How the low-fat high-carb dogma fell apart

By Jerome Burne

The Brexit effect – ideological conflicts, bitter disputes over facts, distrust of experts, trolling abuse on twitter– seems an apt description of what has been happening recently in the supposedly evidence-based world of nutrition. The striking difference is that it is the nutritional establishment that is resorting to insults and playing fast and loose with the actualité.

One dramatic and unbelievable example is still ongoing in Australia. The the main medical regulatory body – the AHPRA (Australian Health Practitioner’s Regulatory Authority) – has been holding secret hearings, from which there is no appeal, to investigate the work of an orthopaedic surgeon. And what has he been up to? Suggesting to diabetics that they could benefit from following a low carb diet to reduce the risk of having their feet cut off.

And what does he know about this matter? Dr Gary Fettke has been an orthopaedic surgeon for over 23 years and he looks after most of the diabetic food complications in northern Tasmania. Last month he told an Australian Senate enquiry: ‘My patients are lying around in hospital with obesity- related conditions, amputated limbs and non-healing rotting flesh. I believe that it is the nutritional advice they have been given that has put them there in the first place.’

Did he have any evidence for this radical claim? ‘I have studied the science and biochemistry of our dietary guidelines,’ he told the hearing ‘and found them wanting in substance and riddled with vested interest politics.’

Top journal concerned about evidence for low fat

Fettke may already be cheered to know that his view is strongly supported by the current issue of top medical journal The BMJ. It is both concerned about the vested interests in nutrition and supports a detailed critique about the failings of the healthy eating guidelines of the sort the AHPRA is relying on. A detailed analysis (see below) has found the evidence supposedly supporting low fat to be very weak and condemns the failure to properly asses the benefits of low carbs.

The pronouncements of the AHPRA are beyond satirizing and would be hilarious were it not for the damaging effects of the vicious campaign against him, his family and anyone seen to be a supporter. He has been ordered to no longer advise his diabetic patients on nutrition to prevent limb amputation. In particular he cannot tell patients not to eat sugar. And should his advice become mainstream in the future he must not talk about it even then.

Malicious harassment includes having a photo shopped picture of his family kitten being stabbed put up on his locker in the operating theatre, while a Facebook page dedicating to attacking the LCHF diet, with Australian doctors and nurses commenting on it openly, recently carried a post describing a nutritionist who advocated the diet as a ‘moronic money-hungry charlatan.’

The original complaint against Fettke, by an anonymous dietitian, was that he wasn’t qualified to give nutritional advice. The AHPRA told him that he wasn’t ‘suitably trained or educated as a medical practitioner to be providing advice or recommendations on this topic.’ Well which doctors are?

It is ‘inappropriate’ to reverse diabetes

Even more farcical is the most recent complaint, being seriously investigated, which involves ‘inappropriate’ reversal of someone’s type 2 diabetes. If it is upheld, will the patient be force-fed sugar to re-reverse it?

These highlights from the hounding of Dr Fettke are taken from an impressive blog Foodmed.net run by South African medical and health journalist Marika Sboros. She has been chronicling the injustices meted out to Dr Fettke as well as the events in another long running hearing of charges against the South African professor and top nutrition scientist Tim Noakes.

His crime was to respond to a mother on Twitter back in 2014, who had asked about foods suitable for weaning. He replied that good first foods for infant weaning are LCHF. In other words, he was suggesting meat, dairy and vegetables. My whistle-stop account of what happened next is heavily reliant on the work of UK nutritionist Dr (not medical) Zoe Harcombe,

who was awarded a Ph.D in public health nutrition earlier this year for a thesis arguing that there was no evidence to support the low fat guidelines when they were first set out and there is no evidence to support them today. 

Alpha scientist hounded for unconventional advice

At the time of the original tweet Professor Noakes was already a far greater threat to dietary orthodoxy than Fettke. He had been an insider, a heavyweight academic with over 550 peer reviewed publications to his name and a couple of life time achievement awards. When he announced his apostasy a few years ago, saying that he had concluded that the low carb approach was more physiologically plausible and clinically more effective than the conventional low fat high carbs, his colleagues had shown no interest in discovering why this alpha scientist had changed his mind. This was war. 

