lard, duck fat, goose fat, butter and ghee) with polyunsaturated fat (such as fish oils, seeds and seed oils, walnuts and walnut oil) lowers heart disease risk.
As stated in the Australian Dietary Guidelines 2013 guideline 3 (see link below for more information), ‘replacing dietary saturated fat with monounsaturated (such as olive oil, avocado, nuts) and polyunsaturated fats is associated with improved blood lipid profiles and reduced risk of cardiovascular disease. Fat-rich foods are energy-dense, which is prudent to consider in a total dietary pattern that seeks to control overall energy intake. (Link)
You can feel confident that our most recent dietary recommendations are based on the best available scientific evidence at the current time.
Without doubt there is more than one eating style that promises better health. Dietitians, who complete four to five years of study and have to commit to continuing professional development to retain their accreditation, know that. They are highly trained to assess evidence-based science are able to translate it into practical, enjoyable solutions tailored to individual needs, No doubt we are going to understand more about personalised nutrition as the emerging science of nutrigenomics expands.
We already know of the benefits of traditional diets such as the Mediterranean and Japanese diets. But wait until we start having genetic testing and eat according to our genetic blueprint. You will know whether you are better off eating carbs or worse off eating fats. You will be empowered to make food choices relevant to your health risks and you won't need to restrict the foods you enjoy unnecessarily.
We will have to wait a bit for that, so in the meantime keep in mind that healthy eating is not purely about the nutritional value of the food. It's about the love that goes into the cooking, having respect for the people who produced the food, being mindful of sustainability and wastage and the pleasure in sharing food with family and friends as well as enjoying eating delicious food.
David Gillespie quotes one of food activist Michael Pollan's food rules to conclude his article: "Don't eat anything your great grandmother wouldn't recognise as food". I'd prefer to use another of Pollan's food rules to summarise my views: "break the rules once in a while".
Karen Inge is an accredited practising Australian dietitian. See kareninge.com for more.