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00:05
Hey everyone, Mikki here. You're listening to Mini-Mikkipedia on a Monday and I've got to say, for whatever reason, it just appears that nutrition in the news just gets worse and worse, doesn't it? There's hardly ever any good news stories and any stories about nutrition in the news tend to be inflammatory, incorrect and absolutely biased towards a particular way of doing things, be it if it's going to be plant-based or

00:34
red meat or carbohydrate intake, as is the case that I'm going to be discussing today. And the first thing I will say is do not take your nutrition advice from newspaper articles, even if those newspaper articles are based on press releases from universities, because they're very often incorrect and they're very often a little bit sensationalist to get you thinking a certain way. Because that's what, you know, it's news. It's got to be interesting.

01:04
And last week, or at least on the 5th of September, Monash University had a press release published based around a study that researchers had published in a peer-reviewed journal around the association between low-carbohydrate diets and the risk of type 2 diabetes. Now, based on what you think you understand about type 2 diabetes, I'm sure that if I just ask you straight out, what did you think they found, most people would say, because

01:34
elevate blood sugar and that blood sugar elevation can lead to increased risk of type 2 diabetes over time, you'd expect that a higher carbohydrate diet over time leads to increased risk of type 2 diabetes. Well Monash headline, which was then picked up by Fairfax media and splashed across a lot of newspapers in Australia, read that low carb, high fat diets for weight loss actually boost the risk of type 2 diabetes.

02:02
which isn't what you would expect. And I've got to say, it's pretty irresponsible. It's inaccurate. And no wonder newspaper journalists who, I guess they must've just not been bothered to investigate further, just took that headline and ran with it. So I don't know whether it's the fault of the journalist to put it out there in the public eye without actually doing their due diligence and looking a little bit further.

02:30
or it's the responsibility of the university that published this press release to actually look a little bit deeper. And in fact, I think both of them are at fault here. And for what it's worth, there are other people who are very well versed in low carbohydrate diets for health, the likes of Dr. Paul Mason, Dr. James Mueke, who I'm publishing an interview with very soon, the likes of those guys. Peter Brugner is another one.

02:58
are actually writing to get the paper retracted because it is such a terrible paper, it should never have been published in the first place. And I'll briefly discuss some of the issues in the paper. But first, I'll tell you a little bit about the study. So it was a longitudinal study of a cohort of Australians, of which they had data for around 26,000 and they were followed across

03:23
two time points. So the data was collected initially in 1990. They had a follow-up in 1995 and a second follow-up in 2008. And they have about 26,000 people who had complete data points. And they asked them a bunch of different questions around their diet, physical activity, alcohol, smoking, their weight, their BMI, their waist to hip ratio, etc. So a lot of different health parameters were investigated.

03:52
And then they looked for associations between diabetes diagnoses and a low carbohydrate score. So what they did is that they developed a score based on the percentage of energy in the diet coming from carbohydrate. But it was a low carbohydrate score. So the higher the score you got, the more likely it was you had a lower carbohydrate diet. And those with a low score

04:21
more carbohydrate in their diet, which actually is a little bit confusing if I think about it. But anyway, so they split the groups up into five quintiles. They were supposedly equal, but in fact, there were huge differences in the groups of people in the different quintiles. So they weren't actually equal anyway, and I'll get to that. But they split them into five groups based on their low carbohydrate score from the lowest to the highest. So those in quintile one had the

04:49
most carbohydrate in their diet because their LCD, low carb score was the lowest. And those in quintile five had less carbohydrate in their diet. They were more likely to follow a low carb approach. And these two quintiles were compared in terms of health risk. And particularly they were looking at the diagnosis of type 2 diabetes. And they looked at them in year five. So.

05:16
in 1995 and they looked again at them in year 13 which was in 2008. And lo and behold what did they find? They found that those in quintel 5 which had the lowest carbohydrate percentage in their diet had the highest amount of type 2 diabetes diagnoses compared to those with a greater amount of carbohydrate in their diet.

