Why is the ABC censoring debate on anti-cholesterol drugs?

By | Big Fat Lies, Conflicts of Interest | 5 Comments

Last week the British Medical Journal did something that the ABC, our so called independent broadcaster, was terrified to do just a few months earlier. It stared down an attack from the pharmaceutical industry over articles it had published on the dangers of statins (cholesterol lowering drugs). But it’s not too late for the ABC to stop behaving like a drug company marketing department and start behaving like an independent national broadcaster.

In October 2013, Dr Maryanne Demasi, produced a two part series for the ABC’s Catalyst program. The first part suggested saturated fat and cholesterol do not cause heart disease. The show was enormously popular, pulling an audience of 944,000, something which is unheard of for the staid science doco. But it was the promo for Part 2 that really lit up the switchboard.

The Second Part promised to delve into statins, the ubiquitous anti-cholesterol drugs prescribed to a third of Australian adults over the age of 50. Even before it was aired there were strident calls for the show to be killed. One particularly hysterical radio presenter even warned that watching the show may cause people to stop taking statins – something that “could kill them.”

Nevertheless, in a rare display of courage, the ABC risked our lives and ran the show anyway. As promised, it dared to suggest that statins are not everything the marketing spin would have us believe. They are frequently prescribed for people where there is no demonstrated benefit, and they present significant and potentially life threatening side effects. Almost a million Australians tuned in and, as you might expect when a multi-billion dollar revenue stream is on the line, the backlash was intense.

The ABC did what it should do in such circumstances, it launched an independent investigation. Six months later, the ABC’s independent Audience and Consumer Affairs unit presented the results. They found the first show was accurate and impartial and neither the ‘for’ or ‘against’ arguments were misrepresented. But when it came to the second part they found the show failed to mention that statins have benefits when it comes to non-fatal outcomes (for people who have already had a heart attack).

As the problem was a failure to disclose relevant information, the recommended remedy was to provide that information on the ABC’s website. Unfortunately at this point the ABC went to water. Instead of uploading a statement to that effect and moving on, the ABC Managing Director, Mark Scott, decided censorship was the way to go.

He ordered the immediate removal of both programs from the ABC website and also hunted down the copies which were by then appearing on YouTube. They were to cease to exist. Everybody should immediately forget there was ever any such thing.

I get it. The ABC copped a lot of flak from the drug companies and they are very big and very scary. But that is no reason start behaving like a third world despot. The whimpering failure of the ABC to stand up for its story (and the journalist who produced it) is all the more pathetic when compared to the steely resolve displayed by the British Medical Journal over the same issue just last week.

At the same time as the Catalyst show was airing, the BMJ had published an article which questioned the evidence behind statin use in Britain. Like the Catalyst story, the paper claimed that the risks (from side-effects) outweighed any potential benefit. A related article published the same week suggested side effects occur in 18% of people taking statins.

The expected complaints flooded in. Leading the charge was Sir Rory Collins head of an organisation which had received well over a quarter of a billion pounds in drug company funding in the previous two decades. He wanted the ABC solution – immediate disappearing of the articles.

As you might expect, the BMJ launched an independent investigation. Their report, delivered last week, found a minor correction was needed and that nothing else was required. There was certainly no cause to remove the papers. They also pointed out that it was very difficult to determine whether statins were safe or not because the drug companies refuse to make the trial data publicly available.

Statins now consume 1 in every 7 taxpayer dollars spent on drugs in this country. When we choose to spend that much on statins, we are choosing to deny patients access to many other potentially lifesaving treatments.  But statins are not cures for anything, they are a barely effective preventative measure. For most of the people taking them there will be no benefit whatsoever. Worse, there are increasingly obvious signs that statins could inflict serious harm.

But this is not a story about statins. It is a story about censorship.

Rather than promoting an honest discussion of the evidence (well, at least the evidence the drug companies will let us see), our National Broadcaster purged the internet of even the remotest suggestion there is anything wrong.

ABC, we depend on you to display the backbone shown by the BMJ. We need you not to cave into crass commercial interest at the first whiff of controversy. You made the wrong call. The BMJ has made that abundantly clear. But it’s not too late to salvage your reputation. Reinstate the programs and do it now.

Oh, and just to show you haven’t been bought off, you could commission a Third Part to the story. It could investigate why taxpayers are paying for drugs whose side effects data are being actively suppressed. How’s that for an idea? You know where to send the royalty cheque.

When Fructose Free means Full of Fructose

By | Big Fat Lies, Sugar | 3 Comments

Freedom Foods is being cute with legalistic definitions but the discerning fructose avoider should avoid their products.  The company known for its “Free From” range of foods is now touting a Muesli product which it boldly boasts is “Fructose Free”.  

3 Grains closeup

The 3 Ancient Grains Super Muesli has a giant fructose free logo emblazoned across the front of the pack, but close inspection of the fine print on the back tells you that one of the ingredients is “Sugar” and that the product is actually 5.8 per cent sucrose (which is of course half fructose).

When a concerned customer asked what was going on, he was told “The fructose free claim on pack meets current labelling regulations as the product contains no fructose”.  Strictly that’s true, the product does not apparently contain any free fructose, but what about the sucrose?

Ah well, say Freedom, “Sucrose needs to go through a conversion process in the stomach to convert to glucose and fructose.”  

Oh I see.  That’s where the misunderstanding lies.  Apparently they apply an ‘outside the body’ definition of metabolism.  But strangely this doesn’t seem to apply to fat.  

When it comes to fat they don’t just say it contains fat, they break it up into saturated fat and total fat.  Saturated fat does not of course appear as a discrete substance (separated from other fats) until it hits our lymph system.  I’m sure that if I were to ask them about that, they’d point out to me that they are required by law to separately identify the saturated fat.

