Confused about dietary fats? My advice is to steer clear of the British Nutrition Foundation

I don’t believe bread, as we commonly eat it, is a healthy or wholesome food (far from it). And last year I was surprised to read a ‘review’ lauding the nutritious attributes of bread and lamenting the fact that, here in the UK, bread consumption is declining. The review was authored by a scientist connected with the British Nutrition Foundation, but was funded by the bread manufacturer Warburtons. You can read my original post here.

The head of the British Nutrition Foundation emailed me with some sort of defence of the article. I wrote about the response and gave my own reaction to it here.

If you’ve been bothered to click on those links and read both the blog posts you may be forgiven for getting the impression I am no fan of the British Nutrition Foundation. The BNF is a charity, and describes itself thus:

The British Nutrition Foundation (BNF) was established over 45 years ago and exists to deliver authoritative, evidence-based information on food and nutrition in the context of health and lifestyle. Accurate interpretation of nutrition science is at the heart of all we do.

This reminds me of the sort of rhetoric we doctors spout about being ‘evidence-based’ when much of medical practice is anything but (we just say it is). And in the case of the BNF, there’s no denying the fact that it takes funding from a wide range of factions within the food industry, and therefore its position is clearly compromised. This conflict of interest possibly helps explain how the BNF comes to publish an utterly one-sided account of the nutritional qualities of bread, with barely a mention of the very real risks associated with eating this food.

During an internet search today I was directed to the BNF website today, and specifically its take on recent research which found that in a study dating back some 40 years, swapping saturated fat for foods rich in supposedly healthy omega-6 (polyunsaturated fats) caused men to be more likely to die, including from heart disease. The authors of the study put it in the context of other similar studies that found no evidence of harm, but no evidence of the much-touted benefits either. At best, the evidence suggests no benefits and possibly some risk. You can read my account of this evidence here.

So, how did the BNF interpret the evidence? Look here to find out. After reporting the findings of the research quite well (I think), the BNF tells us this:

Cholesterol is a well-known risk factor for cardiovascular disease and the intervention group did show a decrease in blood cholesterol which is consistent with previous studies. In addition, more recent prospective cohort studies have shown a reduction in cardiovascular disease risk with a higher n-6 PUFA or n-6 and n-3 PUFA diet.

I see two main problems with this:

1. Why is the BNF telling us about the impact of the intervention on cholesterol? Are they perhaps hoping that by mentioning it we will forget that the research actually showed that the risk of heart disease and death went up (as cholesterol went down)?

2. They refer to ‘prospective cohort studies’. These are what are termed ‘epidemiological studies’ that look at associations between things. However, these studies don’t really tell us much, and in particular they are not useful for discerning what the impact of changing fat intake is on health.

To know that, we need ‘intervention’ studies, just like the ones that showed no benefit from swapping saturated fat with omega-6-laden foods, and some evidence that this strategy may be quite hazardous to health.

The BNF also tell us this:

It is also worth noting that the study was conducted in men who had a high risk of mortality, so although the findings warrant consideration, the results may not be applicable to the general population in the UK today.

But the bods at the BNF should know that, generally speaking, the greatest likelihood of benefits are seen in the people at highest risk. The likelihood is that the results would have been even worse in the standard British population. Then we get this:

The study participants were aware of which group they were in, intervention or control group, and as such it is possible that participants in the control group made more of an effort to make lifestyle changes such as increasing physical activity.

Yes, but it’s the same for those in the intervention group too. In both situations, all we can do is speculate. Which is all we can do when we consider their final point here:

Dietary intake of other nutrients and food groups, such as trans fatty acids and fruit and vegetable intake, were unfortunately not reported.

And finally, their summary:

In summary, although this is an interesting study, more clinical evidence is needed before any generalisation of the findings are made. The advice for consumers should still be to choose foods with a lower saturated fat content and to choose fats and oils that supply primarily unsaturated fats.

This, even though the totality of the evidence does not support this intervention as being healthy.

Notice the title of the BNF statement: ‘Confusion on fats and heart health.’ Quite. It occurs to me that all the BNF have done here is perhaps add to the confusion by giving us its unique take on the scientific evidence. But then again, if you had Unilever as a ‘sustaining member’ of your organisation, what would you do?

