Dr David Unwin can stop people dying of COVID19

3rd November 2020

[By helping them to lose weight]

If you want to avoid dying of COVID19, one of the most important things you can do, if you are overweight, is to shed the pounds

‘….in the first meta-analysis of its kind, published on 26 August in Obesity Reviews, an international team of researchers pooled data from scores of peer-reviewed papers capturing 399,000 patients. They found that people with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die.’ 1

Why? Well, the ‘why’ centres around the damaging effect of raised blood glucose on endothelial cells and… it gets complicated.

For now, though, the most important thing is not to understand the complex metabolic and physiological pathways involved, it is simply to help people to lose weight, and this is where Dr David Unwin comes in.

For years now he has believed, as I do, that the main driver of weight gain, leading on to type 2 (T2) diabetes, is a high carbohydrate diet.

This, of course, is the exact opposite of what we have been told for decades by the ‘experts’ who demonise fat and promote carbohydrates. We have the ‘eat-well’ plate, and the ‘food pyramid’, and hundreds of thousands of dieticians around the world, all promoting carbohydrates as the ‘healthy’ option.

Dutifully following this advice, the entire population of the western world has become fatter, and fatter… and fatter. By the way, this is not a coincidence; it is cause and effect.

Getting back to Dr Unwin, years ago he despaired of ever getting any of his patients to lose weight. It was so disheartening that he furtively studied his pension plan, and dreamed of retirement, so fed up was he becoming. Then one day a patient came in who had lost a lot of weight and kept it off.

At first this woman was reluctant to say how she had done it, as she feared the inevitable criticism. In the end, she told Dr Unwin that she had lost weight, and kept it off, by eating a low carbohydrate diet. In Dr Unwin’s own words:

‘A few years ago, I was interested to find out how a patient had improved her diabetic control.  She confessed she had ignored my advice and learnt a much better way to look after herself, from the internet. I suppressed my wounded pride and looked at the Low Carb Forum on Diabetes.co.uk There were thousands of type two diabetics on there ignoring their doctors – and getting great results (now that is just not allowed).’ 2

Yes, Dr Unwin did not criticize, instead he was intrigued. Could this possibly be true? It went against everything he had been told about healthy eating, and weight loss, and T2 diabetes. Fat has twice the calories, per gram, as carbohydrates and suchlike. Eating fat, he believed, makes you fat, and then you develop diabetes, and heart disease.

Dr Unwin did more research, then he made the decision to work with patients, mainly those with diabetes, to see if a low carbohydrate diet could be beneficial. Lo and behold, it was … very beneficial. It was like a miracle cure.

In 2014 he published a paper on his results on a small number of patients. ‘Low carbohydrate diet to achieve weight loss and improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice.’

‘It was observed that a low carbohydrate diet achieved substantial weight loss in all patients and brought about normalisation of blood glucose control in 16 out of 18 patients. At the same time, plasma lipid profiles improved, and BP fell allowing discontinuation of antihypertensive therapy in some individuals…

Conclusions Based on our work so far, we can understand the reasons for the internet enthusiasm for a low carbohydrate diet; the majority of patients lose weight rapidly and fairly easily; predictably the HbA1c levels are not far behind. Cholesterol levels, liver enzymes and BP levels all improved. This approach is simple to implement and much appreciated by people with diabetes.’ 3

Now, he has published results of a much larger study, on nearly two hundred patients over a six-year period. It is called. ‘Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes’ Published in BMJ nutrition 4.

Here are the main findings, which I nicked directly from the press release:

  • 46% drug-free T2 diabetes remission
  • Significant improvements in weight, blood pressure and lipid profiles
  • 93% remission of prediabetes
  • £50,885 annual saving on the Norwood GP practice NHS diabetes drug budget
  • If every GP practice in England spent the same on drugs for diabetes per patient as Norwood the NHS could save £277 million!
  • Older patients can do as well as younger ones with a low carb approach.
  • The participants who started with the worst blood sugars saw the greatest improvements in diabetic control
  • Four individuals came off insulin altogether
  • Total weight loss for the 199 participants was 1.6 metric tons!

This paper will be attacked, of course. There are massive financial interests involved here. As stated, if every GP practice in the UK used the low carb approach, the NHS could save £277 million (~$350m) in drug costs. Scaled up to the US, with much higher drugs costs, one could be looking at around $2Bn/year. Around the world, who knows, but vast sums of money.

So, you can imagine the joy that this paper will be met with in pharmaceutical company boardrooms around the world. The words ‘lead’ and ‘balloon’, spring to mind. Equally the massive low-fat, high carb food manufacturers will be throwing their hands up in horror – ‘my bonus, my bonus…nooooo.’ You can take your low carb yoghurts and….

As for the rest of us. I can assure you that Dr David Unwin has only ever been interested in one thing. Working out how to help people lose weight and control their diabetes. He has achieved this.

Will his research now be taken up by the authorities around the world? Will we move away from promoting a high carbohydrate diet? You have to be joking. There is far too much money to be lost by companies who exert tight control over the world of medical research, and whose lobbyists swarm around the politicians in rich countries.

Which is a damn shame, because more than ever in this endless COVID19 pandemic, obesity represents a health crisis. This paper, and the tireless work by Dr David Unwin, clearly tells us what we need to do, now, urgently. His approach won’t work instantly, and it won’t work for everyone – nothing ever does. However, it represents hope. It could save hundreds and thousands of lives. Better than any vaccine?

Thank you, once again, Dr Unwin. A man who I think of as a friend. Your research should be shouted from the rooftops. I can only do my bit.

1: https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young

2: https://www.rcgp.org.uk/clinical-and-research/resources/bright-ideas/working-on-weight-loss-with-type-ii-diabetic-patients-dr-david-unwin.aspx

3: https://www.practicaldiabetes.com/wp-content/uploads/sites/29/2016/03/Low-carbohydrate-diet-to-achieve-weight-loss-and-improve-HbA1c-in-type-2-diabetes-and-pre-diabetes-experience-from-one-general-practice.pdf

4: https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-2020-000072

231 thoughts on “Dr David Unwin can stop people dying of COVID19

  1. Doug Brian

    Instead of a high carb diet, obesity seems to be caused by PUFA, specifically linoleic acid in vegetable oil. After linoleic acid makes your adipocytes dysfunctional, carbs makes things worse. Look at the Hyperlipid blog’s explanation of the ROS Theory of Obesity. Blogger is Peter Drobromylskyj.

    Reply
    1. LA_Bob

      I agree with you that linoleic acid has turbo-charged the obesity epidemic. But, people were getting fat on sugar and simple starches long before PUFA thoroughly contaminated our diets. Just limiting carbs is a big first step to limiting the damage from the “official guidelines”.

      Kudos to Dr Unwin for having an open mind and evolving in his views. Kudos to Dr Kendrick for telling us about it.

      Reply
    2. Phil W

      Both the late Fred Kummerow talked about PUFAs as a driver for insulin resistance and now Paul Saladino (The Carnivore Code) is also alluding to the same. There’s in an interview on YouTube of Fred and when asked what PUFAs would do to the cell membrane and I think he said it could block insulin passing across into cells. Certainly the cell membrane would no longer be the highly dynamic functional structure it’s supposed to be.

      Reply
    3. David Bailey

      Doug,

      I am always rather wary of conclusions like yours, because if observational studies are so hard to get bias free at the simplest level, I find it difficult to believe that there is any reliable evidence to blame one specific polyunsaturated fatty acid, even if what you say is absolutely true.

      Reply
      1. sjglaze3

        Hi, the charges against linoleic acid are not based on observational studies but on deep biochemistry at the mitochondrial level of the cell and the electron transport chain. I urge anyone interested to check out Hyperlipid and yelling-stop blogspots or fireinabottle.net.

        Reply
  2. abamji

    Sadly I agree with Malcolm that this research will be ignored because it offends current dogma. Older folk may remember that exactly the same happened to John Yudkin, who reckoned that carbohydrate, not fat, was the problem. In a more recent example (Covid-19) it has been suggested that those of entrenched views and powerful positions massage the data to fit the hypothesis, which is back to front as I have argued for decades now.

    Reply
    1. Marian Callender

      I’ve written before about John Yudkin. (My father worked in the sugar industry for 40+ years so his name was familiar to me from the 1970s onwards.) He was ahead of his time but utterly filleted by the sugar industry. Even a few years ago before he died in his 90s my father was totally opposed to any arguments about sugar and obesity.
      I reduced my carbs 4 years ago. The weight fell off and I am on a quarter of the BP medication I was on.

      Reply
  3. Janet Thomas

    It’s all a bit confusing. The authors of “Mastering Diabetes”, both diabetics, promote a diet that is high in carbs and lower in fat. They maintain that it is fats that do the damage, causing insulin resistance by blocking cells with fat, so that insulin cannot do its job. Their method seems to work for people as well. How can it be the two totally opposite methods work so well?

    Reply
    1. DV

      Janet, I think that some people are more susceptible to weight gain and blood-sugar effects from carbs, others from fat. That’s why it may make sense to try one approach and if that doesn’t work, try the other. I find I’m much more sensitive to carbs than my husband, for example.

      Reply
    2. Dr. John H

      Interesting!

      Let’s take a poll.

      Give a:
      THUMBS UP: Anyone who significantly improved diabetes eating Low Fat High Carb.

      THUMBS DOWN: Anyone who significantly improved diabetes eating High Fat Low Carb.

      Reply
    3. KidPsych

      I’m one of those freaks who wears glucose monitors and tries out OMAD and the like. I’ve been low carb for about a decade, which has vastly improved my health. Since January, I tried to push the envelope and go fully ketogenic (very low carb, high fat). While I got very lean, it didn’t feel very sustainable. I lucked out and stumbled upon Ted Naiman a while back. He agreed to take me on as a patient, which greatly improved my life and health. His core contention is that high protein should be the main focus, with low carb AND low fat. This might not work for everyone, but for me it’s been a revelation as far as the ease with which I can follow this approach (relative to what would be termed ketogenic). I’ve remained lean and enjoyed my diet immensely. And to be clear, if you are eating lean protein, you are consuming significant amounts of fat. It’s just that, rather than slathering one’s steak with butter, you’re mostly enjoying the steak part. He stresses exercise, which might be why I have found his diet so fitting,

      Ted has a nice tool to use: https://www.ptoer.com

      The goal is to balance one’s protein to energy ratio to about 1, which he would contend is fairly consistent with hunter gatherer types. What I adore about his approach is that it’s quite sustainable and understandable from an evolutionary perspective. He’s super open to competing ideas, and in general his ideas seem less dogmatic than those held by many in the “diet war” space. For those interested:

      Reply
    4. spamhelper

      Unfortunately, the low-fat people are largely lying. I hate to use that word, but I don’t have a better one to use.

      There have been literally hundreds of clinical trials of different low-fat diet variants for people with type II diabetes, and with one exception – very low calorie diets – they take people who are quite diabetic and make them a little bit less diabetic; they end up with an HbA1c of around 7.

      This is the reason that type II is considered to be a chronic and progressive disease; the community had decided up front that low-fat diets were the only healthy ones and then found that they just didn’t work.

      Keto diets – as studied in the virta health studies and elsewhere – can get their patients to HbA1c levels of under 6.5% with either removing or reducing diabetes medication; in their first study 25% of their study group got under 6.5% while taking no medications, and a further 35% got under 6.5% while only taking metformin (getting off of metformin was not one of their study goals).

      It would be great if there were other options than low-carb that worked because low-carb is hard to follow (any diet is) and doesn’t appear to work well for some people. But, alas, that doesn’t seem to be the case.

