Macronutrient Confusion is Everywhere Apparently

Thank you to everyone for contributing to my little survey!  I wasn't trying to trick anyone or anything, just get an idea of whether or not there is any so-called macronutrient confusion across the pond (and/or in other countries that have adopted similar nutritional recommendations).

Where'd that come from?  I had a random page hit from a blog discussing a paper by Zoe Harcombe where a commenter had linked to my discussions of Harcombe's credentials.    Yes, Zoe Harcombe -- obesity researcher extraordinaire -- did indeed publish a paper in a "peer reviewed" journal back in March of this year:  Food for Thought: Have We Been Giving the Wrong Dietary Advice?.    In it she, and coauthors, lamented some so-called macronutrient confusion in the UK.

I was wondering if it did, indeed, exist.

So the consensus seems to be that pastries and biscuits and such are to be limited.  The main foods associated with saturated fats are meats, eggs and dairy.  Part of the rationale for limiting pastries is their saturated fat content.  I don't see this as evidence of macronutrient confusion at all, but going into the paper Harcombe seems focused on this minutia.  Billed somewhat as an analysis of Keys' Seven Countries Study, Harcombe writes:

More importantly the [Seven Countries] study classified cake and ice cream as saturated fats, as opposed to refined carbohydrates, an error which is repeated by contemporary food scientists.

Elsewhere:

There is a need to accurately define the macro and micronutrient content of food. Biscuits, savoury snacks and processed food should not be defined as saturated fats because they are substantially carbohydrates. 

Yeah, when I see pastries, I think saturated fats!  Can you pick out the saturated fats in the picture at right?  It comes from the promo videos for the documentary "Carb Loaded" that will be foisted upon us soon enough (complete with interviews with all those still believing in the insulin fairy, and not the one below either ;-)

Don't get me wrong, the demonized macro of carbs is well represented in the above picture.  So, too, are many foods that are "fattening" because of their high calorie content, attributable largely to their fat content.   But that's the US, so I did think it prudent to include a headline from the UK and we note that they have a macronutriently confused lady there eating a cupcake thinking she's eating saturated fat?   Or is the message that, like Banting before her, she really thought pastries to be innocuous routine aliments?

This nonsense really needs to stop if people are truly interested in getting to solutions to the problems so many face.   I contend, the so-called "helpers" aren't really in the business of finding lasting solutions after all, but I digress ...  From the days of the Fat Head glorified diet plate, weight loss regimes have been reduced calorie and not particularly high in any macronutrient except perhaps protein.  The cupcake has no place as the basis for any healthy diet, which is not to say they cannot be enjoyed from time to time by anyone lacking a real physiological reason to avoid them.

Harcombe continues ... 

Meat and eggs are described as saturated fat when their fat content is primarily unsaturated. Butter and cream are one third unsaturated fat, which was not noted in their analysis. So here we have a profoundly influential research project introducing imprecise evaluations of macronutrients which have continued to the present day.

It seems to me that Harcombe is confusing sources of different macros, or listings of foods that might be higher in certain ones than others, with labeling of a food as "a saturated fat".   Are Harcombe et.al. actually arguing that ice cream is not a source of saturated fats? Much as folks would like to tar and feather ice cream for it's sugar content, let's take a basic chocolate ice cream from Cold Stone Creamery. Here 100g is shown to be 55% fat by calories, of which saturated fat represents almost equal calories as sugar at around 35%.  Do we really need to bicker over which demon macro or sub-macro is the most evil in ice cream??

I am somewhat pleasantly surprised to see pastries mentioned as potential sources of saturated fats.  Good on whomever pointed this out!   Many baked goods and "carbs", are just as easily classed as fat sources.   While nobody is going to classify a corn muffin as a fat, 25% (roughly the same as sugar) of calories are indeed fat in this "carbohydrate" with 15% of that coming from saturated fats.  Depending on the era and type of baking, lard was prevalent for pie crusts and the like, as well as frying.  

So while ...  

Natural food such as meat, fish, eggs and nuts contain saturated, monounsaturated and polyunsaturated fats, only the proportions vary. Few people appreciate that it is impossible to eat saturated or polyunsaturated fat alone. Dairy products are the only food group with more saturated than unsaturated fat. Many of the foods demonised by past research groups, even lard, contain more unsaturated than saturated fat.

... is all well and good, the fact that something contains other fats doesn't change the fact of whether it is rich in saturated fats, regardless of ones position on their nutritional value or potential harm.    

The only foods that contain no carbohydrate or protein are oils [22,23]. Sucrose contains only carbohydrate, no fat or protein. Every other food contains protein with fat, carbohydrate or both.

