21st September 2022

Once again, saturated fat is found not guilty [yes, once again]

I suppose that what I am about to tell you is pretty much old hat. Many people, including me, have been saying – for many years – that saturated fat has no impact on cardiovascular disease. Never has, never will. The scientific support for it has always been non-existent, and the hypothesis has always been complete fact-free, evidence-free, thought-free, nonsense.

Indeed, it is more likely that saturated fat may have beneficial effects. It certainly does if you replace fat in the diet with carbs, carbs, carbs … and more carbs. Which is what most people have done. Happily following the idiotic advice of nutritional experts around the world.

Anyway, mainly so that I can sit back and say, ‘I told you so’ once again, here is the abstract from a paper that was published in the European Journal of Preventive Cardiology a couple of weeks ago ‘Saturated fat: villain and bogeyman in the development of cardiovascular disease?’¹

Key comment – to be found at the end.

‘…there is no scientific ground to demonize SFA as a cause of CVD. SFA naturally occurring in nutrient-dense foods can be safely included in the diet.’

Abstract

Background

Cardiovascular disease (CVD) is the leading global cause of death. For decades, the conventional wisdom has been that the consumption of saturated fat (SFA) undermines cardiovascular health, clogs the arteries, increases risk of CVD and leads to heart attacks. It is timely to investigate whether this claim holds up to scientific scrutiny.

Objectives

The purpose of this paper is to review and discuss recent scientific evidence on the association between dietary SFA and CVD.

Methods

PubMed, Google scholar and Scopus were searched for articles published between 2010 and 2021 on the association between SFA consumption and CVD risk and outcomes. A review was conducted examining observational studies and prospective epidemiologic cohort studies, RCTs, systematic reviews and meta-analyses of observational studies and prospective epidemiologic cohort studies and long-term RCTs.

Results

Collectively, neither observational studies, prospective epidemiologic cohort studies, RCTs, systematic reviews and meta-analyses have conclusively established a significant association between SFA in the diet and subsequent cardiovascular risk and CAD, MI or mortality nor a benefit of reducing dietary SFAs on CVD rick, events and mortality. Beneficial effects of replacement of SFA by polyunsaturated or monounsaturated fat or carbohydrates remain elusive.

Conclusions

Findings from the studies reviewed in this paper indicate that the consumption of SFA is not significantly associated with CVD risk, events or mortality. Based on the scientific evidence, there is no scientific ground to demonize SFA as a cause of CVD. SFA naturally occurring in nutrient-dense foods can be safely included in the diet.

Will this paper have any effect on anything? Will it heck!

Although maybe, just maybe, a few people out there will stop for a moment to ponder the known fact, verily the truth, that saturated fat causes cardiovascular disease. As for the rest …

‘Man will occasionally stumble over the truth, but most of the time he just picks himself up and stumbles on.’ Winston Churchill

Just so I am not accused of sexism. Women do this do too. Please now write out one hundred times:

Saturated fat does not cause cardiovascular disease

Saturated fat does not cause cardiovascular disease

Saturated fat does not cause cardiovascular disease rpt x 97

1: https://academic.oup.com/eurjpc/advance-article-abstract/doi/10.1093/eurjpc/zwac194/6691821?redirectedFrom=fulltext&login=false

Postscript

In my last blog I asked the question. Why did COVID19 lead to a spike in overall mortality in England, but not (or far less so) in Wales, Northern Ireland and Scotland? In a number of age groups, there was no impact on mortality – at all.

The most likely answer, I think, is the proportion of ‘non-white’* people living in each country. England has far more non-white people. Around 18% – it is difficult to be absolutely certain about this figure. In Scotland, Wales and Northern Ireland it is about 4%, maybe even less in Northern Ireland.

This difference could also explain Sweden and Norway. The Norwegians do not publish data on ‘race.’ It is considered racist to do so. Which of course leads to problems in situations like this where you might need the data to help protect those of different races.

So, ironically, it could be considered racist to have no data on different races? Discuss. However, the estimate is that around 3% of the Norwegian population is ‘non-white.’ In Sweden the proportion is very similar to that in England.

Therefore, my working hypothesis is that non-white people living in countries at a high latitude, are significantly more likely to be vitamin D deficient.

