Tuesday, 27 July 2021

Tobacco: Australia's new drug war


As authorities target illicit tobacco imports, criminal groups are turning their attention to farming their own crops across regional Australia.

Illicit Tobacco Taskforce Australian Border Force Commander Greg Linsdell said that in the past 12 months there had been a significant increase in seizures involving the domestic growth of illicit tobacco as criminal groups look to maintain their supply after COVID-19 impacted imports.

Incredibly, it has been illegal to grow tobacco in Australia for over a decade and you can get ten years in prison for doing so. People banned from growing plants? It sounds like the War on Drugs and that is basically what Australia is working towards with tobacco.
Unsurprisingly, it has led to all the problems you associate with the drugs war, notably rampant criminality and an industrial scale black market. 

Authorities are also contending with huge illicit tobacco importation attempts. In the most recent fiscal year until the end of May, the ABF seized 512 million cigarettes, a 36 per cent increase from the previous year. The force also seized 748 tonnes of loose-leaf tobacco, compared to 167 tonnes the previous year.

The 2020-21 haul is equivalent to an estimated $1.7 billion in evaded duty – a record amount, compared to an estimated $621 million in evaded duty from the previous year.

During the final week of May, the ABF intercepted almost 10 tonnes of loose-leaf tobacco and more than 7.3 million cigarettes via sea cargo.

It should never be forgotten that this is a totally avoidable political choice. If the government respected people's right to smoke and didn't force the price of cigarettes up to a level that is literally prohibitive, none of this would happen. And maybe you shouldn't have banned e-cigarettes too, eh?

Minister for Home Affairs Karen Andrews said the federal government remained committed to stopping the illegal trade at the border.

“Every time someone uses illicit tobacco, they’re denying the community legitimate tax revenue that funds our schools, hospitals, and roads,” she said. 

It's not legitimate tax revenue though, is it Karen? It's extortion. Your government has set it at such a punitive rate that many smokers have no choice but to buy illicit and none of them have a moral duty to send more money to a government that openly despises them. 

"They’re also playing into the hands of serious and organised criminals, who often import illicit tobacco and sell it to fund importations of harder drugs."

Maybe so, but you were warned about this plenty of times and you preferred to listen to unscrupulous shysters from 'public health' waving around worthless studies claiming that tax rises don't fuel the illicit trade.
Good luck with your new drug war. 

See here and here for more examples of Australia's self-inflicted wound.

Vapers deserve to be angry – they are under attack

First published by Spectator Health in June 2015

There is a perception – on Twitter at least – that vapers are angry and abusive. Ben Goldacre recently described ‘e-cigarette campaigners’ as ‘vile… obsessive, vindictive, abusive, and to an extent that is clearly dubious’. This inevitably led to a string of replies from bewildered vapers that may have confirmed his view, although the vast majority were polite.

From what I’ve seen, vapers are no more likely to be offensive than any other punter on social media, which is admittedly a low bar. After the referendum on Scottish independence and the general election, not to mention the periodic bursts of outrage for which Twitter is notorious, I have seen much worse in recent months than a few e-cigarette users complaining about junk science and needless, destructive legislation. If the people who disagree with ‘austerity’, for example, or with the opinions of Laurie Penny, expressed themselves in the same way, Twitter would be a more courteous and eloquent place.

That is not to say that vapers are not angry but, as this week’s announcement of a ban on vaping in Wales shows, they have just cause. Banning vaping indoors is such a criminally stupid and negligent idea that even the prohibitionists at Action on Smoking and Health are opposed to it. The unintended consequences are utterly predictable. Once people who have switched from smoking to vaping are thrown outside, they may come to the conclusion that they might as well smoke. Meanwhile, smokers who might switch to vaping have one less incentive to do so. The negative effect on health is plain to see, even if we ignore the glaring fact that none of this is the government’s business.

Vapers have every right to be outraged by this evidence-free attack on a habit that is not only harmless to bystanders but positively beneficial to them personally as erstwhile smokers. This is the important point to remember about so-called ‘e-cigarette campaigners’. They used to be smokers. You know how some ex-smokers can seem a little self-righteous and pleased with themselves? Vapers have taken that sense of triumph and channelled it into promoting – or, at least, protecting – the product that helped them quit.

