A false dichotomy – dietary guidelines and the other diet

Dichotomy (2)
A Dichotomy – Black or White.

A dichotomy is a division into two entirely different and often contrasting domains, interests or activities (1). Examples of true dichotomies are black or white. Tall or short.

A false dichotomy is an argument giving a false illusion of there being only two choices whereas in reality there can be at least one other or even many possibilities (2). The argument is set up in such a way as the first choice is eliminated due to it being seen as a terrible choice, and the only other alternative is the second choice.

Over the last decade dietary guidelines have come under attack. Arguments against them are often presented in the manner of a false dichotomy. These are the steps used in that line of fallacy:

Step 1. Present Diet A as the government dietary guidelines.
Step 2. Present Diet A as flawed, weak or scary … making people sick in some way.
Step3. Present Diet B < insert name of alternative diet > as the only other choice.

Step 1. Present the government guidelines as Diet A

Government dietary guidelines were first issued in the early 1980s recommending we eat mainly bread and cereals (preferably wholegrain), vegetables, fruit and legumes; moderately lean meat, low-fat dairy, eggs, fish, and nuts; and only small amounts of added fats, sugar and salt (3, 4). With its emphasis on plant foods, moderate animal foods, and lower fat than previous intakes, the guidelines were labelled as a low-fat diet.

Step 2. Present Diet A as flawed, weak or scary.

Arguments attacking guidelines suggest they were based on flawed science, there are toxic foods we were not warned about and, due to consumption of those toxic foods, there are scary biochemical mechanisms disrupting our metabolism making us sick. Statistics are presented showing a rise in obesity and non-communicable diseases since the first issue of the guidelines, implying they are to blame or are contributory. (5)

Step 3. Present Diet B as the alternative diet.

Having presented the dietary guidelines as scary, the alternative Diet B < insert name of diet advocated by presenter or author of book > as the only other choice.

The false dichotomy

Apart from weaknesses in presented arguments of supposed flaws in the guidelines, such as whether foods suggested as toxic actually are, or whether people actually followed the guidelines; the false dichotomy narrative completely falls over in the presentation of there being no other alternative. No other reason for the rise in obesity and disease risk other than foods we eat. No changes in the fabric of society other than changes in our food environment. No change in our food environments other than the dietary guidelines. No other choice for a healthy diet other than Diet B.

In reality …

There are dozens of contributing factors to obesity and disease. There have been scores of changes in the fabric of our society. There have been a multitude of changes to our food environments (6). There are varying reasons people choose the diet they do (7). There are numerous dietary patterns shown to be healthful (8).

What slips through …

Apart from those weaknesses in the false dichotomy argument, what slips through of concern to me is there has been an emphasis on supposed flaws in the guidelines without strong evidence supporting long-term safety and effectiveness of the alternative diets presented.

Is there any evidence?

It is suggested advice for a safe effective long-term diet requires key supporting evidence across several domains including (a) plausible biochemical/ physiological mechanisms; (b) reliable epidemiological (within populations) studies; (c) clinical studies; (d) evidence for long-term safety and effectiveness; and (e) application of the nutrient or diet in question to complex bodily processes, the total diet and eating patterns. (9, 10)

As most dietary guidelines advocate a diet higher in carbohydrate and lower in fat, the commonly presented exact opposite diet (low in carbohydrate, high in fat) is often depicted as the only alternative. This has become a popular trend. Sometimes the carbohydrate content advised is so low whole foods are excluded including starchy vegetables, all cereals and most fruit. A diet that low in carbohydrate is by default either high in protein and / or high in fat.

I have wondered about this suggested alternative, in particular advocated low levels of certain whole-foods such as starchy vegetables, fruit and cereals; and consuming diets higher in protein or added fat. Where is the evidence for its safety and effectiveness? Does the evidence extend to long-term application?

Five years ago I began hunting for such evidence …

 

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Disclaimer: Nothing in this article or on this website should be taken as medical or dietary advice. Anyone reading any information provided within should seek advice from their own medical practitioner for any issue, disease, illness or health-related problem they may have. Always seek your own advice from a medical practitioner or dietitian before changing your own diet.

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Notes and References:

(1) Miriam-Webster dictionary: dichotomy

(2) False dilemma or dichotomy. Logically Fallacious. Retrieved 07/11/2018

(3) The Australian Dietary Guidelines were first issued in 1982, then 1992, 2003 and 2013.

(4) Dietary Guidelines for Americans 1980. Health.gov. Retrieved 07/11/2018; and history 1980 to 2000. Retrieved 07/11/2018.

(5) Arguments presented include: recommendation to eat a low-fat diet (being bland and boring) drove people to sugar for flavour; due to toxicity of fructose in sugar, addiction, or simply over-consumption of empty calories this leads people to overeat, become over-weight and develop disease; carbohydrate foods trigger insulin, driving fat into storage, holding fat in storage, and raising blood glucose levels; recommendations for a low-fat diet drive us to eat more processed foods. I will address these claims in future posts.

(6) There are many factors that can effect diet and disease. Social changes over the past 50 years include: a change in liquor licensing laws; higher ownership of cars; people drive cars more often, do less housework, eat less at home, eat out more; there are more women working. People can be affected by stress, life events and personal catastrophes.

