The first major study to look at all-cause mortality and cardiovascular disease and nutrition across all 5 continents of the world may have arrived just in time. The study findings have just been published in one of the world’s leading scientific and medical journals, The Lancet and were presented yesterday at the European Cardiology Society conference in Barcelona.
With this study now published, it’s going to be very difficult for governments to continue to tell us to get most of our energy from carbohydrates when there’s now clear evidence that that advice is killing us. The new study out of McMaster University, Canada, gives credence to those of us, including cardiologists, who have long advocated lower carb and higher fat diets. And if that wasn’t enough, it shows that raw and cooked vegetables aren’t equivalent, a difference that’s never distinguished in government guidelines.
In the Acknowledgments section of the paper, the study is claimed to be investigator-initiated and over 50 sources including the Population Health Research Institute (PHRI) at McMaster University, the Heart and Stroke Foundation of Ontario and Canada, the Canadian Institutes of Health Research, "and through unrestricted grants from several pharmaceutical companies (with major contributions from AstraZeneca [Canada], Sanofi-Aventis [France and Canada], Boehringer Ingelheim [Germany and Canada], Servier, and GlaxoSmithKline), and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries."
The sheer diversity and number of the funding sources, the fact that Big Pharma grants were 'unrestricted' and that it was investigator-initiated reduces the risk of vested interest bias or conflicts of interest. The study does however have weaknesses, among the most evident being the reliance on self-reported intake data from questionnaires which tend to vary in accuracy.
Since it’s now almost universally accepted that what we eat and what lifestyles we choose are for most of us the single most important determinants of our health, we have to take government advice seriously. That’s because so many people rely on it, from health professionals through to consumers. It’s of course not as simple as that, as layered on top of what governments tell us are a complex of other factors, linked to preferences or addictions, and a minefield of interacting social, cultural and economic determinants.
The low fat farce
Governments, along with Big Food, have for over 3 decades been locked into the notion that low fat diets are healthy, despite an absence of ‘gold standard’ evidence from randomised controlled trials.
The Lancet study blows this into the long grass. The study, referred to as the Prospective Urban Rural Epidemiology (PURE) study is one of a series. The present one looked at reported dietary intakes, via questionnaires, of 135,335 individuals, across 18 countries (reflecting low, middle and high incomes) on all 5 continents, over a 10-year period. Follow-up continues and will result in further publications.
The researchers found that people between the ages of 35 and 70 on low fat/high carb diets had an increased risk of early death compared with those on a lower carb/higher fat diet. This emphasises that government advice over recent decades to switch out saturated fats and replace them with carbs has been killing people. Interestingly, the apparent protective effect of higher fat intakes occurred whatever the type of fat, whether saturated, monounsaturated or polyunsaturated.
Dietary fat intakes amounting to around 35% of total energy intake had a drug-busting 23% lower all-cause mortality risk. By contrast, diets high in carbs (60% of total energy intake), around the amount consumed when following government guidelines like the UK’s Eatwell or US Myplate guidance, were associated with a higher risk of death.
How long can health authorities and governments hold out before updating their advice on optimal fat/carb intakes?
Optimal veg and fruit intakes
The current PURE study also found that an intake of veg, fruit and legumes of 3-4 servings a day, equating to 375-500 grams, was associated with a lower total mortality and non-cardiovascular mortality.
The researchers found no evidence of benefit for consumption above this level, possibly because it was offset by excessive carbohydrate intake. The authors commented that in some developing countries where vegetables and fruit are expensive, recommending say 3 instead of 5 servings daily, around 400 grams, might be more achievable.
Lead author, Dr Mahshid Dehghan, said in a podcast accessible from The Lancet website that In higher income countries the study findings shouldn’t be looked on as a suggestion to eat less veg, legumes or fruit.
