By Marika Sboros
Irish engineer Ivor Cummins, aka the Fat Emperor, is a man on a mission. In our Vital Signs Q&A series of personality profiles, Cummins reveals the roots of his popular alter ego. Through the lens of the muscular Fat Emperor, he looks at best predictors of and treatment for heart disease.
Spoiler alert: cholesterol means nothing compared to more important measures of risk. Cummins is currently working on a scanner that can rapidly detect heart disease risk. It can also weed out those who don’t need any treatment at all. He covers much else besides, including diabetes, fatty liver disease, dementia and more.
As well, Cummins shows that Fat Emperor is a metaphor for the corporate power that funds science and has grown fat on keeping dangerous dogma going. Therefore, he gets down and dirty on deceit as ‘central in the nutrition science world’.
Marika Sboros: What was your earliest ambition?
Fat Emperor: From a very young age, I was obsessed with technology. I knew I wanted to work with technology, to build things.
Why did you become a biochemical engineer and not a computer scientist?
Probably because at the time, most people perceived engineering to be one of the most prestigious, highest-paid of the professions that include technology. So, I ended up doing biochemical engineering at University College, Dublin. It was the only one offering the degree at that time. We did the biochemistry of life, the Krebs cycle, all about metabolism. It fascinated me.
And after qualifying?
I worked for a US multinational in process development, developing kidney dialysis units. I also got involved in human trials. And I liked the connection through to people.
For the past decade, you’ve worked for a multinational company that makes inkjet micro technologies. What did that teach you?
I honed my problem-solving and managerial skills. Most people don’t know the complex technology involved in microfluidics. Print heads fire out over 20 000 times a second from over 2000 nozzles. In other words, countless millions of microscopic drops arrive on the page at high temperatures and pressures in perfect synchronicity. Any issues that arise are complex to solve.
I also manage a large team of technical specialists and engineers across the world. I ensure that they can solve problems before the business sustains major losses.
How did you move from that world into diet and nutrition?
By chance. I followed the food pyramid and did triathlons for fitness. Around four years ago, I had some routine blood tests. Three came in very high, way outside the range for a supposedly healthy human. Serum ferritin that indicates the body’s iron loading; GGT, a liver enzyme (which indicates fatty liver, also known as non-alcoholic fatty liver disease NAFLD). And, of course, cholesterol.
Did you see a doctor?
Yes. I asked my doctor two questions. What are the probable root causes for those high levels. What are the implications for health and longevity? He gave me weak advice: to eat more whole grains and less fat. I could sense that this wasn’t likely to work. I was already eating according to the conventional food pyramid. So, I went to two more doctors. They said the same thing.
They were good guys but couldn’t explain the blood tests. I realised I would have to do my own research, my own problem-solving. Go directly to the research databases. I had to work out for myself what could have caused my high levels.
How long did it take?
May sound arrogant but within a couple of weeks, I had worked out the solutions. I discovered that the most likely cause was inflammation. Ferritin and GGT indicate inflammation. And that excessive sugars and carbs in my diet were the cause. Crucially, I also discovered that cholesterol didn’t mean anything compared to other measures.
Click here to read: Carnivore Queen: O’Hearn on magic of meat
GGT is a master measure, hugely important. It links to future sickness and mortality. Actuaries are using GGT in their risk analyses but doctors don’t. One thing that can drive up GGT is excessive alcohol. Of course, actuaries are only interested in the money. And they know that even if alcohol is not the driver, GGT is independently associated with future disease and premature death.
However, doctors only learn that GGT indicates excessive alcohol intake. As a result, they don’t realise that it’s an incredibly powerful marker of bad diet. It’s also a driver of liver inflammation, fatty liver and diabetes. Therefore, doctors and patients must act on it because it is a powerful predictor of type 2 diabetes in future.
What happened to your markers?
Ferritin and GGT dropped dramatically and my cholesterol went up a little.
Were you worried about your cholesterol?
No. These days, even orthodox doctors and cardiologists know it doesn’t mean anything. The key is the ratio of triglycerides over HDL (high-density lipoprotein, so-called ‘good cholesterol). My ratio got way better and stayed that way. Even LDL (low-density lipoprotein) levels are misleading.
So you don’t subscribe to the diet-heart hypothesis that saturated fat causes heart disease?
No. Despite many valiant attempts, it’s currently unproven.
