Tuesday, 7 February 2017

The Toddler Paradox - Nutritional Guidelines for Infants

Nutritional Guidelines for Infants – a little drop of sanity in a cesspool of nonsense, or simply further proof of the conflicted and confused world of the nutrition expert? 

From the 2012 Australian Infant Feeding Guidelines:

“Low fat diets are not recommended for children under 2 years of age. Babies and young children grow very rapidly and need the fat supplied in whole milk, cheese and yogurt, and in foods such as eggs and meat, to give the energy they need for growth and development. Young children also need some fat in their diet to provide the essential fatty acids required for healthy brain development.” 

But, unless you are new to this planet, you will be very familiar with the recommendations made for anyone who lives beyond their second year of life:

“Enjoy a wide variety of nutritious foods from these five groups every day:
• Plenty of vegetables, including different types and colours, and legumes/beans
• Fruit
• Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as bread,      cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
• Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
• Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat.”

You may be thinking "yeah, so what?", but I've had a hard time grasping the rationale behind the conflicting advice for members of the same species. 

Maybe I'm just slow, but I'm not aware of another species who instinctively, and almost universally, believe that babies and infants require specific nutrition for optimum health and growth, but then, in the very early stages of their offspring’s development, behave as if those same food sources are harmful.

Of course I'm talking specifically about dietary fat, which is essential, but then quickly becomes 'atherogenic' and something to avoid.

I guess there may be animals that do this, but even if there are, I'm well aware of the dangers of transferring what happens in one species, to what happens in humans. Nonetheless, in an attempt to get my head around the logic, I can't help but imagine an African Wild Dog providing its newly-weaned pups with the internal organs of an impala for the first few weeks, and then deciding it is no longer suitable and instead giving them the lean muscle meat of the impala’s rump. Or stuffing savannah grass into their mouths.

Mate, what the fuck are you talking about?
In the age 2+ recommendations above, I've emphasized in bold those two areas where the adult African Wild Dog is removing the impala’s internal organs and visceral fat, dragging them out in the open and away from her pleading pups, to where the vultures can eat them. 

“Let the vultures have a heart attack”, I imagine her thinking.

But no, those dogs clearly aren't as intelligent as humans, so it would be ridiculous to suggest that you’d ever hear David Attenborough describing such a scene.
If my Mum did that, I would bite her. Really hard
Pointless animal comparisons aside, we’ve all had enough exposure to Nutritional Guidelines to understand that they’re a bit like reading a text book entitled “Ethics in Investment Banking” - both have almost zero relevance to what actually goes on in the real world and there is an inherent pious grandstanding by the authors in terms of what they advise is the route to Valhalla and what worth their nonsense has to the human race.

So, springing from a platform that presumes expert committees who produce nutritional guidelines are a special breed of conflicted, I would like to repeat their, unarguably, excellent advice for little kiddies:
  • Babies and young children need fat for growth and development. 
  • Young children need essential fatty acids for healthy brain development.
  • Babies and young children need the fat supplied in whole milk, cheese and yogurt, and in foods such as eggs and meat.
Cue applause.

If you’re in the habit of feeding your brain the fatty acids it needs, regardless of your age, I'm guessing there are a few questions that should be popping into your well-fed head by now, namely:
  1. Do these people really believe that body and brain development ceases at age 2?
  2. Why are humans given the all-clear to eat fat for the first 24 months of life when the rest of us are told it will lead to inevitable destruction?
  3. Do they hate babies?
  4. Wooah, did they really just say that vegan parents are child abusers? That is so politically incorrect. But yet so true.
  5. If French people are considered by some ‘experts’ as a nutritional paradox, does that mean French infants are a paradox inside a paradox? Enigma wrapped in a paradox’s swaddle cloth? A paradox squared?
Stupid jokes aside, and while it’s quite easy to imagine the baby-eating Bishop of Bath and Wells chairing the guidelines working committee, it still doesn't explain why they've decided to pick this subset of 0-2 years, the population of which, they provide a completely contradictory set of rules.

I like to think I'm not silly, potential Dunning-Kruger notwithstanding, but when I decided to have a closer look at their reasoning, I wasn't expecting to find any intelligent answers. 

But did I find any? Maybe. Maybe not. 

This is so fucking exciting. Read on!!

From page 73 of the Australian Dietary Guidelines (click to zoom):

You only have to look at the titles of their references to understand that the rationale for low fat foods at age 2+ is because they think that dietary fat will result in heart disease. There is no other plausible reason for them using these papers as supporting evidence, and if there is, they haven’t explained it even remotely well.

Bugger brain development, these people clearly want us to believe that the tenuous, and I believe incorrect, hypothesis that eating fat causes heart disease, is more important than the need for appropriate physiological and neurological growth. 

If that makes any sense to you at all, then I feel a great depth of sorrow for your dearly departed ability for cognitive reasoning.

