Continuing Professional Development: Food for thought

Obesity is widespread. A government-commissioned report warned recently that if weight gain continues at current trends, 60% of men, 50% of women and 25% of children will be clinically obese in just over 40 years’ time. The government’s Foresight think-tank said that a mere 10% of men and 15% of women would be a healthy weight by this time, and the researchers predicted that the health problems associated with weight gain would cost the country more than £45bn per year.

The five most common problems linked to obesity are heart disease, type 2 diabetes, high blood pressure, cancer, and osteoarthritis.

Half a million people in Britain may already have undiagnosed diabetes and one in six people over 40 will be diabetic by 2010. Forty per cent of all heart disease in women is attributable to being overweight.

Your workforce is likely to be part of these statistics, so how can it possibly be performing at its best? Yet obesity is the second most preventable cause of premature death after smoking. This article explores how to eat healthily and how implementing a research-based nutrition and exercise programme helped one particular company.

The number of average calories consumed has dropped over the past 15 years, but the percentage of obese men and women has almost doubled in this time. The US has reduced fat from 42% to 34% of calories in 30 years – yet obesity continues to rise. So what is going on?

Our genes have evolved over seven million years. In the beginning, food was scarce and human beings had to physically struggle to get it. But our modern diet is moving away from what our genes once handled well.

We eat too much processed junk food, refined high glycemic load carbohydrates, sugar, potatoes, white bread, white rice, salt (sodium), trans fat and saturated fat, and too little fibre, antioxidants, potassium and protein. This often leads to blood sugar problems, and people with these problems are three times more likely to be overweight.

Nine in 10 people with blood sugar imbalance have difficulty losing weight, with symptoms of blood sugar problems including:

  • Waking up feeling tired

  • Feeling unable to get going without a tea, coffee or something sweet

  • Needing something sweet, or a coffee, at the end of a meal

  • Experiencing energy slumps in the afternoon

  • Feeling tired much of the time.

Factors that affect blood sugar include:

  • The amount of carbohydrate you eat (sugar, fruit, grains)

  • The kind of carbohydrate you eat (high or low glycemic load)

  • The amount of stimulants you consume (tea, coffee, cigarettes)

  • The amount of stress hormones you produce

  • The amount, and kind, of exercise you do.

Effectiveness of the Holford low glycemic load diet

David Haslam, GP and clinical director of the National Obesity Forum, says that there is no question that low glycemic load (GL) is pushing back the boundaries in terms of safe, rapid and permanent weight-loss diets. Although the scientific evidence has been mounting for some time, what Patrick Holford has done for the first time is to create a simple, easy-to-follow guide that helps to naturally integrate GL into our diets so that it’s easy to follow for both short-term weight loss and long-term maintenance.

A growing number of studies provide evidence for why a low GL approach to diet works so well:

1 Low GL diets cause more weight loss: Animals fed high calorie diets providing an identical number of calories but divided between high and low GL diets, showed much less weight and fat gain on a low GL diet. By the end of 32 weeks, the low GL group was not only 14% lighter, but it also had 29% less body fat.

2 Low GL diets cause less rebound reduction in the body’s metabolic rate: One of the main problems associated with dieting is that the body responds to a low-calorie intake by reducing its metabolic rate, therefore burning fewer calories. This means that dieters find it increasingly difficult to lose weight as their calorie intake drops. Low GL diets cause half the reduction in metabolic rate compared to a typical low fat diet.

3 The Holford low GL diet causes weight loss, fat loss, energy gain & supports health improvements: Sixteen people on the Holford low GL diet for eight weeks lost an average of 10.25lbs, equivalent to 1.3lbs per person per week. Body fat percentage dropped by an average of 2%. In addition, 94% reported higher energy levels, 67% had greater concentration, memory or alertness, 67% had less indigestion or bloating, clearer and less dry skin, 50% reported fewer feelings of depression and more stable moods. And there was also a significant drop in blood pressure.

4 Low GL diets are more effective: Holford says: “Overweight or obese people lost more weight on a low GL load diet and had more improvement in lipid profiles than those on conventional diets.”

The review compared the results of six trials comparing low GL diets with conventional diets, based on reducing calories. Other benefits were greater loss in body fat, reductions in bad low density lipoprotein cholesterol, which can contribute to heart and circulation disease, and an increase in good high density lipoprotein cholesterol, which can reduce cholesterol.

This article was written by Professor Patrick Holford, Wendy Nagle, Jo Kyne and Debbie Rix.

More information from or

A DVD of Professor Patrick Holford and Debbie Rix of DB Apparel talking at the Health & Wellbeing at Work Conference in Birmingham this year is available via the e-mail addresses above.


