SlideShare une entreprise Scribd logo
1  sur  48
Following dietary guidelines
is associated with reduced risk of
type 2 diabetes, coronary heart
disease and obesity.
Scientific evidence
[Updated May, 2016]
Registered dietitian, M.Sc, MBA
Reijo Laatikainen
www.twitter.com/pronutritionist
Page 1
Why this slide deck?
• Numerous accusations by some representatives of low carb and
“Paleolithic“ diet communities and by some “nutrition authors”
maintain that dietary guidelines have made us fat and sick:
– “Dietary guidelines have caused the obesity epidemic”
– “Dietary guidelines are not based on scientific evidence”
– “Dietary guidelines are the reason for type 2 diabetes epidemic”
– And so forth
• Quite often these accusations are not addressed adequately.
Consequently, many people buy in the claims.
• This deck is about science. What does the high quality data show
about the evidence of dietary guidelines?
2
1. Randomized mortality &
morbidity trials
2. Prospective cohorts
3. Randomized risk
marker studies
4. Cross-sectional and
case-control cohorts
5 Ecological & animal
studies
Strengthofevidence
Meta-analyses of 1,2 & 3
Modified from: Micha & Mozaffarian.
Lipids. 2010; 45(10): 893–905 and
Evidence Analysis Manual.
Academy of Nutrition and Dietetics
January 2012
Hierarchy of evidence in nutrition
science
Commonly recommended dietary
patterns have many names and
their quality varies little. All are
rather high in carbs:
DASH
Low GI diet
Prudent diet pattern
High quality diet pattern
Healthy diet pattern
Healthy Eating Index
… and so on.
4
Their claim: This food pyramid is the
root cause of OBESITY EPIDEMIC
”Carbs are bad”
”Carbs are bad”
Dietary macronutrients and long
term weight change
Systematic review by Fogelholm
et al 2013
6
Prudent diet, healthy diet and Med Diet
reduce the risk of weight gain
7
Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term
weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
Number of studies showing
reduced risk of weight gain in
long term: 4
Number of studies showing
increased risk of weight gain
in long term: zero
Fiber rich carbohydrates associated
with lower body weight and refined
carbs with weight gain
8
Number of studies showing
reduced risk of weight gain in
long term: 13
Number of studies showing
increased risk of weight gain
in long term: zero
Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term
weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
Meat is associated with weight gain.
Dairy is associated with lower weight
9
Number of studies showing
increased risk of weight gain
in long term: 3
Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term
weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
No evidence that share of carbs in a
diet is a determinant of weight gain
10
Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term
weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
Carbs and weight management
Systematic review by Hauner et al
2012
www.pronutritionist.net11
Intake of carbs is not associated with with
risk of obesity.
12
Hauner H et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake
and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60 Suppl 1:1-58
Fiber rich carbs are associated with
reduced risk of obesity. Sugary drinks
increase the risk of weight gain
13
Hauner H et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake
and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60 Suppl 1:1-58
Their claim: This food pyramid is the
root cause of TYPE 2 DIABETES
EPIDEMIC
”Carbs are bad”
”Carbs are bad”
Type 2 diabetes
Meta-analyses of prospective
cohorts by Esposito et al. 2014,
Alhazmi et al. 2014, Ye et al.2013
and meta-analysis of RCTs by
Gillies et al 2007
Systematic review by Hauner et a.
2012
www.pronutritionist.net15
Healthy dietary pattern is associated with
reduced risk of type 2 diabetes
Page 16
“The results indicated that dietary patterns consisting of healthy foods and/or
nutrient choices and had higher energy contributions from whole grain products,
fruit and vegetables may decrease the risk of type 2 diabetes.”
Alhazmi A., et al. he association between dietary patterns and type 2 diabetes: a systematic
review and meta-analysis of cohort studiesJ Hum Nutr Diet 2014;27:251–260
DASH, Med Diet and healthy dietary pattern
are all associated with reduced risk of type 2
diabetes
Page 17
Esposito et al., Which diet for prevention of type 2 diabetes? A meta-analysis of prospective
studies. Endocrine. 2014 Apr 18
“The results of our study demonstrate that
several healthy diets are equally and
consistently associated with a 20 % reduced
risk of future type 2 diabetes.”
Systematic review of prospective
cohorts and RCTs: whole grains
associated with reduced risk of T2D,
weight gain and CVD
• Cohorts: whole grain users
(48-80 g/day vs ”low users”)
– Relative risk of T2D ↓ by 28
%
– Relative risk of CVD ↓ by 21
%
– Weigh 0,4 kilos less
Page 18
Ye E et al. Greater whole-grain intake is associated with lower risk of type 2 diabetes,
cardiovascular disease, and weight gain. J Nutr. 2012 Jul;142(7):1304-13.
Meta-analysis of RCTs: recommended
diet reduces the risk of type 2 diabetes
19
Gillies et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in
people with impaired glucose tolerance: systematic review and meta-analysis. BMJ
2007;334:29
(The Da Qing IGT and Diabetes Study. Diabetes Care1997; 20: 537-544, Wein et al Aust N Z J Obstet
Gynaecol. 1999;39:162-6., Jarrett et al. 1979)
Share of carbs per se is not associated
with risk of type 2 diabetes.
20
Hauner H et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake
and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60 Suppl 1:1-58
Their claim: This food pyramid is the
root cause of ATHEROSCLEROSIS
(through small LDL particles)
”Carbs are bad”
”Carbs are bad”
Recommended dietary pattern and
coronary heart disease
(CHD)
Meta-analysis by Mente et al. 2009
www.pronutritionist.net22
Meta-analysis: risk of coronary heart
disease reduced by “High quality diet”,
Med Diet and low GI/GL diet
Mente A et al. Arch Intern Med. 2009 Apr 13;169(7):659-69.
High quality diet= a dietary pattern characterized by consumption of
foods recommended in dietary guidelines
Pooled analysis of 2 prospective
cohorts. Healthy diets are associated
with reduced risk of cardiovascular,
cancer and all cause death
Sivu 24
Reedy J et al. Higher Diet Quality Is Associated with Decreased Risk of All-Cause, Cardiovascular
Disease, and Cancer Mortality among Older Adults. J Nutr 2014; February 26, online
n = 492 823, 86 419 deaths, 15 years of follow up.
Total
mortality
CVD
mortality
Cancer
mortality
Healthy Eating Index -22% -15% - 24%
Mediterranean diet -27% -20% -20%
DASH diet -17% -14% -20%
Results shown are for males. Results for women in line with men’s results. All presented
results statistically significant
Meta-analysis of 15 cohorts on
recommended diets
Sivu 25
Schwingshackl L, Hoffmann G. Diet quality as assessed by the Healthy Eating Index, the
Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and
health outcomes: a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet.
2015 May;115(5):780-800.e5