So two references for this groundbreaking revelation.  Seriously, who cares.  But the article goes on and on about a hodge podge collection of foods and even more ridiculous comparisons of foods to perhaps be substituted for.  

Replacing 100 g of cheese with 100 g of olive oil will reduce saturated fats [SFAs] by 7 g and increase monounsaturated fats [MU-FAs] eight fold (64 g) and PUFAs twelvefold. Calorie intake doubles while losing: 25 g of protein; 33% of vi-tamin A and B12 RDAs; 70% of the calcium and phosphorus RDAs and all zinc [28].

Yeah I was thinking of having some cheese with those crackers (almost 4 oz) but instead I thought I'd drown them in a half a cup of olive oil instead.   Or worse ...

If whole milk is replaced with the same oil, all protein and minerals are lost, calories increase 15 fold and all three fats increase substantially SFAs seven fold, MUFAs 91 fold and PUFAs 55 fold [29].

But if I replaced my skim milk over my Special K with olive oil ... sorry, too ridiculous to continue.

I actually think it's Zoe Harcombe who is suffering from confusion -- and not just with macronutrients.  You see her schtick has been this idea that calories don't count and those who don't believe that aren't fit to shine Gary Taubes' shoes.  And yet she lost whatever small amount of weight she needed to and maintained her svelte figure for 15-20 years eating a vegetarian (ovo-lacto apparently, or just lacto?) diet, that was certainly not low carb, and likely quite low in calories.  On her (published) Harcombe diet, vegetarians are allowed to substitute 100 g of brown rice for meat ... say what?  Talk about macronutrient confusion!!    In comments on that linked post, Zoe responded here:

5-a-day is a fairy story and I expose it in my book "The Obesity Epidemic: What caused it? How can we stop it". The idea that we need to eat fibre is another. 1lb does not equal 3,500 cals; we will not lose 1lb if we create a deficit of 3,500 cals. The seven countries study did not study fat. There are so many lies that the public are being fed that we need to try to counter.

There are certainly a lot of fairy stories in her book, but I'm going to be too busy with another nonsensical insulin-fairy screed soon enough to bother going back to one that made nary a wave (thankfully).    

And yet, here's a most confusing comparison of all:

The consumption of oily fish is now considered a must and caution is given over red meat. However if 100 g of pork is replaced with the same quantity of mackerel we double the intake of calories and saturated fat. The intake of MUFAs would triple and PUFAs increase almost seven fold [32,33] with the protein remaining the same. Vitamins are gained and some minerals are gained and others lost.

Do I need to remind anyone this is supposed to be a peer-reviewed journal article?  Pork is the other white meat here in the US, but in any case, Harcombe mixes the proverbial apples with oranges (as she does elsewhere in the article with steak).  If one selects a lean pork tenderloin, a 100 gram portion will contain 143 calories, 4g/1g total/sat fat and 26 grams of protein.  This is hardly a fair comparison to mackerel where 100 grams gets you 262 calories, 18g/4g total/sat fat and 24 grams of protein.    Yeah!  You got someone there Zoe!  Instead, how about you compare to 100 grams of pork butt  containing 256 calories, 17g/6g total/sat fat and 26 grams of protein.  If she wants to quibble that the encouraged mackerel contains almost as much saturated fat as the pork she may have a point.  However the mackerel is only 14% vs 21% calories from saturated fat and the mackerel comes with some 1400 mg of Omega 3's (with about a 0.1:1 O6:O3 ratio) while the pork only contains 75 mg of Omega 3's (swamped out by almost 1800 mg of O6 for a 24:1 O6:O3 ratio).

Arguing that "red meat is not a saturated fat" because sirloin steak (again lean) is only 2% saturated fat is getting misleading.  Again she chooses a lean cut to make her point, but that's 2% by weight which translates to 13% by calories (total fat is 38% of calories in a lean steak!)

OK ... I bothered to turn this into a post instead of commenting on my survey for another reason.  Two actually.  First, I'm going to take one for the team and attempt to read Grain Brain after I'm done with some projects -- or perhaps for entertainment breaks ... we'll see.  What I've skimmed already, as posted in the Grain Brain Quiz, Perlmutter seems to suffer food and macronutrient confusion himself.  Milk and fruit aren't grains or sources of the primary carbohydrate in grains, starch.  Further beer may be made from grain, but it's more the alcohol that's a whole 'nother macro despite Lustig's confusion regarding fructose and alcohol.  

And then there's the continuing forever confusion over macros in the paleo diet, proponents thereof, and the whole shebang.  Whatever one thinks of the Eaton-Konner-Cordain-Lindeberg underpinnings of the modern paleo diet, their writings are what they are, and saturated fat is specifically mentioned as low. Only one paleolithic nutrition trial has exceeded the common Western dietary recommendations for limiting saturated fats to 10%.  So when you see those plates of ribs at the next paleo gathering, just remember they are over 30% by calories of saturated fat and 76% fat by calories.  