Another important finding was that the study showed that consumption of raw vegetable sources was more protective against cardiovascular diseases than cooked veg. We have long known that many phytochemicals, vitamins and other nutrients are heat sensitive and may be damaged by heat, and we also know that certain forms of cooking can introduce new, harmful chemicals and byproducts, especially when starches, sugars, fats and proteins are subjected to high temperatures. These range from carcinogenic heterocyclic amines (HCAs) formed in high temperature cooked meats, to advanced glycation end products (AGEs) that contribute to inflammation and oxidative stress in the body.
Astonishingly, government guidelines simply don’t distinguish between cooked and uncooked foods despite a wealth of evidence showing many are as different as chalk and cheese, including the latest from this PURE study.
Recently, we’ve raised the question with governments in the European Union over whether they can move to force manufacturers of processed meats to include cancer risk warnings. This would reflect the 2015 classification by the International Agency for Research on Cancer (itself an organ of the World Health Organization) of processed meats as proven human carcinogens. Governments might be aware of this, but the majority of the public isn’t and this type of nitrite-preserved processed meat is fast becoming a staple of kids and adults alike.
Would that change if it had a cancer warning on it? We think so.
It’s refreshing that that as more evidence is released, there is ever more scientific support for our own Food4Health guidelines that we believe properly reflect the available scientific and clinical evidence.
Join our campaign
In the coming weeks, we’ll be unfolding a campaign targeting a number of governments with a view to making significant adjustments to their guidelines. Among the hit list of changes to dietary guidelines we will be pushing for are the following:
- Removal of any recommendation to consume low fat foods
- Removal of any recommendation to limit saturated fats
- Total carbohydrate consumption should not exceed 50% of energy intake
- Recommending at least 3 portions a day of fresh uncooked and unprocessed vegetables or fruit
- Minimise consumption of refined carbohydrates (e.g. sugar, white bread, white pasta, pizza bases)
- Minimise consumption of savoury snacks
- Minimise consumption of charred or high temperature cooked meats
- Minimise consumption of processed meats containing nitrite preservatives
We’ll keep you posted on progress of the campaign. In the meantime, if you want generalised dietary guidance, whether for adults or children, that’s based on solid scientific and clinical evidence, please refer to the ANH Food4Health guidelines.
Given that your government won’t be telling your friends and contacts about their defective advice, do them a favour and forward this widely.
your voice counts
30 August 2017 at 10:06 pm
But you have not mentioned the most important factor at all. Who funded the study?
Dr Rob Verkerk
31 August 2017 at 12:33 pm
Around 50 different organisations ranging from McMaster Uni itself, through to government sources (many different countries) and commercial interests including pharmaceutical ones. Our sense is that with so many interests and with the work being investigator-initiated, there is less likelyhood of vested interest bias/conflicts of interest. The full declaration of funders is given in the Acknowledgments of the paper as follows: "The PURE Study is an investigator-initiated study that is funded by the Population Health Research Institute, the Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario, support from CIHR’s Strategy for Patient Oriented Research, through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies (with major contributions from AstraZeneca [Canada], Sanofi-Aventis [France and Canada], Boehringer
Ingelheim [Germany and Canada], Servier, and GlaxoSmithKline), and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries. These include:
Argentina: Fundacion ECLA; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de la Frontera; China: National Center for Cardiovascular Diseases; Colombia: Colciencias (grant number 6566-04-18062); India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and
Innovation of Malaysia (grant numbers 100-IRDC/BIOTEK 16/6/21[13/2007] and 07-05-IFN-BPH 010), Ministry of Higher Education of Malaysia (grant number 600-RMI/LRGS/5/3[2/2011]), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010);
occupied Palestinian territory: the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), International Development Research Centre, Canada; Poland: Polish Ministry of Science and Higher Education (grant number 290/W-PURE/2008/0), Wroclaw Medical University; South Africa: The North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of South Africa, The South Africa Sugar Association, Faculty of Community and Health Sciences; Sweden: grants from the Swedish State under the Agreement concerning research and education of doctors, the Swedish Heart and Lung Foundation, the Swedish Research Council, the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s and Queen Victoria Freemasons Foundation, AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, grant from the Swedish State under
(LäkarUtbildningsAvtalet) Agreement, grant from the Västra Götaland Region; Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi Aventis, Turkey; United Arab Emirates: Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences, Dubai Health Authority, Dubai."