So when a dietitian complained about Noakes’ tweet in February 2014, the Health Professions Council of South Africa (HPCSA) wasted no time in going after him.  In September it charged him with ‘unprofessional conduct’ for ‘providing unconventional advice on breastfeeding’. It must have seemed, wrongly as it turned out, an ideal opportunity to discredit Noakes. He, on the other hand, seized it as an opportunity to set out exactly why his opponents should change their minds.

Unlike the assault on Fettke, this hearing was in public and he was able to call witness so he energetically prepared his case. One of the witnesses was Dr Harcombe. It took over two years for case to be heard. Noakes eventually took the stand in February 2016 at the third hearing session. He continued his evidence in October.

Dossier of 4000 pages defends low carbs

He took more than four day to give his evidence, submitting over 4000 pages and 900 slides on the science.  He began with diet and evolution, moving onto the shortcomings of the hypothesis linking heart disease to fat consumption energetically promoted by American scientist Ancel Keys in the 60’s and early seventies. 

Noakes showed how Keys had cherry picked the data for his famous Seven Countries study and ruthlessly rubbished the work of his contemporary, the British Professor Yudkin, who was putting sugar in the frame. He then introduced a new generation of researchers such as Gerald Reaven and Jeff Volek who are following in Yudkin’s footsteps. Their hypothesis is that insulin resistance (raised by sugar) is at the root of heart disease, along with other chronic diseases, and that cutting carbohydrates is the key to preventing it.

Zoe Harcombe spent two days in the witness box and wrote about it here. (Accessing it needs a modest subscription to her site which is well worth it.) She describes the complex legal and other shenanigans going on in the background, testimony from other witnesses and refers to the amount of personal abuse directed at Noakes himself.

Some of these manoeuvres involved a research paper by Dr Celeste Naudé, head of the Centre for Evidence-Based Health Care at Stellenbosch University, which was trailed as the definitive rebuttal of Noakes’ case.

Key prosecution paper full of holes

Harcombe thought otherwise. ‘It contained more errors than could easily be counted,’ she writes. ‘When these errors were corrected for, diets that were not low in carbohydrate but simply lower in carbohydrates than the standard LFHC diet did better.’ For a full version of Harcombe’s critique see here.

Noakes’ other star witness was top American science journalist Nina Teicholz author of the best-selling and painstakingly researched demolition of the low fat diet hypothesis – ‘The Big Fat Surprise: Why Butter Meat and Cheese Belong in a Healthy diet.’ As well as sales, the book has also garnered rave reviews from the likes of top nutrition journals, The BMJ’s former editor-in-chief, and The Economist.

In the witness box, according to another post from Sboros, Teicholz told how her research into the science supporting the original guidelines had revealed that: ‘top scientists knew there was evidence to the contrary but ignored or suppressed that data for decades.’ She also revealed another little known fact: ‘The US Dietary Guidelines Advisory Committee now warns that low-fat diets cause atherogenic dyslipidaemia. In other words they raise the risk of heart disease.’

Sboros provides more extracts from Teicholz’s testimony in another post all devastating to the low-fat hypothesis. For instance, she explained how one of Ancel Key’s original collaborators went back and reanalysed the data from the Seven Countries Study in 1999. ‘He found that the food that best correlated with heart disease was not saturated fat but sweets.’

Billions fail to prove high fat dangers

She described how the National Institutes of Health in America had spent billions on highly controlled studies, trying (and failing) to prove Key’s hypothesis. ‘In recent years there have been more than a dozen meta-analyses and systematic reviews looking at this data. Nearly all have concluded that saturated fat and dietary cholesterol do not cause death from heart disease.’

Sboros’ gives many more striking examples of why it shouldn’t be Noakes in the dock, (do read her posts) but I have to get on to the latest bombshell that Teicholz’s careful research has detonated under the official litany that the low fat diet is evidence-based and scientific unlike this new faddy low carb imposter.

It was put in place in September last year ago in the form of a detailed critique of the latest Dietary Guidelines for Americans (the DGAs), published in the BMJ ‘After doing the book I couldn’t understand how they yet again supported the caps on saturated fats and failed to mention the benefits of low-carb diets for those battling obesity,’ she told me. ‘Looking at the report in detail I found this was done by ignoring dozens of rigorous studies on low-carb diets.’

