The food revolution or another fad diet?
I have randomly come across the video about the food revolution, presented in 2011 by Dr Andreas Eenfeldt. I was curious what it was going to be about, but then I realized it was all the same old story: carbohydrates are bad, fats are good, so let’s all go munching on butter, fatty meat, cream and cheese to stay healthy and keep the civilization diseases at bay. After the first view I only wanted to write a short article, but when I watched it for the second time a day later to be more precise in my arguments, it came out that this will be a bit lengthy reading.
What is the purpose of a high-fat low-carbohydrate diet?
Firstly I would like to make clear whether Dr Eenfeldt aimed to acutely cure his patients from the metabolic diseases (obesity and type 2 diabetes) and then let them eating really natural and healthy diet or did he aim to promote this high-fat diet as the most effective way to keep the world population healthy and fit, hence as a permanent preventative solution?
Also, what other metabolic diseases Dr Eenfeldt aims to cure? He often mentioned the low-carbohydrate diet as the healthy way to treat the diabetes or obesity, but his presentation points toward other metabolic issues as well, which includes cancer. He demonstrated this by the slide at 8:37 minute (right).
In addition, based on the graphic layout of the diagram I suggest that obesity is a central factor to all of these ailments, because sleep apnea is not a metabolic disease per se, similarly to reflux, although obesity can make people suffering from these two conditions as well.
From the context of the presentation I have got an impression that he aims to PREVENT these diseases by the low-carbohydrate diet which is high in fat as he presented on a specific example: steak, some small portion of vegetables and a special sauce made of butter and egg yolks.
In several moments he compared this high fat diet to the paleo diet, putting his diet into connection with the prehistoric people, because as his diet lacks processed carbohydrates so did the diet of our ancestors which did not grow wheat and other grains.
What evidence do we actually have?
At some point of the presentation Dr Eenfeldt presented this slide:
My question is: Is Dr Eenfeldt sure he understand completely what was said in that statement? I assume he took it as the low-carbohydrate and high-fat diet is the safest way, according the current scientific evidence, to fight off the obesity and type 2 diabetes. And I assume that this equally means to him treating the existing conditions as well as to prevent them. Preventing such condition would require a long-term dietary approach of this kind, possibly during the whole life. Now I am asking: Is THAT safe? Do we have evidence for its safety, too?
The statement explicitly mentions ‘short term‘ effect and no evidence of harm emerging within a short term treatment of this kind. Nothing more and nothing less. And this reminds me the catch-22 situation with the FDA and Monsanto when promoting new GMO crops as safe. There are almost no studies about the safety of these crops and if there are, they are of a short term, making us blinded about the potential long-term effects. Should we get worried about the health impact of the diet based on animal products, rich in fats and proteins and lacking as much carbohydrates of all kind as possible? I do have concerns after I have read the information about the link of high animal diet with the risk of colorectal cancer on the World Cancer Research Fund (WCRF) website and in their report. They provide quite exhaustive amount of information about the potential health risks of such diet, whereas the diet rich in complex carbohydrates, plant based and providing good amount of resistant starch, was found to reduce risk of various forms of cancer.
At 24.58 minute, Dr Eenfeldt displayed a table. It was some list of the metabolic syndrome risk factors and how the low-carbohydrate diet, in contrast to the low-fat diet, helped to improve many of those risk factors. However, I could not read the details of that particular slide and his website did not provide a clearer copy, so I cannot comment on that. However, I would be interested to find out whether the isnulin-like growth factor 1 (IGF-1) was included among the risk factors. I am asking about this because, although it is not a risk factor for the metabolic syndrome per se, this molecule, which is very similar to insulin, has been found to be a very potent predictor in the development of cancer. And people consuming diet high in animal protein and animal products do have increased IGF-1, too.
Therefore, although we do not have the evidence of harm regarding the acute treatment of obesity and type 2 diabetes with a low-carbohydrate diet, it does not mean that there is no evidence for health risks whatsoever, especially if one wants to use this diet as a preventative measure for the entire length of human life. While the positive changes of dietary interventions on blood lipids or insulin sensitivity can be demonstrated in two weeks, the development of cancer takes months or years. None of these intervention trials lasted for so long to provide us with evidence of safety. And, of course, I am well aware about the limitations of the observational data, which form the majority of the evidence base of the WCRF. Nonetheless, the organisation can also provide a substantial amount of scientific evidence of the experimental nature pointing at health risks of high fat and high protein diet and that is why I have decided to use it as an argument against such an extreme diet promoted by Dr Eenfeldt is.
