Alan Y

Age at interview: 48
Brief Outline: Alan Y suffered a heart attack at the age of 46. Since then, Alan has become more aware of the nutritional value of foods, and has made small changes to his diet, swapping unhealthy options for healthy alternatives. Alan has always been quite active but has increased his exercise since his heart attack. Alan is proud of what he has been through.
Background: Alan Y is 48 and works as a fitter in a hire shop. He is married and is white British.

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Alan Y suffered a heart attack around 2 years ago, at the age of 46. At the time he did not realise there was anything seriously wrong, as he felt hot, and had pains in his back. Alan went to the doctors the next day, and had an ECG the following week. He was told that he had 3 blocked arteries and shortly after had triple bypass surgery. Although Alan knows that poor diet and being overweight can cause blocked arteries, his condition was put down to family history, as his father and grandfather also had heart problems.

Although Alan ate well in the past, with lots of fresh food, fruit and vegetables, since his heart surgery, Alan has made small changes to his diet. Whilst he was waiting for his surgery, Alan was given a booklet by the cardio team with information on what foods to eat, and was told to avoid foods that are high in fat. Since then, Alan has started eating breakfast before going to work, rather than snacking on breakfast bars on the go. He has found that foods he thought were healthy, such as yogurt pots with toppings, are not as healthy as he assumed, “You’re better off having just a no fat yoghurt and getting fresh fruit and doing them, making your own yoghurts that way.” Alan has also started swapping other foods for healthy alternatives, such as changing butter for an olive oil spread. Alan now snacks on dried fruit and nuts, and eats more fish. Alan has stopped adding salt to his food, and is more aware of the salt content on food packaging. Alan also makes sure to have foods like cakes, pies and pizzas only rarely, as a “treat”.

After being inactive for around 3 months after his heart attack, Alan built up his activity levels over several weeks. Alan went to the gym as part of his rehabilitation program, and was taught what exercises to do and what he should avoid. Currently, Alan feels his weight is fairly stable. He works a physical job, and also enjoys swimming and taking his dog for a walk, which “keeps me active”. However, Alan feels he could lose a bit of weight, but finds this challenging, “no matter what I seem to try and do I don’t seem to lose any weight”.

Although Alan acknowledges that some people gain weight because of health reasons, he feels that lifestyle factors have also contributed to weight issues in society, “I think a lot of it is just lifestyles because, like you say, people are busy with work, families…people haven’t got time to, shall we say cook from scratch so, and it’s easier to go to the chip shop, the take-always”. Alan suggests that people are not given enough information about nutrition, and has advocated for the colour guide on food packaging to be made more prominent. Alan suggests that meals in hospitals should also be more nutritious; in the past he has found that some wards have served unhealthy options, which is not what patients’ need, “you need nutritional food to make yourself better really”.

Alan is open about his heart problems and wears a t-shirt from the British heart foundation, which has led to people approaching him in public, “I wear the scar with pride and I think it’s like you say, it’s getting over the fact that most people it’s not their fault and being able to talk to other people about what’s happened and I’m proud to show it off”.

Alan’s heart condition and diabetes are stable, but if his health gets worse it would probably prompt him to lose weight.


So, and what are your reasons now for wanting to lose weight, and maintaining weight?

Well, I think as much as anything, I'm going to have to have a new wardrobe if I continue at this rate [laughs]; it's going to be very expensive. But in other terms, I'm assuming that I will feel better again if I go... if I lose weight, but I don’t know. As I say, I go back and say I haven’t seen any evidence which says if I lose ten kilos, that'll be the effect; none of that evidence has ever been shown to me, if it exists.

What would help you to become sort of fully committed to losing and maintaining weight now?

I suspect if I had to have new medication to guard against vastly increased problems with diabetes and heart, then it would convince me I'd have to do something. But as it is it's been stable for so long that there's no incentive to do something from a medical point of view. From a social point of view, I don’t have any problem being the weight I am, it's just in family pressures to some extent. You know, they say, 'Well, oh you're looking a bit fatter than you should be,' you know.


Alan sees GP appointments as “like gold dust”. He isn’t surprised that GPs don’t seem to have time for a discussion about weight.


You sounded surprised when I said, 'Have you talked to your GP about your weight issues,' and you said they don’t have time.


Can you elaborate a little bit more on that?

Well, GPs have got very limited time to speak to you. The slot size you get to speak to somebody is related to having one problem which can be resolved by either a referral or a prescription. They don’t have time for a discussion. And to be fair, if you took time for a discussion, slots with GPs are hard to get so you're depriving somebody else of something that they might need for, you know, to get medication or something like that. So, going in for long, you know, conversation type advice is not the sort of thing that I would think is the good use of GP's time, unless they said, "We will have a clinic," or something which says... which is aimed at people who need, you know, advice on X or Y or Z, whether it's diabetes or heart condition or exercise, or whatever it happens to be.

Or weight control?

Yeah. But for standard GP appointments, they are... they're like gold dust, and you’re very lucky to get one really. I mean for instance, if I wanted a GPs appointment tomorrow, I would have to be online on their website at seven thirty in the morning to book a slot for that day, and goodness knows what happens if you're an older person who doesn’t have internet access, for instance – I don’t know how you do it, because by the time the receptionists come online, half past eight, all the slots have gone. So, that tells you, you know, you don’t want to waste the GP's time in that respect.

