Four Challenges for a Good Life

What the Fat Book Three - Tairua January 2016 #WhattheFatBook #ScottieTPhotoHere’s a little piece I wrote for the Education sector in the Education Gazette, around the big issues for our kids..

Opinion piece: By Grant Schofield, Professor of Public Health and Director of the Human Potential Centre at AUT Millennium, and the Ministry of Education’s Chief Education Health and Nutrition Advisor.

Grant’s family and friends enjoy a day at Frog Rock in Hikuai, Coromandel.

What should a rich, developed country like New Zealand be aspiring towards? I think having a good life for all would be a great aspiration.

But what’s a good life?

A good life starts with having the health to physically and mentally do whatever else you want to. Without that base, you have very little to go on with.

New Zealand’s report card looks pretty poor as far as ‘good health’ is concerned. Yes, we live longer than we ever have, but our healthy life expectancy hasn’t kept up. There’s now a big gap between actual life expectancy and ‘healthy’ life expectancy. Men average 79 years of life, but just 65 of healthy life. Women average 83 years, with 66 healthy. Māori men average 72 years with just 54 years healthy.

And…we spend $18.1 billion on health. But the reality is that almost all of those billions go on sorting out sickness. That sickness system is helping us have longer lives but not necessarily better lives.

Why I am writing this in the Gazette? Shouldn’t we be focused on young people, not old people, as educators?

Well, if we want to change the behaviours that really determine our health, we are going to have to look outside the health system. And we are going to have to start with young people.

The five big things that affect our healthy life are all set up when we are young. It’s about not smoking, less alcohol, better nutrition, better sleep, and how much we move (more activity). We’ve made great progress on smoking and to an extent alcohol harm, but nutrition, sleep, and physical activity are all arguably getting worse.

A recent PISA report from the OECD tells us that exercise and activity are important for the wellbeing of our youth.

Here’s the top four challenges I think we all face in boosting our young people’s health and wellbeing, and ultimately that of society:

Challenge 1: Mobile devices

They are pretty much the most useful device invented. You carry instant access to all the knowledge of humanity in your hand. Awesome. And they are awesome tools. The mobile is a great servant, yet a hideous master.

High device use disrupts sleep quantity and quality, reduces activity, and has the potential to disrupt genuine experiences with friends, and promote bullying. Understanding how to effectively use, but contain mobile devices, in our young people is the critical challenge of our time. As parents and educators, let’s help ourselves too. Let’s model what we want to see in our youth.

Challenge 2: Getting outside

Getting outdoors and moving is effective in improving mood, reducing depression, improving academic performance, and improving sleep. This can easily be a priority in education. Scientifically it makes sense. My challenge to you is how to build this into the rest of your curriculum delivery. The Hauora aspects of the HPE curriculum lend achievements in this curriculum and learning area to also achieving across multiple other areas of literacy, numeracy and inquiry.

Can you take some of your teaching outside and have physical activity involved?

Challenge 3: Free-range kids

Risk and adventure on your own terms is part of growing healthy kids. We now know that frontal lobe development (read self-control and risk management) develops when you engage in unstable outdoor activity. That means play with consequences. Playstations do not help this development. There are no consequences when you crash your car on Grand Theft Auto. There are consequences for poor tree climbing skill.

Schools can allow tree climbing, adventurous and vigorous play, and even some full contact games. I’m not talking about negligence. I’m talking about helping children learn about risk before they are driving a car and exposed to drugs and alcohol as teenagers. We have a choice in society when we learn this. The earlier the better in my opinion.

Challenge 4: Food

It’s pretty obvious that the modern, industrial food supply bears little resemblance to what humans have eaten for most of the time we’ve been on the planet. Highly processed and packaged food is bad for the youth brain, body, learning and their mental health. There is so much infighting and confusion in nutrition science, but one thing we all agree on is that whole unprocessed food is the way to go.

