Gabor Szendi:
Is dietetics the handmaid of the food industry?

This is a serious accusation, and if I were making it in a fit of passion, I would immediately apologize, but unfortunately the facts justify my view

 

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Of course it is not good to suspect the deliberate science faker in anyone. One of the roots of conspiracy theories is that we ultimately deduce the intentions of the people who created the end result from those very end results. If 60-70% of people in the Western world suffer from severe obesity, and the resulting illness and death, it is difficult to resist the idea that this is obviously an intended result. This assumption also seems to be underpinned by the fact that dietary recommendations are published again and again with only slight modifications - ignoring the escalating public health crisis - and repeat the same things, and confront scientific facts in the same way. Are we really victims of a vicious plan, and are people being harmed with false recommendations simply to enrich the pharmaceutical industry? Or is there a more reasonable explanation, that this is the result of a combination of various intricate interests and random influences, and that the ensuing situation is maintained by partial interests? Historical facts support this view.

If I start with the development of farming, it may seem like a bit distant beginning, but I think it's inevitable, because it is important to understand how our present carbohydrate-based diet evolved. Cultivation of cereals became necessary due to population growth, because cultivating one hectare could proportionately support more people than a hunter-gatherer lifestyle. Sure, there were famines, epidemics, and sometimes half of Europe was killed off, but advances in agricultural technology, public health, and medicine by the end of the 19th century largely eliminated these severe crises. At the turn of the 19th to 20th century, 80-90% of the Western world's population lived in the countryside and ate what was produced there. Today 70-90% of the population of developed countries live in cities (Ritchie and Roser, 2019), and eats only what the food industry offers them. Product development of the food industry, which was born at the end of the 19th century, is determined solely by consumer tastes, and the long-term health effects of nutrition have not been studied at the level of the population. People's ancient desire to eat until they are stuffed full every day could now be satisfied on a wider scale.

While in the United States in 1890, 2.9% of the population over 60 was obese (that is, with a BMI above 30 kg/m2), by 2015 41% was obese (Helmchen and Henderson, 2004). In 1960, the category of severe obesity had to be introduced (BMI above 40 kg/m2), and by 2016, 8% of those aged 20-74 belonged to this group. Overall 31% of the US population is overweight, 40% is obese, and 8% is severely obese (Fryar et al., 2018). The situation in Europe isn't much better.

In the 1960s, the rise in obesity and the incidence of heart and cancer deaths started to become a political issue. In 1977 a US Senate Special Committee issued dietary recommendations to reduce the consumption of meat, animal fats, cholesterol, sugar and salt, and to increase the consumption of carbohydrates, vegetables and fruit (Hite et al., 2010). The recommendations were heavily criticized. The recommendations were politically and morally motivated, and scientific research has not shown that the changes really do prevent the obesity epidemic, or associated diseases (Harper, 1978). In fact, the recommendations reflected Senator George McGovern's personal convictions, as he became a believer in Nathan Pritikin's fat-free, plant-based diet (Minger, 2013). The recommendations blew the fuse of the agricultural and food lobbies, therefore in 1980 state guidelines, to satisfy lobbyists, the slogan 'eat less' was replaced with 'avoid consuming too much meat, eggs, salt, alcohol, etcetera.' From egg producers to the meat industry, this sounded like 'eat enough' (Nestle, 2007). The recommendations were not scientifically supported any better than McGovern's were, driven by political ambition. The 'guidelines' considered cholesterol and animal fat intake as the leading cause of heart disease, which came from Ancel Keys' cholesterol theory that was meanwhile becoming a dogma. The theory was based on fake data from its inception, but its introduction and defense served only a scientific lobby (Teicholz, 2014).

In the early 1980s, the Ministry of Agriculture set up a group of experts in nutrition - to eliminate scientific unfoundedness - who worked for many years on the recommendations, published in 1992 - which weren't even recognized after publication. Their last version, which was sent to press, contained the following suggestions: The base of the food pyramid consists of 5-9 servings of vegetables and fruit, 2-3 servings of milk and dairy products, 15-21 dkg of protein (meat, poultry, fish, and eggs) and 2-3 servings of whole grains or rice. According to their recommendations the diet should contain 30% fat and sugar should be below 10%. 'Snacks' (chips, biscuits, etcetera) made from refined carbohydrates were defined as undesirable.

However officials from the Ministry of Agriculture representing lobbyist interests rewrote the recommendations and put 5 to 11 servings of refined carbohydrates (cereals, potatoes, etcetera) into the base of the pyramid, 2-3 servings of vegetables were included, and the proportion of dairy products was doubled. Instead of limiting sugar consumption, 'moderate' consumption was recommended. The most shocking thing for Louise Light, the leader of the group, was that she was the only one who protested - while the rest of her team lent their names to the new diet pyramid (Light, 2006).

In essence these 'guidelines' did not deviate much from the 1977 recommendations, and since then have dominated the western world's national dietary recommendations, with only slight changes - for example French fries have been reclassified as 'fresh vegetables'. Going against the scientific facts, red meat and animal fats are still not recommended, and instead poultry and vegetable oils are recommended.

A similar story took place in England, where in 1979, there was concern over the health of English people, and Professor Philip James was asked to set up a group to formulate dietary recommendations. The report of the group was qualified by various sub-divisions and Ministerial committees which then proposed their revisions. The workgroup revised its recommendations three times between 1980 and 1983, which were rejected every time (Maguire and Haslam, 2010).

Thus, today's dietary recommendations are scientifically completely unfounded, and are merely a summary of the food lobby's and other's interests. In a later recommendation the proportion of vegetables was raised, not on the basis of research, but at the request of the American Cancer Association. The recommendation of polyunsaturated fats instead of saturated fats is not only wrong (Harcombe et al., 2016), but is extremely harmful, as omega-6 vegetable oils (baking oils, margarines) severely increase the risk of cardiac death (Virtanen, 2018). Many well-established studies prove that it's not a carbohydrate-based diet, but rather a lowcarb diet (less than 50 grams of carbohydrates) which is good for health (Hite et al., 2010).

The PURE study, following 135,000 individuals from 18 countries, proved that both the risk of heart disease and overall mortality increased proportionally with carbohydrate intake, while it decreased with increasing fat intake (Dehghan et al., 2017). The dogma of salt reduction has long been overthrown, but even today at a public health level people are still asked to reduce their salt intake through regulation, taxes, and persuasion. An eight-year follow-up study of 95,000 people proved that the higher the salt intake, the lower the heart rate, and overall mortality (Mente et al., 2018).

Dietetics cannot be viewed as science, and dietitians are not scientists, but are employees who are merely promoters and enforcers of those dietary recommendations based on economic and political interests. These dietary recommendations are nowhere near objective scientific results that serve human health. A separate industry has been created that produces 'scientific' summaries and meta-analyses in the interest of the food industry, which then lends scientific insight to these recommendations (Bero, 2017; Ioannidis, 2016). The vegetable oil industry has long been implicated (Teicholz, 2014), and recently it has been revealed how the sugar industry has manipulated studies and summaries about the effects of sugar on health (Gornall, 2015).

The average person only shakes their head when they come across the latest new recommendation that sometimes defies common sense, or contradicts an earlier recommendation. More skeptical members of society are right to feel let-down. And dietitians should not be offended if some of us assume they have made a pact with the food industry, or that they are only capable of repeating official doctrine.

 

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References

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Virtanen JK. Randomized trials of replacing saturated fatty acids with n-6 polyunsaturated fatty acids in coronary heart disease prevention: Not the gold standard? Prostaglandins Leukot Essent Fatty Acids. 2018 Jun;133:8-15.