n = 1,020,642
Diabetes CVD Cancer All cause
mortality
Generally
recommended diets*
-22% -22% - 15% -22%
*) Healthy Eating Index (HEI) or Alternative Healthy Eating Index (AHEI) or DASH diet
Note: people in the cohorts did not follow analysed diets strictly but merely belonged to the
“somewhat adherent” categories. Therefore realeffects for ideal adherence might be even
higher.
Analysis of 304 systematic reviews
and meta-analyses published between
1950-2013*: Dietary guidelines are right
Sivu 26
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 Rev
2014;72(12):741-62
”… these results substantiate certain a priori nutritional
recommendations that are sometimes based on
assumptions about the foods that should be included in
a balanced diet or on characteristics of “healthy” foods”
[review focused on obesity, cancer, type 2 diabetes
and cardiovascular disease]
*) Included study designs 1) interventional study, 2) longitudinal study, 3) case-control study, 4)
cross-sectional study, and 5) ecological study
What they usually DON’T tell: Most
people NEVER followed the pyramid.
Many follow junk food diet (“Western
diet pattern”)
Mostly refined carbs, sugar,
butter, fatty cheese and
processed/red meat
In Nordic countries: only 0,3 % adhere
strictly to recommendations and 9-24 %
of the populations have somewhat
“healthy” diet
28
Nordic monitoring of diet, physical activity and overweight. First collection of data in all Nordic
Countries 2011.
More than 90% of children in US have
poor diet*. Only 0.1% has ideal diet.
29
Mozaffarian D et al. AHA Statistical Update. Heart Disease and Stroke Statistics—2015 Update.
Circulation. 2015;131:00-00.
*) Poor diet: 0-1 dietary goals met
Intermediate diet: 2-3 goals met
Ideal diet: 4-5 goals met.
Dietary goals were:
• Fruits and vegetables: >4.5 cups/d
• Fish: More than two servings/wk
• Fiber-rich whole grains at least 3
servings per/d
• Salt intake less than 3,75 g/d
• Sugar-sweetened beverages:
<450 kcal/wk (~ <1 liter/wk)
More than 65% of adults in US have poor
diet*. Only 0.4-0.6% has ideal diet.
30
Mozaffarian D et al. AHA Statistical Update. Heart Disease and Stroke Statistics—2015 Update.
Circulation. 2015;131:00-00.
*) Poor diet: 0-1 dietary goals met
Intermediate diet: 2-3 goals met
Ideal diet: 4-5 goals met.
Dietary goals were:
• Fruits and vegetables: >4.5 cups/d
• Fish: More than two servings/wk
• Fiber-rich whole grains at least 3
servings per/d
• Salt intake less than 3,75 g/d
• Sugar-sweetened beverages:
<450 kcal/wk (~ <1 liter/wk)
An average person in US eats > 2 times
more refined grains, solid fats and sugars
than recommended and < 50 % of the
recommended fruit & whole grain intake
31
SoFAS: Solid fats and sugar. Source: USDA dietary guidelines, chapter 5
Are our current diets really lower in
fat than ever (as it often claimed by
low carb proponents)?
Case US
Data from NHANES studies
and U.S. Department of Agriculture (USDA)
Page 32
NHANES studies 1971-2010
Absolute intake in grams.
Data is based on self-reports which usually
underestimate real intake
33
Intake of fat, carbohydrates and protein (grams/day/person)
NHANES
Ford ES, Dietz WH. Trends in energy intake among adults in the United States:
findings from NHANES. Am J Clin Nutr. 2013 Apr;97(4):848-53.
Data from USDA (1971-2006)
Absolute availability per person in
grams.
Data is based on balance sheets (food
availability) which may overestimate
consumption of all macronutrients due to
incomplete correction of food waste
35
0
100
200
300
400
500
600
gramspercaptia/day Fat, protein and carbohydrate availability in US
(grams/day/person)
USDA
Carbohydrates
Total fat
Source: USDA, http://www.ers.usda.gov/
Protein
Is there any data that supported
the notion of decreased fat intake
in US?
Yes. Only data that supports this notion is data
that is presented as percentage of total energy
intake (E%). But this is misleading because the
increased intake of carbohydrates over the time,
and thus increased intake of total calories, drives
the percentage of fat calories down.
37
NHANES studies 1971-2010
Percentage of energy intake
38
Intake of fat, carbohydrates and protein
(percentage of energy intake/day/person)
NHANES
Ford ES, Dietz WH. Trends in energy intake among adults in the United States:
findings from NHANES. Am J Clin Nutr. 2013 Apr;97(4):848-53.
Conclusion
• There is no decrease in fat intake in US population during the past
four decades.
• Intake of carbohydrates has increased and intake protein has
remained rather stable during the same time period. Therefore the
percentage of total calories from fat has decreased.
• US population has not followed low fat diet but has only increased
carbohydrate intake.
• It’s misleading to claim that US population had followed low fat diet
as it was described in dietary guidelines in 1980s.
• US population has adopted higher carbohydrate intake without any
decrease in fat consumption
40
The real problem: Western crappy diet
is one of the key reasons for obesity
and type 2 diabetes epidemic
I’m indeed loving it
Western diet, the junk food diet, that many
follow is associated with increased risk of
type 2 diabetes in prospective cohorts
Page 42
Alhazmi A., et al. he association between dietary patterns and type 2 diabetes: a systematic
review and meta-analysis of cohort studiesJ Hum Nutr Diet 2014;27:251–260
“By contrast, there was evidence of an increased risk of type 2 diabetes by
comparing the highest and lowest adherence to unhealthy dietary patterns intake
when all studies were pooled (RR = 1.44, 95% CI = 1.33–1.57, P < 0.005) (Fig. 3).
Analysis of 3 cohorts: Western diet is
associated with increased risk of obesity in
prospective cohorts while recommended
food items seem to protect from weight gain
Page 43
Mozaffarian D et al. Changes in diet and lifestyle and long-term weight gain in women and men. NEJM.
2011;364:2392-404.
Conclusion
• Different universally recommended dietary patterns are associated
with reduced risk of weight gain, type 2 diabetes and deaths.
Dietary guidelines are supported by scientific evidence.
• Guidelines have never recommended use of refined carbs, ie. low
fiber grains, cereals and sugar, which clearly are bad for health
• Majority of people do not adhere to dietary guidelines. Substantial
part of western populations follow western diet pattern
characterized with “junk food”.
• Claiming that people receive heart attack or become obese and
diabetic by following dietary guidelines is unfounded
44
A bonus.
Why there is then so much
controversy around the
guidelines?
Let’s give a word to Seth Yoder
@thescienceofnutrition
45
46
Read this text and you know. Worth
your 20 minutes.
Disclaimer
I’m not saying the recommended diet would
be superior or the only way of healthy eating.
There are several variants of healthy diets.
For example, low carb, “Paleolithic” and
vegan diets can be healthy if food choices are
right.
47
Wellcome aboard!
http://twitter.com/pronutritionist
http://www.facebook.com/pronutritionist
http://www.pronutritionist.net
Reijo Laatikainen, RD, MBA
Images bought and licensed from BigStockPhoto. Snapshots from papers and sites referred to.
Page 48

