Fat v Carbs with Jamie Owen

Wales is one of the fattest countries in Europe.

59% of us are obese or overweight.

And guess what...

that includes me.

Obesity costs the Welsh NHS over £73 million every year.

So why have we become fat?

After all, we've had lots of advice over the years.

We should eat more non-fatty foods, like bread, pasta and potatoes.

But what if that government advice has been wrong all these years?

We are now basing our guidelines on some very dated and poor research.

Now, have a look at this roast.

Would you say this is healthy?

And what about now?

Well, according to a controversial new report,

this really is the healthy option.

Tastes good.

So, apparently, fat is fine.

There is no convincing evidence

that links saturated fat with heart disease.

It's carbs which are the real killer.

A carbohydrate at the end of the day is just sugar.

I'm going to take my life and my belly in my hands and go on

this controversial low-carb high-fat diet, despite warnings from

the medical establishment.

Honestly? I think you're probably going to cause more harm

to your body than good.

Is it time to cut the carbs and fill up on fat?

Now, I am no stranger to diets.

Three years ago, I gave up sugar. I went on a traditional diet

and exercise regime where I ate less and exercised more.

I've reduced alcohol,

I've replaced my nightly carbohydrate fix

with a healthy alternative.

And it worked. I lost a stone and a half.

But I have to come clean -

I may have put just a little back on.

Mm!

Wales has an obesity epidemic.

So when a group of health professionals published

a report that challenged the government dietary guidelines

and proposed that a low-carbohydrate, high-fat diet

could be the answer, I wanted to investigate.

Lovely, thank you very much.

Now, the idea of this diet is to get most of my energy intake from

foods high in fat, such as meat, fish and dairy products,

rather than what the government guidelines suggest,

which is a strict limit on fat. They endorse a higher portion of

starchy carbohydrates like bread, pasta and potatoes.

Dr Zoe Harcombe is a great advocate of the low-carb,

high-fat diet, so what are the ingredients for success?

What I wanted to show you here is what 25g of carb looks like,

and that's what we're going to be trying to get you to do

over the next two to three weeks.

-And why does 25g of carb matter? Why that quantity?

-Yeah.

It's taking you down to your carb intake being about 5% of your

energy intake, but it's just to give you an idea of how little it is of

certain foods and how much you can get of other foods.

This, for example,

would be 25g of carbohydrate in the form of rice.

-And if you like pasta...

-I do like pasta.

..that's your pasta allowance, I'm afraid,

if you choose to take your carb intake in the form of pasta.

-Goodbye, spaghetti carbonara and spaghetti bolognese.

-Yep.

You're getting the idea.

Sunflower oil and olive oil, lard, butter,

these things do not contain carbohydrate.

-You're saying lard is OK.

-Lard is fine.

It's goodbye to the starchy things

the government tell us to base our meals on.

So the good news is that we're going

to serve you some pork and crackling,

and that is what you're going to be able to eat in unlimited quantities.

Oh, my goodness.

-That looks lovely, doesn't it?

-Yeah.

-Crackling, which is fat.

-Yes.

Which is good fat?

Any fat found in real food is good fat.

There is only one bad fat and that's the one made in factories.

It's called trans fats.

So fat that comes from an animal, or plants, or vegetables

are good.

-Fats that come from factories, bad.

-Pretty much.

It smells absolutely wonderful.

Now, I wouldn't normally have all that amount of crackling,

but it looks absolutely wonderful.

Lots of greens.

I usually wouldn't have that many greens.

I'm not a huge fan of my greens,

but I know I'm going to have to fill up on them.

Ordinarily, I wouldn't have this much butter with my food, but...

here goes.

Tastes good.

But if it tastes good, will it do me good?

In life, nothing is usually that simple.

By the way, don't try this at home unless,

like me, you first see your doctor.

Dr Marina Arulanandam is my GP,

so it's time for some tests to see if I'm fit enough

to start this diet experiment.

-Your test results have come back.

-OK.

-You're going to live.

-Yeah.

-Which is very good.

-Yeah.

-You're not pregnant, which is even better.

-Even better.

That is good news. You can tell a lot from blood, can't you?

-Absolutely.

-It's very impressive.

-Absolutely.

OK, so, your cholesterol,

your total cholesterol is 5.6.

So that is slightly higher than we'd expect you to be.

According to the guidelines,

it should be... Anything between four and five would be acceptable.