So is that the difference?  They get to play amateur lawyer and be cute with definitions because at the moment the law lets them get away with it?  It would seem so.  Never mind that by the time sucrose hits our bloodstream (in other words, where it actually becomes useful to us) it is indeed fructose.

Slapping a ‘fructose free’ label on a product you know will be fructose by the time it hits the bloodstream is just plain deceptive.  It pushes the legal boundaries almost to the absolute breaking point.  I expected better from a company that boasts it will  “never stop pushing ourselves to bring you the very best”

Magda proves commercial diet programs are a waste of money.

By | Big Fat Lies, Sugar | 5 Comments

According to the Australian Women’s Weekly actress and comedian Magda Szubanski was paid $32,692 per kilo to lose 26 kilos in 2009 ($850,000). It appears the solution was temporary so now Magda is reportedly receiving $1.25 million to have another go.

Magda joins a long list of celebrities who’ve fallen off the Jenny Craig wagon. But continuous failure doesn’t seem to harm their brand at all. Indeed failure seems to sell more, Magda’s first attempt increased Jenny Craig sales by 307 per cent.

So, does Jenny Craig work (for people who are not celebrities)?

The Jenny Craig diet has been tested in only one randomised, controlled trial.  That is a little surprising (and dare I say, suspicious), given it is one of the largest diet programs in the world.

In this kind of trial, the participants are randomly assigned either to a group following the diet or a group not following the diet (the controls), and the progress of each group is directly measured against the other. The trial compared Jenny Craig with what they called a ‘self-help group’. The self-helpers were given information on losing weight and offered a follow-up counselling session with a dietitian, but otherwise left to their own devices.

The study was funded by Jenny Craig, who also provided all the meals and counselling sessions free of charge. Participants also had access to free weekly one-on-one counselling sessions with a Jenny Craig consultant. If they’d had to pay for all this luvin, it would have cost them $718 for the counselling and $6,240 for the food. Because of all these factors, the study is not a completely real-world example. Throw in $1,500 a month for a personal trainer and a million dollar pay day and you might almost replicate the experience of a celebrity dieter.

In the real world, we’re supposed to pay for the diet, not the other way around. Given that, this study probably represent the best possible scenario in terms of keeping people motivated and sticking to the diet for the entire length of the study, which was two years. Even so 9 per cent of participants had dropped out by the end.

After two years of free Jenny Craig meals, intense calorie restriction (the diets were between 42 and 68 per cent of their normal calorie intake) and weekly counselling, the average dieter managed to drop from 92.2 kilograms to 84.8 kilograms (which means they were still obese – in this trial defined as anything above 81 kilograms). Even the self-helpers managed to drop 2 kilograms!

The good news is that if you can convince Jenny Craig to pay for your food and weekly counselling (don’t hold your breath), you can expect to lose about 7 kilograms in two years. If you started out obese, you’d still be obese and you’d have been starving for two whole years but your pants might fit a little better.

And it seems this astounding lack of success is not a one-off observation.

A 2007 UCLA review of 31 credible long term weight loss studies found that most people on calorie restricting diets (such as that promoted by Jenny Craig and Weight Watchers) initially lost 5 to 10 percent of their body weight. But they also found that the majority of people regained all the weight (plus a bit more) within 12 months. Sustained weight loss was found only in a very, very small minority of participants.

Clearly Jenny Craig understand that since their diet doesn’t work very well, people need to be assured that their inevitable failure is something shared by the best and brightest (by that I mean celebrities, in case it wasn’t obvious).

All of this relies on the punter buying into the myth propagated by the Health and Diet industry that being fat is a character defect. They need us to believe that we put on weight because we are weak willed or lazy (or both). This means that any failure of a diet product is those character defects overcoming our willpower and not that the product was a load of rubbish.

This is, of course, utter nonsense. We are fat because we are addicted to a substance (sugar) which makes us fat. This addictive substance is embedded in everything we eat by the processed food industry so they can move more product (if they could use nicotine they would, but sugar will have to do). We are not fat because we are gluttonous or slothful (or any of the five remaining deadly sins).

If a product doesn’t actually work as promised and the company selling it knows this, then we are well on the way to outrageously unethical (if not downright immoral) corporate behaviour. But I won’t hold my breath waiting for any corporate regulator to do anything about it. Luckily we don’t have to. We have a choice. We can buy into the latest Jenny Craig (or any other diet program’s) weightless yo-yo. Or, we can just stop eating sugar.

Image by Eva Rinaldi from Sydney Australia www.evarinaldi.com (Magda Szubanski) [CC-BY-SA-2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

Stop the Statin madness

By | Big Fat Lies | 9 Comments

It’s official. According to an OECD report released last week, Australians now consume more cholesterol lowering drugs per person than any other developed country. Prescribing rates are 40 per cent above the OECD average. Worse than that, we have tripled our consumption in just the last 10 years.

If you know ten people over the age of 50, then you probably know at least three people taking statins. This class of drugs are now the single most profitable drugs ever made. But they are significantly overprescribed and come with devastating side effects. When unnecessary drugs cause measurable harm, the doctors writing the prescriptions need to check their liability insurance.

Statins are drugs used to lower LDL cholesterol. LDL is often described as bad cholesterol and HDL as good cholesterol. This is because studies have shown that people with proportionally higher levels of HDL and lower levels of LDL in their blood are less prone to heart disease. That message has been pounded home by drug companies because their product, statins, only affects LDL cholesterol.

When a doctor says you have a high ‘bad cholesterol’ reading, they’re talking about your LDL cholesterol being outside a target range of 2.6–3.3 mmol/L. If you get too far out of that range – greater than 6.5 mmol/L (at the moment) – out will come the prescription book and there’s a good chance you’ll be prescribed statins.

