Late Complications

Because carbon dependence is often unrecognised, many patients are already suffering from the late complications when they first come to medical attention. It’s very important to consider CDS as a possible underlying cause when you encounter patients with the following conditions.


The obesity epidemic is probably the single greatest health burden generated by carbon dependence - to date [12]. It is linked closely to carbon consumption both in the form of calories ingested and calories burned in the transport sector. (One US study has found that every hour spent in a car per day is associated with a 6% increase in risk of obesity [9] while a study in Chinese men showed those acquiring a car to be twice as likely to become obese [3].)

Diabetes, Cardiovascular Disease

Although tempting to attribute cardiovascular disease to a deficiency in statins, on closer examination, both cardiovascular disease and diabetes are more correctly understood as further examples of carbon toxicity [14]. Indeed, once carbon use has been allowed to progress to this degree, the doctor is placed in a difficult position, since prescribing the necessary medications is in itself a high-carbon measure. [5]

Colorectal Cancer

Could household members of patients with colorectal cancer be offered routine carbon dependence screening in future? Advocates for the scheme argue that lifestyle factors predisposing to cancer (such as sedentarism, low fibre diet, and consumption of red or processed meats – all recognised features of CDS) are often shared by household members, offering a golden window for early intervention. [1],[2],[15]

Fuel poverty

Most patients by definition start out with high carbon behaviours – such as heating a non-insulated home to T-shirt temperature in winter. However, with a rise in fuel price or fall in income, these practices become unaffordable, and eventually the addict may find himself in prolonged cold turkey (or “fuel poverty”). The chilly living conditions are associated with high blood pressure, strokes and heart attacks, respiratory symptoms and mental ill-health – an examination finding of >/= 4 layers of underwear in the presence of any of these conditions is strongly suggestive of the syndrome. [6],[7],[10],[11]


Poor mobility and falls are another well-known complication of fuel poverty. But in the context of long-term carbon dependence, the risks are compounded by loss of muscle strength and balance through physical inactivity. In addition, the nearly-burnt-out addict may now be boosting carbon intake by popping blood pressure tablets, whose side effects include dizziness.

Social isolation

Following on from the mental distress identified as one of the early complications of carbon dependence, addicts are at risk of progressive deterioration in the quality and quantity of their social interactions. Scattered case reports describe high-flying addicts returning home to find their spouse departed, or younger patients needing mobile phones to communicate even when located in the same room.


* Fortunately, research has recently identified some low-carbon interventions highly effective in both primary and secondary prevention of CVS – see Management pages of this guide.