We owe our kids more than a future full of transplants

According to a report released this week, liver disease now affects more than six million Australians.  The doctors who commissioned the report want the taxpayer to give them more money to manage sufferers.  Fortunately we now know what causes the vast majority of liver disease and that it can be reversed simply by telling people not to eat sugar.  But I won’t be holding my breath waiting for that to become the recommended treatment.

Liver diseases fall into two main groups, those caused by viruses (Hepatitis - currently afflicting about 518,000 Australians), and, accounting for the other 90 odd per cent of cases, those caused by ‘lifestyle’ (5.5 million people).   

The lifestyle group is usually further divided into drinkers (who have the same symptoms but have a history of consuming  more than 2 standard drinks per day for women or 3 for men) and everybody else.  According to the report, Alcoholic Fatty Liver Disease now affects 6,203 people but Non-Alcoholic Fatty Liver Disease (NAFLD) afflicts a massive 5,538,677 Australians.  That’s a pretty big number for a disease was first identified just 30 years ago.

As the name suggests, NAFLD starts out as an accumulation of fat in the liver.  It can then progress through various disease stages and ultimately end in cirrhosis requiring a liver transplant (if you’re lucky enough to find a donor).   There are very few symptoms until the later disease stages, so most people are unaware that they have it all.

NAFLD is frequently described as the liver component of the metabolic syndrome (elevated blood fats, insulin resistance and obesity), because it’s rapid growth has paralleled the same runaway growth in each of the diseases which are a consequence of the syndrome.  More than 90% of obese people and up to 70% of people with Type II Diabetes have NAFLD.  

The number of people with NAFLD is accelerating at a tremendous rate.  Even worse, the age of onset is declining rapidly.  A study published last week revealed that the number of US teenagers with the disease more than doubled in the last 20 years and now affects almost 11% of US children aged 12-19.  If those rates translate to Australia (and there’s every reason to think they might) this means the average high school classroom now contains three children suffering from chronic liver disease.  Every classroom.  Three kids.  

Even though one of the liver’s functions is to make fat from any excess carbohyrdates we consume, the fat is normally exported for storage in all the places that make our jeans too tight.  NAFLD starts when the liver’s ability to export fat is overwhelmed.  The excess fat remains in the liver and begins to create the human version of foie gras.  The best way to make this happen in ducks and geese is to overfeed them (by shoving a metal tube down their throat) with carbohydrates (like corn or dried figs). 

Humans get a little twitchy if you reach for the tube and corn, so overfeeding us has to be accomplished with a little more finesse.  In people, all but one carbohydrate triggers an insulin response which (unfortunately for those expecting to make a bit of human foie gras) shuts down appetite and stops us eating too much. 

The one carbohydrate which subverts this handy appetite control feature is fructose.  So you might expect that a bit of effort has been put into seeing if fructose (and its primary modern delivery vehicle, sugar or sucrose) might be the source of the sudden explosion in NAFLD.

And you wouldn’t be disappointed.  In the last five years research that proves that sugar is the culprit has been pouring in.  Scientists have of course shown that you can give ducks (hmm, I wonder why they chose that experimental animal) and rats NAFLD using fructose.  And a recent series of human studies have also shown that the consumption of soft drinks is strongly associated with the onset of NAFLD (and I don’t think we can blame the water or the bubbles).  But if that wasn’t enough, a pair of very recent trials from Scandanavia have put the icing on the cake. 

The first trial involved feeding four groups of people four different drinks (Coke, skim milk, Diet Coke and a still mineral water).  After 6 months of this, the Coke group had massively (140%) increased liver fat (as well as significantly increased blood pressure, cholesterol and blood triglycerides).  The folks knocking back Diet Coke and water were pretty much the way they were at the start (just in case you thought it might be the water or the bubbles) and the milk drinkers had even slightly improved their liver fat status.  

A similar story unfolded in the second trial.  Some very unfortunate volunteer humans were put on the path to NAFLD (27% increase in liver fat) in just three weeks by overfeeding them chocolates, pineapple juice, soft drinks and sports drinks.  The good news is that the disease was easily reversed with diet (although it did take 6 months).

