230. Statins: Expert Witness, Judge and Jury

The recent spat between the BMJ and The Lancet about statins must leave the ordinary members of the public in a complete state of confusion. If the leaders of the medical professions cannot agree, what chance is there for the non-specialist?

Essentially the key issue is the costs/benefit equation, which relate to the advantages and the side-effects.

In order to assess these, trials are conducted in which similar groups are compared. One is treated with the drug being studied and the other is given a placebo. The vast majority of these are funded by the drug companies themselves.

Pro-statin

The pro-statin position was presented in an article in The Lancet, which was prepared by the Cholesterol Treatment Trialists’ (CTT) Collaboration at the University of Oxford headed by Professor Sir Rory Collins (1). The key points made include the following:

  • Statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken, so larger absolute benefits would accrue with more prolonged therapy, and these benefits persist long term;
  • The only serious adverse events that have been shown to be caused by long-term statin therapy—ie, adverse effects of the statin—are myopathy, new-onset diabetes mellitus, and, probably, haemorrhagic stroke.

It concludes that the benefits greatly outweigh the incidence of adverse side effects and hence:

“It is, therefore, of concern that exaggerated claims about side-effect rates with statin therapy may be responsible for its under-use among individuals at increased risk of cardiovascular events.”

In an editorial in the same issue the editor, Dr. Richard Horton stated bluntly:

“Controversy over the safety and efficacy of statins has harmed the health of potentially thousands of people in the UK(2)”.

Clearly The Lancet has come down firmly in favour of statins.

The doubts

On the other hand the BMJ is not convinced. The editor-in-chief, Dr. Fiona Godlee has written to the Chief Medical Officer, Dr. Sally Davies, requesting an independent review into the use of statins(3). In an article Dr. Harlan Krumholz makes the following points:

  • There is little consideration of the limitations of the trial evidence;
  • The trial populations do not fully reflect the diversity of patients seen in contemporary practice across the world;
  • Few trials have included people over 80 years old, a growing population that has an increased susceptibility to adverse drug effects;
  • The individual trials were also underpowered to detect many relevant harms;
  • The timing of the trials is a matter of concern because, even without statins, the experience of patients with cardiovascular disease even a decade ago is much different from that today (4).

Those who have taken in interest this topic will know that Sir Rory Collins is a very keen advocate of statins. Three years he complained about a paper in the BMJ, which had stated that 18-20% of those on statins suffered side-effects and demanded that it should be retracted. It was accepted that the figure quoted was too high and a correction was issued. Despite this he continued to make protestations and as a result the BMJ established an independent group to conduct an assessment.

The panel unanimously rejected retraction and also noted with concern the failure of Collins to respond to offers from the BMJ to express his views in an article. On the other hand he did give an interview to The Guardian in which he criticised the way the BMJ had handled his complaint (5).

On another occasion he told The Guardian that the bad publicity about statins is:

“.. is a serious disservice to British and international medicine.”

He claimed that it was probably killing more people than had been harmed as a result of the paper on the MMR vaccine by Andrew Wakefield.

 “I would think the papers on statins are far worse in terms of the harm they have done.”(6).

It is also relevant to note that one of the authors involved, commented that Collins had not disputed his conclusion that CTT data failed to show that statin therapy had not resulted in any reduction in mortality over 10 years in those who had  <20% risk of heart disease.

This investigation also revealed that the CTT had received very substantial funding from drug companies over the past 20 years, which amounted to about £1 Million per month in today’s terms.

Making sense of it all

It is impossible to discount the financial aspects related to this issue. Even for a pharmaceutical company, there is big money going to the CTT. As a business, it is buying not only expertise but also the prestige, which goes with the University of Oxford and a high-flying academic, who is a Knight of the Realm and Fellow of the Royal Society (FRS). The last thing that the company wants or expects is any suggestion that there are problems with any of its products. Similarly the recipients of the money will be only too well aware of the company expectations. There is ample evidence to show that the interpretation of research is strongly influenced by the source of funding. So we should not be surprised in the least that the Oxford academics are using every trick in the book to maintain and defend their stance. Effectively they are acting as expert witnesses. The fundamental weakness is that the opposing point of view representing the interests of the public (including patients) simply does not exist. Those who are acting on behalf of the drug industry are regarded as the independent arbiters (ie judge and jury). As things stand at present, the system is heavily biased in favour of the drug companies, which is clearly working to their advantage. If we are to make any progress, then it is imperative to understand that the current procedures are fundamentally flawed and cannot provide independent objective evaluations of drug therapies.

The patient perspective

My own view is quite unequivocal. I would never agree to have statins. Here are my reasons. As I do not have any history of heart disease and there is no reliable evidence, which proves that statins are effective for primary prevention, there is simply no justification for the treatment. Although many people are persuaded because their cholesterol levels are regarded as “high” and therefore have an increased risk of heart disease, this argument is bogus. It is true that there is an association between the incidence of heart disease and the blood cholesterol level for middle-aged men, but this does not demonstrate “cause and effect”. Furthermore the key issue is not death from heart disease but all-cause mortality (ACM). We now know that for people in their 60s and over, which is when most deaths occur, those who comply with the cholesterol guidelines have the HIGHEST ACM! (7). So there is no need to be concerned about a high cholesterol value. For women, those with the highest cholesterol have the greatest life expectancy.

For those who have heart disease, I fully accept that there can be some benefit in terms of “lives saved”. But what exactly does this mean because you will die eventually? What we really need to know is how long has life been extended. Unfortunately it is not very much. In people at high risk (de?ned as those with a 5-year risk of major vascular events higher than 25%), the average delay of a major cardiovascular event has been calculated at 0·09 years (33 days) over 5 years with a statin induced 1·1 mmol/L reduction in LDL cholesterol (8).

Against this, we have to balance the adverse side-effects. There is considerable disagreement about the frequency and severity of these. There is absolutely no doubt they do happen.  While many of these may be relatively mild, in some cases they can be absolutely debilitating. There are numerous case histories of individuals whose lives have been devastated by the effects of statin treatment. Some of these are described in this blog (9). The more severe effects include memory loss and major neurodegenerative disorders including Parkinson’s Disease and Alzheimer’s Disease.

Informed choice

In my case the crucial issue is that, even assuming the most favourable scenario, it only means a bit more time in this world. However I might have to pay a very heavy price to achieve this, which could be a very marked reduction in the quality of life. For me, it is a “no brainer” to keep off statins. The clinching argument is that if I wish to prolong my life there are other strategies I can adopt, which are pretty well free of side effects and are likely to work well. These include adjustments to diet, especially reducing the intake of sugar and refined carbohydrates coupled with regular exercise.

While I do not expect everyone to agree completely with my approach, I would strongly recommend that the medical and healthcare professions adopt a strategy of “informed choice” in which the options are spelled out clearly to the patients, who can then decide for themselves what they would prefer.

This is precisely what Dr. David Unwin is doing with patients who have obesity, Type 2 Diabetes (T2D) and fatty liver disease. They can choose between a regime based on drug therapy or lifestyle change (including diet). Almost invariably they decide against the drugs. To cap it all, the results have been remarkably successful (10).

What is needed is for NICE to endorse Dr. Unwin’s approach and extend it to many other different disease/treatments.

Maybe it is more realistic to see pigs flying high!!

References

  1. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/fulltext
  2. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31583-5/fulltext?rss=yes
  3. http://www.bmj.com/content/354/bmj.i4992
  4. http://www.bmj.com/content/354/bmj.i4963
  5. https://www.theguardian.com/society/2014/jun/13/professor-statins-row-government-intervene
  6. https://www.theguardian.com/society/2014/mar/21/-sp-doctors-fears-over-statins-may-cost-lives-says-top-medical-researcher
  7. http://vernerwheelock.com/179-cholesterol-and-all-cause-mortality/
  8. M Bassan & N Panush (1997) American Journal of Cardiology 79, pp 1001–03
  9. http://vernerwheelock.com/177-statins-a-disturbing-study-about-adverse-side-effects/
  10. http://www.diabesityinpractice.co.uk/media/content/_master/4311/files/pdf/dip4-3-102-8.pdf

229. “Diet and Diabetes” event in Skipton on 10th September 2016

Background

Over 100 people attended this event, which was planned to help those with Type 2 Diabetes (T2D) understand that, contrary to the advice given by most health professionals, this disease can be controlled (possibly even cured) by making simple changes to the diet. There is now overwhelming evidence, not to mention the case histories of thousands of individuals, that this can be achieved very effectively by restricting the consumption of sugar and other starchy foods such as bread, rice, pasta and potatoes. The fundamental issue is that this is in direct conflict with the official advice from the NHS, which states that:

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.”

Introducing the talks, the organiser, Verner Wheelock, stated that the present position is a national disgrace. It is a scandal that patients are being given advice which is clearly not working and usually makes them worse. It is highly significant that the incidence of Type 2 Diabetes and obesity started to increase in the 1980s, when the advice to reduce dietary fat was first introduced. This was actively promoted by the food industry with a wide range of “low fat” products appearing on the market. Unfortunately as the fat was reduced there was a corresponding increase in the consumption of sugar and carbohydrates. We are still stuck with these guidelines, which are regarded as gospel by many health professionals.

Dr. David Unwin

Dr. Unwin, the first speaker, is a GP in Southport, where he is having incredible success with patients, who suffer from obesity and diabetes. His impact can be measured by the fact that he has reduced the cost of drugs prescribed by the practice by £45,000 per annum. A few years ago he almost gave up medicine because he felt that he was not genuinely helping his patients. Thirty years ago, there were 57 diabetics in the practice. Today there are 600 and 21 of them are under 50 years old. Then he discovered the evidence, which demonstrated that T2D can be controlled effectively by cutting down the sugar and carbohydrates. Because the carbohydrates (mainly starch) are broken down to simple sugars, these contribute to the sugar load in the blood, which is effectively T2D.

