Article: The Corruption of Evidence Based Medicine — Killing for Profit

I think trying to avoid blame where blame is due is a mistake it breeds a kind of passive “it’s not my fault” culture that is counterproductive. I don’t think comparing the obesity crisis (driven by overconsumption of calories) to a medical illness is a fair comparison. Neither is comparing food being addictive like a drug is the same. The health crisis in type 2 diabetes is definitely linked to obesity like lung cancer is linked to smoking. Unlike smoking though we all have to eat it’s part of what we need to do to stay alive. That means the advice is always going to center around self control. That means if you are fat you need to change your lifestyle and curb what you eat (exercise is less impactful to lose weight than just reducing the calories in).

consumer pressure (people buying more of a thing/it being popular) is what drives retailers and manufacturers and foodservice outlets to create eating opportunities. If we (the consumer) didn’t purchase these things they wouldn’t exist. The alternative is quite a bit of state control I would think most of us would shun. The sugar tax is a crisis measure to curb consumer spend. If consumers don’t react to that, where do we go from there? Perhaps we should all have a timed vending machine in our homes controlled by the government to only release metered out portion controlled food that meet some calorie balanced meal target guideline? I exaggerate to,illustrate the point, but honestly what do people think is going on?

It is as simple as the consumer having available food to eat 24/7 and not having to expend many calories to hunt or gather it meaning they overeat. I think it’s highly unlikely that E numbers or an imbalance of hunger and satiation hormones are driving the obesity crisis. It’s far more likely to be overeating calories despite what some people say. Yes there is something about eating an imbalanced diet with too many carbs in them...but the easiest way to reduce carbs is to reduce the total amount you eat. Then if you still have problems and are losing weight you can tweak the carb and sugar balance down in favour of other things (vegetables, protein, unsaturated fat etc)

I think this is a case of not blaming the obese person, but accepting that if you are obese you had something to do with it.

Yes it’s difficult to lose weight but the weight gain in the first place is part of the consumer (us) right to choose what they eat and when. Manufacturers and retailers don’t fix the market they follow it.

The recent hype about gluten free on the internet has resulted in over 50% of all purchases being due to people choosing to do it as a lifestyle change vs having anything to do with a health condition for example. The retailers are more than happy to stock a range of higher margin products to service this need (which is equally misinformed). If we all ate less the retailer would just shift to selling the new thing that we wanted and the manufacturers would change to suit it.

From a soft drinks perspective the sugar tax is great for the manufacturer since they get to sell more water and less ingredients as they switch to reduced sugar and sugar free variants.

Whether the price hike on soft drinks will do much for obesity is up for debate...we will have to see.

 

Okay - what if eating LC/HF (low carb high fat) actually did increase satiety to the extent that the person's OWN mechanism for maintaining a healthy weight returned? What if, instead of calorie counting that person naturally ate less (ie fewer calories) on this way of eating, and so started to loose weight without hunger cravings?

Would that not be an interesting break through that might change the whole dynamics of the obesity epidemic?

What if it was the "low fat" movement that messed with the natural homeostasis of weight control in many people?

What if the advice to eat most of your calories from carbs (the healthy eating pyramid) actually sold the population misleading advice? Add to that, the "low fat" food suppliers making "Low Fat" foods high in sugar (so they don't taste like cardboard), and suddenly the obesity health crisis might be more readily explained?

I don't know all the in's and out's of things, but it is obvious to me that the current advice to eat a "low fat" calorie restricted diet with exercise, does not work particularly well to address the current population obesity epidemic.

There are of course always those who don't care and make some very bad dietary & lifestyle choices - and of course they need to take responsibility and cut back on sugary processed foods - BUT there are others who really STRUGGLE to control their appetites because they are effectively sugar addicted.

So @Jonathan Edwards and @arewenearlythereyet whilst I can see your points, I think that calorie counting advice is not quite as perfect as it first seems. There are other ways of achieving fewer calories than simple food denial. If we can create a situation where the person's own satiety stops them overeating, then that must be a) more likely to succeed and b) much more pleasant for the individual concerned.

We do agree on the low sugar/carb angle obviously, but regarding the place of fat in the diet we may have to agree to differ.

Now what were we talking about?