The trials are done, the evidence is clear.  Fructose consumption causes NAFLD in exactly the same way that alcohol causes Alcoholic Fatty Liver Disease.  NAFLD’s alcoholic cousin can be usually be reversed by ensuring the patient avoids alcohol.  So are the experts demanding that GPs be told to adopt a similar practice for fructose?  Nup.    

No, what they want is for the government to spend more money on, well, them.  This week’s report calls for a $6 million dollar a year program (run by the doctors who commissioned the report) to increase awareness of liver disease and a $7.5 million dollar a year community care program to help people who are suffering with liver disease.

Now I’m sure these are admirable programs and I’m sure they’ll go some way to alleviating a little bit of the suffering caused by the overwhelming epidemic of chronic liver disease.  But when the cause is clear and the solution even clearer, we can do much better than throw a bit of cash at some liver doctors.

NAFLD currently has at least a quarter of the population on an expressway to a liver transplant (if the rest of the metabolic syndrome doesn’t get us first).  Yet it can be easily and effectively reversed with a pathetically simple piece of advice – don’t eat sugar.  Those charged with keeping us well, need to immediately start giving that advice rather than lobbying for a better ambulance  to park at the bottom of the cliff. 

A day late and a dollar short? - Australia’s peak health bodies decide sugar is unhealthy (but only when added to fizzy water).

The week before last the Heart Foundation, Cancer Council and Diabetes Australia declared war on sugar. But before you break out the party poppers you should know that it wasn't so much an all-out assault as a slap with a wet tram ticket. And the Dietitians Association couldn't even be bothered getting out the tram ticket, moist or otherwise.

Don’t get me wrong, it’s great to see such august bodies uniting behind an anti-sugar campaign. It’s just a pity the message is so riddled with caveats, exceptions and contradictions as to render it almost completely ineffective. Or was that the point?

The campaigning trio called for action on sugary drinks by “governments, schools and non-government organisations such as sports centres.”

Kellie-Ann Jolly, acting CEO of the Heart Foundation urged the Federal Government to “implement restrictions to reduce children's exposure to marketing of sugary drinks." She went on to suggest that State governments should also limit the sale of sugary drinks in schools and sporting grounds.

The CEO of Diabetes Australia, Greg Johnson, wanted even more direct action, calling for a tax on sugar-sweetened beverages.  The call to action was because these drinks are “associated with a range of serious health issues including weight gain and obesity, which in turn are risk factors for diabetes, cardiovascular (heart) disease and cancer.”

The sugar in soft drinks must be magic. You see when it’s mixed with water it apparently makes you fat and gives you diabetes, heart disease and cancer. But when the very same sugar constitutes 72% of a children’s lunch box snack it is so healthful that it deserves a great big Heart Foundation Tick of approval. And when it makes up almost a third of Uncle Toby’s Oat Gourmet Selections or Kellogg’s Just Right breakfast cereal it gets a tick as well.

But the real sign of its magicness is that it is not always dangerous even when the only other significant ingredient is still just water. Fruit Juice is sugar and water but that is not on the radar of the newly minted crusaders against sugary drinks. Apparently sugar molecules that were once part of a piece of fruit are not evil but those that were once part of a piece of sugar cane (despite being chemically identical) are deserving of taxation and prohibition.

Soft drink is an easy target. No-one is suffering under the impression that a can of Pepsi is health food and not even the Beverage Association at its most brazen would attempt to convince us that it is.

Confected rage on the part of the magnificent three is token (at best) for as long as they continue to ignore (or endorse, in the Heart Foundation’s case) the vast majority of sugar we are sold under the label ‘health food’.

Sugar is sugar. It’s just as dangerous when it’s the primary ingredient in a Heart Foundation approved children’s snack as it is when it’s sloshing around in a bottle of Coke. The Heart Foundation in particular robs this campaign of any shred of credibility for as long as it accepts payment from the processed food industry to endorse their sugar filled ‘health’ food.

The evidence supporting the campaign has been available to these organisations since at least 2007. Despite this, the Heart Foundation in particular has publicly and actively denied that sugar presented any health problem at all. Indeed as recently as 2011 they said

“based on the current level of evidence, sugar is not directly linked to [heart disease], diabetes, or obesity.”

