Monday 20 January 2014

Why we will continue to eat full fat dairy (regardless of what Change4Life say!)

Update:  This entry has received a fantastic 193657 hits and I've received huge amounts of mail from people equally unimpressed with the Change4Life initiative.  You can give feedback about the scheme here
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Last week my eldest brought a leaflet home from school produced by "Change 4 Life, this week a similar advert has been shown on TV.

It's a scheme backed by the NHS, and Nestle is one of their partners.  Perhaps it's just me who finds it ever so slightly ironic that the most boycotted company in the UK (and one of the four most boycotted companies on the planet), who are frequently accused of "contributing to the unnecessary death and suffering of infants around the world", gets to partner with our National Health Service.  And yes I know Nestle are often accused of a whole host of other things, but that alone could fill a whole blog.

The Change4Life promotion feels like something generated off the back of a social marketing survey, ie someone decided there was no point trying to convince people to opt for healthy, instead we should aim for healthier.  Or perhaps Nestle didn't want their profits hit by a decline in confectionery sales - regardless "Swap it don't stop it" is the slogan.

Note the first example, swap your sugar laden fizzy drinks for sugar free fizzy drinks.  A healthy dose of aspartame *thumbs up*.

Next on the list is milk, there is a whole separate advert telling us to swap from full fat to semi when a child is two, then semi or skimmed milk at age five - but is this really a good idea?

Evidence would suggest not.

"Our original hypothesis was that children who drank high fat milk, either whole milk or two per cent, would be heavier because they were consuming more saturated fat calories,’ said Dr. Mark Daniel DeBoer, an associate professor of pediatric endocrinology."
‘We were really surprised when we looked at the data and it was very clear that within every ethnicity and every socioeconomic strata, that it was actually the opposite, that children who drank skim milk and one-percent were heavier than those who drank two-percent and whole.’

I dug out the study which consisted of 10,700 children:

"1%/skim milk drinkers had higher BMI z scores than 2%/whole milk drinkers. In multivariable analyses, increasing fat content in the type of milk consumed was inversely associated with BMI" (1)

In response David Ludwig of Boston's Children's Hospital said:

"Somehow this low-fat milk has become so entrenched in the nutritional psyche, it persists despite the absence of evidence.  To the contrary, the evidence that now exists suggests an adverse effect of reduced-fat milk."

Perhaps someone should tell Change 4 life this?

Perhaps given the study was only last year, we should give them the benefit of the doubt that this information hasn't trickled down to working level yet?

Except this isn't the first study to link reduced fat milk with increased weight.

A 2010 smaller study of just over 800 children found:
"Higher intake of whole milk at age 2, but not reduced-fat milk, was associated with a slightly lower BMI z score" (2)
OK still within the last 5 years, let's go again.

A 2005 study of 12,829 children found:
". Quantities of 1% milk (boys) and skim milk (girls) were significantly associated with BMI gain"
and
"Contrary to our hypotheses,dietary calcium and skim and 1% milk were associated with weight gain, but dairy fat was not." (3)
Which was EIGHT years ago!

In fact I couldn't find any studies at all that showed better outcome when children drank reduced fat milk.

For some that's no surprise.

Last year during a discussion on the Facebook page, a pig farmer replied that it was a well known fact skimmed milk fattens pigs.    Turns out they were right and a quick Google shows it's a well recognised tip.

For those who follow my main blog and work with babies - we can also see this effect in breastfed infants. Consider a mum with a huge milk supply, or a baby not transferring milk effectively at the breast.  Both may result in a feed higher in lactose (sugar) and lower in fat, often called lactose overload - yet we can see huge weight gain in these babies.

Fat slows the digestive process and thus the passage of lactose through the body, giving time for the production of lactase (the enzyme required to digest lactose).  Without fat, lactose travels much more quickly; the body converts the sugar to fat, resulting in weight gain - yet burns off quickly leaving baby hungry again quickly.

