Scotland the Fat BBC Scotland Investigates


Scotland the Fat

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Transcript


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We're fat. Very fat.

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Would you feel sick after eating all this?

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I never feel full.

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Only America is fatter.

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Go.

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It's deep-fried Mars Bars.

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And it's taking its toll.

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You feel like you're dying a slow death.

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Today's fat teenagers will become tomorrow's diabetic 30-year-olds.

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Tonight, I go on a quest to investigate Scotland The Fat.

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You could say this is Scotland's public enemy number one - fat.

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We're storing more and more of it in our bodies

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and it's weighing us down.

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We, Scotland, are now the second fattest country in the world.

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I want to investigate exactly why we're so fat and getting fatter.

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And find out if it's too late to fix.

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Can I just have a bit of that sausage roll there? Thanks.

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This is Glasgow's East End.

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Now, we're not picking on the East End, it's just statistically,

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it's one of the unhealthiest areas in the country.

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And it's match day. So that's a good opportunity for me

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to speak to those in high spirits about what they eat.

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Can these football fans unlock the secret of our bulging bellies?

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Why do you think people in Scotland are so large?

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It's deep-fried Mars Bars.

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-Do we have a problem with our diet?

-No' really.

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Do you know how many calories are in that?

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-About 3,000.

-Do you care?

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No' really.

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How often would you eat a takeaway a week?

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Nearly every night.

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Maybe once during the week but definitely all weekend.

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The East End is also the birthplace of the deep-fried Mars Bar.

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We probably sell about a box a weekend

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and there's about 48 in a box.

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You will sell about 48 deep-fried Mars Bars in a weekend?

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Two days. Yeah.

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You know, that's not that bad.

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Now, a deep-fried Mars Bar a weekend does not a fat nation make.

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There's got to be more to it than that and I'm going to find out what.

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We wanted a more scientific view of the problem

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so we asked 1,000 Scots what they make of their diet.

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And the results were, well, surprising.

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80% of Scots believe they have a healthy diet.

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So how come we're all so fat, then?

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Looking at the statistics, it seems that the extent of the problem

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varies according to where you live.

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So here's my fat map.

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One of those obesity hot spots is the Highlands,

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where less than a third of people are a healthy weight.

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I've come to the northern town of Thurso to meet a woman who

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may help me in my quest to find out why.

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What would you eat in a day?

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Well, I would have...

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That before a McDonalds. And I'd have that as a snack in the afternoon.

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I could easily eat two bars of chocolate.

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A packet of Maltesers.

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-That's a lot of chocolate.

-It is. It's a massive amount.

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That kind of food led to this...

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39 stone.

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No clothes would fit her 7ft-wide waist.

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She resorted instead to making her own clothes

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out of bed sheets and sofa covers.

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Jennifer became so large, she had to rely on her daughter to help her

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with basic personal care.

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When I was at my biggest, I had to literally squeeze the fat

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each side of me to get through the shower door.

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I got to the stage where I couldn't wipe my own backside.

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That was quite humiliating.

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Morbidly obese, and having had her heart stop twice,

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Jennifer was told - diet or die.

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I thought, you know, they're right. I've got to do something about this.

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I've got to take control, otherwise I'm not going to be here.

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But it's a daily struggle.

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Living on benefits,

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she found it easier to snack on cheap high-calorie food.

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Do you know that you can go into a local supermarket

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and you can buy 24 packets of crisps for 69p?

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But you cannot buy a healthy cereal bar that people promote

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that are healthy for that price. Let alone 24 cereal bars for 69p.

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It's just crazy.

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What's it like being the size that you were and

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living in a small community?

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The diet in this area means that people are amongst the fattest.

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Why do you think that is?

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There's nothing to do here.

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I think, the winters are long and people just get bored.

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'Hold on. We all get bored and we're not all 39 stone.

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'Surely there must be a bit more to it than that?'

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If anyone's going to be able to give me an insight into why

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Scotland is so fat, and getting fatter, it's this man.

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Professor Hanlon has been studying our diet

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since I was knee high to an empire biscuit.

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He believes we could be getting fat because it's in our nature.

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You can imagine the scenario, there's the hunter gatherer,

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they've come back from the hunt, the venison is spitting on the fire,

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there's this lovely fat oozing out of it

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and this guy says, aw, no, thanks, erm, I'll have berries tonight.

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Well, he died in the winter and didn't give rise to any children.

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But the chap who sat on his backside and gathered his strength survived.

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So we are the offspring of people who identify high-calorie food

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with exquisite taste, eat it greedily

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and sit on their backsides when they can.

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Professor Hanlon told me

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obesity only became significant from the 1980s.

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It's now an epidemic, he says, unprecedented in human history.

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It arises because almost all of us are slowly putting on weight.

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You leave an average Scotsman to his own devices for a year

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and he puts on a kilogram, 2.2lb.

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And that's a very small energy imbalance -

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only about 30, or 25 calories a day. Less than a digestive biscuit.

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So the whole population is slightly out of balance

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and is moving towards obesity.

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Hold on, half a biscuit a day has caused this obesity epidemic?

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OK. So Professor Hanlon isn't saying exactly that

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but his message is this -

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we are almost hard-wired to eat fatty food.

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Which basically means it's genetic, therefore, not our fault.

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But surely that's true for everyone?

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It doesn't explain why it's people in Scotland in particular

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who are so fat.

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-# Just eat it

-Eat it

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-# Just eat it

-Eat it

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-# Just eat it

-Eat it... #

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Just flip it over.

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There's no getting away from the fact we are all eating much

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more fatty food and ignoring the healthy food.

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But some of us are turning it into a sport.

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# All you can eat... #

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At this Glasgow bar, they run a regular monster burger challenge.

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That's, on your plate, 3lb of meat

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and 1.5lb of bread, cheese and lettuce.

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It needs more meat. THEY LAUGH

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It's pretty tough. Just looking at it, you're thinking,

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"no way," but I'm going to give it my all.

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For some challengers, it's not just a race against the burger.

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One, two, three, go.

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These hardy food athletes have got two hours to eat the entire

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5lb burger and bun.

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If successful, for their efforts, they will win...a T-shirt.

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It's colossally huge beyond even the realms of sanity.

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I'm happy to say, I'm struggling. I don't feel particularly well.

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I can't go on any further.

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You're not going to win your T-shirt now.

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Yeah, I know. Pretty sad.

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Chris, how are you getting on?

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Yeah, I think I'm ready to throw the towel in as well.

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That's all a bit of fun and we are not suggesting for a second that

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people eat meals like that - 5lb weight of food on their plate -

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every single day.

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But it does make you question whether or not we are starting to

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lose sight of what food is meant to be.

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If Professor Hanlon's right and we've always been pre-destined

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to be fat, then that means our ancestors were.

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It's just, when I think of footage of bygone times,

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I don't recall seeing fat people.

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You know, the days before the housewife got her Hoover

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and the postman got his van.

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The reality is, we looked more like this.

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The late 1940s.

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It's post-Second World War, food was still scarce

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and we valued what little we had.

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Those running the home knew how to shop for cheap cuts of meat

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and fish - essentially whatever they could get their hands on.

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It might have required a strong stomach.

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'Pig haven't a leg to stand on.

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'And black pudding is no mystery if you know what to do with it.'

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OK. Some of it might not seem that appetising today.

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But people were making the most of Scotland's natural larder.

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That larder hasn't changed - the way we use it has.

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Take fish, for example.

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'It's said there are 10,000 lobsters in this part of the coast.'

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Our seas are teeming with them.

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Last year, Scottish skippers netted almost 358,000 tonnes of the stuff -

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worth around £500 million - the highest value in a decade.

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But there's a catch. And it's not a fishy one.

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This is Peterhead Fish Market.

