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26 » 2003
WHO diet guidelines devoid of science
Steven Milloy
National Post
Saturday, April 26, 2003
The international lifestyle nannies have struck again. The World Health
Organization just issued new dietary
guidelines allegedly to "combat the growing burden of chronic disease."
Don't change your diet just yet, though. The guidelines are an eleventh-hour
attempt to put a positive spin on the
failed tenure of the WHO's outgoing bureaucrat-in-chief.
The guidelines call for limiting fat intake to 15-30% of daily calories
consumed. Carbohydrates should provide
the bulk of energy requirements (55% to 75% of daily intake), but added sugars
should be limited to 10% --
about a pack of M&Ms or a soda per day. The recommended protein intake should be
10% 15% of daily calories
consumed. Salt intake should be limited to five grams per day.
The WHO says the guidelines are "based on the collective judgment of a group of
30 independent experts" who
reviewed the "best currently available evidence on diet, nutrition and their
effects on chronic diseases," such as
cancer, heart disease and diabetes.
"R-r-r-i-i-i-i-ght," as Austin Powers' Dr. Evil might say.
First, the guidelines' recommendations were pulled out of thin air and are
devoid of science. Not a single scientific
study demon strates they will prevent even a single case of chronic disease or
make you healthier.
The WHO admits as much if you read between the lines -- the guidelines are based
on the "judgment" of panel
members. Opinion, however, is just about the lowest level in the hierarchy of
scientific evidence.
How flaky are the recommendations? Last fall, WHO panel vice-chairperson Shiriki
Kumanyika oversaw a U.S.
Institute of Medicine panel concluding that diet quality was unaffected until
added sugars exceeded 25% of daily
calories. Now months later, Kumanyika's WHO panel recommends a 10% limit. No new
science supports such a
drastic change -- it's simply arbitrary and capricious.
It's not true that the guidelines are based on the "best currently available
evidence."
The WHO "experts" ignored recent studies conflicting with the guidelines,
including two recent reviews by U.S.
experts of gold standard clinical trials concerning dietary salt.
Relying on specific data, the U.S. experts concluded that dramatic reductions in
dietary salt "provide only
minimal reductions in blood pressure during long-term trials" and that "the
magnitude of the effect in Caucasians
with normal blood pressure does not warrant a general recommendation to reduce
sodium intake... the number
of studies in black and Asian patients was insufficient for different
recommendations."
The WHO panel also ignored a recent report from the U.S. Department of
Agriculture concluding: "The evidence
indicates that sugar is not in itself associated with [diabetes, coronary heart
disease, obesity and hyperactivity in
children] and is not the sole offender in the development of dental caries."
The WHO's guidelines have at least two other notable shortcomings.
First, the WHO's premise that chronic disease is a "growing burden" requires
some context.
Most chronic disease develops as a function of ageing. Until recent decades,
many in the Third World became
mortally ill with infectious disease and didn't live long enough to develop a
chronic or "Western" disease. That's
changed. The increase in chronic disease actually signals improved public
health.
Next, universal dietary guidelines constitute nutritional, if not medical and
public health, malpractice. Genetics
and lifestyle vary too much among individuals for a one-size-fits-all diet.
Should the starving be counting grams of fats and sugars?
The report is the brainchild of WHO director-general Gro Harlem Brundtland,
whose term as WHO chief ends in
July. Brundtland is the consummate public health bureaucrat who seems more
interested in shaping her legacy
than improving public health.
When Brundtland took charge at WHO in 1998, about 17.3 million people died
annually from largely preventable
infectious and parasitic diseases, according to WHO's own estimates. Now, at the
close of her five-year tenure,
the WHO estimates the death toll has climbed to about 18.4 million annually.
Good job, Gro.
While infectious disease ravages hapless millions, the ineffective Brundtland
distracts the public with crusades
against lifestyles -- i.e. how much we eat, drink and smoke.
A final irony is that underweight caused by malnutrition is the leading cause of
death worldwide -- according to
the WHO's own World Health Report 2002.
It seems many people could benefit from more fat and sugar, not less.
The nutrition guidelines may indeed add to Brundtland's list of career
"accomplishments." It's too bad she can't
add the one that matters most -- improving public health.
Steven Milloy is the publisher of JunkScience.com and an adjunct scholar at the
Washington-based Cato Institute.
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