Aseem Malhotra

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Aseem Malhotra
Dr Aseem Malhotra.jpg
Born1977 (age 43–44)
NationalityBritish
OccupationCardiologist, writer
Websitehttps://doctoraseem.com/

Aseem Malhotra is a celebrity doctor based in the United Kingdom, known for his controversial views on diet. He is best known as a promoter of a fad diet called the Pioppi diet[1][2] and as one of the founders of Action on Sugar.[3] Maholtra's views on diet and health have been criticised by the British Heart Foundation as "misleading and wrong", and his public questioning of the need ever to use statins has been condemned as a danger to public health.[4] His diet, the "Pioppi diet" was named by the British Dietetic Association as one of the "top 5 worst celeb diets to avoid in 2018".[1] During the 2020 COVID-19 pandemic Malhotra made claims that following his diet could quickly help people combat the virus; such claims were not backed by good medical evidence.[5]

Biography[edit]

Malhotra is a visiting professor at Bahiana School of Medicine and Public Health, Salvador, Brazil.[6] He is a former Consultant Clinical Associate to the Academy of Medical Royal Colleges[7] and a former Honorary Consultant Cardiologist at Frimley Park Hospital.[7][8] He was a cardiology specialist registrar at Harefield Hospital.[9] He is a trustee of the King's Fund.[6]

Malhotra has been particularly prominent in attacking the standard advice on saturated fat consumption to reduce the risk of cardiovascular disease. He denounces what he calls the government's "obsession" with levels of total cholesterol, which, he says, has led to the overmedication of millions of people with statins, and has diverted attention from the "more egregious" risk factor of atherogenic dyslipidaemia. He directs his attention to the effects of sugar and in particular on its role in diabetes.[10]

He believes that over-diagnosis and over-treatment is “the greatest threat to our healthcare system”.[11] He says that in the UK at least £2bn is wasted each year on unnecessary tests and treatment.[12] He co-ordinated the Too Much Medicine campaign by the BMJ and the Academy of Medical Royal Colleges.[6] His claims are supported by Sir Richard Thompson a past president of the Royal College of Physicians.[13]

Malhotra argues against the Lipid hypothesis. With Robert H. Lustig and Maryanne Demasi, he authored a 2017 article in The Pharmaceutical Journal which disputes the link between blood cholesterol levels and occurrence of heart disease.[14] The article was criticized by the medical community. Cardiologist Tim Chico commented that "high cholesterol has been proven beyond all doubt to contribute to coronary artery disease and heart attack ... to say the cholesterol hypothesis is dead is simply incorrect."[15]

Malhotra was described as a charming and telegenic young cardiologist in private practice but was accused by Rory Collins of endangering lives by scare stories about statins.[16] He claims that he is the victim of a “dirty tricks” campaign by Public Health England's chief executive Duncan Selbie who contacted Andy Burnham and the Tameside and Glossop Integrated Care NHS Foundation Trust to warn them against endorsing or supporting his advice before the publication of his book. He says the agency is acting like a front for the food industry.[17]

Pioppi diet and diet advocacy[edit]

Pioppi was the adopted home of Ancel Keys, the pioneer researcher on the effects of saturated and polyunsaturated fatty acids in the diet on serum cholesterol levels, who spent 28 years in the village.[18]

Malhotra's dietary recommendations include the daily consumption of two to four table spoons of extra-virgin olive oil, a small handful of tree nuts, five to seven portions of fibrous vegetables and low sugar fruits and oily fish at least three times a week. He advises people to avoid all added sugars, fruit juice, honey, and syrups, packaged refined carbohydrates, in particular anything flour based including all bread, pastries, cakes, biscuits, muesli bars, packaged noodles, pasta, couscous and rice and seed oils.[19] He has no objection to 85% dark chocolate, butter, coconut oil, cheese or yoghurt or a maximum weekly limit of 500g of red meat or the moderate consumption of alcohol.[20] It promotes a higher fat intake with fewer carbs than the NHS reference intakes.[21]

According to the British Dietetic Association, Malhotra's recommended diet, the "Pioppi diet" is one of "top 5 worst celeb diets to avoid in 2018": it is a "hijacked" version of the Mediterranean diet that makes ludicrous claims about the Italian diet because of a "low-carb agenda".[1] His diet has been described as a low-carb high-fat diet.[22] Malhotra believes that saturated fat is part of a healthy diet, he is known to put a tablespoon of butter and coconut oil into his coffee.[23] Prof Louis Levy, the head of nutrition science at Public Health England says “There is good evidence that a high intake of saturated fat increases your risk of heart disease".[16]

The British Nutrition Foundation expressed confusion about the Pioppi diet as it purports to promote principles of the Mediterranean diet but this diet is low in saturated fat and contrary to Malhotra's idea that people can eat as much saturated fat as they like.[24] Rosemary Stanton also says that in most traditional Mediterranean diets, bread would be a part of every meal.[25]

In 2017 Malhotra wrote an opinion piece for the British Journal of Sports Medicine which made the claim that saturated fat did "not clog the arteries" and that heart disease can be cured with a daily walk and "eating real food".[4] The British Heart Foundation criticised these "misleading and wrong" claims and several researchers took issue with the methodology of the report on which Malhotra based his claims.[4][26][27]