19 Responses to Confused about dietary fats? My advice is to steer clear of the British Nutrition Foundation

  1. Woody 21 February 2013 at 10:23 pm #

    My theory is that confusion always benefits authority figures. More confusion, they win.

  2. Roxie 21 February 2013 at 10:37 pm #

    Well said! Thank you for what you do Dr Briffa. As a result of reading so many articles on your blog, I tweaked my diet a little more: I still eat white rice and not wheat, but I’ve increased my saturated fat intake in each meal and results are astounding! I sleep better, I’m losing weight (small weekly loss), I’m happier, satisfied and able to actually wait until the next meal time for food. Sometimes I’m still a little bit woozy just before my next meal if it’s delayed, but after a large glass of water, I’m good. Keep up the excellent research. Isn’t the Internet wonderful!!!!

  3. Andre 21 February 2013 at 11:00 pm #

    Entirely unsurprising, Unilever is listed as one of the sustaining members of the BNF: (and the rest of that list is a bit of a who’s who of the processed food industry, pretty much). It’s the same thing with the Dutch Heart Association (Hartstichting). People shouldn’t have to get their dietary advice from organisations that are largely funded by companies with enormous financial interests in that same dietary advice. At the very least, each publication from BNF and similar organisations should come prefaced with a boldface warning disclosing exactly which financial interests their sponsors have in the advice being given (ie Unilever peddling their poisonous seed oil based crap)

  4. George @ the High Fat hep C Diet 22 February 2013 at 2:18 am #

    Having nutted around the Sydney study for a few weeks and found that the evidence against trans fats at dietary levels is maybe more ambiguous than I thought (more reading required) i wonder if the problem is that trans fats are more toxic in presence of high PUFA (and vice versa) and less toxic (and possibly beneficial) in context of a more natural SFA/PUFA balance (as in dairy).

  5. Jonathan 22 February 2013 at 9:05 am #

    Post about the difference between naturally occurring trans fat and artificial trans fat. Apparently a difference in the chemical structure makes natural trans fat digestible while the body can’t digest artificial trans fat and doesn’t know what to do with it.

  6. Paul 22 February 2013 at 11:35 am #

    Great article but please proofread it again:
    lamenting fact
    lamenting the fact

    The reviews was
    The review was

    gave me own reaction
    gave my own reaction

    similar studies can found no evidence of harm
    similar studies that found no evidence of harm

    showed that risk of heart disease
    showed that the risk of heart disease

    just like the one’s
    just like the ones

    same for the those in intervention group
    same for those in the intervention group

  7. Eddie Mitchell 22 February 2013 at 11:39 am #

    Another Black Ops and propaganda outfit for the junk food mob is The European Food Information Council. As always the usual suspects are controlling it. It is governed by a Board of Directors which is elected from member companies. Current EUFIC members are: AB Sugar, Ajinomoto Sweeteners Europe, Bunge, Cargill, Cereal Partners, Coca-Cola, Danone, DSM Nutritional Products Europe Ltd., Ferrero, Kraft Foods, Mars, McDonald’s, Nestlé, PepsiCo, Pfizer Animal Health, Südzucker, and Unilever.

    Kind regards Eddie

  8. Dr John Briffa 22 February 2013 at 11:49 am #

    Thanks Paul – even by my standards, that was pretty poor, I admit.
    Thanks for pointing them out and giving me the opportunity to correct them.

  9. Dr John Briffa 22 February 2013 at 11:51 am #

    Eddie – ‘Black Ops’ made me laugh. Of course, the issue you raise is no laughing matter.

  10. See what you drink 22 February 2013 at 7:06 pm #

    What the majority don’t notice is that even diet sodas don’t seem to be smart for your diet. The perversion is tough for your body to method and therefore the sugar substitutes don’t seem to be smart for your body.

  11. Alexander Cranford 23 February 2013 at 1:25 am #

    In Australia we have the Heart Foundation – previously know as the National Heart Foundation that is just an advertising agency for the margarine and vegetable oil industry and is registered as a charity to avoid paying tax. The never answer any curly questions. Sadly they are considered to be a credible body by the media even by the ABC and the Australian Consumers Association. I am unsure what the general public thinks.

