The spice of life

I’m sick of nutritional thought-terminating clichés. They are repeated ad nauseum everywhere from morning TV to a doctor’s surgery. One of my pet peeves is “Eat a wide variety of food“. I was not surprised to see this statement in the recent draft of Australian Dietary Guidelines.

What does it even mean?

There seems to be a strange notion floating around regarding our human nutritional  requirements. Since we need a wide variety of micronutrients and each food (apparently) only contains a limited amount, we best to stay on the safe side and eat a little bit of everything. This idea is perpetuated by the constant mentions of newly discovered “miracle” compounds in the media.

Reading all these you would be forgiven to think that to obtain optimal health you need a fridge full of exotic berries from Africa, a pseudo-grain from South America, tea leaves grown on a particular valley in Sri Lanka and a vegetable you have never heard of from the Pacific islands.

The ADG draft pitches another argument in support of the variety theory:

“Dietary variety has the benefit of diluting potential toxicants found naturally in food”

They go on to mention the potential vitamin A toxicity from excess liver consumption (most westerners today would gag at the mention of liver anyway) and a potential of mercury poisoning from fish for pregnant women (enough to scare off anyone from consuming any measurable quantities of DHA/EPA. What? Babies’ brains need those?)

This makes no sense (#FFS).

Let’s take ourselves from our first world everything-is-readily-available-when-I-need-it mentality and apply some good old fashioned common sense and a bit of evolutionary logic. Is it really likely that the compound which will turn on some beneficial gene expression in humans world wide just happens to be only found in a berry from Colombia? Hey, evolution, that’s a major oversight! It took the rest of us, non-Colombian population, 2 million years to work out how to build planes and stuff and this perfect nugget of nutrition was sitting there all this time?

It amused me no end that quinoa made it into the list of cereals recommended to be eaten as part of the 5 food groups daily (Guideline 1) in Australia.

“Eat a wide variety of nutritious foods from these five food groups daily: 3. grain (cereal) foods mostly wholegrain, such as bread, cereal, rice, pasta, noodles, polenta, cous cous, oats, quinoa, barley”.

But enough about South American wonder foods. What about a humble blueberry? All those anthocyanins and phenolics repairing the oxidative damage inflicted by the food group number 3. Has to be good for you, right? And lucky for us, health-conscious consumers, blueberries are available all year around courtesy your friendly local supermarket giant.

I still remember picking wild blueberries in a Russian forest as a child. We looked forward to a month-long blueberry season,  doing a few forest trips around July to check if berries were ready for picking. Some super keen villagers would go a few days early just to beat the crowds, their payback for keenness was a few extra hours of forest-wandering. The official start of the season would see whole families venture into the woods, each person laden with a ten litre bucket, me, a child, proudly carrying a one litre container. People would gorge on blueberries for a few short weeks, sell the excess, make mountains of blueberry jam. Every kid would be walking around with a dead giveaway of blueberry gluttony: purple lips. And then it was over for another year.

Think of it next time you buy your punnet of blueberries in the middle of February.

In the world where most fruit, vegetable and berries are farmed and/or transported across the planet we have lost a concept of seasonality. Even a 100 years ago these foods were not available everywhere all year round.  Is there any scientific evidence to suggest that eating food out of season or out of your area is harmful? Nope. But I don’t see any sense in chasing variety for variety’s sake.

“The most recent dietary survey data available for Australian adults – the National Nutrition Survey 1995 – showed an increasing number of foods being consumed by adults in that year compared with 1983 [44]. It is expected that the variety of foods consumed has continued to increase since 1995. This is largely as a result of cultural diversity in the population arising from waves of immigration from European countries after World War II and Asian and African countries since the 1970s [99, 100]. Initially, new varieties of fresh fruit and vegetables, grain (cereal) foods and different types of meat and legume/beans became available. Increasing demand for convenience and/or fast foods – also as a result of changes in social and economic conditions – has led to the availability of approximately 30,000 different types of foods and drinks [101]. However, many of these – particularly snack and fast foods and drinks – are energy-dense and nutrient-poor, so care is required to choose diets consistent with the Guidelines [102]. ” (the draft of ADG)

(my bold italics)

30,000 types of food? Looks like our diet is varied enough. And it’s not just the snacks, fast foods and drinks. Ask your grandmother if she knows what cous cous is (forgo this step if you grandmother is from North Africa).