Oh yes the Corruption of Evidence Based Medicine.
I apologise for derailing the thread. xx

 

Whilst I agree changing people’s lifestyle needs ia multifaceted approach I think most of what you quote are non scaled tidbits of information...we need to critically examine science and it’s relevance to the scale of the problem, not create a pastiche of possible conditions or interesting phenomena to argue a case. This is the fake bloggers technique...avoid scale at all cost and argue something that affects 0.01% of the problem as the thing that affects all of the problem. This is how the gluten free myth took hold and started a whole load of bonkers research on leaky gut.

The fact is the total numbers involved (way over the numbers of people with ME or heart disease or anything else ) make it impossible for us to try and argue it’s anything but a simple thing that wasn’t there 30-40 years ago.

It’s supply and demand and unless someone can argue a more complicated case with incidence of numbers that is not going to crush the more simple facts.

 

I don’t think I have said anywhere that you can’t reduce your calories in a specific way?

I am perfectly happy for people to try any weird and wonderful diet they like as long as it’s nutrient rich and doesn’t create other problems (I mainly have a problem with diets that avoid fruit and veg and eat too much protein and too much saturated fat but apart from that the more varied you go the better)

I also think the satiety use of fibre with protein is interesting to help this...but ultimately you need to reduce calories consumed whichever way the individual feels is best. Extreme exclusion diets though are the creation of people who don’t appreciate the need for a balanced omnivorous diet and so,etimes they are plain irresponsible but it’s free speech etc.

I was responding to the “don't blame me for being fat it’s someone else’s fault’ narrative.

 

I know, and I was replying with some reasoning that would lift at least some of that blame off the shoulders of the obese.

Having felt "blame" for being ill with ME, I dislike seeing others who struggle with health issues being so directly blamed for their situation. Things are rarely as simple as we are led to believe by the media, and the "obese slovenly layabout" is another media meme I dislike.

 

Me too. I'm slower to swallow apparently simple solutions for any health issue. This endocrinologist always highlights that obesity and particularly attempts to reverse it are more complex than we like to think:

https://www.irishtimes.com/news/hea...em-battles-efforts-of-many-research-1.2775981

That's a lay article but plenty of publications when you search PubMed/similar.

 

My understanding was that the government was placing a levy on certain soft drinks not that they are forcing soft drinks producers to reduce the sugar in their drinks.

I'm not sure that will have any impact because massive companies like Coca Cola are extremely sharp with marketing and the first thing you do to reduce the price is try to sell more in bulk. So if the tax had any impact on their unit sales they would just sell the multipacks in 6 instead of four for example on an offer price, people would buy it as a "value purchase" and consume more.

I'm not sure the current proposal is like the one in Scotland wherby there is a minimum price set on units of alcohol to try to prevent irresponsible selling of alcohol.

Its amazing that even though we set limits on alcohol per volume in alcoholic drinks for adults yet its perfectly ok to allow 10 teaspoons of sugar in a can of soft drink and market them towards kids.

I doubt even a 10p tax on a single can of coke would prevent kids from purchasing it with their pocket money etc. The only current outcome I can see if that's the full extent of the proposal is that the government collects more revenue from the sale of soft drinks enabling them to give more money to the banks to pay off "our" austerity debts.

What a lovely full circle for the corporate banking elites.

 

Yes I agree I have also felt the effects of having a stigmatising illness since I have ME too. I also have another stigmatising illness that I have had as a child.

I am also overweight so I have sympathy with anyone trying to lose weight. However what I find really repugnant is people who manipulate people’s tendancy to hope for an easy option by peddling non scaled poor science or worse just novice and some would say hypocritical advice on diet and nutrition (eg. Food bloggers Jamie Oliver, tv presenters endorsing fad diets etc)

I have no illusion that weight loss is my responsibility, as is getting overweight in the first place. I am trying to talk about facts about populations of people not individuals. I am not casting blame but I would ask anyone feeling upset or annoyed by this ../who’s responsibility is it?

 

I think you are missing the point @Keela Too. Of course it is sensible to find the dietary mix that is easiest to starve on (reduce calories on). But that will depend on the individual. They can work that out for themselves if they know what the calorie counts are. The point is that there is no sense in 'high fat' because you don;t want to be high on anything. If cutting carbohydrate more than cutting fat is easier to cope with while you are dieting then fine. But equally if cutting fat is easier then that is just as good if you end up thinner.

