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Monday 18 January 2010

5 A Day and Other Urban Myths

In the UK, politicians feel it incumbent upon themselves, to dictate lifestyles and healthcare for their citizens. They develop quangos to promote these objectives and protocols to achieve them, are foisted onto often overworked Doctors in the form of QOF's ( quality outcome frameworks ). The Doctors involved are rarely, if ever consulted to see if these are of value to his/her patient cohort and most will follow the dictat, either because they can't be arsed to check the science, or the money's too good to turn it down.

We also have that illustrious body, the Food Standards Agency, who exhort us to get our '5-a-day', take exercise and eat a 'healthy' balanced diet which shuns virtually all forms of fat. Well, is there any use in doing this or not and where does the information upon which it's based come from ? It was, to all purposes plucked from the ether. The 'balanced diet' advised, is largely based upon  limited protein and large amounts of starches and very limited fats and certainly no saturated fats. This is lunacy of the dangerous kind and all it's likely to achieve, especially for the overweight, middle aged, is a descent into obesity and/or diabetes. It seems that this Agency, with its vast budget for TV and Newspaper advertising, is isolated from the real world and knowledge of  the rising tide of obesity that Western Society is seeing, along with little in the way of a reduction in CHD and CVD (heart disease) together with strokes.

Since this dictat to the proletariat, was formulated in the 1980's to lower these disease factors, things have steadily become worse, yet no one seems to see a causal link. Surely, it's intuitive that if a policy is pursued, that after 30 years is yielding no fruit (sic); in fact is worsening a situation, then is it not time to halt and at least review the position ? Is it not sensible when one is in a hole to cease the excavation process (and review the depth) ?
The arch devil, most hated of all is fat, particularly saturated fat and we are all ordered to cease it's consumption because our arteries are clogging up with it, just like those water pipes in hard water zones. They even use this as an illustration in the advertisement. It's viewed as the ghost at the feast; the elephant in the room and we will suffer long and painfull deaths if we even look at dripping. The elevated lipids (fats) consumed are held responsible for just about everything that goes wrong in the human body, especially CHD, CVD, Stroke and Cancer. This has spawned an industry devoted to low fat products, cholesterol reducing supplements (even magarine!). low or zero fat milk and worst, soya milk!

This is frankly complete and utter tosh and neatly brings us to the belief that fat and cholesterol are the same, which they aren't. Cholesterol is the essential steroid metabolite found in all cells in animals and is transported throughout the body in blood plasma. Without it we are all dead. We could not absorb fat soluble vitamins, manufacture any steroid hormones or have a beating heart. It is more important than almost any other element of our cellular make-up and is largely, but not completely made in the body. Except in incredibly rare cases we all have the correct amount to sustain our lives. Whilst it is associated with LDL and HDL it is not either of these and elevated levels of these lipoproteins does not confer any real indication of health or otherwise.

Before every one starts to nod off  lets get back to fat. Fat does not instantly turn into cholesterol, in fact we could not eat enough of any fat or any food come to that, that would supply our daily needs for cholesterol. It is, in the main, synthesised in the liver, or in fact every cell in our bodies except the brain. If you eat less cholesterol yielding foods your body simply compensates by producing more of it internally. If, however you eat more and more starches (=carbohydrates = glucose) you will in fact become fatter as a result and likely increase your risk of the killer diseases including of course diabetes. This simply is because our bodies cannot tolerate large amounts of glucose yielded by starches without sending them for storage and all storage of energy is in the form of lipids or glycogen. We are in fact quite primitive beings and have not yet evolved to a wholly starch based diet because we are only a spear throw from our ancestors who largely lived on fats and protein. Grains, potatoes,pasta and rice are an anethema, to our metabolism and together, with the vast amounts of sugar and fructose we consume have been largely responsible for the inexorable rise in obesity.

We get fructose from juices, fruit, especially apples, pears etc together with grapes and other exoctics like pineapple and bananas. In small quantities they do little harm to normal diets although fruit juice is a problem because of its concentration of the natural sugar fructose. Now that most soft drinks makers use cheaply produced high fructose corn syrup (HFCS) as a sweetener, the situation is worse. Even sugar (sucrose), being a disaccharide needs to be metabolised by division into glucose and sucrose. Fructose of course already is. So high intakes of fructose, found in juices, soft drinks and of course fruit in varieing quantities is not really a good route to health. This is especially true of juice, as it is not something that was available much in the past, but is now,  by the intervention of modern production methods. It is of course, highly concentrated fructose and is often fortified with additional sugars. So whilst exhorting us to cut down on sugars, we are also told to drink juice and eat fruit which in effect cancels out the effort we make to kurb (our often ) 'sweet tooth'. It is highly contradictory, but the logic seems to escape those that advocate it !

Whilst I would not suggest the abandonment of fruit, I would advocate caution in the extreme. Berries and small fruits like grapes in limited amounts, confer other vitamins and essentials, that are good for you, provided they are used sparingly. Vegetables, generally green leafy types, do the same with little carbohydrate content. Root vegetables as they are pretty much like potatoes, and are very high in starch. The odd apple or pear or bananas too, are useful, especially the latter, if not too ripe, as this increases the fructose considerably. But, 'five-a day' is stretching healthy intake too far.

Primitive Northern humans, did not eat a diet, especially in Winter, high in any carbohydrates especially sugars and prior to the 2nd World War when we still had a very low carbohydrate intake, there was almost no discernable heart disease. Many Doctors went through their whole careers without seeing a single case, unless it was (rarely) triggered by Rheumatic Fever or some other disease. Today, you would be hard pressed to find one that hadn't handled hundreds. Does this 'paradox' together with others in Science, such as the French paradox, not impinge on the pointy heads at the DofH or the Food Standards Agency. Are they so sure of their ground, that they do not need to read the science, the trials, the refuting evidence that continually highlights the facts of the diet-fat-heart hypothesis as being completely wrong ? Or does this dept. and other servants of the people live entirely in a vacuum of denial ?

I suggest that they read some science, especially this;-
http://www.ajcn.org/cgi/content/abstract/ajcn.2009.27725v1

It lists the meta-analysis of  twenty one studies involving 347,747 subjects over 5-23 years and concludes that dietary saturated fats are not linked to an increased risk of CHD or CVD. No doubt no equivocation. It is the most recent in a long line of scientific evidence that tells of the myth that it all is.

So tuck into the bacon and eggs with a light heart and in the knowledge that you 'do no harm' which is more than the buggers that are telling you otherwise do.

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