Why is The Guardian doing this?

The challenge was inspired after the local hospital was the first in the country to ban sugary drinks and food from its canteen. Simon Smith, who has a background in dietetics and a strong family history of type 2 diabetes, took over as head chef of the hospital in May last year. He said The Pioppi Diet “catalysed” a discussion with the chief executive, Karen James, to transform the food served to staff.

Why give Aseem Malhotra space to sell his diet book? Given that it’s nonsense?

Aseem Malhotra’s bid to become famous and sell his diet book protect the health of the nation has provided this blog with some hilarious content over the years, but he hits new heights of comedic gold in the Sunday Times today.

The low carb/LCHF movement to which Malhotra belongs is ultra-conspiratorial. Being essentially a cult based on magical thinking, it blames other people’s failure to share their beliefs on a vast and growing network of corrupt scientists and government agencies. You might wonder what motivates so many scientists, dietitians and bureaucrats to hide the truth about killer carbs, thereby condemning millions of people to ‘diabesity’, but the answer is obvious: they’re all in the pay of Big Food/Big Soda/Big Grain/Big Ag! Wake up sheeple.

Malhotra denounced the British Dietetic Association as Big Food puppets after they dissed his diet book. He has since added the British Heart Foundation and the American Heart Association to his list.

32 thoughts on “Why is The Guardian doing this?”

  1. The town gave up sugar? The entire town?

    “Tameside residents were encouraged to go on a 70-day sugar-free challenge to mark the 70th anniversary of the NHS.”

    Ah, no. The local nomenklatura decided the town was going to do it.

  2. However the ‘carbs are killing us’ theory of diet contains more truth than the official State Health Service line that hi carb/low fat diets are the way to go…………….its not surprising people get a bit heated when they discover the medical establishment have been lying to them for decades about the what foods they should be eating for a healthy diet, and said advice is based on fake research. Not only that they’re still saying it, despite the truth about saturated fat not being bad for you being made public for a number of years now.

  3. The obesity/type two diabetes epidemic began with the food pyramid promoted by various official bodies based on research funded by the food industry. LCHF is basically going back to the advice of a previous era when we were all thinner.

  4. The velvetgloveironfist blog guy is usually pretty shrewd, so it’s disappointing to see him defend the indefensible. It’s like defending – and by appeals to authority no less- that icon of the Global Warming scam, the notorious and thoroughly debunked Hockeystick chart.

    Aseem Malhotra, as someone presenting the case against carbs, is correct here.

  5. There is nothing new in this.

    Staff canteens at the NHS hospitals I worked in (all in northern England) did the most amazing breakfast fry-ups. The cheapest possible ingredients of uncertain, but definitely animal, origin, coated in lard at the gamey end of its working life. Not a carb in sight, bar the odd lonely bit of oatmeal in the black pudding.

  6. @wat dabney: yes I thought it very odd that someone who has been fighting the mendacious health blob over smoking for (probably) decades was prepared to write the following:

    You might wonder what motivates so many scientists, dietitians and bureaucrats to hide the truth about killer carbs, thereby condemning millions of people to ‘diabesity’

  7. BiG: some months ago I went for pre-op blood tests, and after nearly passing out I was sent downstairs to the canteen for a Full English.

  8. ‘By reducing starch and sugar, Watson has also managed to send his type 2 diabetes into remission.’

    He did what doctors have been prescribing for decades. And it worked. Yawn.

    ‘His story reflects what the science is telling us: a systematic review comparing a healthy low-carbohydrate diet versus a healthy low-fat diet published in the American Journal of Clinical Nutrition last month revealed the former to be superior for glucose control, as well as for limiting heart disease risk factors in the short and long term for type 2 diabetics.’

    Diabetes is problems with sugar management. ‘A healthy low-fat diet’ [whatever the fvck that is] is a non sequitur. This is STUPID.

    Note that ‘reducing starch and sugar’ is a prescription for people WITH diabetes. It does absolutely fvcking nothing for people who don’t. It’s like all the people avoiding glutens when they have no celiac desease – it does absolutely nothing for them.

    ‘But in addition to individuals making diet and lifestyle changes, policy changes are also essential to tackling the most important root cause of the obesity epidemic: the obesogenic food environment. The success and sustainability of healthy dietary changes will only occur if we make the healthy choice the easy choice.’

    Yes, government must choose for everyone.

