Just Follow The Rules, Not Easy!

Just Follow The Rules, Not Easy!

By Jenny Hirst

One report maintains that most of the benefits from weight loss achieved through dieting come with the first 5-10kg lost, but because dieting is stressful, 90% of people fail to achieve this, or if they do, they usually put the weight back on within a year. People with diabetes are no different to the rest of 90% of the population who fail. Or are the incentives of the long-term complications sufficient to keep people with diabetes on the straight and narrow year in and year out, especially for those who not only have to adhere to the healthy diet but also to a weight reducing diet too?

I am sure that for some people, looking to the future is sufficient to enable them to stick to the diet, but not for everyone nor is it sufficient to just hand out a diet sheet and an explanation of what people should do. If you are 15 years old ‘the future’ looks a long way off when all your pals are eating burgers at 3 o’clock in the afternoon. If you are 45 years old when diagnosed, you have a lifetime of eating habits, and possibly drinking habits, that have to change. A diet sheet alone does not bring about these changes.

For me, as the mother of a child, now grown up, diet always produced conflicts and guilt.

Conflicts and guilt
My memory of meeting a dietitian for the first time was when my daughter was in hospital 34 years ago at diagnosis. I couldn’t believe my eyes – she was very pleasant with an attractive face and she kindly went through the diet with me which, in those days, was very different and much more restricted. But she was, to put it bluntly, fat. I realise that Mum’s are sensitive at diagnosis but I could hardly contain my anger! How dare she tell me about the need for a strict diet for my little girl, which as she pointed out, would be healthy for the whole family, when she was fat?

She then told me to cut out all sweet stuff, cakes, puddings and above all thickening in the gravy. I know this sounds ridiculous now but she said it! It caused me real problems because I was brought up in Yorkshire and was taught from very early days that the way to a man’s heart was through his stomach and what could be better than roast beef, Yorkshire pudding and good thick gravy? Remember I had a husband and a son to think of as well as my daughter, so I really had great conflicts going on in those first few months.

What was I to do?

• I couldn’t give my daughter thickened gravy.
• I couldn’t give her different gravy from the rest of the family and make her ‘different’. I couldn’t give the men thin gravy as it was against all my Northern teachings – I might lose a husband and my son would never learn the value of good thick gravy!
• I couldn’t disobey the dietitian.

In the end I resolved the conflict and we all had good thick gravy but this then left me with a huge sense of guilt because I was disobeying the dietitian’s orders. I always felt that I should confess at the clinic, but I never did.

So diet and dietitians have always made me feel pretty bad. The dietary advice conflicted with my cultural background and I had difficulty resolving this. Whichever way I had resolved it within the family, I would have felt guilty. The fact that I did not confess my disobedience at the clinic just added to this guilt.

Feeling inadequate, confused and a bit dim!
To add to this, dietary information always makes me feel pretty inadequate, confused and a bit dim. They keep changing the goal posts! I realise that knowledge has improved over the years and there is research to show the benefits of the present healthy eating recommendations but we do seem to be getting mixed messages.

• If we are supposed to eat the healthy diet recommended for the rest of the population, why do diabetes magazines have pages of recipes in glorious technicolour?
• Why did we stop counting carbohydrates? Well some of us never did and it is interesting that carbohydrate counting appears to be coming back!
• How are the newly diagnosed supposed to balance their insulin and their food if they don’t know the carbohydrate content?
• Now we also have the glycaemic index and I have to admit that the title alone is a total turn off for me.
• What is wrong with talking about simple things like fast acting or long acting carbohydrates, fats and proteins?

So if you are feeling the pressures of the diet for your diabetes, you are not alone!

Here are just a few of the things I have learnt over the years:

• Dietary information needs to be simple. We need to know the basic food information about carbohydrates, fats and proteins in a language that we, the patients or carers, can understand.
• If you are a man with diabetes and your partner does the cooking, she needs to know what you should and should not eat to avoid undue anxiety on her part from lack of dietary knowledge. If you are a woman with diabetes, then you probably feel the pressures to cook ‘ordinary’ food for the rest of the family and this may make diet more difficult for you.

To our health professional advisers I say:

• Don’t expect too much of us. Set targets that we can achieve so that we don’t always feel to be failing. Recognise that if we know what we should do, and don’t do it, we probably feel bad about ourselves anyway, so don’t be judgmental.
• Recognise that changing eating habits may cause confusion, conflict and guilt for all sorts of reasons – cultural, social or work circumstances. That bingeing on sweet stuff can be a compensation for frustration, sadness or boredom in people with diabetes just as much as those people without it.
• Recognise that some rules do actually make it easier for people than to just have a system of ‘healthy eating’. Too much freedom can cause confusion and anxiety, whereas rules can give a sense of security.
• Remember that just because healthy eating is good for everyone, does not make it easier for people with diabetes. We do not really have a choice, unlike the general population, so this does make it different and more difficult. We HAVE to eat a healthy diet.