On top of a filing cabinet at my company’s offices there is regularly an open tub of chocolates, inviting anyone passing to dip in and grab themselves an Orange Creme, a Golden Barrel, a Mini Flake, or all three. I pass the chocolates en route to the office kitchen to make myself a cup of tea. However, I don’t partake. It’s not that I don’t appreciate the gesture, but for at least the last three years I’ve been Type 2 diabetic and therefore chocolate in all its forms, along with bread, pasta and almost all the foods containing ‘complex’ carbs, are no longer my friend.
It’s my own fault: I indulged too much in such things and gained a lot of weight that clogged up my pancreas until it stopped working properly. That’s the broad science of it. Now, like an alcoholic never touching another drop for fear of returning to addiction, I mostly avoid carbs to prevent myself going blind, losing my feet or needing kidney dialysis if I let blood sugar levels return to where they were when I was first diagnosed.
You can’t survive by not consuming carbohydrate, however. It’s just that I have to look out for things that contain too much of it and not eat them. Occasionally I’ll have a pint of Guinness, but I’ll stick to just the one before moving on to water or a diet drink. It doesn’t bother me. I can still be sociable, it’s just that I’d prefer to remain sociable for as long as I can. I don’t get resentful, either: I’ve grown used to my own family consuming chocolate around me (usually around nine in the evening), in much the same way as I’ve long rejected any envy over people eating sandwiches, pasta or naan bread in front of me. I know what it can do to me, so I let it go.
However, the chairwoman of Britain’s leading food watchdog has another view. People bringing things like cake into the office for colleagues should be considered, she says, as harmful to their health as passive smoking. “We all like to think we’re rational, intelligent, educated people who make informed choices the whole time,” Professor Susan Jebb of the Food Standards Agency said, speaking in a personal capacity. “I have made a choice, but people were making a choice to go into a smoky pub.”
Whilst not saying the two issues are completely identical, she has combined them into the same thinking. The Times reported her as saying: “With smoking, after a very long time, we have got to a place where we understand that individuals have to make some effort but that we can make their efforts more successful by having a supportive environment. But we still don’t feel like that about food.”
Frankly, I’ve never equated smoking and someone leaving a birthday cake in a communal area at work, even in working cultures where someone is always bringing in confectionary. As an ex-smoker, too, I’m also conscious of what my fumes did for those I worked with when I last smoked, almost 30 years ago (including - ugh - in a small office with two non-smokers).
I get the point, though. Two-thirds of adults in the UK are classed as overweight and a quarter obese. Worse, Type 2 diabetes now accounts for one-in-twelve UK adults, with cases in children and young adults quadrupling in Britain since 1990 - a faster increase than anywhere else in the world (rubbishing the idea that it is a condition of middle-age). Type 2 diabetes is mostly lifestyle-induced, too and - to some extent - self-inflicted. And I’m more than conscious that my own lack of self-restraint now contributes to the £6 billion obesity-related health conditions cost the NHS.
Politicians have argued for and against other measures to curb unhealthy lifestyles, such as banning the advertising of junk food, much as cigarette marketing was outlawed years ago, or stopping retailers from offering two-for-one deals on treats. Jebb, too, has added to this debate, telling The Times: “Advertising means that the businesses with the most money have the biggest influence on people’s behaviour. That’s not fair. At the moment we allow advertising for commercial gain with no health controls on it whatsoever and we’ve ended up with a complete market failure because what you get advertised is chocolate and not cauliflower.”
At the end of the day it is all about choice. And that choice requires strength of discipline. The brain is also very clever in prompting temptation, or forgetfulness. We can too easily mindlessly graze our way through a plate of biscuits left in a meeting room, or that box of Celebrations passed around without thinking - if we let ourselves, that is.
Food brands are obliged these days to include nutritional facts on their packaging, which for someone like me who has to make a smart decision is extremely helpful. But is the solution that bad foods should be outlawed altogether? Of course not. Even I can have that occasional Guinness, though with 18g of carbs per pint, your granny was right in calling it a meal in a glass. Moderation is key which, I know, is often easier said than done. Harder is finding healthier food choices when eating out, and here is where I’d like to see the hospitality industry do more. Some pubs and restaurants do understand: asking to remove potatoes or chips from an order and replace them with salad is increasingly easier. More and more establishments get the idea of ‘bunless burgers’ or ‘burritos-in-a-bowl’, too. But I appreciate that as a diabetic I remain in the minority. Plus, you can’t vouch for the sugar and salt used in recipes - avoidance is, I’ve accepted, only a mitigation.
Actually, the worst place I’ve ever experienced for food is, counter-intuitively, a hospital. When I spent time as in-patient for a diabetes-related condition a couple of years ago my breakfast choices would either be cereal or scrambled egg on white toast. Every morning. I chose a small dollop of the egg every day, with the only bonus being an added sausage on Sundays. Dinner would be whatever meat and vegetables I could extract from a lasagne.
While I’ve got on top of things, and smugly lost weight to, now, manage my condition, others aren’t so diligent. Obesity and overeating are diseases in their own right. There are psychological reasons why some people eat themselves into being overweight, despite longstanding public information about the risks. But a nanny state is not the answer. Of course, the NHS could be more interventionist, but given pressures on the health service and GP surgeries in general, for a doctor to instruct someone to lose weight probably requires an in-person appointment, and would usually only come about because the individual is there for something else. No one, I suspect, rings up their GP to say “I’m fat - help me”.
“If a doctor comes across somebody with high blood pressure, they would feel, culturally, by training, by guidelines, by practice, that they must offer this patient treatment for their high blood pressure and explain to them why it was important,” Susan Jebb told The Times. “At the moment, if a doctor comes across a patient who is overweight, they mostly ignore it. The status in medicine comes from treating rare diseases with very expensive medicine and technology, and obesity isn’t either of those.”
She has a point. Obesity has, weirdly, been accepted culturally. I used to watch the American sitcom Roseanne and never once thought that Roseanne Barr’s titular character or her screen husband John Goodman were putting their health at risk by being large people. It almost seemed like a blue collar badge of honour. The Sopranos was, more or less, about hefty, masculine men who ate mounds of spaghetti-and-clams, wore oversized untucked shirts, and were more likely to die from a rival’s 9mm bullet than heart failure. Thanks to these cultural references I, too, embraced the large untucked shirt look because they allowed me to be fat without, apparently, consequences.
When I lived in America, and on my many visits there since, I embraced the drive-through culture that put me literally at arms-length reach of a supersized burger-and-fries combo from the comfort of a car. The contradiction here, though, is that in America there are, actually, plenty of healthy food choices, and healthy lifestyle opportunities are everywhere. In California, where I lived, you worked alongside trim-looking joggers, gym-goers and outdoor junkies whose cars had bike and ski racks permanently mounted on them. Even in “overweight America”, you had a clear choice.
I’ve clearly made some bad ones, and didn’t realise that I had. But today, I walk past that open tub of Roses because I can. It’s another choice. It just shouldn’t have to be everybody else’s.
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