These ignored studies, as she set out in the article, included: ‘Several long term trials of 2-years duration demonstrating that these diets are safe and highly effective for combatting obesity, diabetes and heart disease.’

Top guidelines committee used weak methods

The failure to properly assess the low carb diet, she concluded, was because the body responsible for gathering the evidence for the DGA – the US Dietary Guidelines Advisory Committee (DGAC) – had used ‘weak methods’ and didn’t reflect the ‘best and most current science’.

Her paper also found that that the government’s recommended diets are generally based on a ‘minuscule quantity of rigorous evidence that only marginally support claims that these diets can promote better health than alternatives.’ Among the reasons put forward for this mess, she hypothesises, were ‘financial conflicts of interest, outside agendas and a desire to confirm existing advice.’

The paper generated a furious response. A Washington, DC-based advocacy group, the Centre for Science in the Public Interest (CPSI), issued a call for a retraction signed by more than 170 researchers and academics – including all the members of the DGAC – claiming that it contained eleven errors and should be withdrawn. 

A remarkable vindication

According to its standard procedure, The BMJ commissioned an outside review to assess whether this was necessary. Just over a week ago on December 2 the BMJ announced that having corrected a couple of minor points Teicholtz’s article would stand.

The review concluded that Teicholz’s criticisms of the methods used by DGAC were ‘within the realm of scientific debate.’ Not only that but they merited ‘further investigation of the composition of the committee.’ The review also agreed that the way the DGA came to its conclusions were out of date and lacked sufficient detail.

It was a remarkable vindication of her work. A lone journalist had taken on the most influential nutritional body in the world along with 170+ nutritional experts and exposed their shortcomings. The impact of this should be huge. It is hard to see how the two ongoing trials can survive this major challenge to the prosecution in both cases. Teicholz formal response to the review’s finding is here.

The Brexit-effect distrust of experts is obviously not a sensible policy in general but as far as those in the diet and nutrition establishment are concerned it seems justified. We obviously don’t have a scientific evidence-based system for deciding complex nutritional issues. Instead it falls to courageous and independent clinicians and journalists to put their careers on the line in a push for a long overdue change. 

Jerome Burne

Jerome Burne

Jerome Burne is the editor of HealthInsightUK. He is an award-winning journalist who has been specialising in medicine and health for the last 10 years and now works mainly for the Daily Mail. His most recent book “10 Secrets of Healthy Ageing” was written with nutritionist Patrick Holford. He blogs at “Body of Evidence” – jeromeburne.com. 2015: Finalist for 'Blogger of the Year' award from Medical Journalists' Association.

27 Comments

  • Love it Jerome!! I am so hopeful that the “end” of the debacle of the last 40-50rs of shoddy health advice from our governments is insight (pun deliberate). Interesting times we live in.

    • I couldn’t agree more! Our government’s food agencies persist in peddling advice which is both wrong and worse still has probably been responsible for the epidemic levels of obesity and diabetes (and all the additional health problems that they inevitably lead to) which plague this country today.
      This has also not been without its victims in the scientific world: in this country Professor John Yudkin was ignored and sidelined when he tried to warn of the dangers of sugar (big sugar, even then) and its possible link to obesity and heart disease. Many of his ideas have now been vindicated, however the supposed dieticians and nutritionists persist in peddling their nonsense (snake oil and smoking mirrors) and unfortunately doctors (whose training in nutrition is extremely limited) follow the party line.

  • Great article Jerome. Well done.

  • Despite not changing their recommendations, the NICE Clinical Guideline CG181 says at page 110 “No evidence of benefit was found for the following dietary interventions: low fat, increased fibre, increased oily fish and increased fruit and vegetables.”

    https://www.nice.org.uk/guidance/cg181/evidence/lipid-modification-update-full-guideline-243786637

    I don’t see many references to this report in blogs etc.

  • If Fettke had invented a new method for cutting off diabetics’ feet in half the time they would fete him as a hero.

    Dieticians are the Taliban (or in earlier centuries the Crusaders) with their Holy Writ of HCLF and a complete inability to observe its abject failure for decades now. Scientifically they are an irrelevance but in the Real World they have far too much power and are backed by Big Money.

