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Lifestyle and nutrition to combat diseases (of affluence)

We know this, but we don’t act on it: eat healthily, move more, address our stress levels and sleep well. Internist and Professor of Diabetology Hanno Pijl is fascinated by the effect that a healthy lifestyle can have on health. He researches how this lifestyle is achievable and satisfying, for patients with diabetes, for example.

Poor eating habits are very difficult to change. We are biologically driven to eat sweet things. Storing up calories was previously crucial for survival, as you did not know when your next meal would be. Nowadays, you can get high-calorie foods anywhere and at any time. Our body’s evolution has not caught up with this change. Also, we are not built for long periods of sitting, but according to the RIVM lifestyle monitor, we spend almost 9 hours a day sitting down.

Doctors are not there to get chocolate out of people’s minds and to talk them into going to the gym. They have ten minutes per patient and they can’t be miracle workers in this time. Although the treatment guidelines for diabetes, for example, state that lifestyle should be addressed first, most doctors immediately prescribe a pill.

Or a whole slew of pills. Diabetes patients who visit Dr Pijl sometimes take up to ten pills a day. This is not sustainable throughout a whole lifetime given the serious side-effects of this medication. In addition, these drugs merely treat the symptoms of the disease and not the disease itself.

The chance of developing type 2 diabetes is massively increased by unhealthy eating, overweight and low physical activity.

Creating food scarcity

Pijl wanted to do something about this and has launched a study that is unique worldwide. He is testing an intervention that causes people to adjust their lifestyle in such a way that it is sustainable for their entire lives so that they can lower their drug intake.

Based on the assumption that the human body is made to deal with periods of scarcity, he artificially builds a short week of "scarcity" into the lives of his diabetes patients once a month. They receive a package at home with the food for that week, accurately weighed and prescribed. They do not have to say goodbye to their chocolate stockpiles forever, but only for one week.

Activating the survival mechanism

A week of scarcity encourages body cells to switch from growth and multiplication mode to survival mode: they start repairing themselves and cleaning out waste. These waste products trigger inflammation. The thinking is that chronic inflammation contributes to the onset of diabetes. By interrupting this chronic inflammatory process, the body can recover and drug intake can be reduced.

Pijl’s intervention is based on fundamental research by American Valter Longo, with whom he works closely. In animals, Longo has succeeded in entirely curing diabetes with this method. Pijl’s study should provide insight into the long-term effects of intervention in humans. Does it really have a lasting effect on their health? And can this eating pattern be maintained?

Pijl hopes so. A healthy lifestyle is cheaper than medicine and healthcare costs are putting great pressure on the economy. He even foresees a discussion about legal measures. "There is a limit to an individual's freedom to choose how he lives. That limit is determined by the law. In my view, the smoking ban in public areas is a measure that discourages people from smoking. A decision was taken by society to limit smoking. A similar decision can be taken to reduce the sugar content in foods.” This is also a form of in-built scarcity.

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