An epic battle for hearts and minds appears to be underway, concerning the relative merits of alternative approaches to tackling obesity at the population level through diet and nutritional advice. The National Obesity Forum and the Public Health Collaboration (PHC) have released a controversial report, which asserts that mainstream dietary guidance on low-fat and lower cholesterol diets may have resulted inadvertently in adverse (some say “disastrous”) consequences for public health over recent decades.
Report attacks official guidance on low-fat diets. London: NHS Choices; Behind the Headlines, May 23rd 2016.
Public Health England: Advice to eat more fat ‘irresponsible’. London: BBC Health News, May 23rd 2016.
This relates to:
Eat Fat, Cut The Carbs and Avoid Snacking To Reverse Obesity and Type 2 Diabetes. London: National Obesity Forum and the Public Health Collaboration (PHC), May 20th 2016.
This argument is reinforced via the following PHC account of the development of healthy eating guidelines historically and internationally. Further references are supplied.
Healthy Eating Guidelines and Weight Loss Advice For The United Kingdom. London: Public Health Collaboration (PHC), May 27th 2016.
Classic Intolerance of Ambiguity (or Just Plain Bad Science)?
The best form of defence is attack… ? The Public Health Collaboration (and the National Obesity Forum) have been roundly-slated by experts and officialdom for their efforts to raise this alternative viewpoint. Individuals within the PHC / NOF have themselves (in their turn) been accused of endangering public health by encouraging unhealthy dietary habits, and mercilessly vilified for muddying public opinion on the issues. They have further been accused of ignoring the bulk of systematic reviews on the subject while selectively cherry-picking evidence which just happens to suit their viewpoint.
PHE response to the National Obesity Forum and Public Health Collaboration opinion paper. London: Public Health England, May 23rd 2016.
Fall-Out and Collateral Damage
Four influential anti-obesity campaigners have resigned, perhaps unnecessarily.
National Obesity Forum campaigners quit over low-fat report. London: BBC Health News, June 3rd 2016.
Looking to the Future?
It is too early to judge how this debate will play-out. It would be disappointing if future research failed to explore the crux of these issues raised by the PHC / NOF’s allegations (“just in case”). Officially voiced outrage and the suppression of outsiders’ voices cannot be healthy for the future of science; intolerance regarding alternative viewpoints would also be contrary to the spirit of an open learning culture in the NHS and beyond.
Reassurance For the Perplexed
In the meantime, Public Health England (PHE) stands by the mainstream drift of existing dietary guidelines, which have their latest revised and re-launched presentation in the Eatwell Guide and the Eatwell Plate:
The eatwell plate: external reference group review. London [Online]: Public Health England, November 2014, updated March 17th 2016.
The Eatwell Guide. [Online]: NHS Choices, 2016.
The Eatwell Guide. London: Public Health England. March 18th 2016.
December 2016: Headline Update
More recent research on the effects of high fat diets, again dismissed by the experts as inconclusive:
Claim high-fat diets can prevent diabetes ‘unproven’. London: NHS Choices; Behind the Headlines, December 12th 2016.
This relates to:
Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).
Veum, VL. Laupsa-Borge, J. [and] Eng, Ø. [et al] (2016). Visceral adiposity and metabolic syndrome after very high-fat and low-fat isocaloric diets: a randomized controlled trial. American Journal of Clinical Nutrition. November 30th 2016. [Epub ahead of print].