Study: Many ingredients reduce the risk of death or disease rather than increase it.
Introduction
The Great British Bake Off (TGBBO) – known as The Great British Baking Show in the United States and Canada – features amateur bakers each week in a series of baking challenges, culminating in one winner. The recipes include a variety of delicious and luxurious confections, including suitable Christmas treats. However, many of the Christmas recipes on the show may not be as unhealthy as some believe, according to a new research paper published in the annual issue of the British Medical Journal known for its light-hearted scientific papers.
History of The Great British Bake Off
The Great British Bake Off premiered on-air in 2010 on BBC, quickly gaining popularity that expanded across the Atlantic. The show is inspired by traditional baking competitions in English villages (see any cozy English murder mystery for reference). Currently, Paul Hollywood and Prue Leith serve as the judges of the show, while Noel Fielding and Alison Hammond host the show, providing commentary (sometimes inappropriate). Each week features a theme and three challenges: the signature challenge, the technical challenge, and the showstopper challenge.
New Study in the British Medical Journal
The four co-authors of the new study in the British Medical Journal (BMJ) – Joshua Walach from Emory University and Yale University, Anant Gautam, Reshma Ramachandran, and Joseph Ross from Yale University – are passionate fans of The Great British Bake Off, considering it “the greatest baking television show of all time.” They are also fans of sweets in general, noting that the Catholic Church in England during the Middle Ages issued a decree requiring the presence of Christmas pudding four weeks before Christmas. These puddings resembled soup more, containing ingredients like prunes, raisins, carrots, nuts, spices, grains, eggs, beef, and lamb. Thus, these puddings were “healthier” than modern confections that contain much butter and sugar specifically.
Healthy Ingredients in Christmas Sweets
Walach and others wondered whether modern confections might be healthier than generally believed, conducting a comprehensive review of existing scientific literature to arrive at their own “umbrella review.” Establishing direct causal links in nutrition is very challenging, whether discussing observational studies or systematic reviews and meta-analyses. For example, many previous studies focus on individual ingredients and do not take into account the overall dietary impact and lifestyle. They may also rely on self-reports from study participants. “Are we really going to accurately report how much candy we ate hysterically at midnight after everyone else had gone to bed?” the authors wrote. Systematic reviews have their own weaknesses and biases.
Specific Ingredients and Their Impact on Health
The authors wrote, “But bah humbug, it’s Christmas, and we’re done being Scrooge in the study design.” “We took this opportunity to overlook the flaws of observational nutritional research and conduct a study that allowed us to feel morally superior while enjoying the referred Christmas candy ingredients (such as chocolate). Overall, we hoped to provide evidence suggesting that we need to eat Christmas candy and enjoy it too, or at least provide evidence that would impact our shared greed or guilt this holiday season.”
Ingredients and Their Effect on Health
The team examined the TGBBO site and selected 48 recipes for Christmas cakes, cookies, pastries, and puddings, such as the Black Forest Yule Log by Val and the boozy ruby tea and chocolate panettone cherry. There were 178 unique ingredients in those recipes, and the authors categorized them into 17 main ingredient groups: baking soda, baking powder, and similar ingredients; chocolate; cheese and yogurt; coffee; eggs; butter; food colors and flavors and extracts; fruit; milk; nuts; peanuts or peanut butter; flavored flour; salt; spices; sugar; and vegetable fats.
Analysis
Results
Walsh and others identified 46 articles that reviewed health and nutrition related to those components for analysis. This resulted in 363 links between components and the risk of death or disease, although only 149 were statistically significant. Among those associations, 110 (74 percent) reduced health risks while 39 (26 percent) increased risks. The most common components associated with risk reduction were fruits, coffee, and nuts, while alcohol and sugar were the most commonly associated components with increased risks.
The Impact of Alcohol and Sugar
Take Pro Lyth’s signature chocolate Yule log as an example, which contains “a small amount of diluted Irish cream.” Most of the harmful associations were related to the alcohol content, which several studies showed increased the risk of liver cancer, stomach cancer, colon cancer, gout, and heart rhythm disorders. While alcohol can evaporate during cooking or baking, the filling that contains cream retains the alcohol, which does not diminish through baking. (Lyth often expressed his preference for alcoholic desserts on the show.)
In contrast, Raffa’s frozen fantasy cake contains several healthy ingredients, especially almonds and passion fruit, and thus carries a significantly low risk of disease or death. The same applies to Hollywood’s Stollen Bowl, which contains almonds, milk, and a variety of dried fruits. “Overall, without eggs, butter, and sugar, this dessert is essentially a fruit salad with nuts,” the authors wrote. This certainly poses a significant caveat, as eggs, butter, and sugar constitute the dessert. However, Walsh and others note that most dietary studies that demonize sugar focus on the nutritional effects of sugar-sweetened beverages, and none of the Christmas dessert recipes in The Great British Bake Off resembled such beverages, “undoubtedly because they would result in a non-crunchy dessert base.”
Study Limitations and Conclusion
The BMJ study relies on evidence from previous observational studies, and Walsh and others did not consider the quantity of each ingredient used in any given recipe. Regardless of whether the recipe called for one raspberry or a whole cup of raspberries, this ingredient was treated with the same weight in terms of its protective effects against the presumed harmful effects of butter. Would a weighted analysis have been more accurate? Certainly, but it would have been far less enjoyable.
So, is this a true Christmas miracle or a fun academic exercise in creative justification? Perhaps we shouldn’t overthink it. “It’s Christmas, so enjoy your desserts in moderation,” the authors concluded.
Source: BMJ, 2023. DOI: 10.1136/bmj‑2023‑077166 (about DOIs).
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