So reduced fat = higher sugar.  Hang on isn't that what is actually shown to be harmful to health?

Check out whole and skimmed milk at Tesco and you will note that the latter carries 5.0g of sugar per 100ml, whilst full fat has 4.7g.

The other problem is that cutting fat also makes milk less nutritious.  Full-fat dairy is an excellent source of fat-soluble vitamins A, D, E and K - when you absorb the fat, you pull the nutrients through with it.  Remove the fats, bye bye vitamins.

If Change 4 Life actually want to make people healthier, the best "swap" would be from standard supermarket milk, to full fat organic, grass fed.  

But that would be too out there right?

A 2013 study examined 384 samples of organic and conventional whole milk over 18 months taken from around the United States, found that organic milk contained 62 percent more omega-3 fatty acids and 25 percent fewer omega-6s than non-organic milk. (4)

Researchers highlighted that over the last century, intakes of omega-6 fatty acids in western diets have dramatically increased, while omega-3  intakes have fallen. The resulting imbalance has been linked to an increased risk of cardiovascular disease, cancer, excessive inflammation and autoimmune diseases.
You can read the more about the nutritional differences here.

Change 4 Life then go even further in telling us we should be swapping full fat butter for low fat spread.

If you're working from archaic evidence, this might make sense - but oh dear NHS you are distributing this guff to a nation of school children and their families.  It's really inexcusable.

If you would like to learn more about butter v margarine, click here, here, here and if that isn't enough Google "butter healthy" to read pages and pages more.

The trouble is that Change 4 Life are still working from the premise saturated fat is bad, and I guess it's hard for a health care system to hold their hands up and admit that for the last 20 plus years they got it wrong.

Sweden, a country that has consistently better health outcomes than Britain (5), has however done just that.

Following the publication of a two-year study by the independent Swedish Council, during which the committee reviewed 16,000 studies, came a switch in dietary advice; the report advocates a low-carbohydrate, high-fat diet, as the most effective weapon against obesity.

"Butter, olive oil, heavy cream, and bacon are not harmful foods. Quite the opposite. Fat is the best thing for those who want to lose weight.

Committee member Prof. Fredrik Nyström said:

“I’ve been working with this for so long. It feels great to have this scientific report, and that the skepticism towards low-carb diets among my colleagues has disappeared during the course of the work. When all recent scientific studies are lined up the result is indisputable: our deep-seated fear of fat is completely unfounded. You don’t get fat from fatty foods, just as you don’t get atherosclerosis from calcium or turn green from green vegetables.”

Professor Nyström has long advocated a greatly reduced intake of carbohydrate-rich foods high in sugar and starch.  This means doing away with sugar, potatoes, pasta, rice, wheat flour, bread, and embracing olive oil, nuts, butter, full fat cream, oily fish and fattier meat cuts. “If you eat potatoes you might as well eat candy. Potatoes contain glucose units in a chain, which is converted to sugar in the GI tract. Such a diet causes blood sugar, and then the hormone insulin, to skyrocket.”


And that's the problem isn't it?  Many schools are still teaching an out of date food pyramid, often referred to as the Standard American Diet (SAD).  Take a look at what that claims we should eat most - carbs.  Probably wont shock you to hear it was the US Department of Agriculture that developed this beauty ;)

I asked nutritionist Michael Walne BSc PHNutr of Your Nutrition Matters for his thoughts:
"Dietary Fat and Body Fat are synonymous. High fat foods = Obesity, Heart Disease; Stroke; etc … Right?
I have treated clients who have suffered from high blood cholesterol levels for most of their adult life; their condition ‘hereditary’; having followed the standard approach to managing their cholesterol – reducing fat intake, reducing saturated fats with regular often intensive exercise – they watched their cholesterol levels creeping closer to that pivotal figure where the mighty statins step in (global market value c.$20b) and make everything ‘alright’.
What did these people need? Were there any hidden fats in their diet? Was their metabolic rate to blame? Or was it their genes?
Do you know what fixed their blood cholesterol levels? They cut out sugar. They cut out carbohydrates of the refined kind. Not just sweet carbs, but white flour carbs; all of them.
True health cannot be achieved if we limit truly good fats. Fat, not sugar and spice, is what we are made of… If we listen to this standard approach to fat we allow the refined carbs of the West to supply us with an excess. And it is this excess that the body has no choice but to turn into unhealthy body fats."
So please Change4Life, if you can't get it right, leave it alone.