    They have been fighting sensible doctors and dieticians (there are a few and the number is growing) for over a decade now, trying to prevent the “inappropriate” reversal of diabetes on forums and other blogs.

  • Excellent analysis of extraordinary events, Jerome. More detail you get the more incredible it all seems and the parallel w Brexit is a good one. Thanks

  • Journalists have done a huge amount to sort out the current nutritional and health disaster, whilst dietitians have fought hard to make it worse.

    I’m grateful to Gary Taubes, Nina Teicholz and many others, including Marika Sboros, who has reported brilliantly on the Tim Noakes hearing, and our own Jerome Burne.

    Not being a ‘qualified’ dietitian is an advantage. Here’s the current dross offered by the UK dietitans website for diabetics. It’s shameful. There’s more good science in voodoo.

    https://www.bda.uk.com/foodfacts/diabetestype2.pdf

  • It’s funny. That “expert” analogy has also been foremost in my mind. I applaud your eloquent summary, & its contextualisation to current times. I have a colleague whose borderline pre diabetic state is heading for full blown type II. He won’t change to LCHF because his GP tut tuts the concept.

  • Jerome

    You say the BMJ external review of the article was “a remarkable vindication of her work.” Really?

    Have you read the findings of the external reviewers [1]

    “In the specifics of these arguments, however, the Teicholz article has major deficiencies. In particular, Teicholz’ argument that the panel did not follow its own processes seems contrived and superficial. Transcripts from its public meetings indicate clearly that they defined, in advance, the types of evidence,
    including external systematic reviews, that would be used.(6,7) In general, the use of external systematic reviews is consonant with current standards for conducting systematic reviews and guidelines, which emphasize the need to avoid duplication of effort when possible.(8-10)”

    “However, compared with other BMJ investigations and most investigative journalism, this article is poorly researched and poorly documented.”

    “Many of the author’s arguments in the BMJ article and in her rebuttal to the CSPI letter reflect a lack of knowledge of current practice in guideline development and systematic review methods, and it does not appear that she consulted any experts or published works on these topics.”

    “Despite these very concerning issues, I do not recommend that the article should be retracted on the grounds that it is “riddled with errors.” While there are errors, the main problem is that the article contains interpretations, opinions, and poorly informed judgments about what is and isn’t “standard” or “established methods” when it comes to systematic review and guideline development.”

    “The decision to publish the article as a BMJ Investigation is regrettable. The article is better described as an opinion piece, editorial, or even an example of lobbying literature than an independent investigation. Within the article, the phrases “an investigation by the BMJ” and “The BMJ has also found that the committee’s report used weak scientific standards…” obscure the fact that all of the assessments of the DGAC process and findings are the author’s, and that the investigation consisted entirely of a “critical review” of the report by the author.

    If this is how “vindication” looks its a good job they weren’t critical!

    Regards
    Slipp

    [1] http://www.bmj.com/sites/default/files/response_attachments/2016/12/Teicholz_Helfand_report_011216_4ja.pdf

    • Editorial

      Thanks for taking the time to post such a detailed selection of comments from one of the reviewers. Nina Teicholz has already responded to it which I paste below in its entirety. I havn’t linked her comments specifically to the points that you have quoted but I’m sure you can find reponses to your points if you need to.

      I find her response as compelling as her original critque and regard it as further vindication of her remarkable tenacity and clear thinking.

      “In his review of my article Dr. Mark Hefland finds that my assertions are within the realm of legitimate scientific discussion and concludes that the piece does not merit retraction. He writes:

      “It is entirely legitimate to raise and debate the overarching, central claim that the DGAC did not review the science impartially and consequently drew the wrong conclusions from it. In raising the question of bias, it is also reasonable to contrast the panel’s endorsement of a vegetarian diet despite weak evidence with its strong stand against saturated fats despite conflicting evidence. Previous versions of the Dietary Guidelines have been criticized for relying too heavily on observational studies and on expert consensus.(4) The DGAC’s conclusions are largely unchanged from the previous Dietary Guidelines, raising the question of whether their modified process has the same problems.(5)of me and the article. ”

      Hefland also writes that he “found nothing to contradict Teicholz’ central concern that the DGAC’ processes to protect against bias are inadequate.”
      Yet Hefland makes a number of new, entirely unsubstantiated criticisms of the piece. These are entirely extraneous–outside the scope of what he was asked to do by The BMJ. Moreover, they are all entirely negative, suggesting a bias on his part against me or this article.