      Reply
  4. Steve

    “… people with obesity who contracted SARS-CoV-2 were 113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die.’”.
    63% of adults in the UK (approx 31.5M) are obese.
    Maybe this is another reason why incorrect lifestyle choices have turned ‘bad Flu’ into a killer.

    Reply
    1. Dan Anderson

      In the US, 70+% of people are overweight, half obese, and weight tends to increase with age as we stop working so much but eat at least as much. Those facts would have to be worked into the concluding figures, then consider how much time it takes to lose weight and if being in a state of weight loss at the time of illness is harmful when resisting Covid.

      Reply
  5. Antony Sanderson

    If I feel like cheering up I watch YouTubes “Dr. David Unwin – ‘Why black swans matter: The
    difference N=1 and noticing success can make” Real lump in the throat stuff – and so optimistic and encouraging.
    Did we ever find out why NICE suspended Dr Unwin’s Sugar Infographics from their site?
    Couldn’t be conflict of someones’s interest surely.

    Reply
    1. Terry Wright

      “Did we ever find out why NICE suspended Dr Unwin’s Sugar Infographics from their site?”

      It was a media attack: same journalist who attacked Dr K/Zoe Harcombe and others last year over statins; you could suggest they are paid attack dogs; of course, I couldn’t possibly comment;

      in this Tim Noakes talk; https://www.youtube.com/watch?v=jyzkv5uFGt8 at 2hrs5mins in, he discusses what he calls “the big bribe”: where the harvard school of nutrition received generous sums of money in 1965 from the US sugar industry to write an impartial report on sugar; you will not be surprised to hear that they exonerated sugar; could the same have happened above? I would leave it to others to speculate.

      Reply
  6. sergeykushchenko

    Dear Dr Kendrick, I heavily promote the low carb approach to diabetes for the last 7 years, Please take a look at my work https://endocrin-patient.com/. Also, You may take a look at the book Dr. Bernstein’s Diabetes Solution.

    Low carb diet is a miracle for blood sugar control. But it is not so great for weight loss. We would be happy to have something better.

    Reply
        1. spell100

          Watching YouTube is enough. All the information needed to adopt a LCHF diet and reverse diabetes is available online. Reading books is absolutely unnecessary.

          Reply
        2. spell100

          Diabetics do not need to read any book to control the disease. Watching YouTube is enough.

          All the information needed to adopt a LCHF diet is available online.

          Reply
  7. jeanirvin

    Thank you for highlighting this. I found low carb 10 years ago, lost 21 lbs and have never looked back but I face a lot of criticism from friends and acquaintances about my diet, even though I stay the same healthy weight and take no regular medication. I am 72 years old.

    Reply
    1. Tommo

      I have recently learned how to fast for three days once a month without any discomfort or particular detox issues. Day 3 = ketosis. My friends also give me a hard time about this “dangerous” practice. However they never critise other friends who regularly knock back a can of diet coke and a Big Mac. I’m the one without a weight issue and med free.

      Reply
  8. janetgrovesart

    Thank you for that, Dr. K. and Dr. U. It’s one of those areas where we can say “My body, my responsibly” and to hell with what dieticians/big pharma tell us. What they don’t know won’t hurt them and can only benefit we low-carbers. I’ve been ‘doing’ this for years now (taking up again what I was told back in 1958 in a specialist diabetic clinic.) it works. I lost over two stone and have never regained it and my stats are lovely. Until I caught Covid in January I hadn’t had as much as a sniffle for years.

    Reply
  9. David Grimes

    Reversing obesity is laudable but at this time of national emergency due to Covid-19 it would more pragmatic to consider a more readily reversible approach. It is well-established that low blood levels of vitamin D are more likely to be found in obese people than in the general population. In that vitamin D is essential for optimising immunity in response to serious infection, and as low blood levels of vitamin D are more likely to lead to death, would it not be advisable to give to obese people as a matter of urgency vitamin D in a dose that might need to be 10,000 units each day to achieve a blood level greater than 30ng/ml (75nmol/L), which is necessary to minimise the risk of death.

    Reply
    1. Janet Love

      David, tongue-in-cheek reply: Until the LCHF weight loss kicks in, we chubbies can use our larger solar panel area to gather more Vit. D than our skinnier friends. Doing both will keep us healthier !

      Reply
    2. JustSaying

      NICE continues to claim that “there is no evidence” for vitamin D for COVID-19. https://www.nice.org.uk/advice/es28/chapter/Advisory-statement-on-likely-place-in-therapy Unfortunately many lay people will interpret “no evidence” as “it doesn’t work” rather than “we haven’t looked at/run the right trials yet”. The biggest effect seems to be on those who are deficient (<25nmol/L), deficiency is common, and the June 2020 SACN study of vitamin D and respiratory tract infections that they reference doesn't consider trials on people who are deficient.

      Reply
    3. Terry Wright

      we would entirely agree, Dr Grimes; we have appreciated your long-standing advocacy for Vit D: you have highlighted the role of Vit D; with the rona this year, your prescience has stood out: definitely: 10,000 IU of Vit D a day; …. if a 20 yr old; in the midday sun in summer for 20mins; can make 20,000 IU; how can we deny 10,000 IU daily for anyone in the dark UK?

      Dr Aseem Malhotra has suggested that if folks were to ditch the sugars and starches; they could see some metabolic improvements in 3 weeks:

      so Dr Grimes a combination of daily Vit D; and ditching sugars and starches; seems a valuable two-pronged focus on general health: there are many more respiratory viruses that will afflict folks over the northern european winter; we have been over-focused on the rona.

      Reply
      1. David Grimes

        Obesity and Vitamin D. Which direction is causal? In practice it does not matter and I agree with a two-pronged attack. Vitamin D supplement would be sensible at present as its benefit would be rapid. Weight loss will take more time but with more benefits. What would be the effect of weight loss on blood levels of vitamin D, without supplements? An interesting research project.

        Reply
  10. Bob

    I’m such an ignoramous. I had assumed that the problem with obesity and bother was simply the mechanics of breathing when severely compromised by, well, fat and covid.

    So it would be handy for you to dwell on the mechanisms for a bit, for the benefit of your thicker readers.

    Reply
  11. johnplatinumgoss

    My advice: Go on a medically-supervised water fast. Then get a pushbike. Do short bike rides to begin with. Gradually increase the length. Be patient. Only the water fast will remove weigth quickly.
    Jogging might get weight down faster than cycling but it plays havoc with the joints. Cycling is gentle. In fact when I could hardly walk I could cycle with much less effort. I have a theory that swimming is not likely to remove weight because the cold water encourages fat to keep you warm – but no science behind the theory.

    Reply
  12. Nestor Fulcanelli

    Good info, but I object to the “dying of Covid”. Where’s the isolated “virus?” CDC admits they have NO isolated virus sample!! Then what do the “tests” detect? Exosomes, cell debris, and computer simulations again. Not to mention outright lies and distortion of stats for high level societal manipulation.
    Surely Dr. K. is aware of this. Anyone reading nomorefakenews.com and the many many articles on the fakery around naming so-called viruses as we swing from one planscamdemic to another, will call this out.

    Reply
    1. Harry de Boer

      In the mean time, use the highly successful HCQ+ or IVM+ cocktails that, by empirical evidence, have proven to be a cure for covid-19.

      Reply
  13. Martin Back

    If you want to understand the immune system better, here’s a long article in the New Yorker. Although to be honest, I’m not sure if I understand more or merely have more facts to be confused about.
    https://www.newyorker.com/magazine/2020/11/09/how-the-coronavirus-hacks-the-immune-system

    At long last, a picture of the whole system was coming into focus. It was all interconnected. Innate immunity kicks off the immune response, as cells at the site of infection use their receptors to recognize and combat invaders, and release interferons and cytokines to raise the alarm. Various types of white blood cells respond, having been routed to the infection via the bloodstream. They identify and eat foreign cells, returning the digested bits, via the lymph nodes, to the thymus and the bone marrow, as intel. In the days that follow, antibodies and killer T cells—the weapons of adaptive immunity—are built to spec.

    “… in reality, the immune system has simply, in the face of pathogen attack, staggered from one emergency to the next. It just uses whatever is lying around. It is hoping against all possibilities to try to survive a little bit longer. Whatever crazy solution it comes up with—so long as it works, it will be accepted.” The result is a system of great flexibility and power, which, pushed the right way, can be made to collapse upon itself.

    Reply
  14. Roger Bartlett

    DM2 – 11 years in…very low carb or ketogenic(75% fat, 20% protein, 5%carbs).
    After 1st year…

    Weight -50lbs lost (48lbs still lost)
    Background retinopathy – reversed
    Neuropathy – reversed
    NAFLD – reversed
    Hba1c – always below 5.5 / 34 last 10 years.

    No drugs required.

    Diabetic nurse, condescendingly … oh well, if it works for you…

    Reply
    1. Terry Wright

      well done Roger; so many N=1 anecdotes; the plural of N=1 is a pile of data of outstanding results; well done again;

      so pleased to hear of your success; talking to a friend the other day; just retired as a UK GP: he took an interest in ultrasound; that was strongly discouraged by some hospital specialists!

      He saw his role with U/S as identifying abnormal features; and referring them on; he felt he could say what seemed normal.

      He commented to me how much NAFLD he saw …. asymptomatic liver enlargement … it precedes frank presentation of T2 diabetes. The incidence of NAFLD rises each year. It is said to be the commonest cause of liver transplantation for women; in the US. Crazy.

      Reply
  15. GB

    Dr. Kendrick thank you for this vital post. Global obesity is a public health tragedy that claims many more young lives than Covid19 ever will. The rise of obesity in children and young adults is particularly alarming. Decades of their lives will be blighted by metabolic disease. An NHS friend who worked in ICU during the late spring told me the only patients she was caring for were obese males with Covid19. Depressingly Dr. Unwin’s vital research will be ignored as there is no money to be made from it and the responsibility for change lies with parents and individuals.

    Reply
    1. Steve

      GB. Yes parents and individuals need to take responsibility for their lives and health but experience tells us that the societal infrastructure has a big impact. Over the last 50 odd years the UK has been on a suicidal rush to adopt the ‘american way of life’ and now we are seeing all the problems associated with the consumerism of the land of the free. The ‘government’ must take a large chunk of responsibility for where we are. The free market favours the mega rich, multinational over the small, local enterprise. We’ll never solve the problem if we only treat the symptoms.

      Reply
      1. Steve Prior

        Yes, I very much agree with your points.

        One of the biggest contributors to our and corporate behaviour is the structure of the money system.

        Neo-liberalism and the self, combined with the current money system will naturally reward the few and penalise the many.

        Governments current solution is to subsidise the wages of the lowest paid to offset corporate profit taking.

        Cheers

        Reply
    2. Terry Wright

      “An NHS friend who worked in ICU during the late spring told me the only patients she was caring for were obese males with Covid19.”

      we have heard similar stories: …… cases were: male; late 50s and over; hypertensive; T2 diabetic; obese; on statins; heart disease …… often BAM ethnicity …..

      those with keto insight recognise the themes of hyperinsulinaemia; insulin resistance; all from carb loading ……. how to manage ……. stop putting in your mouth, what your body cannot tolerate ..

      Reply
  16. juliawands

    I’ve followed a low carb diet for years, probably decades, starting with the much maligned Atkins diet. Not because I have diabetes; originally for weight loss, and subsequently because it made me feel better. It seems a shame (vast understatement) that unless you have the self motivation and/or have an open minded GP, essentially you are stuffed, and consigned to years of medication and worse. I’ve ‘followed’ Dr Unwin for a while. We need more people like him and you. Thanks.

