TRANSCRIPT: The Saving Australia Diet
MELISSA DOYLE: Every day, close to 300 Australians will be diagnosed with type two diabetes and most wouldn't have known they had it or much about its deadly consequences. We've gathered together a team of doctors and some of the world's highest-profile advocates of good food and health, including MKR's Pete Evans and the 5:2 diet's Michael Mosley. They believe that even though food and lifestyle caused this disease, it can also cure it. PJ Madam is following the three average Aussies determined to change their ways and conquer type 2.
MAN: Spaghetti marinara or fettuccine. Oh!
MAN: There's a secret in eating a chocolate - break it in half, put it inside a roll and eat it with a roll.
(CHIPS CRUNCH)
WOMAN: Chips and chocolate together - oh!
You told me I was the one... #
MAN: Well, who couldn't love a pizza? They are magnificent.
MAN: I enjoy my scones as well, with a lot of cream and jam.
WOMAN: Chicken kebab with the lot.
MAN: Ice-creams and alcohol.
MAN: Big, thick battered fish. Nothing like it in the world.
WOMAN: I hear 'em call my name. "Cassandra! Come eat me!"
PJ MADAM: They are the faces of an Australian health crisis spiralling out of control. Tony, Cassandra and Jack are facing the killer disease type 2 diabetes.
Where'd it all go wrong? #
TONY: The idea of being on a dialysis machine or the idea of, you know, having to inject myself every day, that doesn't win me at all.
CASS: It's only just since being diagnosed as a diabetic that I'm learning how much sugar is in everything.
JACK: It's a problem when people can't control their eating.
MICHAEL MOSLEY: It's absolutely terrifying. I mean, really, really terrifying. But I think the tendency amongst the medical profession has been to downplay it. The idea is that we can treat it, you come in, we give you the drugs. What they don't tell you is, you know, even if you're treated, it means it's cutting your life expectancy by 10 years. They're also probably not telling you that we don't really know how effective these drugs are.
PETE EVANS: The future of my children, the future of their children, the future of this country depends on us having an understanding of how we can actually get our next generations through, hopefully without it... keep escalating. We've gone from having a diet high in fat to one that's high in starchy carbohydrates. That is a fact.
PJ MADAM: Type 2 diabetes didn't pick them. Our trio picked type 2 diabetes. Because like so many Australians, Tony, Cassandra and Jack chose a lifestyle that put them at enormous risk of developing type 2.
TONY: I don't think I've ever been on a diet. I could never really see the point.
PJ MADAM: Tony Benneworth is 65 and old-school. When it comes to food - whatever's in front of him, and plenty of it. Tony's a carb-loader. Bread, potatoes and pasta are his weakness.
TONY: The nights you come home and you've really had a tough old day are the nights you tend to take 150 biscuits and cheese to bed with you. (LAUGHS) Funny, that, isn't it?
Alright, now... #
PJ MADAM: Back in the day, he was one of Tasmania's best cricketers, long before there was a focus on health and fitness.
TONY: In my day, we were cricketers who, God help us, didn't want to be an athlete. Running two laps of the oval to me was a hell of a big effort. A warm-down was a cold beer, and a warm-up was a couple of smokes. I was always known as 'Bellyworth'. Isn't that interesting?
What's your game, baby? #
TONY: Motorcycle mad Tony was actually diagnosed with type 2 eight years ago, but being Tony, he did nothing about it. His wife, Linda, knows all too well how stubborn he can be.
LINDA: To be honest, Tony's been in denial about his diabetes and... ..the food that he should be eating.
TONY: I agree. Back then, it was almost too hard and who cares? But I guess I do care now.
PJ MADAM: Tony's new diet has been designed by Launceston doctor Gary Fettke. He's an orthopaedic surgeon who's decided prevention is much better than one of the horrific consequences of type 2.
FETTKE: I used to do one amputation every 6 to 12 months and now I'm doing one a week.
PJ MADAM: One a week?!
FETTKE: One a week.
PJ MADAM: From diabetes?
FETTKE: From diabetes. It's as simple as that.