Contenu connexe

Tendances

Glycine: The Versatile Anti-inflammatory Nutrient
Glycine: The Versatile Anti-inflammatory NutrientGlycine: The Versatile Anti-inflammatory Nutrient
Glycine: The Versatile Anti-inflammatory Nutrient
Vladimir Heiskanen
 

Tendances (20)

Low carb diet in diabetes, 2 year results
Low carb diet in diabetes, 2 year resultsLow carb diet in diabetes, 2 year results
Low carb diet in diabetes, 2 year results
 
Sydney diet heart
Sydney diet heart Sydney diet heart
Sydney diet heart
 
Diet discussions, dieticians view wcsj 2013 helsinki
Diet discussions, dieticians view wcsj 2013 helsinki Diet discussions, dieticians view wcsj 2013 helsinki
Diet discussions, dieticians view wcsj 2013 helsinki
 
Diet and ldl particle size
Diet and ldl particle sizeDiet and ldl particle size
Diet and ldl particle size
 
Low carb diet and long term weight loss
Low carb diet and long term weight lossLow carb diet and long term weight loss
Low carb diet and long term weight loss
 
Lyon Diet Heart Study
Lyon Diet Heart StudyLyon Diet Heart Study
Lyon Diet Heart Study
 
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional Risks
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional RisksPlant-based Eating: Enhancing Health Benefits, Minimizing Nutritional Risks
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional Risks
 
Proceedings boston 2013
Proceedings boston 2013Proceedings boston 2013
Proceedings boston 2013
 
How to reduce cancer risk
How to reduce cancer riskHow to reduce cancer risk
How to reduce cancer risk
 
Metabolic Syndrome - June 2014
Metabolic Syndrome - June 2014Metabolic Syndrome - June 2014
Metabolic Syndrome - June 2014
 
Lchf cvd
Lchf cvdLchf cvd
Lchf cvd
 
Diabetes 101
Diabetes 101Diabetes 101
Diabetes 101
 
Obesity and Cardiovascular Disease
Obesity and Cardiovascular Disease Obesity and Cardiovascular Disease
Obesity and Cardiovascular Disease
 
Jose María Ordovás-El impacto de las ciencias ómicas en la nutrición, la medi...
Jose María Ordovás-El impacto de las ciencias ómicas en la nutrición, la medi...Jose María Ordovás-El impacto de las ciencias ómicas en la nutrición, la medi...
Jose María Ordovás-El impacto de las ciencias ómicas en la nutrición, la medi...
 
REGULAR YOGURT CONSUMPTION MAY HELP PREVENT CARDIOMETABOLIC DISEASES - Andre ...
REGULAR YOGURT CONSUMPTION MAY HELP PREVENT CARDIOMETABOLIC DISEASES - Andre ...REGULAR YOGURT CONSUMPTION MAY HELP PREVENT CARDIOMETABOLIC DISEASES - Andre ...
REGULAR YOGURT CONSUMPTION MAY HELP PREVENT CARDIOMETABOLIC DISEASES - Andre ...
 
