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Obesity - its true causes and cure

Unearthing the Truth
Published by in Food and health · 25 July 2020
Tags: obesitypreventing_obesityweight_loss
When I was born very few people in the UK were fat, let alone obese. In the 1950s in my secondary school of 500 boys there were was only one fat boy and maybe two or three others who were on the plump side, yet today over a third of 10- to 11-year-olds are overweight. Among the adult population the situation is even worse. Two-thirds are overweight and nearly one-third are clinically obese, a condition which produces all kinds of health problems. According to a report by Public Health England issued on July 18th this year, the likelihood of death from the corona virus is 40% greater for someone who is obese. Obesity is an epidemic almost as serious as the corona virus. In the ten years between 2004 and 2015 the annual number of UK hospital admissions with obesity as the primary or secondary cause of hospitalization increased more than tenfold, from 40,741 to 440,288. By 2017/18 it had risen to a further 711,000! By now it could be approaching a million hospitalizations every year. So what has caused this dreadful state of affairs to occur?

The primary cause of obesity is not a lack of physical activity. Work nowadays does generally require less physical exertion than it used to, but even in the 1950s there were plenty of people with sedentary lifestyles - drivers of trains, buses, taxis and lorries, and multitudes of workers in offices and banks. They would all have spent relatively long working hours seated in their vehicle or at a desk, yet obesity was almost non-existent. Exercise is very important for other health reasons, but its effect on weight is far less than you might suppose. A standard fast food beefburger, a deep-pan pizza or a helping of syrup sponge pudding and custard each contains about 500 Calories [1]. An adult weighing 76kg or 12 stone would have to walk up and down stairs at a steady rate for 66 minutes to burn off that amount of energy instead of storing it as fat. Even a plain digestive biscuit provides enough fuel to climb up and down stairs for 10 minutes. Try doing that and you'll realize how hard it is. So if you are eating too much you will have to do an awful lot of exercise to lose weight! Furthermore, a problem with relying on exercise to control your weight is that it makes you feel hungry so that you can end up eating even more!

The two main causes of obesity are (1) eating and drinking too much, and (2) eating the wrong kinds of food. So how has our diet changed in the last seventy years?

(1) There are several reasons why we eat and drink more than we did when I was growing up:

  • First, food is relatively much cheaper than it used to be. In 1950 people spent about 20% of their disposal income on food, but by 2013 this had fallen to only 10%. So while food does cost more than it used to in terms of pounds and pence, in real terms it costs far less. And we are much more likely to buy something if it doesn't cost much.
  • Secondly the number of fast-food shops on the high street has increased beyond all recognition since I was a child. So far as I recall, fish and chips was about the only fast food available, whereas in our local high street now there are five different fast food shops within only a few yards of each other.
  • Thirdly, we eat and drink a lot more manufactured foods and drinks and alcohol than we used to, many of which contain added sugar. Sugar is the worst of the four macro-ingredients for putting on weight.
  • Fourthly, snacking seems to have become a habit during my lifetime.
  • Finally, of course, we are bombarded on television with advertisements for food and alcoholic drinks, and the food ones are nearly all for manufactured food products high in carbohydrates and sugar. When did you last see an advertisement to eat carrots, or even eggs? These advertisements must be effective in persuading us to buy food or the companies involved would not spend so much money on them. So whether we are out and about or at home, we are constantly being pressurized to eat and drink more, and with low prices and home deliveries it is easier and easier to do so.

I'm sure the government is right to propose banning advertisements for junk food before 9 pm, but if the Prime Minister is serious about dealing with obesity his first action should be to ban all the vending machines in hospitals that encourage visitors to buy chocolate bars and crisps and sugary drinks, almost everything that people should avoid to remain healthy and not get overweight. I can understand why private hospitals have such machines: they produce more paying patients for them! Personally I believe the government should also tax all sugar to discourage us from using it, just as it taxes alcohol and tobacco. Sugar is probably the major cause of Type 2 diabetes, as well as a contributor to obesity, and I'm sure the Chancellor would welcome the additional income he would get.

(2) But now we come to the second main cause of obesity, which I believe is the bigger one. Simply put, we are eating too many starchy carbohydrates and too little fat!

