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When I was writing February’s News Round Up I came across a ‘diet and lifestyle’ article in The Independent newspaper (Feb 24th) titled “How to scrap fad diets and lose weight the healthy way” with a subtitle “Clare Collins, Professor in Nutrition and Dietetics and the University of Newcastle, explains how to leave “quick-fix” regimes behind once and for all”. I was intrigued as it seemed to be taking a swipe at diets such as paleo, gluten-free and low carb without actually naming them. All of these diets get written off by journalists as ‘fad’ diets, despite the medical literature surrounding them, and they usually find some stooge with a PhD to trot out the usual trite advice – “it’s all about a balanced diet… blah blah… 5 a day… blah blah blah… eat less exercise more… blah”
The article encouraged readers to identify where their diet quality was lacking then introduce the missing ‘healthy’ parts bit by bit. Professor Clare Collins tells us “Improving your diet quality means eating more fruit and vegetables, lean meats, poultry, fish, eggs, tofu, nuts and seeds, legumes, dried beans, wholegrains and dairy”. Well, apart from the grains, tofu and beans I can more-or-less go along with that. It seemed on the face of it to be basically promoting real foods.
Helpfully, half way down the article was a link to a Healthy Food Quiz that allowed readers to identify ‘how healthy your diet is’. Healthy according to whom I wondered? The article suggest taking the quiz, which would provide a ‘healthy eating score’ along with feedback on what you could do to improve your diet. The idea is to make some improvements, and retest yourself to see if the score has gone up. Seemed like a bit of harmless fun. Thought I’d give it a go.
Now, I eat a kind of paleo/traditional diet which contains virtually no processed or industrialised foods. My main meals are cooked from fresh ingredients based around meat, fish and vegetables, with breakfast and lunches including salads, eggs, sea foods, nuts, fruit and dairy. Pretty much as per Professor Collins introductory list above, except with no grains, soy or vegetable oils, so I expected to gain a pretty high score.
I completed the quiz, filling in several pages of tick boxes. It took no more than a few minutes. Eventually the results… I clicked submit, and waited as the loading icon rotated hypnotically…
“Overall diet score 23/73“. What? That’s only just over a third marks! “Needs work” Wow! Really?
It was at this point that I was told my diet was being compared to the National Guidelines for Australia. “Your total Australian Recommended Food Score is low.” Australia? First I was puzzled. Then I realised that the University of Newcastle mentioned in the heading was Newcastle Australia, not Newcastle UK which helpfully is called Newcastle University to make sure the two institutions don’t get muddled up. Silly me. Doesn’t it strike you as a bit odd that the Independent – a UK newspaper – didn’t mention the Aussie connection? It made me think they may have received some payment to run the article blind. But why?
When I looked at the recommendations that this quiz produced for me I laughed. They were so wrong as to be funny. At this point I might have put the whole thing aside as a bit of Sunday Newspaper info-tainment, but in the feedback section it stated that the results are being used for research by the University of Newcastle. The quiz website explains “our nutrition research team will use the results to find the healthiest eaters in Australia. Will it be the women, the men, children or adolescents?”.
OK. As a research question it’s not exactly up there with the pressing nutrition questions of our time, but it shows the authors of this quiz are actually using it as a survey to collect nutritional data which I assume they think will have scientific validity. So, it seems this isn’t a vague lifestyle quiz, but a variation of the much maligned research tool a food frequency questionnaire. Indeed one question in the quiz asks “Do you agree that your anonymous quiz answers may be used for research purposes?”, so they are clearly intending to do something with the data.
As an aside, it seem a bit bizarre that an Australian nutrition survey has been promoted in a UK newspaper. It’s hardly going to help answer their research question if lots of Brits fill it in. How is that going to tell them about the healthiest eaters in Australia? I suspect they have not told us the real purposes of this data. And, call me cynical, but I can’t help feeling the data will be used to secure a grant or support a policy rather than promote nutritional knowledge. But hey ho, this is just a side issue in this decidedly dodgy data-gathering exercise, as you will see.
My Healthy Eating Quiz results
As I said, after completing the survey I received an overall rating of ‘needs more work’, scoring a measly 23 out of 73, and was advised I was some way off meeting the Australian dietary recommendations. Intriguing! What do they think I am missing? In what way do they think my diet is inadequate? The ‘How to improve your score’ feedback revealed the problem, but the issue, it quickly became clear, was with the survey, not with my diet.
