Aussie dieticians are wrong about fat

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By Leith van Onselen

In the wake of a report issued by the UK National Obesity Forum and Public Health Collaboration calling on patients to eat more fat (including saturated fat) and eat less carbs to tackle obesity and type 2 diabetes, Australia’s dieticians have once again defended the existing failed dietary guidelines. From The Australian:

Eat Fat, Cut the Carbs and Avoid Snacking, by the National Obesity Forum and Public Health Collaboration, calls for an urgent overhaul of current dietary guidelines.

The authors cite a number of studies, before concluding that a low-carbohydrate, high-fat diet of real foods is an “acceptable, effective and safe approach” to weight loss and health

They say eating fat does not make you fat, saturated fat doesn’t cause heart disease and that full fat dairy is likely protective, and processed foods labelled low-fat, lite, low cholesterol or proven to lower cholesterol should be avoided.

“Eat fat to get slim, don’t fear fat, fat is your friend,” says consultant cardiologist Dr Aseem Malhotra, advisor to the forum.

The Dietitians Association of Australia (DAA), which has 5900 members, defended the Australian Dietary Guidelines – similar to those in other countries – saying they were evidence-based and provide a framework for healthy eating.

“A diet high in saturated fat is a risk factor for heart disease, one of our nation’s biggest killers,” the DAA said in a statement.

“Saturated fats tend to increase LDL (unhealthy) cholesterol in the blood and current evidence suggests these should be eaten sparingly to minimise the risk of heart disease.

Seriously, what planet are Australia’s dieticians on? They are about two decades behind the latest science.

Since the Australian food pyramid was first introduced in 1982, it has told Australians to consume large quantities of high glycemic foods, such as breads and cereals and minimise fat:

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This food pyramid remained largely unchanged for 33 years until the pyramid was improved in 2015 to promote the importance of unrefined carbohydrates like vegetables and lessen the importance of refined carbohydrates like breads and cereals:

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Common amongst both pyramids, however, is the recommendation to consume large quantities of carbohydrates and minimise the consumption of fats.

The problem with this recommendation is that consuming carbohydrates generally elicits a strong glycemic response (i.e. raises blood sugars quickly) whereas consuming fats elicits almost no glycemic response (i.e. keeps blood sugars stable):

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Given Type-2 diabetes is a disease of insulin resistance, why on earth would dieticians recommend eating foods that elicit the greatest blood sugar response? It makes absolutely no sense.

The dieticians are also way behind on the issue of saturated fat. The latest science shows that LDL – the so-called “bad cholesterol” – is a useless measure on its own. Rather, what is most important is the composition of LDL particles (i.e. small dense LDL particles are dangerous whereas large fluffy ones are benign), the level of triglycerides in the blood (the lower the better), and the level of HDL – the so-called “good cholesterol” (the higher the better). Dr Peter Brukner has a good explanation of what to look out for here.

The latest evidence shows that consuming saturated fats, in the absence of high carbohydrates, improves the cholesterol profile, namely by:

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  • Lowering blood triglycerides (good);
  • Raising HDL (good);
  • Raising LDL, but changing the profile from small dense to large and fluffy (good); and
  • Raising total cholesterol (indifferent).

In fact, 25 separate randomised control trials comparing a low-carb, high fat (LCHF) diets against high-carb, low fat diets shows the LCHF dieters having 3.5 times better health outcomes than low fat dieters with more improved cholesterol profiles, better blood sugar control and lower blood pressure. Download the comparison spreadsheet for yourself here.

The fact is that the link between saturated fat, cholesterol and heart disease was only ever a hypothesis and was never proven, and more and more scientists are coming-out against the standard dietary guidelines, as revealed last year by ABC’s Catalyst:

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It’s time for the Dietitians Association of Australia to get with the program and update its thinking on diabetes, saturated fat, and heart disease.

[email protected]

About the author
Leith van Onselen is Chief Economist at the MB Fund and MB Super. He is also a co-founder of MacroBusiness. Leith has previously worked at the Australian Treasury, Victorian Treasury and Goldman Sachs.