Ahh ... Perlmutter must have been thinking of Robb Wolf's first paleo meal when he envisioned the diet of our ancestors to be 75% fat, 20% protein and 5% carbs.  In his book, Perlmutter is clearly trying to align himself with paleo allies (smart move as they are likely to gloss over the book and promote it heavily just because of the title and premise).  

So let me conclude here with a few comments.  

1.  Zoe Harcombe's paper is disturbing in two main ways.  First, it doesn't really discuss Keys' study, just perpetuates the myth that every and all dietary recommendations are rooted in it. Second, it is described and classed as "peer reviewed" and thus academic in nature.  Apparently nowadays any organization can start a journal, construct a publishing process (including paying for the publication directly) and establish a so-called "peer review".  As flawed as the old guard peer review process is, it will be all the more important moving forward to take with a grain of salt anything published in this new brand of pay-for-play journals.  

2.  There never has been this dichotomy over fat vs. sugar impacting health.  As was mentioned in several comments on my survey, the UK recommends limiting sugar as well as fats, and sweets are right up there in the peak of the old US Food Pyramid.  The explosion of sugar free products well predates that of low fat products and one of the first things most dieters do is either cut down or out on sugar or replace it with artificial or other non-nutritive sweeteners.  Nobody, but nobody, is drinking a Big Gulp at a WW meeting because it's "non fat".  While some foods did increase the sweetness as fat was cut, this notion that fat was replaced with sugar is absurd.   If you compare Snackwells chocolate chip cookies with Chips Ahoy and match calories, they contain almost identical sugars (around 7 grams/100 cal) and even fat (around 5 grams/100 cal).  The older Snackwells may have been lower in fat, but if you have around 6 grams of fat in a serving and cut that to 4 grams, guess what?  You can market it as 33% less fat and oh doesn't that sound like a green light?  LOL.  

The truth is that in the UK and US and other countries with similar dietary guidelines and practices, we do NOT consume the food pyramid.  Pizza, beer, soda, donuts and whatever latte with a flip from Starbucks aren't on the pyramid.  If there is any "macro" confusion it is that the "vegetable" we here in the US have most increased consumption of is the potato.  Sinister carbs right?  Nope.  In the form of french fries.  

3.  If there is macronutrient confusion in the current system, whatever it is that these various gurus are suggesting to replace it with seems ever the more confused.   If you want to turn the nutritional tide you're going to have to do better than some 30 day elimination diet, the macronutrient composition of which is even still under debate with a trendy paleo label slapped on it.    You have to do the dirty work of making science-based recommendations to replace that which you see as flawed.  It's funny though how that science keeps pointing back to traditional diets being mostly low fat, plant based, meat-on-the-side types of fare.    There are scant few examples of human cultures consuming majority meat diets.  The vast majority consume majority plant diets -- and that would include Western cultures up to and shortly after WWII where obesity was an affliction of affluence and true endocrine disorder.  When relative widespread prosperity hit, this increased predictably.  

It's time to correct both the macronutrient confusion as well as the food-type misinformation that has been spread through the paleo gurus and hangers-on of similar ilk.  This is if they are serious about changing things and not just about making money off of a trendy label.  

You want to know how to best do this?  Read a nutrition text book.  Seriously.  They are not all that difficult a go, and if you can read the content on any of the paleo blogs, you can read a nutrition textbook and be far the wiser for it.  They're expensive you say?  Not any more than 10 books from various gurus you'll eventually be hopeful to give away (or ebooks you can't even use to start a fire or look smart by displaying them on the shelf with different title jackets of literary masterpieces).  And for less if you go back just one edition and look about the internet.

I have this book.  There are newer and older editions about, with different covers and some variation on the authors.  It is excellent.  Not dumbed down, not over the head.  Requires little if any background.  There are a ton available HERE (I have no affiliation with the authors, publisher or that site) that you could have delivered to your doorstep for less than bottle of paleo supplements your nutrient dense diet is supposed to preclude the need for, and a package of overpriced coffee your fat burning self is supposed to have too much energy to even bother with. 

Or you can waste your time with Harcombe and Sisson and Bailor and Wolf and Davis and Perlmutter and Lustig and Feinman ... And then someone like me, trying to straighten out the crapola they fed you in the name of nutritional science.  Don't get me wrong, I love having you read what I write.  But I'd rather you learned the basics correctly the first time from credible sources.   The unknown is fascinating enough to explore without having to rehash the basics that have been known -- correctly -- all along.