‘Non-white populations in Europe are at higher risk of vitamin D deficiency than their white counterparts. For example, compared with white populations in the United Kingdom, Norway, and Finland, the non-white population subgroups have 3- to 71-fold higher yearly prevalence of vitamin D deficiency.’ ¹

Vitamin D deficiency increases the risk of mortality from COVID19:

‘The all-cause 30-day mortality was 13.8% in the group of patients with sufficient plasma 25(OH)D levels and 32.1% among those with deficient plasma 25(OH)D levels. Cox regression showed that plasma 25(OH)D levels remained a significant predictor of mortality even after adjusting for the covariates sex, age, length of the delay between symptom onset and hospitalization, and disease severity.

Conclusion

Vitamin D deficiency predicts higher mortality risk in adults with COVID-19’ ²

The ratio between 13.8% and 32.1% is 2.3. Which is big.

A number of people suggested race, and vitamin D, as a possibly hypothesis. I agree with them. Now, what are we going to do about it …before winter arrives that is. I recommend several thousand units of vitamin D each day, until March.

I recommend this for everyone.

I would like to reinforce this, because other studies have shown that giving people Vitamin D, once they are infected, does nothing. It is too late. So, start now. In this case prevention truly is better than (no) cure.

*I use the term non-white as it appears to be most acceptable way of describing those who are not, genetically, native to countries such as England. I do realise that whatever term is used to try and describe ‘racial difference’ some people will be offended. This is the reason why the term BAME: black, Asian and minority ethic is not being used anymore (Please be assured that I mean no offence).

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527850/
2: https://clinicalnutritionespen.com/article/S2405-4577(22)00293-5/fulltext

9th December 2020

Gary Taubes has a new book out called ‘The Case for Keto,’ which he sent to me in the form of a real book with real pages, that he wanted me to read. Which I have.

I then suggested I should do a review and stick it up on my blog. I shall say, right up front, that I strongly recommend this book.

This may not be a surprise to those who know my thoughts on diet, heart disease and suchlike. In my case Gary is preaching to the converted. This is a book which covers the fact that fats, saturated fats, indeed any fats (other than trans-fats, and the industrially produced fats from grains) are perfectly healthy. Humans have eaten them for millennia.

You don’t see cave paintings of early humans out scything autumn wheat fields. No, you see pictures of men, because men always get the easy jobs, chasing woolly mammoths with spears. They are not just taking the mammoths out on early morning exercise, and throwing the spears to play catch. They are throwing those spears at the mammoths, and chasing them into spike filled pits, then eating them – saturated fats and all.

Anyway, as Gary makes very clear, despite the endless claims that animal fats are bad for us, when you get down to it, the evidence simply does not exist. The idea that fats make us fat and diabetic and kill us with heart disease is simply a ‘meme.’

An idea so widely held that everyone just believes it must be true. So much so that there is no need to even think about it. Fat gets into your body, floats about and gets stuck to your artery walls. Fat, cholesterol, same thing innit? ‘My mind is made up, don’t confuse me with facts.’

I think I should mention that Gary first gained considerable fame in this area with his book ‘Good Calories, Bad Calories.’ In the UK and Australia, it was called. ‘The Diet Delusion.’ This is where he first looked at the idea that fats were bad for us and found it to be based almost entirely on hot air.

So, if it is not fat in the diet that is capable of causing weight gain, diabetes, heart disease, and other such nasty things, what is it? As Gary points out clearly, and inarguably, the answer is sugar. By sugar, he means carbohydrates (all sugars are just simple carbohydrates).

Slightly more complex carbohydrates are bread, and pasta, and rice and potatoes. These are just made up of lots of glucose molecules stuck together. Many people are unaware that our body takes in pasta, bread, rice etc. and simply breaks them down into sugar. So, pasta = sugar. Bread = sugar. Potatoes = sugar. Just as much as sugar = sugar. They all have the same effect.

Gary goes through the history of the brave individuals who have been those pointing out the damage that can be caused by excess carbohydrate intake for decades. Those who have been squashed flat by the mainstream. An English professor of nutrition, John Yudkin, tried to make this all clear in his book on sugar(s): ‘Pure, white and Deadly’ first published in the early 1970s. He was attacked and shouted down by Ancel Keys – the main promoter of the diet/heart hypothesis.

