Arthur Stewart Truswell – A Short Bibliography

Arthur Stewart Truswell was born in England on 18 August 1928.

Stewart Truswell studied medicine at Liverpool University and University of Cape Town graduating with a Bachelor of Medicine, Bachelor of Surgery degree with honours at University of Cape Town in 1952 and Doctor of Medicine at University of Cape Town in 1958 for his thesis ‘Researches in Human Nutrition‘.

Stewart was conferred a Doctor of Science (DSc) on 15 May 1998 by the University of Sydney.

A Doctor of Science is a research-based doctoral degree which is higher than a PhD, is awarded for significant, original and distinguished contributions to a specific field of science. It signifies the highest level of academic achievement in science and provides recognition to scholars who have made substantial advancements in their field.

During his time at the University of Sydney, Stewart established the Human Nutrition Department and the Department of Biochemistry as one of the two leading Centres of Human Nutrition Research and Education in Australia and made significant contributions to the University of Sydney in research, teaching and administration. He fostered and maintained strong international links and his research received high international recognition. In recognition of his outstanding and sustained service to the university, the senate conferred the title of Emeritus Professor on 1 February 1999.

Stewart was the Foundation Boden Professor of Human Nutrition at the University of Sydney taking up the position in 1978 until retiring from the University on 31 December 1998.

Professor Truswell was an academic general physician in Cape Town. This was followed by the position of professor of human nutrition at London University and subsequently becoming a professor at Sydney University.

John Yudkin was a British physiologist and nutritionist and the founding Professor of the Department of Nutrition at Queen Elizabeth College, London.

Yudkin wrote several books recommending low-carbohydrate diets for weight loss including This Slimming Business and Eat Well, Slim Well.

In 1971, Stewart was Yudkin’s successor as Head of Department of Nutrition at Queen Elizabeth College, London University.

Professor Truswell was a member of the Royal College of Physicians committee in 1976.

Stewart wrote the uncredited Preface of the Dietary Goals of the United States second version – McGovern Report 1977. 1

He wrote an editorial for The BMJ in 1984 about the UK Department of Health and Social Security’s Report that followed the dietary advice of the Royal College of Physicians.

Books include:

  • Essentials of Human Nutrition (with Jim Mann, University of Otago, Dunedin) 2
  • ABC of Nutrition 3
  • Cholesterol and Beyond 4

Stewart was in South Africa in 1955 working with Dr Brian Bronte-Stewart in Cape Town. Ancel Keys was in Cape Town at the same time.

Stewart was a hospital doctor in Cape Town in the 1960s. At this time he was involved in !Kung bushman (San) of the Dobe urea, in Botswana. He wrote three articles regarding the San bushman. Below are extracts from the three articles below. 5 ~ 6 ~ 7

In general they show no qualitative deficiency of specific nutrients though they are thin and may be undernourished (by our standards) at some seasons. They show little or no obesity, dental caries, high blood pressure or coronary heart disease Their blood lipid concentrations are very low and live to a good old age if they survive infections or accidents.

Collecting the plant food is mostly women’s work while the men do the hunting exclusively.
Men hunted animals including antelope, zebra, porcupine, wild hare and lions. They collected eggs and wild honey.

Women were responsible for gathering various plants, including berries, roots, nuts and other plant materials. They also collected insects and larvae.

Veldkos refers to the wild plants and foods gathered by the San that consists of berries and bulbs, eggs collected and any small animals they come across including tortoises and spring hares that are dug from their burrows with digging sticks, insects and their larvae.

Honey played a significant role in their diet.

They dried meat for later consumption.

A high proportion of an fatty acid (⍺-eleosteric acid) was found in mongongo nuts (Ricmodendron rautanenii) and plants such as bitter melon. Mongongo nuts was a major source of calories in the !Kung (Engclter & Wehmeyer 1970).

⍺-eleosteric is a conjugated linolenic acid. Its appears to have anti-cancer properties. 18:3 n-5 (trans-9, cis-11, cis-11)

In 1971, Professor Truswell left South Africa – returned home to England, where he took up the chair of nutrition at London University. Stewart was John Yudkin’s successor as Head of Department of Nutrition at Queen Elizabeth College, London University.

