Beating the virus: We need to cut glucose and prescription drugs not calories and fat

By Jerome Burne

It’s official. Being over-weight is bad for your health. For decades we have been getting fatter and we now top the European weight league.

 We knew that dropping a bit of weight could cut the risk of heart disease and make you beach ready, but it meant going on boring diets and even if you lost a few unsightly pounds, you’d probably soon put it back again. 

Now Covid-19 has ruthlessly exposed the deadly relationship between an expanding waistline and a shrinking life expectancy and action is promised.

Our self-confessed portly Prime Minister’s brush with death has pushed weight loss up the public health agenda and plans are underway to get us all on bicycles with large sums being poured into cycle lanes along with vouchers for bike repairs.

But what are the chances the new campaign will work? After all, the weight loss industry is already worth billions and not noticeable successful.

A nutritional version of austerity

An outline of the campaign is already emerging. The long-standing idea that too many calories are at the root of the problem means that more stringent calorie counting is being called for. One proposal is to list the calorie count of dishes on restaurant menus, turning meals into a maths test.  

And if you are being advised to cut calories that inevitably involves going low fat on the grounds that it has twice the calories of carbs.  Exercise completes the prescription by using up lots of calories. ‘Move more and eat less’ is the catchy slogan for this remedy.  The food industry is to be roped in and encouraged to make healthy changes to their junk food products containing hard-to-resist sugar and fat combinations not found in nature.

There are familiar, logical reasons why these should work; what is depressing is the fact they have all been shown to fail, which has been blithely ignored by the nutritional establishment. For at least a decade, independent researchers have been pointing out the lack of evidence for long term benefits from calorie counting and the faulty assumptions it made about our physiology – covered below.

The new push to beat obesity also ignores the deeper lesson of the virus – that the health and resilience needed to deal with infection is not a matter of fixing a single vulnerability – carrying too much weight – what’s needed is a system that works in harmony. We are ecologies rather machines. A well-functioning gut, for instance, allows the immune system to mount an effective defence and control inflammation, which in turn affects emotional responses in the brain. 

Running won’t empty your fat stores

The clash between the common-sense story about calories and what is actually going on in the body shows up clearly with exercise. Cycling is a green way to travel and peddling to work a healthier option than public or private transport. But it is unlikely to have much of an effect on the national waistline.

Exercise experts have known this for years, but the idea it must have some effect still lingers. After all, half an hour’s hard peddling is going to burn off a significant number of calories and that’s the key to weight loss – right?

Well, no. This is a misunderstanding that comes from applying a household budget formula to slimming, with calories as the currency.  Eating more than you expend equals a surplus, eating less equals a withdrawal from the fat stores. Clinging to this model will ensure that the obesity reduction drive will fail.

This equation has been given a spurious precision by the fact that fat contains – gram for gram – twice as many calories as carbohydrates. So, you need to reduce fat and boost carbs  – and there is an equation that tells you how much you will lose.

PHE doesn’t have evidence to support calorie-cutting formula

It is described in a weight loss leaflet put out by the British Dietetic Association. ‘One pound of fat contains 3,500 calories, so to lose 1lb a week you need a deficit of 500 calories a day”. The idea is so pervasive that it seems inevitable that after the bike initiative there will be a fresh promotion of the budget formula to keep Covid-19 at bay. 

So, what is wrong with it? The answer was set out in amusing detail by Dr (nutritional) Zoe Harcombe ten years ago and is still being ignored. First, she contacted the official bodies involved in setting weight-loss guidelines and asked them for evidence supporting the formula. None were able to tell her. The DoH didn’t know, nor did Dietitians in Obesity Management, nor NICE. The Association for the Study of Obesity (ASO) did send data from a trial, claiming it proved the formula; in fact, it comprehensively disproved it.

It was a study of just 12 people who cut 600 calories off their daily diet for a year, the amount recommended by NICE. Applying the formula, this should have produced a weight loss of precisely 60 pounds for each one of them.

A weight loss formula that predicts nothing at all

 In fact, the average weight loss was 11pounds with wide individual variations, that ranged from 17.2 pounds to 0.0.8 pounds So not actually a formula that could predict anything at all. No subsequent trials that involved calorie counting diets did much better. Certainly, none lost the predicted amount. Yet the formula is still being used to say how much you will lose by cutting a specific number of calories.

In her blog Dr Harcombe suggested that the organisations that have been relying on the fake formula for years need to: ‘Issue a public statement saying that it does not hold (and) there is no formula for predicting weight loss.’ No such apology has ever been offered.

