Thursday, June 29, 2006

Doctor Calls For Moratorium On Dietary Recommendations Not Backed By Evidence

Dr. Wilshire says new AHA dietary guidelines lack scientific backing

There's a man I'd like to introduce you to who I had the distinct honor of meeting for the first time back in January this year at the Nutritional & Metabolic Aspects of Carbohydrate Restriction conference that took place in Brooklyn, New York. His name is Dr. Gil Wilshire, FACOG, a Reproductive Endocrinologist, and better known as MR. Regina Wilshire (Ha! Regina will LOVE that!).

Yes, he is the husband of my fellow low-carb blogging buddy from the Weight of the Evidence blog -- and strong supporter of the science behind livin' la vida low-carb -- Regina Wilshire. Dr. Gil also has a lot to say about the American Heart Association's new dietary guidelines which prompted Regina last week to offer a $1,000 ransom to the first person who could come up with a one-day menu that fits the new recommendations (several have tried, but as far as I know nobody has been able to accomplish this seemingly easy task yet).

In this special op-ed piece entitled "Enough is Enough" appearing on Regina's blog, Dr. Wilshire said the new recommendations made him "angry, dumbfounded, and very frustrated" because so much of it is rooted in 50-year old "fatally flawed" conclusions which were never based on sound science and Level 1 medical evidence.

Having gone unchallenged for decades, Dr. Wilshire said the "extremists are now becoming ever more so" now that the evidence is beginning to stack in favor of the low-carb lifestyle while the low-fat lie has been exposed.

"What I find so alarming and disturbing is the fact that in the past half century NOT ONE SMIDGEN OF LEVEL 1 EVIDENCE HAS BEEN GENERATED TO SUPPORT THESE RECOMMENDATIONS," Dr. Wilshire exclaimed. "I don't know how to say it any louder or clearer."

One of the basic tenets of the medical community is to confirm any method or approach with "rigorous scientific validation," Dr. Wilshire added, stating he would never use any medical procedure on one of his patients without going through this process.

"Why should public dietary advice be an exception?" he asked.

Expressing his deep dissatisfaction with what the AHA has done recommending a dietary approach that is sorely lacking in ANY scientific validation, Dr. Wilshire is challenging ANYONE to show him the evidence that "supports low fat and low cholesterol dietary recommendations for the population at large."

"Show me some high-quality data," Dr. Wilshire inquired. "Show me that someone has bothered to properly test the 50 year-old hypothesis."

His solution to this dilemma is to place "an immediate moratorium on all population-wide dietary recommendations that lack support from well-performed, prospective, evidence-based human studies."

"Sanity in this field will only come out of a complete overhaul," Dr. Wilshire concluded. "We need to tear down the current edifice of confusion to its most basic foundations, and rebuild it from the bedrock up."

Why HAVE we bought into the low-fat diet as THE one true way to nutritional salvation for so long? Because we've been told? Who told us? Well, it was our doctors and nutritionists, of course. So THEY are the ones who should bear the brunt of responsibility for obesity and need to take Dr. Wilshire's challenge seriously.

While he admits this may not be in "our country's best economic interests" because of the industries that would be adversely impacted by such a move, Dr. Wilshire says he is okay with not resorting to such measures so long as the AHA guidelines are not referred to as "good nutrition, evidence-based, a balanced diet or healthful eating and expect me to buy it or promote it to patients with chronic disease."

"We are in a health crisis in the United States," Dr. Wilshire interjected. "Surely, with all of our accumulated knowledge and wisdom, we can find a workable solution that is supported by evidence, is economically feasible and returns our population to good health."

WOW, wasn't that inspirational to hear from a real live doctor in the United States of America?! Are there ANY other doctors out there who feel the same way and would be willing to admit it? Hurray for Dr. Gil Wilshire for having the testicular fortitude to say what is on his heart and mind about this issue because it is one that will not be going away anytime soon.

What can WE as the patients do to help spread the word about this idea of a moratorium on all dietary recommendations not supported by clear Level 1 evidence? Share your concerns with your doctor or dietitian, write a letter to the editor of your local newspaper, and even contact your Congressman and Senators to educate them on this important. With obesity getting worse and worse, something really needs to be done about the information we are being given regarding a healthy diet.

Dr. Gil Wilshire has started the ball moving. Now we must help keep the ball rolling until something is done to change the same old, same old that has led us down this path to begin with. Change will never happen if you just sit on your hands and expect it to. You must play an active role and be willing to share the truth with everyone you know. Now go do it!

7-1-06 UPDATE: It looks like Dr. Gil Wilshire is not the only medical professional fed up with the failed dietary recommendations being hoisted on the public. Dr. Eric Westman, the researcher from Duke University who contributed this recent study about low-carb diets helping people with diabetes, made some eye-opening comments along the same lines as Dr. Wilshire in this recent article in

Westman also took issue with the lack of hard outcomes data to support the recommendations for reducing saturated fat and cholesterol intake. "In all the other sections, there are data that link the problem and the recommendations to good data, but this section is particularly weak," Westman argued. In the data cited, saturated- and trans-fat intake is linked to LDL-cholesterol changes, he noted. "Show me a study where these recommendations [for reducing saturated-fat intake] have led to improved outcomes: there isn't one ... In the drug world, you can't rely on intermediate outcome measures anymore, so that makes me wonder about saturated fats. This is pretty controversial to say, but I think we just need better science to say that saturated fat is bad."

Amen, Dr. Westman! We need more scientists and doctors willing to say these things publicly to have the expected impact on our culture. Can we round them all up and hold a press conference to make a big splash in the meida about this? Dr. Wilshire? Dr. Westman? Can it be done? If we care about the health of our country and where we are headed right now, then this is not an option but a MANDATE before it is too late.


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