We need to remember that the UK health service was devolved in 1999, with England, Scotland, Wales and Northern Ireland managed separately from this point forth. Hence, this Department of Health announcement was for England only.

On 15 March 2011, the Department of Health issued a press release on what they call “The responsibility deal.” The government believes that  partnering with the food and drink industry “can be the most effective way of tackling some public health objectives.” The purpose of the food and drink industry is to sell as much food and drink as possible. The government believes that we need to be consuming less food and drink to lose weight. How these aims can be compatible, therefore, baffles me.

The pledges announced in the March press release include:

- Calories on menus from September this year;
– Reducing salt in food so people eat 1g less per day by the end of 2012;
– Removal of artificial trans-fats by the end of this year;
– Achieving clear unit labelling on more than 80 per cent of alcohol by 2013;
– Increasing physical activity through the workplace; and
– Improving workplace health.

We know that putting “Smoking kills” and “Smoking will harm your unborn child” on cigarette packets makes no difference, so why would putting a calorie number on food make any difference? It won’t and we know already that it won’t – here is an article about a study done in the British Medical Journal to prove this.

The October ‘new’ news

Health secretary, Andrew Lansley, and England’s Chief Medical Officer, Professor Dame Sally Davies, launched the ‘new’ proposals, but there really was only one thing new:

1) Davies called for everyone to be more  honest about their eating and drinking habits – so, not only are we greedy and lazy, we are now liars too!

2) We have been told to “slash” five billion calories a day. If the population of England approximates to 50 million people, that’s 100 fewer calories per person per day. No knowledge whatsoever of the difference between calories has been demonstrated with this headline grabbing number.

3) Astonishingly – this was the only new bit – the Scientific Advisory Committee on Nutrition (SACN) – advised that the recommended daily calorie intakes for both men and women should be raised. We are told to eat less, but our intake guidelines should go up? Davies tried to explain this by saying – our daily intake should be raised but we are still eating more than this, so we still need to cut back. This is confusing at best and ludicrous at worst. I do not think that we should be raising calorie recommendations in the midst of an obesity epidemic. Not because the obesity epidemic is about calories (because it isn’t), but because it sends the wrong message. If health were going to suffer by not raising these calorie limits then raise them – but at a completely different time, so as not to confuse the public. However, I am far from convinced that anyone’s health would suffer if we did not raise calorie limits – health is about what we eat and the vital nutrients that we consume – not the amount of petrol we put in our tank. Putting petrol in a diesel car is the worst thing we can do to a vehicle. Putting sugar, transfats and empty calories in a human body is equally harmful.

The calorie intakes, just for the record, have been increased from 2,550 to 2,605 for men and a whopping 1,940 to 2,079 for women.

The chair of the SACN working group, Alan Jackson, has declared interests in Nutricia (a specialised unit of Danone food company) and Baxter Healthcare (see page 32). The full list of members of the energy requirements sub committee is on p19 of that link. Ian Macdonald has declared interests with Mars Inc, Mars Europe, Unilever, Nestle and Coca-Cola – just what we want on a Scientific Advisory Committee on Nutrition! Andrew Prentice, also on the group, ‘only’ has connections to Tanita Scales and Danone. His wife, however, (see p34) has the most extraordinary list of declared interests: Beveridge Institute for Health and Wellness, Diabetes UK, Institute of Brewers & Distillers, Milk Development Council, Optimal Performance Ltd, The Rank Prize Funds, Tanita UK Ltd, World Cancer Research Ltd, Weight Watchers UK Ltd, B Kassardjian Fund – Zurich, Dee Caffari Ltd, Mars, BBC, Rosemary Conley Diet & Fitness Club, National Trust, Coca Cola, Outsights, Nestle, Emap, Kelloggs, Almond Board California, Nunwood Consulting, Pepsico, GlaxoSmithKline, British Institute of Sport, The Pelican Buying Co, National Institute of Nutrition and J Sainsbury. Go girl!

The bottom line

The bottom line is that the English government thinks that people just need to eat less and do more and they will lose weight. As I detail at length in my book The Obesity Epidemic this has been Plan A for more than three decades and we have continued to get more and more obese. We have known since Benedict’s 1917 study that eating less leads to short term weight loss and then regain to beyond the starting weight. This was confirmed in the definitive eat less experiment – the Minnesota Starvation Experiment - initial weight loss, followed by regain plus 10%. At least 9 out of 10, if not 19 out of 20, of the personal consultations that I do start with the explanation “I didn’t really have a weight problem until I went on my first diet. I lost weight, regained and more. I went on another diet, lost weight, regained and more.” When they say ‘diet’, my clients mean a calorie deficit diet – the eat less/do more that the government thinks will get us out of this mess.

Here’s an interesting statistic for you:

The MAFF (Ministry of Agriculture Fisheries & Food) National Food Survey tells us that we were eating 2,290 calories per person per day in 1975 and, by 1999, this had fallen to 1,690 calories per person per day. If we apply the 3,500 calorie formula (notwithstanding that this formula is also wrong, but it’s the one that government and all calorie advisors rely upon), to the change in annual average calorie intake, all other things being equal, we should have lost an average of 62.6 pounds per person during this period. Instead obesity rose nearly ten fold during this time.[i]

The DEFRA (Department for Environment, Food & Rural Affairs) report notes the continual decline in calorie intake. The Family Food Survey for 2001-02 comments on the short term: “Energy content of the household food supply has decreased considerably over the last 5 years.” The Family Food Survey for 2002-03 notes the same trend over the longer term: “Average energy intake per person in the UK is unchanged in 2002-03 compared with the previous year, although it has been declining since 1964.”[ii]

The Food Standards Agency (FSA) web site also acknowledges the above conundrum, “Since the 60s we’ve been consuming fewer calories from household food (this doesn’t include eating out). However, there are an increasing number of people who are overweight or obese. The reasons for this are not clear.”[iii]

We need to eat better, not less. We need to return to eating real food, not the empty calories dominating the eatbadly plate. We need to eat naturally produced meat, fish, eggs, dairy products, vegetables and salads to ensure that our bodies can use the calories that we eat for our basal metabolic needs. We absolutely cannot afford to eat the empty sugar and flour calories, which we are eating.

