The Guidelines - Based On Evidence Or An Article of Faith ?
The Australian Dietary Guidelines claim to be the product of 'evidence based science'. They are not, instead they rest on an article of faith. They are a religious, not a scientific, document.
All religions rest on an article of faith. This is the one idea that CAN NOT be challenged, debated, discussed, or argued about. It MUST be accepted, to do otherwise is to place yourself outside the ranks of the faithful.
It is not possible to be a Christian and not believe Jesus died on the cross and was resurrected three days later.
It is not possible to follow Islam and not believe the Angel Gabriel recited God's word to the Prophet Mohammed who wrote it down in the Koran.
It is not possible to follow Judaism and not believe God handed down the Ten Commandments to Moses on tablets of stone.
It is not possible to believe in mainstream nutrition and the recommended guidelines without accepting the 'diet/heart hypothesis' - eating saturated fat causes heart disease.
This is stated openly in the Guidelines themselves (p.69).
This is the only such statement in the entire document, it is their article of faith.
The Dietary Guidelines do contain evidence in support of their recommendations, and the document makes great effort to demonstrate that this is the case. The only claim to authority the recommendations have lies in the assertion that they are "realistic, practical, and – most importantly – based on the best available scientific evidence." (p.iii)
This claim is reinforced at every step of the way. Each of the Guidelines includes a section where the supporting evidence is listed, and graded for the strength of its support, either A, B, C, or D. This is done to reinforce their authority, and also to give the impression that each recommendation is the end result of a carefully weighed, objective reading of what is known in relation to the subject. The only exception is Guideline 5, where this was not deemed necessary, but here too a whole number of citations are given.
The Preface to document explains the purpose of this exercise,
"Providing the recommendations and the evidence that underpins them in a single volume, the Guidelines will help health professionals, policy makers and the Australian public cut through the background noise of ubiquitous dietary advice that is often based on scant scientific evidence."
The Guidelines are 'evidence based', this is the basis of their superiority over the 'background noise, it is why the 'experts' of the nutrition mainstream should be listened to.
evidence of association
On closer examination, much of this evidence is quite weak. There are some As, some Bs, but mostly it consists of Cs. The Guidelines acknowledge this, but explain it away in terms of the difficulties involved with conducting rigorous studies when it comes to diet. This is a genuine issue. All four grades only refer to 'associations' between a dietary factor and disease, of these grade A is 'convincing', B 'probable', C 'suggestive', and D 'weak'. (p.5). This is a real weakness. Everyone familiar with the nutrition space knows how often the phrase, 'correlation does not imply causation' is used whenever a controversial topic is being debated. The problem for the authors of the Guidelines is, if an association does not imply causation - then WHAT IS THE USE OF IT ? The entire object of the exercise is to demonstrate a connection in the evidence between a dietary recommendation - eat this, don't eat that - and a positive or negative health outcome - eat fatty meat, get a heart attack. Causation HAS to be implied, or else why should anyone follow any of the recommendations.
This is a problem, but it is not fatal to the project. If the authors can demonstrate that their recommendations are the BEST possible, even with the limitations of the available evidence, then their authority can be maintained. After all, the same difficulty applies to any competing set of recommendations, at least one that rests on science rather than, say, tradition, custom, and culture.
Even so, the evidence presented is surprisingly poor. Guideline 1, for example, is simply a restatement of the 'Calories In, Calories Out' (CICO) model, 'Eat Less, Move More', and yet even here the points in support listed as Grade A come over as underwhelming. Here they are -
The problem with these items is this - they do not address any of the objections to the CICO model, or demonstrate its superiority over its scientific rivals (the Insulin Model of Obesity). This is another indicator that the audience these Guidelines are addressed to, the nutrition mainstream, are members of a religious cult, rather than a science based community, and in fact are being carefully shielded from the ACTUAL debates currently raging in the scientific world over diet and nutrition. Instead we get a list of platitudes 'fat babies are more likely to grow up fat', that explain little and are, to be frank, not very helpful.
And this is Guideline 1, the one with far and away the most Grade A support.
None of this matters, however, no one really cares. All of the points listed above, and throughout the document in support of each Guideline, can be CONCEDED, if necessary. Even Guideline 1 could be dropped, if push came to shove, the nutrition establishment could still continue, down but not out.
The nutrition mainstream can survive any such setback, EXCEPT ONE, its article of faith, the diet/heart hypothesis.
Religions are complex beasts. They might have a single, or very small number of central tenets, articles of faith such as the Five Pillars of Islam, but on this foundation grow to contain a vast body of knowledge and literature extrapolating and interpreting what it all means. Islam has the Hadiths, the various schools of jurisprudence, scholarly pronouncements and debates that fill libraries. Christianity and Judaism likewise.
But the article of faith is NEVER under discussion, acceptance of this article is the price of entry into the debate, the terrain on which it is conducted. 'It is established'.
For the nutrition mainstream, the same applies to its article of faith. This is why it stands out in the document, the ONLY item of evidence not graded either A, B, C, or D. This has nothing to do with it not being derived from associational or correlational studies, for in fact that is exactly how it was originally 'proved', but that is irrelevant. The only thing that is relevant is that it 'is established'.
That the diet/heart hypothesis is unassailable was also revealed in the way Guidelines were drafted, how the evidence that is their basis was gathered and evaluated. The article of faith was deliberately excluded from this process. This is how it was done,
"The Working Committee... developed 27 complex search questions for the literature review in areas emerging in the literature and areas included in the 2003 edition of the dietary guidelines where the evidence base may have changed. A number of established food, diet and health relationships covered in the 2003 edition, where the evidence base was unlikely to have changed substantially, were identified as not needing specific search questions to be asked. For example, the relationship between diets high in saturated fat and increased risk of high serum cholesterol." (p.111)
You can question anything, but not our article of faith.
The Working Committee assigned to the task was in safe hands, the Dietitians Association of Australia having been commissioned to oversee the literature review. The DAA are the high priests and priestesses of this religious cult, dutiful servants of the post-Christian, post-Modernist globalist, corporatist and consumerist order the Guidelines serve. (I explain this here)
This sets the Dietary Guidelines at odds with the world of science. Just as the 2013 edition drafting process was getting underway, Gary Taubes published his masterpiece 'Good Calories, Bad Calories', detailing the scientific position in relation to both CICO and the diet/heart hypothesis, the story of how both emerged to become our current dogma, and the status of their main competing theory, the Insulin Model (Taubes named it the Carbohydrate Hypothesis but Insulin Model is the more common term nowadays).
In the world of actual science, the diet/heart hypothesis is ANYTHING BUT established, in fact at this point of time it is UNDER SIEGE. (see here).
The problem this presents for the nutrition mainstream is that their cult is based on a claim to be SCIENTIFIC, evidence based. This makes them vulnerable. If the diet/heart hypothesis does fall, as looks increasingly likely, this will throw them into a crisis. It will also make them unpredictable and dangerous, as Tim Noakes, Gary Fettke, and others have already found out. Exactly how this will play out I have no idea, but it will be a fascinating process to observe, and to take part in. I invite you to do so.