update 10 Dec 2016 remember that quotations from experts are in italics:
Note noteworthy timeous new reviews: in the latest 7 dec BMJ :
Advice on sugar and starch is urged in type 2 diabetes
advising on low sugar low starch to treat obesity diabetes,
and correction The scientific report guiding the US dietary guidelines: is it scientific?
of the extensive comment on bad new USA guidelines by Nina Teicholtz of 2015 ,
together with reviews of Gary Taubes new book Dec 2016 on The Case against Sugar http://articles.mercola.com/sites/articles/archive/2016/12/11/gary-taubes-the-case-against-sugar.aspx , being a bigger disaster than even smoking and other drugs..
These help to back up Tim Noakes, Zoe Harcomb, Richard Feinman, Peter Wise and at least two dozen other scientific teams around the world, and Integrative medicine, against the fastfood-pharma – hightech medicine – hospital industry trying to discredit Banting diet and needed proven supplements for deficiencies – of natural vits D+C+ iodine +magnes + multisupps , cannabinoids, fishoil + BID HRT (eg melatonin, cholecalciferol, progesterone etc), and other natural supps, and homeopathy,-
so as to keep people profitably sick by the sugary lowfat diet and smoking, vaccines , and patent Big Pharma-raincheck prescription antimicrobials, statins, fosamaxes and ranelates, antithrombotics, designer hormone substitutes,screening mammo and chemotherapy, bariatrics , nsaids, ACEIs and ARBs, antidementia, patented antidiabetics, analgesics, opiates,calcium, aluminium, mercury, and psycho-pharmaceuticals- none of which address the CAUSES of disease as do coaching on better diet, lifestyle and integrative medicine. …
Even more remarkable is the total ignoral of the 25 + scientific RCTs done http://smashthefat.com/science/ and published since 2000 that validate very low carbs high fat Banting (calorie distribution: 8.5% carbs, 62% fat, 30% protein) as much better than the current USA – RSA low fat (54% carbs, 29% fat, 17% protein) generous PUFA and carbs diet. See update review of the experts below at https://healthspanlife.wordpress.com/2015/08/29/adopting-low-carbs-high-fat-healthy-diet-for-most/
The Universities Stellenbosch+Cape Town 2014 Naude, Volmink ea
critique of Banting Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis notoriously ignored https://www.ncbi.nlm.nih.gov/pubmed/25007189
most of these scientific studies among numerous other errors noted at the time .
Harcombe and Noakes have now published Mistake or mischief: The universities of Stellenbosch/Cape Town low-carbohydrate diet review: debunking the Naude, Volmink ea critique. http://www.samj.org.za/index.php/samj/article/view/11605/7753 A major error of the US/UCT analysis was that it missed the point, did not even consider the very low carbs high fat (+- 8.5% vs 62% fat) intake of the ketogenic Banting regime. The Naude review classified low carbs as diet cals below 45% carbs, high fat as diet cals above 35% from fat. So they did not analyse at all the ketogenic +-8% very low carbs, 60%+ ie very high fat Banting diet.
The latest is Prof Richard David Feinman’s series of papers from the prestigious SUNY State Univ. NY https://feinmantheother.com/ . on the benefits of Warburg ketogenic ie low carbs diet for cancer, never mind obesity diabetes, and epilepsy ( which goes back to 1931 on Pubmed) , the latest eg Nel ea 2014 Jefferson Med College USA https://www.ncbi.nlm.nih.gov/pubmed/24675110and perhaps Autism Spectrum Disorder https ://www.ncbi.nlm.nih.govpubmed/27841033
. Now Prof Peter Wise emeritus oncologist from ImperiaL College London has thrown a cat among the pigeons http://www.bmj.com/content/355/bmj.i5792, in his November 2016 BMJ critique of Cancer drugs, survival, and ethics, pointing out how ‘Despite considerable investment and innovation, chemotherapy drugs have had little effect on survival in adults with metastatic cancer’. A meta-analysis 2004 explored the contribution of cytotoxic chemotherapy to five year survival in 250 000 adults with solid cancers from Australian and US trials.3-important effect was shown on five year survival only in testicular cancer (40%), Hodgkin’s disease (37%), cancer of the cervix (12%), lymphoma (10.5%), and ovarian cancer (8.8%). In the remaining patients—including those with the commonest tumours of the lung, prostate, colorectum, and breast—drug therapy increased five year survival by less than 2.5%—an overall survival benefit of 1 to 3 months., as in Europe. Drug treatment can therefore only partly explain the 20% improvement in five year survival mentioned above. The approval of drugs with such small survival benefits raises ethical questions, including whether recipients are aware of the drugs’ limited benefits, whether the high cost:benefit ratios are justified, and whether trials are providing the right information. In search of ethics : Many irregularities and competing interests—in pharma, in trials, in government approval, and in the clinical use of cancer drugs—impact ethically on the care and costs of patients with cancer. . Spending a six figure sum to prolong life by a few weeks or months is already unaffordable, and inappropriate for many of the 20% of the (Western) population who will almost inevitably die from solid tumour metastases. Ethical cancer care demands more prompt and radical treatment of localised and regional disease, together with highly skilled, earlier, supportive care are the important yet underfinanced priorities in cancer control. Finally, aggressively targeting the less than ethical actions of stakeholders in the heavily veiled medical-industrial complex may be the only way forward: current market driven rather than health driven priorities and practices do not benefit cancer patients.”
