Forty years ago, our government told us to eat less fat and more carbohydrates. Tragically, we have seen an explosion in type 2 diabetes, obesity and other nutritional diseases and, alarmingly, these diseases are now being diagnosed in our children.
By Dr. Evelyne Bourdua-Roy, Dr. Barbra Allen Bradshaw and Dr. Carol Loffelmann
Worldwide, obesity has tripled since 1975 and childhood obesity has increased 10-fold. In today’s food-led environment, five in 10 children will develop type 2 diabetes in their lifetime. Even more shocking is that 80 per cent of First Nations children in Canada will develop type 2 diabetes.
Problems with Canada’s Food Guide
When we took fat out of our food, we replaced it with sugar and refined carbohydrates to make it taste better. We displaced traditional foods with processed ones, and ultra-processed foods now make up 48.3 per cent of our daily calories.
Traditional methods to combat the growing disease burden have not worked, so we have formed a network of Canadian health professionals who have gone “back to school” to stop this crisis. We have learned there was never good evidence supporting the advice to eat less fat and more carbohydrates. Our dietary guidelines are heavily based on the “Dietary Guidelines for Americans”, but the National Academies have raised serious concerns about the scientific rigour of these guidelines.
Others have also noted the lack of scientific rigour, describing political influence by powerful individuals and big food manufacturers. The sugar industry, for example, sponsored and influenced scientific research in the 1960s.
Our nutritional health crisis is fixable
We have experienced devastating unintended consequences from making dietary policy with faulty information. Now that we understand that sugar, not fat, is implicated in most chronic nutritional diseases, we can actually help our patients. If these people reduce their intake of the sugar and refined carbohydrates that have helped cause the disease, they may be able to reduce or eliminate many of their medications. This is no more restrictive than needing to avoid gluten if you have celiac disease, or animal products if you choose to be vegan or vegetarian. Insulin-resistant people are simply intolerant to carbohydrates.
Our grandparents had it right by cooking with whole, unprocessed food. A low-carbohydrate, healthy-fat way of eating flies in the face of current guidelines, but this worldwide food revolution is making people well and can save our health care system.
We are advocating for dietary policy change
Health Canada is revising Canada’s Food Guide, and we are advocating for guidelines based on rigorous, updated science. We have submitted a letter to Health Canada asking for whole-food guidelines that reflect the current state of evidence on issues such as saturated fat, animal products and salt intake. This letter has been signed by 717 of our colleagues, some of who are considered world experts in therapeutic nutrition and research.
Health Canada has published a set of guiding principles regarding the new Food Guide, with many positive changes. However, there is still a notable focus on reducing saturated fat, animal-based protein and salt, which is not supported by current evidence. We submitted a rebuttal letter and were disappointed to receive a standard reply from the health minister. We feel that our concerns have been ignored.
The only time we should be recommending changes to our food or macro-nutrient intake is when we have incontrovertible evidence of its benefit or harm. The evidence surrounding saturated fat is still in a state of flux. If the experts disagree then we cannot make recommendations and the guidelines should remain silent.
Rather than advise a reduction in saturated fat, we should follow the lead of the Heart and Stroke Foundation of Canada. In 2015, this organization reviewed the same evidence as Health Canada and judged that a percentile cap on saturated fat was not warranted.
What this means for the general Canadian population
If low-carbohydrate nutrition is so successful in treating metabolic disease, does it mean that everyone should eat this way? A personalized, low-carbohydrate approach works best for diseases of insulin resistance; we suggest that a carbohydrate-restricted diet should be first-line therapy in type 2 diabetes.
For the rest of us, the evidence especially from the recent, Canadian-led epidemiological PURE study suggests that we should consume fewer refined carbohydrates and more natural fats than is currently recommended. We should focus on whole food and ditch processed, refined products.
Why bother changing the Food Guide?
Not everyone can just ignore the guidelines. For example, hospitalized patients with diabetes are given foods such as juice, toast and sugary low-fat yogurt. Kids are given juice in school because the Food Guide says it is a serving of fruit. Schools must choose dairy products that are low in saturated fat, but we have studies showing the benefits of full-fat dairy.
A grassroots movement
A grassroots food movement can be incredibly powerful, but change must ultimately come from the top. We must ask our schools to reduce sugar, and our hospitals to remove sugar-sweetened drinks and to serve more whole, nutritious food. We expect unbiased dietary advice from our diabetes and obesity organizations, and we must challenge why they receive financial support from food companies that create products implicated in causing these diseases. Finally, we must help our health care colleagues learn the power of eating real, whole food with respect to disease prevention and reversal.
We must act now. Help us tell Health Canada by signing our public petition. Do your own research. Question your health providers and policy-makers. Knowledge is power. We have the knowledge now is the time to start using it.
Dr. Evelyne Bourdua-Roy is a family doctor and founder of Clinique Reversa; a clinic dedicated to reversing type 2 diabetes.
Dr. Barbra Allen Bradshaw is an anatomical pathologist in
Abbotsford, BC, who has come to understand that eating whole, unprocessed food can reverse our nutritional disease epidemic.
Dr. Carol Loffelmann is a Toronto anesthesiologist who believes the burden of complex chronic diseases can be lessened by eating an evolutionary appropriate diet.