Public Health England Decries Low Carb Diet

Low carb diets were called out on Thursday, March 17 by Public Health England. The agency stated that carbohydrates are the backbone of a healthy diet and that meals low in carbohydrates do not provide vital nutrition because they lack the fiber crucial for digestion.

The agency doubled down on its healthy eating advice to urge Britons to consume more potatoes, pasta, bread, and other starchy carbohydrates to increased fiber intake by more than half, from 19g a day to 30g a day.

In addition to five portions of fruit and vegetables a day, people need the equivalent of two wholemeal breakfast cereal biscuits, two thick slices of wholemeal bread and a large jacket potato with its skin. The experts declared that it was important to choose wholegrain options to obtain the most nutrition from carbohydrates.

The Eatwell Guide increases the amount of starchy carbohydrates from 33 to 37 percent of recommended daily intake.

The officials also warned people not to rely on supposedly healthy “juicing” diets for their nutrition. Fruit juices and smoothies should be limited to a

single 150 ml glass per day because they are packed with sugar and rarely include fiber. An agency spokesperson said, “There seems to be a juicing trend, and low-carb diets are popular, but the scientific evidence is telling us otherwise."

Fiber helps the body digest food, as well as keeping people feeling fuller for longer. Fiber is also known to protect against certain cancers, heart disease, and diabetes. One in nine cases of bowel cancer is linked to eating too little fiber.

Sian Porter, of the British Dietetic Association, said: "You still need to watch your portion size, but starchy carbohydrates should form the basis of any diet."

The guide also urges Britons to eat less cake, biscuits, and sweets, red and processed meat, and dairy. However, Terry Jones, of the Provision Trade Federation, told Farmers Weekly this was a "kick in the teeth" for hard-pressed dairy farmers.

He added: "I find it staggering that, at a time when ministers are expressing support for the sector, an agency of government should not only encourage consumers to reduce consumption of dairy products, but also seemingly ignore the positive role they can play in public health."

Doubling down in their encouragement of eating carbohydrates is not the way to create healthy eating and will encourage more obesity and more diabetes in Great Britain.

Is the High Carbohydrates Era Finally Ending?

Yes, the high carbohydrate advice is slowing, but it is still not ending. With the Academy of Nutrition and Dietetics being a puppet of Big Food, it will take more than a few people advocating for the healthiness of low carbohydrates for people with type 2 diabetes to move the dial.

Dr. Osama Hamdy, Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Management at Joslin Diabetes Center, Assistant Professor of Medicine at Harvard Medical School does say that a low carbohydrate diet is beneficial for people with diabetes. We need more medical professionals saying this and pointing out that the Dietary Guidelines produced every five years for the USDA and HHS are based on weak scientific evidence.

The guidelines were started in 1977, when the Select Committee On Nutrition and Human Needs of the US Senate chaired by Senator George McGovern recommended that people increase their carbohydrate intake to 55 to 60 percent of the total caloric intake, while reducing fat consumption from approximately 40 percent to 30 percent of the total daily calories. The aims of these recommendations were to reduce health care costs and maximize the quality of life of Americans.

The proposed cost saving was predicted to result from the possible reduction in the incidence of heart disease, cancer, as well as other killer diseases. Despite controversy, the United States Department of Agriculture (USDA) created in 1980 a food pyramid representing the optimal number of servings to be eaten each day from each of the basic food groups. Carbohydrates were placed at the base of the pyramid (making up the largest portion of caloric intake, 6 to 11 servings per day), and fats were placed at the tip of the pyramid to show that they should be “used sparingly.”

As we all know now, these recommendations turned out to be the opposite of what the USDA expected. What has been aptly described as a “national nutritional experiment” contributed to the increased prevalence of obesity. And, contrary to the main aims of the recommendations, the prevalence of type 2 diabetes and cardiovascular disease went up significantly.

What happened should have been expected. An increase in carbohydrate intake results in an increased insulin response to carbohydrates, which through its fat-storage promoting action increases obesity. And, it has been shown, that accumulation of fat inside the belly (visceral fat) is associated with chronic inflammation that is directly related to type 2 diabetes and heart attacks.

