Cardiologist Dr Aseem Malhotra is kind of a big gun in the health world.
In the UK, he has been instrumental in changing the dialogue on public health. Self-described as “one of the most outspoken cardiologists”, his mythbusting editorial on saturated fats made international headlines and he regularly features on “most influential” activist lists. He and Sarah have also been catching up for years on the science behind the trends.
And now Dr Aseem is on tour in Australia, asking: “Is it time to bring back the fat?”
The global health epidemic.
In Australia alone, almost two thirds of adults are considered obese or overweight, and a quarter of children are the same. More than 1.4 million people have type 2 diabetes, and another 500,000 may be undiagnosed.
But far from being the fault of fat, Aseem states that sugar and refined carbs are to blame. (Sound familiar?!)
“Obesity isn’t even the major issue – it’s a marker of the major issue, which is insulin resistance,” he says. “We call it the ultimate cause driving metabolic diseases. Sugar, particularly, is an independent risk factor to chronic disease and insulin resistance.”
And the prognosis isn’t good.
“Eventually, our health systems will become bankrupt,” says Aseem. “There will be more chronic disease, an economically unproductive population, reduced quality of life. More misery. It’s very worrying.”
The case for a sugar tax.
So, if sugar is to blame – and such dark times lie ahead – how do we reduce consumption?
With sugar harbouring the same addictive qualities as nicotine and companies falling over themselves to mislead consumers about how healthy their products are, Aseem argues passionately for a sugar tax.
“There’s a debate about whether a tax takes away personal responsibility. To have personal responsibility, you need information and choice, and people have neither,” he says. “Sugar is so prevalent in our environment that it’s unavoidable. The personal responsibility argument is complete and utter nonsense.”
In an ideal world, Aseem would also extend that tax to all added sugars. But he concedes that soft drinks – “a low hanging fruit” – will get the ball rolling.
“This tax will pressure the food industry to gradually reduce the sugar in processed foods. People’s palates adjust. In theory, it shouldn’t even affect sales, because they won’t be in competition if they do it together.
“A tax would have the most incredible impact on population health within a short space of time.”
A bitter pill to swallow.
One thing’s certain, we can’t rely on our current health system for a cure. In fact. Aseem states that some medications prescribed for lifestyle diseases are in fact part of the problem.
“It’s estimated that prescribed medications are the third most common cause of death globally,” he says. “People need to understand that doctors have to use biased information to make clinical decisions. In my view, that’s unethical.”
Aseem brings up the issue of statins (he has led the charge against their overprescription). He believes that the benefits of the drug have not only been grossly exaggerated, but the side effects have been underplayed.
“Many studies that drive guidance to prescribe are sponsored by industry, and the pharmaceutical industry has an obligation to produce profit for their shareholders,” he says. “But they don’t have a legal responsibility to give you the best treatment.”
Scientific study or marketing exercise?
And it’s not just pharmaceutical companies subject to corruption.
In our recent interview, professor and health activist Marion Nestle was dismayed to learn of the questionable “Australian Paradox” – a University of Sydney-funded study that claimed sugar couldn’t possibly be responsible for the country’s obesity crisis.
But Aseem is emphatic that it’s just the tip of the iceberg.
“The editor of The Lancet Journal, Richard Horton, said that possibly half the published literature is false,” he reveals. “The big problem is collusion between academic institutions and financial gains with industry. Statistical manipulation goes on and the universities cover it up because they don’t want to bite the hand that feeds them.
“We have a responsibility to fix this. All industry-sponsored studies should be seen as marketing until proven otherwise.”
So who can we trust?
If we can’t bank on food labels, pharmaceutical advice or scientific research, where exactly do we find that mystical blueprint for perfect health? As Aseem (and Sarah) say, trust the oldest people in the world.
Aseem follows the Mediterranean diet – in a nutshell, lots of vegetables, healthy fats and no added sugar – which is famed for giving long life and good health. Although he protests it’s not really a diet at all.
“It’s just delicious food! People love that they can have butter and cheese again.”
And what about all that scary fat?
“When you cut out processed food, then eating fat is just as likely to make you fat as eating green vegetables.”
“Cut sugar and eat more whole foods and fats,” he sums up. “You will see the impact on your health very quickly. Have more open conversations with your doctor. And be more wary of taking pills. Lifestyle changes are going to have a much bigger impact on quality of life – our health rarely comes out of a bottle.”
Agree with Aseem on the sugar tax? Sign and share our petition for an Australian sugar tax at Change.Org/sugartaxAU.
By Rachel O'Regan