tat* by Andy Altmann

Some people collect wine or classic cars; others collect coins or stamps. Andy Altmann collects graphic ephemera – or what he calls ‘tat’. Altmann developed his interest in scraps during his career at Why Not Associates, the multidisciplinary studio he founded upon graduating from the Royal College of Art over three decades ago. Now, the graphic designer has compiled his collection in a singular, self-designed publication. Here, Altmann speaks to LUX about how the book mirrors his design evolution, and why brash design need not be devoid of beauty

1. Of all the things you might collect, you chose ‘tat’. Why?

It’s hard for me to explain exactly why I collect tat*. When I was a young boy, my mother noticed me sitting at the kitchen table, carefully studying the label on an HP Sauce bottle. When she enquired why, I apparently replied, ‘someone must have to design this’. I was instinctively attracted by the lettering, the colours and the illustration of the Houses of Parliament on what is still my favourite condiment. It’s a classic example of what was once known as ‘commercial art’. It did its job and pulled me in.

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However, I didn’t start collecting any graphic ephemera until I was studying graphic design at St Martins School of Art in the early 1980’s. We were encouraged to keep sketchbooks, where we could practice our drawing and put our creative thoughts down on paper. I wasn’t as gifted as some of my peers at drawing, so I started to turn these sketchbooks into idea notebooks where I would also stick in any relevant piece of graphic ephemera. With time, these developed into pure scrapbooks with more and more tat* lovingly glued into their pages. There is a great nostalgic attraction to the particular era that the ephemera has been produced in. But it is also my fundamental fascination with popular culture, including the history of Pop Art, which was and still is a huge influence on me – where the everyday is embraced and celebrated.

2. tat* emphasises the disposability of graphic ephemera even while immortalising it in book form. What fascinates you about that interplay?

These ephemeral pieces of tat* were not designed to survive for a long time. They had a job to do and, in the majority of cases, they end up in the bin. There is certainly irony in me celebrating what some may see as poor graphic design, destined for the trash, ending up in a fancy hardback coffee table book. But I hope people can also see the beauty in the ugly. The cheap production values of much tat* means that the printing is often poor and mis-registered – but to me, this only adds to their aesthetic attraction. I don’t know why this should be: maybe it’s like a stamp collector who is looking for a printing mistake, which makes a stamp much rarer. I think it may however be that they just feel more human, less perfect.

tat* by Andy Altmann

3. You frequently extrapolate memories from the graphic scraps reproduced in tat* – of your upbringing in Warrington, or sitting and watching World of Sport with your grandfather. Could we call it a diary of sorts?

I guess it is a kind of diary, as it illustrates moments through my life in association with printed pieces of ephemera. They can evoke various memories of where I may have found them, who gave it to me or a subject that is dear to me. A good friend of mine, on reading a copy of the book, described it as now being his ‘favourite autobiography’. I really like that description. It was a revelation to me, as I had not thought of it in that context, but it’s a really interesting way of viewing it.

As a graphic designer, it is rare for me to be asked to write about anything. I consider myself more of a visual person, so I was hesitant to include any written words in the book. But I was encouraged by friends to have a go at including relevant stories after recounting some of them when showing them work-in-progress spreads. In the end, I found the writing a really enjoyable and rewarding experience, and it turned the final book into a much more interesting piece of work.

Read more: Pioneering Artist Michael Craig Martin on Colour & Style

4. Much of that depicted in tat* is brash, erroneous, or what might be considered ‘bad’ graphic design. What value is there to be derived from this kind of design?

Having a collection of graphic ephemera can be useful to any practicing graphic designer. It’s a library of visual thoughts. Some may be deemed naff or crude but any piece could spark an idea, illustrate a great colour palette, inspire a typographic layout or choice of font. It doesn’t really matter that it may be considered ‘bad design’ – there may well be something that could be taken to start a tract of creative thought.

I was a co-founder of the multidisciplinary design practice Why Not Associates. I used to keep all my scrapbooks of tat* in the cupboard next to my desk. If a designer was having a creative block I used to encourage them to flick through some of the scrapbook pages in the hope that they may spark an idea or just freshen the mind. Some of our best ideas started from a thought inspired by a piece of tat*.

tat* by Andy Altmann

5. tat* is clearly fascinated with vintage or retro design. Would you say that any one period inspires you most as an artist and, if so, which one?

