Response to the BBC Radio 4 broadcast of The Food Programme ‘The Eatwell Guide’, aired July 2nd 2018.
A consensus response from Health Professionals to the BBC broadcasting of unbalanced and misleading advice that fails to adhere to the evidence-based Eatwell Guide. We are concerned that the BBC’s narrative will continue to fuel the current epidemic of chronic disease.
In the recent broadcast on BBC Radio 4 of the Food Programme, “The Eatwell Guide”, aired 2nd July 2018, unbalanced and misleading advice was put forward by the presenter and guests, which was biased in its coverage as it focussed on opinion rather than the science. This only adds more doubt and confusion for people struggling to regain control of their health.
The programme was aired despite Professor Levy, Head of Science of Public Health England (PHE), warning that promotion of fat would further confuse and mislead the public, many of whom do not follow the Eatwell guidance.
“What we need people to do, is to actually start eating consistently with the Eatwell guide. Confusing messages, suggesting that the guide is wrong and that we should eat less carbohydrate will only increase the risk of heart disease and that will have the same impact on the NHS as current levels of obesity.”
Professor Louis Levy
Less than 9% of airtime was given to explain the science behind the current Eatwell Guide
The table and chart below shows the breakdown of airtime
The Eatwell Guide balances robust evidence-based research with a consideration of people’s current eating habits and their acceptance of change. Consideration is also made towards the food industry to be able to deliver available foods and sustain the economy. With respect to the latter, compromises are made.
There are governmental conflicts of interest between PHE and the Department for Environment, Food and Rural Affairs, which compromises health advice and food production. There are stark scientific data demonstrating the unsustainability for the planet of an economy heavy on meat, dairy and fisheries. Continued land degradation and mass species extinction has resulted in a gradual drive for more choice and accessibility of plant-based options in supermarkets, restaurants and canteens. Thus further emphasis should now finally be put on a predominantly whole food plant-based (WFPB) diet, given the data supporting its role in promoting longevity whilst preventing chronic disease.
The Eatwell Guide is in accordance with other World leading dietary advice, which is gradually shifting towards more whole plant foods and reducing foods derived from animals. The public may in turn be more accepting of the science when they experience the improved physical health and emotional well-being to be expected with these changes. To put it simply — if they don’t know, how can they achieve optimal health and well-being?
Examples of current international recommendations consistent with the Eatwell Guide include:
WHO — Healthy diet
Belgium — Food triangle | Flemish Institute for Healthy Living
Canada dietary review — Summary of Canada’s Food Guide Consultation
USA myplate — MyPlate | Choose MyPlate
Harvard healthy plate Healthy Eating Plate & Healthy Eating Pyramid
It is adaptable to meet the recommendations of the WFPB “PCRM PowerPlate” Power Plate — The Four New Food Groups | The Physicians Committee
As a consensus of Health Professionals, we support a predominantly plant-based diet whilst limiting foods derived from animals thus delivering a Whole Food Plant-Based (WFPB) variant of the Eatwell Guide.
We recognise the mounting scientific evidence which is converging to advocate:
● Promotion of bean and legume consumption as an alternative to meat.
● Promotion of whole grains and fibre rich foods.
● Promotion of plant-based omega 3 fats (PUFAs) (ground chia and flax seeds).
● Promotion of healthy fats sources, such as avocados, nuts and seeds.
● The continued reduction of saturated fats and refined oils (RDI under 10%).
● Promotion of plant-based alternatives to dairy.
● Raising awareness that meat is not essential for a healthy diet.
● Advise that red and processed meat consumption is limited to rarely or none.
● Advise that other meat intake guidance is limited to only occasional.
● Advise that contamination of fish, from heavy metalsandpersistent organic pollutants, results in long term health issues and concerns. Women of childbearing age should be made aware that exposure may have a lifelong debilitating effect on the unborn child.
● Limit egg consumption due to its high saturated fat and cholesterol content.
● Promoting the provision of plant-based menu options in hospitals, schools, workplace canteens and care homes.