    Reply
        1. AhNotepad

          However, we must be careful not to equate overweight with metabolic dysfunction and poor health, any more than seeing as lack of obesity. as indicating a healthy metabolic function, and good health. From Robert Lustig https://youtu.be/jpNU72dny2s this indicates that a larger proportion of the US population that is not obese, has poor metabolic function, than those that are obese. It’s a case of not all calories are the same. There’s also the cancer aspect.

          Reply
    1. Marian Callender

      As a (now retired) nurse I came across Malcolm when I was researching cholesterol and diets, for my own interest. That lead me to low carb as a possible way to reduce my increasing BP. In BMI terms I’ve always been in the normal range but had been started on medication. I never told my GP I was changing my diet til it had some obvious effect.
      I’ve learnt that dominant group think in many areas of modern life blinds people to other explanations that might be more effective. Just do it your way. If it doesn’t work you can try something else.

      Reply
  17. Sheona Watson

    Is this not just like The Atkins diet ? When it came originally I lost weight …and when I read his book he claimed the same ….. lots of type 2 diabetics after loosing weight on his diet no longer needed medication

    Reply
    1. Frango Asado

      Sheona, all it amounts to is seeing through the absurd “food fads” of the 1960s and 1970s. At that time otherwise sane scientists and doctors began contradicting what everyone had known from time immemorial: that healthy food is meat, fish, dairy, eggs, and a reasonable allowance of vegetables. Fruit is nice, but it’s full of sugar and essentially a luxury: “Nature’s candy”.

      Nobody needs to eat grains of any kind (unless they can’t afford proper food, which alas is true of many people worldwide). If in doubt, read Dr Davis’s “Wheat Belly” books for chapter and verse.

      Reply
    2. spamhelper

      Atkins is keto at the start for the initial period, but are allowed to go back to a higher carb amount after the initial period. That seems to work well for some people, not so well for others.

      Keto diets stay at that initial period level of carbs the whole time.

      Reply
    3. Terry Wright

      “Is this not just like The Atkins diet ? ” …… yes Sheona. Dr Atkins received numerous ad hominem attacks; I found his book very instructive: he was way ahead of the game; in recognising hyperinsulinaemia as the driver; Dr Eric Westman studied Dr Atkins work and has supported it.

      Gary Taubes documents how Dr Atkins heard Dr Pennington talk of his low-carb successes; and Dr P had learnt from Dr Blake Donaldson; who in 1920 in New York started low-carb in his practice; having 1) spoken to anthropologists at the Natural History Museum as to what was the predominant diet of man; 2) spoken to Vilhjálmur Stefansson https://en.wikipedia.org/wiki/Vilhjalmur_Stefansson

      Reply
  18. Jeremy

    I started dieting 10 weeks ago. I’m 6′ 5” age 59.

    I’m simply fasting every other day – nothing solid on fast days, just liquids: tea, coffee, water, wine. Regular meals on an eating day.

    I’ve gone from 17st 0lb to 15st 5lb. Lost 23lbs.

    Gonna keep going until Xmas day.
    Hope to get to 14st. 7lb.

    Mind over matter 🙂

    Reply
    1. Steve B

      Unopened, pasta keeps for over two years, so something to fall back on when the supermarket shelves have been stripped bare

      Reply
          1. Steve-R

            Not if it was desiccated prior to harvest by liberal application of glyphosate based Round-Up, thank you very much.

        1. LA_Bob

          Spam is not ideal food. It is processed ham and pork shoulder likely from corn-fed pork, so probably more PUFA than you want. But I think of it as great emergency food, such as after an earthquake.

          If you can’t cook, you can’t eat pasta. But you can still eat Spam.

          Reply
          1. Steve-R

            Make your own starter from the natural yeasts on the flour and you will only need flour, water, and – of course – salt.

  19. judith neaves

    Hi Malcolm,
    There is hope, the Newcastle team have agreed with NICE about their slimming drinks for diabetes, and popular books such as Dr Moseley Fast diet ( 2012 ) and his more recent book Fast800 , and also Tim Spector ( of the C19 kings and zoe app) in Spoon Fed and the diet Myth. However I was interested in Spoon Fed Tim stated that there is some variation in type of diets people respond to , so we cant have a one size fits all approach, and he also emphasizes the importance of avoiding highly processed foods as many of the long list of ingredients have many changes to hormones and metabolism , many of which are not favourable. We are however still stuck with the high fat CVS disease nonsense, as Tim Spector stated “ no serious scientist believes the high fat is cause of CVS disease”
    Keep well and keep your posts coming

    Good reading

    Judith

    Dr Judith Neaves GP.

    Reply
  20. dearieme

    Let me recommend my toffee diet.

    I finish my main course and crave something sweet. A supermarket desert contains – it says on the package – 80g, much of it carbohydrates. So instead I chew a toffee: 7g. As time has run on, sometimes I find I don’t even need the toffee. Small steps in the right direction.

    Reply
    1. Frango Asado

      Believe me, you can quickly correct your taste and lose the need for sweet things. When I were a lad, I distinctly remember putting five or six teaspoonsful of sugar into each cup of tea or coffee. At some point I decided to keep my teeth – such as were left – and stopped taking sugar altogether. Soon I realised that a drop of milk provided plenty of sweetness, but that the real charm of those drinks is their own taste – which doesn’t need to be covered up by sugar.

      Good treats to finish a meal include cheese (preferably a variety of aged types), nuts (Brazils, almonds, walnuts, pecans, etc. – but not peanuts, which aren’t actually nuts), or a little fruit (berries are good, and delicious with cream of course).

      But if you have enough good healthy animal fat in your main course, you won’t feel hungry when you’ve finished it.

      Reply
      1. Frango Asado

        As I have said before, it’s interesting that the upper classes – from royalty on down – have traditionally stuck much closer to a Paleo diet than the toiling masses could. When I was at an English public school (needs must when the Devil drives) one of the many counts on which the posh children of rich parents looked down on me was my apparent liking for rice pudding, spotted dick (with custard) and the like. And masses of confectionery.

        They were accustomed to finishing a meal of venison, grouse or duck with cheese, nuts and/or fruit.

        No wonder the aristocracy has usually been not only better armed and richer than the proles, but better nourished and hence stronger and healthier. And longer-lived.

        Reply
  21. Mark Heneghan

    I don’t want you to get a swelled head, but I number 3 UK doctors that have influenced me, a GP, the most in the last few years, and they are Dr David Unwin, Dr Zoë Harcombe, PhD, and Dr Malcolm Kendrick.

    Reply
    1. superquag

      “Stakeholder” An entity which holds you down while it drives a stake through your wallet, drains away wealth and eventually your health.

      Reply
    2. superquag

      Even more blatant than a ‘sugary soda’ drink company promoting their product as part of a desirably Balanced Diet.

      Reply
  22. Joanne McCormack

    As a GP I taught people about low carb diets too. They work well, especially if combined with intermittent fasting.

    Reply
    1. jeanirvin

      Yes, I’ve followed Joanne online. She has been running support groups for her patients for some time now. Thank you, Joanne!

      Reply
    2. AhNotepad

      Hi Joanne, you may have been posting here for a while, and I hadn’t twigged, but of course you are one of the GPs everyone would like as their GP, along with Malcolm, David Unwin, and others who contribute to this blog. That’s one of the benefits of making some youtube videos which pose questions to the authority approved protocols.

      Reply
  23. Eggs ‘n beer

    And Dr Steven Gundry, an American heart surgeon who has been working hard for nearly twenty years now to do himself out of his day job.

    His book, The Plant Paradox, explains, based on an evolutionary viewpoint, why carbs and several other foods cause obesity and a range of other illnesses. He follows that up with an entirely scientific explanation of the microbiology behind the problem, involving the gut, liver, metabolism and that most important part, why the mitochondria don’t function properly on a high carb high solanaceae diet. Then he tells you exactly how to change with a range of diets including vegetarian and vegan for those so inclined, and even how to reintroduce certain carbs once you have everything under control (white bread and rice, for example, NOT brown, and peeled, de-seeded tomatoes).

    It’s easy to skip the technical bits, but for me it was a breath of fresh air in that every aspect of the diet is backed by solid reasoning and fact. Something that is invariably missing from most dietary methods. A year ago I would have called it a thoroughly scientific approach, but that phrase has been made meaningless in this COVID world.

    Reply
  24. Ali

    I was doing Low Carb ?High Fat long before it became fashionable & might have even been on the Low Carb Forum when Dr. Unwin was looking, & boy did we get some stick from the high carb diabetics….🙄

    I followed it for well over 8 years, & initially everything was hunky dory, but regardless of what I tried I just could lose no weight. In fact I actually GAINED an extra 30+lbs on my already ample frame. I tried it every which way but loose, even going Zero Carb for a while, but still no weight loss. Eventually towards the end of my low carb journey my insulin resistance became so bad that injected insulin was hardly working. It was a very scary time.

    As my digestion had been struggling to process the animal protein for some time, regardless of what I tried, in the end I threw in the towel & went plant-based. To give my poor beleaguered digestion a break, I juiced for the first month, & by the end of the month not only had my insulin sensitivity returned, but my blood sugar had also dropped & I had to radically cut my 8nsulin by more than half – from 50+ units to just 20-25 units. I also lost 11lbs of this VERY stubborn weight.

    I have been plant-based now for nearly 3 years. I eat a very high carbohydrate diet but can still maintain on 25 units per day or even less if I keep the fat intake very low. A fat free day of eating just vegetables & fruit can be as low as 15 units, despite me consuming heaps of carbohydrate.

    The point is that not all carbohydrates are the same. There is a World of difference between nutrient-robbing highly refined carbohydrates & nutrient-rich whole food carbohydrates & lumping them all together into one category is like saying chocolate is the same as poo because they are both brown…..😶

    Reply
    1. Jim

      Read what people eat – or ate – in the ‘Blue Zones’ such as Ikaria, Sardinia and Okinawa. NB: the ‘Okinawan diet’ is probably from the mid 20th.C before US junk food spread around the world. They seemingly have little in common except for no junk food. Maybe intolerance to carbs. develops after years or decades on a US or UK type junk food diet.

      Reply
      1. Ali

        Intolerance to carbs has developed since the ‘civilised’ world started to consume far more refined sugar in their diet & refined wheat flour. These days flour is stripped of its ‘nutritional powerhouses’ the germ & bran through the rolling mill process, partly because the majority prefer white bread, cake & biscuits & partly because removing those elements also removes the natural oils, like Vitamins A & E which will eventually rancidify & that is not good for shelf-life & profit.

        Breadmaking has also undergone backwards changes. Gone is the traditional ‘slow-rise’ methods (minimum 6 hours, but the longer the better) that give far more time for the yeasts to work on digesting the sugars & starches & gluten proteins, making the stuff far more digestible in favour of the introduced in the 60’s ‘Chorleywood’ fast-track, churn-it-out-and-damn-the-consequences processing.

        Between the lack of nutrients (they don’t call refined wheat & sugar ‘empty-calories’ for nothing), especially B vitamins (found in abundance in the germ & bran) – so crucial for digestion, nerve support & repair & heaps of other functions, & the hopeless breadmaking process, Is it any wonder carbohydrate, wheat/gluten & sugar intolerance is such a thing?