World Health Organisation data tells us that the average UK citizen consumes 38 kilograms of sugar per year.[iv] Statistics from the Flour Advisory Bureau note that UK per capita flour consumption reached 74 kilograms in 2008/9.[v] This represents a few calories short of 1,150 per person per day from those two ingredients – when did that become a healthy balanced diet?

What the government should have done

I set out in Chapter 16 of The Obesity Epidemic what should be done to reverse the obesity epidemic. Here are the headlines:

1) Tear down the eatbadly plate from every surgery, hospital and school in the country and never allow it to be shown again. Tell people to eat real food from now on and nothing but real food. If nature provides it – eat it; if food manufacturers provide it – don’t. That’s the only healthy eating food message that the government needs to have  to start to reverse the obesity epidemic.

2) Ban trans fats. In the unlikely event that we were bold enough to ban sugar, trans fats and sweeteners, this one step would be sufficient to reverse the obesity epidemic (whether such bans are necessary is a matter for debate). Trans fats should be singled out for an immediate ban (as has happened in Denmark and Switzerland). The National Heart Forum summed up their position on trans fats in the opening to their paper calling for a ban on these substances: “Industrially produced Trans fats (IPTFAs) are harmful to health, they have no nutritional benefits and there is no known safe level of consumption.”[vi]

3) Fiscal policy (taxation). I cannot conceive of any government having the courage to ban sugar, trans fats and sweeteners. Hence, if we lack the leadership qualities to ban nutritionally void substances, the minimum that we need is a deterring and punitive tax on each of them. We need to be very specific about the targets. In May 2009 Dr. Tim Lobstein called for a ‘fat tax’,[vii] while talking about junk food and pizza. The reiteration of the notion that ‘fat is bad’ is incessant. We must stop this forthwith. Here is a blog on the October 2011 Denmark fat tax and how misguided this is. The target of fiscal measures needs to be processed foods and no real food should ever be demonised again. Again, although this step may not be necessary, it would be sufficient and we are almost expecting the impossible from our populations to tell them to avoid processed food while the food manufacturers are simultaneously promoting BOGOF’s (Buy One, Get One Free) on biscuits, cakes, confectionery and all the things that we need help to resist. David Kessler’s book, The end of overeating, gives full details of what humans are up against in terms of food industry tactics.[viii]

Taxation would merely be a return to previous public policy, albeit from centuries ago. Adam’s Smith’s The Wealth of Nations (1776) noted “Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation.” Just under one hundred years later, the sugar tax was repealed. If sugar is not banned, the tax needs to be reinstated.

The objective of such taxation should primarily be to reduce consumption, but any revenue generated can have an added benefit of subsidising real food and/or the health services that are impacted by such consumption. Using sugar as an example, I would put a minimum 100% (double the price of the product) tax on any product containing non naturally occurring sugar (any added ‘ose’).[1] This would immediately discourage food manufacturers from adding sugar, completely unnecessarily, to ham, cottage cheese, tins of chick peas, kidney beans and other healthy products. I would put at least a 200% tax on any product where all sugars added together are the majority of the composition of the product. For any product (e.g. children’s sweets) where the entire product is essentially sugars (with a bit of crushed animal innards, gelatine, for bonding), we should multiply the current price by four or five fold. The proceeds from taxes on sugar, trans fats and sweeteners should subsidise real food for people who are currently least able to afford it. We cannot hope to solve an obesity epidemic when we can buy ten doughnuts or one cucumber for the same price.

Other fiscal measures should be considered. Corporation tax can be raised on companies that make processed food and lowered, or eliminated, on companies that provide completely unadulterated natural food. The local butcher must become the provider of choice for meat, not McDonald’s. Today, I can buy one pound (454 grams) of grass fed steak for the same price as a regular cheeseburger and medium fries and mayo chicken and a McFlurry original and a medium drink and a double cheeseburger.[ix] This is not conducive to healthy eating – particularly in the sections of our population who can least afford, and most need, real food. Kessler details some of the most contemptuous examples of fast food: “One of the signature hamburgers at Hardee’s is called the Monster Thickburger, which famously contains 1,420 calories and 108 grams of fat.” “Yet even that pales in comparison to a slice of Claim Jumper’s Chocolate Motherlode Cake … 2,150 calories a slice”. (Note the use of the word ‘mother’ to imply approval). Such inhumanity to man should be met with an “Inhumanity Tax”. It’s not far away from manslaughter, if you are familiar with the legal definition.

If this sounds extreme, how does “90% of today’s children being overweight or obese by 2050” sound?[x] And, why would this be considered extreme? I am merely suggesting that we return to eating what we used to eat before we got too obese to function as human beings.

England has one of the worst obesity epidemics in the world. Thanks to the conflict of interest and ignorance of the English government, they now have one of the worst obesity strategies in the world. Relying on the profit motivated organisations that want us to eat ‘fake’ food instead of real food, to lead a return to the real food that would signal their demise, is naive at best and fatal at worst.

[1] As an example, fructose in a whole apple is fine, as this is the form in which nature intended us to eat fructose. Fructose added to sweeten other products is not necessary.

[i] I calculated this mathematically year on year and analysed the average calorie intake for 1975 and then that for 1976 and used the 3,500 calorie formula to work out what the average person should have gained/lost between these two years and repeated this for each year between 1975 and 1999 to calculate the overall number of pounds that should have been lost on average. The overall number was calculated cumulatively, as some years people should have gained weight and most should have produced weight loss – all according to the calorie theory.

[ii] http://www.defra.gov.uk/evidence/statistics/foodfarm/food/familyfood/index.htm

[iii] http://www.eatwell.gov.uk/healthydiet/seasonsandcelebrations/howweusedtoeat/ changingtastes/

[iv] http://www.whocollab.od.mah.se/expl/globalsugar.html

[v] http://www.fabflour.co.uk/content/1/31/facts-about-bread-in-the-uk.html

[vi] http://www.heartforum.org.uk/Policy_Consultations_2093.aspx

[vii] http://www.medindia.net/news/British-Expert-Calls-for-Fat-Tax-on-Unhealthy-Foods-to-Save-Children-51144-1.htm

[viii] David Kessler, The end of overeating, published by Rodale, (2009).

