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By Jane, Aug 17 2018 09:15AM

If you are concerned by the headline on BBC today that suggests that low-carb diets could shorten life then here is my take on it.

The study was based on a questionnaire provided to a large number of people 25 years ago and repeated 19 years ago. It then measured their all-cause mortality 19 years later.

This is interesting material but it so a long way from being good research. Questionnaires are a notoriously bad way of measuring dietary intake; people recall badly, people exaggerate and people who care about their diet are more likely to record accurately. 25 years ago not many people cared much about their diet, except perhaps for vegetarians or other groups who took diet seriously and were more likely to make healthy choices.

25 years ago low-carb dieting was not popular or well documented, apart perhaps by Dr Atkins, and so the people who were labelled low-carb in the study were likely to be eating very differently from what is recommended on a low-carb diet today.

Also there is no measurement of whether these people’s diets might have changed over the subsequent 19 years. We know that diets have changed a lot over the last 2 decades, particularly for people who might have been on a higher fat & protein diet, in particular trans-fats have largely gone; whereas people who cared about their diet 25 years ago are more likely to care about it still, and hence more likely to still be alive.

And so the best way to summarise the report is by saying the people who ate a “low-carb” diets 25 years ago are more likely to have died since then than people who ate higher carb diets 25 years ago. If only we could go back in time and tell them!

To suggest that this means that higher-carb diets are more healthy than low-carb diets now would be quite wrong.

This report provides an association, with no description of the possible causes of the findings. 19 years later we have research from much better studies that shows that low-carb diets can improve health outcomes for most people, in particular by lowering obesity and reversing diabetes.

If you want to know more about this important subject please get in touch.

By Jane, Jun 7 2018 08:39AM

The Truth About Carbs
The Truth About Carbs

There have been a growing number of documentaries on TV lately about diet and health. Last night we had another entitled “The Truth About Carbs” on BBC1, presented by Dr Xand van Tulleken

The show presented a number of subjects related to carbohydrates including their effect on genetic inheritance and the way that different types of carbs are processed differently by the body. This was all very interesting but the central theme of the show and the one of greatest interest to me was the effect of carbohydrates on diet and health.

The program introduced Dr David Unwin and his dietary intervention trial that for the last 4 years has been helping diabetics at his practice in Southport reduce or remove their dependency on drugs. This work has saved the NHS huge amounts of money and save the patients from a life (and probably an early painful death) driven by this terrible disease.

In a small demonstration a group of patients were shown how to change their diet in simple ways and left to it (no fitness coaches pushing them to perform more burpees here!). In 2 weeks they all lost significant weight and they all reduced the key marker of diabetes (their HbA1c level). They all reported finding the diet easy to manage and looked forward to continuing with it.

Compare these results to the team in last week’s Crash Diet program where the group of patients were told to each just supplement shakes and cajoled along by a TV crew including the government’s advisor on obesity Dr Susan Jebb; all of them found the diet hard to stick to and had no idea whether they would be able to stick to the new low-fat diet that was introduced at the end of the show. Both approaches achieved the same short term results but only one of them looked to be an achievable long term lifestyle choice.

There will be criticisms of The Truth About Carbs, in particular they barely mentioned the word ‘fat’ in the show. This may have been a deliberate tactical decision by the show’s producers as it’s a contentious subject; but in order to embrace a low-carb lifestyle it is important to remove the fear of fat that so many of us have ingrained in our minds from childhood, and to learn about good fats and bad fats and how to choose and use them.

Now I admit that I am biased here; I have known Dr David Unwin for the last 3 years and he is a founder member of the PHC charity that I am a patron of; we are trying to get the government to change its advice on heathy eating. But it is the research and published results of David and his partners that has convinced me that this is the right direction for the treatment of obesity and diabetes (both types 1 and 2) in this country. Because it is results like his that matter; not what this scientist or that blogger says on twitter, but what happens to many thousands of real patients who are ill and want to get better.

Many doctors still regard diabetes as an un-treatable disease and prescribe medicine for life. But now there is a choice; Dr Unwin’s dietary program will be made available by the Royal College of General Practitioners to every GP in the country, as a choice to be offered to all diabetes patients.

Next time you see your doctor why not ask about it? It might just change your life.

By Jane, Apr 27 2018 11:05AM

What do you see? Unfair or just fast?
What do you see? Unfair or just fast?