From reference 719 - "it is increasingly clear that cholesterol concentrations can be elevated during childhood and adolescence and that increased concentrations in childhood are associated with increased risk of atherosclerosis and CVD in adulthood."

"For children between 12 months and 2 years of age for whom overweight or obesity is a concern or who have a family history of obesity, dyslipidemia, or CVD, the use of reduced-fat milk would be appropriate."

So, now it's from age 12 months that low fat foods are appropriate. Fascinating.

Here’s where I try and make this post shorter than the guidelines themselves. On my quest for logic, I started with the Australian Nutritional Guidelines, the moved to the Infant Feeding Guidelines, which strangely is hard to locate in its original location, but is fairly similar to the overarching guidelines. 

There is also a food modelling publication, t
he front page which suggests it is put together by the Dietitians Association of Australia, so I guess it’s not surprising that it suggests that low fat dairy should be given to kids even earlier - from age 13 months. 
Low fat dairy after age 1. Plus the joys of polyunsaturated margarine. Yay.

There is also a 1,105 page document entitled "The Australian Dietary Guidelines Evidence Report" which is chockablock full of papers that supposedly back up the guidelines and most references to infants inevitably lead to cholesterol levels as the ultimate guide to health. Brilliant.

They do briefly mention on page 398 that Ness et al, a paper on the Boyd Orr cohort, found that saturated fat and total fat in childhood diet was found to be protective of all causes of mortality and deaths attributable to cardiovascular disease."
"not consistent" with the dogma...next!

But of course this was fobbed off and thrown on the "not included studies" list. I'll give them the benefit of the doubt, that they don't deserve, that the study was crap (it seemed on par with a lot of the other papers they used), but i
t eventually becomes evident that reading thousands of pages of justification for recommendations that don't make any sense is a waste of life. 

Specifically, mine.

Fortunately, I found an interview of two of the experts involved in formulating the guidelines and they happened to be talking about the very issue I was trying to clarify.

Unfortunately, because I thought I had the logic sussed, they didn't mention cholesterol levels or heart disease at all. It was all about kilojoules and the extra energy in full cream milk.

apparently 98% of what kids' eat is not required for growth - take that fact to the bank, people.

Sounds terribly convincing
I did waste time checking out the American Scientific Report of the 2015 Dietary Guidelines Advisory Committee, where they made it similarly unclear:

"There is near universal agreement that human milk is the preferred complete nutrition source for healthy full-term newborns and infants for the first 6 months of life, with continued breastfeeding recommended until age 12 months…Human milk is high in fat (45–55 percent of total calories), saturated fat, and cholesterol."

But then, in the same publication: After age 1 - "However, the dairy fat in whole cow’s milk is a major source of atherogenic saturated fat, cholesterol, and calories and a poor source of the essential fatty acids LA and ALA."

Saturated fat and cholesterol in human milk is good, but if it comes from a cow, it's atherogenic. I had no idea cows were so dangerous.

So, hoping to put the issue to bed, it would seem that the people who wrote the Australian guidelines think that eating fat will make anyone over 2 overweight, but the actual guidelines suggest, by the references they provide, that it's actually the arterycloggingsaturatedfat that is the problem.

Whether it's the former or the latter, or a combination of both, I have come to the conclusion that the way they've gone about explaining it makes about as much sense as the Goldman Sachs employee who would dearly love you to believe that they have been recommending you invest in a specific collateralised debt obligation (CDO), but then putting their own money in an investment that bets your CDO will fail, all because it's in the interest of 'making markets' and it's all for the greater good. 

Look, anyone who is convinced of the diet-heart hypothesis or the 'calories in, calories out' hypothesis is not going to be convinced of any list of studies that I can provide that contradict either - so I will not waste my time. That might sound like a cop out, and it probably is, but we’re all guided by our individual biases. I may seem sarcastic and flippant about it all, and yes, I understand that you can’t relate the biology of a dog to a human, but I’m not seriously trying to. I'm talking about what constitutes logical thought processes and what your gut is telling you.

Not your macrobiome community, the other one.

Our biases are based on our upbringing, research and personal experiments, as well as the relentless back and forth between people on the internet who think they know the truth, and when you've taken all that into consideration, you have to make a decision. What it all boils down to is - does the recommended advice make sense to you or does it smell like stupidity wrapped in bullshit?

What is plain to see, when you dig through the opaque reasoning, is that the Nutritional Guidelines Working Committee, whose job it is  to guide the health of our nation, base their recommendations on the beliefs that: 
  • Eating fat, even saturated fat, provides essential nutrients for physiological growth.
  • Saturated fat may be nutritious but it also causes heart disease, makes you obese, and will start damaging arteries at a young age and lead you to chronic diseases in later life (fuck you, evolution!)
  • The trade off in this perplexing scenario is to recommend humans eat fat, but only for the first 2-2.5% of expected life span.
  • They really hope that this hedging of bets works.