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It's the biggest fish market in the whole of the UK,

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actually, possibly even in Europe.

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Every day they sell 160,000kg of fish.

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INDISTINCT SHOUTS

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'I hooked up with one of the fish market's oldest customers -

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'and I don't mean in age.

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'He's been buying fish here for almost 30 years.'

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Do we hold our hands up or do we hold a card up or anything to bid?

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No, no. You wink your eye.

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What's the wink like? Show me?

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HE CHUCKLES

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Have I just bought some fish?

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Now you may have spotted that Fermin Lasa here isn't local.

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He's from Spain. And that's the catch.

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He, along with most other customers here,

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is taking what he buys overseas.

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Everything we buy here is for Spain, everything.

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-Oh, everything will all leave this country?

-Yeah.

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Traditionally, the French and Spanish are big fish eaters.

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I would love the Scottish people or English people to be

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-big fish eaters as well.

-But why aren't we?

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It's traditional.

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I don't find the demand in our country, in the UK.

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So if you took some of the monkfish or the hake, put it on a plate and

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took it to somewhere, Edinburgh or Glasgow and said, what's this fish?

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I believe most people wouldn't even know what it is

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or even what to do with it.

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The main export markets for our seafood are generally

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France, Spain, and Italy - the three thinnest nations in the world.

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A happy coincidence?

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From what the fish guys are telling me,

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Scotland simply isn't eating its own fish.

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We're stuck on haddock.

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We don't eat the hake, the monkfish, the megrims, it's the French,

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it's the Spanish, it's the Italians that are getting our fish.

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Maybe if we started to follow their diet, would we be healthier?

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Would we be less fat?

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We did used to eat fish.

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Herring, pickled or rolled in healthy oatmeal,

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was part of our staple diet and the picking of it, a massive industry.

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When stocks collapsed in the '70s,

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we turned our attentions to another fish.

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It's just, we like this one battered.

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Last year, we ate 13 million fish suppers in Scotland alone.

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No oatmeal in sight and the only thing pickled now is the onion.

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Is it this shift away from traditional, less healthy ways

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of cooking which is making us the second fattest country in the world?

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Food writer Catherine Brown has spent years studying

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traditional cooking methods used by Scottish housewives.

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They would've had a great big, black iron cauldron

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which would've hung over the peat fire.

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They would've put their haggis and their dumplings and their vegetables

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and big chunks of meat and everything would've gone into it.

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And they hung it over the fire, on a chain,

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which hung over the old peat fire, which is a very slow, gentle heat.

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So everything simmered slowly and developed flavour.

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But many of these traditional Scottish dishes

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aren't making it into our kitchens. Take Scotch broth, for example.

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A thick soup of meat, potatoes, vegetables, barley and lentils.

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Would you say this was a nutritious plate of food?

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I would. I mean, that is an entire meal in one bowl.

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And I don't see, if you ate like this two or three times a week,

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how anybody could have weight issues eating food like that.

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No, because it's very sustaining because it's got everything in it.

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Now, that traditional food,

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which Catherine has very kindly just made for me,

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is very nutritious. But what's interesting is,

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the people who used to eat that kind of diet, they didn't get fat.

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There were very few obese people in those days.

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To find out the true nutritional value of a meal like this,

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I've had it analysed at one of the world's top centres

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for the study of food nutrition.

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Sylvia Stephen has compared our bowl of Scotch broth with

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four of our most popular snacks.

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-The thing in common is they all contain the same calories.

-No?!

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Each plate contains 267 calories.

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-That chocolate is 267 calories?

-Correct. Yes. 267 calories.

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-Is it?

-So how long would it take you to eat that?

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-Seconds.

-Exactly.

-I'm sorry, but seconds.

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And how long would it take you to get through your bowl of soup?

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That would be my meal.

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And I think just the attitude to that is that it is just a snack.

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That's a quarter of a pizza.

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-Most people would probably eat the whole pizza.

-That's right.

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'In fact, that whole pizza is the equivalent of three

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'of our bowls of Scotch broth.'

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Now if I said to you, would you sit down

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-and have three bowls of soup, please, this lunchtime?

-No, no.

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But if I said to you, would you sit down and have this pizza?

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-I could.

-Yeah, and I think most people could as well.

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'I want to know what would happen if you put one modern Scot

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'on a traditionally Scottish diet for one week.

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'Would they lose weight?'

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And behind that door is my guinea pig.

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Someone who's struggled with her weight her entire life.

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She is now prepared to undergo a traditional diet

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to see if it could help shed those pounds.

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How much has weight been a part of your life and who you are?

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I've been overweight my whole life.

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I've been right up at 25 stone. I don't exercise an awful lot.

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I don't eat badly. But I can, I can go all day without eating.

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Then I snack when I come in.

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Then have my dinner and then still don't feel full, so keep going.

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I never feel full.

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Tracey says her size has led to some rather uncomfortable situations,

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like the day her doctor told her she needed a CT scan.

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He said, the first thing we'll have to do is send you for a CT scan.

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And I was like, oh, right. That's fine.

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And he goes, oh, but see your size, you might not fit in it and you

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might have to go to Edinburgh Zoo where they scan the elephants.

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I was mortified. I came out and that's all I thought.

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That's all I could remember from that day. I came out.

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SHE LAUGHS I looked at the nurse...

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I just came out.

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I went home with my dad, just like that, how did you get on?

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I was like, I may need to go to Edinburgh Zoo for a scan.

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I was absolutely petrified to tell anybody on the day that

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I was going for my scan in case I didn't fit in the scan machine.

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But it was fine. I did. I had plenty of room, actually.

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The 41-year-old now wants to get bariatric surgery

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to curb her weight.

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'But could a traditional Scottish diet save her

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'from the surgeon's knife?

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'I'm giving her a traditional diet we've created

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'and I'm asking her to film how she gets on.'

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It's day one of the traditional Scottish diet and I'm just about

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to weigh myself so I can see how much I actually lose this week.

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Wait till we see what happens.

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I weigh exactly 18 stone.

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Breakfast for Tracey is porridge with a choice of milk or cream.

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So here goes. My first time ever eating porridge.

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Lunch would have been the main meal of the day.

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A choice of stovies, herring in oatmeal, or Scotch broth.

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Mmm, tastes lovely.

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The evening meal would traditionally have been a lighter affair,

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such as kippers, pickled herring, or more Scotch broth.

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I'm about to tuck in to my kipper with my oatcakes.

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I have to say though, my whole house stinks of fish.

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Not very pleasant.

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I spent hours this afternoon cooking,

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something that I don't do often.

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It's not long before the high volume of oats

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and lentils starts to take its toll.

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I feel quite bloated and the

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constipation's been really bad this week.

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How did you get on?

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-I struggled towards the end, I have to say.

-Did you?

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Yeah, uh-huh. It took a lot of organising to get the, you know,

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because the meals were switched around.

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So your dinner was at lunchtime

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and what you would maybe have for lunch was at dinner time.

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So that took a lot of organising when I was working.

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And oh, my goodness, I'm so fed up of the same food after a week.

0:19:480:19:51

All I wanted was a slice of toast.

0:19:510:19:53

The million dollar question is,

0:19:530:19:56

the people who ate the traditional diet, they were not fat. OK.

0:19:560:20:00

Did you lose weight?

0:20:000:20:02

No. SHE LAUGHS

0:20:020:20:03

-You didn't?

-No, I didn't.

-Really?

0:20:030:20:05

I didn't lose weight, however, I finished the diet on the Friday

0:20:050:20:09

and between Friday and Monday, I lost 4lb.

0:20:090:20:12

So I'm not going to say I didn't lose any weight

0:20:120:20:14

as a result of the diet, because you don't know.

0:20:140:20:16

Well, it was certainly an interesting experiment.

