Fay Paxton (PhD) is an Australian-based naturopath and nutritionist. She has taught nutrition at the Southern School of Natural Therapies and has worked as a consultant for dietary and herbal supplement manufacturers. She is an author of a popular text book, Foundations of Naturopathic Nutrition. 1
Advocate for low-carbohydrate diets
Unfortunately, the book advocates high-fat, low-carbohydrate paleo diets and cites Lorain Cordain’s The Paleo Diet, the CSIRO high-fat, low-carbohydrate diet studies. 2 and Maastricht University’s high-fat, high-protein diet study.
On page 39-40, Paxton states:
The Maastricht University High-protein Diet Study
The Maastricht University study compared the effects of a low-fat, high-carbohydrate diet and two versions of a low-fat, high-protein diet on weight loss and maintenance following a very low-calorie restricted diet. Metabolic and cardiovascular risk factors in “healthy” obese subjects were examined. 9
There is no such person as a “healthy” obese subject. There is no mention of medication taken. The chances are high that the subjects are taking some medications. The average BMI is over 32 with a small standard deviation – the majority of the subjects are obese. They are obese at the start of the trial and obese at the end.
Subjects were excluded from the study if:
- fasting glucose was > 6 mmol/L or
- triglycerides > 2.3 mmol/L or
- total cholesterol levels of > 6.5 mmol/L were increased or
- diastolic blood pressure exceeded 100 mm Hg or
- the subjects were unable to lose at least 5% of their initial body weight during the weight loss period.
So, the study actually excludes the people who should be able to be assisted because their baseline results are too high and excludes those who do not lose “sufficient weight”. The study then has the audacity to conclude that it is a great diet for assisting those with weight loss. How many people were excluded who did not lose sufficient weight?
Forty-eight subjects completed the study that consisted of an energy restriction period of 5–6 weeks followed by a weight maintenance period of 12 weeks. During weight maintenance, the high carbohydrate group supplemented with maltodextrin (a carbohydrate) or protein in the form of casein or whey and consumed a “low-fat diet”.
Note that these components are received as supplements and not as part of a balanced diet.
kcal / day
from baseline %
|High Protein - casein||34.5||42.2||24.0||1828||10%|
|High protein - whey||35.2||42.1||24.3||1812||20%|
The high-carbohydrate (63% by energy), low-fat (21% by energy) diet is not a low-fat diet or a high-carbohydrate diet.
The high-protein diets (35% by energy) far exceeds the Recommended Dietary Intake (RDI) of approximately 8%-10% when calculated using the WHO recommendation of 0.84 g/kg body weight. Note that the RDI meets or exceeds the requirements of 98% or the population. The actual requirements are less.
As Russel Henry Chittenden noted over 100 years ago, consuming excess protein produces toxic wastes which is detrimental to health. 10
Ketogenic, calorie-restricted diet studies confound the results as they are studying two separate interventions: ketogenic intervention and calorie-restricted intervention. A plant-based, calorie restricted diet shows all the benefits of restricted food intake without the damaging effects of ketogenesis. 11 12
A widely cited paper, funded by “an unrestricted grant from the Atkins Center for Complementary Medicine”, a supporter of low-carbohydrate, ketogenic diet studies, showed side effects of headaches, constipation, diarrhea, and insomnia for those on a ketogenic diet. Also, the completion rate was not high at only 55%. Let’s face it, who wishes to life a live on a starvation diet with the above side-effects. The extensive range of supplements, required to mitigate the side-effects of the diets, were provided by Atkins Nutritionals, Inc., New York.
I have written about the shortcomings of the CSIRO high-fat diet studies at:
The Paleo Diet
On pages 54-55, Paxton extols the virtues of Lorain Cordain’s Paleo Diet. Paxton’s claims that Neanderthals and early humans were largely carnivorous, subsisting mainly on animal flesh and fish, is conjecture.
There is no evidence that our predecessors were largely carnivorous. Orangutans, gorillas, bonobos and chimpanzees mainly consume plants. Chimpanzees consume the most animal-sourced foods – mostly coming from termites.
According to Richard Wrangham 17, it was the discovery of fire and cooking that transformed humans and our society – not the eating of meat which commenced some 500,000 years previously.
|0.2||Homo sapiens||Modern humans|
|1.8||Homo erectus||Use of fire and cooking, change to society with man-woman pairs and sharing of food with partner.
Similar appearance to humans, with large change to anatomy. Smaller digestive system, mouth and jaw, loss of hair.
Food more energy dense, softer and easier to digest, less astringent and sweeter. Much less chewing time. Cooking destroys bacteria.
|2.3||Homo hablis||Tool makers and meat eaters|
|3-6||Australopithecus sp||Ape-like Australopithecus.
Lucy was an A. afarensis that lived in Ethopia 3.2 mya.
Dr Katharine Milton is a professor of physical anthropology at the University of California in Berkeley. She received her Ph.D. in anthropology from New York University in 1977. Her field of expertise is the dietary ecology of primates, including human ancestors and modern humans.
