Flavour of the Week

Defending “Nutrition Nannies”


flavour-of-the-week-logoWe read with great interest the debate articleNever mind those nutrition nannies” by Margaret Wente in the Globe and Mail this past Saturday. In the article, she highlights the many wrongs of nutrition experts and how confusing this has made navigating the nutrition waters for consumers.

We’re the first to admit when nutritional science takes it too far or is found to be terribly wrong. In fact, we’ve ‘fessed up to some major past missteps in part 1 and part 2 of our Nutrition 180s and Consumer Confusion posts, like trans fat, BPA and artificial sweeteners. But we also like to point out when the media grossly overstates things…

“The science isn’t settled after all. Almost everything the medical establishment, the health commissars and the nutrition nannies have been telling us for the past 60 years is just flat-out wrong.”

That hurts. And we couldn’t disagree (with most of your points) more!

#1. There’s no reason to worry about saturated fat. While we agree that saturated fat may not be the horrible villain it’s been painted to be for decades, recent findings are no green light to chow down on bacon double cheeseburgers!



“To start with, saturated fat won’t raise your cholesterol and give you heart attacks. Neither will butter or cheese. Do you hanker after a juicy marbled piece of steak? Help yourself!”

 

Ms. Wente goes on to quote a recent meta-analysis published in the Annals of Internal Medicine (1), which in a review of 76 studies found that intake of different types of fat – saturated or unsaturated – had little impact on risk of cardiovascular disease. It’s important to note that only 27 of the 76 studies were randomized controlled trials (the gold standard for investigating causation, not just correlation).

Even Dr. Walter Willett, who Ms. Wente quotes later on regarding vegetables, called the meta-analysis “misleading and [conclusions] should be disregarded” (via the Harvard Public Health website). Burn!

#2. Salt is not the enemy. We definitely take issue with the notion that consuming3,500 and 4,000 milligrams of sodium a day ” is a-okay! New evidence of the Institute of Medicine (2) has caused some questioning of recommendations to reduce sodium intake to 1,500 mg per day… but they certainly don’t recommend consuming the levels Ms. Wente suggests are “hard-wired.”

salt
“According to Dr. Gilbert Ross of the American Council on Science and Health, anthropological studies suggest that humans are hard-wired to consume between 3,500 and 4,000 milligrams of sodium a day – about what we do now.”


In the Institute of Medicine’s brief on the “Sodium intake in populations: assessment of evidence: summary of primary findings and implications for clinicians” report, they state that “the evidence on health outcomes is not consistent with efforts that encourage lowerng of dietary sodium in the general population to 1,500 mg/day” NOT that it’s time to bring back the salt shaker! Subsequently, the Canadian Hypertension Education Program (3) urge have updated their recommendations to limit sodium to 2,000 mg of sodium per day. Note: not upwards of 4,000 mg per day.

Also keep in mind that the American Council on Science and Health, a consumer advocacy group quoted by Ms. Wente as supporting higher sodium recommendations, was recently exposed to have some pretty strong ties to food industry giants like Coca-Cola and McDonald’s (as well as big tobacco). Hmmmm….

#3. Vegetables and fruits are “feh”. That one really stung. We could fill many blog posts simply extolling the well-established virtues of vegetables and fruit, and how delicious they can be. In our books, certainly not “feh” in taste or nutritional benefits!

brussels sprouts
“If you hate Brussels sprouts, you’re in luck, because they don’t do any good.”

 
We happen to like Brussels sprouts, and do believe that they and their produce brethren DO you plenty of good! Unlike the assertions regarding saturated fat and salt, this dig at produce is supported only by a Dr. Walter Willett quote: “Diet and cancer has turned out to be more complex and challenging than any of us expected.

Indeed, the relationships between dietary intake as a risk factor for cancer is complex and multifactorial, but we seriously doubt Dr. Willett is suggesting vegetables and fruit are useless in reducing your risk of cancer!  You would be hard-pressed to find a meta-analysis looking at risk of ANY chronic disease that suggests higher vegetable intake (and usually fruit too) is a bad thing.

#4. Nutrition studies are often flawed. Okay, she’s got us on this one and we totally agree! As we did in our four-part series The War on Spurious Science

oops sign
“They also expose the awkward truth about diet and nutrition studies: that they’re very, very difficult to do well. They often have so many confounding factors that the supposed link between cause and effect can be extremely shaky. And many diet studies yield results that later studies can’t replicate.”


All excellent points. We agree that pretty much ALL nutrition studies have major flaws that limit not only the ability to draw conclusions, but also to implement in any meaningful way with a “guarantee” of success. Because individual variability in response to dietary intake is impossible to capture. But short of randomizing people at birth to a specific diet or nutrition plan, measuring everything that goes in (and out) of them, and following them for a lifetime we won’t have perfect answers. But the science of nutrition is constantly evolving, hence some of the 180s that have been done in the past!

No Baloney’s advice? We agree with Ms. Wente on several points, namely the interactions between the food you eat and your risk of disease are very complex, and the relationships between the supposed “bad” foods and ill health are not as clearcut as we once thought them to be. But we are no “nutrition nannies”! We are constant and steadfast in the belief that Real Food Wins Every Time.

We’re sure a lot of the statements in the article are intending to be somewhat tongue-in-cheek, so at least Ms. Wente ends the article on a positive note:

“…here’s my best advice: Eat real food that you like, but not too much. Avoid sugar and carbs. Stay hydrated. And if you go to Paris, make sure to have lots of cheese.”

Okay, we wish she would have gone with “limit sugar and refined carbs”, however, the advice isn’t terrible. Though… she still didn’t mention to eat your vegetables and fruit. But still, not too bad.

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