New Zealand becomes first country to specifically warn against low carb, paleo and intermittent fasting

MoH topical q and A

Yes true, New Zealand released its new nutrition guidelines late last year.

No real surprises in them.  Little improvement over the old ones really, as well as a few interesting things like the “four food groups“. In case you are wondering, these are vegetables and fruit, grains (at least 6 servings a day), low fat dairy, and (some) lean sources of protein like nuts, fish, legumes etc.

They do now have an emphasis on whole, unprocessed foods, and do have a statement about limiting alcohol, which are both commendable.  They also say that fat is important. But in every part of the detail it’s all about low fat and high carb. They also have a section on “Making Healthier Food Choices”  which starts well by talking about unprocessed foods, but deteriorates into food labels and the Health Star rating system – which basically endorses processed foods.

Here’s a list of how to make healthier choices. It gives you an idea of where this is all going.

Instead of this Use this
Butter Margarine or other plant-based unsaturated spreads
Lard and/or dripping Water (for roasting meat), small amount of plant-based unsaturated oils (see below)
Coconut oil Small amount of plant-based unsaturated oils, eg, canola, olive, sunflower or rice bran oils
Full-fat milk Low- and reduced-fat milk
High-fat cheese, eg, mild, Colby Reduced-fat cheese, eg, edam
Coconut cream ‘Lite’ coconut cream or milk, or use half water and half coconut cream
White bread Higher fibre, dense whole grain bread
High-fat takeaways Healthier option takeaways, eg, kebabs or wraps with plenty of salad, non-fried Asian rice or noodle dishes with plenty of vegetables
Sugar-coated breakfast cereal Whole grain cereal, eg, porridge or whole wheat breakfast biscuits
Muesli bars Fresh fruit or a small handful of unsalted nuts
Chippies and a cream-based dip Raw vegetable sticks and hummus, or homemade popcorn (go easy on the salt)
Sugary drinks Water. It is nice chilled, with fresh mint and/ or a slice of lemon
Fruit juice Glass of chilled water and a piece of fruit
Dried fruit Fresh fruit

I’ve writen about this before, and we’ve sent in detailed scientfic and public health rationale for moving away from the current approach (MOH dietary guidelines feedback REVISED Appendix 9.5.14). We even suggested the real food guidelines – a set of public health nutrition guidelines which we think are much more sensible given the state of scientific evidence such that it is. The main idea being that there is an emphasis on eating real, whole food and forgetting about the emphasis on the mythical whole grain, the demonising of saturated fat, and low fat high carbohydrate in general.

But here’s the bit we found most objectionable

MoH topical q and A

“This resource provides answers on some topical issues around eating (nutrition) and physical activity. The responses are based on the Ministry of Health’s monitoring of international research. Any new research is considered alongside the existing body of evidence and best international population health advice.”

Here are the first few topics…judge for yourself

Sat fatFoods high in saturated fat include butter, cream, cheese and the fat from meat as well as coconut oil and palm oil. The link between saturated fat consumption, blood cholesterol levels and heart disease is well established, with evidence building over the past 60 years. Recent comments, highlighted in the media, have promoted high saturated-fat diets. These comments oppose widely held nutritional understanding of a healthy diet.

The current body of evidence supports replacing saturated fats with polyunsaturated fats, to reduce the risk of heart disease and stroke. In practice, this means using unsaturated fats such as plant-based oils and spreads instead of butter if needed for cooking and spreading. The few recent studies that endorse high saturated-fat diets are not sufficient to refute the existing body of evidence.


My verdict: This single issue is the one which makes it so hard for these people to move on to a more sensible set of public health nutrition guidelines. Decades poor research and poor interpretation of meta-analyses have lead the “old boys” into cognitive dissonance that means they will never change their minds. The public is now more savvy and is likely to realise that this is just silly. Recent sales of butter (up) and margarine (down and Unilever is thinking about abandoning its manufacture) are good evidence of this.

LCHF MoHLow-carb, high-fat diets are sometimes promoted as a better way of losing weight than diets that contain more moderate and balanced amounts of carbohydrate and fat.

However, it is not the proportions of macronutrients (carbohydrate, fat and proteins) that affect weight loss but the total energy in the diet. While people can lose weight with some low-carb, high-fat diets, this happens with other energy-controlled eating plans as well. Importantly, there is no evidence of the long-term benefits or safety of such diets. Based on all the current evidence, the Ministry of Health does not recommend low-carb, high-fat diets for weight loss.