He provoked counterattack from vested interests: Twenty UK medical oncologists retort in BMJ: http://www.bmj.com/content/355/bmj.i6487.As UK health professionals specialising in the drug treatment of cancer, we think that Wise’s analysis strays into the territory of unbalanced opinion.
So we come back to addressing the causes of disease for both prevention and treatment, by integrative ie combining natural and hightech means.
updated 29 Aug 15
Six months later after the first World fat>carbs HFLC groundbreaking congress in Cape Town, Pubmed and Google search show no obvious new information on this life-and-death topic that the February Cape Town International Banting Congress highlighted. .
but the publication of Real Food Revolution II Raising Superheroes now provides much new evidence and impetus.
While carnivores ( mammals and pterodactyls-birds) from ~300million years ago survived the extinction of the carnivorous big dinosaurs sixty million years ago, so have current carnivorous primates- tarsiers– and us carnivorous humans nurtured from conception on animal protein and animal fats:
Top anthropologist Prof Gail Kennedy (of UCLA and much work at Olduvai Gorge) in her classic 2005 Journal of Human Evolution article “From the ape’s dilemma to the weanling’s dilemma: early weaning and its evolutionary context“ summed up >2million years of evolution of exclusive human breastmilk ie animal-protein-and-fat>carbs -based infant feeding: ” Although humans have a longer period of infant dependency than other hominoids, human infants, in natural fertility societies, are weaned far earlier than any of the great apes: chimps and orangutans wean, on average, at about 5 and 7.7 years, respectively, while humans wean, on average, at about 2.5 years. Assuming that living great apes demonstrate the ancestral weaning pattern, modern humans display a derived pattern that requires explanation, particularly since earlier weaning may result in significant hazards for a child. Clearly, if selection had favored the survival of the child, humans would wean later like other hominoids; selection, then, favored some trait other than the child’s survival. It is argued here that our unique pattern of prolonged, early brain growth and the neurological basis for human intellectual ability cannot be sustained much beyond one year by a human mother’s milk alone, and thus early weaning by one year, when accompanied by supplementation with more nutritious adult foods, is vital to the ontogeny of our larger brain, despite the associated dangers. Therefore, the child’s intellectual development, rather than its survival, is the primary focus of selection. Consumption of more nutritious foods derived from animal protein increased by ca. 2.6M yrs ago when a group of early hominins displayed two important behavioral shifts relative to ancestral forms: the recognition that a carcass represented a new and valuable food sourced potentially larger than the usual hunted prey; and the use of stone tools to improve access to that food source. The shift in the hominin ‘‘prey image’’ to the carcass and the use of tools for butchery increased the amount of protein and calories available, irrespective of the local landscape. However, this shift brought hominins into competition with carnivores, increasing mortality among young adults and necessitating a number of social responses, such as alloparenting. The increased acquisition of meat ca. 2.6 M yrs ago had significant effects on the later course of human evolution and may have initiated the origin of the genus Homo.”
The thesis of Raising Superheroes by Kennedy’s summation of human brain dietary evolution from babies nurtured on animal meat and fat is supported by serious studies: a 2010 critique in The Keto Diet for Health; in the textbook Guts and Brains ,2007 ed paleoarcheologist Wil Roebroeks at Univ Leiden .; and University Michigan anthropologist John Speth’s Springer Verlag 2010 The Paleoanthropology and Archaeology of Big-Game Hunting – Protein, Fat, or Politics?
Many sensible voices including locally like Kath Megaw encourage breastfeeding till at least a year in South Africa. Certainly http://www.nhs.uk/conditions/pregnancy-and-baby/pages/solid-foods-weaning.aspx doesnt say anything different from what sense and the authorities quoted below say- breast milk and then mushy whole food.