    Note that people with diabetes have already been told not to drink sugary drinks. Most follow that dictum. So NHS action is against people who are not involved. Banning bread from everyone, cos some people have celiac disease, who avoid bread anyway.

    It’s government run amok. When is the Ecksian Purge coming?

  9. “yes I thought it very odd that someone who has been fighting the mendacious health blob over smoking for (probably) decades was prepared to write the following”

    Because Aseem Malhotra is just another faction within the mendacious health blob – a founder member of the ‘Action on Sugar’ health campaign ‘charity’ who was thrown out for being too nutty even for them.

    (“Action on Sugar is a group of specialists concerned with sugar and its effects on health. It is successfully working to reach a consensus with the food industry and Government over the harmful effects of a high sugar diet, and bring about a reduction in the amount of sugar in processed foods.” Prodnoses, in other words.)

  10. -“He did what doctors have been prescribing for decades [reducing starch and sugar]. And it worked. Yawn.”

    But they haven’t though. Which is the entire point.

    For the last 50 years the medical profession has wrongly daemonised saturated fat and all but ignored sugar and other carbs. Diabetes II is described and treated as a chronic, progressive and almost inevitable condition (and treated with insulin, which only worsens the problem) when it is nothing of the sort.

    – “Note that ‘reducing starch and sugar’ is a prescription for people WITH diabetes. It does absolutely fvcking nothing for people who don’t.

    Yes it does. It prevents people developing diabetes and all the complications that come with it.

  11. – “Because Aseem Malhotra is just another faction within the mendacious health blob ”

    That may be the case, but lets not conflate medical science with policy and lobby groups.

    The guy can be correct on dietary advice and on the profound consequences of nutrition, whilst at the same time being a dick for wanting to impost such policies on the population.

  12. “The guy can be correct on dietary advice and on the profound consequences of nutrition, whilst at the same time being a dick for wanting to impost such policies on the population.”

    True. And he could also be simultaneously right about the incorrect anti-saturated-fat advice previously given by the former consensus while being totally wrong about supporting the very similar-looking anti-salt, anti-sugar, anti-fructose, anti-carb, anti-“processed”, anti-“junk” advice the consensus is giving now.

    The diet industry is filled to the brim with hundreds of competing fads and scare stories. As each in turn is discredited, it is simply replaced by a dozen more.

  13. All three of the ferrets in this particular sack Malhotra, the sugar ban not, and Christopher wotsit, are jerking their knees before engaging their brains. It is all much more nuanced than that. For a start moderate or low carbon has been a practise amongst both Type I and Type II Diabetics for 25 years or more to my personal knowledge, as an effective way to manage calorie intake and blood sugar.

    Fad die, my arse.

    Of the above, wat dabney and NIV are about right, whilst Gamecoc’ is dancing the Simplistic Wibble.

    are jerking their

  14. “Because Aseem Malhotra is just another faction within the mendacious health blob – a founder member of the ‘Action on Sugar’ health campaign ‘charity’ who was thrown out for being too nutty even for them.”

    He may be, however the quote was not about him, it was Snowden expressing derision that the other medical profession and health bansturbators opposed to Malhotra could ever be lying sacks of shite when it comes to saturated fat vs sugar/carbs…..when he knows for a fact they are when it comes to smoking.

    The disconnect was alarmingly large and obvious.

  15. Bloke in North Dorset

    GameCock,

    “It’s like all the people avoiding glutens when they have no celiac desease – it does absolutely nothing for them.”

    The Feeakonomics guys did a program on celiacs disease and interviewed the Italian guy who first discovered it. When asked about those who don’t have it going gluten free he pointed out that:

    1. They needlessly making themselves poorer and
    2. Unless they were taking supplements they were seriously damaging their own healt

    http://freakonomics.com/podcast/demonization-gluten/

  16. About a dozen years ago my GP warned me that I should take precautions against becoming diabetic. He recommended a low fat diet.

    So I made an appointment with a different GP in the same practice. For the same purpose he recommended a low carbohydrate diet.

    Medical Science, eh?

  17. There is advocating a low carb diet, and there is advocating effectively zero carb. Malhotra is in the zealot category.

    Personally, if high carb diets were terribly bad, I wonder how they came to be the staples of our diets. You’d think the Southern Chinese, who for centuries have eaten amazingly high amounts of rice, would be keeling over left and right with diabetes.

    What has changed, and why diabetes rises, is that we eat too damned much. And much of that too much is carbohydrate.

