Dr. Zoë Harcombe on the Mess: The Money vs. the Evidence

thank you very much a few thank-yous to start off with first of all thank you Greg as Pat said without Greg we all wouldn't be here so thank you for who you are and for what you do and thank you very much for inviting me to be with you today I they want to thank Karen because the direct invite came from Karen I've known Karen since the South African conference that was put together for Professor Tim notes and she is quite simply amazing I think everybody would agree with that and I'd also like to thank Brad and T on their logistics in getting us here and getting us ready work quite superb so thank you to all of those people especially alright so I want to talk about the money versus the evidence in the context of the mess and you've seen this great graphic outside this room if any of you haven't heard me speak before I tend not to clutter up my slides with references but there are a lot of references so if you want to go to my site forward slash CF for CrossFit 19 all the references are on there and I recommend the very first reference highly because it's an article called the mess written by Greg and to sum up the mess it's basically the escalating disease the escalating medical costs which many people are profiting from but none are combatting effectively and that sums up what the mess is all about so imagine you're a multi-million dollar food company advice that supports your products would obviously be very helpful public health advisors who promote your products would be very helpful too and those public health advisors having a monopoly on promoting your products now that would be super really helpful but that is exactly what is going on in the u.s. then when I wrote my obesity book it was back in 2010 it's one of the books out in reception there's passages I look at and I think I would really love to update those especially the dietary fat stuff and those passages I'm pleased that I was writing about ten years ago and in the conflicts of interest chapter I looked at the sponsors that were partnered with the American Dietetic Association as it was known then and those were some of the household names now behind those organizations at the time I was doing this research ten years ago four hundred and sixty seven billion dollars behind the American Dietetic Association now wind forward to today they now call themselves the Academy how arrogant is that of nutrition and dietetics they have a different set of sponsors and they only now have about a hundred billion in back in now if you go to the most recent Dietetic report for the Academy of Nutrition and Dietetics their revenue amounts to 2.8 million so they are doing a shared load of stuff on very very little money and I suspect because it's got this kind of back in behind that organization now where does the monopoly come in well there was an organization called the Commission on Dietetic registration that was set up in 1969 and as of this month a hundred and four thousand dietitians and nutritionists are registered with this organization and there are legislative bills in almost all the states in the US so where you've got the red states those have the full monty of protection for the dietitians and the nutritionists who had given out in essence the fake food company advice and so there are 27 of those and the District of Columbia you've then got seventeen in green they're the next level down they've got a protected title situation but it has the same effect if you're not a registered nutritionist or registered dietitian according to their advice you can't practice in those states you've got three in the yellow that have a degree of protection but you'll still find it difficult to have a carte blanche advice consultation operation in those three states and then let's hear it for the three rebels because you've got Michigan Arizona and New Jersey beautifully positioned there in white who've said so far and they've held out we're just not having this and you can see the organization behind that on these sides but it creates a conflict because we've basically got the law because on the left hand side you've got a very typical extract from those acts that operate in those states this one just happens to be from Illinois but it's basically saying if you're trying to practice without being licensed under this act then you're committing I think it's a class 1 misdemeanor in most states you can be prosecuted you can't be fined I don't think they go as far as throwing you in jail but every time you offend you can be fined so if you ignore the ban and and offend again you get fined again but that clashes right up with your fabulous First Amendment because your First Amendment which is not shared by other countries in the world we're fighting for free speech at the moment you've got a First Amendment that says you've got a right to say what you feel and what you believe and where does that stack up well before I even knew some of the things that were going on with CrossFit I'd prepared this presentation when I was back in Wales and there were a couple of cases that really really caught my eye I had no idea that CrossFit are actually involved in these cases that this is a guy called Steve Cooksey and Steve Cooksey was catastrophic ill so he was chronically obese he was a couch potato these are his own words he was really an unhealthy guy and he was rushed to hospital almost into a coma and they said to him you've got type-2 diabetes and so therefore you're now going to be on insulin and drugs for the rest of your life and you now need to eat a low-fat high-carb diet a cook sees quite a challenging kind of guys so he said this doesn't really make sense I've got a condition whereby I can't handle glucose and they're telling me effectively to eat glucose so he did the opposite and he lost 78 pounds and he put his type 2 diabetes into remission and he looks like he does now but that's when he came across the legislative powers of the dietitians and the nutritionists who are protected so he started his blog sharing his own story because he wanted to inspire other people you don't have to take this advice that you're being given and his blog started in 2010 but it was when he started an advice column on his site and it was called Dear Abby just a fictitious person send in your queries I'll give you back my opinion and that's when the dietitians kicked into touch so by January 2012 off he had