PJ MADAM: For Tony to survive, keep all his limbs and avoid a lifetime of medication, Gary's convinced him to go LCHF: Low carbohydrates, healthy fats.
PETE EVANS: Fat does not make you fat if it's eaten properly. Fats come in the most beautiful little packages. Avocados, nuts and seeds, eggs, and then the fats from the animals.
MAN: G'day, mate. How are ya?
PETE EVANS: How are ya?
PJ MADAM: It's a little like the regime espoused by MKR's Pete Evans, a friend of Gary's, and here to guide and inspire Tony.
TONY: Now, Pete, I'd like you to meet my wife Linda.
PETE EVANS: G'day, Linda. How are you?
LINDA: Hello. Lovely to meet you.
PETE EVANS: Ask me how many people that this hasn't worked for. I have not met
or heard of one person that has adopted this way of life that has not improved their life.
For you, type 2 diabetes - it's really simple. We just need to lower your carbohydrate intake. Will you do it?
TONY: Yes. Absolutely. I'm totally committed to it.
PJ MADAM: Pete and Dr Gary want Tony to kick carbs because of their rapid conversion to sugar in the system.
FETTKE: Low-carbohydrate, healthy-fat eating is about eating lots and lots of vegetables, particularly the ones that are above ground, the green leafy ones, and it's about avoiding the processed foods.
TONY: I can walk up town and walk past a window and see my dirty, great big gut hanging out, and that's stupid. I've got to do something about that.
PJ MADAM: The nation's diet means someone in Australia is diagnosed with type 2 diabetes every five minutes. They've eaten their way into a disease that was once thought to be irreversible.
FETTKE: Diabetes is the inability of a person to control the blood glucose as a result of how much glucose and carbohydrate they've eaten.
PJ MADAM: That glucose, or sugar, is broken down by the body by insulin from the pancreas. Normally that insulin converts the sugar to energy, but insulin can only handle so much. Too much sugar and insulin won't keep up. That sugar will build up in the blood instead. And that's when it all goes pear-shaped.
MOSLEY: Persistently high blood sugar that does further damage. And because, you know, all your organs, your brain, your heart, your kidneys, things like that, are fed by blood from your arteries, that's why the damage occurs there.
CASS: Take the kids to school, come home, have coffee, have coffee, have coffee, have coffee. Pick the kids up from school, have coffee. Um...maybe a soft drink. And then have a great big massive dinner because of not eating.
PJ MADAM: And, Cass, how do you take your coffee?
CASS: I take my coffee white, with three sugars and milk. If I'm at home, I'll do three.
Sometimes I'll slip and put four and I would have up to 10 a day normally.
PJ MADAM: 10 a day?!
CASS: 10 a day.
PJ MADAM: In western Sydney, arguably Australia's type 2 hot zone, single mum of three Cassandra Floyd has just been diagnosed with the disease. She's 36 and she's a fast food fiend.
CASS: Well, there's the Kentucky, Red Rooster, the kebabs. Can I get a chicken kebab...
MAN: Yep.
CASS: ..with cheese and barbecue sauce, please?
MAN: She's got this difficulty of understanding what a good diet is, a healthy diet. Managing three kids, cooking them a healthy meal is always a challenge for her.
CASS: Hi, Dr Verma. How are you today?
VERMER: Hi, Cassandra. I am fine. Have a seat.
PJ MADA: Cass's doctor, Vishal Verma, has been trying to get her to change her ways for years.
VERMA: I have told her very clearly that she needs to lose weight, she needs to eat healthy and she needs to exercise regularly.
PJ MADAM: How did you get to this point?
CASS: I think I got to this point just through my own laziness. It was easy to take the kids to school, come home, do a bit of housework, sit on the lounge, watch a bit of TV. Before I knew it, one hour turned into four hours, four hours turned into eight hours.
I've always put my girls first, but it's good to see my girls are also now putting me first too and telling me, "No, Mum, you need to get yourself better." So, I'm doing that. That's what I'm doing.
PJ MADAM: What do you think would happen if you didn't change your lifestyle?
CASS: I probably wouldn't be here in the next 6 to 12 months, maybe. My body would shut down and I'd be a lot sicker than what I am and probably in hospital and... That's not a lifestyle for the kids, so...