0:20:160:20:20

And by all accounts, a pretty healthy experiment.

0:20:200:20:22

But for Tracey's busy lifestyle, sadly, it's a no.

0:20:220:20:27

The traditional Scottish diet seems to be a bit of a contradiction -

0:20:270:20:31

lean meat, vegetables, pulses on the one hand,

0:20:310:20:35

and fatty foods like cream, milk and butter on the other.

0:20:350:20:38

Yet, despite eating some stodge, people back then weren't fat.

0:20:380:20:43

So what's the missing link? What's making modern Scots so fat?

0:20:430:20:48

I'm back at the world-renowned Rowett Institute to find out.

0:20:490:20:54

People used to eat an awful lot more than we do now, in terms of calories.

0:20:540:20:58

But the reason why they didn't become obese was

0:20:580:21:01

because they had so much higher levels of exercise.

0:21:010:21:03

You would walk everywhere. Physical labour was much, much more common.

0:21:030:21:08

Is it true that we're actually eating fewer calories today

0:21:080:21:11

than our ancestors were?

0:21:110:21:13

-Yes. Substantial amounts.

-Really?

0:21:130:21:15

I mean, yeah. If you look at some of the diaries that we have

0:21:150:21:18

from the 1940s, 1930s/1940s, we've got the diary - a food diary,

0:21:180:21:22

it's not an accurate one - but a food diary of a medical doctor.

0:21:220:21:25

And he would be eating on average somewhere round about

0:21:250:21:28

-3,000 calories a day.

-OK.

0:21:280:21:30

-Our recommendations now are round about 2,000, 2,500.

-Yeah.

0:21:300:21:33

So he would've been eating substantially more.

0:21:330:21:35

But he wouldn't have been overweight

0:21:350:21:37

because he would've been walking everywhere.

0:21:370:21:39

You know, the general level of exercise was much higher

0:21:390:21:42

than it is today.

0:21:420:21:44

Now, at this point in the film, you're probably expecting me to film

0:22:000:22:04

some healthy people working it off in the gym.

0:22:040:22:07

That's just a bit too obvious.

0:22:070:22:09

I'm going to meet some people who can eat what they want,

0:22:090:22:11

as much as they want, and as often as they want.

0:22:110:22:14

Oh, and they don't get fat.

0:22:140:22:16

They say an army marches on its stomach.

0:22:220:22:25

So what better place to come to understand the importance of food

0:22:260:22:30

than here - the home of the Third Battalion

0:22:300:22:33

of the Royal Regiment of Scotland at Fort George near Inverness.

0:22:330:22:36

They've kindly agreed to let me join in a typical training exercise.

0:22:400:22:46

Which means I need a uniform.

0:22:460:22:49

Come on, get a move on!

0:22:490:22:51

One top. Trousers. Hat. Jacket. Badge. Shirt. And a red hackle.

0:22:510:22:57

Sign here. Come on, hurry up.

0:22:570:22:59

On operation, these guys will carry anything up to 95lb in weight

0:23:070:23:12

on their backs.

0:23:120:23:13

A single foot patrol, like this one, can see them cover more than

0:23:150:23:20

a dozen miles, sometimes carrying casualties - in this case, me.

0:23:200:23:24

Add into the mix the Iraqi desert heat, the close combat fighting

0:23:260:23:29

in Afghanistan and it's easy to see how these guys need to fuel

0:23:290:23:33

their bodies with as much energy as possible to deal with it all.

0:23:330:23:37

This is one day's food?

0:23:430:23:44

-Yeah, this is one day's food.

-How many calories is in this box?

0:23:440:23:47

Well, you'd probably usually find that for instance,

0:23:470:23:50

in the mainland UK, when we're conducting training,

0:23:500:23:52

it'd probably be about 4,000 calories.

0:23:520:23:54

Whereas in Afghanistan, because the guys are burning out

0:23:540:23:57

an awful lot more calories,

0:23:570:23:58

you'd probably find that it's up to about 6,000 calories in a meal.

0:23:580:24:01

-That is huge.

-Operational meal. Yeah, it is.

0:24:010:24:04

If you were eating this kind of food back home, civvy street,

0:24:040:24:08

this amount of food, this amount of calories.

0:24:080:24:10

The normal civilian's no' going to be able to burn that off.

0:24:100:24:12

So if you were going to eat food like this, you would put on weight.

0:24:120:24:15

-A lot of weight?

-Of course you would, aye.

0:24:150:24:17

That's three times the amount a man, a civilian male, should be eating.

0:24:170:24:20

On civvy street, people are eating hundreds or even thousands

0:24:210:24:26

of extra calories a day.

0:24:260:24:28

Without the exercise,

0:24:280:24:31

it means they're simply storing that excess fuel as body fat.

0:24:310:24:35

My friends all have day-time jobs.

0:24:370:24:38

So during the day, they'll probably go to a burger bar

0:24:380:24:41

at lunchtime because it's on the site.

0:24:410:24:42

So they're eating fatty, greasy foods.

0:24:420:24:44

My friends are getting fat. It's simple as.

0:24:440:24:47

I notice it, they notice it.

0:24:470:24:48

So how many calories would you say you're eating in a day?

0:24:480:24:51

About 4,500, 4,000.

0:24:510:24:54

If you were eating those 4,500 calories a day

0:24:540:24:57

back on civvy street, do you think you'd put the weight on?

0:24:570:25:02

Probably be close to death. That would be sheer obesity.

0:25:020:25:05

Somebody my size to eat that many calories.

0:25:050:25:08

OK, then, gents. Power back and then straight up.

0:25:080:25:12

Come on. Flat on the floor.

0:25:120:25:15

If you don't have fuel in the machine, you can't work.

0:25:150:25:17

That doesn't matter if you're sedentary, sat at a terminal,

0:25:170:25:20

or a computer terminal or at a desk or

0:25:200:25:23

if you're running around with 50lb of weight on your back.

0:25:230:25:25

You need to eat. Food is fuel. So it's massively important.

0:25:250:25:28

The relationship between what you eat and the ability for you

0:25:280:25:33

to perform can probably never be more important than to you guys?

0:25:330:25:37

Yeah, absolutely. Using the machine analogy again,

0:25:370:25:40

if you put diesel in a petrol car, it won't go anywhere.

0:25:400:25:43

So if you put the wrong fuel in the human body, it isn't going to

0:25:430:25:46

work to the full capacity it could do if you put the right fuel in it.

0:25:460:25:49

So the right diet is imperative.

0:25:490:25:51

Now these guys are eating anything between 4,000 and 6,000 calories a day,

0:25:510:25:58

but they're burning off between 4,000 and 6,000 calories a day.

0:25:580:26:02

And that's why they're not getting fat.

0:26:020:26:04

It's beginning to sound to me like we might be the second

0:26:040:26:09

fattest nation in the world because we've forgotten the basics.

0:26:090:26:13

Do you think we've lost sight of what food is supposed to be for?

0:26:130:26:17

Food is for many things, and always has been.

0:26:170:26:21

I mean, its basic function is to nourish the body.

0:26:210:26:24

It provides us with solace, it alleviates boredom.

0:26:240:26:27

It performs multiple functions that have nothing to do

0:26:270:26:29

with its nutritional quality.

0:26:290:26:31

But it's a bit like football. It's mostly a spectator sport.

0:26:310:26:35

So, we all have shelves of cookery books, and we may have

0:26:350:26:38

wonderful gadgets in our kitchen that we could make anything with.

0:26:380:26:41

But, you know, how often do we actually drag them out and use them?

0:26:410:26:45

You know, I can recognise that shelf of books.

0:26:450:26:48

I've got one just like it. And it's got me thinking.

0:26:480:26:51

Have we not only lost sight of what food is actually for -

0:26:510:26:54

to sustain us - but have we lost sight of what food is, full stop?