  12. john barr 23 February 2013 at 7:47 am #

    Alexander, there are a few of us GPs in Australia who are well aware that the Heart Foundation is the same as the British Nutrition Foundation. I really became aware of it a few years ago, when as typical brainwashed Australian GP, I got most of my info from the drug reps. Then it was trumpeted in the weekly medical magazines that MacDonalds had been given the Heart foundation “tick of approval”. Even in my dulled state that was too much. The Heart Foundation is also sponsored by the usual ‘Big Fast Food and ‘Big Food” suspects. My eyes were opened,and I try to talk to my colleagues, but they are mainly blinkered. As I am sure John Briffa is aware, we are handed down guidelines, like the NICE guidelines in UK. If your treatment of patients varies a lot from those guidelines, you are liable to be investigated by the authorities, who almost by their very nature will uphold the trash peddled by the drug companies.
    After reading a large article in a weekly magazine by ‘Doctor” Alan Davies about the benefits of fructose, I now doubt the integrity of anything I read in these rags. The more closely I look, the more I see the hand of the establishment in almost everything written.
    There are some of us GPs trying to change patient and views.

  13. Modesty 23 February 2013 at 3:18 pm #

    Had a quick look at the BNF web site, and never seen so much rubbish about nutrition, dismissing the role of sugar and fructose in role of metabolic syndrome/obesity/diabetes and same about the bread. Agree with you to stay clear of BNF regarding any diet advice.

  14. Eddie Mitchell 23 February 2013 at 4:06 pm #

    HEART UK -The Nation’s Cholesterol Charity another bent outfit ?

    “At HEART UK we’re passionate about preventing premature deaths caused by high cholesterol.”

    We’re committed to raising awareness about the risks of high cholesterol, lobbying for better detection of those at risk & supporting health professional training. It’s also why we work with a variety of partners to promote healthier lifestyle options.”

    When I read that, I got a nice warm feeling thinking what a great charity, and how lucky we are to have these wonderful people looking after us. Then I spotted the “we work with a variety of partners to promote healthier lifestyle” statement. Most of my regular readers know I have one keen sense of smell, and I was smelling four pound of condemned veal. So, who are these “partners” oh dear, all the usual suspects. The same sort of mobs that are called acknowledgements at DUK.

    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.” Call me a cynical SOB but have I got a keen sense of smell or what.


  15. Diane Smith 24 February 2013 at 12:21 am #

    Yeah, just had a look at the British Nutrition Foundation’s website – not only do they advocate the continuing of eating vegetable oils and avoiding saturated fat, they also tell us that artificial sweeteners, including aspartame are beneficial and pose no risks to health – they’ve even made a nice little video to help reassure us all. Hmmmm……

  16. Lorraine 28 February 2013 at 9:55 am #

    This reminds me of when studies / articles do not necessarily have solid results but will conclude by writing something like “..make sure you eat a low fat diet with lots of whole grains…”. It’s really annoying.

  17. DB 9 March 2013 at 2:25 am #

    So, the big question is…. How much fat do we need? What are the guidelines that we should follow? How about some URLs?

  18. Chris 11 March 2013 at 12:39 pm #

    My mind tends to tar the British Nutrition Foundation and the British Retail Consortium with he same brush. These are two organisations whose primary interests and concerns are to represent the needs and interests of certain stakeholders or ‘member’ companies. They appear to arrive at preference sensitive stances and opinions upon matters and tend to talk up the perceived benefits of certain policies and innovations while at the same time they may be witnessed either not recognising risks or talking them down. It should be remembered that consumers bear the brunt of risks stemming from imperfect advice or policy, while those who bank the receipts from sales bear the greater prospects of the perceived benefits.

    Ben Goldacre, author of ‘Bad Science’ makes a clear direction in his latest offering ‘Bad Pharma’ that decent people can unwittingly become involved, perhaps by tiny increment, in indecent process. He assessment is correct, of course, and it is as applicable to the die hard stance of fats and to an absence of sufficient regard or ambition for the nature of causality involved ion prospects of many chronic diseases constituent to our times. Some of the directions and opinions that have stemmed from the British Nutrition Foundation and from the British Retail Consortium seem to me to represent instances of otherwise decent people unwittingly driving indecent process and all for the want of an open mind and the want of recognition of the presence of bias afflicting themselves.

    Ben directs we should seek these people out and tell them.


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