The recent ruling on hyperandrogenism from the International Association of Athletics Federations (IAAF) which Lord Coe heads is perhaps racist, it is perhaps stupid, but more importantly it appears to be saying that sport (and in particular middle distance running) is no longer about being the best male or female, instead we have to level out the natural advantages that some humans have over others, particularly if we feel the particular trait to be more male or female than we are comfortable with.

The ruling says that women with high testosterone levels should take drugs to reduce them or be forced to compete with men.

All women are not the same; nor are all men. Some women are better suited to being high jumpers or better at tennis; some men have a natural disposition to be able to run fast, some are better at playing computer games.

It has been shown that women who have more testosterone are at a slight advantage in some sports. This should not be a surprise to anyone. Just as those with long legs are at an advantage when it comes to the high jump and netball, and those who are 5’ 6” and of a slight build appear to be at an advantage as marathon runners, but a distinct disadvantage on the basketball court.

If we start to categorise people in terms of their testosterone levels (or any other trait) then gender will become irrelevant. Should men with low testosterone levels be allowed to take supplements (currently this is illegal), or should they be allowed to compete against women? How level would that playing field look?

The ruling appears at first sight to be aimed at one athlete, Caster Semenya. Research quoted by the IAAF suggests that throwing events and the pole vault might be affected more than running, so why limit the ruling to track events from 400m to 1500m? If the ruling goes ahead in this sport surely before long it will need to apply to football, rugby….. in fact any sport where being stronger or faster is an advantage.

All top level women runners athletes will now be forced to have their testosterone levels monitored. This "male shaming" could drive many women out of sport just as we are trying to achieve gender equality. And what is a “high level” anyway? Where should we draw the line? Should women with particularly low testosterone be allowed to take some for fairer competition?

Or is it that Coe and the IAAF have their own notions of what being female means? This in itself is most worrying, this ruling has been cited as racist but I don’t see it that way at all, I see it as women being told how they should be in order to to be a proper woman; they want their track and field stars to be feminine. It’s old-school sexism, bullying and vilification and it is not nice.

"Sport For All” meant that everyone should be encouraged to run out onto the field and play sport. In trying to create a level playing field the IAAF are actually levelling the players instead.

Surely the biggest result of this ruling is that less people will want to come out to play!

By Jane, Jan 4 2018 10:16AM

These days everyone in my industry likes to claim that their ideas are "evidence-based", and yet so often the evidence that they refer to is either anecdotal or from their own poor quality research, often ignoring years of respected research that states the opposite view.

I don't like to refer to scientific evidence unless it is clear, well presented and comes from a source with no conflict of interest. And in the field of nutrition this is very rare!

Each year, the London-based analytics company Altmetric releases a ranking of the 100 most popular research articles that year, across all scientific diciplines.

Here is their report from last year. Take a look at number 1. Here is the summary:

"1. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study

Yet another piece from The Lancet with a catchy title, this study compared the diets of 135,000 people from 18 countries. The result? Low-fat diets were associated with a higher likelihood of heart attacks and heart disease.

Meanwhile, low-carb diets appeared to be significantly healthier, just once more affirming the notion that dietary fat is not the enemy, while excess sugar definitely causes harm.

Global dietary guidelines should be reconsidered in light of these findings, the researchers wrote in the paper."

I agree. This is why I support the Public Health Collaboration in our attempts to do just that.

By Jane, Dec 19 2017 12:36PM

I read an annoying article on the BBC website last week and it has been stuck in my mind ever since. So I hoped that venting my feelings here might get rid of them in time for Christmas!

The article's title was "Top five celeb diets to avoid in 2018, according to dieticians". So it started with a spelling mistake; read on to see if it got any better.

The diets included the Raw Vegan, Alkaline, Pioppi and Ketogenic diets, as well as Katie Price's Nutritional Supplements. So only one celebrity there then!

What we got was actually a glossed-over review of a report from the British Dietetic Association, who seem to want to have a pop at celebrities who, just like the rest of us, want to loose weight. Apart from one exception, the report just listed the diets under review and found some celebs who happen to use those diets. I suspect that this was the main draw of the BBC article, a picture of Katie Price. I was so impressed that I copied it for my post.

The treatment of the Vegan diet was strange, it actually sounded rather good to me, and apart from saying that potatoes shouldn't be eaten raw it gave little to explain why you should avoid such a diet.

