Australia’s response to the diabetes epidemic – shooting the messenger.

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On the Sunday current affairs program in New Zealand there was a report on the diabetes epidemic in South Auckland. This is our largest (and growing) health problem, and two of the players in this tragedy had messages that stood out. An elderly woman, overweight and now condemned to thrice-weekly dialysis, told us “I didn’t do anything wrong”.

How right she was. The Ministry of Health website still offers this “healthy eating” advice – “Fill up on breads, cereals, pasta and rice.”

Junk epidemiology and junk food

The epidemiologists from Harvard recently grabbed headlines with claims that polyunsaturated fats are the healthiest fats, that chicken is one of the healthiest animal proteins, and that plant proteins are healthier than animal proteins. In South Auckland, a staple food is Kentucky Fried Chicken. Chicken is a meat naturally high in polyunsaturated fat, KFC is fried in “healthy” polyunsaturated vegetable oils, and therefore a good source of these, and it even comes with a bean salad – plant protein. This junk food meal, eaten wherever diabetes is rampant (the franchise only came to New Zealand in the 1970’s), actually ticks most of the boxes thrown up by junk epidemiology.

With this sort of dangerous misinformation on official government websites and in the media, how can anyone know what is “right” or “wrong” when it comes to their risk of type 2 diabetes?

The look of success?

One chap in the Sunday program, Kim, had it figured out. He’d reversed his diabetes by, firstly, losing weight rapidly on a low calorie diet (like the Newcastle diet, but with real food instead of Optifast), by exercising regularly, and by eating a diet described as “lots of vegetables” – we saw a delicious looking stir-fry – “no bread, potatoes, rice, pasta” – he didn’t even need to mention sugar.

Incidentally, what is a “fast-acting” carbohydrate? Previously, it was assumed that fast-acting carbohydrates were sugars or juices. It is now known that this is not true, and if there were a fast-acting carbohydrate, it would probably be a starch. “Fast-acting carbohydrate” is a term we need to eliminate from our diabetes vocabulary. – Marion J. Franz, MS, RD, LD, CDE

“So what’s left?” asked the interviewer. “Eggs, meat?” “You’d be surprised how much there is left that’s good to eat!”

Now, the direct end result of type 2 diabetes is a series of complications which include cardiovascular disease, retinopathy, neuropathy, kidney disease and gangrene (caused when vascular damage cuts of blood supply to the extremities, usually the feet, compounded by neuropathy preventing pain warning of injury, and infections fed by high sugar levels and suppressed immune function). Gangrene often requires the amputation of the affected parts, and the surgeon who has to perform this procedure is an orthopedic surgeon.

The case of Dr Gary Fettke

Gary Fettle is a friend of mine. He’s also an orthopedic surgeon in Tasmania, Australia who performs dozens of these operations on patients with type 2 diabetes every year. “I used to do one amputation every 6 to 12 months and now I’m doing one a week”. Seeing, as anyone can who has eyes in their head, the link between diet and diabetic blood sugars and the risk of complications (hardly controversial), he had dared to make a study of nutrition and diabetes literature – something which, as a highly trained medical professional, he was well able to do – and advise his patients, and the public, about how to eat to beat, and avoid type 2 diabetes and/or its complications.

Now Dr Fettke has been banned from giving any diet advice, to patients or in any media, until further notice.

Why? What he is advising is plainly good sense as well as evidence-based. It’s the same message Kim gave on the Sunday program, except that Dr Gary Fettke is a highly trained medical professional with hundreds of hours of clinical experience.

Here’s a great response to the silencing of Dr Fettke, written by Tyler Cartwright for the Ketogains website, that puts the case better than we can.

Meanwhile the Australian authorities continue to allow Associate Prof Sof Andrikopoulos to give diet advice, despite his telling the Australian public to eat sugar with burgers – based on his experience with mice. (I guess that also makes the soft drinks at KFC part of the healthy menu now).

Gary’s not the first and won’t be the last

In 2005 the Swedish dietetics authorities tried to silence Dr Annika Dahlqvist. Their heavy-handed actions led to a court case in 2008 which Dr Dahlqvist won, publicising the benefits of LCHF all over Sweden, and as a result  a significant proportion of the Swedish population soon knew about the diet, and butter sales went up – leading to much hand-wringing around the world among people committed to outdated bad advice, but no adverse effects in the Swedish population – according to the Swedish government’s health data base, heart attacks are now at an all-time low.

20-85+ 39,418 38,846 37,150 34,780 34,140 32,814 32,149 29,823 28,783

Heart attacks in Sweden by year, 2006-2014.