That’s why I’d like to introduce you to the ‘HI’ (Human Interference) factor. The guide to healthy eating need not get into the ins and outs of fats, carbs, sugars and so on. All we need to ask ourselves is, “Was this plant/animal recently alive in nature running around or growing somewhere?” Yes = eat it. No – it doesn’t resemble anything recently alive = don’t eat it. If we can start a movement around this approach, we will be most of the way to eating healthy again. Big Food companies, who market highly processed, sugary foods won’t like this one bit. In my opinion, Big Food shouldn’t be welcome in our schools. They are behaving exactly like Big Tobacco did – creating confusion, buying science, giving misinformation, and associating themselves with sport and young athletes.

That’s it. Challenges, not answers.

Democracy in action, food labelling and sugar. Have your say.

Here’s your chance everyone…The Australian and NZ governments are calling for public consultation on food labelling, especially around sugar.

The letter I got is pasted below. Make your submissions at this link 

So, they are asking us what we think. Let’s not just complain afterwards…Have a go if you care about what we eat.

———————-paste—————

Dear Stakeholder
 
The Food Regulation Standing Committee (FRSC) is inviting submissions from stakeholders on the labelling of sugars on packaged foods and drinks. A Consultation Regulation Impact Statement (Consultation Paper) has been prepared to seek information on this topic from stakeholders, including industry, public health and consumer organisations and other interested parties.
 
The Consultation Paper is available on the Food Regulation website.  As this is a public consultation, we ask that you forward this invitation to any other relevant parties that would be interested in providing a submission.
 
Information provided in response to the consultation will be drawn upon to prepare a Decision Regulation Impact Statement which will identify a preferred policy option to recommend to the Australia and New Zealand Ministerial Forum on Food Regulation (the Forum) in relation to the labelling of sugars on packaged foods and drinks. The Forum is comprised of Ministers responsible for food regulation from the Australian Federal Government, New Zealand, and Australian States and Territories governments.
 
Submissions need to be lodged through the online Portal and should be supported by evidence. Peak organisations are expected to consult their members on the questions in the Consultation Paper and provide a single response on behalf of their members. Duplicate submissions are not necessary. Submissions that are not evidence-based, or do not directly answer the questions in the paper may not be drawn upon in preparing the Decision Regulation Impact Statement for the Forum.
 
Submissions close at 11.59pm on 19 September 2018 Australian Eastern Time.
 
If you have any questions about this consultation process, please contact the Food Regulation Secretariat at the email address below.
 
Thank you in advance for taking the time to make a submission.
 
Kind regards
 
Food Regulation Secretariat
 

 
Website: www.foodregulation.gov.au | Email: FoodRegulationSecretariat@health.gov.au
Phone: +61 2 6289 5128 | Postal Address: MDP 707, GPO Box 9848, Canberra ACT 2601
 

National Business Review’s fasting challenge

This is a good little watch. Last month I sat down with Todd Scott CEO of the National Business Review, and Chris Keall also at NBR. Chris had let his weight get away on him and needed to front up to this. Todd was in pretty good shape, but is always aiming to be a high performer. He was looking at a reset to be in his best possible shape.

So they took on a fasting challenge following our “super fasting” protocol in What the Fast? 

Here’s the full article and video here, it’s a great little video of the outcomes 4 weeks later …some great men’s weight loss results for both Todd and Chris, as well as some interesting mental health (including medication reduction) outcomes for Todd.

Enjoy

 

#letschangemedicine

Our health system is awesome at fixing up sickness, if I have an accident or get an infectious disease, get ear ache or a sore tooth, then it’s good to know that we have world class medical professionals and a system to deal with all of that.

But, let’s face it, our health system is not so awesome at preventing us getting sick, and providing us with the tools to have a great life where we are the best we can be.

Let’s face it, we spend billions on sickness and very little on health.

Let’s face it, we need to change medicine.

I’m a big fan of what has been achieved in medicine. We stand on the shoulders of giants in so many ways – Louis Pasteur, Florence Nightingale, Marie Curie, Joseph Lister, Otto Warburg, Watson and Cricks….

