Obesity and Diabetes During a Pandemic: A Plan of Action is Vital

When figures began to show that COVID-19 was proving to be far more dangerous for those with either type of diabetes (associated with almost 1 in 3 coronavirus deaths, according to The Guardian), as well as those carrying excess weight, the government made inroads to direct citizens towards a more slimline silhouette.  Type-I diabetes, of course, is not about weight, but is an autoimmune response.  Given an already overworked immune system, people with Type-I diabetes are 3.5 times more likely to die from COVID-19.  However, 9 in 10 diabetics suffer from Type-II diabetes and most of those cases are because of obesity.

July and August’s press was full of discussion of Boris Johnson’s “sin tax”, labelled by Forbes as the UK’s “hard-hitting $13 million anti-obesity campaign” (something, it suggested, which should also “wake up” US food companies in deciding what to advertise to North American citizens; no strangers to obesity themselves, over 40% of the adult population there are now classed as such).  Under our Prime Minister’s summer proposals for the NHS Better Health campaign, “pre-watershed adverts for junk food” and other HFSS (or High in Fat, Sugar, and Salt) products – which, it was thought, could even include cheese, yogurt, and olive oil – were to be banned (i.e. not aired before 9pm).  Further, BOGOF (or Buy One Get One Free) deals on junk food were to be scrapped and alcoholic drinks and restaurant and takeaway menus (where such companies employed over 250 staff) were to display calorific and fat content information for customers.  Not a bad idea, really.

For it goes without saying that obesity, together with Type-II diabetes, is really a very serious issue for Britain – pandemic or no pandemic.  Diabetes UK records that two in three adults in England alone are overweight or obese.  The third fattest country in Europe (until Brexit, of course, and placed after Turkey and Malta), Tam Fry, the chairman of the National Obesity Forum, has declared the UK’s weighty problem a “national emergency”.  The PM’s personal battle against coronavirus seemed to have sparked an epiphany.  No wonder, when University College London-conducted research began to evidence that those who are obese are 70% more likely to be admitted to hospital with COVID-19, and those simply overweight 40% more likely.  Though it should be mentioned that underweight people are 6% more likely, too.  The PM’s statement came also, though, as Health Secretary Matt Hancock stated that, by losing a mere 5lbs, overweight adults could potentially aid a £100 million saving for the NHS (Which? finding that “obesity-related illnesses cost the NHS £6 billion” annually).  Protect the NHS, indeed.

And when you have the likes of the slimmed-down, ever-popular Hairy Bikers (Si King and Dave Myers, who together lost a combined weight of 6 stone) cooking to beat Type-II diabetes, you soon realise the current climate is, erm, shaping up as the time to make a difference to one’s appearance via one’s health.  Again, this can only be viewed positively.

Diabetes UK estimates that over 12m Brits are at risk of developing Type-II diabetes.  Setting aside concerns reported across the national press in August about the increased chance of children developing Type-I diabetes if in some way infected by the coronavirus, it is nonetheless worrying that one in three children (between the ages of only 10 and 11) are either overweight or deemed to be obese.  What on earth are we doing to our young?

Sadly, it starts with ourselves: children are mimics.  If a parent is overweight or obese, the likelihood of their son or daughter being so is greatly increased.  The NHS-conducted Health Survey for England 2017 found that 28% of children of obese mothers were also obese, and 24% of children of obese father’s were similarly obese.  Shockingly, 47% of obese mothers and 52% of obese fathers considered their obese children “about the right weight”, according to The Guardian’s review of the survey.  Education, it seems, is key.

Children need at least 60 minutes of exercise each day in order to develop healthy bodies (and minds).  The lockdown might have necessitated more screen hours to stay sane and connected, but that doesn’t oblige an increased sedentary lifestyle.  Nonetheless, when it comes to diet, it really is a case of nurture versus nature.  Given the widespread proliferation of sugar in processed foods – as well as drinks (they don’t need sugary sodas and juices, water is fine; nor do our own tea and coffee breaks require any sugar, let alone multiple spoonfuls) – it’s no wonder that kiddies’ waistlines have expanded.

However, it’s not necessarily as simple as that.  After the government announced its planned reforms to tackle the nation’s ever-expanding waistlines, the ‘i’ reported that 20 million Brits cannot afford healthy food.  Poverty and obesity, it appears, shamefully go hand in hand.  Again, as discussed earlier in this issue (“The Vevolution is Here: World Vegan Month & Veg Pledge 2020”), the issue of food deserts becomes a very real concern.  Why should it be that only money buys health?

The charity Obesity UK, founded in 2010, works by an eight-part plan of action that includes raising awareness and understanding of obesity, which it wants recognized as a disease.  Originally called HOOP UK, it was formed as a social media platform by Leslie McCormack in order to support parents of children with obesity.  More a charity aiming to reduce weight stigma and discrimination on a national as well as local level than offering any ameliorative research, Obesity UK provides a voice for those who are obese and seeks improvement of access to healthcare treatment.

