Beat the diabetes timebomb
Life-saving series by Dr Michael Mosley
Diabetes cases double in 15 yrs 5 million Britons now have disease
AS A MEDICAL student back in the 1980s, I had a fighting weight of 11 stone (70kg) and I didn’t ever worry about my body size. But like many people, I gained a few pounds in my 30s, and a few more in my 40s, letting out a notch on my belt and going up a waist size in trousers every time, but I’d look at myself in the mirror, suck my tummy in, and think: ‘Yep, I’m in pretty good shape for a man my age.’
Then a routine blood test in 2012 revealed, to my horror, that I had type 2 diabetes — and I subsequently learned that my stealthy weight gain had overwhelmed my body’s ability to function properly and was now putting my health at risk.
What shocked me was the way fat had accumulated around my abdomen so gradually I had been somehow lured into the obesity trap without even noticing.
I am certainly not alone. Even though 28 per cent of the population is categorised as obese and a further 36 per cent as overweight, I’m pretty sure most people think a bit of a belly is perfectly acceptable. They look at their friends and see most of the men in 36in jeans like mine were, or women opting for size 16-18 clothes and they feel comforted.
But this gradual weight creep is a ticking time bomb storing up some very serious health problems for the future.
I wish someone had warned me how easy it is for the pounds to pile on without realising, and how dangerous that could be for my health.
That’s why I want to warn you.
IT’S EASY TO BE LURED INTO THE OBESITY TRAP
You might feel healthy right now, but if you’re heavier on the scales than you were in your 20s, and if you continue to let the weight creep on, you could find yourself staring down the barrel of the diabetes gun, just as I did.
It is crisis time, and we need to act NoW.
I was shocked to read that last year, between May and December, more than a million people in England were admitted to hospital with weight- related problems ranging from type 2 diabetes to heart disease, gallstones and arthritis in the hip. This is a startling number, the highest ever recorded by the NHS and a huge 17 per cent increase on the previous year.
That same period, which covered the first and second Covid lockdown, also saw a terrifying rise in reported levels of stress and anxiety, as well as an ‘unprecedented’ fall in activity levels, according to a survey by Sport England.
All of which adds up to a toxic cocktail of ill health that I fear is going to impact the NHS for years to come.
on top of this, and closely related, is another shocking statistic, this time provided by the charity Diabetes uK: the number of people in the uK with diabetes recently hit an all-time high of 4.8 million and is expected to reach 5.3 million by 2025.
Diabetes occurs when your body is no longer able to keep your blood sugar at a healthy level.
Type 2 diabetes is the most common form of the disease in the uK, accounting for over 90 per cent of all cases, and happens when your body stops producing enough insulin to bring your blood sugars down, or you become insulin n resistant — your body stops reacting - to insulin.
To find out if you are at risk, k, do the quiz (see panel) or get t your blood sugars measured d by your GP.
The tragedy is that much of this s is preventable. We know, for example, that people with obesity are seven times more likely to develop p type 2 diabetes than those who are e a healthy weight, illustrating how w serious weight gain can lead d to serious health problems.
But the report also says that t 13.6 million could be at serious risk of developing type 2 diabetes in the future because of prediabetes s (raised blood sugar levels which h are not yet in the diabetic range). Around one in three of us are already in this danger zone where blood sugar levels are raised, but not yet in the diabetic range.
This is also the result of an unhealthy lifestyle and, unless you act, is likely to lead to diabetes in a few years time. In the meantime, persistently raised blood sugars will damage your immune system and your major blood vessels, making you more vulnerable to other diseases. A third of those who died of Covid-19 in the uK had diabetes.
SMALL TWEAKS CAN HAVE A HUGE IMPACT
So, WHAT can you do about it? Starting today and continuing next week, in a series backed on the latest science, I will be looking at the lifestyle changes you can make to keep yourself in shape and prevent the pounds piling on. If you already have raised blood sugars or raised blood pressure, my advice can help put those twin evils sharply into reverse.
Prevention is better than cure and the first thing to recognise is that diabesity (diabetes plus obesity) does not happen overnight. You don’t put on two stone over Christmas (or at least most of us don’t). It gradually creeps up, year after year, decade after decade. Studies show that most of us put on around 1 lb a year from our mid 20s to our late 50s, and only then do the rising numbers on the scales begin to slow.
We are told that two thirds of Brits are overweight or obese (making us the fattest in Western Europe), but those figures include people in their 20s who have yet to put on much weight. According to NHS digital, the figures for middle-aged people are much worse than that — 82 per cent of men between the ages of 55 and 64 are overweight or obese, while women peak a decade later, by which point seven out of ten are an unhealthy weight.
That’s what happened to me. In my 20s I was a trim 11 stone (70kg), with a 30in waist and I could eat anything I wanted. Which I did.
A new job, however, meant long hours, stress and less sleep. I married Clare, who I had met at medical school, and we had four children. This was lovely, and we were (and are!) very happy, but I began to feel the pressures of parenthood, along with the pressures of work. I snacked more, did less exercise and the weight crept on.
By 2012, when I was 55 years old, I weighed 88kg, nearly 14 stone. I had put on 42 lb over the course of 30 years and the odd thing, looking back, was that I was in total denial of this simple fact. I looked in the
Obesity crisis blamed for rise
mirror and thought I looked in good shape. Yes, my blood pressure was a little bit high and I now had to buy trousers with a 36 in waist (even those were extremely tight) but I couldn’t see that I had a problem.