Your claim that "These days, school lunches are almost certainly healthier than most packed lunches - and tastier too!" is frankly insulting.  Perhaps if school lunches were lower in carbs and higher in fats, concentration and behaviour may even improve?

Distributing material via schools and media is powerful, most parents want to do what is right for their children and will follow this guidance. My own daughter was concerned about fat consumption after reading the leaflet, if things don't change the next generation will be lost to the myth fat makes you fat as well.

References
  • 1. Arch Dis Child 2013;98:335-340 doi:10.1136/archdischild-2012-302941
  • 2. J Am Diet Assoc. 2010 Apr;110(4):563-70. doi: 10.1016/j.jada.2009.12.025
  • 3. Arch Pediatr Adolesc Med. 2005 Jun;159(6):543-50
  • 4.Organic Production Enhances Milk Nutritional Quality by Shifting Fatty Acid Composition: A United States–Wide, 18-Month Study Charles M. Benbrook, Gillian Butler, Maged A. Latif, Carlo Leifert,
  • Donald R. Davis, Published: December 09, 2013 DOI: 10.1371/journal.pone.0082429
  • 5.  Civitas, Healthcare Systems: Sweden & localism – an example for the UK? Oct 2013


32 comments:

  1. full fat doesnt make you fat.. i get that, but what about artery damage? is there any research to say that this is safer than the authorities say?

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    1. Au contraire, low-fat is more likely to lead to inflammation that causes artery damage. Cholesterol is not a problem it is a solution, to inflammatory damage of the arteries. One major cause of this is insufficiency of antioxidants - scurvy, in other words. The connective tissue lining the vessels splits and cracks, and Low Density Lipoprotein is MADE by the liver to patch up the cracks. Want healthy arteries? Eat raw veg and naturally produced saturated fat, and avoid stress.

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    2. isn't due to the effect of animal protein found in the china study? http://bit.ly/ChinaStudyWiki

      @ packer99 Low same sized packaging equals higher animal protein content since these are used to supplement most if not all low fat foods. http://bit.ly/ChinaStudyWiki

      by the same process high saturated fats products contain less omega fatty acids. so i find your coments and this article erroneous if not deliberately misleading.

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    3. @Proper Ghandi, saturated animal fats that are low in omega 3 and high in omega 6 comes from cattle in feeding lots that are reared on a diet of gmo corn based feed, they spend their short lives standing in their own excrement and urine where disease and bacteria gets into the fat cells of the animal. The China study conveniently ommits the facts about the omega 3 rich saturated fats that come from organically reared grass fed cattle that don't receive any hormone treatment or gmo corn feed. So no the statements here are not erroneous.

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  2. http://www.express.co.uk/news/health/438600/Eating-fat-is-good-for-you-Doctors-change-their-minds-after-40-years

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  3. Actually the USDA has not used the food pyramid since 2005. They now use a plate as a visual aid, teaching people "how to build a healthy meal". A paper I found interesting was http://www.choosemyplate.gov/food-groups/downloads/MyPlate/ExecutiveSummaryOfFormativeResearch.pdf

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  4. Wow, I didn't know they recommended low-fat milk and 'low-fat spread' over butter...being low-carb/high-fat that's blasphemy to me! Although I do recognise that not everyone is low-carb/high-fat and so I'd not expect everyone to follow my 'rules' such as ditching that whole 'five per day' thing on the fruit, root vegetables, etc...the idea that fat (even saturated fat) is bad has been debunked for some time now, and is true across almost all diets.