30 August 2017 at 10:37 pm
Who funded this research?
There was national or local organisations in participating countries that helped with funding.
Also unrestricted grants from several pharmaceutical companies (with major contributions from AstraZeneca [Canada], Sanofi-Aventis [France and Canada], Boehringer Ingelheim [Germany and Canada], Servier, and GlaxoSmithKline), and additional contributions from Novartis and King Pharma* http://www.thelancet.com/jo...
*King Pharma have U.S. marketing and distribution rights to Altace (Ramipril). This drug is used to treat high blood pressure and congestive heart failure.
And they have our heart health at heart, of course, so to speak.
Dr Rob Verkerk
31 August 2017 at 12:50 pm
Yes, we have made additions to include more detail of funding; but feel biases linked to specific funders are likely to have been tempered by the number and diversity of funders (around 50), the fact that pharma grants were unrestricted and that the PURE studies have been investigator initiated.
30 August 2017 at 10:37 pm
Excellent article ANH. Public Health should be ashamed of itself for peddling out poorly evidenced information that has without doubt contributed to this country's alarming rates of obesity and diabetes. I find it ironical that the Hippocratic Oath is to first do no harm when much harm will have occurred to individuals and society at large as a result of this unfortunate dogma.
30 August 2017 at 11:23 pm
Liked the start, not so sure about the end. In that bit about cooked vegies, add heating the wrong sorts of oils like sunflower and safflower oil (salad oils! NOT for cooking - and you haven't mentioned trans-fats at all here. Most of the "evidence" against saturated fat actually refers to trans-fat, not saturated fat at all).
I recently read it's better to eat some vegetables cooked - cruciferous vegetables specifically as cooking reduces the thyroid-killing properties by 90%.
I'd also appreciate not having cancer warnings all over everything - don't breathe the air, don't drink the water. I don't want a cancer warning on my TV or on others' microwaves, and there have been cancer warnings on cigarette packets for ages, people still smoke. I've known about nitrates and cancer for decades, I still eat processed meat and I even read a vegan recently who is tempted by the smell of cooking bacon. I think most people have heard of nitrates and cancer, they still don't care. What about a cancer warning on everything containing sugar? Pancreatic cancer is one of the nastier ones...
Dr Rob Verkerk
31 August 2017 at 1:00 pm
Thanks for the comment Andrea. The paper is limited in how it breaks down intakes of individual fat groups, and so has only related mortality and CVD to intakes of the 3 main fat categories: monounsat, PUFA and sat fats. Totally agree that there are much more data looking specifically at risks and benefits within these categories but this kind of big picture study can't have that kind of granularity. But what it certainly says is regardless of the saturated fat intakes, higher was more protective so you could argue it's even more relevant because we know there are some saturated fats, trans fats in particular, but also say diets very high in palmitic and myristic acids, may promote inflammation and increase risk of inflammation. The issue of cooking and raw is a complex one and you are right that some veg deliver higher levels of nutrients and fewer harmful ones when cooked rather than when raw. Again, the PURE study is broad brush, and the fact this difference emerged is of interest and may relate more to inappropriate types of cooking, the details of which could not be tracked by the study.
Simon Best http://www.caduceus.info
31 August 2017 at 1:33 am
Does this essentially vindicate the high fat, low carb, ketogenic diet advocated by Dr Thomas Siegfried and the growing supporters of his Metabolic Theory of Cancer? I think so!
Dr Rob Verkerk
31 August 2017 at 1:08 pm
It goes a long way towards showing that the high carb fad that has been promoted for over 3 decades because of mistaken concerns, propagated by health authorities, governments, dieticians and Big Food over the consumption of saturated fats is causing significant unnecessary CVD. Obviously inflammation is central to all chronic diseases, from CVD through to cancer, T2D, obesity, osteoarthritis and Alzheimer's. But this study didn't look at cancer. As follow-up continues, I'm sure the investigators will be looking at cancer. At one level the strength of a study of this type is it's big data, broad brush, multi-country approach. The inevitable weakness is its lack of granularity.
