Episode 2 Food: Truth or Scare

Everyday we're bombarded with conflicting information

about our favourite foods.

One minute, we're told something is good for us, the next,

it's not, and we're left feeling guilty about what we're eating.

So, we've been wading through the confusion to separate

the scare stories from the truth

so that you can choose your food with confidence.

Hello and welcome to the programme that's all about getting past

the scare stories and the terrifying headlines to find out

the truth about what we're eating.

It's easy to worry when you see the front pages

saying you shouldn't be eating certain foods,

but while it's definitely the case some of us are eating

too many of the things that are bad for us

and not enough of the ones that are good for us,

that doesn't mean we should panic and stop eating them all together.

And, of course, sometimes you just need to know how much is too much.

Certainly, I need to learn that.

Which is one of the things we'll be getting to the bottom of today.

And we'll see how that ties into a story that has dominated

front-page headlines in recent months,

and, I should add, it had a real effect on my own life.

Coming up on the programme today:

Constant headlines about diabetes are daunting,

but when I was told I was at risk of developing the condition,

changing what I eat every day stopped it in its tracks

and the same could work for you.

The good news is if you get to the healthy weight for your height,

you can really dramatically reduce your chance of developing

type 2 diabetes.

And, how much is too much?

How we are being misled about portions by the size of our plates.

See, I go off plate size.

If I have a big plate, I will eat a big plate.

First, it's hard to miss the message that we should all eat

at least five fruit and veg a day, and while many of us do

at least try and follow that advice, we don't all manage to get there.

Me included.

I started working with this stuff around the same time

they launched the five a day campaign and,

if I'm brutally honest, I don't always get mine.

Maybe it's time this greengrocer learnt a bit more about

his fruit and veg.

I'm starting, perhaps surprisingly, in the United States of America.

Land of the French fry, birthplace of the burger, home of the hot dog.

But it was here, too,

that one of the most familiar food messages of recent times was born.

The recommendation that we eat five servings of fruit and veg a day.

It's healthy to eat five servings of fruit and vegetables a day.

So, be good to yourself. Ask for it.

And if it was good enough for our American cousins,

then it was good enough for us Brits.

In 2003, we took on five a day, too.

Dinner is served!

Visit NHS/5aday for tips on how you and your family

can eat more fruit and veg.

But it turns out whilst we can all remember the message,

we're not so good at hitting the target.

In fact, on average, we only get about four portions a day each.

-Do you know much about your five a day?

-Er...

-Yeah, I think I'm quite good with it.

-Yeah?

-Yeah.

-I'd love to say yes, but not always.

-OK.

Obviously being a mum of two little ones, getting them to eat

anything sometimes is a challenge, but we try.

So, you don't get your five a day, is that right?

Sometimes I do, but sometimes I can go without...

-Maybe I just have one piece of fruit all day.

-Yes.

And then if I'm working late I don't really have time.

Adding to this,

the five a day message has become blurred by reports and headlines

suggesting all sorts of food and drinks

might contribute to that daily target.

I'm all for people eating more fresh fruit and veg.

I try and make sure my family get their five a day, too,

but I still think there is some confusion as to what counts

and what doesn't.

So, to put that right, I've enlisted the help of nutritionist

Charlotte Stirling-Reed for a five a day fact find.

-So, we're going to go shopping today?

-Yes.

Where better to get stuck in than at a market?

-This is probably a good place to start, isn't it?

-Yes, absolutely.

Different fruits and vegetables

contain different amounts of vitamins and minerals.

But there's one vegetable that doesn't count

and it catches some of us out.

Something I think is a little bit unfair

is the trustee, humble potato not counting as one of your five a day.

Is that right?

It doesn't count towards one of your five a day, no.

It doesn't have quite the same make-up as other fruits and vegetables,

like different colour carrots or berries or pears and apples.

So that's why it counts towards your starchy foods

-and not necessarily one of your five a day.

-I think that's a shame.

I think it should count.

There is a small and exclusive gang of veg that, like the potato,

don't contribute to your five a day because they are starchy.

Yams, cassava and plantain.

But despite what you might have heard or read

amongst all the contradictory information out there,

just about every other fruit and veg do make the grade,

whether they are fresh, frozen, dried, or even tinned,

though the last one only counts

if the fruit isn't swimming in sugary syrup.

But it's hard to know how much counts as one portion,

so we asked the Cock & Swine darts team from Manchester

to see if they could work it out.

Apple - haven't a clue with an apple.

I'd say one apple.

I reckon two.

-Two tomatoes?

-I reckon.

-Two of them, yeah?

-Half a potato.

-It depends if you have a bag of chips.

Keep up, lads - potatoes don't count, however they are cooked.

