Can You Prevent Childhood Obesity with a Lot of Carbohydrates?

Action plan2

Childhood obesity should be prevented as early as infancy, according to a health initiative in Jönköping, Sweden. Unfortunately, the advice seems old-fashioned.

A reader examined this, and told me that in Jönköping they use Stockholm County Council’s Action plan for overweight and obesity. This was hailed as being extremely ambitious when it came out in 2003, and the objective was to halve the proportion of obese citizens within a decade.

Unfortunately, reality came in the way and the plan didn’t exactly succeed – instead of being cut in half, the obesity rate increased greatly!

When you take a look at the latest version of the document it’s not hard to guess why. The dietary advice given is the same old advice that has been shown to be the worst in tests in scientific studies (for children too) and the worst in tests in the recent SBU (Swedish Council for Health Technology Assessment) report: Less fat, more carbohydrates.

For example, they suggest that childhood obesity should be prevented by serving “a large proportion of bread, potatoes, pasta and rice”. This sounds like a recipe for a grand failure. Which is exactly what happened.

Now it’s time to swallow pride, learn something from all the failures, and start following accepted science and proven experience. Adults seeking help deserve this, and our children deserve this. Moreover, licensed health care professionals are required to do so.

All about food for kids


  1. FrankG
    "Insanity: doing the same thing over and over again and expecting different results." ~ Albert Einstein
  2. JT
    How about making baby formula by prescription only - to be used as an absolute last resort - mothers should have to either breastfeed or express. Not a popular statement to make, but hey, I've said it :)
  3. Ondrej
    On the other hand the pasta loving Italians - who have the lowest BMI in Europe - eat a carbohydrate predominant diet.

    Even the doctor agrees:

    "May 17 2011 14:28

    Great blog!!!
    I love everything, and I've myself assured that LCHF works...
    But though, I have one dilemma : How come Italians are not fat and they are eating pasta and pizza all the time and ice cream of course :)
    I really miss pasta :(
    May 17 2011 14:46
    Well some pasta loving Italians are not so skinny you know... ;)

    I think many Italians eat pretty well though, they love their food and it's often real home cooked food. Antipasti is usually fairly low carb and so is often their secundo piatti (meat, fish).

    When I was there two years ago they had loads of different kinds of butter in the stores and there weren't many low fat products to be found. I would guess their ice cream/gelato have quite some fat in it too, they are probably far too proud of it to change it into fake low fat ice cream. :)"

    Replies: #6, #12
  4. Paul the rat
    Here is to healthy Italians !!! (no offense intended just for illustration purposes, one of many studies. Let those who can reason draw conclusions)

    Int J Clin Pract. 2007 Jan;61(1):32-8.

    Features of metabolic syndrome in non-diabetic Italians and Brazilians: a discriminant analysis.
    Leite ML, Nicolosi A, Firmo JO, Lima-Costa MF.

    Department of Epidemiology and Medical Informatics, Institute of Biomedical Technologies, National Research Council, Milan, Italy.

    This aim of this study was to compare the characteristics of metabolic syndrome (MetS) in a Brazilian and an Italian population. The subjects were non-diabetic men and women aged 40-74 years from population-based surveys: 1242 from Brazil and 1198 from Italy. Logistic regression models were used to compare adjusted prevalence rates and make a discrimination analysis to distinguish the subjects with a diagnosis of MetS in the two groups. Dyslipidemia [low high-density lipoprotein (HDL)-cholesterol] and impaired fasting glucose were more prevalent among the Brazilians, and increased blood pressure and abdominal obesity (in men) among the Italians. Generally, the Italians showed higher prevalence of overall obesity and high pulse-pressure, and the Brazilians had higher prevalence of metabolic markers of insulin resistance. Among the subjects with the syndrome, HDL-cholesterol was the most discriminant factor, followed by plasma uric acid levels (which were higher in the Brazilians). The Italian men had a larger waist circumference and the Italian women higher body mass index values than the Brazilians. Italians had higher systolic and lower diastolic pressure values. The patterns of the metabolic alterations seemed to be more linked to insulin resistance among Brazilian subjects, whereas obesity seemed to play a more important role among the Italians. Although they are not sufficient to support the hypothesis of differences in the underlying pathophysiological processes between these groups, our results illustrate the difficulty of using a single unifying definition of MetS, and suggest that different benefits may be obtained from treatments targeting obesity, blood pressure or insulin resistance.