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Alan finds it difficult to believe that any young, slim dietician could understand what an older overweight man has had to deal with. He doesn’t take their advice seriously.


Historically, I've had advice from dieticians, but unfortunately, theirs is theoretical advice, and it doesn’t apply to the real world, and they're usually very young, and young ladies who have never had to look at their weight, so they don’t really have any real world experience of say a middle aged person who would know about dealing with their weight. So, they give you theory advice, and you look at it and say, "That’s fine, but what about in practice?" so I tend to discount it, to be honest. I know that the problems are you eat less, and you exercise more; that’s the simplest way of doing it.

They have given me dieticians to talk to in the past, and as I said before they tend to be twenty-two, seven stone, size zero [laughs].

So, it's not...

Well they have no credibility, that’s the problem. They have no credibility because you can't ... you can't relate... they can't relate to what you’ve been through. You know, if they were mid-thirties, and they're always women, so if they're mid-thirties and had children, they would understand an awful lot more about weight change, wouldn’t they?


But they aren't; they're still young, you know, recent graduates.

Well you have seen a dietician, that has... you have been referred by the diabetes nurse or by...?

Yes, yeah, but it hasn’t happened for a long time now because, as I say, it was... it wasn’t successful.


Because I couldn’t take them seriously, and they couldn’t give me evidence as to what, you know, if I did that then would be the effect, so

Hm mm, OK. So, what you would like is sort of advice or to lose weight, if you don’t lose weight this might happen?

Yeah, well not might happen, will happen. I'm actually looking for cause and effect, not well, I think it maybe, you know. I can do maybe, but if a healthcare professional is telling me I need to lose weight, I want to know why - you know, give me the reasons why, and back them up. If you can't back them up, why should I believe it; why should I take it seriously?


Before his heart attack Alan Y used to regularly eat cereal bars as healthy snacks. Afterwards, he found those particular ones to be ‘full of sugars and salt’.


Better, yeah because with my job I wasn’t, I was starting at 7 so I wasn’t eating anything before I went out and I used to have the breakfast cereal bars that you get in the packets, and I was having that at ten o’clock. Eating a lot of the Special K things, you know, having lots, not really looking at the time beforehand and then following heart attack and being in hospital, put on lansoprazole you must eat within half an hour anyway. So, I was then, I was having them when I woke up and then having cereal before I went out. So I totally cut out the cereal bars, which then when they say to you, “Yeah, because they’re full of sugars and salt.”  So with just doing that and some small changes has made, and then going to the gym and everything else.

Okay, okay. So a small change that made a difference.

Yeah, things that you, you think you’re doing healthy by having say, like you say, having cereal bars but then when you look at them what’s actually in them, you’re not doing as good, even when you’re, who did I ask, about like the brand name yoghurts. You think, ‘Yeah, you’re doing well because you’re having yoghurt and you’re having fruit.’ And then you get told, “No, they’re not that healthy. You’re better off having just a no fat yoghurt and getting fresh fruit and doing them, making your own yoghurts that way.”


Alan Y uses social media to support campaigns that interest him, like to improve food labelling.


I did sign one of the, I do some of the change.org, I’m on their website and one of their recent ones was the key, the colour guide, guide for, like you say, the saturates and salts in food where not everybody’s put it on, and but some people put it in black and white so it doesn’t look as bad.  

Whereas, if every food had the colour coding system it makes life, because you can then just pick it up and see what, I know veg is good for you and stuff like that so it doesn’t need it. But like you say, stuff that’s like your meats and stuff and so you know straight away what is good for you and what isn’t bad for you. I think that would be…

That’s good.

That would be a big thing to as long as people look at it and don’t just go, “That’ll do, that’ll do.”


A local online support group and the British Heart Foundation have helped Alan Y to cope with his heart attack and heart surgery.


I think a lot, because I’m on, there is a Facebook site called British Hearties which a gentleman from [City] has set up.

Ah okay

…and some of that and I think it’s Heart Blocker through the British Heart Foundation. I think a lot of it is not getting yourself depressed, is keeping yourself in a good mood. I’m one of them, who’s to say, I’m a half full glass person. I’m not half, I’ve actually got a t-shirt from the Heart, British Heart Foundation and it says, ‘I’ve survived…’ was it ‘I’ve survived a heart attack,’ or ‘I’ve had heart surgery.’ ‘I’ve had heart surgery and all I’ve got is this lousy t-shirt.’…


….and I’m proud to wear it because yeah, I’ve had the heart attack. I’ve had the operation and I’ve spent a couple of days last year up in [City] and while I was just walking, this other couple came and were talking, noticed the t-shirt. “Oh” they said, “you’re young.” And I went, “yeah well,” and we were stood talking for about twenty minutes because I can’t remember which one, it was either him or her, and said, they’d had heart problems and they were, like I say, had to talk about it. Just and I actually went to Silverstone last year, one of work colleagues and I wore it there walking round Silverstone. So I wear the scar with pride and I think it’s like you say, it’s getting over the fact that most people it’s not their fault and being able to talk to other people about what’s happened and I’m proud to show it off.

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