Printed in the Irish Medical Times, Monday April 22 2013.
By Dr. Neville Wilson
The recent exposure of “junk food”, parading as healthy meals for hospitalized patients ( Irish Medical News 4 March 2013) is a disturbing revelation, raising serious questions about the standard of dietary care offered to our most vulnerable patients.
Health professionals responsible for the dietary requirements of these patients should be afforded an opportunity to review their practice with endeavours to initiate required changes under the guidance of a proficient clinical nutritionist.
The reported list of frozen commodities being lined up for patient consumption may reflect some shortcomings in nutritional awareness that require to be rectified under supervision.
Understandably, the logistics of purchasing food and planning feeding programmes under present economic constraints is formidable and challenging.
The reported purchase of 89 tons of frozen chips, and the vast tonnage of waffles, wedges, pizzas or burgers, on the planned dietary schedule for bedridden patients, reflects an ill advised perception of safe and healthful dietary choices.
While this shopping list appears to be shameful, it must be noted that the high content of polyunsaturated fats, present in these commodities, has the official endorsement of our national dietary policy, as reflected in the “Official Guide to Healthy Eating”.
None of the listed items are typical saturated fats, and to falsely implicate them as such, according to one senior HSE dietician, reflects gross ignorance of what a saturated fat is, and how it’s beneficial nutritional qualities contrast with those of the unhealthy and potentially harmful polyunsaturated fats, and transfats, so ubiquitous in the Irish diet, and reflected in the hospital food plan in question.
The reported Hospital shopping list, that includes many frozen items, and other pre-prepared choices, is loaded with polyunsaturated fats and trans fats, and is guaranteed to increase the patient burden of omega – 6 inflammatory fats, proven culprits in the cause of cardiovascular disease and other inflammatory disorders.
The food managers in the hospital kitchens can hardly be blamed for their selections of pseudo food, since their selected items conform to the national dietary preferences, which repeatedly call for a replacement of dietary saturated fats by polyunsaturated fats and carbohydrates.
National food directives consistently vilify dietary saturated fats, in support of American Heart Association policy, thereby discouraging their public consumption on the grounds that they “raise cholesterol”.
These directives ignore the fact that saturated fats promote heart health, and that organic eggs, meat ,butter and tropical oils , are healthier choices, and should be promoted as part of a healthy diet to all members of the population.
The promotion of polyunsaturated fats as “heart healthy” alternatives to saturated fats is misguided, and does not serve the best health interests of consumers, especially those on hospital beds and compromised by co-morbidities.
The fearsome warnings, by some senior HSE dieticians, about saturated fats and their “cholesterol raising” potential is unfounded, and ignores the fact that saturated fats optimize HDL levels, which are heart healthy, reduce the levels of atherogenic lipoproteins, and protect the elderly from having too low a cholesterol level, which is a proven health hazard and risk for respiratory and gastrointestinal infections.
Despite their recent (and timely ) revisions, the national dietary guidelines continue to perpetuate the questionable dogma that poly-unsaturated fats and dietary carbohydrates should replace saturated fat. (The Food Pyramid).
Recent findings from the Sydney Diet Heart Study, as reported in the British Medical Journal (5 Feb, 2013), revealed a 75% increased risk of death from heart disease in subjects who sacrificed dietary saturated fats in favour of omega 6 poly-unsaturated fats, the so called “heart healthy” diet, as promoted by the American Heart Association, and endorsed by our own national dietary guidelines.
This increased risk was present in the group consuming polyunsaturated fats, despite having lower levels of LDL cholesterol than those consuming saturated fats.
These findings have important implications for our long held conventional beliefs about nutrition and diet, and must challenge the authors of current dietary guidelines to review and revise the content of their public health statements. (http://drnevillewilson.com/2013/03/04/lost-and-found-the-fat-facts/)
Such revisions should also be embodied in the dietary guidelines and nutritional directives issued to hospital and nursing home staff, as well as to practicing clinicians in the health industry.
An added concern regarding nutritional requirements, across all age groups, is the recent decision by the IMB to terminate the reimbursement of heart-healthy omega – 3 fish oils for deserving patients, a decision that is likely to compromise the essential dietary intake of omega – 3 and tilt the omega -3 / omega -6 balance in favour of the latter, thereby increasing the potential for inflammatory disorders of the heart, lungs, musculo-skeletal and central nervous systems.
At the very least, these supportive nutrients should be freely available to all hospitalized patients.
The current list of pre-packaged and pre-prepared items on offer to hospitalized patients by the HSE is an unfortunate concoction of polyunsaturated fats and trans-fats, and NOT saturated fats, and a ready recipe for disaster.
The implementation of such a dietary policy is guaranteed to compromise, rather than enhance, the potential for health and wellness of already compromised patients, and should be abandoned with immediate effect.
Dr. Neville Wilson.
The Leinster Clinic.
22 April 2013.