    Unfortunately I've come across many nutritionists who still believe the 'fat=bad' myth, so maybe this is where Change4Life is getting this message from, or maybe it's because it's what they think people expect - often those in an authoritative position (doctors, teachers, government funded health projects) will give inaccurate information or half truths based on outdated information as it's easier than explaining the facts to the uneducated masses...telling people of Britain that fat is good, out of context and without the science, would either have people ignoring all the good advice from Change4Life or will have people scoffing down nothing but [unhealthy] fatty foods.

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  5. I just wish the government would put as much effort into getting women breastfeeding. We know this has a beneficial effect on obesity and diabetes.

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  6. Great article, that advert bugs the hell out of me every time it's on the TV, telling people to drink chemically loaded drinks and swap to chemically loaded low-fat versions of stuff is insane.

    Eat less, move more. Eat as natural as you can find and afford.


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    1. 'Eat less, move more.' Pithy. Absolutely the best advice (except for anorexics?!). 'Eat as natural as you can find and afford.' Just brilliant. You should be advising Governments. A few years ago, the Radio 4 Food Programme opened my eyes to a phrase used in the food industry called 'adding value'. The goal is to produce foods that are more convenient & attractive, as cost-effectively as possible, so as to generate the best profit margin. Nutrition isn't a part of this process. 'Adding value' means value for the manufacturer, not the consumer. So when you are out shopping, remember this: it's likely that the more processed the food, the less nutrition you're going to get out of it. That means: don't buy convenience food, buy the raw stuff, learn to cook, freeze the surplus. I buy good quality butter, always have done. It smells and tastes good. I wish we didn't homogenise milk, it's not natural. I've stopped drinking milk because of that. Manufacturers carbonate drinks to disguise the chemically taste: let most carbonated soft drinks go flat and then taste them - yuk. The only carbonated drink I drink is tonic water in my gin!

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    2. Drink real milk, unpasteurized and not homogenized, highly nutritious!

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    3. I fully agree, there is one farm within travelling distance of us that is allowed to sell untreated milk and you can really tell the difference ! critics will say that potentially there's more risk from bacteria etc but the fact is that it is completely outweighed by the vastly superior farm and milking conditions. the farms selling pasteurised milk GET IT WHENEVER YOU CAN !

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  7. Tina - http://www.zoeharcombe.com/the-knowledge/fat-does-not-clog-up-our-arteries

    Megan - yes I saw the change in US pyramid in 2005, however my daughter was taught just a few months ago using the old pyramid x

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  8. Thanks for this. The best solution, given that Change 4 Life will probably not listen to the science because it goes against what their corporate sponsors want, is to produce your own "infographics" that will be spread via internet memes. Just make sure to make the scientific sources accessible from the meme, via a link on the meme image itself.

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  9. My youngest daughter came home with this leaflet yesterday. It is so flawed that I have been getting more and more wound up about it. My partner just said 'bin it and forget about it' but I can't forget about something that I know will be influencing the way millions of people feed their children and how those children make their food choices in the future!

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  10. It's a side argument, because the science has been available for a very long time on any pasteurized 'milk product'. It is the most allergenic food on the planet. Here is an alternative, and yes, full fat is best. Even 'whole' pasteurized milk is only 3%, and most folks are not aware of that. http://www.realmilk.com/

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  11. A big problem in the UK is that people want cheap food which the supermarkets are happy to supply. The farmers have little choice & the supermarkets push them to make it as cheap as possible. Cheap is best, everyone wants a bargain.

    The food suppliers have many tricks to make things cheaper and all have a detrimental effect on the quality & nutritional value of the food. Other dirty tricks like adding water to meat, feed to make live stock grow quicker & larger. Everything goes against nature. You get out what you put in. If you eat food that is far from natural it's no surprise it has a negative effect on our health.

    I would like to think most farmers would like to produce honest food for an honest price however people need to make the change in order for that to happen.