Moreover, it appears that except of the first diagram above, Dr Eenfeldt seems to completely leave the cancer out from his presentation. All was focused on the body weight, some focus has been made on type 2 diabetes, also the cardiovascular diseases and their risk factors, as you can see from the following slides, which he used to support his arguments:
Although I accept that obesity itself is a risk factor for cancer and other metabolic issues, there are slim people who are getting cancer as well. Therefore I do not think that treating obesity will make the world cancer free. The data suggests that diet low in fiber and protective plant compounds, which are found in green vegetables as well as in root vegetables and fruits, has been linked with increased risk of various forms of cancer.
The dietary trends were not as it was presented here
It feels like a deja vu. All the same story again. Dr Eenfeldt said at 8:20 minute that the obesity started when we
“begun to eat refined carbohydrates and sugars instead of fat.”
He even supported this claim with the following diagram, saying:
“In the western world we did not replace the fat only with root vegetables or brown rice, we replaced it with sugar frosted donuts, French fries, ice cream, white bread, soda and juice, for example.”
Except of two things:
- French fries, ice cream and often donuts are also full of fat.
- Western world has not replaced the fat with anything. It kept eating more fat, and added more carbohydrates, including sugar, for decades. At least in the U.S. I do not know how about Sweden or other European countries. The UK trends were similar to those in the U.S.
The truth is that the Americans did not stop eating fat. They did not even eat LESS fat in grams. They ate more fat, too as they gradually increased their sugar consumption over the decades, up to year 2000 when this had changed. Until then they ate more of EVERYTHING in general and the sugar and fat intake shared the same trend like twins. Therefore, instead of sugar in the diet, the increased prevalence of obesity and related metabolic diseases correlated more with the positive energy balance overall. Please read the whole article about the dietary trends in America so that you get the complete picture of what has been happening there. Dr Eenfeldt also often mentions the situation in the U.S. and reports biased information, similarly to Dr Lustig.
What about the fad diet based on the Food Pyramid model?
The following slide summarizes how Dr Eenfeldt announced that the traditional food pyramid and newly the plate version of healthy dietary recommendations were fad, in contrast to his so called healthy high fat diet:
What he pointed at, was, that the government dietary recommendations did not work because people got fatter and sicker despite they were meant to maintain a good health of the particular population. You know what? The fact is that people got fatter and sicker because they DID NOT FOLLOW the dietary recommendations. If they did follow these guidelines and maintained their energy balance, the current epidemics of obesity and metabolic issues would not happen. Do you see somewhere the processed food forming majority of the healthy and balanced diet? Are the Bounty bars at the bottom or the top of the pyramid, in regard to the pitiful lunch he received at the symposium he mentioned at 30:12 minute of his presentation?
When reading the official recommendations, you will find they put emphasis on wholemeal bread and bakery. The fruits and vegetables form the second level in the pyramid and at least 5 portions of these should each of us consume daily. Then there are some dairy and proteins and on top there are fats, sugars and confectionery. No more than 10% of the added fat and sugar calories were allowed as the discretionary calories.
How different are these recommendations from the previous slide dominated by sugars, processed carbohydrates (white bun and the french fries stripped off the fiber) and cheap vegetable oils, including in the doughnut. How much real fruits and vegetables do you get in a fast food menu, except of the pickle and a leaf of lettuce or a slice of tomato? The strawberry or banana milkshake will most likely contain artificial flavorings, not a real fruit content. The ketchup is also more sugar and starch than tomato. And tell me whether you can get a Graham bun or any bakery made of wholemeal flour in a usual fast food outlet?
I personally follow the dietary guidelines quite closely and I do not have weight issues anymore. I do not eat chocolate bars, I do not eat full-fat dairy or I do not use too much oils or fats for cooking. I almost always have brown bread which is truly wholemeal, not just died with caramels. Fresh or gently cooked fruits and vegetables form a large part of my diet. I do not eat fatty bacon and the meat is truly lean when I have some. There are occasional sausages of various sorts, but these are an exemption rather than rule.
So, do you find it fair calling the dietary recommendations a fad, when they were not followed by the population and therefore not able to prove their effect?
Why avoiding all carbohydrates?
That slide at 40:37 minute about New science for weight loss and diabetes in terms of low-carb approach was impressive. However, this rises several questions:
- Is the diabetes caused by high carbohydrate diet as such?
- What is the high carbohydrate diet actually?
- Are all carbohydrates the same?
We now know that there is no evidence for causal link between high carbohydrate diet and type 2 diabetes, as long as these are complex carbohydrates, rich in fiber, and the energy balance has been maintained, including some physical activity. There is more into the type 2 diabetes development than the macronutrients composition of the diet.
You could hear Dr Eenfeldt talking about a real food in contrast to the processed food produced by food industry. However, he only pointed at processed foods based on starch while there is a whole sector of food processing industry focusing on meat, too. And this includes bacon.