That’s right, the exact opposite of what they now say about the sugar in soft drinks.

They must have found their library card because now it appears they’ve finally caught up with decades of research and mustered the gumption to acknowledge (some of) that evidence – albeit in half-hearted and non-revenue-endangering fashion.

The research on dietary sugar intake is just as damning as the evidence that has now convinced them to act on soft drink. Sugar doesn't suddenly become dangerous when combined with water and bubbles. It’s dangerous all the time.

How many people million more people need to suffer from the lifelong debilitation (of Type II Diabetes) caused by the sugar added to everything we eat before Diabetes Australia is prepared to accept that evidence. How many more deaths from Heart Disease need to occur before the Heart Foundation is prepared to bite the corporate hand that feeds it?

Until those who are supposed to care, stand up and acknowledge the obvious, the suffering will continue. Until the Heart Foundation are prepared to say no to corporate sponsorship and demand action on all sugar, their gormless flailing at the easy targets will render them less and less relevant. In this age of profit driven, processed food we need real, independent advocates not corporate flunkies.

Act on Sugar before it’s too late.

What do you do when a strategy you’ve been executing for almost 30 years is plainly not working? If you’re the nutrition hierarchy in Australia, apparently the answer is you just keep doing what you’ve always done.

In 1981, the National Health and Medical Research Council (NHMRC) published the very first set of guidelines aimed at making Australians healthier. Fat was blamed for the increasing rates of obesity and heart disease, so the guidelines were focused on fat consumption. In short, fat makes you fat and sick and you should eat a lot less of it. Sugar was also mentioned but only because it rots our teeth but it was ok to consume ‘in moderation’ (whatever that means).

I very much doubt that anyone actually pores over the guidelines while they fill their shopping trolley, but many of us use them without realising it. They are the basis for the nutrition (daily intake) recommendations on every packaged food we buy. They form the foundation for every piece of advice any government agency or nutritionist gives us (from school canteens to hospitals). And every meal for our military forces is created using a policy based on the guidelines.

Because of this, the eat-less-fat message got through to us loud and clear. Between 1980 and 1995, the average Australian successfully decreased the amount of fat they were eating by 5% and the amount of cholesterol by a whopping 18%. We replaced the fat with carbohydrates (bread, cereals and sugar), increasing our consumption by 16.5%.

Unfortunately the obesity statistics went in exactly the opposite direction to our fat consumption. In 1980, two in five (39%) Australian Adults were either overweight or obese. By 2011, only two in five weren’t (63.4% were overweight or obese). In just 28 years, all that low-fat eating (or was it the high-carbohydrate eating?) had managed to increase the number people with a weight problem by 64 per cent!

Heart disease sufferers didn’t fare much better. The percentage of the population afflicted doubled between 1989 and 2011 (despite significant advances in health care for heart patients in that period).

Evidence that fat makes you fat and sick was suspiciously lacking by the time the revised guidelines came out in 1992. And the evidence that the theory was nonsense was there in spades by the time the third release hit the streets in 2003. Increasingly sugar was being fingered as the culprit but that evidence was suspiciously absent from the reviews undertaken at that time.

The guidelines are currently being reviewed ahead of publication of new version (hopefully next year). So can we expect a sudden change of heart from the nutrition elite? History suggests pigs may be approaching the runway before that happens.

The draft update to the new NHMRC dietary guideline on sugar suggests they plan to change from this

“Consume only moderate amounts of sugars and foods containing added sugars.”

To this:

“Limit intake of foods and drinks containing added sugars. In particular, limit sugar-sweetened drinks.”

Again, no actual limits or recommendations will be included.

The reason for this momentous change (go on, I bet you can spot a difference if you look hard enough) is that the NHMRC has unearthed very high quality evidence which tells it that consuming soft drinks makes us fat. Apparently sugar is dangerous when combined with bubbles and water but is otherwise ok.

