A GP has emailed Lockdown Sceptics with a short piece about obesity, which she calls the elephant in the room. Given its links to susceptibility to COVID-19, we have to start talking about it.
Forgive me if this offends you. For the past 16 months we have an elephant in the (COVID-19) room that we seem to refuse to talk about. As a clinician working in a very large London GP practice, I’ve been wondering if and when patients might spot the elephant and take some action. It hasn’t happened yet.
So what is the elephant you ask? It’s the undeniable fact that a healthy weight and lifestyle which includes regular exercise will (almost definitely) reduce your risk of dying with an infection such as Covid by an enormous amount. To name it and shame it, the elephant’s name is specifically obesity. Yes there are genetics, yes there is age, yes there are the random unlucky ones. But for the vast majority who become seriously ill with COVID-19, obesity is a significant contributory factor. The vast majority of patients who end up in ITU with Covid have a BMI of >25 and it often does’t end well for them.
Now you might think that’s not relevant to you as you have checked out the infection fatality risk in your age group (and hopefully the Covid ship has sailed anyway…) and you know it’s ridiculously low. However, is that really a good excuse? So you might get Covid and not die (I certainly hope you don’t), but what about the increased risks of developing diabetes, cancer, heart disease, strokes, infertility, difficult labours, long Covid (the list goes on and on)?
So, I’ve spent 16 months talking to my patients about this. (Contrary to public perception we have been doing something!) Have they listened? Well, yes, I would say most of them hear me out. However, what has struck me is that a few of them (a generally well educated, affluent bunch) were genuinely surprised by what they heard. They had no idea there was such a strong correlation between obesity and increased risk of dying or being very unwell with Covid. But sadly in the majority of cases I fear I’ve wasted my breath.
So, who’s to blame? SAGE wouldn’t deny it, Boris has mentioned it, the BBC have whispered about it… But the mystery remains as to WHY WE AREN’T SHOUTING ABOUT THIS FROM THE ROOFTOPS?!? Is it because the media and the rest of the band wagon are afraid of fat shaming? Or would a massive increase in health promotion distract from all the fear mongering and vaccine obsession? Boris has the perfect platform to mention this every time he does one of his irritating lectures to the nation.
I’m not writing this piece to rant. I’m writing it because maybe this is the forum to speak out and start to create a change that will not only reduce people’s risk of dying from diseases like Covid, but, more importantly, will reduce the risk of them getting innumerable diseases. Maybe what is needed is to separate statement of fact (obesity carries significant health risk) from subjective judgement (it’s your fault you’re obese). If we remove the subjective element, then perhaps we’d be able to talk about it in a more objective and calm way? It would allow us to state plainly the health risks, and (more importantly) facilitate weight loss for those who want to attempt it. It is very sensitive subject and until we stop worrying about causing offence we won’t be able to have a proper grown up discussion.
Update: Gary Johnson, the Managing Director of Inpharmation, has emailed us to correct the impression, given by the author of this piece, that obesity is a more important risk factor than age when it comes to susceptibility to COVID-19.
I know from reading your site regularly that you will be well aware that the risk of increasing age spans several order of magnitude. Whereas the risks from obesity are a fraction of an order of magnitude.
The best data I know of for the demographics and outcomes for patients on critical care is the INARC report on COVID-19 in critical care.
While it is true that around four fifths of the COVID critical care population have a BMI of over 25, this misleads. Firstly, the cut off for obesity is 30 and not 25. Secondly, as we age, we put on weight and the average age for critical care COVID patients is around 60. So we need to compare the critical care COVID population with the sex and age matched general population. You can see this on page 65 of the INARC report. The COVID critical care population is a just a little more overweight/obese than the general population. In earlier INARC reports, the proportions have actually been quite similar.
And, while it is true that it often does not end well for overweight COVID patients on ITU, it is no more true for them than for other COVID patients who end up on ITU. On page 65 of the report you will see that, surprisingly, a lower percentage of obese patients in critical care die (34.6%) than of non-obese patients. The worst outcome is for those patients with a BMI of <25, with 42.2% of those in critical care dying.
Please don’t get me wrong, I am not advocating obesity – just fact checking.
Keep up the great work.
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What good timing – on 27th May at 9 p.m. on BBC1 there is a programme called ‘What Are We Feeding Our Kids?’ (there was also a related article in The i newspaper – 18th May). It’s presented by Dr Chas van Tulleken. He spent a month eating mass-produced foods and made himself ill. UPFs are the problem – Ultra Processed Foods. He also found that they are addictive. They contain chemicals, sweeteners, emulsifiers and preservatives – the label on your food really shouldn’t list the contents of a chemistry lesson.
