How to slow down the global spread of Type-2 Diabetes? Simplify the message.

​Why is so little progress being made in slowing down the dramatic rise in obesity and Type-2 Diabetes around the world? Why is this exploding diabetes crisis akin to watching a huge global train wreck in slow motion?

Every country that’s been invaded by the standard overly-processed Western Diet is ‘enjoying’ rising levels of obesity and type-2 diabetes.

Highly westernized islands in the Pacific lead the inter-related obesity and diabetes charts, with enclaves like Kuwait and the Bahamas not far behind. The U.S. is the first large country on the list, leading in percentage terms, followed by New Zealand, Canada and Australia with the UK close behind. The witty comment that ‘diabetes is caused by speaking English’ might have had some relevance ten years ago, though in absolute numbers, China and India now dominate. 

​​​As they play catch-up with their increasingly westernized food and lifestyles, the situation is predicted to go from bad to worse. Yet mainstream views continue to be divided about the underlying causes.

The global diabetes crisis - like watching a slow-motion train crash, with no way to stop it.

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This guest post is written by an expert in the field of consumer communications: James Capon 

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While everyone accepts that diet plays a big role, entrenched opinions, definitions and varying viewpoints on today’s junk food culture combine to stop a clear message emerging. Battles between different dietary approaches and the views of their advocates continue to play out, using information and misinformation from both established viewpoints (who hate change and don’t want to accept they might be wrong) and from numerous health pundits. Add to that many industry groupings and lobbying groups from the Bigfood and Bigpharma categories who also chime in, concerned about the potential impact on their future profits.

​Looking ahead, one thing is clear: Type-2 Diabetes, as well as being debilitating for more and more individuals is likely to become financially unsupportable for many governments. They simply won't be able to afford to care for all those afflicted. And it's all so predictable.

Taken from IDF 2015 report

Confusion reigns

You have to feel for the confused 'Man or Woman on the Street' when it comes to diets, diabetes and obesity.

Information can be so divisive and confusing that it’s often just easier to be a cynic, claiming that next week’s advice will be different... and yet, in doing so, you avoid taking any personal responsibility.

At the time of writing, mainstream health authorities continue to push a low-fat message, and although sugar has morphed into today’s public enemy number one, most diabetic patients are told that other refined carbs, particularly when combined with artificial sweeteners, are perfectly acceptable.

"You're seriously asking me why I'm so confused?"

Popular press: a mouthpiece for whoever feeds them information.

​Diabetes support groups working within the guidelines of national health authorities have chosen to push the 'low-fat' and  ‘bad sugar’ messages above all else. Because of this, you can still observe global ‘westernized’ citizens in coffee bars and cafes around the world devouring their blood sugar stimulating sandwiches in the mistaken belief that it's the butter and ham which will make them ill, rather than the mass-produced bread that surrounds it.

All the while, food industry lobbyists push extreme stories at the tabloid newspapers whose readers now consider frequently changing and contradictory headlines simply to be the norm. They prefer us to remain confused and cynical, as they continue to muddy the waters.

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In a world of alt-facts, we still trust our doctor

If like me, you’ve reached the conclusion that eating a real food diet with fewer carbohydrates is the best way to go - whether you are diabetic or not - you’ve probably read books, considered the available research and carried out some successful self-experimentation. You may have been influenced by the well-researched, thought provoking nature of Gary Taubes' or Nina Teicholz’s writing, or perhaps the inspirational approach taken by Professor Tim Noakes in South Africa. Whichever the case, your new-found convictions are probably strengthening.

But for most people, to really deeply believe in the effectiveness of a health message means getting our convictions at the grass roots level, communicated to us by a General Practitioner.  That's simply because generalist doctors belong to the declining group of influencers who still enjoy our trust. In a recent Ipsos Mori poll, Doctors led the field with an 89% trust factor, leaving bankers (37%) and politicians (21%) far behind.

Doctors like Aseem Malhotra (albeit a cardiologist) and Rangan Chatterjee (famous for his Doctor in the House TV series) with their lifestyle related lower-carb, higher-fat convictions, have been gaining influence. Their approach adds to the more day-to-day experience of practitioners such as Dr David Unwin in his award winning Southport GP practice, or the considered advice from diabetes expert Dr David Cavan as outlined in his bestseller, Reverse Your Diabetes. If you intuitively agree with the benefits of such a lower-carb lifestyle approach, then with doctors like these on your side, you are in good company.

In an attempt to unify and amplify these low-carb messages and promote real food, the Public Health Collaboration PHCUK was founded in 2015 aiming to: “improve the healthy eating and weight loss guidelines currently given by the NHS” - particularly for pre-diabetics and diabetics.

Less than two years old, the PHCUK is off to a great start but contradictory mainstream messages from official sounding sources like WebMD or the Mayo Clinic which still state that carbohydrates should be your major source of energy add to the general confusion.

In addition, studies using a low-carb definition of 10% of consumed calories may contradict other research which says that 40% can already bring large improvements – or it may be the opposite!! And so on.

In the press, relative weight, food density and calorific impact get mixed up in discussions featuring numerous 'industry   experts' ; in supermarkets, daily calorific percentage values found on labeling make things even more confusing for the lay person. And let's not forget the views of our much-maligned nutrition/dietitian community who tend to push the “we’re all different” or “no one diet fits all” message and… true confusion reigns. 

One of the excellent PHCUK lower-carb Real Food booklets.

