OH! Magazine - Australian Version March 2014 (Australian Version) | Page 16

DR JOANNA
MCMILLAN

FAT versus SUGAR
Dr Joanna McMillan sets the record straight once and for all,
about whether fat or sugar is a greater health villain.
hen I first started as a dietitian we
were still in the phase of blaming
fat for all our ills. The thinking behind
this was that fat is energy dense stuff
with more than twice the kilojoules of
protein or carbohydrate, it’s the least
satiating, and saturated fat in particular
was singled out as being a contributor to
heart disease.
Governments and nutrition experts
around the world advised us to lower our
fat intake. Food industry responded to
these recommendations by producing
lots and lots of low fat and fat free
products. Surely all this action would
result in beneficial changes to our health.
But it didn’t.
The first question has to be did we
actually follow the advice? Fast food
intakes continue to climb. The 1995
nutrition survey data shows on average
Australian adults obtain about a third
of their energy from fat – that’s not a
low fat diet. Of course it may be that
those trying to lose weight did as
recommended and ate less fat, while
others were eating more.

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ISSUE 8 ( OH! MAGAZINE )

But if we put that debate to one side, the
real issue is we made a change to a
macronutrient – not the overall dietary
pattern. We said ‘eat less fat, especially
saturated fat’ without talking specifically
about foods, combinations of foods and
which foods to eat instead.
So here’s what happened. We didn’t just
try to cut down on fatty foods and use
less oil or butter. We started to eat foods
we had never eaten before. Fat-free rice
crackers, heavily processed cereals,
bagels (99 per cent fat free!), pikelets,
baguettes (with no butter or cheese of
course), fat-free lollies and low fat
prepared meals based on rice and
potatoes, and a whole host of low fat
snack bars and treats.
These are not natural whole foods. They
are all foods with a moderate to very high
glycaemic index (GI). They cause large
and rapid rises in blood glucose levels
and in turn require a lot of insulin to be
produced in the body to deal with them.
Insulin’s job is to get glucose back within
the range it needs to be in the

bloodstream, and get the excess up into
cells where it is needed as fuel, or stored
for later use – when no more food is
coming in. Trouble is, in the modern
world there is never long before the next
snack or meal appears. We also now
understand that glucose ‘spikes’ after
meals and high levels of insulin are risk
factors too.
Low fat diets do exist all around the
world. The Japanese diet is the best
example and the Japanese have one of
the longest living and healthiest
populations. But they are not eating
these foods. They are eating lots of plant
food, seafood, seaweed and only a little
meat. They also have white rice – every
day and almost at ever meal. But it is
balanced with activity in the traditional
communities at least, and with portion
control. They practice ‘hara hachi bu”
which means ‘eat until you are 80 per
cent full’. They meditate or practice tai
chi and so manage stress much better
than we do in the West. So there are all
sorts of lifestyle patterns here that could

www.drjoanna.com.au

( Nutrition )