In the light of the excellent paper by Zoe Harcombe and her team which demonstrated conclusively that there was no reliable evidence on which to base the official dietary guidelines when first devised in the USA and in the UK, the BBC has featured this issue in a radio programme (1). This includes interviews with Zoe herself and Aseem Malhotra who explained why the advice to reduce total fat and especially saturated fat (SFA) is fundamentally flawed and has been a crucial factor responsible for the current high levels of obesity and Type 2 Diabetes (T2D). These were followed by what I can only describe as an extraordinary interview with Simon Capewell, who is Professor of Clinical Epidemiology at the University of Liverpool. He also has roles in which he advises the British Heart Foundation, the European Society of Cardiology, Heart of Mersey, National Institute of Clinical Excellence, Public Health England and the World Health Organisation. In his opinion the research by Zoe Harcombe is flawed because it failed to consider the totality of evidence. He goes on to say that there have been “over 1000 papers” since then which support the current guidelines. He cites the work of his own research team which claims it has established that there is a fall in the intake of SFA which is correct. Then he goes on to say there has also been a fall of 20% in the levels of blood cholesterol (TC) from which he concludes that this proves the advice has been responsible for the fall in the death rates from heart disease. To his credit the interviewer points out that this is all based on epidemiology, which cannot demonstrate “cause and effect”. The interviewer quite rightly suggests that there may have been other factors which have contributed to the decline in deaths from heart disease, such as the reduction in smoking and the improvements in treatment. It is true that the mortality due to heart disease has fallen and improvements in treatment and care have had a major impact. According to British Heart Foundation statistics, the percentage of women aged 55-59 years old dying after a heart attack almost halved between 1968 and 1998 while that for men aged 60-64 fell by a third (2). This report comments that measuring morbidity is much more problematic than monitoring mortality so we cannot be sure that there has actually been a genuine decrease in the chances of suffering from heart disease and if so the magnitude of the change.
Anyone who considers that lowering TC is beneficial must be deluded. Just watch this You Tube video (3).
Simon Capewell goes on to imply that Ancel Keys was correct when he concluded that there was a direct correlation between the amount of fat/SFA in the diet of different populations, the level of cholesterol in the blood (TC) and the death rate due to heart disease. In fact he even states that Keys has been vindicated by subsequent studies. This position is absolutely remarkable. The fact is that the work of Keys was full of inconsistencies, was based on data from 6 different countries and made the fatal mistake of assuming that an association is evidence of cause and effect. The work of Keys has been totally discredited by Zoe Harcombe (4), Malcolm Kendrick (5) and most recently by Nina Teicholz (6). The reality is that when information is obtained from many different countries there is no relationship. It just so happened that Keys conveniently omitted:
- Countries where people eat a lot of fat but have little heart disease, such as Holland and Norway
- Countries where fat consumption is low but the rate of heart disease is high, such as Chile.
I would strongly recommend that if you really wish to understand what went on then have a look at these references. It is absolutely disgraceful and it simply beggars belief that anyone should even attempt to justify this rubbish!
Simon Capewell states that the dietary guidelines were “prophetic and solid” and “that history has demonstrated how very sound they were”. This is unbelievable! How on earth can anyone reach this conclusion, when we look at the current state of public health in the UK, the USA and most of the rest of the world????
Obesity is an obvious issue of concern but a more accurate indication of public health is shown by the incidence of T2D, which in the UK had doubled in the last 15 years. Those with T2D have a reduced life expectancy and an increased risk of retinopathy, stroke, kidney failure, heart disease, cancer, Alzheimer’s Disease and amputation of limbs.
A man diagnosed with diabetes at age 40 will lose almost 12 years of life and 19 Quality Adjusted Life Years (QALYs) compared with a person without diabetes. A woman of the same age will lose about 14 years of life and 22 QALYs (7).
T2D is caused by excess glucose in the blood. This stimulates the pancreas to produce insulin. The continuous production of high amounts of insulin cause damage to the various body organs which can result in many different chronic diseases. The solution is obvious…..lower the blood glucose by reducing the consumption of sugar and the other foods that contain carbohydrates, which are broken down to produce glucose. These foods, primarily potatoes, bread, rice and pasta must be replaced by other foods, especially those animal products such as meat, dairy and eggs, all of which contain fat. This is direct contrast to the current guidelines which Simon Capewell praises so highly.
The evidence has been very neatly summarised in a recent paper (8). There is absolutely no doubt that this approach works very effectively. At least one of the authors, Dr Jay Wortman, has been able to cure his T2D by altering his own personal diet along these lines. There are literally hundreds of individuals who have achieved exactly the same result (9). The presentations at the recent Low Carb Summit in Cape Town showed just how persuasive our knowledge is at present. Several practising clinicians showed how successful the Low Carb High Fat (LCHF) diet with their own patient records (10).
So we have now reached a point where we have the knowledge not only to halt the current inexorable rise in the incidence of chronic disease but to reverse it. Regrettably the official approach by government and the NHS in the UK is making things worse with the result that millions are suffering unnecessarily and many of these are dying prematurely. It is imperative that there is a complete re-evaluation of public health policy. We have to accept that what is being done at present is one of the main reasons why things are deteriorating.
To identify why there is so little progress, we only have to consider the views expressed by people like Simon Capewell who seem to defend the status quo come what may. Because of his role with so many key organisations, he has enormous influence. But in order to maintain his stance he has to manipulate and misinterpret the evidence.
If we are ever to make the break-through, it is essential the Simon Capewells of this world are tackled at every possible opportunity. His errors are so fundamental that you do not need to have specialised knowledge to do so and I would encourage all those who are aware of the benefits of LCHF, especially those with personal experience, to make your views known to anyone in a position to make the changes. For a start the forthcoming General Election in the UK is a timely opportunity to force the issue on the political agenda. If enough of us rally round then maybe the message will begin to get through.
- Zoe Harcombe (2010) “The Obesity Epidemic” Columbus p 87
- Nina Teicholz. (2014) “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet” Simon & Shuster New York