Down the rabbit hole

Many assume that because I critisise the conventional approach to nutrition that I am a rebel. An alternative, slightly nutty medical practitioner in flip flops, long tribal skirt and myriads of beads hanging from her neck: “So, you have a neck of femur fracture? I recommend this delicious broth from organic frog livers followed by cupping of your right buttock and acupuncture to your left testicle”. To add insult to injury, I also teach yoga. Victoria has kindly forwarded to me this entertaining representation of a yoga teacher. Thank you, Victoria, I suddenly feel the urge to buy more Lululemon.

I’m not a rebel at all. In fact, I like rules and do not reject them out of some vestigial teenage rebellious principles. My “problem” is that I like to know the reasoning behind the rules. So when the Australian National Health and Medical Research Council, a.k.a the NHMRC, comes out with a Draft of The Australian Dietary Guidelines I do not snigger resentfully. Sure, I find it hilarious that of all the species on the planet humans are the ones who need the leaders of their pack to tell them what to consume to survive. Can you imagine “Dietary Guidelines for Lemurs: reduce incidental consumption of red beetles and increase the portion of green crunchy leaves daily”?

That way! I think...

Tell me what to do and if I agree with it, I’ll follow like a lamb.

So what’s the story?

The last revision of the Australian Dietary Guidelines (ADG from here) and the accompanying Australian Guide to Healthy Eating (AGHE) occurred in 2003. Things clearly haven’t been going that well since we need a multi-million dollar revision 9 years later. But of course, we all know that.

The fact that caught my attention is that the Drafts to ADG and AGHE are available for public comment. That means that you and I can make an individual online submission to the NHMRC until February 29, 2012 (here is the submission page link).

The development of new guidelines is a serious business. The official website, eatforhealth.gov.au, states that more than 55,000 scientific journal articles were researched. In addition, various experts in food, nutrition and health, food industry representatives and the public (not me?) were already consulted. The information on the evidence which formed the scientific basis of the guidelines is outlined in the Evidence Report, formally known as a Review of the Evidence to Address Targeted Questions to Inform the Revision of the Australian Dietary Guidelines (you gotta give it to the government, they are always thorough). Interestingly, the literature review was limited to 2002-2008.  If you think that’s a little Gen Y (nobody before us had any idea about anything) don’t worry. They also used the previous 2003 guidelines as a blueprint. So if somebody stuffed up writing those it’s really nobody’s fault.

One of the major differences in this revision is the emphasis on foods and food groups recommendation rather than nutrients. I am an optimist and I see it as a major step forward. The recent trend towards “nutritionism“, as Michael Pollan called it, resulted in the overhaul of the way we traditionally view food. Food used to unite us, connect families and countries, make us happy and healthy. Food circa 2012 is a combination of “only a 100 calories”, fat free, no-sugar, high fibre, healthy wholegrains, high in antioxidants, reduces cholesterol, calcium fortified, plus vitamin D, low GI…

Any recommendation to step away from nutrients gets thumbs up in my books. A further look into the guidelines however seems to contradict that fine premise, more on that later.

I’m sure that now you are all dying to hear what we should and should not eat. Please be aware that if you are in the US, Canada, Europe or anywhere else in the world where people do not routinely say “you little rippa” and “she’ll be right mate”, none of this applies to you. Please refer to your own government’s advice. Because everybody knows that human metabolism is government-dependent.

Guideline 1:

Eat a wide variety of nutritious foods from these five groups every day:

 plenty of vegetables, including different types and colours, and legumes/beans

 fruit

 grain (cereal) foods, mostly wholegrain, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley

 lean meat and poultry, fish, eggs, nuts and seeds, and legumes/beans

 milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat milks are not suitable for children under the age of 2 years).

And drink water.

Guideline 2:

a. Limit intake of foods and drinks containing saturated and trans fats

 Include small amounts of foods that contain unsaturated fats

 Low-fat diets are not suitable for infants.

b. Limit intake of foods and drinks containing added salt

 Read labels to choose lower sodium options among similar foods.

 Do not add salt to foods.

c. Limit intake of foods and drinks containing added sugars. In particular, limit sugar-sweetened drinks.

d. If you choose to drink alcohol, limit intake

Guideline 3:

To achieve and maintain a healthy weight you should be physically active and choose amounts of nutritious food and drinks to meet your energy needs.

 Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.

 Older people should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight.

Guideline 4

Encourage and support breastfeeding.

Guideline 5 

Care for your food; prepare and store it safely.

If you have read my blog before (or even had a look at my Start Here page) you might know that I have a slight problem with the Guidelines 1,2 and 3. Over the next few weeks I will be looking in finer detail into each of those guidelines and the evidence behind them with the aim to make an online submission. Feel free to join in the fun. Better still, send in your own thoughts on the Draft to the folks in NHMRC.

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22 thoughts on “Down the rabbit hole

  1. Hi Anastasia,
    This is getting in youch email rather than a response to your blog today. I had a long talk to Jamie Scott last week and he gave me your website address. I am an anaesthetist working at a range of public and private hospitals in Melbourne and I have been giving presentations on sugar to groups of nurses, doctors and other hospital staff for the past 2 years.
    I am currently engaged on an added sugar reduction study at Epworth Hospital in Melbourne. I am doing it jointly with a cardiologist and an ICU physician. We have recruited 96 staff members and have followed them up at 2 months. The weight loss results are encouraging. We will follow them up more rigorously at 6 months and hopefully publish our results.
    I have recently (6 months) become interested interested in the low carb-primal-paleo thing and think your blog is great!
    At some stage I would like to organise a meeting probably in Melbourne of all with an interest in this and would want to invite you. Also I’d like to pick your brain on a number of issues as I want to get up to speed on a number of low carb etc issues. Could you give me an email address I can reach you on and/or give me a call on 0417514601 – email address rod.tayler8@gmail.com
    Thanks,
    Rod Tayler
    Visiting Anaesthetist
    Epworth and Alfred Hospitals
    Melbourne

    0417 514601

    • Hi Rod, great to hear from you. Jamie mentioned you were interested and I was hoping you would get in touch. I will send you an email ASAP. Would love for us to share some knowledge and new ideas.

