Obesity: Low-fat Diet

Baroness Jenkin of Kennington Excerpts

Thursday 9th June 2016 Lords Chamber

Asked by

[Baroness Jenkin of Kennington]

To ask Her Majesty’s Government what assessment they have made of recent new dietary advice that contradicts recommendations to eat a low-fat diet to tackle obesity.

[Baroness Jenkin of Kennington (Con)]

My Lords, I would like to thank the noble Lords who are speaking in this debate; it is especially appreciated as the timing is not what we originally expected. Before I get to the heart of today’s debate about dietary advice, let me start with the basics and the seriousness of the current situation. Obesity and its related illnesses are costing the country a fortune and it is not sustainable. Only this week Simon Stevens, chief executive of NHS England, told the Health Select Committee that we now spend more on obesity-related conditions than on our police or fire services. Figures from the US released yesterday show that 40% of women in the States are now obese—and we are not far behind. On current trends, three in four adults will be overweight or obese in twenty years’ time.

If we do not wake up to the extent of this crisis, the NHS could end up bankrupt. Enormous amounts of money are already spent on treating diseases that are entirely preventable. After my Question on this topic a couple of weeks ago, a severely disabled friend told me how frustrated he felt that, because of the costs of obesity, there is much less money available for the needs of people like him who have no control over their condition. The problem is that we in the western world live in an obesogenic society—one that tends to cause obesity. For almost all of us food is readily available, most of us never feel hunger and our lives are increasingly sedentary compared to the generations before us. It is all too easy to put on weight and maintaining a healthy weight is also a challenge. If we see someone slim today, we assume them to be a person of real self-discipline.

I declare an interest: six years ago, I was 28 pounds heavier. I was fat. I disliked it, but seemed unable to do anything about it. Like millions of others, I tried every diet going, back to grapefruit and hard-boiled eggs, which I think was a 1970s fad. I remember one diet based on ration coupons—it was not a bad idea given that as a country we have never been as healthy as we were during rationing. You name it, I tried it. I finally gripped it thanks to Louise Parker, and I recommend her common-sense approach as set out in her recently published book, Lean for Life. If you put two or three strangers together—women, anyway—the topic is an immediate ice-breaker: how to lose it, how to keep it off, what tips do you have, what works for you? It is a source of endless fascination.

One pound of fat equates to 3,500 calories. If you consume an extra 100 calories a day—just one small glass of wine, for example—you will put on 10 pounds a year, 20 pounds in two years; it is all too easy. But it can work the other way round: cut out that daily glass of wine and, all things being equal, you will lose 10 pounds a year. While on the topic of alcohol, how is it possible that there is still no calorie labelling on alcoholic drinks?

I read recently of an experiment where two groups of people spent an evening out at the pub. One group had calories included on their drinks menu and consumed an average 380 calories each. The other did not and drank the equivalent of 764 calories—double the amount. One piña colada, for example, is 245 calories, approximately the same as a Mars bar. How many people know that, or that a pint of beer and a packet of crisps contain a similar number of calories? It is not uncommon for people to drink two or three cocktails or large glasses of wine or to have three pints on a night out, but would they necessarily eat two or three chocolate bars or packets of crisps? People want this information and it should be made transparently available.

We currently spend £1 million every hour on type 2 diabetes. If the number of people affected increases at the present rate—400 new diagnoses every day—by 2025 there will be 5 million people with diabetes in this country. Half these people have diabetic complications: heart disease, eye disease and kidney disease, and there are more than 100 amputations a week as a result of vascular disease in people with diabetes. This is unsustainable.

The good news is that it does not have to be this way. Earlier this week we heard of mounting evidence to show that losing weight is the best way to fight cancer. A daily brisk walk of just 25 minutes was shown to almost halve mortality rates for breast cancer sufferers, while a waistline larger than 35 inches increased death rates by a third. This may be an added incentive for some, assuming that doctors are aware and pass on the information. Should the messages be clearer and tougher? A friend of mine lost five stone when his doctor made it clear that he was unlikely to see his daughters grow to adulthood. Some may disagree with this approach but it worked for him.

In the interests of research for this debate, I watched a few programmes over the weekend. “Junk Food Kids: Who’s to Blame?” was absolutely tragic. Those poor children have multiple teeth extractions, simply because they are drinking fizzy drinks and fruit juices instead of milk or water. They have dreadful diets and take no activity. I also watched a couple of episodes of “Lose Weight for Love”, which is currently on the television, where obese couples locked into cycles of overeating which threaten their relationships as well as their health are separated from their co-dependent partners for 10 weeks to learn better habits on their own, at the same time supported by a team of experts. The issue for them is more than food, it is their psychological relationship with food.

The series has taken a holistic approach to diet change and weight management by offering psychological therapy alongside behavioural, diet and exercise interventions. This joined-up thinking does not happen in healthcare as money is siloed into different specialisms. For long-term change to occur, we need to understand why food is so often used to self-medicate. All the couples have lost substantial amounts of weight and appear to be motivated to keep it off. A year later, one couple have lost six stone each.

I think every single one of the participants admitted that before the programme they drank litres of fizzy, sugary drinks every day, which provided no nutritional value at all—empty liquid calories. I commend the Government for taxing them. But at the same time as introducing the tax they really need a publicity campaign about what sugar does to your body. It seems to me, as a lay man, quite right that sugar has become dietary enemy number one, along with processed snacks. I was fascinated by the Guardian’s long read “The Sugar Conspiracy”, published on 7 April, and I recommend the Sugar Smart app as an easy way of checking the amount of sugar in any product.

Yet although losing weight is simple, it is not easy. Giving up sugar is horribly difficult. I could happily go home this evening and eat a tub of ice cream and a packet of chocolate biscuits, but I will not. Once upon a time I might have but I am now motivated by concerns about my long-term health. While I appreciate that the accepted golden rules for a healthy, cancer-free life are not fool-proof, I try to live by them: no smoking, limited alcohol, healthy weight and regular exercise. Should the Government be looking at carrots—I do not mean the vegetables—for those who achieve these goals and thereby potentially save a lot for our overstretched health service?

The current dietary advice is confusing. For example, the Eatwell Guide recommends basing meals on potatoes, bread, rice, pasta or other starchy carbohydrates. Are we so sure that this is good advice? After all, we feed starchy crops to animals to fatten them, so why would they not have the same effect on us? For years we were told not to eat more than two eggs a week, but then research showed that cholesterol in eggs had almost no effect on blood cholesterol. The consequences of that advice were that egg producers went out of business and the population missed out on affordable, natural, nutrient-filled food as it swapped it for sugar-laden, industrially processed cereals. Recent reports have added to the confusion and muddled messages help nobody. So for the sake of our NHS, our nation and especially our poor chubby children, I urge the Government to focus on accuracy and clarity when they finally publish their obesity strategy.