My verdict: For goodness sake, have a look at the scientific evidence. We know that these diets work well for weight loss, especially for those people who are insulin resistant.

PaleoThe ‘paleo’ or palaeolithic diet is an eating pattern claimed to be based on the diet of early ‘hunter-gatherer’ humans from the Palaeolithic period (around 2.5 million to 10,000 years BC). The diet consistsof vegetables, some fruit, nuts, naturally occurring fats and oils, meat and seafood. It excludes dairy products, grains, legumes, processed oils, sugar, salt, alcohol and coffee. The premise for the diet is that modern humans remain genetically adapted to the eating patterns of their ancestors, and so this continues to be the optimal way to eat for health.

Although the paleo diet includes many healthy foods, it is also linked to a number of issues. In particular, copying a ‘true’ Palaeolithic diet is difficult as very little is known about the diet of these early people and many of the specific plant and animal foods around during the Palaeolithic period no longer exist. Also, significantly, the diet excludes entire food groups that are important to healthy eating patterns. Examples are grains, legumes and dairy products.

Yes, New Zealand nutrition recommendations specifically go out of their way to tell people who have a template of eating that is based on whole unprocessed foods – those humans mostly ate for almost all of their evolutionary history – that this is not healthy and you shouldn’t do it!

My verdict: This is an embarrassment.


The little research available on intermittent fasting diets in humans has shown people can lose weight following this eating plan. Perhaps the best-known version of intermittent fasting is the 5-2 diet, where a person has five days of ‘normal’ eating and two days of a much lower energy intake (approximately 2100–2500 kilojoules per day, which is 25 percent of requirements). Over time, it reduces total energy (kilojoules) intake, which is the likely cause of the weight loss.

At present, no studies have shown how sustainable this eating pattern is or how it impacts on long-term weight or health outcomes. Possible immediate side effects from the ‘fasting days’ are extreme hunger, low energy levels, light-headedness and poor mental functioning. The quality of the diet on ‘normal’ days will also impact on health outcomes in the long term.

The 5-2 diet is not recommended for people with insulin dependent diabetes.

OK, because people with insulin couldn’t figure out how to adjust their insulin and this will drive hypoglycaemia? I assume everyone else can do intermittent fasting though by only selecting this group, cool.

My verdict: Yes more research needs to be done with fasting, but it could be really useful for people who are metabolically dysregulated and could even help some Type 2 diabetics who are dependent on insulin get off insulin. Why is this diet (one which doesn’t even restrict “food groups”) chosen as a target over the dozens and dozens of really silly ones out in the public space?

Fruit MoHRecommendations to decrease sugar intake refer specifically to ‘free sugars’. Free sugars include all sugar added to foods as well as sugars that are naturally present in fruit juice, syrups and honey. This recommendation does not apply to the sugar that is found naturally in the structure of foods such as whole fruit and dairy products.

As well as sugar, whole fruit provide a range of nutrients including dietary fibre and phytonutrients (beneficial chemicals found in plants). Fruit along with a range of other foods is part of a healthy eating pattern.

Specifically what nutrients will people eating a whole food diet without fruit miss out on? So if your blood sugar is raised by eating fruit, especially high sugar fruits like grapes and bananas then thats OK – especially if you are insulin resistant and this provokes hyperinsulinemia?

My verdict: There is a widespread belief that unlimited fruit is OK no matter how poorly you can control your blood sugar and insulin. This belief is rubbish.  Limiting fruit is a good option for people in this category.

There you go. New Zealand – the first country in the word to give women the vote, a country that prides itself as early adopters and innovators, is again first! We’ve warned people off low carb and paleo. That’s a shame really because these are two of the most promising ways to help fix the current metabolic diseases that affect our quality and quantity of life, and cost us billions of dollars.


28 Comments on “New Zealand becomes first country to specifically warn against low carb, paleo and intermittent fasting

  1. Love this comment about paleo: “It is not a healthy eating plan,” followed by their description of paleo: “The diet consists of vegetables, some fruit, nuts, naturally occurring fats and oils, meat and seafood. It excludes dairy products, grains, legumes, processed oils, sugar, salt, alcohol and coffee.”

    Righto – I see their point. All that simple, wholefood sounds positively deadly.

    Good lord – are the MOH trying to kill us all?

    • I think that is such a pertinent question……is there genuinely an element that having sick people creates lots of business opportunity. Certainly we are all aware of the hold pharmaceutical companies have on modern capitalist economies. Couple that with the fact that many universities are funded by them and therefore have control over a lot of what is taught, it’s not hard to see a link that perhaps there would be too much to lose by having an empowered healthy population.
      Maybe I am too cynical?