Last week I was invited to Canberra to explain why that was just plain daft. I submitted that a refusal to consider any evidence produced beyond 2009 made for a very weak review. I pointed out that the American Heart Association had reviewed the evidence on sugar in 2009 and come out with a position statement which recommended dramatic reductions in consumption. I presented the mountain of evidence that has accumulated since 2009 including high quality human trials. And I highlighted some of the startling conclusions from the current NHMRC evidence report such as “three of the four cohort studies reviewed showed positive associations with fructose[half of sugar] and pancreatic and colo-rectal cancer”

I concluded that given that even their own review (limited and defective as it was) was throwing up high quality evidence of very real harm from sugar consumption, the anaemic recommendation to ‘limit intake’ just isn’t good enough.

It’s a long time between drinks with these guidelines (it will be a decade between reviews by the time this lot are published) and we already have powerful evidence of very real harm from sugar. But millions of real people are making daily decisions about what to shove in their mouth based on this advice (whether they know it or not) with the direct result that they are significantly fatter and sicker than they were the day before.

Let’s not wait until 2023 to get tough on sugar. Let’s not let millions more perfectly healthy children suffer the lifelong destruction of amenity which is type II diabetes. Let’s not stand by and watch the heart disease, kidney disease and pancreatic cancer rates double again. Let’s do something about it now.

Margarine significantly increases your risk of developing Breast Cancer

A review of recent trials published in May this year concluded that the dominant fats in margarine increase our risk of developing breast cancer. But the review (and the studies it discusses) has been comprehensively ignored by the Health Authorities. Is their obsession with pushing margarine for heart health clouding their vision?

Breast cancer is the most common cancer in Australian women. One in nine women will develop the disease in their lifetime.

We are getting very good at detecting and treating the cancer (88 per cent of new cases survive five years or more). But there are no signs of any reduction in the numbers of women developing the disease in the first place. In the last 30 years the incidence has increased dramatically.

An Australian woman in 2012 is almost 50% more likely to develop breast cancer than her mother was in 1982. If the woman lives in the ACT, is white and is affluent, her risk is even higher.

Forty new cases will be diagnosed today. Forty women will discover they have breast cancer today that thought they were well yesterday. And tomorrow another 40 will join the list. And another 40 the day after that. Even more disturbingly three of those women every day will be under 40.

Despite its enormous impact, we know almost nothing about what causes the disease. The best the experts can tell us so far is what many would regard as the bleedin obvious - that we are more at risk if we are female, have relatives that have had the disease (or other cancers) or have previously had the disease (or other cancers) ourselves.

There is nothing in the official advice about the risks associated with polyunsaturated fat consumption. But researchers have known that there is a strong link between high polyunsaturated fat, seed oils (man-made oils extracted from grains and seeds such as canola, sunflower, grape-seed and ricebran) and cancer for more than 40 years.

The Veterans Trial, completed in 1971, was conducted with a population of 846 Californian military veterans randomly assigned to two different kitchens. One kitchen replaced all animal-fat products with corn oil for the eight-year duration of the study. The other kitchen kept on serving a normal high-animal-fat diet.

The purpose of the trial was to determine whether animal fat caused heart disease, but it drew a blank on that front. Heart-disease-related events were slightly less than expected in both groups, and not significantly different from each other. But the researchers noticed something of far more concern. There was the dramatic difference in cancer deaths between the two groups. The incidence of fatal cancers in the corn-oil group was nearly double that of the normal-diet group by the end of the trial.

Ethical approval for more trials on humans was in short supply after that study saw the light of day. But rat studies performed in the 1970s and 1980s consistently noted that mammary (breast) cancer was formed more often in rats fed corn oil (high in polyunsaturated fats) than in those fed coconut oil (high in saturated fats). And a truly disturbing study published in 1997 showed that feeding the rat equivalent of a breastfeeding mother a diet high in polyunsaturated fat (43 per cent corn oil) doubled the rate of mammary cancer in her daughters, caused cancers to appear among them earlier and caused earlier onset of puberty.

In 1996, Swedish researchers decided it was time for a human study to provide some hard data on breast cancer. Scientists from the Karolinska Institute recruited 63,870 women aged 40–76 and monitored their diet and the occurrence of breast cancer for an average of 4.2 years. The dietary questionnaires used in the study enabled the researchers to determine exactly how much saturated, monounsaturated and polyunsaturated fat the women were consuming.