As smokers, vapers spent years being taxed, demonised and kicked into the street. Anti-smoking campaigners would never put it in such blunt terms, but their objective is to make smokers’ lives so miserable that they decide to quit smoking. Vapers did quit smoking, often to their own surprise. They did exactly what was asked of them, but instead of being embraced by their old tormentors, they found themselves with another battle to fight.

The last few years have seen an extraordinarily dishonest campaign of misinformation against e-cigarettes that is as bad as anything I have seen from the ‘public health’ lobby. There has been a concerted effort to portray e-cigarettes as a ‘gateway’ to tobacco, despite all the evidence showing that they are a gateway from tobacco. They have been accused of ‘renormalising’ smoking without a scintilla of evidence. Misleading research has led to numerous unfounded scare stories in the press. Newspaper columnists have written ridiculous articles without doing the most basic fact-checking. Senior medics have explicitly told the public that e-cigarettes are no safer than real cigarettes. At the same time, ordinary vapers who never had any intention of becoming campaigners – and, indeed, are not campaigners – have been accused of being shills for e-cigarette and/or tobacco companies for doing no more than trying to put the record straight.

The irony is that if vapers on social media were part of an ‘astro-turf’ campaign for industry, they would not speak out as bluntly as they do. The ‘public health’ lobby is quite comfortable dealing with the pitched battles that come from having a polite, professional and organised opposition. It is the public they can’t handle.

Stanton Glantz, an activist-academic at UCSF says that he receives ‘hyper-aggressive’ responses whenever he posts a blog about e-cigarettes while Martin McKee, a professor of public health, says: ‘Anyone who suggests e-cigarettes are anything short of miraculous seems to be targeted’. This is a little disingenuous. Glantz and McKee have done rather more than suggest that e-cigarettes are not miraculous. McKee wants e-cigarettes to be regulated as if they were medicines while Glantz has helped bring about the banning of not only the use, but also the possession, of e-cigarettes on his campus in San Francisco.

These are people who have the power to turn their thoughts into deeds. They do not need to attack e-cigarette users verbally, though some do. Last year, the president of the UK Faculty of Public Health was suspended after a late-night Twitter binge in which he used such colourful phrases as ‘obsessive compulsive abusive onanist,’ ‘slave to addiction’ and ‘c***’ to describe e-cigarette users. He was later reinstated and the UK Faculty of Public Health is loudly supporting the Welsh vaping ban in the media this week.

If vapers are frustrated, it is because they are the helpless against the powerful. Combine the sense of righteousness that comes from being an ex-smoker with the sense of injustice that comes from hearing endless lies about something that is dear to you, you have a recipe for righteous indignation. There will be a lot of it around this week, quite justifiably.

Friday, 23 July 2021

A swift half with Kristian Niemietz

Here it is! The Swift Half with my friend and colleague, Kristian Niemietz...

Thursday, 22 July 2021

Last Orders with Leo Kearse

There's anew episode of the Last Orders podcast out, with the comedian Leo Kearse. We discuss censorship in comedy, Henry Dimbleby's lust for food taxes and 'Freedom Day'.

A new Swift Half with Snowdon will be coming soon.

Wednesday, 21 July 2021

You can eat a healthy diet for next to nothing. Here’s the proof

First published by Spectator Health in March 2017

It is a common belief in some circles that a healthy diet is unaffordable. Last year, the chair of the Royal College of GPs said fruit and vegetables were so expensive that it was unrealistic to expect people on low incomes to eat their five-a-day. As five-a-day morphs into ten-a-day, the Food Foundation said at the weekend that people on low incomes would find it ‘impossible’ to eat 10 portions of fruit and vegetables. Meanwhile, fast food chains like McDonald’s are blamed for filling our stomachs with ‘cheap junk food’ and there are growing calls for taxes on ‘unhealthy’ food to address the supposed imbalance between expensive good food and inexpensive bad food.

These beliefs have never been supported by much evidence, however. The Food Foundation says that ‘healthy foods are three times more expensive calorie for calorie than unhealthy foods’, but measuring the cost of food by the calorie — as some studies do — tells us nothing about the price of a healthy diet. By this measure, a low-calorie yoghurt would appear more expensive than a high-calorie yoghurt despite both products costing 50p each. You’d obviously need to buy more of the low-calorie yoghurts if you wanted to consume 1,000 calories, but that is not a useful measure in modern Britain where consuming enough calories to survive is not the problem. For most people, the challenge is to consume fewer of them.