-So it is slightly over where it should be.

-Slightly over.

-But I'm not too concerned about you embarking on this diet.

-OK.

But I've got to reiterate that it has got to be very short-term.

Three weeks, that's the plan. I'm going to do it for three weeks.

Fine, OK.

The other thing to remember is, yes,

you're doing this diet for three weeks,

don't go overboard and think, "Wow, I'm having a high-fat diet,

"I can eat lots of cream and lots of red meat and, you know,

"I can put cream in all my sauces."

Just be a little bit sensible about what you're doing, OK?

You know the risks with high fats.

My doctor has cautiously agreed to my body experiment,

but as expected, she's concerned about my arteries.

Surely a high-fat diet can't be good for my heart.

A prominent supporter of the benefits

of this diet is the London cardiologist Dr Aseem Malhotra.

There is no convincing evidence that links saturated fat with

heart disease.

I wanted to ask him if he thought it was safe for me to do this diet.

'The evidence is very clear, dietary fat does not clog the arteries.

'What is driving this is refined carbohydrates, too much sugar.

'I've treated thousands of people with heart disease over my

'career and what I tell them is that they should follow what I

'call evidence-based scientific studies that tell you

'the best diets for heart health,

'which is what I would say is a high-fat Mediterranean diet, so that

'means, at the base, it means lots of vegetables, green vegetables.

'It means nuts, it means olive oil, oily fish.

'It means cutting out the refined carbohydrates and added sugars.

'See them as a treat but not part of a healthy diet.'

So the fat that clogs up a patient's heart, the kind of patients

you see every day, you're saying that that comes from carbs?

'Well, what is interesting is when you look at the latest data...

'A lot of policymakers, even nutritionists, scientists,

'have not fully appreciated this.

'When you look at the saturated fats in the blood that are

'correlated with heart disease and type 2 diabetes, the ones that are

'driving that and are produced by the liver

'are sugar, starch, alcohol.

'So that is what we need to be concentrating on.

'It is not caused by dietary fat.'

Well, you couldn't get a much stronger endorsement than that,

but this does fly in the face of a lot of the dietary guidance

we've all heard for a generation.

But if a cardiologist says my arteries will be fine,

on with the experiment.

My first day on this diet starts with breakfast - bacon and egg fried

in real butter, but no bread.

I thought I'd miss eating toast and eating cereal,

but I don't really.

The South Wales valleys are the epicentre of the Welsh

obesity epidemic.

I'm in Ebbw Vale to meet Wales' foremost obesity expert and adviser

to the Welsh government Professor Nadim Haboubi,

who advocates a low-fat diet, the opposite of what I'm trying.

I'm embarking on an experiment to undertake a low-carbohydrate,

high-fat diet for three weeks.

-Oh, my God. Really?

-Do you approve?

-Of course not.

-Why?

Losing weight is never impossible.

On any diet, you will lose the weight.

Sustainability is the most important,

and weight maintenance, maintain weight loss.

And I am certain,

from experience..

..that you cannot sustain that.

A high-fat diet has a risk factor.

Very low carbohydrate also have its complication and adverse effect.

This is something we discourage, actually, in the centre,

in this clinic.

We think that people should count their calories.

We think people should be on a low-fat diet.

They should be on complex carbohydrates, not very low.

Not high either.

And they should have a liquid protein intake.

It's a simple equation.

There is no magic about, you know, obesity,

it's just simply we are inactive.

It's amazing how much we have changed,

how much the society has changed.

So your advice to me embarking on this experiment is?

Waste of time.

And, honestly, I think you're probably going to cause more

harm to your body than good.

Well, that's not really what I wanted to hear.

I meet with Paul Hinwood, one of his patients.

I was working 70-plus hours a week,

just grabbing food when I could,

drinking too much,

not doing enough exercise cos I was constantly at work.

So, how much weight have you lost?

Well, I've gone from 230kg down to 213,

and that's just from seeing Dr Haboubi and his team

and using some diet pills and just eating healthily.

There's lots of arguments in the diet world, isn't there,

as to what the right diet is

and almost whoever you speak to contradicts the last person.

But when I started seeing the weight management team,

they told me the facts, the way it was and how it should be.

There's so many different diets and everything out there and

so much conflicting advice off people,

you've got to take as much of it on board as you can,

way up your odds and go for what you think is the best.

