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.