0:26:540:26:58

Have our meals become so processed that we no longer recognise

0:27:010:27:05

simple basic ingredients?

0:27:050:27:07

I want to know exactly how much people know about their fruit and

0:27:070:27:12

vegetables - vegetables like this very traditional Scottish turnip.

0:27:120:27:16

And to do that, I'm going to need a little bit of help.

0:27:160:27:19

'I am back in the East End of Glasgow.

0:27:230:27:26

'How much do these football fans know about their five a day?

0:27:260:27:31

'And I'm not talking about goals.'

0:27:310:27:34

Who wants to do Sam's fruity challenge?

0:27:340:27:37

'Statistics show that people in Scotland eat less fruit

0:27:370:27:41

'and vegetables than anywhere else in the UK.'

0:27:410:27:44

Do you know your pineapples from your melons?

0:27:440:27:48

-Eh...no.

-Would you like to?

0:27:480:27:50

'A quarter of young people eat no fruit or vegetables at all.'

0:27:500:27:54

I've got my banana friend here.

0:27:540:27:57

I want you to tell me if you know what that is.

0:27:570:28:01

-Aubergine.

-You think that's an aubergine?

-Mm-hmm.

0:28:010:28:04

-That's a courgette.

-Courgette, sorry.

0:28:040:28:06

You are telling me you don't know what that is.

0:28:060:28:09

I don't know.

0:28:090:28:10

-What do you think that is?

-Asparagus.

-Asparagus?

0:28:100:28:13

If I said the second word was apple, would that give you a clue?

0:28:130:28:18

-Apple tree?

-It's not an apple tree. No.

0:28:180:28:22

Come on. It begins with B.

0:28:220:28:24

-It begins with a B.

-The next letter is U.

0:28:240:28:28

-Butter...

-Butterscotch?

0:28:280:28:32

Not butterscotch, good try.

0:28:320:28:34

-If I told you first part of the word was pine.

-Apple pine.

0:28:340:28:38

It's not apple pine, no.

0:28:380:28:40

Do you know the fruits and vegetables in that box?

0:28:400:28:44

-Um...

-That one there, look. What's that?

0:28:440:28:48

-Pineapple.

-That's a pineapple.

0:28:480:28:49

Sorry, I don't know.

0:28:490:28:50

-It's a pineapple.

-A pineapple, aye?

-Have you ever had pineapple?

0:28:500:28:53

-Yes, I take a lot of the chunks.

-Yeah, that's a pineapple.

0:28:530:28:56

That's what it looks like before you cut it up. Did you know that?

0:28:560:28:59

-No, I didn't know that.

-Wow.

0:28:590:29:00

-Butternut squash.

-Butternut squash, that's the one.

0:29:000:29:05

I knew it was that. Happy days. HE LAUGHS

0:29:050:29:09

'Now, that was clearly not a very scientific examination

0:29:110:29:15

'of our knowledge of food.'

0:29:150:29:17

For a more accurate picture, let's go back to our MORI poll.

0:29:170:29:20

We may say we have a healthy diet but when it comes to dinner,

0:29:200:29:25

less than a third of working age people

0:29:250:29:28

cook for themselves every night.

0:29:280:29:30

For those Scots living in the most deprived areas,

0:29:300:29:33

17% say they don't cook a single evening meal from scratch.

0:29:330:29:38

And generally more than half of us have three ready meals

0:29:380:29:42

or takeaways in a week. Is this why we're fat?

0:29:420:29:46

That question takes me back on my journey across my fat map.

0:29:470:29:51

I am heading to another of Scotland's heaviest areas.

0:29:510:29:54

This time, North Ayrshire.

0:29:540:29:56

It's home to a rather interesting experiment.

0:29:560:29:59

It's nice to see everybody today.

0:29:590:30:01

Today, we're going to actually make some potato wedges.

0:30:010:30:04

And then we're going to make a pot of chilli.

0:30:040:30:07

This cookery class is being run and funded by the NHS.

0:30:070:30:10

It hopes that if people are taught how to cook,

0:30:100:30:14

it might help lower those obesity figures.

0:30:140:30:16

A lot of the students are single parents

0:30:160:30:19

and each week they're taught a cheap and healthy recipe, which they

0:30:190:30:23

make for themselves and then take home to feed the family.

0:30:230:30:26

Were your cooking skills really quite basic before you

0:30:260:30:28

-started coming here?

-Yeah.

0:30:280:30:30

What kind of things would you have struggled with?

0:30:300:30:32

-Cutting an onion.

-Cutting an onion?

-Yeah.

0:30:320:30:36

-Yeah...

-I mean, that's just common.

0:30:360:30:38

A lot of people have never peeled a carrot.

0:30:380:30:41

That's why we start - we always start with soup and onions.

0:30:410:30:45

People have never actually handled them.

0:30:450:30:47

-So there are people who have never cut a vegetable up?

-Absolutely.

0:30:470:30:50

Do you like garlic?

0:30:500:30:52

Yes. But I've never used it before.

0:30:520:30:54

This is the first time I've stripped a bit and known how to do it.

0:30:540:30:57

Do you do a lot of cooking then at home? Sugar.

0:30:570:31:00

-I was always just basic.

-Really?

-Uh-huh.

0:31:000:31:02

I didn't eat as healthy as I should have until I came here.

0:31:020:31:05

Of the seven meals, potential seven evening meals in a week,

0:31:050:31:09

how many of them would have been ready meals?

0:31:090:31:12

-Five or six, anyway.

-Nearly every night? Yeah.

0:31:120:31:14

Would you eat one every night?

0:31:140:31:15

-Every night.

-Really? Every night ready-made meals.

0:31:150:31:18

Probably Sunday, I would sit down to a cooked meal.

0:31:180:31:20

Will you work with families who have never cooked

0:31:200:31:23

a meal from scratch before?

0:31:230:31:24

Absolutely. We've worked with very vulnerable teenagers who've

0:31:240:31:29

become parents at 16 and they have no skills.

0:31:290:31:33

'And that can be down to more than just ignorance of basic foodstuffs.

0:31:330:31:38

'One in five people in this area live in poverty.'

0:31:380:31:44

Gillian says she sees first-hand the impact that has on what people eat.

0:31:440:31:50

This is quite basic equipment we're using.

0:31:500:31:53

-But, presumably, that's the point?

-Absolutely, because we've found that

0:31:530:31:57

lack of equipment can be a barrier to people cooking.

0:31:570:32:00

Have you got some clients who wouldn't even have

0:32:000:32:02

the basic cooking...I mean, even an oven?

0:32:020:32:04

Absolutely. Even an oven.

0:32:040:32:05

We have some families that all they have is a microwave.

0:32:050:32:08

Which is quite shocking, isn't it?

0:32:080:32:09

Because all they can do is processed meals.

0:32:090:32:12

We've worked with families that work with electricity cards

0:32:120:32:15

and they're metered. It's about cost.

0:32:150:32:18

So when you see recipes that say, switch on an oven

0:32:180:32:21

and cook for an hour-and-a-half, that just wouldn't happen.

0:32:210:32:23

Public health officials here started the cooking classes

0:32:230:32:28

because they made a direct link between poverty and obesity.

0:32:280:32:32

And obesity's a big problem in this particular area?

0:32:320:32:35

It is, it's a huge problem.

0:32:350:32:37

The figures in Ayrshire for overweight and obesity

0:32:370:32:40

in primary one children are about one-in-four.

0:32:400:32:45

So one-in-four of our five-year-olds is not a healthy weight.

0:32:450:32:48

We do find when children come into nursery,

0:32:480:32:50

they've maybe never tried a slice of pineapple.

0:32:500:32:53

They've never had a piece of carrot raw.

0:32:530:32:56

They might never have seen a kiwi fruit.

