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The Unhealthy Plate

MagazineJune 2013 (Vol. 24 Issue 3)The Unhealthy Plate

The British and the US governments have each created a simple image to show us our ideal diet, but but there's a lot wrong with this pictureThe plan on both sides of the Atlantic was to let a picture speak a thousand words

The British and the US governments have each created a simple image to show us our ideal diet, but but there's a lot wrong with this picture

The plan on both sides of the Atlantic was to let a picture speak a thousand words. Concerned about the dietary habits and expanding waistlines of their nation's populations, departments within the US and UK governments came up with the same idea, to use a little image of a plate to show the different types of foods we need to eat in the ideal proportions for optimal health.

The UK's eatwell plate is the more detailed of the two, using specific examples of foods in the different food groups (eggs, fish and meat on the protein side of the plate, for instance). MyPlate, the US version, shows a place setting with a plate simply divided into five food groups, like a pie cut into four different sized and coloured slices- 'fruits', 'vegetables', 'grains' and 'protein'-with a glass to represent 'dairy'.

As First Lady Michelle Obama remarked on unveiling MyPlate in 2011: "Parents don't have the time to measure out exactly three ounces of chicken or look up how much rice or broccoli is in a serving . . . But we do have time to take a look at our kids' plates."

Both icons attempt to depict the recommended proportions of macronutrients in our diet-protein, carbohydrate, fat and sugar-and both have arrived at broadly similar conclusions. Vegetables and carbohydrates take centre stage, while protein plays a moderate role, and fat and sugar minimal ones.

These two icons are being taught in schools and promoted through everything from newspaper articles to cereal boxes.

According to the British eatwell plate, our diet should be roughly:

-15 per cent protein (meat, fish, beans and other protein alternatives)

-15 per cent dairy and milk

-30 per cent fruit and vegetables

-30 per cent grains (bread and other cereals) and potatoes

-10 per cent foods containing fat and sugar.

In the US, the portions are broadly meant to represent:

-30 per cent grains

-30 per cent vegetables

-20 per cent fruit

-20 per cent protein

-1 cup of dairy (including milk, yoghurt and cheese)

But how reliable is this advice? Does it stand up to scientific scrutiny? And is there such a thing as a one-size-fits-all diet?

Flawed science

Both the US MyPlate and the British eatwell plate are based on the longstanding 'received wisdom', which took root in the 1980s, that fat makes you fat and carbohydrates are a comparatively benign alternative source of energy.

Ancel Keys is credited with first postulating the fat-makes-you-fat thesis in the 1950s. In surveys carried out between 1958 and 1970, now referred to as the Seven Countries Study, he examined the fat intakes of seven countries, including the US and Japan and some in Europe, and allegedly demonstrated a clear correlation between mortality due to coronary heart disease and percentage of calories from dietary fat.

From this extraordinary limited data, medicine first hypothesized that high dietary fat intakes caused high levels of cholesterol in the blood, which, in turn, furred up arteries and set up a chain of events that eventually culminate in a heart attack or stroke. According to this reasoning, heart attacks and strokes could largely be prevented by lowering blood cholesterol levels either by the use of drugs or limiting fat intake.

A number of researchers have now demonstrated that the original Seven Countries Study was hopelessly flawed. It has been claimed that Keys's study started out with data from 22 countries, but he chose to focus on seven, and if the fat intakes from all 22 countries had been factored in, no such correlation would have been demonstrated. Keyes later recanted his earlier conclusions, noting that the risk factors for a heart attack were a complex brew of factors, including such things as smoking and overall diet. But by then, his earlier simplistic conclusions had taken a firm hold over governments and been embraced by industry, which could then offer low-fat processed foods as a healthy preventative for heart disease.

The low-fat advocates also overlooked one other essential ingredient: the role of dietary carbohydrate levels. High fat levels can only be manufactured if the body has high levels of insulin, which are created by high glycaemic-index carbohydrates. They overlooked all the common sense evidence demonstrating that dietary fat cannot produce body fat and ignored those few studies showing that sugar consumption had a strong correlation with heart disease.