In May 1978, Stewart moved to the University of Sydney to become the Foundation Boden Professor of Human Nutrition, a post he held until 1996.

Lustig and Yudkin

Dr. John Yudkin was a British physiologist and nutritionist and the founding Professor of the Department of Nutrition at Queen Elizabeth College, London. Yudkin wrote several books recommending low-carbohydrate diets for weight loss including This Slimming Business and Eat Well, Slim Well.

During the 1960s, John Yudkin noted that the consumption of sugar increased in Britain more than any other food item in the last 100 years. Both sugar consumption and total fat consumption (note the correlation is with total fat and not saturated fat) correlated with heart disease but Yudkin concluded that sugar was the more likely cause. 8

Yudkin performed a small study recording the intakes of sugar 70 men: 20 with a recent first heart attack, 25 with peripheral arterial disease and 25 healthy men. The mean daily intakes were 132, 141 and 77 g, with medians 113, 128 and 56g, respectively. The intakes of the patients were significantly higher than those of the healthy controls. Both groups of patients took more sugar in more cups of tea or coffee per day than controls. 9

Yudkin also performed a feeding experiments with rats. A diet high in sugar increased serum triglycerides. Triglycerides are no longer considered to be a high risk factor for heart disease.

This was the extent of Yudkins’s research.

Who is Robert Lustig?

Robert Lustig is a paediatric endocrinologist at the University of California, San Francisco. He is the author of Fat Chance: Beating the Odds against Sugar, Processed Food, Obesity, and Disease. 10

He specialises in childhood obesity and studying the effects of sugar in the diet. He is the director of the UCSF Weight Assessment for Teen and Child Health Program and a member of the Obesity Task Force of the Endocrine Society.

Below are some quotes from Lustig.

Sugar – because of its unique composition is the only food on the planet that is both fat and carbohydrate at the same time.
Is there one reaction in your body that actually requires sugar? Zero.
Even fatty fruits – coconut, olives, avocado – have no carbohydrates.
There is no foodstuff on this planet that have both fat and carbohydrate at the same time. It is one or the other because that is evolution – that is nature – that is what God did.

Sugars are carbohydrates – they are not fats. This is basic chemistry. Fatty acids contain a carboxyl group ( COOH) – sugars do not. It is simply wrong to state that coconut, olives, avocados have no carbohydrates.

In Fat Chance, Lustig states that the browning of bananas is caused by the Maillard reaction due to its fructose content. Browning of freshly cut fruit and vegetables is a reaction caused by enzymes. Maillard reaction is a non-enzymatic reaction between reducing sugars (glucose, fructose, galactose, maltose, lactose) and amino acids that occur from around 140°C to 165°C. At higher temperatures, caramelisation occurs. The golden crust of bread is due to Maillard reactions.

Below is Lustig’s view that insulin resistance and the metabolic syndrome is the root cause of our ill-health.

The smaller, more artery-clogging particles are increased not by saturated fat, but by sugary foods and an excess of carbohydrates. It’s the high carbohydrate or sugary diet that should be the focus of dietary guidelines. If anything is driving your low-density lipoproteins in a more adverse way, it’s carbohydrates. 11

Lustig’s admiration for Yudkin is unfounded. Yudkin was unable to produce the data to support his contention that sugar causes heart disease.

Keys was not the only person to publish papers critical of Yudkin’s analysis. Jeremiah Stamler, Gerry Shaper, Michael Oliver and Geoffrey Rose were prominent researchers who considered that “there was no firm evidence linking intake of dietary sugar and CHD.” 12

Mortality from heart disease started reducing in 1966 in U.S., Finland, and Australia. It was another 10 years before this happened in the United Kingdom because of Yudkin’s influence. 13

Geoffrey Rose believed that there would have been 25,000 fewer deaths in England and Wales if the gains made in Australia and America were duplicated in the United Kingdom. 14

That is a disappointing legacy to have.

