Review of 2024

Happy New Year!

We’re kicking off with a review of last year. This was the year of the verdict in Harcombe/Kendrick vs Associated Newspapers and a number of posts covered the case – especially following the key Judgment on June 25th, 2024.

This was also the 20th anniversary of my first book – “Why do you overeat? When all you want is to be slim” – which was launched at the London Book Fair in 2004. Sharing how that book came about was a popular post.

The most popular note of the year (from replies received) was the 700th – where I shared what I had learned over 14 years of writing Monday notes.

The two part breast cancer post – to screen or not to screen – was also very popular. I sent a copy of these two articles to my doctor when I was phoned to ask why I hadn’t attended breast screening. A paper was published in April with the results from a randomised controlled trial on prostate cancer screening. This enabled me to cover the key screening question for men, having done the one for women.

This was another very varied year for topics – ranging from red meat and type 2 diabetes (again) to the usual attacks on low carb/keto diets. There were some unusual notes – what did the Hadza teach us about metabolism? Do kiwifruits improve mood? Does kimchi reduce beer bellies? (Answers – lots, no and no.)

In February, I went through the updated UK NICE guidelines for CVD so that you don’t have to. Throughout the year, I dissected many claims for plant food consumption. Can plant foods stop prostate cancer progression? Can they reduce the risk of Covid? Can they slow aging? No was the short answer to those three as well.

This was also the year that I got back to doing podcasts (which we started before 2011). They’re quite irregular because I don’t want to go looking for guests. I would rather think “Ooh – I need to talk to Ben Bikman about Ozempic” and then arrange to do so. I had fabulous chats with a number of people last year – Dr Georgia Edes, Gary Taubes, Nick Thompson, James Goolnik, Dr Christy Kesslering, Guy Ben Zvi, Dr Lindsay Browning, Dr Ahmad Malik, Dr Ben Bikman, Hannah Sutter, Jon Furniss, Marc Giradot, Professor Norman Fenton, and Dr Peter Brukner. For topics examples, we covered everything from sleep to teeth and from pets to the history of ketogenic diets.

Here’s a quick summary of each post and a link to the full article for convenience.

January

Are vegetarians & vegans less likely to get Covid-19?
This was a fun one to start the year. It involved 702 people in Brazil – 80% of them women. It claimed that vegetarian and plant-based diets were associated with a lower incidence of Covid-19 than omnivore diets. There were many issues – the diet was self-reported, Covid was self-reported, all groups in this study consumed animal foods (there weren’t enough vegans to study), the usual healthy person confounder was strong, the plausible mechanism wasn’t plausible and more.

EAT Lancet diet adherence.
A paper was published in November 2023, which claimed that people who adhered most closely to the (plant-based) EAT Lancet diet had a lower risk of cancer incidence and all-cause mortality. The huge flaw with this paper was that the paper claimed to have studied the Eat Lancet diet, but it didn’t. I entered into correspondence with the journal and authors. They stopped communication when I said that the paper should be retraced.

Breast cancer – to screen or not to screen – Part 1.
This was the first of a two part note trying to answer the question – breast cancer: to screen or not to screen? To answer this question, I examined two seminal reports (one from Sir Michael Marmot and one from Dr Peter Gøtzsche) and the original trials presented in these two reports. The debate is incredibly important, as screening can cause harm and some of the harms are serious – unnecessary mastectomies, radiation and/or chemotherapy on women who didn’t need any treatment. The question to screen or not to screen is thus a very important one to examine.

PODCAST – Zoë chats with Dr Georgia Ede about diets.

February

Breast cancer – to screen or not to screen – Part 2.
This was the second part of the very important review into the benefits and harms of screening for breast cancer. This second part also shared my decision about screening and how I reached it.

Does plant protein increase the odds of women being healthy agers?
This note was about yet another paper from the Harvard epidemiological article factory. This one claimed that plant protein was associated with healthier aging in women (from the US Nurses’ Health Study) under the age of 60. The data were presented in five groups, so that the top and bottom group could be compared. The paper instead used an invented 3% energy increment for the headline claims. Review of supplemental material revealed the main sources of plant protein were bread, fries, baked goods and cereal, while the main sources of total and animal protein were beef, chicken, fish/seafood, milk and cheese. The study claimed that the ‘junk’ helped while the real foods made little or no difference. That was not the only issue – I listed 10 with ease.