Business benefits of the db apparel health scheme

  • 100% of staff believe the programme is a perk of being at DBA

  • 90% reported lower stress levels

  • 74% reported a better working atmosphere

  • 74% reported a greater sense of community and team relationships

  • 65% said they felt calmer and more able to deal with clients and customers

  • 74% said they no longer have mid-morning or afternoon energy dips

  • 57% reported greater concentration

  • 62% said they are happier at work

  • 73% reported being ill less often

  • Absence rates fell to 0.7%. The savings made significantly offset the cost of implementing the programme.

Wellbeing benefits of db apparel health scheme

  • 60% saw a reduction in their cholesterol and blood pressure

  • Of those with a weight loss goal, 72% lost weight

  • 81% said they had a better understanding of their health and how to improve it

  • 100% thought there is a wide choice of ways to exercise and have been able to find something they enjoy

  • 85% believe they have achieved a better work-life balance by taking part

  • 50% reported better tone, strength and posture

  • 70% reported an improvement in mood

  • Screening programmes have been successful in identifying potential health problems early on. Several people with blood glucose levels in the diabetic range saw these levels revert to normal within weeks of starting the programme.

Case Study: DB Apparel

DB Apparel (more commonly known as Playtex) employs 127 people in the UK, with sites in Woking, Surrey, and Port Glasgow. The company has undergone major change in the past 10 years, including moving manufacturing activities off shore, ownership changes and restructuring. The challenge for DBA was to move from engendering low staff morale to becoming an employer of choice.

The annual power walking event, the Playtex Moon Walk, generates energy and motivation among staff and the company wanted to build on that. The Beyond the Moon programme was developed for the company by Zest4life and Work Life after collecting data about the company’s business objectives and the level of staff health and well-being. The aims were to build a healthier, fitter workforce, and to offer creative interventions that added value by looking at internal challenges and at how the interventions can help address business needs. The approach looks at the business, its challenges, environmental and cultural factors.

Simple health checks and one-to-one assessments for all staff gave individuals a starting point from which to improve their health, and to uncover underlying issues that affected them personally and their performance at work. These were undertaken using structured questionnaires and interviews.

At the start, 49% of staff were not exercising at all, similar to the UK average. This has now improved to 68% of staff engaging in exercise. Education, support and behaviourial change techniques underpin the approach to nutrition. As individuals achieve their personal goals, the business benefits from more motivated and energetic employees.

Measures of the impact of the programme were obtained from follow-up questionnaires and interviews.

CPD quiz

Life-long learning and continuing professional development (CPD) are the processes by which professionals, such as nurses, develop and improve their practice.

There are many ways to address CPD: formally, by attending courses, study days and workshops or informally, through private study and reflection.

Reading articles in professional journals is a good way of keeping up to date with what is going on in the field of practice, but reflecting on what you have learned is not always easy.

These questions are designed to help you identify what you have learned from studying the article. They will also help you to clarify what you can apply in practice, what you did not understand and what you need to explore further.

1 Which of the following is NOT one of the five most common diseases linked with obesity?

a) Type 2 diabetes

b) Heart disease

c) Osteoporosis

d) Cancer

2 Which country has reduced fat in its diet but continues to have rising obesity?

a) USA

b) Japan

c) Australia

d) China

3 Which of the following are we eating less of since the Stone Age?

a) Protein

b) Sugar

c) Carbohydrates

d) Fibre

4 Why do calorie counters find it hard to lose weight after a time?

a) They increase their calorie intake too slowly

b) Low calorie intake reduces the metabolic rate

c) They tend to binge

d) Their diet is unappetising so they don’t stick to it

5 Before looking at individual health, what did this study look at?

a) The location of the business

b) The management of the company

c) The accounts

d) The business, its challenges, environmental and cultural factors

6 In the case study, what type of business is used?

a) Car manufacturer

b) Chemical

c) Clothing manufacturer

d) Retail

7 What exercise event is the company involved with?

a) London marathon

b) Moon Walk

c) Beijing Olympics

d) Commonwealth games

8 What was the sickness absence rate at the end of the pilot study?

a) 7%

b) 5%

c) 0.7%

d) 0.5%

9 Of the business benefits, what was seen as the lowest benefit?

a) Greater concentration

b) Energy dips

c) Stress levels

d) Sense of community

10 What was seen as the highest achievement by individuals?

a) A reduction in their cholesterol and blood pressure

b) Weight loss

c) A better understanding of their health and how to improve it

d) A good variety of ways to exercise and have been able to find something they enjoy

Click here for the answers.

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