Gary maintains a calm and reasonable tone when discussing some of these events. Which is admirable. If I were him, I would be breaking the furniture, and chewing the curtains. He also calmly points out where the evidence is strong, and where it is weak, or where it does not exist at all. He does not overclaim, nor suggest that cutting down on carbs is a panacea that will benefit everyone. It is the calm reasonable tone that is actually most impressive. He knows his stuff, and he lays it out carefully and clearly.

What of the title of the book itself? ‘The case for Keto.’ For those who know this area ‘Keto’ is the metabolic state achieved when the body stops using sugar for energy and starts to break down the stored fats instead. These stored ‘fatty acids’ are converted to molecules known as ketone bodies in the liver. The body is perfectly happy to use them for energy. This is ‘ketosis’. Explaining the title of the book.

Many people think ketones are the preferred energy source for most organs in the body. Virtually the only exception being some processes in the brain, that require glucose, and only glucose, to function.

The downstream benefit to entering ketosis is that, when you burn up fats and ketones, you are also using up your “energy stores” aka fat. So, once you stop burning glucose, and start using ketones, you can finally lose weight. Also, your blood glucose levels fall, your insulin levels fall, and the body has a chance to reset itself.

Gary has spoken to many, many doctors and researchers who are now absolutely convinced that the best way to prevent, even reverse, the wave of obesity and diabetes sweeping the modern world is to change from eating carbohydrates and eat more fats. I agree with him. If you read this book, I believe you will agree with him too. He makes a compelling case. It is the Case for Keto.

29th May 2018

I was sent this article a few days ago: ‘Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults.’ Now, there would be a time when such an article would excite me and fill me with an urge to tell everyone ‘Eggs are good for you.’ Nowadays I tend to sigh and think: “another study for everyone to ignore”. Move along, nothing to see here.

Then I thought again. No, here we have yet more evidence, from a truly enormous observational study, that eating a substance with a very high cholesterol content does not increase the risk of cardiovascular disease. Instead, it protects against cardiovascular disease – not by a massive amount, but not that shabby

So, I decided I should make the effort to spread the message far and wide and throw down a challenge to the ‘What The Health’ brigade.

Here was the main conclusion of the study:

‘Among Chinese adults, a moderate level of egg consumption (up to <1 egg/day) was significantly associated with lower risk of CVD, largely independent of other risk factors.’

Yes, I know, how can you eat <1 egg/day (less than one egg per day)? That is a dietary intake that includes zero. Such is the joy of scientific literature. What they meant was, eating almost one egg a day – I think it was 0.88 of an egg – on average.

Expanding it a bit: compared with non-consumers, those who ate (almost one) egg daily had a lower risk of CVD. An 11% reduction (relative risk).

Splitting that down further:

• Death from Ischaemic heart disease was reduced by 12% (0.88 [0.84-0.93])
• Death from haemorrhagic stroke reduced by 26% (0.74 [0.67-0.82])
• Death from ischaemic stroke reduced by 10%. (0.90 [0.85-0.95]).

There was also a significant dose-response relationships of egg consumption with morbidity (non-fatal illness) of all CVD endpoints (P for linear trend <0.05). Which means that the more eggs you ate, the greater the benefit. Daily consumers also had an 18% lower risk of CVD death and a 28% lower risk of haemorrhagic stroke death compared to those who ate no eggs at all.¹

Of course, the demonization of eggs has become somewhat of a thing of the past by many of those who used to be very firmly ‘anti-egg’. Here is what the British Heart Foundation has to say on the matter:

‘Now current research shows that for most healthy people, cholesterol in food, such as eggs, has a much smaller effect on blood levels of total cholesterol and harmful LDL cholesterol, especially when compared with the much greater and more harmful effects of saturated fatty acids found in foods such as butter and fatty meat. Eggs are, in fact, low in saturated fat. Recent research has also shown that moderate egg consumption – up to one a day – does not increase heart disease risk in healthy individuals and can be part of a healthy diet.

As such, since about 2000, major world and UK health organizations, including us and the Department of Health, changed their advice on eggs and there is now no recommended limit on how many eggs people should eat, as long as you eat a varied diet.’ ²

Given that the BHF are no longer that concerned about egg consumption, based on several other studies, what does this Chinese research add? Well, it demonstrates that eggs are not simply neutral, they are positively beneficial for health.

