Diets: Fat

Lord McColl of Dulwich Excerpts

Thursday 31st October 2024 Grand Committee

Asked by

[Lord McColl of Dulwich]

To ask His Majesty’s Government what assessment they have made of the benefits of diets with adequate fat content for reducing appetite, as an alternative to the use of drugs such as Ozempic.

[Lord McColl of Dulwich (Con)]

My Lords, the Question in this debate lists two different treatments for the same problem: the obesity epidemic. The first treatment is as old as the hills—simply to eat the right amount of the right kind of fat. The other treatment is to use new drugs such as semaglutide, marketed as Ozempic, which have been found to act in the same way as fat. I suggest that the former—the healthy diet—should be where we concentrate our efforts to combat the epidemic.

When we consume healthy fats, gut hormones such as CCK and GLP-1 are secreted in the duodenum, delaying the emptying of the stomach and creating a natural sense of fullness that curbs overeating. When the fat has been absorbed and moves on, normal service is resumed by the stomach. This simple process helps to tackle the root cause of obesity. By contrast, the new weight-loss drugs have serious side effects, including pancreatitis and other problems, along with long-term effects that are as yet unknown.

The new weight-loss drugs require regular injections. They act in a similar way to fat but with a stark difference. Natural fats are safe, inexpensive and readily available in whole milk, nuts, butter and so on. Studies such as those showing lower obesity rates in Canadian children who were raised on whole milk underscore these benefits. Will the Minister ensure that her department considers this evidence instead of the biased propaganda of the food lobby? It was, after all, the food lobby that caused the obesity epidemic in the first place. It put profit over health by encouraging the overconsumption of the wrong types of food.

Since the 1960s the food industry has promoted a low-fat diet, allegedly to address concerns about atheroma, which tends to block arteries. As noble Lords will know from their Greek studies, atheroma is the ancient Greek word for porridge—well, it may be Greek porridge but it is no Scottish porridge, that is for sure. The food industry has excessively promoted low-fat products packed with a lot of sugar; a low-fat diet is pretty tasteless because fat is what gives food its taste. So they had to pour in vast quantities of sugar, which fuels the cravings and excessive calorie intake contributing to today’s obesity epidemic.

Despite evidence supporting the benefits of certain fats, the Department of Health still publishes on the web outdated low-fat guidelines, in part because misleading information such as the Eatwell Guide and the traffic light labelling on food packaging demonises fats without considering their positive role. After years of vilifying fats, we now turn to drugs that mimic fats’ natural benefits—a perfect case of the food industry being hoist by its own petard.

Ultra-processed foods have frequently been blamed for the obesity epidemic, but there is no scientific confirmation of this. It is clear that excessive consumption of UPF can cause obesity, of course. Unfortunately, many so-called scientific publications blur these lines, incorrectly blaming the obesity crisis on ultra-processed foods. Meanwhile, we overlook the impending disaster of nearly 40 million citizens facing premature death from obesity-related diseases.

The argument that obesity is unavoidable because we live in an obesogenic society, with factors such as genetics and thyroid dysfunction, is misleading. These claims suggest that obesity cannot be controlled, which diminishes the role of personal responsibility. The reality is that obesity results from consuming too much food or too much alcohol, regardless of genetics. It does not matter what your genetics are: there is only one way of getting obese, and that is putting too many calories into your mouth. There is no disease that causes obesity per se. A failing thyroid gland is often blamed, but it is the resulting slowing of the metabolism for such a patient that requires fewer calories. If people continue eating the same number of calories, obesity will result.

Beyond the physiological aspects, we need a transparent, evidence-based public health campaign. A well-executed campaign has been successful in the past, although this has been denied in some quarters. Let us look back in history, as most of the answers are in history. The AIDS awareness campaign launched in the UK by the then Secretary of State for Health, Norman Fowler—the noble Lord, Lord Fowler—was highly successful, as was a similar campaign in Uganda. A similar approach to obesity could save the UK economy £98 billion every year.

The Department of Health should encourage practical dietary changes, such as reducing daily intake and incorporating healthy fats, and support these choices through better regulations and labelling to clarify the benefits of healthy fats and reduce confusion about what constitutes a balanced diet. Rather than complex BMI measurements, we need only a simple assessment. For instance, if your waist measurement is more than half your height, you are eating too much of the gross national product.