Dr. Unwin gave some examples of the success his patients have had simply by reducing the consumption of sugar and starchy foods. In one case, the patient had succeeded in getting the blood sugar down from the diabetic to the normal range in 38 days. He was able to stop all drugs as a result. In other words, he was effectively cured.

Dr. Unwin’s approach is one of “informed choice”. He spells out the options, including the use of drugs. However in practice, everyone chooses to try the dietary approach. He has a panel of 50 volunteers, which has shown that this works very well. The members have all lost weight, on average about 8.5 kg.

In order to help his patients, Dr Unwin has worked out the amount of sugar, expressed as teaspoons, produced by a portion of different foods. Some examples include:

Basmati rice, 10.1

Boiled potato, 9.1

Boiled spaghetti, 6.6

Broccolli, 0.2

Eggs, 0

From this it can be seen that some of the foods which are regarded as “healthy” have lots of sugar and are therefore a significant cause of diabetes.

Dr. Trudi Deakin

The second speaker, Dr. Deakin is a dietitian with a Ph. D. She has consistently advocated Low Carb as part of a strategy for controlling diabetes and has not been afraid to challenge the conventional view. She is based in Hebden Bridge and her registered charity, X-PERT Health, produces training programmes, which are now being used by many different NHS Trusts.

She has had tremendous success with individual patients who have suffered from T2D and obesity. It was fascinating to discover that the average weight loss her patients achieved was almost exactly the same as Dr. Unwin’s patients. The main focus of her talk was the official Eatwell Plate, which is promoted by Public Health England. In particular, she focussed on the advice that:

“Starchy foods should make up just over one third of everything we eat. This means we should base our meals on these foods.”

In a devastating critique, Dr Deakin explained in detail how many people who do just that, will end up with a sugar load that will result in Type 2 Diabetes. A typical breakfast based on cereal, milk, toast and marmalade is simply an absolute disaster.

Marika Sboros

The final speaker, Marika Sboros is a journalist who lives in South Africa but spends quite a bit of time in London. The battle for a logical, scientifically based approach to nutrition policies is not restricted to the UK. The establishment all over the world is using every trick in the book to prevent the information presented at the meeting from being disseminated. Many of those who are telling people exactly the same, have been attacked and vilified. In South Africa, Professor Tim Noakes has been charged with professional misconduct. Marika has followed the process very carefully and provided a world-wide audience with ball-by-ball commentary through her Tweets.

Marika Sboros explained that the accusation against Prof Noakes, a top-rated medically qualified scientist, was initiated by a complaint from the president of the dietitians association in South Africa at the time. The charge was based on two tweets, in which he told a breastfeeding mother that good first foods for infant feeding are low carb and high fat, which is basically meat and vegetables.

Prof Noakes had developed T2D and in order to understand the cause had explored the research and realised that his diet, which complied with the official recommendations (and are essentially the same as in the UK) was probably the cause. He switched to a low carb diet: very quickly he recovered good health and he lost weight. Even more remarkable, his performance as a long distance runner, which had been deteriorating, improved.

As a sports scientist, Professor Noakes had advocated carbohydrate-loading for athletes. But in the light of his own personal experience and his re-assessment of the research, he admitted publicly that in the past he had been wrong about the dietary guidelines. The way forward was to focus on a diet which was LCHF (Low Carb, High Fat). Then all hell broke loose. He was attacked by many of his colleagues in academia, culminating in the “trial”. So far there have been two hearings both of which lasted about a week. There will be a third in October, which is likely to be the concluding session. Marika described how the case against Prof Noakes has been an absolute shambles. The legal team supporting him (acting pro bono) has torn it to shreds. By contrast, Prof Noakes has constructed a compelling rebuttal, which provides a powerful comprehensive justification for an LCHF diet based on sound scientific research. If there is any justice, then he should be completely vindicated by the verdict.

Comments from attendees

Kathryn Taylor, Skipton:

“I attended because I have a personal interest in nutrition (I follow an anti-cancer diet), as well as a friend who has T2D.  I came along with a pal who is a practice nurse –she left inspired.

Top slot for me was Dr Unwin: he was an inspirational communicator and clearly a pioneering practitioner with a passion for healthcare and people.  He was not in the least bit patronising.

I’d loved to have heard much more from him, and about his message.   If you run the half day again, my request would be much more from him

Marika’s talk was fascinating to me, as a lawyer (process, injustice etc)”

 Fiona Benson, York:

 “The event was BRILLIANT and thank you so much for organising.  My husband and I have had a long interest in LCHF and we reversed my husband’s diagnosis following the LCHF lifestyle.  We have followed the LCHF lifestyle since reading Dr Atkins book back in 2003.  We have watched how industry (big food and big pharma) continues to dominate decisions and government guidelines and the appalling barriers in place to those professionals wishing to go against those guidelines.    We have also learnt how doctors have virtually no nutritional training as part of their training – they are taught how to identify symptoms and treat with drugs – no money in curing patients. 

The current medical model, as we all know, is at breaking point and privatising the NHS is not the way to resolve the issues. 

I have long heard of Dr Unwin’s work and was delighted that he was speaking close by enabling us to attend and at a very affordable price.”

Frank Kuhne, Bingley

“Members of my family have diabetes, so I have been closely aware of the misery it can cause over many years of a diabetic’s life.  It may have killed my mother early. Associated complications may be killing my brother early, too.

Meantimes, I have become steadily aware of the mountain of very high quality, scientific evidence showing that much suffering can be avoided and/or health regained. The utter shame is that some of this prime evidence has been available for decades; but it has not been acted upon with the urgency it deserves. Is this part of the “Flat Earth” syndrome?

I attended in order to learn more from the knowledge and experience of professional speakers and practitioners, who are tackling a neglect of prevention-and-reversal of diabetes assertively….

The meeting delivered all that I wanted of it….

The approach to the treatment of diabetes within the existing conventional wisdom, or according to the long-established status quo, seems to be one of treating the symptoms of the disease, rather than emphasising and tackling avoidance + cure. (As with cancer?)

I was glad to add my name to the list of others who might like to follow up the meeting.

The low-carb lunch was a fine idea.”

Joshua Fear, Cheadle:

Having worked in Specialist Weight Management and now as a Personal Trainer in the South Manchester Area, I have come into contact with numerous clients who have developed ‘Sugar Diabetes’. The increasing prevalence of this condition is concerning for people living with the disease and health professional alike. The good news is we have a surprisingly straightforward way of combating the rise. Driven forward by Doctors, Dietitians and a forward-thinking Journalist, the recent ‘Diet and Diabetes’ event in Skipton was a revelation for over 60 diabetics, health professionals and carers. Over the course of 3 hours, conventional thinking (and eating) was challenged, dietary guidelines exposed and an old-school ‘meat and two veg’ approach adopted. An invaluable and enlightening event delivered by world-class speakers that empowered everyone who attended.”

Susan Morris, Blackburn:

“I found the “Diet & Diabetes” seminar very interesting. It really does make you consider the benefits of a low carb diet.  As diabetes is on the increase this must be considered as a good option in helping reduce this terrible epidemic. I will personally be changing my diet and I think that an awareness campaign should be introduced nationally”.

 Dr Lisa Gatenby, Registered Nutritionist, Leeds:

“I attended the day as it’s important to keep up to date with research and what is happening in practice. Diabetes is such an increasing condition and we need to find better ways to deal with it, helping people to make changes to their dietary habits and helping them to really understand the condition can have a significant effect.  

It’s great to see some specific wording in the NICE recommendations to allow people to be given choice and information on Low Carbohydrate Diets and I think we need to make sure practice reflects the guidance.”

Deborah Thackeray, Skipton:

“I was delighted to attend the Diabetes Event at the Rendezvous Hotel in Skipton last Saturday. I have a Nutritional Therapy practice in the town, and I am seeing increasing numbers of people with type 2 diabetes or pre-diabetes. It was really interesting to hear diverse speakers talking about this entirely preventable and reversible health condition, with lots of good tips both for practitioners such as myself but also for the public. There was a strong sense that something needed to change. The focus was on food which chimed entirely with my practice. I work with people to help them feel better using food. I would definitely attend another event”.

Colin Faulkner, Colne

“Saturday was great – Dr Unwin’s presentation was inspiring, can’t wait for him to get the OK to release more helpful information on ‘teaspoons of sugar’ equivalents chart etc. can’t understand why more GP’s aren’t motivated to follow his lead – mine included…..”

Final reflections

I decided to organise this meeting because of the total failure of the national policy on T2D, which is an absolute scandal. The disease is effectively out of control. Millions of people are suffering. The usual treatment is not only ineffective but is making the condition worse. As a consequence, the quality of life deteriorates to such an extent that patients become blind and may have limbs amputated. If that is not enough, those with T2D have an increased risk of heart disease, cancer and Alzheimer’s Disease. There is overwhelming evidence that the primary cause of the disease is the excessive consumption of sugar and carbohydrates. There is reliable research and hundreds of case histories, which confirm that T2D can be successfully controlled (possibly even cured) by switching to a diet which is low in carbohydrates and high in fat.

Colin Faulkner was one of the attendees at the “Diet and Diabetes” event. Here is his story:

“I’m 62, retired and have been diagnosed as diabetic since 2002, but was probably suffering for many years before that.

I’ve never been overweight BMI (Bloody Minded Index) in low 20’s and have always been physically active, so diabetes is not just about being overweight…..

For the past 15 years I’ve progressed from diet only treatment to latterly maxing out on tablet medication – my GP classed my blood sugar control as excellent – even though I was always nudging the upper limits, upping the tablets and increasing my exercise regime accordingly.