Asian indian phenotype
Asian indian phenotypeAsian indian phenotype
Asian indian phenotype
 
Glycine: The Versatile Anti-inflammatory Nutrient
Glycine: The Versatile Anti-inflammatory NutrientGlycine: The Versatile Anti-inflammatory Nutrient
Glycine: The Versatile Anti-inflammatory Nutrient
 
actual poster
actual posteractual poster
actual poster
 
Plant Based Diet: Research and Learning
Plant Based Diet: Research and LearningPlant Based Diet: Research and Learning
Plant Based Diet: Research and Learning
 
Butter is not a good choice for low carber
Butter is not a good choice for low carberButter is not a good choice for low carber
Butter is not a good choice for low carber
 

Similaire à Dietary guidelines are right

Systematic Reviews and Meta- and Pooled AnalysesEffects of.docx
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docxSystematic Reviews and Meta- and Pooled AnalysesEffects of.docx
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docx
ssuserf9c51d
 
RunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead PICOT Question1RunningHead PICOT Question7.docxRunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead PICOT Question1RunningHead PICOT Question7.docx
rtodd599
 
PERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docx
PERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docxPERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docx
PERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docx
mattjtoni51554
 
Research Bibliography Assignment
Research Bibliography Assignment Research Bibliography Assignment
Research Bibliography Assignment
Nilam Hypio
 

Similaire à Dietary guidelines are right (20)

18th july 2020 daily global regional and local rice e newsletter
18th  july 2020 daily global regional and local rice e newsletter18th  july 2020 daily global regional and local rice e newsletter
18th july 2020 daily global regional and local rice e newsletter
 
Exercise or exercise and diet for preventing type 2 dm
Exercise or exercise and diet for preventing type 2 dmExercise or exercise and diet for preventing type 2 dm
Exercise or exercise and diet for preventing type 2 dm
 
Mhfl research summary
Mhfl research summaryMhfl research summary
Mhfl research summary
 
MHFL dietary regimen research overview
MHFL dietary regimen research overviewMHFL dietary regimen research overview
MHFL dietary regimen research overview
 
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docx
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docxSystematic Reviews and Meta- and Pooled AnalysesEffects of.docx
Systematic Reviews and Meta- and Pooled AnalysesEffects of.docx
 
Κολοβέρου E, Παναγιωτάκος Δ. Η Μεσογειακή δίαιτα στην πρωτογενή πρόληψη του ...
Κολοβέρου E, Παναγιωτάκος Δ.  Η Μεσογειακή δίαιτα στην πρωτογενή πρόληψη του ...Κολοβέρου E, Παναγιωτάκος Δ.  Η Μεσογειακή δίαιτα στην πρωτογενή πρόληψη του ...
Κολοβέρου E, Παναγιωτάκος Δ. Η Μεσογειακή δίαιτα στην πρωτογενή πρόληψη του ...
 
كتاب المتلازمة الأيضية للدكتور موسى العنزي
كتاب المتلازمة الأيضية للدكتور موسى العنزيكتاب المتلازمة الأيضية للدكتور موسى العنزي
كتاب المتلازمة الأيضية للدكتور موسى العنزي
 
Crimson Publishers-Dietary Lifestyle, Way of Life Practices and Corpulence: ...
Crimson Publishers-Dietary Lifestyle, Way of Life Practices and  Corpulence: ...Crimson Publishers-Dietary Lifestyle, Way of Life Practices and  Corpulence: ...
Crimson Publishers-Dietary Lifestyle, Way of Life Practices and Corpulence: ...
 
PPT nutrigenomics obesity in nutrition.ppt
PPT nutrigenomics obesity in nutrition.pptPPT nutrigenomics obesity in nutrition.ppt
PPT nutrigenomics obesity in nutrition.ppt
 
Dietary fiber and cardiovascular diseases
Dietary fiber and cardiovascular diseasesDietary fiber and cardiovascular diseases
Dietary fiber and cardiovascular diseases
 
Impact of Dietary Pattern on Human Life Quality and Life Expectancy: A Mini-R...
Impact of Dietary Pattern on Human Life Quality and Life Expectancy: A Mini-R...Impact of Dietary Pattern on Human Life Quality and Life Expectancy: A Mini-R...
Impact of Dietary Pattern on Human Life Quality and Life Expectancy: A Mini-R...
 
Impaired glucose tolerance in Pre diabetics
Impaired glucose tolerance in Pre diabetics Impaired glucose tolerance in Pre diabetics
Impaired glucose tolerance in Pre diabetics
 
Crimson Publishers-Interventions in Obesity and Diabetes: Point of View
Crimson Publishers-Interventions in Obesity and Diabetes: Point of ViewCrimson Publishers-Interventions in Obesity and Diabetes: Point of View
Crimson Publishers-Interventions in Obesity and Diabetes: Point of View
 
RunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead PICOT Question1RunningHead PICOT Question7.docxRunningHead PICOT Question1RunningHead PICOT Question7.docx
RunningHead PICOT Question1RunningHead PICOT Question7.docx
 
Diet and diseases and relationship between them
Diet and diseases and relationship between themDiet and diseases and relationship between them
Diet and diseases and relationship between them
 
A Practical Approach To The Management Of Micronutrients And Other Nutrients ...
A Practical Approach To The Management Of Micronutrients And Other Nutrients ...A Practical Approach To The Management Of Micronutrients And Other Nutrients ...
A Practical Approach To The Management Of Micronutrients And Other Nutrients ...
 
Global ‘diet quality’ falling
Global ‘diet quality’ fallingGlobal ‘diet quality’ falling
Global ‘diet quality’ falling
 
PERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docx
PERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docxPERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docx
PERSPECTIVEUnderstanding Nutritional Epidemiology and Its.docx
 
Research Bibliography Assignment
Research Bibliography Assignment Research Bibliography Assignment
Research Bibliography Assignment
 
Nutritional Epidemiological Study to Estimate Usual Intake and to Define Opti...
Nutritional Epidemiological Study to Estimate Usual Intake and to Define Opti...Nutritional Epidemiological Study to Estimate Usual Intake and to Define Opti...
Nutritional Epidemiological Study to Estimate Usual Intake and to Define Opti...
 

