Travel back in time to 1970s Britain and see for yourself why people were so slim

Carbohydrate, fat: it doesn’t really matter. Eat less and do more. 

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We’ve recently had a public spat between two organisations holding opposing views on what we should be eating. In the blue corner, Public Health England (PHE), the body responsible for promoting the nation’s health. In the red, a newly formed, not-for-profit group of doctors, nutritionists and fitness enthusiasts, all of whom believe that official advice is plain wrong. They have styled themselves as the Public Health Collaboration (PHC). To avoid abject confusion, we’ll refer to PHE as the establishment, and PHC as the mavericks.

The establishment’s guidelines were updated in March with the publication of the revised Eatwell Guide. The mavericks launched a counterattack in May with their own report, less snappily but more prescriptively titled Eat Fat, Cut the Carbs and Avoid Snacking to Reverse Obesity and Type 2 Diabetes. What followed was the academic equivalent of a punch-up. The establishment wheeled out numerous senior figures to cast doubt on the mavericks’ methodological credentials, and to describe their proposals variously as misleading, irresponsible and quite possibly fatal. For their part, the mavericks alleged a conspiracy between the establishment and the food industry in pursuit of corporate profit.

The row centred on two putative villains of the nutritional world: carbohydrates and saturated fat. These are our main sources of energy. The establishment view for the past three decades has been that saturated fat is bad, because of its supposed link to heart disease. Instead, the energy content of our diet should come principally from starchy carbohydrates (bread, pasta, rice, potatoes).

The mavericks argue that the evidence implicating fat in the development of heart disease is now discredited. Further, they believe that the establishment’s low-fat, high-carb diet is responsible for the epidemic of obesity and type 2 diabetes now sweeping the UK. In essence, carbohydrate (in refined or processed form) provokes the biggest surges of insulin, and insulin promotes the formation and retention of body fat. The more our energy intake is derived from refined carbohydrate, the more we put on weight and struggle to lose it. Interestingly, this tendency may not be universal. Only some genetic make-ups – those that dispose to the “insulin resistance” behind type 2 diabetes – may be particularly maladapted to a high-carbohydrate diet.

As with many dichotomies, there is some truth on either side, and neither tells the whole story. One way to understand the alarming rise in obesity and diabetes may be a “time travel” documentary in which a typical 2016 family lands back in the mid-1970s. The people they meet would, on the whole, look strikingly slimmer. The shops would also appear exceedingly dull – lots of ingredients but very few ready-meals, no “low fat” products stuffed full of sugar, no chicanes of confectionery-laden shelves to navigate on the way to the tills.

The children would feel short-changed. A standard chocolate bar would resemble a “fun size” version today. Adults would be dismayed by the limited range and relative expense of the alcohol available. They might console themselves with a trip to the pub for a slap-up lunch, only to complain loudly about the measly size of the portions.Present-day mavericks would be heartened by the fat being consumed: meat for most meals, dripping on toast for Sunday tea, gold-top milk. Establishment types would crow at the sugar being ladled on to cereal, and the bread to fill hungry voids. Both would be alarmed at the paucity of fruit, though perhaps not veg, and struck by the sight of children and parents walking to school, the station, the shops.

Energy-rich foods have always been with us, but now we’re bombarded. And burning this fuel is no longer an everyday feature of our lives. Carbohydrate, fat: it doesn’t really matter. Eat less and do more. It’s as simple – and as complicated – as that. 

Phil Whitaker is a GP and writes the New Statesman’s “Health Matters” column. His books include Chicken Unga Fever: Stories from the Medical Frontline (Salt)

This article appears in the 09 June 2016 issue of the New Statesman, A special issue on Britain in Europe

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