Hi I’m Dr Peter Hill from UpFotIt, welcoming you to another of my weekly podcasts on health-related matters that are of concern to a lot of South African’s, as well as to to people in other parts of the world right now. This week the local South African media has been somewhat preoccupied with professor Tim Noakes’s appearance at a Health Professional Council of South Africa hearing regarding a complaint laid by a dietitian in that Noakes is alleged to have provided nutritional advice over Twitter on food he considered suitable for an infant’s first foray into solid food. Noakes stands accused of unprofessional conduct because he allegedly advised a mother to give her infant food based on the so-called Banting diet, which is also known more correctly as the low-carbohydrate high fat or LCHF diet.
There appears to be a number of important questions tied to the matter of Noakes’s alleged unprofessional conduct. Let’s consider 3 of the questions that come to mind:
- Is Professor Tim Noakes qualified to give dietary advice?
- Are low carbohydrate diets dangerous and is there science to back their use in infants?
- Is it unprofessional to use social media for giving health-related advice?
Is Professor Tim Noakes qualified to give dietary advice?
Firstly then, is Noakes qualified to give dietary advice? Of course he is – we all are. He is doing no more or less than what billions of humans do each day: they give and take dietary advice all the time. It’s an inalienable right and practice to give dietary advice. What parent has not, at one time or another, said to a child ‘ eat your vegetables – they’re good for you’. People all around the world make nutrition–related decisions every day not only about their own food but also the food of others, and they do so without have a degree in dietetics. And so what’s the problem?
Are low-carb diets healthy?
Are low-carb diets dangerous and is their use in children backed by nutritional science? Dangerous ? No, to the contrary, a large number of well-designed studies show that LCHF diets are very effective in weight loss and in reducing a number of cardiometabolic risk factors. So what about their use in children? Well, there are two ways of answering this question: firstly, what did our ancestors feed their young on when they were first exposed to solid food and then secondly, what do populations like the Inuit and Maasai, whose traditional diets are predominantly low-carb high fat feed their babies? Baby cereal? No way!
Okay, so our ancestors and tribes like the Inuit and Maasai seem to have been able to raise healthy children on what to all intents and purposes could be considered to be low-carb diets. But what does the nutritional research reveal about low carb diets in children? It may surprise you to learn that very, very low carb high fat or ketogenic diets, are successfully being used to treat severe forms of epilepsy in children. And what’s more there are a number of studies supporting the use ketogenic diets in children with epilepsy. Now if a ketogenic diet, which is a very restricted, almost zero, carb diet is safe to use in children, albeit under medical supervision, then I think it’s reasonable to assume that diet more in line with our ancestral low carb diet , which Noakes appears to advocate, is both safe and good for children.
Is it unprofessional to use social media for giving health-related advice?
The last of the 3 questions I posed earlier relates to the alleged unprofessional use of the Internet and social media to provide dietary advice. In the words of a dear friend and colleague, ‘get a grip!’. Dr Google is the repository of a seemingly endless number of very professional medical websites, blogs, etc. Let’s take a look at just a few: www.webmd.com, www.dietdoctor.com, www.mercola.com and the list goes on. Advice on everything from Acne to Zygomycosis and everything in between.
One of the Internet based resources that is particularly relevant given Noakes’s inquisition, is a series of YouTube videos entitled The Skinny On Obesity which are flighted by the University of California San Francisco under the banner of “Medical School for the Public’. Here we find professor Robert Lustig, a paediatric endocrinologist, discussing just why we are fat, and why our babies are fat and what we need to do turn the obesity and metabolic syndrome pandemic around. These wonderful freely available resources begs the question: how can we, in this day and age, justify denying people access to information? Social media and other media can and should be used to advance the cause of the human condition and that includes nutrition.
Was Noakes wrong to give the mother advice on feeding her child real food or should mothers be giving their babies so-called baby cereal and other processed foods loaded with sugar and hidden sugars? Now here’s what Dr Alan Greene, an eminent American paediatrician and one-time clinical professor at the Stanford School of Medicine, has to say with regard to baby cereal: “Conversion of the white flour to glucose begins while the cereal is still in the baby’s mouth, lighting up the hard-wired preference for sweets (and the cereal is nearly 100% glucose by the time it is absorbed in the intestines)” Dr Greene further commented. “Feeding your baby white rice cereal is much like feeding a spoonful of sugar.”
A popular brand of South African baby cereal contains 33g of glycaemic carbohydrate in a 50g portion. Glycaemic carbohydrate is converted to sugar (mainly glucose) in the body, and most of us know that too much sugar is associated with weight gain. As an average kitchen teaspoon holds about 4g of sugar this means that one portion of this particular baby cereal is equivalent to approximately 8 teaspoonful’s of sugar (33 divided by 4). It could be argued that it is hardly likely that anyone would give a baby 8 teaspoonful’s of sugar to eat, but this what happens because the sugar is ‘hidden’ in the baby cereal.
What would you do?
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Till next week