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While browsing RationalWiki (a website which purports to debunk bad science) it occurred to me that rants are only fun in small doses; so herewith a bit of positivity. Or as close as I’m likely to get to such fluffiness, anyway.

Not so long ago, a bunch of cranks (you can find them on RationalWiki described in even less generous terms) addressed the UK House of Commons regarding the disastrous outcomes of the offical dietary advice. 20 years ago, the idea of Aseem Malhotra and Zoe Harcombe denouncing the NHS before the great and the good would have been unthinkable, so the fact that this even happened suggests that things are about to change.

Zoe, Aseem, and various other doctors and researchers have a very modest proposal: we all ought to be eating proper meals, made from unadulterated ingredients like meat and veg. More specifically, they’re suggesting this:

• Eat whole and organic foods
• Eliminate processed foods, dairy, grains, and legumes
• Edge out bad fats (vegetable oils) with healthy fats (olive and coconut oils, animal fats, eggs, and avocados)
• Aim to consume free-range animals and wild caught seafood
• Introduce bone broths, organ meats, fermented foods, and intermittent fasting into your diet

According to other doctors and researchers, this idea is dangerous, and it should be slapped down forthwith. In their view, the route to eternal life involves processed and synthetic foods like breakfast cereals, margarine, low-fat milk, and vegetable oils. Nevermind that many of the foods that they recommend didn’t even exist until about 100 years ago, or that no human being has ever voluntarily eaten a “low fat diet”. Nevermind that their ideas don’t actually work in practice. The foods that humans have eaten for countless millennia are bad and unhealthy, and must be replaced by things pumped out of factories.

Fortunately, though, it seems that eyebrows are finally being raised. Some of the old codgers who sit in the Houses of Parliament remember the days when a bacon-and-eggs breakfast or a Sunday Roast was considered a healthy, filling meal, as opposed to a “heart attack on a plate”. They perhaps remember various scandals about margarine being linked to metabolic diseases. Hopefully, to them, the modern po-faced diet of preservative-laced fake bread, boiled vegetables, and cardboard breakfast cereals just feels inherently wrong, and they might feel inclined to do something about it.

I think these guys are my favourite bunch of charlatans riding the diabetes bandwagon. Not because their advice is any more laughable than all the others (they all say much the same thing), but because of two items on their website. The first is a statement of their noble aims:

Whilst funding vital diabetes research to establish the causes, prevention and treatment of type 1 and type 2 diabetes; develop improved management and treatment options; and ultimately find a cure, we aim to ensure that people have access to the right information and support to develop a proactive self-care approach to successful self-management, to ensure that they are “staying well until a cure is found…”

Since the aetiology of diabetes Type 2 is quite well understood, and it’s easily curable (although one might split hairs over the exact definition of “cure”), I assume they’ll be shutting down most of their operations real soon now. Although I’m not holding my breath.

And the second is the little sticker at the bottom of this page:

https://www.drwf.org.uk/understanding-diabetes/information-leaflets

which says “Health and care information you can trust”. It’s the sort of thing that the Ministry of Truth might have stamped out in ‘Nineteen Eighty Four’, to hand out to favoured purveyors of approved propaganda. It really is a nice touch to put something like this on a website that’s almost entirely nonsense.

Their “What is Diabetes?” leaflet starts out fairly well, with a pragmatic (if not entirely accurate) description:

In simple terms diabetes prevents your body converting sugars and starches in your food into energy. The body uses insulin to do this. When diabetes is present the body fails to produce insulin or the insulin it does produce doesn’t work properly (insulin resistance).

When we eat food some special cells in our pancreas should produce insulin. The insulin transports glucose, made from carbohydrates in the food, into the cells, where it can be used by the body for energy. Sugars and starches are the most efficient source of food energy and are carried in the blood as glucose. If insulin is not produced, or does not work, the glucose builds up in the bloodstream instead of the cells, causing the common symptoms of diabetes.

So far so good. The layman will get the idea. But then there’s this: “Sugars and starches are the most efficient source of food energy”.

We could probably go off on a tangent about the technical definition of ‘efficiency’, and whether it’s even a useful concept in human nutrition, but we’ve just been told that diabetics have lost their ability to utilise carbohydrates for energy. So why is that sentence even there? It’s meaningless.

This leaflet then has a paragraph on the causes of Diabetes Type 2, where it studiously avoids describing any cause, preferring instead to talk about associations and correlations:

Type 2 diabetes is more likely to affect older people, although it is being found increasingly in younger people – especially if they are overweight and lacking in physical activity. Type 2 diabetes is strongly linked to obesity and tends to run in families. It is more prevalent in people of South Asian and Afro-Caribbean descent. Many people with type 2 diabetes have high blood pressure and cholesterol and may need tablets to control these too.

In other words, it just kinda happens, if you’re unlucky. This is really quite extraordinary, because the DRWF is explicitly a research organisation. In 2017, they brought in £3 million, and disbursed most of that to genuine research projects. And yet, so far, they don’t know anything at all about what causes T2D. Or if they do, they’re being very coy about it.

