It’s what we eat and not how much of it that makes us fat and unhealthy, according to three leading heart specialists writing in the Open Heart professional journal.
Counting calories is not only misleading, according to the article, but can actually lead to poorer decisions and increase the risk of obesity, diabetes and heart problems.
The authors, two from the UK and one from the US, cite the example of a sugary drink, with a calorific value of only 150, compared with four teaspoons of extra virgin olive oil, at 500 calories.
The olive oil has more than three times the calories and yet is known to significantly reduce the risk of heart attack while the sugary drink will significantly increase the risks of developing type 2 diabetes.
Dr Aseem Malhotra from Frimley Park hospital in Surrey, Professor Simon Capewell of Liverpool University and James DiNicolantonio from the St Lukes Mid America Heart Foundation out of Kansas, are surprisingly scathing about their colleagues’ response to the obesity crisis.
They accuse doctors of having too much faith in the limited ability of pharmacotherapy (such as the use of statins) and allowing vested commercial interests from the drug and food industries to dominate and obscure the true nature of the debate.
They suggest that current public policy promotes overtreatment and ignores the benefits of simple, straightforward lifestyle interventions.
They go on to say that the choice of food and not the calculation of calories should be the focus of everyone involved.
A Mediterranean-style diet, rich in oily fish, olive oil, nuts and carbohydrates should be the ideal against which decisions are made.
Cutting out saturated fats, sugars and salt to replace them with fruit, vegetables, fish and fibre should not only be advised but, if necessary, encouraged through taxation and subsidy concluded the article.
While welcoming the debate there has been a robust response from the medical community.
“It is idiotic to suggest that calories don’t count and then advocate a high fat diet,” said Tom Sanders, Professor of Nutrition and Dietetics at King’s College London.
Others suggested that the counter argument to the article’s assumptions lay in its own example, the Greek experience of the ‘Mediterranean diet’ being very different from that of Italy, with Greece experiencing one of the highest obesity rates in Europe.
In fairness to the authors of the editorial, their aim is primarily to reduce heart disease and diabetes, not to slim down the overweight.
Clearly the healthy answer lies in both regulating the amount AND the type of food we eat, but there are questions to be asked about how much time is spent educating people towards a more appropriate diet rather than merely eating less.
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