Diabetes is defined as “a condition where the amount of glucose in your blood is too high because the body cannot use it properly” (“What is Diabetes?”, 2013). There are two different kinds of diabetes: Type I (where no insulin exists for the cells to use as fuel) and Type II (where not enough insulin is created, or it is misused) (“What is Diabetes?”, 2013). According to statistics, diabetes is rampant in the UK: 2.9 million people are diagnosed with diabetes (“State of the Nation 2012 – England”, 2013). Diabetes occurs when the pancreas does not provide insulin to allow glucose to enter the cells of the body, or when insulin resistance occurs. Symptoms include increased thirst, unexplained weight loss, blurred vision, cuts and wounds healing more slowly than normal, and more (“What is Diabetes?”, 2013). There are many risk factors for developing diabetes, including a family history of diabetes, being overweight, over 40 years of age, high blood pressure, or being of South Asian or native African descent (“Diabetes Risk Factors”, 2013). The risks of developing diabetes in the UK are great – 7 million people in the UK are at high risk of developing it (“State of the Nation 2012 – England,” 2013).
Male bus drivers have a special level of risk for developing diabetes, due to the lack of physical activity and risk of heart disease that occurs with the sedentary nature of their work; men especially have a higher risk of developing diabetes (Rosengren, Anderson & Wilhelmson, 1991). Diabetes (whether type 1 or 2) is diagnosed through a process known as the fasting blood glucose test – in essence, doctors check the blood glucose after the patient fasts for eight hours; if it is too high, that person has developed diabetes (National Institute of Health, 2013). The Glycaemic Index (GI) is “a ranking of carbohydrate-containing foods based on the overall effect on blood glucose levels” (“Glycaemic Index (GI)”, 2013). The GI of a food can be affected by the level of processing and the method of cooking that is used. Fatty foods have a lower GI, as do foods with high protein and mixed grains (“Glycaemic Index (GI)”, 2013).Keeping track of the GI of foods can allow one to control the glycaemic effect of their diet; looking for foods with a low GI, such as mixed-grain breads, sweet potatoes and other foods with low GI can create better diabetic results (though a strictly low GI diet is not recommended (“Glycaemic Index (GI)”, 2013).
One possible intervention for tackling the prevalence of diabetes in male bus drivers is to set up cooking classes for men; studies have shown that males have a much lower level of cooking confidence than females, leading to an unhealthier diet (Wrieden et al., 2007). In one intervention, a community-based food skills intervention was set up in eight Scottish urban communities, for both men and women living under social deprivation; these cooking classes were shown to have a measurable and positive effect on dietary choices, cooking confidence and food preparation skills (Wrieden et al., 2007). The amount of fruits and vegetables consumed by subjects increased significantly, and more subjects expressed confidence in following recipes (Wrieden et al., 2007). Cooking classes are an important way to build up cooking confidence, which then leads consumers to choose processed food less often; this may help make male bus drivers better able to make positive food choices.
Another idea to reduce diabetes rates in male bus drivers is to teach them how to choose the correct foods when shopping; the plan is to take an intervention group shopping in order to provide better grocery tips. Rodgers et al. (1994) measured a supermarket intervention in which shopping tips were provided by providing special shelf price labels, food guides for nutritional facts, monthly bulletins and multimedia advertising campaigns (1994). The intervention appeared, according to the results from consumer surveys and purchasing data, to have a positive effect on shopper’s purchasing habits, increasing awareness of the link between cancer and diet (Rodgers et al., 1994). This, in turn, provided an increase in knowledge and attitudes toward nutrition. It is hoped that the same kind of intervention would provide better food outcomes for male bus drivers at risk of diabetes.
Studies have shown that providing healthy snacks as alternatives for professional drivers have had positive outcomes on their food choices (Svederberg, Nyberg & Sjoberg, 2010). Often, meal time irregularity is a significant factor in obesity and diabetes risk factors for bus drivers and other labor force occupations (Svederberg, Nyberg & Sjoberg, 2010). Irregular schedules and limited availability of healthy food has an adverse effect on these occupations, leading to higher risk of diabetes (Svederberg, Nyberg & Sjoberg, 2010). To that end, bus drivers may be able to avoid making poor food choices if healthy snacks were provided to drivers to carry with them on their routs and eat when convenient.
In order to get the subjects of this intervention (male bus drivers) to stick to these new habits and lower their risk of diabetes, there are several tips that can be used (Herron, 2009). First, it is important for subjects to look within themselves to find their own motivations for why they want to reduce their risk of diabetes. Secondly, it is vital to self monitor, and learn how your behavior is affected by low or high blood sugar. Next, it is easy to see how positive changes can accumulate as they are followed; it becomes easier to do better as you start the road to positive life choices (Herron, 2009). Using nonfood rewards to celebrate good choices is a good way to facilitate good behaviors, and they must make sure to substitute foods they want instead of cutting them out altogether. Positive thinking and self-talk can be good, as well as avoiding making excuses for not following through. Finally, getting the proper support can offer accountability in achieving positive outcomes (Herron, 2009).
I will be monitoring the progress of my subjects through surveys and talk interviews with the bus drivers, as well as having them monitor their spending and diet habits. I will have the subjects keep a food journal of everything they have eaten during the intervention period, including keeping track of the GI Index.
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