My wife, who unlike me had put on barely any weight over the years, did occasionally complain about my snoring (which could rattle windows) and she tried to curb my snacking, but I was resistant to her entreaties. My weakness was, and remains, the sweet stuff. I love chocolate, cakes and dessert, and once I start eating them I don’t stop. I could easily devour a packet of biscuits in one sitting.
Then, in 2012, I went for a routine blood test and my GP rang me up later to tell me the news — ‘It looks like you have type 2 diabetes’. Further blood tests confirmed the diagnosis.
THE HIDDEN RISKS OF BEING OVERWEIGHT
MY GP wanted to put me on medication, but I wasn’t keen. My father had developed type 2 diabetes in his late 50s, gone on medication and died at the age of 74 from complications of the disease. Having diabetes, even if it is treated, will still double your risk of getting heart disease or dementia.
You are also 15 times more likely to need a finger, toe, or whole limb amputated at some point down the road.
Another terrible thing about diabesity is that it is skewing the lives of even younger men and women. If you get it when you are in your 40s, which many do, you will probably have to retire early because of a heart attack, stroke or problems with your feet. It will also knock around six years off your life expectancy. That’s scary.
WEIGHT LOSS REVERSED MY DIABETES
For All these reasons, I wasn’t keen to follow standard advice. Instead, I decided to see if I could cure myself, without medication, by losing weight.
I went to the U.S., came across research about the benefits of intermittent fasting, and put myself on what I called ‘a 5:2 diet’, cutting my calories down to around 600 calories twice a week, and eating healthily the rest of the week. By doing this I lost 19 lb and returned my blood sugars to normal, where they have stayed ever since.
Why had losing weight worked? one of the main reasons why you develop type 2 diabetes is because years of overeating mean you have exceeded your personal fat threshold. Similar to a bath: if you add too much water it will overflow.
Your personal fat threshold is largely determined by your genes, which explains why some people can have a normal Body Mass Index and still develop diabetes, while others can be seriously obese and not have blood sugar problems.
When I first developed type 2 diabetes I had a BMI of 27, which is only just above what is considered ‘healthy’ i.e. 18.5 — 24.9. But my large and growing waist suggested that I was carrying too much fat around my gut, and that was my undoing.
Gut fat, also known as visceral fat, clogs up your liver and pancreas, which are essential for regulating your blood sugar levels. Get rid of this fat and there is a good chance these precious organs will recover.
That is what Dr roy Taylor, who is professor of medicine and metabolism at Newcastle University, told me when we first met in 2014. He also told me he had been doing clinical trials which showed that what I had done was not a fluke, that if
you have type 2 diabetes and lose at least ten per cent of your body weight, it is possible to restore your health.
Although he doesn’t think it matters too much what speed you lose the weight, his research has shown that people are much more likely to lose the excess fat, and keep it off, if they start with rapid weight loss, which means roughly 800 calories a day for eight weeks, followed by the gradual introduction of more food.
If you are keen to understand what goes wrong with your blood sugars, and how to put them right, then I strongly recommend his new book, Your Simple Guide to reversing type 2 Diabetes, which was recently featured in the Daily Mail.
Professor taylor’s studies are based on the use of meal replacement shakes, which many people find simple and convenient. others prefer to lose weight and reverse their diabetes by eating real food. that’s why Clare and I wrote the fast 800 recipe books and created the fast800.com website.
CHANGE YOUR LIFESTYLE CHANGE YOUR LIFE
the FAST 800 philosophy is founded on the principles of Mediterranean eating — plenty of fresh food and vegetables, good quality protein in the form of meat, fish, eggs, tofu and pulses, nuts and seeds, plus healthy fats, including lashings of olive oil.
Small quantities of complex carbohydrates such as brown rice and starchy veg are part of this regime, but white carbs are best avoided for reasons I have explained in the box on the right.
Depending on how much weight you want to lose, the fast 800 comes in three phases.
the rapid weight lose phase is suitable for people who have quite a bit of weight to lose or have been told they have prediabetes or type 2 diabetes. this is based on 800 calories a day in three small meals (you can substitute one of these meals with a calorie-counted shake) for between two to eight weeks.
We have found this to be very effective — the weight loss is rapid, which is rewarding and encouraging — and clinical studies have shown that it can be a very effective way to reverse type 2 diabetes.
If you have less weight to lose, or aren’t suitable for rapid weight loss (visit thefast800.com to find out) we suggest a 5:2 version where you follow the 800 calorie plan on two days of the week and eat a healthy, Mediterranean diet for the rest of the week.
to maintain weight loss and keep healthier long term, we recommend a Mediterranean Diet with an element of time restricted eating, which means eating within a ten to 12-hour window, giving your body further benefits of intermittent fasting.
FIND A PLAN THAT WORKS FOR YOU
But RAPID weight loss is not suitable for everyone. So what can you do if you prefer a slower and steadier approach or, having lost the weight, want advice on how to keep it off for good?
that’s where my brilliant new series, starting today and continuing all next week, can help. I will be sharing what I have learnt over the past nine years, often from some of the world’s leading experts, about simple steps you can take that will not only help you get trim — and stay that way — but also improve your fitness, gut health, sleep and mental health.
And because I believe passionately that what we eat really matters, Clare will be providing delicious and filling recipes, some taken from her recent book the fast 800 easy. I hope you enjoy the series. It could be life changing.