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Cashew,
avocado and heart patients: scientific explanations Interpretation
of Nutrition data is difficult due to various nutrient interactions
that take place within the body at metabolic level and also due
to difficulties in controlling various confounding factors (health,
dietary and socio-cultural factors) that may affect the results
of Nutrition Intervention Trials and Nutrition Epidemiological Observations
(see section: Something is wrong - para one). Therefore,
interpretation of nutrition data, particularly translating information
from nutrition trials and epidemiological data in to dietary advice
must be done with caution. Nuts do contain Mono Unsaturated Fatty
Acids (MUFA), which are considered heart healthy. However, such
foods are never recommended to heart patients or the general population
without conditions or limits. The key issue is not nuts or MUFA
but the unscientific and irresponsible manner in which scientific
information has been distorted and disseminated to a large group
of people who are vulnerable to diet related Non Communicable Diseases
(NCDs) via the mass media. The scientific
data presented in this article indicate that heart disease, hypertension
(high blood pressure), and diseases such as diabetes that predispose
an individual to heart disease and stroke are common problems amongst
both the rich and the poor of this country today. The important
question is that in a back drop such as this, how could heart patients
or even healthy people be 'recommended' to consume foods such as
fried salted cashew nuts (high in salt and energy) and also other
energy dense foods such as nuts or avocado adlibitum (without restrictions).
There are different principle of Nutrition and Diet Counseling.
When dietary advice is offered at 'individual level' it is crucial
to adopt a 'Holistic Approach'. When advice is offered on mass media
at 'national level' it is also important to consider the existing
health and nutrition situation of the country i.e.: the Nutrition
Transition that is taking place in Sri Lanka at present. This article
highlights a classic example of a mismatch between the health and
nutrition situation of the country and the nutrition and dietary
advice offered to the public via the mass media. The above misinformation
has created a need to educate the public on the scientific position
with regard to the consumption of energy dense foods. This article
raises important questions in relation to public health, professional
obligations/ethics and media ethics. Background Points to
ponder Dilemma
of the public It is important
to note that on most occasions when some incorrect nutrition information
or dietary advice was offered on the media, I have had many queries
form patients, non-patients and also members of the medical fraternity
inquiring regarding their validity. Just like Mr. Wickramasinghe,
these are people who were somewhat better informed and felt that
there was 'some thing wrong somewhere'. There may be many others
who are confused but are unable to find the correct answers. Most
importantly there are many, including medical doctors who believed
that what appeared in the press was correct. On numerous occasions
many medical practitioners, some cardiologists and the general public
(particularly patients) have expressed their concerns over the incorrect
nutrition information and unsound dietary advice offered to the
public through the print media and have requested me to address
these issues through the media. However, as evident from this publication,
it takes much to undo such misinformation and time was a limiting
factor. After seeing Mr. Wickremasinghe's plea and considering the
continued dilemma of the public (see section: Something is wrong
-para two) I felt it was unethical for me (as a professional in
Nutrition) to remain silent any longer considering that Mr. Wic
is a heart patient and there may be thousands of other individuals
in the same predicament. |
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