        Calories without the nutrients – the vital vitamins, minerals & phytonutrients the body needs in order to process this garbage, is not food. It is ‘pseudo-food’ – Looks good, smells good, tastes good but is a nutritional wilderness ‘hologram’. Unfortunately, many vegetarians & vegans base their diet around this stuff & then wonder why they are getting so sick & weak. Even those who eat meat often have it wrapped in pastry. Invited to a buffet? Just count how little on the table doesn’t have wheat or sugar in it in some form or other….🙄

        That is why there is a world of difference between a crap carb diet & a Wholefood Plant-based diet. Most in the Blue Zones might eat a little meat or fish, but the majority of their diet was based around good whole vegetables & fruit, rice, beans, corn, & in some places Whole unprocessed wheat flour. Nothing remotely processed in sight…..

        Reply
        1. Simon C

          This is true. My sister has been a vegetarian for many years. Some time ago she started having all sorts of physical and mental issues, which ultimately led to electro convulsive therapy. At no point did she or any of her doctors take a long hard look at her diet.

          It was only after I got her onto b12, magnesium and vitamin d and a decent multivitamin that she started improving. She had given no thought to her diet, and her doctors barely gave it a glance either.

          Reply
      2. Ali

        Even those in the Blue Zones weren’t always exempt from processing. A few centuries ago people in Japan & other rice-consuming countries got very sick from eating ‘refined’ (Polished) white rice. ‘Polishing’ the rice unfortunate also removed the germ & bran & the ensuing plague of Beri-Beri (acute Thiamine deficiency swept those countries.

        Guess what? Beri-Beri is very much alive & kicking (our butts) in the modern world. Stripping the germ & bran from the wheat is creating another plague of occult Thiamine deficiency. Whilst ‘Wet’ Beri-Beri affects the heart & CVS, ‘Dry’ Beri-Beri affects the nerves. Yet because it is assumed that Thiamine deficiency is no longer an issue (except perhaps in alcoholics), it is totally ignored as a potential cause of the huge array of heart, CVS & neuropathic issues would rampant today.

        After dumping the nutrient-robbing refined wheat & sugar & addressing the resulting deficiencies with an array of supplements, especially Magnesium, & B vitamins – so crucial for nerve support & repair, I reversed my several years of so-called ‘diabetic’ neuropathy & the other issues – which is a very strong indication that the neuropathy, rather than being ‘caused’ by Diabetes, is almost certainly down to Thiamine deficiency, as very likely is also the huge amount of ‘idiopathic’ & other cases out there.

        Nutrient-stripped Refined carbohydrates burn through B vitamins like a bullet train. It doesn’t take a rocket scientist to realise that sooner or later, in those whose diet revolves around this garbage, demand will outstrip supply & things will start to fall apart…..

        Reply
      3. Terry Wright

        Hi Jim; we always get the “Blue Zones” argument:

        https://www.mikeroberto.com/2019/blue-zones-fraud

        this article is very interesting: Tim Noakes is quite direct now: he calls what he sees as “fraud” if he think it is: this article says the same about “Blue Zones”: it woudl appear to be fraud; you have no documentation of age; in impoverished cultures;

        Reply
    2. Mark Heneghan

      The fact that pre fat revolution, when carbs were part of our diet, just not 55%, that the west had single figure percent obesity figures suggests that at lower levels of carbohydrate that most people could tolerate them – or to put it another way not everybody needs to go keto. Nevertheless, the fact that many people have lost impressive amounts of weight as well as improving their diabetes, triglycerides and blood pressure, with the completely non pharmacological intervention of reducing carbohydrates, strongly suggests that this is a very good thing to do. I have been keeping an eye on Diabetes UK’s attitude to low carb diets, and it is only recently that they have given them a neutral plug. Before that they used the completely disingenuous argument that there was insufficient long term evidence, despite the fact that it has now been around in significant amounts for about a decade.

      Reply
      1. Eggs ‘n beer

        “Carbs”, starches, are all sugars. Cravings for sweet sugars (sucrose, fructose, dextrose) can be satisfied by eating non-sweet carbs such as the glucose polymers in rice, wheat, barley, potatoes. All of which have become much more available and thus cheaper as agricultural techniques improved over the centuries, and especially as the internal combustion engine freed up about one third of agricultural land from hay production for human food. Food is incredibly cheap, particularly carbs and sucrose which are ideally suited to mass production using internal combustion engined machines. As a side note, it’s been estimated that a litre of petrol equates to about 120 hours of labour. This is most obvious with small tools – think chainsaw vs. axe.

        In Victorian Britain people walked an average of 12 miles a day. They lifted and carried more. They sat less (they stood in offices at their desks, for example) and suffered the weather more. Nowadays many people don’t walk at all. Or lift or carry anything (supermarket home delivery people carry the boxes into the house!), and they can eat as much as they want. Yet since then life expectancy from the age of ten (thus excluding childhood diseases) has increased by about 20 years, presumably due to better hygiene, weather resistance (heating and clothing) and – more food.

        So the only reason that anyone is dying of COVID is because changes in living standards have enabled them to live long enough to reach the age category where they are susceptible! Similarly, people are living long enough to develop diseases like diabetes, IBS, arthritis when otherwise they would have died before they appeared. By all means exercise and practice restraint in what you eat, if only so that your longer life is of higher quality than it might otherwise have been, but this is surely just common sense?

        Reply
        1. AhNotepad

          Food prices are rising. It won’t be cheap for long. There are massive crop losses around the world, and the distribution system is being destroyed. People had better start growing their own food where possible.

          Reply
      1. Philip Thackray

        Oh, by the way, I have been low carb for 15 years. Peter thought that exploring high carb / low fat might be interesting as it works for some people.

        Phil

        Reply
  25. Mark Waters

    And Dr Wolfgang Lutz way back in the 1950’s and 1960’s Essential reading My Life without Bread Dr Lutz at 90 ny Valerie Bracken and just as important is Valerie’s book Uncle Wolfi’s Secret a tribute to Dr Wolfgang Lutz which tells in story form why a low carbohydrate works and how to safely go about implementing one. Excellent news Malcolm

    Reply
  26. Frances

    I read Dr Lutz book years ago when translated into English. In about 2000 I had gone to a size 18 and went on a low carb eating regime losing weight and to a size 12 in 3 weeks. I felt great. My mantra and that of my friend who went on low carb with me was: fat doesn’t make you fat, excess carbs make you fat.

    Reply
  27. Steve Prior

    Dear Dr Kendrick

    I wonder whether the headline is a little misleading?

    “Dr David Unwin can stop people dying of COVID19”

    You then go on to explain how obesity appears to affect the outcome of people with Covid-19

    The statement contradicts your explanation and I fear you are going down a route which will bring the nay sayers out in droves.

    I have always supported your position but this headline is simply untrue and untrue by your own high standards of discussion and dialogue.

    You have for example challenged the notion of saving lives and used terms like extending lives.

    DR Unwin may reduce the risk of dying from Covid-19 but he can’t stop people dying from Covid-19.

    Be interested to hear and understand your thinking behind the headline and my interpretation of it.

    Cheers

    Reply
  28. carl297

    More great stuff – thanks. None of this will be surprising to those familiar with the work and publications of Prof Roy Taylor or the books of Dr Michael Mosley (e.g. The Blood Sugar Diet). Sugar is the demon – not fat!

    Reply
  29. Steve

    Diet is a four letter word. People need to address their ‘lifestyle’, they need to make changes that are a permanent part of the way they live, not just follow a regime for five minute then revert to bad lifestyle choices. Binge and purge, the way of the mentally sick.
    The diet, and associated health, industry is a big gravy train that does more harm than good, and some TV and media GPs appear to have dubious ethics when it comes to the mighty dollar. Let’s not give overt publicity to these snake oil charlatans, there is plenty of advice available, for free, like this blog.

    Reply
  30. liz3321

    The lovely Dr Unwin – one of my heroes of the medical world. So unassuming and willing to listen to patients’ experience of what actually works – and then turn it into research.

    Reply
  31. Jill Leslie

    Oh Dear! The wheel and re-invention come to mind! As a dietitian working in the NHS in the late ’60s and ’70s, this is exactly the same advice that diabetics (especially Type 2) were given then. Even earlier than that, some diabetics were still keeping to Dr R.D. Lawrence’s “red and black lines”, which he designed in 1932. (Dr Lawrence became a co-founder of the British Diabetic Association, as it was then – now, Diabetes UK) This is not to pour cold water on Dr David Unwin’s study, whom I have heard give an excellent presentation of his work – nor on that of those who give similar advice – but to question why on earth this advice was changed to the detriment and damage of many diabetic patients in the 1980s.. It is no wonder that the late Professor John Yudkin titled his definitive book on the dangers of refined carbohydrates, “Pure, White and Deadly”.

    Reply
    1. Dr. Malcolm Kendrick Post author

      Because it was decreed that fat/saturated fat caused CVD. It was then found that people with type II diabetes were at greater risk of CVD. So, add the two together and you got – people with diabetes must avoid fat. Which kind of only really left carbohydrates to make up the gap. One stupid thing led to another stupid thing, and you got stupid squared.

      Reply
          1. jeanirvin

            Interesting! 10 years ago, when I looked at Ancel Key’s page on Wikipedia it said he had killed millions of people with his theories about saturated fat. Now, although it acknowledges the criticisms, it says they are all false.

          2. Mark Christopher Wilson

            There is a marvellously readable book that demolishes all the rubbish about “bad” cholesterol and saturated fat called The Obesity Epidemic. It’s by Zoe Harcombe and it’s dead scientific.

          3. jeanirvin

            Yes! I had an email from them wanting money so I told them not unless you can assure me you are impartial and uphold free speech. It was you being deleted that opened my eyes.

          4. LA_Bob

            jeanirvin,

            Agreed. I had literally just donated a few bucks to Wikipedia when I read Dr Kendrick’s post about the action to delete him. Never again.

        1. spamhelper

          See Nina Teicholz’ excellent book “The big fat surprise” if you want the whole story.

          The short answer to your question is that there were good studies that actually showed the opposite effect – replacing saturated fat with polyunsaturated fat led to worse outcomes – and they were never published.

          Reply
  32. Matti Turunen

    I have lost weight 17 kg in one year. Just helping my Blood sugar down by food and berberin + chromium. Also d-vitamin. Same time when I started take berberin + chromium I also start walking in morning and evening. To much of Carbohydrate is of course main problem.

    Reply
  33. Jan

    Thanks for the info. Low carb here I come. Just watching the news how sad it all is. What on earth is stopping Boris looking at both sides, what data is he looking at? It all beggars belief. It is scary how quickly civil rights and liberties have been removed and who can afford £10K to make a statement such as a public protest? How sure are we that people ill with breathing problems actually have CoVid . Can you get a positive PCR with bacterial or viral pneumonia?
    More drs and scientists need to carry on writing and signing “open letters” and the rest of us copying to MPs. There is a small but growing group of MPs who are showing a glimmer of independent thinking.

    Reply
    1. David Bailey

      It is scary, but I think there is some evidence that people aren’t taking this lockdown very seriously. The sky is lit up with fireworks tonight, and I don’t think these are all being let off without friends coming round. There are far more people around than there were at the start of the first lockdown.

      Reply
  34. Shelley Koroneos

    What about insulin resistance?
    Insulin levels rather than glucose levels as the key factor?
    Not just for those who are fat.

