Suggests, John Gloster, Chief Quality Officer (CQO) & Board Advisor KOOH Sports, is a sports physiotherapist from Australia with 24 years’ experience of working with elite athletes. He has worked extensively with international cricket teams for the last 17 years, most notably as physiotherapist to the Indian Cricket Team for 3.5 years as well as Surrey County Cricket in England. John has also lectured and tutored at university undergraduate level in orthopedics and sports related injuries and is currently widely sought as a consultant on many health, fitness and injury related issues.
Gloster, in an email interaction with Ekta Srivastava, Health Technology, talks about the various topics related to diabetes
Current state of diabetes in India and how it needs to be tackled?
- India has been said to be the diabetic capital of the world.
- In 1960, 1 in 100 had type 2 diabetes and in the year 2015, 1 in 10 has been found to be affected with diabetes
- In 1980 virtually no cases of children were diagnosed with type 2 diabetes. In 2000, 1 in 10 have it
- During 2008, 1 in 4 teenagers were found to be pre-diabetic. Currently, 1 in 4 are pre diabetic
- In the year 2000, overall 32 million people were found diabetic in the country. The number doubled to 63 million in 2013.
- It has been estimated that the entire health budget on treating Diabetes related disease will be exhausted by the Year 2025 (The US by 2026)
- According to World Health Organization (WHO), the number of diabetes patients is likely to rise to 101 million in India by 2030.
Emphasis on type-2 diabetes and issues related?
It is extremely important to first understand about blood glucose and what elevates blood glucose levels in the body. What most people don’t realize is that certain food groups, once consumed, convert to blood glucose/sugar (ie, elevate blood sugar levels). All carbohydrates like rice, bread, pasta, chapatti, all grain products, pastries, pizza etc. convert to blood glucose. For example, a bowl of white rice elevates your blood glucose profile the equivalent of 10 teaspoons of sugar.
It is important to understand the concept of ‘cumulative sugar load’ throughout the day, i.e, adding up how much sugar you or your child actually consumes daily. Let’s look at the example below:
The average child’s supposedly ‘healthy’ breakfast is as follows:
- 200ml fruit juice
- bowl of cereal eg, coco pops or similar
- 2 pieces of toast
Now, let’s add up the equivalent glucose (sugar) load this places on the system
- 200ml fruit juice = 4-5 teaspoons sugar
- bowl of coco pops/cheerios = 3 teaspoons
- 2 pieces of toast = 6 teaspoons
Total in this simple breakfast = 13 teaspoons
Add to this coke and soda drinks, sweets, pastries and the numbers start to look very scary.
Every time I enter a child’s birthday party and look at what’s on offer for children to eat – Crisps, soda drinks, pasta, white breads, fried smiley faces, cakes, fries etc. When you add up these into their equivalent in sugar load it is particularly worrying (all of these foods mentioned convert to high levels of blood glucose).
According to the World Health Organization, the recommended total amount of sugar permitted per day for a child is 6 teaspoons (9 for adults). Most children are now consuming approx 20 teaspoons or more in a day.
In order to process this blood glucose elevation from consuming the sugar product or processed carbohydrate, the pancreas produces the hormone Insulin which is responsible for transporting that blood glucose into the mitochondria cells of the body to be used as fuel. However if you are not exercising at high volumes to consume that fuel then the body has to convert it to fat for storage. These unnatural High volumes of sugars in the diet means the pancreas has to work very hard to maintain high levels of insulin to help control blood glucose levels in the body. Over time this leads to ‘insulin’ resistance and ultimately metabolic syndrome and type 2 diabetes.
One of the main reasons for this rapid rise in diabetic numbers is the move away from ‘real foods’ in our diets, towards processed foods and high sugar substitutes coupled with marked reduction in activity levels of children. The widespread use of highly concentrated cheaper sugar substitutes for example HFCS (high fructose corn syrup) has further contributed to the problem. Nearly all processed foods including sauces, pastes and supposedly so-called healthy products also contain this ingredient and should be avoided.
What is the importance of regular exercises and body movement from a very early age.
KOOH Sports has identified diabetes to be a serious health issue for our children now. As this generation is growing up, it is important to take first steps to educate them on what food groups are actually converted to sugar and also where ‘hidden’ sugars can be found in commonly accessible foods here in India. Therefore education of children and parents as well as teachers is extremely important and is high on our agenda. The recent initiative driven by KOOH sports to arrange a school visit in Mumbai of the eminent irishanti-sugar campaigner Donal O’Neill was a keen education initiative to inform children and educators as to how we can identify and tackle this problem. It should be noted that sugar is a non-essential ingredient for humans and for sportspeople a high sugar diet will have an adverse effect on performance and recovery.
We at KOOH have identified the serious issue of declining activity rates in children, especially the current generation as well as children who move into adolescence.
To give an example of USA/Canada regarding activity levels declining in children (and we can expect these numbers in India to be worse due to lack of infrastructure, PE initiatives and mindset, etc)
- Currently children above 12 years of age in the USA have markedly reduced PA levels.
- Boys under 12 years of age are 48% active (i.e, only 48% achieve the recommended 60 minutes of daily physical activity) and girls being 34% active.
- Girls above 12 years of age fall from being 34% active to 3% active (mainly due to a reduced level of motor competence and therefore, confidence to participate) and boys 48% to 11% (Dean Kriellaars, Canada)
Steps the government can take to curb the rising issue of diabetes
Looking at the current situation the Government can take these steps to improve the Situation
- Education on public forums as to the causes of diabetes (backed by proper recent research). Sadly much of the education done in India on these topics is way behind
- Use public figures to help combat the obesity and diabetes epidemic (for example the CM of Maharashtra himself has lost significant weight by adhering to sensible food and low sugar guidelines). Virat Kohli is another low sugar & no processed food ambassador
- Implementation of Sugar Tax (as is now case in UK). Encourage other states to follow the Kerala initiative (‘Fat Tax’) which taxes products that cause you to get fat and promote diabetes, eg, processed foods, sugar drinks etc. Utilization of the funds raised from these taxes to be directed back into the education system to improve physical activity and sports facilities and implementation.
- Stronger Regulation of food advertisements on television (noodles, MSG, juices, sugar, colas etc)
- Improve urban planning like public spaces, cycle tracks, improve footpaths should now be a corporate responsibility to provide these within their infrastructure
- Review vehicle industry incentives (there have been big incentives to setup in India for overseas car manufacturers, The Nano etc.)
- Government should not encourage or offer subsidies to ‘fast foods’ and processed foods companies entering India (PepsiCo etc)
- New age cardiologists and their views on sugar, diabetes and other health related illnesses arising from diabetes. Encourage eminent overseas experts to champion the cause here in India, like, Dr Stephen Sinatra (USA), Dr Aseem Malhotra(UK), Dr William Davis (USA),etc
- Bring more evidence based information and publications on the dangers of sugar and diabetes to the public domain, for eg: John Yudkin’s book “Pure, White & Deadly” etc.
- Continue education on the fact that Type 2 diabetes in almost all cases can be controlled and reversed through proper nutritional advice and regular exercise.
How KOOH Sports is making an impact to address the issue from the grass root level?
Be the brand ambassadors for your children; let your kids be the best brands they can be for you. They are in effect, your brand so let them be the best, physically and cognitively