The Dietitians Association of Australia has pledged to cut financial ties with the sugar lobby following a series of investigations. The DAA initiative and the exoneration of surgeon and sugar critic Dr Gary Fettke are significant steps towards diet reform in Australia.
On World Diabetes Day last year, I wrote an opinion piece about the problems with our approach to treating diabetes. In short, the current dietary advice for people with diabetes is to consume a ‘low fat’ diet based in high-fibre carbohydrate foods like breads, cereals and grains. Notwithstanding this conventional advice, these carbohydrate-rich foods cause major fluctuations in blood glucose levels for people with diabetes. Patients are told to manage the flux of glucose in the blood by using medications like insulin, which come with significant side effects.
A more practical approach is to limit the amount of carbs consumed in the diet and therefore reduce the dependence on high-dose medications. Unfortunately, this common-sense approach runs counter to the advice from many “dietary experts” who claim low-carb diets are a “fad”. The reasons for maintaining this unscientific view have much to do with protecting financial relationships. Our previous investigations have revealed the undue influence of the sugar and cereal lobbies over our trusted public health institutions. But are we now seeing a U-turn in financial conflicts?
This author has spent the last year investigating the influence of the cereal and sugar industries which fund the Dietitians Association of Australia (DAA) and Diabetes Australia. Our investigations revealed these organisations, which issue dietary advice to people with diabetes, are educating their members with learning materials which have been sponsored by the food companies like cereal giants Nestle, Kellogg’s and Sanitarium. Despite robust denials that receiving money from the food industry influences their dietary advice, an overwhelming amount of scientific evidence appears to contradict this position.
In a surprising move, however, the DAA has just announced that it will be ceasing its corporate relationships with food manufacturing and food industry associations by 31 December 2018. Current and former members of the DAA have praised the decision. Many perceive it as the DAA’s renewed commitment to the dissemination of independent dietary advice. In our recent expose, coined ‘Wheatileaks’, secret documents revealed the tactics used by a cereal industry front group to sanitise negative messages about sugar-laden breakfast cereals. The organisation paid money to the DAA, which was complicit in influencing public opinion about the benefits of cereal and cereal products by co-opting influential dietitians to peddle industry-funded science. The leaked documents even propose “active defence” strategies against those who pose a threat to their messaging and branding.
I was specifically targeted after producing a documentary about “Low Carb Diets” for ABC’s Catalyst science program in 2014. Also named in the documents was Dr Gary Fettke, an orthopaedic surgeon who rose to prominence after he was sanctioned by Australia’s medical regulator, Australian Health Practitioner Regulation Agency (AHPRA) for advising his patients to consume less dietary sugar. The vexatious complaint originated from the DAA. Other high profile names include lawyer and author of Sweet Poison, David Gillespie, Paleo advocate and celebrity chef, Pete Evans, and the creator of ‘I Quit Sugar’, Sarah Wilson. The implied effect of this ‘active defence’ was that dietitians with ‘influence’ would write negative press articles, social media posts and lodge complaints to TV networks or universities to shut down scientific debates about these issues. The Wheatileaks documents are damning of the DAA and are likely to have played a role in its decision to sever ties with the food industry.
In another announcement, again both unexpected and positive, AHPRA has over-turned its decision to impose sanctions on Fettke. After subjecting him to a gruelling, three-year inquiry for daring to advise his patients to consume less sugar, AHPRA has relented. Fettke was cleared of all charges. AHPRA reversed its decision to ban Fettke from giving nutritional advice to his patients and issued him with a formal apology. “I would like to take this opportunity to apologise for the errors that were made when dealing with this notification. We recognise that these errors are likely to have compounded any distress that you experienced as a result of being the subject of this investigation”, wrote AHPRA.
This is not just a win for Fettke, but for hundreds of other doctors who’ve remained deliberately silent on this issue, for fear of retribution. Fettke says a Royal Commission is warranted into the egregious influence of food industry on our government’s dietary guidelines.
After what seemed to be uncompromising resistance to the latest scientific evidence, Diabetes Australia has issued a new position statement about ‘Low Carb Diets’ for people with diabetes: “There is reliable evidence that lower carb eating can be safe and useful in lowering average blood glucose levels in the short term (up to 6 months). It can also help reduce body weight and help manage heart disease risk factors such as raised cholesterol and raised blood pressure”, wrote Diabetes Australia.
The statement from Diabetes Australia even suggests that low carb diets may assist people with managing Type-1 diabetes. The new position has been celebrated on social media and among special interest groups, which say it a step towards regaining their trust in public health institutions.
In all, it seems the tide is turning. Slowly. Doctors, dietitians and other health professionals believe the exoneration of Fettke, the acceptance of low carb diets and increased scrutiny over the conflicts of interest, will improve patient care and enable people to make more informed decisions about their health. The time has come for radical reform of our dietary guidelines, ensuring scientific independence and evidence-based advice.
Dr Maryanne Demasi, PhD, is an investigative journalist, scientist and consultant for the Nordic Cochrane Collaboration.