Do kiwifruits improve mood?
This NZ study, involving 155 people, funded by the world’s largest marketer of kiwifruit, claimed that kiwifruit could improve mood in as few as four days. After adjustment, there were no differences between vitamin C and placebo or kiwifruit and placebo. The researchers created a subset of people especially low in vitamin C and claimed results for these. Correspondence with the lead author confirmed that these data were not adjusted. There were therefore no results post adjustment for any group.

PODCAST – Gary Taubes and Zoë chat about science, diabetes, journalism and books.

New UK (NICE) guidelines for CVD.
The National Institute for Clinical Excellence (NICE) is the organisation in the UK that sets medical guidelines for every drug, every intervention, and every procedure. NICE published guidelines for cardiovascular disease (CVD) in July 2014. A revised version was issued in December 2023. This post summarised the six key changes to save you the bother of going through the substantial document. It also shared the declarations of interest among the panel members.

March

The Atlantic Diet.
The Atlantic Diet was described as the abundant consumption of real (not processed), local, fresh, seasonal foods, including fruit, vegetables, bread, cereals and pulses, along with fish and milk products. The trial examined in this post was a 6 month intervention with 250 families. The trial was not randomised and differences between the control and diet groups were not all adjusted for. The paper claimed that 1) the diet reduced the risk of developing metabolic syndrome and 2) the diet group participants had fewer of the five metabolic syndrome components. Notwithstanding that differences between the groups were not adjusted for, neither claim withstood scrutiny.

The Atlantic/GALIAT & Mediterranean Diets.
Inspired by last week’s note about ‘the Atlantic Diet’, this note compared the Atlantic and Mediterranean diets. There are variations of the Atlantic diet (SEAD, Galicia Atlantic Diet etc.). There are many variations of the Mediterranean diet (MDS, modified MDS, MEDAS, Pyramid etc). Both are academic constructs, as opposed to what people actually eat in these regions. I illustrate why in this note.

Why do you overeat?
This post was written to recognise that March 2024 was 20 years since my first book was published. It was called “Why do you overeat? When all you want is to be slim” and it was launched at the London Book Fair on 15th March 2004. In this post I summarise why we overeat, when all we want is to be slim, and I explain how I came to write the book.

PODCAST – Zoë chats with Nick Thompson, aka The Holistic Vet.

Will fasting increase your risk of cardiovascular death?
The short answer was no, of course. The post fully explains how bad this paper was. For example, the global headlines were based on 0.15% of participants who a) died from CVD and b) claimed that they ate within an 8 hour window. The global headlines were thus based on 31 deaths.

April

Trying to get informed consent.
This post shared something that happened in spring 2021, three years previously. I hesitated before sharing this, as I know that the topic is emotive; but the exchange was interesting and important and so I decided to share it. It’s about the history of my research into vaccines for coronaviruses (which I started when I first heard about Covid-19) and how this impacted my response when I was invited for a Covid ‘vaccine’. It’s about my attempt to get informed consent from the authorities inviting me for a medical intervention.

Does kimchi reduce beer bellies?
I do some strange research; little more strange than this Korean paper. I summarised the issues with this paper in a BMJ rapid response. It used Korean, not western, definitions of obesity, which meant that what we know as obesity had not been studied. The claimed results had no consistency or rationale (see the BMJ rapid response). Why were there findings for men and not women? Why findings for some serving sizes and not others? Why for some kimchi and not other types? Why did anything make any difference? The only bit that made sense was that the research was funded by the World Institute of Kimchi, where two authors worked.

Top 10 blockbuster drugs.
I recently needed to look up how much the main statin, Lipitor, had earned during its lifetime. This led me to research that reported the top 10 blockbuster drugs by global lifetime sales. This note summarised what the top 10 are, who makes them, what they are for, why they’re a blockbuster drug, patent expiries, what are the side effects and other interesting findings along the way.

