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In this month’s edition of the American Journal of Clinical Nutrition there is a really good Editorial commentating on a piece of research recently published which shows , surprise surprise that the biggest hazard to health is not Fat but processed carbs. This will come as no surprise to the average low carber but to many this is news. The study is large and has a long duration and provides direct evidence that substituting high GI value carbs for saturated fats actually increases heart disease risk. This article and research was published in the same month that SIGN decided to publish its guidelines on healthy eating for Scotland. Well guess what , the Scottish Government in its brilliance have decided that notwithstanding the published science that they will continue to pursue and healthy eating campaign that recommends high carb / low fat. No wonder that Scotland is the fattest place in the UK.

While all this continues we have the “experts” in the Food Standards Authority mulling over the issue of carbohydrates and their potential impact on heart health. I do hope that they bother to read this study or some of the other studies that support the argument that the biggest problem in our diet is not the fat but the carbs and in particular starch and sugar.

I suspect that by the time the FSA complete their investigation and decide that in fact the carbs are the problem, we will all be a lot fatter or dead. Meanwhile while these slow and rather desperate organisations rummage through old studies and old theories the smart thinkers are way ahead. There are studies now being published which show that low carb diets help epilepsy; PCOS; cancer and many other ailments but we are light years away from this being recognised by your average dietician.

Don’t hold your breath!

It is so disappointing to sit through these election campaigns and no one has brought up the real issue that affects all of us in some way – health. I am not talking about money for nurses or beds for patients but basic health issues.

According to a survey by Diabetes UK in 2008, diabetes costs UK plc £1,000,000 per hour! Yes that is £1,000,000 per hour which adds up to £8 billion per year or £4billion if you don’t count sleeping hours. These estimates don’t include the cost of pre diabetes or obesity. We have all been told that the numbers of diabetics are about to escalate and that will increase the costs to UK plc.

Diabetes can be managed with diet alone but unfortunately the diet that manages diabetes is a low starch low sugar diet and not the eatwell plate promoted by the government. As I have frequently noted in other blogs it is the eatwell plate that is causing the obesity crises.

One very easy win to reduce our deficit and improve the lives of many millions in the UK would be to switch our diet away from starch and sugar. No investment required. No job cuts and no tax. Just a change to the shopping basket.

Good morning
Over the weekend I was delighted to read an editorial piece in the American Journal of Clinical Nutrition by Frank B Hu focusing on the publication of the significant study by Jakobsen et al comparing the association between the intake of saturated fats and carbohydrates. This is the largest epidemiological study ever done looking at the replacement of saturated fats with good and bad carbohydrates and is also notable for its long duration.
To converts like myself the outcome of the study brings no surprises and shows that you actually increase your risk of heart disease etc when you replace saturated fats with carbohydrates.
What Frank Hu very kindly points out, in his editorial summary, is that the low fat carbohydrate based diet (approximately 70% carbs) which is traditional in Asian populations has the potential to cause havoc in a western population. The Asian communities are generally very active and lean in the first place. Therefore the high carb low fat diet is fine. Mix this diet with a passive overweight community and you create an obesity diabetes crises and the reason for this is insulin and insulin resistance.
So the simplistic idea that we should look at thin people around the world and copy their diet is based on a lack of sophisticated thinking and quality biochemistry knowledge.
Let us all hope ( especially those that are obese or diabetic) that this small editorial piece is the first of many shouting from the roof tops that the problem in our diet today is not the fat or the protein but the starch and sugar!

The latest research out of the US suggests that dieting cant work because of the hormone cortisol which is released in stressful situations and causes the body to max out on glucose conversion. This is really not that surprising as stress is linked to our fight / flight survival mode which means that when we are in a stressful situation our body is designed to either make a run for it or fight both of which require energy and both of which will stimulate other hormonal responses. The other hormonal responses are a release of adrenalin and insulin. So when you are stressed your body will turn as much food into glucose as quickly as possible so that it is ready for the fight or flight. If you then sit down as we do and tap away on a keyboard the excess glucose, created by the release of cortisol, will then stimulate a release of insulin which will in turn ensure that you create fat. And so it goes on.
Anyone that has read my blogs before will know that I am definitely in the camp that sees insulin as a critical stimulant of our obesity epidemic and that for many people in the UK eating less and doing more simply won’t work.
Accepting that cortisol has a role to play in weight management is a step in the right direction because it shows that the body is far more complex than the silly notion that a body responds simply to calorific intake. The human body has evolved over thousands of years into a very complex unique machine.
In reality cortisol doesn’t stop all diets working but it will stop low calorie diets working because they do not deal with hormonal response. A really smart researcher should have thought about that before they completed the research.

