Bring home the fat, say top UK doctors, dietitians


By Marika Sboros 

It’s official and from Britain’s highest medical and dietetic levels. Official dietary guidelines really are making you fat and sick.

The high-carb, low-fat, low-cholesterol message that doctors and dietitians have dished up to you for the past 40 years is likely to be the “biggest mistake in modern medical history”.

The UK National Obesity Forum (NOF) and the Public Health Collaboration (PHC)have released a statement saying that eating fat doesn’t make you fat. It also says that saturated fat doesn’t cause heart disease. To avoid type 2 diabetes, you need to avoid “low-fat” foods and foods “proven to lower cholesterol. Among those foods are high omega-6 polyunsaturated vegetable oils and starchy and refined carbohydrates. 

You also need to stop counting calories.

The statement comes from the country’s leading medical specialists, scientists and dietitians. They have called for an urgent revision of the government-sanctioned guidelines. They say that the authorities have ignored the role of poor dietary advice in public health for too long. 

Now truly is the time to “bring back the fat”, they say.

Top academics, doctors, dieticians, nutritionists, sports scientists and health activists have endorsed their statement.

Speedy pushback

Dr Alison Tedstone

It didn’t take long for establishment pushback to happen.  Dr Alison Tedstone, is chief nutritionist for Public Health England (PHE). In a BBC report, she says that the message to eat more fat is “irresponsible and potentially deadly”. (Click here to read PHE’s full response.)

 Royal College of Physicians’ special adviser on obesity Prof John Wass agrees. The Guardian quotes him as saying that there’s “good evidence that saturated fat increases cholesterol”. Wass also says that the NOF and PHC statement quotes selective studies  and “risks misleading the public”.

The statement’s authors are unrepentant. They say that change in dietary guidelines in the US in 1977 and UK in 1983 is a root cause driving the twin epidemics of obesity and type 2 diabetes. They also say that commercial interests have “corrupted science”. The food industry’s “undue influence” on official dietary guideline bodies poses a “significant threat to public health.”

The “real scandal” is that academics, institutions and journals have colluded with industry for financial gain. Their primary responsibility is to patients and scientific integrity.

Flawed dietary guidelines

Prof David Haslam
Prof David Haslam

NOF chair Prof David Haslam is a clinician with a busy practice. He says that treating patients made him realise that guidelines promoting high-carbohydrate, low-fat diets as a universal panacea are “deeply flawed”.

Haslam is a physician in obesity medicine at the Centre for Obesity Research at Luton & Dunstable Hospital. He is also a professor in obesity sciences at Robert Gordon University in Aberdeen. He that says his patients don’t lose weight or improve their health by cutting fats or calories.

Diet in the real world

Working in the real world, rather than a research lab or government department, showed him that people will choose which food they eat. They may need “guidance in how to enjoy their food but simultaneously avoid foods that will do them harm”.

“Current efforts have clearly failed”, Haslam says. For proof: obesity levels are higher than they have ever been. They show no chance of reducing despite the best efforts of government and scientists.

We need a new approach, he says.  But “new” actually means “a return to 18th-century values’. These drawn up “before modern interference with basic principles occurred”.

Consultant cardiologist Dr Aseem Malhotra, a senior advisor to the National Obesity Forum, agrees. Malhotra is member of the Greater London Authority Food Board and founding member of the Public Health Collaboration says,

He is critical of the change in dietary advice to promote “low-fat foods” in 1977 in the US and in 1983 in the UK. It is perhaps “the biggest mistake in modern medical history resulting in devastating consequences for public health”.

PHE guide is ‘a metabolic time bomb’

Dr Aseem Malhotra
Dr Aseem Malhotra

Doctors and dietitians perpetuate this unhelpful advice, Malhotra says. He describes Public Health England’s current EatWell guide as “more like a metabolic time bomb than a dietary pattern conducive for good health”.

The message to the public to reverse obesity and type 2 diabetes must change. “Eat fat to get slim, don’t fear fat, fat is your friend. It’s now truly
time to bring back the fat,” Malhotra says.

He and his co-authors of the statement say that the “most natural and nutritious foods available” – meat, fish, eggs, dairy products, nuts, seeds, olive, avocados – all contain saturated fat. The continued demonisation of ubiquitous natural fat “drives people away from nutritious, wholesome, health promoting foods”.

