To Dr. Agnes Ayton's question (BMJ 21 September 2019) “Is obesity a consequence of individual choices or a disease affecting the population?” one may reply “Nutrition`s the thing - specifically, a surfeit of bad advice ushered in by the 1977 USA Dietary Guidelines directing us to avoid butter and animal fats generally, all of which came to be replaced by carbohydrates”.
In physiological terms, the blight`s insulin resistance (IR) admirably investigated by the late Professor Gerald Reaven.
Over the decades since, this dietary shift has ignited a world-wide epidemic of Type II diabetes - as ever greater numbers slip into Insulin Resistance. In the same issue of the BMJ we learn from the Pioneer 100 Wellness Project that, of 109 subjects undergoing routine checks, 59 were identified to have diabetes or pre-diabetes.
The burden - financial and in morbidity - of this nutritional shift may eventually come to exceed most other calamities befalling man over the ages.
Rapid Response:
Re: Obesity is a public health emergency
Dear Sir,
To Dr. Agnes Ayton's question (BMJ 21 September 2019) “Is obesity a consequence of individual choices or a disease affecting the population?” one may reply “Nutrition`s the thing - specifically, a surfeit of bad advice ushered in by the 1977 USA Dietary Guidelines directing us to avoid butter and animal fats generally, all of which came to be replaced by carbohydrates”.
In physiological terms, the blight`s insulin resistance (IR) admirably investigated by the late Professor Gerald Reaven.
Over the decades since, this dietary shift has ignited a world-wide epidemic of Type II diabetes - as ever greater numbers slip into Insulin Resistance. In the same issue of the BMJ we learn from the Pioneer 100 Wellness Project that, of 109 subjects undergoing routine checks, 59 were identified to have diabetes or pre-diabetes.
The burden - financial and in morbidity - of this nutritional shift may eventually come to exceed most other calamities befalling man over the ages.
Time for a paradigm shift?
Dr. Georges S. Kaye
London
gsk@georgeskaye.com.
Competing interests: No competing interests