By Marika Sboros
If you harbour any doubt that low-carb, high-healthy-fat (LCHF) diets are becoming medical mainstream, the recent Public Health Collaboration (PHC) annual conference in London dispelled it.
Former Australian cricket team doctor Peter Brukner set the tone in his opening address on May 19. It is “almost negligent”, even close to “criminal”, he said, for doctors not to put patients on LCHF diets for diet-related illnesses. That was fighting talk and it resonated with speakers who expressed similar sentiments.But there was another strong sign that LCHF is becoming mainstream.
The PHC gathering took place in the stately building of the Royal College of General Practitioners (RCGP). As a venue choice, it was inspired. It has made the RCGP into the strongest orthodox medical endorsement yet for the benefits of LCHF diets.
And it signalled that London is emerging as a global LCHF hub.
The stellar list of speakers was another ringing endorsement. Among them were GPs, cardiologists, an endocrinologist, obesity, metabolic and nutrition researchers, a psychologist and a registered dietitian. Delegates also signalled support for rapidly changing nutrition science times. They included medical, dietetic and nutrition experts, students and more ordinary mortals from across the UK, Europe and globally.
In Part One of a two-part series, Foodmed looks at who and what are driving the changes.
There were some echoes in the august chamber of the RCGP building. One was that an LCHF diet can reverse type 2 diabetes, or at least to put it into remission. Another was that obesity is not from gluttony and sloth. Rather, it’s from a ubiquitous “obesogenic environment” – that promotes weight gain and is not conducive to weight loss.
There was a consensus that physical activity is vital for health. But there was also a consensus that it’s just not a great weight loss tool.
Along with those echoes came the harsh spotlight on the “usual suspects”: sugar, grains, refined, processed foods and vegetable oils. And of course, unscientific dietary guidelines that promote these ingredients came in for a sound drubbing.
British public health and obesity researcher Dr Zoë Harcombe laid waste to the “eat less, move more” guideline that conventional organisations regularly dispense.
Among them: the British Dietetic Association (BDE), the Department of Health (DOH), NICE (National Institute for Clinical Excellence) and the NHS (National Health Service).
The “eat less, move more” idea is based on CICO (Calories In = Calories Out) principle, Harcombe said. It is also based on a formula: “To lose 1lb of fat you need to create a deficit of 3,500 calories.”
Where do the organisations get the formula from? Nowhere. Harcombe asked them and none could answer. She showed that promoters of CICO don’t understand the laws of thermodynamics.
“We invented the weight conversion and we got it wrong,” Harcombe said.
Thus, she showed that CICO is unscientific – in a word, “bollocks”. CICO doesn’t work for either gain or loss, Harcombe said. A calorie isn’t a calorie, the body isn’t a “cash machine” for fat and humans aren’t “bomb calorimeters”. The body can and does adjust and weight is ultimately all about storing and unstoring fat.
Brukner was equally scathing about official dietary guidelines. He elaborates on that in his new book, A Fat Lot Of Good, How the Experts Got Food and Diet So Wrong and What You Can Do to Take Back Control of Your Health
In his opening address, he cited statistics showing that Britain is the “fat man of Europe”. Two-thirds of British adults are overweight and millennials are “the fattest generation”. It’s also official, Brukner said, that Britain has the “worst diet in Europe”. Life expectancy in the country has fallen so far that “a million years of life could disappear by 2058”.
Excess sugar and intake of “ultra-processed” foods are major culprits. Brukner showed a slide describing ultra-processed foods as “a chemical sh*tstorm”.
He showed that LCHF benefits more than just obesity, diabetes and heart disease. Brukner gave evidence for LCHF and ketogenic (very-low-carb, very-high-fat) diets in treatment of cancer, dementia and autism. He showed how Big Food and Beverage companies copy Big Tobacco’s “playbook”.
One of his slides showed British Nutrition Foundation’s conflict of interests in links with food and beverage companies.
In closing, Brukner acknowledged LCHF pioneer “heroes” who face stiff establishment attack. Among them, British cardiologist Dr Aseem Malhotra and South African sports scientist Prof Tim Noakes.
Brukner has also faced attack for his anti-sugar, pro-LCHF stance. He said that Australian sports nutritionist and RD Louise Burke has openly stated that he and Noakes “should be in jail” for their opinions.
SUGAR THE ‘NEW TOBACCO’
Malhotra gave the opening address on the second day of the conference. He showed why he is the bête noire of medical and dietetic establishments and food (particularly sugar) and drug industries.
He opened with a quote by American-Canadian Dr David Sakett, a pioneer of evidence-based medicine: “Half of what you learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation. The trouble is nobody can tell you which half. The most important thing to learn is how to learn on your own.”
Malhotra said that vested interests have hijacked evidence-based medicine and made it difficult for “honest doctors to practise honest medicine”. The result: “an epidemic of misinformed patients and doctors and a complete healthcare system failure.”
He expanded on the “obesogenic environment”. It includes hospitals that have become “branding and marketing opportunities for junk-food companies”.
Malhotra supported the idea of sugar as “the new tobacco”. He said that diet has more of an impact on health than tobacco, alcohol and physical inactivity combined.
NO NEED TO APOLOGISE
Malhotra also identified two major public-health scandals. One is regulators who fail to prevent misconduct by pharmaceutical and medical device companies. He called it “corporate crime”. The other: doctors, institutions and journals who collude with industry for financial gain.
He showed how establishment attacks against him have intensified after publication of The Pioppi Diet, which he co-authored with Donal O’Neill. One source of those attacks: BDA spokespersons Sian Porter and Duane Mellor.