Not to worry, even though the DRWF doesn’t know what causes T2D, they can confidently tell you what you should do if you have it:

• Eat 5 or more portions of fruit and vegetables a day
• Reduce fat, especially saturated (animal) fat
• Reduce salt intake – the most effective way of doing this is to cut out as many processed foods as possible
• Increase intake of omega 3 oils – try eating at least two servings of oily fish per week
• Reduce alcohol intake

Although sadly, as they blithely admit, this advice won’t actually do you any good:

type 2 diabetes is a progressive condition and, in time, tablets and/or other forms of medication are likely to become necessary and may even progress to insulin injections.

And there’s really no obvious reason why their little list of non-sequiturs should have any effect. It’s the exact same advice given to the general population. But we’ve established that T2D is a disorder of carbohydrate metabolism, so why are they advising the diabetic to eat more carbohydrates?

Wait, what? That’s not in the list.

Unfortunately, it is, and they probably don’t even understand that it is. If you reduce the fat in your diet, then by definition the carbohydrate content must increase (protein is set fairly robustly by your appetite – it’s hard to eat either too much or too little of it). Given that most people only eat 200-400kCal/day as protein, and Healthy Eating advice for the general public advises 10% of calories as fat, the implication is that 70%+ of a diabetic’s diet should be carbohydrates. Let us here remind ourselves that:

If insulin is not produced, or does not work, the glucose builds up in the bloodstream instead of the cells, causing the common symptoms of diabetes.

And what does fat have to do with anything, anyway? Why do we have to reduce it? Why are vegetables and fish essential? Why is salt a factor? Maybe these things actually are important. But we’re not told why.

All that’s happening here is that the DRWF are reciting the Credo. We believe in one macronutrient, the giver of life, carbs without end, Amen.

Diabetics are told to consume less fat and salt not because their condition is exacerbated by those things, but because to consume them is a venial sin.

The DRWF aren’t doing anything unusual here. You can find virtually identical advice, and the same avoidance of (or complete misunderstanding of) the causes of T2D on many other official websites; we will stroll past the entire rogue’s gallery over the coming weeks and months. But I’m still giving DRWF four points out of five for pure holier-than-thou weaseliness. If you have nothing better to do on a rainy afternoon, I encourage you to trawl through their website yourself, and see how many untruths you can spot.

The DRWF have at least a little reassuring news for diabetics. Having diabetes can really be a riot:

Whether you have type 1 or type 2 diabetes, newly diagnosed or ‘old hat’, parent or carer, attending a Diabetes Wellness Event is a great way to meet new friends, share stories of living with diabetes, learn about all aspects of the condition and related health from a host of clinicians and healthcare professionals, in a relaxed and friendly environment.

My goodness, what fun. It almost makes up for having your toes amputated.

Socialised medicine is a wonderful thing. I’m sure all of you guys working in the NHS agree with that, or you wouldn’t be there. If you break your leg or come down with the lurgy, there’s nothing more wonderful than being able to turn up at the ER or your GP’s surgery, and know you have a good chance of getting fixed … for free.

I live in a country where socialised medicine works exactly like that. That country is not the UK. If I had a broken leg or the lurgy in the UK, I’d be hard-pressed to get anything better than third-world service, because you’re so busy dealing with fat people.

But I have nothing much to say to fat people. This letter is about you.

You now spend a quarter of your budget dealing with the consequences of bad diet. That’s thirty billion pounds, roughly £1000 for every taxpayer in the country.

I’m sure you realise that there are about thirty countries where the per-capita GNI doesn’t even reach £1000, so it’s lucky they don’t have the UK’s problems, isn’t it?

Except … oh, they do. We’ll come back to that another day.

So. That thirty billion pounds that you’re spending on diabetes, obesity, heart disease, and all the associated complications. It’s a bit of a waste of money, isn’t it? I’m sure you’ll agree that most people don’t want to be fat, diabetic, or on a waiting-list for a CABG, would you not? So it seems to me there are only two possible reasons that this situation exists:

• The NHS has lost sight of its mission to keep the country healthy, and you are quite content to waste vast amounts of tax revenue on (a) making lots of people ill and (b) pretending to fix them once you’ve done so. In other words, you are bad people.
• You don’t actually know what’s causing this epidemic, despite mountains of research suggesting that the terrible diet that you promote is playing a primary role. In other words, you are incompetent.

It’s not much of a choice, is it? Perhaps you’d like to add a third option? I really can’t think of one.

I’m not going to dissect your disastrous advice here – the other blog posts will do that, in bite-sized pieces – but I’m going to point out something which doesn’t seem to bother you:

You are telling people to eat a diet which no human has ever voluntarily eaten in our entire evolutionary history, except under conditions of extreme poverty. You are telling people to eat things which are guaranteed to cause obesity, and which we can infer (from basic biology) may cause diabetes. And you know full well, being medically-qualified people, that this is the case.