notifications from the North Carolina Board of Dietetics and nutrition that he was essentially practicing without a license now in May 2012 this organization here the institute of justice helped him with his lawsuit and CrossFit are helping both of them so they took on the case on the basis of the First Amendment and in June 2013 and if you look at the references for this slide seven there is a fabulous judgment there which is well worth a read because some of the statements in that Fourth Circuit opinion are really interesting how they talk about the law coming up against the First Amendment and they actually come to the conclusion that they cannot allow cook cease appeal to go forward without actually saying that there is a direct clash so the outcome of that case was a victory for Cooksey the Institute of Justice and I now know CrossFit because three things came from that case first of all North Carolina board needed to change their acts because it was recognized it was breaching the First Amendment the second key thing to come out from that case was that cook C was allowed to continue to give his free advice and the third observation was that there is a problem not just in North Carolina but there's a problem globally across the states where we've got these acts rubbing up against the First Amendment and online was the key word that they used and I do wonder if there's a difference between online and perhaps one-to-one consultations so the final statement that came from cook C's lawyer was that North Carolina can no more require him to be a state registered dietitian then they can require his fictitious Dear Abby to become a state licensed psychologist so that's where that case ended so right up to date July this year just a week ago Heather delcostello was an unlicensed health coach according to this article well yeah she started her company in 2015 in California which if you remember was one of those yellow states so it's not quite as bad as the green or the red ones she was offering a six-month program where you'd have 13 one to one consultation but in 2017 she moved to Florida and Florida was one of those red states and Florida then issued her very very quickly with a case saying you are unlicensed and you are practicing in effect as a dietitian so enter again the Institute for justice and the July ruling that has just come out has actually supported the Florida Dietetics Board to say we don't think Heather should be allowed to practice ongoing as a nutritionist and the Institute of Justice are arguing both on the First Amendment principle and also one that I think may have even more success the monopolistic practice principles because this is outright monopolistic practice and when you realize the monopolistic practice is backed by the who's who of the fake food industry it makes you realize this is even more outrageous so the law the lawyers for Heather this was their summary statement they are going to be appealing they're basically saying for decades since 1969 when this credentialing agency was formed it has been knocking up against the First Amendment and they've been breaking that amendment in the view of the lawyers so this case is not finished yet now for practitioners out there and I came to realize this for my involvement in the Professor Tim Noakes case because of course we had that crazy situation was a tweet and advice are you actually in a consultation if you're on Twitter of course you're not but I think the really safe areas for any practitioners are in giving out information and in giving opinions and if you don't call it advice it's very difficult for somebody to say you're not allowed to give information and you're not allowed to give your opinion particularly in this country with an amendment that you've got so what is the advice that these guys are dishing out well it's the absolute classic Dietary Guidelines for Americans my plate and food labels so I'm just gonna whiz through what they think we should be eating so I'll start with food labels because it's probably going to be the quickest but you go on their website that's the kind of advice you get on a food label how to read a food label what to do if you see X Y Z n on a food label this is what the policy should be on food labels if you don't know what something is without reading the label then don't put it in your mouth what are you doing so that's that one dealt with then we have my plate I must admit when I saw my plate come out I thought how can people be so nutritionally ignorant so if my ladies I'm not sure it's working very well here but if you can see the protein down on the right hand side what they're trying to do here is to say these are the food groups that we should be eating protein is not a food group protein is a macro nutrient how dull do you have to be to not know the difference between a food group and a macronutrient so they've missed out all of these food groups all the ones in bold the reference on this slide is a blog that I wrote on what I think the food groups are and I'm happy to debate them I think there are nine you can separate out nuts and seeds if you want you can separate out beans and lentils for all I care but I'm going with nine so they didn't include meat fish eggs legumes nuts and seeds because of course they lump them all together in protein and we'll come on to a great little graphic in a second which shows how dull they are because they don't know where the protein is so clearly I haven't got a lot of time for my plate because it's so nutritionally ignorant and then in the Dietary Guidelines for Americans essentially what they're saying is eat the usual stuff aged through healthy whole grains protein is back in there again dairy and of course vegetable oils but don't eat saturated fat salt and sugar so I want to go back to food nutrition 101 and I hope there's probably some doctors and nutritionists whatever in the audience I hope there's still something to take away for each of you because when you study nutrition rather than being taught nutrition and there is a very very important difference because if you taught nutrition you're taught the usual nonsense if you study it you can work it out for yourself so go back to the basics of what food is why do we need to eat because we seem to have forgotten why we're eating food is mostly water and then of course food is macronutrients and we have three macronutrients and from protein we have essential amino acids we have