  18. “Personally, if high carb diets were terribly bad, I wonder how they came to be the staples of our diets. You’d think the Southern Chinese, who for centuries have eaten amazingly high amounts of rice, would be keeling over left and right with diabetes.”

    Historically high-carb diets became staples because most of mankind lived at the Malthusian limit.

    Accordingly people largely died before there was much risk of developing Type II.

  19. “if high carb diets were terribly bad, I wonder how they came to be the staples of our diets.”

    Thats easy – your average person for the vast majority of human history has had had bigger problems in life than obesity and type 2 diabetes in middle age. Just getting enough calories to survive was a win, as was avoiding death by infection. Grains and starches provided that high energy hit that was absolutely essential when a) food was in short supply, and b) everyone was expending massive amounts of calories in living. Fast forward to post WW2 Western Europe as food becomes cheaper and cheaper, and people are more and more sedentary, and also are living longer and longer due to medical advances. Then the downsides of high carb diets start to make themselves known. Plus of course saturated fat has been demonised since the 70s.

    The problems of high carb diets are problems of affluence and longevity – we haven’t had the combination of universally available cheap food and freedom from most causes of premature death for more than 50 or 60 years.

  20. @Gamecock, September 29, 2018 at 11:49 am

    +1

    Each person is different; I need/like a high carb & high fibre diet. High fat makes me queasy, high protein makes me too hot. Low carb/fibre results in painful constipation.

  21. “He may be, however the quote was not about him, it was Snowden expressing derision that the other medical profession and health bansturbators opposed to Malhotra could ever be lying sacks of shite when it comes to saturated fat vs sugar/carbs…..when he knows for a fact they are when it comes to smoking.

    The disconnect was alarmingly large and obvious.”

    As Snowden put it elsewhere:

    Now, I am as happy as the next man to believe that a scientific consensus can be wrong, but if it is a choice between trusting nutritional scientists on the one hand and a bunch of keyboard warriors and diet book salesmen on the other, I will go with the consensus.

    It all comes down to evidence. Scientists generate data as evidence, and then they interpret it. Sometimes they interpret it wrongly, but to prove that you need *better* evidence. Or you need to *show* that the evidence doesn’t prove what they think it does. You can’t just say: “Scientists sometimes get things wrong, therefore they’re wrong here too.” Weak evidence still trumps having no evidence at all.

    I don’t agree with Snowden on everything – some of the things he says/cites I don’t think are correct. But I’ve always respected him as someone who pays respectful attention to the evidence on a subject, and who I would expect to be persuaded by better evidence/argument if it was given to him.

    “Thats easy – your average person for the vast majority of human history has had had bigger problems in life than obesity and type 2 diabetes in middle age. Just getting enough calories to survive was a win, as was avoiding death by infection.”

    The thing about food supply in pre-history was not that it was especially short, but that it was intermittent/unreliable. Most of the time there’s plenty, every now and then there’s a famine and a lot of people die. So there’s still plenty of evolutionary reason to adapt to times of plenty, too.

    Long term, humans eat within about half a percent exactly as many Calories as they burn. That doesn’t happen by accident. It’s as precisely controlled as breathing. And it means that if the amount you burnt was fixed, the difference between obesity and starvation would be 1% of your intake – an amount so small that we couldn’t even measure it accurately today, and completely implausible in pre-history.

    The amount you eat, the amount you burn, and the amount you store are all controlled by your biochemistry, for the purposes of keeping you alive through times of famine.

    So think for a moment about the amount you store. Clearly this is a trade-off – the more you store, the more cushion you have against famines, but the more weight you have to drag around with you all the time. The best trade-off varies, depending on how vulnerable one is during the famines. Thus, young people will be able to fight for what food there is (whether by hunting, gathering, or stealing), and children will be fed by their parents – the ones to go first during a famine will be the old people. Thus, it makes sense for people to get heavier as they get older, as they need more just-in-case reserves during the hard times.

    Consider also that in some circumstances food is short and unreliable, so there is an advantage in being small and so require less energy. But sometimes food is plentiful – the land is bountiful and the humans are underpopulated. In these circumstances the big risk is others moving in. The advantage now is for bigger stronger humans to fight off rivals, and retain territorial control of the food supply. Plentiful food makes bigger bodies sustainable. So we should predict that if food becomes more plentiful then people should grow bigger – taller, broader, heavier. The ideal body proportions will change.

