Health: Non-communicable Diseases

Lord McColl of Dulwich Excerpts

Thursday 6th October 2011 Lords Chamber

[Lord McColl of Dulwich]

My Lords, I thank the noble Lord, Lord Crisp, for introducing the debate. As he has indicated, I intend to speak only about the terrible epidemic of obesity. It is the worst epidemic to affect this country for 100 years. It is killing millions, costing billions and the cure is free: eat less.

What a strange world. Half the world is dying of starvation; the other half is gorging itself to death. Obesity is a disease which wrecks the human body; it causes an enormous amount of distress, disease and suffering. In the United Kingdom there are over 2 million people suffering from diabetes as a result of obesity and a further 750,000 have diabetes but do not yet know it. So-called adult diabetes has reached epidemic proportions and now affects teenagers and young children. Parents seem to be unaware and unconcerned that their children are obese and there needs to be a great deal of education in this field.

Sport, of course, is important, but green spaces and sports centres do not influence the physical activity of children. Social inequalities are no longer a major factor in obesity. All children are at risk, regardless of family income or postcode, as the noble Lord, Lord Crisp, mentioned. Obesity leads to inactivity rather than the other way round. Obesity comes first. Reducing the intake of calories, rather than physical activity, is the key to weight reduction. Most obesity starts before children go to school; Professor Terence Wilkin and Linda Voss, of the Peninsula Medical School, have done a lot of work on the subject and found that 90 per cent of excess weight in girls and over 70 per cent in boys is gained before the child ever gets to school.

What else does obesity cause? The arteries become silted up with fatty material, called atheroma. As noble Lords know from their Greek studies, atheroma means porridge. It may be Greek porridge, but it is not Scottish porridge. It silts up the arteries and can cause heart attacks, strokes and blockage of the arteries of the leg, leading to amputation. Blindness is another result, as are high blood pressure and cancer. The excessive weight wears out the joints, so people need their knees and hips replaced. Obesity leads to cirrhosis. We always think of cirrhosis in terms of alcohol poisoning, but now the commonest cause seems to be obesity, so we have a big problem.

An even greater problem with this epidemic is that politicians refuse to admit that the cause of obesity is overeating. The Minister stated in Question Time on 12 September that his reason for refusing to believe that overeating was the main cause was that he was following the advice of NICE. Indeed NICE stated that:

“A person needs to be in ‘energy balance’ to maintain a healthy weight—that is, their energy intake (from food) should not exceed the energy expended through…exercise”.

This obsession that Ministers have had for some years that it is a balance between what you eat and how much you exercise is the crucial mistake. The real balance is between calorie intake and the total expenditure of energy in the body. We have to run miles to get rid of a pound of fat and, bearing in mind that as little as 25 per cent of the calories we eat go on exercise, where do the other 75 per cent go? They go on the numerous activities of the body over which we have no control. The heart beats several million times in a lifetime, the kidneys filter a vast quantity of blood—about 360 pints over 24 hours—and there are myriad other activities in other organs, such as the liver, pancreas, bones and the alimentary tract. Where do those who believe that the energy from food is all used up in exercise imagine the energy comes from to run the heart, the pancreas, the liver and so on? Perhaps they imagine they run on air—perhaps hot air.

What could the Government do to encourage the food industry, canteens and restaurants to serve smaller portions of food? There is a company called Cook, which has 50 outlets and prepares meals of the right size—meat, two vegetables and gravy. They are cooked, frozen and then stored. They can be heated in five minutes, giving an instant meal of the right size, the right quality and the right price.

During the war, we had no obese people. We had the right quantity of food and the right kind of food. The only people who were obese were those who used the black market, and we children used to point our accusing fingers at them. Surely most mothers who are making their babies and children obese do not realise the terrible damage that they are doing, condemning them to a life of hardship, suffering and early death.

Bearing in mind that most obese people cannot exercise because they are so overweight, all they have to do to lose weight is eat less. The noble Lord, Lord Soulsby of Swaffham Prior, has given me permission to tell your Lordships the following story. As you know, he cannot exercise because he is confined to a wheelchair, but he decided to take three stone of weight off. He used a really revolutionary technique: he took three stone of weight off by eating less. There are no mysteries, only mysterious people.

Telling obese people that they have got to exercise is demoralising because they cannot. Most of them realise that it is nonsense to say so. What hope is there of dealing with this very serious epidemic if Ministers deny its cause? Exercise is of course very important—it is ideal for the functioning of the heart and control of cholesterol, and it gives one a sense of proportion and well-being—but it does not deal with the obesity epidemic. Of course I recognise that it is not the job of politicians to tell people how to live their lives, but it is surely the duty of government to speak the truth and give a lead. By continuing to stress that exercise is the answer, politicians are misleading the public.

The message is absolutely clear: this is the most serious epidemic to affect this country for 100 years; it is killing millions and costing billions; it will wreck the NHS for sure. The answer is simply to eat less. When obese people reduce their weight, then they can begin to exercise to keep fit—but not to solve the obesity epidemic.

I have been to see the director of NICE to reason with him, and he has now admitted that its advice is wrong. I have also been to see the Chief Medical Officer, and she has admitted that the advice is wrong. So the Minister is out on a limb. When will he listen to the Chief Medical Officer and NICE?