NICUS the Nutrition Info Centre of University Stellenbosch recommendations on line for 6-12mo infants certainly advocate increasing meats, fish, vegs, fruits & pulses. But the SA Guidelines on weaning 2012 Introducing solid foods from Stellenbosch University Dietetics says plainly “Complementary food is semi-solid porridges & milk that are given from six to eight months, then vegetables or fruit and then progressing to a mixed diet in mashed form small portions of solid food given until 12 months, when family foods are integrated”. ie NICUS advocates while weaning off breast, get baby (hooked) only on cereals for 2 months. where is the evidence to justify solely cereals as started diet? There is no good science published to justify this belief, marketeering; and no parallel in the non-primate infant world. .
NICUS say further: “Both early (< 4 months) and late (> 7 months) introduction of gluten should be avoided. Gluten should be gradually introduced while the infant is still being breastfed as this may reduce the risk of celiac disease, type 1 diabetes mellitus and wheat allergy.
“More than 14% of energy from proteins in the eight- to 24-month period may cause an early adiposity rebound and the development of overweight in young children. A dietary fat intake of 30-45% of total energy is recommended. The American Heart Association (AHA) has a limit of 40% fat of total energy with an emphasis on a more liberal intake of unsaturated fat and a focus onensuring adequate intakes of omega-3 fatty acids in infants and children.
In fact scientific evidence has never supported the obsession against eating (animal) saturated fat, triglycerides; nor human need for promoting the plant protein gluten. As we were and are taught in basic biology, only water, essential aminoacids- protein, essential fatty acids- fats- and the trace ~two dozen vitamins and minerals are, as eg all textbooks say, essential nutrients required for normal human body function that either cannot be synthesized by the body at all, or cannot be synthesized in amounts adequate for good health (e.g., niacin, choline), and thus must be obtained from a dietary source. . So its marketing hype that gluten is any more of an essential macronutrient than sugar, carbohydrates .
Wiki succinctly lists essential ie indispensable macronutrients (like the trace ~two dozen micronutrient vitamins and minerals) as: Essential fatty acids (EFAs) and essential amino acid EAA nutrients
The Wiki entry on gluten has a major paragraph on the common problem of gluten intolerance (especially wheat) , but no claim that it is an essential nutrient- for the simple reason that the gluten-containing cereals eg wheat and related grains, (including barley and rye) are like carbs not essential foodstuffs, and commonly cause distant health problems.
But the alarming disinformation is in that RSA article Introducing solid foods table 1 and the NICUS table Nutrient requirements @ 6 to 12 mo. Their recommended figures are: “total fat RDA 30gm/d ie ~270kcals and protein 13.5gm ie 54kcals on a total average RDA calorie intake of 710kcals”. That leaves the majority ie the balance of the energy intake- 385kcals to be made up by carbohydrates – ie 385/4 = ~ 95gm carbs. That gives their recommended (non-protein) carbs:fat energy ratio as 385:270 ie >1.4– which they imply can come also from plant oils. This RDA contrasts with the long-known (see below) (white and black) mothers’ s breast milk carbs:(animal) fat energy ratio of almost half (of what NICUS recommends 1.4:1): 30:38 kcals/gm ie ratio~0.8.
And even more dangerously, that Univ Stellenbosch table gives the RDA of vitamin D as 5mg/d ie 40 000iu/d. Neither that gross overdose, nor 5mcg/d = 400iu/d, are near the modern proven necessity of perhaps 1000 iu/d in swaddled urban babies – the vast majority of whom in Africa are black and therefore make even less vit D3.
rice milk: as http://everythingbirthblog.com/2012/01/rice-milk-why-it-says-not-to-give-it-to-children-under-five/ rice / and Noakes’ team says, Rice/ricemilk – like the vast profitable fast food industry in baby purees and formulae- is ( like the killer Food mega-industry carbs and plantoil-based food pyramid of the past 40 years of Ancel Keyes ea ) a marketing (Gerber’s) legend, but not a necessity or good for babies- it lacks fat and protein; and may be contaminated with eg arsenic!
As the Real Food Revolution book II Raising Superheroes says, promoting natural real food is not about banning carbs or promoting high protein intake – thats impossible and unnecessary on mixed real food- but eating more fresh unprocessed energy, as mostly animal incl fish fat more than natural ie plant carbs, as in breast milk; with rarely if ever processed foods including synthetic transfats and refined carbs like sugars, “white” flours and starches, and the derived alcohols.
17 May 2015 ADAPTING AND ADOPTING BANTING FOR BABIES a la Canadian-WHO recommendations and age-old good practice. canada-guidelines-advise-meat-as-baby-first-food/ Health Canada clarifies stance on meat for babies
Prof Tim Noakes’ team asks for all to sign petitions supporting his argument. We can doubt he needs it since he knows better than most how strong the evidence is.