[ix] Rump steak was £14 per kilo (£6.36 per pound) and McDonald’s had the first five items listed for 99p and the double cheeseburger listed at £1.29 (June 2010). http://www.mcdonalds.co.uk/food/saver-menu/saver-menu.mcdj?dnPos=0

[x] One of the forecasts of the Foresight Report: “Tackling Obesities: Future Choices” (October 2007).

Nutrition is a fascinating topic. There is little more important to human health than what and how we eat.  Modern epidemics of obesity and ill health are capturing media headlines and the attention of curious minds alike. This is a subject about which many people want to know more. However…

When I am asked to recommend a course on nutrition I can’t. I am not aware of a single programme being offered anywhere in the world, which is evidence based and which presents facts, rather than the current myths presented as facts. That doesn’t mean that there isn’t one, but I don’t know of one and I would be surprised if there were one given the extent of the misinformation being perpetuated by the vast majority of people working in this field.

What do you want to learn?

My starting advice to someone interested in studying nutrition would be to be specific about what you want to know. The British Dietetic Association curriculum for training as a dietician is detailed here. If this is your first higher qualification, the background in basic sciences and biology may be useful to you. For those who already have a degree and/or studied science to a reasonable level at school, reading a cell biology, physiology and biochemistry textbook will deliver the required background.

My passion is obesity. There is more than enough to study on this topic to do nothing else for the rest of one’s life. Hence I am not interested in (using the attached curriculum by way of example) immunology, microbiology, (food hygiene), clinical medicine, pharmacology, sociology and social policy, communication and educational methods and definitely not interested in ‘food’ science. Nature provides food – that’s the only food I want to understand. I’m not particularly interested in dietetics for the prevention of general disease (besides the fact that eating real food will achieve this naturally) and I’m only interested in public health to the extent of how we managed to get ourselves in the midst of an obesity epidemic.

Becoming a dietician

When I set out to study nutrition more formally, I investigated training as a dietitian. I rejected the prospect very quickly on two grounds:

i) With 1.5 billion overweight people in the world, this is more than a big enough arena in which to specialise. As detailed above, I have no interest in the vast majority of the dietician curriculum and have no time to ‘waste’ on such topics when I could be spending that time reading obesity journals.

ii) Upon investigation of the weight management part of the course, I discovered that the first lesson is the calorie formula. I would be told that energy in equalled energy out and that to lose one pound of fat a deficit of 3,500 calories must be created.

Thus the one part of the course that I would be interested in, would be of no use to me. Presumably I would need to reproduce answers that I know not to be true to pass, or fail as a result of giving my honest answer. A quick analysis of the 58 page curriculum document confirms that I made the right decision: the word weight does not appear once; the word obesity does not appear once; the word calorie does not appear once and the word diet only appears six times and in a very general context of the word diet e.g. UK diet or diet and lifestyle.

A third reason became apparent when I was researching for my book The Obesity Epidemic: What caused it? How can we stop it? Conflict of interest…

Here are the sponsors of The American Dietetic Association. Here are the program partners of the Dieticians Association of Australia. Here are the major partners of the Dieticians Association of Australia. Here are the associate partners. I detail in my book, The Obesity Epidemic, how unwilling the British Dietetic Association is to disclose its conflicts of interest. After a number of email exchanges, a BDA spokeswoman confirmed “we have been delighted to work with the Sugar Bureau…” The chief executive’s foreword (Andy Burman) in the 2008-09 annual report of the BDA notes “We now have our first national partners with Danone and Abbott and we hope to announce new partners over the coming year or so.” There is reference to a “Bird’s Eye” education award, but no mention of other partners or sponsors. The accounts for 2009 showed a turnover of £2,359,013 with no details of the source for this revenue. The notes to the accounts, which could add detail to this number, are for the eyes of BDA members only. A press release, dated 1 March 2007 entitled Kellogg’s: commitment to health and wellbeing, informed me that Kellogg’s had been the lead sponsor for the British Dietetic Association’s annual obesity intervention campaign since 2002 (and may still be).

Here are the members of the British Nutrition Foundation. Here are the sustaining members of the British Nutrition Foundation.

It is a complete disgrace that our nutritional ‘education’ has been infiltrated in this way. The partner that most disturbs me is Abbott Nutrition. This company makes an infant formula called Similac. The feeding guidelines on the Similac web site range from 1-2 weeks to 9-12 months, so this is clearly a product designed for babies. The can of baby formula, of the part that is not water, contained 43% corn syrup solids and 10.3% sucrose. “It’s a baby milkshake,” said a horrified Robert Lustig in the video “Sugar: The Bitter Truth“. I wanted to analyse a product for myself, so I chose Similac Isomil Advance, Soy Formula and the composition of this was 50% corn syrup, 14.2% soy protein isolate, 10.4% high oleic safflower oil, 9.7% sucrose, 8.2% soy oil and 7.5% coconut oil. If a baby is unfortunate enough not to be breastfed, the infant can be started on a diet of 60% sugar from the first moment something is put in its mouth.

It is clearly in the interests of ‘food’ companies to partner with those giving us dietary advice – and to start as close to birth as possible. Does the public know that our advice is so conflicted? How can we “Trust a dietician to know about nutrition” (their slogan) when this conflict of interest exists?

Nutritional ‘education’

That’s the conflict inherent in our nutritional training, what about the content of programmes?

I only know one way to learn and that is to “get the facts”. I am a thinker, not a feeler. If I am told something I need it to be evidence based. I want to know the source of everything – where did that come from? when did this become known and so on. This stood me in good stead studying economics (maths, statistics options) at Cambridge. Applying the same rigour to the subject of nutrition was the most shocking thing I have ever done.

During the three years of full time research for The Obesity Epidemic, the following nutritional beliefs did not hold up to scrutiny. Please note – these points are only in the part of nutrition related to dietary advice and weight loss. There may be many more errors in the teaching of nutrition outside my areas of interest.

