The dangers of believing doctors
Over the weekend BBC News reported that the Conservative MP for St Ives, Derek Thomas, had been forced to apologise after claiming on Facebook that diabetes is 'completely avoidable through good diet and exercise'. Clearly this is nonsense but Thomas says he only posted the comment based on conversations with 'two health professionals'. Which only goes to show the dangers of taking every notion put forward by a doctor as unquestionable truth.
Firstly, it would seem that type-1 diabetes – the most common form in childhood – has nothing whatsoever to do with lifestyle. The NHS Choices website explains:
Type 1 diabetes is an autoimmune condition. Your immune system (the body's natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them, destroying them completely or damaging them enough to stop them producing insulin. It's not known exactly what triggers the immune system to do this, but some researchers have suggested that it may be due to a viral infection. Type 1 diabetes is often inherited (runs in families), so the autoimmune reaction may also be genetic.
But most cases of diabetes are type-2 where the body stops responding to insulin properly. It's true that there is quite a strong correlation between obesity and type-2 diabetes but whether obesity causes diabetes or whether it is the case that obesity and diabetes have related causes is not clear. It is certainly true that roughly half of type-2 diabetes cases in the UK are in people who are not heavy enough to be called 'obese'. People from ethnic minority backgrounds – particularly from South Asia – seem to have a markedly higher risk than others. And the biggest risk factor of all is age.
No doubt changes in diet and activity can help many people to avoid or control type-2 diabetes. But the claim that it is solely caused by lifestyle is simply not true. What is true is that many doctors promote such claims way beyond the quality of the evidence and seem to believe that manipulating our habits – based on the sage advice of the medical profession, of course – is the way to achieve health and happiness.
Given that such advice has, over the years, proven to be contradictory or just plain wrong (remember when we were told eggs were bad for us?) we cannot rely on the latest fashionable ideas to judge how to live our lives. Such ethical choices are tricky and complicated but the best person to make that choice is an individual, not the members of the public-health lobby or politicians in Westminster and Brussels.
Most importantly, it is absolutely wrong for the government to interfere in our personal choices through bans, regulations and taxation based on whatever bee is currently in the bonnet of the medical profession. Of course people will always be keen to know how they might make healthier choices, but there is a big difference between advice and prohibition. That's why it's vital to constantly make the case for choice and freedom.