How many people died as a consequence of the ABC’s Catalyst cholesterol program?

According to a new University of Sydney study thousands of preventable heart attacks and strokes may occur as a result of a biased television program.

On 24 and 31 October 2013, ABC television’s Catalyst program aired a two-part series that questioned the link between blood cholesterol and heart disease, and whether current dietary advice or statin medication was effective in lowering heart disease risk. Although the first program on diet was very biased Catalyst may have got away with it as the science around diet and heart disease is considered rather ‘soft’ and is still unfolding.

However, the second program on statins, cholesterol and heart disease was on very firm scientific ground. The last time I looked there were 24 meta-analyses on statin medication and heart disease risk and all showed benefit. But rather than present this perspective Catalyst decided that the public interest would be better served by sowing seeds of doubt.

There were howls of protest. To their credit, other journalists at the ABC took aim at Catalyst. Media Watch presenter Paul Barry said … Catalyst struck us as sensationalist and grossly unbalanced; and some of their so-called ‘experts’ had questionable qualifications.

The ABC’s health guru Dr Norman Swan considered the health implications saying that People will die as a result of the Catalyst program …. It doesn’t get much stronger than that. Was Swan going over the top, or did he just have a good understanding of his subject?

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Modern Diet Myth No. 10: Australian teenagers eat 40 teaspoons of sugar a day

In the movie That Sugar Film Damon Gameau set about testing the effects of a high sugar diet on his healthy body. He increased his sugar intake to 40 teaspoons a day on the basis that this was ‘just slightly more than that of the average teenager worldwide’.

That’s an interesting claim but is it true?

Actually, it’s a strange measure to have chosen as it is almost impossible to verify. Most countries in the world simply don’t have good dietary data on teenagers, or adults for that matter. Let’s look at the available data and consider whether the claim is close to being right.

Any global average for sugar intake will be greatly influenced by typical intakes in populous countries such as China, India and Indonesia. Yet sugar intakes in these countries are very low – of the order of 20 grams per day or less, which equates to a miserly 4 teaspoons of sugar per day.

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Modern Diet Myth No. 9: Processed foods are bad for your health

We regularly hear that processed foods are not good for health. Truth or myth?

What’s wrong with food processing?

There are three major criticisms of food processing and how it affects the nutritional quality of foods. The first is that processing lowers the nutrient content of a food either by exposing it to heat or by discarding a nutrient-rich portion. Secondly, during processing so-called ‘nutrients of concern’, such as saturated fat, salt and sugar, may be added. A third criticism is that processing may alter the nature of a food unfavourably, for example, by increasing its glycaemic index.

All of these things are true, so processed foods are obviously worse for health than unprocessed foods. Right?

Not so fast.

What’s right with food processing?

If you buy a piece of lean rump steak from your local butcher, do you eat it in its natural raw form or do you toss it into a hot frying pan first? Yes, this heat processing causes some loss of nutrients but we do it because cooked meat tastes so much better than raw meat. Also, cooked meat is much safer to eat than uncooked meat.

The same issues apply when food is processed by a food manufacturer. Safety is the paramount concern and strict regulations must be adhered to. Modern processed foods are so safe that any breakdown in food safety standards usually makes front page news.

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Modern Dietary Myth No. 8: Saturated fat is better for you than carbohydrate

One of the more commercially driven myths circulating at present is the idea that somehow saturated fat is better for health than carbohydrate. Virtually all the low carb advocates push this argument, but why would they do that?

The changing science

The science relating to how much of what we should eat for good health has certainly evolved in recent decades, but it’s not a simple story.

• In the early 1980s, most health authorities recommended that saturated fat in the diet should be limited to lower heart disease risk.

• At that time trans fats were thought to be neutral but by the 1990s they were considered be as bad as saturated fats. And by the 2000s trans fats were thought to be worse than saturated fat.