      • Hi Anastasia,
        Thank you so much for your blog, I’ve just found it and have browed through the pages with excitement. Not only it has valuable nutrition related content but also the statue of Lenin put smile on my face, I come from the same part of the world, or rather nearby 
        I’ve started paleo /primal eating 3 months ago now and since then have been trying to find the local network or online community including medical practitioners in Melbourne or Australia. Please count me in if you and Rod will decide to organise any gathering in Melbourne.

        Thanks again and good job!

        • Hi Inga, another Aussie! Congrats on changing your diet, you will reap more and more benefits with time. There are a few Australians (including a few Melbournians) chatting primal/Paleo on Twitter, come and join us.

    • It’s all true, Sam. We have practically adopted Arj Barker by now.
      I am not aware of any outside interests impinging on the nutrition information here (not that there aren’t any) but I do hear horror stories about the US. In either case we just tend to follow whatever you guys are doing in the land of the free.

  2. Whoa, the Shit Yogis Say almost makes me almost want to buy Lululemon as well, but too bad I can´t (life in Spain). thank you Anastasia and Victoria!

    Besos and ready to get my freestyle Yoga OOOnnnnnnmmmmmmmm
    Jenny

  3. At least there is no butter-shortage in the US and a grass-fed fat is free in the healthy food store near me. Fat phobia makes it all possible. Thank you, FDA.

    • I guess we are all indirectly benefitting from the scare tactics of the conventional wisdom. By the way, Galina, thanks for the mention on DietDoctor.com. Also great to have your insights on the Russian diet, past and present. It takes me back to my childhood :)

  4. “Please refer to your own government’s advice. Because everybody knows that human metabolism is government-dependent.”

    [evil grin]

  5. I’m sorry if I’ve encouraged you to overspend on Lululemon. As long as you’re not stocking up on this atrocity, we can still be friends: http://2.bp.blogspot.com/_oCrRmo1NSQ0/TICSUWESL-I/AAAAAAAAG84/tqVn6oiJoJs/s1600/harem+pant+group.jpg Lululemon Harem Pants- seriously… what were they thinking?

    I have a similar thought process to you re: reasoning behind rules. Just because I think dietary modification can remedy or prevent a number of ailments does not mean I am (or will be) a crystal-wielding, woo-loving, idiot. I’m ridiculously practical- lets use logic, evidence, and reason to get things right and keep things simple.

    • Oh- and I totally thought “I bet that’s because they only wanted to be bothered with articles easily available online” when you mentioned that they only looked at papers from 2002-2008!

    • It’s the challenge we will always face. If you are not mainstream you are already alternative, woo, crystals and homemade kombucha (not that there is anything wrong with kombucha). It’s like there is nothing in between. I reckon it’s just easier to label someone alternative so you don’t have to take them seriously. Heaven forbid, they might actually be right. As physicians we will have to draw some definite lines.
      And you can never have too much Lululemon, although I’m with you on harem pants, or as they are affectionally called here “poo-catchers”.

      • I must admit to owning the lululemon vinyasa scarf (pictured in the video) plus a pair of tres dear leggings dubbed “dressage pants” that were supposed to be equestrian-inspired, but basically they are fancy leggings with a tiny ruffle and cost too much! Oh, and a very awesome running shirt. Lululemon is the greatest threat to my kids college fund this side of icebreaker.

  6. I debated whether or not to make a submission, but then I read the draft and found some of what it said doesn’t even match the studies they cite. That’s when I decided to make a submission. Perhaps the dodgiest section is the reduce saturated and trans fats.

    Here’s my response to that section
    http://thepaleopremise.blogspot.com/2011/12/dietary-guidelines-for-australians-2011.html

    An important change (there aren’t many) is they now don’t make any recommendations on limiting dietary cholesterol.

    There’s also a very well written criticism of the USDA guidelines, some of which applies to the Australian ones too.

    http://www.nutritionjrnl.com/article/S0899-9007(10)00289-3/abstract

    • Hi Steven,
      Do it! Make a submission! I like what I see on your blog, great to have another Aussie on board. Thanks for the link, I’ll definitely take a look.

  7. Thanks Anastasia, I’ve actually been enjoying my low carb journey more with a time too. I’ve also started exercising after decade of neglect, some weight and resistance training. I’ve lost over 10kg and feel and look fitter. More and more I learn about the common conventional it makes me mad and upset as I haven’t been able to convert my family over. I’ve just got on tweeter :)

  8. i like the idea of regularly measuring growth of your children…what for exactly? no idea, just do it for no apparent reason?
    take them to doctor “she’s only grown 1 inch in the last 6 months doc, what do i do?”
    also that low fat is bad for you until you are 2 then it becomes good for you?!!

    • What do you do? Water them harder! Also, Eddie, didn’t you hear about the magical fat fairy who comes on the eve of every child’s 2nd birthday? One flick of her Ancel Keys-approved wand and voila! The child’s metabolism switches over to low fat mode. And from that day onwards every gram of fat that passes their lips ends up in the walls of their arteries taking them closer and closer to a heart attack in 50 years time. Who cares about brain development?

    • I think it takes a special type of determination and blind faith to close your eyes and carry on in light of the overwhelming evidence to the contrary. Katie, it’s great to see another health professional who prefers to use their own mind instead.

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