Dr Chris Steele’s Health Concerns

Chris Steele: One of the most troubling of today’s health concerns has to be obesity. Scientists labelled obesity as an epidemic some 30 years ago and it has got worse. Obesity is causing a huge increase of diabetes—we’ve now got over three million people with diabetes in the UK and there’s an estimated one million with Type 2 diabetes who don’t know they’ve got it, because you don’t get any obvious symptoms when diabetes starts. The consequences of diabetes include stroke, blindness, heart attack, kidney failure and circulation problems that can lead to gangrene—there are hospital wards where they do leg amputations because of gangrene, and seven out of 10 of those amputations are caused by diabetes. Other problems occur in the pelvis with men getting erectile dysfunction, and you also get an effect upon the nerve fibres, where you lose sensation and you get pins and needles in the fingers and feet. It’s just a horrendous condition.

That’s just one consequence of obesity. You’ve got others such as increase in risk of certain cancers and an increase in the risk of heart attack and stroke due to the fat around the waist—which is called central obesity. If you have a large waist size you’re at an increased risk of all those conditions: a man shouldn’t be over 38 inches and a woman shouldn’t be over 32 inches. Of course with obesity you’ve also got the strain on the joints, the wear and tear of arthritis and immobility. In any doctor’s mind, the most important of today’s health concerns is obesity—and it’s getting worse.

Everyone once blamed fat for causing obesity, but now we see sugar as the new ‘villain’. What do you think of this?

Everyone has thought for a good few years that fat makes you fat but that is no longer the case. Sugar is the number one culprit. People say ‘a calorie is a calorie is a calorie’, but a calorie of protein is not the same as a calorie of sugar. When sugars are absorbed the pancreas puts out insulin, the hormone that brings your sugar levels down, to keep them normal. With a diet that’s high in sugar, which we have today, the body is getting so much sugar it cannot produce enough insulin or the insulin is not working properly—that’s called insulin resistance.

I spent three hours walking around my local Tesco recently looking purely at the sugar content of foods and it’s hidden away in all sorts of foods, especially in ‘low fat’ products. So you may think you’re eating a healthy low fat diet when in fact your sugar intake has increased. What people should be doing, if they’re looking at food labels, is to look at the carbohydrates content, because it lists total carbohydrate and then carbohydrate ‘as sugar’. You’d be surprised to see where sugar is hidden away. Apparently 80 per cent of products in the supermarket contain sugar—80 per cent! It’s the sugar content that’s causing the problem, causing the obesity, causing the diabetes and all the other diseases I mentioned earlier.     

A study recently found that that people who live near busy roads have a higher chance of developing dementia. We get a lot of reports about the links to, or cures for, dementia. Is there really any proven way of avoiding the condition?

These are reports that the population see in the national newspapers and in fact if you go and look behind the headlines as to where these reports come from and look at the science, you find that these are really not very good studies at all—but this is hard to get across to the public. And with dementia, because we are an increasingly elderly population, you will get an increase in the condition: as the brain ages, it deteriorates. Now, as to what might prevent this, no one knows, except for things like keeping physically active, keeping mentally active—doing things like quizzes and crosswords, keeping your mind working—and then a good social life with people around you.

We know that binge drinkers and alcoholics are putting their health at risk but if you count yourself as merely a ‘social drinker’ are you still setting yourself up for health problems in later life?

It’s fairly easy to go over the recommended 14 units a week, and we know a lot of people are way over that. You know you’re not an alcoholic per se but you are consuming too much alcohol and the consequences of that include cancer of the lips, cancer of the tongue, cancer of the throat, cancers all over your body, and there’s a second change and that is a fatty liver. Now, fatty liver is a healthy liver that has been infiltrated with fat, so it’s not working correctly. It’s usually thought of as a disease caused by just alcohol but it also can be caused by excess sugar in your diet. And of course don’t forget with every alcoholic drink you take, you are putting empty calories into your body.

In your opinion what do you think will be the next serious health challenge that we’ll face?

In my opinion obesity is the most prominent of today’s health concerns and the next I think is probably dementia. Remember dementia is not just Alzheimer’s. There are other common types of dementia and one in particular is called vascular dementia where the arteries—hence the word vascular—are narrowed and hardened due to high cholesterol and high blood sugar. Vascular dementia can produce mini strokes that can lead to dementia. Because of our modern lifestyle of eating excess calories and not doing enough exercise, we’re going to see more and more vascular dementia. 

See also: Weight Loss Choices

What do you think is likely to be the next medical breakthrough?

Well, it would be nice if it was related to dementia. There’s a huge amount of research going on because of the increase in the elderly population, which means an increase in the incidence of dementia. The other medical breakthrough would be the treatment of cancer. There are hundreds of different types of cancer, it’s not one disease, so we’re not going to get a cure for cancer across the board but cures are being developed in certain cancer areas—patients with leukaemia have a dramatically more positive outlook now and breast cancer survival rates are improving.

If you believe what’s reported in the newspapers it seems that the NHS is constantly in crisis. In your opinion as a GP is this an accurate representation?

I would say definitely the NHS is in crisis, it’s a shambles it really is. The abuse of A&E by the public is disgraceful. A&E is accident and emergency, so whether your case is an accident is fairly obvious, but is your case an emergency? People are turning up to A&E with minor complaints so they’re blocking the progress of patients who have got more serious complaints in the system. And of course we’ve got a shortage of doctors, a shortage of nurses, a shortage of funding for the members of staff and for technology and treatments available now. There’s a huge amount of wastage in the NHS, and that’s got to be addressed, we’ve got far too many managers managing the system. It really frustrates me, the state of the NHS. I have been an NHS GP all my life and I’m a firm believer of the health service but of course it’s very different to how it was when I started. It’s very sad to see the state of the NHS today.

How has it changed since you first started as a doctor?

Well from a GP’s point of view we would give our patients five minute appointments and people might think that’s terrible today but what we did is we gave them a time slot to come in—nine o’clock, five past nine, 10 past nine. I would see 50-60 patients a day and we didn’t take an afternoon off although we did close in the evening and during the night, we were on call over the weekend. General practice is now totally different, you’re ticking boxes to say they’ve done so many vaccinations etc, and patients now have a 10-minute appointment. And the latest recommendation is that a patient should only come in with one complaint per appointment so if you see your GP in a 10 minute appointment all you can do is tell them about one complaint, if you have other complaints you have to make another appointment. Well, the other appointment could be three weeks away and while you’ve been waiting you may have had some different symptoms!

Although we were seeing patients officially on paper every five minutes (some patients would take 15 minutes of your time), you knew the patients very well, you knew the families you knew their parents even their grandparents—so you didn’t need a great amount of time. Now GPs are retiring earlier or going abroad to work with better health systems and there are less new GPs.

If you could pick some easy steps that everyone can take right now to improve their health what would they be?

Today’s health concerns can be easily tackled if you take precautionary measures: number one, walk. Just get out there and walk. With my patients if they want to lose weight, I say go out for a 10-minute walk, turn around and come back—so that’s actually 20 minutes of walking every day come rain or shine. In other words, just be more active. The second one is try and eat a better diet. Less sugar, more fruit and more veg. Third, stop smoking. That’s not easy to do, I worked in nicotine addiction for 40 years and it’s very difficult to quit smoking but any attempt to quit is worth pursuing. Finally, reduce your alcohol intake to no more than 14 units per week.

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