05:42
authors reported that a low carb diet actually increases the likelihood of someone being diagnosed with type 2 diabetes. And on the face of it you'd be like, well where? That just flies in the face of every other single study that's ever been published about carbohydrate and type 2 diabetes. This is a bit strange. First and foremost I would say, well yeah it is strange and so you can't just take one study out of context of all of the other studies that have ever been done.

06:09
This is an observational study. It was not an interventional study. You cannot determine cause and effect from a study like this, but it will not stop media from picking up a headline like that in the press release and running with it. The laypeople don't know that though. And I say that with, I don't know how that sounds, but I just, that's a reality. Like people reading the headlines in the paper or a Monash University press release, unless it's spelled out to them, they may not realize the difference between epidemiology

06:38
which is what almost all nutrition science is based on, which is really, really poor low quality evidence, and a randomized controlled trial, which is deemed to be the highest quality evidence. People just don't know the difference and particularly the way it's reported like that. Outside of just the way that it's reported, if you actually dive into the paper, despite what the press release said and the newspaper articles said, this wasn't a study looking at

07:07
low carbohydrate intake versus high carbohydrate intake. This was a study looking at high carbohydrate intake versus not quite as high carbohydrate intake. So those in quintel 5 who supposedly had a low carb intake had around 37.5% of the energy coming from carbohydrate. Anyone that works in diet and particularly in low carbohydrate nutrition will appreciate that to be considered low carb.

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you want to be looking at about 25% and under in terms of calories coming from carbohydrates. That's what would be a sort of a cutoff for a low carb diet. So the researchers here, clearly they just went from the food nutrition guideline definitions, which look at a percentage of diet coming from carbohydrates and they define that anything lower than the acceptable macronutrient distribution range, which is anywhere from 45 to 65%,

08:06
anything lower than that would be deemed a low carb diet. But those with the highest carb intake had roughly around 55% of their calories coming from carb. Those with a low carb intake still had 37.5% of their energy coming from carbohydrate. So it's not even a particularly low carbohydrate diet anyway. The second point to note is that when you look at other health parameters that were investigated, such as BMI, such as ever smoked or former smoker, or...

08:34
current smokers such as alcohol intake or physical activity. All of these health parameters were worse in the quote unquote low carb group. So whilst you can absolutely adjust them away and they did in a particular model and I will talk about this, you cannot adjust away the effects of these other health parameters. Like it is just not possible and that's quite well acknowledged most of the time. So

08:59
the people who generally had a lower carbohydrate diet compared to those who had a high carb diet also had a lot of other health parameters that sort of put them into a worse category. Yet of course it was the low carb diet that increased their risk of type two diabetes. But I think the major deception, as Peter Bruckner wrote in his little article in defe which just almost made me laugh out loud that this even was published,

09:29
When you look at the association between low carb diets and type 2 diabetes, there was an association in wave 1 when at that first follow up at 5 years, it was no longer there in year 13. So there was absolutely no difference between the groups at the second follow up longitudinally. There was no association between low carb diets and type 2 diabetes.

09:57
print a press release saying that low carb diets boost the risk of type two diabetes. And this is then picked up by media that didn't even bother to go and look at the paper. So that is like the most ridiculous thing I've ever heard. There was no association to begin with. When they adjusted for all of those things, which I said you couldn't even adjust for, there was no difference between the groups. So this was almost a nothing paper. It was an absolute no find. And yet it was a press release was put out.

10:26
about it just last week, which was just super interesting. And in fact, it came on the back of another opinion piece by Dr. James Mueke that talked about the role of red meat in the diet and all of the misinformation that's out there about red meat. So, you know, it was just really interesting timing as well, considering that this is particularly old data. It is from sort of 1990 to 2007. So,

10:54
it's almost 20 years old and now it's just been published. So that's super interesting. So any differences observed with the risk of type two diabetes completely disappeared once they took into account obesity and central obesity. So the waist to hip ratio, which really just beggars belief as to how this even got published in the first place. And the reason why this matters is because people pick up on this stuff.

