1. 1 HEALTHY CONSUMERS AS WELL AS HEALTHY PROFITS? Barry Groves, Ph.D www.second-opinions.co.uk

2. www.second-opinions.co.uk 2 Recent fad diet?

3. www.second-opinions.co.uk 3 William Banting (1796-1878)

4. www.second-opinions.co.uk 4 Banting’s health problems – 1862  5’ 5” tall, weight 202 lbs  He could not stoop to tie his shoelaces  Couldn't attend to the little offices humanity requires without considerable pain and difficulty  He had to go downstairs slowly backward to save jarring his knee and ankle joints  He ‘puffed and blew over every slight exertion, particularly that of going upstairs’  He had an umbilical rupture  He started to lose his sight and hearing.

5. www.second-opinions.co.uk 5 Banting’s diet prior to 1862  BREAKFAST: bread and milk, pint of tea with milk and sugar, buttered toast  DINNER: meat, bread, pastry and beer  TEA: a meal similar to breakfast  SUPPER: a fruit tart or bread and milk.

6. www.second-opinions.co.uk 6 Harvey’s diet plan  BREAKFAST: 4-5 oz beef, mutton, kidneys, fish, bacon or cold meat, large cup of tea, 1 oz toast  DINNER: 5-6 oz fish or meat, any veg except potato, 1 oz toast, fruit of any pudding, any poultry or game, 2-3 glasses claret, sherry or Madeira.  TEA: 2-3 oz fruit, a rusk or two, cup of tea  SUPPER: 3-4 oz meat or fish, similar to dinner, 1- 2 glasses sherry  NIGHTCAP: tumbler of grog: gin, whisky or brandy, or 1-2 glasses claret or sherry.

7. www.second-opinions.co.uk 7 Results of Harvey’s diet – at one year  Weight loss – 46 lbs  12 ¼ inches off waist  He could come downstairs forward  Go upstairs and take exercise freely  Could perform every necessary function  The umbilical rupture was cured  His sight and hearing were restored  His other bodily ailments had ‘passed into the matter of history’.

8. www.second-opinions.co.uk 8 Clinical dietary trial: Edinburgh 1932  high carb / low fat diet - 49g (usual slimming diet)  high carb / low protein - 122g  low carb / high protein - 183g  low carb / high fat diet - 205g Lyon DM, Dunlop DM. The treatment of obesity: a comparison of the effects of diet and of thyroid extract. Quarterly Journal of Medicine 1932; 1: 331-52. Average daily losses:

9. www.second-opinions.co.uk 9 Clinical dietary trial, London, 1957  Lost the least weight on a high-carbohydrate, low-fat diet  Lost the most weight on a low-carbohydrate, high-fat diet  Lost weight even at 2,600 calories a day – but only on a high-fat diet. Kekwick A, Pawan GLS. Calorie intake in relation to body- weight changes in the obese. Lancet 1956; ii: 155-160 Obese patients at Middlesex Hospital:

10. www.second-opinions.co.uk 10 Clinical diabetic trial, 1999  Carbohydrates (unprocessed foods, mainly fresh fruit and vegetables) = 20% of calories Hays J. Paper presented to the 81st Annual Meeting of the Endocrine Society, 15 June 1999. Diabetic patients could eat all the meat and cheese they wanted  Fats – 50% of calories  90% animal fats, 10% MUF olive oil.

11. www.second-opinions.co.uk 11 Clinical diabetic trial, 1999  Average weight loss – 40 lbs  HbA1c down from 3.34 to 0.96 above normal  Total cholesterol down from 6.0 to 4.94 mmol/l  LDL down from 3.46 to 2.73  HDL up from 1.14 to 1.22 mmol/l +6.7%  Triglycerides down from 2.29 to 1.82 g/l. Hays J. Paper presented to the 81st Annual Meeting of the Endocrine Society, 15 June 1999.