Starting at the very beginning – dieticians state that “energy in = energy out.” “You can’t change the laws of the universe”, they say. But there is no law of the universe that says  “energy in = energy out.” I detail in The Obesity Epidemic exactly what the laws of thermodynamics say and which law we have misunderstood and which law we have ignored.

We are then told that 1lb = 3,500 calories. It doesn’t.

We are told that we will lose 1lb if we create a deficit of 3,500 calories. We won’t.

We are told that 98% of diets fail (true for calorie deficit diets) but are continually told to “eat less/do more” despite this.

Five-a-day is a marketing myth. Eight-a-day (drinking) is similarly fabricated. Alcohol guidelines are numbers “picked from the air.”Fruit is essentially sugar (fructose/glucose – aka sucrose) with vitamin C and not much else by way of nutrition. Offal, red meat and butter, the foods most often condemned by diet advisors, are nutritionally exemplary.

Saturated fat is life vital. Mother Nature is not trying to kill us.Cholesterol is life vital. Our own body (which makes our cholesterol) is not trying to kill us. The formula for cholesterol is C₂₇H₄₆O. There is no good or bad version.Grazing (don’t); fibre (pointless); sedentary behaviour (how humans were designed to be) – there’s so much that we have got terribly wrong.

As Kaayla Daniel said at the 2011 Weston Price Conference – “If you’re told it’s bad, it’s good and if you’re told it’s good, it’s bad – work on that basis and you can’t go far wrong!”

Check out this free ebook or any of these presentations: Calories, Energy Balance, Thermodynamics and Weight Loss; Ten diet myths; The Obesity Epidemic to find out more.

Conclusion

I cannot recommend any dietetic or nutrition course because I know of none that will teach the truth about everything from thermodynamics to the role of insulin in fat storage. My genuine recommendation is that you need to study via amazon (Sean Croxton, Underground Wellness, concluded the same) and medical journal web sites.

Read Mary Enig and Sally Fallon Morell on fats; Uffe Ravnskov, Duane Graveline and Dr Malcolm Kendrick on cholesterol and the lipid hypothesis; The Diet Delusion (Gary Taubes); critical reviews of all of these and weigh the evidence for yourself. There will be many more non- conventional wisdom works for different areas of interest. The seminal journals to be read include Benedict (1917); Newburgh & Johnson (1930); Hugo Rony (1940); The Minnesota Starvation Experiment/The Biology of Human Starvation (1950); Stunkard & McLaren-Hume (1959). The Seven Countries Study (1970); The COMA report (1984). There are 400 references here for convenience – the books and journal articles are recommended.

When I started to question the origin of the calorie theory (1lb = 3,500 calories, so to lose 1lb you need to create a deficit of 3,500 calories), I asked the Department of Health, the National Health Service, the National Obesity Forum, The National Institute for Clinical Excellence, the Association for the Study of Obesity, Dieticians in Obesity Management and the British Dietetic Association. None could source the calorie theory. None could prove it.

The British Dietetic Association reply was: “Unfortunately we do not hold information on the topic that you have requested.” It was suggested that I contact a dietitian. I happened to be with several dietitians at an obesity conference later that month (June 2009), so I asked fellow delegates and no one knew where the 3,500 formula came from. No one knew where the ‘eatwell’ plate proportions came from. One dietitian said to me “You’ve made us think how much we were just ‘told’ during our training, with no explanation. A group of us over there don’t even know where the five-a-day comes from.”

I rest my case!

Kellogg’s & Coco-pops

I picked up the main textbook “Examining Food & Nutrition” by Jenny Ridgwell (1996). The age of the book was bad enough, but I was then absolutely horrified to have the book open on a picture of Kellogg’s Coco-Pops – the very product against which the fabulous Children’s Food Campaign have been campaigning so passionately. I have also blogged on this in the past. Flicking to the very next page and almost half of this page was covered by a picture of Bran Flakes (see the scans of the pages below). (The Children’s Food Campaign have also done a brilliant expose of the way in which the food & drink industry are feeding junk messages to their next generation of consumers).

In disbelief, I turned to the inside cover to try to understand how this could be allowed. The companies thanked at the beginning of the book included: the Food & Drink Federation (members include every food & drink company in the UK that you can think of – Cadbury, Coca-cola, Kellogg’s, Mars, Pepsi, Unilever, United Biscuits – as examples, as well as more ‘federations’ like The sugar Bureau, The Federation of Bakers etc) and Sainsbury’s. Kellogg’s & Unilever are also especially singled out for thanks in the first paragraph. The second paragraph goes on to thank: The Federation of Bakers; The Co-op; Kellogg’s again; Lo Salt; Quorn makers Marlow Foods; National Dairy Council; Sainsbury’s again and Whole Earth. Most of the companies are thanked for allowing their product placement pictures to be used – what?! Kellogg’s should be thanking the publisher and a GCSE curriculum should not touch this blatant marketing to children in any circumstance.

A balanced diet

The books starts teaching our children nonsense as early as the first page of content. Under the heading “What is a balanced diet”? the entire text (literally – every single word under this heading – all that children apparently need to know about a balanced diet) reads as follows: “A balanced diet provides all the necessary nutrients in the appropriate proportions and quantities to meet our needs. One way to follow a balanced diet is to make sure we eat a variety of foods which supply a range of nutrients. Carbohydrates in the form of starchy foods such as bread, pasta, cereals and potatoes should be a major part of a balanced diet. We should also aim to eat at least five portions of fruit or vegetables each day.“

No mention of essential fats. No mention of essential proteins. The only macro nutrient singled out to form the “major part” of a ‘balanced diet’ is carbohydrates – ironically – the only macro nutrient that is not essential in any way. Get the bread, pasta, cereals and potatoes – things forming the major part of processed foods – mentioned on the first page. And why five a day? Why teach children things that have no evidence base and were started by fruit and veg companies as a marketing campaign? (In 1991) Does the book author even know this? Does she care?

