Diet guide­lines bi­ased vs poor na­tions — study

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WIDELY pro­moted guide­lines to re­duce fat in­take could be un­healthy for peo­ple in low- and mid­dle-in­come coun­tries whose di­ets are al­ready too starchy, re­searchers said Tues­day.

Health au­thor­i­ties in Europe and North Amer­ica rec­om­mend eat­ing more fruits and veg­eta­bles while cur­tail­ing con­sump­tion of fatty foods, ad­vice also adopted by the United Na­tions and glob­ally.

But peo­ple in poor na­tions cut­ting back on fat may wind up pil­ing on more car­bo­hy­drates — such as pota­toes, rice or bread — be­cause fruits and veg­etable are more ex­pen­sive, the au­thors point out.

“The cur­rent fo­cus on pro­mot­ing low- fat di­ets ig­nores the fact that most peo­ple’s di­ets in low- and mid­dle- in­come coun­tries are very high in car­bo­hy­drates, which seem to be linked to worse health out­comes,” said Mahshid De­hghan, a re­searcher at McMaster Univer­sity in On­tario, Canada and lead au­thor of a study in

Mean­while, a com­pan­ion study, also pub­lished in con­cludes that the rich-world guide­lines — backed by the World Health Or­ga­ni­za­tion — on fruit and veg­etable con­sump­tion could be safely cut back from five to a more af­ford­able three por­tions per day.

De­hghan and col­leagues sifted through the health data of 135,000 vol­un­teers from 18 coun­tries across six con­ti­nents, aged 35-70, who were mon­i­tored for a seven-and-half years.

Peo­ple who met three-quar­ters or more of their daily en­ergy needs with carbs were 28% more likely to die over that pe­riod that those who ate fewer starchy foods (46% or less of en­ergy needs).

Sur­pris­ingly, the find­ings also chal­lenged as­sump­tions on fat in­take: di­ets high in fat (35% of en­ergy) were linked with a 23% lower risk of death com­pared to low-fat di­ets (11% of en­ergy).

“Con­trary to pop­u­lar be­lief, in­creased con­sump­tion of di­etary fats is as­so­ci­ated with a lower risk of death,” De­hghan told AFP.

That cov­ered a mix of sat­u­rated fats (from meats and milk prod­ucts), along with mo­noun­sat­u­rated and polyun­sat­u­rated fats (from veg­etable oils, olive oil, nuts and fish), she added.

The study did not look at so-called “trans fats” from pro­cessed foods be­cause “the ev­i­dence is clear that these are un­healthy,” De­hghan said.

The best di­ets in­clude a bal­ance of 50-55% car­bo­hy­drates and around 35% to­tal fat, ac­cord­ing to the au­thors, who pre­sented their find­ings at the Euro­pean So­ci­ety of Car­di­ol­ogy Congress in Barcelona.

Cur­rent global guide­lines — based mostly on stud­ies done in Europe and the United States — rec­om­mend that 50-65% of one’s calo­ries come from carbs, and less than 10% from sat­u­rated fats.

Over­all, the study found that av­er­age diet con­sists of just over 61% car­bo­hy­drates, 23.5% “good” fat, and 15% pro­tein.

But these av­er­ages hid im­por­tant re­gional im­bal­ances: In China, South Asia and Africa, in­take of starchy foods was 67%, 65% and 63%, re­spec­tively.

A quar­ter of the 135,000 sub­jects — mostly in poorer na­tions — de­rived more than 70% of their daily calo­ries from car­bo­hy­drates, while half had less than seven per­cent sat­u­rated fats in their diet.

The find­ings “chal­lenge con­ven­tional diet-dis­ease tenets” largely based on the life­styles of Euro­peans and Amer­i­cans, Christo­pher Rams­den and An­thony Domenichiello com­mented, also in

De­hghan and col­leagues set out to look for links be­tween diet and car­dio­vas­cu­lar dis­ease, which kills some 17 mil­lion peo­ple around the world each year — 80% of them in low- and mid­dlein­come coun­tries.

Many fac­tors con­trib­ute to these dis­eases but diet is one of the few that can be mod­i­fied to lessen risk.

But while high-carb and low-fat di­ets were clearly as­so­ci­ated with greater mor­tal­ity, no sta­tis­ti­cal link was found with the kind of life threat­en­ing events — strokes, heart at­tacks, and other forms of heart fail­ure — that stem from car­dio­vas­cu­lar dis­ease.

“Most of the cur­rent de­bate about diet and health has fo­cused on car­dio­vas­cu­lar mor­tal­ity,” noted Su­san Jebb, a pro­fes­sor at the Univer­sity of Ox­ford who did not take part in the study.

The re­ported link be­tween high-carb di­ets and ex­cess mor­tal­ity “was from non-car­dio­vas­cu­lar deaths and is un­ex­plained,” she said. —

A RICE ven­dor in Jakarta

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