The real question, therefore, is whether it is cheaper to live off processed food and takeaways than to eat a nutritious, balanced diet. The government’s Eatwell Guide recommends a diet that is heavy on fruit, vegetables, starchy carbohydrates and white meat. All of these can be bought from supermarkets at prices that would have amazed your grandparents. As I show in a new report from the Institute of Economic Affairs, rice, potatoes and pasta can be bought for less than 5p per serving. Grapes, oranges and bananas cost less than 30p per serving and apples and pears can be bought for less than 10p. An 80 gram serving of carrots, tinned tomatoes, peas or cabbage costs less than 8p.

All told, it is possible to have your five-a-day for less than 30p and a nutritious, if plain, diet can be bought for less than £1 a day. Add some muesli, bread, chicken fillets, fish and jam, and you can have a tastier and more varied diet for less than £2 a day.

Compare that to the cost of ‘junk food’. Chocolate breakfast cereals are twice as expensive as bran flakes or muesli. The cheapest own-brand ready-meals cost at least £1 each. Sugary snacks are almost invariably more expensive than apples or pears. An 80 gram serving of crisps is four times more expensive than an 80 gram portion of banana or broccoli, and sugary drinks are not only more expensive than water but are often more expensive than low-calorie soft drinks such as diet lemonade and sugar-free orange squash.

Furthermore, if you compare the diet version of products to their originals, they are usually the same price or less. Brown bread costs the same as white bread, light baked beans cost the same as standard baked beans, light mayonnaise costs the same as full-fat mayonnaise, skimmed milk costs the same as whole milk, and so on. You cannot blame financial constraints on people’s reluctance to buy them.
And it should go without saying that buying the ingredients for a healthy meal costs less than going to a fast food chain. The cheapest adult meal in McDonald’s costs around £4.50. A single meal for a family of four costs the best part of twenty quid.

This is not to say that a bad diet has to be expensive. If you want to live off frozen pizzas, chips and sausages you can do so for a relative pittance. Food, in general, has never been cheaper. But a diet of stereotypical ‘junk food’ is not cheaper than a healthy diet and is usually more expensive.

Unless you have servants to do your shopping, this probably seems obvious. The theory that Britain has high rates of obesity because healthy food is unaffordable is flawed on every level. It does not explain why obesity has increased while food prices have fallen to historic lows, nor does it explain why obesity rates are higher in rich countries than in poor countries. It does not explain why people fail to buy more fruit and vegetables when they become richer and it does not explain the high rate of obesity among people on middle and high incomes.

Why, then, do so many take the lazy assumption that healthy food is expensive at face value? In part, it is because some health campaigners want to portray obesity as an economically driven phenomenon in order to justify taxes and subsidies on food, but there are other reasons. According to a study in the Journal of Consumer Research, people assume that expensive food products are healthier even when they are not. The mere existence of a price premium seems to imply health benefits to some consumers. Organic and gluten-free food, in particular, are assumed to be healthier as a result of their price and because of the exaggerated claims made on their behalf.

The chef Anthony Warner argues that fad diets and wellness gurus ‘focus almost solely on exclusive, exotic ingredients’ such as quinoa and chia seeds at the expense of ‘cheap, easily consumed sources of valuable nutrition like carrots, potatoes, bread and cheese’. If you assume that ‘healthy’ means organic, imported or gluten-free then you will end up spending more money but there are plenty of unpretentious, nutritious fruits and vegetables available on supermarket shelves for next-to-nothing.
Meanwhile, ‘cheap junk food’ is not so cheap, in relative terms. The appeal of Big Macs, ready meals, frozen pizzas and chocolate fudge cake is not that they are cheap but that they are tasty, convenient and require no cooking skills. These are things that people are prepared to pay a premium for — and they do. Price is not unimportant, but if it was the main determinant of dietary choices, we would all be eating ten-a-day.

Tuesday, 20 July 2021

No global booze taxes, UK tells WHO

The UK government has responded to the World Health Organisation's draft action plan on alcohol. The corrupt and incompetent WHO has shifted the goalposts with its Global Alcohol Strategy. It wants to move away from a target of reducing alcohol-related harm by ten per cent worldwide to reducing alcohol consumption by twenty per cent worldwide. This is not going to happen (it wants to do this by 2030!) and there is no economic or ethical justification for it. 

