Dr Aseem Mal­ho­tra re­veals the se­crets of the world’s health­i­est vil­lage

China Daily (Hong Kong) - - HEALTH - By VIC­TO­RIA LAM­BERT

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 fifties, had been brought in as an emer­gency, need­ing an an­gio­plasty to un­block an artery to his heart.

Far from sim­ply thank­ing Dr Mal­ho­tra, 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 cr** 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, op­er­at­ing on hun­dreds of pa­tients with heart disease. “Of course, I had no­ticed more stress on the sys­tem, and that peo­ple were com­ing in with con­di­tions linked to obe­sity.” 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 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 con­fec­tionary 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 own ex­ten­sive re­search, af­ter his burger-and-chips rev­e­la­tion in 2010, he was fas­ci­nated by the way at­ten­tion had been fo­cused on a fa­tally flawed mes­sage: re­duce fat con­sump­tion and choles­terol lev­els.

The more he in­ves­ti­gated, the more con­vinced he be­came that this fear of fat was to blame for in­creased con­sump­tion of sugar and re­fined car­bo­hy­drates, and it is this which has sent rates of heart disease, as well as obe­sity and type 2 di­a­betes, rock­et­ing in tan­dem.

Dr Mal­ho­tra has now dis­tilled his ex­per­tise into an easy-to-fol­low 21-day plan called The Pioppi Diet, which is pub­lished on Thurs­day, and which we will be show­ing you how to fol­low in to­mor­row’s pa­per. 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, which have ac­tu­ally “un­der­pinned the obe­sity epi­demic over re­cent decades.”

It takes its name from a small Ital- ian vil­lage where the lo­cals not only tend to live longer — the av­er­age man has a life­span of 89; many live to 100 — but do so with­out con­tract­ing the chronic dis­eases of age­ing, such as type-2 di­a­betes and de­men­tia, that the rest of the world ac­cepts as in­evitable.

The doc­tor’s in­ter­est in Pioppi was two-fold. The lo­cals’ way of life was clearly fas­ci­nat­ing: was it just diet which kept the pop­u­la­tion so well for so long, and could lessons be ex­trap­o­lated for the wider world?

But Pioppi also has a sort of iconic sig­nif­i­cance. It was the home from home for Amer­i­can phys­i­ol­o­gist, Pro­fes­sor An­cel Keys, who first de­vel­oped the idea of a Mediter­ranean Diet as be­ing the ideal eat­ing plan, in the Fifties. Pioppi is even pro­tected by UNESCO as a re­sult.

But An­cel 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 agreed with.

Vis­it­ing the vil­lage with film­maker Donal O’Neill to make a doc­u­men­tary called The Big Fat Fix in 2015 he was able to ex­am­ine the Piop­pi­ans more closely.

And pos­si­bly the most im­por­tant les­son Dr Mal­ho­tra learnt as he did, was that the word diet as we un­der- stand 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, he con­cluded, which in­cluded ha­bit­ual daily move­ment, lack of stress, good qual­ity sleep, and a so­cia­ble, in­clu­sive so­ci­ety.

“Yes, the lo­cal eat pasta — but only in small quan­ti­ties, and they rarely touch sugar. They only eat dessert on a Sun­day, 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 back 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 in break time at school. 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 Downs 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 GPs; in fact 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 im­pact­ful and im­por­tant food was to health. And we didn’t learn any­thing about it at med­i­cal school. I al­ways ate dessert and choco­late.”

Within weeks of cut­ting out the vast quan­ti­ties of sugar, bread and pasta he had been con­sum­ing from his diet, he shed a stone in weight from his midriff — a happy “side ef­fect” of a healthy life­style which “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 we all took up the chal­lenge, the ef­fect on the NHS 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.”

He thinks “bold” chief ex­ec­u­tives could even end the cof­fee shop cul­ture in hos­pi­tals, which sees staff and pa­tients alike hooked up to end­less lat­tes and muffins.

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 me­di­a­tion, yoga or Pi­lates classes. Or en­cour­ag­ing more so­cial in­ter­ac­tion and friend­ship off line.”

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.”

Don’t fear fat; sugar and re­fined carbs are the en­emy Keep mov­ing — ex­er­cise for health not weight loss (and walk­ing is best) Ex­tra vir­gin olive oil is medicine, as is a small hand­ful of nuts — eat both, every day Get seven hours of sleep a night Stop count­ing calo­ries — not all are cre­ated equal Eat 10 eggs a week — they’re sa­ti­at­ing and full of pro­tein Have two por­tions of veg in at least two meals a day Fast once a week for 24 hours — have din­ner, then don’t have break­fast or lunch the next day

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