How public demand is changing dietary guidelines: the rise of the Public Health Collaboration

The issue of dietary guidelines for people with diabetes has been oft discussed in recent years, especially with the rise in popularity of the low-carb diet, and now it seems that the public are backing calls for change.

Earlier this month, we reported on the Public Health Collaboration (PHC), a group of 12 leading doctors looking to overhaul the dietary guidelines currently recommended by the NHS.

The NHS has previously advocated a high-carb, low-fat diet for people with diabetes, but their current recommendations now focus mainly on eating a balanced diet that’s low in fat, salt and sugar.

One could argue that moving away from recommending a high-carb diet is a step in the right direction, especially given the reported benefits of a low-carb diet, which can reduce blood glucose levels and enable weight loss. Members of the Diabetes Forum have long highlighted how the low-carb diet can be beneficial for diabetes management.

However, the PHC believes the NHS needs to do more. This is why they created a crowdfunding page with the initial aim of raising £5,000 to set them up as a charity.

Sam Feltham, director of the PHC, said: “Our initial £5,000 fundraising target doesn’t sound like it’s enough to change anything on such a large scale, especially if you’re used to big budgets, but we’re in a fortunate position that our founding members of doctors are giving their time for helping write our reports and support our campaigns.”

As of writing, the PHC has received over £9,250 in 18 days. The support has been strong, and indicates people are getting fully behind the campaign.

But who is behind the rise in popularity of the PHC? Well, many of their board members are advocates of a low-carb diet for diabetes management, and are leading healthcare professionals in their fields.

Dr. David Cavan, author of Reverse Your Diabetes, recommends a carb-restricted Mediterranean diet; Dr. David Unwin is known for his studies investigating the low-carb diet; and Dr. Rangan Chatterjee, presenter of the BBC’s Doctor in the House, informs families of the benefits of the low-carb diet. Another member of the panel is Dr. Trudi Deakin, dietitian and chief executive of the X-PERT Diabetes Course. In May 2013, Deakin’s stance on carbohydrate was that “there is no evidence […] eliminating starchy carbohydrates from meals improves glycaemic control in the long term,” but in May 2015, the X-PERT position statement was that there is “emerging evidence that a very low-carb diet reduces the high circulating levels of insulin and is therefore a more effective strategy to improve metabolic health than current nutritional guidelines.”

The PHC is now aiming to raise £10,000 so it can write a second report on diet advice for people living with diabetes.

What does the PHC want?

The PHC wants to combat obesity and type 2 diabetes in the United Kingdom, although it admits that this is a complex problem.

The dual epidemic of obesity and type 2 diabetes is putting a strain on the NHS: 25% of adults in the UK are obese, and over four million people have diabetes; 90% of cases are type 2 diabetes.

The PHC believes current diet guidelines are not specific enough, and that the advice being given by the NHS is making Britons unhealthy.

“With that in mind our solution will be to focus initially on the root cause of the problem by simply improving the healthy eating and weight loss guidelines given by the NHS,” say the PHC.

“Solving a complex problem such as public health is difficult because there are so many moving parts to take into account. With this complexity often what happens is that lots of money is just thrown at the problem instead of taking a step back and actually thinking about what can be done without spending ridiculous amounts of money to work with the current system in place.

“We will improve these guidelines by publishing our first public report on healthy eating and weight loss guidelines given by the NHS in April 2016. Alongside this we will be running a campaign for change that the government will find hard to ignore with the help of our incredibly influential founding members.”

The future of dietary guidelines

It’s hardly a secret that the state of diabetes care in the UK is under scrutiny. Diabetes care for people aged 16 and above currently accounts for around 10% of the NHS’ budget, which is £5.5bn per year.

In December, the new NICE guidelines for type 2 diabetes called for “individualised care”, and for approaches to “individualise recommendations for carbohydrate […] intake”.

Approaches to dietary recommendations seem to be changing, and given the support that the PHC has already received, dietary guidelines are clearly now being discussed by members of the public as well as senior healthcare professionals.

By claiming the government will find their campaign “hard to ignore”, it may well be that the PHC is the greatest resource towards influencing changes in dietary advice.

The PHC’s first report is due in two months’ time.

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Jack Woodfield

Jack is Editorial Manager of Diabetes.co.uk. He works hard, plays fair and sleeps whenever possible. He has type 1 diabetes, doesn't mind being called a "diabetic", and once won a talent show for dancing to Dario G’s 1997 hit “Sunchyme”.

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