The reason for highlighting this fact is, in part, to counter some of the ridiculous claims made by the massively influential documentary ‘What The Health.’ For those of you who have not heard of it, you can search it on the Internet.

It was created by a vegan network, and – amongst other ridiculous statements – made the claim that eating a daily egg was the equivalent of smoking five cigarettes a day. Now it turns out that eating an egg is the equivalent of going out for a five-mile run. Well, not quite, I exaggerate for effect.

I would like to know how the vegan network will decide to ignore and/or rubbish this study. Which they will undoubtedly try to do. Perhaps we should await some more pseudo-science from Dr Bernard, of the Physicians Committee for Responsible Medicine (PCRM). This sounds like a proper scientific organisation, but it is, at core, a highly vociferous, vegan pressure group.

Dr Bernard, up to now, has this to say about egg consumption:

‘Since one egg has the same amount of cholesterol as a Big Mac, it is unnecessary – even detrimental to your health – to consume eggs or egg products. One egg has more cholesterol than your body needs. In fact, any added dietary cholesterol is unnecessary because our bodies already produce more than the amount we require.

An excess of cholesterol leads to heart disease, so it’s no surprise that a 2010 study in the Canadian Journal of Cardiology found that those who consume the most eggs have a 19 percent increased risk for cardiovascular problems.’³

One egg has more cholesterol than your body needs? What, per day, per week, per month…ever? In fact, a large egg contains around 185mg of cholesterol. An average adult will synthesize about 1gram of cholesterol per day. So, please try getting your facts somewhere close to correct.

I should add here that I have nothing against anyone deciding to be vegan. It is a lifestyle choice that I respect and can understand. I don’t agree with it, but everyone is free to make their own decisions. What I do not like is when science is sacrificed at the altar of a belief system, and people are then persuaded to take unhealthy decisions. Such as avoiding eggs.

Having got that off my chest, I will say that, to those who made the “What The Health” documentary, to those in the PCRM and the wider vegan community, I invite you to attack this study. Or maybe you are too ‘frit’ to enter the battleground.

References
1: http://heart.bmj.com/content/early/2018/04/17/heartjnl-2017-312651

2: https://www.bhf.org.uk/news-from-the-bhf/news-archive/2015/may/eggs-and-cholesterol

3: http://www.pcrm.org/nbBlog/index.php/the-incredibly-inedible-egg

28th April 2018

England recently introduced a sugar tax, making it more expensive to buy food and drink that contains sugar. We are mainly talking about soft drinks here, such as Coke and Irn Bru and concentrated orange juice and suchlike. Many people celebrated this as a great step forward in tackling obesity. Including many people that I like, and get on with, and agree with on most things.

Not, on this however. Firstly, on principle, I do not like the idea of using the state machinery of law making, banning, taxing and suchlike to enforce social controls. It is an attack on personal liberty and represents an unpleasant form of the nanny state. Where does it end?

Don’t climb mountains because you might fall and hurt yourself. Don’t swim in the sea, you may drown. Only state approved ‘healthy’ activities are to be allowed. Hmmmm. No thanks. I would rather make my own choices thanks very much.

Aside from this, you must be absolutely one hundred per cent certain that if you are going to use lumbering, soul destroying, personal freedom crushing, state machinery, that you are going to do a lot more good than harm. Indeed, you should do no harm at all.

Especially when it comes to dietary interventions, which will affect every single person in the country. As readers of this blog know, the dietary guidelines introduced in the US and UK in the late 1970s, early 1980s have almost certainly been the main driving force behind the modern epidemics of both obesity and diabetes. Eat less fat and more carbohydrates was the cry. Yes, and look what happened.

These guidelines were not turned into laws and taxes, in most countries, but Denmark did go as far as introducing a fat tax, in 2011. Luckily, they dropped it fairly rapidly. The Netherlands too have considered it, and it may happen:

‘Although the Netherlands has refrained from introducing a “fat tax”, support for such a tax is gaining momentum in several EU member states, thus raising the question whether the EU should consider stepping in so as to adopt an EU-wide “fat tax” scheme that is to be applied in all EU member states.’ ¹

Things have gone a bit quiet on this front. Although it was interesting if we had both a fat tax and a sugar tax. Sugar is just the simplest form of carbohydrate, so you could argue we may shortly have both fat and carbohydrate taxes. What would that leave us to eat? Protein.