It is important that this message gets through. The APPG on Obesity criticises the “nanny state” approach, yet if we seek a hands-off solution, more individual responsibility and awareness will be essential. Imagine the impact if each of the 40 million obese people in this country were to reduce their intake slightly, perhaps by skipping a meal a day or choosing foods with fats that encourage fullness. This approach could improve individual health, reduce NHS expenditure and, ultimately, save many from premature death.

Hospices: Funding

Lord McColl of Dulwich Excerpts

Thursday 24th October 2024 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I, too, thank my noble friend Lord Farmer for initiating this important debate. For most of my professional life, I have been associated with hospices such as St Christopher’s, the Mildmay in the East End of London, the Mildmay in Uganda and the Phyllis Tuckwell Hospice in Surrey. I have learned a lot working in these places.

I remember, for instance, a lady of 28 with an inoperable cancer of the throat. She was in pain and a lot of respiratory distress and needed relief from these symptoms. I explained to her that I could put a needle into her vein and titrate her with analgesics until all her symptoms had gone. She agreed to this. I gave her a surprisingly large dose of heroin, which not only did not kill her but relieved all her symptoms and gave her three weeks of symptom-free life. During that time, she was able with a clear mind to say goodbye to her friends and to tidy up all those loose ends. Some people accused me of hypocrisy, saying, “You’re really killing them and just saying that you’re relieving their pain”. Well, anyone who thinks they know what is in my mind has delusions of grandeur.

Cicely Saunders and I were contemporaries as medical students. Her work on relieving symptoms in hospices was very important indeed. She established without any doubt that the right way was to keep a constant level of analgesia in the blood rather than give patients doses only when they had the pain. If you do this, you require less of the analgesics overall and so the patients are more awake and able to enjoy life. That was a very important contribution. The present laws against euthanasia and assisted dying are like a huge dam preventing great enthusiasm for euthanasia and assisted dying. That dam can sometimes develop a crack for those who want to legalise euthanasia. Once you have a little crack in the dam, the whole thing can give way. Cicely Saunders’s work was an extremely important aspect of this.

As far as the funding of hospices is concerned—

[Baroness Wheeler (Lab)]

Can the noble Lord wind up, please? His three minutes are over.

[Lord McColl of Dulwich (Con)]

There is an urgent need for more funding, as has been said many times, and a partnership between government, charities and local authorities is required.

Food and Drink Industry: Processed Sugar

Lord McColl of Dulwich Excerpts

Monday 14th October 2024 Lords Chamber

[Baroness Merron (Lab)]

We certainly want to reduce sugar intake, and I commend my noble friend for his campaigning on this issue. I know he will continue, rightly, to press me on this. We want to ensure that we learn from experts and will welcome further research in this area. We already have regular meetings with industry and monitor the progress being made. The ultimate prize is not just about looking at reducing sugar and replacing it with sweeteners but finding that our palates are encouraged to adapt to a rather less sweet taste, and that will be the best way forward.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that there are far too many fake rumours going around that the obesity epidemic is inevitable and genetic, whereas the facts are that there is only one cause of the obesity epidemic and that is eating too much and it does not matter what your genetics are? Would the Minister agree that one way of helping the situation would be if the 40 million obese people in this country were to save themselves from a premature death and save the NHS billions of pounds every year by simply reducing the amount that they eat according to the recommendations?

[Baroness Merron (Lab)]

Taking on board the noble Lord’s point, I feel that it is important that we support people to make healthier choices. The noble Lord will be aware of—and I hope will welcome—the Government’s focus on moving from ill health to prevention. We want to make sure that people live well for longer. It is not only about making informed and heathier choices but about having the means to do so. That is why I particularly want to commend the fact that we will be introducing the restrictions on junk-food advertising to children on TV and online. That will make a major contribution.

Stroke Treatment

Lord McColl of Dulwich Excerpts

Wednesday 27th March 2024 Lords Chamber

[Lord Markham (Con)]

The stroke quality improvement for rehabilitation—SQuIRe—services are where we are trying to take best practice from London, France and around the world and roll it out. The good news is that we have the model; it is based on a national model for an integrated community stroke service. We have got that in 65% of locations, with the goal of making it 75%.

