Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report) Debate
Full Debate: Read Full DebateLord McColl of Dulwich
Main Page: Lord McColl of Dulwich (Conservative - Life peer)Department Debates - View all Lord McColl of Dulwich's debates with the Department of Health and Social Care
(2 years, 10 months ago)
Grand CommitteeMy Lords, I have been given permission to sit while giving my speech because I am having great difficulty with my vision. First, I thank the noble Lord, Lord Patel, for initiating this discussion on the report on ageing. The report makes the apt point that, although life expectancy is increasing,
“the UK has seen low rates of life expectancy increases compared with most European and other high-income countries.”
With any medical condition, we must focus first on diagnosis, secondly on aetiology and, thirdly, on treatment. Well, the diagnosis is clear: the people of the UK are the most unhealthy in Europe. Seventy one per cent of those aged over 30 are obese or overweight. When I first mentioned that statistic last year in the Chamber, it was dismissed by a prominent politician as being over the top. I was not over the top; I was just dealing with facts, truth and science.
As the noble Baroness, Lady Sheehan, mentioned, obesity leads to widespread disease, including type 2 diabetes, hypertension, strokes, heart attacks, dementia and many other conditions that cause premature ageing, morbidity and death. The fat in the gross excess of fat cells leaks out, impairs the immune system and leaves the polluted body susceptible to very many diseases, especially infections such as Covid-19. The countries with the highest prevalence of obesity are the ones with the greatest incidence of Covid-19. So when the Prime Minister was accused of being responsible for 130,000 deaths, it was a false accusation. The aetiology of obesity epidemics is simply that people are putting too many calories into their mouths. Therefore, the treatment is, first and foremost, to get obese people to put fewer calories into their mouths. In fact, the Prime Minister was the first national leader to advocate eating less in order to reduce the obesity epidemic. He showed the way by losing three stone himself and coined the phrase, “Don’t be fatty at 50”.
Before we focus on complex solutions, we must first ensure that we have mastered the simple ones. It is not the case that eating less is impossible; what is impossible is to go on eating too much and remain healthy. There is no doubt that eating less requires effort and, for some, it is very difficult indeed, but the effort pays off in terms of morbidity, mortality and improving the quality of life in old age.
It was said that one group of people suffered more from Covid because of poverty and government cuts. Then an honest commentator pointed out that this particular group of people is more likely to suffer from heart attacks, strokes, type 2 diabetes and hypertension, but no one had the courage to say that the cause of those four conditions was mainly obesity. The critics say that they were obese because they could not afford the right food, but they would not be obese if they ate less of the wrong food.
Elements of the scientific world and some authorities have confused the public by mixed and inaccurate messages—for instance, that physical exercise is the answer to the obesity epidemic. The scientific institution known as NICE has maintained for years that all the calories we eat are used up on exercise, but surely one of the 500 employees of NICE could have gone to the gym, exercised for half an hour on a machine and seen how few calories they expended. On average, approximate intake of adults is 2,000 to 2,500 calories a day, which means that a person would have to exercise for four or five hours every day to burn up the calories they ate. This would increase their appetite and their calorie intake. I should emphasise that physical activity is essential for good health but is not an effective way of reducing weight.
There should be a clear message to the public that obesity is a disease that destroys the human body slowly and, as people get older, produces an enormous amount of suffering and death. The Department of Health has not always been helpful, in that it advocated a low-fat diet—but it is fat that acts as a brake, limiting the amount we eat. We clearly need to limit the amount of saturated fat, but unsaturated fat is fine. As fat leaves the stomach it goes into the duodenum and releases hormones that act on the stomach, delaying its emptying, thus giving an early sensation of fullness and satiety. After the fat has been emulsified and absorbed, it moves down the small intestine and normal service is resumed by the stomach. This is a beautiful mechanism that limits the amount we eat but, not surprisingly, the food industry dislikes it.
In the 1970s, Professor John Yudkin of London University set out clearly in his research that fat was not the problem; the problem lay in sugar. The food industry not only deliberately demonised fat but demonised Professor Yudkin. It was influential in his dismissal from his university post. The food industry advocated a low-fat diet, which is not only tasteless but bad for sales. It therefore added large quantities of sugar to the diet, and so the rot set in, with increasing obesity leading to the obesity epidemic.
Whole milk used to play an important part in limiting how many calories people ate. Skimmed milk was an industrial by-product which was at first discarded, then fed to animals and later to humans. The Department of Health has not helped matters by continuing to advocate a low-fat diet. It told GPs not to call patients obese because it was judgmental; it does not seem to realise there is a distinct difference between being judgmental and making accurate diagnoses.
The committee’s report focuses on the cure for the lifestyle choices of an ageing population, but prevention is better than cure. We could save millions from untimely deaths and billions in expenses if we focused on prevention. The struggle to keep an ageing population healthy has no greater challenge than this: the problems posed by bad choices. What is the Government’s role? It is not to tell people what to do. Instead, it is to honestly present them with the facts and the truth, and encourage them to make the right choices to grow older unhindered by increasing morbidity and mortality.