As a busy doctor of 14 years’ standing, nearly eight of them as a GP, Dr Rangan Chatterjee knows all too well how frustrated his patients can be by the limited time they get with him in his busy Oldham surgery.
“Believe me, we feel the same way,” he says. “The NHS works fantastically well in some ways, but the reality is that the ten-minute appointment slot is not remotely enough to get to grips with the chronic lifestyle problems we see today.”
Lifestyle, he believes, is at the root of the majority of the issues he sees every day – the diabetes, the migraines, the gut problems – an ‘’epidemic’’ of conditions that has mushroomed alarmingly in the past 20 years. “The current system lends itself to giving a pill for every ill, but in doing so we are often suppressing the symptoms, not getting to the root cause.”
Such sentiments led Dr Chatterjee to a new three-part BBC series, Doctor in the House, in which he spends time with three families for several weeks to see at first hand how the way they live is directly affecting their health.
And the answer seems to be rather a lot. In each case, after monitoring their daily routine and conducting tests on everything from stress levels to blood sugars, Dr Chatterjee prescribes simple changes in routine and diet, which in turn lead to profound benefits.
Along the way we learn some startling facts: that, for example, diabetes leads to 135 amputations a week – which is a tragedy when, in Dr Chatterjee’s view, in 95 per cent of cases changes to lifestyle and nutrition could prevent or reverse the condition.
At his own surgery, he reveals, he has offered the option of trading a one-on-one appointment for an hour-long consultation with fellow diabetics. “I do a talk on how they can help themselves. You have to think outside the box.”
But for the foreseeable future, Dr Chatterjee accepts people need to take greater responsibility for their own health, particularly those who are in their 40s. Here are some of his key tips.
1. Check your blood pressure
Dr Chatterjee says we should all get our blood pressure checked at least once a year: “It’s a good indicator of overall health. Most pharmacists can do this for you and they can tell you if it’s within reasonable parameters. If it’s not, then you can go to your GP.” Elevated blood pressure, for example, can indicate that you are at increased risk of heart disease or stroke – it can be an important early wake-up call that it’s time to make some changes in your lifestyle.
2. Test your blood sugar
Once a year get your GP to test your blood sugar. “This HbA1c test, as it’s known, can tell you whether you are at risk of developing diabetes,” says Dr Chatterjee. Ideally the reading should be under 5.5 per cent. “The current system is very binary – either you’ve got diabetes or you haven’t. But in fact, it’s a continuum – if one year your reading is 5 and the next year it’s 5.5, in my view you are significantly less healthy. Diabetes doesn’t happen overnight. You can monitor your risk.”
3. Cut the carbs
Visceral fat inside the abdominal cavity is associated with diabetes and heart disease. “A body scan can identify if this has accumulated, but we don’t have the means to provide that on the NHS,” he says. Instead, he offers a “cheat’s guide” in the form of your hip/waist ratio. “Get your practice nurse to measure both, as it’s hard to do it yourself. Your waist measurement should be lower than your hip.
If not, you need to take action.” The chances are the culprits are refined carbohydrates –sugary cereals, sandwiches, pasta. “Reduce those and you’ll quickly see a change in your body shape, which will benefit your long-term health.
4. Switch off and meditate
“Our lives are stressful and I see how my patients struggle to switch off,” says Dr Chatterjee. The answer? Meditation. “I think meditation is a brilliant way to remove yourself from life, even if it’s just for ten minutes a day,” he says. It’s a philosophy increasingly backed up by research: a recent Thai study of 30 medical students showed they had significantly reduced levels of the stress hormone cortisol after a four-day mindfulness course.
5. Don’t fixate on cholesterol
Dr Chatterjee believes that some of the risks of a high total cholesterol reading have been overstated. “People falsely think that if their cholesterol is low, they are healthy… and if it’s high, they need to take a statin. That is over simplistic; high cholesterol is only one of many possible risk factors for poor health. I certainly wouldn’t send off for a home-testing kit. In isolation, it won’t really tell you anything useful in terms of your long-term health.”
6. Fast for fitness
Several recent scientific studies have pointed to the benefits of intermittent fasting, and Dr Chatterjee is also a fan. “We live in an age of abundance now, but as humans we have all evolved from periods of fasting.” He is an advocate of what’s known as time-restricted feeding, in which food is taken within a specific period of the day. “There are many variations, but I tend to recommend ten hours, so if you take your first meal at 8am you would finish eating at 6pm.” Research is continuing into its benefits, although “There is already research indicating long-term benefits to the immune system and the prevention of diabetes. It’s a way of mimicking an old evolutionary mechanism without doing anything too drastic.”
7. Junk the junk food
Dr Chatterjee’s home is a zone free of crisps, biscuits and chocolate, eliminating temptation. “You can’t change what’s outside, but you can change what goes on inside your house,” he says. “The reality is that if you’ve got two chocolate biscuits, you will crack at some point. Then it can quickly become a bad habit. No one is saying you can’t have treats now and again, but you have to be realistic: highly processed food is addictive, and willpower alone isn’t always enough.” Instead he recommends increasing our intake of nuts, seeds, almonds, olives and avocados. These are all quite fatty foods – but good, natural fats that will keep us full.
Doctor in the House is on Thursday 19th November at 9.00pm on BBC1