Working Together To Improve Health

I had the absolute pleasure of attending this year’s Public Health Collaboration conference, along with 230 other like-minded, forward thinking physicians, nutritionists, dieticians, health coaches, personal trainers and members of the public. It was also broadcast live to 60,000 people.

We had come together to celebrate the growing of a movement geared towards improving health, and tackling the major issues of obesity and Type 2 Diabetes, through adopting a low carb lifestyle. And we were afforded a fantastic opportunity to learn from some of the best minds in this field.

 

Sam Feltham has been the brains behind this organization, which is now a registered charity, and put hours of hard work into making this event a huge success – despite having just become a new dad!

 

 

We started with a celebration of one remarkable man – Dr Charles Eugster, who at the grand old age of 98 was still competing in sporting events right up until he passed away this year. He had been due to come and speak at the conference so was sadly missed. He believed that “illness is not a necessary part of ageing”. We celebrated his life with one minute of applause J

After Sam’s opening remarks, Dr Kailash Chand OBE gave a brief talk on the crisis facing the NHS, a model that has transitioned over the years from being a “health” model to a “disease” model. Unless we can start to move towards preventative medicine we are unlikely to be able to sustain a National Health Service that is able to cater to the millions of people suffering from (largely preventable) modern chronic diseases. Dr Chand is passionate about improving the state of the NHS and that passion shone through this brief, but motivating presentation.

Dr Jason Fung gave an illuminating talk about the therapeutic benefits of fasting for those with Type 2 Diabetes and obesity. Studies show that the “Eat Less, Move More” strategy does not work, with 80% of those with 10% weight loss gaining it back – and more – within one year. 

This is because the percentage of calorie reduction when dieting is almost immediately matched by metabolic reduction (a fact that was recognized in 1917 – one hundred years ago!) as our bodies strive to reach homeostasis – the natural state where the body maintains internal balance despite external conditions.

However, in the fasted state, metabolic rate does not lower because the body obtains its energy from stored fat and is replenished with adequate caloric intake during periods of eating. Maintaining normal caloric intake during the eating window ensures that the body does not think that it is in “starvation mode”. We are, in essence, flipping a switch to change the source of our energy from food intake to storage when in the fasted state. It makes sense when you think about it – humans have always had periods of fasting – some by necessity; for example when food was scarce, and some prescribed; for example Ramadan or Lent. Fasting allows the body’s cells to rejuvenate and repair, enhancing the ability of nerve cells to repair DNA. The body also retains its lean muscle tissue - an added benefit – unlike the loss that occurs with traditional dieting.

Next up, Dr Zoe Harcombe led us through the dietary fat guidelines – and whether they should have been introduced. Dr Harcombe has reviewed the many studies surrounding the controversial heart-diet hypothesis and its alleged relationship to dietary fat, finding them to be inaccurate and flawed. Many of the studies themselves cautioned AGAINST a low fat diet, and any recommendations that were made were never trialed. How, then, was it possible that we moved from the knowledge that “farinaceous and vegetable foods are fattening, and saccharine matters are especially so” (Tanner 1869) to “Base your meals on starchy foods” (UK Government 1984).

Ancel Keys, who posited the heart-diet hypothesis with his Seven Countries Study, stated that “The evidence – both from experiments and from field surveys – indicates that cholesterol content, per se, of all natural diets has no significant effect on either the cholesterol level or the development of atherosclerosis in man” (Keys 1954). Why then did the low-fat guidelines even come into existence? Particularly when there were no RCTs to test the recommendations! And more worryingly – how have they persisted for so long when recent evidence clearly points to the fact that this hypothesis is incorrect?! The current dietary guidelines indicate that processed foods such as bread, cakes, pastries, biscuits & sweets make up 24% of intake whilst real meat, fish & eggs a mere 7%! Time for change!

Unfortunately I missed Dr Joanne McCormacks presentation entitled “We need to talk about food” as I attended Dr Fung’s workshop for the health professionals on “Fasting Regimens & Practical Management of Medicine”. I found this to be really useful information on how different fasting protocols can improve and reverse Type 2 Diabetes.

We were given a patients perspective by Laura Scruton, a delightfully open, honest and funny lady, about how real food changed her life. Having been diagnosed with gestational diabetes 23 years ago, which later developed into Type 2 Diabetes, she strictly followed the dietary guidelines, eating a low-fat, high carbohydrate diet, believing that this would restore her health. However this merely led her to gain weight and develop chronic fatigue, carpal tunnel syndrome and rheumatoid arthritis. She found herself on a constant treadmill trying, unsuccessfully, to lose weight. However once she discovered, and followed, the low carb protocol the weight started to drop almost effortlessly, and she was able to come off her diabetes medication and make dramatic improvements with all her other symptoms. She now enjoys excellent health and delivers regular talks to help others in the same situation.

Dr Malcolm Kendrick treated us to a highly entertaining – and very educational – talk on cardiovascular disease and its relation to diet. Whilst there are many environmental factors that do affect cardiovascular health, there is no evidence that saturated fat – from real, whole foods – causes heart disease.

Dr Kendrick suggests that it is damage to the endothelium that increases cardiovascular risk, so anything that promotes this damage, such as lead, smoking, steroids, diabetes, air pollution is a real contributory factor, whilst every factor that protects the endothelium or is anti-coagulent, such as exercise, vitamin C, sun exposure, magnesium reduces the risk.

I attended the workshop delivered by Trudi Deakin, PhD, on the use of education to deliver the real food message. This was a very useful, hands-on guide to using the program developed by Trudi’s business X-Pert Health, a registered charity, that trains healthcare professionals, enabling them to present structured educational programs to people suffering from diabetes.