essential fats that we need to consume but there is no essential carbohydrate this is one of my favorite quotes in the literature is from the 2005 panel on macronutrients and American government documents provided you eat enough fat and protein the lower limit of carbohydrate is 0 there is no essential carbohydrate but there are essential proteins and there are essential fats and obviously in nutrition essential means something that we must consume my cholesterol is essential for life but we don't need to consume it we make it so those are the macronutrients and we then have micronutrients things that we need in smaller quantities and they are 13 vitamins 8 of the B water vitamins vitamin C which is another water soluble vitamin and then the fourth fat soluble vitamins and then approximately 15 16 we could have some debate on the minerals but everybody knows zinc calcium copper magnesium iron and so on those are the things that we need in our diet so this graphic that I've put together I really still can't see if this is working but over on this side what we're doing is looking at the three macronutrients so over on the left hand side you've got pure carbohydrate there is only one pure carbohydrate on the planet and it is chakras 100% carbohydrate arguably not a food because it brings no nutritional value whatsoever and the definition of food is pretty much something that provides nutrition in some form over the other extreme you've got pure fats which would obviously be olive or coconut oil lard is a pure fat butter isn't butter does have some water and some protein and then you can see with the yellow bar over the top protein is in absolutely everything else it's in lettuce is in fruit it's in legumes and steak and all the stuff that you would expect now what I think is really interesting about real food is that nature tends to provide us with either car proteins or fat proteins now think of car proteins as things that come from the trees and the ground they're the things that vegans do eat think of the fat proteins as things that vegans don't eat they're the animals that's your meat fish eggs and dairy and then there's some really interesting foods in the middle because nature really rarely puts carved fat and protein in good measure in the same foods and the exceptions are things like nuts seeds and avocado and it's probably why because I work more with people trying to lose weight than I do with super-fit people I'm more reticent about nuts than CrossFit is because they're what I call Moorish so if I'm working with overweight people if I let people go into that fat carb combo section open a bag of hashes or macadamias you just can't stop eating the damn packets and the fake food companies have worked that out because that's where all their food is so think about muffins or ice cream or McDonald's and the ban or the hotdogs and the ban on the ketchup everything in the fake food world is that fat carb combo which we humans cannot resist we have no appetite restriction when it comes to that area now the other interesting thing is if you're going back to those essential proteins and those essential fats they're found in the animal foods sure you've got protein in lettuce and apples and legumes and all the rest of it but it's not complete protein complete protein comes in animal foods the essential facts particular Omega 3 comes in the form that the body needs it which is EPA and DHA in animal foods yes flax seeds have got ala that's not the form in which the body wants Omega 3 so that's my favorite chart on what food is all about if we wish through carbohydrates 101 we start off with monosaccharides which we know is glucose fructose and galactose and let's call them what they are straight away because monosaccharide just means a single sugar and I think every time we think about carbohydrates we've got to remember that we're talking about sugar so we then have disaccharides or two sugars and you can see how uh krause is just a molecule of glucose and a molecule of fructose and then molto's which is not one we hear about so often is two molecules of glucose so you can immediately see because of the blue that every time you put something in your mouth that's a carbohydrate you're putting glucose into the bloodstream so why would carbohydrates be good for diabetes then we have polysaccharides which are many sugars and we have the digestible form so implants that comes in the form of starch and in humans it comes in the form of glycogen and of course we're told to eat starchy foods so that we can replenish our glycogen storage room and of course if we've got full mikage installs we're never going to be losing weight because the body's got the ready supply of fuel that it can tap into anytime it needs it and then you've got the many sugars of the indigestible kind so we have soluble indigestible carbohydrates that's things like beans and oats we have insoluble carbohydrates which are things like bran and whole grains and of course collectively that is what we call fiber so when people say that fiber is essential fiber clearly isn't essential because we already know that carbohydrates are not essential and fiber is a subset of carbohydrate so fiber is not essential and plus anything that ends up down the toilet how good can it really be for you fats 101 there are three fats we know them as saturated monounsaturated and polyunsaturated and I'd love to call them stable fats mono unstable fats and poly unstable fats because that is what we should be calling them because the saturated fat is the most stable when you've got the carbon atoms in the middle you've got the hydrogen atoms on either side of the carbon you can see it from the top picture over there and it's just forming a perfect stable chain which is why it will be solid at room temperature so you then move to something that's more heavily monounsaturated fat and it will be liquid at room temperature and it might well go solid in the fridge and then the polyunsaturated fats where you've got more than one area where the hydrogen atoms are missing and that will be liquid at fridge temperature now a couple of fascinating facts about fat every single food that contains fat contains all three fats there are no exceptions and one of the things I've come to realize it's discovering that is you will struggle to find a food that doesn't contain at least a trace of fat in fact it may only be a krause that one over on the left-hand side if you