There’s a 50–50 Chance You Will Die Due To This Poor Habit

Tim Spector

“Poor diet is the biggest single factor in causing modern diseases and accounts for nearly half of all deaths” (1)

Tim Spector, famous Professor of genetic epidemiology at King’s College London and expert in personalized medicine and the gut microbiome, 5 years after The Diet Myth, has written again.

In a very similar approach to his previous book, Spector questions in Spoon-Fed what information we are delivered regarding the diet, with a scientific critical viewpoint.

“This book is concerned with thinking about nutrition, diet and food in a different way. It is the antidote to being spoon-fed fairy stories about food that have made us progressively unhealthier and more anxious”.

Focalizing on 23 short chapters, Spector evaluates what works and where truth lies, while acknowledging — considering he’s also involved in the personalized nutrition company ZOE — that everyone’s body is different and can react differently to food.

Here are 8 of the big questions he investigated — and the answers will surprise you.

1) Is breakfast really the most important meal of the day ?

Have you also been fed the maxim “Eat like a King at breakfast, a prince at lunch, and a thief at dinner” ? It for sure works for me. However it seems true only for a subset of people, and skipping breakfast appears to present benefits which could be mediated by a period of 12 to 14 hours of fasting in which the microbiota can clean up leftovers, protect the gut barrier and have a marked circadian rhythm.

2) Does calorie counting help put off weight ?

Probably not. It is difficult to have a real grasp of our own metabolic rate, and the calorie content labelled on foods can be very wrong as it doesn’t consider the variations brought by cooking, associating ingredients, the interaction with the microbiota and participation to break down nutrients, and the reality of what we absorb. For example, because some of the walnut and almond fat can’t be digested, their calorie count is currently overestimated by 20–30%.

3) Do supplements work ?

After studying vitamin D for 25 years, thoroughly publishing on the topic and consuming supplements himself, Spector is now convinced that supplements don’t work. In particular vitamin D supplementation, in recent big studies, he claims, was found ineffective at preventing fractures (2) or even found potentially harmful at excessive doses (3, 4).

Spector argues that we can get enough vitamin D from 15min of daily sunlight exposure, by eating a fillet of oily fish like salmon, or by having a handful of vitamin D-rich mushrooms. I wonder what he would say today about the popularity and importance of vitamin D in the Covid19 context.

His main doubt with regards to supplements is outlined in this quote:

“Our bodies can’t deal with a large dumping of a chemical supplement in our intestines in the way that they can process and absorb them from natural food sources”.

While I agree with the general idea, I wonder what to make of the problem that our food sources appear impoverished in their nutrient content since the agricultural revolution, due to the selection of quickly-grown crops in a soil probably more and more depleted from minerals and microbial life after decades of phytosanitary products spraying (5, 6).

Spector evokes studies relating also to calcium, lycopene supplements, omega-3 oils and a few other vitamins and minerals, but he didn’t sufficiently explore the diversity of plant extracts and plant powders (more respectful of the phyto-complex present in a plant than a concentrated extract), nor did he even mention the whole field of probiotic supplements (which are a totally different category since probiotics don’t work through their absorption into the bloodstream but through their interaction with the gut ecosystem) to be able to extrapolate to such a general statement as “supplements don’t work”. A lot of studies and independent expert panels could contradict this statement. This sounds as exaggerated as saying “drugs don’t work”. Which, at what dose, in which population and for what purpose ?

4) Is it healthy to eat meat ?

While the title of Spector’s chapter on meat is “bringing back the bacon”, his evaluation of the question is definitely mitigated. Statistics he reports say an extra meat portion a day increases risk of mortality and heart disease by 10–15%, and even 30% for processed meat (7, 8).

The Lancet’s Planetary Health Diet (9) is proposing an optimal diet both for health and the environment and recommends to have 13g eggs/day (less than 2 per week) and no to a maximum of 14g of beef (1 small steak per week).

“All of us should seriously consider being flexitarians — if not for the sake of our health then to reduce global warming. Reducing your meat consumption /…/ could be the most important thing you can do for the planet.”

5) What about fish ?

While I cut down drastically on meat 10 years ago, for fish I find it more difficult, given the importance of omega-3 in health, and of sushi feasts in my life.

While fish consumption is associated to a 7% reduction in mortality, it should be compared to the much stronger protective effect of consuming nuts, with a 24% reduction in mortality (10).

