In a response published yesterday, Dr Alison Tedstone, director of diet and obesity at PHE, claimed the article by Dr Aseem Malhotra, interventional cardiology specialist registrar at Croydon University Hospital, titled: ‘From the heart – saturated fat is not the major issue’, was based on “limited evidence”.
Advice ‘based on long standing evidence’
Referring to the article, which questioned the government's sat fat reduction pledge, part of the voluntary food and drink Public Health Responsibility Deal, Tedstone wrote: “Government advice to limit saturated fat intake to no more than 11% of total food energy in order to reduce the risk of cardiovascular disease is based on long standing evidence from the Committee on Medical Aspects of Food Policy (COMA) and is endorsed by the Scientific Advisory Committee on Nutrition, who now provides the UK with independent advice on nutrition.”
She said this advice was supported by a wealth of other evidence and was in line with that offered by other reputable international authorities. She noted that it was also supported by rigorous scientific studies.
“The UK National Diet and Nutrition Survey (NDNS) shows that people are still, on average, consuming saturated fat above recommendations (12.7% for food energy),” said Tedstone. “Therefore based on the totality of the evidence, PHE will continue to advise people to consume a diet that is low in saturated fat and supports the Department of Health’s Responsibility Deal incentives to reduce saturated fat in foods.”
However, she added that PHE also supported “broader changes” to the diet, including reductions in salt, sugar and calorie intake and increasing fruit and vegetable consumption.
‘Literature has been misinterpreted’
In a subsequent response to the same article, Jim Mann, Professor of Medicine and Human Nutrition at University of Otago New Zealand said Malhotra’s article contained “several instances where the existing literature has been misinterpreted”.
Mann also questioned the increasing focus by some academics – including Malhotra – on the greater importance of sugar in the diet on obesity and heart disease. Mann suggested that rather than sugar acting in some special way to cause obesity, the problem was more its “tendency to promote excessive calorie intakes rather than via some unique metabolic pathways”.
“So, we would agree with Malhotra that replacement of fat with sugars in manufactured and other foods is totally inappropriate,” said Mann. “However we would strongly dispute his conclusion that saturated fat is exonerated as a cause of coronary heart disease.”