A Case Study: Middle-aged Pre-diabetic Man

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From the course by Stanford University

Stanford Introduction to Food and Health

7112 ratings

Stanford University

Stanford Introduction to Food and Health

7112 ratings

Around the world, we find ourselves facing global epidemics of obesity, Type 2 Diabetes and other predominantly diet-related diseases. To address these public health crises, we urgently need to explore innovative strategies for promoting healthful eating. There is strong evidence that global increases in the consumption of heavily processed foods, coupled with cultural shifts away from the preparation of food in the home, have contributed to high rates of preventable, chronic disease. In this course, learners will be given the information and practical skills they need to begin optimizing the way they eat. This course will shift the focus away from reductionist discussions about nutrients and move, instead, towards practical discussions about real food and the environment in which we consume it. By the end of this course, learners should have the tools they need to distinguish between foods that will support their health and those that threaten it. In addition, we will present a compelling rationale for a return to simple home cooking, an integral part of our efforts to live longer, healthier lives. View the trailer for the course here: https://www.youtube.com/watch?v=z7x1aaZ03xU

From the lesson

Contemporary Trends in Eating

In this section, we will explore the ways in which highly processed foods differ from real, whole food and the implications of food processing on our health. We’ll also look at how our consumption of sugar has changed in recent decades and explore sensible solutions for people who wish to start eating better. We will also meet Kevin, a middle-aged pre-diabetic man, and find out how a step-wise approach to behavior change helped him change for the better.

Why Are Highly Processed Foods Generally Less Healthy?4:37

Trends in Sugar Consumption & Recommendations4:51

The Case for Cooking6:39

A Case Study: Middle-aged Pre-diabetic Man6:40

A Step-wise Approach to Behavior Change2:58

Meet the Instructors

Maya Adam, MD
Lecturer
Stanford School of Medicine

Around the world today, more than 2 billion people are overweight or obese.

Our global obesity epidemic has been described as the most significant

preventable public health crisis in recent history.

This 48-year-old manager of a construction firm found himself fighting an uphill

battle against a disease that can effect every organ system in the human body.

Kevin's wife had convinced him to visit their local medical clinic,

because she was concerned about his weight, and

the joint pain he complained of every evening after work.

At the clinic, Kevin was told that his fasting blood sugar was elevated, and

that he was prediabetic.

His triglycerides, total cholesterol, and

LDL cholesterol were also elevated and his HDL cholesterol was low.

Standing 5'7" tall and weighing 180 pounds with predominant central obesity,

Kevin's physician calculated a BMI of 28 kilograms per meter squared.

Kevin was informed that he was overweight and suffering from metabolic syndrome,

a collection of biochemical and physiological abnormalities associated

with the development of cardiovascular disease and type two diabetes.

The physician on duty advised Kevin to make some major lifestyle changes.

By eating better, and getting more exercise.

Six months later, Kevin returned to the clinic weighing nine pounds more

than he had at the previous visit.

When the new physician on duty asked if he

had been able to make any of the lifestyle changes suggested by her colleague.

Kevin told a story she had heard far too many times before.

The first week after his last doctor's visit,

Kevin had tried eliminating all of his favorite foods and snacks.

He skipped breakfast, drank a meal replacement shake for lunch and

ate a calorie reduced frozen dinner in the evening.

He had also tried to eliminate the fat in his diet.

The first week, Kevin lost four pounds but as the weeks went on

he found it impossible to stick to this planed restrictive diet and

he noticed that he was replacing his favourite high fat foods

like potato chips and pizza with foods that were high in sugar.

In the evening he would find himself in front of the television,

snacking on multiple packages of Swedish fish.

By the time he went to bed, he would almost always feel he had over eaten.

The soda machine at work became his enemy as he tried unsuccessfully to walk

by without buying the cold soda cans that he ended up drinking usually three or

four times a day.

He and his wife both worked long hours so one of them would usually stops for

take outs on the way and they would end up sharing a pizza and

a two liter of Coke, exhausted from their long days of work.

Regular exercise was difficult for Kevin because of his joint pain and

he often felt that he just didn't have the energy to move.

The physician took notes and asked clarifying questions as Kevin spoke.

Identifying major target areas for change.

Including specific food and

eating behaviors that were contributing to Kevin's uphill battle with his weight.

She asses Kevin readiness to make dietary changes and asked if the couple had

access to simple cooking tools like a pot, a knife and a cutting board.

Then she spoke with Kevin and his wife about the importance of avoiding

highly processed foods in order to achieve their health goals for Kevin.

Together, they came up with a stepwise action plan that would allow them to

gradually reallocate a small amount of time to the preparation of simple,

home cooked meals.

In this way they could once again be in control of the fat, sugar, salt, and

total calories they were consuming.

Kevin and his wife enrolled in a free online nutrition and cooking course and

began tracking their food intake using an online food blog.

To help them control portion sizes,

their physician advised them to buy a set of affordable smaller dinner plates and

glasses that they found at a local hardware store.

The couple kept their meals simple, but made sure that each plate

was composed of one-half plant-based foods like fruits and vegetables.

WIth the other half of the meal made up of lean protein and

whole grain carbohydrates.

Over the next four weeks,

they gradually began to feel more comfortable in the kitchen.

Kevin tried his hand at making veggie omelets and

a stir fry and even a homemade tomato sauce.

He started to feel pretty good about the food that he was able to prepare at home.

On Sundays when they had more time, Kevin's wife would cook a stew or

a pot of vegetable soup and freeze these meals in smaller containers for

later on in the week.

Following his action plan, Kevin gradually replaced the sodas

he once drank daily with unsweetened sparkling water.

Six months later, and with regular follow up visits,

Kevin's weight had dropped to 165 pounds.

And his joints were no longer hurting him, allowing him to start walking regularly.

His fasting blood sugar level and his lipid profile had both improved.

And he told his physician that he had more energy and was actually enjoying his

food more now because he no longer felt guilty about his poor eating habits.

He and his wife found that they talked more

now that they were spending a bit more time in the kitchen together after work.

They sat down for meals together and

made a pact to stop snacking in front of the TV.

They even found their new eating habits to be more economical because they shopped

for groceries once or twice a week instead of buying each meal separately, and

usually buying more food than they needed.

18 months later, Kevin had managed to keep the weight off and

his fasting blood sugar had returned to normal.

Kevin told his physician that he felt better at he age of 49 than he had at 39.

Life as a healthy middle age man was treating him well and

he couldn't imagine ever going back.

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