If I have seen one macronutrient that can cause major health issues, if eaten to excess, it is protein.

‘Protein poisoning (also referred to colloquially as rabbit starvation, mal de caribou, or fat starvation) is a rare form of acute malnutrition thought to be caused by a complete absence of fat in the diet.

Excess protein is sometimes cited as the cause of this issue; when meat and fat are consumed in the correct ratio, such as that found in pemmican (which is 50% fat by volume), the diet is considered nutritionally complete and can support humans for months or more.

Other stressors, such as severe cold or a dry environment, may intensify symptoms or decrease time to onset. Symptoms include diarrhoea, headache, fatigue, low blood pressure, slow heart rate, and a vague discomfort and hunger (very similar to a food craving) that can be satisfied only by the consumption of fat.

 Protein poisoning was first noted as a consequence of eating rabbit meat exclusively, hence the term, “rabbit starvation”. Rabbit meat is very lean; commercial rabbit meat has 50–100 g dissectable fat per 2 kg (live weight). Based on a carcass yield of 60%, rabbit meat is around 8.3% fat while beef and pork are 32% fat and lamb 28%.’²

In my practice I have seen two young super-enthusiastic body-builders who ate virtually nothing but protein and protein shakes and suchlike who became very ill indeed. Only when they cut out the protein did they recover. Now, this is not common, but there are only three macronutrients. Fat, carbohydrate and protein, and we are thinking of taxing two of them? Maybe we should just tax protein as well and be done with it.

‘All food found to be unhealthy, and to be taxed, by order of HM Govt.’

Anyway, to return to the sugar tax. What possible downside could there be to this, you may ask? Apart from infantilising the entire population. ‘You are too thick to make decisions about your life, so we will make them for you.’

Well, if you tax drinks containing sugar, more and more people are likely to shift to drinking zero carb alternatives. Coke zero and suchlike. These drinks contain artificial sweeteners, and so the consumption of artificial sweeteners is bound to rise pretty dramatically. Could this do more harm than good? Well, last year a paper came out in the journal Stroke. Called ‘Sugar and artificially sweetened beverages and the risks of incident stroke and dementia – A prospective Cohort Study.’

The main findings were, as follows:

‘Results—After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer’s disease dementia.

When comparing daily cumulative intake to 0 per week (reference), the hazard ratios were 2.96 (95% confidence interval, 1.26–6.97) for ischemic stroke and 2.89 (95% confidence interval, 1.18–7.07) for Alzheimer’s disease. Sugar-sweetened beverages were not associated with stroke or dementia.’³

In short, those who drank more artificially sweetened soft drinks were nearly three-fold more likely to have a stroke. In addition, they were very nearly three times as likely to suffer from Alzheimer’s disease. This, most certainly, does not come under my definition of ‘first do no harm.’

If I want a soft drink, I shall be paying the sugar tax. I do not want to end up with Alzheimer’s, thank you very much. I would be interested to know if the sugar tax will help pay for the millions of extra people who will now, very likely, develop dementia over the next few years.

1: https://www.twobirds.com/en/news/articles/2013/uk/no-fat-tax-in-the-netherlands

2: https://en.wikipedia.org/wiki/Protein_poisoning

3: Stroke. 2017;48:1139-1146. DOI: 10.1161/STROKEAHA.116.016027

Of course, I am always – ahem – ahead of my time, but I just noted this study that came out very recently. It demonstrates that if you give Vitamin C (along with hydrocortisone and thiamine) for just over two days in patients admitted with sepsis (blood poisoning) the mortality rate falls from 40% to 8.5%. The mortality rate in low income countries is normally around 60%.

Now, this was a small study, but it seems robust. It represents an almost five-fold reduction in mortality, but I think it provides some pretty strong support for the benefits of vitamin C. The conclusions of the study, repeated below were that.

‘Our results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine may prove to be effective in preventing progressive organ dysfunction including acute kidney injury and reducing the mortality of patients with severe sepsis and septic shock.’

Hydrocortisone, Vitamin C and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study

Paul E. Marik, MD, FCCM, FCCP; Vikramjit Khangoora, MD; Racquel Rivera, Pharm D; Michael H. Hooper, M.D., MSc; John Catravas, PhD, FAHA, FCCP

Author and Funding Information

Chest. 2016. doi:10.1016/j.chest.2016.11.036

Abstract

Background:  The global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries.