They were right with the others, though,

so let's see what they make of some foods I'm never quite sure about.

Probably half a bottle of tomato sauce.

Do you know what? I don't think so.

I bet you there is more tomato in there than you'd give it credit for,

so I reckon a good dollop.

Sorry, lads - ketchup doesn't count either.

Salad on your sandwich wouldn't. There's not enough of it.

-I don't think there's enough of it, no.

-Spot on.

It is short of the amount of salad you'd need for it to count.

How about the drink so many of us

would love to be one of your five a day?

Well, it is made from grapes.

One glass of red wine with your meal.

If only, sorry -

no alcoholic drink at all counts towards your five a day.

The darts team is close to defeat, but can they claw back a victory

by guessing how many sprouts make up one of your five a day?

Sprouts?

Apart from them being horrible,

probably about eight or nine, probably.

-I don't know.

-I'd go less than that.

-Less than that?

-Yeah.

Probably about five of them will do one of your five a day.

Well, there is a simple way to work it out,

which applies to all fruit and veg.

If it fills the palm of your hand, it's one of your five a day.

That's a serving of roughly 80g.

For the sprout haters in the pub, that's quite a lot of Brussels.

Wow!

Wow. I'm in the spare bedroom after three.

LAUGHTER

If the portion size is more than you were expecting,

it probably explains why so few of us

are hitting that five a day target

but kids like my little boy, who is three,

won't eat as much as adults, so for them, the same rule applies -

if it fills the palm of their hand,

it counts towards one of their five a day.

-A large banana for a child is far too much.

-Yeah.

It's a palm-sized portion and a large banana for you might be fine,

a small banana for me might be absolutely appropriate,

then a small banana, or a part of a banana, for a young child.

So that's what makes up one of your five a day,

but there is no short cut to get five.

You can't just eat more of the same thing. That doesn't count.

Instead, it's variety that is the key.

And for the best mix of all, go for a range of colours.

The more naturally colourful your fruit and veg,

the more likely it is to be packed with cancer-fighting nutrients.

I love this rainbow chard.

This is a personal favourite of mine

and this is fantastic for many reasons.

-Obviously, it's a good, leafy green.

-Yep.

But it's also bright and colourful and that's what we're being told -

we're told to eat more variety and lots of different colours.

Yep, absolutely - a rainbow of colours,

different fruits and vegetables every day.

Something lots of people wonder about is whether juice counts.

We get through a lot of it in our house,

both on its own and in smoothies,

but I have a sneaking suspicion downing an extra glass

won't get you to that magic five any quicker.

Currently, we recommend about 150ml of juice can count towards

one of your five a day portions,

but, actually, no more than that and there is a reason for that.

It's because when we're blending fruit,

what happens is the sugar becomes much more readily available,

which can have an impact on the teeth

and at the same time as well, you lose a lot of the fibre.

But smoothies are slightly different, aren't they?

Yes, in terms of smoothies,

what we would normally say is because, actually,

you tend to get a lot more of the pulp,

you get a lot more of the fibre in a smoothie as well as the juice,

so, really, we say that smoothies count

towards about two of your five a day.

I must admit, this is something that I do.

I've got a little three-year-old, so we call it a super juice

and in the morning, he'll have a juice

and I know he's had at least two portions

of his five a day and he loves it.

Now, the five a day message

is a simple way to get us all to think about

how much fruit and veg we eat,

but the advice isn't the same the world over.

Like us and the Americans,

the French are advised to eat at least five fruit and veg a day,

but in Denmark, it's six

and the Australian government recommend seven a day,

specifying five veg and two fruit.

In Greece, it's eight, but topping all of those is Canada,

where it's recommended you have up to ten portions

of fruit and veg a day.

Garlic, parsley, mint.

-Wow.

-I'm nearly done, no?

I think the portions might be a bit small, but looking good.

Visiting a market like this,

as I am lucky enough to do in my work a lot,

reminds me what an incredible variety of fruit and veg there is

and it makes me want to eat more than my five a day.

I am biased, but it is such a beautiful product range

and it is so versatile and there's so much you can do with it.

-Getting your five a day should be a pleasure, not a chore.

-Absolutely.

Don't worry about the mechanics behind it,

don't worry about how much, or when or where -

just eat more fruits and vegetables is the simple answer.

Look through the papers on just about any day

and chances are that you'll find a story that talks about diabetes.

There's been such a dramatic rise in cases

that they are now calling it an epidemic,

with the increase typically linked to the fact that so many more people

are classified as obese these days. Chris, look at this - a bit scary.

"A record four million people suffer from diabetes

"as obesity levels soar."

And look, there's one here -

"Soaring diabetes to bankrupt the NHS - cases up 60%."

