Turning the Tide – The role of diet in preventing and even reversing non-communicable diseases (4)

Last week we did a quick dive into the power of big business to manipulate our palates and confuse the science and drive us towards addiction to unhealthy foods.

It is scary how powerful the influence vested interests have over our behaviours.  It is also frustrating how easily we can become confused and lose sight of the hard work and painstaking research of so many pioneers in the field of nutrition science, when the latest attention-grabbing headline seeks to undermine what we know to be right and rational.

ALSO READ : Turning the Tide – The role of diet in preventing and even reversing non-communicable diseases (3) So how do we determine the best diet?  There are a number of ways of doing this.

1. Check out the Blue Zones – studies that have been done on groups of long-lived communities in various places in the world. If these people consistently live longer than the average, they must be doing something right.
2. Look at the long term population studies which include large numbers of people over many years. Examples of these include the Framingham Heart Study – a study of heart disease in the small town of Framingham, Massachusetts, beginning in 1948 with 5209 adults, and including more than 15,000 people over 3 generations.  Other large studies include the Nurses Health Study started in 1976 and including more than 280,000 participants, and the Adventist Health Studies I and 2 which have followed up almost 100,000 people over many years.
3. Read up on the China Study – a comprehensive assessment of mortality rates from cancer and other chronic diseases between 1973-1975 in 65 different counties in China – a huge undertaking looking at disease patterns in one of the largest populations on earth.
4. Check out Ancel Keys, a Minesotta physiologist together with researchers all around the world in the Seven Countries Study which started in the early 1950’s and which eventually lead to the promulgation of the Mediterranean diet.

These are only a few of the better known studies.  What they show is that using large numbers of subjects and long time frames, we are better able to determine patterns of behaviour and lifestyle that impact morbidity and mortality rates.

So many of the studies that have been done that come out with unconventional recommendations – recommendations that go against common sense and give us excuses to maintain our bad behaviours – are based on short term results, and unfortunately are often supported by vested interests in big business or agricultural marketing organisations.

Another way of assessing a particular diet or lifestyle is to look at the long term effects on a whole range of health metrics.

• What effect does this diet have on the progression of diabetes? Is it able to reverse diabetes and many of the complications thereof?
• Is it able to bring blood cholesterol levels down and reverse peripheral vascular disease and even coronary artery disease? That is the ultimate test of an effective diet and lifestyle!
• Is it able to bring down inflammatory markers in the blood and reduce the risks of auto-immune diseases?
• Does it counteract the development of cancer and increase cancer-inhibiting genes and suppress cancer-promoting genes?
• Does it promote a healthy microbiome – mostly but not only the gut microflora?
• What effect does it have on the development of dementia, including Alzheimer’s disease?

Of course, as we mentioned last week, any diet needs to be within the reach of everyone, not only the deep-pocketed members of society – and it behoves Governments to make it easy for struggling communities to afford healthy options. 

In many richer countries, Government subsidies  promote the consumption of highly processed foods, especially in school feeding schemes and support of people in financial distress.  This has to change and there are some powerful advocacy groups that are lobbying lawmakers to bring about change.  But it is a slow process digging away at the mountain called vested interest.

From my considered understanding of the best studies, and what happens to also be recommendations from WHO experts: A diet that is rich in a variety of fruits and vegetables, that is based on whole grains as the staple energy source and makes abundant use of legumes (beans, peas and lentils) and some nuts and seeds as the main source of protein.  It does not exclude animal products, but minimises their use and discourages processed meats.  It discourages highly processed foods and promotes home cooking.

Here is the latest fact sheet from WHO on diet. With the third wave of Covid looming over South Africa, next week I will start a short series on the effect of lifestyle on preventing and minimising the risks of Covid.

Until then, stay safe.

Dave Glass

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