According to Professor Milton:
Comparative and experimental data shows that modern humans, common chimpanzees, gorillas, and orangutans show close similarity to most features of gut anatomy as well as patterns of digestive kinetics. 19
Professor Milton’s conclusion is:
Saturated Fat Link to Heart Disease Sceptic
On pages 97-98, Paxton notes,
Professor Stewart Truswell, Emeritus Professor of Nutrition from University of Sydney wrote an extensive critique of both of these papers. 24
He also stated that:
Professor Walter Willett an epidemiologist Harvard School of Public Health stated:
Note that Siri-Tarino and Krauss received funding from the [US] National Dairy Council.
A similar study by Jakobsen in 2009 reported that reducing saturated fat in the diet and replacing it with polyunsaturated fatty acids (PUFAs) was associated with a significantly reduced risk of CHD. 25
The studies that get the attention in the popular press are those that dismiss the links between saturated fats and heart disease. Any papers that confirm it are ignored.
Paxton ignores the evidence obtained from Seventh-day Adventists studies and the National Geographic Blue Zone studies that have consistently shown that an increase in the consumption of plant-based foods results in an increase in health and longevity. The Japanese and the Okinawans are often described as the longest-lived populations but do not live as long as Californian Adventists. Within the Seventh-day Adventist community, as the diet becomes more plant-based, the health indicators improve. 26
- Paxton, F. (2015) Foundations of Naturopathic Nutrition. Sydney: Allen & Unwin.
- Noakes, M. et al. (2005) Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. The American Journal of Clinical Nutrition. 81 (6), 1298–1306.
- Brinkworth, G. D. et al. (2009) Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. American Journal of Clinical Nutrition. 90 (1), 23–32.
- Tay, J. et al. (2014) A Very Low-Carbohydrate, Low–Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial. Diabetes Care. 37 (11), 2909–2918.
- Tay, J. et al. (2015) Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. American Journal of Clinical Nutrition. 102 (4), 780–790.
- Wycherley, T. P. et al. (2012) Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition. 96 (6), 1281–1298.
- Brinkworth, G. & Taylor, P. (2017) CSIRO Low Carb Diet. Pan Macmillan Australia.
- Noakes, M. & Clifton, P. (2005) The CSIRO Total Wellbeing Diet. Pan Macmillan Australia.
- Claessens, M. et al. (2009) The effect of a low-fat, high-protein or high-carbohydrate ad libitum diet on weight loss maintenance and metabolic risk factors. International Journal of Obesity. 33 (3), 1–9.
- Chittenden, R. H. (1904) Physiological economy in nutrition, with special reference to the minimal protein requirement of the healthy man. An experimental study. New York: Frederick A. Stokes Company.
- Eagles, D. A. et al. (2003) Calorie restriction of a high-carbohydrate diet elevates the threshold of PTZ-induced seizures to values equal to those seen with a ketogenic diet. Epilepsy research. 54 (1), 41–52.
- Mishra, S. et al. (2013) A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. European Journal of Clinical Nutrition. 67 (7), 718–724.
- Barnard, N. D. et al. (2009) Vegetarian and vegan diets in type 2 diabetes management. Nutrition Reviews. 67 (5), 255–263.
- Barnard, N. D. et al. (2009) A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes : a randomized , controlled , 74-wk clinical trial. American Journal of Clinical Nutrition. 89 (5), 1588S-1596S.
- Kahleova, H. et al. (2017) Cardio-Metabolic Benefits of Plant-Based Diets. Nutrients. 9 (8), 848.
- Jenkins, D. J. A. et al. (2003) Type 2 diabetes and the vegetarian diet. American Journal of Clinical Nutrition. 78610–616.
- Wrangham, R. (2008) Catching Fire: How Cooking Made Us Human. Basic Books.
- Milton, K. (2002) ‘Hunter-Gatherer Diets: Wild Foods Signal Relief from Diseases of Affluence’, in Peter S. Ungar & Mark F. Teaford (eds.) Human Diet – Its Origin and Evolution. p113
- Milton, K. (2002) ‘Hunter-Gatherer Diets: Wild Foods Signal Relief from Diseases of Affluence’, in Peter S. Ungar & Mark F. Teaford (eds.) Human Diet – Its Origin and Evolution. p114
- Milton, K. (2000) Hunter-gatherer diets – a different perspective.
- Siri-Tarino, P. W et al. (2010) Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. American Journal of Clinical Nutrition. 91 (3), 535–546.
- Siri-Tarino, Patty W. et al. (2010) Saturated fat, carbohydrate , and cardiovascular disease. American Journal of Clinical Nutrition. 91 (5), 502–509
- Chowdhury, R. et al. (2014) Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk A Systematic Review and Meta-analysis. Annals of Internal Medicine. 160 (6), 398–406.
- Truswell, A. S. (2015) Sceptics undermine effective dietary and heart health advice. The Medical Journal of Australia. 202 (8), 412–414.
- Jakobsen, M. U. et al. (2009) Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. American Journal of Clinical Nutrition. 89 (5), 1425–1432
- Fraser, G. E. & Shavlik, D. J. (2001) Ten Years of Life – Is It a Matter of Choice? Archives of Internal Medicine. 161 (13), 1645–1652.