Where did your Fat Emperor alter ego come from?
After a few glasses of wine with my wife one night. I wanted to put my talks on YouTube as a brand. Not anything commercial, just to spread the message. I saw all these researchers holding on to the flawed science of Ancel Keys for 50 years. Keys’ theory (the diet-heart hypothesis that saturated fat causes heart disease). It doesn’t hold water and many of them likely know it.
It was a perfect case of the Emperor and his new clothes. Few doctors and scientists could face the fact that their theories were flawed. They reminded me of those watching the Fat Emperor and not seeing that he’s naked.
And the fat part of Fat Emperor?
The global obesity crisis is a huge part of what ties it all together. I had a mental image of many poor people who are heavily overweight. And that there are solutions but orthodoxy won’t provide them.
I realised that obesity is a kind of disease that environmental factors cause. But doctors and dietitians still blame the victim. Some people won’t accept that the solution is simply to change the way they eat. But it seemed to me that hundreds of thousands, perhaps even millions, would run with it.
Finally, I realised that the Fat Emperor is also a metaphor for the corporate power that has funded science. It has grown fat on keeping the dogma alive.
What other dietary or lifestyle changes did you make?
Alcohol wasn’t my problem. I switched to low-carb, high-healthy-fat. I cut out all sugars, fruits juices, grains, breads, pasta, sandwiches, lots of rice. If anything, I backfilled with more vegetables. I then increased healthy fat intake.
What were your fat sources?
I ate more grass-fed Irish lamb, beef, fish and began to snack on sardines instead of sandwiches.
Was it easy to make dietary changes?
We’ve been programmed since birth that fatty meat causes heart disease. So, psychologically, it was a little difficult. I had to overcome my programming. The food was tasty but my brain was screaming that I would cause myself problems. However, the rational side of my brain had already answered that.
How did your family react?
My wife, Eilis, is also an engineer. She graduated cum laude but gave up work to run our family of five children. They are aged 17 down to nine, with two-year gaps. Technically, she’s very on the ball. I shared the basics of the research with her. It resonated. She would get angry at the junk science the “experts” have fed us. She was as excited as I was at problem-solving and data analysis. And she also switched to an ancestral, lower-carb diet.
How did the children adapt?
Children like comfort foods, the refined carbs and sugars because these are addictive. So, the kids resisted. Our solution was to remove the offending foods from our environment. We also always have high-quality salamis, meats and cheese. Also, I was endlessly talking about it at the time.
I became not exactly obsessed but angry at what I was discovering. And my children certainly got the message. They have also grown up in our house where I’ve had lots of meetings. They also heard me loudly arguing on technical issues with teams around the world. So, they know that when I say something, I’m probably right.
Were you a cardiologist in a previous life? Is that why the Fat Emperor focuses on heart disease?
My research propelled me to want to work towards reducing modern chronic disease. Heart disease is the biggest killer in the world. And my research showed how easy it is to identify all those millions of people at risk worldwide. And that they could find out their risk in two minutes with a simple, cheap calcium scanner.
Scanning is common in modern medicine these days. You and Dr Jeffry Gerber, Denver’s Diet Doctor, are working on one that he has used for a while now. He thinks it’s amazing. What’s so good about it?
It is essentially the ultimate test for atherosclerosis (plaque build-up inside arteries). It’s a calcification test that scientists developed in the 1980s. Tragically, for various political and economic reasons, the medical profession didn’t adopt the scan.
Name a few of those reasons?
The calcium scan is cheaper and more effective than other screening methods in showing actual level of cardiac disease. It can screen out a lot of people who won’t need any treatment. This causes significant revenue loss for hospitals. It’s also not good for the business of medicine. And using the scan widely will reveal that “cholesterol” is a near-useless marker for heart disease risk. Thus, that would embarrass the cholesterol business. It also has significant financial implications.
Do you mean that many people may never need treatment or may in future?
We’re trying to get the message out there that there’s a quick and easy way to find out your real risk of heart disease. It gives you much more and relevant information than all the other risk factors. The scanner gives a baseline score. But here’s what’s really important. If that score doesn’t change much over the next few years, you have nothing to worry about. And if your score is high now you can take immediate action.
That undermines revenues of hospitals and medical practices. The Widowmaker movie tells the whole fascinating, sad story.
