Bonnie Modugno, MS, RD - Chaos in the Nutrition World
Whole-fat dairy products may lower diabetes risk, so says a Harvard study in Annals of Internal Medicine. The following day Stone Hearth Newsletter noted a study in the American Dietetic Association Journal that states high-fat dairy product eaters have a 40% higher risk of mortality.
Let the food fight begin.
Actually, this food fight has been brewing for about 100 years. In Good Calories, Bad Calories (2007), Gary Taubes painstakingly chronicles the historic struggle to establish the nature of a healthy diet. Of note is a particularly one sided battle over the last forty years.
The proponents of a high carbohydrate, low fat diet won out with a little help from McGovern’s Senate Select Committee on Nutrition that established a form of the US Dietary Goals in 1972. One researcher, Mark Hegsted, was the primary nutrition resource and the proposed goals reflected his position. Many researchers suggested that the high carbohydrate, low fat recommendations were premature, but were paid no heed. USDA adopted the effort as their own and continues to adhere to a one diet fits all orientation.
2010 DIETARY GOALS NOT UNIFORMLY SUPPORTED
The 2010 USDA Dietary Goals were made available for public comment earlier this year. They don’t differ enough from the earlier versions. The scientists on the committee continue to support a higher carbohydrate, low fat diet. There is more attention to how food is grown. There is more emphasis on whole foods. But that doesn’t go far enough for most of us who recognize there is not one right way to eat.
From Walter Willett of Harvard, a reknown nutrition epidemiologist, to Andrew Weil, MD, a media savvy and published practitioner in Arizona, there has been tempest brewing in the teapot. Both of these scientists have blunted stated that fat is not the problem. The nutrition factor most significantly aligned with obesity and other lifestyle disease states is refined sugar and starches. The diseases include cardiovascular disease, diabetes, and cancer as well as a slew of other inflammation based maladies.
LOW FAT OR LOW CARB?
So what is the problem, sugar or fat? The question underscores a bigger problem. The heart of the dilemma is not which diet is better. The real issue is what mix of carbohydrate, protein and fat works best for any one person. This question strikes a fatal blow to the concept that there is one right way to eat. There isn’t.
People are complex organisms, with a host of genetic traits that are influenced by a plethora of environmental factors. It is pure hubris to think there is one right way to eat. The sooner the scientific community comes to acknowledge this truth, the sooner the chaos clears up.
There is no chaos when health professionals recognize that each individual needs to find a range of food intake that helps them metabolize energy effectively. There is no confusion when a person discovers what balance of carbohydrate, protein and fat works best. There is a public health nightmare in the making.
INSIGHTFUL, SKILLED PROFESSIONALS NEEDED
If people are so different, health professionals will need to dramatically improve their game. There is no place in this new world for simplistic diet sheets telling people what food to avoid and what food to include. There is no place for pontificating on the virtues on any one diet. Anyone offering nutrition advice can no longer hinge recommendations on what works for them. That goes for all the lay people anxious to tell others what to eat, too.
There is fabulous opportunity for thoughtful, skilled professionals to assist people in determining an approach to food that works. With more sophisticated insight, dietitians can actually use their science based training to help clients understand their experience with food. Physicians and all other health care providers will either need to step up themselves or refer appropriately.
KNOWLEDGE IS NOT BEHAVIOR
There will be no universal diet plans or diet prescriptions. Dietitians will need to work with the patient to figure out the answers. This will take time, more than the usual 15-30 minute nutrition consult with little follow up. We will finally reach a turning point in nutrition counseling. Effective counseling will replace nutrition sessions that focus on delivering education and assessing knowledge. Knowledge is not behavior.
Now the real dilemma. Who is going to pay for this?