  5. Paul the rat
    Ann Ig. 2008 Jul-Aug;20(4):315-27.
    Overweight and obesity in Italian children aged 6-11 years

    [Article in Italian]
    Cairella G, Casagni L, Lamberti A, Censi L.

    Area della Nutrizione, Dipartimento di Prevenzione, ASL RMB.

    The objective of this study is to obtain reliable data from recent surveys carried out in Italy on the prevalence of overweight (OW) and obesity (OB) in children. We searched in MEDLINE/PubMed, Google and Google Scholar and we included the surveys that fulfilled the following criteria: English or Italian language, time period January 2000-April 2008, target of 6-11 years; BMI evaluated according to IOFT cut-offpoints. Search terms included overweight, obesity, children, Italy, associated with AND/OR. 41 studies have been selected; the percentage of OW varied between 14.7% and 31.3% and OB between 4.3% and 27.3%. In girls, OW values ranged from 11.5% to 34.7% and in boys from 12.6% to 30.1%; in girls, the percentage of OB varied between 4.7% and 29.2%, in boys between 4.4% and 25.8%. There were some variations in the prevalence of OW and OB among diferent regions. The highest values were in Central and Southern Italy, except for Sardinia, where the values were similar to that of Northern Italy. Beyond BMI, the most frequently collected variables were dietary pattern, physical activity, and lifestyle. School is the main site of investigation; third grades (8-9 years) is the most studied age group. The urgency to develop actions to contrast obesity in childhood is confirmed by the prevalence values observed in the Italian regions.

  6. Paul the rat
    "On the other hand the pasta loving Italians - who have the lowest BMI in Europe - eat a carbohydrate predominant diet."

    I bet they do, I bet they do. Brilliant observation young man, send me your CV, I am tempted to give you a job, a position just opened up.

    Let me re-quote conclusions of the above study:

    "...The urgency to develop actions to contrast obesity in childhood is confirmed by the prevalence values observed in the Italian regions."

  7. SEL
    Italians in Italy eat very undercooked pasta (almost crunchy) and in small serves with usually high fat sauces, they also consume alot of olive oil, cheese and meat. The modern youth are getting increasingly fatter as they are eating more junk food. In Australia our Italian neighbours are very traditional in the way they eat and they are lean and do not consume junk food and only pasta occasionally. They mostly eat meat, veg, cheeses, olive oil, fresh herbs and make their own wine. The healthiest looking old couple I have ever seen. Their kids and grandkids are fat, including their doctor daughter and her children who only eat fat reduced everything which is what the 'health authorities' push here in Australia.
  8. Galina L.
    There are children who don't get fat eating bread and sugar, they just bounce of walls and refuse normal food instead. May be they should be given liberal amount of sugar and bread because, according to conventional logic, it looks like it makes them more physically active? My son was that way while growing up. I didn't know about paleo or LCarbing back then, but I had to remove all sugary treats and things like crackers and chips from a household and to hide a sugar bowl on the top shelf because I was afraid my son wouldn't grow properly eating what he wanted. He is almost 21 right now, and doesn't care about sweets at all.
  9. daniel Ferreira
    Doc, when will you be discussing Keto with these "doctors"? on a serious note, its always an uphill battle, look at how they say

    i am paraphrasing, what they said "starvation mode" and how you should eat 100g a day of carbs so you dont go into starvation mode, only one problem with that theory, how can you go into starvation mode if you are actually eating? makes no sense. vid below

  10. Eric Anderson
    A modest proposal

    Why not has a registry of LCHF dieters? Keep data records on weight, height, age, and etcetera. Track cause of death.

    A 5 year study (Yes like the original Starship Enterprise) of enough 85 plus, 75 plus, and 65 plus could document the results of HFLC diets on health.

    Would we observe a 50 percent decline in heart disease? Cancer, stroke, Alzheimer’s, and over all death rates (Age Adjusted)?

    Surely we can find 100 smokers and 200 non smokers over 85 on hclf with good lab work. Periodic blood work would indicate relative compliance with fasting blood sugar and insulin levels along with Hemoglobin A1c.

