What do you do when a strategy you’ve been executing for almost 30 years is plainly not working? If you’re the nutrition hierarchy in Australia, apparently the answer is you just keep doing what you’ve always done.
In 1981, the National Health and Medical Research Council (NHMRC) published the first set of guidelines aimed at making Australians healthier. They had published guides on what to eat since 1954 but these had been focused on the nutrients we need just to stay alive (rather than attempting to improve us).
The 1981 guidelines were different. For the first time they were aimed at preventing chronic diseases. Fat was blamed for the increasing rates of obesity and heart disease, so just like the American version (released a year earlier) our guidelines were focused on fat consumption, recommending we should “avoid eating too much fat”.
And that’s pretty much how the guide has read for the past three decades. In short, fat makes you fat and sick and you should eat a lot less of it.
I very much doubt that anyone actually pores over the guidelines while they fill their shopping trolleys, but many of us use them without realising it. They are the basis for the nutrition (daily intake) recommendations on every packaged food we buy. They form the foundation for every piece of advice any government agency or nutritionist gives us (from school canteens to hospitals). And every meal for our military forces is created using a policy based on the guidelines.
Because of this, the eat-less-fat message got through to us loud and clear. Between 1980 and 1995, the average Australian successfully decreased the amount of fat they were eating by 5% and the amount of cholesterol by a whopping 18%. We replaced the fat with carbohydrates (bread, cereals and sugar), increasing our consumption by 16.5%.
Unfortunately the obesity statistics went in exactly the opposite direction to our fat consumption. In 1980, two in five (39%) Australian adults were either overweight or obese. By 2008, only two in five weren’t (62% were overweight or obese). In just 28 years, all that low-fat eating (or was it the high-carbohydrate eating?) had managed to increase the number people with a weight problem by 58%!
Heart disease sufferers didn’t fare much better. The number of people afflicted increased by 12% between 1989 and 1995 (despite significant advances in health care for heart patients in that period).
Evidence that fat makes you fat and sick was suspiciously lacking by the time the revised guidelines came out in 1992. And the proof that the theory was nonsense was there in spades by the time the third release hit the streets in 2003.
A comprehensive review of the evidence had been published in the British Medical Journal in 2001. It concluded that despite decades of research (and thousands of people participating in random trials), there was “still only limited and inconclusive evidence” that the amount or type of fat you eat makes any difference to your chances of death by heart attack.
The guidelines are currently being reviewed ahead of publication of new version (hopefully next year). So can we expect a sudden change of heart from the nutrition elite? The US experience suggests pigs may be approaching the runway before that happens.
The US guidelines are being reviewed this year as well, but they won’t be changing much because (according to Meir Stampfer, a Harvard professor of nutrition and epidemiology who worked on the 2000 guidelines) scientists on this year’s committee know perfectly well what the evidence says, but few researchers want to shake the status quo or risk confusing the public.
In Australia, status quo is definitely the name of the game as well. The draft update to the new NHRMC dietary guideline released this week takes 678 pages to tell us that not much will be changing.
And you don’t have to look too far to see why. The NHMRC is heavily dependent on the Australian Heart Foundation for scientific review of the evidence on fat and heart health.
Despite the fact that heart foundation researchers have been publishing scientific reviews since 2003 that say things such as:
- “Dietary fat is not an independent risk factor for the development and progression of overweight and obesity”;
- “Eating patterns low in fat and high in carbohydrate may not be beneficial for lowering [heart disease] risk”; and
- “There is no direct relationship between total fat intake and the incidence of [heart disease]”,
None of that science has stopped them plastering their website with messages imploring us to eat less fat (or stopped them jumping into bed with margarine manufacturers and sugary snack makers). Maybe they’re scared the public (yep, you) will get confused by all that science?
For the past three decades the NHMRC and the heart foundation have been spending our hard-earned tax dollars telling us to eat less fat (and by implication, more carbohydrate). For at least the past 10 years, that message has been demonstrably wrong.
Now I guess that would be merely irritating if they’d been telling us that parting your hair on the left caused bad breath (it doesn’t). But millions of real people have made daily decisions about what to shove in their mouth based on this advice (whether they knew it or not) with the direct result that they are significantly fatter and sicker than they were the day before.
Its time those we trust with our health stopped worrying about confusing our pretty little heads and started worrying about the fact that their advice is killing us. I’d rather be confused than dead. How about you?
I thought it was inactivity that was making us fat and sick – if you eat more calories/kilojoules than you use you’ll get fat. Fat is high energy food, I thought the idea was to eat less fat to lower total energy intake and not to replace that energy with other types of food.
Interesting, as usual. Must get a copy of the book. Is it still in print? On-line distributor?
Huh? The advice (eat less fat / less saturated fat) might have been wrong, but the case that it has somehow made us “fatter and sicker” is just not made here.
David, it would be a good idea to check the references you direct us to and read whole sections rather than cherry picking bits to suit your arguments. Read the whole chapter on fats in the Dietary Guidelines and you will discover there is a difference between saturated fats and unsaturated fats. And when you quote overweight and obesity figures, check they are not self-reported heights and weights and whether they are only urban populations (figures differ when you include regional/rural people) and when you average the percentages of men and women who are overweight or obese, (which I assume you did), check your figures. From the DGs chapter on fat (your ref) for 1980, it works out as 36.4%; for 1983, it’s 39%; for 1989, it rises to 40.7%; and for 1995, it’s 55.4% (all NHF figures).
Read the DGs chapter on cereals and p32 will tell you that Australians consumed 69.1kg of bread per head per year in the late 1950s when almost no one was overweight or obese, which fell to 44.4kg/head/year in 1989.
As Tina notes, it is total kilojoule intake and an imbalance with kilojoule output that leads to excess body fat. The Heart Foundation also notes this, although you quoted only part of what they had to say. For example, you quote “Dietary fat is not an independent risk factor for the development and progression of overweight and obesity” (although you appear to ignore the word ‘independent’) but fail to add the following statement (that follows immediately in the NHF report). It says “Dietary fat may increase the risk of overweight and obesity indirectly by increasing the energy density of the diet, hence facilitating excess energy intake.”
As for blaming the Dietary Guidelines for making Australians fat – since when did many people follow them? A Melbourne study found that only about a third of women followed even half the guidelines (and the ones about reducing saturated fat were not among them) and only 2 out of the 10,561 women studied followed all the guidelines.
You can get fat by eating too much of almost anything (except vegetables – unless you fry your spuds in fat), but the major problems contributing to Australians’ current problems are too much alcohol, too many sweet drinks and too many foods high in kilojoules because their fat is made palatable by either sugar or salt. It’s not very scientific, but it’s enlightening to stand by the check-out in any supermarket and note that the fattest people have the most packets of crisps, biscuits, snacks, soft drinks and general junk food. The Dietary Guidelines do not recommend any of this stuff.
However, you do get to have your say on these matters. Check out the NHMRC website and send in a submission.
Dr Rosemary Stanton, nutritionist
What a crock of sh!t