Lifestyle, not medicine, is key to good health

A new book outlines a 21-day lifestyle plan based on the example of Pioppi, an Italian village known for healthy living

As London prepared for the Olympics back in 2012, politicians and public policy figures expressed hope that the momentum of the Games would help spur interest in sports and health across communities. However, some critics took to media channels to highlight the hypocrisy at the heart of it all: that the Games’ biggest sponsors included McDonalds and Coca-Cola, not exactly the patron saints of healthy food.

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Dr. Aseem Malhotra, an outspoken cardiologist, championed the call for such organisations to be banned from Olympic sponsorship, highlighting major diabetes and heart disease problems that existed in Newham, the East London Borough, where the Games were scheduled.
The model village

Pointing out inconsistencies between health policy and the road map to achieving improved health is a theme that Dr. Malhotra has returned to time and again, most recently in his book, The Pioppi Diet, where he and anti-sugar campaigner and filmmaker, Donal O’Neill, return to Pioppi, the Italian village with strikingly high life expectancy and low rates of cardiovascular disease.

Protected by UNESCO — first made famous by Dr. Ancel Keys in the 1970s — for new takeaways on the secret to living a well and healthy life, the book outlines a 21-day “lifestyle plan”. This includes weeding out processed sugars and refined carbohydrates from diets, and incorporating breathing exercises, fasting and specific “movements”. This, they argue, can help reduce the risk of type-2 diabetes and heart disease.

Intriguingly, the book does not rule out saturated fats (ghee, butter, and cheese are among the ingredients included in ‘recommended’ recipes), arguing that fat in unprocessed food is a “crucial” provider of essential fats, while dietary fat has little impact on raising glucose and insulin. “Saturated fat does not clog the heart arteries,” the book advises. They also argue that cholesterol has been wrongly vilified since Keys correlated heightened total cholesterol concentration with coronary heart disease. “If you haven’t had a heart attack and you don’t suffer from heart disease, taking a cholesterol-lowering statin will not prolong your life by a single day,” Dr. Malhotra emphasises.

While the dangers of overmedication are an issue touched upon in the book, it’s a topic close to Dr. Malhotra’s heart, and one that he’s visited on a number of occasions, including most recently in an article in The Pharmaceutical Journal. Published earlier this year (alongside two other medics), it challenges the medical wisdom of wantonly prescribing statins, arguing that despite the extensive developments of medicines to reduce LDL cholesterol there is “no consistent evidence for clinical benefit with respect to either events or mortality.”

“There are so many things wrong with modern medicine… what we do often has marginal benefits at best,” he said at a meeting in central London, estimating that “at least 50% of our health care problems would be resolved if we changed lifestyle and reduced prescribed drugs.” In fact, he argues, the cost of overmedication and consequent side-effects adds greatly to the pressures on already-stretched health-care systems much more than acknowledged. The medical world’s relationship to statins are a clear example of this, he argues, with the drugs giving patients the “illusion of protection,” often leaving them with the feeling that they can simply continue to eat as they wish rather than adopting a healthier lifestyle.

The same goes for diabetes, he argues. “I’ve seen people come off type-2 diabetes with simple lifestyle changes after being on insulin for over 20 years.”

Teaching lifestyle practices

Key to changing things will be revamped government policies (he points to Britain’s plans for a sugar tax as of 2018 as an important forward development) and a reappraisal of medical education. “The significance of lifestyle simply isn’t taught at medical school,” he says. But that’s probably due to a system of distorted incentives among medical specialists, he averred. “Doctors have a responsibility to protect people from the misuses of medicine… but it’s difficult to get a person to understand something when their salary depends on not understanding it.”