Until March 2014 when I was diagnosed with bladder cancer, subsequent operations sorted that, but left me completely debilitated, constantly having to take antibiotics to try and ‘cure’ Urinary Tract Infections.

By October 2015 I was desperate, nothing worked, my daily Blood Glucose readings were way out of range, so I consulted my GP and an Airedale Diabetic consultant.

Their only solution was for me to start on Insulin.

So independent of them I started researching LCHF diets and despite being warned off I started that after Christmas 2015.

Prior to starting (October 2015) my HbA1c was 57mmol/mol, my last result June 2016 was 37 after cutting my diabetic meds from 8/day to 2/day, stopping blood pressure and cholesterol (currently 5.5) tabs.

Also 3 weeks after starting on LCHF the UTI’s stopped.

Note: HbA1c is a measure of the blood glucose over the past 3 months.

It will be evident from this, that the conventional treatment was going nowhere and that the recovery only commenced when Colin took control for himself. The real scandal is that for every person who does this, there are hundreds more who soldier on getting progressively worse.

 

I have made representations to the Government. In particular, I pointed out that:

“Type 2 Diabetes (T2D) can be controlled and in many people actually cured. This is done by removing the cause which is excessive consumption of sugar and carbohydrates, which result in so much glucose in the blood that the body is unable to cope. Unfortunately the official dietary recommendations are in direct conflict with this strategy which includes:

  • ‘’Starchy foods such as potatoes, bread, cereals, rice, pasta should make up about one third of the food you eat’’.

 

The reply from Jane Ellison, the Minister at the time, contained the following:

“Preventing diabetes and promoting the best possible care for people with diabetes is of great concern to the Government. The NHS Five Year Forward View set out a commitment to implement the National Diabetes Prevention Programme to provide lifestyle programmes to pre-diabetic patients in order to reduce the risk of their developing diabetes. The Department is also building on the Diabetes Prevention Programme to improve the outcomes of people with and at risk of diabetes and will put forward our plans in due course.”

In other words she is telling me to “get lost” and there was not the slightest attempt to deal with the points which I made. Had she been doing her job properly (and an effective politician) she would instructed her civil servants to explain why the proposals I had put forward were faulty. In effect she just ignored my arguments.

Unfortunately this Prevention Programme is based on the same old discredited approach which has failed so miserably in the past. So the reality is that as long as this remains the cornerstone of the strategy there will be no progress and things will continue to get worse. It is unbelievable that there is a complete inability to accept that the policy is a total disaster. Imagine the outcry if bridges collapsed or aeroplanes crashed regularly. Yet this is exactly what is happening with diabetes. The professionals seem to be able to avoid responsibility for their own failures and even worse blame the unfortunate patients.

In the light of this, it is obviously pointless to attempt to get any change at government level and so I have decided that I will focus my efforts on the grassroots, which is the rationale for the event at The Rendezvous.

My objectives were to:

  • Make the information about the benefits of a Low Carb diet available to many people who currently are being treated conventionally with drugs;
  • Encourage other to become actively involved in other initiatives to spread the information far and wide;
  • Ultimately build up pressure from the public generally and within the healthcare professions so that the Government is forced to abandon the existing discredited policies.

Business support

So far, I am delighted with the response. Prior to the event, many local companies provided help and support, for which I am extremely grateful. These include:

Broughton Hall Business Park

Craven Energies

Keelham Farm Shop

Wilman & Wilman

Pearson & Associates

Tempest Arms

Verner Wheelock Associates

Hannah Sutter who runs The Natural Low Carb Store personally attended and brought lots of suitable food products for the lunch and has provided support in a variety of different ways.

However, there has to be special mention for Malcolm Weaving and his staff at The Rendezvous for providing accommodation for the speakers and for the event. On top of all this, the Low Carb lunch was superb and demonstrated conclusively that it is possible to produce wonderful dishes without lots of carbohydrates. The chef, Stuart Benson did a great job and spent some time chatting to people and answering questions about how he prepared the items on the menu.

Conclusion

It was very encouraging that there was such a good attendance. Some had travelled quite a distance, coming from as far as Lincolnshire, East Yorkshire, Tees Side, Cambridgeshire, Liverpool, Manchester and Derbyshire.

I hope that we can push on from here and that there will be plenty of ideas and suggestions to help spread the word. I would like to think that “Diet and Diabetes” on Saturday will act as the spring-board for many other activities. There is considerable interest in establishing a Lunch Club based at The Rendezvous and I look forward to hearing from anyone who is interesting in further initiatives.

I can be contacted by email: verner.wheelock@vwa.co.uk

 

 

228. Skulduggery in the Development of the Dietary Guidelines

Background

The development of the Dietary Guidelines in the USA during the 1970s and 1980s has had a huge impact on food consumption patterns ever since. Because the advice to reduce fat was enthusiastically taken up by the food industry with the promotion of “low fat” products, this message was successfully conveyed to consumers. As a consequence, there has been an increase in the consumption of sugar and carbohydrates.

Many other countries, especially in the English-speaking world, followed the lead given by the Americans and devised nutrition policies, which were essentially the same. Looking back, it is now evident that the huge increases in the incidence of obesity and Type 2 Diabetes (T2D) commenced at the same time as the dietary recommendations began to take effect.

The debate about how the dietary patterns contribute to the development of heart disease boils down to the relationship between fat and sugar/carbohydrates. From the perspective of the 1950s and 1960s the question was:

“Do we need to reduce fat or sugar?”

Despite rearguard action, there is little doubt that dietary sugar really is the “bad guy”, which is one of the primary causes not only of heart disease but also of T2D, cancer and Alzheimer’s Disease (AD).

New research

It is especially interesting that a paper has recently been published which reveals the interactions between the sugar lobby in the USA and some of those who had a critical influence on the contents of the US Dietary Guidelines (1). The authors have been able to access some of the relevant correspondence, which is absolutely devastating.

In order to appreciate the significance we need to understand what the position was in the US at the time. In his book “The Diet Delusion” this is described by Gary Taubes (2). He explains that the focus of the debate was on the importance of dietary fat and the role of cholesterol-lowering in relation to heart disease. Although the “Dietary Goals” was drafted by a researcher Nick Mottern, he relied almost entirely on the advice of Mark Hegsted, a Harvard nutritionist. He was an ardent advocate of reducing the intake of fat as a means of tackling heart disease, although he recognized that that this view was controversial.

At the press conference announcing the first draft of the document, Hegsted stated that:

“The question to be asked is not why we should change our diet but why not? There are [no risks] that can be identified and important benefits can be expected.”

Doubts expressed

Even the American Medical Association had genuine doubts and advised the Senate Select Committee that:

“there is a potential for harmful effects for a radical long term dietary change as would occur through adoption of the proposed dietary goals”.

Despite this and other criticisms from many distinguished researchers, these concerns were brushed aside by the Committee, which effectively endorsed the first draft and concluded that:

“..no physical or mental harm could result from the dietary guidelines recommended for the general public.”

Subsequently Hegsted was appointed as head of the USDA Nutrition Center, which would be responsible for implementing the guidelines.

The role of the sugar industry lobby

The recent report is especially significant because it is based on internal sugar industry documents which describe how the industry sought to influence the scientific debate over the dietary causes of heart disease in the 1950s and 1960s.

The sugar industry lobby was especially concerned about emerging research which indicated that there was an association between the level of blood glucose and the incidence of heart disease. There was also convincing research that the level of triglycerides (TG) or fat in blood was determined by the amount of sugar consumed. When the starch which is the dominant carbohydrate in foods, such as rice and bread, only glucose is released. However when sugar (sucrose) is digested, glucose and fructose are released. There were indications that there could be a specific issue with fructose, which in my view, has been confirmed by recent developments.

An editorial in the New York Herald Tribune concluded that the new research strengthened the case that sugar increased the risk of heart attacks.

As a direct result of this editorial, the Sugar Research Foundation (SRF) established Project 226. Effectively this had the object of countering this threat to the sales of sugar. So in July 1965, Mark Hegsted was commissioned by the SRF to produce a review, which would be helpful to the sugar industry. During the next year, he worked on the project. At one point he commented in a letter to the SRF:

““Every time the Iowa group publishes a paper we have to rework a section in rebuttal [emphasis added].”

The Iowa group was responsible for most of the research which worried the SRF.

It is pretty clear from this that Hegsted was not exactly objective in the way he approached the review. Just before the review was submitted for publication, the SRF executive commented:

“Let me assure you this is quite what we had in mind and we look forward to its appearance in print.”

Shortly afterwards, the review was published in the New England Journal of Medicine (3). Unfortunately there is restricted access. From what I can make out, the review simply discounts most of the evidence which suggests that sugar could be a cause of heart disease. According to Kearns et al (1), the authors were guilty of double standards. They note that:

“Despite arguing earlier in the review that epidemiologic evidence was irrelevant to determining dietary causes of CHD, the review implied that the epidemiologic evidence pointed to dietary cholesterol and saturated fat as the primary dietary causes of CHD.”

Conclusion

To put it bluntly, they produced a “hatchet-job” which met the objectives of the SRF. We now know from this latest research that the 3 authors (one of whom was Hegsted) were paid $6,500 (almost $50,000 in current value). This was not disclosed, which is the real scandal. It was clear that there was an obvious agenda and the last thing in the mind of the authors was to produce a balanced, objective evaluation of the evidence. Since then, evidence has emerged, which shows conclusively that the source of funding does influence the results of scientific studies and more importantly the way they are presented. This example is particularly blatant but unfortunately has had a much greater impact than anyone could ever have anticipated. Given the controversy at the time, it is possible that without this intervention the Dietary Guidelines in the US might have been totally different. As a consequence, we may well have avoided the current disastrous level of obesity and T2D.

