Mon, Aug-19-19, 00:07
Location: New Zealand
The same writer has since written another more generalised article about low carb as a follow-up to his earlier opinion piece. This time he sizes up things from a national perspective, introducing us to the key players in New Zealand: Prof Jim Mann who supports the status quo, and Prof Grant Schofield who leads the low carb movement here.
BATTLE OF THE MACROS
The situation is urgent. Everyone agrees with that. New Zealand is now the world's third fattest nation and Ministry of Health statistics say 250,000 Kiwis suffer from diabetes – double the number of 20 years ago.
Even more worryingly, a quarter of the population is pre-diabetic. So on their way to the disease. In the pipeline as a health cost.
If a low-carb diet can fix people as easily as the people of Taupō seem to think, you would expect to be hearing all about keto from the ministry by now.
What does the science actually say? What is the expert opinion?
On the face of it, there is a ding-dong academic battle going on; a standoff between the nutritional old guard and the keto crowd. But more of a consensus could be emerging.
The argument revolves around the acceptable balance of macronutrients – carbohydrate, protein and fat – in the standard diet.
Otago University's Professor Jim Mann represents the health establishment view. He is director of the Edgar National Centre for Diabetes and Obesity Research and also a leader of the Government's current Healthier Lives research challenge.
Mann has been blasting away at the safety of keto diets for a good few years now.
He says the irony is that, when he was a young researcher in the 1970s, the recommended approach to diabetes was in fact a high-fat diet. They had thought of the "starve the disease" philosophy way back then.
"It was just eat as little carb as you possibly can. Have as much cream as you like."
However, also in the 1970s, nutritionists were getting worried about cholesterol and its link to the biggest killer of all, coronary artery disease.
Mann says that led to the formulation of modern advice to steer clear of fat. A healthy diet needed to be half carbohydrate. The solid base of any meal should include plenty of starchy stuff like bread, potato, pasta and rice.
Protein would then make up 20 per cent of our daily calories, and fat the remaining 30 per cent – with the proviso that saturated fat was restricted to 10 per cent of the total.
Mann says his opinion hasn't changed. Saturated fat is still a dietary no-no. That makes it a wrong thing to recommend even for diabetes or pre-diabetes.
But on the other side is keto fan Professor Grant Schofield, director of the Human Potential Centre at Auckland University of Technology (AUT).
Schofield says Mann is just out of date. Plenty of studies are now showing saturated fat is not the heart attack culprit it is made out to be.
Rather, it is insulin dysregulation from eating too much carb which is producing all the excess fat in our bodies and leading to deposits accumulating in wrong places such as our arteries. Sugar and starch are what increase our stroke and heart attack risk more.
Schofield says that means we should return to the sensible principle of just starving diabetes of its fuel.
With LCHF, the macro balance is flipped. The carb allowance is cut to 20 per cent, while protein stays at 20 per cent and fat is increased to be 60 per cent of the daily calorie intake.
Keto is the term for a more extreme version of this, in which carbs are under 10 per cent – a couple of bananas could blow your budget – and fat becomes over 70 per cent.
Schofield says if you eat enough fat, your body is forced to be ketotic, as fat is the only fuel you are giving it. And for those with diabetes or pre-diabetes, it can be a logical choice.
However, the fears about fat in the diet are so institutionally ingrained that any form of low carb still sounds like heresy to the old guard.
"To admit they've been wrong for these past 25 years – well, humans would rather not do that," Schofield says.