An article published in the Sunday Times this weekend touched upon the latest big idea out of our beloved government through the Food Standards Agency. Their big idea is to follow the NY idea of asking food outlets to provide calorie guidance on retail / restaurant food.
The big question to ask oneself is this? Does calorie counting work? Clearly the authors of the article published last week thought otherwise . Are they right? Could the government be wrong?
Whilst the basic idea of eating less and doing more seems totally logical the logic does not account for two very real sciences – physics and bio chemistry. The world looks flat but isn’t.
Unless you drop your calorific intake to starvation levels (Very Low Calorie Diets) there is simply no evidence to show that calorie reduction, as recommended by government, will work. In fact the published peer reviewed science in this subject shows quite the contrary. When I wrote Big Fat Lies I had hoped to engage the government in a discussion on this topic to discover what piece of research I had missed that showed calorie counting as effective in weight loss. Unfortunately the only response I got from the Food Standards Authority was an attack on my status as a lawyer. It is unbelievable that the government continue to peddle this nonsense when there is more than enough evidence to show that it doesn’t work. Here is a short list of reasons why calorie counting is total rubbish:-
• Reduce calories and you reduce your metabolic rate
• Measuring food by reference to calories doesn’t tell you about the quality of the food
• The key is to burn fat and not muscle – calorie counting is more likely to reduce muscle rather than fat
• The rules of thermodynamics show that higher calories can mean more fat burn if you eat the right type of food
• Linking food to numbers is a very bad way to show people how to value food.
• Calorie counting will create a dependency on mass manufactured food.
These are just a few of a long list of reasons why calorie counting is a complete waste of time and perhaps explains why we are all fatter now than we were in the 70s before calorie counting started.
We need to start a campaign which actually works across experts who are united in one message which is stop the calorie counting and start looking at real nutrition.

A big thank you to Dr John Briffa who has responded to a ridiculous blog on the Food Standards Agency web site by Dr Wadge.
Dr Wadge decided to attack Big Fat Lies on the basis of my involvement in golower and the fact I am a lawyer. He does not even begin to challenge the real basis of Big Fat Lies which is science.
Turning to the issue over conflict of interest I suspect that the general public would find it far more worrying that Unilever sit on all the scientific committees. That is a true conflict of interest. Yes I started golower but this is not advertised or promoted in the book which is focusing on science and not product.
The whole problem with the current guidelines on “healthy eating” is that they are not based on robust evidence and experts in evidence are lawyers and not doctors or scientists. The reason I wrote Big Fat Lies is because the evidence supporting a low calorie low fat diet to manage obesity is poor and would not stand up to interrogation in court. It is also true that many of the statements made on the Food Standards Agency website are misleading and fundamentally wrong. If an expert makes misleading or wrong statements which are relied upon then they are breaching a duty of care which exists in law. That is why a lawyer is just the right person to attack the government agency which is actually fuelling the obesity crises by publishing misleading and wrong information.
The shame of Dr Wadge is that he did not confront the science in Big Fat Lies and for that reason it shows that either he doesn’t understand the science or doesn’t know it and in either case he is just another so called expert talking total and utter nonsense with complete disregard for the damage he is doing to the general public who are getting fatter and fatter sicker and sicker..

Last week the NHS published an interesting report providing us with up to date information on obesity in the UK. It did not attract much press attention because it repeats the same sad old story which is that the fat are getting fatter and diabetes and other associated illnesses are on the rise. What was slightly new was that there was a 100% growth in bariatric surgery which reflects the desperation for those who are overweight or obese.
These studies are great but only if someone actually reads them and then decides to take remedial action otherwise why bother spending all that money collecting all that data if you are just going to carry on doing what you are doing regardless. Amazing really.
In the same week we were also told that due to obese people had increased our incapacity benefit bill by £80million. God knows what the bill would be if you then added on all the costs to the NHS dealing with the side effects of obesity. With the average bariatric operation costing £7,000 the figure of £80million would equal 11 million operations.
This is quite an eye opener. Now if you then said that we could get the same results as bariatric surgery for just £1000 that would increase the number of people, who could solve their obesity problem, significantly. How mad is all this? £80million spent unnecessarily on a problem that can be solved by a simple diet change or the surgeon’s knife.

Last week I wrote about the publication of a study which suggests that there is no link between the intake of saturated fats and CVD and this was referred to today in an food industry newsletter. In particular they referred to the actual conclusion of that study:
“Our meta-analysis showed that there is insufficient evidence from prospective epidemiologic studies to conclude that dietary saturated fat is associated with an increased risk of CHD, stroke, or CVD”

The journalist for this particular industry publication then went on to ask for a comment from the FSA ( Food Standards Agency) as this particular government office has only just recently announced that it wants to reduce our intake of saturated fats even further.