But I generally agree that real food is better than processed food. If only his high-fat diet was realistic and sustainable. I will get to this sustainability point later.
For now I would like to express my respect to Dr Lustig, who challenged the extreme low-carbohydrate diet of Dr Eenfeldt with data obtained from examining the glycaemic response of diabetic patients on three various diets: the normal diet, low-carbohydrate diet and high fibre diet. The last two were very similar in outcomes. Testing the diabetic patients was a good idea to see the response of ill metabolism because most of us, healthy people, handle carbohydrates better than diabetics.
In general, we all vary in our glycaemic response to the same foods and some people are better off on a low-carb while others might benefit more from the high-fiber diet. I actually think that the latter is healthier than the former. And the only response we got from Dr Eenfeldt on the Dr Lustig’s challenge was his personal opinion that the high fiber diet would be a small change, producing smaller effect than his extreme diet, so we should aim for the most effective method. But I want the evidence, not his opinions. And this was still within short-term horizon because, as I have mentioned earlier – the long-term effect of such extreme diet is less documented. The population data suggests that high meat intake when accompanied with low fibre intake, corresponding to low intake of vegetables and resistant starches, is associated with higher risk of colorectal cancer. Escaping diabetes few years ago but finally dying from the bowel or any cancer is not such a big win, is it?
Dr McDougall can explain to you the risks of high protein diet and I would very much like to watch an argumentation duel between him and Dr Eenfeldt.
The truth about paleo diet, our ancestry and the quality of food today
The whole event where Dr Eenfeldt delivered his talk was named: Ancestral Health Symposium 2011. The doctor also mentioned the paleo times and how people, or the hominids in the more distant past, were healthy and lean (see picture). Many people today endorse the paleo diet as the correct one, for everyone. Our genetics has not changed that much so it must be the diet that is causing the current problems of metabolic diseases. This leads to a conclusion that if we ate as the Paleo humans ate, we would all be healthy and safe from disease. Is that right? I let Gary Paul Nabhan explain to you how wrong you may be to believe so, but also that it is not that incorrect in a certain meaning.
Overall, there is no such as one size fits all, even in the dietary approach. As you will find out, about one in seven hunter-gatherer tribes living today have a diet which is based on plants, not meat and definitely not on animal fat as the primary source of energy over 24 hours, every day, every year. And they are doing well. There are also vegan enthusiasts of all sorts today, who are doing equally well or even better without the high fat and high protein diet. For each person praising the low-carb diet there is at least one who swears on the opposite. You may find it interesting, as I did when I learned that Eskimos tend to suffer osteoporosis at much younger age than the postmenopausal women in general. This was ascribed to the acidic animal based diet.
In addition, the animals today are not the same as what our distant ancestors used to hunt for. The game they ate was lean and fit and it ate its natural diet, in contrast with the intensively farmed animals today. These are injected with growth hormones for milk production and fed with fattening starch based feed instead of grazing freely on fields. The current high demand for cheap meat pushes the farmers into unnatural farming practices to sustain the business. The same applies for plants. Due to the breeding of various species and cultivating for taste or other properties such as weight or size and a shelf life, the plants are no more rich in the protective secondary compounds as they once used to be or as those which still grow wild. Intensive agriculture further reduced the amount of nutrients the plants are able to extract from the soil and these, mainly minerals, are lacking in our diet, too. Gary P. Nabhan also talks about the secondary plant compounds in his book and other professionals confirm my concerns about the mineral status of the modern plant foods. And, on the website of the Food Doctor itself, a commenter named ‘kat’ wrote it as well:
“Everything you consume is a product of thousands of years of agriculture. Nothing we eat is technically Paleo and Paleolithic diets themselves varied considerably.”
Moreover, in contrast with the recommendations of Dr Eenfeldt, the paleo people did not consume dairy of any kind. So they could not eat butter, cheese or cream with the highest fat content you can find on the market as he recommends to people today. What he recommends is not a natural and healthy diet for people. It is just high fat diet which keeps the insulin down and that is all. OK, it also promotes the ketone bodies formation, which further curbs appetite, but is this a natural state for all of us over 24-hour clock time? Some vegetables forming a minority of this diet will not fix it, especially when they are compositionally inferior to those our ancestors used to consume. Dr Eenfeldt even refuses the parts of vegetables that grow below the ground level, so you would not be allowed eating carrots, parsnips, potatoes, turnips, swede, beetroots and not even garlic or onion, despite many of these are considered as super foods today. And you would not be allowed eating fruits also, despite our ancestors ate a lot of these when there was a season. After all, he did not say he is a true paleo advocate. That is correct. The paleo people did not eat such high amounts of animal or any fats. So in regards to the healthy diet of our ancestors this high fat diet can be viewed equally fad as Dr Eenfeldt calls a fad the diet suggested by the Food Pyramid, which has not been followed by the majority of the population anyway.