Methods:  In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months. The primary outcome was hospital survival. A propensity score was generated to adjust the primary outcome.

Findings:  There were 47 patients in both treatment and control groups with no significant differences in baseline characteristics between the two groups. The hospital mortality was 8.5% (4 of 47) in the treatment group compared to 40.4% (19 of 47) in the control group (p < 0.001). The propensity adjusted odds of mortality in the patients treated with the vitamin C protocol was 0.13 (95% CI 0.04-0.48, p=002). The SOFA score decreased in all patients in the treatment group with none developing progressive organ failure. Vasopressors were weaned off all patients in the treatment group, a mean of 18.3 ± 9.8 hours after starting treatment with vitamin C protocol. The mean duration of vasopressor use was 54.9 ± 28.4 hours in the control group (p<0.001).

Conclusion:  Our results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine may prove to be effective in preventing progressive organ dysfunction including acute kidney injury and reducing the mortality of patients with severe sepsis and septic shock. Additional studies are required to confirm these preliminary findings.

For various reasons, including a chest infection that just will not clear, I have been quiet recently. (When you are physically unwell, your brain doesn’t work. At least mine doesn’t). I have coughed more in the last six weeks than in the rest of my life put together x 10.

Anyway, my brain cleared enough to read an e-mail by Gary Fettke, who has promoted the high fat low carb lifestyle for a long time. He, like many others has been ruthlessly attacked for doing this. Professor Tim Noakes was accused of exactly the same thing, and the South African authorities dragged him to court in order to silence him (not yet sure of the verdict).

Gary Fettke is an Australian orthopedic surgeon who has suffered the same fate as Tim Noakes. However, in Australia it seems you can be accused, tried and found guilty without having any chance to defend yourself in person. This is not a court of law, but the Australian Medical Board (AHPRA) who can – as with the General Medical Council (GMC) – strike you off being a doctor. Which for a doctor is a gigantic punishment.

Previously, Gary had been told that he could not comment on any area of nutrition for advocating a reduction in sugar intake (to what are now WHO guidelines). Of course, as with all such cases the ‘authorities’ changed the goalposts from a discussion on low carb high fat (LCHF) and turned the discussion into something else.

Namely, that Gary Fettke, as an orthopaedic surgeon should never give advice on dietary matters. “The fundamental fact ‘is’ that you are not suitably trained or educated as a medical practitioner to be providing advice or recommendations on this topic as a medical practitioner.”

This of course allows the AHPRA to silence him, without discussion any of the science, and no chance of any appeal. So, his suspension about discussing any matters of diet has now been turned into a lifelong ban. Please read Gary’s e-mail:

Hi everyone,

It is with frustration that I write to inform you that I have been ‘silenced’, forever, by the Australian Medical Board, known as AHPRA.

We have a draconian system here in Australia where anonymous notifications can go in and they are investigated for public safety. The accused can only submit material but never have right of reply. It is a star chamber.

I recently got to present that ‘opinion’ of the process and the fabricated evidence at a Senate Inquiry. My evidence on the failings of AHPRA was granted parliamentary privilege which allowed a tell all opportunity. Within a few hours I received an email final determination of the 2 ½ year investigation. Coincidence or just another kick in the guts?

My verbal submission and the whole issue of bullying and harassment in the hospital system is linked from http://www.nofructose.com/introduction/senate-inquiry-into-medical-complaints-process-in-australia/

My first notification in 2014 was from an anonymous dietitian for me advocating cutting back sugar intake to what is now the WHO recommendations. Behind closed doors, with no right of reply or appeal, the goal posts shifted and I was investigated for the whole LCHF concept, for being disrespectful to health professionals (the Dietitians Association of Australia and the Heart Foundation, but never an individual) on social media and for failing to disclose a conflict of interest (COI) in our Nutrition for Life Centre, whilst on social media.

The good news is that AHPRA have decided NOT to argue the LCHF concept. I submitted enough material for a thesis and they have accepted that LCHF may be that the benefits of the LCHF lifestyle become the accepted best medical practice.