The drug manufacturers have met with considerable success driving home this message (via your local family doctor). Australians now spend 1,400 per cent more on statins than they did just two decades ago. The drugs now consume one in every eight dollars spent on medicine by our Pharmaceutical Benefits Scheme (PBS).

And while there is no doubt that consumption of statins will reduce your LDL cholesterol there is no evidence that they will have any effect on your likelihood of suffering a fatal heart attack – unless you are a man who has already survived one.

But ‘men who’ve already suffered a heart attack’ (and lived to tell the tale) is a very small market. The only way statin use could grow as rapidly as it has, was to convince doctors to prescribe them as a preventative measure among people whose only apparent sign of ill health is a higher than ‘normal’ blood-cholesterol reading.

Due to progressive widening of the definition of ‘abnormal cholesterol’, worldwide sales of the drugs broke through the US$ 34 billion mark in 2008. And one of the most popular statins, Lipitor is now responsible for one in every four dollars earned by the World’s largest drug company, Pfizer. But even that is not enough. The marketing machine continues to roll on. Just this month, the latest marketing victory (an arbitrary shifting of the definition of normal) has seen the number of potential users of statins in the US expand by up to 70 percent.

Recent comprehensive reviews of all of the major high-quality trials on statins have concluded that for people without known heart disease (who make up around 90% of those being treated) taking statins did not alter the overall risk of dying at all.

The risk of these people suffering a non-fatal heart attack was 1.6 per cent lower, but that’s an extraordinarily small improvement, especially given the overall risk of death was unchanged. It means that 60 otherwise healthy people have to be treated with statins for five years in order to prevent just one of them suffering a non-fatal heart-disease event. This puts the drugs in the category of being almost completely ineffective for such people. By way of comparison, we need to treat 11 people with antibiotics in order to completely cure 10 of them.

When the data are broken down by gender and age, the results became even less impressive. Statins do not reduce total death rates in women at all. And men aged over 70 (those most at risk of fatal heart attacks) enjoyed no benefits either (indeed they may have been harmed). The only people the drug appeared to help were men aged 30–69 who had already suffered a heart attack, and then only by a very small absolute margin.

If there were no side-effects from statin drugs then this would merely mean that we are all the victims of shameless (and shameful) profiteering. But there is now growing evidence of significant harm.

Statin use increases the risk of developing Type II diabetes by an average of 9% (but it could be as high as 50% in some women). One in ten statin users experience muscle damage with up to 75 per cent experiencing some form of muscle pain. And there is emerging evidence that the drugs are linked to memory impairment.

Going back to our hypothetical 60 healthy people being treated for five years (so that one of them avoids a non-fatal heart attack), at least 1.2 will develop diabetes (who would not otherwise), 6 will experience muscle damage, up to 45 will suffer serious muscle pain and there is a reasonable risk some of them will suffer memory loss. Worse than that, these risk calculations largely come from studies sponsored by the drug companies, so it’s safe to assume they represent best case scenarios.

The evidence of harm has become so clear that last year, the US FDA (Food and Drug Administration) required manufacturers to include warnings of these risks on the labels and prescribing information datasheets.

And that, ladies and gentlemen, is what turns profiteering into negligence. Negligence occurs when someone who owes you a duty of care takes action which they could reasonably foresee would be likely to cause you injury. Are the drug company’s negligent? Nup. They are simply providing a medicine which has been approved by our regulators for sale in very limited circumstances.

No, the legal blame will land squarely at the feet of the professionals we rely upon to first do us no harm. Doctors clearly owe patients a duty of care. And in cases where the likelihood of harm exceeds any potential benefit the prospect of a successful claim becomes very real.

Doctors would be well advised to ensure their use of statins is as conservative as the evidence says it should be.  In general the evidence says they should only be prescribed for men aged 30–69 who have a history of coronary heart disease – a very small subset of the approximately 1 million Australians currently taking the drugs.

Statins are not harmless placebos. They are powerful medications which significantly reduce our body’s ability to produce two of our primary repair molecules, cholesterol and co-enzyme Q10. They should not be handed out like lollies at the school fete. Patients given an ineffectual drug which causes lifelong harm (in the form of Type II Diabetes) will rightly seek redress from the medical professional who prescribed it.

The growing public awareness of the risks and (lack of) benefits to these drugs will almost certainly result in significant litigation in the not very distant future. If doctors don’t wish to be the fall guy for the billion-dollar drug company pay-day then they need to think very carefully about how many of their statin consumers really should be taking the drugs.

It’s time to stop mainlining statins

By | Big Fat Lies | 2 Comments

In Australia, statins (the class of drugs used to lower blood cholesterol) now chew up 13 per cent of the money paid out by the Pharmaceutical Benefits Scheme (PBS), and the amount shelled out for them by the Australian taxpayer (via the PBS) grew by a third in just the last year alone

That’s a worry for taxpayers, but with one in three Australians over the age of 50 now taking them, a greater concern is that new research suggests statins significantly increase the risks of Type II Diabetes and dementia.

The United States Food and Drug Administration is worried enough about those little ‘side-effects’ to require that statins immediately carry warnings about diabetes and cognitive impairment.  But here in the land of nod, we’ve happily become the world’s biggest statin pill-poppers.

Don’t get me wrong.  Statins do work. The studies have shown that they do lower LDL cholesterol and they do reduce heart-disease in younger men who’ve already had a heart attack. But there’s a good deal of evidence to suggest that the benefits for these folks had nothing to do with the cholesterol-lowering and quite a lot to do with their blood-thinning properties.

Unfortunately (for drug marketers) ‘younger men who’ve already suffered a heart attack’ (and lived to tell the tale) is a very, very small market. The only way to turn a buck from statins was to convince doctors to prescribe it (and the PBS to fund it) for ‘prevention’ (among people whose only sign of illness is being diagnosed with a higher than ‘normal’ blood-cholesterol reading).