find a nutrition label on the next packet of blueberries you buy there may well be a trace of fat which means there's all three fats in the blueberries and the second interesting factoid about fat is only dairy products have more saturated than unsaturated fat not the saturated fat is bad and unsaturated fat is good but just to set the record straight so you will now be able to answer this question I don't worry I won't pick on any but which of these foods has more saturated than unsaturated fat it is the low-fat milk because it's only dairy that has more saturated than unsaturated fat so what you've got on this slide and we've got some post cars I've got some one a website they're not with us but I've got a website with this picture on there and we can always get some cars sent over to Greg if some of you want to hand these out because these are just great to have in your handbag to have a bit of a laugh with people because what we've got on this slide is the first number is the total fat in that item so you've got steak you've got eggs you've got an oily fish mackerel lard I love the lard one almonds olive oil and of course that low-fat milk first number is the total fat out of a hundred grams so it's immediately also a percentage the second number is the saturated fat content of each of those products so come down to the lard lard is mostly monounsaturated fat eggs are mostly monounsaturated fats take ditto so then our super powers that be will tell us to eat oily fish but they'll tell us not to eat red meat in the name of fat well oily fish has got twice the total fat and one and a half times the saturated fat of the red meat steak that I pulled out of the USDA database so how does that work and then look at olive oil which is supposed to be the elixir of the Mediterranean diet well we've got fourteen times the total fat in olive oil and seven times the saturated fat and the people say yes but you wouldn't have a hundred grams of olive oil you might have a hundred grams of steak okay but one tablespoon of olive oil has got more saturated fat than a 100 gram pork chop so how crazy is our diet advice when you start looking into nutrition and just while we're sticking with steak because I know we love our steak and we've been very generously given a lot of steak since we arrived on Sunday they say some really really really dull things about steaks and the to dullest things that they say about steak is one it's going to clog your arteries and I think there's probably only one way in which that could happen that would be if you intravenously injected it other than that I can't work out a mechanism and then the second thing that they say is it's full of saturated fat well it isn't the first thing it's full of is water before you cook it almost all food is the main ingredient is water vegetables of course are upper at about 90% then it's full of protein complete protein that's gonna make us healthy and strong then you've got a little bit of ash and minerals then you've got the fat which remember from the previous slide amounts to 7% and of that just a couple of the percent are saturated fat so saturated in fact literally is the last thing that steak is and yet they're running around telling us not to eat red meat in the name of saturated fat so we're now going to look at the evidence because we looked at what they're telling us to eat and we've looked at nutrition 101 so we know what's going on with food and carbohydrates and fat so if we want to look at the evidence for what they're telling us to eat and then the evidence for what we think they that we should be eating then let's have a look at this now this is commonly viewed as the evidence pyramid so right down at the bottom you've got test-tube research you might have animal research moving up the pyramid you get to things like case reports or opinion pieces you've got to be coming in at the top of the pyramid to be having some seriously credible evidence and over recent years and this is debatable it is generally seen that a systematic review when you go through all the literature and look at all the studies you don't cherry-pick and then pulling those together in something that we call meta analysis that's generally regarded to be the top of the evidence tree and if you can pull together randomized controlled trials where there was actually an intervention so you can establish causation that's supposed to be at the top of the tree they will then try to pull together things that we call epidemiological studies and we'll come on to those in a minute because they are nowhere near as good so we're trying to get stuff up at the top of that evidence pyramid and so I'll start off with the meta-analysis of randomized control trials evidence for the Dietary Guidelines for Americans and the Academy for Nutrition and Dietetics and I didn't forget to put anything on that slide because that is the meta-analysis evidence of randomized control trials for their diets there is none there is arguably only one RCT that is large enough and long enough that is actually tested this diet which is rich in veg and fruit and grains protein of course in everything dairy oils etc and it was of course the Women's Health Initiative which was the main paper was published in 2006 and those were the key findings so you've got large enough and long enough you've got 48 nearly 49 thousand women over 8 years the intervention was to have more vegetables more fruit more grains less fat and it made no difference whatsoever now some really interesting things that we need to note before we move on from this Women's Health Initiative so immediately every man in the room can ignore it it was conducted on postmenopausal women I haven't seen a woman in the audience yet who looks over 30 so it also doesn't apply to any of you it's a very very select group it's what we call non generalizable you can't then apply it to the general population even if they had found something and the next thing that is so important because we're trying to talk about evidence base here remember that the first Dietary Guidelines for Americans came in in 1980 and in 1977 they were being put together by Senator McGovern so back in 1977 we had the fruit veggies low-fat high-carb advice coming in women were recruited they were enrolled into this study between 1993 and 1998 that's 20 years after the advice has already been given so we can categorically say it is not evidence-based because for something to be