It was in the eighties that things went horribly wrong. All fats were deemed bad for us and a lot of manufactured food was pushed as low fat and therefore good for you. However, taking fat out of food alters texture and taste and so to help rectify this, things like sugars were added. Low fat meals are not very satisfying either, leaving you hungry soon after.
The right sort of fats in the correct proportions do not make you fat. In fact they are very good for you and needed by your body – nuts, avocados, salmon are good examples of foods containing healthy fats. Sugar however –… Read more »
Why don’t we try just not telling people what to do? If you’re fat you might die younger. That’s your choice and your business. I don’t believe anyone who is obese is obese “out of ignorance” or all things being equal would not rather not be. So there is no point in harassment campaigns, tax on Mars bars, etc etc, all the usual futile nonsense you know this is going to result in.
Obesity may be a strong co-morbidity, but it nowhere near diabetes. Diabetes on its own can lead to peripheral vascular defects leading to limb amputation, or even worse. The inflammatory nature of the reaction against SARS-CoV-2 will inevitably make things worse.
I genuinely couldn’t care less about how anyone else choses to live their life within the law. If that means they eat or drink more than is healthy which leads to poorer health outcomes that’s entirely their business.
What truly irks me as someone who takes a lot of care to maintain a healthy immune system (even though I still like a few drinks and the odd bit of chocolate) is that I’m now facing the prospect of exclusion from “large events” and travelling because I won’t take a (so called) vaccine.
Apparently it’s not alright to point out that a person’s entirely avoidable health issues greatly increase the load on the NHS (ruthlessly exposed by a mild respiratory virus) but it is alright to shame and coerce healthy people into taking an unnecessary, synthetic, experimental drug largely for the benefit of the avoidably unhealthy.
The problem with obesity is that there are too many businesses making money from it. (I know all about it, my wife had a problem with it for years – we divorced in 2009!).
Car manufacturers market a lifestyle where people don’t walk. (Our government has actually stopped rail companies from advertising during the pandemic – so more people travel by car). Clothes retailers and manufacturers make more sales to the well-built than to skinny types. I’m a skinny type and I have clothes I had for 40 years; I wear them till they wear out. The well built will often fluctuate between sizes (my ex varied between a 16 and 26 in the 18 years I was with her) and, of course, need to buy clothes as their size changes. Tech manufacturers have given us a world where you don’t have to get off your bum to order a pizza, or walk further than your front door to collect it. TV companies strive to get people to sit in front of the screen for as long as possible (if you’re out exercising, you’re not watching TV…) Food companies & supermarkets package food in family-size packs, you can’t (except… Read more »
I’d love to stay and poke a sharp stick into some salad-dodgers, but I need to go and do an hour on the rowing machine.
The problem is that our state-run healthcare system has little incentive to work out the reason why people struggle to stay a healthy and lose weight, ending up on ever more useless drugs (including for depression) and an early death. Most GPs are ignorant about the root causes of many Metabolic Syndrome symptoms, including hypertension, weight gain, type2 diabetes etc. The NHS guidelines on treatment are useless and out of date. A big problem is undiagnosed Insulin Resistance and “secret diabetes”, compounded by gut problems such as IBS. There are initiatives such as the NHS approved “low carb programme” that are starting to tackle the problem but NHS inertia and vested interests prevail. Also, by the time people are diagnosed as Type2 or have had a heart attack it’s much more difficult to restore their health – and YES for many people Type 2 is reversible.
Sadly, most practising medics that are aware of the solution seem unwilling to speak out, or are very muted about it and us patients have become too reliant on the “all-knowing” NHS. The evidence is there, e.g. not all fats are bad for you. Mostly it’s highly-processed foods that do the damage. For many… Read more »
Also the VERY poor testing of the thyroid. The routine testing is just the TSH – or Thyroid Stimulating Hormone – which being a Pituitary hormone tells you little about the thyroid and its production of T4 and T3.
Once diagnosed – often taking years – patients often remain under-treated needing other meds – statins, blood pressure meds, anti-depressants which of course are bigger earners for Big P h a r m a.