A comprehensive review published in 2007 of all of the major high-quality trials on statins concluded that for these not-sick people (who make up the overwhelming majority) taking statins did not alter the overall risk of dying at all.

The studies showed that we would need to treat 67 otherwise healthy people with statins for five years in order to prevent just one of them suffering a heart-disease event. This puts the drugs in the category of being almost completely ineffective. By way of comparison, we need to treat 11 people with antibiotics in order to completely cure 10 of them.

When the data were broken down by gender and age, the results became even less impressive. Statins delivered absolutely no benefit for women at all. And men aged over 69 (those most at risk of fatal heart attacks) enjoyed no benefits either. The only people the drug appeared to help were men aged 30–69, and then only by a very small absolute margin.

The reason for the disappointing results may be that statin drugs work by shutting down the enzyme we use to manufacture cholesterol.  Unfortunately we also use that same enzyme to manufacture one of our primary anti-oxidants, co-enzyme Q10. Shutting down cholesterol production also means shutting down Q10 production (and thereby impairing our ability to fight heart disease and other types of inflammation).

This might be why (although these drugs have a big effect on cholesterol levels) they have very limited effect on heart-disease outcomes. It might also be that although statins lower cholesterol, this has nothing to do with why they lower risks for people who’ve already had a heart attack. Just like aspirin, statins reduce clotting. And just like aspirin, the people who benefit the most from statins are those who’ve already suffered a heart attack. But no one will make a fortune selling aspirin at 97 cents a box.

However they are not merely harmless profiteering.  A series of studies has suggested relationships between statin usage and increased diabetes and cognitive impairment (dementia to you and me). And a significant independent analysis of the trials, conducted in 2011 by the ever reliable Cochrane Review, concluded that becasue of this doctors to be cautious in prescribing statins to people who hadn’t already had a heart attack.

Statins are powerful drugs that alter the function of important liver enzymes, and the evidence suggests that the only class of people who benefit are younger men who’ve already had a heart attack. The only people who should be given statins should be this very small group (and then only if their doctor feels the benefit outweighs the risk of diabetes and dementia).

The US regulators are ringing the alarm bells.  But here the Australian Heart Foundation is more concerned that not enough people are taking preventative medication.  The Australian Medical Association is much more cautious.  They say statins should only be prescribed to high risk patients.  Good advice, but clearly someone isn’t listening.  Heart disease rates are high but don’t come anywhere near needing to put a third of the over fifties on statins.

Meanwhile millions of Australians continue to take a drug they don’t need and which the evidence says significantly increases their chronic disease risks.  We need to stop slavishly following the drug marketing agenda.  The practise of mass (and accelerating) prescription of statins must stop immediately.

Want kids with allergies and asthma? Feed them Margarine.

By | Big Fat Lies, Vegetable Oils | 3 Comments

One in four Australians now suffers from an allergic and immune disease and the numbers are increasing at obscene rates. So on Monday, the Allergy and Immunology Foundation of Australasia was created to tackle the problem. They want money to find a cure for allergies, asthma and other immune diseases, but I’ll tell them the cure for free. Don’t let pregnant mothers and children consume vegetable oil.

Reported rates of Hay Fever, Asthma and Eczema have doubled in the last 15 years according to survey data. Hosptilisation rates for the most extreme form of allergic reaction, Anaphylaxis (life threatening acute inflammation usually in response to food) also doubled between 1994 and 2005. And the biggest overall change has been a five-fold increase in anaphylaxis admissions for children aged 0 to 4 years (as compared to just double for the rest of the population). Five times as many admissions in just ten years!

The thing that all of these diseases have in common is that they are part of our immune system’s inflammatory response. Any injury or infection causes an automatic and immediate inflammation. The swelling, pain, redness and heat are all functions of our inflammatory response. Without inflammation, wounds and infections would never heal.

Our inflammation response is almost entirely controlled by substances derived from polyunsaturated fats. So when asthma and allergy rates started exploding, the logical place to look for an explanation was the massive increase in polyunsaturated fats in the diet.

Vegetable oils such as canola, sunflower, soybean, grapeseed and rice-bran oils all contain large amounts of the polyunsaturated fats involved in controlling our inflammation response. But these oils are a very recent addition to the human diet. For the entirety of man’s time on this planet prior to the 20th century, the only fats we consumed were those derived from animals (like butter or ghee) or tropical fruit (like olives and coconuts). Those traditional fats have very small amounts of polyunsaturated oil.

Controlling that inflammation response is a very fine balancing act that is dependent on exactly the right amount and ratios of polyunsaturated fats being present in our diet. Small amounts of these oils are a critical component of our immune systems. But, because they are rare, overloading with them can push it way out of balance. Chronic (or uncontrolled) inflammation leads to a host of diseases including allergies and asthma.

Our bodies are very good at ensuring we have enough polyunsaturated fats to keep everything working. They were rare in our food supply before the last century so we store any we can get for later use. Unfortunately this scrooge-like approach means that now that they make up the majority of fats in the processed food we eat, most of us are storing vast quantities.

An easily identifiable source of vegetable oil in the diet is margarine. So scientists have conducted a number of large scale trials to see if there is any relationship between margarine consumption and allergic disease. And guess what, trial after trial has concluded that children who consume more margarine have double the rate of medically diagnosed eczema, hay fever, allergies and asthma. This is true in Finnish children, German 2 year olds and 3 year olds ‘liberated’ by the fall of the Berlin (and having the bad fortune to then be exposed to a diet containing margarine) to name a few.

Even when the kids themselves are not chomping on margarine or vegetable oils, if their mother did during the last four weeks of pregnancy, they have at least a 50% greater chance of having eczema, hay fever or allergies for life. To get to the bottom of why that might be, scientists have recently been comparing the amounts of polyunsaturated fats in a pregnant mother’s cord blood supply (the unborn baby’s food) to the likelihood of the child going on to develop chronic allergic disease.

