TV3’s weight loss series, Downsize Me ended recently amid controversy over the accuracy of some of the nutritional information, and the approach taken by the presenters in promoting the weight loss.
The New Zealand Dietetic Association, who recently met with presenter Damian Kristof to outline their concerns, currently have several complaints pending with the Broadcasting Standards Authority.
We asked two nutrition experts, who have been involved in making the complaints, to comment on the show, and to highlight some of their concerns.
Nikki Talacek is a Registered Dietitian, she works with one of New Zealand’s leading weight loss surgeons Michael Booth and provides dietary advice to obese patients undergoing bariatric (weight loss) surgery. She also sees other non-bariatric surgery patients such as those with gastrointestinal problems, general weight loss patients and people with eating disorders. She has been working as a dietitian for 7 years, with previous experience in the public hospital system where she advised medical, surgical and intensive care patients on dietary issues. After watching Downsize Me, she comments here on some of her concerns:
“Downsize Me is a show that I’m sure most people have heard about. Like all shows, it has its good points and its not so good points.
“I think it is always nice to start with the good. Downsize Me has brought awareness to the growing obesity epidemic, and the need for everyone to stand up and take notice. Obesity can cause an array of health problems, including Type 2 diabetes and heart disease, so the more awareness that is brought to this issue, the better. Downsize Me also encourages people to move away from convenience based foods and takeaways and back into cooking, which any dietitian will tell you is a good thing.
“Unfortunately, though, there are some not so good points to the show, which cause great concern to dietitians. Many of these are based on sweeping statements made by the host Damian Kristof. Several of these statements are only backed up by small isolated studies, with the majority of the scientific research available showing results contrary to his beliefs.
“For example, Damian has frequently stated that an increased sugar intake can cause Type 2 diabetes. This in itself is incorrect. One of the risk factors for Type 2 diabetes is obesity, which is caused by excess calories in the diet. For every 1% absolute increase in the prevalence of obesity, it is estimated that an additional 2,300 people will develop diabetes[1]. Sugar is a source of energy and if consumed in excess may lead to weight gain. However, credible scientific research concludes, the total amount of sugar consumed by an individual is not independently associated with the development of Type 2 diabetes[2],[3].
“Another of my concerns is that Damian often recommends a goal of 1.5-2.5kg of weight loss per week. This is an unhealthy and unrealistic weekly target. Steady weight loss over a longer period favours reduction of fat stores, limits the loss of vital protein tissues, and avoids the sharp decline in resting metabolic rate (RMR) that accompanies rapid weight reduction. To minimise the decrease in RMR, a reasonable weight loss of only 1% of body weight per week is recommended for obese individuals[4]. Any weight loss over this amount tends to be from either water losses or lean body mass.
“The weight loss recommendations by Damian could potentially lead viewers to think they need to lose a large amount of weight every week to be successful. This could lead to nutritional deficiencies if not medically supervised, which the general viewing public are unlikely to be. In addition, it could lead people who are successfully losing 0.5-1.0kg (or slightly more) per week to give up as they think they are not losing enough, when in fact they are doing extremely well.
“Overall I think Downsize Me could potentially cause undue alarm to viewers because Damian promotes the idea that sugar can cause Type 2 diabetes (which is incorrect); recommends excess amounts of weight loss (which is inappropriate); creates the impression that the participant has to stop eating carbohydrates altogether otherwise they will get diabetes (which is inaccurate); and suggests that participants can reverse the diabetes they already have (which is not possible through dietary change alone). Further, his promotion of coconut oil for cooking is not advisable, as this oil is high in saturated fatty acids. My primary concern, though, is that Damian often gives advice which is contrary to Ministry of Health guidelines regarding healthy eating, and this can be very confusing for the public.”
Kath Fouhy is a Registered Dietitian with a degree from the University of Otago. She is a leader in the field of nutrition and dietetics, currently working as a nutrition consultant, providing one-on-one consultations as well as presenting at seminars and lectures and writing articles about food and health. Many of Kath’s clients are athletes; she also has a strong interest in gastroenterology and food allergies. In addition, she provides nutrition information for weight loss/gain, pregnancy and medical nutritional problems such as heart disease and diabetes. Here she outlines some of her concerns.
“Around two thirds of New Zealand adults are classified as overweight or obese, which means that it has now become ‘abnormal’ to be a healthy weight. More frightening is that one third of our children are classified as overweight or obese, and it has been predicted that this generation may be the first to not out live their parents.
“With health conditions such as obesity, diabetes and heart disease constantly in the news, many science-trained individuals are joining forces and trying their best to do something about it. However, everyone has an opinion on food, which has lead to a lot of contradictory information in the media. It seems that every time I pick up a women’s magazine, search the internet, or turn on the TV, I get told something different: no carbs, low carbs, low-fat, fruit only until lunch time, 2 litres of water a day, don’t snack…..it is no wonder people get confused.
“In reality, weight loss is actually a numbers game, so the only way you can achieve weight loss is to eat less than you expend. But when people hear that, they often think, ‘Oh no, I have to go on a diet’. Some people think of the word ‘diet’ as the word DIE with the cross at the end! Unfortunately, the moment you start to feel deprived on a weight loss program, that is the day it will stop working, because the hardest thing about weight loss is not losing the weight but keeping it off. That means that whatever changes you make you should be able to sustain FOREVER.
“The recent series of Downsize Me inspired many people to get off the couch and turn their lives around, but it was a shame to see that in the last show that many of the participants had regained some of their weight, when they probably should have been still losing it.
“Food is very social and New Zealander’s love entertaining, so it is important that these situations are taken into account. For example, it shouldn’t be a case of “you can’t eat ice cream for the next 10 weeks” but perhaps something like – “use ice cream as a treat item – that means once per week and put it in a cone because you can’t put 4 scoops in a cone like you can in a bowl”.
References
1. The Evidence Based Best Practice Guidelines (of New Zealand) Management of Type 2 Diabetes 2003
2. Institute of Medicine (IOM). Dietary Carbohydrates: sugars and starches. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. National Academies Press, Washington (2002)
3. Janket SJ, Manson JE, Sesso H, Buring JE, Liu S. A prospective study of sugar intake and risk of type 2 diabetes in women. Diabetes Care. 203; 26(4):1008-15
4. Understanding Nutrition 7th Edition 1996, pg 277 (Chapter 8 Energy Balance and Body Composition). Whitney EN, Rolfes SR
To talk to these or any other scientists about issues raised here, please contact the Science Media Centre on tel: 04 499 5476 or email: smc@sciencemediacentre.co.nz.
Notes to Editors
In New Zealand, dietitians are registered to practice under the Health Practitioners Competence Assurance (HPCA) Act 2003. A dietitian must have studied a prescribed degree in nutrition and then completed a postgraduate diploma in dietetics before gaining registration and being placed on the Dietitians Board Register at www.dietitiansboard.org.nz. Further to the initial registration, each year a New Zealand Registered Dietitian must be certified in order to gain an annual practicing certificate. This means that the dietitian is fulfilling the requirements for ongoing professional development, is meeting expectations when individually being audited and is complying with the Code of Ethics. A person using the title New Zealand Registered Dietitian is certified as meeting the high standards for practicing nutrition and dietetics in New Zealand. Dietitians are experts in nutrition; there is no other protected title under law in New Zealand for practicing in the field of nutrition.
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