News

08-07-2018

The AMA has called for the documentary 'The Magic Pill' by celebrity chef Pete Evans to be removed from the Netflix streaming service. He offers a low-carb, high fat diet as a sole treatment for autism, asthma and cancer . The AMA and other medical organisations are concerned that the" the risk of misinformation is too great" to allow the continued streaming of the documentary.

Although the connection between health and diet is extremely important, the exclusion of key food groups in the long term is not supported by modern nutritional science. The main problem in our food environment is that most of the foods available, affordable, advertised and accessible are not healthy foods, but junk foods.

The ketogenic diet was developed as a treatment for epilepsy in 1924 at the MAYO Clinic. Research found that the diet was effective in reducing the frequency and severity of seizures in patients with severe epilepsy, but many people, including Hollywood celebrities have adopted the extreme diet for quick weight loss. The diet involves eating very small amounts of carbohydrates, medium amounts of protein and getting most of your daily intake from fats. Carbohydrates are the body's preferred source of energy and as we reduce our intake of carbohydrates,  ketones are produced by the liver from fat and used as fuel. 

There is a range of dietary approaches that are called "ketogenic" diets. The classical ketogenic diet has a ratio of 4g fat to 1g of combined carbohydrate and protein. It is  85-90% fat, which is not a palatable diet due to the significant restrictions on food quantities and types, including breads, cereals, fruit, some vegetable and dairy products. The carbohydrate intake is limited to just 20-50g per day ( a slice of bread contains 15g) and the various adaptions of the diet suggest consuming high volumes of animal products such as beef, above-ground vegetables such as spinach, kale, broccoli, mushrooms and cabbage, fats such as coconut, olive and macadamia oil, high fat dairy products, nuts and seeds, certain fruits such as avocados, strawberries, blackberries and lemons, sweeteners such as stevia, drinks such as almond milk, tea and coffee, herbs such as coriander, rosemary , basil and garlic powder.

The most common side-effects of the diet initially is bad breath, reflux, lethargy, hypoglycaemia ( low blood sugar) and constipation (due to the restricted vegetables, grains and fruits). Other possible side effects include renal stones, gout, selenium deficiency, pancreatitis, raised cholesterol, reduced bone density, altered immune function, altered liver function, nutrient deficiencies and poor growth in children. There has not been a huge amount of research into the diet's long term benefits, but a strict low-carbohydrate diet may improve type 2 diabetes and possible reduce some types of brain tumour as an adjuvant therapy to other standard cancer treatments. Several observational studies suggest this diet actually increases mortality from cardiovascular and diabetes related conditions.

In studies of the ketogenic diet and seizure control in children, a substantial proportion of patients who have a significant benefit in seizure reduction on the diet discontinue the diet due to intolerance and difficulty with maintaining the rigid, reduced eating plan.

The paleo diet's exclusion of key food groups is not supported by modern nutritional science. 

A spokesman for the Dieticians Association of Australia, Professor Clare Collins stresses that the ketogenic diet should not be considered flippantly as something anyone  should follow. The individual needs to be under the supervision of a doctor and a dietician and be monitored for side-effects. The diet requires considerable planning and preparation.

In the scientific literature, the ketogenic diet is used therapeutically in some conditions, but a very limited number. There is no evidence that the ketogenic diet alone can cure cancer,  tumour cells are very adaptable in the way they use their metabolic fuel and the notion that a cancer will be starved if you stop putting sugar into someone who has cancer is simplistic and wrong. There is also no evidence as to the use of this diet in the treatment of autism spectrum disorder, with only one study showing encouraging results ( a study of 30 children with autistic behaviour, 7 were unable to tolerate the diet, 18 of the 30 adhered to the diet with improvement in several measurement scale results . Studies are underway for other neurologic conditions including narcolepsy, depression, Alzheimer's disease, traumatic brain injury and schizophrenia. The expert consensus guideline members all state that there is insufficient evidence to recommend the ketogenic diet for these conditions other than under research protocols and guidelines.

There have been small short term studies suggesting the participants following a low-carbohydrate ketogenic diet compared to medium carbohydrate ketogenic diet were less hungry on the lower carbohydrate diet and did lose more weight, but another study published in the American Journal of Epidemiology found low carb diets no more effective that low-fat diets in the long term.

The Magic Pill documentary follows people suffering different chronic diseases who adopt a high-fat, low-carb diet and are shown to drastically reduce their symptoms. Cases such as a woman who claims her breast cancer significantly reduced size and another of a non-verbal child with autism who is able to speak for the first time after 10 weeks following the diet. The AMA President is concerned about the claims and made the request for removal of the programme from the streaming service as he said "all forms of media have to take a responsible attitude when trying to spread a message of wellness".

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