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Whittington Health NHSUCL

Too much fat or not too much fat?

Public Health England (PHE) and the National Obesity Forum recently had a very public disagreement about diet - particularly about the benefits of eating a low fat diet.

The National Obesity Forum has published a report claiming that low fat diets are bad for you, and that PHE is being influenced by commercial food manufacturers.

PHE say that the report is irresponsible and not backed up by scientific evidence.

If you dig underneath the headlines, and look at what each side is really saying, both points of view have merit, and both also have flaws.

The National Obesity Forum report says that people should concentrate on eating healthily, cutting back on processed foods, and that eating some full fat foods can be included as part of a healthy diet. Quite rightly they point out that low fat foods often have large amounts of sugar and other additives as substitutes for fat, as these make the product tasty. Sugar and additives aren't necessary in a healthy diet.

PHE claim that there is good evidence that eating large amounts of saturated fats and a high calorie diet can lead to health problems, including raised cholesterol. Prof John Wass, the Royal College of Physicians special advisor on obesity, said "what is needed is a balanced healthy diet and regular physical activity". The British Heart Foundation (BHF) support the PHE view, saying the report doesn't have the robust evidence required for some of the claims to be taken seriously.

It is unfortunate that two organizations have chosen to disagree so publicly, confusing people who want to eat healthily.  It would be more helpful if they could concentrate on the things they agree on, but that wouldn't make good newspaper headings!

There are some things that both sides agree on.

  • We should look to increase the amount of fresh food we eat and to reduce our reliance on processed foods.
  • Low fat alternatives are often processed to remove fat and may have added sugar.
  • We should eat a balanced diet, and that this needs to include some fat.

A potential benefit of all this uncertainty is that it has encouraged experts to look again at what the evidence tells us.

Diabetes UK and the Diabetes Specialist Group of The Association of UK Dietitians have looked at recent evidence relating to saturated fat specifically in the management of type 2 diabetes.

Their findings included:

  • There is no evidence that an increased intake of saturated fat reduces the risk of cardiovascular disease
  • Mediterranean style diets (high in monounsaturated fats) improve blood glucose control and cardiovascular risk in people with type 2 diabetes

They state that more research is needed before any changes are made to the current healthy eating guidelines.

Until then "information relating to fat should be considered within the context of a diet that promotes health; that is:

  • higher in vegetables, fruits, wholegrains, dairy, seafood, legumes, and nuts;
  • moderate in alcohol (among adults);
  • lower in red and processed meat;
  • and low in sugar-sweetened foods, particularly sugar-sweetened beverages, and refined grains."

Or put simply: "Eat food. Not too much. Mostly plants." (quote from Michael Pollan)