It also wants member states to raise taxes on alcohol and give the money to the WHO. And it wants a Framework Convention on Alcohol Control modelled on the Framework Convention on Tobacco Control (we tried to warn you this would happen).

The UK, quite rightly, is not having this. In some curt comments at the end of the UK's response (p. 490), HM Treasury tells the WHO where it can stick its FCAC and its global alcohol tax.

HM Treasury (HMT) are carrying out a review of alcohol duty. HMT is not in agreement to a direction of travel that seeks to put alcohol on the same footing as tobacco. Particularly the mooted suggestion of creating a FCTC-equivalent for alcohol, as this would be unviable. 
HMT further commented on the action points in section 6: 
  • Global target 6.1: 50% of countries have increased available resources for reducing the harmful use of alcohol and increasing coverage and quality of prevention and treatment interventions for disorders due to alcohol use and associated health conditions. 
  • Global target 6.2: An increased number of countries with earmarked funding from alcohol tax revenues for reducing the harmful use of alcohol and increasing coverage and quality of prevention and treatment interventions for disorders due to alcohol use and associated health conditions. 
This would not be supported in any way. It’s antithetical to HMT to hypothecate taxes, and we would say that resourcing of alcohol prevention/treatment is a matter for member states in line with their national circumstances and not something to be determined by WHO targets.

That's them told. Maybe the WHO should spend a bit more time working on infectious diseases and a bit less time worrying about what people drink.

Note that the document says that hypothecated taxes as 'antithetical' to the Treasury. Bad news for anyone who believes that the revenues from Henry Dimbleby's proposed sugar and salt taxes would be earmarked for cuddly causes. Remember how campaigners said the revenue from the sugary drink tax would go towards school sports and breakfast clubs? It never happened.

Obesity and physical inactivity - the evidence

First published by the Spectator in 2015

Part One

You may have heard the news that the nation’s doctors have had a change of heart about physical activity and no longer believe it to be a sensible way of staying slim. Don’t be too quick to put your feet up. All is not as it seems.

The doctors responsible (or, arguably, irresponsible) for this claim are Aseem Malhotra, Tim Noakes, and Stephen Phinney. Malhotra is a Croydon-based cardiologist who rose without trace several years ago, first attacking junk food and then climbing aboard the anti-sugar bandwagon. Now the scientific director of the wacky pressure group Action on Sugar, he explicitly tells people to eat more saturated fat and implicitly tells people not to bother exercising – unusual advice from someone who looks after people’s hearts for a living. Last year, he wrote an article for the British Medical Journal which was investigated and corrected after it made insupportable claims about the safety of statins. It turned out that Malhotra had brushed aside concerns raised by one of the peer reviewers. His Action on Sugar briefing papers have also contained very questionable assertions.

Malhotra’s co-author, Tim Noakes, is a South African paleolithic diet advocate currently promoting a new diet book. He disputes the evidence that high cholesterol is a risk factor for heart disease and is currently being investigated by the Health Professions Council of South Africa for ‘disgraceful conduct on social media’ after telling a mother on Twitter to wean her infant on to a low-carb diet. (Noakes appears to be taking this in his stride.) Stephen Phinney, the other co-author, is a scientific advisory board member of Atkins – as in the Atkins Diet – and has written several books extolling the low-carb way of life.

They are not, in short, typical doctors. Together they wrote a short editorial for the niche British Journal of Sports Medicine, in which they made the striking and unambiguous claim that ‘physical activity does not promote weight loss’. They then praised the alleged virtues of fat and called for legislation to clamp down on carbohydrates, especially sugar.

Curiously, the authors’ poorly referenced, 1,000-word opinion piece became a national news story. The op-ed was (wrongly) described as a ‘scientific study’ by the Independent and the trio were (questionably) described as ‘international experts’ by the BBC. Indeed, the Beeb’s claim that ‘Physical activity has little role in tackling obesity – and instead public health messages should squarely focus on unhealthy eating, doctors say’ made it sound as if this was the consensus view of the medical profession rather than the eccentric opinion of three Atkins evangelists, one of whom is a lobbyist for a pressure group.