On P10, we have the old (1994) “Balance of Good Health” plate, which has a prominent picture of puffed wheat cereal and breakfast flakes cereal – a quick glance and it passes for Bran Flakes no problem. We have the usual appalling array of processed food, which is still featured on the Eatbadly Plate - the September 2007 replacement for the BOGH plate. On the BOGH version of the plate in our children’s book, we have white bread, white rice, sugary baked beans, sugary yoghurt, crisps, lemonade, cake and man-made spreads (don’t put nature’s butter on view, whatever happens).

On P13 (scan below) we have a picture of Bran Flakes – beautifully positioned – full length all the way down the right hand side of the page. You can’t miss it. On p23 we have a tub of low fat spread and this fat-phobic section of the book stresses that we should choose (Unilever) low fat spreads and not (nature’s) butter.

There is one interesting fact that this section states correctly (I was surprised a) that they knew this and b) that they admitted it) “cholesterol in food has very little effect on blood cholesterol levels.” For “very little” read “none”. However, the text goes on to say “saturated fats from the food we eat are important factors which affect blood cholesterol levels.” This is the subject of significant debate, which the book should have known about even in 1996 when it was published, but all the more reason to have school textbooks as up to date as possible – particularly in an evolving topic, such as nutrition. (I would like the book to explain, biochemically, precisely how any real fat eaten in real food can raise cholesterol. I would also like the book to explain, given that cholesterol is only found in animal foods – meat, fish, eggs, dairy – and given that eating these has no impact on cholesterol in the blood – why are children/people told that these will raise cholesterol levels when we know that they don’t).

P26 & 27 are the  Unilever thank you pages – a double page spread of spreads. Ha ha. “Gold low fat spread” (I did say this was an out of date textbook); “Gold unsalted low fat spread” and “Gold lowest low fat spread.” There is then a table comparing two Unilever “Gold” products with a Waitrose spread and two from their rival St Ivel. Unilever win the calorie count (the focus of the table) by a mile. Go Unilever! (Butter was not in the table and the table did not measure natural levels of vitamins A and D, or butter would have cleaned up. Go away Nature!)

Then we have the p34 Coco-Pops and P36 Bran Flakes promotions to children. Because these foods have little to no natural nutrition, they are invariably fortified. The textbook fronts this off by saying “Some foods are fortified with vitamins which are manufactured. These are identical in structure to vitamins found naturally in food and behave in the body in the same way.” Really? You don’t need fat to accompany fat soluble vitamins any more? I’ve seen numerous studies showing that the whole food, with the accompanying macro nutrients, antioxidants and phyto nutrients,  is the best way to get vitamins. And what about minerals? Or essential proteins? Or essential fats? Do we not need these?

This is what our children are being taught – lies to position food industry products as nutritious equals to real food. Mother Nature doesn’t need to fortify her foods – they are naturally abundant in nutrients. If cereals have to add vitamins in to have any nutritional value, what does this say about them? They are high calorie, sugary vitamin tablets – that’s what.

On p45, all about dietary fibre, the first four products listed are not the products highest in dietary fibre, nor the products in alphabetical order, they are the cereals – All Bran, Weetabix, Porridge oats and cornflakes. Only one of those can come in a natural form – oats. Tomatoes, lentils and peas are at the bottom of the list.

P99 devotes just one side (less than the space devoted to Bran Flakes packets) to eggs and cannot find a good thing to say about them. Salmonella and cross contamination are mentioned and eggs are described as little more than things that bind ingredients together. This is part of the dual strategy of cereal manufacturers 1) promote one’s own sugary products and 2) denigrate what people used to eat for breakfast, so that your products become the preferred alternative. It is disgraceful for a GCSE textbook to be supporting this propaganda.

What caused the obesity epidemic?

I could go on turning the pages with misinformation after misinformation. No mention of the difference between retinol and carotene and the necessary, and not always possible, conversion to obtain vitamin A in the right form; margarine claimed to be a good source of vitamin D – not naturally it isn’t. That’s an even higher calorie vitamin tablet. No mention of vitamin K1 and K2, or the need to get both plant and animal forms of this vitamin. Vitamin E is declared as “deficiency rare.” Last time I looked at the UK Family Food Survey, the average Brit was getting barely the ridiculous UK Recommended Daily Allowance (we are apparently only ‘allowed’ a certain level of nutrition) and this, 10mg per day, is two thirds of the minimum USA ‘allowance’ – unless we need less of this vital antioxidant than our American friends? There is no mention that vitamin B12 is the unique nutrient that is only found in animal foods (hence why humans are not intended to be vegan). Instead, the textbook tells children that B12 is found in breakfast cereals – the high calorie vitamin tablets again. Not naturally it isn’t – again.

My favourite page is p173 where there is a highly revealing graph (the one on the right hand side of the page scan below), which tells us lots about the obesity epidemic, but the book doesn’t realise that it is sat on a gem. Rather amusingly, the text next to the graph says “The chart below shows how our eating habits are changing. We are slowly changing to a healthier diet.”

The graph then shows that, between the years of 1971 and 1991 (don’t forget how out of date this is) the index of breakfast cereal consumption has gone up from 100 to about 170; the index of white meat (think KFC) has gone up to approximately 175. The index of red meat (beef and veal – quality stuff) has gone down from 100 to approximately 60 and the index for eggs has more than halved from 100 to less than 50. So – having breakfast cereals for breakfast is apparently healthier than eggs. Just one thing – obesity for men was 2.7% in 1972 and 22.6% in 1999 and obesity for women was 2.7% in 1972 and 25.8% in 1999. So, during this time when our diet was ‘healthier’ – according to the companies funding our children’s text books – obesity multiplied almost ten fold, diabetes type 2 has reached almost epidemic levels and childhood obesity has become a household term.

WJEC Board

The WJEC specifications for teaching this Home Economics: Food & Nutrition GCSE include in their specification of tasks (p17):

Cereals make an important contribution to the diet.
(a) Investigate the role of cereals in the diet.
(b) Develop a range of ideas for dishes using cereals.
(c) Plan a course of action for making a selection of dishes using cereals.
(d) Make and present the selection of dishes.
(e) Evaluate your work.

I could understand if they wanted children to know about the super foods liver, eggs or spinach, but fortified cereals?