0:32:560:32:59

And never used cutlery before?

0:32:590:33:01

There's lots of children who don't use cutlery

0:33:010:33:03

because meals often come in a box.

0:33:030:33:05

Being fat used to be a sign of wealth.

0:33:050:33:10

Tribal leaders, statesmen, royalty - the bigger you were,

0:33:100:33:14

the more money you had.

0:33:140:33:16

But could the opposite now be true?

0:33:160:33:18

Does being poor now mean you're more likely to be fat?

0:33:180:33:23

Is this why Scotland has such high levels of obesity,

0:33:230:33:26

because we have such high levels of poverty?

0:33:260:33:30

I met a GP whose patch includes one of the most

0:33:300:33:33

deprived areas of Scotland.

0:33:330:33:35

He's worked here for more than 30 years.

0:33:350:33:38

I think all classes have got heavier, but I think in

0:33:380:33:41

more deprived areas there is probably more obesity.

0:33:410:33:45

Food is cheaper and fat, sweet foods are the cheapest

0:33:450:33:52

that you can get.

0:33:520:33:54

And people just stuff their faces with that sort of stuff.

0:33:540:33:56

How bad is the situation? Do we take it seriously enough?

0:33:560:34:00

I think that food is becoming a bit of a mystery to people.

0:34:000:34:05

When I was being brought up as a child, we got home-produced food

0:34:050:34:12

all the time. And I think that over the years, as we've allowed,

0:34:120:34:17

you know, the multinationals to take control of our diet,

0:34:170:34:21

we've lost control of that.

0:34:210:34:25

Dr Spence has got me thinking.

0:34:250:34:28

What would happen if people did have control?

0:34:280:34:31

What if money wasn't an issue?

0:34:310:34:33

Would they make the healthier choice?

0:34:330:34:35

Time for another unscientific experiment.

0:34:350:34:40

I can see you're eating a fried egg roll.

0:34:400:34:43

Could I tempt you with a piece of fruit?

0:34:430:34:45

I'm back in the East End with a tray full of delicious

0:34:450:34:49

yet incredibly cheap mini pork pies

0:34:490:34:52

as well as some healthy but expensive pre-cut fruit salads.

0:34:520:34:56

Can I tempt you with some free healthy fruit or a pork pie?

0:34:560:35:02

'I'm going to be handing them out for nothing.

0:35:020:35:05

'I wonder which people will choose? Fruit or pie?'

0:35:050:35:11

-You take as many as you like.

-That one's lonely. It's saying to me.

0:35:110:35:14

-I don't like pies.

-You don't like pies?

-No.

0:35:140:35:16

-Do you like fruit?

-I like fruit.

-Would you like some free fruit?

0:35:160:35:19

Yeah, OK.

0:35:190:35:20

'Two pies for every fruit so far.

0:35:200:35:24

'What do these Canadian tourists think of our diet?'

0:35:260:35:28

It's very hard to find anything nutritious to eat.

0:35:280:35:31

It's surprisingly difficult.

0:35:310:35:33

Can I stop you and see if you would like some free fruit or a free pie?

0:35:330:35:38

I'd like some free fruit.

0:35:380:35:40

Would you like a pie? You want the fruit! Good girl.

0:35:400:35:43

You don't want anything? OK. As you were.

0:35:430:35:47

So that's all the fruit gone and the pies are the ones that are left.

0:35:470:35:52

That surprises me.

0:35:520:35:54

The processed pies, at 60 pence for three,

0:35:540:35:57

were certainly cheaper than the healthy option here.

0:35:570:36:00

The fruit came from packs which cost £2 each from the supermarket.

0:36:000:36:04

A price which would be regarded as an unnecessary luxury

0:36:040:36:07

by families on a low income.

0:36:070:36:10

Yet, take money out of the picture, and fruit was what they chose.

0:36:100:36:13

So maybe there is something to this theory

0:36:130:36:16

that poverty leads to obesity.

0:36:160:36:18

'I've come to Edinburgh to the New Town Cookery School

0:36:210:36:24

'where I've decided to set chef Fiona Burrell a challenge.'

0:36:240:36:28

This is a supermarket value meal.

0:36:280:36:32

Spaghetti Bolognese - 60 pence. Which if you're on a fixed income,

0:36:320:36:37

that's a pretty difficult price to try and beat.

0:36:370:36:39

Actually, it doesn't look that unhealthy.

0:36:390:36:41

Would you be able to make this for the same price

0:36:410:36:45

or even beat it, do you think?

0:36:450:36:47

I think...I mean, that is a very cheap price,

0:36:470:36:50

but I think you can beat it.

0:36:500:36:51

But you have to buy more than just enough for one person.

0:36:510:36:55

I noticed on the ingredients of our supermarket value dish

0:36:550:36:58

that they have beef stock, beef gelatine.

0:36:580:37:01

Well, the gelatine I think is in there to make it look...

0:37:010:37:04

It sits on the pasta better.

0:37:040:37:06

So it's just like a packing agent almost, just to fill it up?

0:37:060:37:09

I think it's to fill it up

0:37:090:37:10

and make it feel a little more full in the mouth.

0:37:100:37:13

So it looks like it's very meaty and saucy and all the rest of it.

0:37:130:37:16

But actually, there's not as much meat in there as you might think.

0:37:160:37:20

My meal doesn't take as long as yours to prepare.

0:37:200:37:23

You need a knife. Stab. Put in...

0:37:230:37:28

Is this the right time to tell you I am vegetarian?

0:37:310:37:33

-Ah.

-THEY LAUGH

0:37:330:37:36

Our sound man is tasting it for me.

0:37:360:37:38

Was that the ready meal

0:37:380:37:39

or was that the freshly cooked spaghetti Bolognese?

0:37:390:37:42

Without doubt, I suspect, that was the ready meal.

0:37:420:37:45

Well done. This cost me 60 pence to buy in the supermarket, OK?

0:37:450:37:51

How much did it cost you to make that?

0:37:510:37:54

With the extra meat, which was almost double the meat, not quite

0:37:540:37:57

double but nearly, that one cost, I think it was about 54, 55p.

0:37:570:38:02

-So cheaper? With double the meat?

-Yeah.

-Incredible.

0:38:020:38:05

OK, so it takes twice as long, twice as much effort

0:38:050:38:11

to make a meal from scratch, but you know what,

0:38:110:38:14

it's actually cheaper and healthier.

0:38:140:38:17

So in answer to the question of whether poverty is what's making us

0:38:170:38:20

unhealthy, it's poverty making us fat,

0:38:200:38:23

I think today's proven that it's not actually true.

0:38:230:38:26

It's not just the price at the checkout

0:38:290:38:32

that we need to be looking at.

0:38:320:38:33

The cost to public health of obesity is massive.

0:38:330:38:37

In Scotland, the NHS bill is around £200 million a year.

0:38:370:38:44

And that's a conservative estimate.

0:38:440:38:46

Experts say the number of people in Scotland getting weight-loss surgery

0:38:460:38:51

has increased fourfold over the last ten years.

0:38:510:38:56

This is surgeon Mr Majid Ali. Based in Ayrshire,

0:38:560:39:01

he carries out bariatric surgery like this every week.

0:39:010:39:06

This patient is having the size of his stomach reduced

0:39:070:39:11

with a gastric sleeve.

0:39:110:39:13

What it does is basically restrict the capacity of the stomach to

0:39:130:39:18

accommodate large volumes of food.

0:39:180:39:20

The yellow stuff you can see is fat.

0:39:220:39:26

Mr Ali has to burn through a lot of it just to get to the stomach.

0:39:260:39:29

Today's operation has cost the NHS £7,000.

0:39:310:39:34

Mr Ali says demand for his services is huge.

