In Healthy Eating Tips

The eatwell plate debate

Government advice on what we should eat can be hard to digest. Joanna Blythman rates the current guidelines.

Later this month, in a bout of nutritional spring cleaning, the government plans to unveil a new “eatwell” plate, that now-familiar image of the diet it exhorts us to follow. Don’t expect much of a transformation from the last one, which came out in 2007. The ingredients on the new eatwell plate will only be “refreshed” to reflect the latest tweak of official healthy-eating advice: that we should be eating less sugar and more fibre. Otherwise, we are told, the officially endorsed script will remain the same.

We will be reminded again that we should all be drinking semi-skimmed or skimmed milk, using spreads rather than butter, basing our meals on starchy foods, consuming five portions of fruit and vegetables a day and reducing our salt intake at every opportunity.

That is what governments and assorted public-health “experts” have been advising us to do for decades, to discouragingly little effect. Despite the sustained efforts of the orthodox public-health establishment, the nation’s waistband continues to expand, and with it the toll on our health. How come? Are we Britons really just unbiddable citizens, who, through our own lack of self-control, are failing to follow the government’s wise dietary prescription, or could the advice be wrong?

Flick down to the comments section of the healthy eating pages of the NHS Choices website and it’s clear that many people don’t trust the official advice. This from a type 2 diabetic: “I feel bound to point out to you that the dietary guidelines I received from the NHS were beyond logic.” Some contributors supply links to scientific research and plead that the authors of NHS advice examine them.

This rebellion against government doctrine is symptomatic of a build-up of pressure from a growing number of medics, scientists and nutritionists on both sides of the Atlantic. We’re witnessing an unstoppable tide of opinion demanding that the orthodoxy we have been fed since the 1960s be binned and replaced by an alternative that is fit for the purpose.

The case against cholesterol and fat
Do you remember when we were told to avoid foods containing cholesterol? Guess what — US government advice has just been rewritten to let this one-time nutrition villain off the hook. Dietary guidelines there now state that cholesterol is “not a nutrient of concern for overconsumption”. In the UK, this maligned substance has yet to be fully rehabilitated.

Saturated fat, on the other hand, remains at the heart of the diet debate. NHS Choices states: “Eating a diet that is high in saturated fat can raise the level of cholesterol in the blood. Having high cholesterol increases the risk of heart disease.” But is saturated fat found in meat, dairy foods and vegetable oils really an artery-clogging killer? The case against it is melting away like a pat of butter left out in the sun. A review of 72 studies published in the Annals of Internal Medicine in 2014 found that consumption of saturated fat was not associated with an increased risk of coronary disease. This echoed another significant review in 2010 that concluded there was no convincing evidence that saturated fat causes heart disease.

Our government has set up a working group to review scientific evidence on fatty acids and health, but it won’t publish its draft report until 2017. Meanwhile, we are still being advised to eat full-fat foods “sparingly”.

Whole milk makes a comeback
The government guidance on milk is unequivocal: “Choose lower-fat milk.” However, last October, a rigorous study published in the Journal of Nutrition found that people who consume full-fat dairy products are less likely to be afflicted with “metabolic syndrome”, the risk factors predicting heart disease and type 2 diabetes. Earlier last year, a study by Cambridge University and the Medical Research Council found that saturated fat in dairy foods can actually protect against type 2 diabetes, underlining mounting concern that, by avoiding saturated fat, we may be depriving ourselves of some useful nutritional benefits.

A new look at salt
Government advice on salt, once considered unassailable, is also in dispute. In 2014, the New England Journal of Medicine published a study of 100,000 people that found that those who stuck to lower-salt-intake guidelines had more heart trouble than those who didn’t. As one lead author said: “There is no longer any valid basis for the current salt guidelines. So why are we still scaring people about salt?”

In some circumstances, low sodium levels in the blood — hyponatraemia — have also been associated with health problems, including liver and renal failure.

Calling time on carbs
The current version of the eatwell plate encourages us to think it is fine to eat liberal amounts of white bread, cornflakes, Weetabix and refined grains. Indeed, it features an array of cakes, biscuits and confectionery that resembles a 1960s binger’s idea of a midnight feast. The strategy from NHS Choices has been to recommend incremental “healthy eating swaps” that nudge us further along the path of dietetic rectitude. It asks us to believe, for instance, that replacing a blueberry muffin with a currant bun would be a purposeful step in that direction. Yet this advice is not tempered by this vital piece of cautionary information: refined carbohydrates are rapidly broken down into simple sugars in our bloodstream, fuelling overproduction of insulin, the hormone that promotes fat storage.

Still stuck on sugar
Although the government toughened its advice on sugar last year to reflect the overwhelming evidence that excess sugar is devastating to our health, the sweet-toothed still have plenty of room for manoeuvre. A four- to six-year-old child, for example, can consume the equivalent of five sugar cubes daily (an amount that would shock many responsible parents) and yet stay within government guidelines. The current eatwell plate even shows a can of cola. So who can be blamed for inferring that sweet, fizzy drinks and substantial quantities of sugar have a state-approved daily place in a normal healthy diet?

Perhaps, when we see the new-look eatwell plate, that worrying can of cola will have been removed, thus giving us more confidence in the rest of what’s on it. But if you have long since suspected that the essential “healthy eating” prescription doled out by successive governments is fundamentally useless, you may have already stopped paying attention.

An unofficial guide to healthy eating

■ Eat foods that are as close to their natural state as possible. There really is no better designer of human health than nature.

■ Eat as much organic food as you can afford. This will dramatically reduce your exposure to potentially harmful pesticide residues.

■ Base your diet on whole ingredients that you cook yourself. This will help reduce your exposure to unnecessary chemicals in food additives, hi-tech processed-food ingredients and food packaging.

■ Wean yourself off sweet drinks — it’s easier to drink excess sugar than it is to eat it. Drink water instead.

■ Don’t be afraid of foods that your forebears ate liberally if they could. Red meat, whole milk, lard, offal, eggs and cheese are all extremely nutritious foods.

■ Love fruit and vegetables, but don’t make a fetish out of them.

■ Scan the ingredients listings on processed foods. The more they contain, the more suspect the foods are.

■ Make sugar an occasional treat and avoid white carbohydrates.

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