    Reply
    1. Mark Heneghan

      When I was in medical school, to help understand the management of Type 1 diabetes, a friend of mine suggested the ( slightly simplistic) bath analogy, where the bath temperature represented the blood glucose level, the hot tap the glucose intake, and the cold tap, the insulin secretion. Changing either the hot or cold flow will adjust the temperature. Anyone that has ever looked after diabetics in extremis will know that by and large this analogy works. The problem with mainstream management of diabetes is that it puts no brake on the glucose (ie carbohydrate) intake, meaning that you need a compensatory increase in insulin to control it (either your own pancreatic insulin, or injected). In the bath analogy, before long the bath is full to overflowing ( the equivalent of being overweight) in an attempt to keep the water from getting too hot, where all you needed to do was to turn the hot tap down or even off, meaning that you need to put less cold water (insulin) to keep the temperature constant, and you haven’t got an over full bath. Of course it is an analogy and is only for demonstrative purposes, and is not intended to be a proof.

      Reply
      1. Terry Wright

        thanks Mark; reading GC, BC by Gary Taubes; I was aghast to read that in the early 1960s; when the radioimmunoassay for insulin was developed; that they could show that many T2 diabetics had RAISED insulin levels; 60yrs ago; it has never seeped into common knowledge; tragic.

        1970 onwards: Dr Kraft of Chicago did insulin levels; as he did GT tests; he showed how elevated insulin levels were in some; …… could he get anyone to listen?

        Most doctors do not know that T2 diabetics have HIGH insulin levels;

        (they assume the T2 diabetics have LOW insulin levels …….. so prescribe insulin …); how sad.

        Reply
    2. Tish

      Hello Shelley. I agree it’s not all about diet.

      Since the pancreas’s glucagon works in partnership with insulin it has to be considered too. As I understand it, not only does it raise blood glucose levels to prevent them being too low but it acts like adrenaline as a stress hormone, to increase blood glucose levels – which results in the release of blood clotting factors to repair e.g. injury from combat.

      So we have the parasympathetic system working in opposite ways to the sympathetic, and also insulin and glucagon working in opposite ways to keep a balanced, or what the body considers necessary for the occasion, blood sugar level.

      Let’s remember Malcolm’s page 214 of The Great Cholesterol Con which explains how our opposing systems can be confused when we eat while we are stressed. Our sympathetic and parasympathetic systems are active at the same time against each other instead of in collaboration. Not good for insulin production when things are so disrupted.

      Reply
    3. spamhelper

      What is mostly ignored about insulin resistance is the accompanying hyperinsulinemia.

      The biggest cause IMO is that fatty liver leads to the disregulation of gluconeogenesis. In a normal metabolism, when you have low blood glucose and low glycogen stores, the liver makes glucose from metabolic leftovers (glycerol, amino acids, etc.) If you eat something with carbs, blood glucose goes up, insulin is released, and the liver stops doing this.

      In fatty liver (NAFLD), this regulation is broken, so the liver makes glucose all the time. That means the pancreas releases insulin all the time, and one of the big effects of insulin is to turn off fat metabolism. The extra glucose makes the person less tolerant of carbohydrates, which makes them more likely to accumulate more liver fat and make the problem worse.

      Obesity is largely a disorder of fat metabolism rather than a disorder of fat intake.

      Reply
      1. Terry Wright

        “What is mostly ignored about insulin resistance is the accompanying hyperinsulinemia.”

        thanks spamhelper; indeed, there seem two schools of thought:

        Insulin Resistance (IR) springs from Hyperinsulinaemia (HI); that HI comes first was strongly researched and documented by Robert Stout of QUB; as shown by Gary Taubes.

        The opposing school; typified by Jerry Reaven; was that HI sprang from IR:

        Gary Taubes said that Stout lost, and Reaven won; Dr Nadir Ali seems now to be firmly behind the Stout viewpoint: HI leads to IR …………..

        Reply
        1. andy

          Hi Terry,
          The best explanation of IR that I have seen is that under chronic HI cells will down-regulate number of insulin receptors, less insulin receptors will allow less glucose transport into cells, resulting in high blood glucose and high insulin levels. The brain runs primarily on glucose, under IR there is adequate glucose available, but entry into cells is restricted by reduced number of insulin receptors. Result is a brain deprived of energy. Other cell types such as cardiomyocytes would also be affected.

          Reply
  35. Mark Heneghan

    I realise that it is a typo or because written in a hurry, but you give the same extrapolated figure for England and the U.K., implying that they are the same, which won’t go down well with your fellow Scots, and doesn’t go down here in Wales either, before we even consider Northern Ireland.

    Reply
  36. Steve B

    Sorry if this is off topic

    In my local shop no body wears a mask . It’s like nobody cares

    But then i thought about the death of princess Diana.
    I remember the hysteria of (middle class?) people, but people where i lived shrugged and said how sad it was that little kids lost their mother Then they got on with their lives

    Long live the working class

    Reply
    1. Mark Heneghan

      Have you ever heard the phrase ‘never generalise’ with its implicit self contradiction? As I remember during the Diana madness there were many grumpy doctors, lawyers, bankers and teachers muttering in the background about the hysteria of it all.

      Reply
      1. Steve B

        I’m sorry if i offended with my generalisition.
        It was a long time ago but i seem to remember tearful people on tv saying it was just like losing a member of their own family Nobody from my part of the world (dim as we are ) would have said anything as crass as that

        Reply
        1. Mark Christopher Wilson

          As soon as the hysteria about Covid started, I told anyone would listen it was exactly the same as the Princess Diana hysteria. Exactly the same forces at play; Government and even the Queen bounced by emotion into carrying out insane, illogical actions.

          Reply
        2. Mark Heneghan

          Offended is too strong a word, more that I could see weaknesses in your argument, the main one being that you haven’t defined middle class. You also haven’t given any figures. I can’t draw from my own experience because I tend to switch channels whenever the royal family are discussed in the media.

          Reply
    2. AhNotepad

      Steve B, were you meaning that it appears nobody cares about the effect they might have on others? I don’t see not wearing masks as an indication of carelessness, any more than wearing a mask indicates thoughtfulness, when it could be just blind obedience to a poorly reasoned diktat.

      Reply
      1. Steve B

        AH

        It might be carelessness or thoughtlessness but there is also a “screw you” attitude which is sometimes good but sometimes not

        Reply
        1. AhNotepad

          Steve B, sorry, but “screw you” is an opinion, and I doubt you have evidence for a wide spread attitude of this. I don’t wear masks because I am confident that they have no useful benefit in stopping disease spread. I am not being careless, thoughtless, or having a “screw you” attitude” Others will tell me I am wrong, but they have no supporting evidence.

          Reply
          1. Steve B

            AHNotepad
            I didn’t mean that YOU have a “screw you” attitude. I haven’t got a clue about what you think or what makes you tick. I was talking about the people in my neighbourhood and i don’t need to prove what they think. I absolutely KNOW what they think

          2. AhNotepad

            Steve B, I didn’t think you were suggesting I had the “screw you” attitude. I was just illustrating the point that not displaying the government anti-social behaviours would not always be an indicator. The people that do have the “screw you” attitude are the likes of Vallance Witty, Johnson, Hancock and the rest of the scheming crew.

    3. Steve

      I quite often see paid up members of the Covid death cult out walking in the country lanes with their face nappies on, or driving past with their windows closed and face nappy on. WTF ?

      Reply
    4. David Bailey

      I have gradually come to realise that the working class have a much firmer grip on reality and seem to recognise a scam when they see one.
      I is interesting to know why that is. Maybe if you go to university and learn about the paradoxes of relativity, and quantum mechanics, you lose some of your natural common sense.

      I too was amazed by the crazy reaction to Diana!

      Reply
  37. Christopher Palmer

    The matter of weight gain in the human adult involves only the order of 30 billion adipocytes (aka lipocytes) becoming hypertrophied with TAG. These cells only become hypertrophied under certain physiological conditions (balance of hormones) The foremost physiological requirement to establish and maintain the hypertrophy of adipocytes is hyperinsulinaemia

    The leading driver of hyperinsulinaemia id chronic hyperglycaemia whose foremost driver is the high carbohydrate diet. Despite what people typically think about dietary fats and weight gain fats are actually the last obesogenic of the three macronutrient groups. Whereas carbohydrates become glucose in the blood by default, and proteins can undergo gluconeogenesis to become glucose in the blood under certain conditions, TAG breakdown largely proceeds down a metabolic pathway that does not yield much in the way of glucose. The fatty acid constituency of TAG yields ketone bodies which are then converted to ATP and that bypasses the pathways by which glucose may be produced. Only the glycerol moiety of TAG can undergo gluconeogenesis to become glucose in the blood and that is a tiny fraction of the calories that can be derived from the metabolism of TAG. Fats in the diet do cause hyperinsulinemia and consequentially they do not promote hyperphagy either, and so a low carbohydrate permits that TAG can be released from adipocytes, be metabolised, and the persons may lose weight in just the way nature prepared for.

    The above are the details that Jeremiah Stamler failed to incorporate into yet another of his hasty hypotheses. The calorie balance principle holds true but rather more about rests upon the contrasting states rest upon hyperinsulinaemia vs. hypoinsulinaemia

    Reply
  38. fairweather

    While I agree that low carb or even keto diets will improve the health of manymiddle-aged and older women like myself, we may still find post-menopausal central obesity impossible to control. Given the links between this form of obesity and a range of health risks, that’s a matter for concern. Reducing my blood sugar by going HFLC, along with intermittent fasting and optimal treatment for hypothyroidism, has brought dividends in all aspects of health – except for my girth, which keeps expanding no matter what.

    Reply
    1. Jeremy May

      My sympathies Fairweather and well done with your positive efforts. It must be disheartening for you. BUT may I suggest the majority of women are pre-menopausal plenty of whom are obese. May I also suggest that he majority of them contribute to their own obesity suffering that distressing condition, an over-active knife and fork.

      I despaired at my friend recently who bought a new freezer then ranted and railed because it wasn’t big enough to take an extra-large frozen pizza without taking it out of the box!

      Reply
      1. KJE

        A lot of the men I see have huge beer guts probably caused by overactive elbow lifting. Always blame the patient. Many women suffer with thyroid problems which are notoriously poorly treated in the UK – and often ignored even when blood results are way outside the reference range and there are plenty of symptoms. Probably ignored because there are more female sufferers and ,as you say, they are all lazy and prone to overeating – and they are hysterical and need antidepressants (ooh! funding points). This has a lot to do with weight gain in women. Incidentally, some study or other found that many cv19 patients had low T3, so perhaps not so off topic after all.

        Reply
        1. Penny

          The diagnosis and treatment of hypothyroidism in the UK is a disgrace. Many are left extremely ill by the reliance on a TSH test; if ‘in range’ then it cannot be hypothyroidism; usually an anti-depressant is offered. This problem has been compounded by the almost total lack of understanding of the role of T3 and the withdrawal of T3 from patients who already had been prescribed this consigning them to a life of illness. That is not to say that all people (women mostly) who are overweight are hypothyroid but a large percentage probably are and therefore cannot lose weight until optimally medicated, which rarely happens. It would be sadly ironic if Covid-19 patients are given T3 when those who are hypothyroid and desperately need T3 are having theirs withdrawn on cost grounds.

          Reply
          1. fairweather

            Penny, I’m in complete agreement with you over the treatment of UK hypothyroid patients and the withdrawal of T3 treatment by most NHS regions. I’ve achieved optimal treatment by sourcing T3 privately, and I seem to need a large dose in order to control symptoms – larger than the NHS would have prescribed at any time in the past, I believe. When I first started taking T3, all the excess weight fell off steadily, with concurrent improvements in other aspects of health. Then came menopause, and a complete reversal of my weight loss. So galling!