 

 

In this recent Australian TV series, The Saving Australia Diet, Dr Fettke is seen advising the patient Tony on how to treat diabetes with the LCHF diet, with the help of chef Pete Evans. For no good reason that we can see, other than some virulent local strain of the Tall Poppy syndrome, the Australian establishment hates Pete Evans, and this has made some scientists who should know better indulge in bottom-of-the-barrel stunts like Ass Prof Sof Andrikopoulos’s “Paleo mouse” attacks on low carbohydrate diets. It is almost certainly his association with Pete Evans that has drawn the complaint that has led to Dr Fettke being silenced.

Of course, this kind of heavy-handed, bloody-minded action is only possible because Dr Fettke is a health professional, and therefore subject to the discipline of a regulatory body, even if it is being abused for unworthy personal ends and is clearly not in the public interest. Pete Evans, on the other hand, is a member of no such body, so he can’t be silenced, thank goodness.

This is why it’s important for everyone who speaks on nutrition to have a proper qualification – so they can be silenced when they embarrass the authorities, for example by being right about something the government and its appointed experts have been consistently wrong about. Especially in the middle of an epidemic, when damage control is the order of the day.

Well, here’s an idea – instead of “damage control” being about saving reputations, can’t we have damage control that will mean saving feet, eyes, and kidneys?

We don’t always say good things about Aussies (us New Zealanders, and vice versa), but they are our mates really and Gary Fettle is one of the good ones.  Shame on you Australia and the Australian Medical Authorities for allowing this to happen.

16 comments

  1. Beautiful post Grant. My goal is to also publicly support Dr. Fettke. I do not quite understand why the Australian authority has so much leverage that they can threaten and silence healthcare professionals. I have a short and to the point post in support of Gary here: https://www.facebook.com/jeffry.gerber/posts/10209368657840680

  2. Marilyn Schroeder · · Reply

    Thank you Grant for putting your voice into print. AHPRA’s actions are unconscionable particularly because their deliberations and edict have been made behind closed doors, denying Gary an opportunity to defend himself. That may yet come hopefully. Meanwhile an intelligent, knowledgable and articulate medical practitioner is being denied the right to treat his patients with honesty and integrity.

  3. Michael · · Reply

    Haha, “Ass Prof”. That reminded me off the Seinfeld “Assman” episode. I think the usual abbreviation is “Assoc Prof”, probably for obvious reasons.
    But I agree with your sentiments with as regards to Dr Fettke. A terrible situation.

  4. I have just sent a Letter to the Editor to two newspapers. All doctors in Australia need to know that they may find themselves in hot water if they offer dietary advice. Does anyone know a journalist?

  5. The Fetkkes are amazing and inspiring. The ‘silencing’ may turn out to be a positive – at least, I hope it does – due to the publicity and awareness it drums up.

  6. The authorities should be careful what they wish for. What say AHPRA rule the medical professionals should not give nutritional advice? What happens in GP land where we are asked to give lifestyle advice, advise diabetics and manage weight problems. Who will take that load then? And if we do not have a formal qualification in exercise prescription them we shouldn’t give advice on exercise? They are digging themselves a big hole perhaps?

  7. This is actually guaranteed to backfire and is a real help to us — in essence, any doctor could be stopped from recommending diets. Far more damaging was the attack on Jennifer Eliott by her own professional group — DAA (Dietitian’s Association of Australia, or something like that) — causing her to lose her job. For global harm, the “nine blind mice” study that grant mentioned is the bottom of the scientific barrel — 9 mice, generically engineered to be prone to obesity got fat on a low carb diet, a scientific breakthrough that had the University of Melbourne saying that Paleo diets make you fat — published in a Nature journal — no, not Nature but a small journal that Nature Publishing Group bought or standard and branded — along the lines of Trump University. All unpleasant but in the end they will do themselves in. Eventually, everybody will see that if they had anything to offer, the terrorist approach wouldn’t be necessary.

  8. Hmmn, maybe my GP will have to stop telling me to eat less saturated fat next time my cholesterol is high. Actually, my GP is so old-fashioned she just tells me to eat less fat – “you only need a tiny bit”. No doubt we’ll be hearing less about “portion sizes” too.
    It’s interesting how this plays out in different countries. In all the controversy over the Public Health Coalition UK press release, no-one suggested that they should leave diet advice to the dietitians, or if they did, no-one backed it up with legal threats.
    I think there is a specific problem with Australia and it has to do with Australian Union culture, the idea that you can be guaranteed a job for life if you join the right club, no matter how corrupt or incapable you turn out to be, and that anyone not a member of that club who tries to do your line of work can be bullied until they give up.
    A surgeon has to make judgement calls about weight, nutritional status, and metabolic health before he can operate. Gary is now in the position of being able to tell a patient “I can’t operate till you lose 10 Kg” but not being able to tell them the easiest way to do that.
    Can he pass on a useless brochure on weight loss written by a Government agency? Can he pass on an LCHF meal plan written by an accredited dietitian? Can he leave magazines in the waiting room that feature interviews with Pete Evans?
    Prof Feinman is right, these tactics can only backfire. Pinning the attack on Paleo (or LCHF, it’s not clear what the target was) on the 9 mouse study has exposed the old guard to defeat in detail in the journals, and attempts to silence an altruistic doctor are the kind of thing the media thrives on.
    http://www.nature.com/nutd/journal/v6/n8/full/nutd201631a.html

    The irony is that adherence to low-carb diets seems to improve when people think that they are “sticking it to the man”.