Indeed, such treatment is for the most part only available privately – something a 2018 University of Oxford study called for to be changed.  Diabetes UK reported that the study, published in the British Medical Journal, evidenced participants losing three times the weight of those on a standard diet when following a low-calorie liquid diet.  Consuming “specially formulated drinks, such as flavoured shakes and soups, as well as the odd protein bar”, the 12-week plan was followed up with counselling for a 2-year period, so as to better the participants’ relationship with food.  After one year, the average weight loss was 10.7kg (or 1st 10lb).  Given the positive results, the scientists suggested that such a diet should be offered as an NHS obesity treatment.

In August this year, the ‘i’ reported that Turning the Tables, “compiled by cross-party think tank Demos”, wants to go further than the government’s obesity campaign proposals, with their scrapping of Public Health England (PHE) and forming of The National Institute for Health Protection (NIHP), as The Grocer reported.  Rather, Turning the Tables wants “a levy on nitrite-cured meats”, further funding for cellular agriculture (i.e. lab-grown meat), subsidies for healthy food, and updated packaging and labelled informed in conjunction with the Food Standards Agency (FSA).  Knowledge is power.

The 14th November marks World Diabetes Day, when awareness will be raised in myriad ways (though perhaps not to the extreme of Noah Barnes, the American boy who walked 4,200 miles across the States with his father in 2017 to fundraise for a cure for Type-I diabetes).  But you might yet be wondering what precisely diabetes is.

People with diabetes have higher blood sugar levels (or high blood glucose).  This is because their body (specifically, the pancreas) is either unable to produce insulin and in fact their immune system attacks the very cells that would produce insulin (Type-I diabetes) or their cells don’t produce enough insulin and don’t respond in the correct way to insulin (Type-II diabetes).  Pre-diabetes, by contrast, is quite literally just that: elevated blood sugar levels, but only approaching the range seen in diabetics. 

Hyperglycaemia occurs when blood sugar levels are too high.  Symptoms of this having happened include fatigue, excessive thirst, the need to urinate more frequently, and blurred vision.  It should be noted, though, that a chromium deficiency can also present itself as high blood sugar, due to the role of chromium in blood glucose management.  Conversely, hypoglycaemia, or a sugar crash, is when masses of insulin are released into the bloodstream resulting in low blood sugar.

The World Health Organization (WHO) recommends a maximum daily sugar intake of 25g for adults (circa 5% of the total daily calorie intake).  To this end, carbohydrate intake has to be carefully monitored by diabetics and pre-diabetics as, when broken down, carbs become simple sugars.  Highly processed carbohydrates are to be avoided, while wholegrains in moderation are an important part of a well-balanced diet when having to control blood glucose levels and keep overall blood glucose (HbA1C) maintained.  Indeed, a study conducted by researchers at Lund University, Sweden, found that wholegrains can actually stabilise blood sugar levels for up to 10 hours. 

Medical News Today reported on a recent international study back in June that found that two portions of full fat dairy per day decreased the likelihood of developing diabetes and/or high blood pressure: this can perhaps be linked to the lower sugar content in such products than their low-fat counterparts.  Meanwhile, a previous study published in Panminerva Medica in 2014 suggested that Delphinol (or extract of maqui berries) could be of assistance in blood glucose level maintenance, as well, reducing the speed at which glucose is absorbed into the bloodstream.  This, due to active delphinidin inhibiting sodium glucose co-transporter (SGLT) and thereby lessening the likelihood of blood sugar spikes post-eating.

The 11th November marks the start of Sugar Awareness Week.  If you are of the female of the species, it might be wise to step away from the sugary soda for another reason as well: research which has been conducted for the last 25 years and is ongoing has found that those women who regularly consume even one serving per day of “calorific soft drinks, sweetened bottled waters or teas and sugar-added fruit drinks” are 20% more at risk of cardiovascular disease, at a 21% greater risk of stroke, and 26% more likely to require such procedures as angioplasties.  Published in the Journal of the American Heart Association, the research allowed that this was due also to the fact that in raising insulin and glucose levels in our blood, the tendency towards increased appetite and developing obesity is worsened by sugar intake.  And, of course, obesity is a major risk for cardiovascular disease.

Fat stored around the abdomen is the most dangerous.  Considered hormonally active, it is a major factor in elevating diabetes risk.  Indeed, fat tissue in particular is where cytokines are produced, inflammatory response immune cells which were highlighted during the pandemic’s height as patients displayed symptoms of “cytokine storms”, or massive inflammatory responses.  Yet, weight isn’t entirely a question of fat.  As we age, we lose muscle mass.  Even though we might be eating the same diet, we actually need fewer calories the older we get due to this muscle mass loss.  And those extra pounds – at least for women – won’t go to the hips and thighs anymore in gynoid fat distribution.  Rather, the android fat distribution of perimenopause sees any extra poundage transfer to our middles. 

Eating well and nutritionally complete is only effective if combined with aerobic and resistance exercise, though.  Think cardio and weights; and think protein.  If you want more amino acids in your diet than one egg could possibly ever provide, consider the wide variety of plant-based wonders.  At the end of the day, by adopting a healthier, more wholesome diet and active lifestyle, you’ll be protecting yourself against unnecessary risk of serious disease and feel happier overall. 

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