    I am not saying everyone should start to grow their own veg & rear their own animals. This is not difficult to do on a small scale but I appreciate land is expensive in the UK. However everyone that has a garden can make a small effort. Time outside working & away from the TV or computer can only be a good thing.

    You can buy as much food as possible from local farms. Yes it is more expensive than Asda but if it is an organic farm then the quality will be so much better and the money is going directly to the farmer. Unpasteurised milk is not only healthier but tastes great. We've been drinking it for thousands of years so why do people think it will make them sick. If you source it from a single organic farm it's safe.

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  12. I agree with everything you say in rejection of this change 4 life propaganda, as well as the benefits of full fat dairy over skimmed or low fat products. I eat this way myself, and have always felt that calories are a very loose idea that don't really explain what your body does with the food's ingredients.
    there's no reason for me to disbelieve any of this information but as a skeptic I make it a habit of looking into things before patting myself on the back for having been right all along.

    So I followed the link to the diet doctor site, and read what he had to say. And it looks good. Although who is this guy? A doctor, a man of science, writing on a report but not adding his sources?
    Then I looked up the SBU study that you and the diet doctor referenced, and found that the information published doesn't say exactly that at all.
    I read the results in English and the relevant piece of information in their assessment of studies is that in OBESE individuals, a low carb diet is better than a high carb diet for short term weight loss (six months.)
    There is no mention of fat not making you fat. And it did not come up with any solid change to dietary advice. Also, there was no marked difference or not enough data to show one, in weight loss after 6 months using a low fat or low carb diet.
    I read this study because while I wholeheartedly believe that the closer the product is to its original form, ie, the less processed, the better it is for your health and weight. But this is just general common sense and so far, in this particular form, high fat is better has NOT been proved scientifically. the studies just aren't there, and the ones reviewed by Sweden's SBU related only to obese individuals.

    I also googled a bit and found a debunk:
    http://experiencelife.com/newsflashes/debunking-news-of-swedens-low-carb-high-fat-guidelines/

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  13. While I absolutely agree that drinking higher fat milk is better for us, especially children, I think you could be making some assumptions about these studies that you can't make from the results. I don't think that you can conclude that low fat milk causes weight gain in children from these studies - the only thing we can conclude is that consumption of low fat milk does not prevent weight gain in children.

    This does still mean that the change4life recommendation for the milk swap are effectively useless though

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  14. This comment has been removed by the author.

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  15. Anyone one who actually recommends you consuming sugar-free products is not to be trusted.

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  16. everything in moderation and be more active. Just common sense really, At least in the UK we don't have to worry too much about the rubbish they put on food in the USA

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  17. When I read articles like this I always remember the phrase "lies, damn lies and statistics". This study was not a double blind study which means it's valueless, or more accurately utter rubbish. Without making the study double blind, you are not measuring anything useful. For example, if you did a survey of gyms with very good facilities for disabled people, you may find more disabled people there, but that doesn't mean going to those gyms is more likely to make you disabled! Same applies here, it could easily be that mums who are already concerned about their child's weight give them skimmed milk, not that the skimmed milk is MAKING the child overweight. The only way that lower fat milk could promote weight gain over full fat milk is if it caused the child to consume more calories elsewhere, which isn't part of the study. Conversely, it has been clinically proven that protein satiates appetite and skimmed milk has more of it by volume than full fat does. In Dr DeBoer's own study conclusion he says: "Consumption of 1%/skim milk is more common among overweight/obese preschoolers, potentially reflecting the choice of parents to give overweight/obese children low-fat milk to drink." Well no shit Sherlock, so what have you learned - precisely nothing, you just got a good bit of free publicity from being controversial and scared a few people into doing the wrong thing. Muppet.

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    1. By the same token, I assume that you are sceptical about the Lipid hypothesis, held by many - clinicians included - as sacrosanct. Yet when examined across different ethnic populations rapidly falls apart.