Dr James Muecke, Robert Lustig, William Davis, Nina Teicholz, the award-winning cardiologist Aseem Malhotra, Marianne Demasi, Gary Taubes, Arne Astrup and Ronald Krauss need to be held accountable for the misinformation that they are disseminating. The reason that they are so successful is that they generate a narrative of the heroic crusader going into battle against the evil forces of authority.

In 2016 Robert Lustig has published an updated version of Yudkin’s book Pure, White and Deadly: How Sugar Is Killing Us and What We Can Do to Stop It. 15

A2 Milk Case

Casein is the group of insoluble proteins found in milk. Whey is the group of soluble proteins. Casein comes in three types: ɑ-casein, β-casein and κ-casein with β-casein occurring in three variants: A1, A2 and B. The B variant is minor.

Most cow’s milk contains a mixture of A1 and A2 β-casein. A2 milk refers to milk that only contains the A2 variant of β-casein.

Milk from Guernsey, Jersey, Asian cattle, human milk, and other dairy animals such as sheep, goat, donkeys, yaks, camel and buffalo contain mostly A2 β-casein.

Holstein Friesians cows are the black and white dairy cattle that originated in the Netherlands. More recently, Holstein refers to stock that has been further developed in America whereas Friesians refer to the traditional European stock. These breeds contain significantly more A1 β-casein. 16

β-casein from cows contains 209 amino acids. The only difference between A1 and A2 variants is one amino acid at position 67. A1 milk contains histidine at position 67 whilst A2 contains proline. A peptide containing seven amino acids, β-casomorphin-7 (BCM-7), is formed when A1 milk is digested but not when A2 milk digested. 17

β-casomorphin is a casomorphin which is a biological active opioid.

Robert Elliott observed a much lower rates of type 1 diabetes amongst Polynesian children that were raised on the Polynesian islands compared with those raised in Auckland. He attributed this to the differences in the β-casein profile. 18

Elliott was the lead author of a conference paper that examined the effects of feeding casein to non-obese diabetic (NOD) mice. The conclusion was that:

The induction of diabetes by casein in the NOD mouse appears to be restricted to casein containing the A1 variant of beta-casein. 19

An experiment was performed independently at three centres (Ottawa, London and Auckland) in an attempt to duplicate these results. The diets for the mice were coded so that the researchers were not aware of nature of the diets fed to the mice. 20

The conclusion of this paper was:

These findings show that it is not likely that diabetes could be prevented solely by removing or altering the cows’ milk component of the diet […].

The above conclusion did not prevent Elliott and Hill from applying for US and New Zealand patents. Patents have been issued, listing Robert B Elliott and Jeremy P Hill as the inventors. The US patent has been assigned to New Zealand Dairy Board and the A2 Corporation Limited. The patent claims that:

The invention is based on the discovery that certain variants of β-casein may induce Type-1 diabetes in susceptible individuals while other variants do not. The invention consists of the selection of non-diabetogenic milk producing cows and recovering and processing their milk and milk products. Another aspect of the invention is selectively breeding cows which produce the non-diabetogenic milk. 21

The a2 Milk Corporation was established to:

Pioneer the scientific understanding of the A2 protein type so more people can enjoy the nutritional goodness that only comes from real and natural milk. 22
Note that it does not assist people who are lactose intolerant.

Professor Boyd Swinburn prepared a 43-page report 23 for the New Zealand Food Safety Authority. His conclusion:

The evidence does not support such dietary changes [replacing A1 β-casein with A2 β-casein] as a recommended clinical approach with a known likelihood of benefit.

Professor Stewart Truswell conclusions are:

The A1/A2 milk hypothesis was ingenious. If the scientific evidence had worked out it would have required huge adjustments in the world’s dairy industries. This review concludes, however, that there is no convincing or even probable evidence that the A1 β-casein of cow milk has any adverse effect in humans. 24
The A1/A2 milk hypothesis was ingenious. If the scientific evidence had worked out it would have required huge adjustments in the world’s dairy industries. This review concludes, however, that there is no convincing or even probable evidence that the A1 β-casein of cow milk has any adverse effect in humans. 25

Stewart’s critique was instrumental in the failure of the A2 Corporation.