evidence-based the evidence must come first and it never can be evidence-based because the evidence wasn't there first so what I'm hearing now is at a conference in London in May and there was a Cambridge academic and they're starting to talk about evidence informed because they know they're never going to win the evidence base because it wasn't there at the time so then we turned to the epidemiological evidence and there are three fundamental thought floors with epidemiology and I'm going to be glancing at Gary quite a lot here because Gary hates epidemiology more than possibly anyone else in the world quite rightly first floor obviously with epidemiology is that it can only ever establish Association and not causation so what I've got here is some data or some studies from the fiber wholegrains world so this one came out in January of this year by Reynolds and they were claiming that there would be a 15% difference in all cause mortality if you've got people having 30 grams of fiber a day versus 5 grams of fiber a day I mean seriously how bad is your diet have to be that you're not even having 5 grams of fiber a day you're not even having a vegetable or not from what I can work out so anyway they established the Association they then look at relative not absolute risk so that 15 percent number is relative not absolute risk now with a meta-analysis you don't have the detail of the studies in that top level paper so to understand what's going on with absolute risk you have to go down a level so I went to yang which was one of the most important papers in an umbrella review that had been done on fiber at the time and yang very helpfully came up with the 16% difference in all cause mortality so I know that I'm looking in in roughly the right area and the absolute risk in this case was 0.68% over the duration of the studies so when you apply that 16 percent difference it comes down to the difference between point six three and point seven three so that's the difference between six in a thousand and seven in a thousand and that's if it were causal and it isn't because you don't get into causation unless that top number is a hundred percent you've got to have something like double the Association before Bradford Hill criteria would kick in so who cares even if it were causal you're going to go out and eat 30 grams of beans just to avoid that kind of risk and then possibly the most important aspect the healthy person confounder because every time you look at epidemiology there's a characteristics table and you look at the people in the 30 grams today of fiber and you look at the people in the 5 grams a day of fiber and I just picked up one study here to give you the exact figure so this is the zoo study which was key in that Reynolds paper twice the alcohol intake for the lower fiber guys one and a half times as likely to be obese one and a half times as likely to be in the lowest activity category one and a half times as likely to be in the lowest education every time you see an epidemiological study or a meta-analysis of all of those studies those are three things going on and the healthy person can founder I think is one of the most important a Gary said in the Denver conference earlier on this year what they're doing with epidemiology is they're taking that super healthy person who doesn't smoke and doesn't drink and is super active and well educated and high income and they just happen to eat in this way and what they're saying is if everybody else in that way they would be as healthy as that super healthy person which of course is madness because they've got every other advantage on top of that going on so that then drives you and you can insert any words you like for the word fiber so when you spot that healthy person when you see that epidemiological study is the thing that they're talking about a marker of the fact that the person is healthy or is it what makes them healthy I think somebody who eats whole grains and beans and pulses is a healthy type of person I don't think giving those beans and pulses to another person who's going to make them healthy maker market is a really important thing so it got me thinking why let's explore this healthy person just a little bit more why do they even find a 15 percent difference even though it's relative race why do they find a difference so I came up with this 2x2 matrix because at the same time they were trying to say you've got to eat your healthy whole grains because you've got to be having loads of fiber so I split the food groups there's a nine food groups from earlier on and I put them into this thing that I've called the carb fiber matrix up in box say you've got a lot of stuff that we so it's high fiber but low in carbohydrate and then in box C you've got stuff that's low carbohydrate low fiber over in box B's where they want us to be living so it's high fiber high carbohydrate and then I think we've got agreement if we could get the conflict of the fake food companies out of the way we should please have agreement that we shouldn't be occupying box D which is low fiber high carbohydrate just pure junk so what kind of person is occupying box B well because we're in America I think it's the kind of Gwyneth Paltrow kind of person now Gwyneth Paltrow loves fruit and vegetables so much she actually named her children Falls and muesli no I jest she actually named her children Apple and Moses but he's pretty close don't you think so she's up there now she's healthy if she eats legumes it's not gonna make a difference to her health and then down in box D and remember when they're doing these fiber studies they're not comparing box B with box C or with box a they're comparing that dreadful dreadful diet down in box D and love him or hate him you've got to admit he doesn't eat well but that that's what you're comparing so that sure healthy person confounder think Donald and think Gwyneth and you'll be just about there so the latest meat bashing that we had this was only six weeks ago or so so another study came out this one was from the UK makes it slightly different a rasher of bacon a day and you're all gonna die it came from this article in the Journal of Epidemiology and I'm far more interested in non significant findings than I am in significant findings because non significant findings tell you a lot so in this study there were a shedload of non significant findings but they didn't report them they just reported the one where they found