Besides being a fantasy, the calorie fake formula ignores the fact that such diets inevitably contain significantly more carbs than fat, which means, of course, a rise in blood sugar, which is a ‘gateway drug’ for diabetes and obesity. So, given we know that diabetics are also very vulnerable, about the worst possible diet for seeing off the virus. 

It also results in a widely unbalanced ratio between healthy omega 3 fats, the richest source being certain fish, and omega 6 fats that come mostly from industrially produced vegetable oils. It should be 1:2 or 3 and is currently closer to 1:20. 

Obesity battle and the clash of diets

At this point, the new national weight-loss program arrives at a nutritional, evidence-based car crash. The new initiative involves making information more available, getting GPs involved and paying weight-loss organisations such as Weight Watchers to deliver programs. 

But what information will be put out and what will the programs involve? 

The official NHS bodies and the organisations are still largely wedded to the low-fat high carb approach, as promoted in the current PHE Eatwell Guide.

 But this has been subject to a detailed critique by independent researchers such as the American journalist and author of the Big Fat Surprise, Nina Teicholz and clinicians who have set out the health and weight loss benefits of severely restricting carbohydrates and encouraging a high intake of healthy saturated fat. Diabetics following this approach can significantly reduce their drug use and some can reverse the disease. 

The Hybrid Diet, a book I co-authored with nutritionist Patrick Holford, fills in some background and contains more recent research. 

Discovering the exercise paradox

Ignoring the low-carb approach would mean relying on a weight loss model that has done nothing to stem the obesity tide for decades. What makes a switch difficult is that it flies in the face of what the medical profession has been taught and traditional dietitians are still teaching.  

The widespread belief in the household budget calorie theory has also coloured ideas about the benefits of exercise, especially in relation to weight loss, which the Johnson campaign has seized on. 

There is no doubt that exercise comes with a host of benefits, such as cutting the risk of various disorders, but researchers have also identified the ‘exercise paradox’. A heavy workout doesn’t seem to burn more calories than doing very little. The research was summarised in a New Scientist article last year. 

It tells how the men and women of a hunter-gatherer tribe in Tanzania use remarkably little energy while looking for food for much of the day; burning only slightly more calories than if they were commuting and spending the day at an office job. Other studies on people living in Western cities found their levels of activity didn’t predict their weight. 

Dietitians embrace food giants’ obesity theory

The current explanation is that our metabolic system can adjust the rate calories are burnt by different bodily functions. It seems to be able to cut back on the amount used by exercise, for example, to allow enough for mental and emotional activity. Where exercise can help weight-loss is to make it less likely the pounds you’ve dropped will creep back on again. 

Given the exercise paradox has been known for a while, it is depressing/shocking that the calorie budget theory is favoured both by the big food and fizzy drinks companies as well as traditional dietitians. A plausible reason why the companies promote it is that it distracts attention from the weight gain linked with sugar and other processed carbohydrates. 

This makes it unlikely the government will succeed in its plan to persuade the big food companies to cut back on their industrially processed cheap junk food, which forms a major part of the diet of many of those who are poor and obese, and concentrate on providing fresher and healthier food.

Strong evidence for this scepticism emerged five years ago, in 2015 when the  BMJ published an article which began: ‘An investigation has uncovered the extraordinary extent to which key public health experts are involved with the sugar industry and related companies responsible for many of the products blamed for the obesity crisis,’

How food companies reneged on their deal

It described what had been the outcome of the government’s ‘Responsibility Deal’ with the big food companies, which was designed to: ‘support and enable our customers to eat and drink fewer calories’. Sound familiar? 

It had been launched in 2011and signed up 39 of the major supermarkets and food manufacturers but by 2015 its failure was clear. Rather than reducing calorie consumption, it had gone up by 11.7% over the previous year. 

Although the companies had signed up to the goals of reducing calories and sugar, they had simply refused to make any of the changes that might actually achieve them, such as ‘reducing the promotion of food high in fat salt and sugar.’ 

The companies made no secret of their real intention in trade publications, which promoted the claim that obesity had nothing to do with sugar. ‘A high fat, high energy diet, combined with inactive sedentary life-styles are the two principle factors increasing the risk of obesity’ was one of the quotes from The World Sugar Research Organisation (WRSO). 

There is of course research supporting this view but as the BMJ pointed out: ‘Nearly all nutritional research is either done by the companies themselves or by dietitians funded by the industry. Reviews of studies to see if sugary drinks caused weight gain were found to be five times more likely to find no link if the sugar industry had paid for them’. There’s little evidence of any significant change.

How we failed the viral stress test

The new beat-obesity drive is based on discredited strategies and is far too unambitious to deal with the multiple failings of our public health system that the viral stress-test revealed.   