The idea that burning off calories does not help prevent weight gain is idiosyncratic to say the least, but the media haven’t misrepresented them. That is what they say in their article and there is no reason to think they don’t believe it. Malhotra has previously boasted of having convinced the Minister for Public Health that ‘physical inactivity is not linked to obesity’. Their evidence for this claim seems to boil down to the fact that obesity has risen in recent decades despite levels of physical activity remaining the same. Therefore obesity must have risen because people are eating more calories.

The trouble is, it is not a fact. As Public Health England noted in a major report last year, ‘People in the UK today are 24 per cent less active than in 1961’. British Heart Foundation figures show that British adults are walking less (from 255 miles per year in 1976 to 181 miles in 2012) and the proportion of British children who walk to school has dropped from 70 per cent in 1980 to less than 50 per cent today.

At work, we are less physically active than ever. Jobs in agriculture declined from 11 per cent to two per cent of employment in the 20th century while manufacturing jobs declined from 28 to 14 per cent. Less than one in five adults report doing any moderate or vigorous physical activity at work. Outside of work, 53 per cent of us take part in no sports or exercise at all.

You don’t need to be a social historian to see that Britons are leading increasingly sedentary lifestyles. Only a minority of households owned a car in 1965. Today, only a quarter do not. In Britain, as in all western countries, there have been what the World Health Organisation describes as ‘decreased physical activity levels due to the increasingly sedentary nature of many forms of recreation time, changing modes of transportation, and increasing urbanisation’.

If Malhotra et al’s theory seems counter-intuitive it is for the simple reason that it doesn’t stand up. They provide no new research in their ‘study’ and only cite one article in support of their claim about physical activity. That, too, is an opinion piece from the fringes of the scientific debate and has been widely criticised. The phrase ‘overwhelming evidence’ can be overused, but it can certainly be applied to the countless studies showing that physical activity helps prevent weight gain – and to the data showing that rich westerners burn fewer calories than their grandparents.

Why claim something that can so easily be challenged by reference to laboratory, animal and observational trials? Why fly in the face of empirical evidence and lived experience?

The answer, I think, lies in political pragmatism. Governments are not yet ready to pass laws forcing people to exercise, so it makes sense for the likes of Action on Sugar to focus on the food supply where regulation is more likely. A soda tax is more realistic than a sofa tax. If politicians view obesity as a cultural symptom of greater wealth and structural changes in the labour market, they will be less likely to support taxes, advertising bans, graphic warnings and all the other interventionist policies that you would expect from a campaign group which claims that ‘sugar is the new tobacco’.

This, admittedly, requires a certain amount of self-delusion, since the cold facts show that physical activity is not the only thing that has declined since 1980 – sugar consumption has too. But what are activists to do? Bore people with all of the science? Leave them alone? Of course not. Better to trust the media to be suitably deferential to them on account of their PhDs. The media did not let them down last week. The closest Malhotra came to being challenged was when the National Institute for Clinical Excellence said that an obesity strategy that ignored physical activity would be ‘idiotic’.

The multi-million-pound diet industry is, largely if not wholly, based on the conceit that there is more to weight loss than calories in and calories out. Supposed diet gurus will be ignored by right-thinking people, but the line between these people and the medical establishment is becoming increasingly blurred.

It’s difficult to say which is more depressing – three medics making a highly doubtful claim which, if acted upon, would probably harm people’s health, or the media taking a one-page editorial from an obscure journal and reporting it as news. Since most people don’t take health reporting too seriously, the damage to the public is likely to be negligible. It is more likely to be a blow to the reputation of the ‘public health’ lobby, but given the say-anything, do-anything mentality of some self-styled public health experts, it is a blow that is well deserved.

Part Two

Last week I mentioned a widely reported article in the British Journal of Sports Medicine which claimed that ‘physical activity does not promote weight loss’. The article was taken down by the journal last week due to ‘an expression of concern’. It remains offline as I write this, but the controversy rumbles on. At the risk of further upsetting the low-carb community (who seem particularly antagonistic to the doctrine of ‘calories in, calories out’), I am returning to it today.

Let’s start by looking at a series of blog posts by Jason Fung of Intensive Diet Management that have been doing the rounds on social media. He, too, argues that ‘there is no measurable association between obesity and physical activity’. In his first post, he argues that people are exercising more than ever and yet are becoming fatter and fatter. The positive correlation between obesity and exercise, he says, shows that physical activity really doesn’t make much of a difference.