We’ve come so far, but each change has been painful and slow.

It took more than 50 years to move on the evidence that smoking kills to doing something about it. It took about the same time for the evidence that asbestos caused lung cancer to doing something about it. Also, in 1846, Hungarian doctor Ignaz Semmelweis found that hand washing after autopsy of dead mothers reduced neonatal death from sepsis 9-fold. He never got to see his breakthrough as he was ostracised, institutionalised, and in a twist of fate died himself of sepsis.

The time has come for change. Nutrition as medicine is a no brainer. The evidence is already there.

What’s different this time is that we have the crowd. Just like the consumer is demanding a change in regard to single-use plastic bags so to is the consumer now beginning to ask for change in the medical arena. We expect our doctors to understand nutrition and lifestyle medicine. So #letschangemedicine. We don’t have to wait for another 50 years.

Here’s what to do:

Step 1: Watch this TedX talk on the video below – just out by NZ researcher Julia Rucklidge on nutrition and mental health. It’s a game changer.

Step 2: Start making a noise yourself. People want to listen, they will follow!

Step 3: Stand by, we’ve got some bigger announcements coming in the next couple of weeks about how we are going to contribute to #letschangemedicine

 

 

 

 

 

 

How to reverse the diabetes epidemic in 3 years.

It’s out! I’m honoured to be part of an authorship team with Prof Robert Lustig and Cardiologist  Dr Aseem Malhotra, two rock stars of nutritional science and public health. These two guys are driving change and challenging dogma.

The paper, just published here in the Journal of Insulin Resistance, is an up to date report on the science of sugar, and offers an eight-point plan to reverse the diabetes epidemic within three years.

From the press release….

“Three international obesity experts, NHS Consultant Cardiologist Dr Aseem Malhotra, Professor Robert Lustig of the University of California San Francisco and Professor Grant Schofield, Auckland University of Technology have authored the most comprehensive up to date report on the science of sugar with an eight-point plan that if implemented will result in a reversal in the epidemic of type 2 diabetes within 3 years.

We have particularly focused on the tactics of the food industry, acting in the same way as Big Tobacco does. We are calling out The US Academy of Nutrition and Dietetics, British Dietetic Association (BDA), and the Dietitians’ Association of Australia who all receive annual contributions from the food industry.

Here’s our eight-point  plan, all of which are evidence based to reduce population sugar consumption, and all of which were successful in curbing tobacco use.

  1. Education for the public should emphasise that there is no biological need or nutritional value of added sugar. Industry should be forced to label added and free sugars on food products in teaspoons rather than grams, which will make it easier to understand. GS comment: We need a better food labelling system and all free sugars should be included in this. It should be obvious to the consumer how much sugar there is in products.
  2. There should be a complete ban of companies associated with sugary products from sponsoring sporting events. We encourage celebrities in the entertainment industry and sporting role models (as Indian cricketer Virat Kohli and American basketballer Stephan Curry have already done) to publicly dissociate themselves from sugary product endorsement. GS comment: Like alcohol and tobacco in sport, the tide has turned and the untrue associations between sporting success and sugar are no longer tolerable to society. The gig’s up Big Sugar!
  3. We call for a ban on loss leading in supermarkets, and running end-of-aisle loss leading on sugary and junk foods and drinks. GS comment: Supermarkets in New Zealand can’t loss lead on tobacco and alcohol, just add sugary drinks and junk food as well.
  4. Sugary drinks taxes should extend to sugary foods as well. GS comment: NZ needs to join the club on sugary drink taxes, but if we want to change the three As (affordability, accessibility, and accessibility) then this tax must also extend to other junk foods. We could use the money for public health. Of our billions spent on health, the fact is most of it goes on sickness. 
  5. We call for a complete ban of all sugary drink advertising (including fruit juice) on TV and internet demand services. GS comment: As above, like tobacco and alcohol the tide has turned. Big sugar should be on notice.
  6. We recommend the discontinuing all governmental food subsidies, especially commodity crops such as sugar, which contribute to health detriments. These subsidies distort the market, and increase the costs of non-subsidised crops, making them unaffordable for many. No industry should be provided a subsidy for hurting people. GS comment: Why do some counties make sugar cheaper yet healthy real food is costly. Sugar=wrong thing to subsidise.
  7. Policy should prevent all dietetic organisations from accepting money or endorsing companies that market processed foods. If they do, they cannot be allowed to claim their dietary advice is independent. GS comment: Let’s save these guys because they clearly can’t identify that taking food industry money is a serious conflict of interest and undermines their credibility.
  8. We recommend splitting healthy eating and physical activity as separate and independent public health goals. We strongly recommend avoiding sedentary lifestyles through promotion of physical activity to prevent chronic disease for all ages and sizes, because “you can’t outrun a bad diet”. However, physical (in)activity is often conflated as an alternative solution to obesity on a simple energy in and out equation. The evidence for this approach is weak. This approach necessarily ignores the metabolic complexity and unnecessarily pitches two independently healthy behaviours against each other on just one poor health outcome (obesity). The issue of relieving the burden of nutrition-related disease needs to improve diet, not physical activity. GS comment: Being fit is really good for you, but unfortunately big food is using it to confuse us about the solution to nutritional-related disease. Let’s treat these two things as important and separate, not run them against one another.

