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Time to spread butter again? Study questions historic advice

By Tim Sandle     Feb 11, 2015 in Health
For several decades the fats associated with butter and cheese have been on a list of substances to consume in moderation. This original advice is not evidence-based, according to a new study.
The call to reassess the health risks associated with fatty dairy products has come from a paper published in the journal Open Heart, which is part of he portfolio of publications published by the British Medical Association (BMA.) The paper has made headlines around the world; however, it is important to understand what the research is reporting and what it is not.
The paper is titled "Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis" and the lead author is Dr. Zoe Harcastle (Institute of Clinical Exercise and Health Science, University of the West of Scotland.) The intention of the paper was to review national dietary guidelines introduced in the U.S. in 1977 and, later, in 1983 in the U.K. These sets of legislation had the aim of reducing coronary heart disease (CHD) by reducing fat intake. The targets for such reductions were dairy products, advising people to cut their overall fat consumption to 30 percent of total energy intake and lower saturated fat consumption to ten percent of total energy intake.
The authors of the new paper were concerned that no detailed analysis of the evidence base for these fat reducing recommendations had been undertaken. in order to fill this gap, the new study looked at the evidence collected from randomized controlled trials conducted in both the U.S. and U.K. over the intervening years since the original legislation was passed.
The paper reviews a mass of data. This includes information relating is almost 3,000 men across six dietary trials. With this population, there were 370 deaths, caused by a variety of different factors. There were 207 deaths from coronary heart disease in the groups that eat diets rich in dairy products and 216 death from control groups.
Following statistical analysis, the researchers concluded that there were no differences in all-cause mortality and therefore no differences between different diets. Although the groups that did not consume a high fat diet saw a reduction in cholesterol levels, there was no significant association with heart disease.
The European Union and the United States are facing off over the use of some restricted cheese desig...
The European Union and the United States are facing off over the use of some restricted cheese designations, such as the name Parmesan.
Wikimedia Commons/Dominik Hundhammer
On this basis, the authors conclude that "government dietary fat recommendations were untested in any trial prior to being introduced." In addition, the dietary recommendations were introduced for 220 million US and 56 million UK citizens by 1983 are not supported by any evidence. Moreover, the authors note that many nutritionists who pushed people away from a high fat diet simply directed people towards a high carbohydrate diet, which, in hindsight, was not necessarily any healthier.
As a note of caution, the study does not infer that it is necessarily good practice to suddenly rush out and eat a high fat, dairy product diet. The study is critical of advice issued by governments between 1977 and 1983. Since then dietary advise has been revised. A balanced diet is always the best option, the study notes.
It also stands that not every academic thinks that the original advice was flawed. Interviewed by the BBC, Professor Christine Williams, at the University of Reading, states the claim that evidence was insufficient is "misguided and potentially dangerous."
Furthermore, Rahul Bahl, of the Royal Berkshire NHS Foundation Trust, told The Guardian: “There is certainly a strong argument that an overreliance in public health on saturated fat as the main dietary villain for cardiovascular disease has distracted from the risks posed by other nutrients, such as carbohydrates...Yet replacing one caricature with another does not feel like a solution.”
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