Sunday 15 April 2012

Dr Aseem Malhotra doesn't know what he's talking about

An article has appeared in the Observer under the byline of Aseem Malhotra. He is a medic and, not coincidentally, has a God complex and a shaky grasp on facts and figures. Like Liam Donaldson and many others before him, he seems to have tired of healing the sick and wishes instead to indulge his political ambitions without all the bother of having to get elected.

Malhotra has written several articles about so-called junk food, on the last occasion asking "For Big Tobacco, should we now read Big Food?" He appears to believe the absurd prediction that 90% of the population will be overweight or obese by 2050 (despite rates having been flat or declining for ten years), and has swallowed the idea that heart attacks fall dramatically after smoking bans are introduced (they don't). Today's article is headlined...

We must demonise junk food for the sake of our children

Calling for demonisation is not likely to get a warm reception round these parts, especially if the rationale boils down to 'think of the children'. Still, let's give him a chance.

A consultant psychiatrist friend, on his recent appointment to a new job, was so disgusted by the detrimental effect of the unchecked consumption of junk food on his patients' health that he successfully banned vending machines selling chocolates, fizzy drinks and crisps from the hospital grounds.

All in a day's work for your average medical busy-body, interfering in matters beyond their expertise (the guy is a psychiatrist, remember).

He wondered whether I – as a clinician – believed the consequences of eating junk food were as bad for our health as smoking cigarettes. "No, not as bad," I replied, "in many ways it's far worse!"

Oh, to be a fly on the wall when these two intellectual titans conversed. It must have been like a Pete and Dud sketch. ("You think hamburgers are worse than fags, Pete?" "Oh yes, Dud, I reckon they're far worse. Gotta be, haven't they?") If you're going to make a statement as stupid as that - dangerously stupid, in fact - you'd better have some pretty impressive evidence to back it up.

It is estimated that diet-related diseases are responsible for 35 million deaths worldwide, dwarfing smoking-related ones of 5 to 8 million.

Nice statistic. Shame it's rubbish. As the briefest Googling would have told him, 35 million is the total number of deaths caused by "obesity, cardiovascular diseases (CVD), cancer, and diabetes" worldwide, representing 60% of all deaths every year globally. In other words, he has combined the total number of deaths attributable to the diseases of old age and defined them as 'diet-related'. It is true that they can be diet related - just as they can be related to a number of other factors - but that hardly justifies presenting the bald statistic as if all these deaths could all be prevented by modifying diet, let alone drawing the conclusion that 'junk food' is more dangerous than smoking. Doing so suggests either appalling ignorance or a degree of mendacity.

As BenSix says..

CiF commentators passing off misunderstandings and received wisdom as fact is hardly new. Yet when a practicing doctor can make – unless I’ve made a ridiculous error – such a ridiculous error it drives home how lax the standards of epistemic rigour can be in today’s society.

Indeed. It is the old problem of the media assuming that someone knows what they're talking about just because they work in the medical industry. 

So what is the biggest culprit of the obesity epidemic and how do we combat it? According to Professor Robert Lustig, a child obesity expert at the University of San Francisco, it's sugar (including sweeteners) and processed carbohydrate.

If you ever find yourself reading an article in which Robert Lustig is cited as an authority, a good rule of thumb is to put it down and do something more productive with your time. This is not the first time Malhotra has cited Dr Lustig in an article and we have encountered him before. He is an anti-sugar crank and borderline conspiracy theorist who indulges in some of the strangest beliefs in the Bay Area - no mean achievement. He think that sugar-sweetened beverages have created "the biggest public health crisis in the history of the world" and seems to believe that bee stings are a sign from God that we shouldn't eat honey.

He describes sugar as being addictive and toxic...

Indeed he does. Because he doesn't understand what either of those words mean.

...and has called for a ban on the sale of sugary drinks to under-17s and a consumer tax on any substance with added sugar. This would be a good start.

And a start is all it would be, I'm sure. Presumably to be followed by minimum pricing of food and a display ban for sweets. The former was reported earlier today. The latter is hinted at here...