The Alkaline diet got a slightly fuller review, in particular the statement that "according to Cancer Research UK, while eating more fruit and vegetables may help you lose weight, the pH of your food will not impact the pH of your blood". I was underwhelmed by the list of celebrities endorsing the diet: Tom Brady and the Duchess of York; oh, and Gwyneth Paltrow, which reminds me - diet means a way of eating, not a weight loss plan. The BDA clearly do not agree with me here!

With Katie Price Nutritional Supplements the article hit its target market at last. There was a great picture of Katie (wouldn’t we all like to look like her?) and the diet promises rapid weight loss. Katie’s shakes are much like any other meal replacement shakes, if you can stand them you will lose weight but are they nutritionaly balanced and how long can you seriously keep it up for?

Now we moved on to the Pioppi Diet, and I have to admit that this is the reason I started reading the article in the first place. The BDA accused the authors of "hijacking" the Mediterranean diet with their agenda, saying it was "ridiculous" to include coconut oil or cauliflower for a pizza base as one of their suggestions.

Let's be clear here, the BDA are saying that it is ridiculous to replace an unhealthy ingredient, Flour, with a healthy one, Cauliflower. The diet is aiming to reduce the carbohydrate content of our diets, it does this by suggesting that we eat healthy vegetables as replacements for nutrient-free fattening carbohydrates; Cauli-rice for rice, Courgetti for spagetti. What is ridiculous about this? No this is not typical Mediterranean food but the book clearly states that it is an approach that combines the best of historical evidence and new science. It does not say that this is what the people of Pioppi eat every day.

And then the BBC article quotes the the British Nutrition Foundation who state here that:

"The advice to cut out starchy carbohydrates such as bread, pasta and rice is inconsistent with a Mediterranean dietary pattern, which typically includes these foods (mostly wholegrains) at every meal".

Perhaps I eat in the wrong resteraunts but as far as I am aware in traditional Italian meals pasta tends to be used in small quantities as a starter sometimes and the main course is typicaly meat or fish with veg. Puddings are rarely sweet. When Registered Dietitians say things like this it makes you wonder where they get their cherished certificates from - Pizza Hut perhaps?

The BBC then redeem themselves by giving the author a chance to respond:

"The Pioppi Diet is an independent evaluation that marries the secrets of one of the world's healthiest villages with the latest medical, nutrition and exercise research to bust many myths prevalent in today's weight loss and health industries. It has received endorsements from a number of eminent international doctors, dieticians, Cochrane researchers and sports scientists."

Just one thing missing here - Celebrities! Unless, like the BDA, you count Keith Vaz and Andy Burnham, whose job it is to try and reduce the burden on the NHS caused by poor nutritional advice. Other then these C-list celebs there is just a bunch of doctors and scientists trying to help people make healthy choices.

Lastly we get the Ketogenic Diet. The BDA report actually makes this diet sound rather good: "If you're cutting out carbs, such as pasta, you're cutting out creamy sauce. If you're cutting out bread, you're cutting out butter. If you're cutting out biscuits, you're cutting out sugar." - Yes, that is the whole point, well nearly; the mention of butter suggests that they still prefer the bread in the sarny not the butter,

The list of side-effects is disengenuous, they are not common and they quickly go away - unlike the diseases the diet is trying to prevent! They mention deprivation of vitamins and minerals, but they don't mention which ones they are referring to. Is there something good in pasta that we don't get from vegetables and natural fats? No, there is not.

They also state that most of the initial weight loss seen is often associated with water/fluid losses; this is a schoolboy/girl error; of course it is! Initially you loose the glycogen (and water) that you used to rely on, then you start burning fat. Either they are trying to misslead or they are just playing stupid! Yes this diet takes careful planning to maintain, but that is bound to be true of all successful diets, if it were not then we wouldn't need the BDA, would we?

I actually think that the "problem" with the Keto and Pioppi diets (they are almost the same thing of course) is that you do not need a Dietitian to help you adopt them. Just a friendly web site written by doctors trying to help you live longer.

It is clear from the outset that the the BDA are a bit miffed. They don't like the fact that doctors and celebrities might dissagree with some of the things that they say. According to their website this report was "eagerly anticipated" , I expect that this is because Dietitians like to indulge in a bit of character assassination at this happy time of year.