0:39:410:39:47

When I started in Ayrshire and Arran, I had an influx of patients,

0:39:470:39:51

a huge number of patients, wanting the operation.

0:39:510:39:55

So I had to ration the operation to the people who will benefit the most.

0:39:550:39:59

Some people argue that this operation is seen as a quick fix.

0:39:590:40:02

It is not a quick fix by all means, you know.

0:40:020:40:05

This is a dangerous surgery, very expensive.

0:40:050:40:08

What's the youngest aged patient you've operated on?

0:40:080:40:12

-I think the youngest is about 18.

-18?

-18. Something like a 45 BMI.

0:40:120:40:18

Obesity in itself is associated with increased incidence of cancer,

0:40:180:40:23

heart diseases, metabolic syndrome.

0:40:230:40:26

To be honest, I think that the NHS is struggling.

0:40:260:40:31

If we don't do anything about the morbidly obese patient,

0:40:310:40:35

then we have to pay more than the price of the surgery.

0:40:350:40:39

Have you caught a fish?

0:40:390:40:41

This man is one of Mr Ali's patients.

0:40:410:40:44

Once morbidly obese, David McAtee

0:40:440:40:47

he had a stomach bypass to reduce the amount he is able to eat.

0:40:470:40:51

'His meal sizes are now a fraction of what they were.'

0:40:510:40:56

And that's what I can eat now, the inside of that.

0:40:560:40:59

-You use this as your dinner plate?

-That's my dinner plate.

0:40:590:41:02

That's all you can eat?

0:41:020:41:04

That's all I can eat and I'm full up.

0:41:040:41:06

At his heaviest three years ago, David weighed 28 stone.

0:41:060:41:12

He's lost a lot of his family to obesity.

0:41:120:41:16

My mum died from being obese, my step-sister died from being obese.

0:41:180:41:23

That, that was really hard.

0:41:230:41:26

You saw this happen and yet you just carried on eating, getting bigger.

0:41:260:41:32

-Mm-hmm.

-If you hadn't had the gastric surgery,

0:41:320:41:37

what would have happened?

0:41:370:41:42

I'd have died. I would have died.

0:41:420:41:46

No doubt?

0:41:460:41:47

(TEARFULLY) I'd have been where my mum was.

0:41:470:41:52

-She died through obesity?

-Uh-huh.

0:41:550:41:57

How close do you think you were to that?

0:42:000:42:03

Really, really close.

0:42:030:42:04

Really close.

0:42:070:42:08

'David and his wife take me to their local supermarket

0:42:080:42:12

'to show me what they used to buy.'

0:42:120:42:14

-Would this have been an area you'd have avoided?

-No.

0:42:140:42:17

-You'd have walked right past that?

-Right past that and to here.

0:42:170:42:22

'David told me his choice of what to buy was heavily influenced

0:42:220:42:25

'by what was on special offer. And those offers were

0:42:250:42:29

'nearly always for high-calorie, high-fat processed food.'

0:42:290:42:32

How long would it take you to eat your way through that 22 pack?

0:42:320:42:36

-22 pack, a day and a half.

-Would it?

-Mm-hmm.

0:42:360:42:39

'Research suggests the choices we make in the supermarket

0:42:390:42:43

'are influenced by where a product is placed,

0:42:430:42:46

'how easy it is to reach, even the colours of the packaging.

0:42:460:42:50

'Is this what's helping us get so fat?

0:42:500:42:52

'I've come to the leafy suburbs of Bearsden

0:42:520:42:56

'to meet a woman dubbed the "food psychologist,"

0:42:560:42:59

'who's spent years studying why we buy what we buy and eat what we do.'

0:42:590:43:05

Companies pay a lot of money to get into particular locations

0:43:050:43:08

in the supermarket because they know that those locations are what sells.

0:43:080:43:11

So usually, one of the first instances is when you walk in,

0:43:110:43:13

whatever's right in front of you.

0:43:130:43:15

As you're leaving, you know, to pay, they're prime spots as well

0:43:150:43:19

because people tend to pick things up and grab them at the same time.

0:43:190:43:22

'Dr Ferguson has studied the biological effects of what

0:43:220:43:26

'we eat on our bodies.

0:43:260:43:28

'She says we can become

0:43:280:43:30

'hooked on some of the common ingredients added to processed food.

0:43:300:43:33

'One of them is MSG.'

0:43:330:43:36

MSG switches off that little trigger that tells your body that

0:43:360:43:41

you're full but it makes you want more and more

0:43:410:43:44

because it makes food taste really, really good.

0:43:440:43:46

Dairy, gluten, they contain glutomorphines

0:43:460:43:48

and kesomorphines and they have that sort of opiate... opium effect

0:43:480:43:53

on the brain so they lock into your opiate receptors.

0:43:530:43:56

We become quite hooked on these.

0:43:560:43:57

'And addicted to chocolate? Well, it might not be your fault.'

0:43:570:44:01

Chocolate has got phenylethylamine, which is mood boosting.

0:44:010:44:05

So again, there's a lot of things in food that

0:44:050:44:08

we don't necessarily think about.

0:44:080:44:10

Often, to get the food cheap, we have to add in the fillers,

0:44:100:44:12

the preservatives, the flavourings, the enhancers.

0:44:120:44:15

Our body doesn't recognise this stuff.

0:44:150:44:18

It's not natural for us to be eating these foods

0:44:180:44:21

and it confuses our system.

0:44:210:44:22

I think a lot of times that's why we're piling on the weight.

0:44:220:44:26

So, it seems, listening to Dr Ferguson,

0:44:280:44:31

that it isn't actually our fault we're so fat.

0:44:310:44:34

We're being tricked, she says, into buying what we buy.

0:44:340:44:38

And when we eat it, we're tricked into wanting more.

0:44:380:44:42

The finger of blame, it would appear, is being pointed

0:44:420:44:45

very firmly at the automatic doors of the supermarket.

0:44:450:44:50

'The ready meals market is worth more than £2.5 billion a year.

0:44:500:44:54

'The voice of the major supermarkets,

0:44:540:44:56

'who didn't want to be filmed,

0:44:560:44:58

'is the British Retail Consortium.'

0:44:580:45:01

You just need to walk into a supermarket

0:45:010:45:03

and the very first thing you are confronted with

0:45:030:45:05

at the barriers are the promotional offers. It's not the healthy stuff.

0:45:050:45:09

I would slightly disagree with that.

0:45:090:45:12

About 40% of products in a supermarket are on promotion,

0:45:120:45:15

so you can imagine how many different varieties of fruit

0:45:150:45:17

and vegetables are on promotion.

0:45:170:45:19

Alongside, you know, some of the cakes and biscuits.

0:45:190:45:22

We make no bones about that.

0:45:220:45:24

But what I am saying is, it is absolutely possible to buy

0:45:240:45:29

a very affordable, nutritious diet at any supermarket.

0:45:290:45:33

I can go into a supermarket this afternoon

0:45:330:45:36

and I can buy a 24-packet of crisps multi-pack in for less than £2.

0:45:360:45:42

-You could.

-I can't buy the equivalent in healthy food.

-I just don't...

0:45:420:45:48

-24 blueberries just doesn't cut it.

-I just do not agree with this.

0:45:480:45:52

It's actually cheaper to eat good nutritious food, fresh fruit

0:45:520:45:57

and vegetables, as it is to buy processed food but

0:45:570:46:01

there's nothing wrong with buying some of those products on promotion,

0:46:010:46:05

provided that you eat them as part of a healthy diet.

0:46:050:46:07

The ready meal market is massive and it's growing.

0:46:070:46:11

Bearing this in mind, do you think you are doing enough

0:46:110:46:15

to make them as healthy as they can be?

0:46:150:46:19

They are one of the few products that has absolutely clear

0:46:190:46:22

front-of-pack labelling on them.