What happened in my case was that they discovered

that I had a very high blood sugar spike, so once you have that,

your GP is down on you like a tonne of bricks, so really,

I changed my diet enormously under guidance, under medical guidance,

and I certainly gave up a lot of sugar,

but I can't help but wonder, if I'd eaten differently growing up,

cos my mum baked a lot, that things might have been very different,

so I wanted to find out just how I could have become

so close to being diabetic.

We've sleepwalked into what is a crisis.

It is spiralling out of control, it is extremely worrying.

By 2025, it's predicted that five million people in the UK

are likely to have diabetes.

An increase of 60% over the past ten years.

Most of them will have it

because of their lifestyles

and in particular, what they eat.

I'm constantly concerned about children, my children,

how much sugar they are taking on board,

whether or not their bodies can handle it.

Diabetes is definitely something I worry about,

because my grandmother has got it, so I always keep an eye on it.

I already had it for three years, even before I found out.

I was pretty shocked, but as a fit guy in my 30s,

I thought, "You're indestructible,"

but all of a sudden you're falling asleep most of the day,

you're feeling tired all the time and that's the diabetes.

But while the risk is real,

more positive headlines have started appearing,

suggesting that there is a glimmer of hope

and even that choosing the right foods could reverse the condition.

Currently, more than four million people are thought to have diabetes,

and there are two types - one that you are born with,

but the other you can develop at any time, as I very nearly did.

I'd had a routine blood test,

because I have an underactive thyroid,

and I rang my doctor to say, "How did those tests work out?"

He went, "I don't know what you've been doing,

"but nearly all your blood tests are out."

After further investigation, he told me

that I was what is sometimes referred to as "pre-diabetic".

Now, that means I was at risk of developing type 2 diabetes,

because my blood sugar levels at that point were abnormally high.

He said, "Your liver function is out, your kidney function is out.

"It might be to do with what you are eating."

It was a total bolt out of the blue.

Type 2 diabetes already affects one in 17 people in Britain

and I didn't want to be the next.

I started looking back at what I had eaten over the years

to see how I could have got myself into this worrying situation.

I grew up in Northern Ireland and we didn't have very much money,

but the one thing we always had was an abundance of food

and it meant, because my mum was at home every day,

we never were allowed to go to school in the morning

without a cooked breakfast.

Then we'd ride our bikes home for a full cooked lunch as well

and after that, it was just a few more hours

until we were eating again.

You had to have something in the afternoon

when you came back from school

and then dinner would have been dinner, whatever it was.

Nearly always meat, fish, two veg.

Always potatoes, then you had to have supper before you went to bed,

so sandwiches or a bit of her teacake or something like that.

You had a lot of food in one day and I look back

and I think my parents were fabulous and I had a very happy childhood

and I think that happiness in childhood

partly revolves around food and the goodness

and the good feeling that that gives you.

Food was always so central to our family life,

as indeed it still is today.

There's one corner of my kitchen that the rest of my family loves,

but for me, it's now out of bounds.

My grandchildren used to call me Nana, but now I'm a "Glo", OK?

They go, "Glo, what have you got in your goodie cupboard?"

Well, this is my goodie cupboard

and every time they come in through the door, they go,

"Glo, we have to go to the goodie cupboard,"

and as I only have them for a day or two at a time,

I don't feel too guilty.

And knowing what I know now,

it's easy to see how the foods I used to eat could have increased

the amount of fat in my body and caused me to gain

just that bit of extra weight,

a key factor, of course,

that raises your risk of developing type 2 diabetes.

My sister Lena had developed type 2 in her 60s.

I later found out that if you are related to someone with diabetes,

you've got a greater chance of developing it too.

As Natasha Marsland from Diabetes UK explained,

I was just one of the many people

who don't realise that they are at risk.

-How big is the problem in this country?

-It's a huge problem.

Diabetes is the leading cause of blindness

in the working-age population.

It causes strokes, heart attacks, amputations and unfortunately,

and I certainly saw this in the NHS when I worked as a dietician,

people have been diagnosed too late,

so they are having their heart attack before their type 2 diabetes

is being picked up and we know,

had it been picked up ten years earlier,

they could have got their blood glucose levels under control,

got the right care and treatment and support and done something about it.

That is pretty frightening, isn't it?

It is frightening, because those people don't know it,

so they're not getting the right care and support and treatment.

It's estimated there are around half a million undiagnosed cases

of type 2 diabetes in the UK.

That's a big worry, as early diagnosis is vital

in being able to properly manage the condition

and many people don't realise they are at risk.

How would you pick it up on a regular basis?

Is it by going to your GP for a test or what?