When us Seniors’ generation was born around WW2, as in ancient times we were from > 6 months age gradually weaned off breast onto and brought up on real fresh food- butter, cream, home-grown veggies, fresh fish and pasture-fed meat /hens (and thus eggs and whole cows’ milk); with a tsp of codliver oil a day as the quintessential brainfood for those of us not brought up on oily ie pelagic sea fish..
Food was produced (like us humans) – especially by us mostly poor – without antibiotics, GMO, pesticides; and packaged, dressed without plastic, let alone massive electromagnetic exposure (microwave, TV, computers, cellphones and then WiFi). Like most on the planet, we had no cars or TV, so we also got plenty of sunshine- vits cholecalciferol D3, and ascorbic acid C (from abundant organic sun-drenched fresh fruit) – and exercise walking/ cycling to transport/ school/ sport or outdoor work as herders, farm/ building labourers etc if not the minority of us in shops/ factories/ office. Basic education and care – literacy-numeracy and hygiene – was provided mostly by state schools competing widely with mission schools, staffed from dedicated teachers’ /nurses/theological training colleges with intensive community experience; and (if mostly from the bible) literate parents from church/ libraries and radio.
But in our >50 years in medicine, all those aeons-old social foundations have increasingly been wiped out , especially in Africa by the ever-more corrupt advertising (especially on TV) and Fast Food- GMO- Disease Industry in partnership with corrupt oligarchy government that closed teachers’ and nurses training colleges; and rural /farm depopulation with mass migration driven by government-led poverty to city ghettoes. .. .
Already by 1970, teaching hospitals- following USA -devised corrupt industry factory-farm-food marketeering (not science and nutritional evidence-based) – started (by the non-medical Ancel Keys) nagging us via our medical school cholesterol clinics to start cutting cholesterol ie meat- dairy- fat intake in exchange for increasing intake of factory mass-produced refined and then genetically modified and insecticide-laden carbohydrates (sugar, maize, soya) and unproven synthetic hydrogenated seed-oils; and cholesterol-busting drugs like clofibrate, the statins, and aspartame – none of which were ever scientifically validated, and have been increasingly incriminated like sugar, fructose and smoking the past 30 years as major health pollutants. .
The scientific evidence has never the past 50 years shown benefits even matching harms from the profit-driven junk marketing of cholesterol-busting drugs and diets – artificial low-animal -fat cholesterol high carbs diets , and synthetic omega6 hydrogenated plant oils like “margarines” and Cremora, and sunflower cooking oils – for any common disease let alone average lipidemias. But the American public was bludgeoned into obeyance/obeisance and then silence, and have suffered increasing obesity and disease ever since – to the joy of the profiteering Fast Food and Disease Industry and their lobbyists in and outside governments. Now the SA Dieticians’ Association attack Noakes (and thus pre-1960s healthy normal world practice, and still Canadian guideline) diet promotion of more animal fat calories than carbs calories for weaning infants;
but the milk comparison the Dieticians quote in their attack- like the figures in the breastmilk Wiki review – shows remarkable conformity between UK mothers’ breast milk and eg Bantu mothers (1950)- milk has about 26% more calories/100gm from animal fat ie +- 38cals than from milk carbs +- 30cals, with protein ~1.1g%.. Obviously, LCHF promoters do not preach no-carbs diets since there is no such real food free of carbs.
The message has always been to take more fat calories than carbs calories, especially not refined empty calories like sugar and commercial fructose-laden drinks and GMO maize. Laymen have difficulty grasping that these refined simple sugars are slow cumulative poisons like longterm smoking, aspartame (Canderel) , oral synthetic sexhormones, fluoride, aluminium, mercury, lead, excess iron, etc. And obviously with poverty and dependency increasing in RSA due to almost worst- in-the -world State schooling since 1994, infant mortality from joblessness and thus stress, violence , malnutrition are increasingly rife in the Born-Frees ie those born in the new South Africa since 1990.
