A Recent History of Nutritional Modelling
Bearing in mind how critical food and nutrition is to our health, there is a remarkable amount of confusion and misinformation about this topic. And, this level of confusion is not new. To be accurate, some of the confusion is driven by changes in scientific knowledge. However, most is driven by individuals or groups who parade a certain position (under the guise of science) and who usually have a product to sell you. Full disclosure, I have been on the band-wagon of some of these nutritional models but came to my conclusions based upon the best science at the time. If I were to include my time spent becoming educated at the University of Calgary and at Palmer College of Chiropractic – West, I have been in the health and science game for 41 years. Now, this is a long time considering how rapidly science can change, and there has been a significant amount of change in the field of nutritional science in the last 10 – 15 years (more on this later). In my opinion, there have been two stalwart interpretations that have influenced the field of nutritional health in my career. One of them has turned out to be a horrible example of how “science” is used to manipulate culture, and the other a great example of the reproducibility of science. The first is the “Fat-Myth”, and the second is the support of the plant-based diet.
The first story is right out of the “truth is stranger than fiction” mould. I will skim the surface of this story, but will give you enough information so that those interested can look deeper into the topic. The information is readily available with a little digging.
During the 1950’s, a researcher from the University of Minnesota, Ancel Keys, put forth his scientific model that saturated fat was the basis behind rising rates of cardiovascular disease. His thesis was borne out in a now well documented paper titled “The Seven Nations Study”. In this peer-reviewed publication, Keys findings were that inhabitants of the seven countries he studied demonstrated higher levels of cardiovascular disease and that this phenomenon was associated with the tendency for people in these countries to consume higher levels of foods containing saturated fats. This paper has gone through remarkable levels of scrutiny, both scientific and cultural. Of note is the now well-known fact that Keys studied more than seven countries. It was identified that the countries that consumed higher levels of saturated fats but did not have higher levels of cardiovascular disease were excluded from the publication. This is a scientific “no-no” called “selection bias” where the data is essentially hand-picked to support the assertion or hypothesis being put forward. One of the other criticisms of the study was that the background data revealed that a number of the subjects had very high levels of carbohydrate / sugar consumption, and yet this was not included as a potential mechanism of the outcome. That is, there were no “controls” on other dietary influences which, in science, always puts the conclusion of the study in doubt. Nonetheless, the study was published and accepted within the “scientific community”. How this happened is the second part of the story. It has been reported that Keys, in spite of the shortcomings of the study, was a promoter of his views in a manner that is uncharacteristic of the scientific model. He essentially bullied (my word) those around him to capitulate to his findings, not the least of which was the American Heart Association. The rest of the story is in the details, but suffice to say that the outcome of Keys’ influence was that the mainstream medical model of cardiovascular disease became that higher levels of fat consumption contributed mightily to the problem, and secondarily, that food production and manufacturing has gone through a 50 year period of reducing or eliminating fats from food and, while doing so, attempted to convince us that this was the best thing to do.
The second nutritional influence has a significantly higher level of scientific validity, and yet is still not applied with consistency from a cultural perspective. The story has none of the mystery, nor the influence of personality that the “fat is bad for you” contributes. Simply, over the course of my career, study after study after study have repeated this: People who get the majority of their food volume from plant sources are healthier and live longer than those who do not. Interestingly, the science does not say that one must be vegetarian / vegan or any of the related “all-plant” models. The science does say that any of the “primarily plant” models produces the improved health outcomes. There have been many models, and the one that is the most well-known, and likely the most studied, is the Mediterranean Diet. Interestingly, and beyond plant volume, this diet has always included higher amounts of fats (primarily unsaturated) than the model put forth by Keys.
So, where does this leave us? If you answered, “confused”, then you would be one of the many millions who are unsure about what they should or shouldn’t do when it comes to decisions about what to eat. I mentioned a little earlier that there have been remarkable changes in the science of nutrition in the past 10-15 years. Let’s delve into this briefly to bring some light to the issue.
It has been known for a very long time that cellular inflammation (not acute inflammation like when you sprain your ankle) is the underlying basis of disease. What has become evident with more recent advances in the field of biochemistry is that there are known “drivers” of cellular inflammation. That is, circumstances that initiate the process of inflammation. In another blog I will get into more detail about this, but for the time being let me say that what we put in our mouth can be one of the primary drivers of cellular inflammation. The next big news is that the scientific community has, for the most part, rallied around the understanding that eating fat is not bad for us. Now, both of these “discoveries” didn’t happen yesterday – they came about over many decades of study. It might be frustrating for people who don’t follow scientific discovery to appreciate that changing scientific interpretations is like getting a locomotive moving along the tracks. There is a lot of energy (study) that has to be contributed to get the locomotive moving, but once it has momentum, it starts to move forward pretty easily. We are at the point where there is significant “momentum” supporting these two points – first, eating fat does not cause cardiovascular disease (nor does eating fat make you fat) and second, eating the wrong foods contributes significantly to cellular inflammation.
And this brings us to the current state of nutritional affairs. What is the best food model to follow? There are a lot to choose from, and each one borrows aspects of information that has been gleaned in the last 10-15 years (or longer). Most of you have probably heard of the Ketogenic Diet – this is a model that turns the Ancel Keys assertion on its’ head. In the Keto Diet, up to 70-80% of daily calories come in the form of fats. Only 10% come from carbohydrates and 10-20% from protein. Another is the Paleolithic Diet which is commonly misunderstood. Paleolithic refers to the nature of the diet that was likely consumed by our ancestors prior to the agricultural revolution that took place about 10-12,000 years ago. At that time, it is believed, our ancestors were Hunter-Gatherers and the modern day Paleo diet us is supposed to mimic that model. The Hunter/Gatherer model has a preponderance of the food from plant sources and animal sourced food when available – logic tells us that plants are easier to catch than animals. Many in our time have come to the conclusion that Paleo diets mean that you get to eat meat for breakfast, lunch, and dinner – not true. The next contemporary model is the “Low Carb” diet. This model comes out of the data that concludes that high carbohydrate levels in our diet lead to higher blood sugar levels and therefore all the associated problems, including weight gain. The problem with the Low Carb model is that in most cases, proponents “throw out the baby with the bath water”. That is, by reducing carbohydrate levels to as little as 25 grams per day, they are reducing (almost eliminating) one of the most consistent scientific principles of nutrition – high plant volumes. Remember, plants are (to the greatest extent) carbohydrates. In fact, the Ketogenic model does the same thing. And, the Paleolithic Diet gone wrong (incorrect emphasis on animal sources of food) also removes large amounts of plant-based nutrition.
So, it seems there are cracks in the nutritional foundations of even the most modern of food models. It would be reasonable to ask, “What on earth I am supposed to eat?” Well, I am a proponent of another model – known as the Anti-Inflammatory Diet. This model takes the best of the available nutritional science and wraps it up in a form that is remarkably healthful and easy to apply.
In a subsequent blog I will provide a detailed description of the Anti-Inflammatory model. Stay tuned!
Dr. Michael Breen is the co-owner of the Chiropractic Family Care Centre and has been in Private Practice in Calgary, Alberta for over three decades. Dr. Breen graduated from the University of Calgary Faculty of Kinesiology in 1981 (Honours) and from Palmer College of Chiropractic – West in San Jose, California in 1986. His foundational clinical work is in the field of Health Optimization. He uses his background in athletics and chiropractic to aid his patients in recovering physical capacity and uses his background in nutrition and functional medicine to aid his patients in the recovery from chronic illness. He is the co-founder of the Healthy Transformations program. Dr. Breen can be reached at email@example.com.