Last month one of my blogs focused on a rash of stories bigging up the supposed nutritional properties of bread. It turns out that this ‘news’ had been based on ‘research’ published in the Nutrition Bulletin – a publication of the British Nutrition Foundation (BNF). I challenged the notion that bread provides some essential role in the diet, and pointed out some of the health problems that might be associated with eating bread. The head of the BNF, Professor Judy Buttriss took exception to this, though at the same time admitted that the review had been paid for by Warburtons (purveyors of bread). You can read the original blog post and Professor Buttriss’ objections here, as well as my response to her here.
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I did email Professor Buttriss suggesting that she might like to comment further, but I’ve not had a peep from her. I’m not holding my breath. I do hope, though, that Professor Buttriss is wising up to the idea that the BNF cannot just produce any old rubbish industry-funded ‘research’ and expect us to gratefully swallow it whole without thinking. The rules have changed in recent years, and I urge Professor Buttriss to understand that this latest episode highlights to people just how cosy the relationship between the food industry and nutrition organisations can be. Recognition of this can only sap at the credibility of the BNF, I think. Also, my sense is the fact that Professor Buttriss has chosen not to respond to the points I put directly to her in my follow-up blog post does not reflect well on her or the organisation she heads.
Now, today, I read this story in the UK national daily The Express which tells us how stupid we all are for thinking fibre can be found in foods like chocolate, eggs and beer, and bemoaning the fact that some us can go short on fibre if we eschew bread. Sound vaguely familiar? Well, you won’t be too surprised to learn that these nutritional nuggets have come from a survey conducted by, wait for it….Warburtons. On this occasion, it appears that the BNF has not been co-opted to help Warburtons sell its message, though GP (family physician) and TV doctor Dr Hilary Jones makes all the right noises with a general condemnation of low-carbohydrate diets.
The original industry paid-for pro-bread review seemed to me to provide a wholly biased account of the role of bread in the diet – a piece of balanced ‘science’ it most certainly was not (in my opinion). So, what about this latest salvo from Warburtons? Is fibre all that important, as is claimed?
The sort of fibre found plentifully in, say, wholemeal bread is known as ‘insoluble’ fibre – more colloquially referred to as ‘bran’ or ‘roughage’. This is said to provide bulk to our stools, and help prevent constipation and colon cancer.
Actually, insoluble fibre can irritate the gut, and provoke symptoms such as bloating and discomfort. On the other hand, the other main form of fibre – ‘soluble’ fibre – tends to improve bowel symptoms such as constipation and abdominal discomfort [1]. Soluble fibre is found abundantly in natural, non-processed foods such as fruits, vegetables, nuts and seeds.
The idea that insoluble fibre helps prevent colon cancer is often expressed, but is not supported by the research, either. For example, studies show supplementing the diet with fibre does not reduce the risk of cancerous tumours or pre-cancerous lesions [2-4].
The authors of a review on the role of fibre in lower bowel conditions including cancer concluded that “…there does not seem to be much use for fiber in colorectal diseases”, adding that their desire was to “emphasize that what we have all been made to believe about fiber needs a second look. We often choose to believe a lie, as a lie repeated often enough by enough people becomes accepted as the truth” [5].
References:
1. Heizer WD, et al. The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. J Am Diet Assoc. 2009;109(7):1204-14
2. Fuchs CS, et al. Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med. 1999;340(3):169-76
3. Jacobs ET, et al. Intake of supplemental and total fiber and risk of colorectal adenoma recurrence in the wheat bran fiber trial. Cancer Epidemiol Biomarkers Prev. 2002 11(9):906-14
4. Alberts DS, et al. Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. Phoenix Colon Cancer Prevention Physicians’ Network N Engl J Med. 2000;342(16):1156-62
5. Tan KY, et al. Fiber and colorectal diseases: separating fact from fiction. World J Gastroenterol. 2007;13(31):4161-7
Really good writing Dr Briffa. Could somebody stop the incredible silly “fibre challenge” going on in the channel 4 food hospital which by the way is all together silly and sometimes very non-scientific talking about antioxidant, the importance of fibres, avoiding saturated fat etc. Most people seeking help and advice would benefit from a low carb diet (this evening included a gentleman that would have benefited from you books)
“the vast majority are actually clueless about nutrition, a survey revealed last night.”
I wonder why.
Dr Jones supports an industry sponsored survey, quotes another baseless reccomendation (five a day) and has also talked rather breezily about the total reversal of the NHS (I suppose) position on egg consumption from “eat very few” to “eat with impunity”.
I was suprised to read Britons eat the least bread in Europe, I wonder if that means we eat less wheat/carbs.