  2. Gosh….I feel your pain…..definitely embarrassing….especially comments such as “not enough long term evidence”…….when there is plenty long term evidence that the low fat high carb. diets are not working!

    Not too surprising though really, as an outsider I have been disappointed with NZ’s lack of progressiveness. I think it may have run out of steam shortly after giving women the vote!

    A resourceful country with a tiny population should be the model of exemplary behaviours, with lots of scope for experiment and exploration, instead it wallows in UK/US style fat cat style management.

    Still, as long as people are online and active on social media, the message is getting out about the dangers of all types of sugar and the trend will continue. I am sure you guys will not lose your passion and enthusiasm and the growing number of people who have switched eating habits will be the healthy proof that there is a lot more to eating than the total number of calories consumed.

  3. Just appaling!! I’m gutted – how much of a step in the wrong direction is that advice!! Idiots. There really should be an “I don’t like” button for this. Guys – help support our Public Health Collaboration – with Sam Feltham and Dr Aseem Malhotra, here in the Uk to get the Gvt listening – it’s at the crowdfunding stage so please go to

    If we can get one gvt to listen then the others should follow…….

  4. Obviously they don’t read world wide research in NZ. Bless them!

  5. 2013 Australian Dietary Guidelines: “A number of established food, diet and health relationships covered in the 2003 edition, where the evidence base was unlikely to have changed substantially, were identified as not needing specific search questions to be asked. For example, the relationship between diets high in saturated fat and increased risk of high serum cholesterol. “

    So this document was over 200 pages long and had 1128 references and they didn’t bother with checking recent refs about saturated fat because they ‘know’ it is bad.

    • “A high-fat, high-saturated fat diet decreases insulin sensitivity without changing intra-abdominal fat in weight-stable overweight and obese adults”

      The conclusion states:

      A diet very high in fat and saturated fat adversely affects insulin sensitivity and thereby might contribute to the development of type 2 diabetes.

      Still too many carbs – at 27% – thats over a quarter of the content of the high fat diet the subjects were told to eat. HFHC is not a good idea either.

  6. Butter sales are rising – inspite of new Zealand’s nonsense – and fake butter (aka margarine) sales are falling. Maybe new Zealand needs to keep up to date – as the people are reading and walking the talk. Unilever one of the biggest fake butter factories is isolating its business – perhaps in anticipation of class actions. Question: why eat an un-natural fake product that your body is not designed by evolution to process when there is butter???

  7. Eat butter, coconut oil, not fake stupid dumb yucky margarine, i love butter its true makes you feel great, i remember wen I was 8 (1978) we had nice skin teeth, hair, was skinny as, cause we ate butter and drank yummy cream, ate cheese and NZ real meat grass fed cooked in yummy dripping…..until them dumb as McD’s moved in we got freakn FAT cause they cooked our food in vegetable oil, canola oil FAKE OILS that made us FAT…….EAT NZ BUTTER….EAT NZ MEAT nice real foods….. not dumb grain fed meat fake meat makes us fat

  8. the long term evidence lies in the fact that people survived the paleolithic area and made it over the centuries to industrialization, and from that time on humans will soon extinguish due to food foreign to human species.
    Why are they advice such crap? the industry will loose billions and billions if people would eat natural food, they cannot sell their wheat, their burgers, their medication, their insulin, their skin products, their packages (no plastic anymore) and their commercials and ads, their research sponsored by xy and it goes on and on. It is a big conspiracy! Eat recognizable food that come without a long ingredient list and much package and you are fine! it is that simple!


    Sorry mate but I don’t know what science you’re reading…
    Fruit improves blood sugar control.

    Animal products are what should be avoided with diabetics(and people in general) as they produce a massive spike with carbs

    Saturated fat and cholesterol are associated with heart disease. The controversy can easily be explained. Its a cutthroat world and people like to hear good things about their bad habits. It makes for easy book sales and increases animal product profits.

    If dietary saturated fat and cholesterol didn’t raise serum cholesterol levels, then explain why vegans and vegetarians have lower cholesterol.

    Thank you!

    • Yes fructose in fruit is better than sugar and fructose not in fruit….but it still raises blood sugar more than eating a low sugar vegetable. So you have not be careful of not doing what you are accusing me of?
      Yes eating fat raises cholesterol but how does that cause heart disease? It reduces risk by reducing ApoB and increaisng HDL. Your A causes B and B causes C so A causes B argument doesn’t cut it.
      I do agree that adding fat to carbs in insulin resistant people causes insulin spikes – so don’t eat the carbs they are not essential whereas the fat and protein are?

