The Immunity Protocols of Pioppi

Thursday, November 12, 2020

I know I’ve said this before, but it feels as if the Angry Chef is fast approaching its inevitable conclusion. I’ve now produced a trilogy of books (number three available for pre-order now) written a newspaper column, been reviewed in Nature, upset a lot of people, and had more impact on the UK food discourse than I ever thought possible.  

Weirdly, it does feel as if some of the battles I have spent the last few years fighting are starting to be won. The Coronavirus pandemic has shown up many of the worst dietary quacks for what they really are; intellect-free contrarians, more concerned about clicks, follows and revenue streams than they are about science and truth. They have always been this way, and whilst it was only about diet, few cared enough to demand change. But monetising an actual pandemic is far less likely to be forgiven. In a world where it was only the affluent and worried well having their fears exploited, dietary nonsense tended to thrive unchecked. With the arrival of a genuine health crisis, this quackery has been exposed for all to see.

I sincerely doubt that many of the quacks mentioned in my recent ‘Carbspiracy’ post will recover their lucrative careers once the effects of this virus have passed. Certainly none deserve to. They have disregarded the safety of others, exploited people’s fears, dismissed or silenced better qualified experts, and disseminated dangerous, even deadly, advice to their followers. If and when the long awaited vaccine starts to be rolled out, I predict that many will disgrace themselves further by claiming there is no need to take it if you’re avoiding carbs. 

Ivor Cummins has encouraged people to cut the filter layer out of disposable masks, presumably so his many You Tube followers are more easily able to infect people with a killer disease unchallenged. Zoe Harcombe claimed early on that Covid-19 was no worse than flu, implied mask wearing was dangerous to health, and campaigned against social distancing measures because there hasn’t been a randomised controlled trial. Tim Noakes memorably decided that Cross-Fit and diet were all the protection he needed from infection, and has been busy sharing increasingly bizarre conspiracy views on lockdowns, masks and vaccines to his many followers. Many of the charlatans and snake oil pedlars that I tried for years to expose on this blog have been shown up in glorious, horrifying detail by the pandemic, and will be condemned to obscurity after it. I bid them farewell and good riddance. Say ‘hi’ to David Icke at the next demo.

But frustratingly, there is one that got away. A dietary zealot equally guilty of exploiting the pandemic for gain, yet somehow slippery enough to be taken seriously. Aseem Malhotra has depressingly managed to stay relevant these past few months, appearing regularly in the media, relentlessly hawking his products and personal brand.

As Captain Science and I often lament, despite numerous blogs and articles, we have never managed to get this awful, arrogant, narcissistic, self-aggrandising fucker to shut the fuck up. He still gets into the media, still gets published in the BMJ, and there is a very real danger of hearing his smarmy, judgemental fucking voice whenever I turn on the radio. Even when #cardiologistseatingdonuts started trending in response to his Twitter posts food-shaming hard working NHS staff, when actual real-life doctors and cardiologists were widely ridiculing his judgemental attitude to food, Malhotra remained in the public eye. The fact that some serious, influential people still take this repellant waste-of-air seriously, is the Angry Chef blog’s greatest failure.

Malhotra has been regularly trotted out since the start of the pandemic, with some media outlets describing him with the laughable monicker of ‘professor of evidence based medicine’, on the back of a weirdly opaque visiting professorship from Brazil’s 33rd best medical school. He found a precious bit of limelight to stand in by fat-shaming the prime minister a few months back, and a few hours in the sun when he started shouting at donuts on social media, before abusing a woman for baking some cakes to thank doctors and nurses at a local hospital. But even then, his star hardly diminished. There is an argument that it has in fact brightened. What exactly do we have to do to make the world understand that this man is just a pointless diet zealot? 

To be honest, I did hope that when he released a new diet book at the end of August entitled ’The 21-Day Immunity Plan’, rushed out to exploit pandemic fear, it might cause right thinking people to stop in their tracks. When that book carried a front cover endorsement from US Uber-Quack Mark Hyman, I guessed that Malhotra’s days were numbered. When Malhotra himself described his diet as ‘the best vaccine against coronavirus’, I really thought that must be it. I expected that the world would wake up to what a shameless, exploitative charlatan Malhotra really is, and finally condemn him to a life of obscurity.

But no. His ‘book’ sold well, reaching the Sunday Times Bestsellers’ list. The media appearances continued, with him being given huge opportunities to spread his views unchallenged. He still wrote extensively for newspapers and magazines. No one cast doubt on his dubious qualifications. The inconsistencies within his claims about clinical experience remain unaddressed. A man with no primary research experience, who has been widely dubbed a danger to public health, whose previous diet book was crowned the worst celebrity diet of 2017 by the British Dietetic Association, who once caused the British Heart Foundation to issue a statement that his claims were ‘misleading and wrong’, and has drawn comparisons to Andrew Wakefield from one of the UK’s top cardiology professors, was being trotted out as an expert on evidence based medicine and public health, despite a complete lack of experience in both fields. 