Well, that is sound advice. Although, I must admit,

I'm starting to find it a little confusing,

though one thing is clear -

the medical establishment is pretty reluctant to buy into this diet.

But some doctors are now recommending it to their patients.

The only one I can find in Wales is GP Dr Angharad Powell.

I think that we got the dietary guidelines wrong.

A report from a few years ago showed that about 58% of adults were

overweight, 22% of adults were obese.

You can imagine that a GP's workload is very much skewed towards

people with obesity and associated chronic diseases.

You know, my view is that much of that work load, much of that

morbidity could be prevented with a change in our approach to diet.

It's difficult when we talk about protein and fats and carbohydrates.

What does that mean in terms of food?

And I agree entirely.

I think, you know, there are a few phrases that people find helpful.

One of them is banish the beige.

I quite like that one because it means cutting out bread,

it's cutting out pasta,

it's cutting out potatoes and processed foods.

I think people imagine with a high-fat diet you're eating

a stick of butter with a couple of nuts on the side.

That isn't what I eat.

High fat is in relation to the proportions

to the other nutrients - the carbohydrates and the protein.

This isn't going to be for everybody and it isn't for all the

patients I see, but certainly,

I think we should be offering it as part of the suite of options

to patients as opposed to a kind of dietary dogma that we all

kind of know as individuals doesn't work, but we just think that

it's us that went wrong.

But I don't think we could have all gone wrong.

So what do Dr Powell's patients make of her unorthodox advice?

Catherine Johnson has been on the low-carb, high-fat diet for

nine months since she found out she had type 2 diabetes.

There are things that are vital for us in order for us to live.

Carbohydrates aren't on that list.

My blood sugar's come down from 19.5, which is dangerously high,

and it's now average.

It's at five, 5.5, which is pre-diabetic,

so I have halted my diabetes.

And your weight has dropped off?

Yeah, and that was the happy side effect,

that I lost three-and-a-half stone.

But physically, it's so much more than just that.

Before, I found that by two in the afternoon I was tired

and I needed to nap.

I'd begun to feel fuzzy, some days as though I was underwater,

as in my head just wouldn't clear and I couldn't think as straight,

whereas now I've got a lot more energy.

My thinking is sharper. I feel... I feel back to the way I was.

I hadn't realised I'd changed

until I came back to how it used to be.

People want a magic bullet, they want a magic tablet because

it's easier. People don't want to have to make the changes.

That's a frightening thing for people to do.

This diet has clearly worked for Catherine,

so it's going to be interesting to see how it works for me.

So far, so good.

I've kept a food diary of the last seven days.

My new life is breakfast of bacon and eggs,

steak and veg for lunch,

chicken breast for tea.

Brunch on Saturday was fish, ham, veg, salad and...

Well, you get the picture. It's a completely new life.

None of my usual potatoes, chips, bread, toast, sandwiches.

No alcohol at all.

The upshot is I started this experiment weighing 14.5st.

I weighed myself this morning, and after seven days, I weigh 14st.

So I've lost half a stone. So this works.

Having said that, Professor Haboubi did say that

if you go on any diet, you will lose weight.

But to keep up with my experiment,

I do have to widen my repertoire in the kitchen.

I'm in Pontypool to meet a cafe owner who says

he reversed his type 2 diabetes diagnosis by ignoring GP advice,

researching online and losing weight on the low-carb, high-fat diet.

Let's see if Mark Gregory has some recipe ideas for me.

I've done this for a week now

and I can see the menu could get slightly predictable,

so I'm in need of inspiration.

Talk me through some breakfast ideas.

Eggs are nature's multivitamin. Lots of eggs!

Omelette for breakfast - why not? Frittata.

Lunch... Actually, I don't bother.

Do you know what? I don't feel hungry.

One thing I've learnt is you can go without.

The idea is you start burning your body fat,

so skip a meal - it doesn't hurt.

-What about dinner?

-Bolognese with meat sauce, if you like,

but chuck in all the vegetables, serve it with rice cauliflower.

So when the punters come in here

and they want something from their favourite cafe,

you sound like the sort of preacher man behind the till.

I won't preach. But I think, you know, if the government

are allowed to push their version of a healthy diet,

then I'm allowed to tell people - if they WANT to know -

what choices they should be making, and it is all about choices.

Think about your diet, making choice.

It's a valid point.

Why is the low-carb, high-fat diet not widely offered

as an option for those trying to lose weight?