    We know that over the past 150 years, the average height of people has increased by about 10 cm. (The Dutch by 19 cm!) It was famously noted in World War I how the officers were all considerably taller than the enlisted men. This has pretty much got to be an inbuilt evolved response – probably triggered by plentiful food during childhood. It’s too short a time for tallness to evolve from scratch, but a ‘tallness switch’ that can be turned on and off to adapt to circumstances is entirely plausible.

    If the ideal height changes, why not the ideal BMI? Could it all simply be an evolved response to better nutrition?

  22. NiV

    Long term, humans eat within about half a percent exactly as many Calories as they burn. That doesn’t happen by accident. It’s as precisely controlled as breathing. And it means that if the amount you burnt was fixed, the difference between obesity and starvation would be 1% of your intake – an amount so small that we couldn’t even measure it accurately today, and completely implausible in pre-history.

    The amount you eat, the amount you burn, and the amount you store are all controlled by your biochemistry, for the purposes of keeping you alive through times of famine.

    For some strange reason, you have never seemed able to accept the obvious explanation for this – a natural equilibrium.

    Large bodies consume more calories than small bodies. Put on weight, you burn more calories. Lose weight, you burn fewer calories.

    That is a perfectly natural equilibrium process that more than explains your 0.5% or 1% stuff above.

  23. Hmmm. Apols, my mistake! In the light of day, I misread what you said. You are not in fact arguing against any such larger body / smaller body equilibrium process..

  24. “For some strange reason, you have never seemed able to accept the obvious explanation for this – a natural equilibrium.

    Large bodies consume more calories than small bodies. Put on weight, you burn more calories. Lose weight, you burn fewer calories.”

    Ah well, the ‘strange reason’ in my case is that I remember when I was about 20 I used to eat what I liked – routinely exceeeding 5000 kcal/day, and didn’t gain weight, while nowadays I eat less than half of that and am a stone and a half heavier than I was back then. Strange, eh?

    I think one of the previous times we were discussing this I managed to find a plot of energy intake versus BMI, showing that the two were only very weakly correlated. There were people with high BMIs with moderate to low calorie intake, and the people with the highest calorie intakes had some of the lower BMIs. The regression line did slope up, but the r^2 on it was pretty poor.

    Unfortunately, I can’t find it now. For some strange reason, it’s nearly impossible to locate actual scatterplots of energy intake versus BMI for individual people. The nearest I can find is this one of basal metabolic rate versus BMI. Or there’s this one of total daily energy expenditure versus body weight. They look pretty similar to the one I remember.

    “Hmmm. Apols, my mistake! In the light of day, I misread what you said. You are not in fact arguing against any such larger body / smaller body equilibrium process..”

    No problem – you’re evidently remembering one of our previous conversations, and I’ve not changed my view since then.

    However, if you can find some empirical ‘energy expenditure versus body weight’ data plots to show me what you mean, I’d be very interested.

  25. However, if you can find some empirical ‘energy expenditure versus body weight’ data plots to show me what you mean, I’d be very interested.

    Lordy Lordy, you are joking?

    OK, I very clumsily missed off “on average”, because, agreed, different metabolisms will create lots of noise.

    Apols, I had backed off because I realised I was mis-quoting you, and hence assuming we were agreed on the logical conclusion of that earlier discussion.

    Re age 20 versus later in life, we dealt with that before and agreed the “change of metabolism” thingies that happen, one major transition for many people being typically around 30-35.

    The point that is self evidently true is that – “all other things being equal” (and that’s crucial, it doesn’t matter if a high metabolism person has a higher calorie input requirement than a lower metabolism person) – reduced calorie input for the same person will ultimately result in a new revised lower weight equilibrium, and vice versa. It becomes a smaller body and requires fewer calories, a new lower weight equilibrium will be found.

    Or to put it a different way, some variation of catastrophe theory is not a good predictor for calorie input versus weight…

    Or, there is no magical number of calories below which one suddenly goes from “lard bucket who simply can’t help themselves, and it’s not their fault” to “dead from starvation”. There is a graduation, and therefore if fatty genuinely wants to, he or she can lose weight.

    That much presumably we agree on..:) And – before introducing a different angle on it – that was all that I was trying to say in my larger bodies versus smaller bodies comment above, apologies if it wasn’t obvious. I do get the rest and agree, reducing inputs creating revised lower metabolisms (and lower calorie requirement) and hence it’s all very difficult to lose weight etc, and lots of other variations / complications.