31 August 2017 at 1:49 am
excellent article thank you
Teresa Hobday http://the%20Rose%20Clinic
31 August 2017 at 9:50 am
Some veg are better cooked, eg, carrots and tomatoes. Generalised information should be small and then encourage people to work out what is best for them individually.
Dr Rob Verkerk
31 August 2017 at 1:00 pm
Thanks for your comments - we agree fully!
Brian Steere http://willingness-to-listen.blogspot.co.uk/
31 August 2017 at 10:38 am
We are being lied to as a matter of course - as the 'normal' state of affairs. Lying is systemic and pervasive to the replacement of true governance by predation of a corporate-led system upon the Living - for the nature of the parasite/predator is of fear-defined rules of a fear denied and aligned consciousness. We can see this at the social or political level and we may also notice it at the thinking or personal level.
In the self-separating self-protective gesture of hiding fear, living communication - as a giving and receiving of worth - is sacrificed to the driven need to rule out and defend against the feared - that is now 'seen' or assigned to external causes and to the Other.
This segregated 'self' operates a phishing attack of identity theft - as a false foundation that calls on power and protection - but whose 'guardian' becomes the very thing it thought to have escaped. Defences DO the thing they defend against.
The confusion of the natural self - or true of being - with the fear-defined adaptation is an adulteration of our primary 'diet' - of receiving the 'word' or self-world definitions pertaining to our unique expression and embodiment; the feeling and knowing of how to be within the wholeness of a greater being.
For as we accept true - so do we then act from - and by acting from give forth or extend as teaching - to ourself and others - by demonstration, agreement and reinforcement.
And so true discernment needs to be called forth and given priority over the fearfully driven wish to overcome, escape or redefine that otherwise operates as 'the mind' or the thinking, feeling and reaction of a 'split-off' sense of self seeking power over life in fear that takes any form as the masked off sense of power and 'freedom' from consequence - as a result of complex thinking and the 'outsourcing' of pain to fuel private gratifications of 'self-vindication' within the framing of a feared exposure in powerlessness and invalidity.
"And who told you you were naked?" said the Lord - indicates a Movement within being of enquiry and revelation of an invalidity - a nothingness - where a private sense of power seemed to insinuate itself in place of true.
Look to the integrity of the Template - that is the 'word' of definitions and meanings you give and accept true - for the symptoms are not the cause, though the mind that is built as the ruling out of cause in a world of false effect must experience its own belief as 'reality' until such mind is noticed for what it isn't and paused of, rested of, and released from 'service' for a more integrated and directly felt discernment of living communication and relationship.
Yes - I speak to the 'deep end' that may seem impenetrable to conventional 'thinking' but the awakening from deceit is from the false root uncovered. Otherwise for every branch cut off, three more grow - and the shifting of forms operates the desire to persist in a 'better' or more 'comfortable' deceit.
Freeing the mind from toxic guilting - or blaming is essential to seeing clearly. Self-illusion is not an actual attack upon true - excepting the determination to persist in it against your own recognition of true desire fulfilled must interject between true needs met - as a deceit of a seeming 'self-power' in opposition to a deprived and denied sense of 'you' - that becomes 'your' strategy to adopt in reaction of like kind.
Living relational communion is the ordinary natural context of being that a corporatocracy of rule-based thinking operates to deny - and yet is WHOLLY dependent upon - for there is NO self-separate 'independent' life - nor leverage from such external presumption - over and upon life. But the wish that such be true is the distortion mapping of a reversal in consciousness. The lie and the father of the lie is the wish that overrides a true free willingness that MUST induce division in the mind as split purpose - and emotional conflict that - if not released - becomes a basis for protecting the conflict by covering over with layers of 'self-assertion' of what seems to be a survival urge - but set in terms "I WANT IT THUS!" - or "only on my terms" - which is demand of a 'getting' mind given focus and priority over the natural receipt of being, the unqualified being of you - that automatically extends to your relations to reflect as shared recognition and appreciation - unless you would use your brother or world to get self 'specialness' instead.