Source: Dr David Unwin & PHCUK. Click to expand

On that count by the way, it is self-evident, a truism, to say that we’re all different, yet it's pretty much irrelevant when it comes to preventing or stopping the rise in Type-2 Diabetes cases around the world. After all, not everyone who smokes 20 cigarettes per day dies from lung cancer, but only the smallest minority would now dispute the validity of banning ads or adding warnings to cigarette packets. The successful battle against lung cancer has been fought with a clarity of purpose and conviction… not by nickel-and-diming interpretations and dimensions of difference.

What's true is that for most of those diagnosed as pre-diabetic, and pretty much all those who suffer from Type-2 Diabetes, the evidence is overwhelming. A lower-carbohydrate, higher-fat diet, based on eating real food helps almost everyone, and the specific proportions of carbs and fat that work best for you are indeed, a matter for personal trial and error. My personal tip: start low with the carbs and then gradually increase. I'm  currently at 60-70 grams of net carbs per day - and I suppose that the fact I know this clearly puts me in the nerd category:)

Confuse them and you'll lose them

Professional marketers and communication specialists know that if you confuse people, you lose people. In the field of diabetes and possible dietary solutions, that's exactly what is going on today.

​Over the years, successful strategies have used the acronym, KISS (Keep it Simple Stupid), to anchor their most effective slogans and value propositions. Now, I believe that it’s high time such an approach is adopted when recommending the diabetes related benefits of a low-carb lifestyle.

So what’s stopping this? What’s getting in the way? A lot of vested interests maybe? Some minor disagreements certainly, but also I suspect, a fear on the part of some, of dumbing down the precise medical facts. While it’s true that you can’t get all the information across in a short message, you do increase greatly the chance that your message will be remembered. After all, if no-one remembers what you said, or if everyone remembers different aspects of what you were trying to communicate, you may just as well not have bothered.

Put aside the quibbling and communicate straightforwardly that a disease caused by eating too many carbohydrates, can only be ameliorated and/or reversed by eating fewer carbohydrates.
​It’s as simple as that.

Keep it simple stupid (KISS)

​Let’s begin by simplifying the communication chain:
What are the 3 core problems associated with type-2 diabetes?

1. The cost: personal and societal.
2. The personal hardship and pain: from drug related side-effects (stomach problems, a lack of libido, reduced levels of personal energy) to amputations, blindness & worse.
3. The impact on friends and loved ones.

What’s the best solution?

• Drop the carbs to avoid the downward spiral of increased diabetes medication and poor quality of life.

Why bother?

• Reducing your dietary carbs, particularly highly processed starches and sugars, helps you to be healthier, happier & live longer; you may even get off your meds, enjoying life to the fullest.

But I still want proof:

• The Science: Dietary carbohydrates are the principle driver of higher blood glucose which stimulates insulin secretion; fueled by more carbs, this starts a vicious downward cycle in your body resulting in insulin resistance and leading to full-blown Type-2 Diabetes.
• The Practice: Examples from www.diabetes.co.uk and Dr David Unwin’s well-documented experiences with patients and patient groups show numerous success stories. More are on the way.

So what must I do? What is the KISS message?

• Cut the carbs. Just as the smoke you inhale into your lungs dramatically increases your chance of getting lung cancer, the sugar and starch (carbs) you eat elevates your blood sugar, increasing your chance of becoming diabetic and/or making your Type-2 Diabetes worse.

From tacit agreement to conviction

OK - you're nodding your head in acquiescence, yet not totally convinced. This is where I come in - the experienced communications guy.

​The oldest parts of the brain (in evolutionary terms) are responsible for your fight or flight response, but also for the final say when it comes to decision making. When you’re absolutely sure of something, your New Brain (Cortex) will decide rationally what the right course of action is to be, but you won’t completely buy-in to that decision until the instinctive part (Old Brain) chimes in and agrees. Put differently, you make decisions based on emotions and then post-rationalise the whys, wherefores and other ‘reasons’ for moving ahead.

The decisive yet instinctive Old Brain sees simple, straightforward relationships between things. It hates complexity. That’s why I firmly believe that there is little chance of shifting mind-sets unless there is a stronger and clearer starting position. That's why, Type-2 diabetes needs to be defined as what it really is, at least in 99% of cases; a disease of carbohydrate intolerance.

If it would help in reaching agreement more quickly, perhaps we could all agree on: “Type-2 Diabetes is primarily a disease of carbohydrate intolerance”.
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When defined and communicated in this way - as a disease of carbohydrate intolerance – it becomes clear, logical and much easier to understand for all those at risk. "It stands to reason: I need to reduce the amount of carbohydrates I eat at every opportunity - in particular, by avoiding both sugar and starchy food".

Crucially, if your GP uses that same language of 'carbohydrate intolerance', because of that existing bond of trust, your Old Brain will chime in with its support too.

Communications Summary

If you are one of the many who would like to help reduce the spread of Type-2 Diabetes among those eating Westernized diets today - and that's almost the entire world now: 

• Let’s simplify messaging.
• Let’s agree that Type-2 Diabetes is primarily a disease of carbohydrate intolerance.
• Let’s put aside the quibbling and communicate straightforwardly that a disease which is caused by eating too many carbohydrates can only be ameliorated, and even reversed, by eating fewer carbohydrates.

It’s as simple as that.

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Tell it like it is: this food represents the pathway to Type-2 diabetes - it's full of starchy, sugary carbs.

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This guest post was written by: James Capon MBA, a communications expert, former President of Levi Strauss in San Francisco and partner with SalesBrain Europe. He began eating low-carb a few years back and feels much better for it.