Its successor, the A2 Milk Company sells A2 milk in Australia, New Zealand and the United States. It exports A2 Infant Formula to China.

The EFSA report, released in 2009, found that:

A cause and effect relationship is NOT established between the dietary intake of BCM7 (beta-casomorphin-7), related peptides or their possible protein precursors and non-communicable diseases. 26

The non-communicable diseases were autism, cardiovascular diseases and type I diabetes.

A2 milk has about 8% market share of the milk products market in Australia.

Who is Rajiv Chowdhury?

The recent academic positions held by Rajiv Chowdhury are listed below.

Florida International University: Miami, Florida, US
01/12/2021 to present | Professor and Chair of Global Health (Global Health)

University of Exeter: Exeter, Devon, GB
2021 to 2021 | Professor of Global Public Health (Health) University of Cambridge: Cambridge, Cambridgeshire, GB

University of Cambridge: Cambridge, Cambridgeshire, GB
01/01/2017 to 2021 | Associate Professor in Global Health (Public Health and Primary Care)

He has obtained the following academic qualifications.

University of Cambridge: Cambridge, Cambridgeshire, GB
01/10/2009 to 30/09/2013 | PhD in Epidemiology (Public Health and Primary Care)

University of Cambridge: Cambridge, Cambridgeshire, GB
01/10/2006 to 30/09/2007 | MPhil in Epidemiology (Public Health and Primary Care)

University of Dhaka: Dhaka, BD
31/12/2003 | Bachelor of Medicine, Bachelor of Surgery (MBBS)

He is a Fellow of the American College of Epidemiology, a position he has held since 2021.

Rajiv has published over 200 articles.

Rajiv quote:

The smaller, more artery-clogging particles are increased not by saturated fat, but by sugary foods and an excess of carbohydrates. It’s the high carbohydrate or sugary diet that should be the focus of dietary guidelines. If anything is driving your low-density lipoproteins in a more adverse way, it’s carbohydrates. 27

Stewart wrote an article Sceptics undermine effective dietary and heart health advice (2015) that was published in the Medical Journal of Australia. 28

In all, Chowdhury et al omitted or incorrectly reported 25 studies of omega-6 PUFAs and CHD. The protective effect of PUFAs would have been clear if all published studies had been included in their meta-analysis. Changes to established public health guidelines should not be advocated unless all the relevant evidence has been reviewed.
It seems inappropriate, however, for supplements trials to be pooled with dietary trials in which participants consumed both less saturated fats and more PUFAs.

The Harvard epidemiologists Walter Willett, Frack Sacks, Meir Stampfer reached the following similar conclusions.

The meta-analysis of dietary fatty acids and risk of coronary heart disease by Chowdhury et al. contains multiple errors and omissions, and the conclusions are seriously misleading, particularly the lack of association with N-6 polyunsaturated fat. For example, two of the six studies included in the analysis of N-6 polyunsaturated fat were wrong.

Thus, the conclusions of Chowdhury et al. regarding the type of fat being unimportant are seriously misleading and should be disregarded.

Willett also commented:

The controversy should serve as a warning about meta-analyses. These analyses compile the data of individual studies to reach a clear-cut conclusion. It looks like a sweeping summary of all the data, so it gets a lot of attention. …
But these days meta-analyses are often done by people who are not familiar with a field, who don’t have the primary data or don’t make the effort to get it. 29

Russell Henry Chittenden and Protein Intake

Russell Henry Chittenden was professor of physiological chemistry at Yale from 1882 to 1922.

He published a 473 page book in 1904, Physiological economy in nutrition, with special reference to the minimal protein requirement of the healthy man. An experimental study 30

The book is still available.

He wrote:

Fats and carbohydrates when oxidized in the body are ultimately burned to simple gaseous products – easily and quickly eliminated…

With proteid (protein) foods – when oxidized, (they) yield a row of crystalline nitrogenous products which ultimately pass out of the body through the kidneys. (These nitrogen-based protein byproducts) frequently spoken of as toxins – float about through the body and may exercise more or less of a deleterious influence upon the system, or, being temporarily deposited, may exert some specific or local influence that calls for their speedy removal.