They found no association between the total fat or saturated-fat (the dominant fat in animal fats) intake and a woman’s risk of developing breast cancer. Monounsaturated-fat (the dominant fat in Olive Oil) consumption reduced the risk of breast cancer by 20 per cent but polyunsaturated-fat consumption did exactly the opposite. Just as the rat studies had predicted, the women consuming the most polyunsaturated fat were 20 per cent more likely to develop breast cancer than the women consuming the least.

Since that study, further human studies have found significant associations between dietary polyunsaturated fat consumption (in particular the omega-6 fats which dominate seed oils) and the risk of developing breast cancer. A review of the studies conducted by the Université Joseph Fourier (Grenoble, France) and published in May this year concludes “there are several recent and concordant studies that strongly suggest that dietary omega-6 [polyunsaturated fats] … increase the risk of breast cancers.”

Meanwhile the Australian Heart Foundation is busily telling ‘Mums’ that they should be replacing butter with margarine. They are doing this because for the last 30 years they have been telling people that plant fats reduce the risk of heart disease.

Unfortunately there is no evidence that this is true. Indeed it is likely that the omega-6 fats in margarine significantly increase the risk of heart disease and death. Even more unfortunately the margarine they want all our mums to eat is made from the very oils the French review concluded “increase the risk of breast cancer.”

This evidence is compelling. It demands critical discussion. It demands widespread publication. And it demands public warnings. But none of this is happening. The folks charged with safeguarding our safety are asleep at the wheel (I’m being generous). And the folks with a buck to make from selling us seed oils appear to be running the show.

We are not talking about a rare disease afflicting tropical fish. Breast cancer is a blight upon the community. There is not one person who will not be personally affected by the tragedy of this very modern epidemic.

Our mothers, sisters and daughters (and even very occasionally our men folk) deserve better. Somebody wake the watchdogs – please. And while you wait for them to stir, stop eating seed oils.

The Australian Diabetes Council needs to clean up its act.

It’s Diabetes Awareness Week.  But the Australian Diabetes Council continues to advocate a solution that the science shows will make the disease worse rather than better.  Is their position mere negligent incompetence or is there something more sinister afoot?  Either way it is ordinary people who will pay the price.

Type II Diabetes (90 per cent of all diabetes is Type II) is a disease of carbohydrate metabolism.  Sufferers can no longer properly convert the carbohydrates they consume into energy.  The result is that their blood glucose level is permanently too high. 

A permanently high blood glucose level leads to damage to the fine capillaries of the eyes and kidneys as well as the blood vessels transporting food and oxygen to our lower limbs.  Uncontrolled Diabetes will eventually lead to blindness, kidney disease and lower limb amputation.

 

Every day in Australia nine limbs are amputated because of this disease.    Worse than that, it affects more than twice as many people today as it did in the nineties.  And that number is likely to triple in next fifteen years.

You don’t need to be a scientist to figure out that if a person has trouble dealing with carbohydrates they should eat less carbohydrates.  After all that is exactly the approach taken with other similar problems.  For example people who can’t properly digest fats (because their gall bladder is compromised) are advised to eat a lot less fat.

And if that was your hunch you wouldn’t need to look too far for science to back you up.  In 2010 the Harvard School of Public Health published the results of its meta-analysis of the research on the relationship between sugar sweetened drinks and diabetes. They reviewed eight high quality studies which involved 310,819 participants and 15,043 cases of Type 2 diabetes. Each of the underlying studies was significant in its own right and all had been concluded between 2004 and 2010.

All but one of the studies revealed a strong (and significant) association between sugar and diabetes. Taken together they showed that consuming one or more soft drinks (or fruit drinks or vitamin waters) per day would increase your chance of contracting type 2 diabetes by 26 per cent.

As convincing as this meta-analysis is, it just confirms what a very strong series of studies (on the link between soft drinks and diabetes) have been saying for the last decade, sugar consumption significantly increases the incidence of type II Diabetes.