something for a rush of bacon we'll come on to that in just a second so the non significant findings they found were for bowel cancer and poultry and for fish and for dairy interestingly if you ever want a study to say that dairy is not gonna be a problem for bowel cancer believe it or not this vegan study is gonna help you out cheese and even bowel count some red meats because of course the headline was about red meat but as soon as you get into the detail of the paper they drop the red meat bit and they're into red and processed meat and then really interestingly because we're told that all this fruit and veg and fiber etc is gonna save us from bowel cancer there was not an inverse association with all of those or tea or coffee and bowel cancer so they found nothing protective among the things that they liked to tell us to eat so in their association not causation they were claiming there's a 19% difference if you have 25 grams of bacon a day which is basically a rusher of bacon this is what the absolute risk boiled down to it boiled down to eight cases intense hour some people in six years so one in 10,000 person years and that got headlines around the world that's epidemiology for you and of course the healthy person confounder was absolutely in full swing in this paper the meat eaters processed meat in the Maine were much more likely to be older and smokers and drinkers with a higher BMI higher body fat higher non-steroidal anti-inflammatory users which is not great for the bowel and lower vegetable eaters so they have everything stacked against them and they don't even always adjust for all of those things so that's epidemiology so right the things that's that's what they say we should be eating so I think we're in agreement there there is just no evidence for the fruit and veg and all the rest of it and then this is what they say we shouldn't be eaten if you remember it was sugar fat and salt now when sugar we agree we agreed that sugar is is not great for people but what they don't seem to realize is that when they're recommending carbohydrates they're recommending sugar because they don't seem to know that they are single sugars and double sugars and many sugars so that level of ignorance as well astounds me salt we disagree why on earth do they demonize salt so they demonize salt on the basis that there is a relationship between salt and blood pressure which in the short-term there would be if you went out now and had a salty bag of something you would find yourself getting thirsty because that's your body's driver to take him potassium to balance out the sodium potassium and to get you back to normal but if you having a salty die every day and and by I think it's an unnatural salty diet so I think anything that they see with salt is actually more just a reflection of a process food diet because natural food is naturally balanced in sodium and potassium but anyway even if you care about the blood pressure angle this is something that came from the nineteen ninety-four coma report that's the Committee on medical aspects of nutrition it was a British report and it was saying that the review group recommendation was to reduce salt consumption by three grams a day that's practically having the average salt consumption and they said that that might affect systolic blood pressure that's the first number you get in the blood pressure reading by three and a half million grams per liter and the final quote comes from one of Gary's books he might even recognize it there because Gary said exactly the same in the diet delusion good calories bad calories cutting our average intake of salt in half which is really difficult to do in the real world might get something like four to five drops in somebody with hypertension already and perhaps only a couple in the rest of us it makes no difference whatsoever and they're not setting targets that we have in salt they're trying to say oh if we just got rid of it by 0.2 of a gram or something it would make a big difference Harvey it's gonna make bugger all difference so stop demonizing salt and if they had any evidence to link salt directly with any chronic condition they would produce it and they have none the fact that they cannot produce that tells us that they have not you will only ever hear them say that salt raises blood pressure and blood pressure is associated with heart disease and blood pressure is associated with heart disease but is that because if you've got heart disease your blood pressure goes up so is it a marker or a makeup I don't think salt has got anything to do that now fat we disagree and we disagree and this was the subject area of my PhD so what I wanted to do for my PhD was to go back in time to say is this stuff evidence-based was the evidence there at the time that we introduced those two dietary fat guidelines to have no more than 30% of our diet in the form of total fat no more than 10% of our diet in the form of saturated fat so I did that evidence based pyramid thing I did the systematic reviews and the meta analyses I did them first of all with RCTs then I did them with the epidemiological studies and the unique thing about the PhD was that I went back to the time when the Dietary Guidelines were introduced so the first two studies were done on the data that were available at the time to those dietary guideline committees and there were only six studies there are only six RCTs that would have been available to that committee you'll know them as things like the Rose kornel trial the Oslo diet Heart Study the Sydney diet heart study there were only six and none of them are concluded that we should intervene in any way make any dietary interventions in fact a couple of them warned about their interventions and so the rose corn oil said that they were quite worried that it would didn't appear to be beneficial and could indeed be harmful and Woodhill warned about the toxicity the potential toxicity of his intervention of a vegetable oil diet and the low fat diet committee actually the final sentence of that paper from 1965 says a low-fat diet has no place in the treatment of myocardial infarction heart attack and yet the committee went ahead and introduced those guidelines so I'd also looked at the epidemiological evidence the cohort evidence and that would include things that you will have heard of like the Framingham study maybe the London Bankim busman's study and absolutely the seven countries study you will all have