The central issue for my silencing has been that my primary medical degree and my further qualifications as an Orthopaedic Surgeon are not satisfactory to give nutritional advice. “The fundamental fact ‘is’ that you are not suitably trained or educated as a medical practitioner to be providing advice or recommendations on this topic as a medical practitioner.”

If it wasn’t so serious it would be farcical. This decision is non-appealable under National Law. The determination is life long and by its wording, does not allow me to even do research in the area or gain further qualification because that would involve me communicating in the area of nutrition. The only thing I have not clarified is if it affects international boundaries.

We have put up the post this morning re the AHPRA decision and the launch of our community fund to keep the LCHF message going

The web page is

http://www.nofructose.com/introduction/help-be-a-voice-for-lchf-after-gary-is-silenced/

and the Facebook one is off Belinda Fettke No Fructose

https://www.facebook.com/belindanofructose/posts/1175659919195124

The other parts of the AHPRA decision I can live with.

I will not force anyone to eat LCHF, not that I ever did or ever could.

I will show respect to the medical profession (doesn’t stop me from thinking otherwise).

The COI allegation is unproven as I do declare my vested interest for all patients that I send to Nutrition for Life. I admit guilt for not doing that in social media but the doctor/patient relationship is not defined in that context. I pointed out to AHPRA that they shouldn’t be applying jurisdiction in an area that is undefined. That went down like a lead balloon.

I also pointed out that AHPRA don’t govern nutritional advice in Australia. Another lead balloon.

I had a recent notification, again from an anonymous dietitian, and have been investigated for ‘inappropriate’ reversal of someone’s Type 2 Diabetes and was also reported for what I was ‘about to say’ at a hospital food national conference. AHPRA actually asked me for a copy of my speech BEFORE I gave the talk. I refused as it was an infringement of the right of free speech.

AHPRA have just this week decided to close that investigation but have warned me that they will be observing me to see if a ‘pattern of behaviour’ continues, presumably in relation to reversing more patients’ diabetes.

I hear rumours that I have ‘attacked’ health professionals at a personal level – that is simply unfounded and I think started by some naysayers. Alas, I am having some sh!t thrown at me at times. If you hear something, then let me know please.

If this sounds like a horror story, it is. I honestly thought that this would just fade away but strange things do happen when you upset the ‘industry’. Just see what’s happening with Tim Noakes. The only thing in Tim’s favour is that it has gone to court. Mine is a closed process with no right of appeal, unless I can continue to have politicians assist.

My next step is to challenge the process via more closed groups and that will be years of tying me up. I am going the public awareness path as the finding lacks the common-sense conclusion. We are liaising with some media channels and politicians. It’s all we can do.

Any support would be appreciated. Happy to liaise. Feel free to forward this email as it is.

Cheers.

Gary

Gary Fettke
Orthopaedic Surgeon
M.B.,B.S.(University NSW), F.R.A.C.S.(Orthopaedic Surgery), F.A.Orth.A.

Science evolves by being challenged. Not by being followed. @thegaryscience

If you think this is all completely ridiculous, then please circulate widely, and make as much noise as possible.

I think that the four words ‘I told you so’ should only be thought, and never written down. No-one likes a smart arse. But sometimes it is impossible to resist….just impossible. In this case I have failed. ‘Father forgive me, for I am weak.’ So, here goes…’I told you so.’

Some of you may be aware that the US dietary guidelines are going to be changed. For some reason it is required that the full report is suppressed for about a year. Presumably so that everyone can pile high their defences when the attacks begin. ‘I think you will find that I have always, ahem, supported these ideas.’ Cough, shuffle of papers….cough. ‘Sorry, no time to take questions.’ Exit left.

The entire report, I believe, stretches to about a bazillion pages. However, here are four of the highlights.

• Cholesterol is to be dropped from the ‘nutrients of concern’ list. [I love that phrase ‘nutrient of concern’].
• Saturated fat will be… ‘de-emphasized’ from nutrients of concern, given the lack of evidence connecting it with cardiovascular disease.’ [Whatever de-emphasizing may be. Pretending you never said it in the first place, I suppose].
• There is concern over blanket sodium restriction given the… ‘growing body of research suggesting that the low sodium intake levels recommended by the DGAC (Dietary Guidelines Advisory Committee) are actually associated with increased mortality for healthy individuals.’
• And…’ The identification and recognition of the specific health risks posed by added sugars represents an important step forward for public health.’