So, what should we be doing? The greater vulnerability of people who are overweight and /or diabetic indicates a faulty metabolic system, which means there is a problem in the balance between their blood glucose and insulin. This in turn: ‘plays a role in inflammation and respiratory disease’ according to a recent editorial in BMJ Evidence-Based Medicine.

The best diet to restore the balance is one that is low in carbohydrates and much higher in healthy fats which, the editorial continues, ‘is a safe and effective way to achieve good control of blood sugar and to lose weight.’ The diet, also known as ketogenic, comes with other benefits such as making intermittent fasting easier and provides several ways to regulate the metabolic system. 

The other group that showed up as particularly vulnerable to the virus were those in care homes. Current prescribing practice means they are on an increasing number of drugs and highly likely to be deficient in various minerals and vitamins, including those specifically needed by the immune system. Greater medical attention to nutrition and less on prescribing would benefit not just the elderly in care homes but all of us. 


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 “The Hybrid Diet” was written with nutritionist Patrick Holford, published 2018. Award: 2015: Finalist for 'Blogger of the Year' Medical Journalists' Association.


  • “There are familiar, logical reasons why these should work; what is depressing is the fact they have all been shown to fail, which has been blithely ignored by the nutritional establishment”.

    See “The Vision of the Anointed: Self-Congratulation as a Basis for Social Policy” by Thomas Sowell, passim.

    “Sowell presents a devastating critique of the mind-set behind the failed social policies of the past thirty years. Sowell sees what has happened during that time not as a series of isolated mistakes but as a logical consequence of a tainted vision whose defects have led to crises in education, crime, and family dynamics, and to other social pathologies. In this book, he describes how elites,the anointed,have replaced facts and rational thinking with rhetorical assertions, thereby altering the course of our social policy”.

  • The sugar industry peddle their wares, I pedalled 40 miles yesterday for my exercise – and a few other minor typos remain – but basically agree whole-heartedly with the content of the post. Exercise will reduce weight if you are prepared to put in the effort but fasting and low-carbing are more efficient.

    • Editorial

      Thanks for picking up on typos – spelling never been a strong point, I put it down to mild dyslexia which has been passed on to several children, who battled with spelling and grammar at school.They say there are compensating benefits in perception. The daughter works in interior design and can enter a room and instantly see how it could be reconfigured to make it work or look better. The son discovered on leaving university, that he was able to see “patterns in numbers that other people can’t”. He now makes a fortune in an on-line gambling firm.
      Unfortunately none of these upsides apply to me. Apologies for going off topic but do think it is neurologically interesting.

  • Great article, Jerome. Initially when this drive was announced I thought aha maybe we’ll see some sense now (especially as the Health Minister has widely broadcast his weight management success on a low carb/Med lifestyle change) – as a low carb doctor I’m ready for action. But my heart sank as I realised the same old dross was being wheeled out (literally it seems with this bicycle nonsense). I stopped listening and reading about this initiative and buried my head in my hands!!

    But undeterred I will continue to advise my NHS patients in the meantime re low carb because it gets results – and also advise them to ignore the Government.



  • Hi Jerome,

    Thanks for that. I’m going to disagree with you here. Pretty much everyone i’ve come across who has lost meaningful weight (over 10k) and kept it off has used a similar technique to the one I did. I’ve lost about 20-25% of my body mass (95kilo-73) ten years ago and far more important changed a lot of the body mass from white fat to lean mass and brown fat.

    The system for losing weight includes your points of not overburdening the body with toxins like pharmaceuticals, but I expect it is possible to lose weight and take pills at the same time (I wasn’t).

    The fastest/most effective way to lose weight is to 1) eat only organic plants no processed foods or sugars 2) minimise protein intake on an intermittent basis 3) minimise fats and never heat fats 4) eliminate starches and focus on fibrous plants to feed microbiome 5) Sweat (sauna or hot bath) 6) sweating exercise for at least 6 hours a week, typically 12 hours a week. Long runs, bike rides, ball sports, some stretchersizes.

    It may also be worth experimenting with intermittent fasting where we eat even less for 2 days a week or in a 6 hour daily window. I did not try that but have seen this work.

    Main take away? Eat little. Eat plants. Exercise a lot.

    The rest is just bull. It doesn’t matter if a calorie is a calorie. Counting them is pointless if we want to lose weight. I thought about it as a bar of butter. I could see how hard it is to burn through a half pound of butter. So I would bike 30 miles around Richmond park twice a week.

  • Hi Jerome – is this a mistake? “And it’s not just carbs that will need cutting”. First line of second paragraph – A nutritional version of austerity. You were talking about calorie counting then it changes to carbs here. Which we all know need cutting, but the point was the gvt was talking about calories! LOL. Great article and points! As usual xx

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