The Pitfalls of ‘Advising’

It is really not easy being a government health agency. Whatever you say, you will be wrong in someone’s eyes (sometimes wrong in almost everybody’s eyes) but the purpose of your existence is to advise, so advise you must, even when there really is no advice to give. (The question of whether you have any right to advise anyone about their health is of course an entirely different matter, but not for discussion now…)

Take, for example, the Food Standards Agency’s latest pronouncements on the introduction of gluten into an infant’s diet:

After looking at all the evidence in detail, the COT (Committee on Toxicity) and SACN (Scientific Advisory Committee on Nutrition) concluded that:

• introducing gluten-containing foods before three months (13 weeks) might be linked to an increased risk of coeliac disease
• the evidence currently available is not strong enough to make specific recommendations about when gluten should be introduced into infants’ diets beyond three months of age
• the evidence is not strong enough to support a recommendation to introduce gluten before six months of age
• there might be an increased chance of infants developing coeliac disease if they are not being breastfed when gluten is introduced into the diet

Errr…  And if you thought that was confusing, try the FSA’s efforts two years ago on eating peanuts while pregnant or breastfeeding:

Pregnant or planning to have a baby:

• If you would like to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy, you can choose to do so as part of a healthy balanced diet, unless you yourself are allergic to them or unless your health professional advises you not to.
• You may have heard that some women, in the past, have chosen not to eat peanuts when they are pregnant. This is because the Government previously advised women that they may wish to avoid eating peanuts during pregnancy if there was a history of allergy in their child’s immediate family (such as asthma, eczema, hayfever, food allergy or other types of allergy). But this advice has now been changed because the latest research has shown that there is no clear evidence to say that eating or not eating peanuts during pregnancy affects the chances of your baby developing a peanut allergy.
• If you have any questions or concerns, you should discuss these with your GP, midwife, health visitor or other health professional.
• If you choose to avoid eating peanuts or foods containing peanuts during pregnancy, you can do so by reading the ingredients list on food labels, where peanut must be declared by law if it is an ingredient.
• Find out more about what to eat when planning to have a baby or pregnant on our eatwell site.

Breastfeeding or have an infant under 6 months old:

• If you would like to eat peanuts or foods containing peanuts (such as peanut butter) when you are breastfeeding, you can choose to do so as part of a healthy balanced diet, unless you yourself are allergic to them or unless your health professional advises you not to.
• You may have heard that some women, in the past, have chosen not to eat peanuts when they are breastfeeding. This is because the Government previously advised women that they may wish to avoid eating peanuts when they are breastfeeding if there was a history of allergy in their child’s immediate family (such as asthma, eczema, hayfever, food allergy or other types of allergy), in case small amounts of peanut in their breast milk increased the chance of the baby developing a peanut allergy. But this advice has now been changed because the latest research has shown that there is no clear evidence to say that eating or not eating peanuts when breastfeeding affects the chances of your baby developing a peanut allergy.
• Government advice to all mothers is that you should try to exclusively breastfeed your baby until about six months of age. Breastfeeding provides benefits to both mothers and babies.
• If you have a child under 6 months and are not breastfeeding, then there is no reason why you should avoid consuming peanuts or foods containing peanuts, unless you yourself are allergic to peanuts or have been advised not to consume them by your health professional for other reasons.
• If you have any questions or concerns, you should discuss these with your GP, midwife, health visitor or other health professional.
• If you choose to avoid eating peanuts or foods containing peanuts when you are breastfeeding, you can do so by reading the ingredients list on food labels, where peanut must be declared by law if it is an ingredient.
• Find out more about what to eat when breastfeeding on our eatwell site.

The FSA allergy department is a really hard-working and  well meaning organisation but when there is so little sensible advice that they can give, might they not do better to give none at all? But then, where does that leave all those confused people who have reason to think that their child might be atopic, allergic or gluten sensitive?… Better training for those health professionals maybe?