What can be done to encourage healthy living?

Just read this article on amputations due to diabetes

Quite apart from the misery these people endure is the cost to the NHS. I’m sure a huge amount of NHS expenditure is easily avoidable if only we could encourage people to look after themselves. Yes I am aware of the poverty/junk food trap.

That’s a grim read before bed.

I suppose don’t eat processed food and exercise daily. Not sure how you would persuade people to stay healthy.

Stop the large food companies lobbying and donating to politicians plus tax and regulate addictive unhealthy food.

what Horatio says.  Our poor food and high rates of obesity are basically down to unethical behaviour from food companies.

Yep, needs heavy government involvement.  Forcing people to exercise is going to be tricky but removing all foods that are unhealthy is easy enough although the cries of nanny state and I didn’t vote for this would be heard for years (which would be a fair point!).

If unhealthy foods were not an option then the manufacturers of them would either cease or change to make healthier foods or be replaced by companies making healthier foods.  It is how the governments should lead the private sector.

Have a listen to this

https://www.bbc.co.uk/sounds/play/m0021xv1?partner=uk.co.bbc&origin=share-mobile

Ultra-Processed Foods (UPF), as defined by the NOVA Food Classification system, are the most problematic, and are causing more addicted like behaviours in people. They say if the addiction was formalised, then Government’s would have to do more to regulate these foods and the food industry

Dont know but banning all unhealthy food is a non starter. Better regulation of how food is made definitely but a ban no chance.

The public need to take some personal responsibility as well, why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example.

Maybe there needs to be some acceptance that without draconian controls this problem wont go away (and draconian controls aren’t and option). Also need the NHS to do an about face and properly concentrate on prevention rather than cure. That also includes being blunt with people whem they first present with issues about the serious need for lifestyle change to hopefully shock a few into realising its on them as much as anyone to change.

Healthy food needs to be the cheapest option, make all the ultra processed stuff really expensive (it already is tbh, but obviously not enough)

Active travel needs to be the easiest, safest and cheapest option also.

why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example.

That is really missing the point. I like full fat coke. It’s no worse or better than the sugar free alternatives that are just as bad

Its the main foods that people eat that are full of fat, sugar, salt etc

why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example.

I don’t drink fizzy pop often but when I do its always full fat as I cannot stand the taste of artificial sweeteners.    some research also shows artificial sweeteners also are implicated in obesity because your body is expecting sugar so produces insulin dropping your blood sugar and making you more hungry so you end up eating more

Start with motorway service stations, their food options are abysmal.

why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example

Why does anyone drink any fizzy sugar crap on a regular basis?

although the cries of nanny state and I didn’t vote for this would be heard for years

Only till their preferences cause them to die early.

I’m sure a huge amount of NHS expenditure is easily avoidable if only we could encourage people to look after themselves.

“Easily” ?

That also includes being blunt with people whem they first present with issues about the serious need for lifestyle change to hopefully shock a few into realising its on them as much as anyone to change.

Yeah. Doesn’t work.

Obesity is mostly a disease of poverty. That’s where we need to start.

We also need to understand that short of Bariatric surgery, obesity isn’t reversible. There are some effective short and medium term interventions that work for some people, but in the long term the vast majority regain the weight.

Joined up travel policies, sugar taxes and walkable neighbourhoods probably have a part to play too.

Availability, cost, simplicity, education, culture, human nature.

Heathier options need to be available, particularly for eating out and takeaways. If I want to buy a healthy lunch, I have far more choice in London than I do locally. Availability is driven by commercial factors.

Unhealthy options seem cheaper when eating out. Bag of chips? Burger? Cheaper compared to a freshly made salad with enough in it to compete on attraction with the burger and chips.

Simplicity. Many people know that cooking from scratch with fresh ingredients can be cheaper than buying a ready meal but it takes perceived time and effort. Which leads to…

Education. I didn’t really learn to cook until after uni. Before that I used to heat frozen things. It took time to learn how I could turn a few things into a healthy meal in 20 minutes. But not everyone feels they have the time and energy to do that.

Culture. If I’m in the (London) office with others we’ll go to Itsu 90% of the time, Pret the other 10%. No-one has ever said “lets go to McDonalds”. We’re lucky to have the money, availability and knowledge to pick places with healthier options.

Human nature. We crave fat and sugar. If it’s there in front of me I’ll eat it, so I’ll avoid those temptations.

People need to be happy and optimistic to stay healthy, I think. The world is not a happy place for a lot of people. Diet and mental health seem to be linked.