The article started with these wise words from Sian Porter of the BDA: "If something sounds too good to be true, it probably is."

Well Sian, the Pioppi diet does not sound too good to be true. It just sounds like wise advice from a rather clever cardiologist who is just trying to keep as many of us as possible off his operating table.

And lastly the BDA proudly state this at the foot of their report:

" Uniquely, dietitians use the most up-to-date public health and scientific research on food, health and disease, which they translate into practical guidance to enable people to make appropriate lifestyle and food choices."

Perhaps this is what pisses me off the most. This arrogant sense of natural superiority is probably part of the reason that our dietary guidelines have remained so badly wrong for such a long time. The notion that only a registered dietition can read a scientific report and disseminate the contents to the wider public is preposterous.

By Jane, Oct 4 2016 10:20AM

We watched a very interesting pair of programmes on BBC1 last night discussing the epidemics of Obesity and Diebetes.

Firstly Fat vs Carbs took a brief look at the low-carb high-fat diet. Secondly Panorama's Diabetes the Hidden Killer provided an overview of the impact that diabetes is having on individuals, families, the NHS and the country.

In the first programme Jamie Owen took a balanced but brief look at LCHF. The NHS are still unable to embrace this diet as a realistic choice, despite the evidence that it is working for many people who are taking their health into their own hands. There are a few doctors willing to discuss the diet with their clients, but they appear to be taking a risk to their own careers by doing so.

It's a shame that Jamie only experimented with the diet for 3 weeks. After making such a good start and suprising his doctor with the results (his cholesterol levels came down and he lost 6KG) it would have been interesting to see if the progress he had made continued into the longer term as it has done for so many others.

I was appauled by the doctor who runs a weight loss clinic in the middle of an area with the highest obesity in the country and certainly does not recommend the diet to any clients. He talked about high risk and low adherance and yet his clients all suffer from exactly these issues. This sums up the scale of the problem perfectly. He considers high fat to be a risk but is not affected by the heaps of new scientific data to the contrary. And even if high fat were a risk that risk would pale into insignificance compared to risk and cost of type 2 diabetes afecting his neighbours.

There was also a spokesperson for the British Dietetic Association, she was priceless; especially after listening to Sam Feltham describe an analysis of all the available randomised control data comparing low-fat vs high-fat diets. Without referring to any evidence of the government's guidlines being based on any science at all she said that her job was to weigh up all the information and advise the best approach. I looked at their website and aparently they did do some reseach costing just £16,000 in 2009 and so she is not entirely wrong here! She would not recommend LCHF, apparently there is not enough long-term data on its safety or efficacy (to which Jamie should have replied "but humans have been eating this way for millions of years"). Well, we have the data for her recommended diet and it is an unmitigated disaster. She has her head in the sand and it is people like her that advise our government.

The Panorama programme was scary. The scale of the problem of type 2 diebetes is vast. Up to 10% of the NHS budget is spent on it and it effects twice the number of people than all cancers do. Living with diabetes is dreadfull, and dying of it is gruesome for all concerned. Graphic pictures of a leg amputation made me shudder, but this is happening every day.

Someone gets diagnosed with diabetes in this country every 2 minutes!

I was saddened to see so many diabetics sat at home or in hospital eating cereals, potatoes and sweet drinks, or following a prescribed diet based on carbohydrates, the very thing that has caused their disease in the first place. If you have a disease that is caused by insulin in-sensitivity and high blood-glucose levels then why on earth would you choose to eat more and more carbs, which turn to glucose in the blink of an eye as soon as you eat them? And the answer is that this is the diet recommended by Dieticians, the NHS and their sponsored charity

We were told that the only 'cure' for type 2 diabetes is bariatric surgery. This may be the case for someone who has had the disease for many years and now had a high risk of death, but there are alternatives for everyone else.

Panorama did not mention the success that some GPs have been having recommending their patients adopt a LCHF diet, a natural dietary intervention as aposed to ripping out 70% of your stomach. People who had watched the fat vs carbs programme would have been left wondering why.



I'm Jane Roweth, owner of Aspire Fitness Solutions (I'm the one wearing red) and in this blog I'll be leaving day-to-day business behind and commenting on some of the wider issues in the health and fitness industry.


I've been around this industry for 20 years now and I have a lot of experience and opinions to share.


I'll also be sharing some of the stories that have been making Aspire such an inspiring place to work for the last 9 years.