We do know there are risk factors that you can't do anything about.

For example, your age -

if you are over the age of 40 if you're white, for example,

or over the age of 25 if you're South Asian,

that increases your risk.

If you have got a family member with diabetes, that increases your risk.

Having high blood pressure increases your risk as well.

There is two main factors - being overweight

and having a sedentary lifestyle

and also carrying the fat around your middle

that you can do something about.

I hadn't realised I was a prime candidate

for developing type 2 diabetes,

so I was very lucky that a routine blood test

had spotted abnormalities in my blood sugar levels,

but others might not be quite as lucky as I was,

so to help anyone who is at risk of becoming diabetic,

before they develop the full-blown condition,

the NHS and Diabetes UK are focusing on a campaign

to raise awareness of exactly what being pre-diabetic means.

Pilot schemes across the country

will encourage people to take action,

because as I discovered,

changing what you eat can stop type 2 diabetes developing.

The good news is, if you lose the weight,

get to the healthy weight for your height,

you can dramatically, really dramatically, reduce

your chance of developing type 2 diabetes.

When I was first diagnosed by my GP,

he told me to cut things out like fats and sugar from my diet.

Gone were the cakes I loved

and all those chocolate biscuits and the sweets

and I'm afraid there was worse to come.

As I tried to make sense of all the information about diabetes,

I was determined to stop my pre-diabetes

developing into the full-blown condition,

so I met a specialist called Dr Abbi Lulsegged and he wanted me

to change my eating habits even more and cut out carbs as well.

It's not just sugars that affect diabetics, but carbohydrates

and the reason for that is because, ultimately,

those carbs will be broken down into simple sugars

and that's what stresses the pancreas,

the cells that make insulin.

So bread, potatoes and pasta were also added

to my list of no-go foods.

According to Dr Abbi, they were part of the problem as well.

Many people, of course, never consider themselves overweight,

but one of the biggest risk factors in type 2 diabetes is excess weight

around the middle and, like a lot of people, I have experienced that.

When you ask which of the food groups will contribute

to that weight around the middle,

there is no food group better at doing that than carbohydrates.

The body is very efficient at storing excess carbs,

it's not going to get rid of it

and that storage system goes directly into fat,

but it's also the bad fat, the fat around the abdominal organs.

There are conflicting opinions about whether cutting back on carbs

really is the best approach to either tackling pre-diabetes

or trying to combat the full-blown condition,

but as far as Dr Abbi was concerned,

there was too much in my diet that wasn't good

and they all had carbs in common.

If we look at this thick slice of white bread here,

it has approximately 19g of carbohydrates.

For some people who have diabetes

who need to lose weight around the middle,

they need to restrict their carbohydrate content

to less than 20g total in one day.

That's the equivalent of one thick slice of white bread.

-Wow, so no bread?

-No bread.

And, of course, for an Irishwoman to have to give up potatoes...

-Not good.

-Yes, I know.

I had to sacrifice so many foods I love

and, believe me, it was a sacrifice,

but I was concerned about my health

and I was determined to give it a go.

I didn't want to start taking tablets,

so I trained my mind to get rid of that sweet yearning

that my mother really had given me almost from birth.

But, of course, there are times when I find it very difficult to resist.

I'm trying to reverse a lifetime of food habits and it's not easy,

but my blood sugar levels are now back to normal, I'm glad to say,

and I've been advised that if I stick to the way

I'm eating these days, I should be fine.

The difference changing my diet has made was huge

and that could even be the case

if you do go on to develop type 2 diabetes,

because, as we'll see later in the programme,

in some cases it seems changing what you eat

might even make the condition reverse altogether.

Still to come, the truth about how much you should put on your plate

and why we are getting our portion sizes all wrong.

Right, ladies, what are we going to have for lunch today?

-I don't want too much.

-You never do.

-I just can't eat too many things.

The food we eat has amazing powers

and can help our bodies conquer all sorts of common conditions.

GP Dr Rangan Chatterjee sees patients every day

whose problems could be helped, or even solved,

by changing what they eat,

so we asked him to share some of his secrets.

Today I'm going to investigate some common problems that people have

with their bones and look at what foods can help.

The adult human skeleton is made up of 206 bones,

more than half of which are found in the hands and feet.

As our skeleton supports our entire body,

it's not surprising that we actually need strong, healthy bones.

Unfortunately, not everybody has them.

About three million people in the UK have osteoporosis,

characterised by fragile bones, prone to breaking quite easily.

Over 300,000 people are hospitalised every year

due to fragility fractures caused by osteoporosis.

Most people don't even know that they have got osteoporosis

and, actually, their fracture is the first indication

that there's something wrong.