Weight gain is very common with low thyroid. http://www.thyroiduk.org
My ex was on antidepressants for 18 years (still is as far as I know) and I’m sure that influenced her attitude to her weight
I’m aware of patients, especially diabetics, being told they must not use low carb diets or they will have their treatment withdrawn. “We can tell if you’re complying because your triglycerides will go up” like that is a good thing.
Worse still a lot of doctors have been instructed not to encourage or even discuss other than low fat diets. I don’t know if this is still happening but it wouldn’t surprise me.
BMI is a very poor indicator of health and far too simplistic.
When I was 50 I went to a Wellman clinic and the nurse took my height and weight and age and consulted a chart which said I was close to being clinically obese! She looked at me (my shirt was off for other tests), looked at my defined chest, shoulders, plus reasonable six-pack and said “well that chart is a load of nonsense! Doesn’t take account of bodybuilder types”
At 64, and a stone or so lighter, I am still supposedly obese at BMI of 26. I am nowhere near obese as anyone who has seen me in the gym would agree on. Muscle is heavier than fat so it makes a nonsense of the indicator. Okay to use it to frighten the genuinely obese perhaps?
BMI has never worked for those with an athletic physique, it never has an was never intended to be used as such; the same with any general height/weight tables. It’s a guide for the masses who aren’t athletes.
Thanks for your comment.
I agree with you that BMI doesn’t work for an athletic physique (when is a physique athletic or non-athletic?) but doctors and nurses should be made aware of that.
I have to admit that I can’t think of any other simple way except, perhaps, using fat calipers or similar.
Obese would be over 30,
At 26, that is slightly overweight. For you, with muscle, that may not be fat at all. If I had a BMI of 26 though, I’d look like a proper lard arse.
I have at least one patient a day come in and laugh about how much weight they have gained over the past year. Usually also jabbed and terrified of Covid…
The trouble is that much of the education around losing weight is wrong. I have struggled with my weight all my life. I’ve yoyo dieted and even developed two eating disorders in my teens following strict diets. I finally discovered ketogenic diets late in life and for the first time the weight dropped off. It was confirmed by a genetic test that my body gains weight quickly and lets go of it reluctantly and that I am profoundly carb sensitive. Therefore the ‘everything in moderation’ or carb heavy diets recommended in government guidelines will never work for me. I suspect that there are more people with metabolisms like me and as long as they are being told lies about the ideal diet for their particular bodies, they will be locked in a never-ending struggle with excess weight.
Everyone is like you, the guidance is completely misguided, everyone will become carb sensitive eventually. Not to mention the accelerated Alzheimer’s, inflammation related illnesses and diabetes we get to endure along the way. 100 years ago dropping carbs to lose weight wasn’t even considered controversial, every housewife knew it.
Great article. Frontline doctors have had the opportunity to tell us what they observed in COVID patients. Hopefully, more will be willing to have this conversation with their patients without feeling squeamish about it. Then, it is the patient’s choice, to take responsibility for their health. A thank you to this doctor for discussing his/her observation.
But this isn’t a ‘frontline’ doctor. It’s a GP, who’s probably spent most of the past 14 months hiding behind his/her receptionists, imagining that the ocasional phone conversation counts as a consultation and is ok for patients.
And anonymous; so not THAT prepared to have the difficult conversations, eh?
The point about why certain health matters haven’t been ‘shouted from the rooftops’ is one of the many dogs that haven’t barked during this long night.
If the government and SAGE (if it is still possible to treat them as separate entities) were really actuated by a concern for public health (and if, therefore, this were a genuine public health emergency), they would have spent the multi-million-pound advertising budget they cooked up with the media bosses on sober and sensible advice and guidance on, inter alia, the importance of fresh air, exercise, vitamins, good food, sunshine, company, intellectual stimulation and productive work.
Spring 2020 was the most beautiful in memory but most people were indoors, with the windows shut.
Confining people to their homes, bombarding them with relentlessly negative and mendacious ‘news’ and prohibitive injunctions, enforcing mask-wearing, destroying local community networks, weakening family connections, increasing dependence on digital devices, rigging the market in favour of retail distribution corporations and fast-food delivery franchises, deliberately fostering a climate of hostility and fear – all of this (and there is much more), was not the handiwork of a government concerned about the well-being of its citizens, and neither was it the… Read more »
Yes, as I just posted in another thread. The real elephants are in the room with the most vulnerable, namely..
