Dr Aseem Malhotra, That’s Numberwang!

At the risk of looking obsessed I simply could not allow yesterdays Daybreak performance by Dr Aseem Malhotra to pass without comment. Having written previously about his errors on camera I think this appearance gives a good indication of what is going wrong.

When faced with an opportunity to put forward evidence to support his case for the war on sugar, Malhotra is so effected by his inbuilt cognitive biases and desire to shock that he spews out the largest number available to him from a study he has read. You can tell when this is happening because he quickens the pace of his speech and mumbles to cover the fudge.

The best transcript  I can make of the passage at (1:57) is

..we have a real problem with Type 2 diabetes which is currently costing the NHS close to £20 billion indirectly, in direct costs…..and that’s set to double by 2035

Now that may get a free pass from morning TV presenters paid to bowl gentle underarm deliveries to guests to hit for six, but anyone with half a brain will point out this makes absolutely no sense at all. The idea that Type 2 Diabetes costs the NHS nearly £20 billion currently and will cost nearly £40 billion in 2035 is just not credible.

Firstly, you cannot indirectly have direct costs. There are direct and indirect costs. When discussing the NHS the direct costs of Type 2 diabetes (treatment, intervention, complications) are the relevant ones because they are the ones actually incurred by the NHS. You would be hard pushed to show that indirect costs  of Type 2 diabetes (increased death and illness, work loss and the need for informal care) are paid for by the NHS.

When you look at a summary of the study [Edit: Full Paper can be seen here, thanks @JoBrodie] he presumably is referring to, other errors become obvious. Not only has he lumped in the indirect costs, but these costs are for both Type 1 and Type 2 Diabetes. In a discussion about diet, Type 1 diabetes is irrelevant because it is not caused by diet.

To present the indirect (£13.9 billion) and direct costs (£9.8 billion) of both Type 1 and Type 2 diabetes as if they are all direct costs to the NHS for Type 2 diabetes is incredibly misleading.

The best estimate is that Type 2 Diabetes has a direct cost to the NHS of £8.8 billion per year, with a further £1.5 billion as the estimated cost of undiagnosed individuals. This is a shocking figure in itself, but why does he feel the need to inflate this to a barely credible £20 billion and pretend it will hit £40 billion in 2035?

That’s Malhotra. That’s Numberwang!

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