What a load of nonsense….

I received an email from a doctor friend of mine yesterday with the most ridiculous document attached. The title reads:

“Joint Statement on Low Carbohydrate Diets for Health and Weight Loss by Nutrition Society of South Africa (NSSA) and Association for Dietetics in South Africa (ADSA)“.

I am sure you can guess what it had to say…. pathetic (and unsubstantiated) drivel about how ineffective Low Carb diets are.

You can access the original document here.

My favourite statement would have to be:

The opinions that low carbohydrate diets are the best and the

solution for obesity (and many other illnesses), arise from good marketing and public relations, rather than good

science.

Uhm… yes, you read that right and no, I didn’t make that up.

What’s up with the Association for Dietetics in South Africa (ADSA)? And why the need to out out this silly paper which is badly written and shockingly referenced?

In my opinion this disaster was prompted by the hammering they are taking as a result of the HPSCA/Noakes trial or “Banting for Babies” as it has become known.

To me it seems a desperate attempt at trying to prove themselves as knowledgable.

SHAME! I think this may have backfired and instead what has been proven is that they are a mockery of an association.

Now don’t get me wrong, I know some GREAT dietitians but it seems that the few ego-driven individuals heading this sad association are getting it all wrong.

Here are some of the comments from my Facebook post on this topic:

Maybe the authors (or their ghosts) just did not (want to) do a proper homework and (deliberately) ignored the mountains of RCT evidence, metaanalysis and systematic reviews?

Uhm, yes it would seem so. This happens OVER and OVER again leading me to the conclusion that they may not be able to interpret properly?

The opinions that low carbohydrate diets are the best and the solution for obesity (and many other illnesses), arise from good marketing and public relations, rather than good science.” Say what? http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0139817

Don’t let a bad ADSA article stand in the way of good science! ADSA cherry picks what they put out and won’t even put their names to the article (I mean, I don’t blame them do you?)

I’ve actually had to read through this twice to believe that somebody actually drummed up this drivel !
At very least if they are going to challenge low carb diets they should familiarise themselves with exactly what low carb eating entails. They couldn’t even make factually correct statements about what we do / do not eat. And as for the bit about bariatric surgery being the only solution to extreme cases of obesity – I’m at a loss for words.

Yes baffles me as well. Also something I picked up at the HPSCA/Noakes trial was their inability to seperate Low Carb diets from ketogenic diets. Epic fail!

You had more than ten years of my life to help me with Diabetes. I ended up at 164 kg, unable to walk even 100 m, with severe sleep apnoea, taking 270 units of insulin daily. That was the result of your protocols.

In 18 months, LCHF has turned my life, symptoms of diabetes have reversed, 61 kg down, no longer need insulin injections, no sleep apnoea.

They’ll say: “Those are just anecdotes…”

Jeez, this really is a sign of desperation. Note, no one from ADSA or NSSA prepared to put their names to this document. Sensible move to stay anonymous, I’d say, given the weakness of their arguments. These poor deluded desperate dietitians continue to commit a fatal flaw here – actually many, but one in particular: reductionist thinking – that science is just a numbers game. The poor things don’t know that 60, 100, 1000, 10,000 weak studies will always be weak studies. There’s no or strength – or safety – in weak numbers. They need to go back to university and learn from academics who are not in the thrall of food and drug companies.

Sadly it seems they are not willing to look further than their varsity textbooks from the 80’s.

What a load of cr*p! They are wrong. Just because they wrote it all down does not make them right. Now they are just wrong on the record. (Apparently anonymously on the record). And sustainability is a separate issue. Last time I checked Registered Dietitians don’t have expertise in sustainability.

True story, but according to ADSA they are…

It appears that ADSA have some sort of problem with logical reasoning. In this “getting the facts right” advice, they explain everything about eating and diabetes – except that the explanations and facts contradict each other (“eat more fruit” vs “too much fruit not a good idea” etc). Poor readers. This is utter non-sense.

I don’t think they really understand how it all works.

so their first (and I’m assuming their most important) argument against a diet *not low* in fat is the ENVIRONMENT?!

Yes, I know. What next?

Surely if they have strong evidence on the health aspects, that would be first and foremost.
Maybe they don’t.

I promise you they don’t.

My friend,but more importantly brilliant Dietitian, Dr Caryn Zinn wrote the following comment on her Facebook page.

LCHF: ONE STEP FORWARD, TWO STEPS BACK… or in this case, 10 steps back.