Stress
Lack of activity
Lack of sunlight
Poor infection control in healthcare settings
You’ve got to hope the health establishment don’t latch on to obesity with anything like the same zeal as SARS-Cov-2. No doubt they will fix on and mandate the wrong solutions like low fat diets. You can imagine weighing scales on entry to restaurants. Mask wearing to prevent snacking. And expect to be coerced into taking an obesity vaccine https://pubmed.ncbi.nlm.nih.gov/24365968/
Blimey! I thought you were joking, but if that paper is real, obesity vaccines are part of an “exciting research area”.
I agree with the comments that the government response to covid has made most of us much more unhealthy. Apart from the initial restrictions on exercise, there is the quarantine confinement (I emailed Whitty about the detrimental effects on my mental and physical health – no reply), the closure of restaurants where “proper” food is available whilst fast food remained available etc etc. Also, happy people are healthier and healthier people are less likely to be ill or to be less ill if they do catch something. The government had an opportunity to encourage people to take more exercise and change their lifestyle for the better while on furlough. Instead we are banged up and it is hard to know how the policies inflicted on us could have been bettered if they wanted us to suffer detrimental effects. How Whitty, Valance etc haven’t been struck off for gross damage to public health beats me. Does nobody making these policies have any common sense?
The big unanswered question is – why are obese people more at risk? The risk is not in getting infected, but getting very sick if they are infected. For several months, indeed since the excess risk became evident, I have been suggesting that the leptin status should be investigated. Leptin is a hormone produced in fat cells. The bigger the cells the more they will produce. Leptin is what’s known as a pro-inflammatory substance. Covid-19 is a hyperimmune state induced by infection with SARS-CoV-2 infection. It is highly like that leptin may accentuate the development of immune overreactivity. But as far as I am aware no-one has investigated this. It’s time they did.
Ron Rosedale explains this quite well.
https://thefatemperor.com/ep67-ronrosedale-md-crucial-explanation-on-how-to-avoid-serious-viral-impacts/
I doubt very much that the virus is short sighted and can only see very fat people.
There’s an every growing body of evidence showing the causal links between over consumption of highly processed “foods”, gut health and the immune system. I don’t know so much about Leptin specifically but by the time someone has an excess of adipose tissue the damage is already being done to the immune system.
Fat shaming, though horrible in the moment,may well be the trigger people need to do something about it….
After the birth of my son thirty years ago, I could not lose the extra weight I had gained; I remained at between ten and half and eleven stone for many years. I finally came down more to the ten and a half; but I’m a short individual and even I had to admit I didn’t feel comfortable. However….all the diets, low-fat, low carb, don’t eat this that and the other, they all failed. I also had a blood sugar reading that was kind of ok but still a bit high; battled that as well, but again couldn’t break the problem.
Finally….a couple of years ago I read an article about problems people were having with dairy, especially milk. Many seniors (I am one) had given up milk entirely and were using other milk-type products.
I changed to goats’ milk, dropped cows’ milk entirely and within two weeks had cleared a lot of bloat and lost a couple of pounds weight. Months later I was below ten stone; when covid started I eventually couldnt get so much goats’ milk, so went over to one of those fortified types in cartons. A year later I am now nine stone.
COWS’ MILK.… Read more »
Oh yes, good point. Milk from Friesians and the later derivative Holsteins has significantly different protein than old breeds like Jerseys and of course goats. It doesn’t bother me like wheat but many people have problems with modern milk
Maybe we should stop talking about obesity completely. Maybe we should stop talking about weight and dress sizes too for that matter. I spent ALL my 20s and 30s trying to keep a BMI of 26.5. I ate very little and all healthy whole foods. I finally stopped worrying about food as I was becoming very miserable with the struggle to maintain an unsustainable weight for me.
Once I realised that as a 5ft 10in woman who did not have the frame of a bird and could not maintain a healthy so called BMI weight of 11.5 stone I also stopped worrying about dress. I still eat sensibly with just two meals per day. I don’t eat much fruit but do eat loads of vegetables. I also have fat in my diet. Fish, animal and vegetable. I have been a size 16 easily maintained 12.5 stone for 25 years. According to BMI I am overweight. I am comfortable with my body for the first time in my life. It has taken me 50 years to stop listening to the ‘experts’ and make my own choices.
I suspect much overweight is due to a complex number of issues. Much… Read more »
Obesity and type 2 diabetes are the top co-morbidities.
The immune systems of obese people are already under stress even before they are infected with covid. The infection then bombards their immune systems thus triggering a huge, life threatening overreaction.
This is yet another example of lack of plain speaking regarding anything to do with covid.