PODCAST – Zoë chats with James Goolnik about dental health.

Prostate cancer – to screen or not to screen.
The CAP trial was a cluster randomised trial of PSA testing for prostate cancer. It involved approximately 400,000 men, recruited in clinics across England and Wales. This post reviewed a paper which had presented the latest (15-year follow-up) results from the CAP trial. It found a slightly lower incidence rate of prostate cancer deaths in the intervention group. However, the 10-year follow-up and the 18-year follow-up found no difference for prostate cancer deaths. There was no significant difference in deaths from any cause (the measure that matters) for the 10, 15 or 18-year follow-ups. As with the breast cancer screening review, over diagnosis was an issue (approximately one in six cancers were overdiagnoses.) These would have been treated and treatment for prostate cancer can harm – incontinence and impotency being common outcomes. If being invited to a PSA test makes no difference to overall mortality and can unnecessarily harm, the question to screen or not to screen does not seem difficult to answer; with one caveat…

How I approached a paper on protein.
This was a really popular note. I reviewed the latest paper claiming that plant protein is better than animal protein (which makes no sense). Instead of just reviewing the study, I walked the reader through how I review a study so that you too can find the ‘tricks’ in these papers.

May 

NHS weight loss programme: the results are in.
The National Health Service (NHS) in England launched a digital weight loss programme in April 2021. Six service providers were commissioned by NHS England to provide a 12-week programme focused on eating less and doing more. Nearly 64,000 people in England were referred to the programme by their doctor. I reviewed the first published results – what proportion of people took up the programme? How many completed the programme? What was the weight change? Did these research questions differ by sex, age, ethnicity?

Can plants stop prostate cancer progressing?
A population study (association, not causation), which used data for just over 2,000 US men diagnosed with prostate cancer, claimed that a diet rich in fruit, vegetables and nuts could HALVE the odds of prostate cancer spreading. The study was from the Harvard team, as usual. The researchers invented (subjective) measures of healthy/unhealthy plant/animal scores. The indices rated ‘good’ plants as good and ‘bad’ plants and animal foods as bad. The study examined prostate cancer progression and mortality. Nothing was claimed for mortality. There was essentially one claim for cancer progression (the headline claim). Nothing else was found. The paper was fatally flawed. I explain why and how.

PODCAST – Zoë chats with Dr Christy Kesslering about metabolic health and cancer.

The perfect English patient.
The UK has been using a scheme called the Quality and Outcomes Framework (QOF) since 2004. The QOF assigns points for healthcare targets which general practitioners (GPs) (family doctors) are incentivised to meet. The points can earn approximately £135,000 for a practice of 9,000 patients and thus targets are worth achieving. The targets and points tell us what is valued by the UK government/healthcare system. This enables us to see what the perfect patient would be – the one who earns their doctor the most money.

Semaglutide & heart disease.
Semaglutide is the new weight loss injection sensation. It has the brand names Ozempic and Wegovy. This note reviewed three academic papers on semaglutide, including the latest claim that semaglutide would reduce cardiovascular events. The weight loss achieved with semaglutide is striking. The side effects are striking too – from pancreatitis and retinopathy to hair loss and gastritis. The results were weak and could be explained by the drop out rate (many people can’t tolerate the drug).

PODCAST – Zoë chats with Guy Ben Zvi about Omega-3s and fish oils.

June

Is LCHF associated with CVD?
The short answer to this one was also no, of course. The longer answer was that the study started with data for over 500,000 participants. From these, the researchers identified just 305 people who completed one “what did you eat yesterday?” dietary questionnaire at the start of the study, who weren’t on statins and were consuming <25% carbohydrate and >45% fat (i.e., lowER carb highER fat). Just 305! It got worse…

Do fish oil supplements raise the risk of heart disease?
A paper generated global headlines that taking fish oil supplements might raise the risk of heart disease and strokes. The risk ratio for arial fibrillation was small. The risk ratio for stroke was not statistically significant and should not have been reported as a finding. There were eight findings in total. One (the atrial fibrillation claim) found against supplements; the other seven found in favour of supplements. The headlines should have been “Seven times as many associations found in favour of fish oil supplements and heart disease as against.”