Publicity material calls it a film that could ‘literally save your life’. It also reveals the ‘hidden battle’ some good people are fighting inside America’s medical establishment. And that this battle pits ‘prevention against intervention, keeping scans in the shadows while cardiac surgeries soar’. Is that hyperbolic?
No. Widomaker is required viewing for anyone who wants to avoid having a heart attack.
You are giving up your day job to work on the scanner and nutrition research fulltime. How can you afford to do that?
I’m fortunate that I have a backer, (Irish businessman) David Bobbet. He funded the Widowmaker.
You don’t focus only on heart disease in your work. You also focus on diabetes, cancer, more recently dementia and neurological diseases such as Parkinson’s. What’s the connection?
Heart disease has common causes with many cancers. And the elephant in the room is type 2 diabetes. They are all connected with common causal pathways. If you identify all the pathways, feedback loops and mechanisms, you minimise not just heart disease. You also reduce the risk of type 2 diabetes, cancer, Alzheimer’s. Doctors now call Alzheimer’s type 3 diabetes. That’s because it is simply a different way that hyperinsulinemia and insulin resistance manifest over time.
I recently heard a doctor call Parkinson’s type 4 diabetes. Would you agree?
Oh yes, I suspected as much several years ago. Fixing diabetic physiology will collapse risk of many modern chronic diseases. It’s like this complex engineering production line. You go in to fix one problem. And when you find out what’s wrong in the line and fix it, many other things get better on the line.
That’s the engineer in, not the Fat Emperor talking?
It’s analogous to complex problem-solving in engineering. There are common roots driving most common modern chronic disease. Therefore, if you understand root causes and apply the fix, you get massive benefits. The magic is to understand root causes properly. That’s the mecca for engineers. Of course, you could just find mitigating solutions. A band-aid, something that helps but is expensive and not very effective isn’t much help. Real engineers find root causes and the most effective way to fix them.
What does Fat Emperor say is the root cause of chronic disease?
The primary cause is related to what drives elevated insulin in your body. Many things drive up insulin, not just excess carbs. It’s not that simple. But when you understand it, it’s not that complicated. If you smoke heavily, you also drive up insulin and insulin resistance (IR). And if you eat too many sugars and other refined carbs, you do the same thing.
Lack of sunlight and disrupted microbiome bring you to the same sorry place. Same with eating processed vegetable oils chronically. If you get poor sleep or are under too much stress, IR rises. if you can put together the primary drivers of insulin dysregulation and address them all, you get magic.
You have a book out in early 2018 with Dr Gerber, Eat Rich, Live Long. It has 10 levers or rules. Care to share some?
The first three are what we call elimination levers. You must eliminate sugars, refined carbs, industrial vegetable (seed) oils and processed foods that are filled with both of those. The sooner you eliminate those, the quicker you will you are free. It’s a bit like cigarette smoking. If you really want to stop smoking, just stop. You can’t keep smoking a cigarette now and then. You’ll soon be back in the grip of the addiction.
The next lever is to adopt a low-carb, ancestral, high-healthy-fat diet. When you do that, you gain control over your appetite. That’s a huge factor. Fasting behaviours help. Meal-skipping is extremely healthy. It’s a key rule always to include. There is lots of evidence for benefits of fasting. It stimulates autophagy (literally “self-eating”), it is anti-cancer. It helps to fix metabolism in overweight people, including those who are insulin sensitive.
I thought overweight people were insulin resistant?
Many are, but people can be obese and otherwise metabolically healthy. They need to use appetite control and apply that lever to skip meals. The best strategy for them to lose weight is not so much to go hard keto (extremely low-carb). That won’t help them as much as someone who has insulin resistance. Fasting particularly helps those who are insulin sensitive but overweight.
Do trolls on social media sometimes tell you and the Fat Emperor to stick to engineering?
I hear that often. But medical science is as much art as science. It is also very much a technical sphere. To be correct in anything here you need a strong technical nature and aptitude. You need to research directly from the published scientific literature from the last 60 years. You need strong problem-solving ability to integrate all of the data into the most likely correct solution.
That won’t be possible if you simply went to nutritional college courses. And if you have learnt a little about nutrition while your lecturers fed you bad information. A degree in nutrition doesn’t make you an expert in modern chronic disease. Likewise, a medical degree may leave you well short of what you require. Doctors don’t have much training in nutrition and metabolism. So, they are caught short also.