References

  1. C E Kearns et al (2016) http://archinte.jamanetwork.com/article.aspx?articleid=2548255
  2. Gary Taubes (2007) “The Diet Delusion” Vermillion: London
  3. http://www.nejm.org/doi/full/10.1056/NEJM196707272770405

 

 

 

 

 

227. Letter to the Prime Minister on Diabetes

Dear Mrs May,

Congratulations on your appointment. I wish you every success in your new role, which will undoubtedly be very challenging.

Diabetes policy

I am taking the liberty of writing this letter because of my serious concerns about the national policy on diabetes. I understand from articles in the media that you suffer from Type 1 Diabetes (T1D). From a public health perspective, Type 2 Diabetes (T2D) affects many more people. Currently, expenditure by the NHS on diabetes is about £10 Billion per annum. In addition, there are the costs to the economy, not mention the scale of human suffering. The incidence has approximately doubled in the past 15 years and it is expected that this rate of increase will be maintained for the foreseeable future. Current policies are simply not working.

Understanding diabetes

T1D is caused by the failure of the pancreas to produce sufficient insulin, which is required to control the level of glucose in the blood, by directing it to the liver and the other vital organs where it is utilised. Before the discovery of insulin, there was no effective treatment for T1D.

T2D is different because it is caused by the persistent consumption of diets which have a high content of sugar and carbohydrates. In order to cope with this, the pancreas has to increase the production of the natural insulin. This excess insulin causes a reaction in many organs which reduces the sensitivity to insulin (referred to as “insulin resistance”). As a consequence the pancreas has to produce even more insulin so that it can control the blood sugar. After several years, the inevitable result is catastrophic failure of the pancreas and at this point, the blood glucose increases and if it is being monitored, T2D will be diagnosed.

Why current policies are not working

According to the official Diabetes Prevention Programme, the definition of T2D is a:

“condition of insufficient insulin production”.

So it follows from this that much of the emphasis for treatment is to apply insulin therapy. It should be obvious that this will not work because the basic problem has been caused by the natural production of excessive a mounts of insulin. Applying even more will only make things worse by increasing insulin resistance.

The key to success in controlling T2D

The most effective way to cope with T2D is to eliminate the primary cause, which is excessive intake of sugar and carbohydrates. This has been successfully demonstrated by hundreds of individuals, whose case studies have been published on the internet. Here is one example from Ian Day who sent me the following information:

“I was diagnosed Type 2 Diabetes in 2,000 at age 61. I was advised to eat the NHS “healthy diet” with plenty of starchy carbs, low fat, sugar and salt. I was also advised that however well I complied, diabetes was progressive and would lead to problems with eyes, kidneys and possible stroke and heart disease.

It’s inevitable – the nature of the disease.

Sure enough the disease progressed – reduced kidney function, beginning of retina bleeds, chronic tiredness and severe crippling peripheral neuropathy.

In May 2008, with advice from Fergus on the www.diabetes.co.uk/forum I gave up all the obvious carbs.

My blood sugars immediately improved and within 3 months I was out of pain and able to play tennis again.

Now, after 7 1/2 years on a low carb, high fat diet I am well, with NO diabetes complications.

I would not DARE revert to the NHS/Diabetes UK “healthy” diet. It’s poison.”

I can assure you that this is by no means an isolated case. There are literally hundreds if not thousands who have had a very similar experience. Some examples can be found on this website (1). The reaction of many individuals to the conventional advice can be gauged from these links (2, 3, 4).

Increasing consumption of carbohydrates makes no sense

As Ian Day points out, the standard NHS advice is to INCREASE the consumption of carbohydrates. This is absolutely unbelievable. There is no doubt that this official approach is one critical factor which is contributing to our current problems.

The outstanding work of Dr. Unwin

There is comprehensive research which confirms these personal case histories (5). However the work of Dr. David Unwin and his colleagues in their General Practice in Southport is particularly impressive. They have successfully treated diabetics with a diet which is low in carbohydrates (6). In a study with over 60 people the average weight loss was 9kg, the blood sugars were normalised and the fat in the liver was reduced substantially.

The case history of one patient is particularly impressive.

This was a 55-year old woman who started out with an HbA1c of 84 mmol/mol (9.8%) which is effectively out of control and a GGT of 103 iu/L which showed that the liver function was deranged. Essentially this is a bad case of T2D. She had been prescribed metformin. After 3 months on the low carbohydrate diet the GGT was down to 12 iu/L (a reduction of almost 90 %!!) and an ultrasound scan confirmed the liver was functioning normally. She also lost 7.9 kg. In the longer term she has lost a bit more weight, the liver function is fine, her HbA1c is just about OK but she has come off the metformin. She has lost 17 cm from her waist and says she feels “10 years younger”.

(Note HbA1c is a measure of blood sugar and GGT is a marker for Non Alcoholic Fatty Liver Disease).

Dr. Unwin is clearly being highly successful in improving the health of his patients. The other significant result of this work is that expenditure on drugs in the practice has been reduced by over £40,000 per annum.

 

 

How to make progress

The basic problem is that the official guidelines on Healthy Eating are fundamentally flawed. The emphasis on REDUCING FAT and INCREASING CARBOHYDRATES is wrong. Overcoming T2D is achieved by doing the exact opposite.

A so-called healthy diet, which has a high content of carbohydrates is also unsuitable for those with T1D. This is because the higher the intake of carbohydrates, the more insulin has to be used. As this causes insulin resistance to develop, it means that many who are diagnosed with T1D eventually also develop T2D. It follows that those with T1D, should consume a diet which has a low content of carbohydrates so that the amount of insulin which has to be used is kept to the absolute minimum.

The outstanding example of this is Dr. Richard Bernstein. Originally diagnosed with T1D when he was 12 years old, he experienced very poor quality life for 20 years because he complied with the official advice to consume a diet with a high content of carbohydrates. As he had trained as an engineer, he applied his skills to study the disease and devised a series of procedures which enabled him to reduce the amount of insulin required, including a diet which was very low in carbohydrates. He improved the quality of his life enormously and in order to disseminate his knowledge more widely he re-trained as a medical doctor. To-day he is in his eighties and still practicing. His book “Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars” should be essential reading for all those with T1D (and T2D) (7).

Time for a re-think

I have made my views known to the Government on previous occasions only to be given the brush-off. Ministers have not even had the courtesy to respond to the case I have presented. The blunt truth is that for any progress to be made the government advisers will have to admit that current policies are not working, which means that their input has been wrong. It really is time to make a complete re-evaluation of these policies on diabetes and related issues. New and different advisers should be asked to provide new and different perspectives. In South Africa, Professor Tim Noakes has been instrumental in advocating a diet which is low in carbohydrates, which is having a big impact in the country. There are many others who are listed on this website (8). Finally, I must emphasise the vital importance of the work of Dr. David Unwin. An approach which improves health and reduces costs has enormous policy implications. At the very least this should be examined not only by the DoH but also by the Treasury. Any strategy, which is effective and does not increase costs deserves to be carefully scrutinized.

I am convinced there is a genuine opportunity for a policy initiative that would be highly successful and welcomed all over the world. On the other hand, current policies are failing badly. They will have to be changed eventually, so surely it would be preferable for this to happen sooner rather than later?

Yours sincerely

Verner Wheelock

References

  1. http://www.lowcarbdiabetic.co.uk/My%20Friends%20Stories.htm
  2. http://healthinsightuk.org/2015/09/29/time-for-diabetes-uk-to-unplug-ears-and-respond-to-chorus-of-disapproval-demanding-u-turn/ …
  3. https://www.facebook.com/AmericanDiabetesAssociation/posts/10153140618374033 … …
  4. http://www.bmj.com/content/351/bmj.h4023/rapid-responses
  5. http://www.sciencedirect.com/science/article/pii/S0899900714003323
  6. D Unwin et al (2015) http://www.diabesityinpractice.co.uk/media/content/_master/4311/files/pdf/dip4-3-102-8.pdf
  7. R K Bernstein (2011) “ Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars” Little Brown New York ISBN 978-0316-18269-0
  8. http://foodmed.net/gd-home/

226. Could a Low Carb Diet Help Cancer Patients?

Case history of Paul Kelly

An article in the Daily Mail (1) gives a detailed account of how a young man with brain cancer has had remarkable success by switching to a diet which is severely limits his intake of carbohydrates. Paul Kelly, aged 27 years, was diagnosed with a tumour in his brain two years ago and told he just had months to live. An operation was not possible and he was advised that chemotherapy was the only option. He researched the subject and decided that consuming a diet which was low in carbs and high in fat would be preferable to the conventional treatment with drugs. He does not eat any processed foods, refined sugars, root vegetables, starch, breads, or grains. The only carbs in his diet are from green vegetables. He also fasts regularly and monitors his blood sugar twice daily. He takes supplements and anti-inflammatories.

Although the tumour is still present, it has not got bigger and he has certainly done considerably better than would have been expected if he had followed the advice of his doctors.

It is no great surprise to learn that the establishment is not in the least impressed. Cancer Research UK expressed doubts about possible benefits of any diet on cancer. According to Professor Tim Key, of Oxford University’s cancer epidemiology unit, the evidence for this sort of diet is ‘weak’.

I find this response absolutely appalling. If this was an isolated example, I could understand the scepticism but the reality is that it is just one more that can be added to a very long list, where the story is very much the same.

More case histories

A few months ago I did a blog about Archie Robertson, who recovered from Œsophageal cancer, which is one of the most deadly types, with the help of a ketogenic diet (low in carbs and high in fat) (2).