I once met somebody who wondered whether artificial sweeteners caused obesity, based on the fact that their use had risen more or less in line with obesity rates in recent decades. It seems pretty obvious that this is a case of reverse causation. Artificial sweeteners are a response to obesity, not a cause of obesity, just as the rise of jogging and gym membership is a response, not a cause.

To be fair, Fung is not claiming that exercise causes obesity, only that it is not a solution. He cites figures showing that Brits are exercising more than they used to – or, more precisely (and this is crucial), that more Brits are exercising than they used to. Forty-two per cent of British men met the government’s physical activity recommendations in 2008, up from 32 per cent in 1997. At the same time, the male obesity rate rose from 17 per cent to 24 per cent.

But, leaving aside the question of whether people accurately report how much they exercise, why would we expect the minority who exercise to have an effect on the majority who don’t? There is nothing incongruous about obesity rising even if one in ten men are exercising more than they used to. Moreover, there is a conflation between physical activity and leisure-time exercise that is often made by those who downplay the benefits of physical activity.

Office jobs, computers, cars and gadgets have created a more sedentary society which requires fewer calories to be burned. People can offset their less active working and domestic environments by eating fewer calories or burning more calories in their leisure time, but not everybody does. Hence the rise in obesity in recent decades. It cannot be assumed that those who engage in leisure-time exercise are more physically active than previous generations, and it certainly cannot be assumed that the leisure-time exercise of a minority makes the sedentary majority less likely to become obese.

The evidence is quite clear that, on average, calorie expenditure has declined over the years in developed countries. Public Health England (who say that the ‘link between physical inactivity and obesity is well established’) report that ‘People in the UK today are 24% less active than in 1961’. The World Health Organisation has remarked on the ‘trend towards decreased physical activity levels due to the increasingly sedentary nature of many forms of recreation time, changing modes of transportation, and increasing urbanization.’ Harvard School of Public Health says that ‘Physical activity levels are declining’ and that ‘this decline in physical activity is a key contributor to the global obesity epidemic’.

Even this demonstrable fact is disputed by the revisionists. Fung cites a study of hunter-gatherers as evidence that modern man burns the same number of calories as our ancestors. There are a number of problems with this interpretation (see here for a few) and other studies of hunter-gatherers have found significantly higher energy expenditure, but it is not necessary to speculate about prehistoric man for us to see that calorie consumption has fallen over time.

In his 1946 essay, The Politics of Starvation, George Orwell noted that the average Briton was eating ‘about 2,800 or 2,900 calories a day’ despite rationing and a shortage of food that was on the verge of leading to civil unrest. This would be enough to fatten up most Britons today, which is why we are advised to eat just 2,000-2,500 calories a day.

This was not journalistic licence on Orwell’s part. Two years later, the British Medical Journal published a study which found that the average Briton lost weight if he consumed fewer than 2,900 calories. Unless you believe that human metabolism has evolved dramatically in the last 70 years, the only explanation for our grandparents eating more yet staying slimmer is that they burned more energy in their daily lives.

Few people joined a gym in the 1940s. They didn’t need to. Today, there are lots of gyms and lots of obese people, but this is not proof that physical activity is useless in preventing weight gain. Asking whether leisure-time exercise leads to weight loss is a much narrower question than asking whether physical activity is linked to obesity, but to answer it we need to look at the people who are exercising, not at the whole (largely sedentary) population. In the next post, we will do just that.

Part Three

Now let’s look at the effect of exercise on individuals. Fung – who coined the term ‘Calorie Reducation as Primary’, or CRaP, to describe ‘current obesity thinking’ – is unequivocal. In a series of blog posts entitled ‘The Myth about about Exercise’, he writes: ‘There are many benefits to regular exercise. Weight loss, though, is not one of the benefits‘ (italics in the original).

He cites three studies which found that burning off a certain number of calories did not result in a commensurate loss of body weight. He rightly attributes this to a degree of compensatory eating. In other words, exercise creates appetite which can lead to more calories being consumed.

But, in making this point, he downplays the conclusions of the studies themselves, all of which also make it clear that the participants who exercised lost a significant amount of weight.