And finally, because the exam is what this is all about at the end of the day, take a look at this specimen exam: one mark for knowing that strawberry milk shake is higher in calcium than orange & mango juice and another point for knowing that the fruit juice is higher in vitamin C. Question 4 is all about how can we eat at least 4 slices of bread a day – that should fuel the Federation of Baker profits and childhood obesity nicely. Question 9 beggars belief – “Explain how the addition of modified starch is of benefit to the consumer.” Would I get any marks for saying – it is of no benefit to the consumer.  The chemically altered FrankenFood that is modified starch is of great benefit to the producer because it extends shelf life, it is cheap, it speeds up the thickening process (saves more costs) and it takes lumps out of things otherwise so hideous that people probably wouldn’t eat them.

Next time you’re at parents evening – start asking the teachers about how and what they are teaching, not how your little darling is performing. I hope that your little treasure skips nutrition class – better to learn nothing than to learn these appalling, conflicted messages.

Here’s the link to the presentation at last.

The Sunday Times printed a story on the front page on 12 September 2010 of which they should be ashamed. It was entitled “Surgery is better than dieting, says top doctor.” The article quoted Nick Finer, indeed a well known and respected obesity expert, as saying “The only answer to Britain’s obesity epidemic is to offer surgery to anyone suffering from severe weight problems.” He suggested starting with the 1 million people with a body mass index greater than 35 and presumably working down from there. This would be phenomenally lucrative for pharmaceutical companies providing gastric bands, surgical equipment for the operations, drugs taken around the time of the operation, liquid diets (a pre-operation and often post-operation requirement) and, of course, the surgeons who perform these operations.

The real story is that a number of our national obesity experts (most that I have come across) have fundamental conflicts of interest, which should invalidate any so called expertise that they come out with. Why did the article not list Finer’s conflicts of interests? They are easy to find – they were listed in a February 2010 journal declaration:

“Nicholas Finer: Consultant for Novartis, Shionogi, Merck, Abbott, sanofi-aventis, Amylin Pharmaceuticals Ajinomoto and GSK; received lectureship fees from Abbott, sanofi-aventis, Roche and Novo-Nordisk; received grant support from Merck, Novartis, Roche, Alizyme, Pfizer, Johnson and Johnson, Abbott and sanofi-aventis; member of the SCOUT ESC receiving payment from Abbott (honoraria/travel expenses).”

Novartis (Novartis Nutrition) make Optifast : “OPTIFAST® is now being used to induce weight loss as needed before bariatric surgery in several bariatric surgery facilities. Novartis Nutrition has also introduced a brand new line of products, OPTISOURCE™, to help patients meet their special nutritional needs after bariatric surgery. Most of these patients require lifelong protein and vitamin/mineral supplementation after the surgical procedure.” This stuff costs $2500-3500 for a one year programme for one person – not sure if that was factored in to the cost benefit analysis?

Shionogi have two obesity drugs at various stages of R&D.

Merck, Pfizer and Sanofi-Aventis have Cannabinoid Antagonist products. These act to block the cannadinoid receptor 1 (CB1) and are claimed to decrease food intake and help regulate weight. (These try to work on the opposite basis of cannabis ‘giving the munchies’ and the psychological side effects are a concern).

A report about the USA obesity drug and bariatric surgery market lists:
– Alizyme as developing a lipase inhibitor (the goal of this is to stop fat being absorbed – as with the drug Orlistat/Alli. Absorption of fat soluble vitamins is impaired);
– GlaxoSmithKline under emerging drugs for a melanin-concentrating hormone antagonist;
– Amylin Pharmaceuticals as having an emerging Peptide YY3-36 drug;
– Amylin Pharamceuticals and Johnson & Johnson are listed as having other emerging drugs;
– Johnson & Johnson, Merck and Pfizer are listed as having delayed or discontinued drugs in this arena.

The companies profiled in the obesity drug and bariatric surgery market report are Abbott, GSK, Merck, Pfizer and Sanofi-Aventis. Roche make the drug sibutramine (withdrawn from Europe, earlier this year, following an investigation into heart disease amongst people taking the drug. It is still available in the USA). The report where Finer declared his interests was a study of the drug sibutramine and the conclusion was very favourable (would it be reasonable to suggest one would not be supported by a company if one were not supportive of their products?)

I saw Nick Finer present at the Wales National Obesity Conference in June 2010. He introduced me to a graph, for which I am most grateful, done by Marion Franz in 2007. This study reviewed 80 other weight loss studies based on the “eat less and/or do more” principle and this is where Finer gets his statistic quoted in the Sunday Times article: “the average long-term weight loss achieved by most obese adults who diet is 2-3%, so small as to be almost irrelevant.” This is correct. I have seen the study and I am hugely grateful to Elsevier for permission to reproduce the chart in my book “The Obesity Epidemic“. However, this evidence is for low calorie/calorie deficit dieting – it is not for low carb dieting and my own findings (reproduced in the book) are similar to those of Gary Taubes – an unavoidable conclusion that carbohydrate consumption is solely responsible for both fat storage (weight gain) and fat ‘un-stored’ (weight loss).

Finer is quoted in the article as saying “Humans evolved in unpredictable environments where food was scarce and our bodies are programmed to maintain our body weight at all costs.” From this comes the recommendation that we should operate on 1 million of our fellow humans (for starters) to cut them open and make it such that they will never be able to eat normally, digest normally or absorb vitamins normally ever again.

There is no logic in this conclusion. Man and our ancestors have been on this planet since Australopithecus Lucy first walked upright an estimated 3.5 million years ago. We have had an obesity epidemic for about 35 years. Surely our first plan should be to return to what we ate for the 3 million, 499 thousand, 965 years before we got so fat we had to invent bariatric surgery?! How about humans return to eating what we evolved to eat? Meat, fish, eggs, vegetables, nuts, seeds and sporadic fruits if we were lucky?

