Dr. Bondeviks Hudklinikk

The new official dietary guidelines were presented in Norway yesterday, January 31, 2011. All and all they are more specific than earlier and related to foods, not percentages. It is positive that only whole grain products are recommended, not bread in general as earlier and the actual new recommendation for whole grains results in a lower total grain intake recommendation than earlier, which is good. Potato is no longer considered as one of the “five per day” fruits and vegetables, and pulses/legumes are recommended as a healthy alternative to potatoes for the first time in Norwegian guidelines (all be it without specific recommendation for amounts). Nuts appear also for the first time, sadly with a maximum per day recommendation of 20gram. The explanation given is fear that a higher intake may lead to overweight, which of course has never been shown for nuts. In fact double studies show that nuts prevent obesity (provide satiety and stable blood sugar, thereby preventing overeating) and twice the amount daily (around 40g) has been shown to be beneficial in terms of preventing heart disease. The guidelines continue being fat phobic, recommending to keep the total fat intake low, whereas there is no scientific evidence that isolated total fat reduction has any benefits in terms of obesity, diabetes, heart disease or cancer, which are the diseases the new guidelines are supposed to help prevent. Also, they recommend edible oils in general and soft margarines and a low consumption of butter. This is amazing, because there is a huge difference in fatty acid composition between e.g. cold pressed olive oil/rapeseed oil and the refined oils from soybean, sunflower, corn etc., the latter being hig h in omega 6, contributing to chronic inflammation, heart disease and cancer. No margarine deserves to be recommended, since the raw material is highly processed refined oils high in omega 6. On the contrary there is no scientific evidence behind the recommendation to reduce further the amount of saturated fat and dairy fat in particular. At best the relation of saturated fat  to any chronic disease and heart disease in particular is neutral and the effect of dairy fat seems to rather be protective in terms of heart disease prevention.
The attached systematic review shows clearly the following:

The Mediterranean eating pattern has the absolutely best documentation in terms of heart disease prevention. The traditional Mediterranean diet was high in vegetables, fruits, pulses/legumes, whole grains, fish and olive oil, having  around 45% of energy from fats, mainly from olive oil, nuts, seeds and cheese. High intake of vegetables and fruits is also well documented to be protective. Of the negative factors, trans fatty acids and high glycemic index/load foods (sugar, refined flour products, rice, pasta, potatoes) have the best documentation to increase to risk of heart disease. The review finds no correlation between total fat intake, nor saturated fat intake and heart disease (neutral effect).
Finally the new recommendations fail to address adequately the issue of the  high prevalence of vitamin D deficiency in this country and do not recommend sufficient dosage as supplement.