Chapter 6

In this chapter we try to source the formula “to lose 1lb of fat you need to create a deficit of 3,500 calories”. I can trace it back to a diet book from 1918 and I invite others who believe in this formula to see if they can trace it to an earlier date or to confirm if the source I found is the original. There was no proof in the book I found and there has been none since. We go through a 1930’s obesity journal in this chapter, which claimed:

“In conclusion we wish to commit ourselves to the statement that obesity is never directly caused by abnormal metabolism but that it is always due to food habits not adjusted to the metabolic requirement – either the ingestion of more food than is normally needed or the failure to reduce the intake in response to a lowered requirement.” I have italicised the words ‘never’ and ‘always’, as they are strong words. Did the authors proof their claim, beyond any doubt, in their journal article? Did they heck!

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Chapter 7

Chapter 7 is one of my favourite chapters in the book. I was at a university function in the summer of 2009 and I happened to be chatting to an obese dietician. I was trying to understand from her where the 3,500 formula came from and she was looking at me as if I had two heads. I may as well have been challenging the idea that the world is flat. I decided that there was no point trying to pursue the query with this individual, but it did give me the idea that I should ‘go to the top’ and ask the bodies that rely upon this formula, as the foundation for their diet advice, from whence it came.

So, during June and July of 2009 I wrote to the British Dietetic Association (BDA), Dietitians in Obesity Management  (DOM), the National Health Service (NHS), the National Institute for Clinical Excellence (NICE), the Department of Health (DoH), the National Obesity Forum (NOF) and the Association for the Study of Obesity (ASO), to ask all of these expert organisations for proof of the 3,500 formula. The answers absolutely stunned me and I hope that they do you also. Even NICE, supposedly the most evidence based of all the above organisations, admitted “Whilst our guidance does contain reference to studies involving 500 calorie deficit diets we do not hold any information about the rationale behind the statement ‘one pound of fat contains 3,500 calories, so to lose 1lb a week you need a deficit of 500 calories a day’.” That is to say – although we are an evidence based organisation, we have no evidence.

Chapter 7 also has two incredible diagrams – one a study from 2007 with documented evidence from 80 different weight loss methods – all based on eat less and/or do more. You will see what the evidence tells you that you might lose, if you manage to stick to the programme, over a year, two years, three years and four years. I then plot the promise of the calorie theory – i.e. that, if you create a deficit of 1,000 calories a day (7,000 calories a week), you will lose 104lbs in fat alone (more in water and lean tissue) during the year (2lbs a week for 52 weeks). You will not be able to believe the difference between the two charts – what you will lose and what you have been told you will lose.

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Chapter 8

I love the opening to Part 3 – we remind ourselves of why we eat – because we die without the nutrients that food provides. But we also look at the empty calories that we are eating today – almost 1,100 calories of sugar and flour in both the UK and the USA – sugar providing no nutrients and flour providing so little naturally that it is invariably fortified. I do a little experiment, using the United States Department of Agriculture database of the nutritional content of food. I try to see – if only we swapped out these 1,100 largely useless calories for the most nutritious foods – could we get our minimal nutritional requirements met? The interesting lessons are in the exercise itself, as much as the results.

The heart of the story of “The Obesity Epidemic” is the fact that we changed our diet advice –a U-turn more like – and obesity has increased 10 fold since in the UK and many times over in the USA. The most obvious question to ask is “Why did we change our diet advice?” and that is exactly what Chapter 8 does.

We go back to the 1950’s when a man called Ancel Keys set out to try to find a culprit in the search for what was causing heart disease amongst American men (and I mean men). He set out to see if cholesterol eaten in food had any impact on cholesterol levels in the blood and he categorically concluded that it did NOT. He never changed his view on this – although the majority of people today still think they need to avoid eggs (one of the most nutritious foods on the planet) because of the cholesterol that they contain. This just shows how easy it is for wrong information to become folklore.

Having failed to find a connection between cholesterol and heart disease, Keys tried to establish a link between saturated fat and heart disease. This has no logic at the outset, because the same foods that contain cholesterol contain saturated fat. However, Keys hand picked seven countries and did “The Seven Countries Study”. Just as with the experiment in Chapter 4, this is an absolute must read study for anyone working in the field of food, health and weight, but I rarely meet people who have heard of it, let alone studied it.

In Chapter 8, I go back to the original 1970 publication of the 20 volumes of the study and I tear them apart.

If, at the end of this chapter, you still believe that the case has been made against saturated fat, as Dr Kendrick said in his review of the book, you did not understand what you just read.

Chapter 8 is possibly the most important chapter in the book. It will also explain the utterly vital role played by cholesterol in the body and hopefully, by the end of the chapter, you will be as shocked as I am that people are actively trying to lower their cholesterol levels – to lower something quite so life critical.

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Chapter 9

I found Chapter 9 quite fascinating to research for. I managed to get (even when out of print) the original documents for the change in USA diet advice (1977 and the first dietary guidelines in 1980) and the UK documents from 1983 and 1984. They make for most interesting reading. They clearly acknowledge the Seven Countries Study as the inspiration behind the change but, you may be stunned to know, that the UK document admits that the study to prove that fat causes heart disease in any way, shape or form has never been done. You may like to read that again if you thought all the current allegations made against nature’s most stable fat – saturated fat – was in any way evidence based – it is not. The USA document also notes that there was debate about the advice at the time, but that the never tested low fat/high carb diet advice seemed the best option to go for in the absence of certainty.

400 million Americans, Brits and Australians have therefore taken part in a public health experiment. The change in advice came from a biased and non-proven study, which was only intended to help American men with heart disease. It became the standard national diet advice for men, women and children across these huge continents and we have been the guinea pigs to see what happens. What has happened is that the incidence of heart disease has not reduced (we have got better at treating it and particularly in saving people in the first critical few minutes). In addition, obesity has gone up 10 fold in the UK and almost as much in the USA (the USA started from a higher base). That’s quite an experiment.

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Chapter 10

Chapter 10 looks at current dietary advice for the UK, USA and Australia. The amount of carbohydrate that we are telling humans to consume is enormous and unprecedented in human history. The Australian advice is particularly extraordinary and Australians have a growing obesity crisis.

We know that we did a U-turn in our dietary advice. We know why – because we wrongly decided that fat was bad and so people need to eat something and it was decided that this should be carbohydrate, The obvious question to ask then is: did we follow the advice when it changed? If we changed advice, but everyone ignored it, it would be difficult to blame the change in advice for the obesity epidemic.

Using the UK as a study over the period from 1974-1999, when adult obesity increased from 2.7% for UK men and women to c. 25% by the end of the millennium, Chapter 10 looks at what exactly the UK is eating. It is fascinating to see which foods we are eating massively less of and which we are eating massively more of and the clear culprits for the obesity epidemic become obvious.

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"The Obesity Epidemic is the most comprehensive demolition job on the arrogance and ignorance of the health profession I have ever read".
Barry Groves Author of Trick and Treat: How 'healthy eating' is making us ill