The trouble is – there is no money to be made in advising the above. The ‘expert’ who advises a return to eating food – we shouldn’t need to call it real food – will receive no funding from food, drink or drug companies. The whole reason we have the processed food industry is because of the margin that can be made from man-made food in contrast to that which can’t be made from mother-nature’s food. And with the modern illness accompanying modern food and drink we have modern drugs – continually being developed to ‘treat’ the diabetes, obesity, cancer, heart disease, indigestion, irritable bowel syndrome, blood pressure problems and so on, which I am convinced are the result of that modern drink and food. What a wonderful symbiotic relationship between the food, drink and drug industries.

This is why the real story for Sunday’s paper should have been – citizens of the UK will never receive the right advice until so called experts cease to be conflicted. Or, at the very least, have to declare their interest up front so that we can see the promotion for what it is.

p.s. you may like to see another blog I did with death rates for bariatric surgery. I’m not sure if the funeral costs were also factored in to the cost benefit analysis study.

p.p.s Ajinomoto markets aspartame. Here’s Finer promoting aspartame. Here’s what an independent person has to say about aspartame:
Dr. Ralph Walton, Professor and chairman of the Department of Psychiatry Northeastern Ohio University Colleges of Medicine, undertook a comprehensive review of studies available for just one sweetener: aspartame. It was called “Survey of aspartame studies: correlation of outcome and funding sources.” The summary of the report stated: “Of the 166 studies felt to have relevance for questions of human safety, 74 had Nutrasweet® industry related funding and 92 were independently funded. One hundred percent of the industry funded research attested to aspartame’s safety, whereas 92% of the independently funded research identified a problem.” Walton’s overall conclusion was “We have also become much more sophisticated about the impact of a variety of toxins on psychological processes. I am convinced that one such toxin is aspartame.”

“Fast food outlets should consider handing out cholesterol-lowering drugs to combat the effects of fatty food, link here

The article opens with: “Fast food outlets should consider handing out cholesterol-lowering drugs to combat the effects of fatty food, say UK researchers. Taking a statin pill every day would offset the harm caused by a daily cheeseburger and milkshake, the Imperial College London team said. It would only cost 5p a customer – similar to a sachet of ketchup.”

Dr Darrel Francis, one of the team of researchers, was quoted as saying: “Importantly, even partial adherence to statin therapy conveys a mortality benefit, suggesting that statins do not need to be taken daily to have some protective effect”.

I checked the source of these incredulous comments (we’ll cover why below). The researchers were Emily A. Ferenczi, Perviz Asaria, Alun D. Hughes, Nishi Chaturvedi MDa and Darrel P. Francis. Their article “Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices?” was published in the American Journal of Cardiology August 2010. You can read the summary here.

Invariably, I go back to the original medical journal article and find that the media have sensationalised a serious piece of research, taken one statement out of context and blown it out of proportion. Not in this case. The researchers managed to do that in their original summary – here’s an extract:

“The risk reduction associated with the daily consumption of most statins, with the exception of pravastatin, is more powerful than the risk increase caused by the daily extra fat intake associated with a 7-oz hamburger (Quarter Pounder®) with cheese and a small milkshake. In conclusion, statin therapy can neutralize the cardiovascular risk caused by harmful diet choices… Routine accessibility of statins in establishments providing unhealthy food might be a rational modern means to offset the cardiovascular risk. Fast food outlets already offer free condiments to supplement meals. A free statin-containing accompaniment would offer cardiovascular benefits, opposite to the effects of equally available salt, sugar, and high-fat condiments. Although no substitute for systematic lifestyle improvements, including healthy diet, regular exercise, weight loss, and smoking cessation, complimentary statin packets would add, at little cost, 1 positive choice to a panoply of negative ones.”

The only declaration of interest for the article was “Dr. Francis is supported by grant British Heart Foundation, London, United Kingdom.” (Those are the exact words – there may be an ‘a’ and a ‘from the’ missing). Professor Peter Weissberg, medical director at the British Heart Foundation is also quoted in the article. It would be fair to say that Weissberg is quite a fan of statins – Dr Michael Eades does a great blog here showing how Weissberg was defending statins back in February 2007. Eades says “The British Heart Foundation is also funded by, among others, companies that make statins.” I did a quick check on the BHF site this morning and found nothing clearly declared. A separate search on Pfizer (makers of Lipitor) and the BHF reveals a funding relationship – small to Pfizer but useful to the BHF.

There are almost too many levels to go into as to why this article is both horrific and irresponsible. I am struggling to recall a more disgraceful recommendation to come from people supposedly interested in our health. I’ll stick to four:

1) Cholesterol is one of the most vital substances in the human body. We literally die without it. The sensible (and non-conflicted) people working in the field of cholesterol understand how statins actually work. The body makes cholesterol (it is too vital a substance for the body to rely on you to have to consume or get from another source in any way). Statins stop the body making cholesterol. You may think that this is how they impact on heart disease (the evidence for impact is also conflicted and not compelling despite this). The more sensible view is that statin drugs work as an anti-inflammatory agent in some way and the cholesterol lowering is a very unfortunate side effect. The key reason for it being so unfortunate is that statins stop the body’s own working ‘up-stream’ of the production of CoQ10, which has been called the energy spark plug for the body, and this explains side effects from tiredness, being less able to be active and as extreme as irreversible muscle wasting. Given that the brain has one of the highest requirements for cholesterol within the body, forgetfulness and generally being less cognitive are also well known and serious mental side effects.

2) I have no idea where Francis gets his idea of mortality benefit. The evidence is the converse. Lowering cholesterol has been shown to increase mortality – the lower your cholesterol, the more risk of dying kind of relationship. This makes sense given the life vital role of cholesterol.

The Honolulu Study was a 20 year study of cholesterol levels and mortality in 3,572 Japanese American men. The study concluded that “Only the group with low cholesterol concentration at both examinations had a significant association with mortality”. The authors went on “We have been unable to explain our results”. (I.e. we were expecting lower cholesterol to equal lower mortality, not the other way round). All credit to the team for their honest reporting of these unexpected results and their final statement in the abstract: “These data cast doubt on the scientific justification for lowering cholesterol to very low concentrations (<4·65 mmol/L) in elderly people.” (Schatz, Masaki, Yano, Chen, Rodriguez and Curb, “Cholesterol and all-cause mortality in elderly people from the Honolulu heart programme”, The Lancet, (August 2001).)