  39. raywhit42

    Perhaps off topic, but I’m getting increasingly alarmed at what this “IF” scenario is leading the population to believe.

    So, dear Doctor, it seems you are completely off piste with your understanding of Covid 19! Reading the opinions, Tweets, etc of the majority of the UK’s population – from BBC and other trusted social media – It would seem that this disease is at least as deadly as Stage 4 Cancer and infections such as Rabies, with the added “Clout” of being highly infectious by being merely close to an asymptotic carrier. It is common knowledge that leaving the confines of ones own home is a selfish act as it most likely will result in someones death! Even excusable ventures out require careful planning to minimise such risks. Do you realise that anyone over the state retirement age, or indeed somewhat younger, is very likely to die as a result of this deadly new virus, or at best be severely disabled for the rest of their shortened life, think Polio.

    Well, perhaps I am delusional in thinking that maybe, just maybe, experts like Dr. Sunetra Gupta, Dr. Karol Sikora and Dr Mike Yeadon, are right? But then the BBC quickly returns me to reality and the feeling that The Day Of The Triffids has arrived – looks a bit like that looking out of my window. Or worse the “Cull Scenes” on the vintage 1956 sci fi BBC serial “Quatermass And The Pit” have actually come to pass.

    Dear Doctor is the mission of medicine to cure Death? Are they really going for immortality? Would it be like Dennis Potter’s “Cold Lazarus”? Do we really just wish for immortality in a machine, quantity of life vs quality of life. I believe the Chinese have actually succeeded to transplant an extra head onto dog ??? To what effect ??????????????????????

    Please Doctor.

    Reply
    1. AhNotepad

      If you believe the BBC, that is the source of your problem. For the most part, this whatever it is, is not deadly. Some very small proportion of people have died from it. If yo want to do some life saving, there are at least 15other diseases to lok at, not to mention traumas caused by road traffic incidents, alling down stairs, lightening strikes, smoking, the list goes on. Are you 77th brigade/

      Reply
  40. Mark Christopher Wilson

    Surely this has been known about since the Dr. Atkins diet in 2000? I did it and it obviously worked. I’ve kept weight off since then. Oh, and plenty of cigarettes and coffee and alcohol seems to help, too.

    Reply
  41. Steve

    If I may be permitted to go into full rabid aged parents mode: “Thyroid problems Ha, didn’t see many fatties during the war and we didn’t see any fatties in Auschwitz.” Harsh maybe, but the sad fact, and elephant in the room, is that most people are obese because they eat too much and don’t exercise enough – simples ?

    Reply
    1. Penny

      Steve, I have heard this before and it is untrue that all fat people make themselves fat by overeating; there are hundreds of thousands of people in the UK who are struggling with hypothyroidism who are undiagnosed. (Reading stories from ThyroidUK should give you some idea.) For someone who was left to struggle for over 30 years because of a lack of knowledge of thyroid issues by the medical profession and others this attitude is offensive. There were no fat people in Auschwitz because they were starved and even those of us who are hypothyroid would have become thin and died, it is just that we would have died earlier than others as thyroid hormones power every cell in the body; starve the body of food and the cells of thyroid hormones and there can only be one outcome. It has been estimated that 1 in 4 women in the UK over 40 have undiagnosed hypothyroidism. Because the present testing for hypothyroidism is so inadequate, TSH only, many are deemed not to have an under active thyroid when they are blatantly hypothyroid with many of the symptoms but are dismissed because their TSH test is ‘within range’. Perhaps some eat a lot in order to comfort themselves for a life of pain and disability? For someone with untreated hypothyroidism to diet is one of the worst things to do as the body is already struggling with lack of cellular energy and a lack of food stresses the body even more as it is already not fully functioning without adequate thyroid hormones. A lot of the ‘fat’ can be oedema. The late Dr Skinner treated patients with thyroid hormones when their TSH tests were ‘within range’ and the GMC spent years trying to strike him off for this; his patients loved him as their lives were turned around.

      My apologies for going off-topic and for a soap-box moment but this whole issue is of immense importance for those who are hypothyroid.

      Reply
      1. Jeremy May

        Penny.
        I, as most people, are not ignoring, denying or otherwise disbelieving that a proportion of people suffer from various conditions, including hyperthyroidism. I never belittle people who have genuine struggles.
        BUT, a conservative 25% of the UK’s population is obese (approx 15 million), considerably more merely overweight. The trend is increasing too. An enormous number of people, with no underlying difficulties, could help themselves immeasurably by a change of lifestyle.
        Itr’s incredulous that people believe the skewed science that has our nation (world?) in such a mess, but ignore advice and warnings repeated ad nauseam about the dangers of being seriously overweight. The latest above.
        I think it’s fair to say that nobody should gloss over the problems of hyperthyroidism or the menopause. They are real and distressing. But the problems of obesity and excess weight should not be shouted down and glossed over because the voice of a minority is louder.
        Everybody should be heard and helped in equal measure.

        Reply
        1. KJE

          But it’s not as simple as just eating less and exercising more. We had fat kids at school, and they ate and exercised exactly the same as the skinny kids, as there was no choice – no sweets etc allowed. No getting off games or PE. No sitting indoors when you were ordered go outside. Perhaps they spent the entire school holidays eating, but since term time is much longer than holidays, I don’t think that could explain it. There has to be more to it

          Reply
          1. janetgrovesart

            When I was at school in the 40s and 50s there were almost no fat children AT ALL and so on into the 60s. Who ate Pizza, pasta, rice (apart from pudding once a week) pot bloody noodles, ready meals, takeaways (apart from fish and chips once a week, if that) and all the other edible tat that passes for food these days.

          2. KJE

            We ate rice and curry on Monday (made from Sunday roast leftovers), mashed potato most days and no end of jam tart and stodge puddings for dessert. Sometimes we had tinned spaghetti – vile stuff – but pasta wasn’t really a thing. Supper was white bread crusts covered in marg and sugar – choice of brown sugar or white. And we did have fat kids – not many, and looking at old photos, my best friend who was considered “chubby” would seem quite slim by today’s standards. Don’t know what that proves.

          3. Martin Back

            We had one really fat kid at my primary school in the ’50s. His father owned a very successful snack foods business. I myself was definitely on the chubby side. (I grew to hate the term “puppy fat”.) In my case, the cause was over-indulgence in white bread and apricot jam sandwiches.

            I now believe my childhood overeating was an attempt to self-medicate because of a stressful home life. (My parent’s marriage was on the rocks but divorce was frowned upon in those days.) Significantly, once I left home and went to boarding school and the army, my weight normalised.

          4. Mark Christopher Wilson

            I’m with Janet on this. Quality of diet is the most important thing. My kids are incredulous when I tell them Lucozade came in an orange cellophane-wrapped bottle and was only ever given us when we were in bed, very ill. I think the nation’s diet started going down the nick in the mid-70s with the advent of freezers and microwaves. The reason the French are the thinnest people and also consume the highest amount of saturated fat is they eat food like we used to eat in the 60s and they are willing to spend top dollar for the best stuff.

      2. Steve

        Apologies, wasn’t intended to be offensive or to imply thyroid problems don’t exist.
        However, what I wrote was “… most people are obese …” NOT “… untrue that all fat people make themselves fat by overeating …” which you implied I wrote.
        Let’s be clear, what I originally posted is: “63% of adults in the UK (approx 31.5M) are obese.” A couple hundred thousand with thyroid problems represents only around 0.6%. So, I stand by my statement “MOST people (99.4%) are obese because they eat too much and don’t exercise enough”.

        Reply
          1. Joe Dopelle

            Dr Fung states this very clearly. He says that you control your health and your weight by what you eat and drink, and you build muscle by exercise. Neither diet nor exercise can substitute for the other, although having more muscle and being fit does contribute to health and perhaps make you hungry for a better kind of food.

        1. LA_Bob

          Steve,

          There are fat people who will tell you they are hungry almost all the time.

          We’ve heard for decades about the plight of people without enough food who go to bed hungry. Imagine, just imagine, someone with plenty to eat who is almost always hungry. When I was younger I would marvel at someone who wears a refrigerator and complains about dinner being late. Such people also complain that exercise is like torture. Normal weight people don’t have these problems. They have appetites which can be satisfied. Exercise is fine, even a pleasure.

          Any theory of obesity has to explain why the overweight have unregulated appetites and such difficulty with exercise.

          Reply
          1. jeanirvin

            I think hunger is a call for nutrition from your body. If you are eating ‘food’ that is not nuritious or if you are very low in a particular nutrient, your body will call for more food in an effort to address the balance.

          2. Joe Dopelle

            I agree with jeanrvin. If a person is starved of good-quality protein, for example – a common syndrome nowadays, believe it or not – or B vitamins, A and D, or even iron or magnesium – they may very possibly go on feling hungry as their body demands the missing nutrients. But if all they have is what the government recommends, they can eat all day and all night and still be deficient.

            It’s wickedly cruel and cynical.

        2. DaveL

          If you want a good explanation of why the First Law of Thermodynamics doesn’t explain obesity (ie, calories in, calories out), read Gary Taubes’ Good Calorie, Bad Calorie. Basically, it’s a regulated system, and when it gets off kilter for overweight people, the energy gets redirected to fat cells for storage, metabolism and physical activity depressed, and to top it off, because they are effectively malnourished, overweight people also get the urge to eat more. The idea that it is “bad moral fiber” or some such thing does such people an injustice.

          Reply
          1. AhNotepad

            Unless you can demonstrate “gluttony”, I would argue it does not exist as a wilful act. Stopping eating is controlled by satiety, if this signal is not present then I suspect many people will continue eating. Satiety signal comes from eating the right food, so eating te “wrong” food does not give this signal. It maybe argued eating the wrong food is a bad decision, but most peple have no idea what they eat is causing the problem.

          2. spamhelper

            And bad moral fiber doesn’t help explain why people in the 1970s were mostly of normal weight despite adult fitness not really being a thing, while people now are mostly overweight even if they work out.

    2. spamhelper

      The advice to “eat less and move more” has been, at its very least, a public health disaster; it has been the party line for decades and populations have just gotten heavier.
      I personally found that when I hit my 50s, I started gaining weight, despite eating a “healthy low fat” athlete diet and riding my bike about 100 miles a week, plus a fair bit of walking. Trying to eat less didn’t work, and spending more time exercising wasn’t really practical. What advice would you give me, or the other people in my cycling group who were in similar situations?

      What I did was teach myself enough biochemistry and physiology to understand how things really worked, flipped my diet to the low carb side, and dropped 19 lbs in 3 months, back to my high school weight, which I’ve maintained for a couple of years. I feel better, I don’t have energy issues, and I have better performance on the bike and for long runs.

      Reply
      1. Steve

        You’re right, it’s too simplistic to say eat less, it’s more a case of saying eat the right stuff in appropriate quantities.
        Junk food, take-away’s, snacks and processed meals are part of the problem that has led to the modern obesity epidemic. These things didn’t really exist before the 60s/70s when obesity was less of a problem.
        For ‘most’ people bad lifestyle is the problem and, I contend that, diet is not the solution as what is really needed is a lifestyle change.

        Reply
        1. Steve B

          In the 60’s and 70’s we didn’t half eat some crap. Does anyone remember Angel Delight, Angel Cake, Dandelion and Burdock guzzled by the gallon, Rice Crispies covered in copious amounts of sugar?
          We ate that rubbish out of sheer ignorance but none of us were fat because we were outdoor kids always on the go. Each Sunday we would cycle to East Midlands Airport to watch the planes (a 28 mile round trip) Our parents thought this was a normal thing for kids to do. They would probably be prosecuted for child abuse in this soft day and age.

