Earlier this year Dietitians Association of Australia (DAA) led a successful advocacy campaign to stop the controversial book ‘Bubba Yum Yum: The Paleo way for new mums, babies and toddlers’ being published by the large publishing house, Pan Macmillan Australia. DAA’s intervention, which was supported by the Public Health Association of Australia (PHAA), means the book won’t appear on the shelves of major book retailers in Australia.
DAA’s concerns with the book:
Through routine media monitoring, DAA became aware of the book in February and later gained access to some of the content of the book, which was authored by Australian celebrity chef and vocal Paleo diet advocate Pete Evans, blogger Charlotte Carr and naturopath Helen Padarin. In summary, DAA’s concerns included:
DIY infant formula: This recipe (based on bone broth, chicken liver, a probiotic, coconut oil, cod liver oil and virgin olive oil) was promoted in the 0-6 month section of the book. While in the text the authors acknowledged breastfeeding as best, the book also stated: ‘(The DIY infant formula) is however a wonderful alternative and the next best thing when breast isn’t an option’.
It became immediately obvious that there were key nutritional issues with the DIY infant formula, particularly around excessive Vitamin A, excessive protein, high iron levels, lack of calcium and missing nutrient declarations (including iodine, selenium and sodium).
DAA asked Food Standards Australian New Zealand (FSANZ) to analyse the nutritional composition of the DIY infant formula, based on the recipe in the book – with alarming results. For instance, it was significantly higher than breast milk in Vitamin A (749% higher), Vitamin B12 (2,326% higher), sodium (879% higher); it contained no carbohydrate and insufficient calcium.
The DIY infant formula was promoted as ‘mimicking the nutrient profile of breast milk’, but the FSANZ analysis showed this was not the case. In addition, the World Health Organisation and Australia’s National Health and Medical Research Council (NHMRC) state that breast milk is best for babies and that infant formula is the only suitable substitute if breast milk is not available.
Another problem relating to the DIY infant formula was the lack of instructions in the book for parents around preparing and storing the formula, and around how much to feed babies.
Wider problems with the cookbook: A wider, overarching problem was that the cookbook (targeting young children) is based around the Paleo Diet. Few studies have been published examining the benefits (and risks) of the Paleo Diet in adults and none examining the effects in children, let alone babies or toddlers.
Other, more specific problems with the cookbook include the use of ingredients that are not recommended in Australia for infants within the first 12 months of life due to microbiological risks – such as honey (due to botulism risk) and runny eggs (due to salmonella risk). DAA consulted with the New South Wales (NSW) Food Authority on these issues, and provided information from this organisation to Pan Macmillan.
DAA advocacy efforts paid off
DAA is pleased the publisher took the concerns raised by the Association seriously, on the grounds of public safety. In the lead-up to this decision, DAA led contact with Pan Macmillan, through written communication and a face-to-face meeting, on behalf of all of the health agencies involved.
PHAA worked closely with DAA on this issue, and other groups consulted or informed included:
Australian Breastfeeding Association (ABA)
NSW Department of Health
NSW Food Authority
Australian Medical Association (AMA)
New Zealand Ministry of Health
Dietitians New Zealand.
Importantly, DAA alerted the Ministerial Office of the Federal Minister for Health Australia about the Association’s concerns with the book, through a letter co-signed by the PHAA and the ABA. The Department of Health then investigated the book.
Despite the serious issues with some of the content of the book, DAA understands the authors have decided to independently release a digital version of the book, with an independently-published print version to follow. DAA is unsure whether any of the content will be altered by the authors prior to its release. However, the Association has outlined these concerns directly to the authors, and the potential risks with some of the recipes have been widely reported through the media.
Positive ‘spin offs’ from advocacy in this area
In reporting on the issues around Bubba Yum Yum, many media outlets have mentioned issues around self-appointed ‘experts’ (including celebrities) providing nutrition and health advice to the Australian public. And several key Australian journalists have raised issues around duty of care for book publishers when taking on books containing dietary advice, not backed by evidence.
In a recent Australian Women’s Weekly online piece, the AMA was quoted calling for health advice issued by celebrities and alternative wellness advocates to be scrutinised more rigorously before being published in books or online to protect the public. Part of the article states: ‘Alternative health advocates and their publishers should be prepared to take responsibility for health claims or advice that they give, just as a doctor is liable for the care and advice they give to patients.’