{"id":3280,"date":"2014-10-20T17:23:43","date_gmt":"2014-10-20T16:23:43","guid":{"rendered":"https:\/\/www.zoeharcombe.com\/?p=3280"},"modified":"2020-06-18T11:55:55","modified_gmt":"2020-06-18T10:55:55","slug":"trust-me-im-a-doctor-not-on-nutrition","status":"publish","type":"post","link":"https:\/\/www.zoeharcombe.com\/2014\/10\/trust-me-im-a-doctor-not-on-nutrition\/","title":{"rendered":"Trust me I’m a doctor – not on nutrition"},"content":{"rendered":"
Michael Mosley was back on our screens last week (15 October 2014). I do like MM. I like his bedside manner. I like his preparedness to self-experiment and he’s becoming more and more aligned with the real foodie way of thinking, as shown with his confession on exercise here <\/a>and on fat here<\/a>.<\/p>\n However, he and the other doctors on Trust me I’m a doctor<\/em> (TMIAD), are being badly let down by whoever is advising them on nutrition. Doctors receive barely a few hours of training in nutrition, despite Hippocrates\u2019 advice “Let food be thy medicine<\/em> and medicine be thy food.<\/em>”<\/p>\n The carb experiment<\/strong><\/p>\n Dr Chris van Tulleken, one of the twins who did the Horizon fat vs. sugar experiment <\/a>in January 2014, is one of the TMIAD presenters. He took part in a ‘ground-breaking’ experiment, in an Italian restaurant, with the positioning statement: “starchy foods, like potatoes and pasta, have lots of calories but can you make these goods better for you<\/em>?”<\/p>\n The study lead was Dr Denise Robertson from the University of Surrey. The 10 participants were given 100g (cooked weight) of pasta (with a tomato based sauce), 3 days in succession. On day one the pasta was hot, just cooked; on day two the pasta was cold, having been chilled overnight; and on day three they had the chilled pasta re-heated.\u00a0 This is a good experiment design, as the same subjects are used for all three interventions thus minimising any impact of different people responding differently to the same circumstances. The participants took their own blood samples every 15 minutes for the 2 hours following the pasta consumption.<\/p>\n Robertson’s hypothesis was that cooking the pasta differently would “reduce its calories.”<\/p>\n Tulleken narrated: “starchy foods like this are very quickly broken down into sugars … high sugars, and the resulting insulin, are unhealthy and they may make you feel hungry soon after a meal. And that’s the problem with refined sweet sugars, but it’s also true for things like pasta, potatoes, white rice and white bread<\/em>.”<\/p>\n The results<\/strong><\/p>\n A graph was shown of the rise in blood glucose levels after eating first the freshly cooked pasta.<\/p>\n <\/p>\n The average fasting blood glucose level is 5.6 mmol\/L, but the normal range is wide and most people fall into a fasting blood glucose range of 3.3-7.7 mmol\/L. The starting average blood glucose level for the group of 10 was 4.6 mmol\/L (reading from the graph on the TV as accurately as possible). The peak blood glucose level occurred after 30 minutes – 6.6 mmol\/l. At 120 minutes, the mean blood glucose levels were 5.3 mmol\/L.<\/p>\n The chilled pasta peaked at about 6.4 mmol\/L and the peak was slightly later than the freshly cooked pasta. However, the graph shown on the programme put the fresh pasta and chilled pasta alongside each other. I don’t know about you, but I found the difference between the green and blue lines completely underwhelming.<\/p>\n Robertson explained what had happened as follows: “We know that when a starch, such as potato or pasta, is cooked in water and then it’s allowed to cool, you’re changing the structure of that starch. You’re changing it in such a way, it becomes resistant to the normal enzymes that we have within our bodies. And, because the enzymes don’t work on it, it releases less glucose and so you get a lower glucose response<\/em>.\u201d<\/p>\n Tulleken clarifies “So it’s good for you because you get a lower blood sugar<\/em>.”<\/p>\n Robertson: “You do and it’s now called resistant starch. And resistant starch, because you’re not digesting it will move down your intestine; it will end up in your large bowel and it becomes part of your dietary fibre<\/em>.”<\/p>\n It got a bit more interesting when the two-day-old chilled pasta was re-heated. The graph for this one led Tulleken to exclaim: “astonishingly, it reduces the rise in glucose by another 50% making it even healthier<\/em>.” You can see the second graph below<\/p>\n <\/p>\n The blood glucose peak for the re-heated pasta is 5.7 mmol\/L. The 50% is a relative claim, using the 4.6 mmol\/L starting blood glucose level and is highly misleading. The red line is more different from the green line than the blue line is, but it’s not ground-breaking and here is why…<\/p>\n The programme could have produced a flat line – none of the ‘bad’ rise in glucose, sugar peak and insulin production by either 1) giving the subjects meat or fish or 2) giving them the pasta packaging to eat!<\/p>\n What this experiment has done is to make food less digestible so that it doesn’t produce the physiological changes that occur when the body registers that we have eaten food. The ultimate indigestible substance would be the cardboard box from which the pasta came. “But that would be stupid – it has no nutrients<\/em>“, I hear you cry and you would hit the nail on the head. This experiment seems to completely disregard the reason why we eat. We eat food because we need nutrients to survive: essential fats; complete proteins; vitamins and minerals. This experiment is celebrating indigestibility \u2013 the pointlessness of eating something.<\/p>\n White pasta has little enough nutrition to start with. When it has been boiled once, chilled in a fridge overnight, left for another day and then re-boiled – how many nutrients do you think survived? I don’t know. I can tell you what it had after it was first cooked. And then compare it to the meat or fish that the participants could have enjoyed in the same Italian restaurant:<\/p>\n