APPG
These are the references for the presentation to the All Party Parliamentary Group for Diabetes, held at Westminster on February 26th 2019. The (very short) presentation can be seen here.
Slide 2
The Panel on Macronutrients. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients): The National Academies Press, 2005. (Quotation comes from p275)
Slide 3
Gordon Wardlaw, Smith. A. Contemporary Nutrition. Seventh edition ed: McGraw Hill; 2009 10 February 2008.
Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. The Lancet. 2017.
Slide 4
Carter J.P. Eating in America; Dietary Goals for the United States; Report of the Select Committee on Nutrition and Human Needs US Senate. Cambridge, MA, USA: MIT Press 1977.
Slide 5
Harcombe Z, Baker JS, Cooper SM, et al. Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart 2015.
Slide 7
Harcombe Z, Baker JS, Cooper SM, et al. Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart 2015.
Harcombe Z, Baker JS, DiNicolantonio JJ, et al. Evidence from randomised controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis. Open Heart 2016.
Harcombe Z, Baker JS, Davies B. Evidence from prospective cohort studies did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review. Br J Sports Med 2016.
Harcombe Z, Baker J, Davies B. Evidence from prospective cohort studies does not support current dietary fat guidelines: A systematic review and meta-analysis. Br J Sports Med 2016.
Harcombe Z. Dietary fat guidelines have no evidence base: where next for public health nutritional advice? Br J Sports Med 2016.
Slide 8
Skeaff CM, Miller J. Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials. Ann. Nutr. Metab. 2009.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American journal of clinical nutrition 2010
Hooper L, Summerbell CD, Thompson R, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane database of systematic reviews. 2011.
Chowdhury R, Warnakula S, Kunutsor S, et al. Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis. Ann. Intern. Med. 2014.
Schwingshackl L, Hoffmann G. Dietary fatty acids in the secondary prevention of coronary heart disease: a systematic review, meta-analysis and meta-regression. BMJ Open 2014.
Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database of Systematic Reviews 2015.
Harcombe Z. Dietary fat guidelines have no evidence base: where next for public health nutritional advice? Br J Sports Med. 2016.
Slide 9
https://www.zoeharcombe.com/2016/03/eatwell-guide
Slide 10
https://www.zoeharcombe.com/2018/07/the-eatwell-guide-is-nutritionally-deficient
Slide 11
Harcombe Z. Designed by the food industry for wealth, not health: the ‘Eatwell Guide’. Br J Sports Med 2016.
https://www.nutrition.org.uk/aboutbnf/supporters/memberorganisations.html
https://www.zoeharcombe.com/2016/03/eatwell-guide-conflicts-of-interest
Slide 13
Evidence to date – summary article:
McKenzie LA, Hallberg JS, Creighton CB, et al. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes 2017.
There are three evidence-based options for putting T2D into remission:
1) Bariatric surgery.
Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery. New England Journal of Medicine 2004.
2) A very low calorie diet.
Lean MEJ, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet 2017.
Bauman WA, Schwartz E, Rose HG, Eisenstein HN, Johnson DW. Early and long-term effects of acute caloric deprivation in obese diabetic patients. Am J Med 1988.
3) A low carbohydrate diet.
Westman EC, Yancy WS, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & metabolism 2008.
McKenzie LA, Hallberg JS, Creighton CB, et al. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes 2017.
Saslow LR, Kim S, Daubenmier JJ, et al. A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes. PLoS One 2014.
Unwin D, Unwin J. Low carbohydrate diet to achieve weight loss and improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice. Practical Diabetes 2014.
Unwin DJ, Cuthbertson DJ, Feinman R, VS S. A pilot study to explore the role of a low-carbohydrate intervention to improve GGT levels and HbA1c. Diabesity in Practice 2015.
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