With wild fish raising increasingly alarming questions of stock depletion, microplastics contamination and heavy metals, an alternative could be to include more chia seeds, walnuts and flaxseed in your diet, all of which provide nice quantities of omega-3. I personally find a handful of seeds or nuts blend very well in a morning smoothie.

6) Would it be good for you to go vegan ?

A meta-analysis shows that vegans, when compared to omnivores consume less energy, less saturated fat, have a lower BMI, waist circumference, LDL cholesterol, triglycerides, fasting blood glucose and blood pressure (11). Thus, they have a more favorable cardiometabolic profile — probably in part because they eat more fibre, antioxidants and anthocyanins, improving not only heart health, but also gut and mental health (12).

What about the lack of protein ?

“Contrary to popular belief, although vegans and vegetarians do consume about a third less protein on average compared to omnivores, they still exceed the daily recommended intake” (13).

7) Does diet impact mental wellbeing ?

Yes. A diet high in varied plants and seeds reduces levels of depression while a junk food and low fibre diet increases it (14). An interventional study even found dietary advice to be as effective as psychotherapy at preventing major depression ! (15)

Mood and depression are affected by gut diversity, and the microbes missing in depressed people are those producing key brain chemicals. (16)

8) After all the hype, is alcohol healthy or not ?

That’s an important one that got me into many discussions with my boyfriend, who turned out to be right. While I was worried about daily assumption of alcohol — considering 10% of users become addicted, with the dramatic consequences we know — there seems in fact to be a U-shape relationship between alcohol intake and health. One (for women) or maximum two (for men) glasses of red wine per day lead to 20% less heart disease than abstinence (17). Red wine is rich in polyphenols which are associated with an increased alpha-diversity of gut microbes (18) — but this is not true of beer or spirits.

These are just 8 out of the 23 major food questions discussed by Spector in the Diet Myth and Spoon-Fed (the two books largely overlap). As the author himself concludes, we all need to take personal responsibility to learn more, to educate our children better, and to advocate for governmental subsidies that make more sense — to stop subsidizing processed foods instead of fruits and vegetables.

And although we are all different, there are healthy eating messages that can apply to everyone, such as eating more fibre and plant-based foods and cutting down on sugar and ultra-processed products. Bon appétit !

References:

1. Murray et al. U.S. Burden of Disease Collaborators. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA. 2013

2. Trajanoska et al. GEFOS/GENOMOS consortium and the 23andMe research team. Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study. BMJ. 2018

3. Bischoff-Ferrari et al. Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline: A Randomized Clinical Trial. JAMA Intern Med. 2016

4. Smith et al. Effect of annual intramuscular vitamin D on fracture risk in elderly men and women — a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford). 2007

5. Davis, D. R. (2009). Declining Fruit and Vegetable Nutrient Composition: What Is the Evidence?, HortScience horts, 44(1), 15–19. Retrieved Jan 30, 2021, from https://journals.ashs.org/hortsci/view/journals/hortsci/44/1/article-p15.xml

6. https://www.nytimes.com/2015/09/15/science/a-decline-in-the-nutritional-value-of-crops.html

7. Wang et al. Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies. Public Health Nutr. 2016

8. Etemadi et al. Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study. BMJ. 2017

9. Willett et al. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019

10. Schwingshackl et al. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2017

11. Benatar & Stewart. Cardiometabolic risk factors in vegans; A meta-analysis of observational studies. PLoS One. 2018

12. Billingsley & Carbone. The antioxidant potential of the Mediterranean diet in patients at high cardiovascular risk: an in-depth review of the PREDIMED. Nutr Diabetes. 2018

13. Clarys et al. Dietary pattern analysis: a comparison between matched vegetarian and omnivorous subjects. Nutr J. 2013

14. Lai et al. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. Am J Clin Nutr. 2014

15. Reynolds et al. Early intervention to preempt major depression among older black and white adults. Psychiatr Serv. 2014

16. Valles-Colomer et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol. 2019

17. Xi et al. Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults. J Am Coll Cardiol. 2017

18. Le Roy et al. Red Wine Consumption Associated With Increased Gut Microbiota α-Diversity in 3 Independent Cohorts. Gastroenterology. 2020

19. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

20. Spoon-Fed: Why Almost Everything We’ve Been Told About Food is Wrong by Tim Spector, published by Cape, 2020

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Nina Vinot

Nina Vinot

My Education is in Biology, Agronomy and Nutrition My Career is in Health-Promoting Bacteria My Passion is to Benefit Life, Happiness and the Planet