Eat Well or Die Slowly: Your Guide to Metabolic Health


20th Sep 2020 Wellbeing

The rates of metabolic diseases such as dementia, heart disease and diabetes in the UK have risen dramatically since the 1980s. Nutrition expert Dr Estrelita van Rensburg believes that the reason for this is simple: we are eating too many carbohydrates.


That we are consuming more carbs should come as no surprise as it is line with the Government’s official ‘Eatwell’ nutritional guidelines, but as the author of Eat Well or Die Slowly points out, this guidance may well leave an unpleasant taste in the mouth when you discover how it originated…

By Dr Estrelita van Rensburg

In New York in 1917, American author Rebecca Oppenheimer published her book, Diabetic Cookery Recipes and Menus, advising the public to eat butter, cream cheeses, meat, poultry, fish and eggs, and to completely avoid carbohydrate-based foods such as sugar, bread, flour, grains, sweet fruits and dried fruits. This advice provided a lifeline for diabetics in an era before insulin was discovered in the early 1920s.

Ms Oppenheimer’s guidance, however, is still relevant today and, as I shall explain, not only for diabetics.

But first a quick biology lesson. Diabetes is known as a ‘metabolic disorder’. Our metabolism consists of chemical processes that our bodies use to transform food into the fuel that keeps us alive and healthy. As the word ‘disorder’ would suggest, illnesses arise when our metabolism is adversely impacted by medication, infections or an unhealthy diet.


Dr Estrelita van Rensburg warns that our diets contain too many carbohydrates, and that this is leading to a rise in metabolic disease.

In today’s world, the typical response from a GP after diagnosing a metabolic disorder, such as diabetes or hypertension, is to put their patient immediately on prescription medication. This often starts a lifelong journey of not only increasing doses of medication but also the addition of different types of drugs over the remainder of the patient’s life.

The tragedy is that, with regard to lifestyle-related diseases such as diabetes, the diet of the patient is often not discussed. Neither the patient nor the doctor is aware that the basic underlying cause of the condition is that the patient’s carbohydrate intake is too high for the body to cope, and that they suffer from the underlying metabolic condition called ‘insulin resistance’.

What happens when we eat carbohydrates?

Of the three macronutrients in our diet (fat, protein and carbohydrates), only carbohydrates are non-essential for life. When we eat, the enzymes in our digestive system break down all food products into their smallest components. For most carbohydrates this molecule is glucose. In practical terms, all carbohydrates (sugar and starch, including bread, pasta, potatoes, anything made from flour etc.) all ultimately break down to glucose, the molecule from which our cells produce energy.

Although we need glucose to provide fuel for our brain and other organs, the amount needed can easily be produced by the liver from fat and protein, a process called ‘gluconeogenesis’. The hormone insulin is required to help glucose produce energy in our cells. Any glucose overflow is promptly converted first as stored energy in the liver and muscles, and secondly as fat in the liver and abdomen (imagine an expanding waistline over time).  Because of its fat-storage ability, insulin is called the ‘fat-storage hormone’.

Scientists have noticed that high levels of carbohydrate intake over years results in high insulin levels, which often results in the metabolic condition called ‘insulin resistance’. When the disease of insulin resistance manifests in our muscles it is called ‘diabetes’; in our livers it is called ‘fatty liver disease’; in our brains it is called ‘dementia’; and in the ovaries of women, ‘polycystic ovary syndrome’. Interestingly, the alternative name for dementia – ‘type 3 diabetes’, was coined in 2005 by Dr Suzanne de la Monte, a neuropathologist at Brown University, Rhode Island.

If a high carbohydrate intake is harmful, why is it so common?

We are all aware that the UK ‘Eatwell Guide’, advises the public about the quantity and type of food that is best for health. What most people don’t know is that these guidelines were adopted in the UK in 1983, mirroring the advice of the Dietary Guidelines for Americans which was introduced in 1980.

The American guidelines were the work of a hopelessly unqualified Senate Select Committee on Nutrition and Human Needs led by Senator George McGovern. In 1977, they recommended that the American public should reduce their fat intake from 40 to 30 per cent (saturated fat capped at 10 per cent) of calories and increase their carbohydrate intake to 55 to 60 per cent of calories. Since then, this diet has been adopted by most countries globally, including the UK, and, sadly, heralding the dramatic rise in lifestyle diseases, including obesity, diabetes, dementia and cancer, that we see today.


Why was fat, and not carbohydrates, targeted as undesirable food?

The US Committee’s decisions were heavily influenced by the research of Ancel Keys, the late American biochemist, who proposed that cholesterol and fat in the diet were the key drivers of heart disease. In a now famous article, in the January 1961 issue of Time Magazine, he claimed that “…saturated fat, … increases blood cholesterol, damages arteries, and leads to coronary disease.”

To support his theory, he embarked on several studies between the 1950s and 1970s which claimed to prove the association between the amount of fat in the diet and the number of deaths from heart disease, all of which have since been discredited, based on serious design flaws and the omission of relevant data. Re-analyses showed that the food that correlated most closely with deaths from heart disease was not the vilified saturated fat component, but sugar and vegetable oils. Vegetable or seed oils are man-made substances, produced by mechanised processes, high in polyunsaturated pro-inflammatory omega-6 and trans-fats, of which there has been a dramatic rise in consumption over the last 70 years.

Keys had his critics, especially Professor John Yudkin from the Queen Elizabeth College in London, who based his observations from different countries across the globe, and suspected that sugar was actually the prime suspect in the rising epidemics of obesity, diabetes, hypertension and heart disease. Nevertheless, Keys was very influential having allies on the boards of the most powerful bodies in American healthcare, as well as the food and drinks industries, which benefitted greatly by deflecting attention away from their sugar-laden processed food products.

What about Cholesterol?

The pharmaceutical industry took its cue from Keys in the 1950s that cholesterol was an ‘undesirable substance’ and started to investigate molecules that would block the manufacturing of cholesterol in our livers and brains. These ‘cholesterol-lowering drugs’ or statins were first marketed in 1987. Their benefits have been vastly overrated, e.g. for people not suffering from heart disease or without a history of a previous heart attack, research has shown that taking a cholesterol-lowering statin pill will not prolong their life by one single day. Statins are also associated with serious side effects: increasing the risk of developing diabetes, Parkinson’s and Alzheimer’s disease, muscle and joint pains, fatigue, memory problems and heart failure to name but a few.

The curious question is why is cholesterol, which has been vilified for decades now, actually bad for us when it is a vital molecule found in every cell in the body, is essential for normal brain function, and forms part of many hormones, including vitamin D? The pharma industry remains quiet about this, especially since global sales are on track to reach an estimated $1 trillion in 2020. I will leave it to the reader to form their own conclusions.

What to do then?

The prevalence of metabolic diseases continues to rise in the UK and other Western countries. I strongly suspect that it will not decline until the UK’s ‘official’ nutritional guidance is updated to reflect scientific fact.

The sensible thing to do is to cut back on our daily carbohydrate intake and make up the loss with extra good fat (full fat) and protein.

Looks like the advice from Rebecca Oppenheimer is still spot on, more than 100 years later!

Eat Well or Die Slowly: Your Guide to Metabolic Health by Dr Estrelita van Rensburg and Issy Warrack is available now on Amazon, priced £6.99 in paperback and £4.99 as an eBook. For more information, visit www.wellnesseq.net/ 

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