They cite recent high-quality research that suggests full-fat dairy protects against type 2 diabetes and obesity. They also refer to a survey from investment bank Credit Suisse. It shows a “substantial level of misinformation” amongst doctors and nutritionists in relation to dietary advice.

“Most shocking is that 83% of doctors thought butter was worse than margarine. 66% believed vegetable oils are beneficial for health.”

Real markers of CVD risk

Popular read: The idiot’s guide to LCHF

Given the immediate health threat that diet-related disease poses, education curricula for undergraduate, postgraduate and continuing medical education must incorporate current, evidence-based nutrition. Health professionals and the public must shift focus away from total and LDL cholesterol as a marker of cardiovascular health, they write.

“Evidence clearly shows that a cholesterol profile characterised by high triglycerides and low HDL is more predictive of cardiac risk,” they say. It is also a reliable surrogate marker of insulin resistance – the most important risk factor for heart attack in young men.

The authors describe type  diabetes as a condition of “carbohydrate intolerance” . They cite the work of award-winning British GP and clinical diabetes expert Dr David Unwin. Unwin has saved the country’s National Health Service (NHS) £45,000 per year for medications for diabetes. That’s compared to the average for his clinical commissioning group. He has done so simply by putting his patients on a low-carb, high-fat (LCHF) diet

“Replicating these results in the 9400 surgeries across the UK could potentially save the NHS £423 million/year on diabetes medications alone,” the authors say.

Veg oils are ‘not food’

Referring to industrial vegetable oils, they say that omega-6 rich vegetable oil (such as sunflower and corn oil) can “barely be considered a food”. Research links to the oils to an increased risk of death, coronary heart disease and cancer in humans.

They say that a call for a revision of the guidelines is not only about preventing disease. It is also about nutritional interventions that address and eliminate the root causes of chronic disease. 

Research shows that prescription medications are the third most common cause of death globally after heart disease and cancer. This should be “a wake-up call”, the authors say. It shows that the future of healthcare will require a strategy that incorporates evidence-based lifestyle changes to treat illness in addition or often as an alternative to medical treatments which come with side effects”, the authors conclude.

Dr Robert Lustig

US paediatrics professor, Dr Robert Lustig agrees. He heads the Division of Endocrinology and Member, Institute for Health Policy Studies, University of California, San Francisco and is President of the Institute of Responsible Nutrition. He says that says the newly elaborated science of nutrition highlights the reasons for failure in dealing with the obesity and diabetes epidemics. Thus, national guidelines need to change.

Brazil leads the way

Brazil is a good example. The country has just issued dietary guidelines that are about real food, not just nutrients or calories, says Lustig.

Likewise, the new NOF and PHC  guideline focuses on real food over processed food. It also makes the case that “the entire healthcare complex needs to relearn nutrition in order to be effective advocates for their patients”.

Dr Trudi Deakin
Dr Trudi Deakin

Dr Trudi Deakin, chief executive and research dietitian for X-Pert Health is a founding member of the PHC. She says that dietitians’ professional code of conduct states that it is their responsibility to keep abreast of the latest research evidence.

As a result, this allows them the freedom to work outside non-evidence based guidelines.

“Dietitians, therefore, have the opportunity to set the record straight. They can provide dietary advice that will  impact positively on people’s health and wellbeing by preventing and potentially reversing obesity and type 2 diabetes,” Deakin says.

Deakin is author of Eat Fat: Step-by-Step Guide to Low Carb Living (X-Pert Health).

Samuel Feltham is a director of PHC and a Master Personal Trainer. He says that one of the biggest misconceptions is that people can eat what they like as long as they exercise.

“Nothing could be further from the truth. It’s time to promote a real-food lifestyle. It means nourishing the body with the best fuel. It also means the right type and amount of exercise for good health for all ages and all sizes, not for weight loss,” Feltham says.



  1. I am interested in LCHF to lose weight and to control my type 2 diabetes which is in its very early stage.
    Having started this way of eating I have found it necessary to gain more knowledge , but find it difficult to get help from UK as opposed to US organisations/doctors.

    • Hi Zena, there are growing numbers of doctors and nutrition specialists who understand LCHF lifestyle to treat or prevent obesity, diabetes, etc. Have a look at the Low-Carb World Map I run on for contacts who can help you. There is a link on the home page.

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