Wednesday, December 14, 2011
Food Hospital Blog
Went out Tuesday 13th Dec
I discovered this week was that there is a device called a “bloatometer” which measures exactly what you think it would. It was used on 47-year-old Alan who arrived complaining that his stomach swelled up so he looked pregnant after every meal. He felt ill and old and worst of all had gone right off sex.
Just as you didn’t really need a device to tell you Alan was swelling up, a range of blood tests only confirmed what was all too obvious - Alan was seriously not well in a number of other ways, such as having type 2 diabetes. His blood sugar level was 14.4 instead of between 4.1 and 6.1, he was 7 stone over weight and had high cholesterol. He was given just four weeks to show that he could turn the situation around with diet or, he was warned, it was onto the pills.
The good news about this was that the diet Alan was put on was more useful that the regular low fat HBD (healthy balanced diet) that most doctors would recommend. All refined carbs such as white bread and sugary breakfast cereals were out. Only a couple of years ago the Diabetes Association recommended low fat diet allowed you the equivalent of 60 teaspoons of sugar a day. Instead Alan had to instantly get into nuts, whole grains and a rainbow of colourful fruit and vegetables. The bad news was the business as usual warning that unless he could show results in just four weeks he’d have to start on the pills.
Alan did improve a bit but the program has resolutely avoided saying anything about whether patients get any help to go from fry ups to fruit. That’s realistic –you’re unlikely to get much from your GP - but it makes a totally unreasonable demand on the patient and is clearly very ineffective – we spend 600 million plus a year on diabetic drugs.
There’s a big debate about whether you can “cure” diabetes with diet but what’s very clear is that when people do stick to the low glycaemic diet I recommend, the majority see an impressive drop in their markers for diabetes. Blood sugar levels, fats in the blood, excess weight – all come down to normal, which seems pretty close to a cure to me. What makes a big difference though is having a team to help people through it like our Zest4Life program. To learn how you can prevent or reverse diabetes you should read my book - Say No to Diabetes There are numerous papers you can read here that show just how effective a low gl diet is in fighting Diabetes.
Critics say that sort of support costs too much. But suppose it cut the diabetes drug bill by 30% - not unreasonable – that would release 200 million. How much support would that buy? No one has done the figures, not even a pilot. Yet the benefit wouldn’t just be limited to diabetes. It might well result in similar savings in the drug bill for hypertension – another disorder the hospital treated this week.
Like diabetes, even though it can be very effectively treated by diet and lifestyle it is also the basis for a huge drug bill – around 450 million a year. Joan arrived at the Food Hospital with a blood pressure of 143/92 when healthy is around 130/80. She was put on what’s called the DASH diet that aimed to push up her levels of potassium and magnesium (two minerals crucial for controlling blood pressure that don’t usually feature much in official recommendations). The result was that her blood pressure came down to close to normal.
All of which is good but hardly surprising since big controlled trials dating back ten years have shown the DASH diet effective at not only lowering blood pressure but also cutting the risk of heart disease by around 24%. Since diabetes and hypertension often go together just how much could be saved with a serious effort to support patients make the changes? And we are not just talking drugs for diabetes and hypertension - guidelines recommend statins and aspirin as well.