• The Cost of Diabetes

        At a time when the NHS is in crisis, it is staggering to think that the cost of treating Type 2 Diabetes (and its complications) is estimated to be more than £12bn per year. At present it is thought that around 1 in 16 of the UK population has Diabetes (diagnosed, or undiagnosed) and this number has doubled in the last 20 years.

        So what is Diabetes?

        Diabetes is a medical condition characterised by high levels of glucose (sugar) in the blood stream. It is caused by either the immune system attacking the insulin-producing cells in the pancreas (Type 1), or the body’s cells not being able to react to, and deal with, high levels of sugar in the blood (Type 2). Type 1 is an auto-immune condition which is non-reversible, typically managed through careful monitoring and regular medication, and tends to be identified at a young age.  Type 2 is more often diet and lifestyle related, and the good news is that small changes in these areas can have a significant positive impact.

        Why is blood sugar balance so important?

        Carbohydrates in our diet are broken down into simple sugar molecules when we digest our food. These sugar molecules enter the blood stream and give us a source of energy for our body and brain. The body is a clever beast, and it understands that sugar levels need to be stable. Too much in the bloodstream is harmful and can cause tissue damage; too little and we are deprived of the energy source we need to function and survive. We therefore have our own in-built mechanism to regulate this, which is where the pancreas and its hormones come into the story.

        When we eat, and sugar enters our blood stream, our pancreas releases the hormone insulin, which then travels to the bloodstream and carries the sugar molecules away to safety, storing them in cells as fat (glycogen). When blood sugar levels dip too low, the brain signals the pancreas to release a hormone called glucagon, which breaks the glycogen stores, converts them back to glucose, and carries it back to the bloodstream to give us energy we are craving. We therefore create our own in-built larder to store and release energy.

        This worked perfectly back when we evolved and had irregular access to food, but modern living has now thrown a huge spanner in the works, and is creating a health crisis. Our 24 hour access to meals and snacks means we are overdosing on the sugar, storing it as fat, and then overdosing again before our body has the chance to break down and use what we have stored. This has a number of implications for our health; we are gaining weight at an alarming rate, and we are damaging our blood sugar regulation by over stressing it.

        The insulin demand to deal with more and more sugar becomes ever urgent, the body tissues receiving the insulin tire and eventually fail; a situation known as insulin resistance. Blood sugar levels then rise and the body is in severe danger, resulting in diabetes and associated health complications such as damage to the nerve endings in the eyes, kidneys and extremities. When uncontrolled this can result in blindness, kidney failure, amputations, and eventually death.

        That’s the doom and gloom bit over. How can you find out if you are at risk; and more importantly, what can you do about it?

         Look out for symptoms associated with Pre-Diabetes and Diabetes, such as:  

        Fluctuating energy and slumps; particularly after eating

        Mood swings, irritability and depression

        Cravings; particularly for sugary and junk food

        Frequent trips to the toilet; excessive thirst

        Headaches, shakiness or dizziness

        Difficulty sleeping or poor concentration

        Weight gain – in particular around the waist

        Make small but important changes to your diet

        Foods to include:

        • ‘Break the Fast’. Start the day with a good breakfast to kick start your metabolism. Low sugar muesli or porridge with nuts, seeds and live yoghurt are ideal. Add cinnamon, which can help regulate insulin and reduce sugar cravings.
        • Combine complex carbohydrates (brown rice, lentils, pulses, oats) with lean proteins, such as fish, chicken, eggs or beans. Protein takes longer for the body to break down, so will slow the release of the sugar into the bloodstream.
        • Eat small, frequent snacks every 2-3 hours throughout the day; e.g. in between meals, eat an apple with a handful of nuts or seeds; hummous on Ryvita or with raw vegetables such as carrot sticks. Fibre in fruit and vegetables also helps to slow the release of the sugar.
        • Eat healthy fats such as oily fish (salmon, sardines, mackerel, tuna), flax or hemp seeds, walnuts (all omega 3 essential fats) or olive oil drizzled on your vegetables. Seeds can be ground onto muesli or eaten as snacks.  
        • Eat your greens; in fact all vegetables. They are rich not only in slow releasing carbohydrates, but also plenty of other nutrients to keep you healthy.

         Foods to avoid:

        • Avoid alcohol – it is full of sugar, with little nutritional value, and not only quickly converts to fat, but also depletes B vitamins which are essential for energy metabolism.
        • Avoid processed foods ie cakes, sweets, chocolate, cakes, crisps and biscuits.
        • Switch from white bread, rice and pasta to brown alternatives. These will release sugar more slowly into the blood stream and keep you feeling full for longer.
        • Never skip meals! This creates a rollercoaster of blood sugar levels.