One of the most vital ingredients in the prevention of osteoporosis,

regardless of age, is calcium.

Most obviously found in dairy produce,

it's often taken in supplement form as well.

You may have seen press reports

linking these supplements to heart attacks,

but it seems that the risk is more pronounced

in women who take more than double

the recommended daily amount.

In any case, you don't need supplements

to get your 700 milligrams of daily calcium -

just three glasses of milk or about 90g of cheese will do that for you

and there are many more perhaps surprising ways

to boost your intake as well.

It's not only milk where we get our calcium from.

There are other foods that are full of calcium -

kale, spinach, or things like sardines.

Other foods that are rich in calcium are tuna, mackerel,

nuts, dates and pulses...

..all of which have become familiar to Jill from Exeter.

She was diagnosed with osteoporosis five years ago

and has transformed her diet,

adding plenty of calcium-rich green, leafy vegetables.

I steam my vegetables in order to maintain the minerals

and vitamins in them and I make sure

that I have my five portions

of fruit and vegetables every day.

I'm finding that all the efforts that I'm making

are having an effect, because my recent tests with my consultant

showed that the process of bone loss is slowing down,

I'm not deteriorating at the rate expected,

so I'm hoping that I'll stay healthy for as long as possible.

But osteoporosis isn't the only common bone complaint

that can be helped by diet.

Osteoarthritis is the most common form of arthritis

and is generally known as the "wear and tear" arthritis.

The condition causes pain, swelling and stiffness in the joints

and if it isn't treated, it's likely to get worse over time.

But the right foods can slow down this process.

Eating lots of leeks, garlic or onions

is said to ward off osteoarthritis,

as indeed is the diet which is often called the world's healthiest.

A Mediterranean-style diet, including things such as olives,

olive oil, fatty fish and avocados

can absolutely help with your symptoms alongside your medication.

These foods are all rich in omega-3,

believed to have inflammation-busting benefits

that can alleviate swollen arthritic joints.

Other inflammation-fighting foods are said to be green tea,

soy beans and I bet you've not heard of this one -

a spice that's been commonly used in India

and China for over 2,000 years.

There is growing research suggesting that the Indian spice turmeric -

it's that yellow spice that you find in curries -

can often be very helpful for arthritis sufferers.

As well as cooking with turmeric,

some people recommend adding a tablespoon to a glass of warm milk

and even mixing it with mustard oil

and massaging it all over the affected area.

But there is also a whole host of foods

osteoarthritis and osteoporosis sufferers should avoid,

because they can aggravate symptoms,

mainly sugars, saturated fats and salt, plus a big no-no is alcohol,

which can deplete the calcium levels in the body.

As with most things, prevention is better than cure,

so the foods we choose can be key

to keeping our bones healthy enough to last a lifetime.

Now, the nation's ever-expanding waistlines are often blamed

in news reports on the fact that we eat more now

than we've ever done before and while that's partly down

to what we eat between meals,

it's the meals themselves that are the real culprits,

because when it comes to dishing up dinner,

lots of us have eyes much bigger than our bellies,

but there is another end of the scale too -

those of us who eat too little,

something that happens more and more as we get older.

So how much should we be eating and how much is too much,

or indeed, too little?

We've recruited four generations of one family to help us find out.

Three out of every five people in the UK are overweight,

but while we eat more than ever before,

it's often without even realising it,

because judging the right portion size isn't always easy.

Putting it onto the plate

and judging it is sometimes a little difficult.

I look at a helping on the plate and think, "That's far too much,"

but I still eat it up.

I'm just English - I just clear the plate,

as we politely have done for many, many years.

But part of the problem - judging portion size -

is that our plates are getting bigger.

In the early 1990s, the average dinner plate

was 25 centimetres across, but now it's grown to 28 centimetres.

One big-name kitchen company told us

it's had to start making wall units bigger to fit the modern-sized plate

and studies suggest that the bigger your plate, the more you will eat.

Although not everything filling those plates

is necessarily some people's first choice.

Dad, why do I have this much veg?

This is the Kay family from Bolton - mum, Ruth, dad, Peter,

12-year-old Jensen and seven-year-old JJ

and they all agree on their approach to portion sizes.

There's no portion control. We just eat what we want, basically.

See, I go off plate size. If I have a big plate, I will eat a big plate.

And the same rule applies for JJ and Jensen.

I do give the boys quite large-sized portions of food,

because I don't want them going off eating rubbish.

I need to know that my boys are fed and my boys are healthy.

So how much should we have each day?

Well, in total, across all meals,

an average adult woman needs just under 2,000 calories

and a man needs 2,500.

But it's one thing knowing that

and quite another to recognise what it looks like.

First and foremost, I don't think this bowl is big enough.