The Diet Association fails to ask simply: where are the references for promoting protein-and fat-rich food for weanlings? They are listed abundantly in the social and medical literature of the past century, especially the current literature we seniors in health science practice have read weekly the past 50 years from the 1960s; and conveniently now analyzed in depth by medical journalist Nina Teicholz and her numerous experts of the past 50 years she interviewed, in chapters 5 and 6 of The Big Fat Surprise 2014 (Scribe Pubs, Australia & UK);
following in the footsteps of contrarian ie high-carbo-sceptic investigative nutritionists like the archetypal insulin-resistant William Banting 1869 (ironically a distant kinsman of Fred Banting the Nobel-winning discoverer of insulin 50 years later) and his physician Dr William Harvey; Vilhjalmur Stefansson from 1923; Arthur Pennington 1949; Robert Atkins since 1963, Gerald Reaven from 1965 (Syndrome X); WPU Jackson & George Campbell in Cape Town from 1968, Denis Burkitt and Tom Cleave in Africa from 1970, James le Fanu since 1984 (the Rise and Fall of Modern Medicine 2001); Gary Taubes since 2001 (Good Calories Bad Calories 2007); Rooseboom ea 2006 (The Dutch Winter Famine of 1944-45); and Sam Feltham Slimology 2014, the 25 RCTs so far from many universities reported between 2000 and 2014 that Feltham et al detail eg ( in his book Slimology) by numerous contrarian academic clinician experts; all these authorities show that for health and reversing obesity in adults, the LCHF diet is uniformly more successful than the HCLF diet.
By contrast, Zoe Harcombe and colleagues at W Scotland University 2015-in Evidence from randomised controlled trials did not support the Keys- McGovern USA introduction of dietary fat guidelines in 1977 and 1983: Harcombe ea’s systematic review and meta-analysis have confirmed what we practitioners have read consistently in the science journals and experienced for the past 50 years, that the USA-led switch from our till post-WW2 healthy natural farmfresh high fat low carbs diet (to the factory-food low fat low cholesterol high carbs diet with cholesterol-busters) was never based on any good scientific studies, merely on wrong beliefs and profiteering; and has aggravated the obesity-diabetes -cancer pandemic.
BABY DIET EVIDENCE? And similar Canadian-and WHO paediatrician -led studies reported below in weanling babies and animals have confirmed that, contrary to the excellent development always seen in nature in weanlings on the natural highfat>carbs animal protein diet that we seniors were brought up on, the still-heavily marketed junk food commercial low-fat low-meat high cereal weanling diets (which the SADA dieticians insist is best) stunts growth and development and promotes the epidemic childhood obesity and diabetes we are seeing. .
Increasing adverse experience with antibiotics, multiple vaccines, factory foods eg formula milk powders, GMO crops, tap water, doctored dairy milk, aspartame, pesticides like DDT and Roundup glyphosphate, crops grown in heavily polluted but nutrient-exhausted soil, and grain/antibiotic/hormone grown foods partly explains why we should avoid as far as possible exposing (future and current) pregnant women and infants to antibiotics, sugar, concentrated fructose, commercial dairy and processed refined cereal products, and aluminium-mercury-tainted vaccines, as far as possible.
In conclusion: it is sad that ADSA the Association for Dietetics in SA, attacks evidence-based Banting proponents personally instead of rebutting in academic scientific robust debate – the scientific media- the best scientific references and policies as thoroughly assessed and promoted by real-world experts below. Clearly, ADSA cannot quote any good science to support its contrary destructive commerce-based policy (of the past ~40 years ) about diet providing the majority of energy as sugars and hydrogenated omega6 – (it and the local medical schools havent done so) instead of low carbs high animal-fat natural food- so now it hides behind the sub judice rule.
Gwyneth Paltrow 2013 has provoked the wrath of the dietetic establishment by saying that she avoids feeding her children bread, rice and pasta, because she believes that these carbohydrate foods aren’t good for them. Paltrow was writing in her new low-carb, gluten-free cookbook, It’s All Good, which is out in April, and whose recipes are said by her publisher to “form the basis of the diet Gwyneth goes back to when she’s been overindulging, when she needs to rebuild, or lose weight.” Dieticians who subscribe uncritically to government nutritional guidelines have been wheeled out to testify to how ‘vital’ carbohydrate is in the diet, and warn in the bleakest terms of the dangers of restricting it. “Paltrow is putting her children, aged eight and six, “at risk of nutrient deficiencies”, warns one. Her children “won’t be able to think straight as their brain won’t be functioning”, says another. In the same Daily Mail piece, it is even observed that Paltrow’s children are thin – shock horror! – as if this was automatically cause for concern. So accustomed are we to the sight of overweight children, thin ones are beginning to look unusual …… read on
