02 June 2016
Free-from Diets
The right line ‘pour garder la ligne’?
by Lynda Goetz
Should you feel the need to shed a few pounds before heading off to the beach this summer, you might think that a good place to start looking for information would be the NHS website. Type something like ‘NHS dietary advice’ into your search engine and you will almost certainly find, as well as the Twelve Week Diet Plan (have you got time?!), ‘The Eatwell Guide’. This is an interactive guide which gives advice on a balanced diet. Apart from the advice to eat 5 portions of fruit or vegetables a day, which most of us have heard about even if large numbers choose to ignore, it also advises that we should base meals on ‘potatoes, bread, rice, pasta or other starchy carbohydrates’ which ‘should make up just over a third of the food we eat’. On the dairy or dairy alternatives we should be eating ‘lower-fat products where possible’. Other advice is that, ‘All types of fat are high in energy and should be eaten sparingly’. Another section advises on how to cut down on fat.
However, all is not as straightforward as the NHS would have us believe. This advice, which has effectively been the official line since the 1970s, is not, it seems, the last word in healthy eating after all. According to articles in several newspapers last week, a damning report by the National Obesity Forum accused major public health bodies of working with the food industry and misleading the public. The report claimed that the promotion of low-fat foods is ‘probably ‘the biggest mistake in modern medical history’ and not only a cause of obesity, but also of type 2 diabetes. This viewpoint, although disputed, is not exactly novel. Last autumn, Harvard University researchers published a review in The Lancet of 53 diet studies covering over 68,000 people and concluding that higher-fat, lower-carbohydrate diets resulted in longer term weight loss than low-fat diets. Other studies, such as one from Sydney University published earlier in 2015, found that whilst a high-protein low-carbohydrate diet might help you lose weight it might also help you die younger. Nutritionists have long claimed that many ‘low-fat’ options promoted as ‘healthy-eating’ are high in sugar and could in fact be causing people to gain weight.
This most recent report, rebutted by Dr Alice Tedstone, chief nutritionist of Public Health England, as lacking peer review and drawing on only 43 studies (as opposed to the ‘thousands’ considered as part of the official guidance), argues, inter alia, that eating fat does not make you fat; that saturated fat does not cause heart disease; that full-fat dairy is probably protective and that processed foods labelled ‘low-fat’ or ‘lite’ or’ low cholesterol’ should be avoided. Reaction to the report amongst the scientific community has been mixed, but many consider it to have been selective in its use of material. The truth of the matter seems to be that, as in so many areas, our scientific knowledge is constantly being expanded and that as time goes by earlier studies prove to have revealed only part of the story. Some may remember that back in January there were a flurry of articles around the subject of saturated fats and in particular whether butter was not after all as bad for us as we had been led to believe.
An interesting couple of articles by James Gallagher, BBC Health Editor http://www.bbc.co.uk/news/health-34846832 on 5th and 6th January this year looked into these issues in some detail, including discussing the results of a 2014 study by the University of Cambridge with Dr Forouhi at the MRC epidemiology unit who was part of the research team. That 2014 research concluded that there was no ‘clearly supportive evidence’ for the guidelines which encourage cutting saturated fat from the diet. However, as Dr Forouhi warned, extrapolating over-simplified messages for the public from such research is dangerous and unwarranted. Although new research is advancing understanding, we are still a long way from knowing how all the different types of saturated fat work (saturated fatty acids are chains of between 4 and 18 carbon molecules) and how they interact with other food types.
Add to this conflicting advice the latest fads in ‘gluten-free’ foods and ‘clean eating’ from self-proclaimed life-style experts, and it is perhaps no surprise that many people are unsure of what constitutes a healthy diet. Ruth Rogers, founder with the late Rose Gray of the famous River Café in West London, interviewed this week by Elizabeth Day in The Telegraph, has no doubts on the matter. In her view the key to healthy eating is lots of vegetables and seasonality. However, she also recognises that this does come at a cost. The Hemsley sisters, Jasmine and Melissa, who came to prominence a few years ago with their cookbook, ‘The Art of Eating Well’, have recently been criticised for giving advice based on ‘bad science’, but they do not claim to be nutritionists and their message at its heart is to eat slowly, to use ‘pure’ unprocessed ingredients and to enjoy both cooking and eating.
A mere 1% of the adult population and 5-9% of children in the UK suffer from food allergies. These are not the same as food intolerance https://www.allergyuk.org/food-intolerance/what-is-food-intolerance which does seem to be something more prevalent or of which we are more aware. However, for those of us not suffering from such problems, eating and cooking food should be amongst the pleasures of life, to be shared with family and friends – enjoyed mainly in moderation, but with occasional excesses not resulting in endless recriminations and guilt. If we pick our food from the massive variety available as a result of international trade and learn to cook it in the many different ways we have discovered from international travel, then it will be enjoyable, not a matter for constant examination and worry, or a source of anxiety. We do not need food to be fat-free, gluten-free (unless we have coeliac disease), diary-free (unless we are lactose intolerant) or sugar-free. Some people may need to avoid certain foods, but on the whole, what all diets should be is neurosis-free.
Lynda Goetz is the author of Top-Level Cookery for Two published by the New English Library 1981
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