-BOYS:

-No.

-No?

We asked the Kays to measure out

a portion of pasta they'd normally serve at dinner time.

-Right, how much do you eat?

-Per person.

-Is that enough?

-BOYS:

-No.

-Yeah? Are we happy as a family?

-BOYS:

-Yeah.

-Yeah?

-You would happily eat that much?

-Yeah.

So how does that compare to the portion they should be having?

-ALL:

-Oh! Wow.

-That's nothing.

-OK!

The family served up a lot more than an adult's correct portion,

which is roughly 80g, or about the size of your fist.

It might not look like much now, but when it's cooked,

that 80g portion will almost triple in size.

If that's for you two, what's it going to be for me and JJ?

JJ and Jensen should also be eating portions of pasta

that are about the same size as their fist before it's cooked,

which again is a lot less than Ruth and Peter would typically give them.

Nutritionist Yvonne Bishop-Weston says it's a trap

a lot of parents fall into.

Children's portion sizes need to be smaller than adults',

especially in one sitting, and if we look at the stomach sizes,

this is the stomach size of an average two-to-six-year-old,

so JJ's stomach might be a little bigger than this,

but this is the size of an adult's stomach

so, clearly, portion sizes need to be smaller with children

than they do with adults.

But that doesn't mean the kids

need to eat fewer calories throughout the day.

In fact, seven-year-old JJ needs about 1,900 calories a day,

almost the same as his mum.

And 12-year-old Jensen

needs about 300 calories a day more, 2,200,

so to pack in those extra calories despite their smaller stomachs,

the boys should eat more often than both Ruth and Peter.

Adding good fats found in foods like avocado, nuts, seeds and hummus

will give them more healthy calories in each mouthful.

Your hand is a, well, very handy way to judge

how much you should serve at each meal.

As well as a fist-sized portion of dried pasta,

a portion of meat is about the size of your palm.

That's the same as one portion of veg.

A helping of cheese should be about the same of two fingers,

a portion of rice should be about a handful

and a portion of bread is the size of your whole hand.

If you want butter on it,

the correct amount is roughly the same as your fingertip.

But all that is hard enough to control at home,

what about when we are eating out?

Portion sizes in restaurants can also be ridiculously big.

We are being given bigger plates,

we are being given bigger portions and then on top of that,

if we add dessert, we could be adding as many calories

in one pudding as we would be having in a main meal at home.

One American study found that when we eat out,

we consume an average of 200 calories more

than we would normally do at home,

thanks often to starters,

desserts and other extras.

Of course, it's fine for most of us to go out, to treat ourselves,

to have a really indulgent meal,

but if we do that more and more often, then isn't the likelihood

that we are going to think that that is a normal portion?

That's going to translate to our portion size at home

and put us at risk of being overweight,

at risk of diabetes, cardiovascular disease and other health conditions.

-That looks a nice table - let's just go in here.

-Yeah.

Ruth eats out every week with her mum Marjorie

and her grandmother Edith.

Right, ladies, what are we going to have for lunch today?

-I don't want too much.

-You never do.

-I just can't eat too many things.

Both Marjorie and Edith find themselves faced with portions

that are typically a lot bigger than the ones

they would normally serve themselves.

Is there a child's menu, Mum? You often do better on the child's menu.

Ruth's mum Marjorie is 70

and while she's noticed her appetite drop over recent years,

she still worries she might be serving herself too much.

So, Mum, why do you think you should eat less than me?

I am retired now, so I don't get up at six o'clock in the morning

and get busy, busy, busy.

I still do gardening, I still do housework,

but not at the rate and speed I used to do it at.

But whilst Marjorie has misgivings about how much is on her plate,

she does usually still eat it.

But her mum, 96-year-old Edith,

says her appetite is far from what it used to be.

Do you find that as you have got older,

-you portions have got smaller?

-Definitely.

-Yeah?

-Yeah.

Well, I have a dinner, but quite often,

when it comes to tea time, I'm not really hungry.

Why do you think your appetite has decreased over the years?

Oh, old age. I'm not as active as I was. You don't need it.

At all. Not when you get older.

Unfortunately, Edith isn't right.

The number of calories we need every day does start to reduce

as we get older, but not by as much as you might think.

At 70, Marjorie may be less active than she used to be,

but she still needs almost the same amount of calories each day as Ruth.

And even though Edith eats a lot less than both of them,

she still needs around 1,800 calories a day.

In our older years, we do need less calories

and that's probably because most of us are not as physically active

as we were when we were younger.

Edith may well be 96 and hasn't got a great appetite any more,

but she still needs the calories to maintain her body

and be well and healthy.

What I find is a lot of elderly people are eating much too little.