It felt as if something was needed. Lacking any real power or influence, I decided the best course of action was to write a juvenile blog post with lots of swearing. So, in an act of bravery as great as any seen during the horrifying last few months, I successfully persuaded Captain Science to buy ‘The 21-Day Immunity Plan’ and give it a read. 

The rest of this post is a description of the shocking events that unfolded…..

Yes, fuckers. You owe me. Everyone fucking owes me. Making me read that atrocious shit, like I’ve got nothing better to fucking do. Fuck you all. I actually feel significantly less intelligent now.

Hello Captain. Don’t worry, you’re probably still smarter than most of us. How was the book? Nice bit of lockdown reading?

Fuck off. 

Careful, people don’t like it when you swear. We get more complaints about you swearing than we do about me, which is strange, because I write all your swear words into our conversations to liven them up, largely because I struggle to create rounded female characters.

You don’t write them all in. And you take the worst one out quite a lot, because we can never say c*** on this blog for some fucking reason. And I’m not at all surprised that people complain about me, a woman in science, fucking swearing all the time, but not about you. I suspect we all know what the fucking difference is.

I guess. But it’s an odd world we live in. Tell me about the 21-Day Immunity Plan. You’ve owned it for more than 21 days now, so I am guessing you’re immune.

It’s fucking atrocious. I barely know where to start. He kicks off with an Einstein quote, which is about as narcissistic as it gets. I think he sees himself as a low carb Einstein.

How about we start with him hating fat people?

Yes, he definitely hates fat people. Wants to blame them for everything. Although we knew that anyway. After all, he had previously attacked dietitians, doctors, nurses and even the Prime Minister for being fat.

If nothing else, if that’s all he’s got to say about the current Prime Minister, he’s lacking imagination. Either that or he fancies a political career and doesn’t want to narrow his options. Throughout the book Malhotra blames fat people for getting the disease, blames them for dying from it, says that a vaccine will not work properly if there are too many fat people around, tells us that the virus will be more likely to mutate within fat people’s bodies (for which he provides no reference, but seems to be based on a mouse study that doesn’t really say that), and blames his late mother’s health problems on her having ‘excess body fat’, even though she suffered from Rheumatoid Arthritis. He claims that coronavirus has been so bad in the UK and the US because of the prevalence of obesity, rather than things like ineffective track and trace systems, poorly functioning health care, an inability to protect care homes, a lack of hospital beds and a failure of political leadership. In Malhotra’s world, fat people are killing themselves, but they’re also killing the rest of us. 

We have learnt to expect this sort of vile prejudice from Malhotra, so perhaps worse is witnessing his further descent into dangerous health woo. He seems to blame all problems on a vague, over-generalised view of inflammation, lauds the power of mindfulness…

Ha ha ha ha ha ha ha. Mindfulness. Stupid C***.

…., baselessly claims sugar and ultra processed foods are addictive, advises people who cannot sleep that they should get some more sleep, says that you should deal with stress by doing some special breathing, tells everyone they should fast for 16 hours a day, and suggests taking high dose vitamin C tablets for reasons that are not quite clear. 

Evidence Based Medicine my fucking arse. He’s telling people to take 75 times the RDA, which by the way is 40mg, not 100mg like he claims. And presumably the professor of Evidence Based Fuckery hasn’t seen this study that showed high dose vitamin C infusion had no effect on inflammatory bio markers. Or maybe when he says there is no evidence of harm from a high dose, he somehow missed this, which shows the danger of renal stones. Or this, about the negative gastrointestinal effects. Diarrhoea, nausea, abdominal cramps, rebound scurvy, erosion of dental enamel and lowered B12 status anyone? Fuckety fucking fuckwit.

Worse still, at least from a chef’s point of view, is Malhotra’s also-to-be-expected demonisation of my beloved carbohydrates. ‘Low quality’ carbs to be avoided in the fight against coronavirus are, apparently, pasta, fruit juice, potatoes and ‘all types of bread’. Obviously he can fuck right off with dissing potatoes, but ‘all types of bread’? What? Fucking what? All bread? How does someone who once wrote a diet book supposedly about the health benefits of Italian food, get away with saying people shouldn’t eat bread or pasta. It’s almost as if he does no research and cannot think lucid, joined up thoughts.

Probably carb deprived.  

The potatoes comment is based on the usual garbage association studies that Malhotra would ridicule if they did not confirm his bias, including a study that actually shows an association with French Fry consumption (the shocking finding that unhealthy people sometimes eat a lot of chips), and also showed that Type 2 Diabetes could be reduced by switching fries for whole grains. Given bread and pasta aren’t allowed, and all low carbers hate rice, I’m really not sure where those grains are supposed to come from in any normal person’s diet. Perhaps a nice spoonful of raw millet and a nose bag full of oats. 