For nine months, Chittenden recorded his body weight which reduced from 143lb (65kg) to 128lb (58kg) consuming 40g of protein a day. He had ‘greater freedom from fatigue and muscular soreness than in previous years of a fuller dietary’ and no longer suffered ‘sick headaches’ and ‘bilious attacks‘.

A group of five men connected with Yale University who had lives consumed a diet of 61 grams per day for 6 months. They had a positive nitrogen balance. Nitrogen balance is a measure of daily intake of nitrogen minus their daily excretion of nitrogen. Since protein is the main source of nitrogen consumption, it determines if the amount of protein consumption is more or less than requirements.

Another group of 13 males from the Hospital Corps of the U.S. army. They did intensive workouts at a gymnasium. They remained in good health on 62 grams of protein daily.

His final trial comprised of 8 Yale student athletes, some who were Olympic-class athletes. They ate an average of 64 grams of protein daily. Their athletic performance improved by an impressive 35%.

Chittenden in 1904 concluded that 35–50 g of protein a day was more than adequate for adults.

Stewart believes that the golden age of nutrition occurred in the first half of the 20th century. This is when the foundations of nutrition were researched and discovered including the importance of vitamins, minerals, alpha-glucans and beta-glucans.

Alpha-glucans and beta-glucans are both types of complex carbohydrates (polysaccharides) made up of glucose units, but they differ in their structure and properties. Alpha-glucans are found in starch and glycogen, while beta-glucans are more abundant in plants, fungi, and some bacteria. Beta-glucans are known for their potential health benefits, particularly in relation to heart health, immune function, and blood sugar control.

The primary source of alpha-glucans in our diet is wheat where it is stored in the endosperm. This is frequently removed in processing to prevent spoiling – to our determent. This was first bought to our attention by in 1847. (Yes, more than 170 years ago) by Daniel Carr in his book The Necessity Of Brown Bread For Digestion, Nourishment, And Sound Health: And The Injurious Effects Of White Bread. 31

He wrote:

The coarse parts of the what should never be separated from the fine; the made into bread in the ordinary manner. This would render medicine comparatively useless for the cure of almost every symptom associated with digestion.

Professor Francois Magendie (1783-1855) fed dogs white bread and water, all the animals dying within 50 days. All animals fed bread containing bran ‘continued to thrive on it very well‘.

The studies that get the attention in the popular press are those that dismiss the links between saturated fats and heart disease. Any papers that confirm it are ignored.