[Lord McColl of Dulwich (Con)]

My Lords, as there are 40 million people at risk of stroke because they are obese or overweight, would it be a good idea for the Government to recommend, as I have done for some time, that people have one fewer meal a day? That would reduce their weight and their expenditure.

[Lord Markham (Con)]

My noble friend is correct that weight and obesity is a major factor in all sorts of conditions, including strokes. Encouraging people to eat correctly, in a healthy manner, is absolutely the right way to go.

As this is the last time that I will see your Lordships, I wish all noble Lords a happy Easter. I for one am looking forward to the break.

Cancer Research UK Report

Lord McColl of Dulwich Excerpts

Tuesday 5th December 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely. I thank the noble Baroness for the work that she does in this field. I welcome the manifesto, specifically on rebuilding the global position in research. We have done a good job on that: we have gone from a position of 26% of the clinical trial responses being in time to international standards to over 80%. The biggest prevention method that anyone could take is to stop smoking because, as we know, that is the biggest cause of lung cancer, so we are introducing steps to prevent smoking. On early diagnosis, we have introduced an excellent example in lung cancer. Some 60% of people used not to be detected until they were stage 4, which is often too late. Now, through the mobile lung cancer units, we are detecting 70% at stage 1 or 2, where they have a 60% chance of survival. Across the field, we are doing a lot on this that we can feel proud of.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister recognise that one of the causative factors of cancer is obesity? Some 40 million people in this country are obese, and according to the latest estimate it is costing £100 billion a year. Is it not time to adopt the campaign technique that Norman Fowler—now the noble Lord, Lord Fowler—successfully conducted in the 1980s? He had the courage to state the truth and make sure that it was successful.

[Lord Markham (Con)]

Yes, we are taking extensive action on the obesity front. As well as being a major cause of cancer, it is the cause of a lot of ill health. We have taken a lot of action against 96% of the reasons given in obesity research on calorific intake, with regard to what people buy in supermarkets. Also, the soft drinks industry levy—the sugar tax—has decreased sugar in drinks by at least 14%.

Children’s Health: Ultra-processed Foods

Lord McColl of Dulwich Excerpts

Wednesday 25th October 2023 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, in this debate it is very important to consider the science and history of the obesity epidemic. The history is that the food industry in the 1960s promoted a low-fat, low-fibre diet, which makes people eat more and become obese. Science has exposed the errors of the food industry; the science is that when fat enters the duodenum, it releases from the duodenal mucosa a hormone called CCK, which delays the emptying of the stomach and makes the patient feel full early on in a meal. It is a beautiful mechanism for preventing obesity, which is why the food industry hates that mechanism and keeps on recommending a low-fat diet, which is so tasteless that it had to add large quantities of sugar to entice people to eat its rather tasteless products.

A recent study from Canada revealed that thousands of children fed on whole milk, with plenty of fat, were much less likely to be obese than those who were not so fed. Unfortunately, the Department of Health seems to be obsessed with low-fat diets, in spite of the evidence. I even had a letter just last month from a Parliamentary Under-Secretary for Health, who again recommended a low-fat diet.

The removal of fat and fibre, in the form of wholemeal bread and vegetables, increases appetite and obesity. That is why we must ensure that food contains plenty of fibre and the right kind of fat. Highly processed foods appeared many years later than the beginning of the obesity epidemic and much more work needs to be done to determine exactly how appetite stimulators are supposed to work.

Another important misleading aspect is the great emphasis on telling obese people that the whole subject is so confusing, difficult and multifactorial. It is just telling them, “Well, it’s just one of those things, and you don’t need to bother too much”. They say anyway that it is genetic. What do they mean by that? It does not matter what your genetics are, there is only one way of becoming obese: by putting too many calories into the mouth. We need much more scientific work to reveal how much genetics could increase obesity. There has also been an attempt to glamorise obesity, stating that you can be “fat and fit”. The paper that purported to make that claim is very superficial and incomplete.

In summary, we need to emphasise the fact that the removal of fat and fibre and the insertion of sugar has caused the obesity epidemic. We do not need complicated formulae like BMI. It is best to keep things simple. A simple slogan is: if your waist measurement is more than half your height, you are eating too much of the gross national product and you are on the road potentially to a premature death from a variety of very unpleasant diseases.