Give unto Caesar means do what you need to do in the 'world' without using it to feed the self-specialness of the wish for power - whether expressed positively or negatively.
Aligning in the true is the natural freedom rising from the releasing of the recognition of false as false. Which is NOT the same as the hatred and denial of the false as an act of self-vindication. THAT is the market for the repackaging and redistribution of 'evil' in trojan disguise. But of course such hatred and urge to deny is felt very intensely as part of the 'territory' of uncovering the true from the false - but now there is a basis for choice instead of blind reaction. Use it - or lose awareness that you have it. The aligning in the movement of being restores and reintegrates presence that aligns all things truly - including the undoing of grievance - however out-pictured - - as willingness allows.
31 August 2017 at 1:11 pm
Interesting comment! Thank you.
03 September 2017 at 10:39 am
Thank you for the excellent article. In plain understandable language and so I have passed to family and friends. Just Love the Title. So, captures the interest. I listened to James Maskell interview you on the recent Interpreting your Genetics summit - incredible info. Can't pretend to have grasped all of the info but your ways of detoxification list is written down to refer to. And.... Great to hear a British Voice (I know James is British and Dr Chatterjee but welcome to the club) I hope you will be interviewed more frequently now on other summits, so that many can benefit from your knowledge and research. Thank you again
06 September 2017 at 10:16 am
I found a few thimgs that may be useful to share.
Simon Sinek " leaders est last " - interview.
The undermining of our biological and hormonal homeostasis via for one example, the "sugar in everything" in the food chain,, non-native EMF ( cellphones and wifi to children.? brain development takes 20 years to fully form? ), technology substituting human communication and learning, lack of medical care, instability within considered stable underpinning societal structure.
This gives: constant high cortisol, low dopamine, low oxytocin. Low self esteem, creating and ongoing of fear and danger ( summarising interview by the same), doom and gloom via the media, depriving people of ability to make informed decisions and only exist by a "follow"- led approach. I think this seems to resemble some of what was being said above in extremely eloquent and profound language.
Epigenetics: long term gene adaptations via long term hormonal and biological dysfunctions. Several interviews exist on his topic. Links to LCHF and ketogenic diets to help downregulate insulin. Low fat means high sugar.
Awareness check if I may: read labels of everything you buy. Sugar in mayonnaise, sugar and dextrose in cured meats, etc... Don't just say yes to it do something about it. If you care individually you can care collectively. It starts with us.
Re eastblish normal hormonal balance by living a simple life, you/we don't need most of the material debt inducing stuff that's out there. Eat whole foods, cook from scratch, bin the convenience excuse. Talk to people, see your friends, make time for your friends, switch off all wifi at night get mechanical clocks. Support your local market farmers and organic growers initiatives around you; buy organic whenever you can. It's not difficult but we got to see clearly what's staring in front of our noses first.
12 September 2017 at 2:36 pm
I'm wary of this study due to the source of the funding which invariably influences the focus and subsequently the outcome, Rob. Big food & drug are very happy with the low fat model; who stands to gain from unlimited saturated fat?
It is now beyond doubt that the focus on low fat has contributed greatly towards the increased consumption of refined carbs, sugar & processed vegetable oils with a catastrophic effect on the health of this planet. Any evidence that helps us move away from this way of eating has to be welcomed.
I'm not totally convinced, though, that we should let the pendulum swing entirely in the other direction and actively promote a diet high in saturated animal fat. Cow's milk is a wonderful food - if you happen to be a calf. Unprocessed dairy products - especially in the fermented form - in the right amounts can be beneficial for some people. If you have arthritis, asthma, sinusitis, eczema, psoriasis or acne they can cause problems. Pork products are highly problematic with many people too and red meat for arthritics is usually unhelpful. It may be the protein rather than the fat that is the issue here - but as you know the 2 go hand in hand.
So while I agree that some unprocessed saturated fat is better than a whole load of refined carbs & oils, we just need to ensure that the correct balance is struck.
Your voice counts
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