  26. The main thing I wanted to argue is: it’s more complicated than commonly assumed.

    I agree that all else equal bigger bodies require more energy to move, I don’t agree that this is the reason for the 0.5% match between input and output, but I’m not intending to argue any more about it. (Unless you ask me to.) I’m happy with “it’s complicated”.

  27. @PF, September 30, 2018 at 3:55 pm

    “…“change of metabolism” thingies that happen, one major transition for many people being typically around 30-35″…

    +1

    33/marriage for me – both?

  28. @ NiV
    The calorie intake adjusts to the calorie consumption but not instantaneously. In my youth I used to gain more than a stone in weight when going home for Christmas; on several occasions I have lost more than half-a-stone in a week when I dramatically increased the amount of exercise. Sure that fits with your view that calorie intake vs consumption balances in the long-term but if “long-term” means more than a year, as it does it many modern cases it’s not good enough to protect early man from starvin to death.

    @ PF I took up marathon running at 37 and – for the next 20+ years – took nearly a stone off my central weight (about which I oscillated both before and after. My anecdotal view is that marriage, not reaching 35, is the main cause of men putting on weight – how does *your* wife react to your not eating her cooking?

  29. “The calorie intake adjusts to the calorie consumption but not instantaneously.”

    Agreed. It’s quite complicated, involves multiple mechanisms operating on different timescales, and is largely not understood. It’s still a matter for active research.

    As I’ve seen it explained, there is a set ideal range – with an upper and lower point – between which there’s no particular action and it’s just random – you eat whatever food comes along, but don’t have any issues when it doesn’t. Within this range, you can lose weight with no effort, just by eating a bit less.

    When it hits the end points, the first thing to react is the appetite. At the top end you lose your appetite (and in the longer term the metabolism ramps up), at the bottom end you become obsessed with finding food. If you still don’t eat, you lose weight. There’s no point in storing fat if you’re not going to use it. This is for short-term famine conditions, like for a season.

    At about 6 months on moderate dieting, it counts as a long-term famine and the body starts making metabolic adjustments. These have a higher survival cost. You reduce your ability to find food through lethargy and tiredness, and you shut down non-essential systems like your immune system. You become more susceptible to disease and cold and injury. However, the energy you burn drops with the slower metabolism to match your intake, and you survive.

    Generally speaking, every diet works for the first six months, and then most people gradually put the weight back on over the next 3-5 years with the slowed metabolism. The faster you take it off, the faster it goes back on again.

    However, sometimes weight changes dramatically and more permanently when the set-points of the ideal weight range shift. It’s not really understood what sets them, or what moves them, but when they do the weight can shift dramatically within a few months, without effort. One effect we know about is age – as you get older the set points move up. Another is gut flora – a sudden change of diet, the effects of taking antibiotics, or in recent times the ‘faecal transplant’ technique have been seen to cause sudden weight changes. There’s also Ad36 infection which damages the fat cells. And there’s evidently a link to other metabolic diseases like diabetes – although whether diabetes sometimes causes obesity, obesity sometimes causes diabetes, or something else causes both is impossible to tell at the moment.

    And sometimes there are cases where the control mechanism is obviously broken, and you get people who starve themselves to death (terminal illnesses and old age commonly results in severe loss of appetite), and at the other end people who weigh 600 pounds and can’t get out of bed without a crane. That’s clearly a metabolic illness. And it’s also a clear demonstration of how effective and precise the control system is normally, because that’s exactly what would happen to *everyone* if the appetite and metabolism really were random and uncontrolled.

    At 3000 kcal/day, you eat a million kcal/year. That’s the equivalent of about 300 pounds of fat, and just a 10% disparity would see you gain 30 pounds a year. That’s roughly what the government prodnoses say we’re overeating by. It’s also roughly the accuracy with which the Calories in many foods can be measured – which means that even if you counted every Calorie you could only do it about that accurately, and most people are actually about 30-50% out.

    People *don’t* routinely put on two stone a year, every year, let alone the 6-10 stone that the higher figures would suggest, and the actual energy people burn is about 50% higher than the prodnose’s recommendations. The spread in requirements across the population is enormous – so it makes no sense to be handing out a single ‘recommended daily intake’ number that applies to *everyone*, irrespective of their size, shape, or metabolism. It *certainly* makes no sense to be buggering about reducing portion size in restaurants or ready meals.

    Medical science *knows* all this. It’s known much of it for more than 50 years. But the politically correct prodnosed campaigners and diet book salesmen evidently don’t, and the public don’t know enough to disbelieve them. Such is modern society.

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