Aseem Malhotra's war on reality

Our old friend Dr Aseem Malhotra of Action on Sugar was feeling pleased with himself on Tuesday after rubbing shoulders with the public health minister Jane Ellison. Read about it and weep.

Public health minister has agreed that physical inactivity is NOT linked to #obesity. It's all about calories consumed! @SimonCapewell99
— Dr Aseem Malhotra (@DrAseemMalhotra) March 3, 2015

I asked, Do you agree public health minister that physical activity although important for health is NOT linked to #obesity - 'YES' she said
— Dr Aseem Malhotra (@DrAseemMalhotra) March 3, 2015

It is not clear whether she said 'yes' because she fervently agrees with his anti-scientific clap-trap or if she said 'yes' to humour him before wandering off to find someone else to talk to, as you would with a mentalist at a bus stop. All we know is that he was so delighted with this coup that he was still banging on about it yesterday...

Yesterday in parliament the minister agreed that physical activity has many benefits but weight loss is NOT one of them! @ProfTimNoakes #NHS
— Dr Aseem Malhotra (@DrAseemMalhotra) March 4, 2015

Physical activity not linked to obesity? Physical activity no good for weight loss? As fact-checking goes, this is real fish-in-a-barrel stuff. Do we really need to cite evidence for the laws of thermodynamics? If people like Malhotra are being taken seriously, perhaps we do. So let's go.

Here's what Public Health England says:

The link between physical inactivity and obesity is well established... People in the UK today are 24% less active than in 1961

Here's what the Harvard School of Public Health says:

Obesity results from energy imbalance: too many calories in, too few calories burned. A number of factors influence how many calories (or how much “energy”) people burn each day, among them, age, body size, and genes. But the most variable factor—and the most easily modified—is the amount of activity people get each day.

...Despite all the health benefits of physical activity, people worldwide are doing less of it—at work, at home, and as they travel from place to place. Globally, about one in three people gets little, if any, physical activity. Physical activity levels are declining not only in wealthy countries, such as the U.S., but also in low- and middle-income countries, such as China. And it’s clear that this decline in physical activity is a key contributor to the global obesity epidemic, and in turn, to rising rates of chronic disease everywhere.

And here's what the World Health Organisation says:

Global increases in childhood overweight and obesity are attributable to a number of factors including:

• A global shift in diet towards increased intake of energy-dense foods that are high in fat and sugars but low in vitamins, minerals and other healthy micronutrients;
• A 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.

Here's a study from 1996:

In recent times, affluent societies have become less physically active, and this has undoubtedly contributed to the increased incidence of obesity. 

Here's a study from 2000:

Weight loss induced by increased daily physical activity without caloric restriction substantially reduces obesity (particularly abdominal obesity) and insulin resistance in men. 

Here's a study from 2005:

Regular physical activity 45-60 min per day prevents unhealthy weight gain and obesity, whereas sedentary behaviors such as watching television promote them. Regular exercise can markedly reduce body weight and fat mass without dietary caloric restriction in overweight individuals.

Here's a study from 2008:

Physical inactivity in adolescence strongly and independently predicts total (and especially) abdominal obesity in young adulthood, favoring the development of a self-perpetuating vicious circle of obesity and physical inactivity. Physical activity should therefore be seriously recommended for obesity prevention in the young.

Here's another study from 2008:

Persistent participation in leisure-time physical activity is associated with decreased rate of weight gain and with a smaller waist circumference to a clinically significant extent even after partially controlling for genetic liability and childhood environment.

Here's one from 2009:

Sustained PA [physical activity] for at least 30 min d(-1), particularly if more intense, is associated with a reduction in long-term weight gain, and greater duration is associated with less weight gain. Sedentary women of any baseline weight who increase their PA [physical activity] will benefit, but overweight women appear to benefit the most.

Here's a study from last year:

Men and women who commuted to work by active and public modes of transport had significantly lower BMI and percentage body fat than their counterparts who used private transport.

I could on, so I will.

Here's another:

Obesity appears when energy intake exceeds energy expenditure. The most important variable compound of energy expenditure is physical activity. The global epidemics of obesity seem closely related to reduced physical activity and sedentariness widely increasing nowadays.

Here's a study from 2006:

We confirm that there is irrefutable evidence of the effectiveness of regular physical activity in the primary and secondary prevention of several chronic diseases (e.g., cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis) and premature death.

 Here's a study from 1999:

Summary results for all outcomes except cancer were generally consistent in showing that active or fit women and men appeared to be protected against the hazards of overweight or obesity.

Here's a study from 2003:

There is compelling evidence that prevention of weight regain in formerly obese individuals requires 60-90 minutes of moderate intensity activity or lesser amounts of vigorous intensity activity. Although definitive data are lacking, it seems likely that moderate intensity activity of approximately 45 to 60 minutes per day, or 1.7 PAL (Physical Activity Level) is required to prevent the transition to overweight or obesity. For children, even more activity time is recommended.

Here's another from 2003:

We found that in the National Weight Control Registry, successful long-term weight loss maintainers (average weight loss of 30 kg for an average of 5.5 years) share common behavioral strategies, including eating a diet low in fat, frequent self-monitoring of body weight and food intake, and high levels of regular physical activity.

Here's a study from 2007:

Exercisers with greater increases in pedometer-measured steps per day had greater decreases in weight, BMI, body fat, and intra-abdominal fat (all p trend < 0.05 in both men and women). Similar trends were observed for increased minutes per day of exercise and for increases in maximal oxygen consumption.

And here's one from last year:

The proportion of adults who reported no leisure-time physical activity increased [between 1988 and 2010] from 19.1% (95% CI, 17.3-21.0) to 51.7% (95% CI, 48.9-54.5) in women, and from 11.4% (95% CI, 10.0-12.8) to 43.5% (95% CI, 40.7-46.3) in men. Average daily caloric intake did not change significantly. BMI and waist circumference trends were associated with physical activity level but not caloric intake.

I don't want to labour the point here folks, but seriously. "Physical activity is not linked to obesity"?! This guy is regularly presented on television as an expert on this subject. He now has the ear of government. Is it asking too much for his views to be on the same planet as mainstream science?

As I said three years ago, when I first came across this guy, Aseem Malhotra doesn't know what he's talking about. He really should not be taken seriously by anybody.