Friday, 11 May 2018

Wiping out diabetes in three years?

From the front page of the Daily Express today...

Diabetes WAR: Sugar tax on foot [sic] top [sic] WIPE OUT diabetes as top doctors develop radical plan

A COALITION of international health experts have proposed a tax on sugary foods to reverse Britain’s obesity and Type 2 diabetes epidemics.

Who are these health experts? Step forward Aseem Malhotra, Robert Lustig and Grant Schofield. The first two names may be familiar to you. Malhotra currently bills himself as an honorary consultant cardiologist so I assume that he has stopped practising and is now a full time diet entrepreneur. You can read what I thought of his first book here. His next book is due out in 2019 and promises to be an 'insight into medical corruption' so that should be fun.

Lustig has also written a couple of books and, unlike Malhotra, has some relevant qualifications, but his views about fructose and diabetes are on the fringes of scientific thinking. His main claim is that sugar consumption directly causes diabetes. This is not endorsed by mainstream scientists, nor by diabetes charities, who believe that obesity increases diabetes risks but that sugar cannot do so in the absence of obesity.

Grant Schofield is a new name to me, but I was not surprised to find that he has written a series of books about the wonders of saturated fat. Like Malhotra and Lustig, he is on the Low Carb, High Fat (LCHF) gravy train or, as he puts it, the Low Carb, Healthy Fat movement.

Their 'no-holds-barred report' is actually a commentary in the obscure Journal of Insulin Resistance. This journal seems to have been created specifically to promote the LCHF diet and has only produced three issues since starting up in 2015.

The authors argue for tobacco-style regulation of sugary products, including sin taxes and an advertising ban. The journal isn't listed on PubMed so I can't read the article, but you can see the main points here. (UPDATE: As Jonathan points out in the comments, you can access the full version for free here.) It's much as you would expect, with Malhotra managing to include a dig at the British Dietetic Association with whom he has been feuding ever since they described his book as one of the year's worst celeb diets.

There is also the argumentum ad tobacco industry, a popular fallacy among people who want to act without evidence. The premise of this idiotic idea is that the tobacco industry cast doubt on the evidence that smoking kills in the 1950s, therefore: (a) anybody who questions health claims is like the tobacco industry and (b) any health claim that is contested must be true. Malhotra expands on this stupid theme in an editorial in the Express.

To complete this confederacy of dunces, anti-smoking zealot Simon Chapman pops up in the Express to offer his support. He and Malhotra recently became chums in Australia.

Simon Chapman, of the Sydney School of Public Health, said: “If you want to control malaria, it’s essential you control mosquitos. If you want to control obesity, diabetes and cardiovascular disease, you must control the mosquito’s equivalent - the food industry.”

This is a line that Chapman has been using for decades about the tobacco industry. All he had to do was replace 'lung cancer' with 'obesity' and 'tobacco' with 'food' and hope that nobody remembers his repeated assurances that there is no slippery slope, such as when he said this in 2012...

Look, if the slope is slippery, it's the most unslippery slippery dip I've ever seen in my life. We started banning tobacco advertising in 1976 and there has been no other commodity where there has been anything like a serious move to do what we've done with tobacco. And that's because there are great big differences between tobacco and all other commodities.

So, you know, the comparisons with hamburgers and chocolate bars and alcohol and such with like that, they're just really don't stack up.

And if you think that there's no chance of the government acting on the policy recommendations of attention-seeking cranks, don't forget that Malhotra's sugar tax campaign was ultimately successful (albeit after he had 'parted ways' with Action on Sugar) and Sadiq Khan has just capitulated to Jamie Oliver by banning HFSS food advertising on London transport.

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