The involvement of The Daily Express in the promotion of what could be termed the ‘science of manipulation’ (a term coined by E F Schumacher) is nothing less than scandalous IMHO. When they report supposedly innovative advances in the treatment of disease their reports frequently offer outlooks that favour commercially lucrative advances and ignore the potential in possible low-input solutions. Low-input solutions get to grips with causality and seek to address deleterious effects by removing the cause. The Express shows great willingness to make ‘science’ stories front page news but demonstrates little regard or curiosity for the science of linking cause with effect. Instances I have in mind, and I have several, are marketing and advertising really, and bear no relation to responsible journalism or science at all. It is morally repugnant if and when it occurs.
And there is nothing like the appeal of becoming a celebrity physician on the TV, or one with a regular newspaper column, to act a selection pressure filtering both the physicians private opinion and those opinions that are promoted via media channels and celebrity. Their opinions tend to favour the familiar and they tend to lose sight of the merits of retaining measures of curiosity and scepticism. Best not to come across to the would be audience as harbouring radical opinions or it will confront their sensibilities and put them of watching or reading. Of course the paymasters, would be advertisers, have their take on affairs too.
.. as a selection pressure .. !
As always John an excellent article regarding BNF. The way to learn a great deal about these sort of outfits is ‘Follow the money’ Another institution, that may not be what it first appears to be is HEART UK -The Nation’s Cholesterol Charity. The money.
” During 2011 and 2012 we have worked with the following commercial partners:Abbott Healthcare Alpro UK AstraZeneca BHR Pharma Cambridge Weight Plan Cereal Partners UK (Sh Wheat) Food & Drink Federation Fresenius Medical Care (UK) Limited Genzyme Therapeutics Hovis Kellogg’s (Optivita) Kowa Pharmaceutical Europe Co Limited L.IN.C Medical Systems Limited Merck Sharpe & Dhome PlanMyFood Pfizer Premier Foods Progenika Biopharma s.a. Roche Products Limited Unilever (Flora) Welch’s (Purple Grape Juice)”
It gets worse, “Development of this website was made possible in part through a grant from Pfizer Ltd.”
http://heartuk.org.uk/partners/our-partners/
Keep up the great work.
Eddie
Is bread is so perfect a food, why is it necessary to add so many things? Same with cow’s milk. Humans evolved without bread, and probably only ate grass seeds when starvation was close. Yes, your ancestors would have been close to dying before they would eat the stuff we made into “essential food” today.
A very interesting post and interesting comments, especially Chris’s observations on the role of popular media in perpetuating food and health myths.
Neal’s comment about how the British eat less in the way of wheaten bread than other European nations reminded me that the way bread is made in this country may not resemble bread production across Europe. The innovation of the Chorleywood Bread Process led to the mass production in the UK of rapidly proved dough, in order to increase output. The slow traditional process of making a yeast ‘sponge’ to prove overnight, before finishing the process the next morning, is still widely used in Europe. I’m no expert in the science of this, but my understanding is that the traditional process helps neutralise the content in the grain that can cause digestive upset. I usually avoid gluten grain now, and eat only very small amounts of other grains. Occasionally, I will buy a slow-fermented (2-3 days in the making!) dark rye loaf, that looks and tastes like genuine pumpernickel. It comes from a rural artisan bakery a few miles from my home. I eat one or two slices, and freeze the rest in blocks. It has never caused me any upset yet, despite being made with a gluten grain.
Perhaps you’d like to ask Fiona Hunter a question on the Netmums Q&A session, Dr Briffa!
http://www.netmums.com/coffeehouse/live-webchats-657/q-warburtons-nutritionist-fiona-hunter-806/830061-q-expert-nutritionist-fiona-hunter-15-19th-october.html
Tom
Thanks – I went to take a look at this and will be blogging about it today.
John
People ask me how I am losing so much weight. Generally, I don’t say discuss it unless I am asked. Then after I tell folk I gave up processed food; particularly bread, in favour of plenty of fresh meat and fish, they look shocked. They tell me I will ruin my health. After twelve months low-carb I can only say, ‘Really? I wonder When?’
Dr Briffa, you may already know this, but Dr Hilary Jones is one of the doctors which gives advice to those using the a famous low calorie and low carb weightloss programme. I completed this diet myself (and lost 50 pounds) and saw him in videos offering support for the plan.
The diet is ketogenic and I have kept the weight off following low carb ever since. the programme teaches you about ketones and staying below 50 grams of carbs per day. I am therefore surprised he would be so in favour of bread and carbs as he must understand how limiting carbs can aid weightloss.
This certainly makes me think that he will support any cause which pays him enough…