For decades, people have heard their Doctors say, “You need to lose weight”. Yeah, good advice, but HOW?
For decades we were told that a low-fat diet is optimal. Doctors have been spreading that particular agenda based on what? Evidence? Piss-poor “research” paid for by commercial interests. The notoriously biased work of Ancel Keys.
So, in adopting the USDA Food Pyramid, the medical profession has been a very large part of the problem. You study medicine for years, but gloss over the subject of nutrition and once you are qualified, you are basically drug dealers with a degree in medicine.
The standard treatment for Type-2 diabetes is Metformin followed by insulin when it inevitably fails. The more aggressively that Doctors treat T2D the worse it gets.
Thankfully, there have been some brave individuals like Tim Noakes who took on the Medical Establishment and won. He was ruthlessly persecuted for opposing the “accepted wisdom” about low-fat diets. There are still many Doctors who really believe the dogma and insist that cholesterol causes heart disease so they hand out Statins which reduce the cholesterol numbers but do nothing to reduce the risk of death or morbidity.
So, you’re right about… Read more »
I’ve been struggling with stomach issues for years now, after ruling out a few things my Dr wants to give me antidepressants (but he’s giving me them for ‘anxiety’ not depression after I raised concerns about going back down that road). I mentioned that when I juice fasted for a week the symptoms went away, crickets. “well do you want the prescription or not?”
Try giving up wheat. It may not work but it’s worth trying. I gave up wheat when I discovered how badly it spiked my blood glucose and found the chronic heartburn and farting went away.
I can get away with small quantities of wheat such as the rusk in sausages. More than that and my guts start to grumble. More still and the heartburn and farting comes back.
Wheat has been bred to yield more but seems to have become more toxic for more people.
I don’t think the hesitancy is about fat shaming. I think that people know fully well that their lifestyles and bodies are unhealthy! but that people are prepared to accept this extra risk in exchange for the benefits – ie cake and being lazy etc.
But this is how it should be! If someone’s actions don’t cause others harm then they should be allowed to do whatever they want to themselves.
The reason that this is now an elephant in the room is that the new covid hysteria is completely opposite to that – we are no longer allowed to make individual choices about what is right for own health and crucially what is an acceptable level of risk. Plus our own Gov would have to put their hands up to all the extreme lengths they’ve gone to to make everyone’s health worse!
I’m frankly astonished at the criticism of this article with which I agree 100%. I’m 68 this week, and although an active professional equestrian trainer, since 60 years of age, weight had crept on despite a largely very healthy diet. Last year after lockdown, I saw some photos from a magazine photoshoot I’d been asked to take part in. I was horrified at how fat I looked on a horse. I had been unhappy with my weight and I know had contributed to self loathing whilst going through business worries and a very difficult house sale.
I had been on various diets but nothing seemed to work. I had my thyroid checked as several close family members had thyroid problems. But all ok.
But I resolved to lose weight – 13 st and 5ft 8″, having stayed down to 10st or under, with considerable self restraint – for my whole life until late 50s – and I have done it successfully,
but slowly. I never weighed myself but had a recent doctors appointment and was weighed. Down to just over 11 stone. I still want to lose another 5lbs, but will stay permanently on this diet, just adding enough… Read more »
The vast majority of patients who end up in ITU with Covid have a BMI of >25 and it often does’t end well for them.
Ok, but what’s the proportion of BMI>25 in the population as a whole? How does this compare with the covid figures? Same for BMI>30.
Again and again, we see stuff like this put forward without context. And is it actual BMI that matters? Or is it general metabolic health instead?
It should hardly need stating that BMI is a crude and very often misleading measure. Some of the fittest people I know will have BMIs > 25. But they’re all muscle.
For any BMI ‘overweight’ or ‘obese’ person, is the weight around the waist or in the shoulders?
How does susceptibility to covid, and other respiratory illnesses, vary with weight and metabolic health? There’s a very interesting serious of questions here, which cry out for answers. But scarcely any of the commentary I’ve read so far, both in articles and in BTL comments, scratches the surface.
Perhaps Will J. should get on the case.
Meanwhile, the concept of ‘fat shaming’ is a horrible, horrible thing.
Odd this article came up, after watching Wall-e last night. The human race has become obese, trapped in their constantly connected to the web chairs, where they spend all day consuming goods from the mega corporation.
The issue always circles around diet and body size/shape, but the reality is you can eat mountains of food, as long as you burn off the excess. Lack of activity is the real problem and lockdowns have exacerbated that issue massively.