The first of these studies concluded that ‘physical activity expressed as energy expended per week is positively related to reductions in total adiposity’. The second found that people who exercised most intensively did not lose more weight than people who trained less intensively, but the crucial fact remains that all the subjects who trained lost more weight than those who didn’t. All exercise groups had a significant reduction in waist circumference. Similarly, the third study concluded that ‘supervised exercise, with equivalent energy expenditure, results in clinically significant weight loss’.

By the time he gets to his third ‘Myth of Exercise’ post, Fung has almost given up on his claim that ‘there is no measurable association between obesity and physical activity’ and is instead arguing that exercise is merely less effective than dietary change.

He cites a 2007 study involving people who exercised for around 45 minutes a day. After a year, their body mass index (BMI) had dropped by 0.5 and 0.6 (for men and women respectively) while the BMI of the control group either rose or stayed the same. Moreover, those who exercised the most lost the most weight.

Fung views this amount of weight loss as trivial, saying: ‘Colour me unimpressed. Exercise is just not that effective for weight loss.’ That’s a matter of opinion, but it’s rather different to claiming that weight loss is not one of the benefits of exercise.

As the killer blow, Fung discusses marathon running, which he evidently sees as the ultimate test of the exercise/weight loss hypothesis. He relishes the chance to talk about a 1989 study of people who were training for one:
Endless chub rub (chafing between the inner thighs). Miles upon miles on the dreadmill.  But so worth it, right?  Average body fat loss for men …  5 pounds.  Average weight loss for women … zero.

What Fung doesn’t mention is that this study was not aimed at achieving weight loss and there is no evidence that the participants wanted or needed to lose weight.

The men had a healthy average BMI of 23.4 before they started training and the women were a slender 21.1. Both groups consumed significantly more calories while training, mainly from carbohydrates, and both groups actually did lose weight. The men lost an average of 2.7 kg and the women lost 0.9 kg, though the latter was not statistically significant. Both groups also lost fat as a percentage of body weight (from 16.6 to 13.4 per cent for men and from 24.9 to 23.6 per cent for women) although there were were too few participants for these results to reach statistical significance.

The literature on physical activity is very large and Fung is entitled to select any part of it to make his case, but if these studies debunk the claim that exercise helps people lose weight then you can only wonder what the rest of the literature says.

Unsurprisingly, other studies make the case for physical activity even more convincingly. Listing a few in chronological order:

• A randomised control trial published in 2000 found that ‘weight loss induced by increased daily physical activity without caloric restriction substantially reduces obesity’.

• A 2003 study from the US found that ‘moderate-intensity exercise sustained for 16 months is effective for weight management in young adults.’

• A 2004 study of overweight women from Singapore found that an eight-week exercise programme ‘significantly reduced body weight, body mass index, percentage body fat and waist circumference’.

• A 2005 review concluded that ‘Regular exercise can markedly reduce body weight and fat mass without dietary caloric restriction in overweight individuals.’

• A 2009 study of middle-aged women found that ‘body mass, body composition, waist circumference, and high-density lipoprotein cholesterol changed favorably’ after a 30 minute, five days a week exercise routine.

• A 2009 study of younger women found that physical activity was ‘associated with a reduction in long-term weight gain, and greater duration is associated with less weight gain’. Moreover, it found that ‘sedentary behavior independently predicted weight gain.’

• A 2012 study found that a moderate-intensity exercise programme reduced BMI by 2.4 per cent amongst post-menopausal women, rising to 10.8 per cent if combined with a reduced calorie, low-fat diet.

• A 2013 study from the US concluded that ‘supervised exercise, with equivalent energy expenditure, results in clinically significant weight loss’.

I could cite many more studies (and have before) but there is no point in labouring a point that should be obvious: if you burn off calories they cannot turn into body fat.

The simple, unavoidable fact of human physiology is that you can’t lose weight without creating a calorie deficit. Whether you do this by eating less, moving more or a combination of the two is a matter of preference. Some people may find it too difficult to change their diet while others may find it too difficult, or too time consuming, to start exercising. Some find it easy to cut out alcohol or sugar, while others find it easier to play more sport.

Since nobody denies that physical activity has health benefits that extend beyond weight management, it could be argued that a calorie burned is better than a calorie foregone, but the crucial thing is to eat fewer calories than you burn. If your preference is for radical dietary change then by all means make your case – but don’t let your interest in ‘calories in’ blind you to the importance of ‘calories out’.