Last updated on Saturday 14 June 2025 at 15:31 by administrators

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Footnotes

  1. McGovern, G., Talmadge, H. E., Kennedy, E. M., Nelson, G., Cranston, A., Humphrey, H. H., Percy, C. M., Dole, R., Bellmon, H., Hatfield, M. O., Schweiker, R. S., Stone, A. J., & Matz, M. L. (1972, November). Dietary Goals for the United States—Second Edition.
  2. Mann, J., & Truswell, A. S. (Eds.). (2017). Essentials of Human Nutrition (Fifth Edition). Oxford University Press.
  3. Truswell, A. S. (2003). ABC of Nutrition (Fourth Edition). BMJ Publishing Group.
  4. Truswell, A. S. (2010). Cholesterol and Beyond: The Research on Diet and Coronary Heart Disease 1900-2000. Springer Netherlands.
  5. Truswell, A. S., & Hansen, J. D. (1968). Medical and nutritional studies of !Kung Bushmen in north-west Botswana: A preliminary report. South African Medical Journal , 42, 1338–1339.
  6. Truswell, A. S. & Hansen, J. D. L. (1976) ‘Medical Research among the !Kung’, in Kalahari Hunter-Gatherers: Studies of the !Kung San and Their Neighbors. Harvard University Press. pp. 166–194.
  7. Truswell, A. S. (1977) ‘Diet and nutrition of hunter-gathers’, in Health and Disease in Tribal Societies. Elsevier Amsterdam. pp. 213–221.
  8. Yudkin, J. (1963). Nutrition and palatability with special reference to obesity, myocardial infarction, and other diseases of civilisation. Lancet, 281(7295), 1335–1338.
  9. Yudkin, J., & Roddy, J. (1964). Levels of dietary sucrose in patients with occlusive atherosclerotic disease. Lancet,284(7349), 6–8
  10. Lustig, R. (2013). Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease. Penguin Group.
  11. OʼConnor, A. (2014, March 18). Study doubts saturated fat’s link to heart disease. Sydney Morning Herald. https://www.smh.com.au/lifestyle/health-and-wellness/study-doubts-saturated-fats-link-to-heart-disease-20140318-3502m.html
  12. Truswell, A. S. (2010) Cholesterol and Beyond: The Research on Diet and Coronary Heart Disease 1900-2000. Springer Netherlands.
  13. Truswell, A. S. (2010) Cholesterol and Beyond: The Research on Diet and Coronary Heart Disease 1900-2000. Springer Netherlands, 9.2.
  14. Truswell, A. S. (2010) Cholesterol and Beyond: The Research on Diet and Coronary Heart Disease 1900-2000. Springer Netherlands, 31.4.
  15. Yudkin, J. (2012). Pure, White and Deadly: How Sugar Is Killing Us and What We Can Do to Stop It (2012 Edition). Penguin Books.
  16. Pasin, G. (2017) A2 Milk Facts – California Dairy Research Foundation [online]. Available from: http://cdrf.org/2017/02/09/a2-milk-facts/ (Accessed 18 December 2017).
  17. Truswell, A. S. (2005) The A2 milk case: a critical review. European Journal of Clinical Nutrition. 59 (5), 623–631.
  18. Elliott, R. (1992) Epidemiology of diabetes in Polynesia and New Zealand: child health research unit Pediatric and adolescent endocrinology. 2166–71.
  19. Elliot, R. et al. (1997) The role of beta-casein variants in the induction of insulin-dependent diabetes in the non-obese diabetic mouse and humans, in 1997 International Dairy Federation.
  20. Beales, P. et al. (2002) A multi-centre, blinded international trial of the effect of A1 and A2 β-casein variants on diabetes incidence in two rodent models of spontaneous Type I diabetes. Diabetologia. 45 (9), 1240–1246.
  21. Elliott, R. B. & Hill, J. P. (2002) Method of selecting non-diabetogenic milk or milk products and milk or milk products so selected. United States Patent 6451368

  22. The a2 Milk Company (2017) About us – The a2 Milk Company [online]. Available from: https://thea2milkcompany.com/about-us/ (Accessed 27 December 2017).

  23. Swinburn, B. (2004) Beta casein A1 and A2 in milk and human health. Report to New Zealand Food Safety Authority.
  24. Truswell, A. S. (2005) The A2 milk case: a critical review. European Journal of Clinical Nutrition. 59 (5), 623–631
  25. Truswell, A. S. (2005) The A2 milk case: a critical review. European Journal of Clinical Nutrition. 59 (5), 623–631
  26. European Food Safety Authority (3 February 2009). Review of the potential health impact of β-casomorphins and related peptides. EFSA Journal. 7 (2): 231r. doi:10.2903/j.efsa.2009.2
  27. OʼConnor, A. (2014, March 18). Study doubts saturated fat’s link to heart disease. Sydney Morning Herald. https://www.smh.com.au/lifestyle/health-and-wellness/study-doubts-saturated-fats-link-to-heart-disease-20140318-3502m.html
  28. Truswell, A. S. (2015). Sceptics undermine effective dietary and heart health advice. The Medical Journal of Australia, 202(8), 412–414.
  29. Kupferschmidt, K. (2014, March 24). Scientists Fix Errors in Controversial Paper About Saturated Fats https://www.science.org/content/article/scientists-fix-errors-controversial-paper-about-saturated-fats
  30. Chittenden, R. H. (1904). Physiological economy in nutrition, with special reference to the minimal protein requirement of the healthy man. An experimental study.
  31. Dawson, P. (1908). Biography of Francois Magendie. Albert T. Huntington.

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