Back in May, two non-profit organisations,

the Public Health Collaboration and the National Obesity Forum,

released a report that directly challenged

the UK Government's current dietary advice.

Samuel Feltham is the director of the Public Health Collaboration

and one of the key people behind this controversial report.

-You are going against received medical wisdom, aren't you?

-Yeah.

The problem is that received medical wisdom

doesn't have any strong evidence that it's true.

So there's been several analyses of the scientific evidence,

and each and every time it shows that

a better approach for people to lose weight, become healthier

and even reverse things like type 2 diabetes

is by following a low-carb, high-fat diet.

You are seriously suggesting that the official dietary guidelines

are making us fatter?

-LAUGHING:

-Yeah, absolutely.

Obesity has tripled and diabetes has doubled,

and those dietary guidelines have not changed.

So, arguably, the healthy eating guidelines that have been set

have caused the problem.

These are some pretty strong claims.

I need to get the other side of this increasingly complex story.

The British Dietetic Association represents clinical dieticians

and advises the government on health and diet.

Dr Amanda Squire is their spokesperson in Wales.

The low-carbohydrate, high-fat diet in very short bursts

is not necessarily a problem.

What we are concerned about is

there is a lack of substantial long-term evidence

for its ease of use, its safety of use

and, actually, what the long-term effects are,

regards to your general health

and your risks of coronary heart disease and obesity.

The evidence for the current arrangements

aren't terribly good either, are they?

There is some discrepancies on all evidence.

Research, as you know, is a group of people

that will publish their findings.

Different groups will find different findings.

As dieticians, what we do is interpret

that complex and often confusing information

and put it in terms that the general population can understand

and go on to carry out in their day-to-day lives.

Well, we've had donkey's years of following the current guidelines.

Would you say they're a success?

They are a success because...

We've got an obesity crisis.

Yes, our obesity rates aren't ideal,

but they're certainly not increasing at the rate they were.

We're never going to see dramatic changes,

we're never going to see dramatic improvements,

because it takes a long time for research

to filter through to the public.

So, how are we expected to weigh up all this conflicting advice?

Anyway, my current diet experiment continues.

So, at the end of week two, 14st.

I haven't put any more weight back on or lost any more. I'm stable.

I'm missing things like fish and chips, takeaways,

and I'm missing eating lots of fruit,

which ordinarily I would do.

This regime dictates that you can't eat too much fruit

because of the amount of sugar,

but I'm managing, I'm getting through on this,

it's not too onerous.

Losing weight is an awful lot about what you eat.

Exercise is, of course, important, but you cannot outrun a bad diet,

however many legs you've got.

Here in Pembrokeshire, Jonathan Williams may have hit upon

my perfect low-carb, high-fat takeaway.

-Lobster and some seaweed butter.

-Lovely.

That's our secret ingredient.

This is the cornerstone of everything we cook with,

which is the laverbread mixed with Welsh butter,

and we've been doing this for about, I don't know, four, five years.

So we put the lobster in there.

The lobster's just caught off the beach.

I've always been a massive advocate of eating butter.

I'm not sure about you, but...

We've spent 30 years being told butter's bad for you

-and now it seems it isn't.

-No.

It's quite interesting how it turns around.

And when they've been queuing outside here all day

thinking this is really cool and really trendy, and I'm sure it is,

but you're not doing anything new at all.

I mean, they were doing this 100 years ago.

They called it "real food".

It was free food, they got it off the beach.

Yeah. I mean, yeah, you can't give away my secrets now, Jamie.

I mean, it is. I think people are so used to...

I don't know whether it's media

or what's happened in the last 30, 40 years of people kind of...

You know, all these different diets coming out.

And it's funny how it's almost turned full circle now

and we're kind of almost going back to where we were 100 years ago,

before the big companies came in

telling us what to do and what to eat and how to live your life.

Just basic, good, local food - it's simple.

So, how does it feel to be the next big thing, then?

That you are it, you are the low-carb, high-fat trendy diet?

Yeah, it feels pretty good.

I do like my bread rolls to mop up my butter from time to time.

I think, you know, I think everything in balance,

everything in reason, and I think you should not be afraid of butter,

you should not be afraid of these things. I think, you know...

-I think they're all good.

-A healthy takeaway.

-Well, yeah.

-It's not possible, surely.

-In a way.

I would offer you some, but...

That is so good, isn't it?

So lovely.

You get to eat that every day on your diet, Jamie.