Bizarrely, considering I have two or three meals per day based around fish/meat and vegetables and even eat my own home grown veggies, I was only given a ‘getting there’ ranking (12/21) for vegetables. Similarly for animal protein (4/7) ‘getting there’. This is bonkers. There are simply not enough meal opportunities in the day to eat more meat and veg. I eat the widest range of these foods of anyone I know! For example, last night I had fish (hake) with butternut squash, green beans, cheesy leaks and broccoli. What more do they want of me???
Ironically, I managed to gain an ‘excellent’ for vegetarian protein sources (3/6) – mainly due to eating eggs and nuts most days.
My worst categories, receiving zero scores were grains – no surprise there – but also dairy (0/11) and water intake (0/1). Considering water first: the only options on the survey were: “3 or less glasses per day” or “4 or more”. I probably only drink one or two glasses of water per day, BUT, I drink 8 cups of coffee/tea. What do they think coffee or tea are made with? Do they really think that water is only hydrating when it comes out of a bottle or tap? Water in beverages, fruit, veg and soups is completely and irrationally excluded from the survey!
According to the authors, the quiz is encouraging people to eat a wider range of foods. But is that true? In the vegetable section, for example, they provide a long list of veggies against which you have to choose either: “1. Less than once a week or never”, or “2. Once a week or more often”. By dividing up the options like this some strange outcomes are created. Take for example Mr A who eats a different vegetable each day of the week in rotation. He will identify seven veg that he eats once a week or more often. On the other hand, Mr B has a fortnightly rotation, eating 14 different veg over two weeks – far more diverse than Mr A, yet he would have to tick “Less than once a week or never for each vegetable” and would be classified as needing to eat a wider range of veg!
Similar problems occur in the meat sections, where inexplicably ‘mince’ is in a separate category to pork, whilst beef and lamb are put together in a third category. Trying to decide how many of each group one eats per week is quite tricky.
Back to my results… I came out low for dairy because most of my milk intake is in hot drinks (I get through 3 litres of milk per week in this way) but for the option “How many glasses of milk do you drink” I was forced to put “less than 1 per day”, because I don’t drink milk by the glass nor put it on cereal which were the only things they asked about. As you can see, the questions themselves are creating incorrect dietary estimates.
For ice cream the survey options are “Less than 1 per week or never”, “Between 1 per week and 1 per day”, or “2 or more per day”. That middle range is way too large. The difference between someone who has ice cream once per week vs once per day is huge! Questions like that will encourage people who eat it only once per week to tick “Less than 1 per week or never” because they feel closer to that category and don’t want to be lumped in with people who eat ice cream every day. This is an example of how these surveys promote under-reporting.
For cheese the options were: “Less than 1 per day or never”, “Between 1 per day and 3 per day” and “4 or more portions per day”… What? Who eats cheese four or more portions per day – that’s two cups of cheese per day, which equals (click click click…) 240 grams or half a pound of cheese! I think that I eat quite large amounts of cheese per week, and I eat it most days, but not every day, so again I was forced to choose “zero or less than 1 per day”.
I also eat 50g of full-fat double cream (50% fat) most days, but there was no question about cream, only cream cheese, so this survey had me down as ‘low dairy’. The advice they gave me was “Eating an adequate amount of dairy has also been linked with maintaining a healthy weight. Aim for 3 serves of reduced fat dairy foods per day.” Don’t they know that the healthy weight maintenance associated with dairy applies to full-fat dairy not low fat? [See our posts: ‘full fat milk less fattening than skimmed’ and ‘Why we pass on the semi skimmed and low fat dairy’]
In the grains section, the main question was “What kind of bread do you eat” and offered four options: Brown, White, Other or a combined “I’m not sure/I don’t eat bread”. Why are these last two rolled into one choice? If I was cynical I might think the survey has been deliberately designed to avoid revealing how many people have given up gluten/grains!
A similar question in the dairy section was handled differently, but equally bizarrely.
The three options for “what kind of milk do you drink” were: “1. Reduced fat milk, skim milk or soy milk”, “2. Full cream milk, rice milk or other milk” and “3. I don’t drink milk”. Why did “I don’t drink milk” get its own category this time but not for grains? And why the weird mixing of categories for the other two options? Seperating skimmed from full fat milk makes sense, perhaps, but why then include soy milk in with the skimmed, yet rice milk in with full-fat milk? There is no logic to that whatever, and it will just make any conclusions meaningless.
In my results they advise that “dairy is a good source of calcium”, yet allowing soya milk and rice milk to be conflated with cow’s milk makes any assessment of calcium intake meaningless. Indeed earlier this year we heard of a baby suffering scurvy due to being raised on almond milk. These milk substitutes do not have the same nutritional profile as dairy and should not be treated as equivalent.
