[MUSIC]
Almost everyday we hear in the media about certain diets
that are very good for you and how to lose weight.
And they change almost every month or at least every year.
In terms of protein and carbohydrate and fiber and glycemic index and
Stone Age and low carb, low fat. And for some reason, it, it seems to
be a little strange if, if you think there should be some solids behind it.
But we must also realize and admit that there are many studies
that have been conducted and published in even world respected,
high quality journals that are not really giving us the
full truth about the diet and health relationship.
And why is it so?
Well, you can imagine we have information
from population studies where it's really difficult
to draw any cultural conclusions from populations
that is the, what we call observational studies.
But they can give us some hints about, and about relationships based on associations.
But what we normally do is we do the randomized control trials
where we randomly allocate people to eat different diets,
and then we, after some times, we do different
measurements to try to see if one diet is
more effective than another to produce some health effects.
That could be reductions in blood pressure,
cholesterol blood sugar or body weight, body fat.
And of course this is really the, the background
for substantiation of different diets and also different
diet books, that you have some randomized trials.
But one of the problems with the randomized trials are that,
you know, you wouldn't like to just to have a trial for
a couple of weeks, you would like to have a trial, maybe
for six months or maybe two years or maybe even five years.
If it's a, a trial that should try to show
that one particular diet is better to produce a weight loss,
but also to keep body weight off for an extended time.
And to prevent weight regain, you probably need more than a year.
So now I'm going to involve you with a major problem.
And I don't know if you're been thinking about that before.
Would you like to be enrolled
into a trial, a dietary intervention trial?
We'll your suppose to eat the same food everyday or the
same diet everyday, for maybe two, three years.
If you are, and you have no inference on, in what group you will end up.
So, maybe you are allocated to a low fat diet.
Where it's forbidden really to eat that
much fat. And it's not just today and tomorrow.
It's every day for maybe a year or five years.
Or would you like to skip all the carbs?
So, you know, no bread, rice, pasta,
couscous, or sweets for the next five years.
I think you wouldn't.
And per- personally I would never sign up for a study like that.
Maybe for a month or
two, but not for two years. So why do people do this?
Well, a lot of people do this fortunately because it's necessary
for research, but if you go in and really check what they're
eating after one or two years, you will see that they're not
complying with the food composition and the diet they were randomized to.
And that's really
a problem.
So many trials where they ask people, what do you eat?
And they ask them to write everything down.
Then you will see it looks like they are really eating
what they were supposed to eat after six months, one year.
But, if you check their blood levels of some markers of fat intake or
check their urine for nitrogen excretion, which is a marker of how
much protein they eat.
You will see that they are not complying, they don't adhere to the diet.
It was a long story to justify that we're using a supermarket to control
the diet, because we, many years ago, we realized that maybe one trick
to get people to eat the diet is to give them all foods free of charge.
For the whole family and from
our own supermarket.
And it all you know, maybe it's, it's very costly actually but we realize that
if you give them all the food free of charge, they actually eat the foods.
And we can measure that in their urine and in their blood that they are compliant.
So, that was the whole idea is really to,
not to rely on just telling them to do something.
And go to their own supermarkets and
spend their own money to find the foods, then go home and compose it.
No, no, no, we wanted to supply them with
all the food free of charge from our supermarket.
And then use the bar codes to control the composition in terms of
fiber and, and all the dietary advices that, that characterizes
the new Nordic diet. So this is really a very unique way
to do it. It's very effective.
But is very costly, but you can rely on
res-, the results you get out of it, because people,
they don't get all the, the food for your charts
and throw them out or give them to their pets.
No, no, they essentially consume them. And that's good, because
then we can see the real effect, what we call the efficacy of the diet
on various health parameters.
You can say that this maybe is a little artificial situation.
And, and how can we translate that into normal people who subsequently
are supposed to, to find these foods in the supermarket and purchase them.
Well, therefore we also had a sociological part of the study,
where there were, the, the participants in the study where interviewed
about how they felt this was. We simply wanted to identify
barriers to get this new diet into the society among ordinary
people who would pick it up and use it. Because this is also very important.
Not just to see the, look at the efficacy, but also look at the feasibility.
Is this something we can get,
translate into and get anchored into the society.
So the next thing you will hear are presentations about the supermarket
study and also some of the sociological interviews about it.
[MUSIC]
Dr Arne Astrup, MD, DMSc.Professor, Head of Department