Plus de Reijo Laatikainen

Proteiinipitoiset ruuat ja vakavat sairaudet
Proteiinipitoiset ruuat ja vakavat sairaudetProteiinipitoiset ruuat ja vakavat sairaudet
Proteiinipitoiset ruuat ja vakavat sairaudet
Reijo Laatikainen
 

Plus de Reijo Laatikainen (20)

Paasto lihavuuden hoidossa2.pptx
Paasto lihavuuden hoidossa2.pptxPaasto lihavuuden hoidossa2.pptx
Paasto lihavuuden hoidossa2.pptx
 
Ultra-processing of food. Definition, consequences for health and emerging cr...
Ultra-processing of food. Definition, consequences for health and emerging cr...Ultra-processing of food. Definition, consequences for health and emerging cr...
Ultra-processing of food. Definition, consequences for health and emerging cr...
 
Kauratuotteiden ravintosisalto
Kauratuotteiden ravintosisalto Kauratuotteiden ravintosisalto
Kauratuotteiden ravintosisalto
 
Planetaarinen ruokavalio
Planetaarinen ruokavalioPlanetaarinen ruokavalio
Planetaarinen ruokavalio
 
Body weight planner
Body weight plannerBody weight planner
Body weight planner
 
Kihti, nivelrikko, nivelreuma ja ravinto
Kihti, nivelrikko, nivelreuma ja ravintoKihti, nivelrikko, nivelreuma ja ravinto
Kihti, nivelrikko, nivelreuma ja ravinto
 
Hullua menoa ravintotutkimuksessa ja -keskustelussa
Hullua menoa ravintotutkimuksessa ja -keskustelussaHullua menoa ravintotutkimuksessa ja -keskustelussa
Hullua menoa ravintotutkimuksessa ja -keskustelussa
 
Maitotuotteet ja terveys laajan tutkimusnäytön mukaan
Maitotuotteet ja terveys laajan tutkimusnäytön mukaanMaitotuotteet ja terveys laajan tutkimusnäytön mukaan
Maitotuotteet ja terveys laajan tutkimusnäytön mukaan
 
Ruokavalio tulehduksellisissa suolistosairauksissa
Ruokavalio tulehduksellisissa suolistosairauksissaRuokavalio tulehduksellisissa suolistosairauksissa
Ruokavalio tulehduksellisissa suolistosairauksissa
 
Gluteeni kummittelee
Gluteeni kummitteleeGluteeni kummittelee
Gluteeni kummittelee
 
Terveelliset ruuat 304 katsauksen mukaan
Terveelliset ruuat 304 katsauksen mukaanTerveelliset ruuat 304 katsauksen mukaan
Terveelliset ruuat 304 katsauksen mukaan
 
Proteiinipitoiset ruuat ja vakavat sairaudet
Proteiinipitoiset ruuat ja vakavat sairaudetProteiinipitoiset ruuat ja vakavat sairaudet
Proteiinipitoiset ruuat ja vakavat sairaudet
 
Suomalaisten energiaravintoaineiden ja ruokien kulutus
Suomalaisten energiaravintoaineiden ja ruokien kulutusSuomalaisten energiaravintoaineiden ja ruokien kulutus
Suomalaisten energiaravintoaineiden ja ruokien kulutus
 
Sokerin kulutus suomessa ja yhdysvalloissa
Sokerin kulutus suomessa ja yhdysvalloissaSokerin kulutus suomessa ja yhdysvalloissa
Sokerin kulutus suomessa ja yhdysvalloissa
 
Kasvisten ravintovertailu
Kasvisten ravintovertailuKasvisten ravintovertailu
Kasvisten ravintovertailu
 
Hedelmien ja marjojen ravintovertailu
Hedelmien ja marjojen ravintovertailuHedelmien ja marjojen ravintovertailu
Hedelmien ja marjojen ravintovertailu
 
Hiilihydraattien ravintosisältövertailu
Hiilihydraattien ravintosisältövertailuHiilihydraattien ravintosisältövertailu
Hiilihydraattien ravintosisältövertailu
 
Ravinto, verenpaine ja terveys
Ravinto, verenpaine ja terveysRavinto, verenpaine ja terveys
Ravinto, verenpaine ja terveys
 
Ruokavalio ja sydän- ja verisuonisairaudet Suomessa
Ruokavalio ja sydän- ja verisuonisairaudet SuomessaRuokavalio ja sydän- ja verisuonisairaudet Suomessa
Ruokavalio ja sydän- ja verisuonisairaudet Suomessa
 
Suolavertailua
SuolavertailuaSuolavertailua
Suolavertailua
 

Dernier

CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...
CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...
CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...
ocean4396
 
Failure to thrive in neonates and infants + pediatric case.pptx
Failure to thrive in neonates and infants  + pediatric case.pptxFailure to thrive in neonates and infants  + pediatric case.pptx
Failure to thrive in neonates and infants + pediatric case.pptx
claviclebrown44
 

Dernier (20)

CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...
CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...
CAS 110-63-4 BDO Liquid 1,4-Butanediol 1 4 BDO Warehouse Supply For Excellent...
 
5cladba raw material 5CL-ADB-A precursor raw
5cladba raw material 5CL-ADB-A precursor raw5cladba raw material 5CL-ADB-A precursor raw
5cladba raw material 5CL-ADB-A precursor raw
 
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS by Dr M.KARTHIK EMMANUEL
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS  by Dr M.KARTHIK EMMANUELCONGENITAL HYPERTROPHIC PYLORIC STENOSIS  by Dr M.KARTHIK EMMANUEL
CONGENITAL HYPERTROPHIC PYLORIC STENOSIS by Dr M.KARTHIK EMMANUEL
 
Scleroderma: Treatment Options and a Look to the Future - Dr. Macklin
Scleroderma: Treatment Options and a Look to the Future - Dr. MacklinScleroderma: Treatment Options and a Look to the Future - Dr. Macklin
Scleroderma: Treatment Options and a Look to the Future - Dr. Macklin
 