  9. The Sunday program was disappointing. No experts to point out that exercise was futile, and as – Dr Sarah Hallberg points out – a distraction from getting the diet right. And no real discussion of what the most successful diet actually was.

    But yeah, the Streisand Effect (http://knowyourmeme.com/memes/streisand-effect) can only help.

    1. The Sunday program was a good snapshot of where we’re at if low carbers don’t give their opinion. We had Kim, following Michael Mosley, and representing low carb on his own, though mixed up with exercise, not a bad combination in that context. We had the endocrinologist, blaming sugar, fat (in this context almost all the fat being eaten was refined and heated vegetable oil) and salt.
      remind me again how many calories there are in salt. We had the vague ideas about “eating better” and exercising more, which people will probably struggle to get right and adhere to, and which they seemed understandably reluctant to start.
      The contrast between the self-informed Kim and the other people, who were waiting to be told what to do and weren’t getting as clear a plan from the authorities as the one Kim had found on the internet, was noticeable. Kim probably didn’t even live in the disadvantaged area of South Auckland that the program was about.

  10. Marilyn Schroeder · · Reply

    Meanwhile in Australia, it just gets worse. Federal funding has just been withdrawn from a successful South Australian child obesity program! https://twitter.com/mpwoodhead/status/765678615602221057

  11. robert lipp · · Reply

    these authoritarian luddites need to be retired. perhaps a job digging coal may match their skills

  12. Peter Leid · · Reply

    The entire staff representing the AHPRA that “felt compelled to issue the gag order” on Dr. Gary Fettke MUST be brought to justice. The only conceivable way this board of individuals have done this is through pressure from industry. Not Science. It is a perception of revenue loss by industry that drives this “last century” tactic. Some might feel this is a blinkered thinking response from industry. I do not. Industry knows EXACTLY what the truth will do to the billions they have invested in producing food with the ingredients they have created. Industry knows exactly the loss of revenue that will follow – medicines for cardiovascular diseases, diabetes, Cancer, dementia and Alzheimers disease will all slow and fail. The unholy alliance of food and pharmaceuticals (one supposedly NOT knowing what the other is doing) will be uncovered and exposed for what they really are, what they are responsible for. This is a global case of mass murder in the interests of revenue ONLY. It is only through people like Gary Fettke that the TRUTH WILL OUT. Will him silenced for the time being, it is the responsibility of all like minded men and women to stand up and be counted.

  13. Julia Burton · · Reply

    When will someone sue the relevant authorities i.e The Heart Foundation and Diabetes Australia for promoting dietary advice causing illness and injury? As a Type 2 diabetic AND a scientist, I am really angry that the advice I followed for the last 25 years using the so-called food pyramid, caused my diabetes. Now that I’ve researched LCHF and understand the science behind it and the lack if scientific protocol led by Ancel Keys in promoting low fat,high carb, I realise we have all been led into this obesity epidemic by government backed incorrect dietary advice.They have allowed vested interests to dictate the agenda on dietary health.
    Even now, I struggle with aspects of LCHF because of a lifetime of brainwashing that “fat is bad” and “carbs are good”! People like Garry Fettke, Prof Schofield and Pete Evans and more need to keep getting the message out…..for the sake of public health in the future. Otherwise a large number of today’s children are going to die young or suffer a middle age full of poor health.

  14. Maria Rattray · · Reply

    I recall this line from my high school history days – ‘There is something rotten in the state of Denmark’.

    Well, there’s something pervasively rotten in the medical association, and we’re not just talking about Australia here. I actually responded on FB to Belinda Fettke. where I told her about this doctor who was pursued relentlessly by the FDA for treating cancer with nutrition They didn’t win by the way, but they almost destroyed him.

    https://www.google.com.au/?gws_rd=ssl#q=alive+and+well+dr+binzel

    The reason we (the authorities) can’t condone wellness is that there’s no money in it, plain and simple.

  15. Kathleen Anderson · · Reply

    What short memories people must have too…..my mother is 83, brought up in the Scottish Highlands in a fishing family with a traditional LCHF diet

    All during my growing up years Mum has said if she puts on any weight ‘Oh …must cut out the potatoes and bread’

    It was second nature. Everyone knew that was what you did to lose weight.

    Of course the normal diet was meat, eggs, fish butter and full fat milk. No processed foods and very little sugar.

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Richard David Feinman

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