Even more compelling is the experience of Jane Plant who is Professor of Geochemistry at Imperial College in London. For 5 years she was the Chief Scientist for the British Geological Survey (9). In 1987 she was diagnosed with breast cancer, which recurred 5 times and by 1993 had spread to her lymph system. At this point she took matters into her own hands by applying her training and expertise to try to identify what was causing her disease. As a result she devised simple changes to her diet and lifestyle which produced a complete cure. Her book describes how the story unfolds and contains details which may be used to cure or prevent cancers of the breast and prostate (3).

When she visited the clinic, she repeatedly asked the doctors and nurses what actually caused her breast cancer and what she should do to reduce the risk of it recurring. While it was accepted that a high level of oestrogen in the blood was a contributory factor, Jane was especially interested to learn what changes she should make to her diet which would help to lower her oestrogen levels. They seemed to be completely flummoxed by her persistent questioning and so she was referred to a dietitian. This was equally fruitless because although the dietitian agreed to look into the matter but did not deliver and even failed to return telephone calls. Essentially the advice was to forget about the breast cancer, get on with life and think positively!

Failure to address the primary cause

During my research in recent years it has become blindingly obvious to me that the inherent flaw inherent in much of medicine is the widespread failure to take any interest in the cause of the various diseases as the experience of Jane Plant illustrates so clearly. Unless the cause can be identified and appropriate steps taken to remove it, then it follows that the risks of developing the disease remain in place. All the conventional treatments for cancer, surgery, radiation and chemotherapy are simply directed at tumour removal, which are essentially symptoms. Since the actual cause has not been addressed, there is every possibility that another tumour will develop. One of the few area of genuine progress has been with lung cancer, following the identification of tobacco smoking as the predominant causal factor. Successful reduction in smoking has resulted in a concomitant reduction in the incidence of this cancer.

Diet is a key factor

It is unbelievable that so many cancer specialists and researchers pay so little attention to the nature of the diet. On the other hand there has been enormous emphasis on the genetic aspects, despite the fact that the dramatic increase in cancer incidence over the past 70-80 years could not possibly have been related to genes.

As researchers like Thomas Seyfried have shown, many cancers are caused by a disruption of the body’s metabolism, which in turn is a reflection of the type of diet being consumed (4). The starting point is the research of the famous German biochemist Otto Warburg who discovered that cancer cells develop from normal healthy ones because they are unable to produce energy by the usual process of glycolysis, which is dependent on a supply of oxygen. Instead they have to utilise a fermentation, which does not require oxygen (anaerobic). This is known as the Warburg effect.

Basically this means that cancer cells are dependent on a supply of glucose to function. Hence it follows that if this supply can be cut off or at least severely restricted, then this may be an effective way of controlling the cancer. In practice this can be achieved by replacing the sugar and carbohydrates in the diet with fat. Although the official advice is that carbohydrates are essential in order to provide energy, this is nonsense because the healthy body cells and organs can utilize fat as a source of energy. However it may take a day or two to get the fat burners working.

Conclusion

The experience of Paul Kelly and others is not surprising to anyone who takes the trouble to study the scientific literature. It is totally irresponsible on the part of the establishment figures to be skeptical of these case studies. The progress with cancer has been absolutely pathetic even though enormous resources have been expended in many countries, especially the USA. If there was genuine concern for the welfare of patients, the success of Paul Kelly and other should be used as a springboard for a new approach to cancer research and treatment, The reality is that these are seen as a threat to very powerful vested interests for the very simple reason that the scope for making money out of dietary advice is minimal compared with the sale of drugs at exorbitant prices!!!

References

  1. http://www.dailymail.co.uk/health/article-3691808/Quitting-carbs-saved-life-Cancer-victim-given-months-live-refuses-chemo-claims-diet-meat-dairy-s-alive-two-years-later.html
  2. http://vernerwheelock.com/212-recovering-from-cancer-case-history-of-archie-robertson/
  3. Jane A Plant (2000) “Your Life in Your Hands: Understanding, Preventing and Overcoming Breast Cancer”. Virgin: London
  4. T N Seyfried (2012) “Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer” John Wiley New Jersey ISBN 978-0-470584-92-7

 

 

225. Another Nail in the Cholesterol Coffin

The “Lipid Hypothesis”

Are you worried about your blood cholesterol (TC) level? For many it is a fact of life (and death) that if you have a high TC level this means an increased risk of dying from heart disease. Hence it follows that steps should be taken to lower it in order to reduce the risks. It is this rationale which underpins the case for using statins and for the dietary advice to reduce the consumption of saturated fats (SFAs) and to increase that of polyunsaturated fats (PUFAs). A recent paper in the BMJ is a further addition to the huge amount of evidence that challenges the validity of this hypothesis (1).

This is a re-examination of the data from the Minnesota Coronary Experiment (MCE) which was a trial done between 1968 and 1973. This was to determine if the replacement of SFAs with a vegetable oil, rich in the PUFA linoleic acid (LA) would reduce the incidence of coronary heart disease (CHD) by lowering the TC. The original report was published in 1989 (sometime after the end of the study!) (2). In this latest report, the researchers had access to data, which had not been used in the preparation of the earlier one. Information was obtained for 2355 individuals with an age range from 20 to 97 years. Slightly more than half were women and 25% were 65 or older. The average TC was 208 mg/100 ml (5.39 mmol/L). In order to lower the TC, the diet was altered by reducing the SFA from 18.5% to 9.2% of Calories. The Increase in PUFA was largely due to LA which increased from 3.4% to 13.2% of Calories. During the study there was also a small increase in the LA content of the control diet from 3.4% to 4.7%.

The researchers have attempted to answer three questions.

Did the MCE intervention lower serum cholesterol?

The answer to this question was a definite YES. There was of 31.2 mg/100mg (0.8 mmol/L). As expected, there was also a small reduction in TC of the controls because of the increase in LA in the diet.

Did the MCE intervention reduce risk of death?

 This is the $64,000 question. If the conventional wisdom is correct then there should be a substantial drop in the risk of dying from heart disease. However my big gripe about this is that I need to be sure that there is not an increased risk of dying from some other cause. So I am only interested in the impact on all-cause mortality (ACM). It was found that there was no reduction in ACM for those who changed their diet and there were strong indications that there was actually increased mortality in those aged over 65 years.

Was the change in serum cholesterol related to risk of death?

In contrast to what would be expected according to conventional wisdom, the reduction in TC of 30mg/100mg (0.78 mmol/L) was accompanied by an increase in death rate of 22%. Even more disturbing is that was restricted to those who were over 65 years old. In this group, the ACM was increased by 35%. Post-mortems were done on some of the participants and the results showed that the incidence of myocardial infarcts in those who altered their diet was double that of those in the controls.

Not just an isolated example

While the advocates of the Lipid Hypothesis may try to brush this off as an isolated study, the reality is that it fits in perfectly with lots of other information, which all point to the same conclusion. I have described many different studies on the relationship between TC and ACM in a previous blog (3). I concluded:

“Without exception all-cause mortality is highest in those with the lowest levels of TC. In older people those with the highest cholesterol have the highest survival rates, irrespective of where they live in the world. The picture which emerges is totally consistent.”

The evidence continues to pile up

More recently in June 2016, BMJ Open published a meta-analysis based on 19 carefully selected studies, which involved just over 68,000 participants. This highly relevant because the focus is on the LDL-Cholesterol (LDL-C) the so-called “bad” one. The analysis found that there was either a lack of an association or an inverse association between LDL-C and mortality among people older than 60?years. In almost 80% of the total number of individuals, LDL-C was inversely associated with ACM and with statistical significance. To make it quite clear what this means is that those with high values for the LDL-C, the risk of dying (from any cause) is less than with those who have lower values. Or to put it another way, those who comply with the official guidelines for LDL-C are more likely to die than those who are regarded as “at high risk for heart disease” because they have a raised LDL-C.

Results like this have been emerging for years. As long ago as 1992, there was a conference to consider a whole series of investigations which came to similar conclusions (5). These were just brushed aside because they posed a threat to the National Cholesterol Education Program (NCEP) in the USA, which was already in place. The explanation put forward was that the low cholesterol was caused by the incipient disease. This possibility was eliminated by excluding data for people who died in the first 4 or 5 years.

A more likely explanation is that the high cholesterol is beneficial and that low values increase susceptibility to diseases that prove to be fatal. This view is supported by the fact that LDL-C binds to various microorganisms and their toxic products thereby inactivating them. Hence those with high LDL-C would have some protection, which would not apply to those with low values.

Conclusion

The implications of this knowledge are absolutely mind-blowing. If these results are reliable and there is so much from a variety of different sources, they really do have credibility, then it is totally irresponsible to advise them to lower their cholesterol. It is comparable to advising a person with gold-plated final year salary scheme pension to give it up for something that is much more risky. Those in a position to take effective action to address this fiasco, to put it mildly, have been totally irresponsible. Perhaps CORRUPT would be more accurate to describe what is going on. All I can say is that if you are advised to reduce your cholesterol by diet or drugs, then show your adviser the information shown here, which all comes from high quality authoritative sources.

References

  1. C E Ramsden (2016) http://www.bmj.com/content/bmj/353/bmj.i1246.full.pdf
  2. I D Frantz Jr et al. (1989). Arteriosclerosis 9 129-35 doi:10.1161/01.ATV.9.1.129
  3. V Wheelock http://vernerwheelock.com/179-cholesterol-and-all-cause-mortality/
  4. U Ravnskov et al  (2016) http://bmjopen.bmj.com/content/6/6/e010401.full
  5. D Jacobs et al (1992) Circulation 86 pp 1046-1060

 

Time for a “Chilcot Inquiry” into the UK Policy on Diabetes

Chilcot: a devastating critique of government in the UK

The report of the Inquiry conducted by Sir John Chilcot is a devastating condemnation of the Blair government’s decision to participate in the invasion of Iraq in March 2003. It provides a long list of failures, which demonstrates unbelievable incompetence, which has resulted in death, destruction and suffering on a huge scale. One of the key factors was the crucial role of the reports on intelligence.

