{"id":6205,"date":"2017-07-19T19:45:58","date_gmt":"2017-07-19T18:45:58","guid":{"rendered":"https:\/\/www.zoeharcombe.com\/?p=6205"},"modified":"2018-01-13T15:15:18","modified_gmt":"2018-01-13T15:15:18","slug":"designed-by-the-food-industry-for-wealth-not-health-the-eatwell-guide","status":"publish","type":"post","link":"https:\/\/www.zoeharcombe.com\/2017\/07\/designed-by-the-food-industry-for-wealth-not-health-the-eatwell-guide\/","title":{"rendered":"Designed by the food industry for wealth, not health: the \u2018Eatwell Guide\u2019"},"content":{"rendered":"
After a year, I am allowed to publish BJSM articles on my site, so here is my editorial on the ‘Eatwell Guide’ from 13th June 2016<\/a>…<\/p>\n <\/p>\n <\/p>\n Introduction<\/strong><\/p>\n The Balance of Good Health<\/em>, a picture of a segmented plate, was launched by the UK Department of Health in 1994. In September 2007, this was relaunched by the Food Standards Agency as the Eatwell Plate. The changes were cosmetic. In March 2016, the Eatwell Plate was relaunched as the Eatwell Guide. Many of the changes were again cosmetic.<\/p>\n The Eatwell Guide was formulated by a group appointed by Public Health England consisting primarily of members of the food and drink industry rather than independent experts.<\/p>\n What changed?<\/strong><\/p>\n The Eatwell Plate became the Eatwell Guide; the knife and fork disappeared; the segment names were tweaked and the images on the plate became drawings, not photographs \u2013 looking even less like real food. None of this would have any impact on epidemics of obesity or type 2 diabetes.<\/p>\n The segment proportions changed: starchy foods increased from 33% to 38%; fruit and vegetables from 33% to 40%; \u201cmilk and dairy\u201d became \u201cdairy and alternatives\u201d (soya) and almost halved from 15% to 8%; non dairy protein stayed at 12%, but was renamed to \u201cbeans, pulses, fish, eggs, meat and other proteins\u201d (the incomplete vegetarian protein listed first and an ignorance of the difference between a food group and a macro nutrient demonstrated). The purple segment (previously foods high in fat and\/or sugar) became (unsaturated) oils and spreads. Unilever\u2019s response was to place adverts in national newspapers to celebrate their \u201cdedicated section\u201d.<\/p>\n The indefensible can of cola was removed. The biscuits, sweets, cakes, crisps and chocolate remain, however; moved from the purple segment to be given prominence on the bottom left of the diagram, along with ketchup and ice cream.<\/p>\n Evidence<\/strong><\/p>\n The primary issue with the Eatwell Guide, as with its predecessors, is that it is not evidence based. There has been no randomised controlled trial of a diet based on the Eatwell Plate or Guide, let alone one large enough, long enough and with whole population generalisability.<\/p>\n Dietary advice to base meals on carbohydrates is the consequence of dietary advice to restrict fat. Protein is in all foods \u2013 except sucrose (arguably not a food) and oils\/lard \u2013 and thus tends to comprise approximately 15% of energy intake. The introduction of a total fat recommendation of 30% of calories was concomitantly a population directive to consume 55% of energy in the form of carbohydrate [1]. The fat guidelines were without evidence base [2] and the carbohydrate advice was not tested. Not even the hydration message holds water [3].<\/p>\n The 2015 US Dietary Guidelines [4] are conspicuously silent on the subject of total fat. The recommendation appears to have been quietly dropped rather than confessionally reversed. The UK is behind the times.<\/p>\n Weight and calories<\/strong><\/p>\n In 2009, in personal correspondence, the Food Standards Agency confirmed that the Eatwell Plate percentages were based on weight. Food weight matters little to the human body. Calories, macro and micro nutrients count. Given the vastly different calorie content of 100g of fruit and vegetables vs. 100g of oils, the plate proportions change substantially when calories are counted (Table 1):<\/p>\n <\/p>\n <\/p>\n