They’ve found that there is a very direct relationship between the level of polyunsaturated fat in that blood supply and the risk of allergic disease. Not only that, the relationship is clearly dose-dependent. Want to give someone allergies or eczema or hay fever or asthma for life? Just increase the polyunsaturates. Want to decrease the risk? Just decrease the polyunsaturates. Simple.

Chronic allergies are not a case of the sniffles and a mild rash. They can be (and increasingly are) lifelong sources of extreme danger. We now live in a society where a growing array of foods can kill us on contact and where asthma can snuff out a life just as efficiently.

We don’t need more foundations to waste money on research. The research is done. We don’t need nutritionists telling us this gunk is good for us. The research says it’s very bad for us. And we don’t need our doctors helping sell it. They should be counselling us to ditch it. There are no good reasons to consume vegetable oils, but there is a growing list of reasons to avoid them like the plague.

It is very rare that science (particularly nutrition science) provides an answer that is this unequivocal. Vegetable oil consumption before or after birth causes lifelong allergic disease and asthma. The cause is obvious and the cure is even more obvious. We just need to stop eating vegetable oils, if not for us then to at least give our kids a chance.

Image courtesy of Sura Nualpradid / FreeDigitalPhotos.net

Is the Heart Foundation’s advice killing us?

By | Big Fat Lies, Conflicts of Interest, Sugar, Vegetable Oils | 13 Comments

This week the authors of a major ongoing assessment of our health released their 12 year update. It’s a sobering document. We are all getting fatter and very much sicker at an alarming rate. But the really disturbing thing is that the Australian Heart Foundation’s advice is making things worse not better.

The AusDiab (Australian Diabetes, Obesity and Lifestyle) study has been monitoring the health of a random selection of 11,000 Australian adults since 2000. The results of the 12 year follow-up were published this week.

The update shows that the number of us with Type II Diabetes has increased by 41%; that obesity has increased by 22%; that almost half of us now have chronically high blood pressure (this is despite a 30% increase in the use of medication to control it); and that the average 25 year old gained 7 kg on the scales and 7 cm round the waist; all in just over a decade.

During all of the period of the study (and for many years before that), the Heart Foundation has campaigned for changes to our food supply that they say would combat exactly those problems. They wanted the saturated animal fats removed from our food and replaced with seed oils (described on the label as ‘vegetable oil’, ‘canola oil’, ‘sunflower oil’, ‘safflower oil’, ‘soy oil’, ‘rice bran oil’ or ‘grapeseed oil’). And they have had considerable success. All fast food outlets now fry in seed oils. There are no products on the supermarket shelves which use animal fat. And in every food category there is at least one major brand that has been certified by the Foundation (with a Tick) as being low in saturated fats.

They have won the war on animal fat and ensured that it has been almost completely replaced by oils extracted from seeds. There is just one remaining bastion of saturated fat, butter. But don’t worry, the Foundation has a plan there too, eat more margarine. They reckon that once you overcome the taste of margarine you’ll soon be enjoying the “great benefit” of more “omega 6.” Omega 6 fats are a significant component of seed oils (vegetable oils) but are very rare everywhere else in nature. The only problem is that research is telling us that they the Heart Foundation has gotten it very, very wrong on these fats.

One of the key pieces of research they rely on for the supposed benefits of margarine (and seed oils in general) has recently been reanalysed. This new analysis has turned our understanding of the heart health benefits of margarine (and in particular the omega-6 fats which are a primary ingredient) upside down. The researchers were able to recover lost data about the exact fats fed to the volunteers in the original Study and then apply modern statistical techniques to that data.

What they found was truly disturbing. Not only was there no benefit to the people substituting margarine for butter, doing so significantly increased the risk of death from heart disease (by 70%) because of the huge increase in omega-6 fat consumption in the margarine chomping group.

The margarines used in that trial have similar levels of omega-6 fats to those (and just about everything else) being promoted by the Heart Foundation for the last three decades. Based on this research, the Foundation is actively encouraging people to consume something that almost doubles the risk of death from heart disease. Let me say that again just so it’s clear. The research says that following the Heart Foundation’s advice almost doubles your risk of death from heart disease.

Extraordinary though that is, it is not the worst of it. These are also exactly the same fats that other research has repeatedly shown to double our risk of breast cancer. And I’m not just talking about rat studies here (although there are more than enough of them). I’m talking about at least 7 major human population studies and 2 long term controlled trials (human again) which all come to exactly the same conclusion. The more omega-6 fat (found primarily in vegetable oil) you consume the more likely you are to suffer from breast cancer.

Worse than that, the rat studies are showing up something that (thankfully) no-one dare try on humans. When you feed pregnant mothers this stuff, their female pups have double the rate of breast cancer – even though they don’t consume any vegetable oils after birth.

This makes the heart Foundation’s chosen marketing vehicle especially horrific. You see, rather than simply run an ad telling us to eat margarine, they’ve decided to create a social media storm with the express purpose of getting mums to consume the exact substance that the research resoundingly shows doubles the rate of breast cancer and nearly doubles their risk of death from heart disease. And if the rat studies are right, those mums (trying to do the very best for their families) may be making very dangerous choices for their unborn daughters.

As if this were not bad enough, the Foundation continues to persist with a bizarre stance on the question of sugar. Last Thursday, the ABC’s venerable science program, Catalyst ran a special feature on the dangers of sugar. It detailed the, now well established, evidence that sugar is not only responsible for the obesity epidemic but is also strongly implicated in a long line of chronic disease including Type II Diabetes and Heart Disease.