We believe the BBC should rectify this misinformation and include, for future health and food programmes, reference to WFPB diets as an evidence-based way of preventing and reversing many diseases, including obesity, diabetes, heart disease, stroke, dementia and many cancers.
The BBC could have been more unifying by drawing on what the low carb approach, the Eatwell guide and the WFPB approach have in common — limiting sugars, refined flour and overly processed foods whilst increasing vegetables, fruits and healthy whole grains and pulses — so the public can act with confidence to boost their health and that of their family.
We sign below to say we condemn the BBC for unbalanced reporting and misleading the public on health advice.
Signed: Doug Bristor, Dr Shireen Kassam, Dr Gemma Newman, Dr Mahesh Shah, Dr Sue Kenneally, Dr Alan Desmond, Dr Luke Vano, Dr Guiditta Sanna, Dr Hilary Binns, Dr Laura Taylor, Dr Mark Craig, Dr Arvind Maheru, Dr Shandeep Momi, Dr Jenny Ashdown, Dr Kirrili Taylor, Dr Yoginee Gokool, Dr Manmit Kaur, Dr Justice Reilly, Dr Hannah Short, Dr Josh Cullimore, Dr Anna Borek, Kate Dunbar, Dr Rebecca Ellen-Jones, Dr Miriam Martinez Biarge, Dr Amy Phillips, Dr Samasuri Howes, Dr Martin Ashby.
Additional points
The advantages of a ‘low carb’ eating pattern using whole foods is gaining traction, and for understandable reasons. People lose weight, they can improve their blood sugars and in some cases they can reduce their cholesterol. This is positive. In addition, removing refined flour, processed foods and refined sugar from the diet is of course a huge improvement. But there is so much data to show that in the long term, a low carb strategy is associated with reduced lifespan and increased risk of heart disease, our biggest killer. It helps to look at many sources of evidence, rather than short randomised controlled trials (RCT) or anecdote, to see how a dietary pattern can affect health. Cellular biology confirms that animal proteins cause cellular ageing and stress. Dietary saturated and trans fats contribute to mechanisms of insulin resistance. Saturated fats, which are mostly found in foods derived from animals, disrupt insulin from being able to carry and transport glucose. In other words, high blood sugars are the outcome of insulin resistance, (leading to obesity and diabetes) but not the underlying cause.
Epidemiological data confirms animal proteins and trans fats increase mortality. Studies of the most long-lived populations confirms a 95% plant- based diet is what they all have in common. Emerging research into the microbiome supports the crucial importance of dietary fibre (only found in plant foods) for optimal colonisation and gut health, which minimises the incidence of chronic disease.
To say carbs alone makes us fat is illogical. People refer to donuts and pastries as carbs when in reality they are mostly sugar and fat. We need to move the health conversation forward from vilifying all fats and all carbs and recognise that in order to help the public understand how to boost their health, there must be an emphasis on vegetables, fruits, grains, beans, nuts, seeds and water to drink. Any other approach is disingenuous and will lead to further apathy and confusion among the very people we are trying to help.
The 2018 World Cancer Research Fund recommendations for cancer prevention (www.wcrf.org) state ‘eat a diet rich in whole grain, vegetables, fruit and beans’ and ‘limit consumption of red meat and processed meat’. Also, the BMJ has just published a specially commissioned review series on nutrition and health. In the paper titled Dietary fat and cardiometabolic health: evidence,controversies, and consensus for guidance (BMJ 2018;361:k2139 doi: 10.1136/bmj.k2139) it states that ‘Much of the evidence suggests that the risk of coronary heart disease is reduced by replacing saturated fat with polyunsaturated fats (including plant oils)…… ’. This means that we should be lowering the amount of fats from animal foods and replacing it with fats from plant foods. In addition it states ‘The consumption of very low carbohydrate, high fat diets assumes that high levels of dietary fat and saturated fat can be consumed for a lifetime without the risks outweighing the benefits. A point of controversy is whether such assumptions can be accepted without long term clinical trials’. Increasingly, observational studies show that low carb diets are detrimental to long-term health.
