Obesity has taken centre stage after Boris Johnson admitted that his recent coronavirus scare may have been related to his obesity. He is now pledging to do something about it. His sudden interest in the UK’s obesity problem is getting a lot of ink space in both the tabloids & broadsheets and airtime on radio & TV. Andrew Marr even covered it this morning on his BBC talk show. Will anything become of it?
A few weeks ago when I was on the medical wards there was a social media shit storm when Krispy Kreme doughnuts pledged to give NHS staff free doughnuts and dropped off a free delivery to the Royal Free staff. The issue, raised by many critics, is that Krispy Kreme (big business) and doughnuts (ultra-processed foods) represent the problem with our food environment.
Yes, we have a massive problem in the UK. Well over 50% of calories consumed in the UK are from ultra-processed foods (see study below), which are produced by the large food companies. These foods increase dramatically the amount of free sugar we consume and hence drive up insulin levels and over time it causes the cascade that leads to obesity, impaired glucose tolerance, insulin resistance and the metabolic syndrome.
What needs to be considered is that the consumption of ultra-processed foods and the associated obesity epidemic are a core component of the social determinants of health (SDoH). For Boris Johnson to address obesity from a political perspective he is going to have tackled a much wider set of social issues. Is he up to it? I doubt it. However, I am hopeful that the COVID-19 epidemic, his near-death experience and resulting social consequences of the lock-down will give him the necessary motivation to support a ‘nanny state’ that he as always so despised in the past.
Historians have been pointing out that it often takes an international crisis to bring people together for the common good and to make them realise that we are all in it together. A good example is the NHS; it was created in response to the sense of togetherness induced by the national response to the second world war. I suspect the same thing will happen post-COVID-19. It is predicted that all politicians will move left and more money and resources will be lavished on social spending. Let’s hope this reduces inequality, improves education and the lived environment and tackles our reliance on cheap processed and ultra-processed food. The consequences could be slimming down of the national waistlines and a healthier nation.
How is this relevant to MS? Getting ready for having COVID-19, which may be just around the corner for many of us, is maximising our chances of not getting the severe form of the disease. To do this you may have to improve your lifestyle and get all your comorbidities treated and under control. For some of us this may be shedding a few pounds. I am aware that this is easier said than done, which is why I would recommend you consider trying intermittent fasting or a low carbohydrate diet. The good thing about these two diet options is that they may have additional benefits for your MS.
Fernanda Rauber et al. Ultra-Processed Food Consumption and Chronic Non-Communicable Diseases-Related Dietary Nutrient Profile in the UK (2008⁻2014). Nutrients. 2018 May 9;10(5):587.
We described the contribution of ultra-processed foods in the U.K. diet and its association with the overall dietary content of nutrients known to affect the risk of chronic non-communicable diseases (NCDs). Cross-sectional data from the U.K. National Diet and Nutrition Survey (2008⁻2014) were analysed. Food items collected using a four-day food diary were classified according to the NOVA system. The average energy intake was 1764 kcal/day, with 30.1% of calories coming from unprocessed or minimally processed foods, 4.2% from culinary ingredients, 8.8% from processed foods, and 56.8% from ultra-processed foods. As the ultra-processed food consumption increased, the dietary content of carbohydrates, free sugars, total fats, saturated fats, and sodium increased significantly while the content of protein, fibre, and potassium decreased. Increased ultra-processed food consumption had a remarkable effect on average content of free sugars, which increased from 9.9% to 15.4% of total energy from the first to the last quintile. The prevalence of people exceeding the upper limits recommended for free sugars and sodium increased by 85% and 55%, respectively, from the lowest to the highest ultra-processed food quintile. Decreasing the dietary share of ultra-processed foods may substantially improve the nutritional quality of diets and contribute to the prevention of diet-related NCDs.