See those people with eating disorders – bingeing on chocolate and icecream all day and then berating themselves for their lack of self-control? You did that. But you blame them, because they’re just lazy gluttons, aren’t they?

See those people on the kidney-transplant list, victims of heart-surgery “complications” or chronic glucose toxicity as a result of uncontrolled diabetes? You did that. And you know you did it. That’s your advice in action.

See those people waddling around the supermarket filling up their trolleys with healthy pasta and low-fat spreads, who go home to count their calories and rejoice because they’ve lost half a kilo this week? You did that. They’re following your advice to the letter.

They’re all eating the Healthy Diet. Isn’t it odd how eating a Healthy Diet can make you ill? But of course you know full well, being medically-qualified people, that it isn’t healthy at all.

Of course, if one develops heart disease, then statins are the answer. How lucky we are, to be living in an era when such things are available to all! Clinical trials show these drugs have little or no real effect on heart disease, but they do reduce cholesterol very effectively. And because cholesterol causes heart disease, the NHS has done the best that it can.

There may be some slight flaw in the logic in that previous paragraph, but this doesn’t seem to bother you.

If one develops Diabetes Type 2 – then metformin is the answer. Metformin doesn’t cure diabetes, and in the context of a high-carbohydrate diet it will cause pancreatic failure, but in that eventuality the NHS has limitless supplies of insulin, and it’s free! The patient will become massively fat and develop heart disease. But heart disease is caused by high cholesterol, and obesity is caused by too much dietary fat, so the patient will be given statins, and told to eat a Healthy Diet, and all will be well.

That last sentence is complete, unmitigated nonsense, but that doesn’t bother you either.

I could go on like this all day. But if I hold up this mirror too long, you may turn away, and you need to hear the rest.

You could stop all this, if you want to. You could stop it tomorrow. When people stop eating a Healthy Diet, these apparently intractable chronic diseases rapidly disappear – sometimes within a matter of days. You can stop creating this needless make-work for yourselves, patching up those poor broken bodies that you destroyed in the first place.

All you have to do is this: stop telling people to eat bad food. When they come to you ill and desperate, you can stop browbeating them into continuing with their Healthy Diet. You can stop giving them pills that simply cover your mistakes; instead, you can stop making the mistakes in the first place.

You can stop telling them scare stories about getting fat if they eat too many calories. They’re already fat, and they’ve been following your low-fat, calorie-controlled diet since forever, so they know you’re telling lies.

You can stop telling them scare stories about getting heart disease if they eat too much saturated fat. They’ve been eating lots of “complex carbs” and polyunsaturated vegetable oils since forever, and they’ve still got heart disease. So they know you’re telling lies.

You only get away with all this because people trust their doctors implicitly. Even when a doctor tells lies, he is believed. The cognitive hoops the average human brain has to jump through to make this work doesn’t bear thinking about.

But I suppose you can’t stop, can you? Because you know what will happen.

Lawyers.

For 30 years or so, you have been harming people. You’ve been doing it in full knowledge of the underlying biology. And you – as individuals – have profited mightily. Heart surgeons and diabetic specialists would be thin on the ground if you had not willfully, gratuitously spread illness and death among the population are are charged to protect.

To admit you’re wrong would be unthinkable, because the legal consequences would be disastrous. Thousands would lose their jobs, or at least their reputations. Entire industries based on your low-fat, low-calorie religion would crumble. A few might even go to jail, although I doubt it.

And the lawyers will all be buying new BMWs.

I’m afraid I don’t have any easy solution for you. You put yourselves into this position, and you’re going to have to extricate yourselves as best you can. You may have to throw some of your number under the bus.

Or you could keep telling lies and harming people. It’s totally up to you.

Hello.

The Anti-Nutritionist is not a happy bunny. In fact he isn’t a bunny at all, and has a particular problem with the fashionable belief that humans should eat rabbit food. Because this would be good for the planet, you know. I’ll say more about this later; for now, I’ll simply say that I have a problem with Nutritionists in general, and this here blog exists to poke fun at them.

Perhaps once a week, I will pick my favourite Nutritionist to mock, or a government institution, or an NGO, or a corporation. There is a purpose to this – apart from my possibly pathological need to mock people – and it is this. Nutritionism (I should thank Ben Goldacre for coining this term) is not just a harmless conceit, and a certificate in nutrition is not just a consolation prize for people who can’t get a proper degree. The latter is a license to bamboozle, and people who hold such licenses have caused harm, misery, death and economic ruin on a vast scale. Just as an army marches on its stomach, so does a country thrive or fall on what its people are eating, and when they’re told to eat rubbish by experts, bad things happen. Very bad things indeed.

Rational debate doesn’t work in these scenarios, because the underpinning of Nutritionism is not fact but ideology. Nutritionism is a religion, and I’m here today to tell you about hellfire and damnation. These are my theses, and I will be nailing them to the church door, one by one, over the coming months. If nothing else, you might find them entertaining.