The true diet of our ancestors and the common misconception about it was excellently pointed out by Sarah Bowles-Flannery when saying:
“That’s the big mistake everyone makes on paleo diets. They go mad on meat but their diet should be three-quarters vegetables and fruit, the rest lean protein and healthy fats such as nuts, avocados and seeds.” Source: The Telegraph.
Finally, I would like to bring to your attention something I came across quite recently. It was in the video of Dr McDougall and you can hear him talking about it at 31 minute. He explained the reason for a common misconception that paleo people did not eat starches and grains: the archaeologists, anthropologists and other scientists commonly found animal bones around the fireplaces, but not plants or grains. Of course they did not because bones naturally ‘survive’ ages while plant matter decomposes quickly. Only very detailed examination under the microscope could reveal more facts about the actual diet of our distant ancestors 105 000 years ago. That is far older times than those 10 000, right? What is more, they also consumed underground vegetables, including tubers, rich in starch. It often could be a life-saving practice as these are quite moist and that could mean a relief from thirst in dry savanna. I remember watching a documentary where native Africans did exactly that: they found a plant, dug into the soil and revealed a juicy root which helped them to quench thirst when they were on the hunt whole day without the modern solution such as bottled water.
(Un) sustainability of the high fat animal based diets
As promised earlier, I am going to highlight few important aspects of this high-fat dietary approach, which its advocates rarely seem to consider. The truth is that the animal based diet for the entire human population on Earth (we want all of them to be healthy, right?) is unsustainable and unrealistic.
Globalization and increasing demand for animal proteins among the constantly increasing world human population has led to the depletion of three quarters of marine life. Only a small number of wild salmon exists in the oceans in comparison to the past. And the high demand for tuna fish has led the scientists to an idea of injecting stem cells of the tuna into the gonads of mackerel which should then produce more tuna. Crazy? The constantly reducing fish catch resulted in farming the most popular fish, which is fed with grains instead of their natural food they catch in the seas. The result is overpopulation of this fish in small space, high risk of infection, which has to be kept at bay with antibiotics and the resultant meat you put on your table is not of the quality you would expect and it also is not healthy. But do you care as far as you get your protein and fat on the plate? The same happened for any mass produced stock, whether it is beef, pork or chicken.
Another important point is the WATER. Without water there is no life. Without clean water, there is no healthy life for humans. As much as 6000 people die each die as a consequence of not having access to clean water. You may as well be aware about how demanding for water sources is the animal farming, in contrast to the agriculture, weight per weight or calorie per calorie. For example:
“Estimates of the water required to produce a kilo of beef vary, from 13,000 liters up to 100,000 liters . Whichever figure you use, the damage is plain when you consider that the water required to produce a kilo of wheat is somewhere between 1,000-2,000 litres.” Source: Down to Earth website.
And this is not only about the demand for water. It is also about the pollution of water. Agriculture and animal farming have became an industry and as such they largely contribute to the pollution of the air, land and water, including the vast underground water reservoirs which are not renewable.
Hectares and hectares are deforested each day to give land for animals to graze on or to grow crops to feed the animals and to satisfy the worldwide demand for animal protein. This is also unsustainable practice as the rainforest will hardly ever recover on the newly created infertile land. Do you call this a revolution?
And, as I am coming to the end of this article, I wonder what happened to the people Dr Eenfeldt presented at the beginning of his presentation – those people who have high carbohydrate and low fat diet? What happened to the unprocessed complex carbohydrates, lots of fibre and plant foods, keeping those people healthy and fit as he said at the beginning? Their thriving on the low fat NATURAL diet seems to be forgotten under the weight of the amazement about the short-term effect of this extreme low-carbohydrate and high-fat diet. Please, do not take me wrong. I acknowledge the positive effect of this extreme diet in a short-term and on diseased people as far as the evidence is taken into account. But for the rest of us, after what you have read in this article, I do not consider this diet healthy for the whole population and also for the whole planet in a long-term perspective. There is more into health than our own health today and there is more into the nutrition than focusing on macronutrients only. Let’s be real.
Just because you were patient and brave enough to read through the whole article, I have decided to share with you this funny cartoon. It states in three main points the nature of ancestral life and diet, in contrast to the fad high-fat diet promoted by Dr Eenfeldt as healthy, natural or real. There is nothing real or healthy on consuming a lot of butter or dairy and avoiding fruits or some vegetables. And the paleo diet was not at all high in fat. Our ancestors were also more physically active than we are today. Any wonder they were healthy and in such a good condition?
I now hope that you understand how false the high-fat diet is in relation to the human evolution and our ancestry. All I can agree with Dr Eenfeldt is that highly processed food is not good for us and that’s it.