ALEX: And what about things like bread? Would you eat much bread, do you think?
PJ MADAM: Guiding and inspiring Cass is dietitian Alex Parker. Alex and Vishal have hit on a low-GI diet that's high in fibre and wholegrain carbohydrates. It's based on the current guidelines by the Dietitians Association of Australia.
VERMA: She should be increasing cereals, bread which are rich in fibre, fruits, vegetables. She should definitely be avoiding foods which are too rich in unsaturated fats.
ALEX: We can see if you're having rice, we want to keep it to about half a cup of cooked rice, or if we're having pasta, it's about the same. And you can see there that there's plenty of room left on the plate to add vegetables and also get some of that lean protein in there.
CASS: I need to do it to make myself healthier. If I don't do it, then I may as well get a coffin and start planning a funeral.
PJ MADAM: If Cass and Tony do nothing about their type 2 diagnosis, it will get them.
DOCTOR: Some of the risk factors - so, heart disease, premature death, increased risk of stroke, impotence, blindness, renal problems, amputation.
FETTKE: It's not just the amputations. It's the problems that come before that.
It's the ulcerations on the feet, it's the pain, it's the loss of function and it's the foot deformity. If you've got a chronic foot ulcer that's smelly and it's fungating - and I know that sounds terrible, but that's what it is - it is almost like a modern-day leprosy.
JACK: Food to me is like a cigarette to a smoker, I suppose. That's food to me.
PJ MADAM: Jack Merolla is a self-confessed sugar addict. He and his wife, Daniella, and their two adult children live in Perth. He's a manager at Fremantle Port.
How would you describe his eating habits?
WIFE: Wow. (LAUGHS) Um... He can eat for two people. That's it. Chocolate is his obsession. Ice-cream as well. Italian, Mexican, Asian food - any food, he will eat.
JACK: But once I've eaten and I think, "Well, did I need that? "I wasn't really that hungry." But even trying to convince myself that that wasn't necessary, two hours later I'm eating again.
PJ MADAM: At 50, Jack doesn't look obese, but with type 2, you don't have to. He is what's known as 'skinny fat', or a TOFI: This on the inside, fat on the outside. The stress of moving to a new country with a young family triggered years of binge eating.
JACK: My doctor actually warned me. He says, "Look, you're starting to head to a diabetic stage. "You're pre-diabetic. You've got to start doing something about it." I think to myself, "I'm not being fair to Daniella." Because when we emigrated, we don't have any family here. She's only got me. We need each other as a family. So if something happens to me, I've disrupted this whole family. And I think it, truly I do, I think it, but it doesn't stop me.
DANIELLA: If he keeps going the way he's going, he will get a heart attack. My biggest fear is that we won't grow old together.
DOCTOR: He's 50. He's got a choice now that he can do this diet and he can be around for a lot longer, or if he doesn't take up this opportunity, he will be experiencing complications within the next few years, and who knows what will happen?
PJ MADAM: Jack's family doctor, Patrick Garratt, has recommended the eight-week blood sugar diet devised by Dr Michael Mosley. Michael gave the world the 5:2 diet, but this is different - a strict limit of just 800 calories every day. But it's not just any 800 calories.
MOSLEY: A Mediterranean-style diet is the best way to go, and that basically means a diet which is fruit and veg, obviously, but also lots of oily fish, the occasional glass of red wine, lots of oily nuts, plenty of olive oil in your things and occasional bits of dark chocolate. Going on a really fast weight-loss diet appears to be much more effective than trying to do it slowly and steadily, which is absolutely the reverse, obviously, of what most people will tell you.
PJ MADAM: Dr Garratt has come to London to visit Michael Mosley and discuss Jack's predicament.
MICHAEL: Hi, Patrick.
PATRICK: Hello, Michael.
MICHAEL: Nice to see you.
PATRICK: Welcome to sunny England.
MICHAEL: Cheers. Thank you.
PATRICK: Brought the weather for you. (LAUGHS)
MAN: Jack is one of those guys that he's reached 50 and he's just put on a few kilos.
