Obesity is at an all-time high in the UK, so much so that even the National Health Service (NHS) dubbed Britain, the ‘Fat Man’ of Europe. Addressing the prevalence of obesity and type II diabetes, United Kingdom’s National Obesity Forum and Public Health Collaboration have recently published their guidelines in a report. In an editorial review, nutritional experts, however, have lambasted the report and called it “flawed”, stating that the report should have come up with policies to deal with obesity and diabetes based on existing scientific evidence, instead of over-simplifying fats and carbs intake.
Currently more than 65.3% of men and 58.1% of women in the UK are obese or overweight with a body mass index (BMI) over 30. Obesity and related diseases such as diabetes are costing the UK’s economy more than £47 billion a year in healthcare and social expenditures, which is more than what they spend on wars and counter-terrorism efforts.
Dr Alison Tedstone, the chief nutritionist at Public Health England (PHE), said “Today 25% of the nation is obese and 37% is overweight. If we reduce obesity to 1993 levels, where 15% of the population was obese, we will avoid five million disease cases and save the NHS alone an additional £1.2bn by 2034. ”
To combat the rising girth of the British population, the UK’s National Obesity Forum was established and tasked with formulating guidelines for healthy eating. According to the National Obesity Forum report people need to “eat fat, cut the carbs, and avoid snacking to reverse obesity and type 2 diabetes.” The statement has been criticized for not taking scientific evidence in consideration.
Since obesity is a problem of such magnitude, many experts were not satisfied with the 10 advices in the report. Experts believe diet and lifestyle are at the root of the obesity epidemic. The focus of the report was supposed to be on obesity and diabetes, but what it gave was an over-simplified view on links between fats and cholesterol with heart diseases.
However, some advices in the report were deemed sound such as ‘eating fat does not make you fat’, ‘we should stop counting calories’ (interestingly), ‘snacking will make you fat’, and ‘evidence based nutrition should be incorporated in the education curriculums of all healthcare professionals’.
What raised the red flag, however, were controversial statements such as ‘saturated fat does not cause heart disease and full fat dairy is likely protective,’ and ‘limiting starchy and refined carbohydrates can prevent or reverse type 2 diabetes.’ Although data has shown sugar sweetened beverages cause obesity in children, it does not mean all types of carbohydrates should be taken out of the diet. For instance, some starches and fibers (e.g., those present in whole grain foods,) are beneficial for people with type 2 diabetes.
Similarly, many current cohort studies have shown ‘saturated fats’ present in ‘red meat and eggs’ pose a risk of type II diabetes. In simpler terms ‘saturated fats’ are molecules which remain solid at room temperatures. Consuming more quantities of saturated fats has been linked with high levels of LDL cholesterol in the blood, which can subsequently lead to heart diseases and stroke. Additionally the guidelines called for avoiding the consumption of foods with even low or light amounts of cholesterol, even though the levels of cholesterol in the blood are directly affected by the levels of saturated fats. Saturated fats are most commonly found in processed foods. As a general health rule the consumption of processed foods is detrimental to health.
The report should have focused more on recommending foods and diets which battle obesity and related morbidities. For example evidence has proven foods such as vegetables, fruit, yogurt, tea and coffee, lower the risk of diabetes. In the same way a Mediterranean diet also lowers the risk of diabetes. Even though multiple studies recommend a Mediterranean diet for good health, none was promoted in the forum’s report.
The report also failed to address the role of smoking and physical activity in the prevalence of obesity, even though quitting smoking and increasing physical activity can prevent or reverse the effects of both obesity and diabetes.
In a similar manner across the pond, the US Center for Disease Control and Prevention (CDC) reports more than one-third of the US adult population, i.e., 34.9% or 78.6 million, to be obese. Currently the annual medical cost of obesity related disease and management in the US is believed to be $147 billion. In total contradiction to the UK’s new recommendations, the American Heart Association (AHA) recommends limiting saturated fats and not eating more than 5%-6% of saturated fats per day, which further calls the claims of the forum in to question.