Is olive oil a superfood?
This was another very popular post. It was inspired by a podcast I did where I described olive oil as “not all that.” It explained why I said that – covering facts about fat, facts about olive oil, anti-oxidant/anti-inflammatory and cholesterol lowering claims made about olive oil. It covered how PREDIMED did not find in favour of olive oil. It closed with the circumstances in which it is OK to use extra virgin olive oil.

PODCAST – Zoë chats with Dr Lindsay Browning about the importance of sleep.

Recent learnings about blood pressure & meds.
This was a personal one. I was trying to help a friend to better understand blood pressure (BP) and medications for high blood pressure and I discovered many findings that I didn’t know. These included the difference between wrist and cuff blood pressure machines, measuring at home vs in the clinic and the efficacy of BP lowering meds.

Harcombe/Kendrick vs Associated Newspapers – The Judgment.
On June 25th, 2024, the Judgment was handed down in the case that Dr Malcolm Kendrick and I brought against Associated Newspapers for articles published in the Mail on Sunday and Mail online during the first weekend of March 2019. It was good news for us.

July

As a result of the June 25th Judgment, July’s notes were devoted to going through the 125,000 word Judgment to guide readers through the basics and the facts and some of the most striking passages…

Harcombe/Kendrick vs Associated Newspapers – The right-to-reply.
This note reproduced the email that I first received from the journalist at the Mail on Sunday and my reply to the accusations he made. Both are reported verbatim. This ‘right-to-reply’ turned out to be crucial to the case and subsequent Judgment. Malcolm and I didn’t know this at the time. In hindsight, we were both so relieved that we replied and with such detail and robust academic referencing.

Harcombe/Kendrick vs Associated Newspapers – The basics of the case.
This note went through the basics of the case: who, when, what, defamation law, the defence put forward by the Defendants, the summary Judgment and what this case was and wasn’t about.

Harcombe/Kendrick vs Associated Newspapers – The Facts Part 1.
This note went into some of the facts of the case. It enabled me to share passages from the Judgment, which we first became aware of during pre-trial exchanges of information between the parties. It is fair to say that some of the emails and WhatsApp messages that became discoverable were jaw dropping.

Harcombe/Kendrick vs Associated Newspapers – The Facts Part 2.
This second note about the facts of the case covered what became known as “The Hancock statement” in reference to the then UK Health Secretary, Mr Matt Hancock, Member of Parliament. This was a key part of the case. This note also touched on the importance of a paper which became known as “the LSHTM paper” (the London School of Hygiene and Tropical Medicine paper). The influence of the experts with whom the journalist was working was the third key aspect of the case covered in this note.

What the Hadza taught us about metabolism.
This was a complete change of tack away from the court case to share some really interesting findings from a book I had read called “Burn: The misunderstood science of metabolism” by Dr Herman Pontzer. The key finding, from living with and meticulously studying the Hadza tribe was that “The bottom line is that your daily activity level has almost no bearing on the number of calories you burn each day.” The implications are profound: obesity can’t be blamed on sedentary behaviour; exercise won’t solve obesity; and more.

August

Is night light a risk factor for T2D?
Using data for 85,000 people in the UK Biobank study, a paper published in the Lancet claimed that there is an association between exposure to night light and the onset of type 2 diabetes (T2D). Aside from the fact this was a modelling exercise, there were many issues with the study. It didn’t cover the most obvious association with the onset of T2D – any snacking that might have been going on while being exposed to light at night.

Soups & Shakes for T2D.
Since 2019, the UK National Health Service (NHS) has been offering a ‘soups & shakes’ programme to adults recently diagnosed with Type 2 Diabetes (T2D). This week’s note was about a paper published in August 2024, which reviewed the outcomes from 7,540 people who started this soups & shakes programme before the end of 2022. Depending on the participant group chosen, it could be claimed that 2% or 32% of people achieved remission of T2D.

PODCAST – Zoë chats with Dr Ahmad Malik about prioritising patient values in medical care.

