Can dietary interventions treat diabetes' deathly global heathcare burdens?

Less numerous and plentiful are those who stride the governmental and bureaucratic halls of power (many in obesity-related, pre-type 2 diabetes states) with an understanding of the increasingly compelling economics that dietary interventions can not only be more effective healthwise in resolving this “time bomb” as it has been called, but that they can be cheaper ​too.

Costs associated with diabetes treatment are estimated at €1m+ per HOUR​ to the UK’s National Health Service, cost levels mimicked worldwide, leading an increasing number of academics and NGOs – if not governments (yet) – to wonder if enough is being done to battle the obesity driven, type 2 diabetes pandemic from a dietary point of view.

Some estimates put the global cost of treatment for the problem at €200bn, expected to rise to €300bn by 2025.

“One of the biggest health challenges”​

Tracy Kelly, the clinical manager at leading health charity Diabetes UK, told NutraIngredients, “Diabetes is one of the biggest health challenges facing the UK today.”​

“Early intervention and support are vital to tackle the drastic increase of the condition and its expensive and devastating complications,”​ she said, noting obesity and overweight as the main risk factors in the rise of type 2 diabetes.

“The Government has launched campaigns to encourage people to lead healthier lifestyles, such as Change4Life however more needs to be done to raise awareness of the importance of keeping to a healthy weight, undertaking regular physical activity and maintaining a healthy balanced diet to reduce the risk of type 2 diabetes. Only then will we stem increasing costs to the NHS.”​

Between the supermarket and the emergency ward​

A philosophical shift is required says Peter Wennstrom, the branding and nutrition expert and president of the Healthy Marketing Team based in Sweden, a country that has a fine tradition in greater good-benefitting social programmes, but one that like most others, is being squashed by public diabetes treatment costs.

“Diabetes together with hypertension and elevated cholesterol is topping the list of diet-related illnesses that is killing people and also killing welfare budgets,”​ Wennstrom said.

“Eating ​wrong is one of the biggest threats to our lives. The best selling medicines of today are drugs that treat obesity, type 2 diabetes and high levels of cholesterol. And the welfare system cannot handle the increasing cost of medical treatment for diet-related problems. Especially chronic illnesses like diabetes.”​

Wennstrom said unhealthy food choices and widespread nutrition ignorance among both governments and consumers was permitting a status quo, “where society prefers to medicate rather than educate.” ​

His solution: “Try to intercept the consumer between the supermarket and the emergency ward.”​

Management of wellness, markers of wellness​

This kind of interception,Wennstrom observed, could occur in an environment where regulation changes were driving scientific enquiry to ever-more-specific illness markers, and with it, wellness markers.

“A preventive approach means that we must combine the medical perspective with a nutritional perspective on health = the management of wellness. This means that we must promote research and consumer information about the markers of wellness.”​

“In this context healthier foods including functional foods and nutraceuticals are both preventive and agenda-setting for the whole society. It starts a positive spiral where new nutritional science attracts entrepreneurs who create new innovative products that attracts early adopter consumers.”​

He added: “​Products and health communication educate on the food-health connection. Producers educate both retailers and consumers and there´s a positive cooperation between science and health authorities. Note that the final point is crucial to push healthier eating into the mass market consumer who is reluctant to change her habits unless it is fully supported by society. The attitude of governmental stakeholders will directly influence the majority of consumers.”​

Societal commitment​

Cara Welch, PhD, the VP of scientific & regulatory affairs at the US trade group the Natural Products Association, agreed gaining societal commitment to real dietary change was the key challenge.

“We’ve seen time after time that burdensome healthcare costs can be alleviated by investing in preventative measures both with nutritional foods and dietary supplements,”​ she said.

“However, this does require commitment to education about proper nutrition and continued research in diet and nutrition, whether it be established dietary supplements that already have multiple studies publicising their benefit or new dietary ingredients that have the potential to be ground-breaking. It also requires a concerted effort to ensure consumers have access to these products.”​

Incentivisation, addiction, prevention​

Robert Verkerk, PhD, the executive and scientific director of the Alliance for Natural Health International pointed to a 2004 World Health Organization (WHO) platform advocating nutritional solutions to the obesity-diabetes problem that few governments had adequately heeded.

“​To date most governments have paid little more than lip service to the idea,” ​he said.​

“The problem is incentive, both from the perspective of the consumer, as well as from the food industry and health profession. The typical consumer has in some ways become an addict, and to get them to transition between less healthy diets and lifestyles to more healthy ones, requires more than just pointing out the direction they should move in.”​

"The medical profession has no experience of real prevention. The model is still based on people only responding once they have entered a dysfunctional state. This is just too late to be either efficient or sustainable. The education given to doctors on nutrition and lifestyle mediated healthcare is negligible, and even that given to dietitians is greatly limited. ​

"We need to see a revolution in healthcare education, where healthcare, in the true sense of the word (not to be confused with disease management), is something that is proactively handled in the home, at work, at schools, in universities and through all branches of the healthcare professions. This takes time, but it’s better to start, than never to begin.”​

Pharma focus​

Back in the US, Mark Blumenthal the founder of the Texas-based American Botancial Council, lamented the ongoing prevalence of the traditional disease-drug model in the medical system there.

“Medical and pharmacy groups, theoretically, should be educating about the potential benefits of dietary supplements, but, predictably, much of the mind-set in these areas are still focused on conventional drug pharmacotherapy and not the increasingly promising herb and dietary supplement options.”​

According to the World Health Organisation (WHO), diabetes affects over 220 million people globally and the consequences of high blood sugar kill 3.4 million every year. If such statistics weren’t scary enough, the WHO is predicting deaths to double between 2005 and 2030.

The total costs associated with the condition in the US alone are thought to be as much as $174 billion, with $116 billion being direct costs from medication, according to 2005-2007 American Diabetes Association figures.