To think the NHS’ dietary advice is wrong?

[Breakingmad]

Specifically this part? Surely we shouldn’t be basing our meals on starch?

Here’s the link to the full article. I really disagree with the ‘fat is the enemy’ message too re full fat milk, fatty cuts of meat etc.

www.nhs.uk/live-well/eat-well/

Yabu.

Most western diets contain too much protein/more than we need.

We need high fibre carbs - beans and pulses, some whole grains, starchy root vegetables.

Agreed on the fat though. In many cases where fat is removed worse things replace it (additives, processed crap or sugar).

Do those who say "all carbohydrates are sugar" believe that all carbohydrates are equally bad as each other - I mean, is a potato as bad as an orange as bad as a biscuit?

"Convincing evidence supports reducing saturated fat to decrease cardiovascular disease risk"

"High total fat-adjusted saturated fat intake was associated with increased postrate cancer aggressiveness"

(Higher) saturated fat intake negatively impacts upon breast cancer survival"

" Saturated Fat Is More Metabolically Harmful for the Human Liver Than Unsaturated Fat or Simple Sugars"

10g of carb will raise my blood sugar by exactly the same amount, be it high fibre low sugar whole grain or pure granulated sugar.

Thats unusual. Diabetics I know have said the opposite, whole grain makes a clear difference to processed/white

Also let's not forget, lots of vegetables and plants like beans & roots contain.... carbohydrates.

I agree with you. It may be different for others but if I eat as many carbs as recommended I feel awful and really struggle controlling my weight. Carbs gives me constant hunger, sugar cravings and energy spikes and drops. Ever since dropping it drastically I have become a healthy weight with more energy. I still give my children carbs with every meal, but do feel like they would be better without it too but I'm hesitant to go against the guidelines.

@lljkk

Don't think MM is a "qualified nutritionist". MM qualified as a psychiatrist after working as a banker. I can't even find MM on the GMC register, he relinquished that long ago. He stopped practising medicine in 1985 says Wikipedia, or maybe 1996 (other sources).

From what I remember of the last of his books I read, I suspect that had it been submitted to a journal rather than a book publisher it might not have made it. I’m assuming he didn’t think that anyone would actually check the studies quoted to make sure they were relevant to his point.

He does seem to be quite good at spotting a bandwagon though.

YANBU

Fibre is INCREDIBLY important for the body to function well. And these days most people don't have nearly enough (cooked healthily obviously).

That advice is really out of date. The NHS is really behind on a lot of this stuff.

My Mum reversed her diabetes through a very low carb diet as advised by a private Dr. The NHS nurse she saw gave her some very strange & incorrect diet advice. It’s true that carbs are converted to sugar in the body.

Also it's time they stopped disseminating 'one size fits all' guidance

No expert but if I have a carb breakfast of toast / porridge I am weak and shakey by 11ish. If I fast until lunchtime I am barely hungry at all and feel great (and have lost 2 stone). So I’m with MM.

By starch they probably mean as found in unprocessed vegetables not grains.

YANBU but you can’t have a sensible discussion over this at all. Many doctors spend very little time learning about nutrition. I feel torn about the dietitians. Yes it’s a protected job title but where does the university funding comes from? Does it come from any of the large food manufacturers? I’d like to know.
Having said that, Zoe Harcombe is worth of listening to.

Dr Unwin’s sugar chart is excellent and clearly illustrates how much sugar is in many “healthy” food items. phcuk.org/sugar/

@HalloHello

What should we be basing our meals on? Carbs aren't the enemy. Fat, I agree, is also not the enemy as such, although saturated fat is.

Sugar is the enemy. That's what we all need to be aware of.

Actually there is plenty of good evidence now to show that saturated fat isn’t bad for us. In fact it slows down our digestion, so sugars from carbs etc, are released into the blood stream slowly. The enemies are trans fats and refined sugar. The NHS still gives advice based on what was known in the ‘70s!

According to research the gut biome is very important to health. And the way to a healthy gut biome is to eat the greatest variety possible of plant foods - not just veg but fruit, nuts, whole grains including rice, seeds and pulses.

The body turns carbs into sugar. Thats why they affect the insulin mechanism.

This

it's still recommending unsaturated spreads like Flora. That seems very 1980s.

Actually there is plenty of good evidence now to show that saturated fat isn’t bad for us. In fact it slows down our digestion, so sugars from carbs etc, are released into the blood stream slowly. The enemies are trans fats and refined sugar. The NHS still gives advice based on what was known in the ‘70s!

I’m not sure this is entirely true. There was a meta analysis showing that saturated fat wasn’t bad for us, but they got the maths wrong and attributed a large study that did show adverse outcomes from diets high in saturated fats as not showing adverse outcomes. IIRC once they corrected that it changed the results of the meta analysis. They also managed to miss out a number of studies showing adverse effects which should have been picked up in their literature trawl.

I think there was a bit of a debate between the authors about whether the whole thing should be retracted.

The whole saga got a lot less coverage than the original ‘saturated fat isn’t bad for you’ coverage that the original publication of the paper got.

I think the issue is that when people hear carbs and starch, they think bread, pasta, white rice and chips. I am on a high carb low fat plant based diet, and I eat brown rice, sweet potatoes, white potatoes and other unprocessed starches, and it IS a good diet. I have energy, and I am losing weight slowly and steadily and have kept it off for three years now.

I still give my children carbs with every meal, but do feel like they would be better without it too

Please please please do not give children a low carb diet.

The "sugar" that carbohydrates (including unprocessed healthy high fibre carbs) is converted into is energy that children need. Our brains need glucose. It is not the enemy.

YANBU. This is outdated advice and does not reflect more recent research.

@RafaIsTheKingOfClay

Actually there is plenty of good evidence now to show that saturated fat isn’t bad for us. In fact it slows down our digestion, so sugars from carbs etc, are released into the blood stream slowly. The enemies are trans fats and refined sugar. The NHS still gives advice based on what was known in the ‘70s!

I’m not sure this is entirely true. There was a meta analysis showing that saturated fat wasn’t bad for us, but they got the maths wrong and attributed a large study that did show adverse outcomes from diets high in saturated fats as not showing adverse outcomes. IIRC once they corrected that it changed the results of the meta analysis. They also managed to miss out a number of studies showing adverse effects which should have been picked up in their literature trawl.

I think there was a bit of a debate between the authors about whether the whole thing should be retracted.

The whole saga got a lot less coverage than the original ‘saturated fat isn’t bad for you’ coverage that the original publication of the paper got.

Correct me if I’m wrong, but I think the meta analysis you are referring to is from 2010. There is considerable good research since then demonstrating that consuming saturated fat is not unhealthy and should form part of a healthy diet. This is one example from 2018 link.springer.com/article/10.1007/s13668-018-0238-x

Ok, starches...in moderation. Breads and pastas have NO BUSINESS taking up 40% of a person's plate. That information needs to stop.

Absolutely, it is 2010 and they are still using this guideline. I am disheartened that they do not use the 2019 information that the NHS has. All they have to do is administer the newer research. Why aren't they doing this?

But overweight people won't be following the NHS Eatwell recommendation. If they were, they wouldn't be overweight.

If you rationally examined their diet, you'd find higher amounts of sugar and processed food, rubbishy snacks etc and likely larger portion sizes than recommended and smaller amounts of wholegrain foods and fruit and veg, which is what the NHS recommends people eat, along with lean unprocessed protein containing foods in modest amounts.