MAN: He's got a bit of a tummy on him, hasn't he?
MAN: A little bit, yeah.
MAN: He's lacking a bit of energy.
MAN: And has he got a sweet tooth?
MAN: Oh, he loves his cookies, his gelato ice-creams. Yeah, definitely a sweet tooth.
MAN: I really look forward to seeing how he gets on, then.
PJ MADAM: So, tell us about the blood sugar level.
MAN: Sure. I mean, it's not easy, but this is for pre-diabetics and diabetics. So you're gonna have to lose about 10-15% of your body weight. By doing the 800-calorie, then that cuts your risk of becoming a diabetic by about 90%. So at every level, losing weight, particularly gut weight - fat around your abdomen - is going to lead to massive improvements. That's why I'm talking 800 calories. 800 calories is the lower end of normal. It's not super low.
MAN: Here is your first meal in your new lifestyle.
PJ MADAM: It's about half of what's considered average, and about a quarter of what Jack eats every day. It's going to be tough.
JACK: So if I hopefully can help someone out there by them watching that I have a similar problem to them that they think they don't have a problem, trust me, mate, you have a problem. You've got to do something about it.
(TONY, CASS AND JACK LIST FOODS)
CASS: That would have to have probably been the biggest sugar diabetic overload you will ever have.
GARRATT: Increased risk of: (LISTS RISKS)
This is a really, really serious disease.
Pour some sugar on me
Ooh, in the name of love... #
GARRATT: The problems with our diets at the moment - we've got a wealth of food out there, it's easily accessible, and we have the opportunity to eat any time of the day or night. Too much food and too much of the wrong foods have really led to this.
WOMAN: I was wondering if I could take your order?
JACK: Yes. You go first.
PJ MADAM: Time for one last indulgence before it's all about to change.
JACK: I'll start with the arancinis. And then I'll have, as the main meal, I'll have fettuccine carbonara.
PJ MADAM: His choice - a rich, creamy dish high in carbs...
JACK: Very tasty, eh?
PJ MADAM: ..reveals the enormity of the challenge ahead.
WOMAN: And what would you like for dessert, guys?
JACK: Your chocolate lava cake.
WOMAN: Choc lava cake.
PJ MADAM: High in sugar, high in fat...
JACK: I'm not gonna waste a drop.
PJ MADAM: ..and this is not unusual.
MAN: May I take your order?
PJ MADAM: In Tasmania, Tony takes us to his favourite restaurant.
TONY: I'd like the calamari as an entree.
WAITER: Yes.
TONY: And the fettuccine carbonara as a main course.
WAITER: Main course. Mm-hm.
PJ MADAM: Like Jack, Tony goes for the creamy carbonara.
CASS: Ready?
PJ MADAM: In Sydney's west, Cass and the kids head to their favourite takeaway.
CASS: Can I get a Filet-O-Fish meal? Do you still have the McBites? Can I get one of those? Can I get a Big Mac meal?
WOMAN: Large?
CASS: Um...sure.
WOMAN: Thank you.
CASS: Oh, my God. Yum!
PJ MADA: This constitutes a normal meal for Cass and the girls. It can't go on.
CASS: I'm the one setting the lifestyle example. I'm the one that prepares the food and the dinners and everything. I'm the one that does all the grocery shopping. So if I don't change that now, then they're only gonna fall down the same path that I've fallen down.
PJ MADAM: So with the help of her three girls, Isabella, Gabby and Shanae, Cass has decided to rid the kitchen of any temptations. This is a big deal. And soon the hard reality of the new regime dawns on the kids.
GIRLS: Please don't throw that out! (SOBS)
CASS: Come on. Aww.
PJ MADAM: The tears are partly because we're throwing away Shanae's favourite food.
But it's also concern for Cass. Type 2 could end her life way too soon.
CASS: Having diabetes, I don't know if you're aware, but the doctors told me I'm at risk for things like, you know, kidney failure and liver failure and things like that, if we don't take a hold now and cut all these sugars out. What's a little bit of food and sugar when... Like the girl said, the life's more important.
GIRL: (SOBS)
PETE EVANS: I can sympathise and I have empathy for everybody, because, uh, how society is at the moment and how we as a population eat is common but it's not normal.