Two decades ago (when there were half the number of sufferers there are today) reducing carbohydrates in general and sugar in particular was exactly the advice given.  But strangely the Australian Diabetes Council’s  (ADC) advice to Type II Diabetes sufferers today amounts to advocacy for increasing the amount of carbohydrate. 

Yesterday, their Chief Research Officer Dr Alan Barclay told the Today program that Australians hoping to prevent the onset of this terrible disease should eat less fat, less salt and more fish.  He gave no advice about sugar either during that interview or in the similar one he also gave to Alan Jones.  Neither does a word about sugar appear in the detailed booklet on preventing diabetes published by the ADC yesterday.

The official position of the ADC on sugar is that it has nothing to do with Diabetes.  Indeed it “want[s] to end the myth that sugar causes diabetes.” It’s a position which is (strangely) almost identical to the one maintained by CSR Sugar and Nestle Australia.  The ADC instead recommends “that people with diabetes choose at least one serve of a low G.I. food at each meal and snack.”

Sugar is a moderate to low GI food and pure fructose (which is one half of sugar) is the lowest GI carbohydrate available.  It shouldn’t therefore come as much of a surprise that foods high in sugar feature heavily in lists of processed food awarded Low GI certifications.  One type of pure sugar (made by CSR) has even managed to have itself certified as being low GI.

Besides being ADC’s Chief Research Officer (and oft-quoted spokesperson), Alan Barclay has some other strings to his bow. He is also a director and vice-president of the Glycemic Index Foundation (GIF). GIF exists to dispense GI Symbols.

Prospective supplicants submit their fare for testing, pay the ‘testing fee’ and, if adjudged worthy, receive a little blue G that they can display on their labels.  They can leave the proclamation of healthiness on the label for as long as they continue to pay for the privilege with a percentage of their product sales.   Some currently certified foods include, Nestle Milo (46% sugar), a range of Nestle muesli bars (around 25% sugar), USANA Meal replacement shakes (around 27% sugar), CSR’s Low GI Sugar (100% sugar) and of course Danisco pure fructose (100% fructose).

When the ADC exonerates sugar and steers sufferers in the direction of Low-GI foods, they are driving demand for the services of GIF, and the products certified by them.  Doctor Barclay’s involvement in both organisations is a clear conflict of interest (which should, at the very least, be disclosed with every appearance he makes on behalf of the ADC). 

The studies linking sugar and diabetes are large, well conducted and reliable yet they are ignored on both the ADC website and in Dr Barclay’s most recent public advice to those seeking to avoid diabetes. 

People with type II Diabetes will heed the ADC’s advice.  They will seek out low fat foods (which are usually high in sugar).  They will ignore the sugar content of foods and they will look for foods which bear a Low-GI certification.  This will inevitably increase their sugar intake and the science says they will significantly increase their risks by doing so. 

If this was about increasing the risk of your fingernails going green then I would say, so what.    But far more is at stake in this game.  Almost 300 Australians will contract an appalling, life destroying, disease today.  And they’ll be joined by another 300 tomorrow, and another 300 the next day. They will suffer every remaining day of their (foreshortened) life even though the science on how to avoid it has been clear for at least a decade. 

I don't pretend to know ADC's motivations, but telling at-risk people that it is ok to eat sugar is an extraordinary abuse of a position of trust.  Real people are suffering because of the ADC’s incompetent advice. It needs to clean up its act and it needs to do it now.Type II Diabetes is not a game.

Stop it or you’ll go blind

Macular degeneration is the primary cause of blindness in Australia today.  And evidence is mounting that the likely cause of the disease is consumption of vegetable oils.  But once again Australia’s Dietitians Association is on the side of the processed food industry instead of the consumer (or in this case, the patient).

Our eyes are exquisitely complex pieces of machinery which work much like a camera.  Light from the outside world hits the the retina at the back of our eye.  The macula is the centre of the retina. It is responsible for our detailed vision.  If our macula is damaged, we can no longer see fine detail, drive, read or recognise faces. 

Macular degeneration begins in a layer of cells underneath the retina called the Retinal Pigment Epithelium (RPE). The RPE is responsible for transporting oxygen and other nutrients up to the retina and moving waste products down to the blood vessels underneath. It also contains a specialised immune system which reacts to some of the more dangerous waste products produced by the macula. 