          Reply
          1. KJE

            I ate all that stuff (hated Angel Delight – disgusting) but we had to eat it at school – you weren’t allowed to leave anything, and I wasn’t active as I had asthma and no inhaler, so I couldn’t run or do sport. (one kid whose father was a German doctor had an inhaler, but they weren’t offered by NHS back then). But I was still skinny. So doesn’t look as though exercise has much to do with it

    3. anna m

      Steve,

      Simplistic, yes. People suddenly began to get fat around 1980 (in the US). They had plenty to eat for decades before that. Yes, there is an increase in some bad habits like drinking soda and between meal snacking.

      Reply
  42. Ray

    Replying to AhNotepad.

    OH my GOD, Am I a 77th brigader, OMG again. NO I AM NOT, PERIOD. Read my post carefully please.

    I am a person who has had their life, or rather their quality of life, curtailed by the present panic which is beginning to seem as the fairly normal winter maladies, but all under the same Logo, viz COVID 19. Covid is Flu & Flu is Covid, not to mention all the other nasty bugs which most likely have “Associate Membership”. It worries me that really nasty infections could slip under the wire only to be diagnosed by the rubbish PCR test as Covid, and therefore not be correctly treated, Meningitis or Sepsis anyone?

    As for the BBC, please don’t annoy me further. De-fund the BBC. I was eligible for a free license, now no longer although I’m holding back right up to the line.

    I could almost lay a bet, although any sensible bookie wouldn’t accept it, that each time you tune in it is less than a few minutes – lot of the time instantly – that Death, Cases, ICU admissions, and advice to stay Home to save lives, is the first thing I hear or see. No hopeful messages, no cheer, NOTHING. The BBC disgusts me. Sometimes I look at them on line to try and insert some balance to the arguments, but its only p***ing me off.

    To the BBC may I also add Wikipedia. By no means an neutral and unbiased organisation. Wikipedia is less than useless to research many historical events or personalities, and forget anything political or non mainstream like diet supplements or holistic medicine. Its very sad that Wikipedia is not only the “Must Go To Site”, but seems to have a monopoly as seemingly alternative sources just “Copy & Paste” Wikipedia.

    Reply
    1. AhNotepad

      Ray, thank you for your reply. Looks like I made the wrong inferences. Sorry about that, but that’s the trouble with writings, they may not be read the way the writer intended.

      The beef I have about the BBC is they are short on facts, and long on political rhetoric, and they pretend they are objective by using “fact checkers”, a misnomer if ever there was one.

      Reply
      1. David Bailey

        I made the same inferences as you did. I do think it is important when writing a Ray did, to make sure that the meaning is clear. One way to do that, is to write it in Notepad (say), read it several times, and only then cut and paste it into a reply.

        I gave up my TV license about a year ago – if you do that on the website (as opposed to just stopping paying) they seem to leave you alone.

        Reply
  43. spamhelper

    I tend to agree that there are really powerful forces pushing to continue the low-fat high-carb mantra; not only do the drug companies make significant amounts on diabetes drugs (and statins, of course), but the recipe for the majority of processed foods is cheap grains, sugar, and vegetable oil, and they will fight hard to defend the huge profits they get.

    There has been some movement; the official ADA guidelines now consider low carb as something that is no longer demonic, and the current ADA president noted recently in an interview that she uses a low-carb diet.

    Reply
  44. Tish

    Hello all.
    The following is a link which includes the feats of my father’s brother Patrick Garstin, MC, and his band of SAS brothers. It also pays homage to the bravery of the French people in a village. I do not post it to show off (although of course I share some family pride) but to explain my disgust at the pathetic and selfish behaviour that is being shown today because of some virus. What would Patrick have made of it? (He underwent real torture before being murdered.) He would have been disgusted, and rightly so.

    https://www.talkradioeurope.com/clients/dlewis281020.mp3?fbclid=IwAR2wfRl87WndkiTIDSSumXDBDUUkW9XlkRo3sCEwkxDYRTm9YcwX0dcJxaw

    Reply
    1. Steve

      Tish.
      Off topic, but – today, 8th Nov, Remembrance Sunday is the day we celebrate the lives of those who made the ultimate sacrifice to protect our freedoms.
      It’s very indicative of where we are today and the leanings of our government that many of the Remembrance Services have been cancelled or banned.
      So much for freedom, so much for those sacrifices, what have we become ?

      Reply
  45. watchingthestream

    Just two points. I think we need to stop using the word diet, as there are two parts to losing weight, losing weight and maintaining that weight for ever. It’s more of a lifestyle change not an 8 week diet followed by going back to the same lifestyle. Lifestyle is a better term as it brings in other important factors like exercise, sleep, social contact etc.

    Also, I’m really not as sure about this knowledge being suppressed as you suggest. In the US, a best selling book is Gary Taube’s “Why we get Fat” published 10 years ago. It’s a great read as it gives practical advice on diet. Tom Watson’s book “Downsizing” in the U.K. advocates the same lifestyle change and incidentally he cured his Type 2 diabetes.

    Reply
  46. Mark Heneghan

    It is true that it is difficult to get T3. I get better results than just using the TSH as a guide by asking the patients how they (1 in 50 women, 1 in a 1000 men) feel, and if still symptomatic push the dose up. There is no law that says you have to have the TSH right in the middle of the range. An endocrinologist friend of mine has often advised that as long as you don’t suppress the TSH to ‘ unrecordable’ you are pretty safe pushing the dose. The patients seem better too. If diabetic it usually improves their HbA1c too by increasing basal metabolism.

    Reply
    1. Penny

      I am pleased to hear that you understand the importance of T3, Mark Heneghan, if only there were more. ThyroidUK recommend a TSH of 1 or below for someone who is hypothyroid to feel better, sadly the reality is that GPs do not treat hypothyroidism even with a TSH of over 10; a TSH of, say 5, is dismissed. Very important, IMHO, is that the relationship of T3 to T4 is measured as this will highlight a conversion problem; a DI02 test would throw up any genetic problem. (I have a record of a T3 test which showed a blood level of 0.01 (no range given) I was told that I was not hypothyroid when I could barely stand.) Very few GPs or endocrinologists understand Thyroid Hormone Resistance and panic when the TSH drops very low when taking T3 and start talking of heart arrhythmia and osteoporosis. As someone who has THR and has a virtually unmeasurable TSH I can attest that I have none of these problems and many on ThyroidUK are the same; drop my T3 dose and my brain stops working. Over reliance on T4 monotherapy keeps many unwell; perhaps more weight should be given to treatment with NDT.

      Reply
      1. Mark Heneghan

        Sorry to hear of your experience. My approach is based on symptoms, with blood tests in the supportive rather than central role. Thus, if you are a woman (typically) that feels tired, mentally sluggish, gaining weight, with little appetite, have a raised tsh with a low/borderline t4 and positive thyroid antibodies, then the diagnosis is not in doubt, and the primary aim should be relieving symptoms, not getting the numbers normal. I accept that thyroxine doesn’t help everyone, but so many guideline driven GPs are simply underdosing their patients because they use their eyes on the computer blood file to titrate the dose, rather than their ears, when they should be asking ‘how do you feel now?’ Sadly, so much of my job has moved away from relieving symptoms, (the most important thing to the patient), by using clinical judgement, while we hide behind guidelines, and push the largely useless preventative medicine agenda that is QOF.

        Reply
        1. KJE

          What do you do with people like me? Low everything (TSH, FT4, FT3, cortisol, sex hormones) – but can’t get a diagnosis of central hypo and no pituitary tumour. People with hashis or primary hypo think they have problems!

          Reply
  47. Martin Back

    I follow Tim Noakes on Twitter and he’s been promoting David Unwin for some time. It certainly makes sense — if your body can’t handle sugar, don’t give it sugar, or anything that turns to sugar like carbs.

    Having said that, I’m not entirely sold on LCHF, although I have cut down on carbs and increased my saturated fat intake and feel better for it.

    For one thing, the animals our ancestors hunted were probably pretty lean and fit, They had to be, to escape from predators. No well-marbled steak for Og! In the Bushman heaven, all the animals they hunt are fat, unlike the stringy gazelles they have to cope with on Earth. (They get most of their fat from Mongongo nuts.)

    For another, we like sweet things and start digesting starch immediately as we chew it, which tells me we are biologically adapted to value sugars. But of course there is tremendous competition for ripe fruits and berries from other creatures, so we probably had to eat things before peak ripeness and couldn’t overload with sugar before our bellies were filled with pulp. Until grains arrived.

    Farmer Joel Salatin makes the point that before mechanization, grains were expensive. It took human and animal labour to plough, plant, harvest, process, transport and store grains. So people probably couldn’t afford to overeat. Not to mention that wheat e.g. was ground with the germ intact and naturally leavened, so it was much more nutritious than today’s wheat products.

    These days nutrition-poor but calorie-rich starchy and sugary foods are so cheap, so accessible, and so heavily marketed, it’s no wonder we overeat on the stuff, given our biological bias to favour sweet things. And that quality nutritious foods like meat, eggs, and dairy have been demonized.

    My personal opinion has been that as long as you are getting all your essential nutrients, your bulk calories can come from carbs or fat, it doesn’t matter. Although the more I read about insulin spikes and the like, the more I realise that highly processed and quickly-digested carbs and sugars are a no-no. Quality matters.

    Reply
    1. Steve B

      Martin

      if grains were so expensive to produce why did humans bother becoming farmers?
      Grains were probably cheap to produce by the peoplle who had to do the work while the very new landowning class could sit on their arses.

      And for the first time in human history a regular surplus of food could be produced.

      Reply
      1. Joe Dopelle

        “…while the very new landowning class could sit on their arses”.

        Or, more likely, spend most of their day hunting, fishing, riding and practicing with edged weapons. So that the landowning class over the hill didn’t ride in one night, kill them, and take over their land and serfs. (Although that might still happen from time to time).

        “Uneasy lies the head that wears a throne”.

        Reply
    2. Frango Asado

      “No well-marbled steak for Og!”

      Actually, all (living) animals have plenty of fat in and around their organs. Zoologists and other observers have often reported seeing a leopard or other predator tear into a kill, eagerly consume the fat around the kidneys and liver (togther with as much liver, kidneys, stomach and guts as it feels the appetite for) and then walk away, leaving the carcass almost intact with all the lean muscle meat that you will find in our shops. Og might not even recognise steak as food – certainly not the kind he prefers.

      And of course predators in cold countries (including humans) preferentially eat blubber, along with presumably enough leanish meat to supply their protein needs.

      One of the hardest tasks for anyone trying to adopt a healthy natural LCHF diet is to start swallowing all that fat we were taught as infants to cut off and push aside. Luckily, as long as it is cut into reasonably small pieces, it needn’t be chewed: pure fat usually slides right down the throat. People who eat raw meat find that if you cut it up into spoon-sized pieces, they can be swallowed whole rather like mussels.

      As for digestion, it has been known for a very long time that the human stomach digests meats more quickly and more thoroughly than any vegetable matter. Typically meat and fat are reduced to a yogurt-like consistency in about an hour or less, ready for the small intestine.

      Reply
      1. Jerome Savage

        Re “human stomach digests meats more quickly and more thoroughly than any vegetable matter” The universal understanding is different, in that a large meat intake is tyring & demanding on the body’s resources, hence the considerable amount of time carnivores spend just lion around (sorry) and the tendency to sleep off that Sunday roast with an afternoon couch in.