As unbelievable as it seems, they simply assumed that sugars and refined starch had nothing to do with heart disease.

A highly-stacked plate

The recommendations of the eatwell plate and MyPlate both betray the heavy hand of the food-industry giants. There's no doubt that the high levels of carbohydrates, milk and dairy were the result of commercial pressure from the powerful manufactured food industry.

In assembling earlier versions of its food icon the US government did not deny that the public-relations agency (Porter Novelli) it hired to help create it also counted food manufacturers among its clients. The bulk of manufactured food relies on refined carbohydrates, which are allowed on both plates.

Another commercial pressure was undoubtedly from the dairy industry. The eatwell plate calls for up to 20 per cent of dairy a day, clearly ignoring the copious research linking pasteurized and homogenized dairy products to allergies and perhaps even increased levels of cancer, especially ovarian and prostate cancers.

Although the ostensible reason for the inclusion of dairy is the prevention of osteoporosis, the evidence for that is so far inconclusive. One comprehensive study following nearly 80,000 women aged 34-59 for 12 years found that high consumption of dairy products failed to protect against bone fractures.

Harvard disagrees

When an earlier version of MyPlate, a food pyramid, was released, Meir J. Stampfer, chairman of the Department of Epidemiology at Harvard's School of Public Health, and Walter C. Willett, professor of nutrition, complained that it did not pass scientific muster. They then reconstructed the 'Healthy-Eating Pyramid' as an alternate and more accurate model of ideal food consumption.

Harvard has now produced its own Healthy Eating Plate, and the Harvard revision is a great improvement over MyPlate, in that it promotes whole grains and acknowledges the role of omega-3 fats. Nevetheless, it still accepts the underlying premise of the US Department of Agriculture (USDA), which created MyPlate: carbohydrates are 'healthier' than fats, and so should predominate in the ideal diet; saturated fats are bad for us and have no place on the plate ; and proteins are not required in the proportions we once thought we needed.

Here are all the things wrong with what we thought it was the healthy plate:

Mistake 1: The recommendations are based on the persistent, and flawed, notion that dietary fat of any sort makes for fat and heart disease. Stampfer and Willett concluded that the scientific evidence does not show a strong link between fat intake and cholesterol and coronary heart disease or stroke. Healthy fats, whether monounsaturated or polyunsaturated, actually lower the risk of heart disease, according to Stampfer.

Based on the latest evidence, saturated fats do not in fact clog the arteries as we have been led to believe.The famous ongoing Framingham study, which has followed a population in a small town in Massachusetts for many decades, discovered that the more saturated fat, cholesterol and calories consumed by people, the lower their blood cholesterol.

All fats receive a bad press, despite ample research indicating the substantial health benefits derived from all natural fats like omega-3s.

Mistake 2: The icons don't acknowledge the importance of saturated fats in the diet. According to the Weston A. Price Foundation's Sally Fallon and fats expert Mary Enig, saturated fats perform critical functions in the body-such as protecting bony surfaces, cushioning internal organs, strengthening cell membranes, building and protecting the nervous system, brain and liver, and helping to protect against osteoporosis, to name but a few. Saturated fats also support the immune system.

Placing unnecessary limits on fats can lead to gallstones and many other health problems. Restriction of saturated fat in particular has been identified as causing fatigue, poor concentration, depression and even weight gain because the serotonin receptors in the brain need cholesterol to function properly. Several well-studied native populations have rates of saturated fat consumption greater by various orders of magnitude than what is now recommended, yet still have far lower rates of heart disease.

Mistake 3: The plates don't offer any information on levels of vital essential fatty acids, which tend to form too small a percentage of the average British and American processed diet. The US recommendation that allows 14-25 g/day of polyunsaturated fats (through high levels of polyunsaturated oils in foods and processed foods) suggests an unhealthy ratio of omega-6 to omega-3 essential fatty acids, which should consist of no more than a two-to-one ratio of omega-6 to omega-3 fatty acids. And fish is given only a minor role on the plate, even though it's a vital contributor of omega-3 fatty acids.

