Preaching Nutritional SINs
by Leigh Reeve AdvAPD

Is your social media feed collapsing under the strain of a veritable food fight?

For what seems like an eon in social media terms, we’ve watched authors, chefs and celebrities dish out over-simplified dietary advice. Quit this, cut that. Easily digestible catch-cries that attract a cult following.

It’s Single Issue Nutrition – a SIN in both acronym and its teachings. To quote Dr David Katz “…if you focus on only one nutrient you will invent a whole new way of eating badly”1.

Single Issue Nutrition always gets in the way of positive health outcomes because the fact is nutrition is complex. The quality of a diet cannot be determined by the exclusion of a single nutrient, food or food group.

This time around it’s sugar and other carbohydrates (including most grain foods) in the firing line, but we have seen it all before. Turn back the clock 30 years and it was fat. Forty years ago it was sugar and carbohydrate again.

But, what have we learnt from single issue nutrition approaches of the past? For me it was three key rules:

  1. Something else will fill the gap
  2. You miss out on nutrition and health benefits, and
  3. There is a flow on effect.

So based on these learnings, what happens if we jump on the bandwagon and “cut carbs”? Unfortunately, this is not just a hypothetical, we’re already seeing the damage of the current focus on single issue nutrition.

Something else will fill the gap

When people eat less of their kilojoules from carbohydrate containing foods like breakfast cereal or breads or fruit, then they are likely to eat more fat, including saturated fat, as a proportion of their kilojoules – it’s mostly simple maths.

It seems we’re already missing a healthy balance of carbohydrate and fat. Just last month the ABS reported that half of all Australians aged two years and over were eating less than the recommended intakes of carbohydrate for good health (45-65% of daily kilojoules)2. Conversely, a significant proportion of Australians have fat intakes above the recommendations (20- 35% kilojoules), including one in five 14-18 year olds2. Keep in mind that these recommended ranges are very broad and allow for many styles of healthy eating.

In some foods there is also a nutrient replacement. In the 80s, what replaced fat in many low fat foods was carbohydrates, often sugars, and no one should have been surprised. The fact is something had to fill the gap. Now we are seeing a push for more foods and recipes with reduced sugars or less carbohydrate. Since the replacements are most likely to be other carbohydrates or fat/saturated fat, kilojoules are likely to be the same or higher and there may be no overall advantage. In fact there may be negative impacts on saturated fat intake and glycaemic load.

You miss out on nutrients and health benefits:

By making a blanket rule to cut out carbohydrates or grain foods, for instance, you miss out on all the benefits that these foods can offer. Carbohydrate-containing grain foods play an essential role in good nutrition as key sources of fibre, iron, magnesium, iodine, carbohydrates and B-group vitamins including folate and thiamin. Again we’re already behind in our intakes of some of these nutrients. For example, the ABS data recently revealed that one quarter of Australian women and girls need more iron and confirmed that cereal foods are one of the primary sources3.

Avoiding carbohydrate also means less whole grains and cereal fibre, both of which are strongly linked to health benefits. Just last month, new research from the Harvard School of Public Health found that people with the greatest cereal fibre intakes had a lower risk of premature death from a range of chronic diseases including cancer, heart disease, respiratory disease and diabetes, compared to people with the lowest cereal fibre intakes4. Previous research found wholegrains may be more protective against major chronic disease than fruits and vegetables5.

There is a flow-on effect:

Foods are seldom consumed on their own. It’s not just about the food or food group you cut out; it’s about missing the foods that are often paired with them.

In the case of cutting carbohydrates or grain foods, skipping foods such as breakfast cereals often means less consumption of milk, or fortified milk alternatives. You might think that’s easily replaced but the reality is breakfast cereal and milk accounts for almost one third of our children’s milk consumption6 and therefore a significant part of their calcium intakes. Again the ABS indicates that we are off the mark here. Their latest data demonstrates most Australians need more calcium2.

Single Issue Nutrition is never the answer. The simple answer is enjoying sensible amounts of nutrient dense foods, most of the time. The challenge is to make it as compelling as the SIN catch-crys. How I would love to see people proudly instagramming delicious meals based the core food groups – vegetables, grains, fruit, protein foods, dairy – rather than celebrating the nutrients or foods they exclude.

Thankfully more sense is coming back into the conversation as qualified nutrition professionals, who understand the potential impacts of the SIN approach, continue to support variety, moderation and balance as a counter to self-appointed, poorly informed, promoters of fad-diets.

Leigh suit cereal variety IMG_0882 Leigh Reeve is an Advanced Accredited Practising Dietitian and Director of the Australian Breakfast Cereal Manufacturers Forum (ABCMF). Leigh has over 30 years experience as a dietitian and is passionate about sharing practical, evidence-based nutrition information and delicious food ideas.


References:

  1. 1. NZ Nutrition Foundation. http://www.nutritionfoundation.org.nz/news-and-hot-topics/latest-news/10597-Media-Release%3A-Dr-David-Katz-shares-his-knowledge-at-Symposium Accessed 9 April 2015.
  2. Australian Health Survey: Usual Nutrient Intakes, 2011-12. Acceptable Macronutrient Distribution Ranges (AMDR). http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4364.0.55.008Main+Features2102011-12   Accessed 9 April 2015.
  3. Australian Health Survey: Usual Nutrient Intakes, 2011-12. Australians need more calcium. http://www.abs.gov.au/AUSSTATS/abs@.nsf/mediareleasesbyReleaseDate/66CD968FD6543C84CA257DFF000CA851?OpenDocument Accessed 9 April 2015.
  4. Huang et al. Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals.BMC Medicine 2015; 13:59 DOI 10.1186/s12916-015-0294-7 http://www.biomedcentral.com/1741-7015/13/59
  5. Fardet, A., Boirie, Y. Associations between food and beverage groups and major diet-related chronic diseases: an exhaustive review of pooled/meta-analyses and systematic reviews. Nutr Reviews. 2014. Vol 72 (12):741-762. http://www.ncbi.nlm.nih.gov/pubmed/25406801
  6. F Fayet, L Ridges, N Sritharan, P Petocz. Breakfast cereal consumption is associated with higher micronutrient and milk intake among Australian Children. Australasian Medical Journal 2011 4(12):775.
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