Ingredients that should be eaten only occasionally have, for many of us, become part of our staple diet and with them come sinister health risks. As we enter the New Year
is it worth looking again at some of the things we do every day and thinking if 2009 is not the year for change?
The 21st Century Epidemic
Over the last ten years we have been bombarded with statistics about the rising incidence of obesity. In 2004 it was reported that 65% of men and 55% of women were either overweight or obese. By 2010 these figures were to have risen to 75%. However, in 2008, a number of reports have already suggested that we have reached the 2010 figures. It would appear that we are ahead of the obesity curve. For many,
being what is called ‘overweight’ is in fact ‘normal’. This normalization of a health problem is a big concern for healthcare professionals as it is appearing to have the effect of reducing the perceived need or desire to consider changing. It may even mean that less people believe it is actually possible to change. One of the reasons for this might be that being overweight, for many, does not seem to cause an apparent problem. But there is a problem, as Diabetes UK has been advertising in their ‘Beware the silent assassin’ campaign. The problem is the explosion of the incidence of Type 2 diabetes and its consequences.Diabetes is a condition caused by a lack, or a reduced effectiveness, of the hormone insulin which controls the level of sugar in the blood. There are three types of diabetes: Type 1, where the pancreas fails to produce enough insulin; Type 2, where the body becomes resistant to the message insulin sends; and gestational diabetes, which occurs in pregnancy. There are about 250,000 Type 1 diabetics in the UK and the numbers diagnosed each year are fairly stable. There are currently just over 2 million Type 2 diabetics and it is estimated that there are as many as a further 1 million undiagnosed individuals. There has been a doubling of the incidence of Type 2 diabetes in the last three decades and it is estimated that the number of diagnosed sufferers will double again to 4 million by 2025, or 1 in 15 of the population. A figure that never fails to stagger me is that 1 in 3 babies born today will become diabetic – unless we change!
The consequences of this hidden epidemic are terrifying. Being diagnosed with Type 2 diabetes takes 10 years off your life expectancy and it is associated with multiple long term complications that eat away at your quality of life. These include heart disease (80% of diabetics die from cardiovascular complications), kidney disease, blindness and amputations, to name but a few. The financial costs are not small either. It is estimated that 10% of the NHS budget is spent on diabetes, which is £9 billion each year, or £1million an hour! It is these costs and their inevitable escalations that means the NHS will struggle to manage in the years to come. The incidence of Type 2 diabetes is rising because of changes in our lifestyles. For a large majority of people, Type 2 diabetes is a lifestyle disease, and remains a choice.
What is causing the development of Type 2 diabetes?
The cells that listen to the message insulin sends appear to become hard of hearing or less responsive. Insulin is known as the ‘hormone of storage’ and the message it give the cells is to take sugar (glucose) from the blood and store it away or metabolize it. Glucose can be stored in the liver and muscles as glycogen (the human equivalent of starch). Once this store is full, any excess glucose is stored by converting it into fat. We now believe that consuming foods that release their sugars quickly – high glycaemic index foods or refined carbohydrates (like white breads, white rice, white
pasta, confectionary and pastries) – cause the body to make large amounts of insulin, more than would have been made if the same number of calories had been eaten
from a lower glycaemic index food or unrefined carbohydrate (like vegetables, salads, beans and lentils or whole grain products). As the cells in the body get bombarded
by insulin, they gradually reduce the number of receptors they express, becoming less responsive to the message. So, to have the same effect, the pancreas has to produce even more insulin. Eventually the pancreas finds it cannot keep up with the insulin
required to keep the blood glucose under normal control and at this point the individual becomes a diabetic. Unlike many diseases, as you develop diabetes and your pancreas fails, you often don’t notice much to begin with. It is not uncommon for a diabetic to take many years before presenting with a problem that leads to a diagnosis. This explains why so many people are wandering around yet to be diagnosed. During this time there is a process of ongoing damage to the body, particularly to the smaller blood vessels, which causes problems in the eyes, kidneys and heart.
Make the Change
The good news is it is possible to reverse this insulin resistance and make the body more sensitive to the insulin message. This can not only reduce the risk of
developing Type 2 diabetes, but it also represents the ideal mainstay of management of those who have been diagnosed. As we go into 2009 it is worth remembering that choosing to make small changes to your day-to-day life can have a staggering
effect on wellbeing, without stopping you from enjoying the occasional celebration – it just shouldn’t be a way of life.
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