heard of that only one of those six studies suggested that there was even a relationship between saturated fat and heart disease not many people know the seven countries study found nothing against total fat whatsoever so there was absolutely no evidence underpinning the guidelines when they were introduced so then you bring it forward and you say okay let's be generous there wasn't evidence at the time is the evidence there now the RCT evidence isn't there now the epidemiological evidence isn't there now and if you want to read one paper from all of my PhD Thank You B GSM for putting that on open view it just wraps up all of those four studies and says where the evidence was if there was any and the overall evidence is resoundingly we should not have introduced those dietary guidelines and those Dietary Guidelines on fat should not be there today and I'm not alone in thinking this and the final chapter of the PhD you have to put your own research into context of what everybody else is doing and many people have also been looking at this area and you may well recognize some of these names skia familiar or one of the first to kick it off back in 2009 you've got the very well-known Siri Torino paper you've got the two Hooper papers which are the Cochran ones Chowdhury 2014 string shacking and Hofmann and only put in two sorry four of our papers not the eight findings that I could have put in and that amounts to 40 separate findings and a finding might be looking at saturated fat and heart disease or saturated fat and cardiovascular disease or it might be total fat and all cause mortality there were 40 different findings among those different teams of researchers and the most important thing to notice on that combined slide and that is the totality of the evidence where people also looked at mortality that's really important because there's no point dying less of one thing to die more of something else so those that people looked at mortality 37 out of 40 found nothing why is that not the headline why is the newspaper headline not 37 independent findings from different teams of researchers came to nothing whatsoever so what were those three well one was from Chowdhury saying that trans fats seemed to be bad for cardiovascular disease coronary heart disease whatever no disagreement I think from anyone in the audience on that one and the other two then came from the Hooper study and it should have been again important for Hooper to say we found nothing if I bring up some of the things here because this is where the Hooper study will come in nobody has found anything against total fat ever not even the Hooper study and then Hooper will also report as do all the others there's nothing significant for all cause mortality or coronary heart disease mortality or cardiovascular disease mortality or fatal heart attacks a non-fatal heart attack stroke clarity as coronary heart disease events nothing for all of those they found one thing for cardiovascular disease events and swapping out saturated fat and swapping in polyunsaturated fat so they said we recommend that you do that you eat less saturated fat more polyunsaturated fat in the name of cardiovascular disease events and they just repeated that finding four years later and those are the only findings that we have against saturated fat now when you look at the body of that massive paper and I always credit dr. Trudy Deacon for finding this on about page 157 or something they did a sensitivity test and they said let's look at the studies not just where they set out to swap out saturated fat and swap in polyunsaturated fat but where they actually achieved what they set out to do and the finding falls away so in the studies that actually did that swap there's again nothing to report and that is the totality of the evidence again it's saturated fat so I'm sorry dietitians Academy whatever you want to call yourself you can't keep standing up there and saying there's a problem with fat or a problem with salt because the only problem is with sugar so what do I think we should be eating well if again we could get rid of the con fix could we perhaps agree that real food would be a good idea some people say well what's real food well oranges grow on trees cartons of orange juice don't fish swim in the sea breaded fish sticks don't it's not tough you can teach a five-year-old its way to gets very excited when you start talking about real food it's like come on guys grow up choose that food for the nutrients it provides remember why we need to eat because we need those complete proteins essential fats vitamins and minerals eat a maximum of three times a day another piece of their advice is that we should eat little and often we should graze I have this little stain unless you are a cow or want to be the size of one stop grazing because you will end up that way now these are not the dietary related ones or just flash these up manage alcohol intake to manage fat burning because alcohol the issue is not calories you can't process the calories from alcohol you cannot store them as fat what's going with alcohol is it inhibits the operation of glucagon so you cannot burn body fat while you're processing the alcohol it can be helpful for diabetics not to be abused but it's not great for trying to lose weight and then this was the phrase that I used in my 2010 obesity book I hadn't heard of CrossFit then but it's functional fitness do what we're designed to do lug things around walk clean garden if you've got a cleaner and a gardener and then you're going down a conventional gym they're getting a better workout than you are that's crazy so we backed this what should we be eating well point clearly that's where we should be focused in terms of macronutrients because we're going to get the complete protein and the essential fats in the form that we need them in those animal foods on the right hand side and I probably should have declared an interest earlier I was a vegetarian for 20 years I did not want to discover that when I discovered that it was not a good day but you have to go with the evidence and the evidence says you need to eat red meat and oily fish and so you need to eat red meat and oily fish so then if you look at the micronutrients and what I've done on this slide is put up one of their five a day that's a laugh as well isn't it an Apple brown rice so you've got your healthy whole grain so you've got lentils legumes you've got a green vegetable and then