Precisely. You need around 1 Calorie per minute just to stay alive, for cell respiration, so approx 1400 calories a day. If you stand rather than sit, another Cal per min. If you walk, that takes maybe 2 – 4 Cal per min. So most people, if they only waddle to and from the car park, and walk around the supermarket, need maybe 1700 Cal per day. That is a tiny amount of food on a plate if it mainly consists of carbs.
I reckon humans were designed to consume more like 4000 Cals per day, hunting and grazing for food and raw materials. Farm labourers, coal miners, etc needed wedges of carbs for energy needs. Before the 1990s nurses were generally slim, they spent all day running round servicing the needs
of patients. Now the majority are overweight bloaters sitting in front of computers serving the needs of computer databases and processes “to manage patient care”.
Modern work in front of a computer will kill us, modern food production kills us, and the medical industry also wants to harm us. All due to corporate vested interests. People en masse need to understand basic biology and nutrition.
Good point. The low carb diet has become popular, as lifestyles have become less active.
We evolved as long range hunter/gatherers. I imagine our ancestors were a range of sizes and shapes, but most would have needed to eat a reasonable amount, in order to survive their environment.
School food prior to 1980s consisted of a slice of meat, veg and potatoes. Then proper food was replaced with slurry meat (sausage rolls, burgers) and carbs (pasta). The so called healthy menu at my child’s school consists largely of pasta, never roast meats. Yet they don’t permit salt on the table. They excuse the inexcusable by quoting NHS recommended diets. That genocidal organisation needs disbanding.
But although you can burn off mountains of energy, if a large proportion of the energy is in the form of carbohydrate you can still be insulin/leptin resistant and hypertensive without necessarily being overweight (however that’s defined and it’s pretty arbitrary).
Almost the entire medical and government advice on diet is wrong. Putting carbs as the foundation of the food pyramid and demonising fat is probably the single most destructive public health measure ever. Millions of life years ruined or lost to pad their pockets.
Great post! True!
Yeah, focus on the meat in the burger, rather than all the crap that goes with.
The food pyramid came from the US Department of Agriculture, not any health-related organization.
BMI is pretty much meaningless, it has units of kg m-2 (body weight divided by height squared). For people of Asian ethnicity the “ideal” maximum is 23.9. If the BMI drops towards the minimum then menstruation becomes erratic or stops particularly in teenagers.
True! Most competing sports people’s BMIs are in the grossly obese range because muscle is heavy.
Bio impedance machines (not even that expensive) properly measures fat, water, bone – why is the NHS not using this?
That’s interesting. I didn’t know that. I look mildly chubby if my BMI goes up to 24ish. There must be a better measure.
This was the part when I realised this is just trolling. As if the Pig Dictator hectoring us about our weight as part of his “irritating lectures” (which I haven’t tuned in to watch for over a year) would be effective, after he’s locked up everyone at home periodically, banned people from socialising with friends & family, destroyed jobs and scared the shit of many people. Sitting at home with booze & food is about the only joy left in life for many people.
Unless of course you reject all this and put your energy towards exiting the controlled system. Healthy mind leads to a healthier body.
Strange to give space to an article that goes against the general anti-government-interference that is the raison d’etre of this site. My body, my choice.
Apparently we all consume massive amounts of sugar nowadays compared to a few decades ago. Back in the 1970s and 1980s, the supermarkets used to display the sugar and flour on the shop floor on the pallets they arrived on. So much was sold it simply wasn’t possible to display on the shelves. Housewives (dare one use the term) bought these items weekly. All meals were home cooked from scratch. Pies, dumplings, cakes, puddings cooked from basic ingredients. People were not, generally, overweight, as can be seen in old tv footage, news etc.
Nowadays there is a tiny section of supermarket shelving dedicated to sugar and flour. Hardly any seems sold in its basic form, compared to the pallet loads that used to be put out daily. Yet apparently we are consuming loads more sugar than a few decades ago. It must all be hidden in partially prepared foodstuffs and ready meals, and soft drinks. People are unwittingly consuming vast quantities of sugar, which is down to the food industry. The supermarket shelves are now full of partially prepared meals, not raw ingredients. The meat counters are tiny compared to when I was a kid, but the sections with… Read more »
In all seriousness.. perhaps this GP should focus on something more important i.e. something that isn’t the sniffles aka covid 19. I don’t know.. MS, ME, Lupus, cancer, …