Framingham similarly concluded that “There is a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years (11% overall and 14% CVD death rate increase per 1 mg/dL per year drop in cholesterol levels).” (Anderson, Castelli and Levy, “Cholesterol and Mortality: 30 years of follow-up from the Framingham Study”, Journal of the American Medical Association (JAMA), (1987).)

Dr Malcolm Kendrick in the brilliant “The Great Cholesterol Con”, does a clever calculation on this quotation and translates this into – a reduction in cholesterol from 5 to 4 mmol/L would increase your risk of dying by 400%.

3) This study makes the usual mistake of not starting from a clear control basis. Remember the item chosen? A 7-oz hamburger (Quarter Pounder®) with cheese and a small milkshake. So we have all three macro nutrients – fat, protein and carbohydrate. We have primarily, if not exclusively processed food. We have sugar, white buns, processed meat and cheese. What were these guys trying to measure? Fat always takes the attack in the media, but this is processed food being analysed. I would mind less if the headings were “eat processed food – pay the price” but it is in the interests of the food industry to attack fat when the precise culprit is their processed food.

4) I almost can’t find the words to describe the irresponsibility of  the proposal that Statins should be given out like Smarties as an antidote to eating processed food. Two very bad wrongs don’t make a right. I detest processed food and yet I would rather eat a burger every day than take statins. Read The Great Cholesterol Con and learn from a non-conflicted doctor what these drugs really do and how they are implicated in cancer, muscle damage, liver damage, mortaility we have seen above and, perhaps the ultimate irony, there are those who think that statins are responsible for the heart failure they are supposed to alleviate. Again – if you know the role of CoQ10 in heart muscle, you can see that this is highly plausible.

However – the ultimate irresponsibility must surely be that a pregnant woman can walk into a burger bar, day and night, and, if this bunch of drug pushers get their way, she can pick up a statin as well as a ketchup sachet and risk deforming her unborn child. Drugs are not tested on pregnant women for a reason. Cholesterol levels rise in pregnant women because it takes a lot of cholesterol to make a healthy baby (this is why eggs are relatively high in cholesterol – it takes a lot of cholesterol to make a healthy chicken or duck etc). To lower a woman’s cholesterol levels while she is trying to make a healthy baby is medical malpractice in my view. Check out the patient info for Lipitor - the statin worth about $12 billion (last time Ben Goldacre kindly quantified it for us).

“Do not take Lipitor if you are pregnant or think you may be pregnant or are planning to become pregnant. Lipitor may harm your unborn baby.”

“If you get pregnant stop taking Lipitor and call your doctor right away.”

“Do not take Lipitor if you are breastfeeding. Lipitor can pass into your breast milk and harm your baby.”

“Do not take Lipitor if you have liver problems.” (presumably because it’s going to harm your liver, so you’d better have a strong one?)

Dear people of the world – your doctor may be conflicted, your heart charity may be conflicted. Anyone who tells you that statins are the wonder drug and should be given out like sachets of ketchup had better be conflicted, because I cannot think of any other reason for being so irresponsible.

Harcombe Diet followers will immediately spot the error – either in this write up from the Daily Mail Science reporter (Fiona MacRae) or from the press release itself. Food allergy and Food Intolerance are seriously different – potentially fatally. Food allergy absolutely is not in the mind – ever! If you suffer an anaphylactic shock after coming close to a peanut, you have a peanut allergy (and likely problems with many, or all, nuts). If you are like a friend of mine, who has a life threatening allergy to kiwi fruit, you know about it and it’s not in your mind – if it gets near your body, let alone inside you, it can kill.

Food Intolerance is the ‘too much/too often’ problem and the body literally becomes intolerant to this over-consumed substance. It’s the body’s way of saying “I can’t tolerate this substance any more“. (Sadly the withdrawal symptoms that accompany intolerance mean that you will crave the very food(s) to which you are intolerant).

What’s the most likely food intolerance in the UK? (USA and Australia also)? Wheat. Why? Because we eat it several times every day as a general rule: wheat toast or wheat cereal for breakfast; wheat muffins, wheat biscuits, wheat cereal bars etc for mid morning; wheat sandwiches or wheat pasta salad for lunch; more wheat snacks in the afternoon; wheat pasta, or wheat pizza or wheat pies or wheat pastry for dinner and then more wheat snacks in the evening.

The Flour Advisory Bureau statistics tell us “UK flour consumption per capita reached 73.3kg in 2002.” That means 1.4 kilograms of flour consumed per average person in the UK per week. I can’t find a single ingredient that we eat more of .

So – back to this study: researchers at the University of Portsmouth blamed internet searches and celebrity food fads for “make-believe allergies and intolerances” (that allergies mistake again) and said that, as a result, millions of people are unnecessarily restricting their diets – starving themselves of their favourite (interesting choice of word; try ‘addictive’ also) foods and of key nutrients (no nutrients in sugar and bread/cereals need to have added vitamins to be worth consuming, so clutching at straws here nutritionally).

You read on and find that the report was written by Dr Carina Venter – a dietician who specialises in allergies (allergies or intolerance? This is quite important). Then you get to the point in the article where I break out into something between a smile and a grimace – I don’t know whether to laugh or cry. The study was funded by the Flour Advisory Bureau. Now what was the most common food intolerance again?!

Dr Hilary Jones (love him) answered a question in the News of the World Sunday supplement (love it) in the October 2009 issue and said “About 45% of people suffer from food intolerance“. Personally, I have yet to find someone who does not feel better and lose weight faster when they avoid wheat. Sugar and flour are still the two products that I rarely consume – even after over 10 years of being in Phase 3. Has my health suffered in any single way? Quite the opposite.

Sadly in this world of conflicts of interest and food interested parties sponsoring diet advice – you are better off being your own judge and taking charge of your own health. If you do Phase 1 (it’s only 5 days) and feel better and then try the advice on food intolerance -  reintroducing foods and testing and keeping a diary -  you will see what makes you feel well and unwell. Your body will tell you – if it can be heard over the conflict of interest advice!

Good luck – Zoe x