The retrospective econometric analysis and prospective Markov modelling both predict that the prevalence of type 2 diabetes will start to reduce three years after implementing these measures. This calamity has been 40 years in the making — three years is not too long to wait!

Here’s some great expert reaction so far….
“The science against sugar, alone, is insufficient in tackling the obesity and type 2 diabetes crises — we must also overcome opposition from vested interests”

Martin McKee, Professor of European Public Health London School of Hygiene and Tropical Medicine said, “We now know how Big Tobacco works, pushing products that kill millions. This paper makes a compelling case that Big Food is doing the same. Maybe these corporations don’t care how they are seen. But if they do care about their reputation, then this paper shows that they have a lot to do to clean up their act.”

Tim Lang, Professor of Food Policy, City University of London, Centre of Food Policy said, “This is an important paper with fair but firm recommendations. Slowly but surely, evidence and awareness are growing that a fundamental change is needed to national and international food policies. Food manufacturing has sweetened diets unnecessarily. Influence is bought by funding arms-length organisations who take the money and cloak themselves in spurious arguments on consumer freedom. Actually, the public worldwide is conned. The impression is given that a tweak here or there will sort out obesity and the runaway non-communicable disease toll. Media ought to realise they give airtime and space to what are effectively anti public health fronts. Declaration of funding should be made before airtime is given.”

Simon Capewell, Professor of Clinical Epidemiology
Department of Public Health and Policy, University of Liverpool said, “BigSugar, Big Tobacco and Big Food all use the same HARMS tactics to deny culpability: H Heaps money for politicians, journalists & scientists

  • H Heaps money for politicians, journalists & scientists
  • A Attack PH opponents & groups
  • R Recruit cronies
  • M Misinformation
  • S Substitute ineffective interventions.

Simon Chapman, Emeritus Professor, Sydney School of Public Health University of Sydney, AUSTRALIA said, “The 2005 satirical movie Thank you for smoking featured a triumvirate of tobacco, alcohol and firearms lobbyists, sharing their strategies at weekly meetings they call The MOD Squad (Merchants of Death). If the movie was remade today, a fourth member from Big Sugar would be mandatory.

These modern chronic disease vectors all use the same playbook. If you want to control malaria, it’s essential you control mosquitos. If you want to control obesity, diabetes and cardiovascular disease, you must control the mosquito’s equivalent – the food industry”

Patti Rundall OBE, Policy Director of Baby Milk Action said, “A key tactic used by the food industry and all industries whose harmful practices should be regulated, is to create ‘front groups’ that represent their interest while sponsoring individuals in positions of influence – especially health professionals or anyone holding a position of trust. This allows them to secretly hijack the political and legislative process; manipulate public opinion and appear respectable. Since 1996, eight world Health Assembly Resolutions have called for conflict of Interest safeguards for those working in infant and young child feeding. These safeguards need to be implemented and extended to all those providing nutrition advice – transparency is an essential first step.”

