It's only fair to share…

Those old enough to remember the 1970’s will recall that society looked different. Those too young can look at pictures of groups of people from that era. Aside from the fashions (although they will no doubt have a resurgence one day) and the architecture, the most striking difference is in the size of the people.

Back then relatively few people were overweight or obese.  In her book, Big Fat Surprise, science writer Nina Teicholz has a simple graph showing rates of overweight on the “y” axis versus time on the “x” axis. It is a fairly straight line till the early 1980’s when there is an inflection, and the line starts an upwards trajectory.

What happened at the time of this inflection? The introduction of low fat dietary guidelines.

You might expect that a major recommendation about health and diet would be rigorously tested and assessed before being promoted to the public. Especially when the recommendations lead to major changes in people’s dietary behaviour. This would also be consistent with the screams by academics and public health figures for “evidence based” or “scientific” medicine.

Sadly, you would be wrong. A 2015 review published in the BMJ found that the introduction of low fat guidelines in dietary recommendations in the USA and UK (applicable in other countries too) had absolutely no basis.

Forty years later Dr Vinay Prasad contrasts the onus of individual doctors compared to public health. The former is obliged to discuss treatments with individual patients, to be open and honest about gaps in knowledge and potential for side effects or harms as part of informed consent.  He notes “…if anything, Public Health has a greater obligation to generate data than the cancer (Prasad’s specialty) doctor.

Yet rather than admit error, or at the very least concede that their policies have created a massive problem, public health now wants to medicalise the issue further and push medications.

The Australian Newspaper reported that “The national clinical treatment guidelines for obesity are set to undergo an overhaul – shifting away from the notion weight control is “primarily the individual’s responsibility” ­– as the advent of highly effective weight-loss drugs ushers in a “new paradigm” in care”.

Eat less and move more is apparently too simple. Now to be fair, it is misleading as the type of food eaten matters which brings us back to the failure of low fat diets and guidelines. However, what we put into our mouths and how much or little exercise we do weight remains our responsibility.

Professor Judi Porter of Deakin University, which will lead the review told the paper “It’s really exciting that we’re moving from really two paradigms of how to manage weight – behavioural or lifestyle approaches, and bariatric surgery – to now having this new approach with the pharmacotherapies.”

It is exciting that we can prescribe drugs for people to treat the problem we essentially created for them.

Meanwhile Tufts University in the USA has produced a new “food compass”. The compass gives high marks to a number of processed foods encouraging consumption of Frosted Mini Wheats and Great Grains Banana Nut Crunch whilst discouraging eggs and beef. Nina Teicholz observes “…Tufts is funded by quite a few of the same companies whose ultra-processed foods are awarded top rankings. She also notes “…95% of the last advisory committee for America’s top nutrition policy, the U.S. Dietary Guidelines, had at least one tie with a food or pharmaceutical company”.

Tufts University previously gave a high-ranking Purdue Pharmaceuticals executive, Dr. David Haddox, who in 2003 said OxyContin was not addictive, the title of adjunct associate professor of public health and community medicine. Tufts Medical School Professor Daniel Carr said in 2009 “We owe much to the Sackler family, whose initial and ongoing support has been indispensable”.

The World Economic Forum (WEF) is encouraging people to eat hyper-processed fake foods to “save the planet”. And wants 15 minute cities which makes exercise much harder (don’t get me started on how lockdowns contributed further to obesity and ill health). The small problem with hyper – processed foods is that they increase the risk of cancer. It is absolutely the case that those who choose to be vegetarian, or vegan have numerous options which do not involve processing chemicals to make them taste like meat.

Of course there is not much money to be made in this. Thus governments force dairy farmers to pour milk down the drain whilst prices soar.

A cynic could suggest that there is pattern here. Give people advice which makes it more likely they will become overweight and potentially ill and then sell them pharmaceuticals. Aside from some large corporations, their investors and government funded academics/doctors it is hard to see who else benefits in this scenario.

Being healthy is almost becoming a radical act. However you have the power to do so. Eat mainly real rather than processed foods, be active, get adequate sleep, manage your stress, spend time outdoors and drink mainly water.

This does not require “exciting” pharmaceuticals or government action.

I will give the last word to Vinay Prasad.  Whilst referring to the pandemic policy rather than diet, substitute 40 years for three years and nothing has changed.

“Does public health need to generate evidence? Yes, the obligation lies with them, and if they don’t do so after 3 years, they have failed the people they sought to serve. As time moves on, and the lies become more apparent, don’t be surprised if the people come to dismantle and defund their institutions. Reduce them to rubble. Even then, with nothing, I am sure, they will still be making things up”.