It’s a crying shame for the dietetic profession, of which I remain a member, that it does not wish to blend robust research with practice in a holistic sense when it comes to its stance on the carb-restricted, higher, healthy fat way of eating and living. Why can’t this way of eating be portrayed as it actually is? Why can’t dietetic professionals avoid warning people about LCHF eating, rather than embracing the fact that it actually works for many population groups? Why can’t egos and patch protection simply be set aside for the purpose of optimal health?

This LCHF-warning article (essentially what it is) is an unfortunate read, and sadly for us better-informed dietitians, this is doing nothing to endear the public to us. While I sound like a stuck record, here are my top 5 comments about this very disappointing Joint Statement on Low Carbohydrate Diets for Health and Weight Loss by Nutrition Society of South Africa (NSSA) and Association for Dietetics in South Africa (ADSA).
1. The report states that carbohydrate restriction can result in an unbalanced and restrictive diet.

CZ: Unbalanced… what does this word mean in science? Unbalance of what exactly? Food groups yes, but surely if you’re not eating the exact number of food group servings, this shouldn’t matter if you’re obtaining the micronutrients you need for optimal health for a range of sources? – which is easy to do on (well-formulated) LCHF eating. Restrictive? Perhaps, but isn’t any healthy way of eating (including the way of conventional wisdom) be considered restrictive in some sense? Don’t you need to be somewhat restrictive in our toxic, fake food environment to achieve optimal health goals?

2. The report states that LCHF eating can be expected to result in suboptimal micronutrient intake, especially thiamine (Vitamin B1).

CZ: Just enter an LCHF vs a conventional day’s food intake into a computer analysis programme to see that it is the so-called “conventional balanced diet” that fails to tick all the micronutrient boxes. What is never acknowledged in these LCHF-slamming type articles is that the RDIs were developed in the context of the conventional high carb, low fat paradigm. Thiamine is often cited as the LCHF at-risk nutrient. Firstly, this is not true (in a well-formulated LCHF diet). Secondly, consider this: One of Thiamine’s key roles in the body is carbohydrate metabolism. When carb is restricted, could it be that there is less need for thiamine meeting 100% of its RDI? Hhmmmm interesting point!

Let’s face it, RDIs might not be all they’re cracked up to be, in the context of LCHF eating. Just thinking out aloud…

3. The report over-emphasises extreme carb restriction (i.e., the ketogenic diet) and states that if someone was to do keto, this would permit only one medium-sized apple (about 180 g) with meats, fish and pure fats per day. It states that any further intake of vegetables, dairy, and nuts (etc…), lead to this quota of carbohydrates being exceeded.
CZ: Firstly, if the whole world went LCHF, keto would be for around 5% of the population, so let’s stop pretending that this will ever be a public health message. LCHF is about eating whole, unprocessed food, with an exact carbohydrate amount sitting across a fairly wide spectrum. Secondly, my keto plans for my clients would certainly not look like “an apple plus meats, fish and pure fats”, with no veggies, nuts or dairy. Seriously? Neither would anyone else’s that knows what they’re doing in this area. A crystal clear indication that the understanding of this way of eating is simply not there.

4. The report shows other countries national macronutrient guidelines which are cited as “known to be associated with reduced disease risk and provide adequate intakes of essential nutrients”.
CZ: A naive assumption that all countries have got it right! Plus a blatant ignorance of the range of RCTs out there that show superior health for LCHF eating when compared with conventional wisdom. It’s also not just about weight loss, in fact weight loss is only one of the positive spin offs here. No surprises that there is no acknowledgement of the fact that longitudinal, epidemiological correlation-based studies have informed our current macronutrient guidelines, and robust, cause and effect-based RCTs haven’t.
5. Lucky last (…the last laugh, that is). One of the last paragraphs states this: “Dietary patterns have and are rapidly changing in most countries, with natural or minimally processed foods of plant origin being displaced with industrialised food products. Aggressively marketed, ultra-processed foods now dominate our food systems. These foods contain less protein and fibre, more free sugars, total, saturated and trans sodium and, for solid products, more energy per volume, than whole or minimally processed foods”.
CZ. LCHF is ALL about whole, minimally processed foods, so here is the irony. I fear that it is the mixed messages “within” that is confusing the public. How can you endorse whole unprocessed foods, and then slam LCHF in the same breath?

BOTTOM LINE: A serious D..I..S..C..O..N..N..E..C..T.

 

Could ADSA and NSSA be stuck in the dark ages?