The conclusion of Chilcot was that:

“The Government’s strategy reflected its confidence in the Joint Intelligence Committee’s Assessments. Those Assessments provided the benchmark against which Iraq’s conduct and denials, and the reports of the inspectors, were judged.

As late as 17 March, Mr Blair was being advised by the Chairman of the Joint Intelligence Committee that Iraq possessed chemical and biological weapons, the means to deliver them and the capacity to produce them. He was also told that the evidence pointed to Saddam Hussein’s view that the capability was militarily significant and to his determination – left to his own devices – to build it up further.

It is now clear that policy on Iraq was made on the basis of flawed intelligence and assessments. They were not challenged, and they should have been

Parallels with public health

 Although public health might seem to be completely different from a decision to go to war, the similarities in terms of policy formulation are quite striking when considering the present policy on diabetes.

As I will explain, huge numbers of people are suffering from diabetes, especially Type 2 (T2D) and current policies are one of the major reasons why their condition is deteriorating. As a consequence, they are forced to endure a poor quality of life and many of them die prematurely.

The incidence of diabetes has doubled in the past 15 years. It costs the NHS about £10 Billion and all the indications are that it will continue to increase for the foreseeable future. It must be obvious that the existing policies are failing badly. Nevertheless the politicians continue to persist with precisely the same strategy.

Diabetes is diagnosed by raised levels of glucose in the blood. Type 1 (T1D) is the result of damage to the pancreas so that it has lost the ability to produce insulin. It is the insulin which keeps the blood glucose under control. For those who suffer from T1D, insulin therapy is essential for survival. By contrast, T2D develops gradually and almost certainly is caused by persistent high consumption of sugar and foods which contain starch, which is broken down in the gut to release glucose. We now have good evidence that the solution to T2D is to tackle the basic cause by reducing the consumption of sugar and other sources of carbohydrates in the diet.

In the UK, the main emphasis for the treatment of T2D is on the use of drugs to control the blood glucose. With respect to lifestyle, the advice is to take more exercise, which is makes good sense. Patients are also advised to lose weight, even though the usual approach of calorie reduction has a very poor record of success. The conventional advice on diet is to reduce the fat and replace it with carbohydrates.

Policy is just not working

 So the fundamental problem is that the key element of the official Diabetes Prevention Programme is one of the primary causes of the current epidemic. Those who follow the advice to increase the consumption of carbohydrates inevitably get worse, while those who do the exact opposite invariably show some improvement. Furthermore there are numerous examples of individuals who have been able to stop taking drugs altogether by adopting this approach.

The big question is:

“Why does government and the health/medical establishment persist with a fundamentally flawed policy?”

It is quite clear that there is a complete failure/inability to conduct an objective analysis of the issues. There must be another agenda, which is a powerful driving force. All the indications are that any information which does not fit in with the current predominant concepts are simply discounted. This is an exact parallel with the attitude to “weapons of mass destruction” (WMD). A recent BBC radio programme has revealed that there were several intelligence reports, which concluded that Sadam Hussein did not have WMD. One of these cost the Americans $200,000. All of these were rejected on the grounds that “they would say that!”

Failure to challenge the advice from the “experts”

 The standard advice is accepted without being challenged. When I wrote to my MP with evidence showing the benefits of a low carb diet for those with T2D, my letter was forwarded to the junior Minister in the Department of Health (DoH), Jane Ellison. This is the reply:

With regard to low carbohydrate diets, the Scientific Advisory Committee on Nutrition (SACN) has published its report “Carbohydrates and Health” in July. In that report, SACN considered evidence from a wide range of prospective studies and randomized controlled trials that investigated the relation between consumption of carbohydrates and various health outcomes. The evidence considered by SACN for this report does not support the suggestion that consuming a diet low in carbohydrates and high in fats would reduce the risk of type 2 diabetes, but found that greater consumption of sugar sweetened beverages is associated with increased risk.”

This SACN report is very poor because it ignores much relevant research which provides sound justification for the use of low carb as a means of controlling T2D. The reply from the Minister made no attempt to reply to the specific points which I made.

A lost opportunity

 Although I am writing this when a new Prime Minister has just taken office, Jeremy Hunt will be continuing as the Minister responsible for health. This suggests it is unlikely there will be any change for the better. Yet the reality is that if the present trends continue, the costs will not be sustainable. Eventually, new policies will have to be devised and it would make very good sense for this to happen sooner rather than later.

Conclusion

In the meantime, I have no doubt that pressure will be building up from the grassroots, as more and more individuals find out for themselves that T2D can be overcome by relatively easy changes that can be made to the diet.

 

 

 

 

 

223. The Practicalities of Changing your Diet

The objective

The fundamental objective is to reduce the amount of carbohydrates being consumed and largely replace them with the healthy fats. You should make the changes gradually so that your body can activate its fat burning capabilities. The approach should be try out a variety of different strategies, so that you can identify those that are feasible and acceptable to you and to the other members of your household.

Focus on sugar initially

The starting point really has to focus on sugar and as much as possible should be eliminated. If sugar is used in tea or coffee if you cut it out altogether your taste buds will soon adjust if you persist. If possible, it is best not to use sweeteners, especially saccharin and aspartame. Some information on sugar-free baking is available here (1). The big problem is that sugar is present in so many processed foods. Sugar-sweetened soft drinks are full of sugar and certainly should not be consumed very day. Ideally find an alternative. Although fruit juices are perceived as healthy they do contain sugar and so should only be consumed in small quantities. Unfortunately sugar is included as an ingredient in a very wide range of foods. It you look at the ingredients, glucose, sucrose, fructose, maltose, dextrose, molasses and fruit syrup are all used to indicate a form of sugar. Probably the most insidious products which are promoted as “low fat” or “diet” and therefore portrayed as “healthy” to consumers. The reality is that these are invariably formulated by removing the fat and replacing it with sugar and/or sweeteners. Choosing these means you suffer a double whammy because the nutritious fat has been lost and replaced by sugar, which is damaging to health. Although it is to be expected that sugar will be present in biscuits, cakes and confectionery, it will also be found in savoury products such as soups, pasta sauce, bread, crisps, sauces, pizzas and baby foods. Many breakfast cereals, including some mueslis are major sources of sugar.

Just eat real food

Ideally if you are genuinely interested in modifying your habitual diet the best way by far is to limit processed foods as much as possible and prepare your own food at home using your own ingredients. So the emphasis in this section will be on what to buy and how to prepare a variety of meals that will be healthy and tasty.

Careful with starchy foods

In addition to the sugars, it will be necessary to limit those foods which are rich in carbohydrates. Essentially these are bread, potatoes, rice and pasta which contain starch which is broken down during digestion to release glucose that is absorbed into the blood. If these foods are refined then the glucose will be released quickly causing a rapid rise in the blood concentration. Hence insulin has to be produced to cope with it. The refining also means that fibre and vitamins are probably removed. Therefore it is best to choose whole grain varieties if possible when these foods are being used. Health problems may be encountered with wheat and wheat products. Some people are gluten intolerant for example. So it may be preferable to choose other cereals such as oats and rye, which tend to release the glucose quite slowly.

If it accepted that processed foods are kept to a minimum this means that there will have to be preparation in the home. The key to success is to ensure that there is a supply of ingredients available so that the resulting dishes have a composition which is low in carbohydrates and has all the appropriate fats.

This a challenge which demands a fundamental change in mind set. So much of what has been drilled into us has been wrong. It is essential to appreciate that the SFAs which in past have been condemned are actually important nutrients and therefore should become a regular part of the diet. On the other hand, the PUFAs which have been promoted as healthy because they “lower cholesterol” should be avoided because that rationale is no longer valid. Furthermore as the PUFAs are primarily omega-6s, increasing consumption simply pushes up the omega-6: omega-3 ratio to values that not consistent with good health. On the contrary, we need to reduce the omega-6s and increase the omega-3s in order to reduce the ratio. This is believed to be one of the critical factors which was responsible for the dramatic reduction in deaths due to heart disease and all causes in the Lyon Heart Study. Similarly as explained above the “low fat” versions cannot be remotely considered as healthy.

The Real Meal Revolution in South Africa

With respect to the carbohydrates, a very useful guide has been devised by Professor Tim Noakes and his colleagues in South Africa, which classifies foods as green, orange or red, as determined by the content of carbohydrates (2). Here are some examples:

GREEN which are very low in carbohydrate content and so there is no limit on the amount that may be consumed. Eggs, fresh meat, high quality sausages, cottage cheese, cream, butter, olive oil, coconut oil, duck fat, pumpkin seeds, pecan seeds, all green leafy vegetables, avocados, cauliflower, mushrooms, onions and tomatoes.

ORANGE which contain a medium amount of carbohydrates (between 6 and 25%) and should not be consumed in excessive amounts. Apples, bananas, blackberries, gooseberries, grapes, oranges, peaches, raspberries, strawberries, cashew nuts and butternut squash.

RED which contain lots of carbohydrates and should only be eaten occasionally. Flour, bread, cakes, biscuits, couscous, rice, pasta, thickening agents, all processed foods, fruit juice, potatoes, legumes, beetroot, peas, parsnips and of course sugar in any shape or form as well as any foods which has sugar as an ingredient.

