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How Can We Flatten The Curve?

Updated: Oct 29, 2023

Have you ever wondered why so many of us struggle to maintain a healthy weight? I find it alarming that since I qualified as a doctor (exactly 30 years ago this month!) I’ve observed a massive increase in the girth of the UK population and a simultaneous rise in the prevalence of life-limiting disorders such as diabetes, cancer, autoimmune diseases, depression and dementia.


Apparently not. These and many other chronic health problems are related to our 21st century western lifestyle and are therefore potentially preventable. Simply put, our bodies have have not evolved to tolerate the way we live today and our diets in particular. In a world where a plentiful supply of every type of food is available to us whenever we open our fridge or delivered to our door at the click of a button, it’s a strange paradox that this ubiquity is part of the problem.

Snack culture

Whole supermarket aisles are dedicated to this dangerous habit that has crept into our everyday lives. They tempt us with ultra-processed confections designed to hit our brain’s pleasure centres and keep us coming back for more. Ever noticed how it is almost impossible to eat only one biscuit or just a few crisps?

Why do we snack?

In the last 40 years the medical profession have told us to follow a low fat diet. This has inevitably resulted in a shift towards consuming more carbohydrates than ever before. The problem is that eating carbs, whether sweet or starchy, results in a rapid rise in blood glucose, often referred to as a spike. Glucose is an essential fuel for our bodies but as any diabetic knows, it must be tightly controlled, as high levels damage our tissues.

The hormone insulin, is released by the pancreas to bring the glucose back to a safe level, ushering it into our cells to be stored as glycogen in our liver and muscles, or as fat. The steeper the glucose spike, the more insulin is released and more precipitous the drop, resulting in hunger pangs and cravings for something that will quickly elevate glucose again (i.e more carbs). Consultant Bariatric Surgeon, Dr Andrew Jenkinson, in his excellent book Why We Eat (Too Much), refers to this as the "glucose roller coaster”.

The perils of grazing:

Every time we eat, the rise in our blood glucose and insulin for the next two hours or so is known as the post-prandial state. Only when these levels fall and we enter the fasted state will we start to use the stored glycogen and fat. If we snack, the body remains in post-prandial storing mode and we gain weight.

We are slowly cooking:

When glucose collides with other molecules, it causes damage in a process called the Maillard reaction. A term familiar to MasterChef fans, it’s the same thing that causes browning of cooking food. Damaged tissues incite inflammation which, over the years, becomes chronic. This is now recognised as the basis for many degenerative diseases which were rare a hundred years ago but are now so prevalent. Biochemist and self-titled “Glucose Goddess”, Dr Jesse Inchauspé describes this process in her book The Glucose Revolution, a life-changing and highly recommended read.

So how can we best eat to control our weight and prevent future disease?

1. Fast. Digesting and processing food is stressful for our bodies and we need time to recover. Studies of intermittent fasting have also shown benefits for mood and concentration. If you’ve never tried it before, start by eating breakfast later and your last meal earlier, then gradually increase your fasting window and reduce your eating window. Only water, tea or coffee (without milk) should be consumed whilst fasting. I started intermittent fasting in 2018 and lost almost 10kg over the ensuing 18 months. I now eat my first meal no earlier than midday and aim to eat dinner by 6pm, giving my body an 18 hour fasting window. This practice has become so habitual it is now effortless.

2. Vinegar. A glass of water with 1tbsp of vinegar before a meal is not as unpalatable as it sounds, (particularly apple cider vinegar) and will flatten your post-prandial glucose spike. Ideally, sip it through a straw to protect your teeth.

3. Greens first. The fibre in vegetables reduces the speed of absorption of the glucose contained in what comes next.

4. Proteins and fats second. They slow down stomach emptying, helping to flatten the glucose curve and also prolong the feeling of satiety.

5. Carbs last. With fibre, proteins and fats already on board you are less likely to over-eat and what you do consume will be absorbed more slowly.

6. Desert. If you need to satisfy a sweet tooth, then indulge it but only directly after a meal and not as a snack, as the glucose responses are very different.

7. No snacking. You now understand why.

8. Exercise. If possible, get active after you have eaten. A ten-minute walk will bring your post prandial glucose levels down, as your muscles will be using up the glucose before it can be stored.


Studies have shown that well controlled blood glucose levels even slows down ageing of the skin, so the healthy eating habits detailed above will help you achieve a glowing, youthful complexion. For more skincare advice, products, aesthetic medical and surgical procedures, contact Dr Julia Sen Health & Wellness Clinic on 07939 286850 or email


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