Dr Joanne McCormack is a general practitioner and is the named GP for safeguarding children in Warrington, Cheshire. Since starting at her practice 24 years ago, she has seen the incidence of diabetes in her patients increase sevenfold. In recent years, she has taken a keen interest in the role diet in health and wellbeing. Dr McCormack runs frequent low carb meetings, as well as her website – fatismyfriend.co.uk, where information on the meetings can be found. She is also one of the founding members of the Public Health Collaboration. This talk was delivered at the PHC conference 2018 at the Royal College of General Practitioners in London.
Dr McCormack runs frequent low carb, behavioural change meetings in multiple locations to aid patients in losing weight, improving their diabetes control and improving their general health. Rather than just delivering a lecture, Dr McCormack invites members of the audience up onto the stage to help read scripts that have been copied from actual consultations she’s had with patients. The aim of this is to show people, including other healthcare professionals, how one might be able to have an effective dialogue with patients regarding healthy eating and real food.
With the help of the audience, Dr McCormack presents several scenarios, including a mother of an overweight child, a father of a child with asthma, a young woman with bad eczema, an elderly lady with poorly controlled diabetes and an overweight lady struggling to lose weight. She shows how in each case, with the patient’s permissio, she can bring up the idea of nutrition and a real food, low carb diet to see if the person would be interested in making some lifestyle changes. It is perhaps interesting to note how the diet can impact on such a range of health conditions and how easily this can be improved.
Dr McCormack runs a free low carb behaviour change group in a church about every other week, which aims to help people change their eating over the course of about eight weeks. The group is mostly aimed at people who are overweight or have diabetes, but anyone who is interested in improving their lifestyle and health is welcome. Built into the content of the group is the motivation of ‘hope’, which is something Dr McCormack has learnt a lot about from Drs David and Jen Unwin (see their joint talk from the 2017 PHC conference here). Using this, she asks her group to think about their goals, visualise what progress they would like to see a year from now and think about which steps may come in between.
While the content of each group meeting varies, Dr McCormack runs through some of the key topics that she likes to bring up with the participants. Firstly, she finds it important to help people understand the impact of different types of foods on their blood sugars, especially if they have diabetes. To this point, she encourages diabetics to ask their healthcare professional for a blood glucose meter to help illustrate this. Dr McCormack finds that the most important meal to discuss tends to be breakfast; she goes on to compare high carb and low carb breakfasts as an example of how one can change their diet to allow more stable blood sugars and better health.
An important concept that’s often brought up in the groups is that of mindfulness, particularly when it is applied to eating. Dr McCormack opines that this is an important part of behaviour change and that keeping calm and relaxed allows us to make better choices and maintain a healthier body. Mindfulness can include the practice of appreciating the food you’re eating and not eating it too quickly. While this sounds simple, being more mindful could completely reset one’s relationship with food. Another important aspect of behaviour change is habit release. For example, if someone drives a different way to work or sits in a different chair to normal, then this may help them to make lifestyle changes in other areas too.
While she recognises that this may be disagreed on by somen, Dr McCormack advocates initially dropping one’s daily carbohydrate intake to around 30 grams if they have diabetes. She explains that this allows people to see how their body deals with that amount and this creates the most rapid change. She acknowledges that people can take all the time they need to read around the subject and prepare, but opines that this method will yield the best results for many people with diabetes. Dr McCormack advises learning what around 10 grams of carbs looks like in a meal, so that one can get used to what kinds of foods to include in a low carb lifestyle.
If you would like to view Dr McCormack’s Public Health Collaboration talk from the previous year, click here