Last week the front page of The Times carried a story that was an opening shot in a revolution. I’m sure that the editors didn’t intend it as that and that the readers didn’t see it that way either. It was a story about shifting from the long recommended low fat diet to one that cut back on carbohydrates instead. Standard fare for the cuddly lifestyle pages, hardly material for social upheaval.

I’m not given to melodrama but I think I have just spotted that the cancer establishment is getting ready to perform a massive, unthinkable, screeching U-turn. Impossibly expensive new drugs are out and diet, exercise and supplement (yes you read it right) are in.

The complicated and confusing debate about statins – are they worth taking or not; are they safe or do they have nasty side effect? – has suddenly plunged into anarchic and uncharted territory by the claims of a new rival drug.

There can be few people who think that putting an increasing number of children on SSRI anti-depressants is really a good idea but then reflect that it’s just one of those things. Cash strapped NHS; time-poor GPs; waiting lists of months for therapy; drugs cheap; they may help some.

We all agree that Alzheimer’s is a dreadful disease and something has to be done about it because there’s no treatment and it’s costing billions. So prevention would be a good idea, wouldn’t it, especially since if it works it would both cut your risk and save vast amounts of money.

There is a feature of mine in the Daily Mail today which deals with recent research showing the rapid benefit a high fat low carb diet can have on a dangerous disorder known as NAFLD (non-alcoholic fatty liver disease). You’ve probably heard about fatty liver disease in connection with drinking too much. This version looks like being the result of eating too much carbohydrate.

Given this blog’s commitment to tackling chromic disease by helping people change their lifestyle, I was delighted to discover that the BBC 1 was devoting its prime time 9.00 slot to a three part series about passionate young GP, Dr Rangan Chatterjee, who goes to stay with patients and turns their unhealthy lifestyle around.

The sugar tax is obviously a very sensible idea but it’s much more than that. It’s prophetic, it’s a sign of a major change, it’s the swallow that could be heralding a medical summer. The tax is shorthand for a long running battle around what is a healthy diet, which turns out to be about a lot more than just diet.

Generally we don’t trust utopias. If they don’t remain fantasies but emerge into the real world, we expect them either to rapidly descent into rigid authoritarian hells or to disintegrate into factions and unproductive chaos.

It’s generally agreed that the NHS is not in good health but there’s no clear diagnosis. There are plenty of suggestions – lack of funding, uncompassionate nurses or box-ticking managers. But I want to suggest another one: the crisis in evidence based medicine (EBM).