Nutrition & Health News This Week

Best diet for IBS, Nestlé sneaks in sugar, Guardian's "Death by Diabetes," and more

What’s the Best Diet for IBS?

A clinical trial in Sweden published this week in The Lancet Gastroenterology and Hepatology, found that a low-carbohydrate diet was just as effective as the “low-FODMAP” approach for reducing symptoms of irritable bowel syndrome (IBS), and both were more effective than drug treatment.

Widely considered the standard of care for IBS, low-FODMAP diets restrict nuts, most dairy products, and several types of “fermentable” carbohydrates such as wheat, legumes and many fruits. The approach is usually combined, as it was in this trial, with general IBS dietary advice: to chew food thoroughly, eat regularly, and avoid excessive fat. 

For the Swedish subjects, food was delivered to their homes for a month. The results were impressive for both diet groups: 71–76% of participants reported significant improvements in their gastrointestinal symptoms. Only 58% did in the drug treatment group. Six months later, the diet-group participants still had fewer symptoms than they did at the start of the trial, even though they followed the diet less closely. 

The fact that both dietary approaches had similar benefits raises new research questions. FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols,” all short-chain carbohydrates that are absorbed poorly by the small intestine. These are thought to be the cause of IBS, yet people in the low-carb group continued to consume some fermentable carbs while still experiencing significant improvement in gastrointestinal symptoms. Additionally, they increased their fat intake, which is believed to exacerbate IBS. 

The trial was funded by the Dietary Science Foundation, a Swedish non-profit whose mission is to fund clinical trials on diet and health. Since our own government has largely abandoned funding meaningful clinical trials on this important topic, grassroots science is now our best bet.

The Guardian Dares to Say Low-Carb Outloud

For years, the American Diabetes Association (ADA) has been a scandal hiding in plain sight: on a mission to end diabetes yet promoting advice that seems to do the exact opposite. Maybe a national conversation will be sparked by two blockbuster articles published this week in the Guardian’s new series, “Death by Diabetes: America’s Preventable Epidemic.” 

The author is Neil Barsky, a journalist, former hedge fund manager, and founder of the Marshall Project who himself had type 2 diabetes until he read books by Gary Taubes and adopted a low-carbohydrate diet. A self-avowed innocent in the world of food politics, he couldn’t fathom why this diet was not recommended for all diabetics, a problem he lays out in his first piece: “Low-carb diets work. Why does the American Diabetes Association push insulin instead?” 

The main answer, Barsky suggests, lies in the ADA’s ties with the food and pharmaceutical industries, including $134 million in donations from 2017 to 2024. The nature of the apparent grift is described in Barsky’s second article, about a recent lawsuit filed by a nutrition expert who says she was fired by the ADA for resisting pressure to publish recipes laden with Splenda products after the artificial sweetener company gave the ADA more than $1 million in 2022. She found it unethical to recommend pouring 1/3 cup of Splenda into a cucumber-and-onion salad, and so, like seven other ADA nutrition professionals in just three years, was soon out the door. 

These pieces in the Guardian (US version) stand out against a dearth of US media coverage on the low-carbohydrate diet and type 2 diabetes, which is an ongoing, open scandal. The existence of a safe, natural solution for a diabetes epidemic affecting 128 million Americans and costing nearly $1 trillion a year has been a bizarrely taboo topic for US news outlets for years. A friend who contributed regularly to the Washington Post told me how her editor responded a few years ago to a low-carb/diabetes story pitch: ‘We aren’t interested in that line of thinking’ was the reply.  And the New York Times has barely run an item on the subject since a 2016 op-ed by the late Dr. Sarah Hallberg, then medical director of a weight loss program at Indiana University Health Arnett, and Dr. Osama Hamdy, a medical director at the Joslin Diabetes Center at Harvard Medical School. This piece so incensed the Times’ senior science writer, Gina Kolata, that she retaliated days later in an attack piece, opening with a quote from a retired ADA medical officer: “When you look at the literature, whoa is it weak. It is so weak.”

Why is the media so hostile to low-carb? The explanation could fill a book, but for many years the answer was mainly institutional bias mixed with—perhaps—pressure on publications from food and pharma advertisers. Now, fears of climate change and the animal-rights agenda stand in the way of recommending a diet higher in animal foods, as low-carb tends to be. All the more reason to read and share these Guardian pieces, since clicks will encourage the Guardian editors to keep publishing this good work. (The link to both stories is here.)

Highly recommended nutrition conference in London in May

Our friends at the Public Health Collaboration (PHC) are holding their annual conference on May 18-19, in London, bringing together a superb line-up of metabolic and mental experts. It will address some big questions on nutrition like “How do we reverse the type 2 epidemic?” with Gary Taubes, Dr. Ken Berry and Dr. David Unwin, and “Can we fix mental health with food?” with Dr. Rachel Brown and Dr. Iain Campbell. 

The conference will also feature debates on contentious topics, including: “Does cholesterol cause heart disease?” featuring Dave Feldman and Dr. Adrian Soto-Mota (arguing that high LDL-cholesterol may not be a significant indicator of heart-disease risk in lean, healthy people) versus Peter Lansberg, a well-known lipidologist from the Academic Medical Center in Amsterdam and Mike Fisher, a consultant cardiologist from Liverpool. The other debate will ask, “Does red meat shorten lifespan?” for which metabolism expert Ben Bikman and carnivore Dr. Anthony Chaffee will face off against Federica Amati, head of nutrition at the Zoe diet company, which recommends a Mediterranean diet.

These lectures and debates are some of the most interesting nutrition events taking place today. Also, your participation will support this great grassroots charity that is actively working to reverse chronic disease in the UK. (Early bird prices available for another week) Book at http://phcuk.org/conference

This week in Plant Based Foods

The promise of Beyond Burgers and Impossible Meats is that we can have the experience of eating meat without killing animals. One result: the purveyors of these plant-based meat analogs, or PBMAs, are changing the nature of plant-based diets from traditional, minimally processed whole foods – legumes, grains, nuts, fruits, and vegetables – to highly processed meat alternatives. Nutrition science can’t answer whether they’re good for the planet, but it can answer whether they’re good for us.