Dr Sheila Innis’ recent review Impact of maternal diet on human milk composition and neurological development of infants Am J Clin Nutr. 2014;99:734S-41S. http://www.ncbi.nlm.nih.gov/pubmed/24500153 from Univ British Columbia, Vancouver, Canada concludes unequivocally what vast evidence shows: that animal fat especially Omega3 marine DHA & EPA are crucial for neurodevelopment and all membranes – such natural saturated animal fats make up some 20% of adult brain. Maternal nutrition has little or no effect on many nutrients in human milk; for others, human milk may not be designed as a primary nutritional source for the infant; and for a few, maternal nutrition can lead to substantial variations in human milk quality. Human milk fatty acids are among the nutrients that show extreme sensitivity to maternal nutrition and are implicated in neurological development. Extensive development occurs in the infant brain, with growth from ∼ 350 g at birth to 925 g at 1 y, with this growth including extensive dendritic and axonal arborization. Transfer of n-6 (omega-6) and n-3 (omega-3) fatty acids from the maternal diet into human milk occurs with little interconversion of 18:2n-6 to 20:4n-6 or 18:3n-3 to docosahexaenoic acid (DHA) and little evidence of mammary gland regulation to maintain individual fatty acids constant with varying maternal fatty acid nutrition. DHA has gained attention because of its high concentrations and roles in the brain and retina. Studies addressing DHA intakes by lactating women or human milk amounts of DHA at levels above those typical in the United States and Canada on infant outcomes are inconsistent. However, separating effects of the fatty acid supply in gestation or in the weaning diet from effects on neurodevelopment solely due to human milk fatty acids is complex, particularly when neurodevelopment is assessed after the period of exclusive human milk feeding
. The Canada guidelines The Canadian statement 2013 reads unequivocally: POSITION STATEMENT Weaning from the breast: Barbara Grueger; Canadian Paediatric Society , Community Paediatrics Committee Paed Child Health 2013: updates the similar previous Canadian Paediatric Society position statement 2004. ” – “North American parents have traditionally introduced rice cereal as a first food. There seems to be a movement away from this practice in the general mama community, especially white rice cereal. Baby-led weaning is a method of foods introduction wherein the baby is offered whole foods. The baby has complete control with this method. For example, you steam a whole artichoke, place it on baby’s tray and allow him to decide what to do with it. Infant cereal, pureed meats and fish are recommended as first foods by the American Academy of Pediatric AAP, Canadian Paediatric Society (CPS), Dieticians of Canada, Breastfeeding Committee for Canada, Public Health Agency of Canada, and Health Canada. CPS also identifies poultry, cooked egg yolk and well-cooked legumes (beans, lentils, chick peas) to be good sources of iron and suitable for first foods”.) Exclusive breastfeeding provides optimal nutrition for infants until they are six months old. After six months, infants require complementary foods to meet their nutritional needs. This is when weaning begins. Weaning is the gradual process of introducing complementary foods to an infant’s diet while continuing to breastfeed. The timing and process of weaning need to be individualized by mother and child. Weaning might be abrupt or gradual, take weeks or several months, be child-led or mother-led. Physicians need to guide and support mothers through the weaning process. “Breast milk is the optimal source of nutrition in infancy. Breastfeeding protects infants from a wide array of infectious and noninfectious diseases. With few exceptions, healthy term infants require only breast milk (with vitamin D supplementation)  to meet all their nutritional requirements until they are about six months old. The Canadian Paediatric Society, Dietitians of Canada, Health Canada and the WHO recommend exclusive breastfeeding for the first six months of life and continued breastfeeding with complementary foods for up to two years and beyond (no upper limit has been defined). Iron from meat has the best bioavailability and can be readily absorbed from the gastrointestinal tract. After six months of age, when breastmilk alone cannot provide enough, additional protein sources (such as meat, fish, egg yolk, tofu, lentils and cheese) are needed. Roughage should also be introduced to the diet, although it is not clear when adding fibre becomes necessary. There is no conclusive evidence that delaying the introduction of eggs, fish and nuts (including peanuts) beyond four to six months of age helps to avoid food allergies. As a greater variety of solids and liquids are introduced to a baby’s diet, weaning will progress. “A review of the literature using MEDLINE (1966 to 2012), the Cochrane database and relevant websites, WHO, the Canadian Paediatric Society, Health Canada and the American Academy of Pediatrics, concluded: Given the limited nature of evidence on weaning, the recommendations in this statement are based largely on expert opinion and consensus. “Generally, infants were breastfed longer in ancient times than in Western societies today. Mothers in Zulu societies have traditionally breastfed their infants until 12 to 18 months, at which point a new pregnancy would be anticipated. Ancient Hebrews completed weaning at about three years. Around the world it is not uncommon for children to be completely weaned at two to four years of age. Anthropological studies have described final weaning at the following points: when the infant reaches four times his birth weight; when the infant’s age is six times the length of gestation (ie, 4.5 years); or when the first molar erupts. “The early introduction of mixed feedings began in early 19th-century Western society. Prominent contemporary physicians such as American Pediatric Society founders