Malhotra has questioned the worth of statins, saying they may not be of benefit to anybody.[4] Rory Collins, an Oxford medical professor, has sharply criticised such pronouncements, saying they could be as dangerous to public health as Andrew Wakefield's bogus claims about vaccination and autism.[4]

During the 2020 COVID-19 pandemic, Malhotra published a pamphlet claiming that following his dietary advice could grant "metabolic optimization" which would, in 21 days, decrease the risk of viral infection. Such claims are not backed by good evidence. David Gorski has written that Malhotra's claims have an element of victim blaming because they shift responsibility for disease onto individuals, many of whom are unable to follow the kind of diet Malhotra advocates.[5]

Bibliography[edit]

  • The Pioppi Diet: A 21-Day Lifestyle Plan (with Donal O'Neill), Penguin Books, 2017 ISBN 9781405932639
  • The 21-Day Immunity Plan, Yellow Kite, 2020 ISBN 9781529349672

References[edit]

  1. ^ a b c "Top 5 worst celeb diets to avoid in 2018". British Dietetic Association. 7 December 2017. the authors may well be the only people in the history of the planet who have been to Italy and come back with a diet named after an Italian village that excludes pasta, rice and bread
  2. ^ Mellor, Duane. (2017). "Dietitians like me don't take the Pioppi Diet seriously". The Spectator. Retrieved December 2, 2018.
  3. ^ O’Hara, Mary (18 November 2015). "'We need to make people get angry about sugar' says cardiologist campaigner | Mary O'Hara". The Guardian.
  4. ^ a b c d e Boseley S (30 October 2018). "Butter nonsense: the rise of the cholesterol deniers". The Guardian.
  5. ^ a b David Gorski (31 August 2020). "Can 'optimizing your metabolism' through diet prevent or cure COVID-19?". Science-Based Medicine.
  6. ^ a b c "Dr Aseem Malhotra". Kings Fund. 2018. Retrieved 4 December 2018.
  7. ^ a b Malhotra, A; Noakes, T; Phinney, S (August 2015). "It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet". British Journal of Sports Medicine. 49 (15): 967–968. doi:10.1136/bjsports-2015-094911.
  8. ^ Hobbs, FD Richard; Banach, Maciej; Mikhailidis, Dimitri P.; Malhotra, Aseem; Capewell, Simon (14 January 2016). "Is statin-modified reduction in lipids the most important preventive therapy for cardiovascular disease? A pro/con debate". BMC Medicine. 14 (1). doi:10.1186/s12916-016-0550-5.
  9. ^ "Lose weight and live longer: Dr Aseem Malhotra reveals the secrets of the world's healthiest village". Telegraph. 25 June 2017. Retrieved 4 December 2018.
  10. ^ Malhotra, Aseem (22 October 2013). "Saturated fat is not the major issue". British Medical Journal. 347: f6340. doi:10.1136/bmj.f6340. PMID 24149521. Retrieved 13 May 2015.
  11. ^ "'Over-treating' patients is wasteful, unnecessary and can cause them harm, campaign claims". Independent. 13 May 2015. Retrieved 13 May 2015.
  12. ^ "Is the failure of health regulation damaging our well-being?". Guardian. 1 February 2015. Retrieved 13 May 2015.
  13. ^ "Health experts are calling for a 'Chilcot-style inquiry' into excess prescription drug deaths". I news. 11 April 2018. Retrieved 4 December 2018.
  14. ^ Demasi, M; Lustig R. H; Malhotra A. (2017). The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance. The Pharmaceutical Journal doi:10.1211/CP.2017.20203046.
  15. ^ "Expert reaction to new report on statins and the cholesterol hypothesis". Science Media Centre. Retrieved December 2, 2018.
  16. ^ a b "Butter nonsense: the rise of the cholesterol deniers". Guardian. 30 October 2018. Retrieved 31 October 2018.
  17. ^ "Tom Watson's diet doctor hit by government 'dirty tricks'". Times. 23 September 2018. Retrieved 4 December 2018.
  18. ^ "Ancel Keys" (Press release). The American Physiological Society. 2004. Archived from the original on 2007-09-27. Retrieved 2007-11-13.
  19. ^ "What is the Pioppi diet?". BBC. 29 August 2018. Retrieved 4 December 2018.
  20. ^ "I came up with the low carb diet Tom Watson used to lose seven stone. This is how it works". I news. 23 September 2018. Retrieved 4 December 2018.
  21. ^ "Reference intakes explained". NHS UK. Retrieved 4 December 2018.
  22. ^ Snowdon, Christopher. (2017). "The Pioppi Diet is a superficial lifestyle guide based on distorted evidence". The Spectator. Retrieved November 28, 2018.
  23. ^ O'Connor, Anahad. (2016). "An Unconventional Cardiologist Promotes a High-Fat Diet". The New York Times. Retrieved November 28, 2018.
  24. ^ "BNF response to the Pioppi diet". British Nutrition Foundation. Retrieved November 28, 2018.
  25. ^ "Should you try the Pioppi diet?". New Daily. 12 October 2018. Retrieved 4 December 2018.
  26. ^ Scutti, Susan (27 April 2017). "Does saturated fat clog your arteries? Controversial paper says 'no'". CNN. Retrieved 13 May 2020.
  27. ^ Mole, Beth (26 April 2017). "Experts: Headline-grabbing editorial on saturated fats "bizarre," "misleading"". Ars Technica. Archived from the original on 13 May 2020. Retrieved 13 May 2020.

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