How do you start your day?
Randomly. I sometimes skip breakfast and have a coffee with heavy cream. Or I have a few eggs and maybe some bacon.
What do you eat for the rest of the day?
If I have breakfast I usually skip lunch because I’m not hungry. If I skip breakfast, I’ll have meat and salad, olive, cheeses, maybe some greens and tomato. My evening meal is usually a classic meat, or fish with veg, very light on potato.
I try not to snack but occasionally have cheese, olives or dark chocolate – 85%.
Do you ever fast?
I love the feeling of fasting and I do intermittent fasting regularly, 16 to 20 hours. If I skip breakfast and lunch, I essentially fast for 24 hours.
Do you take vitamin and mineral supplements?
Not much. I occasionally take potassium and magnesium. I sometimes take a spoon of cod liver oil. And I have a vitamin D lamp which is a better way to get vitamin D. The weather in Ireland is crap, as we all know. It rains a lot of the time. But I keep an eye on the weather forecast in summer. If I know it’ll be sunny, I make sure to get good exposure without burning.
What’s the least healthy thing you do?
I’m indulgent with wine. I should probably drink a little less. But then again, my diet is good so I don’t think a little extra wine will hurt much.
Does the Fat Emperor have other secret bad habits?
No, our hearts beat to the same health rhythm.
Have you had mentors in life?
Yes. Jim Martinez, a technical manager. He was a hugely impressive individual in my life. He was both technically astute and a great leader of people also. Also Mark McKenzie – a master level engineer who came to Ireland when I started in the corporate section. He was not just a brilliant technical expert. He knew how to lead people to finding solutions for the most complex of problems. My current mentor is David Bobbett – a hard act to follow but I’m still learning!
What makes a good leader?
You need conviction and the ability to articulate clearly a goal that’s worth achieving through to an end point. You need charisma and a sense of humour. And you need to be authentic. Even if people don’t agree with you, they sense when you are authentic. That can move things forward quickly.
And a bad leader?
One with flawed logic. Bad leaders may have vision, but seek a destination that isn’t worth pursuing. They may be flawed in the key elements that move people forward. Or they may have hidden agendas. You may you only discover this over time and realize that they lacked authenticity of purpose.
Current nutrition leaders are a prime example globally. They are driven to protect their reputation after giving the wrong advice for 30 to 40 years. They have led people into diabetes, obesity, heart disease, even cancer. However, this they did through ignorance mainly. They are now frantic that no-one can prove them wrong. Many outspoken ones operate from hubris and pride. They may have believed for decades that they were right.
They are, I think, beginning to realise that they have been wrong. The truth that is emerging will damage them and their business. They have a dog in the fight, for sure. And they will continue to fight against the emerging science of low-carb.
Ever read a book that changed your life?
In a roundabout way, The Biochemistry of Life by Prof Steven Rose. It’s a great book for an introduction to biochemistry.
What are you reading now?
Nothing but research papers really. When I get a few moments, I’ll read novelists like Sebastian Faulkes, (a British literary novelist) or superb American authors like Cormac McCarthy.
What ‘s the best advice anyone ever gave you – or the Fat Emperor?
Jim Martinez once told me: “Ivor, you’ll be correct on any technical question 95% of the time. Go with your judgment and show leadership. If you’re wrong in rare cases, you’ll get over it. Have the courage to lead. That’s what progress requires.”
And this new field (of controversial nutrition science) you have to be quite aggressive. You also have to show leadership because many people are fighting back. They’re trying to suppress the evidence for their own gain or personal reasons.
Any pet peeves?
Mostly people who don’t understand the mechanisms, physics and maths of science; who are entrenched in their belief systems and will use any data, no matter how weak, to further their argument. Deceit is central in the nutrition science world. Also, the vast majority of nutrition specialists are flying blind. And they parrot dogma based on crap data and weak associational studies mainly. It really annoys me, so it’s time for them to get off the pot.
If you could edit your life, what would the Fat Emperor change?
I wouldn’t change much. I’ve learned from bad experiences, so I wouldn’t take those away. And maybe 10 years ago, I should have changed careers. If I’d known then what I know now, I would have done medicine. But perhaps I may be just as effective in changing paradigms in my current and future roles. And I’m shaking things up along the way…