      It’s notable that Hefand is the director of a center that is both funded by, and solely in service to, the US Department of HHS, which was the lead government agency for the 2015 DGAs, the very document critiqued in this article. I believe this represents a rather large potential conflict of interest and could very well be why Hefland takes such a critical tack.

      Two important points:
      • None of Hefland’s new accusations are substantiated by any factual information
      • On most of the points that Hefland argued for corrections to the piece, he failed to make a persuasive case. The BMJ did not agree with him. In other words, his arguments against the article were found to be in error.

      In sum, Hefland is making unsubstantiated and erroneous arguments against this article, which point to significant bias on his part. Whether this is due to the fact that he is a contractor to HHS is unknown.

      Below I respond to each of these sequentially, using his alpha-numeric system for reference. Overall, the only finding by Hefland that has been upheld by The BMJ is that for two reviews, I did, indeed, overlook pre-defined methods for the literature searches. Yet even this finding does not change my article’s assertion that the reviews in question was still unsystematic in a number of ways.

      E. Hefland claims that my article has “major deficiencies” and that my arguments are “contrived and superficial,” which he substantiates by saying that
      (1) I failed to acknowledge that the DGAC stated, in advance, the types of evidence it would use,
      (2) That I should not have critiqued the DGAC’s use of outside review papers.

      My reply:
      Hefland misunderstands the claims of my article on both these points.
      (1) I do, in fact, acknowledge, in my Rapid Response, that the DGAC provided a general methodology section in which it describes the general types of evidence used. However, the mere fact of stating methods in advance does not imply that these methods were systematic. A systematic review is defined by many more factors than simply whether general categories of evidence have been pre-defined. The finding in my article, as confirmed by both outside reviewers is that much of the expert report did not, in fact, employ a rigorously systematic approach.
      (2) My article does not make any claim that the DGAC should not have used outside review papers; the article objects only to the use of outside review papers by the American College of Cardiology and the American Heart Association, since these are private associations supported by industry and might have introduced a potential conflict of interest.

      Thus, I believe that Hefland’s negative judgments about my article are not justified by the facts he presents.

      F. Hefland documents that I self-published a thorough critique of the 2015 DGAC report and that this was funded by the Laura and John Arnold Foundation.

      My reply:
      My BMJ piece was indeed based on a portion of the findings in my self-published report, which I largely completed in the spring of 2015. I felt compelled to do this research because, like many people who follow nutrition science, I could not understand how the expert report could reach the conclusions that it did; On many topics, the report seemed to ignore either the best or most recent science, and I sought to understand why.
      The last decade-plus of my life has been devoted to trying to ascertain the truth about nutrition science and policy. Foundations often fund work by journalists on topics of public interest, so there is nothing untoward in this arrangement.

      H. Hefland states my work is “poorly researched” and “poorly documented” because I did not cite interviews with people whom he thought should have been consulted.

      My reply:
      Hefland might not understand the work of journalism, wherein much research is conducted without necessarily citing every interview or source. In fact, I did interview members of the federal government, other experts, and former members of the DGAC for this article; Hefland has no factual basis for asserting otherwise (and he never contacted me to ask). Most of the subjects I interviewed did not want to be quoted. I also contacted the chair of the DGAC, Barbara Millen, and gave her the opportunity to respond to every claim in my article. Her responses are quoted in the piece.

      I did not watch all the video proceedings of the DGAC, because any relevant material should have been included in the 471-page expert report, which I read in its entirety. Moreover, The BMJ published 3 tables that I compiled, comprising hundreds of facts–altogether an enormous amount of supporting evidence; perhaps Hefland missed these.

      J.through U.
      Hefland asserts that there are 4 errors in the piece. In 3 cases, The BMJ agreed with my arguments and downgraded Hefland’s proposed corrections to “clarifications.” On the 4th issue, regarding the questions of systematic methodology, The BMJ agreed that corrections were needed due to the fact that for two reviews, I overlooked pre-defined methods for the literature searches.