11:22
You'll hear it on the news. It is printed in the newspaper articles. People who may potentially be looking to solutions for their metabolic health, look at newspaper headlines like this and then think, well, low-carb's not gonna work. Look, it's gonna just increase my risk and not decrease it. And that's an issue. It's an issue when two thirds of the population are classified as overweight or obese. It is an issue when looking at population statistics in the US, which is

11:51
where there is data, 94% of Americans have one or more factors placing them at poor metabolic health. Most of the Western population is unhealthy. You probably aren't because you're listening to this podcast, you take an interest in these issues and you take good advice around what to do around your metabolic health. But I have to say you are not the norm actually.

12:15
This is, we live in this little bubble where we think everyone is engaging in the same information and has access to the same information and they just don't. And these myths of quote unquote a healthy diet are just perpetuated in the media time and again and it frustrates me if I'm honest. So that's why I just thought I would talk about it. So the major issues in this paper was in fact this wasn't low carb versus high carb. This was.

12:44
high carb versus not quite as high carb. This wasn't an issue about carbohydrate intake at all, actually, it was more an issue around the obesity and the risk of type two diabetes. This was misrepresented by Monash University and picked up by media and absolutely put out there for everyone to read, potentially.

13:07
biasing people against the low carbohydrate approach which is known to be the most effective approach for reducing type 2 diabetes risk so it absolutely impacts on the potential health outcomes of everyone and It's irresponsible basically. It's an irresponsible thing for Monash to do so super disappointing and Yeah, that's really what I've got to say about it. I will say and I think it's an interesting point

13:32
Another thing that Dr. Brugner brought up and Dr. Paul Mason, who I'm hoping to get on the podcast to discuss with him, is that the intake of seed oils in the group that had a lower carbohydrate diet was actually quite a bit higher than that in the higher carbohydrate diet. And they argue that the increase in seed oils increased the risk of not type 2 diabetes, but obesity.

14:01
So that's something that I'm wanting to have a bit of a deeper dive with Dr. Paul about that because I think it's an interesting point, but I just don't know enough about that to really comment on. And in fact, if you're picking apart a paper like this, I don't think you can really then say it's this thing here because actually overall, this is just a bit of a rubbish paper. And it was littered with errors as well, as Dr. Peter Brachner points out. You know, they...

14:28
had the quintiles were supposed to be of equal groups, yet there were 2000 more in quintile one compared to quintile five. They had many of the numbers and percentages quoted don't add up and the authors had confused killer gels of energy with killer calories, which is a really basic error that was clearly not picked up along any of the chain of command when it comes to publishing this paper. So, you know, I just think that this is a good one to highlight as some of the issues around

14:58
nutrition in the news and why you just can't rely on it really. And it really makes me question how much of published research can you rely on? Like if you do a deep dive in papers, are you going to find errors like this in a lot of papers? I will say this is a bit of a side note, but Cliff and I looked at a paper that was looking at a position stand for female athletes and some of the references used to justify some of the recommendations. We're just...

15:24
like mine, just wrong, they flat out wrong. And that just makes you question the peer review process, makes you question a whole bunch of things. So I'll be out there fighting the good fight for good nutrition research and good nutrition reporting. And yeah, and I hope that you will be too. So, you know, put a complaint in, wherever you put a complaint in, to Monash University, why not? That's my little rant for a Monday morning. Let me tell you though, I'm gonna give you some good information on Wednesday.

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at 1pm and 7pm with my weight loss seminar, which I run just before we kick off Monday's Matter which is my awesome fat loss program. And I'm going to give you some real solid advice. This is absolutely evidence based. There is so much data on the things that I talk about that it's really robust. It's nothing like this that I've just discussed. So we're going to put a link in the show notes to that or head to my website and put your name in that pop up box. It is free, obviously. It is run twice.

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So if you can't make the 1pm, then make the 7pm. If you can't make either of them, it is being recorded. And I'd love to see you anyway. I just love sharing this information. So if you've got any questions that you want me to answer, then let me know, hit me up on threads, Twitter, Instagram @mikkiwilliden, Facebook @mikkiwillidenNutrition, or as I said, head to my website, mikkiwilliden.com. All right team, you have the best week. See you Wednesday.