When the RPE wasted disposal system fails, junk from the retina builds up underneath the RPE. These junk deposits, known as drusen, appear as yellow spots on the retina and are visible in a normal eye examination.  As the disease progresses, vision loss happens because the RPE cells die (‘dry’ macula degeneration) or because the RPE cells fail to prevent blood vessels from growing into the retina (‘wet’ macula degeneration) from below the RPE.

The macula contains a high concentration of some of our most specialised hardware, the rod and cone cells that allow us to see in fine detail and in colour.  These cells are unusual in that they use polyunsaturated fats in their membranes rather than the saturated and monounsaturated fats used by most of the remainder of our cells. 

If you’ve ever wondered what an essential fat (like omega-3 DHA) is essential for, there’s a big part of your answer.  The omega-3 DHA fats make up the outer segments of the light sensitive cells in the retina and are the most frequently replaced cell membranes in our body. 

When these molecules are exposed to light they oxidise rapidly (this is thought to be an important part of how our light sensing cells work).   Normally oxidation is a very bad thing because of the waste products it produces (broken bits of fat molecules and free radicals). 

But our body didn’t fall off the back of the potato truck yesterday.  The special immune system built into the RPE does a magnificent job of getting rid of all the junk, so the oxidation is not normally a problem.  That is unless we use the wrong kind of polyunsaturated fats. 

Researchers have consistently found that people with macular degeneration have abnormally low levels of Omega-3 fatty acids in their retina.  This has inspired many studies which look at the dietary fat breakdown of the participants. 

As expected a lot of those trials have shown that when people are eating a diet high in fish (the principal dietary source of the correct omega-3’s) they tend to have less macular degeneration.  But closer analysis of the figures has unearthed a very worrying exception.  They are only better off if they are also NOT eating omega-6 fats.  Indeed, people eating a diet high in omega-6 fats are twice as likely to have macular degeneration as those eating a diet low in those fats (regardless of how much omega-3 they are consuming).

We have known for at least two decades that our body isn’t that picky when it comes to omega-3 and omega-6 fats.  If we need an omega-3 polyunsaturated fat and the only one handy is omega-6 then our body just goes ahead and uses that.  And there’s no reason to suspect that our body isn’t doing exactly the same thing in our eyes. 

A number of researchers have speculated that what is going on in macular degeneration is that when we eat too much omega-6 fat, our body is simply using that instead of the preferred omega-3.  When the omega-6’s are oxidised, their waste products are different to those produced by the omega-3’s.  This waste is not recognised by the RPE, not cleaned up by its immune function and accumulates as the drusen which lead to macular degeneration.

The only place we are likely to encounter significant quantities of omega-6 fats in our everyday life is in, well, everything.  Over the last two decades, the Australian Heart Foundation and the Dietitians Association of Australia (DAA) have been busily ensuring that the dominant health message in this country is that we should be eating those fats (rather than ‘unhealthy’ saturated fats).

The omega-6 fats occur in large quantities in ‘vegetable oils’ made from seeds (canola, cottonseed, soybean, sunflower, safflower, rice-bran and grape-seed).  And it is exactly those oils which now form the basis of every margarine, every fried food, every ‘ovenfry’ food, most biscuits, most breads, and most ‘heart-healthy’ products on sale in Australia today.

Faced with this research, the DAA’s response is exactly the same as their response to research that sugar is an extremely dangerous addition to our diet – denial.  Worse than that, their official position appears to be a rerun of a press-release provided by the Australian Oilseed Federation (the folks representing those with money to make out of seed oils).

Macular Degeneration is a debilitating disease which now affects a significant proportion of our population. The average Australia is four times more likely to suffer from macular degeneration than they are to suffer from Dementia.  One in seven Australians over the age of 50 (a little over a million people) has macular degeneration and this number is likely to increase by at least 70 per cent by 2030.

There is now significant evidence of the role of seed oils in the development of the disease.  But once again, the folks charged with looking out for our health are squarely on the side of their corporate sponsors. 

Luckily there is something you can do without their assistance.  Don’t eat seed oils.