What the Fast! preorders live

What the fast! cover

Hi everyone,

After a big year of research, writing, and testing of our low-carb fasting method – “Super fasting” we are finally good to go.

We are super excited about What the Fast!, and how it continues the challenge on conventional nutritional-science wisdom. We’ve wrapped up the latest science, practice and yum recipes to provide you with a brilliant structure to mange your eating week (the sub-title is “How Monday and Tuesday will change your life”).

I really want to take the opportunity to thank the team, especially my co-authors Dr Caryn Zinn (aka the Whole Food Dietitian) and Craig Rodger (aka The Michelin-trained Chef), as well as Blackwell and Ruth our publishing partners.

I really hope you like it.

The book is available for pre-order now at whatthefatbook.com

There is a limited initial print run available and we expect this will sell out.

The kindle version is also available for preorder.

Thanks again everyone for all your support, its been quite a journey over the last few years.

Grant Schofield
Professor of Public Health
Director Human Potential Centre
AUT University

what-the-fat-books
The whole range!

We are recruiting for a low carb research study

images

We’re recruiting participants for a research study about low carbohydrate diets.

The study “How low do you need to go? Comparing symptoms of diet induction and mood with outcomes from diets containing differing levels of carbohydrate restriction” seeks to help us understand the effects of differing types of low-carb diets on symptoms of carbohydrate withdrawal (known as ‘Keto-Flu’) and on outcomes from dietary intervention.
http://www.carbappropriate.study/

We are seeking healthy, non-diabetic people aged between 24 and 49 who are currently seeking weight loss. Please be aware that due to the nature of this study those who are currently, or have previously followed a ketogenic diet may be ineligible and people who are current or former clients of mine or my Secondary Supervisor Caryn Zinn Dietitian are ineligible to participate.

Find out more and register your interest here: http://www.carbappropriate.study/

The battle over the causes of cardiovascular disease heats up!

By George Henderson and Grant Schofield

In today’s Guardian, there’s a report on the backlash against an editorial in the British Journal of Sports Medicine entitled “Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions”.[1]

The authors are cardiologists Aseem Malhotra and Pascal Meier, well known for their support of low carb interventions (Pascal Meier is also editor of BMJ Open Heart). And, coming as a surprise to us, Rita Redberg, a cardiologist who is better known as the editor of the high-impact American journal JAMA Internal Medicine (perhaps making this the first meta-editorial). We recently had a letter published in JAMA Int Med questioning the analysis in a Harvard epidemiology paper concerning dietary fats and mortality (Wang response), so maybe this shouldn’t have been a surprise if they’re open to readers questioning the established wisdom.

The editor of BMJ British Journal of Sports Medicine has supported low carb in the past, publishing papers by Tim Noakes and Aseem Malhotra; there’s a fine tradition of the “reforming journal” which is being revived around the dietary guidelines question today, with some journals (the BMJ itself also comes to mind) not being afraid to court controversy.

Malhotra

The gist of the article is in the graphic above and in this press release:

Journals from BMJ Press Release:

Embargoed 23.30 hours UK time Tuesday 25 April 2017

BRITISH JOURNAL OF SPORTS MEDICINE

Popular belief that saturated fats clog up arteries “plain wrong” say experts

Best form of prevention and treatment are ‘real’ food and a brisk 22 minute daily walk

The widely held belief among doctors and the public that saturated fats clog up the arteries, and so cause coronary heart disease, is just “plain wrong,” contend experts in an editorial published online in the British Journal of Sports Medicine.