Drs. Luther Emmett Holt and Job Lewis Smith recommended that weaning begin at around nine to 12 months of age or when the canine teeth appeared. Smith recommended against weaning during the summer months because of the risk of “weanling diarrhea”. As weaning was recommended earlier and earlier, infant mortality increased. Introduction of weaning foods was an important cause of infant mortality in the 19th century. In the early 20th century, mothers were encouraged by the medical community to raise their children scientifically or “by the book”. In the 1920s, the United States government published Infant Care, referred to at the time as the “good book” and read by women from all socioeconomic groups. It recommended cod liver oil, orange juice and artificial feeding. “In 2008, according to the Public Health Agency of Canada, 87% of children were breastfed for some period of time while only 16.4% were exclusively breastfed for six months. Still, this figure represents a steady increase in breastfeeding rates over the previous five years. Breastfeeding duration varies depending on maternal age. Only 11% of infants of mothers aged 25 to 29 years continue to breastfeed exclusively for six months, compared with 20% of infants of mothers 35 years or older. The most common reason mothers give for weaning is a perceived insufficiency in milk supply. Women who breastfeed for longer than three months most often cite return to work as their reason for weaning. Canadian breastfeeding practices may continue to improve because many mothers receiving employment insurance can delay their return to work for 12 months postpartum. Nutritional and developmental issues : At around four to six months of age, most infants are developmentally ready to handle puréed foods. They are developing the oral motor coordination necessary to accept different food textures. However, they are at risk for choking on chunky food pieces such as nuts, whole grapes and hot dog wheels that require advanced oral motor coordination not achieved before three years of age. “Sucking and chewing are complex behaviours with reflex and learned components. The learned component is conditioned by oral stimulation. If a stimulus is not applied while neural development is occurring, an infant may become a poor eater. There is a relationship between prolonged sucking without solids and poor eating. While it is ideal for infants to be exclusively breastfed for six months, it is also true that after a certain age, human milk alone cannot supply all of an infant’s nutritional requirements. Individual circumstances may make it appropriate for some infants to start complementary feedings as early as four months of age. “Age-appropriate intake of calories and micronutrients is important for growth, motor and mental development. Delaying the introduction of nutritional solid foods much beyond six months of age puts an infant at risk for iron deficiency anemia and other micronutrient deficiencies. Picciano et al followed older weaning infants (12 to 18 months of age) by collecting data on dietary intake and growth. Many of the study children were ingesting less than the recommended levels of fat (less than 30% of total calories), iron and zinc. Grains, whole milk, dairy products and meats were identified as important sources of iron, vitamin E and zinc. By four to six months of age, iron stores from birth are diminishing, necessitating the introduction of iron-containing foods at six months of age for all infants. Iron supplementation after the first weeks of life or at four months of age for the exclusively breastfed infant has been recommended by some groups. When there is a delay in introduction of iron fortified foods, oral iron supplementation needs to be considered. The process of weaning While the best method for transitioning from fully breastfeeding to complete nutritional independence is not known, the process should meet the needs of both baby and mother. Physicians may refer mothers to the La Leche League’s website and the Canadian Paediatric Society’s Caring for Kids website (see Resources for parents, below). Weaning can be either natural (infant-led) or planned (mother-led). Gradual weaning (infant-led weaning) occurs as the infant begins to accept increasing amounts and types of complementary food while still breastfeeding on demand. With gradual weaning, the complete wean usually occurs between two and four years of age. In Western cultures, there remains a relative intolerance to this type of weaning and many mothers who breastfeed their older baby or child become “closet nursers”. Closet nursing takes place privately, at home. This relative secrecy tends to compound erroneous beliefs about appropriate breastfeeding duration.
2012: .http://www.cbc.ca/news/health/steak-and-tofu-recommended-for-babies-1.1199034 and
http://www.thestar.com/news/canada/2012/09/24/hold_the_pablum_’give_that_baby_some_meat’_new_canadian_guidelines_advise.html : Megan Ogilvie Health Reporter, 2012 Forget squash and sweet potatoes; steak is now recommended for baby’s first solid food. In a major departure, new Canadian guidelines say parents should be offering their six-month-old infants meat, fish, poultry or meat alternatives two or three times a day.. these iron-rich foods should be the first that babies consume when being introduced to solids. The recommendations, part of a joint statement quietly released last week by Health Canada, are sure to give some parents pause. Previously, it was recommended that babies start out eating infant cereals, followed by fruits and vegetables, as they transition to solid foods.
