Posted on 07/30/2002 11:40:12 AM PDT by ijcr
AMID calls for a major initiative on obesity, research suggests that parents should seek an alternative to the quick-fix carbohydrate breakfast out of a box, writes Robert Matthews
The experts warned that it would happen, and last week it did. The first cases of adult-type diabetes were found in teenage children, triggered by a condition now reaching worrying proportions in the UK: obesity.
A year ago, medical researchers revealed that the prevalence of fat children has doubled since the mid-1980s, with more than one in 10 in this country now classed as overweight. The finding prompted dire warnings about the future impact on the health service, with obesity being linked to increased risk of heart disease and Type II diabetes.
The future has arrived. Type II diabetes, normally seen only in adults and in children from ethnic minorities, has been diagnosed in four obese white teenagers whose bodies can no longer cope with carbohydrates. All of them will need medication for years to come, and are at greater risk from a host of other conditions, from cataracts to kidney failure. The researchers called for a "major initiative" to tackle the problem of childhood obesity, prompting the Department of Health to issue assurances that it was already on the case, armed with a plethora of advice on healthy eating.
With rates of obesity among Britain's adults expected to hit 20 per cent by 2005, questions are starting to be raised about the reliability of this advice.
For parents worried that they may be contributing to their children's obesity by feeding them inappropriate or even unhealthy foods, the conflict between the old nutritional orthodoxies and new research now emerging is even more disturbing. For generations, it has been taken for granted that starting the day with a bowl of cereal will not only give children the energy they need to get through the morning until lunchtime but is better for them than most other breakfasts. What's more, almost all the cereal manufacturers promote their products as being particularly healthy and helpful in the fight against heart disease.
The manufacturers have taken their advice from nutritional experts who have insisted that a healthy diet is one that is low in fat. The scientific reasons are well-known: fat clogs arteries and leads to coronary heart disease and early death. Health-conscious consumers have been anxiously trying to remember if they should be substituting saturated fats for monounsaturated or polyunsaturated ones.
They need not have bothered - there is still no good scientific evidence that dietary fat of any kind affects the risk of heart disease. The most recent review of the evidence, published last year in the British Medical Journal, concluded that despite decades of effort and 31,000 patient-years' worth of data, there is still "only limited and inconclusive evidence" that cutting down on total, saturated, monounsaturated, or polyunsaturated fats has any effect on the risk of heart-related disease and death.
Even this is putting it charitably, as none of the evidence for even the "limited" reductions in cardiovascular disease and death achieved statistical significance. How can it be, then, that the fast-food guzzling Americans are dying in droves from heart attacks? The simple answer is: they are not. Rates of deaths from coronary heart disease in America have been plunging for decades, while fat intake and obesity have soared.
It is a similar story with carbohydrates, long touted as a key part of a healthy diet. The reasoning is that, ounce for ounce, these contain only half as many calories as fat and so can be eaten in bigger, more sating quantities.
It is another of the supposed benefits of a bowl of cereal for breakfast - for, as anyone who has ever read the side of a cereal packet will know, the contents are high in carbohydrates and low in fats.Yet researchers have failed to show any clear link between fat intake and an increased risk of heart disease. So swapping fat for carbohydrate seems unlikely to make much difference.
Indeed, researchers now admit there is very little evidence for the supposed benefits of a high carbohydrate diet. What does exist, however, is evidence pointing to a subtle but nasty twist in the standard dietary message.
Scientists used to believe that carbohydrates were all much the same, with the same effect on the body. Now they have found that - as so often in human nutrition - things are not quite as simple.
Like fats, carbohydrates come in different forms, reflected in their so-called glycaemic index (GI). High GI or "fast" carbohydrate foods - typically found in refined foods such as white bread and breakfast cereal - are rapidly absorbed by the body, and produce a surge in blood-sugar levels.
In contrast, low GI or "slow" carbohydrates - found in apples, oranges, pasta and porridge - take longer to be absorbed, and raise blood sugar levels slowly.
Until recently, no one knew what effect this might have on the risk of heart disease. After tracking the health of more than 75,000 women for a decade, a team from the Harvard School of Public Health has recently made a worrying discovery. In stark contrast to the case of dietary fat, the team found a clear link between carbohydrates and heart disease. The worst culprits were the "fast" carbohydrates found in refined foods, which almost doubled the risk of coronary heart disease.The implications could hardly be more startling: the mantra of low-fat, high-carbohydrate diets repeated for decades may not simply be ineffective - it may actually be harmful.