It’s time to shift the focus away from lowering blood fats and cutting out dietary saturated fat, to instead emphasising the importance of eating “real food,” taking a brisk daily walk, and minimising stress to stave off heart disease, they insist.

Coronary artery heart disease is a chronic inflammatory condition which responds to a Mediterranean style diet rich in the anti-inflammatory compounds found in nuts, extra virgin olive oil, vegetables and oily fish, they emphasise.

In support of their argument Cardiologists Dr Aseem Malhotra, of Lister Hospital, Stevenage, Professor Rita Redberg of UCSF School of Medicine, San Francisco (editor of JAMA Internal medicine) and Pascal Meier of University Hospital Geneva and University College London (editor of BMJ Open Heart) cite evidence reviews showing no association between consumption of saturated fat and heightened risk of cardiovascular disease, diabetes, and death.

And the limitations of the current ‘plumbing theory’ are writ large in a series of clinical trials showing that inserting a stent (stainless steel mesh) to widen narrowed arteries fails to reduce the risk of heart attack or death, they say.

“Decades of emphasis on the primacy of lowering plasma cholesterol, as if this was an end in itself and driving a market of ‘proven to lower cholesterol’ and ‘low fat’ foods and medications, has been misguided,” they contend.

Selective reporting of the data may account for these misconceptions, they suggest.

A high total cholesterol to high density lipoprotein (HDL) ratio is the best predictor of cardiovascular disease risk, rather than low density lipoprotein (LDL). And this ratio can be rapidly reduced with dietary changes such as replacing refined carbohydrates with healthy high fat foods (such as nuts and olive oil), they say.

A key aspect of coronary heart disease prevention is exercise, and a little goes a long way, they say. Just 30 minutes of moderate activity a day three or more times a week works wonders for reducing biological risk factors for sedentary adults, they point out.

And the impact of chronic stress should not be overlooked because it puts the body’s inflammatory response on permanent high alert, they say.

All in all, a healthy diet, regular exercise, and stress reduction will not only boost quality of life but will curb the risk of death from cardiovascular disease and all causes, they insist.

“It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat,” they write.

“Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 minutes a day and eating real food.”

But, they point out: “There is no business model or market to help spread this simple yet powerful intervention.”

The push-back in the Guardian made use of the Hooper at al 2015 meta-analysis of diet-heart RCTs:[2]

Dr Amitava Banrejee, a senior clinical lecturer in clinical data science and honorary consultant cardiologist at UCL, said: “Unfortunately the authors have reported evidence simplistically and selectively. They failed to cite a rigorous Cochrane systematic review which concluded that cutting down dietary saturated fat was associated with a 17% reduction in cardiovascular events, including CHD, on the basis of 15 randomised trials.”

This is nonsense.

1) The Hooper 2015 Cochrane meta-analysis gave no information on reducing saturated fat, because the only reduction in events was seen in some studies where saturated fat was replaced with polyunsaturated fat, not with carbohydrate. Based on population epidemiology, it’s likely that replacing carbohydrate with PUFA – and keeping SFA the same – would have had as much or a greater effect, except that this was never tested in these RCTs.

2) There were no reductions in heart attacks, strokes, cardiovascular deaths, or all-cause mortality from saturated fat replacement in Hooper 2015. The only reductions were in “unblinded” event outcomes, where the LDL level is one of the diagnostic criteria.

3) Hooper 2015 included many studies in which SFA was reduced by replacing processed food (pizzas, pies, desserts) with wholefoods (nuts, whole grains, fish, fruit). This improvement in food quality should have produced some benefit independent of fats. Ramsden et al isolated those studies where PUFA cooking fats and spreads replaced more saturated cooking fats and spreads, and there was no benefit overall, with some harm from high omega-6 interventions and a suggestion of benefit from omega-3 ones.[3] In fact, the Hooper et al studies that improved food quality should have produced better results than they did, and it is possible that the focus on saturated fat reduction and on keeping total fat low hampered them.