    Would the Norwegian’s ever vote the Nobel in Medicine to a Swede? Time will tell.

  11. Eric Anderson
    On the subject of breast milk! High insulin levels have been demonstrated to reduce or stop the ability to breast feed. So why not a study of HFLC breast feeding? Maybe all gestational diabetics should consider Metformin both during and after pregnancy to compare ability to breast feed? Maybe a better option than formula! Eric
  12. FrankG
    So let's play stereotypes and lump all Italians into the same pasta-munching group?

    But surely they eat a "Mediterranean Diet*" -- at least those who live on the Med.? Except then there are many who live up near the Alps... Oh dear!!!

    * Last time I counted there are dozens of countries with Mediterranean coastlines so what is this homogenous "Mediterranean Diet" anyway?!?

    Even the doctor agrees:

    "... many Italians eat pretty well though, they love their food and it's often real home cooked food. Antipasti is usually fairly low carb and so is often their secundo piatti (meat, fish).

    When I was there two years ago they had loads of different kinds of butter in the stores and there weren't many low fat products to be found. I would guess their ice cream/gelato have quite some fat in it too..."

    In any case it seems that the "lowest BMI in Europe" is a relative term -- if that really bad boy-band brings out a compilation of their "greatest hits", do you think that guarantees great music? :-P

  13. Paul the rat
    This is nice review.

    Adv Nutr. 2013 May 1;4(3):294-302. doi: 10.3945/an.113.003657.
    Dietary fats and health: dietary recommendations in the context of scientific evidence.
    Lawrence GD.

    Department of Chemistry and Biochemistry, Long Island University, Brooklyn, NY, USA.

    Although early studies showed that saturated fat diets with very low levels of PUFAs increase serum cholesterol, whereas other studies showed high serum cholesterol increased the risk of coronary artery disease (CAD), the evidence of dietary saturated fats increasing CAD or causing premature death was weak. Over the years, data revealed that dietary saturated fatty acids (SFAs) are not associated with CAD and other adverse health effects or at worst are weakly associated in some analyses when other contributing factors may be overlooked. Several recent analyses indicate that SFAs, particularly in dairy products and coconut oil, can improve health. The evidence of ω6 polyunsaturated fatty acids (PUFAs) promoting inflammation and augmenting many diseases continues to grow, whereas ω3 PUFAs seem to counter these adverse effects. The replacement of saturated fats in the diet with carbohydrates, especially sugars, has resulted in increased obesity and its associated health complications. Well-established mechanisms have been proposed for the adverse health effects of some alternative or replacement nutrients, such as simple carbohydrates and PUFAs. The focus on dietary manipulation of serum cholesterol may be moot in view of numerous other factors that increase the risk of heart disease. The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs, which are discussed here. This review calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs, for which mechanisms for adverse health effects are lacking.

  14. GiGi
    Many of the research papers regarding celiac disease and gluten sensitivity are coming out of Italy right now. There has been a huge increase in both there. Some communities in Italy are screening their children before entrance into kindergarten for genetic gluten sensitivity. Bravo to the Italians! They are trying to do what it takes to ensure the health of their citizens. Pasta, and other wheat products, may be on the decline there as more people tune into to this very real problem.

    By the way, I enjoy your blog Andreas! My maiden name was Bengtsson. It must be the Swede in me! ;)

  15. PatrickP
    I Iived in Rome for six months and observed that although Italians regularly eat pizza and pasta they eat them in small portions and the pizza is very thin.
  16. Wade Henderson
    Whether its Italians this time or Asians other times, if you show a group who eats a good portion of their calories in carbs and remains slender and healthy, you are then given all manner of explanation about how that can be.

    Its like there are people who either never travel the world or do so with blinders, so they can keep cramming their theory into a narrow little slot that aligns with their set beliefs.

    Lots of people in lots of the world eat a traditional diet with loads of carbs and yet remain slender and healthy.

    There are the standard carbs that people ate for centuries and their are the modern incarnations.
    Too often people with a theory to protect mix the two together.... or say that in our modern western societies they can't be separated.

    The truth is you can still eat the older diets in new modern countries. All the old ingredients are there, just not in colorful boxes on "eye level" shelves.

    PS, and the older style carbs aren't carbonated.

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