Diabetes: It’s Time To Tackle Lifestyle Misinformation

People with diabetes can’t always tell fact from fiction. And with the internet awash with conflicting sources of information on diet, exercise and glycaemic control, it’s easy to see why. In the space of just two weeks, the Daily Express alone published or republished 17 clickbait headlines on diabetes, often misleading, and designed to appeal to readers’ fears about their health.

Here are a couple of them:

Of course, that’s not to understate the public health crisis currently facing the nation – a recent estimate by Diabetes UK suggested a record 12.3 million people are now at elevated risk of developing Type 2. But we urgently need to stem this flow of misinformation.

Even the broadsheets can be prone to misrepresenting scientific evidence. The Guardian, for example, ran in August with the headline “No healthy level of alcohol consumption, says major study”. That referred to a major mata-analysis of 694 studies to work out how common drinking was, and a further 592 that assessed the health risks, accounting for a total 28 million people and published in The Lancet.

The researchers found that for each extra drink consumed in a day, the harm increased, and that the lowest level of harm was zero drinks – the basis of the Guardian’s headline. It isn’t, however, that simple.

The study showed that 918 in 100,000 people who consume one drink a day can expect to experience an alcohol-related health issue. Yet 914 of those people will experience such a health issue no matter what, meaning only four in 100,000 do so as a direct result of consuming one drink a day(1). The study also did not account for other factors that may have been the actual cause of harm – drinkers are more likely be poorer and to smoke, for example.

Again, this is not to understate the risks; it’s beyond doubt that drinking is detrimental to health. The point, however, is that misleading headlines create a widespread lack of understanding what constitutes an achievable, healthy lifestyle – with significant implications for public health.

Many people are unaware, for example, that consuming carbs, not fats, is what typically leads to weight gain. Another common misconception is that Type 2 diabetes is a sign of having eaten too many sweets, rather than too much bread and pasta.

Peer support groups for diabetes can be tenuous in reliability too. A 2011 study of health social networks, published in the Journal of the American Medical Infomatics Association, found that only 50% were aligned with clinical practice recommendations (n=10).

Users of Changing Health’s programme for diabetes management, which combines evidence-based education on diabetes with behaviour change support, consistently tell us they were overwhelmed by the sheer volume of conflicting viewpoints on diet they had found online. Their GPs typically only have the time to hand them a stack of leaflets, and while the NHS website goes some way to helping, there’s more that could be done.

We must counter this deluge of misinformation by providing more people with clear, evidence-based guidance and support. If we don’t, there’s only one likely outcome: incidences of diabetes will continue to rise and with them, the strain on health economies across the nation.

1: New York Times, 28 August: https://www.nytimes.com/2018/08/28/upshot/alcohol-health-risks-study-worry.html

Reversing Type 2 diabetes: one year on

In July 2017, Tina C, a Fire Prevention Officer from Northamptonshire, achieved something incredible. She had been diagnosed with Type 2 diabetes two years earlier and needed medications to keep her blood sugars in check day by day. She was feeling lost, was struggling to keep a check on her diet, and things were getting worse.

Then came the call from the BBC. A second series of the hit documentary How to Stay Young was on the cards, and Tina had been selected to participate. If she was up for it, she would embark on a strict, 12-week diet and exercise plan supervised by Changing Health’s Professor Mike Trenell, with the aim of reducing her “real body age”. She would undergo extensive testing at four, eight and twelve weeks to assess everything from her weight and blood glucose levels to quality of sleep and cognitive function.

Tina accepted. The diet took some serious willpower; calories were reduced to just 800 per day, with each meal logged in the Changing Health app alongside Tina’s daily physical activity levels for her lifestyle coach to feed back on. It was a dramatic shift from Tina’s normal habits, but she kept it up.

Success At Reversing Type 2 Diabetes

Fast-forward 12 challenging weeks, and there was big news. Watched by millions across the UK on BBC1, Professor Trenell gave Tina the results from her final round of tests. Had she walked in and there and then, Professor Trenell told her, he wouldn’t say she has diabetes. He’d say she haddiabetes.

She was gobsmacked. She had taken control of her health and transformed her life. And a year on, she’s kept it up. “It’s been a difficult year with some big challenges,” she says. “Sometimes your mind gets unfocussed, you end up comfort eating – in April I lost my way. It was the first time I’d felt like that, and it disappointed me.

“But then, 6-8 weeks ago, something reclicked; I’ve gone back to being strict with myself, logging my foods and exercise in the Changing Health app and re-reading the learning content. It’s really important to have the facts, because when you do you realise you’re in control. I reminded myself that my health is something I can change. It is possible.”

Reversing Type 2 Diabetes With Low Carb Diet

Perhaps the most drastic change in Tina’s lifestyle over the past year has been her meal choices. “I used to just load up on carbs, thinking they would fill me up – not realising that carbs actually turn to sugar in your blood! Now I’m eating a lot of vegan meals and plant-based foods… and sugar-free baking has changed my life! I use a lot a cacao in my cake recipes; it’s just a matter of getting your taste buds used to it.