• Three decades ago carbohydrate was thought to be the ideal replacement for saturated fat, which led to widespread support for low fat diets. But by the late 2000s scientific support for low fat diets had dropped away.

• Although the early science indicated that unsaturated fats may be the best option to replace saturated fat in the diet somehow they were less preferred to carbohydrate. Their time has now come.

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Modern Diet Myth No. 7: Fluoride is a toxic drug

Cursed with having studied nutrition at university I had been labouring under the misunderstanding that fluoride was a nutrient that helps prevent tooth decay when consumed in small amounts. But after a quick surf through the net I now realise that fluoride is actually a toxic drug that causes many serious health problems, including thyroid dysfunction, weight gain, osteoporosis, infertility, neurological harm, impaired visual-spatial organisation, early onset of puberty, arthritis, hip fractures, depression and behavioural problems.

Yikes! Why are our so-called health authorities putting this dreadful toxin in our drinking water?

Fluoridation: the pollution of our precious bodily fluids

An enlightened few have known about the dangers of water fluoridation for decades and have tried to warn us. In Stanley Kubrick’s 1964 film, Dr Strangelove, there is a telling scene in which General Jack D. Ripper, played by Sterling Hayden, ignores a hail of bullets from his own troops and asks a cowering colleague whether he has ever heard about water fluoridation.

Ripper then explains that “… fluoridation is the most monstrously conceived and dangerous communist plot we have ever had to face … I can no longer sit back and allow Communist infiltration, Communist indoctrination, Communist subversion and the international Communist conspiracy to sap and impurify all of our precious bodily fluids”.

Of course, General Ripper has totally lost it. Prior to the fluoridation scene he ordered the 34 B52 bombers under his command to make an unprovoked nuclear strike on Russia.

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Modern Diet Myth No. 5: The low fat diet was the result of fraud and conspiracy

As new scientific evidence has emerged the low fat diet has slowly fallen from favour. But the myth-makers are suggesting the whole thing was a con, born out of fraud and carried along by a conspiracy.

The origins of the low fat diet

The low fat diet had its origins in 1980 with the publication of the first Dietary Guidelines for Americans. The recommendation to ‘Avoid too much fat, saturated fat and cholesterol’ was intended to lower blood cholesterol and reduce the risk for heart disease. Although the focus was really on lowering saturated fat, it was thought that lowering total fat intake may help prevent some cancers and obesity.

In Australia, the simpler guideline ‘Avoid eating too much fat’ was adopted to aid its communication.

Keys versus Yudkin

The low fat diet had a low key launch. Yet these humble origins are now being re-imagined as the disastrous consequences of a fight to the (professional) death of two of the great nutritionists their era – Ancel Keys and John Yudkin. As an epidemic of heart disease raged in the post-war years Yudkin pointed his finger at sugar. But Keys argued that the effect of different fats on blood cholesterol was the key mechanism affecting heart disease risk, and he won the day.

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Modern Diet Myth No. 4: Fructose turns to fat

Fructose – the dietary villain de jour – is currently giving rise to more myths than anything else and they all seem to relate to fat. Fructose supposedly leads to fatty liver and too much fat in the blood. To top it off, fructose is said to be uniquely fattening! Where do we start?

Fat in your liver

Most of the carbohydrate we eat ends up in the bloodstream as either glucose or fructose. The myth goes that glucose is the good sugar as it is used to power the brain, the muscles and most of the cells in the body. And the fructose is the bad sugar which is quickly taken up by the liver and turned into fat, giving rise to fatty liver.

Unfortunately for the myth-makers, no reputable health authority in the world agrees. Fatty liver is certainly a common problem but the experts see it as part of the metabolic syndrome – a cluster of abnormalities linked to central obesity and insulin resistance, where the cells of the body become less sensitive to insulin.

There is no recommended diet for fatty liver. Instead, health authorities encourage people with fatty liver to lose some weight and increase their physical activity, both of which improve insulin resistance.

