Ignore the low-carb cult: eating lots of fat won’t really make you slim

    23 May 2016

    Science and newspapers don’t really mix. The media work on 24-hour news cycles and want dramatic developments. Science works slowly and gradually, usually on subjects that are too complex to be easily grasped by lay men. The media are looking for hidden threats and magic bullets in everyday living. In science, such breakthroughs come about very rarely.

    Put simply, the demand for revolutionary scientific discoveries that can be understood by lay people is much greater than the supply. This creates a vacuum to be filled by smooth-talking gurus peddling easy answers. The field of nutrition is particularly prone to this since everybody eats food and lots of people struggle to maintain a healthy weight. One only needs to look at the front page of the Daily Express most days to find a disease that can be prevented, caused or cured by the consumption of a single ingredient.

    Action on Sugar, a small pressure group set up in 2013, have received a vast amount of media coverage by appealing to the public’s appetite for easy answers. Not only do they focus on a single nutrient, but they have a cartoon villain (‘Big Food’) and an easy answer that absolves consumers from having to take personal responsibility (food reformulation).

    In their early days, their chief spokesman was Dr Aseem Malhotra, a Croydon-based cardiologist with a knack for sloganeering. To borrow a phrase from Peter Cook, Malhotra rose without trace. One minute he was writing factually inaccurate articles for the Observer about ‘junk food’, the next minute he was describing himself as a ‘world leading expert in the prevention, diagnosis and treatment of heart disease’ who ‘reigns supreme in his fight to raise awareness about the health benefits of a sugar-free diet’.

    Malhotra parted company with Action on Sugar some time ago, but he has remained a fixture on breakfast television ever since. Last year, he was in the news after making the extraordinary claim that there is no link between physical inactivity and obesity. Having fallen under the spell of Dr Robert Lustig, an American endocrinologist who blames obesity on high fructose corn syrup (a type of sugar that is barely consumed in the EU due to quotas), he drifted into the low-carb, high-fat (LCHF) movement via Gary Taubes and Nina Teicholz.

    This is where this things start to get weird. There is no doubt that some people lose weight on the low-carb diet, but the empirical evidence in support of LCHF as opposed to a low-fat or other low-calorie diet is far from compelling. Moreover, there is a cult-like element to the LCHF movement — which is basically a rebadged version of the Atkins diet — that makes it disposed to conspiracy theories.

    The low-carbers are obsessed with government dietary guidelines which they think have been hijacked by low-fat zealots for reasons that are unclear but which probably involve Big Food and the ‘diabetes industry’. They blame dietary guidelines for the rise in obesity since 1980 despite the fact that hardly anybody is aware of them and almost nobody follows them. If only we could go back to eating steak, butter and lard, they say, there would be no obesity.

    That brings us to Malhotra’s latest pressure group, the Public Health Collaboration, which has today released a report telling people that a calorie is not a calorie and that we should eat fat if we want to lose weight. The report has been released in partnership with the National Obesity Forum, on whose board Malhotra sits as a ‘senior advisor’, and it was Malhotra who spearheaded the publicity drive with words that you don’t expect to hear from someone who looks after people’s heart for a living: ‘Eat fat to get slim, don’t fear fat, fat is your friend.’

    As health advice goes, I personally find the idea of living on bacon and cheese pretty appealing. I also find the idea that ‘public health’ people have made mistakes with their nutritional advice in the past both plausible and attractive. The trouble is that science simply does not support the sweeping statements in this report and even Malhotra’s erstwhile colleagues at Action on Sugar have reacted with fury.

    As the Centre for Evidence-Based Medicine (CEBM) points out, several of the claims made in the report contradict information on the National Obesity Forum’s own website. I recommend reading the CEBM response and the response from the Science Media Centre to get an idea of how far Malhotra has now wandered from mainstream science.

    He and his band of low-carb evangelists will doubtless regard the backlash as further evidence that the scientific establishment is running scared of a brave medic who dares to speak truth to power. The reality is that this is one headline-grabbing gimmick too far. Malhotra’s career in daytime television is secure, but he has finally become an embarrassment to the health lobby.