0:46:220:46:23

So you can see exactly what's in that product.

0:46:230:46:26

The difference is, if you buy your curry in the supermarket,

0:46:260:46:28

you know exactly what you're getting.

0:46:280:46:30

You buy your curry from the local Indian takeaway,

0:46:300:46:32

do you know what you're getting in that?

0:46:320:46:34

You know, regardless of who we blame for this obesity epidemic,

0:46:340:46:38

one thing is certain -

0:46:380:46:40

the consequences of all of this are not only life-changing

0:46:400:46:44

but life-threatening.

0:46:440:46:46

For many, it really is a case of diet or die.

0:46:460:46:50

They informed us that they gave you the all-clear...six months ago.

0:46:500:46:55

-Uh-huh.

-And yet you...

0:46:550:46:58

Ten years ago, Edinburgh man Ricky Callan

0:46:580:47:01

was a successful character actor.

0:47:010:47:04

We've stopped your money until such times as we recoup the overpayments.

0:47:040:47:07

-What?

-We've stopped your money, Mr Ingram.

0:47:070:47:11

He's always been big.

0:47:130:47:15

He was more than 20 stone at just 16 years of age.

0:47:150:47:21

There was me and a couple of mates, every lunchtime

0:47:210:47:23

in secondary school, we went to the chippy.

0:47:230:47:25

We used to walk, it was about half a mile away from the school,

0:47:250:47:29

to get something from the chippy and then walk back.

0:47:290:47:33

Ricky's obesity led to a diagnosis of type II diabetes.

0:47:330:47:38

Often a weight-related condition, it's where the body doesn't

0:47:380:47:42

produce enough insulin to maintain normal blood sugar levels.

0:47:420:47:46

Left untreated, it can damage blood vessels, nerves and internal organs.

0:47:460:47:52

When a small blister on his foot became infected,

0:47:520:47:55

Ricky's doctor told him they would need to operate.

0:47:550:47:58

He said, we're going to try and do this bit of surgery where we

0:47:580:48:02

take so much away and stuff like that and see how it

0:48:020:48:05

goes from there.

0:48:050:48:06

But we could be looking at a below-knee amputation.

0:48:060:48:10

I thought, is he telling me that I'm going to lose part of my leg?

0:48:100:48:14

The infection was worse than first thought

0:48:140:48:17

and Ricky had to have a below the knee amputation.

0:48:170:48:22

I've lost half a leg. I've got three toes amputated on the other foot.

0:48:220:48:25

I've had both eyes operated on. I've had cataracts done.

0:48:250:48:28

I've recently had kidney failure. There's only bits of me here now.

0:48:280:48:32

Because the thing about diabetes is, it's like...it just eats

0:48:320:48:35

away at you and you feel like you're dying a slow death and that

0:48:350:48:39

you're being pulled apart like, like, you know, like an Action Man.

0:48:390:48:44

They're taking a bit of you at a time until there's nothing left.

0:48:440:48:48

And it's torturous and it's sometimes painful

0:48:480:48:51

and it feels never-ending, you know.

0:48:510:48:57

Sounds like hell.

0:49:000:49:03

(TEARFULLY) Yeah.

0:49:030:49:06

-Sorry.

-No.

0:49:060:49:07

Did you think life would be like this?

0:49:070:49:11

No. And it's my fault, it's my responsibility.

0:49:110:49:15

It's only down to me, you know.

0:49:150:49:18

But like I said, it's because maybe the message isnae serious enough.

0:49:180:49:24

'More than 1,350 people in Scotland

0:49:240:49:30

'have had a foot or leg amputated as a result of diabetes.

0:49:300:49:36

'Most of them were obese.'

0:49:360:49:38

So, if I can give you an idea of the scale of the number of patients

0:49:380:49:42

we see in this clinic.

0:49:420:49:44

'Dr Young is Ricky Callan's consultant at the

0:49:440:49:47

'diabetic clinic at Edinburgh's Royal Infirmary.

0:49:470:49:50

'Not only has he watched the majority of his patients

0:49:500:49:53

'lose their fight against the disease,

0:49:530:49:56

'but he's also seen the recent rise in the number of newly diagnosed.'

0:49:560:50:01

The numbers of people with diabetes in Scotland go up

0:50:010:50:04

by about 10,000 a year and have done now for certainly a decade.

0:50:040:50:08

That increase in type II diabetes is driven in turn

0:50:080:50:11

by the significant increase in the number of obese individuals

0:50:110:50:15

in the Scottish population.

0:50:150:50:16

Dr Young is now seeing patients in their 30s getting amputations

0:50:160:50:22

because of type II diabetes.

0:50:220:50:24

And even after such drastic measures, the prognosis isn't good.

0:50:240:50:29

The chance of surviving more than five years,

0:50:290:50:34

which is considerably less than half,

0:50:340:50:38

and in many cases some studies have said that

0:50:380:50:42

three-quarters or more can die five years after an amputation.

0:50:420:50:46

Sorry, the life span of someone who undergoes

0:50:460:50:50

an amputation like this is around...?

0:50:500:50:53

-Less than five years.

-Less than five years?

0:50:530:50:55

Less than five years.

0:50:550:50:56

Today's fat teenagers will become tomorrow's diabetic 30-year-olds.

0:50:560:51:03

Or even diabetic 20-year-olds, in many cases.

0:51:030:51:07

And so, it will take a generation really of change before we will see

0:51:070:51:13

the numbers going down.

0:51:130:51:16

And that will be certainly and potentially too late for many

0:51:160:51:23

of the people that we see around us on our high streets at the moment.

0:51:230:51:27

'It's a stark warning

0:51:270:51:29

'and yet some doctors I spoke to said it was one which they felt

0:51:290:51:33

'was either not strong enough, or, in some cases,

0:51:330:51:37

'not being voiced at all.

0:51:370:51:38

'Professor Mike Lean is a consultant at Glasgow's Royal Infirmary.

0:51:380:51:43

'He believes part of the problems lies in the mixed messages

0:51:440:51:48

'coming from those whom he says should know better.'

0:51:480:51:52

With all our efforts for health promotion

0:51:520:51:54

and campaigns for healthy eating, if you walk into the main

0:51:540:51:58

outpatient entrance at Glasgow Royal Infirmary you will see a

0:51:580:52:02

wall-sized banner, perhaps 15 metres by 4 metres, advertising Irn Bru.

0:52:020:52:06

It's colossal. It's the first thing people see.

0:52:060:52:09

There's a little tiny healthy eating thing hidden away.

0:52:090:52:13

'Professor Lean is also critical of the vending machines

0:52:130:52:16

'dotting hospital corridors.

0:52:160:52:19

'He says they could sell healthy snacks, but don't.'

0:52:190:52:22

Foods which can be kept in vending machines tend to be high in sugar,

0:52:220:52:26

high in fat and very low in everything else.

0:52:260:52:28

So a good example of exactly what we should not be giving to,

0:52:280:52:32

certainly to patients or to anybody who has health concerns.

0:52:320:52:35

'But most damning for him are the meals sometimes served up

0:52:350:52:38

'to his patients.'

0:52:380:52:40

A patient this morning who came in with angina, chest pains,

0:52:400:52:44

had stents in his arteries.

0:52:440:52:45

What was he given for lunch - macaroni and mashed potato.

0:52:450:52:48

Our health board has got double values.

0:52:480:52:50

'We asked several health boards if we could film in their hospitals.

0:52:500:52:55

'They said no.

0:52:550:52:57

'But I wanted to see for myself what Professor Mike Lean has told me.

0:52:570:53:01

'My first stop is Glasgow's Royal Infirmary.

0:53:010:53:04

'The Irn Bru advert has been taken down, but I want to see how

0:53:040:53:08

'seriously hospitals like this one

0:53:080:53:10

'are taking their healthy living message.'