TEST BANK For Huether and McCance's Understanding Pathophysiology, Canadian 2...
TEST BANK For Huether and McCance's Understanding Pathophysiology, Canadian 2...TEST BANK For Huether and McCance's Understanding Pathophysiology, Canadian 2...
TEST BANK For Huether and McCance's Understanding Pathophysiology, Canadian 2...
 
hypo and hyper thyroidism final lecture.pptx
hypo and hyper thyroidism  final lecture.pptxhypo and hyper thyroidism  final lecture.pptx
hypo and hyper thyroidism final lecture.pptx
 
HyperIgE syndrome: primary immune deficiency.pdf
HyperIgE syndrome: primary immune deficiency.pdfHyperIgE syndrome: primary immune deficiency.pdf
HyperIgE syndrome: primary immune deficiency.pdf
 
TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...
TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...
TEST BANK for The Nursing Assistant Acute, Subacute, and Long-Term Care, 6th ...
 
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptxSURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
SURGICAL ANATOMY OF ORAL IMPLANTOLOGY.pptx
 
DIGITAL RADIOGRAPHY-SABBU KHATOON .pptx
DIGITAL RADIOGRAPHY-SABBU KHATOON  .pptxDIGITAL RADIOGRAPHY-SABBU KHATOON  .pptx
DIGITAL RADIOGRAPHY-SABBU KHATOON .pptx
 
ROSE CASE SPINAL SBRT BY DR KANHU CHARAN PATRO
ROSE  CASE SPINAL SBRT BY DR KANHU CHARAN PATROROSE  CASE SPINAL SBRT BY DR KANHU CHARAN PATRO
ROSE CASE SPINAL SBRT BY DR KANHU CHARAN PATRO
 
Failure to thrive in neonates and infants + pediatric case.pptx
Failure to thrive in neonates and infants  + pediatric case.pptxFailure to thrive in neonates and infants  + pediatric case.pptx
Failure to thrive in neonates and infants + pediatric case.pptx
 
A thorough review of supernormal conduction.pptx
A thorough review of supernormal conduction.pptxA thorough review of supernormal conduction.pptx
A thorough review of supernormal conduction.pptx
 
Is Rheumatoid Arthritis a Metabolic Disorder.pptx
Is Rheumatoid Arthritis a Metabolic Disorder.pptxIs Rheumatoid Arthritis a Metabolic Disorder.pptx
Is Rheumatoid Arthritis a Metabolic Disorder.pptx
 
In-service education (Nursing Mangement)
In-service education (Nursing Mangement)In-service education (Nursing Mangement)
In-service education (Nursing Mangement)
 
Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...
Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...
Unlocking Holistic Wellness: Addressing Depression, Mental Well-Being, and St...
 
Renal Replacement Therapy in Acute Kidney Injury -time modality -Dr Ayman Se...
Renal Replacement Therapy in Acute Kidney Injury -time  modality -Dr Ayman Se...Renal Replacement Therapy in Acute Kidney Injury -time  modality -Dr Ayman Se...
Renal Replacement Therapy in Acute Kidney Injury -time modality -Dr Ayman Se...
 
World Hypertension Day 17th may 2024 ppt
World Hypertension Day 17th may 2024 pptWorld Hypertension Day 17th may 2024 ppt
World Hypertension Day 17th may 2024 ppt
 
PREPARATION FOR EXAMINATION FON II .pptx
PREPARATION FOR EXAMINATION FON II .pptxPREPARATION FOR EXAMINATION FON II .pptx
PREPARATION FOR EXAMINATION FON II .pptx
 
Cardiovascular Physiology - Regulation of Cardiac Pumping
Cardiovascular Physiology - Regulation of Cardiac PumpingCardiovascular Physiology - Regulation of Cardiac Pumping
Cardiovascular Physiology - Regulation of Cardiac Pumping
 

