![]() Very exciting news this past week! The Academy of Nutrition and Dietetics (AND), formerly known as the American Dietetic Association, released surprising yet highly welcome comments regarding The DGA (Dietary Guidelines Advisory Committee) Scientific Report, which include the following statements: "The Academy supports the decision by the 2015 DGAC not to carry forward previous recommendations that cholesterol intake be limited to no more than 300 mg/day, as 'available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol.'" Conclusion: No restriction on cholesterol "In the spirit of the 2015 DGAC's commendable revision of previous DGAC recommendations to limit dietary cholesterol, the Academy suggests that HHS and USDA support a similar revision deemphasizing saturated fat as a nutrient of concern." Conclusion: Saturated fat no longer a villain "There is a distinct and growing lack of scientific consensus on making a single sodium consumption recommendation for all Americans, owing to a growing body of research suggesting that the low sodium intake levels recommended by the DGAC are actually associated with increased mortality for healthy individuals." Conclusion: Restricting sodium can lead to negative health consequences "Carbohydrate contributes a greater amount to the risk for cardiovascular disease than saturated fat, so the replacement of carbohydrate will necessarily result in a greater improvement in risk." Conclusion: High intake of carbohydrates is more detrimental to heart health than high intake of saturated fat While the AND recommends tailoring recommendations to individual needs (for instance, those with congestive heart failure do need to limit sodium intake), it has done a complete about-face in changing its recommendations that people should restrict sodium, saturated fat, and cholesterol in order to improve their health. And frankly, I couldn't be happier or more proud of my organization for reevaluating their position based on a thorough review of the evidence. When I started this blog and website back in July of 2011, I'd reviewed a lot of research (both current and decades old) indicating low-carbohydrate diets were healthy, despite being significantly higher in fat, saturated fat, and sodium than recommended by major health organizations. I'd also read dozens of accounts by people who'd improved their health by adopting a carbohydrate-restricted diet and, of course, there was my own experience of completely normalizing my postprandial blood glucose levels by doing so. Since early 2011, I've remained a staunch advocate of a low-carb lifestyle, especially for those suffering from diabetes, obesity, insulin resistance, and PCOS. Still, it's been hard explaining to people why my recommendations differ so much from what they've heard from their doctors or other dietitians, as well as what they hear on TV and see on the Nutrition Facts food label (which will need to be revised more than what's been proposed, given the DGAC's findings). As a registered dietitian, I was well aware that I was taking a risk in speaking out against the AND's recommendations. The topics I cover in this blog are certainly controversial, at least from the point of view of most dietitians and health care providers. However, I've worked hard to make sure that every blog post I write is balanced, well-referenced, and takes all of the available evidence into consideration. I also include a disclaimer on my About Me page that my advice may run counter to recommendations of major health organizations, including the AND -- one that I may be able to remove in the near future. Still, in the back of my mind, I've always worried about retaliation from dietitians who feel that I may be providing harmful advice to my clients and readers of my blog posts and articles. I know at least two dietitians in other countries are being threatened with discipline for making low-carbohydrate recommendations that include higher amounts of fat and saturated fat than their governing bodies deem healthy. Because these investigations are ongoing, I can't provide specifics about either case at the moment but will definitely do so in the future. In addition, I've received several emails from other dietitians who want to discuss carbohydrate restriction with their overweight and diabetic patients yet feel they can't because it's not accepted practice at the facilities where they work. It's extremely upsetting to me that those of us who give truly beneficial advice are often seen as "rogue" practitioners who reject "evidence-based" guidelines, and that we need to watch our backs. I sincerely hope that dietetic associations around the world follow the AND's lead in updating their recommendations given the totality of the evidence, rather than maintaining the status quo. Improving the nutritional health of all individuals should be the highest priority of these organizations, and if that means admitting their previous positions were wrong, they should step up to the plate and do so.
20 Comments
Tom McQuinn
5/17/2015 01:52:54 am
Yes! I've always believed that the evidence would eventually win out but I've been losing faith that I would live to see it.