4) Statistical modelling in Hooper et al 2015 used the random effects model, which may have exaggerated the results of the smaller, more favourable trials; had an alternative model, inverse heterogeneity analysis, been used there would have probably been no significant associations at all. Watch this space as we (led by epidemiologist Dr Simon Thornley) prepare to publish an academic paper on exactly this, with a full reanalysis of this Hooper Cochrane review using this new more modern method for the meta-analysis.

Quite a few people cited in the Guardian did support Malhotra et al.

Gaynor Bussell, a dietitian and member of the British Dietetic Association, also offered the authors qualified support. “Many of us now feel that a predominantly Med-style diet can be healthy with slightly more fats and fewer carbs, provided the fats are ‘good’ – such as in olive oil, nuts or avocados,” she said.

However, saturated fats should comprise no more than 11% of anyone’s food intake, she said – far less than the 41% fat level backed by the co-authors.

While carbohydrates should still be part of every meal, people should routinely consume high fibre or wholegrain versions, Bussell said.

Well, this is nonsense. You could easily have a 41% fat diet that was 11% saturated fat if you used some olive oil. Fancy a dietitian and member of the British Dietetic Association making that mistake. But why should saturated fats comprise no more than 11% of anyone’s food (energy) intake? What is the evidence for this cut-off? It is 14% in Scandinavia, 10% in New Zealand – irrespective of the total fat intake which it’s part of, which is surely relevant; did every country pull their figure out of a hat?
And why should carbohydrates, that is, sweet and starchy foods, be part of every meal?
We think it’s probably beneficial to be in at least mild ketosis, and have low insulin levels, for at least part of the day. Otherwise you’re always in the fed state, always packing away energy as cholesterol and fat, instead of using it up. And surely that’s where the fat that can build up in your arteries comes from – whatever puts it there, whether it’s carried there by oxidised LDL particles or by magic pixies, it’s available to go there because it wasn’t used to fuel you, which is why CHD risk due to atherosclerosis is associated with overweight and obesity and offset by exercise.

There’s one criticism that’s probably justified;

Christine Williams, professor of human nutrition at Reading University, said the cardiologists’ dietary advice was impractical, especially for poorer people. “The nature of their public health advice appears to be one of ‘let them eat nuts and olive oil’ with no consideration of how this might be successfully achieved in the UK general population and in people of different ages, socioeconomic backgrounds or dietary preferences,” she said.

Doctors’ visits and PCSK9 inhibitors aren’t cheap either. There is a need to scale healthy low-carb advice for poorer populations. Fats like olive oil are cheap per calorie compared to most healthy foods, but dearer than other oils, so would some canola oil be okay? As far as anyone knows, peanuts and sesame and sunflower seeds are as good as the more expensive nuts. High-fat yoghurts and milk are the same price as the reduced fat versions; this is one way to save money. Whole grains are much more expensive than flour and sugar, but that won’t stop the experts recommending them.

Postscript

In case you think that “inflammation” in the BMJ Sports Medicine editorial was too briefly described or explained, here’s a superb review of the “alternative hypothesis” of heart disease from 2011, which deserves to be more widely read.
Kuipers et al

References

[1] Malhotra A, Redberg RF, Meier P. Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions. 

[2] Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD011737. DOI: 10.1002/14651858.CD011737.

[3] Ramsden CE , Zamora D , Majchrzak-Hong S , et al . Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota coronary experiment (1968-73). BMJ 2016;353:i1246. doi:10.1136/bmj.i1246

The fat emperor again

Ivor Cummings latest talk is worth a watch. He basically does my entire third year “Lifestyle Disease” class in a single lecture. So you can save taking that and just watch this.

I don’t buy the whole “you have to be an engineer to have a problem solving brain” line Ivor.  I’ve heard enough of that from my Dad over the years, who is also an engineer.  True though, they are both good problem solvers.

http://www.thefatemperor.com/blog/2017/4/3/fat-emperor-at-weston-price-limerick-a-root-cause-talk-cholesterol-diabetes