©Gulf News
Dr Aseem Malhotra was in the middle of his ward round when lunch was brought out by the health assistants. He had just reached the bedside of a man whose life he had saved the night before. The patient, in his 50s, had been brought in as an emergency, needing an angioplasty. The man was becoming agitated. On seeing his lunch — a burger and chips — he said: “How do you expect me to get well when you are serving me the same kind of c-- that brought me here in the first place?” “He had a good point,” says Dr Malhotra today. “I used to talk to all the patients about lifestyle changes, such as stopping smoking, they could make to prevent them coming back in. But I hadn’t made the connection to nutrition.”
At the time, Dr Malhotra, now 39, was working as a cardiology specialist registrar at the renowned Harefield Hospital, Hillingdon, and had been a qualified doctor for 10 years. “Of course, I had noticed more stress on the system, and that people were coming in with conditions linked to obesity,” he says. But it was this conversation that triggered his interest in how he could make a difference through diet. Seven years later, his curiosity has become something of a calling. Having extensively researched the causes of obesity, Dr Malhotra became a founding member of Action on Sugar, a pressure group run by senior doctors, and is now a leading figure in the public health campaign against sugar, calling for next April’s “sugar tax” on soft drinks to cover all confectionery products. “I read all the research I could, and concluded that simple lifestyle changes, such as consuming less sugar, were more powerful than any medication doctors can prescribe.”
In fact, when Dr Malhotra began his research in 2010, he was fascinated by the way attention had been focused on a fatally flawed message: To reduce fat consumption and cholesterol levels. The more he investigated, the more convinced he became that this fear of fat had increased consumption of sugar and refined carbohydrates, and it was this that was to blame for rates of heart disease and obesity rocketing in tandem. Dr Malhotra has now distilled all his expertise into an easy-to-follow 21-day plan called The Pioppi Diet. Its central message is to stop fearing saturated fat and cholesterol, stop counting calories and start considering sugar as public enemy number one. Professor David Haslam, chair of the National Obesity Forum, has praised the plan as “fearless” for questioning ingrained nutritional guidelines, that have actually “underpinned the obesity epidemic over recent decades”.
Iconic significance
It takes its name from a small Italian village where the locals not only tend to live longer — the average lifespan is 89 compared with 81 in the United Kingdom — but do so without contracting the chronic diseases of ageing, such as type 2 diabetes, that the rest of the world accepts as inevitable. The interest of Dr Malhotra in Pioppi was two-fold. The locals’ way of life was clearly fascinating: Was it just diet that kept the population so well for so long? And could lessons be extrapolated for the wider world? Pioppi has a sort of iconic significance — it was the home for American physiologist Professor Ancel Keys, who first developed the idea of a Mediterranean diet as the ideal eating plan. Pioppi is even protected by Unesco as a result.
Keys was also famous as the man who demonised saturated fat, theorising that it was the cause of blocked arteries and, as a result, heart disease — a position Dr Malhotra no longer agrees with. Visiting the village with filmmaker Donal O’Neill to make the documentary The Big Fat Fix in 2015, he was able to examine the Pioppians more closely. And possibly the most important lesson Dr Malhotra learnt was that the word diet as we understand it is a misinterpretation of the Greek word diatia, which means lifestyle.
Eating olive oil and fresh fish was just part of the Pioppians’ wider picture, which included habitual daily movement, lack of stress, good quality sleep and an inclusive society. “The locals eat pasta — but only in small quantities, and they rarely touch sugar. They only eat dessert on a Sunday, and pizza once or twice a month. They take time over lunch. They don’t have a gym in Pioppi, but they are constantly on the go.” It’s a prescription, he believes, that could be life-changing in the UK if followed.
“When we recommend food and lifestyle changes, reducing intake of sugar and refined carbohydrates, patients achieve a fast result, definitely within 21 days. I’ve seen type 2 diabetes reverse, something we were taught at medical school couldn’t happen.” Dr Malhotra practises what he preaches, having completely overhauled the eating habits he developed growing up in Stalybridge, Cheshire. “I was a proper sugar addict: Coco Pops for breakfast, a KitKat and a packet of crisps at break time. Luckily I was sporty, but I was always hungry so I snacked all the time. That was normal, wasn’t it?”
Although a talented cricketer, he had been drawn to medicine, cardiology in particular, due in part to the death of his older brother at 13 from heart failure caused by a virus. “Amit, who was two years older than me, had Down’s syndrome, and he taught me about compassion. His death was just bad luck, but it had a real impact on me.” Both of their parents were general physicians. And his father later taught Dr Malhotra to cook, meaning he enjoyed a reputation at Edinburgh University, where he began medical studies, as “the guy who cooks the best chicken curry”. He adds: “But I didn’t appreciate how important food was to health. And we didn’t learn anything about it at medical school. I always ate dessert and chocolate.”
Happy ‘side effect’
Within weeks of cutting out the vast quantities of sugar, bread and pasta he had been consuming, however, he shed a stone in weight from his midriff — a happy “side effect” of a healthy lifestyle that “reduces the chance of heart disease, dementia and cancer, too”. “Diet is the number-one issue,” he adds. “More than physical inactivity, smoking and alcohol, it contributes to more disease and deaths. This should be the message from doctors: That food is medicine. And if all Britons took up the challenge, the effect on Britain’s National Health Service budget would be transformatory too.”
Of course, not everyone will find it easy to transform their entire diet and lifestyle. “Healthy food needs to be made affordable, for a start. And we know that certain groups find this harder than others. If you work a night shift — as I know — you are more likely to eat sugary processed food. So we need to get rid of vending machines full of chocolate bars and ban junk food in hospitals.” There are also those who overeat for emotional reasons: “Comfort eating ties into stress, which is itself a massive risk factor for many diseases. So we need to deal with that, whether that’s by offering yoga or Pilates classes, or encouraging more social interaction and friendship offline.” Lastly, he points out: “There is no such thing as a healthy weight, but a healthy person. That is what we should all be aiming for. Living like a Pioppian would mean a reduction in the 20 million deaths worldwide caused by cardiovascular disease. Plus obesity reversed and levels of type 2 diabetes declining. That’s my ultimate dream.”
— The Telegraph Group Limited, London, 2017
Victoria Lambert is an award-winning journalist who has covered stories as diverse as tetanus campaigns in rural Madagascar to ovarian transplants in St Louis, USA, and most recently the dearth of Frozen themed Lego outside Denmark.