Israel, which has one of the highest ratios of omega-6 to omega-3s (20-32 to one compared to 12-20 to one in the US and Europe), also has the highest incidence of heart disease, type 2 diabetes, cancer and obesity in the world, according to American public-health scientists Alice and Fred Ottoboni.

Fat and fit

Use generous amounts of these traditional fats on your food, which have been part of nourishing diets for thousands of years, say Weston Price Foundation's Mary Enig and Sally Fallon:

-To cook with: butter Coconut, palm and palm kernel oils, Extra virgin olive oils, Suet (beef and lamb) Lard Chicken, goose and duck fat.

-In your salads: Extra virgin olive oil (also OK for cooking), Expeller-expressed sesame and peanut oils, Expeller-expressed flax oil (in small amounts).

Mistake 4: Both plates include an astoundingly small amount of protein.With the opposition to animal fats and the rise of vegetarianism, there has been a relative decline in protein intake as a proportion of calories consumed-from around 14 per cent of energy intakes in the 1960s to 12 per cent now.

Current recommendations suggest that protein accounts for little more than a fifth to a quarter of our total calorie intake. This decision may reflect fat phobia, as many sources of protein (such as red meat) also have high levels of saturated fat.

Although population studies have implicated excess protein consumption in a raft of degenerative diseases, a similar number of studies have not, demonstrating that the evidence is inconclusive.

In some healthy native communities in the past, up to 65 per cent of energy was provided by animal fat. In a study of more than 1,000 dentists and their spouses, those with the fewest health problems ate the most protein, with the healthiest eating similar amounts as Stone-Age man.In less-developed communities, protein is invariably eaten along with its fat, as the vitamins A and D it contains optimizes the uptake and utilization of the protein.

But the only way the quality of protein sources is now judged is by their total fat content, so we are asked to make 'lean', 'low-fat' or 'fat-free' choices. The current recommendations don't take adequate account of the essential need for certain fats from these food sources and for vitamin B12, which is available in limited amounts in plant foods. Neither animals nor plants make B12; animals have to get it from what they eat, but plants must be contaminated by microorganisms that make the vitamin or have it added to them.

The traditional plate

The Weston A. Price Foundation has identified 10 common characteristics of traditional diets, including:

- higher animal-protein intake from meat, fish, eggs and dairy products than both plates recommend(up to 35 per cent of daily food)

- far greater fish and dairy consumption, resulting in four times the calcium and other minerals and 10 times the vitamin A and D and K2 intakes (although the dairy was whole 'raw' milk, unpasteurized and non-homogenized).

- much higher fat intake (30-80 per cent of total diet), but only 4 per cent of calories from polyunsaturated oils naturally occurring in grains, pulses, fish, nuts, animal fats and vegetables.

- near equal amounts of omega-6 and omega 3 EFAs

- much higher consumption of raw foods , including flesh

- about half of food from plants (fruits, vegetables, nuts and seeds)

- some animal bones, usually from gelatine-rich broth

- seeds, nuts and grains that are sprouted, soaked, fermented or naturally leavened to neutralize contents like phytic acid that interfere with digestion.

From 'Characteristics of Traditional Diets', online at www.westonaprice.org/basics/characteristics-of-traditional-diets

Mistake 5: Carbohydrates (including grains, fruits and veg) make up 60-80 per cent of a day's worth of calories, more than a third of which is most likely made up of highly processed grain products. Numerous studies show that high carbohydrate intakes-even when less than the proportion suggested in the two plates-is unhealthy.

Mistake 6: All carbohydrates are lumped together.This means that refined carbs like sugar are considered as 'good' as wholemeal bread or brown rice. The guidelines allow half our grain requirement to be refined. But while the unprocessed carbohydrates consumed in non-industrialized parts of the world contain the nutrients necessary to build lean body tissue, the body has to use certain existing stores of vitamins and minerals such as chromium and zinc just to metabolize refined carbohydrates.

Refined fructose, which has found its way into an ever-increasing number of manufactured foods in various forms, including high fructose corn syrup, has proven in studies to be particularly pernicious. In people with and without good glucose tolerance, high levels of fructose raised levels of blood cholesterol and low-density lipoproteins (LDL), both of which are risk factors for obesity.