      What do you think about the observation that statins are clinically (double blind) proven to reduce heart disease. Statins also are clinically proven to reduce cholesterol. Therefore cholesterol causes heart disease. A logical conclusion or a scientific step too far?

      I agree to a certain extent with your argument, epidemiological studies which form the basis of a lot of health advice are simply statistical analyses or meta- analyses of small scale studies. This approach is fraught with problems particularly as (you infer) correlation is not causation.

      I am deeply sceptical about much of the food advice we receive and as a little irrational monkey with imperfect knowledge will come to my own conclusions. However I do note that there is a significant body of evidence, both anecdotal and from controlled studies, that skimmed milk is a recognised way to fatten pigs... will any of this change my diet? No, I prefer raw milk straight from the farm by my milkman.

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  18. Please tell me the swap was written as a fallacy!?!?

    How can people fall for this? Its sad the UK govt is endorsing this nonsense.

    It sickens me that you bthe uk the daily sugar guideline is 90g!!!!!

    Talk about mixed messages..thats why granny has 2biscuits with every tea time and loads of sweets!

    Anyways..also when iy comes to dairy, the real reason we eat it is for...you guessed it; FAT!!!!!

    I read a study last year that correlated the rise in the "low fat diet" fad that swept the 80's with the increase in autism. Pregnant women on a low fat diet were privy to the spike...food for thought...

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  19. Can't we start a change.org petition or something forcing a re-think? So sad to say "it's wrong but there's nothing we can do..."

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  20. Please be careful when looking at American studies as the rules on their products are a lot different to ours - for instance a lot of skimmed/low fat milk in the US has added sugars of some kind to make it more palatable to the US consumers. This screws up any like for like advice given in the UK. All the information and studies on food and dietary requirements should only look at studies in the country the advice is to be given in, or the person using the study needs to explain the differences in the products contained in the study. Just saying! :)

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  21. When I saw the change 4 life swap poster it instantly didn't sit right with me, low fat and sugar free foods are just fake food full of additives to me and I certainly won't be giving them to my children. I am also opposed to this scheme because if the nestle sponsorship. Nestle have extremely questionable ethics when it comes to the promotion of baby and infant formula.

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  22. Oh and by the way there is already a petition against this: http://www.change.org/en-GB/petitions/department-of-health-for-england-and-wales-end-change4life-links-to-nestl%C3%A9-and-danone?share_id=keRNYOwfhK&utm_campaign=signature_receipt&utm_medium=email&utm_source=share_petition

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  23. Sigh. Whatever happened to everything in moderation? Cook and eat as close to natural as possible and don't overdo either sugar or fat. The healthy eating lessons we were given at primary school in the 70s had more common sense than these guidelines that probably cost millions to put together!

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  24. I am made to wonder as to what the government has to gain from this type of misinformation. What is the outcome? What is the end game? A friend said that the government needed to seem like it was addressing a problem, but I don't buy that for one second. In a society ruled by consumerism the wasting of money on an empty and far reaching enterprise is not the optimum outcome for financial growth. Instead this is a drive towards more processed foods. Maybe the original change4life drive to eat fresh, healthy, homemade foods was too successful, making it nescessary for the muscle at Nestle to step in. Maybe there is a more insidious and far reaching plan being acted out. It could be as easy as getting double industry from milk (where does all that skimmed fat go? Two products for the price of one!) or a much darker agenda (distract, divide, conquer. A populace worrying about their weight isn't going to be bothered with the use of Asian slaves in textiles industry or the use of poisonous means to extract 'natural gas' from the British Isles.). Arrrggghhh! My head hurts!

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  25. Mis-educating people to make bad food choices really strokes big pharma, too. People on natural, whole food based diaries are usually healthy. You can't make money of healthy people. You don't want them dead either, you can't make money off dead people. But if they are just about alive and pretty ill, that is where the money comes from. Preferably ridden with chronic conditions, so we can pump them full of drugs and tell them they'll need them for the rest of their lives. And some other drugs too to counter the side effects. KERCHING!

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