12. www.second-opinions.co.uk 12 High-fat diet clinical trial: 2002  Intervention group: 8% carb, 61% fat Sharman MJ, et al. A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men. J Nutr 2002; 132: 1879-1885  fasting triglycerides - 33%  blood fats after meals - 29%  blood insulin after meals- 34%  HDL +11.5%  Total cholesterol unchanged

13. www.second-opinions.co.uk 13 The Spanish paradox 1966-1990 – heart disease: Men deaths down 25% Women deaths down 34% Serra-Majem L, et al.. How could changes in diet explain changes in coronary heart disease mortality in Spain? The Spanish paradox. Am J Clin Nutr 1995;61(suppl):1351S-9S.

14. www.second-opinions.co.uk 14 The Spanish paradox  Protein and fat up  beef + 96%  pork + 382%  poultry + 312%  full-cream milk+ 73% 1966-1990  Carbs down  bread consumption – 55%  rice consumption – 35%  potato consumption – 53%

15. www.second-opinions.co.uk 15 The Spanish paradox  Increase consumption of foods rich in complex carbohydrates (bread…rice)  Promote moderate consumption of all meat (beef and pork in particular)  Encourage use of skim milk and low-fat cheese….” “Nevertheless, [we] suggest several dietary recommendations that might be applied to the prevention of CVD in Spain: Serra-Majem L, et al.. How could changes in diet explain changes in coronary heart disease mortality in Spain? The Spanish paradox. Am J Clin Nutr 1995;61(suppl):1351S-9S.

16. www.second-opinions.co.uk 16 The balanced diet “Foods can be divided into five main groups. In order for us to enjoy a balanced diet we need to eat foods from these groups.” BDA food plate

17. www.second-opinions.co.uk 17 The balanced diet “No single food will supply all the nutrients your body needs, so good nutrition means eating a variety of foods.” “No single food will supply all the nutrients your body needs, so good nutrition means eating a variety of foods.” (ADA) USDA food pyramid

18. www.second-opinions.co.uk 18 The balanced diet My definition A balanced diet is any diet that supplies all the nutrients the body needs in the correct proportions. In which case, a diet composed entirely of meat, so long as the organs and fat are included, is a balanced diet.

19. www.second-opinions.co.uk 19 Dietary Nonsense of Fructose on Glucose Cut down on Fructose & Glucose

20. www.second-opinions.co.uk 20 Essential foods!  Fatty acids  Amino acids (protein) There are essential: But: There are no essential carbohydrates

21. www.second-opinions.co.uk 21

22. www.second-opinions.co.uk 22 Inuit igloo Eskimo food pyramid igloo _____

23. www.second-opinions.co.uk 23 Maasai of Kenya

24. www.second-opinions.co.uk 24 Blood Maasai food pyramid Milk

25. www.second-opinions.co.uk 25 Other impacts of incorrect diet The Maori of New Zealand

26. www.second-opinions.co.uk 26 Diseases that benefit from low-carb  Acid reflux  Acne  Alzheimer’s disease  Amenorrhoea  Ankylosing spondylitis  Anorexia  Arthritis  Attention-Deficit Hyperactivity Disorder  Cancer  Cirrhosis of the liver  Coeliac disease  Constipation  Coronary heart disease  Crohn’s disease  Crooked teeth  Dental caries  Depression  Diabetes (both types)  Diverticulitis  Eczema  Epilepsy  Gallstones  Glaucoma  Gout  Infectious diseases  Iron deficiency anaemia  Irritable bowel syndrome  Juvenile crime  Kidney stones  Low birth weight  Macular degeneration  Menstrual dysfunction  Mental retardation  Multiple sclerosis  Myopia (short-sightedness)  Nephropathy  Neural tube defects  Obesity  Osteomalacia  Osteoporosis  Retinopathy  Retarded uterine growth  Rickets  Schizophrenia  Slow growth  Spina bifida  Stomach ulcers  Stroke  Ulcerative colitis

27. www.second-opinions.co.uk 27 Main points  Diabetes, heart disease, etc, are not caused by obesity  All conditions are caused by the same thing  Dietary carbohydrates cause all  Obesity is merely evident before diabetes  Answer: Reduce carbohydrates, reduce disease.

