The devil is in the detail, so the saying goes, and the detail has been supplied by decades of peer-reviewed and published research which told us all that fat is the enemy. Generations of people have been born into a world where all sections of society—the media, film, fashion, food, and healthcare have directed us to avoid fat like the plague. Theory based and evidence driven, the studies published and promoted have ubiquitously instructed the public—and our healthcare professionals—to do all we can to minimise fat consumption.
Sugar on the other hand has been hailed as totally necessary. After all, without glucose the brain cannot function—or so we are told. So sugar has had a free ride. It is in almost everything in one form or another, and, doesn’t it make things easy to eat.
This message has been promulgated by the most amazing array of vested interests, from politicians to policy makers, researchers, and institutions, all in need of funding, all in need of resources, and all following, or being led, down the same path. It is difficult enough if you are a healthcare professional to know where the message originates, let alone for a patient. After all, healthcare professionals rely on the evidence and patients rely on healthcare professionals. The message is reinforced by public health messaging, by the food industry, by sports coaches, and even by teachers in schools, so who’s left to take a different view? Who’s left to make a counter argument, propose a different hypothesis, and have research published and acknowledged as equally valid that contradicts the zeitgeist and over turns the previous theory.
Roll the clock forward, and here we are in 2016 with whole countries refuting the fat is bad, sugar is good mentality. Sweden has adopted a low-carbohydrate approach to public health messaging, lifestyle choice, and health interventions. The switch in dietary advice followed the publication of a two-year study by the independent Swedish Council on Health Technology Assessment. The committee reviewed 16,000 studies published up until 31 May 2013 and upended existing advice in favour of a low-carbohydrate model. Here in the UK we see, almost weekly, documentaries and publications advocating that we reduce our carbohydrate intake, especially for the treatment of obesity and diabetes, and yet the accepted advice is still low fat.
As our healthcare professionals you are in a unique position of trust. We want you to ask the questions for us and help translate the plethora of information out there into knowledge, lead us and guide us with your wisdom, and help us better understand how we can lead healthier lives. Food is so important. Food is deeply personal. Food defines us and our relationships. Food, its preparation and place in the home and the heart is fundamental to so many aspects of our lives.
So what ARE we meant to eat?
Paul Buchanan is a patient with Type 1 diabetes. He runs Team Blood Glucose. He is part of The BMJ‘s patient panel.
Competing interests: None declared.