        Reply
        1. Joe Dopelle

          Which is why the invention of cooking is widely seen as the critical breakthrough in human evolution. The difference in the amount of energy required to eat a kilo of meat raw or cooked is remarkable.

          On the other hand, the energy derived from meat compared to vegetation is very much greater. That’s why humans are able to grow and maintain such very large brains, while getting by with relatively small digestive organs.

          Without grains, vegetarianism would be physically impossible for humans. A person simply cannot eat enough raw fruit and vegetables to sustain life.

          For details see Richard Wrangham’s very readable “Catching Fire”. (His “Demonic Males” is also recommended).

          Reply
      2. Martin Back

        Arctic explorers used to get “rabbit starvation” from eating meat with not enough fat, so it is not true to say that all animals have sufficient fat for human consumption.

        Reply
    3. Frango Asado

      “Not to mention that wheat e.g. was ground with the germ intact and naturally leavened, so it was much more nutritious than today’s wheat products”.

      It also usually contained a goodly proportion of minerals, such as sand, grit and dust – not to mention bugs, etc. Merchants who needed to boost their profits might add an extra handful of sand.

      Not in the bread destined for the palace or the temple, of course – that would be a good way to lose a limb or get barbecued.

      Reply
      1. Martin Back

        That reminds me that at one stage there was a fad for gourmet grass for racehorses. This was grass grown under sterile conditions in greenhouses. The salesman’s pitch was, “I wouldn’t give my expensive horses grass that I wouldn’t eat myself,” and pluck and munch on a bunch of his very clean grass.

        It turned out that horses don’t do well on sterile gourmet grass. In the field they inadvertently munch on small quantities of insects and other grass-dwelling creatures as they graze, and that 2-4% of protein they get thereby is an important part of their diet.

        Reply
        1. KJE

          I doubt you’d feed racehorses on grass anyway; they need oats and nuts to maintain performance and condition without getting fat. They don’t live out in fields while competing.

          Reply
          1. Martin Back

            Maybe they’re not out in the fields while competing, but I visited family next door to a stud farm, and the horses were out in the fields all day for the three weeks I was there. It was foaling season, and it was fascinating to watch the young horses. They were a bit uncertain on their long legs, but already starting to run. Little groups would form, then one would dash off, then the others follow him, then form another little group, then a more short dashes, and so on. The foals seemed to love running.

          2. KJE

            A stud farm is a lot different from a racing stable – those things used to be my job, but dressage horses, hunters, show jumpers and so on. Yes, brood mares and young stock will spend a lot of time at grass and young horses are fascinating to watch, actually so are kids (the goat version, not human) and lambs.

          3. Martin Back

            The only time I visited a racing stable, I noticed bags of what looked like brown wood shavings outside the stalls. When I asked what they were, I was told they were bags of dried onion flakes. They keep the horses’ blood thin.

    4. Frango Asado

      In a healthy diet, ALL the calories come bundled with essenital nutrients. Grain products, like sugars, are mostly nutrient-free “empty calories”.

      If you read the Jaminets’ “Perfect Health Diet”, you will see that they begin from first principles by working out what nutrients, and how much of each, we ideally require. Then they look at how many calories we need. Almost all foods contain calories – getting energy is not a problem. The challenge is to cram in as much of as many nutrients as possible without getting too many calories. In other words, to minimise or eliminate empty calories.

      Reply
  48. Mark Heneghan

    Interesting to know that cultivated wheat has a mutation in it which means that the enzyme that breaks down the cellulose bridge connecting the seed to the husk is absent, meaning that the mature seeds don’t disperse in the wind. Normally this would be an evolutionary disadvantage to the organism, but because this feature was valued by the earliest farmers (it hadn’t all blown away by harvest time) it has made the organism VERY successful – symbiosis at its most elegant.

    Reply
    1. Joe Dopelle

      In “Sapiens”, his first and (for my money) best book, Yuval Noah Harari has an enlightened and amusing view:

      “We did not domesticate wheat. It domesticated us. The word ‘domesticate’ comes from the Latin domus, which means ‘house’. Who’s the one living in a house? Not the wheat. It’s the Sapiens”.

      So, asks Harari, what did the wheat offer H Sapiens in return for being domesticated? Not better nutrition, nor security against violence, nor even safety from hunger and even starvation. Just the possibility of multiplying exponentially – the [perhaps rather foolish] definition of biological success.

      “With time, the ‘wheat bargain’ became more and more burdensome. Children died in droves, and adults ate bread by the sweat of their brows… Paradoxically, a series of ‘improvements’, each of which was meant to make life easier, added up to a millstone around the necks of these farmers.

      “Why did people make such a fateful miscalculation? For the same reason that people throughout history have miscalculated. People were unable to fathom the full consequences of their decisions”.

      Every good harvest tempted people to have more children, but they failed to see the long-term implications. Eating grains weakened their immune systems while being crowded together with farm animals encouraged infectious diseases; and even when they had a surplus of food, that just attracted robbers and enemies so they had to build walls and lose workers to become soldiers. “The trap snapped shut”.

      Reply
    2. Steve

      Mark,
      apparently, the wheat commonly used nowadays all comes from a very limited genetic stock that has been ‘developed’ to maximise output. We don’t have the various different varieties easily available that were grown centuries ago (apart from in emergency seed banks), this means wheat production, worldwide, is vulnerable to disease. Eggs all in one basket ? Crazy !!

      Reply
  49. Peter Downey

    Excellent piece, doc. One other man to follow is Professor Stuart Phillips from McMaster University in Canada. With his students he has worked on protein intake particularly amongst older people. Older people are less efficient at taking up intake and therefore need to eat even more protein. He focuses on ‘sarcopenia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269139/ . He can be found on twitter: https://twitter.com/mackinprof
    Also on facebook. Some lectures and intervierws can be found on youtube.

    Reply
  50. Tish

    People are now telling me that, whereas earlier on, nobody seemed to know anyone with Covid19, now everyone knows, or knows of, at least someone with it! They accept the numbers are up because of all the testing but they are not suspicious of the testing. So we are losing doubters to the scared and scary side. Just what the powers that be want.

    I fear things will get worse when the usual winter bugs are tested for Covid and given ridiculous positive results. I seem to have spent the last 8 months making myself unpopular for a lost cause. Sorry to be such a misery guts. Please, has anyone got some positive things to say?

    Reply
    1. Jerome Savage

      How about – a reduction in GDP may be good for the environment ?
      Or an increase in home working may reduce demand for road network expansion ?

      Reply
  51. Norman

    An article discussing cost-benefit analysis and how we should be looking at the situation if we accept that COVID is part of the ‘healthcare’ system

    https://www.spectator.co.uk/article/is-the-cost-of-another-lockdown-too-high-

    Also has anyone noticed this snippet, when looking up health facts since March 2020? … Japan has a low level of healthcare spending for a developed country and has the longest lifespan in the world. 25% are over 65, vs only 18% in the UK.

    Reply
  52. Terry Wright

    throughout the rona hysteria, we have been bombarded with “it is all different …”, “it is special ..” .. “it is novel …. ” …… “it is unique …”

    whilst browsing this https://en.wikipedia.org/wiki/Tocilizumab

    I was intrigued to see “On 30 August 2017, the FDA approved tocilizumab for cytokine release syndrome, a side effect of CAR-T cell therapies”

    I clicked on the link https://en.wikipedia.org/wiki/Cytokine_release_syndrome and lo and behold; the amazing, unique, special, different, novel ……… response to a recent viral infection has been ……… yawn ……. talked about for years …… but like a tired old piece of steak; our manipulative media can make it come alive and seem special …………….

    Reply
  53. Terry Wright

    thanks David; as I suspected though, they are using their old advice: 400IU of Vit D a day;

    https://www.gov.uk/government/news/phe-publishes-new-advice-on-vitamin-d

    they might as well “pi*s into the wind ..” …… as someone deficient needs much more:

    if a 20yr old; in the summer sun; in 20 mins; can make 20,000 IU; why would you be so perverse as to argue that taking 5000 IU a day could be harmful? …. but give them great credit: there are boundless reservoirs of perversity and stupidity in the PHE advice; be it … on diabetes, carbs, heart disease ……. jaw-dropping stupidity will be uttered with all seriousness

    Reply
    1. David Grimes

      A supplement of 4,000 units each would be fine for a slim person, but for the obese, and T1Diabetes 10,000 units per day would be more appropriate. Blood levels should be checked.

      Reply
    1. Frango Asado

      The science of health, like everything else recently, is bedevilled by simplistic answers. Mostly involving the reduction of extremely complex systems to single numbers such as GDP or blood pressure.

      Of course if we all got as much exercise as your typical hunter-gatherer – walking maybe 20-30 miles a day, with occasional bursts of sprinting and tree-climbing – neither obesity nor blood pressure would be much of a concern.

      Reply
      1. AhNotepad

        That’s ok, we have a cure now. Since the advent of covid, all other diseases have declined dramatically in the developed countries, and that is without a vaccine.

        Reply
  54. Martin Back

    I watched a video by an older fitness guru. He said something like, “Strength is the most important thing as you get older… because no one wants to lift your fat butt on and off the toilet.”

    He has a point.

    Reply
  55. Simon

    Looking forward to Dr Kendrick’s next blog post, which has to be on the just announced Pfizer covid-19 vaccine, or rather the wonderful example of “doctoring data” behind it 😉

    The Media headlines scream “90% effective!!!!” yet…

    * 43,538 participants
    * 94 confirmed covid-19 cases
    * so “90% effective” is maybe 85 in the placebo group and 9 in the vaccine group

    now for the real-world absolute differences using those estimated numbers above:
    * 99.61% chance of not testing +ve for covid-19 in the placebo group
    * 99.96% chance of not testing +ve for covid-19 in the vaccine group
    * therefore an absolute difference of only 0.35%

    what we don’t know:
    * how the +ve cases were determined; a test? symptoms? actual illness? hospitalisation? In other words, how do they define “effectiveness”
    * how random the study is; e.g. was it a true 50/50 split in all the same areas, or was it say 100 people in Area 1 get the vaccine, 100 people in Area 2 get the placebo, etc.
    * long-term side effects/problems

    Reply
      1. David Bailey

        I hope you will discuss this ‘vaccine’ some more Malcolm, because from what I have read, it is more like a gene therapy treatment that a conventional vaccine because it splices a gene for the spike protein directly into the DNA of the recipient.

        Can we be sure that this will not get into the germ line?

        I know some past gene therapy trials have gone wrong because the splicing occurs at random locations and so occasionally causes a mutation that causes cancer.

        If you pronounce it safe, I might accept it, but not otherwise!

        David

        Reply
        1. Dr. John H

          David,
          I’ve searched for years to try and find a vaccine that is safe, and I cannot. I can’t see how a fast tracked drug with no real safety testing and zero liability for manufacturers could be anything but a nightmare.

          Reply
    1. AhNotepad

      Well done for clarifying the Pfizer crap speak Simon. This effectiveness figure is misleading, and if we take their figures, then NNT = 43,538/94 = 463. Now, what am I doing wrong here? Surely they can’t be claiming the vaccine prevented 43,444 infections, can they? I note they appear to have ZERO adverse effects.

      Reply
  56. Dr Tim ODowd

    Thank you for highlighting this gentle caring man. He listened, did not preach from a pedestal, he learned from his patient, and he loves this new medicine, actually giving genuine hope and wellbeing to his patients. Well done Malcolm and David.

    Sent from my iPhone

    Reply

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