“The recipes in the Changing Health app have been really useful too. All kinds of foods I didn’t even know about have become staples… Chia seeds, for one, have become a massive part of my life. I have to think of unhealthy foods as evil. I’ll allow myself a treat on very special occasions, for example I baked a normal cake for a 40th birthday, and I’m going to have a slice!

“I make sure that on 6 days a week I’m brilliant, so on the 7th day I can have a glass of wine or something a little naughty! My strategy is to picture my own long-term health. I keep a couple of pics on my phone of how I was before, just to remind myself.”

Beating Diabetes With A Little Help From The Hubby

There’s no doubt that Tina’s husband’s support has been invaluable too; together they’re quite the team. “He gave up six months of his life to lose weight with me and support me through completely changing my diet and starting a regular exercise routine and if he can do it, I can too. I was having a tough time in April, and without him, I would’ve self-destructed. But now I feel so much better. You just feel more positive when your diet is good and when I’m healthy I get through things. I feel really different in how organised I am – literally just ticking things off my to-do list all day!”

“We’ve got two businesses that I help out with; and we always look for different solutions to get the energy we need for a long day without eating sugar. Planning is very important. I’m back down to 1000 calories temporarily so this morning, for example, I had chia seeds and soya milk, for lunch it was chickpea falafels and a green salad, and this evening we’ll have chicken fajitas without the wraps.”

“Having the Changing Health app on hand is like having a little buddy in my pocket. When my husband isn’t there, it’s a constant reminder: what have I eaten this week? It’s engaging, nice to look at and the content is easy to understand.”

“Ultimately, the power’s in your hands to change your health. I still can’t get my head around how I made that difference and changed my life. It’s not expensive, it’s not a lot of work, it’s just you and your mindset. If somebody gave you that chance, if somebody told you could do it – why wouldn’t you?”

Watch Tina’s moving account of her experience reversing Type 2 diabetes

Lifestyle coach Carl on preventing diabetes, changing lives

I became a lifestyle coach to make a difference in people’s lives. The way the Changing Health programme works, assigning each user a personal coach and delivering ongoing one-to-one support over weeks and months, gives me the opportunity to do that. We can explore every client’s needs and tailor-make our behaviour change programme to suit them.

Many of the people we coach have already digested learning content on Type 2 diabetes and how to better manage the condition. However, they’re rarely equipped to put that knowledge into practice. That’s where we come in!

Changing Health user Pat, aged 71 and one of my clients, can vouch for this. She described her experience as “life-changing”.

For years, she struggled to keep her weight under control. She tried lots of approaches, like WeightWatchers and Slimming World. The problem she faced was not losing the weight; it was keeping it off once her initial diet phase was over. It’s something we see often, and the reason we only promote lifestyle changes that are sustainable over the long term.

Before she reached out to Changing Health for help, Pat was diagnosed as prediabetic after an annual check-up at her local GP surgery. She booked her first coaching appointment with me in January 2018.

We agreed on limiting her daily calorie intake to 1,200-1,600, and I asked Pat to write this goal down, and leave it on show around the house somewhere – since research shows this makes you 42% more likely to achieve success! She adopted the low-carb approach, replacing some of her carbs with vegetables and healthy fats and proteins, which keep her fuller for longer.

One of the most effective behaviour change techniques I’ve used with Pat has proved to be self-monitoring. I asked her to use the photo food diary in the Changing Health app, which I can then review. She told me it makes a big difference; not only can she keep a tab on her diet, but she knows I can see her meals, so she tries harder to keep up the good work. She finds the app’s weight tracker and step-counter helpful too, keeping her disciplined and focussed on her goals.

She loves baking, but as we know, this isn’t the healthiest hobby if it’s not enjoyed in moderation. So we agreed that a good way to overcome this and still continue with this hobby was to either halve the ingredients used or bake twice as much with her usual amounts. Perfect!

Three months on, she’s living her new, healthier lifestyle to the fullest. She’s more motivated than ever; since she’s lost weight, she’s feeling the cold more when she goes for a walk. But that’s not an excuse stay in; instead, she went out and bought a good pair of thermal socks and gloves!

Her blood sugar levels speak for themselves. Since beginning the Changing Health programme, Pat’s blood sugar has decreased by 14%, which means it has returned to healthy a level and she’s no longer on her way to Type 2 diabetes. She’s also lost 3.6 kgs, reaching her target weight, and crucially – is managing to maintain it. She’s reduced her BMI too: from 28 to 26, meaning she’s no longer classed as overweight.

She credited her success to having a lifestyle coach on hand for support. As she put it: “The fact that my lifestyle coach is keeping track of my meals and exercise on the Changing Health App is very encouraging and positive.’’

The lesson I’ve learnt from Pat, and many other of my former clients, is this: You’ve always got it in you to make a change for the better. You may just need a little help.

Find out how GP Practice Manager, Sheinaz, also managed to turn her life around with help from one of the Changing Health’s lifestyle coaches.