Last month in my blog, I was talking about the Newcastle research and the diet that is linked with it. This month I want to start by asking if anyone has come to you asking if they can try out this particular diet. I had a gentleman who came to see me three weeks ago to ask if he would be allowed to try this. In response, I told him that we needed to know his renal and liver status before he started, because if either were already compromised this may not be a suitable way forward. If he had not already had his routine blood tests taken recently, for his diabetes check, then he would need those repeating, so that we knew from the outset the position of his cholesterol and blood sugars as well. I explained that we would need to monitor him closely with monthly reviews, so that if he started to experience any changes to his health, we could advise him appropriately; one aspect being how well his kidneys were faring.
This man has now started out on the 800calories/day diet for a period of eight weeks. As I said in my previous blog, my big concern, is if he loses weight, stops the insulin resistance and kicks his pancreas back into action, how is he going to maintain this improvement? I have already had such a conversation with him, and will repeat it when he has finished this eight week diet process. During this time, he will need to make significant and also sustainable changes to his lifestyle.
When the eight weeks is over, he needs to maintain his increased level of physical activity and continue to eat more healthily. At some point he needs advice from a dietician, so that he knows how to manage his eating long-term. I have advised him to monitor his blood sugar levels closely, because he is currently taking gliclazide, and as he eats so much less and starts to lose weight, so his blood sugars will fall and he will need to reduce such medications gradually.
Another newsworthy topic is that of the so called ‘sugar tax’, which is provoking consternation in the food industry. How should this tax be administered and which drinks/foods should be included or excluded? If this is going to be a successful measure to reduce intake of refined sugars, then it needs to give a consistent message, and drinks such as milkshakes which are not in the plan for being taxed, need to be judged in the same light. As it stands, a proportion of the general public will not understand what is being said through this action. The food manufacturers concerned are even now in the process of challenging the Chancellor’s proposals.
What do you think? Will taxing sugary foods and drinks make any difference to what people do? How are we going to change the mindset of the “man in the street”? There does need to be a definite change in our dietary patterns. We need re-educating about what is healthy, and many need teaching how to cook meals from so-called ‘first principles’ or with fresh ingredients. With so many of the population becoming more and more dependant on fast food, pre-prepared meals, packages and jars of sauces to add to meals, education is needed and fast so that we don’t see an epidemic not only of obesity and type 2 diabetes, but also of heart attacks.
What is a practical solution to this problem? What can we as individual health professionals do to stem the tide of obesity and type 2 diabetes? Maybe there should be Quality and Outcomes Frameworkpoints available for assisting our patients to lose weight and maintain it. Should we be paid by results in helping patients achieve their target weight loss? Maybe we need to completely change our focus, because at the present rate of increase, we are soon going to become overwhelmed by the sheer size of the diabetes problem.
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