Reply
Deanne Roberts
5/17/2015 04:32:26 am
Dietitians as a group have been caught in a very difficult position. Trained to be professionals, in practice of recent years they have been asked to function more like technicians - delivering advice and support within pre-set protocols.
Reply
5/17/2015 06:20:44 am
Deanne, thank you so much for your astute and insightful comments. I agree with everything you've said and appreciate your kind words of support more than you can imagine.
Reply
Terry
5/17/2015 07:38:15 am
Franziska - I am so pleased to see this change of policy by the AND. I'm sure you are relieved that they have organizationally caught up with your early and enlightened perspective. Over the years in this low-carb debate, the professionals have quickly brushed off personal experience as "merely anecdotal." I think that people who take this position must be reminded that the early anecdotal evidence in this case was right! I know anecdotes do not carry the same weight and validity as a controlled trial but perhaps they should not be summarily brushed off and dismissed! Thank you for the professional risk that you took in staking out your early enlightened position on carbohydrates, especially for those of us with diabetes.
Reply
5/17/2015 09:24:05 am
Terry, thank you so much for your comments, as well as the great feedback and support.
Reply
Galina L.
5/17/2015 12:17:02 pm
I am glad the Academy finally admitted flows in previous recommendations. I guess it couldn't be easy for them. I hope for the next step - people looking at the individual carbohydrate tolerance and eating according to a BS meter. I am sure you will be recognized as one of pioneers of such sensible approach.
Reply
5/17/2015 10:20:27 pm
Thanks, Galina. Appreciate your comments and feedback.
Reply
5/17/2015 09:54:21 pm
Franziska,
Reply
5/17/2015 10:25:57 pm
Nice to hear from you, Brian, and thanks for making these excellent points. Unfortunately, I'm unable to attend the AADE conference in June, but I hope your experience is a positive one.
Reply
5/18/2015 09:57:42 pm
I actually attended AADE 2013 and had a good experience. Although I have a lot of issues with dietary guidance coming from educators I found them to be a really caring and compassionate lot. As individuals, many of them seem to really understand how carb restriction can be a successful approach to diabetes nutrition. Sadly I also observed that the profession seemed to be aging and members were finding it more difficult to work as educators (for a variety of reasons). So I am heartened to see younger educators such as yourself in the field (yes I called you younger). 5/18/2015 11:42:43 pm
Thanks for clarifying that the conference is in August, but I'm afraid I won't be able to make that one either. Hope you enjoy it! And thank you so much for describing me as "younger." :)
Reply
Mark Carter
5/23/2015 07:56:34 pm
Great reading! I am so glad the science is beginning to prevail. I know following a LCHF diet has helped me feel better, eliminate meds, and loose 70 pounds.
Reply
5/24/2015 10:36:10 am
Thanks so much for your comments, Mark! Congratulations on losing 70 pounds and improving your health via a low-carb lifestyle.
Reply
Hannah Hamlin
5/31/2015 06:15:13 am
This is AMAZING news! I'm so thankful for all your work Franziska. You are a leader and a role model for so many.
Reply
6/2/2015 10:22:16 pm
Thank you so much for your comments and kind words, Hannah! They mean a lot to me. Keep up the great work!
Reply
Hi Franziska,
Reply
6/2/2015 10:20:47 pm
Hi Dan,
Reply
Jenny Jones
7/9/2017 09:06:19 pm
Thank you for your website! And this info from AND specifically. I am an RD who has been out of the workplace for nearly 4 years since having kids. But since I'm keeping up my credentials by taking CEU's, I've been reading books like Keto Clarity, which has opened my mind up to a whole new world and way of thinking about low-carb diets and fat intake. Amy Berger from tuitnutrition.com referred your website to me and I'm so glad she did. I look forward to reading more of your posts.
Reply
7/10/2017 05:42:09 am
Hi Jenny,
Reply
Your comment will be posted after it is approved.
Leave a Reply. |
Author
Franziska Spritzler, RD, CDE Categories
All
Archives
July 2019
|