“The Agency recognises that there is evidence to support an indirect link between saturated fat intake and increased LDL cholesterol, which may lead to increased risk of CHD. This is in line with World Health Organization and other eminent health bodies,”

So let’s just make this clear. You can’t eat saturated fats because of an indirect link that may lead to ……heart disease. This is the vaguest connection I have ever read from a so called serious scientific body. This is the same organisation that released a statement just three weeks ago telling us to stop eating saturated fats because it would definitely save lives…Hello. We have gone from a definite risk to a really vague connection. Well just so that we are all clear. The studies that they are relying on when they make this statement are so flawed it would make you weep.

Secondly the FSA appears to be hiding behind another organisation’s view – the WHO.

This would be all fine and dandy if it was correct but unfortunately for the FSA, the WHO has recently published a study which shows that there is NO LINK between the intake of saturated fats and heart disease. I suspect that the FSA have not been keeping up with publications by the WHO.

So when you feel all warm and cuddly relying on the advice of the FSA and believe that it is backed by the WHO and other eminent health bodies ….STOP. It isn’t. When you reach for the low fat spread believing that it is good for you remind yourself that humans were never designed to artificial fats. And as you tuck into the pasta the rice the bread and the potatoes remind yourself of the fact that this food is perfectly designed for a 17 hour day in the fields and not for the life of a modern man.

This week the Lancet officially recognised its role in the issue over MMR jab and the apparent link with various problems. They chose to officially withdraw the publication of the article which apparently showed the link.
Whilst I must applaud the Lancet for doing this, which is right a proper in light of the various ruling since the unfortunate event, it would be good to know that the editor and the peer review process takes a closer look at how it goes about approving any research for publication. Over the years since I have been looking more closely at various studies published in the Lancet and other medical publications it is disappointing to a significant number of studies published which “misrepresent” actual findings. For example there was an study published in the New England Journal of Medicine ( a most respected medical journal) which talked about low carb throughout the paper but only after a very very close read was it apparent that low carb meant about 125- 250 grams of carbs. This is not nor ever has been low carb. It is true that there is no legal definition of low carb but any expert in diet would know that there is a significant difference between reducing carbs to a level that the body goes into ketosis and simply a general reduction in carbs.
This problem of publication of research which has misleading conclusions is constantly happening and digging into past copies of the American Journal of Clinical Nutrition a 2006 study was published which concluded that there is no benefit to altering the macro nutrients of diets and that everything is based on calorie intake.
If you were a lazy reader it would be easy to read the conclusion and rely on the standards of the publication and peer review process to provide the comfort you need that the conclusion is proper and thorough. Unfortunately if you did not trust the peer review process and actually read the study you would find that:-
1. They studied “adults adhering to A ketogenic low-carbohydrate (KLC) diet or A nonketogenic low-carbohydrate (NLC) diet.” but concluded Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets, ” that is , they studied one diet but drew conclusions about all.

2. If you want to demonstrate metabolic advantage you have to show that some people lost more weight, calorie for calorie, than others, that is, you have to show individual behaviour. The paper is all group statistics.

So the problem faced by the Lancet is probably an issue for numerous publications.

Having been away on holiday for a week, I woke up this morning feeling relaxed and happy with the world. Switching on to Radio Five Live, as I made my morning coffee, I heard Dr Shyam Kolvekar suggesting to the British public that we should all give up butter to reduce the risk of death from cardio vascular disease and immediately my stress levels rose again!
The delightful Shyam Kolvekar quoted a Finnish Nurses Study as the irrefutable evidence of the link between saturated fats and death from heart disease. Since this so called pinnacle study there have been many more clinical trials that have fundamentally questioned the link between saturated fats and heart disease. For example just recently the Annals of Nutrition and Metabolism published a report on Fats and Fatty Acids in Human Nutrition which was part of an Expert Consultation held by the World Health Organization and Food and Agriculture Organisation.
There was two types of studies reviewed – epidemiological (statistical association studies) and intervention studies. Looking at the epidemiological studies first it was concluded that “Intake of saturated fatty acids was not significantly associated Cardiovascular Heart Disease mortality (deaths) “ and “ Saturated Fatty Acids was not significantly associated with Cardio Vascular Disease events “ (such as heart attacks etc )
The intervention studies – which is where they actually compare people on low fat with those not on low fat diets the conclusion was “ fatal cardiovascular disease is not reduced by low fat diets”
But this week there was another significant study published which looked at 21 epidemiological studies and the conclusion was
No association between saturated fat and risk of heart disease and no association between saturated fats and risk of stroke.
So you have to wonder why our friend the heart surgeon is referring to a very old study which has been superseded by many more accurate and significant studies. When you look at his expertise there is no indication that he has a special interest in diet or fat metabolism.