      V. Hefland returns to the same points he made in E. and H. without any greater documentation for his assertions.

      W. Hefland objects to the classification of the article as an “investigation.” How the article was classified was entirely up to The BMJ.

      X. Hefland objects to my critiquing the science behind the Guidelines in other settings.

      My reply:
      I see no inconsistency in making the same science-based arguments, solely in the interest of the public health, to different audiences. My research on the 2015 DGA expert report was conducted in spring of 2015 (see background here), with no idea that it would become a BMJ article nor that I might eventually have the opportunity to present this and other research to policy makers in D.C.; to call it a “lobbying document” is thus demonstrably false and possibly defamatory.
      The arguments that I have made are consistent with aims of any good journalist: to document ways in which a policy is not sustained by the evidence. This is important work, especially when there is evidence that this policy is significant causing harm to the public.

      Y. Hefland repeats the same claims made in E. without any greater documentation for his assertions.

      Z. Despite all of the above, Hefland affirms one of the article’s chief claims: “I found nothing to contradict Teicholz’ central concern that the DGAC’ processes to protect against bias are inadequate.””

      • I would further say that one of the corrections that the BMJ did publish in this case, with reference to the reading of Hooper 2012, was, in my view, unnecessary as Nina Teicholz’s summary of this meta-analysis was not in error and was in fact accurate, and more could have been made of it, as per my rapid esponse
        http://www.bmj.com/content/351/bmj.h5686/rr

        To classify the article as an investigation is completely proper. It is not an opinion piece as an opinion piece mostly deals in concepts, and is free to chose the subjects it responds to, whereas the Teicholz paper tabulated and assessed an extensive number of points and sought to be complete.

  • Thanks, Jerome, for posting. This reply is also on my website–and the formatting there is perhaps easier to read. I had replied to Dr. Hefland’s critique in full when the BMJ published its press release and related content, on Dec 2:

    http://thebigfatsurprise.com/response-dr-hefland/?vhp_flush_all=1&_wpnonce=5fc405ec32

  • What interests me about this whole sorry issue is the charge of inappropriate reversal of type 2 diabetes. Is the conventional wisdom not that diabetes is a progressive disease and cannot be reversed. Gary Fettke’s success in reversing this disease has proved that this is not the case and this is behind the complaints against him. It seems that these people would rather condemn patients to a lifetime of suffering from the nasty disease which is type 2 diabetes than have their useless advice being shown up for the dangerous nonsense that it is. In this case the wrong people are being investigated.

    • Editorial

      Indeed. It seems to me there are grounds for a class action or similar against bodies setting guidelines such as NICE in the UK and the ones involved in prosecutions in S Africa and Australia on the grounds of a dereliction of duty.

      There is obviously a strong argument to the effect that they should have been aware of the evidence in favour of the low carb appraoch and of the flaws in the low fat dogma. If they weren’t that is serious professional failing and if they were then you are straying into criminal territory – knowingly exposing large numbers of diabetics to serious harm.

      This raises the question: at what point did the evidence in favour of the low carb appraoch reach a level where the risk/benefit balance shifted? It seems to me that while this balance is a key one in licencing treatments – notably drugs – there is nothing comparable for assessing a change once the treatment is out in the market.

      It should be the job of bodies setting guidelines but as Teicholz’s critique demonstrates they have failed to even properly consider it let alone come to any informed conclusion.

      • I do agree about class actions but making a convincing case, where one set of ‘experts’ challenges another set of ‘experts’ takes makes an inordinate amount of effort; while there is no guarantee the outcome will favour the truth or righteous.

        My view is that ordinary folks can be encouraged to think, to read, to revise their understanding, and to contribute to a groundswell of revised opinion upon such matters. I think that the rising tide of revised grass roots opinion could amount to a groundswell of public opinion that is enough to embarrass the die-hard and dogmatic ‘experts’ to a point where they are beyond redemption unless they see the light.

        Articles such as yours are not just good, Jerome, they are excellent, but the comments and debate that can follow add to the articles worth and frequently amount to more than the sum of its parts.

        Just gotta keep banging on.