of course you put them up against what I know to be the healthiest food on the planet which is liver steak and sardines so you've got to read me and an oily fish and then just put up some of the things that we need the protein quality is a slightly subjective score it comes from the USDA database you've got along the left-hand side here you've got the recommended daily amount I don't know how accurate they are but it's a guide and then you've got the winner in each row that I've put in red so brown rice wins on calories that's probably not the one you want to be winning on and then just look at live on I mean liver then just cleans up on everything else she needs so this is per hundred grams for all of them you need so little liver just slipped into your diet every now and again to just get this fantastic nutrition sardines then of course start knocking it out of the park on the bone nutrients vitamin D and they will on the minerals as well come to see broccoli does very well on vitamin C but this is one of my other favorite nutrition factoids did you know that liver has almost four times the vitamin C of an apple so of course you've got to be able to get the nutrients from animal foods because carbohydrates are not essential remember back a few minutes ago so then we bring in the minerals and you keep the same foods and because the plant foods come from the ground they should start to do quite well for minerals and I did get a little bit irked when I saw things like brown rice and lentils doing really well so I thought I'm just gonna slip in a new food there because I'm a bit partial to very very dark chocolate so if you put in cocoa powder which is of course the basis of 85% and above dark chocolate then cocoa powder will be all of those healthy whole grains and legumes and fruits and vegetables so jolly good for cocoa so in summary what do I think we should be eating number one real food choose that food the nutrients it provides I think Michael Pollan has famously said eat food mostly plants not too much and I've come to the conclusion we need to eat food mostly animals quite a lot because you do need something like a good 200 gram mistake sorry for you guys in ounces that's like an at least an 8 ounce steak to be getting your zinc requirement for the day zinc doesn't just grow on trees as I'm also fond of saying so Michael will think we should be having the whole grains and pulses and I think we should be having ideally ideally I do understand not everyone can afford it or access it but pasture fed meat eggs dairy fish and berries we agree on vegetables and salads so we do have some agreement with the the healthy whole food guys and then I slipped in one new chart for this presentation that might be worth a little camera photo because I put up at the top what they want us to eat which is the veg fruit grains dairy of course fat-free and then I've put it against what we actually need as human beings so we need the essential fats we need complete protein so the caveat is in the top left hand of the table in the right form for the body so I'm not scoring plants for vitamin A because they provide carotene they don't provide retinol and the body needs retinol and when you get to the fat soluble vitamins the body wants d3 which comes from animals not d2 that comes from plants it wants k2 from animals not k1 from plants it wants heme iron that's the most absorbable form that also comes from animals all the evidence points towards the fact I'm sorry but we need to be eating this stuff down at the bottom of the eggs the dairy the meat and the fish and of course even meats will provide some vitamin C so we have new areas of conflict going on in the world we don't just have the Academy for nutrition and dietetics with their fabulous 100 billion worth of sponsorship behind them you cannot have failed to spot the eat Lancet report earlier on this year and those are the organizations behind the eat Lancet report I've just circled some of them I think it actually would mean easier to circle the ones that either aren't I agree food biotech companies or just fake food companies I think there might be I'm where there's Google in this I think Google is probably being about the only good company but if you like conspiracy theories and gary says he doesn't do conspiracy theories I love conspiracy theories the best conspiracy theory and I don't think it's a conspiracy theory is when you've got the agry tech companies wanting to control us our food supply the eat lancet report is the way to do it because there is only one food on the planet that gives back to soil and without soil we can't grow our own food and that is ruminants so there's cows and sheep and goats and they chew the land and they give back to the land and they host the microflora and then regurgitate them and defecate and we and whatever it's just this fantastic cycle of life that maintains topsoil now go to a vegan world where you don't have those ruminants you don't have the topsoil now these guys are already growing food upside down in greenhouses no soil required if you really want it to control the world's food supply which is surely the Armageddon end game of any fake food or agry food company we are going about it the right way damn red meat promote the vegan agenda get this kind of nonsense in The Lancet call it in the name of climate change when actually you're doing the exact opposite you're destroying the planets ability to grow food this is the final slide the mess which is where we started off if you remember is the combination of runaway medical costs and disease which many profit from and we've gone through a number of people who are profiting from those at the moment from individual dieticians to huge agrochemical companies but none are combating effectively the Academy the Dietary Guidelines for Americans that credential an organization they are at the heart of those who are profiting and yet are failing to combat and their advice is not even evidence-informed let alone evidence-based so I think they need to be countered with an equal and opposite force and I think these guys would probably make a great start thank you very much for listening you

Channel: CrossFit®

Views: 70,298

Keywords: crossfit, nutrition, home, at home, movement, functional, exercise, scale, modify, constantly, varied, ddc, health conference, Dr. Zoë Harcombe, the mess

Id: UzX1QTSSw88

Length: 51min 9sec (3069 seconds)

Published: Wed Sep 04 2019