Eating fat and being fat have become crimes punishable by - we're told - obesity, heart disease and cancer. The marketing of "low-fat" products plays to these fears. Bombarded with healthy eating messages from Government and advertisers, many of us are afraid to eat a meal without first analysing its contents.
Seven out of 10 Irish people said they had reduced fat in the previous year, according to the recent North/South Ireland Food Consumption Survey by the Irish Universities Nutrition Alliance (IUNA). Yet in reality, over the past decade the proportion of fat in the Irish diet has remained stubbornly the same, at 37 per cent, the survey found.
At the same time, claims that "low-fat" is better are being undermined by new research which shows that dietary fat may not be related to obesity, heart disease and cancer.
"Fat phobia" has been encouraged by the Department of Health with no benefit for the general population, claims a senior nutritionist with the National Dairy Council.
"Almost like food terrorism" is how Dr Leon O'Flaherty describes 10 years of "healthy eating" campaigns which have stressed the importance of a low-fat diet. But while "preventing our enjoyment of food", they haven't prevented an "alarming" increase in obesity, says O'Flaherty.
Today, more Irish people are overweight than ever before. Half of all Irish men and one-third of Irish women are overweight, the IUNA survey found. Only four out of 10 people are of "normal" weight. An alarming one-in-five men and one-insix women are clinically obese.
The trend is the same in the US, where obesity has grown by 14 to 22 per cent in 20 years at the same time as the US government has preached the low-fat message, recommending that fat comprise no more than 30 per cent of the diet.
How do policymakers react to O'Flaherty's argument?
"Very concerned", is the reaction of Ursula O'Dwyer, consultant dietician, Department of Health and Children.
"What your readership must ask themselves is - `What is the agenda here?' For the Department of Health and Children our agenda is specific - to improve the nutritional status of the Irish population and help reduce the incidence of diet-related diseases."
The Department takes issue with O'Flaherty's conclusion that "dietary fat does not appear to play a role in obesity" on the basis of the IUNA figures. According to O'Dwyer, discussions with the IUNA survey team have led the Department to the conclusion that "the fat intake versus obesity issue is complex and the national average does not reflect uniform eating behaviour in the Irish population.
Some groups have higher fat intake and may also have other `less healthy' behaviour like taking very little exercise and watching more TV. Eating out, which is on the increase, especially among younger adults, may also be important.
We are waiting for more detailed results before we jump to any conclusions."
She adds: "It is very disappointing that the NDC continue to dispute the Department's healthy eating messages while other generic food agencies like Bord Bia and Bord Glas work actively with the Department."
The Government has long supported the hypothesis that dietary fat is a risk factor for heart disease. But is it?
Fifty years and millions of dollars of research have failed to prove the heart-fat theory. On the contrary, low-fat diets have "little, if any" effect on total mortality from heart disease, according to a review of 27 studies, published in last month's British Medical Journal.
O'Dwyer believes that the controversial BMJ article has been misinterpreted by the NDC, and refers to a statement in the article that there may be a "small but potentially important reduction in cardiovascular disease risk as a result of lowering fat intake". She points out that some experts have interpreted the data as meaning that low-fat diets make people healthier only when people stick to them long enough.
It doesn't help confused consumers that the Harvard School of Public Health was also inconclusive following its massive 20year Nurses' Health Study of nearly 300,000 Americans. Its results suggest that total fat consumed has no relation to heart disease.
The link between dietary fat and cancer is also questionable. For years, US women diagnosed with breast cancer have been encouraged by their doctors to switch to low-fat diets. Yet new research shows no improvement in the chances of surviving breast cancer as a result. However, eating more poultry and dairy products may improve chances of surviving, according to a recent US study of 2,000 women with breast cancer.
"Promoting restrictions in dietary fat often leads to people cutting down on nutritious foods such as meat and dairy products," says Dr O'Flaherty. "Indeed the IUNA survey showed that one-quarter of all women do not consume enough calcium and nearly half of all women do not get enough iron. Many are therefore at risk of iron deficiency anaemia and osteoporosis. These problems are even more acute in teenage girls."
Defending the Department of Health's policy, Dr Emer Shelley, leader of cardiovascular strategy for the Department, states that the low-fat message has never been given in isolation. Rather than being extremist and suggesting that fat comprise no more than 30 per cent of total calories, as in the US, our own Government has advised that fat be limited to 35 per cent of the diet. Such advice has always been tempered by positive messages about enjoying a balanced diet based on the food pyramid.
But could that be part of the problem? Fats are at the top of the pyramid (to be eaten sparingly) and carbohydrates are at the bottom, to make up the greatest part of the diet.
However, it may be easier for some people to gain weight on lowfat/high-carbohydrate regimens than on higher fat diets. Foods such as white bread, pasta and white rice send the glycemic index soaring. The glycemic index measures the speed at which carbohydrates break down into simple sugars in the bloodstream. One theory is that insulin reacts to the sugar high, making the food rapidly stored by the body. So the person cannot access the energy, gets hungry faster and so gains more weight.
Rather than restricting calories, Irish people need to get more exercise, suggests O'Flaherty. Exercise is the one proven way of burning calories and boosting metabolism. According to O'Flaherty, we'd be better off enjoying our food, turning off the TV and getting out for long walks. In fact, the IUNA survey shows that obesity is directly related to TV-viewing. The heavier you are, the more TV you watch. People who are lighter than average watch 17.5 hours of TV per week. People who are heavier than average watch 20.1 hours of TV per week. When it comes to exercise, people of average weight are recreationally active for 8.5 hours per week, compared to 7.4 hours per week for overweight people.
The Department of Health has got the message and will be encouraging exercise in its upcoming May campaign. This makes a lot of sense: if there is evidence of anything, it's that being sedentary makes us fat.