They are not eating enough to keep their bodies going.

Research shows that the average person over 70

eats just 1,600 calories a day, a lot less than they need.

As Edith doesn't have much of an appetite,

I would encourage her to eat small portions, to eat little and often,

so making sure that her food is calorie-dense,

but isn't making her feel too full up.

Right, come on, Mum, take my arm.

But while portion sizes should vary for different generations

of the same family, there is no doubt many of us,

like Ruth and Peter, routinely overestimate how much we should eat.

There are some foods that every day we serve up in bigger helpings

than what should be the correct portion size.

A portion of cornflakes should be 30g,

but one survey found almost nine in ten of us

give ourselves almost half that amount again.

A can of soup should serve two people,

but most of us eat the whole thing.

A portion of chocolate should be 25g,

but the country's bestselling bars

can tip the scales at between 40 and 55g.

Hands up, anyone who's saving half a bar for tomorrow.

After seeing what the proper helpings should be,

the Kays are keen to put their new-found knowledge into practice.

You don't have to eat it, Gran.

I think we've learned quite a lot this week.

-In the past, we've always had big plates.

-Yeah.

And when you see space on the plate, you think, "That needs filling,"

so plenty of veg.

I think I've always been, "My eyes are bigger than my belly,"

but I think we will have a look at the plate sizes

and maybe not be so eager to fill them.

Earlier in the programme, you'll remember I started finding out

what could have led me to being at risk of developing diabetes.

As well as my sister having type 2 diabetes,

I was told that my diet was also putting me at risk.

I think what is the most frightening thing about it

is that my blood sugar reading was just found accidentally,

because I was having a blood test for a different reason altogether

and I just think if they hadn't caught it,

then I might have developed type 2 diabetes

and not known anything about it, really.

It's worrying stuff.

I was really surprised by just how many people

they think are living undiagnosed with diabetes. What was it?

-Like, half a million, wasn't it?

-It is half a million.

That is frightening stuff, isn't it?

I transformed my diet in order to stop developing diabetes,

but changing what you eat is also the key to managing the condition

if you do develop it

and some say that it can even be reversed entirely.

When I was told I was pre-diabetic, it meant I stood a high risk

of developing full-blown type 2 diabetes.

But when Robin Swindell from London was given the same news in 2013,

it was already too late.

Very shortly afterwards, he was told that,

like one in 17 people in the UK, he did have the condition.

I'd been feeling unwell for a while, generally not myself

and I went to the doctor and he gave me a blood test

and when I came back, he gave me the bad news

that I was pre-diabetic

and that I needed to lose some weight and get fit.

I came back about a month later

and discovered that that was a bit too late and I was already diabetic.

Had it occurred to you that you might be diabetic, or pre-diabetic?

Not really. It should have done,

because there is a history of diabetes in my family

and I had been overweight for a long time,

but like most people,

you're pretty good at putting your head in the sand about these things.

But the shock of the diagnosis prompted Robin to clean up his diet

and increase his exercise under the very careful guidance of his GP.

Robin was determined to rid himself of the condition,

with the first priority being to tackle his weight.

So how did you trim your diet? What did you do, or not do?

I've just tried to eat smaller portions,

to pick healthier foods, eat more vegetables.

I had lost enough weight that the doctor was pleasantly surprised.

After a year, he was quite shocked and I had to remind him

that he had asked me to do it and he said,

"Well, yes, but I don't expect people to do what I say."

Well, I have done and my health has been a lot better as a result.

For Robin, being told he had type 2 diabetes was a real wake-up call

to change his lifestyle and while you might think

that by then it would be too late to make a difference,

in fact, there is new evidence that in some cases,

if you put the effort in,

the condition could possibly be reversed.

There is a piece of research led by Newcastle University

to look at the effects of a very low-calorie diet

and results are promising to show that this very low-calorie diet

has put type 2 diabetes in remission, so watch this space.

Now, I didn't follow such an extreme low-calorie diet,

but both the research pioneered at Newcastle, and the no-carb diet

Dr Abbi put me on, target the same dangerous fat deposits.

So explain to me about losing weight around your middle,

how important that is.

What effect does that weight loss have on the organs in your body?

Unfortunately, many people with fat around their middle

think it's a spare tyre, a cuddly spare tyre,

it's something that maybe is a consequence of old age

and they don't need to worry about it,

but what we do know - being overweight and carrying extra fat,

particularly around your middle, is very dangerous.

It's active fat, it's dangerous fat, it's fat around your organs,

your kidney, your spleen and liver

which is pumping out dangerous chemicals and hormones

which increases your risk of heart disease and cancers

and type 2 diabetes, so it's something people need to reduce.