As long ago as 1932 some very overweight British patients were divided into two groups. (Yes, there were some overweight people then!) One group was put on a high carbohydrate, low-fat diet, and the other on a low carbohydrate, high-fat diet. They were both weight-loss diets, but the patients on the low-fat diet lost on average 49gm of weight per day, while the ones on the high-fat diet lost 205gm a day - four times as much [2]! A more recent study in 2005 found the very same thing [3]. The lesson from both studies is that if you want to lose weight you should reduce your intake of carbohydrates, but not your intake of fat. It is carbohydrates that make people put on weight.

The same is true for children. In 2006 it was found that among healthy Swedish 4-year-olds from well-educated families, those eating a higher percentage of fat generally had a lower body mass index [4]. In particular, the children who ate more saturated fat were less likely to be obese.

Why is this? When we eat carbohydrates in the form of starchy foods like bread, potatoes, pasta or rice, the body’s digestive system starts converting them into glucose, which it needs for fuel. If our body finds that we are providing more glucose than it needs right now, being a prudent kind of being it stores some of the excess for future use by converting it into fat. Actually our digestive system can manufacture glucose out of sugars, starches, fats and even proteins. With sugars the conversion process is very fast. It starts even before the sugar reaches our stomachs. With starches it takes longer, but with fats and proteins it takes the longest of all. So when we use protein or fat rather than starch as our main source of energy, glucose is released so slowly into our bloodstreams that we use it up for energy purposes as fast as it becomes available, and there is no need for our bodies to store it as fat for future use.

That's why the World Health Organization advises us to reduce our intake of foods which have a high glycaemic index. Foods having a high glycaemic index are foods which per gram produce a high level of glucose in the blood two hours after eating. So what kind of foods are they? Apart from sugars, the foods with the highest glycaemic indices are starchy carbohydrates. That makes sense, you might say. It means avoiding starch. So tell me, why does the World Health Organization still tell us we should keep off fatty foods and obtain most of our calories from starchy carbohydrates like bread, rice and potatoes? Wake up, WHO! There is nothing wrong with fat…

The reason that so many people including many health professionals think that fat is unhealthy goes back to a publication in 1953 by an American scientist named Ancel Keys. He demonstrated a correlation between the amount of fat in the diets of people in six selected countries and the incidence of coronary heart disease. CHD had been rapidly increasing since around 1940 and was becoming a major health issue. In those days fat was mainly animal fat, which in turn is mainly saturated fat. So with this 'proof' that saturated fat caused heart disease the manufacturers of cooking oils and margarine trumpeted the health benefits of unsaturated fats produced from seed oils, and people turned from butter and lard to margarine and temperate seed oils both for domestic use and for the manufacture of baked products. Coronary heart disease went on increasing as rapidly as before!

Two things were badly wrong with how Keys presented his research. The first is that an
association between two factors does not prove that one causes the other. Most people are in bed when they die, but does that prove that beds kill people? Many people who died of CHD ate a lot of saturated fat, but did that prove that the fat killed them? If Keys had plotted sugar consumption against coronary deaths in those six countries he would have obtained a very similar graph. Therefore, by the same logic, he would have 'proved' that sugar was the cause of such heart failure. And that might well have been nearer the mark. More significant still is that he did not include the results for all 22 countries that he had data for [5]. The countries he carefully omitted to mention showed no such correlation, in fact some of them showed the exact opposite! French people for example eat more dairy fat per head than in any other industrialized nation, yet until not so many years ago France had the second lowest rate of CHD in the industrialized world. And France is not the only country where high fat intake corresponds to low CHD rates. Actually there is no proof at all that the consumption of reasonable quantities of saturated fat is in any way harmful. In fact eating fat is one of the best ways not to get fat! Here's why...