The problem is especially severe for people who already have type 2 diabetes. We know today that increasing the carbohydrate load in the diabetes diet increases what is called glucose toxicity and consequently increases insulin resistance, triglycerides level and reduces beneficial HDL-cholesterol.

Now that we are past the history, Dr. Hamdy isn't really for low carbohydrate food plans. He only advocates a small reduction from 55 to 60% to 40 to 45% which is only a quarter reduction instead of much lower that was advocated by Drs. Elliot P. Joslin and Fredrick Allen, the fathers of diabetes science, successfully treated their patients diagnosed with fatty diabetes (later known as type 2 diabetes) with a diet very low in carbohydrates. Bold is my emphasis.

How Dr. Hamdy considers this much of a reduction leaves me wondering why he even makes that statement. I also have to wonder where he found the information that most medical societies have departed from the recommendation of high carbohydrates intake. A few, yes, and they still believe in low fat which is also harmful and makes for slow weight loss.

Dr. Hamdy is more right when he writes - “Unfortunately, many healthcare providers and dietitians across the nation still recommend high carbohydrate intake for patients with diabetes, a recommendation that may harm their patients and contribute to increasing obesity and worsen diabetes control and consequently increase the chance of developing diabetes complications.” He may as well be writing about his position of high carbohydrates

Be Careful of People Advising Against Low Carb

Before I learned that the glycemic index for foods was developed by using only healthy people, I was an advocate for using low glycemic foods. Now I only use the index as a guideline and nothing more. Several researchers have also recommended using them as guides because they have discovered that certain chronic illnesses do not yield the same results.

Now the author of the glycemic index, Professor Jennie Brand-Miller, is speaking out against very low-carbohydrate meal plans (diets). She was answering this question - If carbs increase my blood glucose levels, wouldn’t a low-carb diet (or even a very low one) make better sense for managing it? Her answer was “In theory, a low-carbohydrate diet seems a logical choice if your aim is simply to reduce blood glucose levels. But presumably your goal is long-term, optimum health with good glycemic control and reduced risk of chronic disease. If so, very low-carbohydrate diets need a little caution because you will be missing out on the micronutrients, antioxidants, phytochemicals and fibre that plant foods (fruit, starchy vegetables, legumes and grains) provide.”

She then avoids talking about fats of any kind when she continues, “In studies that tracked individuals for long periods of time, those eating the least amount of carbohydrate and very high amounts of protein had almost double the risk of dying during the follow up period, especially from cardiovascular disease. You might also find this very low carbohydrate diet so extreme that it's hard to lead a normal social life and enjoy eating because you have to exclude so many favourite foods (think potatoes, oranges and honey).” Bold is my emphasis.

Then she refers to this from Nutrition in July 2014 which the press release can be read here and my blog on it here. She says that the authors, “Call for a complete reappraisal of dietary guidelines for diabetes management and they present evidence for dietary carbohydrate restriction as the first approach in diabetes management. I do think there is some truth in the benefit of modest reductions in carbohydrate intake (to say 40–45% energy). However, I’m not in favour of further reduction because it’s just too hard for most people to comply. Conversely, I'm not recommending an increase in carbohydrate intake to 65% of calories to someone with diabetes; it strikes me as "pushing the envelope" too far.”

For people that do talk about low carb and at least medium fat, read these blogs by David Mendosa, Managing the Condition of Diabetes, Managing Diabetes with a Strange Fat, and Saturated Fat is Back for People with Diabetes. An article in Medscape talks about different fatty acids and how they affect us.

She concludes her article about low carb diets with this statement. “I believe that very low-carb diets are unnecessarily restrictive (bread, potato, rice, grains and most fruits are off the menu) and may spell trouble in the long term if poor quality food takes the place of high quality carbohydrate. Modestly higher protein/low GI diets strike me as a happy medium between low fat and low carb-diets – you can have your carbs, but choose them carefully.”