  • “The Brexit-effect distrust of experts is obviously not a sensible policy in general”

    No, but perhaps we should distrust many more experts that have a personal stake in the side of an argument they choose to support. The myth that experts are above bending the truth for base reasons is well and truly punctured.

    However, that aside, I really hope that the LCHF diet will be ever more generally accepted as a result of campaigners such as yourself.

  • Diabetes
    Type 2 Diabetes accounts for up to 95 per cent of cases in developed countries.Its growth is linked with ageing populations,change in diet reduced physical activity and obesity.It usually occurs in adults but cases in younger and younger age groups are increasing.In Britain there are over one million diabetes and possibly a further million cases as yet undiagnosed.The complications of type 2 diabetes includes blidness,kidney falure and stroke.I know two young men one was 20 and the other 29 both died from complication after developed diabetes from a young age.
    Nutrition
    Experts agree the key to healthy eating is the time-tested advice of balance variety and moderation.We need more than 40 nutrients for good health,and no single food supplies them all.We all individuals where do we get our eating habits?My mother developed diabetes in her 60 and the past 10 years four of my brother developed the diseases also Why? because they don’t eat regularly meals.Now they’re on medication for the rest of their life.Why so many young people develop Diabetes if is preventable?
    Educate yourself stop squandered on junk .
    Do you know the recommended meat is three ounces,similar size to a deck of playing cards?
    Most people eat for pleasure as well as nutrition.
    When the diet includes more protein than the body needs for maintenance and repair tissues the excess is stored in the energy pool.If There is insufficient of fats and carbon-hydrogen stored for this purpose.The unique aspect of proteins is that,in addition to being composed of carbo,hydrogen and oxygen (The chemical composition of carbohydrates and fats,)they also contain nitrogen and amino acid compounds.Certain groups of these amino acids must be available in the food that eaten,since they cannot be manufactured by the body from other material .
    Experts they can write books to inform us about proper diet and vitamins A,C,D,E.K and all the vitamin B complex .Some parts of the wold suffer from acute food shortage from limited varieties of food.The united States .offers its people an incredible range of nutritional possibilities.Solving the problems of inadequate nutrition is not a question of research it is chiefly a problem of more equitable distribution of those that are available .Some people eat too much of the right kind food but far too little of the right kinds of food .All you need is discipline and you don’t have to have experts Lecture you. Doctor Hay’s success in treating diabetes was an unrecognised and a humble genius who had found the key,not only to diabetes .but to all the degenerative disease . Educate yourself stop squandered on junk.

  • The fat lady hasn’t sung yet.

    Recently retweeted by a UK dietician

    https://twitter.com/Jeukendrup/status/809112540315873280?lang=en

    Just how do you cram in that many carbs and still get any nutrition?

    And how are the likes of Chris Froome still alive let alone winning races?

    For that matter, how did the Queen ever live to be 90?

  • “The Brexit-effect distrust of experts is obviously not a sensible policy in general”: the question falls into two parts.

    (i) Areas where there are no true experts e.g. macroeconomics. By their forecasts shall ye know them – no macroeconomist I’ve ever heard of can forecast worth a hoot. So when experts said that on the morning after a successful Brexit vote half the factories in Britain would close, the price of food would double, and our hair would all fall out (as it were) you’d have been mad to take them seriously. Rejection of obviously bogus claims to expertise are, in general, prudent. A suitable response to claims of expertise in such ares is the loud blowing of raspberries.

    (ii) Areas where expertise is a reality but the conventional wisdom happens to be wrong-headed, the obvious two being low fat diets and Global Warming. Some of the problem is past or present incompetence, part past or present lying, much of it is people trying to advance their careers or line their pockets by hewing to the status quo while eschewing critical thought. A suitable response is mass public hangings. I joke, but I rather fear we do need to exercise criminal sanctions against such people. I don’t know whether Keys has succeeded in shortening more lives than Mao, but it must be a good idea to attempt the calculation.