The full lists can be obtained from the website (2). It is important to understand that the changes should be introduced gradually. This information may be used as a guide and to help getting tunes in to the new concepts. It should not be interpreted too literally. While all of the items on the red list are high in carbohydrates, some are excellent sources of other important nutrients including minerals, vitamins and antioxidants. Beetroot has been shown to reduce blood pressure, improve stamina and lower the risks of cancer (3). Green peas lower the risks of developing T2D despite the relatively high content of carbohydrates and are a good source of omega-3s (4). Parsnips are a good source of many minerals and vitamins and therefore may be used instead of potatoes (5).

Nevertheless the green list should be regarded as the starting point and used as the basis for purchasing supplies. It is well worth consulting the full list because there may be items there which have not normally been used in your household. There are a number of foods which are now recognized as especially nutritious (6). These include:

Tomatoes

These are an excellent source of phytonutrients and a range of vitamins and minerals. Tomatoes contain lycopene which is a very effective antioxidant, which reduces the risk of strokes and various cancers, especially cancer of the prostate in men.

 

Avocados

Avocados are rich sources of monounsaturated fat and help the body absorb fat-soluble nutrients from other foods. They also provide close to 20 essential health-boosting nutrients, including potassium, vitamin E, B vitamins, and folic acid. They are also effective in reducing inflammation and in protecting the liver.

Berries

Berries have high concentrations of phytochemicals which boost the immunity, prevent cancer, reduce the risk of heart disease, and prevent seasonal allergies. They contain much lower levels of sugar than many fruits. Blueberries are rich in antioxidants and can prevent premature aging.

Cucumbers

They are rich in vitamin B5 (pantothenic acid), fisetin, vitamin C, vitamin K, potassium, magnesium, manganese, silica, and fiber, and can help the body eliminate toxins. They contain lignans which can help to reduce the risk of many cancers including those of the breast, uterus, ovary and prostate. The presence of certain phytonutrients strongly inhibit cancer cell development.

All types of greens

Most green vegetables are extremely nutritious. Examples include watercress, chard, spinach, lettuce, kale, dandelion leaves and beet greens.

Sprouting

Using the seeds to grow sprouts will provide concentrated nutrients which are even more beneficial than the mature vegetables. Examples include include alfalfa, mung bean, wheatgrass, peas, broccoli, and lentils. The sprouts from sunflower and watercress are particularly nutritious. They are rich in oxygen and can help protect against abnormal cell growth, viruses and certain pathogenic bacteria. It is easy to grow sprouts in the kitchen.

Preparation and cooking

It is important to have a good breakfast. Many of the cereal products found in the supermarkets are high in sugar and if consumed at breakfast will cause a build-up of glucose in the blood. The insulin will then direct the glucose to the liver where it is converted into fat and stored. So it is not in the least surprising that the person soon feels hungry again and may well have a mid-morning snack. When this process is continually repeated the inevitable result is eventually obesity. Porridge made from oats is an excellent food for breakfast because the glucose is released slowly. Nuts, seeds, berries, cream and perhaps a little honey can be added to the porridge. Eggs are also ideal for breakfast and can be boiled, fried, scrambled or used to make an omelette. The advantage of the fat is that it is utilised effectively to meet the requirements of the body so that satiation is achieved. This means the person can keep going until lunch time or longer.

In the summer months there is plenty of scope for preparing salads using plenty of greens which can be supplemented with sprouted seedlings. Boiled eggs, cold meats and cheeses can be used as well. Any number of vegetables including carrots, celery, kale and peppers can be used for dips.

Soups are a great way to consume vegetables. Onions, mushrooms, butternut squash, cauliflower, courgettes, and tomatoes are all ideal ingredients for soups. Various herbs and spices can be used to improve the flavours. Very often best results are obtained by liquidising the soup and adding cream.

For cooking, coconut oil is probably the best one to use. It is very stable and does not decompose when subject to heat unlike the “vegetable oils”. As the coconut oil is quite expensive, butter can be used with it to stretch it out.

Stir fries are quick and easy to do. They can be used all the year round. Coconut oil is ideal and the ingredients can be whatever is readily available such as broccoli spears, kale, spring onions, Chinese leaves, shredded cabbage and bean sprouts. Pieces of chicken, prawns or slices of beef can be added.

Meats can be cooked by roasting and frying as well as in stews and casseroles. Seal the meat first by frying briefly in a pan.

Avoid thickeners to prepare gravies and use the juices from the meat instead. Garlic, black pepper, chillies, sea salt as well as herbs and spices can be added to improve the flavor.

For casseroles, a slow cooker is a worthwhile investment. For a lamb stew, marinade with rosemary overnight and then seal before placing in the cooker. Add some vegetable stock. Once the lamb has cooked add in butternut squash and shallots, bring to the boil and simmer. The same procedure with other cheap cuts of beef or pork. If chicken is used then the time of cooking should be reduced.

Instead of potatoes, use sweet potatoes, which contain less carbohydrates. They can also be used with the skin to make wedges instead of regular chips. Swedes, parsnips and carrots can be roasted or mashed. Aubergines and celeriac are possible alternatives to potatoes.

Conclusion

Adjusting your diet need not be difficult. The starting point should be to understand the basic principles and then make changes gradually. There is tremendous scope to make meals that are tasty and enjoyable. Be prepared to experiment and discover what works best for you and the other members of your household. Positive results should be evident within a very short time, which will provide the stimulation and encouragement to make further progress.

References

  1. http://www.bbcgoodfood.com/howto/guide/sugar-free-baking
  2. http://realmealrevolution.com/
  3. http://articles.mercola.com/sites/articles/archive/2014/01/25/beets-health-benefits.aspx
  4. http://www.whfoods.com/genpage.php?tname=foodspice&dbid=55
  5. http://www.livestrong.com/article/485728-the-health-benefits-of-parsnip/
  6. http://articles.mercola.com/sites/articles/archive/2014/10/20/summer-superfoods.aspx

222. More about the History of the “Cholesterol” Issue.

It is becoming increasingly obvious to anyone who examines the scientific literature with an open mind that the justification for cholesterol-lowering simply does not exist. So I have been digging into the background to try to find out how it all originated. Although the work of Ancel Keys stimuated interest in cholesterol, it was a trial which commenced in 1958, which started the ball rolling with massive programmes. These have continued to the present day.

The Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT)

This LRC-CPT was a major NHLBI study, which cost about $150 million (1). Men with high TC values were recruited. One group was given a cholesterol-lowering drug, cholestyramine, and the other acted as control.

At the end of the trial it was found that 1.6% of those in the treatment group had suffered a fatal heart attack compared with 2.0% of those in the controls. For all-cause mortality (ACM), the results were almost identical: 3.6% in the cholestyramine group and 3.7% in the controls. So in absolute terms this was not exactly a profound difference. Nevertheless this did not prevent Dr. Basil Rifkind, the trials director, from proclaiming that:

“The cholestyramine group had a 19% reduction in risk …. of the primary endpoint of definite CHD, death or definite nonfatal myocardial infarction” (2).

In Time magazine he claimed the study:

“strongly indicates that the more you lower cholesterol and fat in your diet, the more you reduce your risk of heart disease” (3).

Rather conveniently, there was no mention of the ACM data, which would have totally destroyed the credibility of the study.

This information was announced to the media and presented as a great success, which justified the use of cholesterol-lowering as an important strategy in controlling the high incidence of CHD that was such an issue in the USA the time.

These differences were statistically non-significant, which meant that it could have been due to chance and was not necessarily a genuine difference. Anthony Colpo in his book on cholesterol has described how the data was manipulated in order to claim that the results had achieved “statistical significance” (4). In particular:

  • The original protocol specified that because it was essential to be sure that any observed beneficial effect of cholesterol-lowering was beneficial, stringent standards were specified for assessing the differences between the treated and control groups. These were not achieved.
  • The results for fatal heart attacks and non-fatal attacks on their own did not reach statistical significance.
  • When the 2 sets of results were combined, the difference was significant but this was only achieved at the less demanding level.

At a later follow-up, it was reported that after 13 years, the ACM in the drug treated group was 7.5% and in the control group 8.2% (5). It was also noted that the incidences of benign colorectal tumours (50 vs 34), cancer of the buccal cavity and pharynx (eight vs two), gallbladder disease (68 vs 53), and gallbladder surgery (58 vs 40) were increased in the cholestyramine group although these differences were not statistically significant. Another important result was that those in the treated group had a raised incidence of deaths due to violence and suicide. Hence there is a possibility that this could be a specific effect of low cholesterol per se.

The critics

Dr. Mary Enig pointed out that:

“An interesting feature of the study was the fact that a good part of the trial’s one-hundred-and-fifty-million-dollar budget was devoted to group sessions in which trained dieticians taught both groups of study participants how to choose “heart-friendly” foods—margarine, egg replacements, processed cheese, baked goods made with vegetable shortenings, in short the vast array of manufactured foods awaiting consumer acceptance. As both groups received dietary indoctrination, study results could support no claims about the relation of diet to heart disease” (6).

She also revealed that at a workshop to discuss these results there was widespread criticism of the manner in which the information had been tabulated and manipulated.

Another critic, Colin Rose commented in his blog:

Note also that the LRC-CPPT recruited only men with primary hypercholesterolemia, a rare disorder of lipid metabolism that affects at most one in five hundred of the population and a very small fraction of the total number of people dying of heart attacks. The results, insignificant as they were, were then extrapolated to the entire population without primary hypercholesterolemia.”(7).

Even though both groups had the same diet, it was still claimed that the results provided support for the Diet-Heart Theory and were used to promote the dietary guidelines which recommended low fat and low SFA. As Nina Teicholz commented:

“It’s important to understand that this trial did not test diet. Both groups in the study were advised to eat the same low-fat fare. Therefore, diet was not a variable tested in the trial; only the drug cholestyramine was tested in this design. The reason for not testing different diets, the investigators explained to critics, was that the NHBLI could not, in good conscience, deprive any high-risk man of a cholesterol-lowering diet—even though one of the trial’s original goals was to test whether such a diet would protect against heart disease in the first place. It was a Kafkaesque circle of reasoning. Keys’ hypothesis had evidently managed to sail over the normal hurdles of scientific proof such that the mere act of testing the diet was now considered unethical” (8).