Dietary guidelines are right

  • 1. Following dietary guidelines is associated with reduced risk of type 2 diabetes, coronary heart disease and obesity. Scientific evidence [Updated May, 2016] Registered dietitian, M.Sc, MBA Reijo Laatikainen www.twitter.com/pronutritionist Page 1
  • 2. Why this slide deck? • Numerous accusations by some representatives of low carb and “Paleolithic“ diet communities and by some “nutrition authors” maintain that dietary guidelines have made us fat and sick: – “Dietary guidelines have caused the obesity epidemic” – “Dietary guidelines are not based on scientific evidence” – “Dietary guidelines are the reason for type 2 diabetes epidemic” – And so forth • Quite often these accusations are not addressed adequately. Consequently, many people buy in the claims. • This deck is about science. What does the high quality data show about the evidence of dietary guidelines? 2
  • 3. 1. Randomized mortality & morbidity trials 2. Prospective cohorts 3. Randomized risk marker studies 4. Cross-sectional and case-control cohorts 5 Ecological & animal studies Strengthofevidence Meta-analyses of 1,2 & 3 Modified from: Micha & Mozaffarian. Lipids. 2010; 45(10): 893–905 and Evidence Analysis Manual. Academy of Nutrition and Dietetics January 2012 Hierarchy of evidence in nutrition science
  • 4. Commonly recommended dietary patterns have many names and their quality varies little. All are rather high in carbs: DASH Low GI diet Prudent diet pattern High quality diet pattern Healthy diet pattern Healthy Eating Index … and so on. 4
  • 5. Their claim: This food pyramid is the root cause of OBESITY EPIDEMIC ”Carbs are bad” ”Carbs are bad”
  • 6. Dietary macronutrients and long term weight change Systematic review by Fogelholm et al 2013 6
  • 7. Prudent diet, healthy diet and Med Diet reduce the risk of weight gain 7 Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56 Number of studies showing reduced risk of weight gain in long term: 4 Number of studies showing increased risk of weight gain in long term: zero
  • 8. Fiber rich carbohydrates associated with lower body weight and refined carbs with weight gain 8 Number of studies showing reduced risk of weight gain in long term: 13 Number of studies showing increased risk of weight gain in long term: zero Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
  • 9. Meat is associated with weight gain. Dairy is associated with lower weight 9 Number of studies showing increased risk of weight gain in long term: 3 Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
  • 10. No evidence that share of carbs in a diet is a determinant of weight gain 10 Fogelholm M et al. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review.Food Nutr Res. 2012;56
  • 11. Carbs and weight management Systematic review by Hauner et al 2012 www.pronutritionist.net11
  • 12. Intake of carbs is not associated with with risk of obesity. 12 Hauner H et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60 Suppl 1:1-58
  • 13. Fiber rich carbs are associated with reduced risk of obesity. Sugary drinks increase the risk of weight gain 13 Hauner H et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60 Suppl 1:1-58
  • 14. Their claim: This food pyramid is the root cause of TYPE 2 DIABETES EPIDEMIC ”Carbs are bad” ”Carbs are bad”
  • 15. Type 2 diabetes Meta-analyses of prospective cohorts by Esposito et al. 2014, Alhazmi et al. 2014, Ye et al.2013 and meta-analysis of RCTs by Gillies et al 2007 Systematic review by Hauner et a. 2012 www.pronutritionist.net15
  • 16. Healthy dietary pattern is associated with reduced risk of type 2 diabetes Page 16 “The results indicated that dietary patterns consisting of healthy foods and/or nutrient choices and had higher energy contributions from whole grain products, fruit and vegetables may decrease the risk of type 2 diabetes.” Alhazmi A., et al. he association between dietary patterns and type 2 diabetes: a systematic review and meta-analysis of cohort studiesJ Hum Nutr Diet 2014;27:251–260
  • 17. DASH, Med Diet and healthy dietary pattern are all associated with reduced risk of type 2 diabetes Page 17 Esposito et al., Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies. Endocrine. 2014 Apr 18 “The results of our study demonstrate that several healthy diets are equally and consistently associated with a 20 % reduced risk of future type 2 diabetes.”
  • 18. Systematic review of prospective cohorts and RCTs: whole grains associated with reduced risk of T2D, weight gain and CVD • Cohorts: whole grain users (48-80 g/day vs ”low users”) – Relative risk of T2D ↓ by 28 % – Relative risk of CVD ↓ by 21 % – Weigh 0,4 kilos less Page 18 Ye E et al. Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr. 2012 Jul;142(7):1304-13.
  • 19. Meta-analysis of RCTs: recommended diet reduces the risk of type 2 diabetes 19 Gillies et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ 2007;334:29 (The Da Qing IGT and Diabetes Study. Diabetes Care1997; 20: 537-544, Wein et al Aust N Z J Obstet Gynaecol. 1999;39:162-6., Jarrett et al. 1979)
  • 20. Share of carbs per se is not associated with risk of type 2 diabetes. 20 Hauner H et al. Evidence-based guideline of the German Nutrition Society: carbohydrate intake and prevention of nutrition-related diseases. Ann Nutr Metab. 2012;60 Suppl 1:1-58
  • 21. Their claim: This food pyramid is the root cause of ATHEROSCLEROSIS (through small LDL particles) ”Carbs are bad” ”Carbs are bad”
  • 22. Recommended dietary pattern and coronary heart disease (CHD) Meta-analysis by Mente et al. 2009 www.pronutritionist.net22
  • 23. Meta-analysis: risk of coronary heart disease reduced by “High quality diet”, Med Diet and low GI/GL diet Mente A et al. Arch Intern Med. 2009 Apr 13;169(7):659-69. High quality diet= a dietary pattern characterized by consumption of foods recommended in dietary guidelines
  • 24. Pooled analysis of 2 prospective cohorts. Healthy diets are associated with reduced risk of cardiovascular, cancer and all cause death Sivu 24 Reedy J et al. Higher Diet Quality Is Associated with Decreased Risk of All-Cause, Cardiovascular Disease, and Cancer Mortality among Older Adults. J Nutr 2014; February 26, online n = 492 823, 86 419 deaths, 15 years of follow up. Total mortality CVD mortality Cancer mortality Healthy Eating Index -22% -15% - 24% Mediterranean diet -27% -20% -20% DASH diet -17% -14% -20% Results shown are for males. Results for women in line with men’s results. All presented results statistically significant
  • 25. Meta-analysis of 15 cohorts on recommended diets Sivu 25 Schwingshackl L, Hoffmann G. Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet. 2015 May;115(5):780-800.e5 n = 1,020,642 Diabetes CVD Cancer All cause mortality Generally recommended diets* -22% -22% - 15% -22% *) Healthy Eating Index (HEI) or Alternative Healthy Eating Index (AHEI) or DASH diet Note: people in the cohorts did not follow analysed diets strictly but merely belonged to the “somewhat adherent” categories. Therefore realeffects for ideal adherence might be even higher.
