21 May 2015: Bad science and bandwagons

I have written before here on my blog about how divided and vitriolic the nutrition world can be. It seems that there are those who are passionate to the point of being near zealots in pushing one band-wagon or another. And there are a lot of band-wagons to push.

I recently attended a dietitians conference where on more than one occasion the word Paleo was almost spat out it was mentioned with such disgust. The main beef these speakers had was that of ‘poor science’ and that the diet could not possibly be healthy seeing as our Paleolithic ancestors only had an average life span of 23. (Do not quote me on the actual accuracy of that figure – this is merely a repetition of what we as the audience were told as fact.) It seems many facts were conveniently ignored amongst the sniggers from the majority of the audience. Did we forget that many of our ancestors died in childbirth or infancy – about 1/3 of the total population died in the first few years of life. Only ½ made it to their adult years. But they were not dying of non-communicable chronic diseases – the main killers in today’s world – lifestyle diseases that have a high association with diet. They died of infections, parasites, wars, famines and were at the mercy of the environment. Now we can control our environment, we have doctors and hospitals and medicines that not only keep us alive but prolong our lifespans – even if they are unhealthy towards the end or indeed for many many decades. So no I do not think that comparing lifespans is ‘good science’ or a valid nutritional argument. I do not have an association with the Paleo diet, but I do think that many elements of the basis are fantastic in promoting better nutrition and health. In fact I have issues of my own with some elements of the diet and some of the reasoning/science behind some of the principles. I also know that the Paleo diet today is not replicating what was truly eaten. But again this misses the point – the key is that the diet is one rich in vegetables, fruit, nuts, seeds, good quality animal proteins, and high quality fats. Which exactly of these foods is a health problem I am not sure.

At this same conference the word Paleo was also used interchangeably for low carb and high fat. Hmmm again I can’t quite see the connection. Sure you could eat high fat on a Paleo diet. But you could also stick to the ‘rules’ eat lots of fruit, loads of tubers and other vegetables, nuts, seeds and in fact have a very high carbohydrate intake. And yet there it was. Poor scientific arguments being used to accuse of poor science. And that is my frustration. Not being pro or anti any particular diet – but merely being open to evidence and not jumping to conclusions simply because they do not meet your own notions or experiences.

To be fair there were a very small number who throughout the conference stated that they also liked many aspects of a Paleo diet. The recognition that such a diet echoes many aspects of the much lauded Meditteranean diet also must be made.

I also read with interest an article this week in the popular press about diet fads. Gluten free was one which was singled out (again). I agree that the term gluten free has in some circles become synonymous with health and that manufactures and marketers have taken advantage of the growing consumer interest to fill our shelves with gluten free products. Never mind that these are often high sugar, high salt, high fat and make use of refined yet gluten free flours. This does not make them healthy. In any diet. Yet the article suggested that gluten free diets are only of benefit to those with celiac disease and that sometimes people feel better when they remove gluten due to other factors. This might be an intolerance to a particular carbohydrate, called fructan, which is found in wheat but also in other foods such as fruits and vegetables. Or it might be due to a food sensitivity to a chemical that might perhaps be found in the particular gluten containing products they had previously being eating. So clearly the removal or reduction in these problem food will see a reduction in their symptoms. None of this I disagree with. But what I have an issue with is the dismissal of the approach to eliminate gluten products. If this works for an individual and they feel better then what is wrong with that? If by removing gluten grains they are lowering their exposure to the offending carbohydrate or food chemical without cutting out other fruits and vegetables, which inarguably add more nutritionally to their diet than the grain products – then where is the issues? I do not think it is something that as dietitians or nutritionists that we need or should try and steer them away from. The bottom line is that the individual is the only one who can really tell how they are responding to foods and dietary patterns. If they feel better and are generally meeting nutritional requirements then why do we have to try and dissuade them from their approach because it does not meet either our own philosophy or any arbitrary guidelines?

I think the truth is that we do not yet know enough about food, nutrition or the complex interactions within our body to make definitive ‘rules’. Be flexible. Use common sense – natural is without doubt better. But don’t be rigid or closed to other alternatives, new research and ideas.