0:53:100:53:13

Have you got any healthy options? What would be a healthy option?

0:53:130:53:16

-Baked potato with fillings.

-Baked potato with cheese or tuna?

0:53:160:53:20

-Big greasy sausages.

-A what, sorry?

0:53:200:53:22

-Big greasy sausages.

-I know. It's a bit early for a big greasy sausage.

0:53:220:53:28

Chips.

0:53:280:53:29

-Is this the trolley for the ward round?

-Uh-huh.

0:53:290:53:32

Is there any fruit? Do you have any fruit?

0:53:320:53:35

-Eh?

-Fruit. Like an apple or a banana.

0:53:350:53:38

Aye, up the stairs in the other shop. We don't have that at all.

0:53:380:53:41

-It doesn't go on the ward round?

-No.

-What if you wanted a piece of fruit?

0:53:410:53:45

-From the trolley, in the ward?

-We don't have it.

0:53:450:53:47

-You don't have it?

-No.

0:53:470:53:49

'Next stop, Greenock's Inverclyde Hospital.

0:53:490:53:53

'Nice cakes. A sign on the wall says only nine types of cake

0:53:530:53:58

'are allowed on display - to encourage healthy eating.

0:53:580:54:01

'Like all the hospitals I visit,

0:54:010:54:05

'the vending machines are stocked full of high-calorie, high-fat

0:54:050:54:09

'crisps and chocolate, as well as water and fizzy drinks.

0:54:090:54:13

'Finally, the Royal Alexandra Hospital in Paisley.'

0:54:130:54:17

-Have you got any healthy option? Salads?

-No, we don't have salads.

0:54:180:54:24

Have you got any baked potatoes?

0:54:240:54:27

-No, we don't have baked potatoes.

-You do hot pies?

0:54:270:54:29

We've got pies, macaroni pies and scotch pies.

0:54:290:54:32

What's a macaroni pie?

0:54:320:54:34

It's like potato and cheese.

0:54:340:54:35

So it's like a scotch pie with macaroni cheese in?

0:54:350:54:38

You can buy scotch egg bars. It's like a chocolate bar but meat.

0:54:380:54:46

See all the other hospitals we've been to, it's almost as if

0:54:460:54:49

the fruit has been something of an afterthought.

0:54:490:54:52

But actually, this isn't that bad.

0:54:520:54:55

In a statement, Greater Glasgow and Clyde Health Board said

0:54:550:54:59

half of vending machine products were healthy

0:54:590:55:02

and high-sugar drinks replaced with water, fruit juice and diet drinks.

0:55:020:55:06

They say £10 million has been spent on completely

0:55:060:55:09

redesigning their hospital food.

0:55:090:55:11

Following assessment,

0:55:110:55:13

some patients do require high calorie or high-carbohydrate food.

0:55:130:55:17

Hospital trolleys had to be 50% healthy and include fresh fruit.

0:55:170:55:21

The hospital cafes were run by volunteer organisations

0:55:210:55:24

and so the health board has no control over what they sell.

0:55:240:55:27

However, they should comply with the healthy eating policy.

0:55:270:55:31

So, a questionable level of healthy promotions in supermarkets

0:55:310:55:36

and confusing food messages from hospitals.

0:55:360:55:40

'Experts say Scotland is going to keep on getting fatter.

0:55:400:55:45

'Unless we see some radical change.'

0:55:450:55:47

When you walk round the hospitals,

0:55:470:55:49

it's vending machine after vending machine,

0:55:490:55:52

with fizzy drinks, chocolate bars, crisps.

0:55:520:55:55

You go to the canteen and try and get something healthy,

0:55:550:55:58

it's virtually impossible.

0:55:580:56:00

The patient trolleys that we looked at, no fruit.

0:56:000:56:02

It's all chocolate, all crisps, fizzy drinks.

0:56:020:56:05

You can't be happy with that?

0:56:050:56:06

I would be worried if that was happening on a consistent basis.

0:56:060:56:09

That we were finding more on a situation where

0:56:090:56:12

some of our NHS facilities didn't have a healthy eating choice

0:56:120:56:16

for people to choose from.

0:56:160:56:17

And boards have a responsibility to make sure that that is happening.

0:56:170:56:20

If it isn't, then the boards need to take action to make

0:56:200:56:23

sure that it does happen.

0:56:230:56:25

A consultant surgeon told me that one of his heart patients,

0:56:250:56:28

for a meal, was given mashed potato with macaroni cheese.

0:56:280:56:32

Would you say this was double standards by health boards?

0:56:320:56:35

It suggests to me that the boards may have got some of

0:56:350:56:39

their priorities wrong in this area.

0:56:390:56:40

And if there is an issue where some of our boards are giving out

0:56:400:56:44

mixed messages around healthy eating and are not giving

0:56:440:56:47

sufficient prominence to issues around healthy eating,

0:56:470:56:50

then I think they should look at taking action around that.

0:56:500:56:53

'But I've found this problem goes far beyond confusing messages

0:56:530:56:56

'coming from hospitals.

0:56:560:56:58

'The Minister says supermarkets and manufacturers have to do much

0:56:580:57:01

'more to make food, and promotions, healthier.'

0:57:010:57:04

The industry have to recognise that they've got

0:57:040:57:07

a part to play in causing this problem

0:57:070:57:10

but they've also got a part to play in solving this issue as well.

0:57:100:57:13

And if they think they're doing enough at the present moment,

0:57:130:57:16

then the message from government is, I'm sorry, it's not adequate.

0:57:160:57:19

And that's why we're taking forward a range of measures that we

0:57:190:57:22

want to see them taking action on, and if they don't,

0:57:220:57:25

then we're prepared to legislate where necessary.

0:57:250:57:28

'The government says more details of that legislative framework

0:57:280:57:32

'will be revealed in the autumn.

0:57:320:57:34

'There's no doubt Scotland's obesity epidemic is complex.

0:57:340:57:38

'There are no quick fixes.

0:57:380:57:41

'So it looks like we'll be holding on to the dubious honour

0:57:410:57:45

'of being the second fattest country in the world for some time to come.'

0:57:450:57:51

Perhaps there is a glimmer of hope in all this.

0:57:530:57:58

Remember Jennifer Bodek from Thurso?

0:57:580:58:00

At 39 stone, she decided it was time to do something about her weight.

0:58:000:58:06

She went swimming.

0:58:060:58:08

I thought, well, I've got two choices. I just carry on

0:58:080:58:12

and don't do any exercise and I will be dead.

0:58:120:58:15

Or I get in that pool.

0:58:150:58:17

Jennifer now swims two miles every day.

0:58:170:58:21

Her swimsuit decorated with the stark message doctors gave her

0:58:210:58:25

which she says saved her life.

0:58:250:58:27

She's now lost a staggering 17 stone.

0:58:270:58:32

But perhaps the last word should go to my favourite football fan

0:58:320:58:37

back in Glasgow's East End.

0:58:370:58:40

Now this is a staple part of Scotland's diet, OK.

0:58:400:58:47

This is something you will have eaten

0:58:470:58:49

and I will promise you, you will have eaten this.

0:58:490:58:51

Do you know what it is?

0:58:510:58:52

-What? This morning?

-Do you know what this is?

0:58:520:58:55

-A cabbage.

-It's not a cabbage.

-Turnip.

0:58:550:58:58

-It's a turnip! You got one out of three. Well done.

-No problem.

0:58:580:59:02

# I'm huge, I'm fat

0:59:020:59:04

# You know it

0:59:040:59:06

-# You know I'm fat, you know

-Really, really fat

0:59:060:59:10

# You know I'm fat, I'm fat, you know it

0:59:100:59:12

# Really, really fat... #

0:59:120:59:14

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