None of this comes as a surprise to Dr Richard Atkins, the New York-based cardiologist whose book, The Dr Atkins Diet Revolution, has sold more than 10 million copies. Since the early 1970s, Dr Atkins has preached the heresy of a high-protein, low-carbohydrate diet, claiming that it compels the body to burn up vbstored fat and thus lose weight.
Dr Atkins has put the blame for America's high levels of obesity on the dietary advice of organisations such as the American Heart Association (AHA), with its focus on carbohydrates. The AHA, in turn, has publicly condemned his diet for ignoring the dangers of dietary fat and for its restricted food varieties.
The University of Pennsylvania's Weight and Eating Disorders Programme is conducting the first clinical trial of the Atkins diet, comparing weight loss and metabolite levels of those on the low-carbohydrate diet with those on a conventional diet. Professor Gary Foster, who is conducting the trial, says that the preliminary results support at least some of Dr Atkins's claims. "What we've found is that those on the Atkins diet lose around twice as much weight after 12 weeks, and possibly also after 26 weeks," he said.
Just as significantly, those on the diet also had healthier levels of various metabolites and were able to stick at the diet longer. Prof Foster cautioned, however, that questions remain over the long-term effects of the diet and he is planning a larger trial later this year.
Other researchers are also finding evidence that challenges the orthodoxy of current dietary advice. At the Quebec Heart Institute in Canada, scientists compared the effects of the "official" AHA diet on obese men with those of a high-protein diet with slow-release carbohydrates and low fat content.
They found that those on the high-protein diet consumed 25 per cent fewer calories than those on the AHA diet, and again had healthier levels of various metabolites. The team concluded that their high-protein diet "may have unique beneficial effects" for certain obese patients.
The long-ignored role of carbohydrates in obesity is starting to attract attention. A number of studies now suggest that "fast" carbohydrates may contribute to weight gain. The "fast" carbohydrates produce an instant "spike" in blood sugar levels which is rapidly taken up by the body's adipose tissue (fatty) cells. Subsequently, blood-sugar levels drop just as rapidly, producing a craving for more sugar.
The "slow" carbohydrates, on the other hand, release their sugars gradually, without producing a "spike", as the gut cannot break them down so quickly.
A recent review by the US Department of Agriculture Human Nutrition Research Centre, Boston, concluded that switching from fast to slow carbohydrates and whole grains "may help prevent over-eating and is consistent with current dietary guidelines".
Scientists from Harvard Medical School's Division of Preventive Medicine have also concluded that a high intake of the fast carbohydrates was linked to an increased risk of heart disease, adding that obese people are "particularly prone" to the effects of such carbohydrates. Again, rather than blaming dietary fats, the researchers recommended replacing refined and fast carbohydrates with whole grains, fruits and vegetables.
The manufacturers of breakfast cereals are - not surprisingly, given that most promote their products as being nutritionally healthy - keeping a close watch on the emerging science, to see if fast carbohydrates take over from fat as the new dietary evil. Some are already shifting their marketing emphasis toward whole-grain content. Such cereals slow the absorption rate of carbohydrates, and - again, in contrast to fat levels - have been shown to reduce heart disease rates in five major studies.
Kellogg's, which markets Cornflakes, the most famous fast carbohydrate cereal of all, is keeping faith with the low-fat message for now. Aileen Thompson, the European director of corporate communications, said: "As far as we are aware the extensive body of evidence from the majority of health and science experts still points to the link between coronary heart disease and fat intake as one of the risk factors."
The prospect of yet more upheaval in dietary advice fills many nutritionists with dismay. In the end, they argue, the basic message is simple: eat a balanced diet with no more calories than you need. The problem is maintaining this balance: eating just 1 per cent more calories per day can turn into two stones in surplus weight in a year.
"Just a little more exercise could make a big difference," says Paul Trayhurn, a professor of obesity biology at the University of Liverpool. "The trouble is, people now suspect what experts say, and I don't know how to change that."
Parents are responsible for what their children eat. If their kids are so unhealthy they are getting diabetes, there is a breakdown in parenting occurring. Maybe they had bad advice from the food pyramid, but I can't imagine that is the main cause. Parents probably just don't have the discipline to monitor what their kids eat, to insist that they eat healthy, and to punish them if they disobey.
Four cases make an epidemic?
Or serial killers?
Love that old SNL joke "Headlines from the Year 2020": "Oat Bran - The Silent Killer". Love oat bran, too.
Sheesh - sounds just like DU, doesn't it? ;)
Sorry..you lost me....
Actually, it's that cornflakes killer rooster I never trusted.
In fact Post products are more dangerous than J.R. Reynolds.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.