Considering this is a healthy eating quiz it is strange, to say the least, that they fail to take account of any junk foods. My diet, for example, includes virtually no confectionery, sugar based foods, pastries, cakes or fizzy drinks, apart from a small amount of 70%+ cocao solids chocolate. Yet the quiz does not ask about these and would give me the same health ranking if I was regularly downing two litres of cola and three mars bars and a packet of biscuits every day. [O_o]
A similar oversight is the absence of questions about alcohol consumption. I could be drinking ten beers per day, or a bottle of vodka, and get the same healthy eating score. (I don’t do that BTW – I’m rather fond of my liver!). What kind of a healthy eating survey is this?
As you can see from the above, this survey is full of holes, and it is patently obvious that it has zero chance of providing an accurate assessment of the nutritional validity of one’s diet, yet… (get this) … at the end of the survey they promise that in future they will be adding the facilities to provide nutritional breakdown in terms of carbs/protein/fats etc based on the survey responses. They have got to be joking! Any such figures would be so far from reality as to be useless, and to even offer them to the public shows a criminal level of complacency and incompetence.
So who made this dreadful survey? A professor of nutrition no less! Indeed professor of nutrition and dietetics Professor Clare Collins, working ‘with the support of the world’s largest team of Accredited Practising Dietitian researchers at the University of Newcastle Australia’. Dietitians are the acceptable face of orthodox nutrition. Their role is to support the health service, but they are up to their necks in top-down policy. In Australia, Accredited Practicing Dietitians are required to provide nutrition recommendations that adhere to Australia’s Dietary Guidelines. They can’t think outside the box and almost never support any diet outside these guidelines.
Indeed, dietitians that step out of line can be disciplined or lose their license, such as the case of Jennifer Elliott, an Australian dietitian who was having a great deal of success treating diabetics with a lowish carb diet. Despite the fact that she had researched this approach extensively, and had doctors referring patients to her frequently, she was struck off.
Professor Clare Collins Heathy Diet Quiz is really no more than a piece of propaganda. As we have seen, it is not designed to answer any meaningful scientific question, and is incapable of assessing dietary quality. It can produce no valid nutritional data, yet claims to offer advice and, in the future, even a nutritional breakdown. It is fundementally irresponsible, ignores far more immediate dietary factors such as alcohol, sugar and junk food, and offers meaningless and impossible advice.
So how is Professor Clare Collins rewarded for this piece of nonsense/nonscience? According to her webpage (screen shot delow) she has secured a grant from the Australian Government’s National Health and Medical Research Council for $687,000.
You don’t need a degree to see how flaky and scientifically invalid the Healthy Eating Quiz is, yet it appears Professor Clare Collins and her team was awarded “The 2012 Excellence in Research for Australia (ERA), an independent assessment of research excellence, awarded the nutrition and dietetics research group at the University of Newcastle a rating of 5 – ‘well above world standard’ – one of only three Australian universities to receive the top ERA rating.” UNBELIEVABLE! How they reward their lackeys.
Below is a very glossy piece of self-promotion by Professor Clare Collins, explaining the thinking behind her Healthy Eating Quiz. A triumph of style over substance I think you’ll agree.
What makes me angry is that these professors have maintained their positions for the last three decades by hiding behind government recommendations. Despite the epidemic rise in obesity and diabetes that took place under those very recommendations they choose to stick with them, rather than question whether the guidelines actually contributed to the problem they were supposed to be addressing.
As obesity and diabetes rates exploded around them these self-anointed authorities attempted to suppress anyone who was off message, including those free-thinking researchers who had grasped the real issues about food and managed to grasp the right end of the dietary stick for a change.
I am thinking of people like the cardiologist Robert Atkins of low carb diet fame, who’s approach is now used worldwide in epilepsy (ref), neurodegenerative diseases, brain tumors (ref) and diabetes management (ref1, ref2), and Prof John Yudkin, author of now celebrated book Pure White and Deadly (1972) who tried to alert us to the dangers of sugar – now a political hot potato with a sugar tax being taken seriously at parliamentary level.
Both of these genuinely worthwhile scientists were metaphorically ‘thrown under a bus’ through a coordinated campaign to discredit them by dietetic and nutrition authorities of the day for daring to go against the government recommendations. The official dietary guidelines and their proponents made sure these effective ideas were sidelined for decades.
Professor Clare Collins, the University of Newcastle Nutrition and Dietetics dept and their Healthy Eating Quiz are no more than the continuing manifestation of this self-anointed, self-righteous, self-interested pretence at science.
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