I wish I could. That's... Well, it's so simple, isn't it?

-It's just fish...

-Yeah.

-..butter...cook.

-Yeah.

People always say they're really confused about

the food they should eat.

I guess the simple answer is real food. Real food.

Not from a factory.

Straight from the sea, in this case.

Can the answer really be that simple?

And if it is, then why is it not the basis of government advice?

With so much criticism of the government guidelines,

the question that begs answering is who's behind

the dietary information we're bombarded with?

Professor David Miller from the University of Bath

is an expert in this subject.

So, who actually advises the UK Government?

Scientific committees which are made up of working scientists

from the universities of this country,

and they advise the government

on the best science on nutritional questions

and they advise the government what to do about that.

That's how it's supposed to work.

But, of course, there are informal influences by corporations

paying scientists to do research which can distort the evidence base.

The other way in which the corporations influence is

through the process of directly targeting and trying to influence

civil servants, special advisers, government ministers,

and they do that by meeting them directly, by putting on events,

by funding think tanks to attract the minister to come and speak.

And they do it also directly by funding political parties.

So what would you like to see change?

Well, I think the key thing is

to remove the taint and potential corruption

of corporate money in the whole policy process.

The advice should be coming from scientists who,

to the best of their ability and to the best of our system's ability,

don't have conflicts of interest

which could adversely affect the kind of advice that they give.

When it comes to dietary advice,

do you think we should be listening to the UK Government?

Well, if you want to listen to what the UK Government says,

you need to ask the question, what underlies that?

What science underlies that?

And when you look at that closely, it's not the best science.

One thing I am discovering is that

there's no shortage of disagreement on diet.

Governments of every complexion strongly deny

that they're influenced by the food industry,

or that any advice isn't based on objective scientific research.

But there are still many questions which I wanted to put

to the people in charge in Wales, the Welsh Government.

Well, nobody wants to talk to me.

I had wanted to talk to the Chief Medical Officer for Wales

and the Health Minister.

They both work in this building behind me, but they have both

declined our invitation to take part in this programme.

But they have issued the following statement.

They say, "The Eatwell Guide is the UK's national food guide

"which has been..."

"..and forms the basis of Welsh Government dietary advice.

They say, "It's designed..."

"..including in relation to starchy carbohydrates and fats."

So there.

Even though as a devolved nation

Wales has the power to write our own guidelines for public health,

in this case we are following what Public Health England says.

Well, I've been following my own advice.

My three weeks are up and this is my moment of truth.

Good to see you.

Well, here's the big question - how is my cholesterol?

It was a little on the high side when we started this experiment.

Has it gone up or down after a high-fat diet?

So, when we started this process three weeks ago,

your total cholesterol level was 5.6.

Yesterday, when we did this,

your total cholesterol had gone down to 4.9.

So I know I'm throwing figures at you,

but basically what I'm trying to say is, surprisingly,

even though you have been on a high-fat diet,

it appears as though your cholesterol level has gone down.

'Wow. So how much of my belly have I lost?'

So, the last time we did this...

..it was...104.

We're still around about 104,

we haven't really lost anything around your abdominal circumference.

'That's a downer. But what about my weight?'

Hop on the scales, then, Jamie. Do you feel brave enough?

OK, here we go.

So, you were 94kg when we started.

We are now down to 88kg.

-Well done.

-'That is a result.'

Three weeks on, what do you conclude?

It would be very difficult for me to say

whether it has done you any damage or not internally,

because I have no way of finding out

how your liver, your heart, your kidneys are doing after this diet.

What it's done is made you lose a considerable amount of weight.

So for anyone who is contemplating a regime change like mine,

what would your advice be?

They need to come and see either

one of our doctors or the practice nurses,

take advice, be followed up, be aware of the dangers,

the positives and negatives of any diet, not just this diet,

and take that all on board before they embark on it.

This low-carb, high-fat diet may not be for everyone,

but it seems to have worked for me.

I've lost the best part of a stone,

my cholesterol has dropped

and I feel pretty good.

The one thing I've taken from all of this

is to be more aware of the food I eat.

I spent my whole childhood not eating any greens.

The irony now of having to eat lots and lots of greens.

It's very nice.

But the reality is I still have weight to lose

and so does the majority of the population in Wales.

We eat too much, we eat the wrong things,

but confusing, contradictory dietary advice

is a serious contributory factor in our big, fat problem

and that is serious food for thought.