Children’s Health: Sugar

Lord McColl of Dulwich Excerpts

Tuesday 12th September 2023 Lords Chamber

[Lord Markham (Con)]

First, I recognise all the work the noble Lord does in this space. Secondly, I completely agree that reformulation is the big prize as part of this. The House will remember me mention before that Mars, Galaxy, Bounty and Snickers have all reformulated their food, as has Mr Kipling and his “exceedingly good” cakes—they are compliant cakes as well. There is a lot being done here, but there is more to do. We meet the industry all the time and are very happy doing so.

[Lord McColl of Dulwich (Con)]

My Lords, is the Minister aware that, in Canada, thousands of children have been fed on whole milk for many years, and their problems with obesity do not exist? The food industry has deliberately promoted a low-fat diet. It is a lousy diet that tastes horrible; that is why they have had to shovel in such vast quantities of sugar. Could the Minister ensure that the Department of Health no longer advocates a low-fat diet? Fat going into the duodenum acts on the stomach, making it empty more slowly and therefore giving the feeling that the patient has had enough.

[Lord Markham (Con)]

I think one of the things that, hopefully, I have learned in the almost year that I have been answering Questions is when I know the answer to a question and when I do not. I am afraid this is one of the examples of the latter. I will happily look up the Canadian example of the use of whole milk and write to the noble Lord on it.

Adult Social Care: Challenge Procedures

Lord McColl of Dulwich Excerpts

Wednesday 19th April 2023 Lords Chamber

[Lord Markham (Con)]

Yes, absolutely; a large part of it is from central government funding and a large part is from local authority funding, given local authorities’ ability to use a precept and increase council tax. Of the 153 local authorities, 151 have taken that opportunity to increase the council tax.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that in talking about the costs of health and social care, we seem to have forgotten that 40 million people in this country are moving slowly towards suicide by putting too many calories in their mouths, which is costing £27 billion every year?

[Lord Markham (Con)]

I will answer quickly to allow a final question, but yes, our anti-obesity strategy is very much about that.

Bread and Flour Regulations 1988

Lord McColl of Dulwich Excerpts

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

I am very aware of the range of scientific advice on this. I am also aware that the official results of the consultation, which will come out, are not clear cut. A sizeable number of people, 40%, are anti-fortification. As ever, it is about trying to get that balance right. We completely agree on the direction of travel. There is some scientific advice that at too high a level there is a potential masking of pernicious anaemia in the elderly. This is the first step. Let us get all the evidence. The critical thing is getting that first step right.

[Lord McColl of Dulwich (Con)]

My Lords, can my noble friend the Minister find out exactly how many people are involved in the decision-making on this subject? How often do they meet?

[Lord Markham (Con)]

I do not know the precise number; I know there are many stakeholders in this. The devolved Administrations have been involved in all of this. Part of the delay is because, once we go ahead, we have to notify the EU, because of the Northern Ireland elements of it, and that is a six-month notification. We also have to notify the World Trade Organization. All these aspects mean that this is not as quick as we would want, and then we need to let the industry have time to adjust. It is a process involving many people, but we are getting there.

Excess Deaths in Private Homes

Lord McColl of Dulwich Excerpts

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I am definitely seized with the urgency. I was able to speak to Sir Chris Whitty about a number of those, including last summer. The heatwave was a factor then: we had over 2,500 excess deaths caused by the heatwave over those couple of weeks. There were multiple factors. You have heard me say, again from Sir Chris Whitty, that cardiovascular disease is a real concern: for those three years that people missed going to their primary care appointments, they did not get their blood pressure checked in the same way, and we did not get the early warning indicators. That is another thing that you will hear me talk further about, so that we can get ahead of the curve, because those are the areas of excess death that we risk in future.

[Lord McColl of Dulwich (Con)]

My Lords, have we not forgotten something? When we blame all sorts of factors for these excess deaths, have we forgotten that there are 44 million people in this country suffering from the disease called obesity and all the complications that arise from that? This means that these people are moving inevitably to a premature death from a variety of very unpleasant diseases.

[Lord Markham (Con)]

My noble friend makes a good point that prevention is a key part of this agenda, as is the role that we all take in our individual health and well-being. Obesity is included as a key part of this as well. We need a four-pronged approach that tackles the things that we as individuals need to address as well, to make our own lifestyles healthier.