Can a vegan diet slow aging?
This was the second major paper from the TwiNS study, which was featured in a Netflix documentary. The TwiNS study randomised 22 pairs of identical twins to a whole food vegan diet or a whole food omnivore diet. This paper claimed that a short term vegan diet was associated with improved aging markers. However, the major issue was that the study provided the food to be consumed for the first 4 weeks of the 8 week trial and nearly 200 fewer calories were provided to/consumed by the vegan group relative to the omnivore group. There is much evidence that calorie restriction will improve aging markers. Hence we can’t claim that a vegan diet had anything to do with anything.

Meat & T2D again.
This paper broke the record for the number of emails in my inbox asking me to review a study. The paper pooled 31 population studies from 20 countries to make its claims. The claims didn’t make sense (diabetes is about glucose handling & meat contains no glucose). There were many issues with it – including some numbers that didn’t add up – literally.

September

Higher plant fat intake associated with higher deaths.
This was a population study but with a difference. The raw data found that higher plant fat intake was associated with higher deaths. The study claimed the opposite. This was an unusual study in that the food claimed to be healthy (in this case plant fat) is normally associated with a healthier person. Adjustment then moderates the risk ratio. In this study, the highest consumers of plant fat had the least healthy profile and higher deaths. Adjustment flipped this the other way round. That’s what we’re expected to believe, anyway.

PODCAST – Zoë chats with Dr Ben Bikman about the use and effects of GLP-1 Agonists.

What I’ve learned after 700 Monday notes.
This was the most popular note of the year. It was open and personal and it seemed to capture many issues that readers have noticed – from how weak nutritional science is to how little genuine research is currently being done.

Are low carb diets associated with T2D?
An Australian study claimed that a low carb diet was associated with increased risk of T2D. As usual a low carb diet hadn’t been studied. Differences in energy intake were absurd, rendering the declared food intake unreliable. Oh, and the study did not adjust for obesity (BMI or waist to hip ratio (WHR)). When it did, there were no findings. That’s all we need to know.

An introduction to personality styles.
This and the next post took an excursion back to my previous life as a Human Resources Director. I introduced the Myers Briggs Type Indicator preferences: Extraversion (engage externally) or Introversion (engage internally); Sensing (tangible) or iNtuiting (intangible); Thinking or Feeling; and Judging (plan ahead) or Perceiving (lastminute.com). This was done for interest (and many people found it interesting) and as a foundation for next week’s note…

What your personality style means for your approach to healthy eating.
This note used the four Myers Briggs Type Indicator preferences to explore where our preferences can help or hinder our approach to healthy eating. These turned out to be popular notes too – and very readable – with no statistical significance to worry about.

October

Dr Ben Bikman and insulin resistance.
This post was the result of having read Dr Ben Bikman’s book while I was on holiday in September. The book covers: the basics of insulin resistance and the chronic diseases it can cause (Part I); the causes of insulin resistance (Part II); and what we can do about it (Part III). In this note, I focused on the basics of insulin resistance (particularly in relation to diabetes) and the causes.

Harcombe/Kendrick vs Associated Newspapers – An Apology.
Five and a half years after the articles were published in the Mail on Sunday, an apology was published on 13th October 2024. My favourite part was “We also accept that these allegations are untrue and ought not to have been published.”

Keto diets for epilepsy (with Hannah Sutter).
This was the first Monday note based on a podcast. A podcast with Hannah Sutter about keto diets for epilepsy inspired me to research further and this note and the podcast unpacked when ketogenic diets were first used for epilepsy and how other diets for this condition have been developed since.

PODCAST – Zoë and Hannah Sutter discuss ketogenic diets.

The Keto Brain Health Conference.
This was a note based on a conference that I spoke at on 19th October 2024. The note shared the main messages from my presentation “Separating fat from fiction.” Andy managed to record the presentation and drop the slides in for people who had been unable to attend the meeting. Hence this note contained the Full Monty presentation and also the takeaway messages.

