New Nordic/Scandinavian public recommendations on diet and nutrition will be published this autumn. According to an article (English version-Google translation) published in a Swedish newspaper last week the new guidelines will underscore the risks of animal-derived saturated fats. The article is written by three Swedes, two of whom are experts in the field of health and nutrition.
The three start by saying that Swedish scientists and experts on the relationship between diet and health have recently warned about the risks of diets rich in animal fat, often termed LCHF (low carb high fat) and its relationship with the risk of heart disease and stroke. They write: “The message from the experts is clear: The fat diets are a threat to public health in Sweden“.
Furthermore they write: “Studies of few hundred thousands people who have been followed for more than 30 years have lead the experts to a final agreement: The consumption of food products rich in animal fat, and refined animal products must be reduced substantially. A question should be asked whether licensed physicians should be allowed to prescribe LCHF, which is not supported by scientific studies”.
Metabolic Syndrome – A Man-made Pandemic
The metabolic syndrome is characterized by three of the following: 1) elevated blood sugar 2) high blood pressure 3) elevated blood triglycerides 4) Low levels of HDL-cholesterol (the good cholesterol) and 5) abdominal obesity. The common denominator in the metabolic syndrome is insulin resistance.
The prevalence of metabolic syndrome has increased dramatically in recent years, paralleling the obesity epidemic. In the United States, where almost two thirds of the population is overweight or obese, more than one fourth of the population meets diagnostic criteria for metabolic syndrome. In a study published in 2008, the prevalence of metabolic syndrome was around 15 percent in a middle aged Swedish population. Among these individuals obesity is a dominant characteristic.
A systematic review and a meta-anaysis published less than a year ago indicates that carbohydrate restriction has a favorable effect on cardiovascular risk factors. Such a diet leads to weight loss, reduces abdominal obesity, lowers blood pressure, elevates HDL-cholesterol, lowers blood levels of triglycerides and lowers blood sugar. Blood levels of hsCRP are reduced indicating less inflammation.
Another systematic review of randomized controlled trials compared low-carbohydrate vs. low fat/low calorie diets in the management of obesity and related conditions. There were significant differences between the groups for weight, HDL-cholesterol, triglycerides, and systolic blood pressure, favoring the low carbohydrate diet.
So, is there a reason to question whether licensed physicians should be allowed to recommend carbohydrate restriction which most commonly involves increased consumption of dietary fats?
Maybe we should ask ourselves whether licensed physicians should be allowed to not inform individuals with metabolic syndrome about this effective approach.
Will Nordic Experts Lead the New Demonization of Saturated Fat?
The three Swedes point out that new Nordic guidelines written by Scandinavia´s most renown experts will be published this autumn. “The recommendations will highlight the risks of consuming animal-derived fats, which is in line with recommendations from public authorities in the United States, and the European Union. The Nordic guidelines will focus less on the amount of fats and carbohydrates consumed, but more on which types of fats or carbohydrates are good for our health and which are not. Right sorts of fats are oils and other plant based fats, but not animal-derived fat from meat, butter and cream. ”
Furthermore they believe that “with the new Nordic recommendations, the Nordic scientific community will have had their say on the LCHF issue“.
Then they go on to suggest that a special tax should be put on products containing animal and diary fat: “In March 2011, the Danish government started to tax 16 DK for every kilogram of saturated fat in dairy and meat products. Such a tax is needed in Sweden in order to be able to deal with chronic diseases such as heart attacks, strokes and other cardiovascular disease. Now it is time for our politicians to react“.
The Usual Suspects
Once again it seems that public recommendations on diet and nutrition are heading down a narrow road in order to try to establish dietary recommendations that suit everybody. Individual variation and individual needs are not taken into account. Why should we recommend the same type of diet for a young healthy, exercising, normal weight university student, and a fifty year overweight person with abdominal obesity, high blood pressure and pre-diabetes.
Nobody can deny that the obesity epidemic coincides with the initial dietary recommendations put forward almost forty years ago. These guidelines recommended that total fat consumption be reduced and carbohydrate consumption increased. We were led to believe that if we eat less fat we won´t get fat, and we won’t be hit by heart disease.
For the last 35 years fat consumption in most developed countries has diminished. Nobody denies that the prevalence and mortality from coronary heart disease has decreased at the same time. This is due to multiple factors, one of which may be a change in dietary habits. However, despite the dietary recommendations, we have an epidemic of obesity and terrible metabolic disorders threatening to seriously increase the prevalence of many chronic diseases of modern society.
We probably all agree that the consumption of trans fats and refined meat products should be diminished. However, there is no scientific evidence that reducing the consumption of saturated fats will make us live longer or reduce the risk of dying from heart disease.
Furthermore, LCHF is not synonymous with eating more saturated fats. Although you cut down on carbohydrates and increase total fat consumption, you could very well avoid saturated fats and choose mono-and polyunsaturated fats and protein (fish, nuts, legumes and poultry).
Taxing food products in order to improve public health has been debated for many years. Of course, the first thing you have to be sure of is that the product you are taxing is unhealthy. Who’s decision is that? Let’s say a person with overweight and metabolic syndrome loses weight and improves his health by avoiding sugar and eating more fats, including saturated fats. Is it fair to charge him/her extra taxes? By the way, I believe the Danes have abandoned the fat tax, partly because it drove customers to buy food in Sweden and Germany.
If you ever saw the movie The Usual Suspects from 1995 you may remember the phrase “The greatest trick the Devil ever pulled was convincing the world he didn’t exist“. The saying may be traced to the French poet Charles Baudelaire.
And actually, I haven’t mentioned sugar in this article. But it’s not because it doesn´t exist or because it is innocent. For the last four decades, paralleling the decreased consumption of dietary fats and the obesity epidemic, the consumption of refined sugars, fructose in particular has skyrocketed. If you don’t think sugar plays a role in the obesity epidemic and all the metabolic and inflammatory diseases of modern society, the saying that “the greatest trick the Devil ever pulled was convincing the world he didn´t exist” might actually be true”.