Anything else Captain?

Well, there is a point worth making about low carb diets and immunity. It’s probably more relevant to people doing strenuous exercise, but there’s good evidence that very low carb results in the suppression of antibody production, lymphocyte production and natural killer cell cytotoxic activity (ref). So maybe not ideal for an 21 Day Immunity Diet. And some of his other recommendations include butter, steaks and fry ups with bacon and sausages. It really shouldn’t after all this time, but it still pulls my fucking chain that a cardiologist recommends high saturated fat intake when the evidence suggests replacing saturated fat with PUFAs reduces the risk of heart disease (ref).

At one point, he even claims that medical science has had little impact on people’s health, citing a study that lists reasons for improved life expectancy between 1900 and 1999. From this study he manages to cherry pick the reasons that suit his argument such as safer workplaces and recognition of tobacco as a health hazard, but ignores the highly significant ones that don’t, such as vaccination, control of infectious diseases and reductions in deaths from cardiovascular disease. Here, he is not just cherry picking a study that suits his bias, he is actually cherry picking specific evidence from within a single study. And even more bizarrely, in the same section he recognises that fortified foods have contributed to improved health outcomes, but elsewhere forcibly claims that none of us should eat any ultra processed foods, even though all fortified foods fall into the ultra processed category by definition.

There is plenty more. He trots out the insulin hypothesis of obesity, something that has been debunked so many times it now enjoys sleeping on the floor. He cites the usual collection of hapless loons such as Harcombe and Noakes as leading experts, neglecting to mention their latest line in Covid denialism, which you might think is important given his 21 Day Plan is supposedly about fighting Covid.

Malhotra has clearly rushed out this awful book…

Book? It’s less than 100 pages. Including references. It’s barely a fucking pamphlet. And you still haven’t paid me back for it.

…to exploit a wave of public fear, and the result is atrocious, poorly written dross, with the sole purpose of cashing in on the latest health trend. Occasionally this might be excusable, but when that trend is ‘not wanting to die from a horrible infectious disease’ and the evidence presented is so shockingly misleading, publishing such a book is an appalling, unforgivable act. 

Much of it is copied and pasted from his other work, often without the slightest thought. At one point, in a particularly galling passage about fighting stress, he advocates, without qualification, ‘increasing the time spent with friends and family’, seeming oblivious to the highly infectious respiratory disease that his book is supposed to be a response to. In the introduction, he states that his diet plan will ‘optimise your resilience to fighting infection’, suggesting that even his editor couldn’t be bothered to do a read through. I despise Malhotra and everything he stands for, and at every turn this book confirms my worst fears. It is a cheap, shoddily produced work, written by a cheap, shoddy man, created to monetise the world’s fear and suffering. Although it arrived on time and in good condition, so I gave it 2 stars.

By the end, Malhotra allows his delusions of grandeur to fully shine through, creating a vomit inducing 10 point manifesto, mostly involving advertising bans and public information campaigns. He claims, un-ironically, that this will create a world ‘where everyone, regardless of class, colour or creed, has a much better and brighter chance of living a healthy and happy life’

(Do you think this is a bit much Aseem? No? You want your followers to see you as a new prophet? Okay, we’ll leave it as it is). 

Point 10 of his manifesto involves a plan to have medical professionals undergo assessments of their metabolic health to ‘set an example to patients’, which is perhaps his idea of a touching, heartfelt tribute to the hard work of NHS staff during the pandemic. There is no mention of the extraordinary struggle of doctors, nurses and support staff over the past months. There is no acknowledgement that a 100 page diet pamphlet is a pathetic, ineffectual, patronising response to the destructive bulldozer of a disease that has shattered so many lives. 

Malhotra desperately wants us to view him as a brave public health warrior, leading us to the promised land. But what we actually see is a money grabbing diet book author who has rebadged old work so he can sell it to desperate people. A man with the self awareness of a house brick and the humility of a Trump. We can only hope that once the awfulness of this book, in intention and content, is fully realised, it signals the end of his career in the public eye. 

The business model for this sort of exploitative media doctor, peddling a combination of health woo, fat shaming and garbage lifestyle advice, was created in the US by charlatans such as Hyman, Oz, and Mercola. Their rise is surely something that Malhotra has studied and wishes to emulate, especially given the political influence his US equivalents have garnered over the past four years. Such a career can be hugely profitable, and must be tempting for doctors who lack the intellect and ability to succeed in a more conventional medical career. But is incredibly damaging for the rest of us, dangerously undermining the public’s faith in more scrupulous medical professionals. It runs the risk of destroying the reputation of the medical profession at a time when we need to be able to identify reliable sources of advice more than ever. 

Hopefully, the publication of the 21 Day Immunity Plan will mark the point in history where the British public thoroughly reject Aseem Malhotra’s nefarious plans to hoist this American business model into our discourse. Should he fall into the obscurity he so richly deserves, he will not be missed.