PJ MADAM: Before Tony, Cass and Jack attempt to reverse their type 2 diabetes, each is given an extensive medical examination.
DOCTOR: What do you understand about diabetes or what have you been doing to manage it?
TONY: Nothing.
DOCTOR: What's driven you here? And also...
TONY: I'm just not keen on dropping dead in the next few years.
DOCTOR: We're just measuring around the middle.
PJ MADAM: The information collected during the exam gives us their current state of health.
TONY: Come on, settle down. Settle, boy. That's not bad, is it?
DOCTOR: 121.6.
PJ MADAM: These measurements are a starting point for the experiment.
DOCTOR: So, first thing, this is the finger-pricker, which is the simplest term for it.
PJ MADAM: A key indicator of type 2 diabetes is a blood glucose test.
TONY: Bang. That hurt.
DOCTOR: Bang.
PJ MADAM: Blood sugar levels fluctuate with food and stress. The average reading for a healthy adult is between five and six. Tony's reading is 12 and double the average. Jack's is 8.2 and on the high side. And Cass's reading comes Is at 16.3 - extremely high and a huge wake-up call.
CASS: It's gonna be a challenge. I'm not gonna say it's gonna be real easy. It's a challenge that I'm willing to face and it's a challenge that I'm willing to accept.
Doctor: So, Jack, have you had an ultrasound before?
JACK: Yes, I have. Yeah.
PJ MADAM: Jack is going on Michael Mosley's 800-calorie blood sugar diet - the most physically challenging of all the diets.
DOCTOR: And push your belly out again. That's fantastic. That's good.
PJ MADAM: So to be sure Jack is up to it, Dr Garratt is ordering a range of extra tests.
DOCTOR: Just don't want to put you on anything that puts you at risk. We're just checking that everything about your heart is OK, really.
DOCTOR: So he needs to be perhaps a little bit scared. He needs to realise that this is a really, really serious disease and the lifelong implications are severe and that it's not just about losing an inch or so around the waist, it's actually about transforming his life. And if he becomes a diabetic, it's gonna cut 10 years off his life. And that's not gonna please his wife at all.
DOCTOR: And just stay nice and still for about seven minutes.
PJ MADAM: This is called a DXA scan. It creates an image of the body that reveals the fat surrounding vital organs.
DOCTOR: What we've got is - blue is bone, red is muscle and the yellow stuff is fat.
JACK: Gulp! (LAUGHS)
DOCTOR: Your visceral fat equates to 164. OK?
JACK: What's that?
DOCTOR: Below 100 is normal. Above 100 is high risk. Above 160 is very high risk.
JACK: So I'm in the very high risk?
DOCTOR: You're in the very high risk. You're 164.
JACK: Wow.
PJ MADAM: Over the coming weeks, they will have to deal with a lifetime of poor eating habits, stare down temptations and stay the course. We'll be following their ups and downs as they try to defeat type 2.
TONY: It won't beat me. No. I'll do this.
CASS: If I can do it, being one of the laziest people in, you know, Sydney, I think anybody can do it. So, yeah...
JACK: I want to be able to control myself. I want to be able to say, "Look, my life is not just food. "I don't have to involve everything with food."
PETE EVANS: Prevention is much better than the cure. Forget about the financial cost to the nation. Think about the emotional cost that it's costing these families. You know? It's...it's...it's... If we can do something to prevent that in the future, then...it's definitely a fight worth fighting for.
MELISSA DOYLE: And we'll check in with Pete Evans, Michael Mosley, the doctors and our volunteers over coming weeks to see if they can beat type 2 diabetes. On our website and Facebook page, there's more from PJ Madam and info on all the diets.
When we return - the rhino warrior and the team of brilliant scientists determined to save an African giant.
WOMAN: This is a kind of last-ditch stand. You've gotta do everything you can.
STEPHEN: This is it?
WOMAN: This is it.
STEPHEN: We're now down to the last three northern white rhinos.
MAN: Her efforts are heroic to try to save these rhinos.
STEPHEN: That's next on Sunday Night.