What Keys and Danny taught us about metabolism.
This was the first of two notes looking at metabolism. It was inspired by the note I wrote in July, titled “What the Hadza taught us about metabolism”, based on the book ““Burn: The misunderstood science of metabolism” by Herman Pontzer The Hadza book looked at the impact of ‘doing more’ on metabolism. This week’s note looked at two key studies on the ‘eating less’ aspect of metabolism. These were the Dr Ancel Keys Minnesota Starvation Experiment (1950) and a 2016 academic study of the American TV show, The Biggest Loser.

November

The Benedict weight loss study (1917).
This note was partnered with the Keys and Danny note on metabolism. It looked at the classic Benedict study from 1917. Benedict et al recruited 12 normal weight, healthy men. They set out to achieve a weight reduction of 10% and then to try to maintain the lower weight for some weeks. Their key research question was – if we lower weight by 10%, will metabolism be 10% lower? They answered this question and many others related to what happens when we try to eat less.

Glucagon & Type 1 Diabetes (with Jon Furniss).
In recognition of World Diabetes Day (14th November each year), this was a double note week. On Monday we released the video of me talking with Jon Furniss about all things Type 1 diabetes. This was accompanied by a note exploring why glucagon might be as important to understand as insulin in diabetes. On Thursday, we released the podcast of our conversation to the usual channels.

PODCAST – Zoë and Jon Furniss discuss the challenges of living with Type 1 diabetes.

Four diets with exercise – which did best?
This was a systematic review and meta-analysis and so should have provided high level evidence, but there were so many errors – in both detail and methodology – that it should never have got though peer review. It claimed that calorie restriction was best and the keto diet was suboptimal. Both claims can be ignored.

PODCAST – Zoë chats with Marc Girardot about The Bolus Theory.

Mendelian Randomisation – better than epidemiology?
This might be one to bookmark. It was our first look at a technique called Mendelian Randomisation, which will be used more to make diet-health claims in the future. Papers using this technique cannot be dissected in the way in which I dissect epidemiology papers. It’s a ‘black hole’ technique, which would have us believe that there are (for example in this paper) genes associated with dietary fat intake and genes associated with Alzheimer’s Disease (AD) and research using these can claim fat causes AD. I think MR can be a useful tool in a number of fields, but I’m not convinced that food intake is one of them.

December

Covid Data (with Professor Norman Fenton).
This note was about a book I read – Fighting Goliath – by Professors Norman Fenton and Martin Neil. The book’s title is apt, since for much of the past few years, Norman and Martin were battling authorities to either try to obtain data or to challenge data that they were in possession of. This Monday note was also about a podcast I did with one of the authors – Professor Norman Fenton. The Covid era remains a sensitive and often divisive subject. Not even Norman and Martin agree on some issues. My plea in this note was that we should allow all views to be aired – even those we don’t like – because we can only deal with global crises by listening to and debating different views.

PODCAST – Zoë and Prof. Norman Fenton talk about his book ‘Fighting Goliath’

Harcombe/Kendrick vs Associated Newspapers– A Statement in Open Court.
This was the final finale in our case – a Statement read out in Open Court. It set out who Malcolm and I are; what we were accused of; what the then UK Health Secretary, Matt Hancock, had to do with the case; what an academic paper that became known as The London School of Hygiene and Tropical Medicine paper had to do with us (spoiler alert, nothing); and how the allegations were found to be defamatory.

How accurate is your cholesterol test?
This note was prompted by a query from a friend about the cholesterol test. It covered the importance of cholesterol, what lipoproteins are, the difference between lipoproteins and cholesterol; and why there’s no such thing as good and bad cholesterol. It set out what the cholesterol test measures (and what it guesses) and several things that can impact the result – from sunshine to Oreo cookies!

Monday notes in the Royal Courts of Justice.
This was the 715th Monday note. I did not expect any of them to end up in a judgment following a trial in the Royal Courts of Justice, but three have. This note shared which notes appeared in court and what significance they had to the Harcombe/Kendrick vs Associated Newspapers case.

PODCAST – Zoë & Dr Peter Brukner discuss the power of nutrition in health and sports.

Here’s to plenty more unusual and diverse topics to unpack in 2025 and more fascinating people to talk to.

Thank you again for your support for what we do.

Until next time

All the best – Zoë & Andy