Part of the program examined the very high levels of sugar embedded in foods which bear the Australian Heart Foundation’s tick of approval. Professor Michael Cowley, a physiologist and obesity researcher from Monash University expressed surprise that the Heart Foundation would endorse breakfast cereals (for example) that were almost a third sugar. In response, the Heart Foundation said that they ignore the sugar content of foods because (despite abundant evidence to the contrary) they believe it doesn’t make us fat or give us diabetes or heart disease.

The Australian Heart Foundation has spent the last 54 years working to gain our trust as an adviser. Our trust is something you can’t buy, but the processed food industry has found a way to rent the Heart Foundation’s healthy halo. It’s called the Tick Program. Processed foods can gain endorsement from the Heart Foundation by doing what they were going to do anyway. They wanted to use seed oils instead of animal fats because they are loads cheaper. Tick. They wanted to use tons of sugar because food with sugar sells better than food without. Tick.

The only problem is that, through the Tick Program, the Heart Foundation now finds itself in the position of having endorsed hundreds of products that the science says are very dangerous to our health. And it receives a nice chunk of change from the program every year ($2.9m in 2011).

That, girls and boys, is what we lawyers call a conflict of interest. When doctors experience a conflict of interest (say by accepting gifts from pharmaceutical companies), the regulators tighten the rules and (no matter how much it hurts the doctors) puts the brakes on the gravy train.

The same thing happens in just about any profession we depend upon for expert knowledge. We have to be able to trust people we pay to know more than us about a specialist subject. And no matter how morally astute they believe they are, we cannot allow them be led into temptation by conflicts of interest. If we do, we can never be sure if they are giving us advice based on the best evidence or on their own financial interest.

There are now very persuasive reasons to worry about the Heart Foundation’s advice that we should consume seed oils (vegetable oils). And there is just as compelling evidence that ignoring sugar is taking a daily toll on the health of all Australians.

I know it’s embarrassing that the Heart Foundation got it wrong on omega-6 fats and sugar. But they need to suck it up and change their position. Because it is much better to admit being wrong and do something about it than let another 40 women contract breast cancer or another 270 people contract Type II diabetes (and that’s just the toll today – the same toll will be exacted tomorrow and the day after that too).

We don’t need the guardians of our health defending the indefensible. We need them, well, guarding our health without fear or favour (especially without favour). This is not about pride. It’s about doing the right thing and stopping the appallingly dangerous advice – now.

While you wait for the Heart Foundation to do the right thing, here is some simple, free, advice for anyone wishing to avoid heart disease, cancer and Type II Diabetes:

  1. Do not eat any processed food (food in a packet) which has a Heart Foundation Tick – it is more than likely full of sugar or seed oils or both
  2. Do not eat anything that has been deep fried unless you know it was done in olive oil, coconut oil, macadamia nut oil or animal fat.
  3. Avoid any other processed food that contains seed oil.
  4. Avoid any other processed food that contains more than 3g per 100g of added sugar

Warning: following this advice may cause you to live to a very old age, so make sure you’ve got some superannuation

It’s time to stop mainlining anti-cholesterol drugs

By | Big Fat Lies | 19 Comments

In Australia, statins (the class of drugs used to lower blood cholesterol) now chew up 13 per cent of the money paid out by the Pharmaceutical Benefits Scheme (PBS), and the amount shelled out for them by the Australian taxpayer (via the PBS) grew by a third in just the last year alone.

That’s a worry for taxpayers, but with one in three Australians over the age of 50 now taking them, a greater concern is that new research suggests statins significantly increase the risks of Type II Diabetes and dementia.

The United States Food and Drug Administration is worried enough about those little ‘side-effects’ to require that statins immediately carry warnings about diabetes and cognitive impairment.  But here in the land of nod, we’ve happily become the world’s biggest statin pill-poppers.

Don’t get me wrong.  Statins do work. The studies have shown that they do lower LDL cholesterol and they do reduce heart-disease in younger men who’ve already had a heart attack. But there’s a good deal of evidence to suggest that the benefits for these folks had nothing to do with the cholesterol-lowering and quite a lot to do with their blood-thinning properties.

Unfortunately (for drug marketers) ‘younger men who’ve already suffered a heart attack’ (and lived to tell the tale) is a very, very small market. The only way to turn a buck from statins was to convince doctors to prescribe it (and the PBS to fund it) for ‘prevention’ (among people whose only sign of illness is being diagnosed with a higher than ‘normal’ blood-cholesterol reading).

A comprehensive review published in 2007 of all of the major high-quality trials on statins concluded that for these not-sick people (who make up the overwhelming majority) taking statins did not alter the overall risk of dying at all.

The studies showed that we would need to treat 67 otherwise healthy people with statins for five years in order to prevent just one of them suffering a heart-disease event. This puts the drugs in the category of being almost completely ineffective. By way of comparison, we need to treat 11 people with antibiotics in order to completely cure 10 of them.

When the data were broken down by gender and age, the results became even less impressive. Statins delivered absolutely no benefit for women at all. And men aged over 69 (those most at risk of fatal heart attacks) enjoyed no benefits either. The only people the drug appeared to help were men aged 30–69, and then only by a very small absolute margin.

The reason for the disappointing results may be that statin drugs work by shutting down the enzyme we use to manufacture cholesterol.  Unfortunately we also use that same enzyme to manufacture one of our primary anti-oxidants, co-enzyme Q10. Shutting down cholesterol production also means shutting down Q10 production (and thereby impairing our ability to fight heart disease and other types of inflammation).

This might be why (although these drugs have a big effect on cholesterol levels) they have very limited effect on heart-disease outcomes. It might also be that although statins lower cholesterol, this has nothing to do with why they lower risks for people who’ve already had a heart attack. Just like aspirin, statins reduce clotting. And just like aspirin, the people who benefit the most from statins are those who’ve already suffered a heart attack. But no one will make a fortune selling aspirin at 97 cents a box.

