Major Medical Conference Highlights the Need for Better Evidence for Future Dietary Advice

- FLORENCE, Italy, March 24, 2015 /PRNewswire/ --

Public health messages on diet are well meaning but should be based on better, more up-to-date science to protect the public and deliver health benefits, a major conference claims.

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The conference, held in Florence by the Associazione Nazionale Medici Cardiologi Ospedalieri (Italian National Association of Hospital Cardiologists) featured leading international experts in the field of nutrition and medical research.

Michele Gulizia, the National President of ANMCO (Italian National Association of Hospital Cardiologists) and the Director of the Cardiology Division of the Hospital "Garibaldi-Nesima" in Catania, Italy, stated: "Food is a complex system: even though on one hand it is given an almost sick kind of media attention, on the other hand the information about the nutritional facts of the food on our tables is scarce. The issue of fat is a particular example, as fat was often demonized in the past and its correct use has been redeemed only after 40 years of media terrorism. Disinformation about food also concerns carbohydrates, proteins and those weight-reduction diets which exclude some types of nutrients entirely or single elements even in such cases where they are not supported by any medical evidence. This kind of news sometimes has an impact on the nutritional choices of some layers of the population."

An important report published in the Journal of Clinical Epidemiology highlighted that the recommendations issued by the WHO are not correctly spread: in fact, even 'strong recommendations" are often based on studies that are little to very little reliable. The research examined all the WHO guidelines published between 2007 and 2012 and revealed that 289 out of 456 recommendations (more than 55%) classified as 'strong' are based on low-quality to very-low-quality studies (1) . It is therefore hard to believe that the guidelines based on them are themselves reliable; the consequences to public health are uncertain. Moreover, the WHO sometimes issues 'conditional' recommendations, the actual consequences of which in terms of benefits are neither specified nor known. This is a rather peculiar situation, considering that during the Second International Conference on Nutrition held in Rome in November 2014 all the Member States unanimously endorsed that the documents issued by the World Health Organization should only be based on the best studies available and the highest-quality scientific evidence. In addition, it would be more appropriate to write the recommendations based on multicenter observational studies specific about the subject matter that have been published recently, so as to avoid inconsistencies or inferences that often misrepresent the actual information. Suffice it to say that the recommendations in the recent report on the intake of added sugars in the diet of adults and children are based on the examination of 4 observational studies from the '60 carried out in Japan about the onset of tooth decay. Only a note at the bottom of the pages specifies that the 'conditional' recommendations are written when there is no certainty about the balance between risks and benefits or no drawback to adopting the recommendation. Underpinning the conference was the need for more clarity following recent high-level debates about whether individual nutrients, such as saturated fat, sugar and salt, are actually to blame for chronic conditions like obesity, heart disease and type 2 diabetes.

Since the famous Seven Countries Study of the 1970s (2), which blamed saturated fat for raising blood cholesterol levels and promoting heart disease, Western diets have shifted towards low-fat and low-cholesterol foods. Re-evaluation of the low-fat diet has now led to a backlash against sugar and other carbohydrates, leaving the public more confused than ever. To make matters worse, scientists are now at loggerheads about whether fat or carbohydrates are worse for health. A rethink is needed, as was explained at the Florence meeting.

Speaking before he presented at the conference, Professor Dennis Bier from Houston, USA, commented: "The single nutrient approach is necessary to help define biochemical responses to that nutrient, but it cannot capture fully the integrated human response that follows eating whole diets of diverse nutrient patterns and complex food ingredients."

The following speaker, Professor Furio Brighenti from the University of Parma, added: "Future nutrition research needs new and innovative experimental models that take into consideration - beyond the biological effect - other aspects of human nutrition, such as psychological, cultural and social aspects, which are ultimately linked to food choice."

Conference co-chair, Professor Carlo La Vecchia from the University of Milan, said: "30 years of 'lipid-phobia' now appear to be not completely aligned with the scientific reality. Isn't the modern trend of 'carbo-phobia' going to reveal itself as misleading as well? Nowadays, the focus shouldn't be on the total amount of nutrients but the overall composition and quality of the diet." 


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