RE obesity, I watched something not long ago about the links between gut microbiome and health. I don’t know how valid or influential it may be in reality but the processed food influence on gut health seems like a reasonable link to make. I know someone with IBS that seems stress-related and after some months of eating more fermented food and other things that are said to help the gut, for them it’s all reduced considerably. The programme I saw suggested that it can also be influential on weight or obesity.

Dont know but banning all unhealthy food is a non starter.

Why?

The public need to take some personal responsibility as well, why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example.

Couldn’t have given a worse example.  Many studies show that you would be better off drinking the sugar version as it doesn’t tend to lead to cancer.  Personal responsibility doesn’t work well does it.

A little while ago, there was a Jamie Oliver programme about basic / cheap cooking. Regardless of whether you like JO or not, it was eye-opening in seeing how many people simply cannot cook.

Like, can barely boil an egg level of can’t cook. So they existed on takeaways, crisps/sweets/biscuits, because it was all convenient and because they were lazy.

I don’t mean “lazy” in a bad way as such, just that people are lazy and will always take the easiest option. It’s easy to tap on a phone and have a takeaway delivered 10 minutes later, it’s easy to drive the kids 500m to school, it’s easy to lounge on a sofa and eat junk, they’ll do it!

You can put in place the infrastructure for healthier, sustainable transport – bikes, walking etc. You can legislate to, if not ban unhealthy, ultra-processed foods, at least label them as such and tie that in with public education about what that means. You can potentially make UPF less attractive by taxing it. You can look at ways of creating a better work/life balance for people, more time, less stress via, say, a four-day week or universal basic wage.

You can also fund the NHS to run schemes aimed at preventative projects rather than just treating sick people, ie: make them less likely to be sick in the first place. There’s apparently a systemic problem here, in that government has been reluctant to fund preventative measures because, by definition, it’s harder/impossible to measure the number of people who don’t get ill relative to, say, the precise stats you get for say, the number of medical procedures undertaken / drugs prescribed etc. At least according to a mate who used to sit on high-up NHS panels, so it may be (semi)-fiction and is at best anecdotal, but seems believable.

I think you have to accept that it’s a slow-burn process, at odds with our political system which is in five-year election blocks, but it can work, see cigarette smoking as an example. It’s a huge ask though, while convenient UPF is cheap and abundant relative to healthier options. People are time-poor – see also the need for a dual income in many areas to be able to afford housing and the time pressures that brings – and we have an insidious culture of car use for even the shortest journeys.

There’s so many interlinked factors its difficult to know where to start. Regulate the food industry. We used to have a world class salt reduction programme in ready made food that was the envy of the world, no one will be surprised to hear that the Tories watered down the regulations and now we’re back to square one. They need to be forced to either label food correctly or change their ingredients – although this will increase the cost of food, so you might have to do a drastic thing like make a “people’s menu” of food items that are price regulated. Make it easier to get around on foot and by bike, make food education a priority, sort out the mental health crisis, provide meaningful employment opportunities.

You can’t ban food, and I wouldn’t want to go that far, but you do have to restrict it, or tax it, or do something to put it out of the reach of kids pocket money especially.

The public need to take some personal responsibility as well, why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example.

This comment and the responses to it so far highlight one of the problems. There are many perceived healthier options which aren’t actually healthy at all.

Sweeteners have been shown to spike insulin and contribute to diabetes just as sugar does.

Fact is, 90% of what’s on our supermarket shelves is junk. Eating healthy in our current environment takes a lot of knowledge and discipline, which can only suggest there’s something wrong with the environment.

If you want the general public to eat healthily, then it needs to be easy.

Forcing people to exercise is going to be tricky

We don’t need to force anyone to exercise. Most people have no interest in ‘exercise’. All you need is for the average person to incorporate a modest amount of activity into their day.

See the active travel thread. Make it easy (and appealing) to get people moving in their daily routine.

The best example of the success of the food lobbying industry is the completely shambolic food labelling we have in this country.

Many studies show that you would be better off drinking the sugar version as it doesn’t tend to lead to cancer.

There’s not a one sized fits all when talking about coke. If you’re diabetic, diet is ‘better’ than regular, and you need to drink something like 15-20 cans of the diet version a day to be at an increased risk of cancer. But the diet version triggers the same sugar craving response that regular coke does. Personally I’d say; chose the one you like the taste of, don’t have too much regardless.

There is strong evidence that pretty moderate amounts of exercise has a genuinely significant impact on reducing type 2 diabetes – just 30/40 minutes of brisk walking a day.

That should be the focus as it’s simple and easily achievable for most people. Some really hard hitting adverts showing the impact of type 2 diabetes on individuals

Forcing people to exercise is going to be tricky

There’s a massive difference in the level of exercise you need to do to be fit – to do something like mountain biking, and the amount you need to do to be healthy

Fact is, 90% of what’s on our supermarket shelves is junk. Eating healthy in our current environment takes a lot of knowledge and discipline, which can only suggest there’s something wrong with the environment.