      • I see your logic. However, when we look at the blue zones, the longest living populations, they all eat a diet focused around whole plant based food. Which is by default high in carbs, low in fat and adequate protein. The Okinawa’s for example (before they adopted a western diet) had a diet of 85% carbs 9% protein and 6% fat. The longest living population recorded to date are the Californian seventh day Adventist who are one step further, vegan.
        I haven’t come across any populations doing well on a LCHF diet interms of longevity and health long term. Is there any research?
        I’d say don’t eat animal products as they are not essential and keep to whole plant based foods. Provided you take a b12 supplement as the water we drink now is treated and void of b12.
        Whole foods such as fruit, beans and lentils are great for improving Insulin Sensitivity even though they are high in carbs and we actually have evidence eating this way provides great health long term.
        I’d be happy to switch to LCHF if some one could show me some research.
        I agree with the paleo diet, in that the first foods we ate were whole plant foods. I don’t agree with animal products.

        Thanks again.

  10. Hi James,

    perhaps it’s necessary to define “fruit” and provide a little context. To people on low-carb or sugar free diets, fruit just means sweet fruit. Apple, orange, banana, pineapple, grape, sultana, dates.
    It doesn’t include other fruits – avocado, courgette, capsicum, tomato, berries, capers and so on.
    Just out of curiosity, and because I love courgettes (zucchinis to our US readers), I ran a nutrition comparison of a zucchini vs an apple through an online calculator.

    The zucchini compares very favourably with the apple. But it has less sugar – 10g less per 100g.

    Absolutely, for people who aren’t looking to make major changes to their diets, replacing sweet treats with fruit is a good idea. That doesn’t mean that replacing sweet treats and sweet fruit with low-sugar fruit isn’t a better idea. One of the studies you cited relates to blueberries, a low-sugar fruit, but they only fed the purified polyphenols to the subjects.

    In the first study you linked regarding “Animal products are what should be avoided with diabetics(and people in general) as they produce a massive spike with carbs” the fat and protein added to the carb meal was in fact additional calories, the carb meal was 100 calories and the mixed meal was 425 calories – the effect of adding protein and fat has to be seen in this light. It actually lessened the glucose spike but raised insulin more. But I cannot access the full-text to this study, and the abstract doesn’t mention that the fat and protein were animal products. Do you know what the sources of fat and protein were?

    The protein source was “lean hamburger” in the second study, in which “protein given with glucose will increase insulin secretion and reduce the plasma glucose rise in at least some type II diabetic persons.”

    Our message here is in large part about avoiding glucose except in small amounts in high-quality foods, and tailoring the amount of glucose or other sugars you consume to your personal tolerance to avoid both glucose and insulin spikes.

    This second paper is first-authored by Frank Q Nuttall and I recommend other more recent studies by this author into the metabolic benefits of carbohydrate restriction, for example


    You should compare the effects of glucose plus protein (a low fat meal) in diabetes with the effects of an equal amount of energy from fat plus protein. There will be a lower insulin demand and secretion and a lower glucose spike, of course. Whether the protein is animal, vegetable, or mineral won’t matter much.

    Vegans do generally have lower cholesterol; however the few vegans I know cook with coconut oil.
    However, in the Framingham study, people with the highest LDL cholesterol had a significantly reduced risk of developing type 2 diabetes compared to people with low LDL.

    “In multivariable models, a higher LDL-C concentration was associated with lower risk of diabetes (OR per SD increment 0.81, 95% CI 0.70, 0.93, p = 0.004). The GRS was associated with incident diabetes in a similar direction and of comparable magnitude (OR per SD increment 0.85, 95% CI 0.76, 0.96, p = 0.009).”

    In the recent Malmo Diet and Cancer Study, people with the highest intake of saturated fat from dairy had a lower risk of developing type 2 diabetes. Lean meat was associated with diabetes, but fatty red meat wasn’t.

    “Total intake of high-fat dairy products (regular-fat alternatives) was inversely associated with incident T2D (HR for highest compared with lowest quintiles: 0.77; 95% CI: 0.68, 0.87; P-trend < 0.001). Most robust inverse associations were seen for intakes of cream and high-fat fermented milk (P-trend < 0.01) and for cheese in women (P-trend = 0.02)."