That period would be the 1960’s and 1970’s because, as with many people, I think I am most strongly drawn to the period of my childhood. It is where we form our fundamental characteristics and loves that stay with us for life. I guess it’s the basic human desire for nostalgia for our youth. One only has to watch contemporary television to see the many shows dedicated to salvaging objects from peoples childhoods or early adulthood.

Read more: Big Boy Blue: In the Studio with Idris Khan

6. You ran a design studio, Why Not Associates, for 33 years before you decided to embark on more personal projects like tat*. How have you ensured that your designs stay inventive and surprising throughout your career?

I co-founded Why Not Associates with two fellow students on leaving the Royal College of Art in 1987. We never worked for another design company, and I think because of this direct transition we maintained the spirit for experimentation and surprise that we had developed as students. We left the RCA with just three drawing boards, but we were among the first design groups to buy an Apple Mac. We were not scared of the change, unlike many of our contemporaries, and we embraced the technology which led us to be one of the first multidisciplinary design groups. An open mind to change, collaborating with people of all ages and not taking yourself too seriously help to keep new, inventive and surprising ideas flowing.

I don’t think my approach to solving a creative problem has basically changed over the years. I am a curious person who loves researching the background to a project and this always forms the platform to relevant and strong ideas. However, you still need that child-like mind to embrace the unexpected. Look at it upside down and back to front. What at first may seem to be a daft notion or irrelevant idea could turn it into a thought provoking concept.

Find out more: circa.press

Launching our new online series, LUX medical columnist Dr Leyla Sanai discusses two medical books revealing why patients should be aware of the risks and benefits of treatments, and why sugar is our real enemy

Most people believe that there is little uncertainty in medicine. Evidence-based trials show doctors what works, and from there it’s a simple matter of either recommending X or not – where X could be a screening test on a healthy patient, a test on an ill patient, or a treatment. But it isn’t as simple as that, as Steven Hatch’s new book Snowstorm in a Blizzard (Atlantic Books, £14.99) shows.

In this lucidly written account, Dr Hatch, Assistant Professor of Medicine at the University of Massachusetts Medical School, reveals to the reader how to liaise with your doctors to ascertain if the benefit of the proposed procedure or treatment is worth the risk. Of course, the benefits and risks vary from individual to individual based on a whole host of factors such as age, gender, smoking history, family history, and many other variables.

One of the elegant examples Hatch talks us through is the value of routine screening for prostatic specific antigen (PSA), a blood test carried out to detect the presence of prostate cancer. In the years following the popularisation of this test in the early 1990s, the number of cases of men diagnosed with prostate cancer doubled compared with the incidence 15 years earlier. Yet the death rates remained almost the same.

This is because many men have prostate cancer that is never diagnosed and never causes them any harm. In one study, 40% of men who died had evidence of prostate cancer that had not been diagnosed and that had not contributed to their death. In the oldest age group, the incident was around 80%.

In fact, out of every 1000 men over fifty years old screened for PSA, only one life will be saved because of the diagnosis and treatment of prostate cancer as compared to 1000 men over 50 who are not screened. And yet, of 1000 men screened, more than 200 will be found to have an increased level of PSA. These men will all be referred for biopsy. Of the men biopsied, 90 will be diagnosed with prostate cancer. In comparison, in an unscreened group of 1000 men over fifty years old, 70 men will be diagnosed with prostate cancer, either because they present with symptoms or because of a chance finding of a hard prostate on rectal examination for some other reason.

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All of those diagnosed will be given the option of treatment for prostate cancer, which comprises one or more from the list of surgery, radiotherapy, and hormone therapy. But note that 20 more men have been diagnosed with prostate cancer in the PSA screened group then in the unscreened group. Which means that 20 more men in the screened group than the unscreened group will receive treatment for prostate cancer – a cancer that might never have come to light if they had not been screened, and might never have caused them any harm. So twenty men out of the 1000 screened will be put through all the risks of treatment of prostate cancer – a treatment that carries risks such as surgical blood loss, or the small risk of incontinence or impotence – and yet only one of them will have their life saved as a result of the screening picking up a cancer.