  • 26. Analysis of 304 systematic reviews and meta-analyses published between 1950-2013*: Dietary guidelines are right Sivu 26 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 Rev 2014;72(12):741-62 ”… these results substantiate certain a priori nutritional recommendations that are sometimes based on assumptions about the foods that should be included in a balanced diet or on characteristics of “healthy” foods” [review focused on obesity, cancer, type 2 diabetes and cardiovascular disease] *) Included study designs 1) interventional study, 2) longitudinal study, 3) case-control study, 4) cross-sectional study, and 5) ecological study
  • 27. What they usually DON’T tell: Most people NEVER followed the pyramid. Many follow junk food diet (“Western diet pattern”) Mostly refined carbs, sugar, butter, fatty cheese and processed/red meat
  • 28. In Nordic countries: only 0,3 % adhere strictly to recommendations and 9-24 % of the populations have somewhat “healthy” diet 28 Nordic monitoring of diet, physical activity and overweight. First collection of data in all Nordic Countries 2011.
  • 29. More than 90% of children in US have poor diet*. Only 0.1% has ideal diet. 29 Mozaffarian D et al. AHA Statistical Update. Heart Disease and Stroke Statistics—2015 Update. Circulation. 2015;131:00-00. *) Poor diet: 0-1 dietary goals met Intermediate diet: 2-3 goals met Ideal diet: 4-5 goals met. Dietary goals were: • Fruits and vegetables: >4.5 cups/d • Fish: More than two servings/wk • Fiber-rich whole grains at least 3 servings per/d • Salt intake less than 3,75 g/d • Sugar-sweetened beverages: <450 kcal/wk (~ <1 liter/wk)
  • 30. More than 65% of adults in US have poor diet*. Only 0.4-0.6% has ideal diet. 30 Mozaffarian D et al. AHA Statistical Update. Heart Disease and Stroke Statistics—2015 Update. Circulation. 2015;131:00-00. *) Poor diet: 0-1 dietary goals met Intermediate diet: 2-3 goals met Ideal diet: 4-5 goals met. Dietary goals were: • Fruits and vegetables: >4.5 cups/d • Fish: More than two servings/wk • Fiber-rich whole grains at least 3 servings per/d • Salt intake less than 3,75 g/d • Sugar-sweetened beverages: <450 kcal/wk (~ <1 liter/wk)
  • 31. An average person in US eats > 2 times more refined grains, solid fats and sugars than recommended and < 50 % of the recommended fruit & whole grain intake 31 SoFAS: Solid fats and sugar. Source: USDA dietary guidelines, chapter 5
  • 32. Are our current diets really lower in fat than ever (as it often claimed by low carb proponents)? Case US Data from NHANES studies and U.S. Department of Agriculture (USDA) Page 32
  • 33. NHANES studies 1971-2010 Absolute intake in grams. Data is based on self-reports which usually underestimate real intake 33
  • 34. Intake of fat, carbohydrates and protein (grams/day/person) NHANES Ford ES, Dietz WH. Trends in energy intake among adults in the United States: findings from NHANES. Am J Clin Nutr. 2013 Apr;97(4):848-53.
  • 35. Data from USDA (1971-2006) Absolute availability per person in grams. Data is based on balance sheets (food availability) which may overestimate consumption of all macronutrients due to incomplete correction of food waste 35
  • 36. 0 100 200 300 400 500 600 gramspercaptia/day Fat, protein and carbohydrate availability in US (grams/day/person) USDA Carbohydrates Total fat Source: USDA, http://www.ers.usda.gov/ Protein
  • 37. Is there any data that supported the notion of decreased fat intake in US? Yes. Only data that supports this notion is data that is presented as percentage of total energy intake (E%). But this is misleading because the increased intake of carbohydrates over the time, and thus increased intake of total calories, drives the percentage of fat calories down. 37
  • 38. NHANES studies 1971-2010 Percentage of energy intake 38
  • 39. Intake of fat, carbohydrates and protein (percentage of energy intake/day/person) NHANES Ford ES, Dietz WH. Trends in energy intake among adults in the United States: findings from NHANES. Am J Clin Nutr. 2013 Apr;97(4):848-53.
  • 40. Conclusion • There is no decrease in fat intake in US population during the past four decades. • Intake of carbohydrates has increased and intake protein has remained rather stable during the same time period. Therefore the percentage of total calories from fat has decreased. • US population has not followed low fat diet but has only increased carbohydrate intake. • It’s misleading to claim that US population had followed low fat diet as it was described in dietary guidelines in 1980s. • US population has adopted higher carbohydrate intake without any decrease in fat consumption 40
  • 41. The real problem: Western crappy diet is one of the key reasons for obesity and type 2 diabetes epidemic I’m indeed loving it
  • 42. Western diet, the junk food diet, that many follow is associated with increased risk of type 2 diabetes in prospective cohorts Page 42 Alhazmi A., et al. he association between dietary patterns and type 2 diabetes: a systematic review and meta-analysis of cohort studiesJ Hum Nutr Diet 2014;27:251–260 “By contrast, there was evidence of an increased risk of type 2 diabetes by comparing the highest and lowest adherence to unhealthy dietary patterns intake when all studies were pooled (RR = 1.44, 95% CI = 1.33–1.57, P < 0.005) (Fig. 3).
  • 43. Analysis of 3 cohorts: Western diet is associated with increased risk of obesity in prospective cohorts while recommended food items seem to protect from weight gain Page 43 Mozaffarian D et al. Changes in diet and lifestyle and long-term weight gain in women and men. NEJM. 2011;364:2392-404.
  • 44. Conclusion • Different universally recommended dietary patterns are associated with reduced risk of weight gain, type 2 diabetes and deaths. Dietary guidelines are supported by scientific evidence. • Guidelines have never recommended use of refined carbs, ie. low fiber grains, cereals and sugar, which clearly are bad for health • Majority of people do not adhere to dietary guidelines. Substantial part of western populations follow western diet pattern characterized with “junk food”. • Claiming that people receive heart attack or become obese and diabetic by following dietary guidelines is unfounded 44
  • 45. A bonus. Why there is then so much controversy around the guidelines? Let’s give a word to Seth Yoder @thescienceofnutrition 45
  • 46. 46 Read this text and you know. Worth your 20 minutes.
  • 47. Disclaimer I’m not saying the recommended diet would be superior or the only way of healthy eating. There are several variants of healthy diets. For example, low carb, “Paleolithic” and vegan diets can be healthy if food choices are right. 47
  • 48. Wellcome aboard! http://twitter.com/pronutritionist http://www.facebook.com/pronutritionist http://www.pronutritionist.net Reijo Laatikainen, RD, MBA Images bought and licensed from BigStockPhoto. Snapshots from papers and sites referred to. Page 48