    In the latest meta-analysis of saturated fat, trans fats, and disease, the highest vs lowest intake of trans fats found in dairy and ruminant fat was significantly associated with a greatly reduced risk of developing type 2 diabetes. (and there was no association of saturated fat with cardiovascular disease).

    And of course we have had an epidemic of type 2 diabetes since people have adopted the idea that low-fat dairy and lean meat are healthy.


    The first part of this statement does explain some of the more sensationalist media reactions to the kind of science that we explore, for sure. But a book is a more thoughtful and time-consuming enterprise. If your idea were true, there would be a "Big Sweet Surprise – how Sugar, Cakes and Biscuits Belong in a Healthy Diet" on the best seller list, not a Big Fat Surprise.

    I don't resent Fonterra or Alliance their profits, because they sell food that nourishes people. Put their products into a nutrition calculator, and you'll see that they're worth the money. They can be part of a healthy diet. Can they also be part of an unhealthy diet? Absolutely. No food is a foolproof protection, but the less adulterated, ersatz, or refined the food, the better, and these days the sugar and starch and vegetable oil content of food is a pretty good guide to how far it's departed from being good for us.


  11. P.S. James,

    here are some examples of the successful use of a vegan LCHF diet


    A total of 47 overweight hyperlipidemic men and women consumed either (1) a low-carbohydrate (26% of total calories), high-vegetable protein (31% from gluten, soy, nuts, fruit, vegetables, and cereals), and vegetable oil (43%) plant-based diet or (2) a high-carbohydrate lacto-ovo vegetarian diet (58% carbohydrate, 16% protein, and 25% fat) for 4 weeks each in a parallel study design. The study food was provided at 60% of calorie requirements.

    Of the 47 subjects, 44 (94%) (test, n = 22 [92%]; control, n = 22 [96%]) completed the study. Weight loss was similar for both diets (approximately 4.0 kg). However, reductions in LDL-C concentration and total cholesterol-HDL-C and apolipoprotein B-apolipoprotein AI ratios were greater for the low-carbohydrate compared with the high-carbohydrate diet (-8.1% [P = .002], -8.7% [P = .004], and -9.6% [P = .001], respectively). Reductions in systolic and diastolic blood pressure were also seen (-1.9% [P = .052] and -2.4% [P = .02], respectively).


    Effect of a 6-month vegan low-carbohydrate (‘Eco-Atkins’) diet on cardiovascular risk factors and body weight in hyperlipidaemic adults: a randomised controlled trial (2014)

    Intervention: Participants were advised to consume either a low-carbohydrate vegan diet or a high-carbohydrate lacto-ovo vegetarian diet for 6 months after completing 1-month metabolic (all foods provided) versions of these diets. The prescribed macronutrient intakes for the low-carbohydrate and high-carbohydrate diets were: 26% and 58% of energy from carbohydrate, 31% and 16% from protein and 43% and 25% from fat, respectively.

    Primary outcome: Change in body weight.

    Results: 23 participants (50% test, 68% control) completed the 6-month ad libitum study. The approximate 4 kg weight loss on the metabolic study was increased to −6.9 kg on low-carbohydrate and −5.8 kg on high-carbohydrate 6-month ad libitum treatments (treatment difference (95% CI) −1.1 kg (−2.1 to 0.0), p=0.047). The relative LDL-C and triglyceride reductions were also greater on the low-carbohydrate treatment (treatment difference (95% CI) −0.49 mmol/L (−0.70 to −0.28), p<0.001 and −0.34 mmol/L (−0.57 to −0.11), p=0.005, respectively), as were the total cholesterol:HDL-C and apolipoprotein B:A1 ratios (−0.57 (−0.83, −0.32), p<0.001 and −0.05 (−0.09, −0.02), p=0.003, respectively).

    Conclusions: A self-selected low-carbohydrate vegan diet, containing increased protein and fat from gluten and soy products, nuts and vegetable oils, had lipid lowering advantages over a high-carbohydrate, low-fat weight loss diet, thus improving heart disease risk factors.

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  14. I feel James is against the slaughter/farming of animals, and like us seeks out any studies on the net to disclaim any good points to a high fat, moderate protein, low carb WOE. No amount of evidence to the contrary will satisfy him.

  15. This really gets my freaking goat! I lost 75kg doing LOW CARB I tried every other diet before that, they would start well but man.. too hard.. so I stayed and increased until I hit my highest weight and was nearly dead. I tried low carb, and I enjoyed it so much I STUCK WITH IT. Ignore these warning, if it works it’s better than being morbidly obese. Heck if ANYTHING works for you do it, because it’s better than trying and failing.. trust me ❤

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