There has been a massive change in our food environments to include more fast food, pre-prepared food, confectionery, sugar-sweetened beverages; a rise in supermarkets and convenience stores; larger refrigerators, home freezers; chilled beverages, aseptic packaging; high availability of fatty and sweet foods; social trends for gourmet foods, cafe dining, a coffee culture and taste festivals.

(7) Nutritional Guidelines: are we getting them so wrong, or are we getting lost in translation: Duane Mellor, Nutrition and Health August 1, 2018 Editorial.
Dr Mellor suggests diet choices are not simply based on health but also include affordability, accessibility, culture and hedonism (pleasure).

(8) The Dietary Guidelines for Americans 2015; the modelling system behind the 2013 revision of the Australian Dietary Guidelines; and the Dietary Guidelines for the Brazilian Population, all offer varying choices of eating patterns for a healthy diet.

(9) Dietary Reference Intakes. Institute of Medicine. 2011. (Calcium)
The report outlines the hierarchy of evidence to support nutrient intake with clinical trials being highest form of evidence followed by observational studies. There is also reference to requiring plausible mechanisms of biochemistry or physiology being required behind recommendations.

(10) The Longevity Diet. Dr Valter Longo. (New York: Avery/Penguin Books, 2018). Dr Longo describes five pillars of evidence required to support recommended diets for longevity including Juventology, epidemiology, clinical studies, epidemiology, and complex systems.

 

 

 

My food history # 12: Critical events and life catastrophes …

 

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In the 1980s and 1990s, life was skipping along …

Then came the dark events – life catastrophes

As well as significant milestones and some major disruptions, over fifteen years from 1998 to 2013,  I lived through several crises and some distressing catastrophes. A crisis, whilst painful, tends to be a temporary situation or turning point (1), whereas a catastrophe is a complete upheaval (2). Both are demanding and stressful. Continue reading “My food history # 12: Critical events and life catastrophes …”

My food history # 11 – 2000s – health claims, social trends and slow-ticking time bombs

 

Alcohol

Life gets busy

Two years after my youngest child started school I began working full-time.  I became involved in community groups and projects. Life became very busy.
Continue reading “My food history # 11 – 2000s – health claims, social trends and slow-ticking time bombs”

Food History # 9 – ‘Please can you help?’ – Nutrition Studies 1991

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After dramatic improvements in my son, I was inundated with queries from people wanting to try the Royal Prince Alfred Hospital exclusion diet for a range of symptoms. While I was pleased to help, I was concerned I did not have the required expertise to assist. I therefore studied for a Graduate Diploma of Human Nutrition, completed in 1991 through Deakin University. Continue reading “Food History # 9 – ‘Please can you help?’ – Nutrition Studies 1991”

My food history # 7 – food sensitivities – my shattered ideal of a healthy diet

 

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Shattered ideals

After my father had a heart attack, our family diet changed to avoidance of fatty red meat, full-fat milk and butter to one including more fish, chicken and vegetable oils. Those messages and promotion of fibre and fruit, and less refined cereals and sugar stuck with me. Thus, when I started out on motherhood I had high ideals of a healthy diet being wholegrain cereals, vegetables, fruit; and avoidance of excess fat, salt, sugar and refined cereals.

My ideals came crashing down when my second son was a failure to thrive, suffering chronic ill-health from the introduction of solid food. After a three year battle, I sought advice from a specialist at the Royal Prince Alfred Hospital (RPAH) in Sydney. An exclusion diet and series of food challenges (1), proved he was sensitive to salicylates, amines and some food additives (colours, preservatives and MSG). Salicylates are flavour components of many fruits, juices and vegetables. Amines occur in cheese, chocolate, bananas and yeast extracts. On a diet removing those foods he became well and gained weight.

Disclaimer: Please note – an exclusion diet protocol including challenges should only be done under the supervision of a medical practitioner. Other reasons for symptoms need excluding before diet is tried. Some people may experience severe symptoms to challenges. In some instances these need supervision by a medical practitioner or in hospital. 
Continue reading “My food history # 7 – food sensitivities – my shattered ideal of a healthy diet”

My food history # 6 – critical moments … high blood pressure

 

 

Photo 5-8-18, 5 30 59 pm

 

By my late twenties, my red-meat-centred, full-fat dairy, white bread and sugar-treats diet of my childhood had changed. Food swaps after my father’s heart attack meant more chicken and less red-meat, skim milk instead of full-fat milk, oil instead of butter, and fatty foods only eaten socially. I also restricted sugar, confectionery and chocolate. I based my diet around foods high in fibre with wholemeal breads, added bran, and fruit. Thus in the early 1980s, when I started out on motherhood, I had preconceived high ideals on a healthy diet for myself and healthy foods for my children. I believed if I fed my children mainly wholegrain cereals, vegetables and fruit; if I avoided excess fats, salt, sugar and refined cereals; then good health and well-being would naturally follow.

How wrong I was.

My second son was a failure to thrive, suffering chronic diarrhoea and repeated wheezy chest colds from the introduction of solid food. Referred to a paediatrician at 15 months, a series of tests ruled out sinister problems, and he was diagnosed with food allergies. He initially improved on a restrictive diet excluding milk, eggs and wheat. However, he had frequent relapses and it would be another two years before I had the complete answer for him. Needless to say, this was an emotionally distressing time as I battled sleepless nights, guilt-choked days and a socially-crippling diet. Continue reading “My food history # 6 – critical moments … high blood pressure”