Wow so much variety!

I am not for a minute suggesting that you should stick to the boring bland diet of steak and 3 veg (of which one is potato, the other is corn, the third is beans). But the concept of “you will develop a secret micronutrient deficiency unless you eat a huge variety of foods just in case” is dubious at best.

Once again they missed the mark, mistaking quantity for quality.

Milan vegetable market.

The definition of insanity…

It is now exactly 3 days until I start working. To say that I am nervous would be an understatement of the century. For now, I’ve been pushing any hospital-related thoughts to the deepest corner of my mind (from whence they tend to re-emerge just as I’m falling asleep causing me to break into cold sweat). My plans for my last few days of freedom and frivolity are to soak up as much sunshine as possible, ride my bike, watch really bad action movies from the last century (Lethal Weapon, yes, really) and overall do as little as possible.

In between all these exciting activities I also read the draft of the new Australian Dietary Guidelines, as a special type of punishment for my laziness. 288 pages of government-speak is no joke. I find myself re-reading the same paragraph 3-4 times and its meaning still devilishly eludes me. I don’t want my readers to suffer the same fate so I will be feeding you those pearls of wisdom one post at a time. Just a few statements and observations for you today.

“Diet is arguably the single most important behavioural risk factor that can be improved to have a significant impact of health”

I was very impressed with this profound statement in the Introduction. I am sure many of you feel like doing a little fist pump in the air: finally, the role of diet is getting recognised and appreciated not just as something that might make one fat and obese. But also as an important health determinant. Good stuff.

However, seeing diet as a “behavioural” problem has never sat well with me. We fall into that thinking all too easily. Ever glanced over an obese woman eating an ice-cream and did a little “tsk, tsk, tsk” to yourself? But overweight has not always been seen as primarily a  character flaw. One of Leo Tolstoy’s best characters, Pierre Bezukhov, (for those of you who braved “War and Peace”) is described as a big stout man. And no, it is not a reflection of his lack of willpower. And yes, he gets the girl in the end.

Venus and the Lute Player, Titian c.1560. Source Wikimedia Commons

Interestingly, because the media and government health agencies are so preoccupied with being PC, they use different tactics to accuse overweight and unhealthy people of being disgusting slobs without actually calling them “disgusting slobs”.

Here is one used in the Introduction to the Guidelines in the chapter dedicated to adherence.

“Adherence to dietary guidelines in Australia is poor”.

=disgusting slobs continue ignoring our well-meaning advice and insist on becoming a chronic disease burden while laughing into their French fries.

It is such a sad sentence I think they need an emoticon :(

A couple of paragraphs later:

“There have been changes in the intakes of macro-nutrients over the past 3 decades, generally in the direction encouraged by previous dietary guidelines” (my bold italics)

Say what? The compliance is SO POOR that people change their intakes in accordance with your guidelines? (I wrote a post about one of the multi-million dollar lifestyle modification campaigns in Oz and the subsequent “non-adherence”.)

It all becomes clear when we see this statement in a table form.

Call me an optimist but looks like both men and women REDUCED their fat intake, INCREASED their fibre intake and INCREASED their carbohydrate intake.

Kiddies INCREASED their dietary fibre (somebody is actually eating their bran muffins!), INCREASED protein and INCREASED carbohydrate.

It also looks like reduction in fat didn’t result in reduction in total calories consumed. Bugger me! I thought fat being more calorie dense and all…

Does anybody need a reminder on how the obesity and overweight rates in Australia went while we were busy modifying our intakes “in the direction encouraged by previous dietary guidelines”?

“I don’t know why the sacrifice didn’t work.

The science was so solid.”

King Julien XIII, Madagascar 2

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.