My job involves little physical activity. I mainly sit in front of the computer in an upright position or slouching on my hard plastic Ikea chair, to which I added a cushion to ease my back. I recently tried different positions sitting on the sofa or lying down when my back aches. When I read, write or take notes the issue is similar, I tend to sit still for hours concentrated on my work. There is no doubt, that like many writers, I have a sedentary lifestyle. No wonder I developed a Diabetes Type 2 risk condition detected by a recent blood test, a state that adds to my hereditary high blood pressure and asthma, which I successfully control with tablets and inhalers.
My medical practice immediately put me into the diabetes awareness program which included a generous provision of brochures and publications on the topic and four sessions with a facilitator together with all the people at risk in the area. It was very helpful, especially chatting with my diabetes-at-risk fellows, sharing our concerns, guilty indulgences and plans on how to possibly improve our condition without cutting all our food favourites.
For some of us the main problem was exercising, finding the time for it and being motivated. Luckily, it is not only aerobics, jogging or having a run that count. You can also burn calories cleaning the house, gardening, ironing, climbing stairs, typing and even washing dishes, though it takes longer. You should wash dishes for fifty minutes to burn a hundred calories, which is unlikely in everyday life, but ten minutes can add to the other chores and maybe a fifteen minutes walk to the local shops or some gardening will reach the target. On the other hand, absorbing a hundred calories is very easy. A Digestives biscuit, three Rich Tea biscuits or half a pint of beer or Lager make it. It is also true that the body burns calories constantly, for example breathing or digesting food, as bodily functions require energy that is more than 2,000 calories per day. However, our western habit to consume large amounts of food does not help to maintain a balanced weight. Temptations surround us at all levels alluring our senses and almost forcing us to give up. It is hard to choose rice cakes when you have chocolate coated Digestives and Jaffa cakes in the adjacent aisle, or renounce a chocolate and vanilla ice cream in a hot day. We can have it once in a while but it is a treat that cannot be repeated and needs to be savoured in small portions.
Millions of people are at increased risk of developing Type 2 Diabetes in the UK, and probably all around the world especially in Western countries. The NHS spends millions every year to cure patients with diabetes and prevent the spreading of this condition. The long term complications of Type 2 Diabetes are rather threatening: possible sight loss, kidney disease, amputation, heart diseases, dementia, depression and sexual dysfunctions. These conditions are linked to ageing as well and the causes were probably undetected in the past. Today we all try to be more efficient and ageing gracefully seems to be one of the main targets. Most of us live longer than in the past. If the last ten or twenty years of our life are characterised by poor health or mental conditions, it can be very unpleasant and expensive. But what can we do? From what I learned in the Diabetes Awareness course and from the related literature I read, we can do a lot to lower the risk and improve our situation.
First of all, we need to check the diabetes level regularly with an HbA1c test as well as keeping under control the cholesterol levels and high blood pressure. The weight needs to be checked regularly as well as the waist measure and the BMI (Body Mass Index). If you are overweight hurry to lose weight! Your waist should be 80 cm/31.5 inches for women and 94 cm/ 37 inches for men, and the BMI should be below 25. I usually control my weight and the other things once a month at Boots Pharmacy where they have a sophisticated scale that makes all the measurements, but I find it hard to meet the expectations. Is it perhaps because my ageing body is inevitably falling apart in spite of my three yoga and two swimming weekly sessions? I had three pregnancies and my waist unfortunately refuses to go back to eighty centimetres only. According to Boots’ scale I am only two kilos overweight but it is so hard to lose weight. I feel weak and dizzy if I do not eat enough and fat seems to add mysteriously in my middle part leaving my legs and arms skinny.
Switching to a healthier diet was reasonable and positive on the whole. I have much more vegetables, which I love, fruit, fish and moderate amounts of meat, rice, bread and pasta, preferably the wholemeal version. But there is the portion size issue. Portions should be small, very much reduced; the amount of food you take should fit in the palm of your hand, and I have a small hand. The quantity of vegetables should be the size of a light bulb, rice only a tennis ball, meat a deck of cards, cheese a small matchbox and fat or sugar the size of a dice. Fibre is highly recommended as it has a slow release of carbohydrates that makes you feel full and keeps you regular. Another frequent advice is to use smaller crockery so as small amounts of food look bigger in a small plate, an illusory truth effect. Apparently the size of plates has grown in recent years, a detail I missed. Honestly, my grandmother’s plates look the same size of my Wilko plates. Other good tips are to drink more water, it helps you lose weight, and in a restaurant not to face the kitchen or you will be too tempted; then order first so you are not influenced by what other people choose and opt for healthier dishes. Above all, do not have a second helping, ignore free refills of fizzy drinks or salad galore; for us it is only half a pint and a portion that fits in the palm of your hand.
I found it positive that artificial sweeteners are approved and safe and that food labelled as ‘diabetic’ are no particularly benefic. Cooking our own food seems to be the best option and it is recommended to browse carefully the labels when buying packaged food at the supermarket. The amounts of fat, saturated, sugars and salt are colour-coded on the packages where green means low, amber medium and red high. So we need to read the labels and choose green or amber. This is an excellent advice in the artificial OGM manipulated food world we live in. Besides these restrictions, we can have almost everything, even alcohol but in moderation. However, remember to keep weight, waist and blood sugar levels always under control.
The diabetes awareness sessions were very interesting. Damien, the facilitator, conveyed the information clearly and involved the audience in discussions and interactive activities, accepting our suggestions, supporting our small efforts and answering all our questions. Twenty people were enrolled in the course, the great majority white people, there was only one African and two Asians, though it seems that Africans and South Asians are more at risk than people with white background due to their lifestyle and eating habits. What Damien kindly suggested us to do was to change our lifestyle to avoid developing Type 2 Diabetes. We analysed together our ‘bad’ habits and tried to find the motivation to change them. We set goals, supported one another and promised to review our plans. Making sacrifices seems inevitable, not just exercising, which can become a pleasant pastime, a hobby where you meet other people and socialise. The hardest point is to get rid of all the luscious, succulent and unhealthy food that is on display whenever you go. For me it is cakes and biscuits that I love baking and eating. I like experimenting with new recipes and preparing treats for my family we all enjoy, not only for celebrations but also in everyday life. It is a way to reaffirm affections and bonds, a cultural habit that is hard to give up.
With age things become complicated and taking more pills can sometimes increase problems rather than solving them. So we need to keep calm, avoid arguments, or the blood pressure will go sky high, reduce sugar and salt, check the labels and exercise regularly.
There will be follow up sessions to my four core meeting of Diabetes Awareness in the next six or nine months. I am looking forward to it to see Damien and my diabetes-at-risk fellows again with their positive friendly approaches that encouraged me to take action and will support my strong-willed determination to fight diabetes and hopefully avoid complications.