~ by Dr. Neville Wilson (10 May 2015)
Results from the UK Health Forum Study presented to the 22nd European Congress on Obesity in Prague, (6-9 May 2015) should be a cause for alarm amongst all Irish citizens, and also for all professional bodies who assume responsibility for public health initiatives.
The predictions that in 15 years from now 89% of Irish males are likely to be overweight, and 48% bordering on obesity, must serve as a wake up call for a nation that is predicted to be the fattest in Europe by 2013.
The likely prospects for females are no better, with a projected national increase in overweight from 57% in 2010, to 85% in 2020, and an increase in obesity from 23% to 57% within the same time-frame.
The predictions are that females will overtake males in the obesity rankings for the first time, and place themselves at similar risks for developing metabolic disturbances, such as diabetes, hypertension, cardiovascular disease and allied chronic ailments.
While these statistics may be an exaggeration, as proposed by the WHO, whose Global Statistics Report for 2014 indicate a 1% increase in obesity for Irish males between 2010 and 2014, and a 3% increase for females during the same period, the trend remains a worrisome escalation of obesity and diabetes with little evidence of a reduction or reversal.
These emergent statistics are predictive of increased premature morbidity and risks for early mortality for large sections of the population, and have critical implications for healthcare provision and costs.
Family doctors and healthcare providers will be challenged to implement interventive and supportive strategies to counter the failings and failures of Government bodies in the face of this impending tsunami in declining health across the nation.
It has been reported that a new Obesity Policy and Action Plan is currently being formulated by the Irish Health authorities, with hopes to redress the failure by the Government to impose the proposed tax on sugary drinks.
Coupled to these tax proposals should be a public educational policy outlining the harmful effects of dietary sugars and products containing high fructose corn syrup (HFCS), and the public promotion of healthy dietary fats, through avoidance of “fat free” or “low fat” selections, which invariably have a high sugar content.
GOVERNMENT RESPONSIBILITY:
The head of health promotion for the Irish Heart Foundation, Maureen Mulvihill, has called on the Department of Education to publish a “HEALTHY FOOD POLICY”, given the “poor nutritional standard of food provided to scholars in our secondary schools”. (April 10 Irish Times).
Prof. Donal O’Shea, equally concerned by the questionable strategies of the food and drink industry, is justifiably critical of their marketing initiatives to young people, and of invitations to sporting celebrities to endorse food items that are devoid of nutrients and harmful to health.
The junk food vending machines in Public Hospitals is another outlet for popular dietary items that embody dangerous levels of High Fructose Corn Syrup (HFCS) and trans fats, proven culprits in the cause of childhood obesity and diabetes, and Prof. O’ Shea admits helplessness in the face of government intransigence to eliminate this public threat.
Ms Mulvihill reports that the health of the State’s young people is “appalling” and calls on the Government to take action, quoting the Food Pyramid as an example by which “healthy food policy” should be guided.
THE FOOD PYRAMID ?
While the concerns expressed by Ms Mulvihill are valid, and well founded, her appeal to the Food Pyramid, as a guide to healthy eating, is misguided and misleading, since its unhealthy promotion of excess carbohydrates, and restrictions of healthy dietary fats, has left a legacy of chronic obesity and morbidity, for which official health bodies must take a share of responsibility in promoting its implementation in Ireland, following its introduction by the United States Department of Agriculture in 1992.
The nutritional shortcomings of the traditional Food Pyramid, as a model for healthy eating, have long been highlighted, and the fact that it still adorns the walls of many schools and health facilities, and continues to be taught to vulnerable scholars, should be a cause for great concern.
The traditional Food Pyramid was introduced by the U.S Department of Agriculture (USDA) in 1992, and replaced in 1995 because of its many weaknesses.
The replaced Pyramid continued to perpetuate dietary recommendations, regarding carbohydrates and fats, which were not supported by critical science, and was replaced by the Revised Dietary Guidelines in 2011. (See my article –“ A REVIEW OF THE REVISED DIETARY GUIDELINES FOR 2011)
It should be a cause for great concern that Dieticians continue to support and promote an outmoded and faulty Pyramid as a dietary guide, given its pictorial display of breads, rolls, cereals and grains, as an encouragement for young people to consume between 55% and 60% of carbohydrates daily as part of their energy requirements.
Carbohydrates in excess are a trigger for insulin production and triglyceride formation, which leads to increased fat storage in fat cells and inevitable weight gain, with increased risk for developing insulin resistance, diabetes and heart disease.
(Recent studies (MIRACL & dal-OUTCOMES) show that fasting triglycerides are a strong predictor for cardiovascular disease, even in medically treated patients.)
The continued promotion of this faulty and outmoded model for healthy dietary choices illustrates a critical failure, by responsible bodies, to identify and rectify a well camouflaged obstacle to health.
The unwarranted fears of consuming healthy saturated fats like butter, eggs, whole milk, tropical oils and grass fed animal meat, and the public vilification of these fats by many of our leading spokespersons in the health industry, for many years, has promoted a climate of fat-phobia, with the unhealthy consequences of low fat consumption of popular products, which are invariably high in sugar content and harmful to health.
REVERSING THE TREND:
The first step in providing healthy dietary guidelines for our young people is to abolish the Food Pyramid as a guide, and to banish it from all schools and health facilities, and from educational literature which purports to provide guidelines for healthy eating.
Sadly, the Irish Cancer Society, in its dietary guideline booklet, promotes the Food Pyramid as a plan for healthy food choices. This booklet should be revised as a matter of urgency.
The abolition of vending machines which dispense popular items containing HFCS to unsuspecting consumers should follow, with publicised information regarding the harmful effects of sugar and high fructose corn syrup.
We can then start to teach the importance of healthy fats for weight management, heart protection and the reversal of the trend towards diabetes and obesity.
The recently reported attack (under the guise of “orthorexia”) on health conscious people (Irish Times 1 May), and their legitimate concerns about the nutritional content of the foods they select, has the appearances of a veiled attack on health conscious consumers who remain critical of the unhealthy promotion of processed foods, high in refined carbohydrates, and lacking in healthy fats, and for which very reason the traditional food pyramid was abolished in 2011 and replaced by updated dietary guidelines.
The characterization of “healthy food obsession as the new eating disorder” by dietitian Patrice McNamara, is misguided and unhelpful, at a time when consumers need to become more discerning and selective in their dietary choices.
The suggestions by McNamara to never remove one shelf from the Food Pyramid hints at efforts, from some quarters, to retain the Food Pyramid as the ideal eating guide for the Irish Population.
Health conscious consumers should not be dissuaded by these tactics, and are likely to experience the delicacies and health benefits of including in their regular diets the very food items that the Pyramid continues to vilify and seeks to restrict.
Dr. Neville Wilson.
Medical Director,
MAYNOOTH.
10 May 2015.
I have warned my patients over the past 10 years that if they follow the Traditional Food Pyramid as a guide to daily dietary practice, they are very likely to end up looking like the pyramid !
I have also suggested that inverting the Food Pyramid, by placing healthy fats and proteins on the lower shelves, and placing refined carbohydrates on the top shelf, “to be used sparingly”, and following such a food plan, would inevitably lead to health and longevity, and very likely protect against the many forms of chronic disease, which are a direct consequence of chronic inflammation caused by an excess of refined carbohydrates and poly-unsaturated fats derived from vegetable oils high in omega 6.