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Modern Diet Myth No. 2: Legumes should be eliminated from the diet

One of the more baffling pieces of nutrition advice wafting through the internet is that legumes should be eliminated from the diet. This stands in contrast to conventional nutrition advice which encourages intake of legumes. Who would have thought these humble edible seeds, which include beans, peas, lentils and peanuts, would be the centre of a controversy?

At first glance legumes appear to be rich sources of iron and zinc but their critics argue that this is misleading as the absorption of these nutrients is lessened by anti-nutrients, like phytic acid. Phytic acid in legumes binds to these minerals lowering their absorption from the gut. The iron and zinc in meat is more readily absorbed.

The other argument against legumes relates to protein. Compared to traditional ‘protein foods’ such as meat, poultry, fish and eggs, legumes generally have less protein and the protein is of lower quality. That is, some amino acids are in short supply.

So legumes are labelled as inferior foods, compared to red meat.

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Pete Evans is clueless about nutrition

Recently the Weekend Australian (19-20 July) published an article ‘The six foods I never stock at home’ by celebrity chef Pete Evans. Although the newspaper acknowledged ‘his downright fanaticism’, some basic fact checking would have revealed many false claims and inaccuracies.

There is no substantial evidence that proves we need to consume grains to be healthy

I have to disagree with Mr Evans on this point – he seems unaware of grains’ contribution to thiamin intake and the importance of this essential B vitamin.

The healthy diets modelled for the latest Australian Dietary Guidelines contained plenty of thiamin, well above the Recommended Dietary Intake (RDI), but nearly two-thirds of it came from just one food group – grains. If grains were removed from the otherwise optimal diets the thiamin content would fall to well below the RDI. As no other food group is a major source of thiamin it is unlikely that replacement foods could correct the thiamin deficit. If the population adopted Mr Evans ‘no grains’ advice the likely consequence would be the emergence of the thiamin deficiency disease beri beri in vulnerable groups.

Those who strictly follow Mr Evans advice should be on the lookout for the early symptoms of beri beri which include tingling, burning or numbness in the fingers and toes, strange eye movements and vomiting. There may also be loss of appetite and severe constipation. As the heart failure starts to develop you can expect to experience shortness of breath and swelling in the lower part of the legs. In the final stages there will be mental confusion, problems with speech, difficulty walking, coma and death.

Alternatively, you could eat some wholegrain cereal at breakfast and have a sandwich for lunch and live a healthy life, just like normal people.

Image: source

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ABC finally concedes that Catalyst was biased

More than six months after it broadcast two misleading Catalyst programs about diet, medication and heart disease the ABC has admitted there were problems with impartiality and has undertaken corrective action. But there is still something fishy about this.

In October last year ABC television’s science program Catalyst ran two controversial programs purporting to expose myths about diet, medication and cardiovascular disease. In the first program Catalyst presenter Dr Maryanne Demasi challenged the role of dietary saturated fat in affecting risk for coronary heart disease and in the second she questioned the efficacy of statin medication. Essentially, the Catalyst program argued that the world’s leading nutrition organisations and cardiovascular researchers had got it wrong over the last four decades.

Heart Foundation outraged

In an interview on the ABC radio program PM, Maryanne Demasi even stated that the Heart Foundation was ‘certainly supportive’ of the Catalyst program’s evidence. In fact, the Heart Foundation was livid, took offence and submitted a formal complaint. They weren’t alone – the ABC received a total of 146 complaints. To their credit, journalists within the ABC, such as health reporter Dr Norman Swan and Media Watch front man Paul Barry, challenged the accuracy of the programs and the standard of the journalism on display, respectively. For more of detail see my two posts on the Catalyst programs here and here.

Results of independent review

Yesterday, the results of a review of the Catalyst programs by the ABC’s Audience and Consumer Affairs Unit were made public and included findings that standards of impartiality had been breached. Here are some excerpts from the review:

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