Healthy Pregnancy, Baby & Child by Sarah TheHealthyHomeEconomist One of most misguided and damaging pieces of advice coming from the vast majority of pediatricians, dieticians, and other “experts” is to give rice cereal as a baby first food around the age of 4-6 months. This advice is extremely harmful to the long term health of the child, contributing greatly to the epidemic of fat toddlers and the exploding problem of childhood obesity. Rice cereal is never a healthy baby first food. Not only is it an extremely high glycemic food when eaten alone (spikes the blood sugar) but it also contains ample amounts of double sugar (disaccharide) molecules, which are extremely hard for such an immature digestive system to digest. The small intestine of a baby mostly produces only one carbohydrate enzyme, lactase, for digestion of the lactose in milk. It produces little to no amylase, the enzyme needed for grain digestion until around age one.Now, at least one governmental body is waking up to the harmful notion of cereal grains as the “ideal” baby first food. Health Canada in collaboration with the Canadian Pediatric Society, Dietitians of Canada and Breastfeeding Committee for Canada has issued new guidelines for transitioning a baby to solid food and two of the first weaning foods recommended. Meat and eggs! While these guidelines are certain to rile vegetarian and vegan groups, the fact is that meat and eggs are indeed perfect weaning foods for a baby. Not only are these animal foods extremely easy to digest compared with cereal grains, but they also supply iron right at the time when a baby’s iron stores from birth start to run low. The inclusion of meat in these baby first food guidelines is in line with the wisdom of Ancestral Cultures which frequently utilized animal foods for weaning. A traditional first food in African cultures is actually raw liver which the mother would pre-chew in small amounts and then feed to her child. The guidelines specifically note the role that ancient wisdom played in the decision to no longer recommend cereal grains and instead suggest meat: “While meat and fish are traditional first foods for some Aboriginal groups, the common practice in North America has been to introduce infant cereal, vegetables, and fruit as first complementary foods.” Soft boiled egg yolks are also an ideal choice as a baby first food as they supply ample iron as well as choline and arachidonic acid which are both critical for optimal development of the baby’s brain which grows as its most rapid rate the first year of life. Unfortunately, while the suggestion of meat and eggs is a good one, the joint statement from Health Canada also inexplicably includes tofu and legumes which are both a terrible choice as a baby first food. The starch in legumes would cause the same digestive problems as rice cereal and the endocrine disrupting isoflavones in tofu would be a disaster for baby’s delicate and developing hormonal system. But, let’s give credit where credit is due. At least meat and eggs are appropriately included on the baby first food list. Good on you Health Canada! Perhaps your neighbor country to the South will wake up and get a clue about how to properly feed babies based on your lead. I’m not holding my breath. Sarah, The Healthy Home Economist
Int J Obes (Lond). 2005;29 Suppl 2:S8-13. How much protein is safe? Agostoni C1, Riva E. ea University of Milan, Italy Since breastfeeding and human milk seem to prevent, while high dietary proteins in the first 2 yr of life seem to promote later overweight, questions have been raised on the safe levels of proteins in the early years. How much protein (as a percentage of total calorie intake) is safe RESULTS: We should move from the figure of 7-8% in the 4-month exclusively breastfed infants up to the maximum acceptable levels of 14% in 12-24-month-old infants. When protein supply represents less than 6% and energy is limited, fully breastfed infants are likely to enter a status of negative nutrient balance. Over the limit of 14% energy from proteins in the 6-24 months period, some mechanisms may begin to operate, leading young children towards an early adiposity rebound and overweight development, beyond any genetic predisposition. Preliminary data seem to indicate a causal role for whole cow’s milk proteins. CONCLUSION: We suggest maintaining breastfeeding as long as possible, and, in case human milk is insufficient, to introduce infant formulas, appropriate for age, up to 18-24 months, in order to keep protein intakes in the safe range of 8-12% within a diet adequate in energy and balanced as far as macronutrients.
Health Canada clarifies stance on meat for babies By Global News with files from Jennifer Tryon Health September 25, 2012 Health Canada is clearing the air about what kind of solid foods babies should be introduced to. The clarification comes after some media outlets reported Tuesday that the agency changed its list of recommended first foods for Canadian babies to include meat and meat alternatives – like eggs, tofu and legumes – to help meet nutritional needs. For the record, Health Canada has not recently modified these guidelines. Since 2004, the agency has recommended iron-rich foods, such as meat and iron-fortified cereal, as a baby’s first solid foods, because iron is crucial to brain development. Most baby cereals now contain iron. There is no scientific evidence suggesting meat is harder on a baby’s digestive system, but parents are reminded to puree the meat with water or breast milk, so it’s easier for the child to swallow. Registered dietitian Cora Rosenbloom also tells Global National‘s Jennifer Tryon that there’s no reason to withhold eggs. “There’s really no evidence to say that food allergies are going to be more common if eggs are introduced earlier.” Link to Health Canada’s current recommendations. Follow Jennifer on Twitter: @JenTryon