Should you really be eating that?

Daniel Sher educates us and shares practical advice on how to make peace with the food police.

Who are the food police?

People who feel they have the right to comment on your dietary choices.

As a person living with diabetes, here are steps can you take to stop the food police from ruining your day.


One way of coping with the food police is to put yourself in their shoes. Often, they truly are coming from a place of care and concern. Even if their response is inflammatory enough to make you want to pull your (or their) hair out.

Recognise that often, when someone asks, “Are you allowed to eat that?”, the subtext of their question is: “I’m really freaked out by the fact that you have this illness. So, I’m making these comments to help me feel in control”.

Diabetes is tough for us who live with it, but it’s also taxing for our loved ones. Recognise that food policing might simply be a family member’s coping strategy. Once you’ve made peace with this idea, you’ll be better placed to educate and set boundaries to stop food policing for good.


Often, the food police lack an understanding of what people with diabetes can and can’t eat. For example, you may be shocked to learn how many people think that managing diabetes is simply about avoiding sugar. If only it were that simple!

If you’re feeling in a good enough mood, you can use your loved one’s display of ignorance as an opportunity to help them learn more about a) what managing diabetes is really about; and b) what sort of responses are and aren’t helpful.

Ultimately, however, the food police often leave us feeling angry and hurt; and we’re usually not in the right sort of space to educate. This is perfectly okay. In such situations, it’s important to own your anger so that you can set healthy boundaries.

Own your anger

Many of my clients are surprised when I tell them that anger is a good thing. Specifically, anger is a healthy indicator that something is off in a relationship. It’s a catalyst for important interpersonal change. Your anger lets you know that a loved one has overstepped a boundary.

If you’re able to channel your anger into a healthy response (discussed below), you’ll be using your emotion to help you establish appropriate boundaries.

To do this, it’s important to own your anger: acknowledge and accept its presence. Allow yourself to feel it; but give yourself some time to calm down before you act on what you’re feeling!

Set boundaries

Your job, should you choose to accept it, is to set healthy boundaries. It’s possible to do this in a kind way, but you need to be firm and assertive at the same time.

This is where ‘owning your anger’ comes into play. Connect with whatever the food police make you feel – anger, sadness or frustration. Tell them frankly what you feel when they speak to you in this way. This will help them to understand that what they are doing is not helpful or appropriate. The phrases below may be helpful in such circumstances:

  • “I know you’re coming from a place of concern, but what you’re doing is not really helping.”
  • “My body, my health, my choices. Please respect that and ease off.”
  • “If you really want to support me, you’ll stop making me feel ashamed and guilty.”

As a friend or family member of a person living with diabetes, how can you avoid becoming a member of the food police?

Educate yourself

If you believe that the most important aspect of managing diabetes is avoiding sugar and carbohydrates at all costs, you should educate yourself before making potentially harmful comments.

This is a common trap that the food police frequently fall into. You see your loved one eating a delicious muffin and you make a critical comment based on the assumption that they’re mismanaging their condition.

A good place to start would be to read articles on on managing diabetes. However, even if it turns out that your loved one is making a ‘wrong’ or ‘unhealthy’ choice, it’s important to make peace with the fact that, ultimately, it’s their choice to make. Not yours.

Control your urge to control

When we ask someone whether they should really be eating that slice of carrot cake, it’s usually coming from a place of genuine concern. However, it’s not having the intended effect, because it’s likely to infuriate and annoy, rather than encourage healthier food choices.

So, what’s the solution? We need to recognise the fact that our loved one having diabetes elicits, in us, an overwhelming sense of being out of control. By acknowledging this feeling, we see that it leads us to try to control our loved one’s behaviour by constantly monitoring and commenting on their choices.

We need to learn to start accepting the fact that much of life itself is uncontrollable. There are certain things, such as our loved one’s dietary choices, that we need to let go and allow. This doesn’t mean, however, that you can’t do anything to support your loved one in making healthy choices. Read on to learn how to do this in an appropriate manner.

Offer your support

How can you convert your desire to help into a response that is truly useful for your loved one? Stop speaking and start listening. Stop advising and start asking questions. Show your loved one that you are curious and that you care.

Instead of trying to tell them what they should be doing, ask them what you can do to support them. Make yourself available to understand; and be non-judgmentally curious about their difficulties and decisions.

Research shows that social support is incredibly important for us diabetes patients. In most cases, your loved one will benefit simply by knowing that you are there and that you care, in a respectful and non-intrusive manner. Sometimes, your loved one will ask you to back off. In such cases, it’s important to give them their space.


Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital, in Cape Town, where he works with Type 1 and Type 2 diabetes to help his clients thrive. Visit

Should I have a flu vaccine?

Dr Angela Murphy explains why and how a flu vaccine can save millions of lives.    

Every year more than 6000 people die from influenza (flu) in South Africa. Thousands more are hospitalised and many lose income from being absent from work.

What is influenza?

It’s a viral illness which has a sudden onset, causing fever, sore throat, body pains and a headache. In most otherwise healthy adults, it will be an uncomplicated illness and the person will recover within a week.

However, certain high-risk groups, as discussed below, are at risk of more severe infection. Although flu can be treated, it is much better to prevent it. The most effective prevention available is the flu vaccination.

Flu vaccination

A vaccination is designed to get the body to produce an immune response so that when an infection occurs, the body can easily fight against it.

The flu vaccination is an inactivated vaccine i.e. there is no live virus so it is impossible for the vaccine to cause flu.

The flu virus is constantly changing and so the vaccine must be updated every year. The current vaccine contains three different strains of flu which the World Health Organization has predicted will cause this season’s outbreak.

Getting vaccinated

Flu season in South Africa runs from May to September. Ideally vaccination should be done in April as it takes around two weeks for immunity to develop. If during this period, a person is exposed to flu, they may indeed get ill as they would not yet be immune. This illness is not due to the flu vaccine.

It is possible to give the vaccine later in the year, especially in the high-risk groups mentioned below. Preferably, everyone over the age of six months should receive the vaccine, but due to resource constraint the Department of Health has highlighted high-risk groups who are a priority for flu vaccination.

High-risk groups:

  • Pregnant women.
  • Patients infected with HIV.
  • Patients with underlying chronic disease, especially diabetes, lung diseases and heart disease.
  • People > 65 years of age.

Department of Health’s goal

If resources allow, the Department of Health would also like healthcare workers, residents of Old Age Homes, Institutions and Rehabilitation Centres as well as children on Aspirin therapy, aged between six and 18 months, to receive the vaccine.

The dose of flu vaccine recommended by the National Health Laboratory Services is as follows:

  • Adults 0.5ml IMI single dose
  • 3 years – 8 years   0.5ml IMI 1 or 2 doses*
  • 6 months-2 years-0.25ml IMI 1 or 2 doses*

*Two doses should be administered ≥ 1 month apart during first year of vaccination, thereafter one dose.

Side effects of flu vaccine

The vaccine is safe to take in most people but should be avoided if there is a history of severe allergic reaction. Most flu vaccines today are produced using an egg-based manufacturing process and thus contains a small amount of egg protein, called ovalbumin. The Centre for Disease Control in Atlanta, USA recommends the flu vaccine to be safe for most patients with history of egg allergy unless the reaction was life-threatening, i.e. an anaphalaxic reaction. They found in a recent study that the anaphylaxis rate after all vaccines is 1,31 per one million vaccine doses given.

It also better to recover from any flu-like symptoms before receiving the vaccine. Most people will experience little more than the discomfort of the injection. Sometimes there may be a more significant local skin reaction, hoarseness, red eyes, aches and pains, itching and headache. These side effects should not last longer than two days.

How a flu epidemic starts

The flu virus often mutates and different strains arise. When populations are not immune to these new strains, then epidemics arise.

Less commonly, a new strain appears to which most people around the world have no immunity. In this instance, a pandemic arises. The worst of these pandemics started 100 years ago in March 1918 where the Spanish flu killed millions. With today’s improved medical care and availability of vaccines that type of tragedy should not be seen.

Flu vaccine studies

A recent study at Bergen University, in Sweden, confirmed that having the flu vaccine annually improved immunity in the body. The investigators, led by Rebecca Cox, showed that people who had repeated annual flu vaccines had much greater disease-fighting capability than those who did not get the vaccine.

The effects of flu on a diabetes patient

People living with diabetes will know how infection can cause a significant deterioration in their sugar control. Having flu elevates blood sugars due to increased resistance to insulin, and with dehydration it is possible to develop a diabetic ketoacidosis. Paradoxically, hypoglycaemia may also be a feature of flu because of high fevers, sweating, poor appetite and vomiting.

Flu vaccination remains the most effective way to prevent all of this. There are 80% less hospital admissions in diabetic patients who get flu if they have also had the flu vaccine.

Remember, by being vaccinated and becoming immune to the flu, you cannot pass it on. Vaccinate today and keep healthy this winter.



Dr Angela Murphy is a specialist physician working in the field of Diabetes and Endocrinology in Boksburg. She is part of the Netcare Sunward Park Bariatric Centre of Excellence and has a busy diabetes practice.