A high intake of refined carbohydrates can upset the body's glucose and insulin levels. Evidence shows that the recommended six to 11 servings of carbohydrate are rapidly converted into glucose, which produces high levels of insulin that in turn cause unused calories to lay down more body fat and raise cholesterol levels. A high consumption of refined carbohydrates is an established cause of glucose intolerance and diabetes.

Mistake 7: The plates endorse foods that are damaging to good health. The current UK guidelines allow a full 10 per cent of the day's calories to come from refined sugar, a known and accepted cause of obesity, cancer and diabetes-in fact, most of the degenerative diseases of modern times (see WDDTY May 2013).

Variation among native diets

The flawed low-fat, high-carb thesis that forms the two plates was conceptualized through a familiar methodology: looking at a population's disease profile and then working backwards to identify what caused the most prevalent diseases.

But what if we looked at very healthy populations, where 'lifestyle' diseases are almost unknown, and studied the dietary hallmarks in those people?

This is what the Weston A. Price Foundation (WAPF) did, and it came up with strikingly different conclusions.

Price was a dentist who, in the 1920s and '30s travelled around native communities in regions as far apart as Alaska, Switzerland, Australia, the US and the Outer Hebrides. All of these peoples were going through a period of cultural transition.

As a dentist he noted that those inhabitants who were still consuming a native diet had virtually no tooth decay. But those adopting an imported 'Western' diet had smaller jaws, more overcrowded teeth-and early signs of the chronic dietary diseases so characteristic of industrialized nations.

A considerable body of epidemiological and scientific evidence suggests that the best food plate is a lower-carb, higher-fat, higher-protein diet. Nevertheless, there's a huge variation in the macronutrient intakes across healthy native communities.

The Inuits and Native Americans, for example, eat very large quantities of fish because they lack the enzyme that can manufacture the vital omega-3 fats docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) from other types of foods. But Native Americans from inland rural communities generally have the enzyme, so they are able to produce omega-3s from foods other than fish. They are so biologically different from their 'cousins' that their bodies handle macronutrients differently. These fundamental differences in dietary genetics are not unique to less industrialized cultures, but are also documented among Western, industrialized peoples.

What this all suggests is the most radical idea of all-that there may be no one-size-fits-all diet for any of us. The answer to our dietary needs may lie in our unique genes. Depending on what our ancestors ate, we may need different proportions of fats and proteins and carbs.

The perfect plate for you may what your great grandmother had before her, but as a rule of thumb, eat organic, whole unrefined foods, and the biggest portion of your plate should be vegetables, then protein and fats and finally carbs.

Diets that defy the dietary dogma

-Inuits of Alaska: A diet rich in fats and oils, and low in fruit and vegetables. Very low levels of dietary disease and a high consumption of omega-3-rich marine foods. A variant gene for heat and energy production enables them to use dietary fat calories to produce more body heat.

- Masai of East Africa: Mainly meat, blood and milk, including up to 300 g/day of saturated fat. No heart disease, high cholesterol or obesity, and Olympian fitness, but emergent dietary disease after starting to exchange a traditional diet for corn and beans.

- Polynesian Pacific Islanders: Diet high in saturated fat, largely from coconuts. Low cholesterol and no heart disease.

- Maori of New Zealand: High-protein, low-carbohydrate diet built around fish, kelp and roots. High levels of protein (more than 50 per cent of diet) and low in carbohydrate (10-15 per cent).

- Aborigines of Australia: Traditional diet high in carbohydrate, protein and nutrients, and low in fat and sugars; animal foods a major component along with roots, seeds, fruits and nuts; low total energy intakes (1200 kcal/person/day). High intake of animal foods (64 per cent) high in polyunsaturated fats may have protected against cardiovascular diseases, diabetes and related conditions.

Introduction of a high-carbohydrate processed Westernized diet has caused heart disease and diabetes to skyrocket.

- Samburus of East Africa: Around 10 litres of full-fat milk a day equal to up to 400 g of fat. Low blood cholesterol and no heart disease.

Tessa Thomas and Lynne McTaggart


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