Consensus Conference: The Lowering Blood Cholesterol to Prevent Heart Disease

This conference was held in December 1984 and followed on from the publication of the LRCPPT results. The driving force behind it was Dr. Rifkind.

It was concluded that:

“Elevated blood cholesterol level is a major cause of coronary artery disease. It has been established beyond a reasonable doubt that lowering definitely elevated blood cholesterol levels (specifically blood levels of low-density lipoprotein cholesterol) will reduce the risk of heart attacks due to coronary heart disease. This has been demonstrated most conclusively in men with elevated blood cholesterol levels, but much evidence justifies the conclusion that similar protection will be afforded in women with elevated levels. After careful review of genetic, experimental, epidemiologic, and clinical trial evidence, we recommend treatment of individuals with blood cholesterol levels above the 75th percentile (upper 25 percent of values). Further, we are persuaded that the blood cholesterol level of most Americans is undesirably high, in large part because of our high dietary intake of calories, saturated fat, and cholesterol. In countries with diets lower in these constituents, blood cholesterol levels are lower, and coronary heart disease is less common. There is no doubt that appropriate changes in our diet will reduce blood cholesterol levels. Epidemiologic data and over a dozen clinical trials allow us to predict with reasonable assurance that such a measure will afford significant protection against coronary heart disease” (9).

It is absolutely unbelievable how such a conclusion could have been reached in view of the flimsy nature of the results, which in any case were limited to a very narrow sector of the population. The assumption that results data men could extrapolated to include women simply flies in the face of basic biology.

Clearly the objective was to spell out a clear message that blood cholesterol was an important risk factor for heart disease and that there should be a big push to reduce the TC levels, with changes in diet being strongly recommended. As this was a “consensus”, it really is time to get down to business and take steps to overcome what was regarded a major public health issue in the USA the time.

Was there really a consensus?

However, if we dig beneath all the hype, everything in the garden was not quite so rosy. There were a number of individuals who had serious reservations. One of the leading researchers on cholesterol,

Dr. Edward ‘Pete’ Ahrens, a veteran cholesterol researcher at Rockefeller University was highly critical of the LRC-CPPT study that was crucial to the report stated quite bluntly:

“Since this was basically a drug study, we can conclude nothing about diet; such extrapolation is unwarranted, unscientific and wishful thinking” (10).

In an article in The Lancet he spelled out his concerns:

“I would have been content with the consensus statement if it had confined itself to what we do know and what we do not. It promises benefits without giving the evidence to back up that promise. By failing to emphasise what we do not know, the statement sweeps these weaknesses in our evidence under the-rug, as if they were trivial. I have disagreed with that position” (11).

In Science magazine, Gina Kolata noted that Thomas Chalmers of Mount Sinai Medical School and Paul Meier of the University of Chicago both considered that the consensus report was misleading because the impact of the evidence had been exaggerated (12).

Conclusion

There seems little doubt that the entire edifice of cholesterol-lowering has been constructed on a foundation of sand.

References

 

  1. https://www.ncbi.nlm.nih.gov/pubmed/6382999
  2. http://content.time.com/time/subscriber/article/0,33009,921647,00.html
  3. A Colpo (2006) “The Great Cholesterol Con: Why everything you have been told about cholesterol, diet and heart disease is wrong” Lulu
  4. http://archinte.jamanetwork.com/article.aspx?articleid=616413
  5. http://www.westonaprice.org/know-your-fats/the-oiling-of-america/
  6. https://medicalmyths.wordpress.com/drugs/the-lipid-research-clinics-coronary-primary-prevention-trial-lrc-cppt/
  7. N Teicholz (2014) “The Big Fat Surprise: Why butter, meat and cheese belong to a healthy diet” Simon & Shuster New York
  8. https://consensus.nih.gov/1984/1984cholesterol047html.htm
  9. http://content.time.com/time/subscriber/article/0,33009,921647,00.html
  10. http://www.sciencedirect.com/science/article/pii/S0140673685923827/part/first-page-pdf
  11. http://science.sciencemag.org/content/227/4682/40.long

220. Big Boost for Campaign to Reduce Consumption of Carbohydrates

The National Obesity Forum (NOF) and Public Health Collaboration (PHC) has just issued a joint press release which is a direct challenge to the UK Government/NHS advice on healthy eating (1). Introducing the report Professor David Haslam, who is chairman of the National Obesity Forum, said:

“As a clinician, treating patients all day every day, I quickly realised that guidelines from on high, suggesting high-carbohydrate, low-fat diets were the universal panacea, were deeply flawed.

“Current efforts have failed – the proof being that obesity levels are higher than they have ever been, and show no chance of reducing despite the best efforts of government and scientists.”

Professor Haslam is certainly not alone. There is a growing number of medical and health professionals who know from their own experience that the current guidelines are not working despite the fact that many people have altered their diets so that they comply with the Government recommendations. The hard reality is that we have a major public health crisis on our hand because of the unprecedented levels of obesity. Type 2 Diabetes (T2D) is even worse with the incidence having more than doubled in the past 15 years and all the indications are that it will continue to increase for the foreseeable future. The real scandal is that the official advice is to reduce the consumption of fat and INCREASE that of carbohydrates. There is overwhelming evidence that this makes the condition worse. Hence those affected suffer from poor health and some may eventually have to have limbs amputated.

The other side of the equation is that the carbohydrates should be replaced by healthy fats which include the saturated fats (SFAs), which are present in milk and meat but include coconut oil. This is in direct conflict with the official advice which insists that the SFAs must be reduced. The report draws attention to a recent study which found that:

“Compared with subjects on low-fat diets, subjects on low-carbohydrate diets experienced significantly greater weight loss, greater triglycerides reduction and greater increase in HDL-cholesterol after 6 months to 2 years of intervention.”

The report also emphasised that the low calorie approach to weight loss has not been effective, while there are studies which demonstrate conclusively that diets which are low in carbohydrates and high in fat (LCHF) do work successfully. These may have about 65% of calories as fat while the carbohydrate content is only 10%.

The report highlight the work of Dr David Unwin who has used this approach successfully with many of his patients who have T2D, fatty liver disease and wish to lose weight. On top of all this he has reduced the costs of drugs prescribed at his practice by about £45,000 per annum.

Added to this are the personal case histories of numerous individuals all over the world who have successfully treated their own T2D and lost weight. Very often this is in direct conflict with the advice from doctors and dietitians. Last year the American Diabetes Association (ADA) was bombarded on Facebook with messages from individuals who were highly of the ADA’s advice to increase the intake of carbohydrates (2).

It is therefore utterly amazing that there are still many who refuse to accept the obvious and defend the status quo with vigour. For example, Dr Alison Tedstone, who is the chief nutritionist at PHE, said:

 “In the face of all the evidence, calling for people to eat more fat, cut out carbs and ignore calories is irresponsible. Unlike this opinion piece, our independent experts review all the available evidence – often thousands of scientific papers – run full-scale consultations and go to great lengths to ensure no bias.” (3).

Prof Simon Capewell, from the Faculty of Public Health, said:

“We fully support Public Health England’s new guidance on a healthy diet. Their advice reflects evidence-based science that we can all trust. It was not influenced by industry.

“By contrast, the report from the National Obesity Forum is not peer reviewed. Furthermore, it does not it indicate who wrote it or how is was funded. That is worrying.”

These attitudes reflect a “head in the sand” approach. The blunt truth is that the current policies are not only failing but are a major contributor to our current problems. These people simply cannot contemplate that they have been wrong and are incapable of facing up to reality.

This issue has all the characteristics of the Hillsborough incident in Sheffield where almost 100 spectators died at a football match because of the incompetence of the local police force. Although this was clearly shown in an Inquiry conducted by Lord Justice Taylor within months, it took the relatives 29 years before this was recognised by the Government. Documents released subsequently revealed the Prime Minister, Margaret Thatcher, had vetoed effective action by the Home Secretary on the grounds that the police had to be defended. It took concerted action by the relatives to the matter finally resolved.

With respect to nutrition, substitute the medical and health professionals who support the current strategy for the South Yorkshire Police Force. For the victims of the tragedy, substitute all those who suffer from T2D for a start. This means millions of individuals who are being given the WRONG advice which causes their health to deteriorate even further.

There is a clear responsibility on the part of the politicians to act but to date their performance has been absolutely pathetic. They appear to have neither the brains and/or balls to tackle the advisers. We are not dealing with complicated science here. In fact it is really quite straight forward as I have shown in a blog which draws a parallel between T2D and a house which has been flooded with water because of a burst pipe (4). The first step must be to stop the excess water entering the house. With T2D, it is exactly the same. Turn of the supply of glucose entering the body by reducing the consumption of sugar and carbohydrates, which break down to release glucose. Standard treatment of T2D is like telling a householder that the water cannot be stopped: here are some buckets and mops. You must do the best you can with these and face up to the fact that as long as you live in that house you will have to cope with the water coming in all the time!

References

  1. https://phcuk.org/wp-content/uploads/2016/05/Healthy-Eating-Guidelines-Weight-Loss-Advice-For-The-United-Kingdom-Public-Health-Collaboration.pdf
  2. http://vernerwheelock.com/201-let-those-with-diabetes-speak-for-themselves/
  3. http://www.theguardian.com/society/2016/may/22/official-advice-to-eat-low-fat-diet-is-wrong-says-health-charity
  4. http://vernerwheelock.com/170-a-flood-of-sugar/