It’s time to stop mainlining anti-cholesterol drugs

In Australia, statins (the class of drugs used to lower blood cholesterol) now chew up 13 per cent of the money paid out by the Pharmaceutical Benefits Scheme (PBS), and the amount shelled out for them by the Australian taxpayer (via the PBS) grew by a third in just the last year alone. 

That’s a worry for taxpayers, but with one in three Australians over the age of 50 now taking them, a greater concern is that new research suggests statins significantly increase the risks of Type II Diabetes and dementia.

The United States Food and Drug Administration is worried enough about those little ‘side-effects’ to require that statins immediately carry warnings about diabetes and cognitive impairment.  But here in the land of nod, we’ve happily become the world’s biggest statin pill-poppers.

Don’t get me wrong.  Statins do work. The studies have shown that they do lower LDL cholesterol and they do reduce heart-disease in younger men who’ve already had a heart attack. But there’s a good deal of evidence to suggest that the benefits for these folks had nothing to do with the cholesterol-lowering and quite a lot to do with their blood-thinning properties.

Unfortunately (for drug marketers) ‘younger men who’ve already suffered a heart attack’ (and lived to tell the tale) is a very, very small market. The only way to turn a buck from statins was to convince doctors to prescribe it (and the PBS to fund it) for ‘prevention’ (among people whose only sign of illness is being diagnosed with a higher than ‘normal’ blood-cholesterol reading).

A comprehensive review published in 2007 of all of the major high-quality trials on statins concluded that for these not-sick people (who make up the overwhelming majority) taking statins did not alter the overall risk of dying at all.

The studies showed that we would need to treat 67 otherwise healthy people with statins for five years in order to prevent just one of them suffering a heart-disease event. This puts the drugs in the category of being almost completely ineffective. By way of comparison, we need to treat 11 people with antibiotics in order to completely cure 10 of them.

When the data were broken down by gender and age, the results became even less impressive. Statins delivered absolutely no benefit for women at all. And men aged over 69 (those most at risk of fatal heart attacks) enjoyed no benefits either. The only people the drug appeared to help were men aged 30–69, and then only by a very small absolute margin.

The reason for the disappointing results may be that statin drugs work by shutting down the enzyme we use to manufacture cholesterol.  Unfortunately we also use that same enzyme to manufacture one of our primary anti-oxidants, co-enzyme Q10. Shutting down cholesterol production also means shutting down Q10 production (and thereby impairing our ability to fight heart disease and other types of inflammation).

This might be why (although these drugs have a big effect on cholesterol levels) they have very limited effect on heart-disease outcomes. It might also be that although statins lower cholesterol, this has nothing to do with why they lower risks for people who’ve already had a heart attack. Just like aspirin, statins reduce clotting. And just like aspirin, the people who benefit the most from statins are those who’ve already suffered a heart attack. But no one will make a fortune selling aspirin at 97 cents a box.

However they are not merely harmless profiteering.  A series of studies has suggested relationships between statin usage and increased diabetes and cognitive impairment (dementia to you and me). And a significant independent analysis of the trials, conducted in 2011 by the ever reliable Cochrane Review, concluded that becasue of this doctors to be cautious in prescribing statins to people who hadn’t already had a heart attack.

Statins are powerful drugs that alter the function of important liver enzymes, and the evidence suggests that the only class of people who benefit are younger men who’ve already had a heart attack. The only people who should be given statins should be this very small group (and then only if their doctor feels the benefit outweighs the risk of diabetes and dementia).

The US regulators are ringing the alarm bells.  But here the Australian Heart Foundation is more concerned that not enough people are taking preventative medication.  The Australian Medical Association is much more cautious.  They say statins should only be prescribed to high risk patients.  Good advice, but clearly someone isn't listening.  Heart disease rates are high but don’t come anywhere near needing to put a third of the over fifties on statins.

Meanwhile millions of Australians continue to take a drug they don’t need and which the evidence says significantly increases their chronic disease risks.  We need to stop slavishly following the drug marketing agenda.  The practise of mass (and accelerating) prescription of statins must stop immediately. 

Note: Parts of this blog post were ‘borrowed’ from my new book Big Fat Lies.