It horrifies me to see well-known high street brands getting away with the display of chocolates, crisps and fizzy drinks in prominent positions. It's perverse that institutions that represent health and wellbeing and treat the consequences of poor diet allow the sale of such products.

And it is perverse that newspapers which represent knowledge and information should pay people to misinform their readers, but that's life.

You will often hear two defences from big food corporations. The first: it's your choice what you eat

It is. It is the most basic of all freedoms.

...and the second: you need to exercise more.

If you're fat, you do.

In response to the second point, a study by Professor Boyd Swinburn, presented at the European Congress on Obesity in 2009, concluded that excess food intake explains weight gain.

Where would we be without professors, eh?

And so he goes on, mainly giving us a list of what he thinks should be compulsory or illegal. The only silver lining being the Guardian's choice of photo for this story, which suggests a certain mischievousness on the part of a sub-editor while illustrating the cognitive dissonance that surrounds the junk food scare.

Don't eat 'junk food' or you could end up as fat as these poor sods


Ivan D said...

I think that we ought to urgently screen all medics for “stupid, arrogant twat” syndrome. Those who test positive should be fired and sent to an inhospitable island where they can mostly be restricted to annoying each other. Australia might be suitable as the population there seem to appreciate being told what to do by morons so a few extra might not hurt.

Such a policy would effectively clear out the Royal Colleges and have the added benefit of saving a fortune.

nisakiman said...

Ha! Love the pic of the "obese" kids scoffing their MacDonalds' shakes and burgers! Sums it up nicely!

David C said...

From your description, it sounds as if he has included smoking related lung cancer deaths in his 35 million figure for food related deaths. Is that correct?

rental mobil said...

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Christopher Snowdon said...

David C,

He's included EVERYTHING. ALL cancer, ALL heart disease etc. so yes there is double-counting for smoking-related deaths.

Ann W. said...

It made our morning news in Canada this morning. The interview background is almost as funny as the newspaper picture. Check out this poor young lady have a coke in the background at 1:48.
Bold moves to fight obesity
Terence Stephenson, vice-chair, Academy of Royal Colleges, discusses the fact that Coca-Cola and McDonald's are two of the big corporate sponsors of the Olympic Games, and explains why this is most unhelpful in the fight against obesity.

Anonymous said...

I think we can bring this Nazis complex back to reality...

We must demonise the Nanny State for the sake of our children

Anonymous said...

Snowdon said...
David C,

He's included EVERYTHING. ALL cancer, ALL heart disease etc. so yes there is double-counting for smoking-related deaths.

Slim truth in fat and smoking figures

Michael West
November 23, 2011 - 11:39AM.

A leading actuary has lampooned health lobby figures on the costs of smoking and obesity as being extravagantly inflated and based on suspect methodology.

“The numbers are all over the place,” writes Geoff Dunsford in the September edition of Actuary Australia. And they are “big numbers” – the implication being that they are too big.

“Obesity costs $58.2 billion,” he exclaims, “that’s around twice the cost of age pensions!”

The sheer size of the numbers, argues the Sydney actuary, perverts government policy. It can lead to poor spending decisions. The credibility of the numbers from the health lobby is therefore critical to government policy.

The press and the public have been led to believe that the costs to the system are higher than they really are so the government can “justify use of taxpayers’ money on measures to reduce its prevalence and prevention”.

Read more:


Anonymous said...

Illegal ciggies and spirits cost Britain more than 28 billions
Black market cigarettes, fuel and booze cost Britain about £28.5 billion in lost tax between 2005 and 2010. That kind of money would be more than enough to fund a 1% cut in the basic rate of income tax, a report reveals.

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Anonymous said...

I'm a doctor myself, and I couldn't agree more with you. Our "noble" profession was always more about social climbing than compassion or accurate science. Whenever parents wish their children to become "doctors or lawyers" you see the true roots of our profession. By the way, if you want to see the most incredible example of how a TV doctor can sell out, google "Dr. Ranj official website", and get ready to pee your pants with laughter.

Bob said...

Pubmed: A Malhotra AND obesity

Clearly the guy has not published anything peer reviewed on obesity. He is still a trainee and his grasp of the field is poor at best