I was saying that what matters in the end is reducing calories. That is not affected by the relative calorific values of carb and fat, whether in a calorimeter or in the more subtle context of the body. It is just a matter of reducing. And in fact you agree because you say 'There are other ways of achieving fewer calories' - we are both talking of achieving fewer calories because that is the only way to lose weight. And to be honest I have never managed to reduce weight without some degree of conscious food denial - otherwise I just have some extra bread and jam for tea or buy a Mars bar at the petrol station.

None of the complicated arguments about carbs and fats makes any difference at all to the fact that to get weight down you have to eat less!

 

https://www.frontiersin.org/articles/10.3389/fendo.2017.00045/full

Leptin resistance, white and brown fat signalling - one underpinning mechanism of obesity.
Podcast on adipose and insulin resistance easier to understand

https://www.youtube.com/watch?v=ssj0--bQqUw

.
Food for thought

 

This is not explaining anything other than a possible sequence of events that are happening ...it doesn’t exclude eating too many calories as the thing that’s causing the problem?

It is good to understand how things affect people's satiety and in detail the steps from being normal weight to overweight to obese and the steps to type II diabetes etc. However what happens next is the con...using some interesting uncontexted science to infer that eating a certain diet is better than another or as a reason for vilifying certain foods.

It’s interesting that after looking at their rather dodgy mugshots, the next button you see is the donate button.

 

Indeed, I don't deny the need to eat less, and to continue to do so after the "diet" ends. I just suspect that the current paradigm where "low fat" foods are pushed as "healthy" is counter productive & may in fact be stimulating appetite - and so reducing any aspiring dieters' chances of success.

We can agree to differ on the fat issue however.

 

Whenever I see the term evidence based medicine I presume that they mean hearsay about circumstantial evidence.

 

Yes, keto can be evangelical in its enthusiasm. I found the video good for explaining mechanisms.

Whilst cutting down on carbs has helped a bit- with something as complex as metabolism, and a broken metabolism at that, keto does not work for us. Low base thyroid/ adrenal hormones seem to inhibit fat burning. I think my daughter is running on amino acids...not good.

I don' t think it is as simple as reducing calories. The different mechanisms for the macronutrients combined with lifestyle and probably genetics will promote different responses. Fat is higher in calories , but does fill you up for longer. It' s the combination of fat and high GI carbs that seems problematic for most.

Low fat does seem to have been a disaster given the rise of sugar. Sometimes we focus too much on one thing- the bottom line is not one impact but all cause mortality.

 

Sound familiar?
Didn' t catch presentation but will catch up at weekend
https://twitter.com/user/status/986315366912741376

 

Good presentation @Amw66 . I'm about 1/3 way through. So many of the things he says here apply to ME as well. I retweeted Dr Malhotra's tweet with a comment. And he must have been online as he retweeted my tweet.

https://twitter.com/user/status/986898458153013248


As one of those strange coincidences: I was watching a video yesterday, The Big Fat Fix, where Dr Malhotra was co-presenting.
Interesting times.

 

http://www.pulsetoday.co.uk/clinica...-gps-warns-cardiology-expert/20031444.article

 

“What about the number needed to treat to prevent one Mi or stroke. Is this guy seriously saying that 4s woscops et al have shown no benefit from statins. I agree there are side effects and that a mediterranean diet would help.
He should write an article for Pulse detailing all of this so that we can judge the evidence and his judgement of it.”

This is the first comment left and I agree with it...this guy really needs to stop the political deceptiveness and start stating facts that are backed up with evidence ...he seems more comfortable spouting opinion and using his anecdotal experience rather than anything more solid.

I listened to the first half hour of his 2 hr publicity stunt but in that time he showed no evidence, just speculation, wild accusations and quite a bit of self promotion. He presented not one scrap of referenced evidence. Sounds like the techniques used by the BPS lot to me or any of the many misinformed and corrupt internet sellers out there.

Perhaps I have to listen to the rest of this tripe to form an opinion ...I’m pacing myself though because it is a hard slog listening to this drivel.

I would urge anyone being taken in by this man to listen to facts and form an opinion based on solid research and evidence...just my observation but it seems there are quite a few fear based marketing techniques being employed here