However they are not merely harmless profiteering.  A series of studies has suggested relationships between statin usage and increased diabetes and cognitive impairment (dementia to you and me). And a significant independent analysis of the trials, conducted in 2011 by the ever reliable Cochrane Review, concluded that becasue of this doctors to be cautious in prescribing statins to people who hadn’t already had a heart attack.

Statins are powerful drugs that alter the function of important liver enzymes, and the evidence suggests that the only class of people who benefit are younger men who’ve already had a heart attack. The only people who should be given statins should be this very small group (and then only if their doctor feels the benefit outweighs the risk of diabetes and dementia).

The US regulators are ringing the alarm bells.  But here the Australian Heart Foundation is more concerned that not enough people are taking preventative medication.  The Australian Medical Association is much more cautious.  They say statins should only be prescribed to high risk patients.  Good advice, but clearly someone isn’t listening.  Heart disease rates are high but don’t come anywhere near needing to put a third of the over fifties on statins.

Meanwhile millions of Australians continue to take a drug they don’t need and which the evidence says significantly increases their chronic disease risks.  We need to stop slavishly following the drug marketing agenda.  The practise of mass (and accelerating) prescription of statins must stop immediately.

Note: Parts of this blog post were ‘borrowed’ from my new book Big Fat Lies.

Image courtesy of Paul / FreeDigitalPhotos.net

The Glycemic Index has passed its use-by date

By | Big Fat Lies, Sugar | 16 Comments

The glycemic index (GI) is not just bad science, it has a dangerous loophole big enough to drive an ice-cream truck through. Its time it went to the place where old (and wrong) public health messages go to die.

Wendy’s Chocollo (with waffle cone), Bulla Light vanilla ice-creamNestle MiloUncle Toby’s Choc Chip Crunchy Muesli Bar and CSR LoGiCane Sugar all have something in common. Yes, they’d all look pretty good on the dessert menu, but they also share something else. The owners of each of these products (and almost a hundred others like them) have paid for the right to display a GI Symbol.

Much like its more famous cousin (the Heart Foundation tick), the GI Symbol is designed to guide confused consumers towards “healthier choices” in the supermarket.

The symbol alerts us to foods which have a low glycemic index. The GI is a measure of the amount that a food affects our blood sugar levels. Our body converts most of the carbohydrates in our food to blood glucose. This causes a spike and then a decline in the amount of glucose we have in circulation.

But not all foods are equal. Some (like glucose) spike our blood sugar levels more quickly than others (like potatoes). This is because the carbohydrates in some foods are more quickly converted to blood sugar than others.

The glycemic index of a food is measured by comparing the way a healthy person’s blood sugar level responds (over a 2 hour period) to 50g of glucose and how they respond to 50g of carbohydrate in the food being tested (let’s say boiled potatoes). If the tested food produces an effect which is 70% of the one measured for the glucose then it is said to have a GI of 70. A low GI food is one which has a GI of 55 or less (meaning that the blood sugar response is 55% of that of pure glucose over a two hour period).

The theory goes that if we could make sure we were eating just the foods which have a low impact on our blood sugar, then we would keep our blood sugar levels more even (and presumably somehow be more healthy as a result). I say presumably because there is a real scarcity of credible evidence that the GI of a food has any measurable (positive) health impact.

GI may be a pointless academic exercise but it is not a harmless one. It has a hidden danger in that the carbohydrate it assigns the lowest (and therefore the best) rating is fructose (it has a GI of 19). Fructose is a very sweet tasting (almost twice as sweet as sugar) carbohydrate that does not produce a significant blood sugar response.

When this little quirk of fructose was first discovered (in the early 1980’s) it was pronounced a miracle sugar for people with diabetes. They could have sweets just like everyone else and their blood sugar would never spike as long as the sweets were made with fructose. Even some sugar was ok too (because, being half fructose, it also has a low(ish) GI).

Diabetes organisations the world over happily advised diabetics they could eat sugar or, even better, pure fructose. Unfortunately for sweet tooths everywhere, by about 2001, it was becoming abundantly clear that the ‘no free lunch’ rule applied (or was it no free pudding?). Fructose was even more dangerous for diabetics than sugar.

It turned out that the reason fructose didn’t have a big glycemic index was because it is converted to fat (by our liver) and not circulating blood sugar (like just about every other carbohydrate). Telling diabetics (or anyone else, but particularly diabetics) to consume a substance that was immediately converted to fat was a very bad idea (verging on the culpably negligent).

The American Diabetes Association quietly withdrew its recommendation in 2002, but the message never got through to Australia. The Australian Diabetes Council tell us they “want to end the myth that sugar causes diabetes”, apparently because sugar-free diets aren’t “much fun.”

And the folks selling the Low-GI stickers (the GI Foundation – a collaboration of University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation) still tell us it is “best to ignore the sugar content of a food and instead focus on the food’s GI.” A director of the GI Foundation (Sydney University nutritionist Jennie Brand-Miller) even went so far as to say recently that “Unlike saturated fats, trans fats, salt and alcohol, sugar doesn’t actually do any direct harm to the human body.

For the last decade (at least), the research on fructose (and sugar) has shown again and again that exactly the opposite is true. Fructose consumption is a causal factor in obesity, heart disease, hypertension and Type II Diabetes. It is implicated strongly in cancer growth and it is highly likely to be behind the explosion in the number of cases of chronic kidney disease and fatty liver disease.

That all sounds pretty harmful to me. So perhaps that is why the American Heart Association recommended (after reviewing all the evidence in 2009) that Americans needed to dramatically reduce their sugar consumption. Men should consume no more than 9 teaspoons of sugar a day (about a can of soft drink’s worth). That’s less than half the current (vague) Australian recommendation (of about 23 teaspoons a day).

