Life Sciences Industrial Strategy (Science and Technology Committee Report)

Lord McColl of Dulwich Excerpts

Tuesday 23rd October 2018 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, we are grateful to the noble Lord, Lord Patel, for chairing this important committee and for securing this debate. I am also grateful to him for inviting me to speak in the debate on preventive medicine and the role of the NHS. The report draws attention to the health service’s failure to implement the results of research.

The greatest threat to the health of the British people today is the worst epidemic for 100 years: namely, the obesity epidemic. Half the people are either overweight or, frankly, obese. This has produced four million type 2 diabetics, increasing rates of cancer, heart disease, joint disease, gangrene of the limbs, blindness, dementia and many more. We keep being told, “It’s all very difficult—it’s multifactorial, you know”. Only one factor causes obesity, and that is putting too many calories into one’s mouth. We need to eat fewer calories and eat foods that satisfy hunger.

How did we get into this mess of the worst epidemic for 100 years? During the war there was no obesity, because we ate the right food in the right quantity and it satisfied hunger. How? Because we used to eat things like fat, dripping or lard on wholemeal bread, and whole milk—none of this skimmed nonsense. Why did all this change? It changed because the unscrupulous junk food industry realised that fat was an essential food which limited the amount that we ate, and so it demonised fat and advocated and produced food which was low in fat and high in carbohydrates. The problem with this is that low-fat, high-carbohydrate food is pretty tasteless, and so to make people eat it the industry added large quantities of sugar. So the obesity epidemic was born: low fat, high carbohydrate and high sugar, and the nation began to become more and more obese.

In the early 1960s, Professor John Yudkin warned of the danger of a low-fat, high-sugar diet, but the food lobby and other miscreants managed to rubbish his work and have him dismissed from the Chair of Nutrition at the University of London. The science is quite straightforward and has been known for years, although it was not introduced but ignored because of the powerful food lobby. As noble Lords already know, when fat enters the duodenum it releases hormones such as cholecystokinin and gastric inhibitory peptide. These delay the emptying of the stomach and give the sensation of fullness, which satisfies hunger, and you stop eating. When the fat is emulsified and absorbed it passes further down the alimentary tract, then normal service is resumed in the stomach. It is a very precise and effective mechanism. But the unscrupulous junk food industry had to sabotage that mechanism in order to increase its sales and profits. The sabotage involved demonising fat.

This whole subject has been bedevilled by misleading advice, most of it deliberately misleading, allowing the food industry to produce cheap food that does not satisfy, and so people eat more and more of it and get fatter and fatter. The tragedy of all this is that mainly those in the lower income groups are worst affected by the seduction of the unscrupulous junk food industry. Unfortunately, the public have been bombarded with thoroughly misleading information and advice. They have been told that exercise is the best way to get rid of excess fat. You have to run miles to take even a pound of fat off. Only a fraction of the calories we eat is expended on exercise. Of course, exercise is important for general health and a sense of well-being.

Obesity in children has now reached enormous proportions, and the problem starts before the age of five, before they go to school. If a woman is pregnant and obese, she transfers this tendency towards obesity to the child in utero, not genetically but by a mechanism that is not understood, and so we put it into Greek and call it epigenetics. So the die is cast at any early age, and the tendency to obesity is there. But the good news is that it does not need to lead to obesity; it can do so only if the child eats too many calories. There is a condition, myxoedema, where the thyroid gland fails, and people with that condition tend to put on weight. However, they can do that only if they are eating too many calories.

Even today, the Department of Health is still advocating exercise and diet as the answer. Only a fraction of the calories we eat is used up in exercise, so the department should stop talking about how exercise and diet is the solution. It should emphasise that the answer is to put fewer calories into the mouth. Its slogan “exercise and diet” should be changed; it should emphasise diet and give exercise the lower profile as far as obesity is concerned.

Saturated and trans fats should be minimised but not the majority of fats. During a Select Committee on the long-term future of the NHS, chaired by the noble Lord, Lord Patel, we were served up with some rather curious, dubious statistics, one of which was that the obesity epidemic was costing £4 billion a year. I suggested that the point was in the wrong place. It was much more likely to be £40 billion. That is what is wrecking the NHS. Curing obesity could release £40 billion; obviously not all of that would be released but it would be a start.

We have an enormous job on our hands in preventive medicine as we are in the middle of this disastrous epidemic, the worst for 100 years. We need not only to reduce the size of the epidemic but to start preventing the next generation falling into the same trap. I suggested to the Select Committee that we needed an all-out campaign—involving every man, woman and child, every institution and government department—not to tell people what to do but simply to tell them the truth. The answer is to have smaller portions and smaller plates, food that you have to chew, such as wholemeal bread, vegetables and nuts—clearly, avoiding food to which you are allergic. Some of the expert witnesses from the hierarchy told us that all-out campaigns do not work. We pointed out that the Lord Speaker’s campaign against AIDS when he was Secretary of State for Health, as Norman Fowler, was highly successful, largely, I suspect, because he was absolutely honest and direct and did not mince his words.

GPs have been told by the Department of Health not to call patients obese because it is judgmental. They ought to realise that there is a distinct difference between being judgmental and making accurate diagnoses. The message is simple. The obesity epidemic is killing millions, costing billions and the cure is free.