Because starches and sugars are digested much faster than proteins and fats are, the glucose they produce soon disappears, and we feel empty sooner. Our ghrelin response - the hormone that makes us feel hungry - kicks in earlier and we go looking for more to eat in the form of a snack or a bigger lunch or even a takeaway. In 2014 two identical twin doctors conducted an experiment. It was featured in a BBC Panorama programme. For a number of weeks one of them kept to a high-fat high-protein diet, and the other to a high-carbohydrate (sugar and starch) diet. The high-fat doctor, Xand van Tulleken, ate sausage, bacon and scrambled egg for breakfast, while his high-carbohydrate brother Chris ate cornflakes, crumpets and jam. Both breakfasts had the same number of calories. At lunchtime they were invited to eat as much as they wanted of the kinds of foods they were each allowed. Xand had had enough after consuming 855 calories but Chris, his identical twin brother, didn’t feel satisfied until he had consumed 1,250 calories. The explanation given was that protein suppresses the production of ghrelin, so Xand’s protein-rich food satisfied him for longer and he didn’t feel the need to eat so much at lunchtime. And over the period of the experiment he lost 2.5kg more weight than his brother did.

The British Egg Information Service lists five different trials that have compared the weight losses of dieters who eat egg-based breakfasts or lunches with those who eat typical weight-loss meals. In every case the egg eaters lost significantly more weight, because they felt full for longer and presumably were not tempted to cheat on their diet. In one trial the subjects who ate two eggs for breakfast every day lost 65% more weight than subjects who ate a bagel with the same number of calories [6]. In another trial the dieters who ate two eggs for breakfast in addition to what all the dieters ate lost more weight than the dieters who didn't have the eggs!

Foods rich in protein and fat are therefore the best choice for keeping your weight down. Unless you are a vegetarian, this is wonderful news! It means that if you eat eggs and meat and chicken skin and full-fat cheese, and if you drink full-cream milk, you will almost certainly lose more weight than if you stick to skinless poultry, starchy foods and low-fat dairy products. Remember again that meat, lard, eggs and full-cream milk are the kinds of food people ate in my childhood, when hardly anyone was overweight or obese. After I started eating butter and drinking full-cream milk again I lost 6 kilograms in weight over the next few years. It's a great pity that English uses the same word 'fat' as a noun for food and an adjective for being overweight. They are not the same thing. One of the chief causes of being overweight is trying to lose weight by cutting out fat from your diet!

Finally, I mentioned the modern habit of snacking. Snacking can be for comfort or to relieve boredom or merely out of habit (when watching TV for instance); or it may be for reasons of genuine hunger, perhaps because we have not had a satiating breakfast or lunch. Whatever the reason, snacking puts weight on: it is food! If you want to stop snacking, the simplest way to avoid tempation is to put it out of reach. The only way I have found to keep myself from eating biscuits is not to buy any! However if you are a compulsive snacker who can't crack the habit I suggest that you stock up instead on some healthy sugar- and starch-free snacklets like pitted olives, pickled beetroot, cherry tomatoes, walnuts, cheese slices or even full-fat unsweetened yoghourt (but don't eat a whole pot at once!) Alternatively just help yourself to a cup of tea or a sugar-free drink.

So what's the cure for obesity? Assuming that it doesn’t have some physiological cause:

  • Cut out the sugar and cut down the carbs
  • Don't skimp on the protein and fat
  • Cook your own food
  • Crack the snack habit
  • Stick to BBC TV!

You can read further supporting evidence for all the above, based on over 500 peer-reviewed scientific research papers, in my book
Twenty-First Century Nutrition and Family Health.


[1] A 'Calorie' is 1000 calories or a kilocalorie, which is the heat required to raise the temperature of a litre of water by 1°C.
[2] Lyon D M & Dunlop D M. The treatment of obesity: a comparison of the effects of diet and of thyroid extract. Quarterly Journal of Medicine 1932; 1:331-52.
[3] Wing R R & Phelan S. Long-term weight loss maintenance. American Journal of Clinical Nutrition 2005, 82(1 Suppl): 222S-225S.
[4] Garemo M et al. Metabolic markers in relation to nutrition and growth in healthy 4-yr-old children in Sweden. American Journal of Clinical Nutrition 2006; 84:1021-6.
[5] Yerushalmy J & Hilleboe H E. Fat in the diet and mortality from heart disease: a methodologic note. New York State Journal of Medicine, July 15, 1957; 57(14): 2343-54.
[6] Van der Wal J S et al. Egg breakfast enhances weight loss. International Journal of Obesity, October 2008; 32(*10):1545-1551.


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