From Carlos Monteiro
Like the shape of the earth, nutritional epidemiology has not been immune to false controversy
Contradictions are inherent in science. It is they who fascinate the scientist, break his head, wake up and sleep and think about a solution to a particular problem.
For example, it was known that excess salt, fat and sugar favored the development of chronic non-communicable diseases (including diabetes, high blood pressure, obesity). After a certain moment, there was a decrease in the purchase of these ingredients while the rate of chronic illnesses in the Brazilian population only increased. And then? After much deliberation, they found that their purchases were declining as the habit of buying ready-to-eat, ultra-processed products increased – very high in salt, fat, and sugar.
However, there are very well established ideas that encounter contradictions in the Extracience universe. Perhaps the strangest thing is terraplanism – aided by people who can travel in search of the edge of the earth. In the meantime, NASA and SpaceX are launching the first manned mission to the International Space Station.
Nutritional epidemiology has not been immune to false controversy either. In September this year, a letter from the Ministry of Agriculture, Livestock and Supply requested the Ministry of Health to revise the nutritional guide for the Brazilian people. The document was based on a “technical note” written with the clear intention of withdrawing guidelines for ultra-processed products. To quote a playfully absurd argument, it has been suggested that, with the exception of breast milk, no food contains all of the nutrients the human body needs. Ultra-processed or fresh foods would therefore also be unbalanced. In other words, a banana and sausage would be equivalent – in fact, they could be tasted together on the edge of the earth while admiring the universe below.
The recommendation contradicts a number of studies – including systematic reviews and meta-analyzes of those studies – that have linked consumption of ultra-processed products to higher risk of obesity, diabetes, high blood pressure, dyslipidemia, and cardiovascular disease, among others . This is not a controversy.
Perhaps more damaging than denialism is scientific opportunism, which does not refute the knowledge generated but appropriates the evidence to distort it.
The “Tech Note” and the Brazilian Association of the Food Industry (Abia), keen to sell ultra-processed products, said the Brazilian guide is considered one of the worst in the world. To do this, they cited a study by Anna Herforth (Harvard) and Marco Springmann (Oxford) published in the British Medical Journal in July. The ranking of food guides from 97 countries – Brazil took 86th place.
As soon as they found out about the quotation of the work in the Abia communiqué, Herforth and Springmann accused the document of “rough interpretation” and “misappropriating scientific publications”. And they said the study was far from a ranking to assess the extent to which consumption levels of certain food groups like meat and vegetables are in line with goals set for the health of individuals and the planet.
Understanding that food combinations can make a healthy diet possible, the Brazilian guide mainly gives qualitative indications without specifying the consumption levels for each food group. For this reason, the “degree of uncertainty” with regard to the recommendations and objectives was rated as “high”. This “does not mean that the recommendations are bad or need to be revised, but that they have not been quantified in order to achieve certain goals,” say Herforth and Springmann.
The authors’ position proved to be a good antidote to scientific opportunism. Who knows if this is the way to prove that the opportunists like the terraplanists are unfortunately wrong.
Carlos Monteiro is Professor in the Department of Nutrition of the Faculty of Public Health at the University of São Paulo and Scientific Coordinator of the Center for Epidemiological Research in Nutrition and Health (Nupens / USP).
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