Exactly.  Change it so only 10% of the food on the shelves is junk and the environment become much better.  How do you get from 90% to 10% though, sound like tight government control over what is produced and how is not going down well.

There is strong evidence that pretty moderate amounts of exercise has a genuinely significant impact on reducing type 2 diabetes – just 30/40 minutes of brisk walking a day.

That doesn’t sound pretty moderate to a lot of people who currently pretty much do nothing

 it was eye-opening in seeing how many people simply cannot cook.

Having been dating again this year, my eyes were indeed opened as to how many middle aged women could barely cook.

fund the NHS to run schemes aimed at preventative projects rather than just treating sick people, ie: make them less likely to be sick in the first place.

My work is mostly on programmes (usually paid by local councils) to help people get into healthier lifestyles. It feels a bit like tinkering around the edges TBH, but they can work really well when people are engaged. It would be good to see a more holistic and consistent approach generally though. Coverage can be patchy and contract lengths short.

Maybe some pictures of amputated legs on the packaging of food that doesn’t meet a certain level of nutrition or exceeds a set processing level etc. Like the labels on packets of cigs.

Make people happier and make the world they live in a happier place. People who see a happy future for themselves make decisions to ensure and protect that future. Bad diet is just one of the self destructive traits of people who aren’t looking forward to the future.

Forcing people to exercise is going to be tricky
There’s a massive difference in the level of exercise you need to do to be fit – to do something like mountain biking, and the amount you need to do to be healthy

I think this is such a key issue – for all the work the health sector does to encourage healthy behaviour there are much louder, brasher, sparkly, profit motivated voices trampling over those messages and confusing ‘health’ and ‘fitness’. The main harm they cause is to link  ‘exercise’ to  appear to be something difficult, committing, sweaty and complicated. Probably something that requires special shoes and a membership to something, When all thats actually required is walk about a bit. Genuine healthy choices can’t be monetised so the messages get swamped by faddish nonsense.

In health terms the difference between being ‘inactive’ and ‘active’ is loads. The difference between being active and world champion ‘fit’, in terms of health benefits, is minimal. Otherwise marathon gold medalists  and TDF winners would live to be 150 and I’m pretty sure they don’t

I think you’d also have to tackle the TicTocs and Instas of the world – and the advertising world in general, regarding the use of body shapes – male and female that are unobtainable for 99.9% of the population.

Fact is, 90% of what’s on our supermarket shelves is junk.

This is a bit of a throwback – remember the iDave diet thread? What was interesting about the menu it created wasn’t the nutritional science but simply the shopping. By excluding a few key ingredients what you actually did was exclude swathes of what a supermarket sells – there were whole aisles that there was no reason to walk down. Theres such a proportion of shelf space dedicated to calories that you don’t actually put on a plate and consume as part of a meal.

What that thread also revealed was how many folk on the forum who thought they could cook learning that what they actually do is warm things up.

This is a really really tricky one as someone that owns and runs a food shop (very small convenience / village shop)…

We’d love to sell more healthy foods, however they are vastly more expensive than hpf’s. I’m asked why we don’t sell things like cereal bars (which are still an hpf) instead of chocolate – it’s because I can’t sell through a case without half of them going off. The food industry, and in particular convenience foods is almost 100% geared towards sugar and hpf’s the trade magazines advertise and promote only unhealthy foods.

Imo it’s not a foods industry issue it’s an entire society issue. It needs changing, but not through the food industry, do it in schools. Didn’t Glasgow has managed to change how society viewed unhealthy foods by education over the last 20 years or so rather than enforcement.we need to do this at a national level.

regarding the use of body shapes

Thats a whole other problem – colliding health and vanity issues. I think particularly in relation to women’s health the discussion of weight in relation to health and unhealthy expectations placed upon women all get jumbled up

Converse to the TikTok influencers at one end of the scale, at the other we have a more well meaning media that misrepresents weight related risks. Any feature on health/ weight/ exercise /diet will invariably be illustrated by sending some hapless AP out with a camera to film morbidly obese people in the street, tactfully cutting their heads off. I often wonder what the total run time of all the BBCs accumulated archive of headless fat people in shopping centres is.

In most cases morbid obesity isn’t the issue actually being discussed, just, usually, being a little bit over weight. So whatever issue, risk, action is being debated whether its risks to the person or burden on the state – the viewer doesn’t see and being applicable to them but a problem pertaining to or caused by, other people.