Just like skinny leather ties and big hair, the glycemic Index seemed like a good idea in the eighties. It held out hope (for a dessert filled future) to millions of diabetics everywhere. But science eventually found out what was really going on (as it usually does) and the world moved on.

In Australia we got stuck on the notion that GI should work (and to this day stubbornly refuse to acknowledge the fructose loophole). The food industry leapt on the marketing power of a ‘healthy label’ that meant they could still use as much sugar as they wanted. Positions became entrenched. Reputations were built. And as a result we now have folks like the GI Foundation and the Australian Diabetes Council telling us there’s nothing wrong with eating sugar.

This would all be mildly entertaining if we weren’t talking about real people with very real (and very life-threatening) problems. Every day in Australia nine people lose a limb to Type II diabetes (and 275 more people develop the disease). Every day the number of obese children grows like never before in human history. Every day the number of new cases of chronic kidney disease sets a new benchmark.

The science says all of this misery (and lots more) can be traced back to eating sugar. So how about we stop playing ducks and drakes with quaint scientific notions (that protect the processed food industry from having to face reality). How about we start caring about the people who follow the advice they see on a packet of food. How about we face the truth about sugar and demand that those we pay to care – do.

Why the first law of thermodynamics has no place in human nutrition

By | Big Fat Lies | 60 Comments

The first law of thermodynamics says that energy can’t be created or destroyed. Many people (wrongly) think Sir Isaac Newton worked this one out, but it seems it was more likely a Welsh lawyer (score one for the lawyers!).

It’s a law about physical forces that unifies a lot of previous theories that related to heat and mechanical energy. In the nutrition and diet industry, it usually looks more like “energy in must equal energy out” or just “the energy balance equation”. They will even sometimes do an actual equation (I guess to make it look more scientific).

Weight Gain (Energy Balance) = Energy In (Food) – Energy Out (Exercise).

The First Law has been hijacked by the nutritionista because it kinda sounds like it should apply to dieting. As a result it is used more today in human nutrition than in any other domain of human endeavour. The First Law is quoted every time you watch or read any information on diet products, exercise or weight loss programs. And the government throws it your face even more regularly than that.

We are told the only way we can lose weight is to either consume less energy (calories) or burn more energy (by exercising). Fat has almost twice the calories per gram as protein or carbohydrate. This is why fat is often the target of calorie restriction hysteria. Gram for gram you can eat almost twice as much of a carbohydrate and not unbalance your equation.

Sounds logical, right? And I guess that’s why this simple message has so much traction with advertisers.

The only problem is that it is utter nonsense.

The First Law certainly says that when we gain weight there will be an accompanying increase in the number of calories consumed (or decrease in the number burned). It is an equation and in equations each side must equal the other, but that does not necessarily mean that increased calorie consumption causes the weight gain.

It is equally logical to say that gaining weight is the driving force in the equation. In other words, weight gain causes us to consume more calories.

When a child grows they increase their body size and weight. These growth-hormone driven changes cause the child to consume more calories, not the other way around. Not even the most rabid nutritionist would suggest that feeding a 10 year old like an 18 year old would help you get past those awkward teenage years more quickly.

Growth happens because our hormone clock says it should. Calorie consumption just keeps up (so that the energy balance stays, well, … balanced). We are perfectly happy to explain the equation that way when we talk about people who grow vertically. We’re even happy to accept that pregnant women gain weight (other than the baby of course) because hormones tell their bodies to fill the baby-pantry.

Eating is the way we put on weight, it isn’t the reason we put on weight. When a car accelerates, it does so because it has access to more petrol. The petrol doesn’t cause the acceleration, but it does enable it.

But for some reason when Norm grows horizontally, causation is magically reversed. Nutritionists lurch from physics into psychiatry and the cause suddenly becomes greed or sloth (or both).

Just like height gain, weight gain is caused by hormones, but this time it is hormonal dys-function. The fructose half of sugar causes us to become resistant to our main appetite suppression hormones (insulin and leptin). When this happens our appetite is not shut-down when it should be and we just keep eating. And just like a Toyota with a stuck accelerator, our weight accelerates out of control.

Once we understand that weight gain is caused by hormonal dysfunction (a stuck accelerator) many (previously) mysterious things become clear.

A diet that asks you to consume less calories by exercising willpower is doomed to failure. Imagine how successful you’d be if you asked a child to exercise some willpower and stop growing. Fighting hormones with willpower is about as effective as paddling upstream with a barbed-wire paddle. Perhaps this is why the best indicator that you will be heavier in five years is being on a diet now.

Lap band surgery restricts the fuel supply without the need for willpower. It’s like clamping a fuel line in the car analogy. Less fuel gets through for a given squeeze of the accelerator. But our bodies are nothing if not adaptive, so they just ramp up the demand for calories (they push harder and longer on the accelerator). Perhaps this is why a lap-band driven ‘remission’ lasts only 10 years (at best).

Exercise burns so few calories that very few people can commit the time (or willpower) required for it to seriously affect energy balance. But even if they could, using more energy just increases the demand for energy (any gym junkie could tell you that). Lumberjacks eat more than office workers because they exercise more.

Diets, surgery and exercise do not affect the cause of weight gain (which is the hormonal dysfunction created by fructose) and so, they don’t work. Yet they remain the only targets of the billions spent ‘combating’ obesity in this country. All because the nutritionista hold true to a law of physics which has been misapplied to nutrition for the past 60 years.

When nutritionists first started guessing what made us fat, only one of the four major appetite hormones had been discovered. Then, it was (almost) acceptable to squeeze the square peg of a physics law into the round hole of human biochemistry. But those days are long gone and so too should be our tolerance for that kind of guesswork.

Many careers have been built on propagating this nonsense and there are many who will fight hard to protect it. But that should not be an excuse for inaction in the face of a human health disaster of truly epic proportions (pun intended).

Image courtesy of Ambro / FreeDigitalPhotos.net