        Stress has a similar impact on insulin release as sugar, so  find ways to relax with some nurturing activities such as meditation, yoga or pilates. Moderate exercise can also help enormously with glucose and insulin regulation, and also weight management, so keep moving and factor in at least a daily walk.

        For more information visit Diabetes UK’s website and look out for Diabetes Awareness Week from 11-17 June.

        If you are struggling with any of the symptoms above, or are worried about the amount of sugar in your diet, feel free to contact me  for a chat.


      • So..do ‘diets’ really work?



        There was a fascinating insight into the world of dieting this week with the start of a new series on BBC2 which reinforced all my beliefs that fad diets just don’t work. Whilst some of the failure statistics the presenter quoted may be under debate on today’s blogs and forums, the over-riding message that came across was that the concept of the modern day ‘diet’ is an industry fuelled by commercial enterprises with much charisma and a desire for large profit margins.

        Most honest of all was the former Financial Director of WeightWatchers who admitted that the reason the industry is so profitable is because, on the whole, the commercial diets tend to fail, so people return, spend more money and try again.

        It was also fascinating to hear that the industry effectively began back in the US when a statistician for a big insurance company re-defined the parameters of ‘healthy weight’, and in doing so, re-classified a huge proportion of possibly healthy Americans as being overweight. This was latched on to by the US Government and medical institutions, creating a perfect breeding ground for companies hoping to thrive on the guilt and worries of the population and create a solution to this new-found national neurosis.

        We undoubtedly have a growing obesity problem, not just in the UK, but worldwide, with the World Health Organisation now saying that obesity is a great problem than starvation globally.

        So is there a role for ‘diets’ or should we be looking for other solutions? iStock_000019276692XSmall

        Firstly, I prefer to use the term weight management. The words ‘diet’ and ‘weight loss’ imply deprivation, which automatically triggers a mindset of failure. Surely it’s better to embark on something positive and achievable which gives you lasting, healthy and sustainable results?

        Each person should be treated as a unique individual, recognising that weight issues can be caused by a variety of reasons, so it is too simplistic to say that merely eating less is the solution. If that were the case everyone would achieve their targets and we wouldn’t have a national crisis! For some it could be related to medical issues which need to be understood and addressed, such as adrenal insufficiency, thyroid problems, stress or prescription medication. For others, previous experiences and psychological issues can be the root cause.  How many of us were told as a child ‘Eat up – there are children starving in Ethiopia’? These childhood habits can stick and cause immense harm.

        Social factors also need to be looked at; in particular the way we now have constant access to convenience foods 24/7. We eat on the run, and eat mindlessly with little thought or understanding about what or how much we put in our mouths. Combine all these factors and you can see the problem.

        A lucky few might have the wherewithal to change their habits with little apparent effort and hit their goals on their own. However, there are many people who simply don’t have the know-how to unravel all these elements and get back on track.  For them, a structured plan can be useful and group programmes also have their benefits since peer support and encouragement will always help promote success. These things can be hard to achieve on your own!

        Rather than crazy fads, what we need are realistic and achievable ‘health’ programmes which offer long term re-programming of habits without doing anything extreme and harmful which will pile the pounds back on further down the line and leave a frustrating sense of failure.

        Ideally this should combine a medical overview to understand why weight might be increasing; education to learn how each food group is vital for health and wellbeing.

        For some, a group dynamic can help provide additional peer-group encouragement; also psychological support and motivational coaching can help explain habits and overcome barriers to success; but finally expert guidance is vital to develop new healthy habits which become a natural part of daily routine around real life which includes holidays, meals out, birthdays and festive meals. The secret is to learn a few healthy habits, relax around food, and most importantly discover how to enjoy it again.

        Poached salmon with avocado salsa

        So pack away those meal replacements, pills and extreme diet books and take a new approach. Focus on eating lots of the good and tasty stuff rather than obsessing about what you ‘can’t and ‘shouldn’t eat.

        Our practical and realistic weight management programme offers a unique approach combining my qualified nutritional support and advice, with motivational coaching and hypnotherapy provided by Marco from OpenMindz to offer the additional techniques which will help you reach your goals.

        The next 6 week Brighton and Hove Weight Management course starts on Tuesday 1 October in Preston Park, offering a small but supportive group environment. We know it works, so come and join us!

        Contact me for more information.