He ended with a quote attributed to Gandhi: “Many people, especially ignorant people, want to punish you for speaking the truth… Never apologize for being correct or for being years ahead of your time. If you’re right and you know it, speak your mind. Even if you are a minority of one, the truth is still the truth.”
With that, the assembled conference audience gave him a lengthy standing ovation.
Noakes also received a standing ovation after his talk on the second day. (That was the second. The first was when Brukner called him a “superhero” for surviving establishment onslaughts.) In his talk, he presented compelling evidence for LCHF and ketogenic diets for diabetes treatment. He said that people “don’t die from diabetes”, they “die from its management”.
His talk was mostly about the ongoing Health Professions Council of South Africa (HPCSA) trial against him. He presented dramatic new evidence suggesting that the trial was a set-up from the start. Noakes and I document the case in our book, Lore of Nutrition, Challenging Conventional Dietary Beliefs.
FULL-BLOWN TRIAL OF SCIENCE
Johannesburg dietitian Claire Julsing Strydom was president of the Association for Dietetics in South Africa (ADSA) when she started the case by reporting Noakes to the HPCSA for a single tweet in 2014. In it, he said that good first foods for infants are LCHF. It turned into full-blown multi-million Rand trial (estimated at around £1million) that has dragged on for more than four years.
In April 2017, the HPCSA’s committee found Noakes comprehensively not guilty on all 10 aspects of the charge against him. In June 2017, Noakes’s instructing attorney Adam Pike, of Pike Law, uncovered the evidence in a freedom-of-information request to ADSA in June 2017.
The email chain shows Strydom and another ADSA dietitian, Maryke Gallagher, communicating with HPCSA dietetics board member, Prof Edelweiss Wentzel-Viljoen before the 2014 tweet. In one email, Strydom appeals to Wentzel-Viljoen for help in combatting “the Noakes problem”. She and Gallagher say that he and LCHF are harming the dietetic profession. In a reply, Wentzel says that the HPCSA “has a plan” for Noakes.
In February 2018, the HPCSA held an appeal against the not guilty verdict. The appeal committee chair promised a ruling “some time before the end of March”. There has still been no ruling.
BREAKING THE SILENCE
Noakes paid tribute to the three experts who flew in to give evidence in his defence: Harcombe, US science journalist Nina Teicholz and South African-born New Zealand dietitian academic Dr Caryn Zinn. He also acknowledged his legal team: Pike, advocate Michael van der Nest (SC) and Dr Ravin “Rocky” Ramdass.
He ended his talk with a quote from Martin Luther King – “Our lives begin to end when we become silent about things that matter” – and followed it with the Liverpool Football Club anthem, You’ll never walk alone.
At that, the audience rose in spontaneous applause and in a highly charged, emotional moment that left many in tears.
The moments I knew that @HPCSA_ @ADSA_RD trial was worth every second and every cent (penny) and that the LCHF tipping point is much nearer than we think, especially in the United Kingdom. Thanks @SamFeltham @PeterBrukner @zoeharcombe @DrAseemMalhotra @lowcarbGP @MarikaSboros https://t.co/e6sAGPv9yT
— Tim Noakes (@ProfTimNoakes) May 23, 2018
Award-winning British NHS GP Dr David Unwin has emerged as another pioneer making LCHF mainstream. He spoke on low-carb diets to achieve remission of type 2 diabetes. He said that the fastest case of remission he had seen was just 38 days.
However, his talk was titled Low Carb – It’s not just about diabetes. In it, Unwin focused on the effects of insulin and glucose in the body, how it leads to fat and eventually non-alcoholic fatty liver disease (NAFLD).
LIVER’S ‘SILENT SCREAM’
Hepatologists speak of the liver’s “long silent scream” for at least 10 years before a diagnosis of NAFLD, Unwin said. That raises the question: “Why aren’t doctors talking about (NAFLD) and how low-carb can intervene?”
Unwin gave an impassioned plea to colleagues to join him and other doctors who are ” getting patients off insulin, giving them hope, choice and control”. He described it as “wonderful” that some patients “no longer need doctors to manage and put their diabetes into remission”.
British diabetes expert Dr David Cavan echoed those sentiments in his talk on Reversing Type 2 Diabetes in the Real World. Cavan was a diabetes consultant at the Bournemouth Diabetes Centre and from 2103-2016, Director of Policy and Programmes at the International Diabetes Federation in Brussels.
He has also spent time transforming public health in Bermuda.
Cavan said that a “diabetogenic environment” has turned Bermuda into a “diabetes factory”. The country “ticks all the boxes” for increased risk of type 2 diabetes, he said. These include a staple diet of starch – rice and peas – as well as a high intake of sugary soft drinks, easy availability of low-cost junk food, high cost of healthy foods, and sedentary living.
In 2017, Cavan set up a Diabetes Reversal Program in Bermuda in association with Bermuda Diabetes.
Of 30 participants on the program after the first 12 months, all but four lost weight and waist circumference. Six are now in pre-diabetic range and off all medication. Eight stopped all diabetes medications and 11 reduced some diabetes medication. Five reduced blood pressure medication.
Cavan said that the evidence is clear that type 2 diabetes results from modern lifestyles. Adopting a healthier lifestyle can help reverse the condition, “even in the most diabetogenic environments”. And environments must change “to halt the inexorable rise in type 2 diabetes”.
Cavan is author of Reverse Your Diabetes, The Step-by-Step Plan to Take Control of Type 2. His latest book is: Take Control of Type 1 Diabetes: A comprehensive guide to self-management and staying well.
- Part 2: PHC lays low-fat diets to rest!
- All speaker presentations will be available soon on Diabetes.co.uk and the PHC YouTube channel.
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