References — a few of many
Alan Flint, Jennifer K. Pai, John P. Forman, Frank B. Hu, Walter C. Willett, Kathryn M. Rexrode, Kenneth J. Mukamal, Eric B. Rimm. Low Carbohydrate Diet From Plant or Animal Sources and Mortality Among Myocardial Infarction Survivors Journal of the American Heart Association. 2014 Originally published September 22, 2014. This paper shows that consumption of animal proteins are specifically associated with increased risk of death.
Merino J, Kones R et al. Negative effects of a low carbohydrate, high protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk. British Journal of Nutrition 2012. Low carb diets worsen blood vessel suppleness and ability to widen and constrict and stiffening them.
Fleming RM The Effect of high protein diets on Coronary Blood Flow. The Journal of Vascular Diseases October 2000, Vol 51, Issue 10. A study directly comparing low carb vs high (healthy) carb diets showing less blood flow to the arteries of the heart with low carb.
Roden M, Price TB et al Mechanism of three fatty acid induced insulin resistance in humans. Journal of clinical investigation 1996; 97 (12): 2859–65. Fatty acids induce hidden insulin resistance
Roden M, Krssak M et al. Rapid impairment of skeletal muscle glucose transport/phosphorylation by free fatty acids in humans. Diabetes 1999;48(2):358–64. Saturated and trans fats and the fat from our own fat cells impair insulin from carrying glucose
Santomauro AT, Boden G et al. Overnight lowering of free fatty acids with Acipimox improves insulin resistance and glucose tolerance in obese diabetic and non-diabetic subjects. Diabetes. 1999; 48 (9): 1836–41. Removing fat from the bloodstream improved glucose sensitivity
Lee S, Boesch C et al. Effects of an overnight intravenous lipid infusion on intramyocellular lipid content and insulin sensitivity in African — American versus Caucasian adolescents. Metab Clin Exp. 2013; 62 (3): 417–23. Infusing fat into the bloodstream worsens the amount of fat stored in muscle cells and causes more insulin resistance.
https://www.ncbi.nlm.nih.gov/m/pubmed/25198208/. Study showing reversal and arrest of coronary artery disease using whole food plant-based nutrition in nearly 200 people.
https://www.ncbi.nlm.nih.gov/m/pubmed/23550427/?i=2&from=/25198208/related Study showing regression of coronary atherosclerosis through healthy lifestyle in coronary artery disease patients — Mount Abu Open Heart Trial. Advocating whole food plant-based approaches — around 120 people
https://www.ncbi.nlm.nih.gov/m/pubmed/9863851/?i=2&from=/23550427/related The lifestyle heart trial RCT showed coronary artery atherosclerosis reversal in those who had already experienced a heart attack, involving nearly 50 people.
https://www.ncbi.nlm.nih.gov/m/pubmed/14671465/?i=4&from=/9863851/related RCT showing it is possible through a favourable diet, exercise and smoking cessation to show an additional reduction in the five-year risk for heart disease in males.
https://www.ncbi.nlm.nih.gov/m/pubmed/8829954/?i=6&from=/9863851/related In animals in which atherosclerosis was induced experimentally (by a high cholesterol diet), regression of the atherosclerotic lesion was demonstrated after serum cholesterol was reduced by cholesterol-lowering drugs or a low-fat diet.
http://www.jgc301.com/ch/reader/create_pdf.aspx?file_no=S_20170301008&flag=13 Editorial review of 28 studies concluding that a plant-based diet is optimal of hearth health.
Willcox BJ, Willcox DC, Todoriki H, et al. Caloric restriction, the traditional Okinawan diet, and healthy aging: the diet of the world’s longest-lived people and its potential impact on morbidity and life span. Ann N Y Acad Sci 2007; 1114: 434–455. Very high carb, natural unprocessed diet associated with sustainability and longevity.
J. Poore, T. Nemecek Food producer heterogeneity on a global level creates mitigation opportunities with respect to environmental damage caused by food production. Science 01 Jun 2018: Vol. 360, Issue 6392, pp. 987–992 DOI: 10.1126/science.aaq0216 Reducing food’s environmental impacts through producers and consumers.