    • It is rubbish to equate low-fat diets and global warming. The experts were wrong about fat, but any fule can see that for himself. The experts MAY be wrong about global warming, but the man in the street is in no position to experiment. Plainly glaciers and icecaps are melting, global CO2 and methane levels are rising, and forests are being burned (in part because we should only eat LEAN meat and replace the fat with palm oil). These facts are not in dispute and they are sorry facts. Whether these things are linked or not, and they probably are, they are nothing to be proud of.
      There is no sensible reason to try to increase any of these factors, and no reason not to try to decrease them.
      In fact, global warming, climate change, whatever you want to call it, seems a case where Pascal’s wager largely applies.
      Which is not to say that emissions trading or plant-based diets or solar energy rather than nuclear power or any other proposed fix is at all a sensible way to go about redressing things. The only solution that addresses the root cause is contraception, but no-one in power talks about that in this context as it would step on too many voting toes.

      • “but the man in the street is in no position to experiment”: actually, nobody is in a position to experiment – Climate Science isn’t an experimental science, insofar as it is a science at all.

        The key arguments are that the present mild spell is unprecedented, and that the rate of warming since the end of the Little Ice Age is unprecedented. Insofar as the methods used to infer temperatures past are valid, these claims are obvious, demonstrable untruths. If, on the contrary, the methods used to infer temperatures past are invalid, the claims are vacuous.

        The man in the street is being taken for a mug.

      • True we can’t experiment with global warming, but there is expert disagreement (even though the BBC shuts it out), and I hope that as part of President Trump’s new look at this issue, we see some informed public debate where both sides get to put their case.

        I think that we all agree that such a debate would be pretty decisive in the LCHF/HCLF issue, because we know how weak the evidence against SF’s really is. My strong impression is that a two-sided public debate (by experts) about ‘Climate Science’ would be equally decisive in dismissing the threat of CO2. As a taster, here is a physics Nobel Prizewinner discussing the issue:

        http://www.mediatheque.lindau-nobel.org/videos/34729/ivar-giaever-global-warming-revisited/laureate-giaever

  • “In general, the use of external systematic reviews is consonant with current standards for conducting systematic reviews and guidelines.”
    My flannelometer registered this.
    At a meeting in Dublin fairly recently to discuss how the Irish Heart Foundation should proceed against saturated fats, I and some friends listened with incredulity to the bone-marrow deep prejudice against fat etc., by “top” scientific experts. When all this blather was over, I stood up and said that I had eaten per their recommendations for 30 years and had been fat and had suffered from depression etc., and had tried everything, to no avail, until I’d learnt about LCHF and reversing their recommendations, I’d lost and kept all my excess weight off for 3y without hunger and that I felt great. “N=1″, was the brilliant retort from the learned professor in front of the meeting. “There are seven more exactly like me at this meeting”, spake I. No reaction.
    Later on in this dreary affair when they had made their stand clear, I addressed two points.
    Firstly I said that if saturated fat was bad, they HAD to explain the paradoxes of France, and within France, of Gascony, of Switzerland and of Spain. It would be one thing to explain why their diet wasn’t worse than that of other countries, but another thing altogether that it was much better, despite no cholesterol differences at all. Finally I made the point, since Madame Professor had previously in her diatribe rubbished coconut oil, that the Kitavans ate a mostly carb diet, but very low glycaemic index, and ate 18% of their cals as saturated fat, from the coconut actually. Had I slapped Madame Professor across the face with a wet fish, I’d not have achieved a finer facial reaction. However, there appears to be no connection between said visage and her putative brain.
    The point I’m making in the above is that the more evidence you produce against an incorrect hypothesis, the more resistance you get.
    Keep pushing Jerome. You’re doing a great and rather incisive job.

  • Experts only get to be experts by peddling the same ideas as the experts before them. Their reputations depend on defence of the status quo, and anything daring to threaten the foundations of their shaky beliefs needs to be robustly defended, lest the facade should crumble.
    That’s why it’s going to take a paradigm shift before things change.
    Can anyone else feel the earthquake starting?? ☺

  • Dr Unwin, a Southport (UK) GP, has saved his practice £45,000 per year in drug costs, by putting 18 of his diabetic patients on a low carb diet. Not only did many of them come off diabetic meds due to much lower sugar levels but their blood pressure returned to normal levels, as did their cholesterol (no more blood pressure or cholesterol medication). That speaks for itself. If every GP in the U.K. did the same, we could begin to save the NHS!

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