In short. Cholesterol is healthy, saturated fat is healthy, salt is healthy and sugar is unhealthy. I have pulled those four points out of a press release by the Academy of Nutrition and Dietetics, which I reproduce in full, below.

Academy of Nutrition and Dietetics Commends Strong, Evidence-Based Dietary Guidelines Report

The Academy of Nutrition and Dietetics, the world’s largest organization of food and nutrition professionals, commends the 2015 Dietary Guidelines Advisory Committee for drafting a strong, evidence-based Scientific Report outlining recommendations and rational for the forthcoming 2015 Dietary Guidelines for Americans. The Academy supports these recommendations that will improve how and what Americans eat.

“The Academy applauds the evidence-based systematic review of the literature, which is vital to the DGAC’s assessment of the science,” said registered dietitian nutritionist and Academy President Sonja L. Connor. “We commend the Department of Health and Human Services and the Department of Agriculture for their commitment to the Nutrition Evidence Library and their ongoing efforts to strengthen the evidence-based approach for assessing the scientific literature for future dietary recommendations.”

In comments recently submitted to USDA and HHS, the Academy supports the DGAC in its decision to drop dietary cholesterol from the nutrients of concern list and recommends it deemphasize saturated fat from nutrients of concern, given the lack of evidence connecting it with cardiovascular disease.

“Despite some criticism suggesting that changed recommendations illustrate concerns about the validity of the nutrition science upon which the Dietary Guidelines are based, the DGAC should change its recommendations to be consistent with the best available science and to abide by its statutory mandate,” Connor said.

The Academy also expresses concern over blanket sodium restriction recommendations in light of recent evidence of potential harm to the overall population. “There is a distinct and growing lack of scientific consensus on making a single sodium consumption recommendation for all Americans, owing to a growing body of research suggesting that the low sodium intake levels recommended by the DGAC are actually associated with increased mortality for healthy individuals,” Connor said.

The Academy supports an increased focus on reduction of added sugars as a key public health concern. “Among the identified cross-cutting issues, the evidence is strongest that a reduction in the intake of added sugars will improve the health of the American public. The identification and recognition of the specific health risks posed by added sugars represents an important step forward for public health,” Connor said.

In its comments, Academy also emphasizes that enhanced nutrition education is imperative to any effective implementation. “It is critical to ensure that individuals making diet and behavior changes in accordance with the Dietary Guidelines have access to the resources and support necessary to succeed. HHS and USDA must have sufficient resources to commit to improving a number of initiatives,” Connor said.

“The Academy appreciates the opportunity to comment on the Scientific Report and to serve as a resource to HHS and USDA as they finalize the 2015 Dietary Guidelines and develop resources to implement and promote their use,” Connor said.¹

In one way, I commend this press release. At least it has made no real attempt to fudge what is now going to be said. These are the facts.

But you know what. Organisations like this have been haranguing the entire population of the world about the dangers of cholesterol, saturated fat, and salt for the last thirty years. Foodstuffs which they now seem happy to admit, cause no harm, indeed they are almost certainly good for you.

At the same time, they have bombarded us with messages to consume sugar(s). They usually call them carbohydrates, which is disingenuous in the extreme. Carbohydrates are all just sugars in disguise. A disguise that the digestive system can strip off in a few minutes.

Yes, all those healthy fruit and vegetables are simply extended chains of simple sugar(s). And once they enter your digestive system, your body cares not whether or not you ate a carrot or a sugar cube. It delivers them into your bloodstream as sugar [primarily glucose and fructose].

Now there have been a number of people, including me, who have been saying for years that cholesterol and saturated fat are perfectly healthy, salt is good for you and sugar (in large amounts) is bad. We have all been dismissed as cranks and idiots who would have caused the deaths of thousands of people, if they had ever dared to listen to what we had to say.

It turns out the cranks and the mavericks were right. The experts were wrong. Completely and utterly wrong. Damagingly wrong. Whilst the words ‘I told you so’ are temptingly easy to say; and saying them should be resisted. There is another, single word, that appears impossible to say.

Sorry.

1: http://www.newswise.com/articles/academy-of-nutrition-and-dietetics-commends-strong-evidence-based-dietary-guidelines-report