A very low-calorie diet forces the body to burn fat for energy

and in the process, it removes fat deposits from vital organs,

including the pancreas, allowing it to make insulin more effectively.

Of course, such major weight loss should only be attempted

under medical supervision

and while the test in Newcastle was limited to people

who had type 2 diabetes for less than four years,

its dramatic results are a really positive sign

that with more research, perhaps one day,

the battle against diabetes can be won.

I'm lucky that I didn't go on to develop type 2 diabetes

and I am absolutely determined to keep it that way,

but I have to admit, it's been hard work

and it's meant giving up many of the foods I love.

So as I go back again to see specialist Dr Abbi Lulsegged

in order to check on my progress,

it may be time to confess that I have a snack cupboard.

So can I ask how you've been getting on since we last met?

I find it actually quite difficult sometimes

with that mid-morning snack, so I have to admit,

in the middle of my goodie cupboard for my grandchildren,

I do have Rich Teas, so I do resort to that, so is that bad?

It's the odd episode, I would imagine, once in a blue moon?

-Not all the time.

-Not all the time.

-I don't think it's going to break the bank.

-No.

But you don't particularly approve of that either?

I would feel better if...

..there was a healthy attitude to it psychologically,

so in other words, it's the odd Rich Tea,

but you're not then reaching for another one

and then another one and then another one.

The majority of those diagnosed with type 2 diabetes

are considered obese, so losing weight is the key

and the way I have done it with Dr Abbi

is by cutting back on all carbs, not just sugar.

I've found, when I cut out the carbohydrates,

I have to say two stones in weight dropped off, two.

Actually, it was almost too much for my frame,

but it was quite revealing that when the carbs were cut out,

-the weight just dropped off.

-Yes.

Cutting out all carbs is controversial

and isn't necessarily recommended for diabetics,

but there's no doubt that if you are pre-diabetic, as I was,

reducing your intake is likely to help.

No one-sized diet fits all,

but certainly there is a bulk of evidence,

a huge amount of evidence,

that the best way and the healthy way to do that

is to follow a low saturated fat, low-sugar and low-salt diet,

but if you are obviously following a low-sugar diet,

you are automatically reducing your carb intake,

so an element of carbohydrate restriction is necessary

for many people with type 2 diabetes.

The growth in type 2 diabetes has been described

as an unfolding public-health disaster and in Robin's case,

obesity was a major factor.

Transforming his lifestyle and diet

has already had an incredible effect.

How well are you doing, now that you have lost all the weight?

Pretty good. I still have a little bit of weight around the middle

that I'd like to get rid of,

but, yeah, generally my health is very good

-and my prognosis is very good.

-Good.

Certainly, I'm still considered diabetic,

but most of the time, my control is good enough

that my body behaves very normally,

so I just have to keep up with the exercise

and a very careful diet and I should stay that way, hopefully.

Are you encouraged by the fact that there seems to be

a new way of thinking that diabetes can be reversed by diet?

Yes, I think that's very encouraging.

I don't think it's necessarily going to be a cure for everyone,

but it should give everyone with diabetes or pre-diabetes confidence

that if they change their life, their health is going to get better.

That's a message a new NHS campaign hopes to address,

raising awareness of pre-diabetes while there's still time to stop it.

Although my own risk of developing diabetes has now dropped,

it's still slightly higher than average,

so the changes I've made to my diet are for good.

To this very day, of course, when I look at the counter and I see

all that gorgeous Victoria sponge and the coffee cake

and the chocolate cake that my mum would have made,

I have to admit I do yearn for a really big slice of that.

I still wouldn't dream, actually, of having a big slice of cake.

I've trained my mind now not to have that.

If it was for vanity reasons and just losing weight,

I'd be weak as water, but I think when it's for medical reasons,

you can train your mind to do pretty well anything.

Are you worried that you or someone you know

might be at risk of developing type 2 diabetes?

Visit...

..to check out your risk and then start to make positive changes

to your diet with a whole host of easy and very healthy recipes.

One of the things I really want people to get out of this series

is not just a better understanding of the truth behind those headlines,

but also a bit of reassurance about what we are actually eating

so we can relax and enjoy it without constantly panicking

whether we should be having it or not.

Now, whether you are confused about your five a day,

not sure about how much you should be eating,

or just wanting to make sure that your diet and lifestyle

is not setting you on track to develop diabetes,

we really hope that you picked up some advice that will help you

find the right balance between eating healthily

and, of course, happily.

There's more on the topics in today's programme at...

..where you'll also find the iWonder guide to diabetes.

That's where we have to leave it for this time.

Thank you very much indeed for watching

-and we'll see you next time, so from us, bye-bye.

-Goodbye.