And yet – although the doctor in me recognises the distress, effort, side effects, and expense that 1000 patients have to be put through in order to save one extra life from prostatic cancer, the patient, or patient’s relative, in me, screams ‘go for it!’ to my husband and my brother. Because the truth is that although the abstract concept of 1000 patients having to be screened in order to save one extra life might seem excessive to the doctor, to that one patient, that screening test has been – well, life-saving. And this is why the vast majority of patients will choose screening for themselves and their loved ones even if the chance of personal gain is very small. Because what’s a bit of discomfort or even a serious side effect like anaemia or infection compared to the difference between life and death for yourself or someone you love? Only when the risks of screening become so serious as to potentially cause life threatening disease themselves do most patients baulk.

The answer to uncertainty in medicine is education, education, education. If the patient reads up about the risks and benefits of procedures, they can have discussions with their specialists. And of course, much depends on individual preference. One individual may be adamant that they want their PSA checked, even though screening only saves one life in a thousand compared to a nonscreened group. Another may prefer not to undergo the psychological distress of a test and discomfort/risks of a biopsy that, even if positive, may simply be diagnosing a cancer that would never have caused their death anyway. This excellent book does not try to dictate answers – it merely seeks to raise awareness that even with all the technological and pharmacological advances in medicine, the correct answer is not always black or white, but various shades of grey.

* * * * * *

The general public has long been chastised to lower their salt (sodium chloride) intake. Some of us forgo a sprinkle of it on food, and, as a result, eat bland and unseasoned meals. In The Salt Fix (Piaktus, £13.99), Dr James DiNicolantonio, a cardiovascular research scientist and doctor of pharmacy in Kansas City, Missouri, tells us that we have been demonising the wrong white crystal. Sugar is far worse for our health than salt. In fact, he explains to us that low salt diets actually cause all sorts of harmful physiological effects. They increase the heart rate, which puts more strain on the heart. They increase triglycerides, and increase insulin secretion, since insulin helps the kidneys to retain sodium. Insulin stimulates the laying down of fat, and it lowers blood sugar, leading to sugar cravings. In addition, when the body over-secretes insulin, cells can develop resistance to the effects of the hormone, paving the way for the development of type 2 diabetes mellitus, with its attendant risks of heart attack, stroke, and poor leg circulation, and problems in kidneys, eyes and nerves.

We are constantly told that salt raises blood pressure, but approximately 80% of people with a normal blood pressure are not sensitive to the blood pressure-raising effects of salt at all. Of those with borderline raised blood pressure, still 75% will not increase their blood pressure if they ingest salt. And even of those with full hypertension, 55% of them are totally immune to salt’s effect on the blood pressure. The author’s message is that in most people, eating normal levels of sodium is not harmful. In fact, studies suggest that eating between 3 and 4 g of sodium a day does not cause a problem in individuals whose kidneys are working properly, since any excess is excreted, and the high levels protect against the aforementioned risks of low salt diets.

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But national guidelines are slow to follow research. In fact, nutritional guidelines have consistently lagged so far behind research over the past few decades that sugar has had a free pass, despite the many trials showing its deleterious health effects. Risibly, as recent as 2000, US guidelines assured the public that sugar did not predispose to type 2 diabetes. And in the UK, it wasn’t until July 2015 until the government reduced the maximum percentage of daily calories that it recommended could be taken in by free sugars from 10% of total calories to 5%, following consultation with the Scientific Advisory Committee on Nutrition. In fact, the best percentage of free sugars to ingest if you have a sedentary lifestyle is 0%.

Why has it taken so long for public guidelines to match what research has shown for decades? Perhaps it’s because the sugar industry sponsors a lot of research. In 2013, a systematic review of studies published in PLOS Medicine showed that in those studies which were partially or wholly funded by the food industry, or had other similar conflicts of interest with it, 83.3% found no link between sugary drinks and obesity. By contrast, in those studies which have no conflict of interest with the food industry, 83.3% of them showed a definite connection between sugary drinks and obesity. It seems remarkable that even in the 21st-century, research can become befuddled by the influence of industry and politics.

While I would be more circumspect about recommending a dietary intake of salt as high as that which the author recommends, it certainly seems as if very low salt diets do more harm than good. And it is clear to see that it was sugar, not salt, that was the bogeyman at the banquet all along.

Dr Leyla Sanai MBChB MRCP(UK) FRCA(Lond)
Retired consultant anaesthetist