I don’t think people recognise how close to a ‘normal’ weight (and appearance) the boundary to weight related ill-health is. Its not unlikely most of the people on this thread could be at or over that boundary and still be seeing it as an ‘other people’ problem.

That is really missing the point. I like full fat coke. It’s no worse or better than the sugar free alternatives that are just as bad

Its the main foods that people eat that are full of fat, sugar, salt etc

“Sugar-free” soft drinks are absolutely vile stuff. As noted by a couple of folks, aspartame is horrendous stuff and really bad for the body; fructose syrup also does awful things in large volumes too. And “main foods” vs “large quantities of soft drinks” is a false distinction.

The basics are pretty simple. Regardless of how it’s done, healthy food has to be cheaper, and unhealthy food has to be priced to reflect the full cost not just of production but of the health effects of it. Random example, but it’s like chewing gum – how is that only £2 a pack when it can cost far more to remove the stuff from pavements?

Exercise is a tougher nut to crack – those who ‘get’ it will generally lean towards doing exercise, at least occasionally. Those who don’t see the point can’t be convinced that it’s worthwhile; they have to be encouraged through behavioural economics etc

Cast your minds back to Jamie’s school dinners I think it was. He removed shite from the lunch menu and introduced healthier options. Cue a bunch of thick as **** mums doing chippy runs for the children. This kind of mentality will stop any meaningful progress.

In terms of exercise look at cycling for example. Reasons for not taking it up as a commuting option often include the “weather”. I was in Copenhagen a few years back in February. Couldn’t move for cycles, same with Amsterdam. It’s a mindset.

On the positive side I am a member of Pure Gym and it is always busy in the evening and includes couples and groups of younger males and females hanging out. In terms of cost, it is a very cheap way of keeping fit and is accessible to most people. It’s not all doom and gloom.

In terms of exercise look at cycling for example. Reasons for not taking it up as a commuting option often include the “weather”. I was in Copenhagen a few years back in February. Couldn’t move for cycles, same with Amsterdam. It’s a mindset.

I’m gong to be contavercial here but what killed cycling participation in the UK, I’m mind, was the Raleigh Chopper. We weirdly treat it as some sort of cultural icon but it recast the bicycle as a toy and for a lot of people it’s fondly remembered as the last bike they rode before they grew out of cycling. The grifter and even the BMXs that followed all really were part of the same thing.

(I say that as someone who didn’t have a Chopper or a Grifter and had to build a BMX out of rusty remnants from other people’s gardens and wheels from a Dawes shopper becuase by dad bought me a touring bike instead)

on Diet Coke…

why do people still deliberately choose full fat Coke when there are excellent sugar free alternatives as an example.

As above, sweeteners have been shown to cause excessive consumption > obesity > diabetes.

And,

the completely shambolic food labelling we have in this country.

Diet Coke, a completely synthetic product with zero nutritional value and negative health effects, comes out 100% green and healthy according the labels.

There’s so much wrong with the system.

The press always talk about people at risk from type 2 diabetes and their message is if you lose weight and eat a healthy diet all will be well.

I don’t believe it. I am at risk from type 2 diabetes as my blood sugar is elevated, I got the eating for idiots talk from the practice nurse at my GPs which was patronising and little short of insulting.

I cycle between 350 and 500 miles a month (no ebike), when I don’t cycle I walk, kayak, and do other outdoor activities.

I have a vegan diet, which is mostly home cooked, don’t eat fake meat or cheese, don’t eat sweets cakes etc and drink less than 4×330 ml cans of beer a week and drink no soft drinks.

I don’t eat takeaways, and go to eat out very rarely.

I do not eat vast amounts, but I have not lost any weight.

I don’t think its trivial for people to loose weight easily and think that type two diabetes is not that currable by diet and exercise. It may be possible to make short term changes by diet changes but your body tends to compensate and then your weight increases.

The media is selling a narative that type 2 diabetes is your own fault as you have had a poor life style, but I believe it’s as a result to changes in your body. couple this with loss of muscle mass as a result of ageing and people are in trouble.

There needs to be better reseach around type 2 diabetes other than short term diet interventions and any diet intervention study needs to be followed over several years to see the long term results.

There is no easy fix. Just getting people on a bike and changing their diet will be benificial but won’t be a magic bullet. I commuted by bike for most of my working life still had a heart attack in my late 50s and am now facing possible type 2 diabetes what more should I do?

There are many reasons this is such a problem. Something that hasn’t been mentioned yet I think is moderation. The odd can of full fat coke won’t do you much harm, but one every day might. One of the dads at my sons old football team used to drink 3 cans of coke during a 60 min football match that kicked off at 9am. He usually had a snickers in his other hand.