28. www.second-opinions.co.uk 28 Why? Why should the food with the most calories be the best for weight loss and all-round good health? Because it is our natural diet

29. www.second-opinions.co.uk 29 Have a low glycaemic index Have a low glycaemic index Contain relatively little carb Contain relatively little carb Produce only modest increases in insulin. Produce only modest increases in insulin. Palaeolithic Pyramid

30. www.second-opinions.co.uk 30 Summary of evidence  Agriculture very recent in history  For 2.5 million years – diet high-protein, high- fat, low-carb  99.9% of our genes formed before advent of agriculture  We evolved eating an animal sourced diet  ‘Healthy’ diet quite different – and unnatural.

31. www.second-opinions.co.uk 31 “If we do not learn from history, we remain in the infancy of knowledge.” Cicero

32. www.second-opinions.co.uk 32 Dr. James Hays – 1999 “If you have a diet that results in weight loss, lower cholesterol, and a better lipid profile, eventually everybody will be eating that way. It’s going to come whether we like it or not.” Hays J. Paper presented to the 81st Annual Meeting of the Endocrine Society, 15 June 1999.

33. www.second-opinions.co.uk 33 Critique of low-fat, ‘healthy’ diet – 2004 “This diet can no longer be defended... by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate, high-protein diet may have a salutary effect on the epidemics in question.” Weinberg SL. The Diet-Heart Hypothesis: a Critique. J Am Coll Cardiol 2004;43:731–3

34. www.second-opinions.co.uk 34 Children should eat low-carb diet – 2004 “Children especially need to be targeted... we need to rethink dietary advice because the current advice clearly isn’t working.” Professor Julian Peto. The Scotsman, 14 March 2004

35. www.second-opinions.co.uk 35 The challenge To produce foods that do not increase the burden of disease To produce foods that do not increase the burden of disease particularlyforchildren

36. www.second-opinions.co.uk 36 Example More EPA and DHA  More EPA and DHA Less saturated fat  Less saturated fat PUFA increased 3 – 4 times.  PUFA increased 3 – 4 times. Omega-3 milk Australian cattle on pasture fed supplements of tuna oil and soyabean Kitessa SM, et al. Supplementation of grazing dairy cows with rumen-protected tuna oil enriches milk fat with n-3 fatty acids without affecting milk production or sensory characteristics. Br J Nutr 2004; 91 (2): 271-278.

37. www.second-opinions.co.uk 37 Example PUFA increase cancer risk! PUFA increase cancer risk! Omega-3 milk Australian cattle on pasture fed supplements of tuna oil and soyabean

38. www.second-opinions.co.uk 38 The challenge  Reduce sugar by half  Will not compromise taste  Avoid high fructose corn syrup  HFCS compromises immune system  7 times worse for diabetics than glucose  Avoid cereal fillers  Avoid fruit juices  Use whole fruit, reduces sugars, increases fibre. Cut carbs 1. Cut carbs

39. www.second-opinions.co.uk 39 The challenge  Phytoestrogens  Female hormones in males  Abnormal hormone patterns in infants of both sexes  Implicated in cancers  Phytic Acid  Inhibits absorption of minerals  deficiency diseases  Goitregens  Decrease thyroid hormone production  Difficult to digest  May ulcerate gut  Allergenic. Avoid soya 2. Avoid soya

40. www.second-opinions.co.uk 40 The challenge  Animal fats are healthy  Butter, lard, beef dripping, cream  Coconut oil has a very long shelf life. fats 3. To improve taste, texture and palatability, replace carbs with fats

41. www.second-opinions.co.uk 41 The challenge  Oxidise readily  Increase cancer risk  Hydrogenated oils (trans fats)  Raise cholesterol  Weaken circulation  Increase heart disease risk  Compromise immune system  Increase risk of infectious diseases and cancer. 4. Avoid polyunsaturated vegetable oils

42. www.second-opinions.co.uk 42 The challenge  Cardiovascular diseases  Add vitamins B6, B12, folic acid  Cancer  Add vitamin D. Vitamins 5. To improve health, add Vitamins

43. www.second-opinions.co.uk 43 Please, don’t sacrifice the health of your customers for the health of your profit margins.

44. www.second-opinions.co.uk 44 “The trouble with making all these changes so that you live longer is that all the extra years come at the end – when you’re old!”