Day two of the conference began with Sam’s opening remarks, followed by a short talk from Dr Peter Brukner – former doctor to the Australian cricket team and Liverpool football team. Dr Brukner is now devoting his time to raising awareness about sugar consumption and talked about his involvement with Sugar By Half and their commitment to reducing sugar intake and improving health.

Dr Aseem Malhotra gave us an eye-opening view into the world of the cholesterol and statin controversy. We were shown a medical system corrupted by conflicts of interest where “honest doctors cannot practice honest medicine”. The financial influence of individual doctors to earn more, based on the number of investigations and procedures can sometimes put profits before patients with one US cardiologist admitting to ordering $19 million worth of unnecessary investigations and procedures. 43% of cardiologists stated that they would carry out stenting for stable coronary disease even if they felt it would not benefit the patient! He quoted Dr Marcia Angell, editor of The New England Journal of Medicine who stated “It is no longer possible to trust much of the clinical research that is published, or to rely on the judgement of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine”. Similarly, in 2015, Richard Horton, editor of The Lancet, stated that; “possibly half of the published literature is untrue”. And several recent scandals involving research cover-ups led Richard Smith in 2016 to announce “Something is rotten in the state of British medicine and has been for a long time”. Scary stuff!

Husband and wife team Drs David and Jen Unwin amused us with some role-playing and impressed us with the success of their practice at their Norwood Surgery, which is proving to have successful reversal of Type 2 Diabetes through implementing a low carb diet. Their program, which they developed 4 years ago, is saving the NHS money due to the reduction in drug prescriptions – to the tune of £38K over one year. Their presentation started with the statement “First they said it wouldn’t work. Then they said it wouldn’t last. Then they said it would not roll out” – however the Unwins have proved successful on all three counts! Long may they continue to do so.

Dr Tamsin Lewis offered us her “HealthSpan” view of how to spend our lives enjoying good health and normal function. According to recent statistics, up to 20% of life can be spent in an unhealthy state. Dr Lewis presented ways in which we can help to prevent early ageing and live with optimal health. Healthspan looks at areas such as good sleep, dental health, reducing oxidative stress, building resilience to stress, connecting with each other socially, mindfulness, glucose regulation, healthy body composition, cardiovascular exercise, daily activity and a healthy diet. Recommendations include taking supplements where necessary, such as choline for brain health, Vitamin D which is a vital nutrient for a wide variety of human health, Magnesium, fish oils and curcumin amongst others.

Dr Andreas Eenfeldt, aka Diet Doctor, delivered an inspirational talk on “The Food Revolution”, encouraging us all to be a part of helping to change global health. He has long been an advocate of low-carb eating and has grown his website exponentially in recent years, to the point where it has now become his full time job over and above being a doctor. He provides some fantastic, practical advice through this medium on how to improve health and now has 35,000 subscribers to his low carb program.

His message is to “Empower people to revolutionise their health”, and he finished the presentation by offering everyone the opportunity of becoming part of his food revolution, either through directly applying for positions within the Diet Doctor team, or by providing articles and blogs to be posted on the website.

I attended the workshop given by Deborah Colson, on behalf of BANT (the British Association for Applied Nutrition and Nutritional Therapy), aimed at bringing general practitioners and nutritional therapists together to work with more of a “team” approach. This is a really exciting way forward and both the doctors and nutritional therapists present were enthused by this. Being on the same page as far as patient healthcare is concerned is a vital strategy if we are really committed to bringing about real changes – for both the patient and the NHS as a whole. I certainly hope my local medical centre is keen to embrace this idea.

Dr Kesar Sudhra has been delivering low carb nutritional advice to his patients at Manor Park Medical Centre for the past 8 years. This has been a tough nut to crack as the South Asian community (with whom he works) are culturally tied to their diet, so trying to reduce or replace items such as chapatis, parathas and rice is extremely challenging. However, with a level of extraordinary care, understanding, compassion and commitment that goes above and beyond, Dr Sudhra has proven successful time and again, changing the health and lives of his patients, whilst saving money for the NHS. His advice to use the 4 P’s: aPpealing, Practical, accePtable and Palatable when replacing foods is something we can all take on board and implement.

Ivor Cummins and Jeffry Gerber closed the conference tackling “The Primary Causes of Heart Disease”. Ivor spoke about his own battle with health and demonstrated how he had been overweight and had received lab tests indicating highly elevated GGT, cholesterol and ferritin levels.

His doctors were perplexed and had no helpful answers. He undertook his own research and discovered that elevated GGT and ferritin were serious markers for Metabolic Syndrome (Insulin Resistance).

Further research led him to make some dietary changes – moving away from the “highish” fructose, medium fat & protein and excessive carbohydrate consumption (the government recommendations), to that of low fructose, high healthy fat/moderate protein and low starchy veg but lots of non-starchy veg.

Within 8 weeks his lab tests had all reduced to healthy levels.

Dr Gerber showed us the medical data, demonstrating how the majority of heart attacks are due to insulin resistance. Because the current dietary guidelines are not helping to address this we are “putting out fires instead of preventing them”.

So a weekend full of some great insights and a lot of pertinent information to take home, as well as a great opportunity to mix with others who are passionate about health and preventative medicine.

Thank you so much to Sam Feltham – and all the speakers – for producing a conference that did not disappoint.

 

The Public Health Collaboration is not just for the medical profession – it is a public charity that anyone can become a member of. The more we can increase its numbers the bigger an impact we can have on changing the current dietary guidelines and bringing about a real change to health.

For more information, and to become a member of the PHC, click here.

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